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VAKSINASI TGL 28 JUNI 2021

NO NAMA TGL LAHIR ALAMAT

1 SUNARTI 17-08-1987 DESA SURO LEMBAK


2 ABASMAN 16-06-1974 KEL UJAN MAS ATAS
3 FARIDA 14-12-1977 KEL UJAN MAS ATAS
4 EMI KURNIATI 08-05-1976 DESA SURO LEMBAK
5 BAMBANG BUHARI 28-01-1971 DESA SURO BARU
6 LEKSI OKTARINA 05-10-2002 DESA DASPETAH II
7 NURHAYATI 01-02-1979 DESA DASPETAH II
PKM 8 SABIRIN 18-07-1959 DESA SURO ILIR
9 SOPIANTO 09-04-1969 DESA SURO MUNCAR
PKM 10 MAMAT YANI 28-03-1988 DESA SURO ILIR
11 SOPIAN EFENDI 12-12-1970 DESA SURO MUNCAR
12 WATI BANUREA 29-09-1979 DESA SURO ILIR
13 YUSMANI 01-07-1964 DESA SURO BARU
14 BAHRUDIN 13-05-1959 DESA DASPETAH II
15 SUDIHATI 06-03-1976 KEL UJAN MAS ATAS
16 MITA AFRILIA 22-04-2002 DESA SURO LEMBAK
17 YAROS MINI 01-01-1962 DESA DASPETAH II
18 MILYATI 07-06-1974 DESA SURO ILIR
PKM 19 KARMAYANI 08-11-1975 DESA SURO ILIR
20 NELI KUSUMAWATI 03-01-1972 DESA SURO LEMBAK
21 RIDUAN AKASA 09-07-1973 DESA SURO ILIR
22 DEWI SURYANI 06-06-1970 DESA DASPETAH
23 DAHLIJO 07-01-1985 DESA SURO LEMBAK
24 LINDAR YATI 20-07-1965 DESA DASPETAH
25 EYI ISKANDAR 15-05-1966 DESA SURO ILIR
26 IBNU HAJAR 07-07-1973 DESA PG BERINGANG
27 YENTI 21-07-1988 TALANG RIMBO LAMA
28 NENI SUSANTI 27-08-1970 TALANG BENIH
29 TUTI HERAWATI 01-07-1977 SURO MUNCAR
30 M.YAMIN 09-07-1952 DESA SURO ILIR
31 AMRAN 16-04-1949 DESA SURO LEMBAK
32 HERMA YUNITA 07-02-1972 DES DASPETAH II
33 MASWA 16-02-1960 DESA SURO LEMBAK
34 RASID ISHAK 12-08-1962 DESA DASPETAH
35 SALUMA 01-01-1971 KEL UJAN MAS ATAS
36 REVIKA RELIA 01-01-1984 DESA DASPETAH II
37 LENI ASTRI 12-01-1987 DESA SURO LEMBAK
PKM 38 MARIANA 06-09-1980 DESA SURO ILIR
39 ZULKIFLI 06-03-1974 DESA SURO ILIR
40 DINDA PUTRI AUREL 27-05-2002 DESA DASPETAH II
41 SRI MAWARNI 01-03-1964 DESA DASPETAH II
42 JUITA 15-06-1967 DESA DASPETAH II
43 MAWARDI 12-05-1967 KEL UJAN MAS ATAS
44 GUNADI 14-04-1968 KEL UJAN MAS ATAS
45 LELA MURNI 05-02-1960 DESA SURO ILIR
46 EPY INDA 21-07-1980 DESA SURO MUNCAR
47 DAYA 01-07-1964 DESA SURO MUNCAR
48 HADIJA 03-04-1949 DESA SURO MUNCAR
49 ANWAR 27-01-1979 DESA SURO BARU
50 EPA PUSPITASARI 14-09-1990 DESA SURO ILIR
51 M. SANGKRI 08-08-1962 DESA SURO BARU
52 BURHAN 11-11-1960 DESA SURO ILIR
53 EDI SISWANTO 02-11-1963 DESA DASPETAH
54 PARI 14-06-1960 DESA SURO MUNCAR
55 PAULUS ISKANDAR 02-07-1970 DESA SURO ILIR
56 EDWIN ANTONIO 23-09-1995 DESA SURO ILIR
57 TRISNO 03-08-1969 DESA SURO LEMBAK
58 MEMET EFENDI 08-07-1995 KEL UJAN MAS ATAS
59 ABDUL MUIN 12-08-1970 KEL UJAN MAS ATAS
60 YUNI 08-10-1955 DESA DASPETAH
61 JURIANA 01-02-1955 DESA DASPETAH
62 NILAM 15-03-1965 DESA DASPETAH II
63 SUBARNI 03-04-1957 KEL UJAN MAS ATAS
64 JONI 10-11-1984 DESA DASPETAH II
65 DIANA MARIA 09-09-1988 DESA PG BERINGANG
66 ZAINAL 12-02-1964 DESA DASPETAH II
67 FITRI HANDAYANI 08-05-1994 DESA SURO BARU
68 RAMIPA 01-07-1945 DESA SURO BARU
69 SITI TAWIYAH 06-10-1982 DESA SURO LEMBAK
CANCEL 70 NUBI MASBUKI 19-10-1995 KEL UJAN MAS ATAS
71 AGUNG GUSTINEKA 13-08-1995 KEL UJAN MAS ATAS
72 FEBRI ANTONI 28-02-1995 KEL UJAN MAS ATAS
73 NELI YANA 07-09-1983 DESA SURO ILIR
74 ANTONI 04-12-1981 DESA MERANTI JAYA
75 BUDI HERYANI 02-11-1981 DESA SURO MUNCAR
76 JUSLAINI 01-06-1958 DESA SURO BARU
77 DEA VALOVIN 17-03-2003 DESA DASPETAH II
78 EMILIA WATI 07-10-1983 DESA DASPETAH II
79 NURIYA 12-06-1954 DESA SURO MUNCAR
80 NENGSI SUMIATI 11-06-1980 DESA SURO BARU
81 AMIRULLAH 11-08-1976 LUBUK LINGGAU
82 IIS SUMARNI 26-02-1999 DESA SURO ILIR
83 ROLI AMANI 11-11-1982 DESA PG BERINGANG
84 RENALISASI 19-06-1988 DESA PG BERINGANG
85 TUTI PEBRIANTI 04-02-1992 DESA PG BERINGANG
86 IWAN PAJRI 06-07-1990 DESA UJAN MAS BAWAH
87 BUSTAMI 12-12-1962 DESA SURO ILIR
88 ALMIYAH 04-03-1977 DESA SURO ILIR
89 INDAL QODRI 16-03-1977 KEL UJAN MAS ATAS
90 FIRDAUS 10-01-1969 DESA DASPETAH
91 NETI SUMARNI 01-07-1983 KEL UJAN MAS ATAS
92 RAMI ANA 09-07-1985 DESA SURO ILIR
93 SAIDINA YANSI 25-03-1986 DESA SURO ILIR
94 SALMAWATI 01-07-1974 KEL UJAN MAS ATAS
95 MISTRI 22-10-1983 KEL UJAN MAS ATAS
96 EDI USMAN 08-03-1975 DESA SURO ILIR
97 SARNI BANA 24-04-1969 DESA SURO ILIR
PKM 98 ROSMAINA 10-05-1938 DESA DASPETAH II
99 ZAINAL ARIFIN 25-06-1987 DESA SURO LEMBAK
100 YUSNI ANIYA 03-07-1962 DESA DASPETAH
101 LENI SUSANTI 10-01-1983 DESA DASPETAH
102 DEPRI YANTI 26-12-1989 KEL UJAN MAS ATAS
103 SUSANTI 09-05-1999 KEL UJAN MAS ATAS
104 DAMAYANTI 11-07-1980 KEL UJAN MAS ATAS
105 SUDARMI 11-11-1976 DESA SURO LEMBAK
106 ANWAR 16-03-1954 DESA SURO LEMBAK
107 RODI HARYANTO 24-10-1989 DESA SURO ILIR
108 NOVA KURNIA SUSIANTI 11-11-1997 DESA SURO BARU
109 I NENGAH REMBUG 01-07-1963 DESA SURO MUNCAR
110 NI LUH REMBUN 01-07-1964 DESA SURO MUNCAR
111 BURHAN 01-07-1964 DESA SURO MUNCAR
112 HERIYADI 07-04-1972 DESA SURO MUNCAR
113 SINARYA 01-07-1950 DESA SURO ILIR
114 LUKMAN JAUHARI 06-07-1970 KEL UJAN MAS ATAS
115 NANA SUTRISNA 03-06-1995 DESA SURO LEMBAK
116 ANAH 03-07-1978 DESA SURO LEMBAK
117 PITRI 10-04-1999 DESA SURO MUNCAR
118 WIDIA HARYANSANTI 22-05-1999 DESA SURO MUNCAR
119 IRAWAN FAUZI 04-02-1977 DESA SURO MUNCAR
120 RINDA APRIZAH 04-04-2003 DESA SURO LEMBAK
121 SUKARNO 10-06-1969 DESA SURO MUNCAR
122 ELI ASMANI 02-08-1965 DESA SURO BARU
123 ARPAN JAYA 10-04-1973 DESA DASPETAH
124 SURIA WANI 15-03-1967 DESA SURO BARU
125 SAIPUL 17-12-1958 DESA SURO BARU
126 MUZLIHAN JUNIANTO 08-06-2001 DESA SURO LEMBAK
127 MARWAN 01-01-1975 CURUP SELATAN
SASARAN
NIK NO HP
LANSIA PUBLIK UMUM PENDIDIK
1708025703870003 085273359626 1
1708021606740002 085379242265 1
1708025412770001 085267093697 1
1708024805760001 082371247254 1
1708022801710001 081532256613 1
1708024510020001 085369589131 1
1708024102700003 081272624935
1708021807590001 085879681171 1
1708020904690001 082384356503 1
1708022803880001 085789127778 1
1708021212700006 081367539251 1
1708026909790001 081367539251 1
1708024107640086 082377105478 1
1708021305590001 085369589131 1
1708024603760002 081272605744 1
1708026204020002 089632361610 1
1708024101620001 081367539251 1
1708024706740003 082267299709 1
1708024811750001 0895631741414 1
1708024301720001 082186632588 1
1708020907730002 0895631741414 1
1708024606700004 085377273233 1
1708020101850006 085273359626 1
1708026007650001 085273139792 1
1603041505660002 081271040551 1
1708020707730002 082378403868 1
1702196107880000 08995730707 1
1702096708700003 085367333246 1
1708024107770090 081367539251 1
1708020907520002 085768070771 1
1708021604490001 085269889181 1
1708024702720001 083267446964 1
1708025602600001 085856136149 1
1708021208620002 082371168680 1
1708024101710004 085368237985 1
1708024101840007 081367539251 1
1708025201870001 085856136149 1
1708024609800002 085279295517 1
1708020603740001 082269543330 1
1708026705020001 085281739594
1708024103640007 082377742989 1
1708025506670003 081367539251 1
1708021205670002 085368237985 1
1708021404680002 085269804661 1
1708024502600002 085837312974 1
1708026107800001 081367539251 1
1708024107640070 081367539251 1
1708024304490001 081367539251 1
1708022701790002 081273597037 1
1708025409900002 085273249870 1
1708020808620003 082377105478 1
1708021111600003 081367539251 1
1708020211630003 085368657197 1
1708021109680004 081367539251 1
1708020207700003 0816324818229 1
1708022309950001 082269543330 1
1708020308690001 081367539251 1
1708020807950001 085758097299 1
1708020107740103 081261363848 1
1708024810550001 081367539251 1
1708024102550002 081367539251 1
1708025503650001 082371093799 1
1708024304670002 081539354481 1
1708021011840001 082281461965 1
1708024909880004 082268773395 1
1708021202640001 081367539251 1
1708024805840001 083165541912 1
1708024107450032 081367539251 1
1708024610820003 081532256730 1
1708021910950002 085326857350 1
1708021308950005 085268487493 1
1708022802950002 082241481781 1
1708024709830001 081367539251 1
1708050412810001 085367239008 1
1708024211810001 081367539251 1
1708024106580002 081367539251 1
1708025703030004 085788299649 1
1708023710830001 085788857104 1
1708025206540001 081367539251 1
1708025106800003 081373323243 1
1703141108760002 085366061429 1
1708026602990003 083171909509 1
1708025111820003 082181854289 1
1708025806880001 085766357767 1
1702094402920002 082372946847 1
1708020607900001 082387353932 1
1708021212620005 081367539251 1
1708024403770003 081367539251 1
1708021603770002 085669811593 1
1708021001690001 085758150420 1
1708024107830173 085758150420 1
1708024907850001 081367539251 1
1708022503860001 081367539251 1
1708024107800139 081367539251 1
1708026210830004 081367539251 1
1708020803750001 082372522391 1
1708026404690001 081367539251 1
1708025005380001 081367539251 1
1708022506870002 083173838430 1
1708024307620001 081367539251 1
1708025001830001 081367539251 1
1708046612890004 082176213631 1
1708024905990001 085669375238 1
1708025107800003 082186125080 1
1708025111760003 081367539251 1
1708021603540001 081367539251 1
1708022410890006 082376813834 1
1708025111970002 089634249339 1
1708021712630001 081367539251 1
1708025207670001 081367539251 1
1708020107640096 083182765641 1
1708020704720001 085789431303 1
1708024107500046 081367539251 1
1708020607700002 081539376991 1
1708020306950005 081367539251 1
1708024307780002 081367539251 1
1708025004990002 083182765641 1
1708026205990001 089632956019 1
1708021402780001 089632956019
1708020404030002 081367539251 1
1708021006690001 081367539251 1
1708024107630188 081367539251 1
1708021004730005 08538363634 1
1708025503670002 081367539251 1
1708021712580003 082374773282 1
1708020806010003 081367539251 1
1702182606720002 081367539251 1
DOSIS
1 2
1
1
1
1
1
1

1
1
1
1

1
1
1
1 081367539251
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
VAKSINASI TGL 29 JUNI 2021

NO NAMA TGL LAHIR ALAMAT

1 ISHAK 04-08-1959 DESA SURO LEMBAK


2 HAMDAN JUNAIDI 10-04-1982 DESA PG BERINGANG
3 JHON FERIYANTO 22-05-1982 DESA DASPETAH
4 REDI GUNAWAN 04-04-2001 DESA SURO MUNCAR
5 RIA ERSTINA SIANTURI 26-04-1985 CURUP SELATAN
6 HARPID 02-05-1997 DESA SURO BARU
7 HENRY PURNANTO 16-05-1975 CURUP SELATAN
8 KARTINI 08-09-1977 KEL UJAN MAS ATAS
9 EMRON JAYADI 17-07-1975 KEL UJAN MAS ATAS
10 BJ. TEO PURBA 03-091989 CURUP TENGAH
11 SUPRIYATI 24-07-1959 CURUP TENGAH
12 SARLEN PURBA 23-02-1961 CURUP TENGAH
13 TIANSI ADE BORA 20-01-2001 UJAN MAS BAWAH
14 DANAR YOHANES PUTRA 31-01-1994 DESA SURO ILIR
15 AKSI 12-06-1962 DESA SURO LEMBAK
16 JAMILA 20-03-1973 KEL UJAN MAS ATAS
17 ANSONI 10-11-1991 DESA SURO MUNCAR
18 RATI PURWASIH 05-06-1992 DESA SURO MUNCAR
19 RIO SAPUTRA 10-03-1990 DESA DASPETAH
20 YOGI ISKANDAR 06-0301985 DESA SURO LEMBAK
21 MIA ELA LORENZA 02-02-1999 DESA DASPETAH
22 MUALIMIN 10-11-1964 KEL UJAN MAS ATAS
23 LAMPAN 11-09-1960 DESA SURO BARU
24 BAMBANG IRAWAN 15-03-1970 DESA SURO MUNCAR
25 TIN NENTI HERIANA 12-10-1979 DESA SURO MUNCAR
26 KURNIA ASTUTI 09-06-1982 DESA SURO ILIR
27 EMI JALIA WATI 06-06-1976 DESA DASPETAH II
28 MUHAMMAD ILHAM HIJRATUL18-04-1997 DESA DASPETAH II
29 EMIKSA 07-08-1969 DESA DASPETAH II
30 MARWAN ASHARI 15-01-1978 DESA PG BERINGANG
31 ABDULLAH 03-04-1973 KEL UJAN MAS ATAS
32 DIMAS ANDREAN 12-09-2005 DESA SURO ILIR
33 LEN HARYANI 02-08-1977 DESA SURO MUNCAR
34 TRISNA LEPIA 14-04-2008 DESA SURO MUNCAR
35 SUGENG WAHYUNI 30-04-1991 DESA SURO MUNCAR
36 HERI YANTO 11-05-1984 DESA SURO MUNCAR
37 SUMARNI 14-06-1983 DESA DASPETAH
38 SEFTIANO AMARDO 20-09-2002 DESA DASPETAH
39 RAHMAT PURWANTO 10-03-1992 DESA SURO MUNCAR
40 SUHARNI 23-11-1978 DESA SURO MUNCAR
41 SURYONO 02-08-1972 DESA SURO MUNCAR
42 WIRYONO 25-08-2005 DESA SURO MUNCAR
43 NURLELA 10-07-1988 DESA SURO MUNCAR
44 EMI ROSITA 25-07-1986 DESA SURO MUNCAR
45 SUDIRMAN 11-05-1975 DESA SURO ILIR
46 MARZUKI 09-07-1966 DESA SURO ILIR
47 ARISNO 05-05-1970 DESA SURO BARU
48 LAILI KUSUMAWATI 04-02-1974 DESA SURO ILIR
49 HOLIDAINI GUMANTI 12-12-1969 DESA SURO ILIR
50 MARNI PUTRI UTAMI 23-03-1988 KEL UJAN MAS ATAS
51 SUSANTI 12-01-1983 DESA SURO ILIR
52 MARDI 20-11-1953 DESA PG BERINGANG
53 HERWANSAH 08-04-1974 DESA SURO ILIR
54 ASMAWATI 22-04-1979 DESA SURO ILIR
55 JARNI 01-11-1984 DESA SURO ILIR
56 PESI HERILISA 18-05-1991 DESA SURO ILIR
57 MUR YATI 10-08-1953 DESA SURO ILIR
58 SABANDI 07-08-1981 DESA SURO ILIR
59 JON SINADA 02-12-1967 DESA DASPETAH II
60 YENI AYU PITA SARI 22-04-1995 DESA SURO MUNCAR
61 JANATUL HAKIM 13-05-1969 DESA DASPETAH II
62 RATNA SURI 18-05-1961 DESA SURO ILIR
63 DODI ADE RESTA 10-06-1983 KEL UJAN MAS ATAS
64 REKA JULITA 11-02-1992 KEL UJAN MAS ATAS
65 MELIA WATI 09-08-1988 KEL UJAN MAS ATAS
66 RUDI ANTONI 01-09-1981 KEL UJAN MAS ATAS
67 JUNI SUNANDAR 05-09-1979 DESA SURO BARU
68 HERMANTO 12-04-1974 KEL UJAN MAS ATAS
69 LOLA LOVIONA 01-07-2001 KEL UJAN MAS ATAS
70 ARMAN 5/4/1967 TALANG BENIH
71 MADE SURAJE 7/18/1976 SURO BALI
72 YES ASRIN 10/26/1972 DESA SURO LEMBAK
73 YESI PANCA RITA. M 6/28/1988 UJAN MAS BAWAH
SASARAN
NIK NO HP
LANSIA PUBLIK UMUM PENDIDIK
1708020408590001 085856136149 1
1708021004820001 085896473768 1
1708022205820002 082374772772 1
1708020404010002 081367539251 1
1702176604850001 082115674638 1
1708020205970003 089628836352 1
1702181605750001 081273370741 1
1708024809770002 081367539251 1
1708021707750001 081367539251 1
1702190309890003 085789859429 1
1702196407590001 085789859429 1
1702192302610001 085789859429 1
1708026901010002 083165574703 1
1708023101940001 0895344251047 1
1708021206620001 081367539251 1
1708026003730001 081367539251 1
1708021011910005 082307241157 1
1707055203920002 082307241157 1
1708021003900002 085658641851 1
1708020603850004 082377969824 1
1708024202990003 085156592493
1708021011640002 082373293053 1
1708021109600001 081367539251
1708021503700001 081532092405 1
1708025210790003 085267286076
1708024906820002 081367539251 1
1708024606760003 085251428929 1
1708021804970001 085764932733 1
1708020708690002 085208291718 1
1708021501780001 081367539251
1708021707790007 082374962462 1
1708021209050002 082387317194 1
1708024208770001 0895360759718 1
1708025404080001 0895360759718 1
1708027004910005 081367539251 1
1708021105840002 085369762245 1
1708025406830001 082175525193 1
1708022009030001 082175525193 1
1708021003920003 08136921407 1
1708026311780001 081367539251 1
1708020208720003 085609442571 1
1708022508050001 085609442571 1
1708025007880001 081367539251 1
1708026507860001 083169389718 1
1708021105750001 082280609479 1
1708020907660001 085832951108 1
1708020505700001 089628836352 1
1708024402740002 083174163724 1
1708021212690006 083174163724 1
1708026303880004 085382043716 1
1708025201830004 081367539251 1
1708021212540002 082180724850 1
1708020804740004 083169169965 1
1708026204790001 085366071074 1
1708024111840002 085366363365 1
1708025805810001 081367539251 1
1708025308580001 081367539251 1
1708020708810002 082177989696 1
1708020212670001 085267287877 1
1708026504950004 085278215827 1
1708021305690002 085380044456 1
1708025805610001 085832951108 1
1708021004830004 085273913290 1
1708025102920003 085382976606 1
1708024908880004 085758020314 1
1708020409810001 085378884990 1
1708020506790002 081541224987 1
1708021204790003 085367344354 1
1708024107010084 082183115546 1
1702090405670001 085357513367 1
1708021807760002 082326380035 1
1708042610720001 085840723099 1
1708026806880001 082186525694 1
DOSIS
1 2
1 SB 4
1 SM 16
1 SI 15
1 SL 4
1 UMA 12
1 UMB 2
1 PGBR 3
1 DPT 5
1 DPT II 5
1 LUAR 7
1 73
1
1
1
1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
VAKSINASI TGL 30 JUNI 2021

NO NAMA TGL LAHIR ALAMAT

1 LUKMAN JAYA 07-04-1982 DESA SURO MUNCAR


2 ROH 01-07-1963 DESA SURO MUNCAR
3 ELI SAHARA 06-07-1973 DESA SURO MUNCAR
4 RIA SUSANTI 13-04-2004 DESA SURO MUNCAR
5 DJEKSON PANGARIBUAN 02-06-1962 TEMPEL
6 MOSES PANGARIBUAN 07-06-1998 TEMPEL
7 SURIANA 15-03-1976 DESA SURO MUNCAR
8 LUSMINA 20-02-1965 DESA SURO ILIR
9 WARSINAH 28-03-1980 DESA SURO LEMBAK
10 MARIA VERONICA OKTAVIANI 26-10-1998 DWI TUNGGAL
11 HERI BERTUS 16-03-1968 DWI TUNGGAL
12 FIRMAN AJI SATRIA 20-12-2008 DESA SURO MUNCAR
13 FERRY MARTONO 05-11-1979 DESA PG BERINGANG
14 DESSY ARIANCHE 06-12-1985 KEL UJAN MAS ATAS
15 KURNIASI 16-10-1958 CIMANGGIS, PALSIGUNUNG
16 GITA MIRANDA 06-03-2008 DESA SURO MUNCAR
17 HAMBALI 05-07-1971 DESA SURO LEMBAK
18 MAMAN TUBI LASI 27-08-1987 DESA SURO MUNCAR
19 JETTI SIMATUPANG 19-03-1986 DESA SURO MUNCAR
20 RAWWATI 05-07-1965 DESA SURO MUNCAR
21 TAIP 08-06-1962 DES SURO ILIR
22 TUTI NIRWANA 08-08-1981 DESA PG BERINGANG
23 HENDRI 06-03-1983 CURUP SELATAN
24 HAMDAN 01-01-1970 KEL UJAN MAS ATAS
25 YATI 05-10-1975 DESA SURO ILIR
26 SAIPUL ANWAR 05-06-1970 DESA SURO ILIR
27 SAIRIL PANDI 24-04-1974 DESA SURO BARU
28 ETI PUSPITA 02-02-1986 DESA DASPETAH II
29 SABARYATI 03-10-1970 DESA SURO MUNCAR
30 SUPRIONO 23-03-1965 BUMI SARI
31 AHMAD NIZAR 25-11-1966 CURUP
32 JUMILA 20-12-1990 DESA SURO MUNCAR
33 SUBANIA 16-08-1970 DESA SURO MUNCAR
34 AYU WULANDARI 12-12-2000 DESA SURO MUNCAR
35 ULMI YATI 22-09-1982 DESA DASPETAH II
36 SUHARDI 04-09-1983 DESA DASPETAH II
37 DARSI EKAWATI 08-06-1977 DESA DASPETAH II
38 IDHAM HALIK 07-09-1973 DESA PG MERANTI
39 INTON SAMUDRA 21-08-1973 CURUP TENGAH
40 HAMDAN 02-08-1973 DESA DASPETAH II
41 SARMIANI 12-08-1986 DESA SURO BARU
42 SARIPA AINI 12-07-1969 DESA SURO BARU
43 BASARUDIN 02-03-1942 DESA SURO MUNCAR
44 ARI KADESI 02-12-1993 DESA SURO ILIR
45 MUH. ANCHA. S 03-03-1965 DESA SURO MUNCAR
46 DESI HERLINA 30-07-1988 KEL UJAN MAS ATAS
47 ARJONI HERI 10-03-1970 DESA SURO BARU
48 JURI 02-12-1950 DESA SURO MUNCAR
49 LEKSI KARNIA 25-12-1994 DESA SURO MUNCAR
50 UJANG PRANATA 27-01-1974 KEL UJAN MAS ATAS
51 NOVIARTI 06-11-1981 KEL UJAN MAS ATAS
52 WAHID 08-03-1970 DESA SURO MUNCAR
53 MORGIANTO 01-07-1977 KEL UJAN MAS ATAS
54 DONI APRIZAL 09-03-2000 KEL UJAN MAS ATAS
55 TUTI MARYANI 08-03-1985 DESA SURO ILIR
56 SAHRIL YANTO 24-06-1983 DESA SURO ILIR
57 HAKIM 22-05-1956 DESA SURO MUNCAR
58 LINDA PUTERI 24-11-1984 DESA SURO MUNCAR
59 MANSUR 19-09-1977 DESA DASPETAH II
60 DEDI SUPRIADI 03-05-1983 DESA SURO LEMBAK
61 MELIA ANGGRAINI MELIA ANGGRAINI KEL UJAN MAS ATAS
62 WINDA LESTARI WINDA LESTARI DESA UJAN MAS BAWAH
63 WAGIMIN 08-08-1947 PEKALONGAN
64 KURNIATI 12-06-1983 DESA SURO LEMBAK
65 SOFYAN RIKSAWAN 09-02-1985 ADIREJO, CURUP
66 EVA INDRAWATI 05-05-1979 DURIAN DEPUN
67 EMI MARYATI 04-08-1977 DESA SURO BARU
68 LUKMAN WIJAYA 01-07-1981 DESA SURO BARU
69 AILING JULIANTO 12-07-1986 DESA DASPETAH II
70 TOMI SAPUTRA 29-12-2002 DESA SURO MUNCAR
71 ILHAM PRATAMA 01-01-2007 DESA SURO MUNCAR
72 RENI YANTI 12-11-1992 DESA SURO MUNCAR
73 LAMIA 09-04-1985 DESA DASPETAH
74 KURNAIN 23-08-1980 DESA DASPETAH II
75 VIONA SUTRIANI 08-01-1997 DESA SURO BARU
76 AGUNG PRANOTO 23-08-2004 DESA SURO BARU
77 ANIS FITRIA KHALIS 08-11-2005 DESA SURO BARU
78 IDA ASTUTI 01-01-1983 DESA DASPETAH
79 RUSMA LIANA 11-11-1982 DESA DASPETAH II
80 HAMENG KUBUWONO 01-12-1974 DESA DASPETAH II
81 NUR 12-01-1957 DESA DASPETAH II
82 YURIANA 07-09-1986 DESA SURO MUNCAR
83 HALMAHERA 01-07-1982 DESA SURO MUNCAR
84 LIANA 20-11-1994 DESA SURO ILIR
85 ILI MURNI 10-02-1969 DESA SURO ILIR
86 RIA YUNANI 10-07-1993 DESA UJAN MAS BAWAH
87 UMAR USMAN 06-06-1987 DESA UJAN MAS BAWAH
SASARAN
NIK NO HP
LANSIA PUBLIK UMUM PENDIDIK
1708020704820002 085219115431 1
1708024107630151 081367539251 1
1708024607730001 085268526577 1
1702195304040002 081367539251 1
1702180206620001 082280393071 1
1702180706980001 082215019600 1
1702195503760004 085368488092 1
1708026001650002 082377980570 1
1708026803800001 081367539251 1
1702096610990003 083178577661 1
1702091603680001 083178577661 1
1708022012080003 083169389719 1
1708020511790002 085273127537 1
1708024612850002 085832106538 1
3173055610580001 081367539251 1
1708024603080001 083169389719 1
1708020507710001 081367539251 1
1708022708870002 081367539251 1
3275075903860009 081367539251 1
1708024507650001 081367539251 1
1708020806620001 085357794704 1
1708024808810001 085367710541 1
1702180603830001 085764230145 1
1708020101700007 081367539251 1
1708024510750001 089530288178 1
1708020506700003 089530288178 1
1708022404740004 085383616789 1
1708024202860001 082289822529 1
1708024310700001 0859171528970 1
1708022303650004 085268888772 1
1702092511660001 082267518697 1
1708026012900003 085764155922 1
1708025608700001 082384356503 1
1708025212000002 082384356503 1
1708026209820002 082289822529 1
1708020409830002 082289822529 1
1708024806770001 082289822529 1
1708020709730003 081273075535 1
1702192008730001 08153858882 1
1708020208730003 081367539251 1
1708025208860003 089530342311 1
1708025207690001 085709588191 1
1708020203420001 085959737158 1
1708020808860003 082291910505 1
7401070303650001 085274903837 1
1708027007880004 085378014117 1
1708021003700001 08995935397 1
1708024212500001 081367539251 1
1708026512940002 085369036771 1
1708022701740001 085383321041 1
1708024611810001 081368380540 1
1708020803700002 081274406959 1
1708020107770133 081367539251 1
1708020903000002 085609410221 1
1708024803850002 085709040536 1
1708022406830001 085709040536 1
1708022205560001 089652640572 1
1708056411840001 089652640572 1
1708021909770001 085310449492 1
1708020305830001 082377881352 1
1708024202980001 083803305548 1
1708020101040003 085788062059 1
1702080808740001 082312218882 1
1708025206830003 089516776423 1
1702090902850001 081271024004 1
1708054505790002 085267952562 1
1708024408770002 085769956427 1
1708020107810119 085769956427 1
1708021207860001 082175694631 1
1708022912030001 083133383999 1
1708020101070001 089530322917 1
1708055211920001 081367539251 1
1708024904850002 082269024292 1
1708022308800001 085379394662 1
1702194801970002 085838531481 1
1708022308040003 085609442268 1
1708024811050003 089652570211 1
1708024101830005 082374662761 1
1708025111820005 081367539251 1
1708020102740002 085273886146 1
1708025201570001 081367539251 1
1708085507870001 081367539251 1
1708024107820115 081367539251 1
1708026011940002 082372123101 1
1708025002690003 085279238993 1
1708025007930001 085856641908 1
1708020606870001 085856641908 1
DOSIS
1 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
VAKSINASI TGL 30 JUNI 2021

NO NAMA TGL LAHIR ALAMAT

1 KALIL MUKMIN 01-07-1958 KEL UJAN MAS ATAS


2 ROHANIA 10-04-1963 KEL UJAN MAS ATAS
3 MUHAMMAD ADINI 20-09-1984 DESA SURO ILIR
4 HENDRI 10-07-1985 KEL UJAN MAS ATAS
5 YOSI 01-07-1984 KEL UJAN MAS ATAS
6 WAWAN SETIAWAN 07-07-1977 DESA SURO LEMBAK
7 ARPA SURYANI 22-08-1981 DESA SURO LEMBAK
8 SAUDIA 09-10-1964 DESA SURO LEMBAK
9 MESI ANGGRAINI 16-05-1998 KEL UJAN MAS ATAS
10 TRI ADMJAYA SUWITO 20-04-1991 DESA TABA TEBELET
11 JOLI ARDI 30-07-1968 DESA SURO LEMBAK
12 ENDANG FIRMANSYAH 26-01-1978 DESA SURO LEMBAK
13 ANA 01-07-1948 DESA SURO MUNCAR
14 EMON SURYADI 21-03-2953 KEL UJAN MAS ATAS
15 M. SIDIK 01-07-1962 DESA SURO ILIR
16 BILASIN 02-01-1967 DESA SURO MUNCAR
17 FAUZUL ARIF ALFAHROZI 08-04-2002 TANJUNG ALAM
18 SAHRI GUNAWAN 17-02-1992 TEMPEL
19 MARYATI 02-04-1965 CURUP
20 SLAMET RIADI 12-07-1964 CURUP
21 HARMANSYAH 10-10-1975 DESA DASPETAH II
22 PURNAMA IRAWAN 06-03-1998 DESA UJAN MAS BAWAH
23 DENDI WIRANTO 10-10-1998 DESA SURO MUNCAR
24 DONI RISWAN SAPUTRA 22-07-1993 DESA SURO MUNCAR
25 DIKI PUTRA 06-04-1992 DESA SURO MUNCAR
26 SUSILAWATI 10-04-1986 DESA DASPETAH II
27 PUTRA 12-06-1984 DESA DASPETAH II
28 ARAB SAUDI 09-07-1983 DESA SURO MUNCAR
29 HIDAYANI 23-01-1993 TALANG RIMBO BARU
30 SUPRIYADI NAS 12-12-1982 PEKALONGAN
31 ANDRI WIJAYA 11-11-1981 AIR PUTIH LAMA
32 SALASA INDRA JAYA 02-08-2005 DESA SURO MUNCAR
33 ENDI AMROZI 18-05-1986 DESA SURO LEMBAK
34 FUJI PITRI RAHAYU 25-07-2009 DESA SURO BARU
35 UJANG SYARIPUDIN 17-12-1969 DESA SURO BARU
36 EPA SUSANTI 30-07-1975 DESA SURO BARU
37 ANGGI NURCAYANI 29-09-2001 KEL UJAN MAS ATAS
38 ARNI 14-04-1972 KEL UJAN MAS ATAS
39 PEDO APEKO 08-08-1988 KEL UJAN MAS ATAS
40 MEGAWATI 21-03-1962 DESA SURO MUNCAR
41 AMRAN SYAFI'I 28-09-1971 DESA SURO MUNCAR
42 AGUSTIAN 10-08-1998 DESA DASPETAH
43 RIVI YANDI 08-04-1996 DESA DASPETAH
44 BAIYONI 29-09-1981 DESA SURO BARU
45 EFFENDI. B 12-11-1975 DESA DASPETAH II
46 ELI NIRWANA 12-04-1979 DESA DASPETAH II
47 FAREL ADEVIO 24-08-2007 KEL UJAN MAS ATAS
48 RINI SANDORA 14-12-1993 DESA DASPETAH II
49 ISMAEL 10-11-1953 DESA DASPETAH
50 NELLY KURNILAWATI 05-08-1975 DESA SURO MUNCAR
51 ROSIDA IBRAHIM 03-07-1978 KEL UJAN MAS ATAS
52 JAALDI 20-08-1980 DESA UJAN MAS BAWAH
53 ITA FITRIANI 10-12-1988 DESA SURO MUNCAR
54 ROSMAWATI 20-02-1956 DESA SURO LEMBAK
55 HERAWATI 06-06-1978 DESA SURO MUNCAR
56 ELVI SUKAIDA 20-12-1977 DESA SURO LEMBAK
57 SUYITNO 27-08-1950 DESA SURO ILIR
58 PINGKI RAHMAWATI 15-09-2004 DESA DASPETAH II
59 ARPENSASI 18-03-1986 DESA SURO MUNCAR
60 DALINA 25-04-1961 DESA SURO MUNCAR
61 UPIK DAYA 02-06-1965 DESA SURO MUNCAR
62 ANWAR SADAD 15-04-1982 DESA SURO LEMBAK
63 SUSI KARTINA 13-04-1996 SUSUP
64 RAPINA 01-07-1953 DESA SURO MUNCAR
65 YUNITA ABABIL 11-12-1984 DESA DASPETAH II
66 LISA ARDIANTI 15-05-1998 DESA DASPETAH II
67 ANITA 03-01-1982 DESA SURO LEMBAK
68 LIRA MARISKA 22-01-2004 PADANG ULAK TANDING
69 WIWIK 08-10-1975 DESA SURO ILIR
70 MUTIARA HUSNUL KHOTIMAH 01-01-2004 DESA SURO ILIR
71 NOPRI 11-11-1994 DESA DASPETAH
72 SILVIA SEPTIANINSIH 25-09-2005 DESA SURO ILIR
73 DWI BARELIS 14-03-2004 DESA SURO ILIR
74 REKO SAPUTRA 02-03-2007 DESA SURO MUNCAR
75 SALMA 07-07-1983 DESA SURO MUNCAR
76 ALDI NANDA PRATAMA 25-12-2004 DESA SURO MUNCAR
77 RISKA DIANA 24-06-1984 DESA DASPETAH II
SASARAN
NIK NO HP
LANSIA PUBLIK UMUM PENDIDIK
1708020107580130 081367539251 1
1708025004630001 081367539251 1
1708022009840001 082291910505 1
1708021007850003 081367539251 1
1708024107840125 081367539251 1
1708020707770006 085832363122 1
1708026208810002 085841590651 1
1708024910640001 081367539251 1
1708025605980002 081272059933 1
1603072004900001 081272059933 1
1708023007680002 085368346627 1
1708022601780003 085832363112 1
1708024107480037 081367539251 1
1708022103530001 085268022663 1
1708020107620072 083801594810 1
1708020201670002 082376264949 1
1708020804020002 081271916952 1
1702161702920002 081271916952 1
1702194204650002 08117311487 1
1702191207640001 08117311487 1
1708021010750003 085384825364 1
1708020603980001 081367539251 1
1708021010980006 089501617861 1
1708022707930001 082376266077 1
1708080604920001 081367539251 1
1708025004860003 081367539251 1
1708021206840001 081367539251 1
1708020907830002 082375562635 1
1702196301930003 081274137610 1
1771061212820003 085768577175 1
1702091111810003 082325821212 1
1708020208050001 089530342297 1
1708021405860002 081367539251 1
1708026607090001 081367539251 1
1702091712690001 081367539251 1
1702097007750002 081367539251 1
1708026909010001 085268535975 1
1708025404720001 085268535975 1
1708030808880011 082385578107 1
1708026103620001 085766989057 1
1708022829710001 082373387707 1
1708021008980002 082182082633
1708020804960001 082282657804
1708022909810002 081367539251
1708021211750004 085384827699 1
1708025204790001 082366403883 1
1708022408070001 081368380540 1
1708025412930001 085282591756 1
1708021011530001 085279786211 1
1708024508750001 085280470872 1
1708024307780001 081367539251 1
1708022008800005 085268034748 1
1708024201860001 085788375352
1708026002560002 081367539251 1
1708024606780001 081367539251
1708026012770001 083177513052
1708022708500001 085766871395 1
1708025509040004 085783482963 1
1708021803860001 083802103717
1708026504610001 085709769538 1
1708024206650002 081367539251 1
1708021504820003 081367539251
1708025304960001 085664706382 1
1708024107530116 081367539251 1
1708025112840005 085384827699 1
1708025505980001 081367539251
1708024301820003 085838530817 1
1702074201040002 085769132560 1
1708024810740002 081367539251 1
1708024101040003 085709354388 1
1708025111940001 085384910481 1
1708026509050003 082176793559 1
1708025403040001 083176650727 1
1708020203070002 089520384030 1
1708024707830005 085761146656 1
1708022512040003 085761146656
1708026406840003 081367539251
DOSIS
1 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1

1
1

1
1
1

1
1
1
1
1
1
1
1
1
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI TANGGAL 17 JULI 2021

SASARAN
NO NAMA TGL LAHIR ALAMAT NIK NO HP DOSIS 1 DOSIS 2
LANSIA PUBLIK UMUM PENDIDIK LANSIA PUBLIK UMUM PENDIDIK
1 ALDI IRFAN 30-04-2001 CURUP SELATAN 1702183004010001 0895422968065 1
2 ARIES ROBBY 24-08-1994 DESA DASPETAH 1708022408940002 0822768883948 1
3 SANDRA WASI 28-11-1985 DESA DASPETAH 1708022811900001 082376840794 1
4 RITA HERIYANI 06-10-1970 DS TELADAN 1702094610700002 081271171422 1
5 LIA MAYA SARI 08-01-1986 DS TELADAN 1702096801860001 081271171422 1
6 NIA NATALIA 21-12-1989 CURUP TENGAH 1702196112890001 081271171422 1
7 DESI SUSANTI 05-10-1999 CURUP UTARA 1702164510990001 081271171422 1
8 FEVI ANNISA 18-02-2003 CURUP SELATAN 1702185802030003 085766989315 1
9 WIJAYATI 03-05-1967 DS SURO LEMBAK 1708024305670002 082318296349 1
10 JULIAN FERDIANSAH 25-07-1993 TEMPEL REJO 1702092507930001 08113117253 1
11 DEBBY MONICA LESTARI 28-06-1994 TEMPEL REJO 1702186806940001 08113117253 1
12 CHINTIA PUTRI OKTAFIANI 06-10-1995 KEL UJAN MAS ATAS 1671064610950009 085783823906 1
13 ANSORY 15-05-1980 DESA DASPETAH 1708021504800002 082374662641 1
14 NOVI SUSANTI 04-02-1995 DS SURO ILIR 1708024202950002 083173665367 1
15 ANWAR SANUSI 16-05-1984 DS SURO ILIR 1708021605840003 085247127986 1
16 RINI KOSMILITA 30-03-1991 DS SURO LEMBAK 1708027003910002 081271859412 1
17 ANIR BAHRUN 01-01-1983 DS SURO ILIR 1708020101830002 085709513099 1
18 UJANG PIRMANSA 09-09-1969 DESA SURO ILIR 1708020909690004 085769146744 1
19 RINI ARSIH 10-08-1978 KEL UJAN MAS ATAS 1708025008780002 081367539251 1
20 BERLIANDO KUSUMA BAKTI 22-03-2008 TEMPEL REJO 1702182203080001 082377689239 1
21 YAUNA 08-07-1965 DS SURO ILIR 1708024807650001 081367539251 1
22 YUNIARWETI 25-10-1998 DS DASPETAH 1708026510980005 082371361319 1
23 BETARIA KARTIKA 26-10-1984 DS DASPETAH 1708026601840002 082371361319 1
24 SITIN SUMARNI 10-03-1982 DS SURO ILIR 1708025003820001 081367539251 1
25 HENGKI PRANATA 21-02-1998 KEL UJAN MAS ATAS 1708022102980001 085767061301 1
26 IMAN ASLI 10-10-1959 DS DASPETAH II 1708021010590007 081367539251 1
27 ALI MUKMINA 15-03-1980 DS DASPETAH 1708021503800001 082269384688 1
28 AMINUDIN 26-01-1954 DS DASPETAH 1708022601540001 081367539251 1
29 UJANG AMER 01-09-1960 DS DASPETAH 1708020109600001 081367539251 1
30 NULUDIN RABE H. 15-05-1945 DS DASPETAH 1708021505450001 081367539251 1
31 BAHAKIM 10-04-1980 DS SURO ILIR 1708021004800001 085267198952 1
32 SUTARTY 6/22/1969 AIR PUTIH BARU 1702186206690001 085367837312 1
33 RUSDAWATI 8/31/1963 CURUP SELATAN 1702187108630001 082378471763 1
34 MUSLIMAH 3/20/1969 TEMPEL REJO 1702186003690001 082377689239 1
35 SRI WARYANINGSIH 2/25/1969 TEMPEL REJO 1702186502690001 081367640125 1
36 TIARA KUSUMA ASTUTI 7/12/2000 TEMPEL REJO 1702185207000002 082377689239 1
37 ERMAN 10/10/1962 CURUP SELATAN 1702181010620004 085269120478 1
38 SUBEKTI 6/1/1963 TEMPEL REJO 1702180106630004 082377689239 1
39 SUPARTININGSIH 1/1/1971 TEMPEL REJO 1702184101710002 081271226564 1
40 POPI 2/10/1990 DASPETAH 1 1708025002900002 082376840794 1
41 HENDRI KASOGIE 6/7/1990 BUMI SARI 1708020706900009 082228889968 1
42 M. ARIF AWABI 7/11/2002 TEMPEL REJO 1702181107020002 089664251800 1
43 SITI AISYAH 2/5/1985 UJAN MAS ATAS 1708024502850002 085266681603 1
44 WAHIDIN KASMIR 3/18/1969 PELANGKIAN 1708041803690002 085273063917 1
45 YOGIE FIKRIANSYAH 12/29/2000 DURIAN DEPUN 1708022912000006 082279421913 1
46 LUDI ENDANO 7/24/1991 BUMI SARI 1702112407910002 08999561620 1
47 DEDI IRAWAN 10/10/1979 SURO ILIR 1708021107500001 085382572051 1
48 TARMIZI 4/8/1984 SURO ILIR 1708020804840005 081367539251 1
49 JURIAH 8/8/1985 UJAN MAS ATAS 1708024808850006 085658641920 1
50 RESMI MEGA NERI 5/15/1966 CURUP 1708025505660001 085213238859 1
51 DESI MARYANI 2/10/1987 SURO ILIR 1708025002870001 081367539251 1
52 SISMASANTI 10/4/1986 SURO ILIR 1708024604820003 081367539251 1
53 SUNA 01/07/160 SURO ILIR 1708024107600077 083121639174 1
54 BAMBANG WIRANTO 4/13/1987 SURO ILIR 1708021304870002 085709959714 1
JUMLAH Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 Err:522
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
27 SEPTEMBER 2021

SASARAN
NO NAMA TGL LAHIR ALAMAT NIK NO HP DOSIS 1 DOSIS 2 DOSIS 3
LANSIA PUBLIK UMUM PENDIDIK NAKES LANSIA PUBLIK UMUM PENDIDIK NAKES
1 PEBRIANTIKA 2/28/1990 DASPETAH 1708026802900002 081367539251 1
2 AHMAD MAHRONI 5/3/1987 DASPETAH 1708020305870009 081367539251 1
3 NURHAYATI 12/27/1994 SURO ILIR 3603146712940001 081367539251 1
4 MUKLIS MAMEROQI 3/26/1989 SURO ILIR 1708022603890001 085709961873 1
5 ANDI YURIKO 10/4/1982 CURUP 1702090410820003 1
6 ZULKAPLI 1/1/1976 UJAN MAS ATAS 1708020101760008 085379391135 1
7 RAHMADAN 9/12/1989 SURO LEMBAK 1708021209890008 082255080502 1
8 TEGU RAHMAT YUDI 5/2/1988 SURO ILIR 1708020205880004 082179795933 1
9 JEMMY RADEN MAYU 3/27/1998 SURO MUNCAR 1702092703980001 082183314226 1
10 SINAR 8/4/1974 UJAN MAS ATAS 1708024408740001 1
11 ADNAN 4/1/1974 TABA TEBELET 1708040104740003 1
12 SUWONDO 8/15/1972 CURUP SELATAN 1702181508720001 085380631223 1
13 ROSALI 8/5/1992 MERIGI SAKTI 1771060508920004 085337740751 1
14 JERRI SAFTIANSYAH 9/11/1997 TABA TEBELET 1708041109970002 085267374499 1
15 KAHARUDIN 7/26/1984 MERIGI KELINDANG 1709060708850002 085211486042 1
16 RUSLI 3/27/1980 PEKALONGAN 1708022703800006 081368659223 1
17 ANAN 7/1/1948 TANJUNG ALAM 1708020107480046 081271916952 1
18 YUDI ANHAR 1/17/1993 UJAN MAS ATAS 1708021701930001 085768575680 1
19 IRWANSYAH 1/3/1991 SURO LEMBAK 1708020301910005 085758011400 1
20 MAHIDI SURYATO 3/18/1987 PADANG ULAK TANDING 1709031803870003 085366434838 1
21 MONICA RINDI VACHLEFI 11/24/1990 KEMUNING 1671096411900004 082176010165 1
22 BEKA OKTAVIA 10/8/1989 UJAN MAS ATAS 1708034810890004 085382362862 1
23 REVI SILVIA 9/27/1983 SIDOREJO 1702196709830001 085383097983 1
24 RINTO NOVIANTORO 11/22/1980 DUREN SAWIT 3175072211800007 0816784094 1
25 MISWANTO 5/10/1980 SURO ILIR 1708021005800001 085832903474 1
26 DONI SAPUTRA 6/15/1980 GANG NUSA INDAH 1771061506800002 085279997254 1
27 TUNTE BERMANO 25-601993 DASPETAH 1708022506930002 085367245295 1
28 FAUZUL ARIF ALFAHROZI 4/8/2002 TANJUNG ALAM 1708020804020002 081271916952 1
29 SARIPATUL AINI 2/20/1975 SURO LEMBAK 1708026002790001 083181302006 1
30 ROHANA 5/17/1968 SURO LEMBAK 1708025705680001 085269889199 1
31 REKO HARYONO 1/11/1996 UJAN MAS ATAS 1708021101960006 085789117100 1
32 DESSY M 1/14/1900 CURUP TENGAH 1701055512810006 089627144583 1
33 HASNAYANI 5/28/1981 CURUP TENGAH 1771056805810005 085766869298 1
34 SAROPIL 8/14/1978 CURUP TENGAH 1771051408780002 085766869298 1
35 ENDA YULITA 2/10/1995 KELOBAK 1708015002950003 085789382812 1
36 ANISA MELIANA 5/26/1998 CURUP SELATAN 1702186605980001 082387816429 1
37 YOGI SANTOSO 5/29/1994 UJAN MAS ATAS 1708022905940002 082280062994 1
38 RIA PAREZI 9/6/2002 SURO ILIR 1708024609020002 1
39 MADE SURAJE 7/18/1976 SURO BALI 1708021807760002 1
40 ARMAN 5/4/1967 KEPAHIANG 1702090405670001 1
41 RANDI S.CHANIAGO 12/26/1985 DS TELADAN 1702182612850001 085813345132 1
42 DESI SUSIANTI 12/5/1978 SURO ILIR 1708024512800001 1
43 CANDRA 3/11/1984 SURO ILIR 1708021103840001 1
44 SAFRIDA EFRIYANI 9/10/1977 SURO ILIR 1708025009770001 085835676038 1
45 BUDI UTOMO 5/20/1997 CURUP TENGAH 8102012005970004 082371824212 1
46 WINDA PUSPITA SARI 3/31/2003 SURO ILIR 1702187103030001 1
47 ANGGRIA DWI 10/16/1982 CURUP TENGAH 1702195610820001 082371824212 1
48 NOVIANTI 11/30/1978 CURUP TENGAH 1702197011780002 082371824212 1
49 SYAHRONI 12/3/2001 UJAN MAS ATAS 1708020312010001 085764484253 1
50 TARMIZI 11/15/1981 TABA MULAN 1708041511810003 085268320581 1
51 MEFRI NINDITA 9/9/2002 DASPETAH 1708024909020001 085367710695 1
52 ABDUL RAHMAN 2/5/1988 SIDOREJO 1603010502880003 081379925588 1
53 JAILANI 5/3/1984 SUSUP 1709080305840001 083166277946 1
54 MARIZA NOVILYA 11/15/1983 UJAN MAS BAWAH 1708025511830001 1
55 ASEP FRIATNA 4/17/1976 SURO BARU 1708021704760001 1

JUMLAH 1 9 25 1 0 1 5 12 0 1
36 18
*Rencana Dosis 2 27 Oktober 2021

REKAPITULASI
NAKES DOSIS 3 1
NAKES DOSIS 1/2 0/0
LANSIA DOSIS 1/2 1/1
PUBLIK DOSIS 1/2 9/5
UMUM DOSIS 1/2 25/12
PENDIDIK DOSIS 1/2 1/0

DS SURO BARU 1
DS SURO MUNCAR 1
DS SURO ILIR 9
DS SURO LEMBAK 4
KEL UJAN MAS ATAS 7
DS UJAN MAS BAWAH 1
DS PG BERINGANG 0
DS DASPETAH 4
DS DASPETAH II 0
LUAR DAERAH 28 27
UPT PUSKESMAS RAWAT INAP UJAN M
VAKSINASI COVID-19
24 JUNI 2021

NO NAMA TGL LAHIR ALAMAT NIK

1 MUTI ANSYARNI 10/18/1989 SURO BARU 1708025810890002


2 SRI DAYA 2/1/1961 SURO BARU 1708024102610002
3 NUR ASIA 3/10/1955 DASPETAH 1708025003550001
4 TITIN SUMARNI 1/1/1968 DASPETAH
5 SEPTIAWAN ARDIANTO 9/7/1993 SURO BARU
6 MASDALIPA 8/12/1973 SURO BARU
7 JUMILAWATI 9/28/1984 SURO BARU 1708026809840001
8 AZWAR EFENDI SURO BARU 1708022002660001
9 AMIR AMSAH SURO ILIR 1708020403600001
10 JUMIATI 7/1/1980 SURO BARU 1708024107800121
11 YULIA MARGARETA 8/4/1988 SURO BARU 1708054408880002
12 SUYONO 3/2/1961 SURO LEMBAK 1708020203610001
13 RESTRI ALFIONITA 1/20/1973 SURO BARU 1702096001950002
14 YULIANTI 7/30/1995 SURO LEMBAK 1708026807960001
15 MARJANDI 1/3/1966 DASPETAH 2 1708020604660002
16 RUSMINI 1/8/1986 SURO LEMBAK 1708024801860003
17 REPA SYAFTILALOVEFA 8/31/1996 DASPETAH 2 1708023004960002
18 ROSALINDA SYABRINA 4/17/2003 DASPETAH 2 1708024808010001
19 PEBRI YANSAH 9/2/1993 DASPETAH 2 1603090709920002
20 SAIRIN 11/13/1962 DASPETAH 1708021311620002
21 DESI 6/12/1957 SURO LEMBAK 1708025206570001
22 AWALUDIN 7/1/1953 SURO ILIR 1708020107530146
23 DWI DEBBY 6/27/2001 DASPETAH 1708026706010001
24 MURDIK 2/12/1956 SURO LEMBAK 1708021202560001
25 ARNI 12/28/1976 SURO LEMBAK 1708026812760002
26 SAPTIK 4/10/1960 SURO LEMBAK 1708025004600004
27 PARMAN 10/16/1971 SURO LEMBAK 1708021610710004
28 YUSUF 12/2/1972 SURO LEMBAK 1708020212720003
29 EDWAR 2/20/1973 SURO LEMBAK 1708022002730002
30 IROMSI 8/12/1969 DASPETAH 2 1708026802690001
31 MURNI ATUN 2/3/1966 SURO LEMBAK 1708024302660003
32 PARWIL ANGKASA 3/7/1952 SURO LEMBAK 3276020703520004
33 USMAN K 5/21/1952 SURO LEMBAK 1708022105520001
34 MERI SUSYANTI 2/5/1970 DASPETAH 1708024502700002
35 NIRWANA 7/15/1983 SURO LEMBAK 1708025507830002
36 ERNA WATI 5/5/1963 UJAN MAS ATAS 1708024505630001
37 HERLINDA MELYANTI 5/30/1999 UJAN MAS ATAS 170802700599003
38 NASIRWAN 7/1/1967 SURO LEMBAK 1708020107670074
39 REZA OKTAVIA 10/10/1998 UJAN MAS ATAS 1708025010980007
40 BAMBANG NURDIANSYAH 9/28/1981 SURO LEMBAK 1708022809810002
41 JAMILA HERYANTI 4/19/1976 SURO LEMBAK 1708025904760001
42 RAHMI 6/6/1981 SURO LEMBAK 1708024606810010
43 MEZI PURWANTI 2/8/2000 SURO LEMBAK 1702174802000001
44 HIDAYA 3/12/1969 UJAN MAS ATAS 1708025203690001
45 MIRNA WATI 7/1/1968 UJAN MAS ATAS 1708024107650111
46 NANAN 3/5/1956 SURO LEMBAK 1708020503560001
47 AISAH ROYANI 9/30/1978 UJAN MAS ATAS 1708027009780001
48 ISNAINI 3/10/1975 SURO LEMBAK 1708025003750004
49 MUJIB 2/10/1952 DASPETAH 2 1708021002520002
50 DEWI SUMANTI 5/12/1972 SURO LEMBAK 1708025205720001
51 L. SIHOMBING 11/18/1964 TABA MULAN 1708051811640001
52 OSY APRIANTI 4/26/2002 SURO BARU 1708026604020001
53 LUSIANA 7/16/1984 SURO BARU 1708025607840003
54 SUMRATUL AINI 2/13/1970 SURO LEMBAK 170802530270002
55 ARPANDI 4/12/1972 SURO ILIR 1708021204720002
56 MARSAP 4/24/1959 UJAN MAS ATAS 1708022404590001
57 DARNIATI 12/10/1985 SURO LEMBAK 1708025012850002
58 TITIN MELIANI 9/21/1985 SURO LEMBAK 1708026109850002
59 YUSNA LENSI 4/6/1972 SURO LEMBAK 1708044604720002
60 KALBI 3/20/1971 UJAN MAS ATAS 1708027003710001
61 CANDRA WIJAYA 2/14/1992 SURO BARU 1708021402920006
62 ELYATI MURNI 2/20/1995 SURO LEMBAK 1708066002950003
63 LILIS 3/6/1975 SURO LEMBAK 1708024603750001
64 DAHLAN BUHARI 2/1/1974 SURO BARU 1708020102740003
65 SISMA YUNITA 8/15/1982 SURO BARU 1708025508820001
66 YESA PUTRI PRATAMA 6/22/2002 SURO BARU 1708026206020003
67 NANI ELSA 7/1/1984 SURO BARU 1708024107840130
68 SELVI YULIANTI 6/5/2001 SURO LEMBAK 1708024506010002
69 ZAITUN 6/3/1981 SURO LEMBAK 1708024306810003
70 HENDA 8/24/1981 SURO LEMBAK 1708022408810004
71 RATI OKTAVIA 10/7/1992 UJAN MAS ATAS 1771084710920001
72 ALI USMAN 3/8/1967 DASPETAH 2 170802080370003
73 SUHARTINI 5/5/1964 TEMPEL REJO 1702184505640001
74 SAHRIL 4/17/1962 DASPETAH 2 1708021704630001
75 SITI SAHARA 5/1/1960 SURO ILIR 1708024104600001
76 SUPARMAN 8/12/1978 SURO BARU 1708021208780005
77 A. AMIRIL 3/8/1960 DASPETAH 1708020308500001
78 LISNAWATI 3/1/1992 SURO BARU 1708024103920002
79 ZAINUBI BUSTAMI 6/6/1968 DASPETAH 2 1708020606680002
80 RUMIATI 11/20/1971 DASPETAH 2 1708026011710002
81 RIZA WATI 5/7/1983 SURO LEMBAK 1708024705830001
82 SUBARIK 5/14/1978 SURO LEMBAK 1708021405780004
83 CANTIKA WULANDARI 2/22/1996 SURO LEMBAK 1708026202960004
84 RAHMATULLAH 3/8/1993 SURO LEMBAK 3604280803930412
85 ETI SURYANI 8/10/2000 SURO LEMBAK 1708025605000002
86 TRI SUSANTI 2/8/1997 SURO LEMBAK 1708024108980002
87 ROHMAN 5/5/1967 SURO LEMBAK 1708020505670001
88 DRS. KURTUBI 7/6/1957 DURIAN DEPUN 1708050607570002
89 SRI NURMIYANA 5/1/1965 DURIAN DEPUN 1708054105650001

UPT PUSKESMAS RAWAT INAP UJAN M


VAKSINASI COVID-19
25 JUNI 2021

NO NAMA TGL LAHIR ALAMAT NIK

1 P. ROMLI 9/10/1977 SURO BARU 1708021009730003


2 SUPER NENTI 7/12/1969 SURO BARU 170802120769002
3 JAILANI 2/7/1978 SURO BARU 1708020702780002
4 GALANG SASMITA 8/19/1976 SURO LEMBAK 1708021908760005
5 RAZIKIN 4/14/1999 SURO LEMBAK 1708021404990001
6 JUMIA LAILI 6/3/1976 SURO ILIR 1708024306760001
7 PUTRIANA 12/12/1972 SURO ILIR 1708025212720006
8 DESPITA ARYANI PUTRI 12/5/2002 SURO LEMBAK 1708024512020001
9 KOSASI 10/1/1980 SURO LEMBAK 1708020110800001
10 RUDI ANTONI 1/27/1979 TABA TEBELET 1708042701790001
11 SUTRISNO 7/1/1976 SURO LEMBAK 1708020107760138
12 MUSLIM 3/25/1973 SURO BARU 1708022503730002
13 TATANG 11/27/1964 SURO LEMBAK 1708022711690001
14 RUDI HARTONO 3/15/1984 SURO BARU 1708021503840003
15 FAISAL HENDRA YATMO 4/3/1995 SURO MUNCAR 1671140304950003
16 LILIS KARLINA 3/8/1994 SURO MUNCAR 1708024107930072
17 FITRI RAMADAYANTI 1/27/1998 TALANG BENIH 1702096702980002
18 YUNI SUHETI 6/23/1965 TALANG BENIH 1702096306650001
19 ANA YULAEHA 6/2/1990 SURO ILIR 1708024206900001
20 TARMA WATI 3/1/1978 TABA TEBELET 1708040107000091
21 RIKI 10/26/1999 SURO LEMBAK 1708040107000091
22 DEDE SURYANA 9/7/1992 SURO LEMBAK 1708024709920001
23 ASIH 8/10/1983 SURO LEMBAK 1708025008830003
24 SUBARNAK 3/6/1984 SURO LEMBAK 1708020106570002
25 HAMID 1/6/1957 PG BERINGANG 1708020106570002
26 TAUB ALI 5/10/1976 SURO LEMBAK 1708021005760001
27 KARNEN 12/15/1976 SURO LEMBAK 1708021512760001
28 NUR CAHAYA 9/3/1966 SURO LEMBAK 1708024309660002
29 TAUFIK HIDAYAT 12/11/1988 SURO LEMBAK 1708021112880003
30 ROMIA 10/20/1971 DASPETAH 1708026010710001
31 MAHYUDIN 12/10/1969 DASPETAH 1708021012690003
32 KARTINI 7/1/1970 UJAN MAS ATAS 1708024107700119
33 MUHAMMAD FAUZAN 4/23/2002 UJAN MAS ATAS 1708022304020004
34 AFITRI AYU ANINGSI 1/19/2002 SURO LEMBAK 1708025901020001
35 YULISTRI 8/30/1983 SURO ILIR 1708027008830001
36 BAHERI 5/7/1965 DASPETAH 1708020705650001
37 TITIN SUMARNI 9/2/1968 SURO ILIR 1708024209680001
38 HENDI ADEPIO 1/11/1991 DASPETAH 1708021101910002
39 ASNA WATI 9/25/1969 DASPETAH 2 1708026509690001
40 RITA NOVIYANTI 6/24/1988 SURO MUNCAR 1708026406880001
41 NOPEMBER HARYADI 11/9/1986 SURO MUNCAR 1705030911860001
42 ERLAN JAYA 1/17/1984 PELANGKIAN 1708042701840002
43 BETHA RIA SONATA 6/29/1992 DASPETAH 2 1708026706970001
44 SUPARMONO 4/28/1986 UJAN MAS ATAS 1771032804870001
45 M. LUKMAN 7/24/1977 SURO LEMBAK 1708022407770003
46 SARTIKA SARI 10/28/1989 UJAN MAS ATAS 1708026810890001
47 TORIAN PUTRA 11/30/1989 SURO ILIR 1708023011890001
48 PUTRI WIJAYANTI 11/17/1992 SURO LEMBAK 1702195711920002
49 JUNI INDRA JAYA 6/7/1989 SUMBER BENING 1702211070689001
50 RISMAN KARTIAN PUTRI 4/20/1982 MUARA AMAN 1707012004821001
SKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
24 JUNI 2021

SASARAN
NO HP DOSIS 1 DOSIS 2
LANSIA PUBLIK UMUM PENDIDIK LANSIA PUBLIK UMUM PENDIDIK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

SKESMAS RAWAT INAP UJAN MAS


VAKSINASI COVID-19
25 JUNI 2021

SASARAN
NO HP DOSIS 1 DOSIS 2
LANSIA PUBLIK UMUM PENDIDIK LANSIA PUBLIK UMUM PENDIDIK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
9 5 34 1 1 0 0 0
REKAPITULASI HARIAN VAKSINASI COVID 19
19 OKTOBER 2021

SINOVAC MODERNA
DESA DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 JUMLAH
LAN PUB MU PEN LAN PUB MU PEN LAN PUB MU PEN LAN PUB MU PEN
SB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 2
UMA 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 2
UMB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
PB 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
DPT 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 2
DPT2 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
LD 0 0 0 0 0 0 2 0 1 0 4 0 0 0 1 1 9
JUMLAH 0 0 0 0 0 0 3 1 2 0 8 0 0 0 2 2 18
REKAPITULASI HARIAN VAKSINASI COVID 19
20 OKTOBER 2021

SINOVAC MODERNA
DESA DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 JUMLAH
LAN PUB MU PEN REM LAN PUB MU PEN REM LAN PUB MU PEN LAN PUB MU PEN
SB 0 0 10 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 14
SM 0 0 6 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 7
SI 0 0 8 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 11
SL 0 0 10 0 1 0 0 2 0 0 0 0 0 0 0 0 0 0 13
UMA 2 0 21 1 0 1 0 9 1 1 0 0 0 0 0 0 0 0 36
UMB 0 0 13 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 16
PB 0 0 4 0 1 0 0 2 0 0 0 0 0 0 0 0 0 0 7
DPT 1 0 10 0 2 0 0 4 0 0 0 0 0 0 0 0 0 0 17
DPT2 1 0 9 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 15
LD 1 0 1 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 6
JUMLAH 5 0 92 1 15 2 0 25 1 1 0 0 0 0 0 0 0 0 142
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
25 OKTOBER 2021

SINOVAC MODERNA

DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2


NO NAMA TGL LAHIR ALAMAT NIK NO HP

REMAJA

REMAJA
M.UMUM

M.UMUM

M.UMUM

M.UMUM
PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
LANSIA

LANSIA

LANSIA

LANSIA
PUBLIK

PUBLIK

PUBLIK

PUBLIK
KELAS VII.I 1 AMANDA PUSPITA SARI 7/27/2009 DASPETAH 1708026707090001 082279685776 1
2 ANDRE SANTOSO 1/20/2009 UJAN MAS ATAS 1708022001090003 082279685776 1
3 ARIEL FAHMI 11/18/2008 PUNGGUK MERANTI 1708021811080002 082279685776 1
4 ARJUNA ARYA W. 2/16/2009 UJAN MAS ATAS 1708021602090002 082279685776 1
5 BAYU AZMI 11/28/2008 SURO BARU 1708022811080001 082279685776 1
6 BHELA OKTA 12/9/2008 DASPETAH 2 1708024912080001 082279685776 1
7 HABIB FAHRY FADYLAH 3/8/2009 SURO MUNCAR 1708020803090001 082279685776 1
8 INDAH MULYANI 3/20/2009 CUGUNG LALANG 1708026003090001 082279685776 1
9 IQBAL AL-GAZALI 5/12/2009 UJAN MAS ATAS 1708021205090001 082279685776 1
10 MARSEL ANGGARA 6/23/2008 PG BERINGANG 1708022306080002 082279685776 1
11 M. FAHRI ALFAREZA 5/6/2009 SURO ILIR 1708021606090002 082279685776 1
12 NADYA ULFA S. 10/14/2009 AIR HITAM 1708025410090001 082279685776 1
13 NIKENZA ANGGRAINI 10/16/2008 UJAN MAS ATAS 1708024107080004 082279685776 1
14 NOPRIANSYAH 2/1/2008 SURO MUNCAR 1708020107080008 082279685776 1
15 NURUL KOMARIAH 2/23/2007 SURO MUNCAR 1708026302070001 082279685776 1
16 PAREL 12/26/2007 UJAN MAS ATAS 1708022812070003 082279685776 1
17 RANDI WAHYU P. 3/30/2009 SURO LEMBAK 1708023003090001 082279685776 1
18 TOMI KURNIAWAN 11/14/2008 UJAN MAS ATAS 1708021411080002 082279685776 1
19 YESI KURNIAWATI 11/10/2008 SURO MUNCAR 1708025011080001 082279685776 1
20 MELI SURYANI 5/26/1986 AIR PUTIH BARU 1702186605860004 082279685776 1
21 ISYE YULISTA 7/20/1984 AIR PUTIH BARU 1702186007840003 085366821558 1
KELAS VII.2 22 Abdul Wahid Wahyu Khoiri 2/26/2009 Ujan Mas Atas 1708022602090003 085267141679
23 Airin Citra Areka 3/22/2006 Suro Bali 1709056203080001 085267141679
24 Aryo Vicky Pratama 5/8/2009 Suro Lembak  1708020805090001 085267141679
25 Candy Aulia 6/3/2009 Suro Ilir  1708026306090003 085267141679
26 Ciren Yolanda 3/21/2009 Pekalongan   1708026103090002 085267141679
27 Deswita Oktavia 11/27/2008 Pungguk Meranti  1708026711080001 085267141679
28 Dimas Arya Prayoga 6/17/2009 Suro Muncar  1708021706060001 085267141679
29 Enlia Septianti 9/11/2009 Cugung Lalang  1704145109090001 085267141679
30 Exgi Triansa 30-02-2009 Meranti Jaya  1708023001090001 085267141679
31 Ismi Try Wahyuni 6/15/2009 Suro Ilir  1708025508090002 085267141679
32 Ketut Purna Ningsih 2/9/2009 Suro Bali 1708024902090002 085267141679
33 Melati Ayu Dwi Kharina 5/3/2009 Bumi Sari  1708024305090002 085267141679
34 Melsa Nabila 4/15/2009 Ujan Mas Atas 1708025504090001 085267141679
35 Muhammad Daichan 2/23/2009 Suro Lembak 1708022302090002 085267141679
36 Nengah Sila Welsya 8/8/2009 SURO BALI 1708024808090001 085267141679
43 Rindi Juliani 6/23/2008 Pekalongan 1708026306080002 085267141679
44 Selin Oktaviona 10/19/2008 UJAN MAS BAWAH 1708025910080001 085267141679
45 Siti Khairun Nisa 8/15/2009 Meranti Jaya 1708025508090001 085267141679
46 Taufik Saputra 4/15/2008 Bumi Sari 1708021504080002 085267141679
KELAS VII.3 47 ALFINZAH GILANG BAGAS KARA 7/27/2008 Daspetah 1708022707080003 082178331506
48 ANGGUN ANGGRAINI 8/10/2008 Ujan Mas Atas 1708025008090001 082178331506
49 BELLA SAFIRA 10/1/2009 Suro Muncar 1708024110090004 082178331506
50 BUNGA DWI APRIANI WESKUST, KEPAHIANG 1708046004090003 082178331506
53 GEDE OKTARIYANE 10/7/2009 Suro Bali 1708020710090001 082178331506
54 INKA CYNTHIA AINNISA 1/28/2009 Bumi Sari 1708026801090001 082178331506
56 JEFRI APRIANSYAH 8/25/2009 UJAN MAS ATAS 1708022508090001 082178331506
57 JERRI FEBRIAN ARIFIN 2/6/2009 Ujan Mas Atas 1708040602090001 082178331506
58 KARINA 5/21/2009 Suro Baru 1708026105090001 082178331506
59 MARSYAH ENJELA 3/9/2009 Suro Ilir 1708054903090001 082178331506
61 PERICE AMELIA 1/5/2009 Suro Ilir 1708024501090002 082178331506
63 R.J. AL HAFIZT 12/6/2008 Daspetah 1708020612080002 082178331506
66 RIAN HIDAYAT 1/8/2009 Ujan Mas Atas 1708020801090001 082178331506
67 SATRIA RAMADAN 8/22/2009 Suro Muncar 1708022208090001 082178331506
68 SEPTI LESTARI UJAN MAS ATAS 1708026609080001 082178331506
69 SISKA EFRIANA 2/7/2009 Meranti Jaya 1708024702090001 082178331506
70 SUSILO ANDIKA PRATAMA 12/28/2008 Ujan Mas Atas 1708022812080002 082178331506
73 WIDI ANDRIANI 1/7/2009 Ujan Mas Atas 1708024701090001 082178331506
KELAS VII.4 89 ALVIS QODIRUSAPUTRA 10/22/2008 SURO BARU 1708022210080001 089634249539
91 ARTIAN SYAFITRA 9/26/2009 Suro baru 1708022609090001 089634249539
93 BELA SEBTIANI 9/14/2009 Suro Ilir 1708025409090002 089634249539
94 BUNGA FIRZA 10/30/2008 Ujan mas atas 1708027010080001 089634249539
95 CINDY ALFI ANINGSIH 3/22/2009 Curup 1708026203090001 089634249539
96 DELA ANGRAINI 5/18/2009 Pulo geto 1708025805090003 089634249539
97 DEWA SHORI SIMAMORA 11/23/2008 Ujan mas Atas 1708022311080001 089634249539
98 DIOBA TYO BERMANO 1/19/2007 Ujan mas Atas 1708021901070001 089634249539
99 FAREL DEWA NANDA 1/2/2009 Ujan mas Atas 1708040201090001 089634249539
100 FAZA CRISTIAN DYNATA 3/10/2009 Meranti jaya 1708021003090001 089634249539
101 FITRIYAH DWI RAHMA 8/9/2008 Suro Muncar 1708024908080002 089634249539
102 I MADE ARTIKA 8/12/2009 kepahiang 1708021208090001 089634249539
104 KUMAIRAH SEPTIANI 9/9/2008 Suro baru 1708024909080003 089634249539
106 NYOMAN FANNY YURIKE 8/2/2009 Suro bali 1708024208090001 089634249539
107 ODIPUS ORANATA 2/12/2008 Daspetah 1708021202080001 089634249539
108 PUTRI YOLANDA 12/17/2008 Ujanmas Atas 1708025712080001 089634249539
109 RANGGA RAYA SAPUTRA 10/2/2008 Ujanmas Atas 1708020210080001 089634249539
110 RIKARDO AGUSTIN 8/11/2008 Ujanmas Atas 1708051103080001 089634249539
112 TARO AGUSTA WIJAYA 8/10/2009 Daspetah 1708021008090001 089634249539
113 WAYAN KARINA PUTRI 8/24/2009 kepahiang 1708026408090001 089634249539
114 WIDIA NITA 10/1/2009 kepahiang 1708024110090005 089634249539
SENTIA KRISTINA ujan mas bawah 1708026808090001 089634249539
KELAS VII.5 116 ADE PUTRI PRIANKA 8/17/2009 Suro Muncar 1708025708090001 082377571692
117 ALDO SANJAYA 11/25/2008 Ujan Mas Atas 1708022511080001 082377571692
119 ARIF HIDAYATULLAH 11/26/2007 Suro Muncar 1708052611070002 082377571692
120 ARIL PUTRA 12/6/2008 Cugung Lalang 1708020612080001 082377571692
121 BAYU KUSUMA ANGGARA 11/27/2008 Ujan Mas Bawah 1708022711080002 082377571692
122 BUNGA CANTIKA 5/9/2009 Ujan Mas Atas 1708024905090002 082377571692
123 CHAISA CANTIKA NIFA 11/13/2008 Pekalongan 1708025311080001 082377571692
124 DIMAS ANDRIAN 5/28/2007 Ujan Mas Atas 1708022805070001 082377571692
126 FAUZI PRATAMA 9/1/2008 Ujan Mas Bawah 1708020109080002 082377571692
127 FEBRINURAINI 2/7/2008 Ujan Mas Atas 1708024702080002 082377571692
128 FERDY ADEDO 12/18/2008 Suro Ilir 1708021812080001 082377571692
129 IZATUL NAPSIA 1/15/2009 Ujan Mas Atas 1708025501090001 082377571692
130 JERI ARDIANSAH 1/2/2009 Suro Ilir 1708020201090001 082377571692
131 JEZI AULIA CITRA 12/24/2008 Ujan Mas Atas 1708026412080002 082377571692
133 LAURA DWI AULIA 1/10/2009 Ujan Mas Atas 1708025001090003 082377571692
134 MERIZA ERNA WATI 5/6/2009 suro Muncar 1708024605090001 082377571692
136 NATASSYA NABILA 5/15/2009 Pekalongan 1708025505090001 082377571692
137 NORA 12/4/2008 Ujan Mas Atas 1708020412080001 082377571692
139 PUTRINAWATI 7/7/2007 Suro Muncar 1709064707070003 082377571692
140 RAFLIARZENDO MELDI 7/6/2008 Rejang Lebong 1708020607080001 082377571692
141 RAKA SAPUTRA 2/2/2008 Suro Baru 1708020202080001 082377571692
143 STEVEN 10/31/2008 Daspetah 1708023110080001 082377571692
KELAS VII.6 144 ARYA PRATAMA PUTRA 4/28/2008 PUNGGUK MERANTI 1708022804080002 085367837312
145 AYU APRILIANTI 4/27/2008 SURO MUNCAR 1708026704080001 085367837312
147 FAHRE ZHI ARANTA 10/4/2008 SURO LEMBAK 1708024410080003 085367837312
148 FAHRI ARDIANSYAH 1/7/2009 BUKIT BARISAN 1708050701090001 085367837312
149 FANZA KURNIAWAN 3/1/2008 PUNGGUK MERANTI 1708020103080002 085367837312
150 FARHAN ALFIKRI 9/3/2009 SURO MUNCAR 1708020309090001 085367837312
151 FEBI FEBRIANTI 2/13/2009 UJAN MAS BAWAH 1708025302090001 085367837312
152 FUJI FITRI RAHAYU 7/26/2009 SURO BARU 1708026607090001 085367837312
153 GRESIA KUSUMA RAHMA 9/4/2009 SURO MUNCAR 1708024409090001 085367837312
155 MELSI RIZKIYA 6/29/2008 UJAN MAS BAWAH 1708022906080002 085367837312
156 NASYILA MONICA RALITA 3/2/2009 PUNGGUK MERANTI 1708024203090001 085367837312
157 NOLA SEPTIA PUTRI 5/9/2009 UJAN MAS ATAS 1708024905090001 085367837312
158 OBAMA 1/20/2009 UJAN MAS ATAS 1708022001090004 085367837312
159 OKI SETIAWAN 12/18/2008 BUKIT BARISAN 1708051812080001 085367837312
160 PADILA ADITIA 6/26/2009 UJAN MAS BAWAH 1708022606090003 085367837312
161 PALEN 5/20/2009 UJAN MAS ATAS 1702106005090001 085367837312
163 RAFI AHMAD ALHAFIZ 7/6/2008 PUNGGUK MERANTI 1705080607080001 085367837312
164 RAHMAT REANSYAH 7/11/2008 MERANTI JAYA 1708021107080001 085367837312
166 RIRIN 4/14/2009 PG BERINGANG 1708025404090001 085367837312
167 SAKIA MEILINDA 5/5/2009 PULOGETO 1708054606090001 085367837312
168 SHERIN FITRIA 10/1/2008 UJAN MAS BAWAH 1708024110080001 085367837312
169 SIGIT OKTA PENUS 7/14/2009 SURO ILIR 1708021407090001 085367837312

0 0 0 2 19 0 0 0 0 0
JUMLAH
21 0 0 0
UPT P

NO NAMA TGL LAHIR ALAMAT

1 AMANDA 7/27/2009 UJAN MAS ATAS


2 ANDRE SANTOSO 1/20/2009 UJAN MAS ATAS
3 ARIEL FAHMI 11/18/2008 PUNGGUK MERANTI
4 ARJUNA ARYA W. 2/16/2009 UJAN MAS ATAS
5 BAYU AZMI 11/28/2008 SURO BARU
6 BHELA OKTA 12/9/2008 DASPETAH 2
7 HABIB FAHRY FADYLAH 3/8/2009 SURO MUNCAR
8 INDAH MULYANI 3/20/2009 CUGUNG LALANG
9 IQBAL AL-GAZALI 5/12/2009 UJAN MAS ATAS
10 JUWANDA PERMANA 7/9/2009 PUNGGUK MERANTI
11 MARSEL ANGGARA 6/23/2008 PG BERINGANG
12 M. FAHRI ALFAREZA 5/6/2009 SURO ILIR
13 NADYA ULFA S. 10/14/2009 AIR HITAM
14 NIKENZA ANGGRAINI 10/16/2008 UJAN MAS ATAS
15 NOPRIANSYAH 2/1/2008 SURO MUNCAR
16 NURUL KOMARIAH 2/23/2007 SURO MUNCAR
17 PAREL 12/26/2007 UJAN MAS ATAS
18 RANDI WAHYU P. 3/30/2009 SURO LEMBAK
19 RETIKA YERSILIA 1/1/2009 DASPETAH
20 TOMI KURNIAWAN 11/14/2008 UJAN MAS ATAS
21 YESI KURNIAWATI 11/10/2008 SURO MUNCAR
22 MELI SURYANI 5/26/1986 AIR PUTIH BARU
23 ISYE YULISTA 7/20/1984 AIR PUTIH BARU
24 Abdul Wahid Wahyu Khoiri 2/26/2009 Ujan Mas Atas
25 Airin Citra Areka 3/22/2006 Suro Bali
26 Arsi Meli Sugesti 6/4/2008 Ujan Mas Atas 
27 Aryo Vicky Pratama 5/8/2009 Suro Lembak 
28 Candy Aulia 6/3/2009 Suro Ilir 
29 Ciren Yolanda 3/21/2009 Pekalongan  
30 Deswita Oktavia 11/27/2008 Pungguk Meranti 
31 Dimas Arya Prayoga 6/17/2009 Suro Muncar 
32 Enlia Septianti 9/11/2009 Cugung Lalang 
33 Exgi Triansa 30-02-2009 Meranti Jaya 
34 Ismi Try Wahyuni 6/15/2009 Suro Ilir 
35 Ketut Purna Ningsih 2/9/2009 Suro Bali
36 Melati Ayu Dwi Kharina 5/3/2009 Bumi Sari 
37 Melsa Nabila 4/15/2009 Ujan Mas Atas
38 Muhammad Daichan 2/23/2009 Suro Lembak
39 Nengah Sila Welsya 8/8/2009 SURO BALI
40 Rindi Juliani 6/23/2008 Pekalongan
41 Selin Oktaviona 10/19/2008 UJAN MAS BAWAH
42 Siti Khairun Nisa 8/15/2009 Meranti Jaya
43 Taufik Saputra 4/15/2008 Bumi Sari
44 ALFINZAH GILANG BAGAS KAR7/27/2008 Daspetah
45 ANGGUN ANGGRAINI 8/10/2008 Ujan Mas Atas
46 BELLA SAFIRA 10/1/2009 Suro Muncar
47 BUNGA DWI APRIANI WESKUST, KEPAHIANG
48 GEDE OKTARIYANE 10/7/2009 Suro Bali
49 INKA CYNTHIA AINNISA 1/28/2009 Bumi Sari
50 JEFRI APRIANSYAH 8/25/2009 UJAN MAS ATAS
51 JERRI FEBRIAN ARIFIN 2/6/2009 Ujan Mas Atas
52 KARINA 5/21/2009 Suro Baru
53 MARSYAH ENJELA 3/9/2009 Suro Ilir
54 PERICE AMELIA 1/5/2009 Suro Ilir
55 R.J. AL HAFIZT 12/6/2008 Daspetah
56 RIAN HIDAYAT 1/8/2009 Ujan Mas Atas
57 SEPTI LESTARI UJAN MAS ATAS
58 SISKA EFRIANA 2/7/2009 Meranti Jaya
59 SUSILO ANDIKA PRATAM 12/28/2008 Ujan Mas Atas
60 WIDI ANDRIANI 1/7/2009 Ujan Mas Atas
61 ABI 5/3/2006 Suro Muncar
62 ALVIS QODIRUSAPUTRA 10/22/2008 SURO BARU
63 ARTIAN SYAFITRA 9/26/2009 Suro baru
64 BELA SEBTIANI 9/14/2009 Suro Ilir
65 BUNGA FIRZA 10/30/2008 Ujan mas atas
66 CINDY ALFI ANINGSIH 3/22/2009 Curup
67 DELA ANGRAINI 5/18/2009 Pulo geto
68 DEWA SHORI SIMAMORA11/23/2008 Ujan mas Atas
69 DIOBA TYO BERMANO 1/19/2007 Ujan mas Atas
70 FAREL DEWA NANDA 1/2/2009 Ujan mas Atas
71 FAZA CRISTIAN DYNATA 3/10/2009 Meranti jaya
72 FITRIYAH DWI RAHMA 8/9/2008 Suro Muncar
73 I MADE ARTIKA 8/12/2009 kepahiang
74 KUMAIRAH SEPTIANI 9/9/2008 Suro baru
75 NYOMAN FANNY YURIKE 8/2/2009 Suro bali
76 ODIPUS ORANATA 2/12/2008 Daspetah
77 PUTRI YOLANDA 12/17/2008 Ujanmas Atas
78 RANGGA RAYA SAPUTRA10/2/2008 Ujanmas Atas
79 RIKARDO AGUSTIN 8/11/2008 Ujanmas Atas
80 TARO AGUSTA WIJAYA 8/10/2009 Daspetah
81 WAYAN KARINA PUTRI 8/24/2009 kepahiang
82 WIDIA NITA 10/1/2009 kepahiang
83 SENTIA KRISTINA 8/8/2009 ujan mas bawah
84 ADE PUTRI PRIANKA 8/17/2009 Suro Muncar
85 ALDO SANJAYA 11/25/2008 Ujan Mas Atas
86 ARIF HIDAYATULLAH 11/26/2007 Suro Muncar
87 ARIL PUTRA 12/6/2008 Cugung Lalang
88 BAYU KUSUMA ANGGARA11/27/2008 Ujan Mas Bawah
89 BUNGA CANTIKA 5/9/2009 Ujan Mas Atas
90 CHAISA CANTIKA NIFA 11/13/2008 Pekalongan
91 DIMAS ANDRIAN 5/28/2007 Ujan Mas Atas
92 FAUZI PRATAMA 9/1/2008 Ujan Mas Bawah
93 FEBRINURAINI 2/7/2008 Ujan Mas Atas
94 FERDY ADEDO 12/18/2008 Suro Ilir
95 IZATUL NAPSIA 1/15/2009 Ujan Mas Atas
96 JERI ARDIANSAH 1/2/2009 Suro Ilir
97 JEZI AULIA CITRA 12/24/2008 Ujan Mas Atas
98 LAURA DWI AULIA 1/10/2009 Ujan Mas Atas
99 MERIZA ERNA WATI 5/6/2009 suro Muncar
100 NATASSYA NABILA 5/15/2009 Pekalongan
101 NORA 12/4/2008 Ujan Mas Atas
102 PUTRINAWATI 7/7/2007 Suro Muncar
103 RAFLIARZENDO MELDI 7/6/2008 Rejang Lebong
104 RAKA SAPUTRA 2/2/2008 Suro Baru
105 STEVEN 10/31/2008 Daspetah
106 ARYA PRATAMA PUTRA 4/28/2008 PUNGGUK MERANTI
107 AYU APRILIANTI 4/27/2008 SURO MUNCAR
108 FAHRE ZHI ARANTA 10/4/2008 SURO LEMBAK
109 FAHRI ARDIANSYAH 1/7/2009 BUKIT BARISAN
110 FANZA KURNIAWAN 3/1/2008 PUNGGUK MERANTI
111 FARHAN ALFIKRI 9/3/2009 SURO MUNCAR
112 FEBI FEBRIANTI 2/13/2009 UJAN MAS BAWAH
113 FUJI FITRI RAHAYU 7/26/2009 SURO BARU
114 GRESIA KUSUMA RAHMA9/4/2009 SURO MUNCAR
115 MELSI RIZKIYA 6/29/2008 UJAN MAS BAWAH
116 NASYILA MONICA RALITA3/2/2009 PUNGGUK MERANTI
117 NOLA SEPTIA PUTRI 5/9/2009 UJAN MAS ATAS
118 OBAMA 1/20/2009 UJAN MAS ATAS
119 OKI SETIAWAN 12/18/2008 BUKIT BARISAN
120 PADILA ADITIA 6/26/2009 UJAN MAS BAWAH
121 PALEN 5/20/2009 UJAN MAS ATAS
122 RAFI AHMAD ALHAFIZ 7/6/2008 PUNGGUK MERANTI
123 RAHMAT REANSYAH 7/11/2008 MERANTI JAYA
124 RIRIN 4/14/2009 PG BERINGANG
125 SAKIA MEILINDA 5/5/2009 PULOGETO
126 SHERIN FITRIA 10/1/2008 UJAN MAS BAWAH
127 SIGIT OKTA PENUS 7/14/2009 SURO ILIR
128 YENI ISDIYANTI 3/5/1990 BUMI SARI
129 DESI YUNITA 05-02-1988 SURO BARU
130 ROSNI 01-07-1972 SURO BARU
131 JUNDRI 17-07-1982 SURO MUNCAR
132 EDI HARYANTO 06-06-1981 UJAN MAS ATAS
133 LIDIA NINGSIH 05-07-1983 UJAN MAS ATAS
134 HERNANI 14-02-1973 SURO BARU
135 SURMIALIS EMI SUHAINA01-07-1977 SURO BARU
136 APRIA AMANDA 17-04-2003 SURO MUNCAR
137 LEKSI 27-12-1992 SURO BARU
138 DEDDY GUSTIAN 26-08-1976 AIR RAMBAI
139 LIDIA NORA 04-06-1983 AIR RAMBAI
140 INTAN RAMADIANTI 02-09-2009 JL.GAJAH MADA
141 SAHRONI 16-12-1974 SURO BARU
142 AMHAR 25-11-1962 UJAN MAS ATAS
143 RUPIAWATI 21-07-1977 DASPETAH
144 SYARIFUDIN 12-06-1969 DASPETAH 1
145 SUHARTONO 12-12-1972 SURO ILIR
146 TITIN 10-09-1986 UJAN MAS BAWAH
147 DENA MARYANA 05-07-1992 UJAN MAS BAWAH
148 ELLY ELMA YANTI 22-02-1980 UJAN MAS BAWAH
149 NURHAYATI 14-01-1976 UJAN MAS BAWAH
150 SHERLY REPIKA 29-07-86 UJAN MAS ATAS
151 HERWANSYAH 12-12-1969 SURO ILIR
152 KUSTI ARTI 02-07-1981 PULOGETO
153 EKO WAHYUDI 09-06-1978 SURO BARU
154 KHUSNUL KOTIMAH 28-05-2006 SURO BARU
155 SATIEM 13-12-1961 PEKALONGAN
156 RATOMI 06-06-1977 SURO BARU
157 PINGKI RAHMAWATI 15-09-2004 DASPETAH 2
158 SARAH 20-12-1966 UMA
159 HENDRI 06-08-1961 UMA
160 SUPARDI 01-07-1961 UMA
161 SINAR 03-08-1965 UMB
162 UCI 01-07-1977 UMA
163 JAWITA 04-02-1978 UMA
164 SELVI DELVIANTI 20-12-1999 UMB
165 SUWONDO 15-08-1972 CURUP SELATAN
166 JEFRI SAFTIANSYAH 11-09-1997 TABA TEBELET
167 BAYU PURNAMA 10/15/2000 SURO ILIR
168 REDHO ANDREAN 25-08-1999 PEKALONGAN
169 INDAH PUSPITASARI 24-04-1989 SKB
170 BAYU PRAVASTA BAHARI05-01-1990 SKB
171 KARMINA 05-01-1974 SURO ILIR
172 CICI SUNARSI 01-02-1977 SURO ILIR
173 RIZA UMAMI 04-09-1991 UJAN MAS ATAS
174 PARIDA 4/5/1965 UJAN MAS ATAS
175 SRI SUSANTI 16-08-1978 SURO BARU
176 NENGSIH SUMIATI 11-06-1980 PEKALONGAN
177 RATNA YULIS 28-04-1982 UJAN MAS ATAS
178 SUSI NOVITASARI 03-11-1993 UJAN MAS ATAS
179 NASIR NAJEMI 24-02-1967 UJAN MAS ATAS
180 SUSI PRATIWI 12-11-1993 UJAN MAS ATAS
181 YUNIARTI 21-12-1979 SURO BARU
182 SUYOTO 12-11-1966 DURIAN DEPUN
JUMLAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
25 OKTOBER 2021

SINOVAC

DOSIS 1 DOSIS 2
NIK NO HP

PENDIDIK

REMAJA
M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
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0 0 1 3 127 0 0 9
131 9
MODERNA

DOSIS 2 DOSIS 1 DOSIS 2


PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
DPTREMSINO1
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LDREMSINO1
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SBREMSINO1
SBREMSINO1
SIREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
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UMAREMSINO1
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LDREMSINO1
SMREMSINO1
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SBREMSINO1
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LDMUMODER1
1 SBMUMODER1
1 SBMUMODER1
1 SMMUMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 SBMUMODER1
1 SBMUMODER1
1 SMMUMODER2
1 SBMUMODER2
1 LDMUMODER1
1 LDMUMODER1
LDREMSINO1
1 SBMUMODER2
UMAMUSINO2
1 DPTMUMODER1
DPTMUSINO2
1 SIMUMODER1
1 UMBMUMODER1
1 UMBMUMODER1
1 UMBMUMODER1
1 UMBMUMODER1
1 UMAMUMODER1
SIMUSINO2
1 LDMUMODER1
1 SBMUMODER1
SBREMSINO1
1 LDLANMODER1
SBMUSINO2
DPT2MUSINO2
UMAMUSINO2
UMAMUSINO2
1 UMALANMODER1
1 UMBLANMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 UMBMUMODER1
1 LDMUMODER2
1 LDPUBMODER2
SIMUSINO2
1 LDMUMODER1
1 LDMUMODER2
1 LDPUBMODER2
1 SIPUBMODER2
1 SIMUMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 SBMUMODER2
1 LDMUMODER1
1 UMAMUMODER1
UMAMUSINO1
1 UMAMUMODER1
1 UMAMUMODER1
SBMUSINO2
1 LDMUMODER1
0 0 3 0 30 0 0 3 6 0
9 33 9
REKAPITULASI HARIAN VAKSINASI COVID 19
20 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA
M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SB 0 0 0 0 8 0 0 2 0 0 0 0 5 0 0 0 3 0
SM 0 0 0 0 15 0 0 0 0 0 0 0 1 0 0 0 1 0
SI 0 0 0 0 9 0 0 2 0 0 0 0 2 0 0 1 0 0
SL 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 1 0 34 0 0 3 0 0 1 0 10 0 0 0 0 0
UMB 0 0 0 0 8 0 0 0 0 0 1 0 5 0 0 0 0 0
PB 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 7 0 0 1 0 0 0 0 1 0 0 0 0 0
DPT2 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 2 39 0 0 0 0 0 1 0 7 0 0 2 2 0
JUMLAH 0 0 1 2 127 0 0 9 0 0 3 0 31 0 0 3 6 0

139
JUMLAH

18
17
14
4
49
14
2
9
2
53
182
UPT P

NO NAMA TGL LAHIR ALAMAT

1 ANDRA SEPTA PRADITA 06-08-2008 SURO BANDUNG


2 ANDRIAN OCAVIANSYAH 27-10-2008 GALANG
3 CENDI REGINA PUTRI 28-11-2008 DASPETAH
4 HAIKAL PUTRA AL VIKRI 11-08-2007 MERANTI JAYA
5 KELARA CINTA L 28-08-2007 BUMI SARI
6 LESTI MAHARANI HELEN 07-02-2008 PUNGGUK MERANTI
7 M. AL IKLAS 28-08-2008 TERTIK
8 MELI APRI YANTI 21-04-2007 UJAN MAS ATAS
9 MUHAMMAD SAIFULLOH 12-01-2008 DASPETAH
10 NOPRI NANDA SAPUTRA 9/26/2005 PUNGGUK MERANTI
11 PAIZAL IKHSAN FAHREZI 27-05-2008 KEPAHIANG
12 PUJA KURNIASIH 03-08-2008 BATU BANDUNG
13 PUTU KHARISMA 06-12-2007 SURO BALI
14 PUTU PLARASTINI 27-02-2008 SURO BALI
15 RADITIA FIRMANSYAH 29-06-2008 SURO BARU
16 RIKA YULI PRATIWI 27-07-2008 SURO BALI
17 SASQIA MAHARANI 10-04-2008 BUMI SARI
18 SONIA SASKIA PUTRI 26-10-2007 SURO BARU
19 WELI AGUSTIN 07-08-2007 PUNGGUK MERANTI
20 ANGGARA LUKEIS.S 27 - 10 - 2008 SURO LEMBAK
21 AUDI APRILIA AZIZAH 08 - 04 - 2008 SURO BARU
22 AYU PERMADANI 14 - 09 - 2008 PEKALONGAN
23 DWI SATRIO 01 - 09 - 2007 JL. ISKANDAR ONG
24 FAJRI ERLANGGA 03 - 01 - 2008 MERANTI JAYA
25 FAREL 14 - 12 - 2007 KEL. UJAN MAS ATAS
26 INDAH MUSTIKA PURNAM 23 - 08 - 2007 PUNGGUK MERANTI
27 IRGI MUHAMMAD AKBAR 04 - 08 - 2008 BUMI SARI
28 KHEYLA YOPITA SARI 10 - 08 - 2008 SURO BARU
29 LANGIT MEL SAPUTRA 19 - 09 - 2008 KEL. UJAN MAS ATAS
30 MUHAMMAD DIKI SAPUTR 13 - 09 - 2007 PEKALONGAN
31 NABILA AYU SHERLY MAS 02 - 09 - 2008 SURO BARU
32 NANDA 31 - 03 - 2006 PEKALONGAN
33 RAYHAN ARYA JOEL 27 - 07 - 2007 KEL. UJAN MAS ATAS
34 REPA LAURA 28 - 05 - 2008 SURO MUNCAR
35 SARIFAH 08 - 02 - 2008 KEL. UJAN MAS ATAS
36 WAHYU SAPUTRA 04 - 07 - 2006 UJAN MAS
37 AMANDA PRISILIA NOSTI 11 - 04 -2006 CUGUNG LALANG
38 ANDIKA PRATAMA WIJAYA SURO MUNCAR
39 ARIEL RAHMA SAPUTRA 07 -04 - 2007 PEKALONGAN
40 CINTIA PITRI RAHAYU 09 - 10 - 2008 CUGUNG LALANG
41 DENA MARSELA 28 - 08 - 2006 UJAN MAS ATAS
42 DUTA ANUGRAH 14 - 08 - 2008 SURO BARU
43 ELSAH APRIYANITA 04 - 04 - 2008 SURO ILIR
44 KEVIN MELADI 5/17/2006 SURO BARU
45 MADE SAPTA GUNA DAR 01 - 09 - 2008 SURO BALI
46 MUHAMMAD MUSLIM 24 - 06 - 2007 PUNGGUK MERANTI
47 PERI ARYANTO 6/30/2006 UJAN MAS ATAS
48 PIKI SATRIO 15 - 07 - 2008 UJAN MAS ATAS
49 PUTRI MAINI 5/23/2007 PEKALONGAN
50 RAHMAT QURNIADI IDHA 31 - 12 - 2007 PEKALONGAN
51 RANGGA ANDIKA PRATAMA SURO ILIR
52 RENI AGUSTINA PEKALONGAN
53 RIDAN SAPUTRA 16 - 05 - 2008 SURO BALI
54 RISKI PURNOMO UJAN MAS ATAS
55 SALSA NOPRIANTI 11-11-2008 SURO MUNCAR
56 SELSI LESTARI 6/8/2008 UJAN MAS ATAS
57 SISKA HERAWATI 24-10-2007 UJAN MAS
58 SUTRIVI KARTIKA SARI 21 - 04 2007 UJAN MAS
59 ADE RENALDI 16-06-2008 UJAN MAS ATAS
60 ADITIA SUGARA 08-12-2007 PEKALONGAN
61 AGUS HERLIANSYAH 14-06-2005 MERANTI JAYA
62 DION PUTRA PRANAND 14-05-2009 SURO MUNCAR
63 DIRA ADE SAPUTRA 30-07-2008 SURO MUNCAR
64 FEBRIYANTI NURJANA 13-02-2008 PEKALONGAN
65 HIKMA PERMATA SARI 30-04-2007 SURO ILIR
66 ILHAM AL FIKRI 29-06-2008 MERANTI JAYA
67 INES AJENG ADELIA 14-10-2008 PEKALONGAN
68 KEVIN PIORISKI 17-07-2007 UJAN MAS ATAS
69 KHESI ANANDA 02-04-2008 BUMI SARI
70 M. FAREN AGUSTIN 04-08-2007 UJAN MAS ATAS
71 MIRZA AFRILIA ZUMARN 06-04-2008 BUMI SARI
72 ONI AFRIYANTI 27-10-2007 PEKALONGAN
73 RAFA NARA DEIGO 14-06-2008 BUMI SARI
74 RENALDO AGUSTIN 05-08-2008 PUNGGUK BERINGANG
75 RINDIYANI 04-01-2009 SURO ILIR
76 SINTA AMELIA 05-05-2007 PEKALONGAN
77 SINTIAN HAJA AULAH 13-12-2007 UJAN MAS ATAS
78 SONA SELA NABILA 05-03-2009 UJAN MAS BAWAH
79 TIKA MELIZA 16-05-2008 PEKALONGAN
80 TRIO WIDIANTO 15-04-2008 PEKALONGAN
81 VITRIA OKTAPIANI 12-10-2008 PEKALONGAN
82 WINDRIYA SARI 07-07-2007 AIR HITAM
83 YOLANDA MAYANG SAR 23-05-2008 PEKALONGAN
84 ANGGUN KASELA 06 November 2007 Pungguk Meranti
85 ATIKA ROHAYA 04 Juli 2007 Pekalongan
86 CHENI RAMADANI 06 Oktober 2007 Ujan Mas Atas
87 ELDA MARITA 22 Juni 2008 Pekalongan
88 ERLANDO 08 Desember 2006 Ujan Mas Atas
89 FAUZAN BINTANG JAYA 03 Januari 2008 Desa Bukit Barisan
90 FEBI RAHMAN ALFIKRI 24 Desember 2007 Suro Baru
91 KEZIA AULIA 04 Desember 2007 Ujan Mas Atas
92 LIDIA TRI JENIPER 27 Januari 2008 Pekalongan
93 RAHMAT RISKI 06 Juni 2008 Suro Ilir
94 RIZKY ABDULLAH PRATA24 Desember 2007 Ujan Mas Atas
95 SELA SEPRIANI RAMADAN09 September 2008 Bumi Sari
96 SUCI SINTIA SARI 29 Agustus 2008 Pekalongan
97 TEDI RAMADAN 19 September 2007 Suro Ilir
98 VINA MAURA PUTRI 17 Maret 2008 Suro Muncar
99 YOGA PANGESTU 27 Oktober 2007 Meranti Jaya
100 IBRA RIBERY 20 Maret 2008 Bumi Sari
101 ANJELIKA ANANTA 11/24/2007 Pekalongan
102 CHELSYE OLIVIA ERYADI 4/30/2008 Ujan mas Atas
103 COKI ARIANSYA 4/29/2008 Ujan mas Atas
104 DEA AMANDA 3/16/2008 Ujan mas Atas
105 DINDA MAROAN RASOKIN 3/28/2008 Suro Baru
106 DIOSI HIKMA BAGITE 6/16/2006 Ujan mas Atas
107 FADLI ILHAM APRIANSYA 4/16/2008 Suro Ilir
108 FAHRY AL AKBARY. H 7/4/2008 Pulo Geto
109 FANYSAH ARINDRA 5/14/2008 Bumi Sari
110 FAUZAN MAULANA 10/15/2006 Ujan mas Atas
111 FETY PRISCA MELANI 4/14/2007 Cugung lalang
112 KEVIN PAGASTA 7/15/2008 Suro Lembak
113 LUCKY RORIAND 1/21/2008 Ujan mas Atas
114 MANDA YULISTIA 7/10/2007 Pekalongan
115 NUR INDAH SYAHFITRI 6/22/2008 Pekalongan
116 RELESTI MAHARANI 1/9/2008 Suro Baru
117 RENDI WAHYU PRATAMA 1/16/2008 Pekalongan
118 RINALDO 7/3/2007 Cugung lalang
119 SAHRIL MUHAMMAD 4/10/2006 Bukit Barisan
120 ZAHWA YESA PADILLA 7/19/2007 Meranti Jaya
121 AULIA NUR SAKINA 10/4/2008 SURO BARU
122 DODI YUDIRMAN Cugung lalang
123 SUHIDIN 4/14/1965 CURUP SELATAN
124 ANDRI RAMADAN 12/12/1999 Bukit Barisan
125 CHELSI OLIVIA 11/11/2008 UJAN MAS ATAS
126 RISNA LEPIA 7/18/2009 UJAN MAS ATAS
127 RISKI RENI PUTRI 11/15/1997 Bukit Barisan
128 AKHMAD ROSIDY IMANI 9/26/1994 AIR HITAM
129 GUSTI ERWANTO 8/5/1968 SURO BARU
130 YUSNIDAR 9/23/1969 SURO BARU
131 GYOZA DINDA AINNAYAH 10/13/1999 SURO BARU
132 AHMAD MUSLIHIN 2/27/1999 AIR RAMBAI
133 WIDYA PUTRI UTAMI 21-08-2003 PUNGGUK MERANTI
134 SOPIAN HARDIANTO 14-06-1969 CURUP TENGAH
135 ANISA YULIASARI 15-07-2003 PUNGGUK MERANTI
136 NELLY KURNILAWATI 05-08-1975 SURO MUNCAR
137 DEVI IRAWAN 07-08-1985 UJAN MAS ATAS
138 WIDIA ASTUTI 13-06-1979 DASPETAH
139 YENI 12-03-1989 UJAN MAS ATAS
140 RAMA SUHAINA 27-08-1987 SURO MUNCAR
141 MUHAMMAD YANI 08-07-1975 SURO ILIR
142 DONI HARTONO 06-04-1984 UJAN MAS ATAS
143 ARNILA 10-07-1977 UJAN MAS ATAS
144 PARIDA ARIANI 01-12-1981 UJAN MAS ATAS
145 MUHAMMAD HAFIZ R 06-03-2005 TEMPEL REJO
146 JALALUDIN 01-07-1956 DASPETAH
147 HAPSAWATI 01-07-1960 DASPETAH
148 AWETISILAWATI 06-06-1990 SURO MUNCAR
149 SUDIRMAN 10-10-1976 UJAN MAS ATAS
150 HARJULI YANTI 01-07-1979 UJAN MAS ATAS
151 PUTRI JAMILA 23-12-1978 DASPETAH II
152 CHAIRUN NASIR 24-01-1980 PULO GETO
153 TIARA YOLANDA 31-12-2000 UJAN MAS ATAS
154 SUMARDI 04-03-1967 DASPETAH
155 NURHADI 12-09-1968 SURO LEMBAK
156 UJANG ROSIMAN 29-07-1989 SURO LEMBAK
157 LIA HARTANI 01-02-1997 DASPETAH II
158 REPI ARIANTI 20-12-1995 DASPETAH
159 PEPI YARMI 26-05-1989 DASPETAH
160 PITOYO WAHONO 16-03-1958 CURUP UTARA
161 HAMDANI 01-07-1964 UJAN MAS ATAS
162 ASMARA DEWI 01-07-1976 DASPETAH
163 ERNA HERAWATI 01-07-1975 UJAN MAS ATAS
164 ROSALI 05-08-1992 MERIGI SAKTI
165 ANGGI NURCAYANI 29-09-2001 UJAN MAS ATAS
166 MARDALENA 05-10-1981 UJAN MAS ATAS
167 A.RONI 20-11-1981 PEKALONGAN
168 LIDIA SUSANTI 18-02-1985 PEKALONGAN
169 SANTI EFRIANTI 23-02-1995 DASPETAH
170 LENI ANITA 11-07-1984 SURO BARU
171 SUSILA 10-11-1970 SURO BARU
172 ENI MARLENA 12-12-1981 UJAN MAS ATAS
173 SUSI ELIYATI 25-05-1979 DASPETAH II
174 RAHAYU RIANNINGSI 27-12-1960 CURUP UTARA
175 YUSMA DEWI 07-02-1993 DASPETAH
176 RUSLI 27-03-1980 PEKALONGAN
177 ARMADAN WIDODI 06-07-1984 UJAN MAS ATAS
178 AIDA 01-07-1970 UJAN MAS ATAS
179 HANDRA DWI KORA 12-05-1966 KEPAHIANG
180 SINAR 04-08-1974 UJAN MAS ATAS
181 ZULKIPLI 01-01-1976 UJAN MAS ATAS
182 LESSIANA 18-07-1985 SURO MUNCAR
183 RINI SULASTRI 02-01-1995 UJAN MAS ATAS
184 MUKTAR EFFENDI CURUP TENGAH
185 ARMIYAH SURO BARU
186 DWI NOVISARI SURO MUNCAR
187 FADIL ADRIAN 18-07-2006 SURO LEMBAK
JUMLAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
26 OKTOBER 2021

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
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1708027112030001 085764486895 1
3310090403670003 082371093829
1708021209680003 083134371986 1
1708022807890001 082179794289 1
1708024102970001 081367539251 1
1708026012980002 081278962469
1708026605890003 082182051074
1702161603580001 085211276034
1708020107640099 08117311487
1708024107760131 085272760943
1708024107750139 083196517947
1771060508920004 085337740751
1708026909010001 085268535975
1708024510810006 082376370106
1708022011810001 085268583131
1708025802850002 085268583131
1708026302750002 085268313776 1
1708025107840002 085266137683 1
1708025011700004 08953034174
1708025212810001 085841442684
1708026505790001 08575833250
170216671260001 085273824629
1708024702930001 085267123857
1708022703800006 081368659223
1708020607840004 08538000400
170802410770016 085609598887
1708021205660006 085266669330
1708024408740001 085370240870
1708020101760008 085379391135
1708035801860002 083186468957
1708025007950002 0857832532040 1
1

1708021807060001 085709445858 1
0 0 5 4 126 0 1 5
135 9
MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
SIREMSINO1
SIREMSINO1
DPTREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
DPTREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
LDREMSINO1
SLREMSINO1
SBREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
UMAREMSINO1
LDREMSINO1
SBREMSINO1
LDREMSINO1
UMAREMSINO1
SMREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
SBREMSINO1
SIREMSINO1
SBREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SIREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SMREMSINO1
UMAREMSINO1
UMAREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
SIREMSINO1
SIREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
PBREMSINO1
SIREMSINO1
LDREMSINO1
UMAREMSINO1
UMBREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
SBREMSINO1
UMAREMSINO1
LDREMSINO1
SIREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SIREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
UMAREMSINO1
SBREMSINO1
UMAREMSINO1
SIREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
SLREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
1 LDPENSINO2
LDPENSINO1
LDPENSINO1
UMAREMSINO1
UMAREMSINO1
1 LDPENSINO2
1 LDPENSINO2
SBPENSINO1
SBMUSINO1
SBMUSINO1
LDPENSINO1
1 LDMUMODER2
1 LDMUMODER2
1 LDMUMODER2
SMMUSINO2
UMAMUSINO2
1 DPTMUMODER1
1 UMAMUMODER1
1 SMMUMODER1
1 SIMUMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 UMAMUMODER1
LDREMSINO1
1 DPTLANMODER1
1 DPTLANMODER1
1 SMMUMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 DPT2MUMODER2
1 LDMUMODER2
UMAREMSINO1
1 DPTMUMODER2
SLMUSINO2
SLMUSINO2
DPT2MUSINO1
1 DPTMUMODER1
1 DPTMUMODER1
1 LDMUMODER1
1 UMAMUMODER1
1 DPTMUMODER1
1 UMAMUMODER1
1 LDPUBMODER2
1 UMAPUBMODER2
1 UMAMUMODER1
1 LDMUMODER1
1 LDMUMODER1
DPTMUSINO1
SBMUSINO1
1 SBMUMODER2
1 UMAMUMODER1
1 DPT2MUMODER1
1 LDMUMODER1
1 DPTMUMODER1
1 LDPUBMODER2
1 UMAMUMODER2
1 UMAMUMODER1
1 LDLANMODER1
1 UMAMUMODER2
1 UMAMUMODER2
1 SMMUMODER1
UMAMUSINO1
LDPUBSINO2
1 SBPUBMODER2
1 SMMUMODER1
SLREMSINO1
3 0 3 0 26 0 0 4 10 0
9 29 14
REKAPITULASI HARIAN VAKSINASI COVID 19
20 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SB 0 0 3 1 11 0 0 0 0 0 0 0 0 0 0 1 1 0
SM 0 0 0 0 5 0 0 1 0 0 0 0 4 0 0 0 0 0
SI 0 0 0 0 10 0 0 0 0 0 0 0 1 0 0 0 0 0
SL 0 0 0 0 3 0 0 2 0 0 0 0 0 0 0 0 0 0
UMA 0 0 1 0 29 0 0 1 0 0 0 0 11 0 0 1 3 0
UMB 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 1 0 2 0 0 0 0 0 2 0 5 0 0 0 1 0
DPT2 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0
LD 0 0 0 3 64 0 1 0 3 0 1 0 4 0 0 2 4 0
JUMLAH 0 0 6 4 126 0 1 4 3 0 3 0 26 0 0 4 10 0
144
JUMLAH

17
10
11
5
46
1
1
11
3
82
187
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
26 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

SUDAH VAKSIN

REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP TD

DUKCAPIL
MENOLAK

PENDIDIK

PENDIDIK
M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA
IZIN
KELAS 8.1 1 ALDO SAPUTRA 0853838913 MENOLAK 1
2 ANDRA SEPTA PRADITA 06-08-2008 SURO BANDUNG 1708020608080002 0853838913
3 ANDRIAN OCAVIANSYAH 27-10-2008 GALANG 1611032710080002 0853838913
4 CENDI REGINA PUTRI 28-11-2008 DASPETAH 1708026811080002 0853838913
5 DERI ADEPIO 0853838913 MENOLAK 1
6 DIMAS VINO FERNANDO 14-07-2007 SURO MUNCAR 1709921407070001 0853838913 DUKCAPIL 1
7 FAHRI INDARWAN 09-12-2007 UJAN MAS 1708020912070002 0853838913 IZIN 1
8 FATURRAHMAN ZACKY ALFARID 14-01-2007 BUMI SARI 1709021401070001 0853838913 DUKCAPIL 1
9 FIRMANSA MUHAMMAD ADZAN 14-09-2007 UJAN MAS ATAS 1709021409070001 0853838913 SUDAH ENTRY DI KEMBAN 1
10 HAIKAL PUTRA AL VIKRI 11-08-2007 MERANTI JAYA 1708021108070001 0853838913
11 KELARA CINTA L 28-08-2007 BUMI SARI 1708026808070001 0853838913
12 KEYCA KIRANA MELANI TARADITA 08-08-2008 DASPETAH 1708024505080001 0853838913 DUKCAPIL 1
13 LESTI MAHARANI HELEN .W 07-02-2008 PUNGGUK MERANTI 1708024702080001 0853838913
14 M. AL IKLAS 28-08-2008 TERTIK 1708072806080001 0853838913
15 MELI APRI YANTI 21-04-2007 UJAN MAS ATAS 1708026704070002 0853838913
16 MUHAMMAD SAIFULLOH 12-01-2008 DASPETAH 1708021201080003 0853838913
17 NABILA RISKITA SARI 16-01-2008 BUMI SARI 1708025601080004 0853838913 IZIN 1
18 NOPRI NANDA SAPUTRA 9/26/2005 PUNGGUK MERANTI 1708022609050002 0853838913
19 PAIZAL IKHSAN FAHREZI 27-05-2008 KEPAHIANG 1708022705080001 0853838913
20 PUJA KURNIASIH 03-08-2008 BATU BANDUNG 1702184308080001 0853838913
21 PUTU KHARISMA 06-12-2007 SURO BALI 1708024612070004 0853838913
22 PUTU PLARASTINI 27-02-2008 SURO BALI 1708026702060003 0853838913
23 RADITIA FIRMANSYAH 29-06-2008 SURO BARU 1708022905080001 0853838913
24 RAMADAN KITO 27-09-2007 UJAN MAS ATAS 1708022709080005 0853838913 IZIN 1
25 RIA AMELIA 0853838913 IZIN 1
26 RIKA YULI PRATIWI 27-07-2008 SURO BALI 1708026007080002 0853838913
27 SANDI PRADEFTA 20-10-2008 UJAN MAS ATAS 1708022010080001 0853838913 DUKCAPIL 1
28 SASQIA MAHARANI 10-04-2008 BUMI SARI 1871125004080003 0853838913
29 SONIA SASKIA PUTRI 26-10-2007 SURO BARU 1708026610070001 0853838913
30 WELI AGUSTIN 07-08-2007 PUNGGUK MERANTI 1708024708070003 0853838913
KELAS 8.2 31 ANDREAN 082268084975 MENOLAK 1
32 ANGGARA LUKEIS.S 27 - 10 - 2008 SURO LEMBAK 1708022710080001 082268084975
33 AUDI APRILIA AZIZAH 08 - 04 - 2008 SURO BARU 1708024804080001 082268084975
34 AYU PERMADANI 14 - 09 - 2008 PEKALONGAN 1708025409080001 082268084975
35 BENIDIAN PRANATA 082268084975 MENOLAK 1
36 DAPA RAHARDI 082268084975
37 DEPIA FISESAH 082268084975 MENOLAK 1
38 DESTI VIANANTA 19 - 12 - 2007 SURO ILIR 1708025912070001 082268084975 SUDAH VAKSIN 1 1 1
39 DWI SATRIO 01 - 09 - 2007 JL. ISKANDAR ONG 1708020109070005 082268084975 DUKCAPIL 1
40 EPANDI 082268084975 MENOLAK 1
41 FAJRI ERLANGGA 03 - 01 - 2008 MERANTI JAYA 1708020301080001 082268084975
42 FAREL 14 - 12 - 2007 KEL. UJAN MAS ATAS 1708021412070001 082268084975
43 HAIZA SARI 25 - 12 - 2007 CUGUNG LALANG 1708026512070002 082268084975 SUDAH VAKSIN 1 1 1
44 HAZA SARI 25 - 12 - 2007 CUGUNG LALANG 1708026512010003 082268084975 SUDAH VAKSIN 1 1 1
45 INDAH MUSTIKA PURNAMASARI 23 - 08 - 2007 PUNGGUK MERANTI 1708026308070001 082268084975
46 IRGI MUHAMMAD AKBAR 04 - 08 - 2008 BUMI SARI 1708020408080003 082268084975
47 JOS WALADI 082268084975 MENOLAK 1
48 KHEYLA YOPITA SARI 10 - 08 - 2008 SURO BARU 1708025008080002 082268084975
49 LANGIT MEL SAPUTRA 19 - 09 - 2008 KEL. UJAN MAS ATAS 1708021909080001 082268084975
50 MUHAMMAD DIKI SAPUTRA 13 - 09 - 2007 PEKALONGAN 1708021309070001 082268084975
51 NABILA AYU SHERLY MASYITA 02 - 09 - 2008 SURO BARU 1708024209080001 082268084975
52 NADIN GISELA CANTIKA 082268084975 MENOLAK 1
53 NANDA 31 - 03 - 2006 PEKALONGAN 1702187103060002 082268084975
54 POPI SULISNAWATI 082268084975 SUDAH VAKSIN 1 1 1
55 RAYHAN ARYA JOEL 27 - 07 - 2007 KEL. UJAN MAS ATAS 1708022707070002 082268084975
56 REPA LAURA 28 - 05 - 2008 SURO MUNCAR 1708026805080001 082268084975
57 SAKUT ADEPIO 082268084975 MENOLAK 1
58 SARIFAH 08 - 02 - 2008 KEL. UJAN MAS ATAS 1708024802080002 082268084975
59 WAHYU SAPUTRA 04 - 07 - 2006 UJAN MAS 1708020407060006 082268084975
KELAS 8.3 60 AMANDA PRISILIA NOSTI 11 - 04 -2006 CUGUNG LALANG 1708025104080002 085273875149
61 ANDIKA PRATAMA WIJAYA SURO MUNCAR 1708020104070002 085273875149
62 ARIEL RAHMA SAPUTRA 07 -04 - 2007 PEKALONGAN 1708020704070001 085273875149
63 CINTIA PITRI RAHAYU 09 - 10 - 2008 CUGUNG LALANG 1702194910080002 085273875149
64 DENA MARSELA 28 - 08 - 2006 UJAN MAS ATAS 1708026608060001 085273875149
65 DUTA ANUGRAH 14 - 08 - 2008 SURO BARU 1708021408080001 085273875149
66 ELSAH APRIYANITA 04 - 04 - 2008 SURO ILIR 1708024404080003 085273875149
67 HENDRI SAPUTRA 085273875149 MENOLAK 1
68 KEVIN MELADI 5/17/2006 SURO BARU 1708021705060001 085273875149
69 MADE SAPTA GUNA DARMA 01 - 09 - 2008 SURO BALI 1708020109080001 085273875149
70 MIRANTI AGUSTIN 085273875149 MENOLAK 1
71 MUHAMMAD MUSLIM 24 - 06 - 2007 PUNGGUK MERANTI 1708022406070001 085273875149
72 PERI ARYANTO 6/30/2006 UJAN MAS ATAS 1708023006060002 085273875149
73 PIKI SATRIO 15 - 07 - 2008 UJAN MAS ATAS 1708021507080001 085273875149
74 PUTRI MAINI 5/23/2007 PEKALONGAN 1708056305070001 085273875149
75 RAHMAT QURNIADI IDHA 31 - 12 - 2007 PEKALONGAN 1871013112070004 085273875149
76 RANGGA ANDIKA PRATAMA SURO ILIR 1708020411070001 085273875149
77 RENI AGUSTINA PEKALONGAN 1708024608070001 085273875149
78 RIDAN SAPUTRA 16 - 05 - 2008 SURO BALI 1708041605080003 085273875149
79 RISKI PURNOMO UJAN MAS ATAS 1708021002060001 085273875149
80 SALSA NOPRIANTI 11-11-2008 SURO MUNCAR 1708025111080001 085273875149
81 SASTRA MUHAMAD AKBAR 085273875149 MENOLAK 1
82 SELSI LESTARI 6/8/2008 UJAN MAS ATAS 1708024806080001 085273875149
83 SISKA HERAWATI 24-10-2007 UJAN MAS 1708026406070001 085273875149
84 SUTRIVI KARTIKA SARI 21 - 04 2007 UJAN MAS 1306026104070007 085273875149
85 WAHYU ANTONI REBA SURO MUNCAR 1708022608080003 085273875149 1
86 ZAHRA OKTAVIA 10/14/2008 PEKALONGAN 1708025410080001 085273875149 DUKCAPIL 1
KELAS 8.4 87 ADE RENALDI 16-06-2008 UJAN MAS ATAS 1708021606080001 081276192237
88 ADITIA SUGARA 08-12-2007 PEKALONGAN 1708020812070001 081276192237
89 AGUS HERLIANSYAH 14-06-2005 MERANTI JAYA 1708021408050003 081276192237
90 DION PUTRA PRANANDA 14-05-2009 SURO MUNCAR 1708021405090001 081276192237
91 DIRA ADE SAPUTRA 30-07-2008 SURO MUNCAR 1702193007080001 081276192237
92 FEBRIYANTI NURJANA 13-02-2008 PEKALONGAN 1708025302080003 081276192237
93 HIKMA PERMATA SARI 30-04-2007 SURO ILIR 1708027004070002 081276192237
94 ILHAM AL FIKRI 29-06-2008 MERANTI JAYA 1708022906080003 081276192237
95 INES AJENG ADELIA 14-10-2008 PEKALONGAN 1708025410080002 081276192237
96 KEVIN PIORISKI 17-07-2007 UJAN MAS ATAS 1708020603080001 081276192237
97 KHESI ANANDA 02-04-2008 BUMI SARI 1708024204080001 081276192237
98 M. FAREN AGUSTIN 04-08-2007 UJAN MAS ATAS 1708020408070001 081276192237
99 MIRZA AFRILIA ZUMARNIS 06-04-2008 BUMI SARI 1702114604080003 081276192237
100 ONI AFRIYANTI 27-10-2007 PEKALONGAN 1708026710070002 081276192237
101 RAFA NARA DEIGO 14-06-2008 BUMI SARI 1708021406080002 081276192237
102 RENALDO AGUSTIN 05-08-2008 PUNGGUK BERINGANG 1708020508080001 081276192237
103 RINDIYANI 04-01-2009 SURO ILIR 1708024401090001 081276192237
104 RISKI ADITIA 10-07-2007 UJAN MAS ATAS 1708021007080002 081276192237 DUKCAPIL 1
105 SINTA AMELIA 05-05-2007 PEKALONGAN 1708024505070003 081276192237
106 SINTIAN HAJA AULAH 13-12-2007 UJAN MAS ATAS 1708025312070001 081276192237
107 SONA SELA NABILA 05-03-2009 UJAN MAS BAWAH 1708024503090001 081276192237
108 SOPI AGUSTIN 25-08-2008 SURO MUNCAR 1708026508080003 081276192237 DUKCAPIL 1
109 TIKA MELIZA 16-05-2008 PEKALONGAN 1708025605080005 081276192237
110 TRIO WIDIANTO 15-04-2008 PEKALONGAN 1708021504080001 081276192237
111 VITRIA OKTAPIANI 12-10-2008 PEKALONGAN 1708025210080001 081276192237
112 WINDRIYA SARI 07-07-2007 AIR HITAM 1708024707070001 081276192237
113 YOLANDA MAYANG SARI 23-05-2008 PEKALONGAN 1708026305080001 081276192237
KELAS 8.5 114 ANGGUN KASELA 06 November 2007 Pungguk Meranti 1611034611070001 081373473116
115 ATIKA ROHAYA 04 Juli 2007 Pekalongan 1708024407070001 081373473116
116 CHENI RAMADANI 06 Oktober 2007 Ujan Mas Atas 1708024610070001 081373473116
117 DEWA DWI ANDIKA 12 Mei 2007 Daspetah 1708021205070002 081373473116 1
118 ELDA MARITA 22 Juni 2008 Pekalongan 1708026206080001 081373473116
119 ERLANDO 08 Desember 2006 Ujan Mas Atas 1708020812060001 081373473116
120 FAUZAN BINTANG JAYA 03 Januari 2008 Desa Bukit Barisan 1708050301080001 081373473116
121 FEBI RAHMAN ALFIKRI 24 Desember 2007 Suro Baru 1708022412070001 081373473116
122 GITA MIRANDA 06 Maret 2008 Suro Muncar 1708024603080001 081373473116 SUDAH VAKSIN 1 1
123 HANDIKA FRATAMA 10 Juni 2008 Suro Baru 1708021006080001 081373473116 DUKCAPIL 1
124 KEZIA AULIA 04 Desember 2007 Ujan Mas Atas 1708024412070001 081373473116
125 LIDIA TRI JENIPER 27 Januari 2008 Pekalongan 1708026701080001 081373473116
126 MEIKA PUTRI 17 Mei 2008 Suro Muncar 1708025705080001 081373473116 MENOLAK 1
127 RAHMAT RISKI 06 Juni 2008 Suro Ilir 1702180606080001 081373473116
128 RIZKY ABDULLAH PRATAMA 24 Desember 2007 Ujan Mas Atas 1708022412070007 081373473116
129 SELA SEPRIANI RAMADANI 09 September 2008 Bumi Sari 1708024909080002 081373473116
130 SERAWATI 15 Maret 2008 Suro Ilir 1708025503080001 081373473116 DUKCAPIL 1
131 SUCI SINTIA SARI 29 Agustus 2008 Pekalongan 1708026908080002 081373473116
132 TEDI RAMADAN 19 September 2007 Suro Ilir 1708021909070002 081373473116
133 TEMI RAHARDI 081373473116 MENOLAK 1
134 TRISNA LEPIA 14 April 2008 Suro Muncar 1708025404080001 081373473116 SUDAH VAKSIN 1 1
135 VINA MAURA PUTRI 17 Maret 2008 Suro Muncar 1708025703080001 081373473116
136 YOGA PANGESTU 27 Oktober 2007 Meranti Jaya 1708022710070002 081373473116
137 IBRA RIBERY 20 Maret 2008 Bumi Sari 1708042003080004 081373473116
KELAS 8.6 138 ANGRITA SALSA BILA MENOLAK 1
139 ANJELIKA ANANTA 11/24/2007 Pekalongan 1708026411070003 085366821558
140 CHELSYE OLIVIA ERYADI 4/30/2008 Ujan mas Atas 1708027004080001 085366821558
141 COKI ARIANSYA 4/29/2008 Ujan mas Atas 1708022904080001 085366821558
142 DEA AMANDA 3/16/2008 Ujan mas Atas 1708025603080001 085366821558
143 DINDA MAROAN RASOKINA H 3/28/2008 Suro Baru 1708046803080001 085366821558
144 DIOSI HIKMA BAGITE 6/16/2006 Ujan mas Atas 1708021606060002 085366821558
145 DIVA PIOLESI 1/13/2008 Suro Baru 1709085301080000 085366821558 DUKCAPIL/IZIN 1
146 FADLI ILHAM APRIANSYAH 4/16/2008 Suro Ilir 1708021604080001 085366821558
147 FAHRY AL AKBARY. H 7/4/2008 Pulo Geto 1708050407080002 085366821558
148 FANYSAH ARINDRA 5/14/2008 Bumi Sari 1708025408080007 085366821558
149 FAUZAN MAULANA 10/15/2006 Ujan mas Atas 1708021510060001 085366821558
150 FETY PRISCA MELANI 4/14/2007 Cugung lalang 1708025404070001 085366821558
151 KEVIN PAGASTA 7/15/2008 Suro Lembak 1708021507080002 085366821558
152 KRISNA 085366821558 MENOLAK 1
153 LUCKY RORIAND 1/21/2008 Ujan mas Atas 1708022101080002 085366821558
154 MANDA YULISTIA 7/10/2007 Pekalongan 1708025007070002 085366821558
155 NUR INDAH SYAHFITRI 6/22/2008 Pekalongan 1708026206080002 085366821558
156 RAHMA WATI 1/8/2008 SURO BARU 1708024801080002 085366821558 MENOLAK 1
157 RELESTI MAHARANI 1/9/2008 Suro Baru 1708024901080001 085366821558
158 RENDI WAHYU PRATAMA 1/16/2008 Pekalongan 1708021601080001 085366821558
159 RINALDO 7/3/2007 Cugung lalang 1708020307070004 085366821558
160 SAHRIL MUHAMMAD 4/10/2006 Bukit Barisan 1708051004060001 085366821558
161 ZAHWA YESA PADILLA 7/19/2007 Meranti Jaya 1708025907070001 085366821558
7.1 162 AULIA NUR SAKINA 10/4/2008 SURO BARU 1708024410080002 082279685776
163 DODI YUDIRMAN Cugung lalang 1708023004800001 081272690254 1
164 SUHIDIN 4/14/1965 CURUP SELATAN 1702181404650001 085268682751 1
165 ANDRI RAMADAN 12/12/1999 Bukit Barisan 1708055212990001 085788424847 1
7.1 166 CHELSI OLIVIA 11/11/2008 UJAN MAS ATAS 1708025111080002 082279685776 BELUM ONLINE
7.1 167 RISNA LEPIA 7/18/2009 UJAN MAS ATAS 1708025807090001 082279685776 BELUM ONLINE
168 RISKI RENI PUTRI 11/15/1997 Bukit Barisan 1708055511970001 1
169 AKHMAD ROSIDY IMANI 9/26/1994 AIR HITAM 1708022609940002 1
170 GUSTI ERWANTO 8/5/1968 SURO BARU 1708020508680001 085380043899 1
171 YUSNIDAR 9/23/1969 SURO BARU 1708026309690001 085380043899
172 GYOZA DINDA AINNAYAH 10/13/1999 SURO BARU 1708025310990002 085380043899
173 AHMAD MUSLIHIN 2/27/1999 AIR RAMBAI 1702092702990004 089652515880 1
174
175
176
177
178
179
180
181
182
18 6 10 11 0 0 0 0 3 4 0 0 0 0 0
JUMLAH
45 7 0 0
ERNA
PUBLIK

DOSIS 2
M.UMUM

PENDIDIK
0 0 0
0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
27 OKTOBER 2021

SINOVAC MODER
DOSIS 1 DOSIS 2 DOSIS 1

REMAJA

REMAJA
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PENDIDIK
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M.UMUM
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LANSIA
KELAS 9.1 1 ADEO LESMANA 12-02-2005 PUNGGUK MERANTI 1708021202050001 081367640125
2 AGI SAPUTRA 09-04-2006 UJAN MAS 1708025004070002 081367640125 MENOLAK
3 AISAH OKTARIA 20-10-2007 SURO BARU 1708026010070001 081367640125
4 ANDIKA SANJAYA 03-06-2007 UJAN MAS ATAS 1708020306070001 081367640125
5 CANDRA GILANG SAPUTRA 10-03-2006 CUGUNG LALANG 1708021003060001 081367640125
6 DEKO AFRIANDA 25-04-2007 PUNGGUK MERANTI 1708022504070001 081367640125
7 DIKTA RIAZI SATRIYA 20-05-2007 UJAN MAS ATAS 1708022005070001 081367640125
8 DWI KURNIATI 06-02-2006 PEKALONGAN 1708024802060001 081367640125 SUDAH DIENTRY BHAYANGKARA
9 ERWAN SETIAWAN 19-11-2006 PUNGGUK MERANTI 1708021911060001 081367640125
10 FELINZA TAZKIYA 27-07-2007 UJAN MAS ATAS 1708026707070002 081367640125
11 FERI FRASETYO 12-11-2006 UJAN MAS ATAS 1708021211060001 081367640125
12 GILANG 2/19/2005 CUGUNG LALANG 1708021912060001 081367640125 SUDAH DI ENTRY
13 INDA KUMALA DEWI 28-12-2006 PUNGGUK MERANTI 1708026812060001 081367640125 MENOLAK
14 IQBAL PRAYODI 28-03-2007 UJAN MAS ATAS 1708022803070002 081367640125
15 MUHAMMAD ILHAM 19-06-2007 MERANTI JAYA 1702091908070001 081367640125 DUKCAPIL
16 NADIN POETRY SALSABIL 13-09-2006 BUMI SARI 1708025309060004 081367640125 SAKIT
17 NEKA UTARI 25-09-2004 SURO MUNCAR 1708026509040003 081367640125
18 NUR MASYITAH 14-03-2007 SURO BARU 1702195403070004 081367640125
19 PADIL ADI JAYA KUSUMA 17-02-2007 SURO MUNCAR 1708020411080001 081367640125
20 PUTRI SURIATI 30-05-2005 BUMI SARI 1708027005050002 081367640125
21 REZKI RAMADANI 15-10-2005 UJAN MAS ATAS 1708021510050001 081367640125
22 RIYANTI SUSANTI 13-06-2007 BUMI SARI 1605105306070002 081367640125
23 SINTA ROSDIANTI 09-09-2006 SURO LEMBAK 1708024909060005 081367640125
24 SITI MELATI ASA'DIAH 18-05-2007 SURO ILIR 1708025805070001 081367640125
25 TIO GUNAWAN 06-05-2005 UJAN MAS ATAS 1708020606050001 081367640125 MENOLAK
26 TIRA PUSPITA SARI 18-05-2006 SURO ILIR 1708025805060004 081367640125
27 TYO BAGUS RIMALDI 30-07-2007 PULOGETO BARU 1708053007070001 081367640125 MENOLAK
28 WIWIN JULIANTI 21-07-2007 SURO MUNCAR 1708026107070001 081367640125
29 ZAHRA DWI MAHARANI 19--01-2007 BUMI SARI 1708025901070001 081367640125
KELAS 9.2 30 ANDIKA LEO PRATAMA 085268046154 DO
31 AZHARI ALWI 30-04-2007 SUKA RAJA (R/L) 1702173004070003 085268046154
32 AZI DWI KURNIAWAN 01-04-2007 PUNGGUK MERANTI 1708020104070002 085268046154 SUDAH DI ENRTY
33 DEDE ANGGARA PUTRA 26-01-2006 PUNGGUK MERANTI 1708022601060001 085268046154
34 DELISA 29-09-2007 CUGUNG LALANG 1705114410060001 085268046154
35 DIMAS AJI PRANATA 10-11-2008 UJAN MAS ATAS 1708021011060003 085268046154
36 FADLI FIRMANSYAH 26-11-2007 UJAN MAS 1708022611070002 085268046154 SUDAH DI ENRTY
37 FAREL ADEPIO 24-08-2007 UJAN MAS ATAS 1708022408070001 085268046154 SUDAH VAKSIN 1 &2
38 FERDI SANTOSO 20-03-2008 SURO MUNCAR 1708022003060003 085268046154
39 INTAN DWI PUTRI 20-10-2007 PULO GETO 1708056010070002 085268046154
40 JELITA PERMATA SARI 30-08-2008 PUNGGUK MERANTI 1708027003060001 085268046154 DUKCAPIL
41 JOHAN SUMANTRI 18-01-2007 SURO MUNCAR 1708021801070001 085268046154 IZIN
42 JONA MARIO AKBAR 23-03-2007 SURO BARU 1708022303070002 085268046154
43 JULIO OLIVIA MAJEVI 26-07-2006 PEKALONGAN 1708022607060001 085268046154
44 MILAN RAJA DANUARTA 13-05-2007 SURO BARU 1708021305070004 085268046154
45 MUHAMMAD DILHAM 27-12-2008 PUNGGUK MERANTI 1708022712060002 085268046154 TUNDA
46 MUTIARA HATI SAPITRI 06-11-2006 SURO LEMBAK 1708024611060004 085268046154
47 NADIN RAHMADANI 24-09-2008 SURO ILIR 1708026409060001 085268046154
48 NYOMAN NITYA VALSESIKA 24-02-2007 SURO BALI 1708026402070004 085268046154 TUNDA
49 OKTA VIARAHMA DANI 04-10-2006 UJAN MAS BAWAH 1708024410080002 085268046154 SUDAH DI ENRTY
50 RADITYA 5/22/2006 UJAN MAS ATAS 1708022205060002 085268046154
51 RASTI DWI ANDINI 14-12-2007 SURO MUNVCAR 1708025412070001 085268046154
52 REZA ADELA 28-09-2007 UJAN MAS 1708056809070001 085268046154
53 RIKI PRANSISKO 085268046154 MENOLAK
54 SABANDI SUNARIO 20-07-2006 SURO MUNCAR 1708022707060004 085268046154 DUKCAPIL
KELAS 9.3 55 ADI PERIANSAH 082374959831 TIDAK SEKOLAH LAGI
56 AFRISA 23-03-2006 SURO MUNCAR 1708022303060001 082374959831
57 AHMAD DAFI DIANSAH 25-08-2007 BUMI SARI 1708022508070001 082374959831
58 ALAN DEMO PUTRA PUNGGUK MERANTI 1708070605090001 082374959831
59 ANDRE MERLINDO 082374959831 MENOLAK
60 ARDIANSYAH REGI P. 10-01-2007 SURO BARU 1708021001070003 082374959831
61 AZIZAH FITRI UTAMI 11-12-2007 SURO BARU 1708026112070002 082374959831 DUKCAPIL
62 BAMBANG YOGA GITE 082374959831 MENOLAK
63 DELA RELITA 27-08-2007 SURO LEMBAK 1708026708070002 082374959831
64 DITA YOLANDA 11-07-2004 CUGUNG LALANG 1708025107040001 082374959831
65 DWI PUTRI RAHMA 12-06-2007 PEKALONGAN 1708025206070001 082374959831
66 ELSA VEROLITA 20-08-2007 BUMI SARI 1708026008070001 082374959831
67 INDA LESTARI 12-12-2006 SURO MUNCAR 1708085212060001 082374959831
68 MELISA ARIYANTI 28-06-2006 PUNGGUK MERANTI 1708026806060001 082374959831
69 MUHAMMAD IKBAL 20-11-2007 BUMI SARI 1701052011070002 082374959831 IZIN
70 NAILA VERISIA 25-03-2007 BUMI SARI 1708026503070001 082374959831
71 NOVA ELIZA 01-05-2007 SURO ILIR 1708024105070003 082374959831
72 PEMBER PRATAMA 10-11-2006 UJAN MAS 1708021011060002 082374959831
73 REJA PRASETYO 082374959831 MENOLAK
74 ROBI SUGARA 23-03-2007 SURO BARU 1708022803070003 082374959831
75 SISIL NADIN CANDRA 21-08-2007 SURO ILIR 1708026108070001 082374959831
76 TIYA ANITA 12/11/2006 UJAN MAS ATAS 1708025112060001 082374959831
77 YULIO SAPERDI 25-04-2006 PUNGGUK MERANTI 1704146504060001 082374959831
KELAS 9.4 78 ADE SATRIAWAN 8/8/2006 CUGUNG LALANG 1708020808060001 085329888832 IZIN
79 ADELIA PUTRI HADI 20/08/2006 PUNGGUK MERANTI 1708026008060001 085329888832 DUKCAPIL
80 ADRIAN 03/01/2005 SURO MUNCAR 1708020301050001 085329888832
81 ANISA ALFITRA 19/12/2006 SURO BARU 1708025912060001 085329888832
82 CINTIA AGUSTINA 7/8/2007 UJAN MAS ATAS 1702094708070002 085329888832
83 DAFFA ARIANSYAH 11/1/2007 PUNGGUK MERANTI 1708021101070001 085329888832
84 DEO PERNANDO 05/05/2006 UJAN MAS ATAS 1708020505060002 085329888832 IZIN
85 DWI ANDINI LESTARI 18/12/2006 SURO ILIR 1708025812060001 085329888832 TIDAK SETUJU, ASMA
86 ENGGA ANGGARA 12/09/2006 UJAN MAS ATAS 1708021209060001 085329888832
87 EZI RADITIA PRATAMA 31/03/2007 PUNGGUK MERANTI 1708023103070001 085329888832
88 FIKRI ADI PRASETYA 02/12/2006 UJAN MAS ATAS 1708020212060006 085329888832 DUKCAPIL
89 FRENDI JUNANDI 11/06/2007 UJAN MAS ATAS 1708021106070001 085329888832
90 IMEL DIANA 30/05/2007 UJAN MAS ATAS 1708027005070001 085329888832
91 JOVITA AGUSTINA 15/08/2007 PUNGGUK MERANTI 1708025508070002 085329888832
92 MARTA YUDHA 11/03/2006 BUMI SARI 1708021103060004 085329888832
93 MUHAMAD ZAKI SETIAWAN 23/08/2007 BUMI SARI 1708022308080002 085329888832
94 NADIA 19/01/2008 SURO BARU 1708025901080003 085329888832
95 REKAL DEAN ADE PUTRA 16/08/2006 SURO MUNCAR 1708051608060002 085329888832
96 REVAN DWI SAPUTRA 17/07/2007 BUMI SARI 1708021707070002 085329888832
97 ROSNA WATI 29/04/2007 SURO LEMBAK 1708026904070001 085329888832
98 SATRIA ALPAJRI 23/12/2005 SURO MUNCAR 1708022312050001 085329888832
99 SELI OKTA VITRIA 07/03/2007 UJAN MAS ATAS 1708024703070001 085329888832
100 SELMA AZHARI 10/08/2007 SURO ILIR 1708025008070002 085329888832
101 SEPTI JANG SAKTI 27/02/2007 UJAN MAS BAWAH 1708026702070001 085329888832
102 TIO ARDANI 17/03/2007 PUNGGUK MERANTI 1708021703070001 085329888832
103 WAHYU NURDIANWAR 1/5/2005 CUGUNG LALANG 1708020105050001 085329888832
KELAS 9.5 104 AGUNG TRIO PUTRA PRATA 05-02-2007 BUMI SARI 1708020502070001 085379397413
105 AMELIA ANGGRAINI 18-10-2006 PUNGGUK MERANTI 1708025810060001 085379397413
106 ANDREAN DEVANDRA 24-02-2007 SURO MUNCAR 1708022402070001 085379397413
107 DEPRIYANSYAH 01-05-2007 PEKALONGAN 1708020105070001 085379397413
108 DWI PUTRI ANGERAINI 20-07-2007 UJAN MAS 1708026007070001 085379397413
109 FRISKO ADETIO 10-06-2007 UJAN MAS 1708021006070001 085379397413
110 GITA YOLANDA '14-08-2007 UJAN MAS 1708025408070001 085379397413
111 ILHAM PRATAMA 01-01-2007 SURO MUNCAR 1708020101070001 085379397413 VAKSIN 1 TGL 30 JUNI 1
112 IRVAN SYAHRI R. 01-10-2006 UJAN MAS 1708020110060001 085379397413 IZIN
113 JONA EFANDI 02-09-2006 UJAN MAS 1708020209060001 085379397413 SUDAH VAKSIN 1/01 JULI 1
114 KARIN CHELSE NENA W. 25-02-2007 PEKALONGAN 1708026502070001 085379397413 VAKSIN 1 TGL 20 OKTOBER
115 MARCEL REFKOSMAJAYA 08-08-2007 CUGUNG LALANG 1708020808070001 085379397413
116 MARIO OSCAR DS BUMI SARI 1702172009070003 085379397413
117 MARSYA AMANDA. A 08-04-2006 UJAN MAS 1708024604060001 085379397413
118 MIFTAHUL JANNAH 13-10-2006 SURO ILIR 1708025310060001 085379397413 VAKSIN 1 TGL 30 SEPT
119 MUHAMMAD ALFIQRY 15-10'2005 BUMI SARI 1708021510050002 085379397413
120 NADIA DWI PUTRI 16-12-2006 CUGUNG LALANG 1708025612060003 085379397413 VAKSIN 1 TGL 20 OKTOBER
121 NOVIA RENSISKA 26-11-2006 UJAN MAS 1708026611060001 085379397413
122 RAHMAD FEBRI SYAH PUTR 09-02-2007 UJAN MAS 1708020902070001 085379397413
123 RAMANDA 06-02-2006 UJAN MAS 1708020602050001 085379397413
124 REKI SANJAYA 16-07-2007 SURO MUNCAR 1708021607070004 085379397413
125 REPALIA 02-06-2007 SURO BARU 1708024206070002 085379397413
126 RISKI PUTRI 10-07-2007 UJAN MAS 1708024804070001 085379397413
127 SEPTI TRILIA BELA A. 12-09-2006 TANJUNG ALAM 1708025209060005 085379397413
128 SUCI RAMADANI 23-09-2006 PEKALONGAN 1708026309060003 085379397413
129 THE FIQRI D.S 085379397413 MENOLAK
130 WINSI PUTRI 23-03-2007 SURO MUNCAR 1708026303070002 085379397413
131 YUDHA MUHAMAT AGUNG 03-05-2004 PUNGGUK MERANTI 1708020305040005 085379397413
KELAS 9.6 132 ANDIKA PRANATA 18-07-2007 SURO MUNCAR 1708021807070003 081367750299
133 ANGGA SAPUTRA 02-12-2008 UJAN MAS ATAS 1708020212060004 081367750299 IZIN
134 ANISA MELANDA 23-05-2007 SURO MUNCAR 1708026305070002 081367750299
135 ARDANA SAMITRA 29-11-2006 UJAN MAS ATAS 1708022911060005 081367750299 IZIN
136 DANDY WIJAYA 01-12-2006 PEKALONGAN 1708020112060004 081367750299
137 DANIL ADE PUTRA 24-07-2006 MERANTI JAYA 1708022407060001 081367750299
138 DECA AULIA 11-01-2008 UJAN MAS ATAS 1708025101080005 081367750299
139 DOVAL RISKI KARLES 23-07-2007 UJAN MAS ATAS 1708022307070002 081367750299
140 FAUZAN EFENDI 05-01-2007 BUMI SARI 1708020501070001 081367750299
141 FEBI ARIYANTI 22-02-2007 UJAN MAS ATAS 1708026202070003 081367750299
142 FLENALDO SYAQLI F. 11-07-2007 PUNGGUK MERANTI 1708021107070001 081367750299
143 GUSTIANTARA IRAWAN 12-08-2007 SURO MUNCAR 1709011208070005 081367750299
144 INTAN SADEWO 16-02-2007 SURO ILIR 1708021407910005 081367750299
145 KAROLIN PEBIOLA 22-11-2005 SURO MUNCAR 1708026211050001 081367750299 MENOLAK
146 KEPIN 29-06-2006 SURO MUNCAR 1708022906060001 081367750299
147 MAREMUR 07-04-2007 PUNGGUK BERINGANG 1708020704070002 081367750299
148 MEILA CAHYA PANIA 08-05-2007 PEKALONGAN 1708024805070002 081367750299
149 NANA RAHMAYANI 27-09-2007 SURO ILIR 1702186709070001 081367750299
150 NASWA ZIZAR ARIFAH 10-09-2007 PEKALONGAN 1708025009070002 081367750299
151 NAYLA FAIZATUL KHUSNAH 10-11-2007 BUMI SARI 1708025011070001 081367750299
152 OKTARI RAMADEYANTI 22-10-2007 MERANTI JAYA 1708026210070001 081367750299
153 RIKI SAPUTRA 03-02-2007 UJAN MAS 1708020302070001 081367750299
154 RIRIN RENALDI 26-06-2006 UJAN MAS 1708021105050001 081367750299
155 TARA FEBI DWIYANTI 22-02-2006 PEKALONGAN 1708026202060001 081367750299
156 TIARA LESTARI 28-12-2007 SURO BARU 1708026812070001 081367750299
157 ZAKIA SALSABILA 29-06-2007 BUMI SARI 1708026906070002 081367750299
KELAS 9.7 158 AGIM NASTIAR 4/29/2006 suro Muncar 1708022904060002 085273887675
159 AISYAH TRI AFRILIA 4/20/2006 Meranti Jaya 1708026004060001 085273887675
160 ANDI JULIAN SAPUTRA 7/16/2006 Bumi Sari 1708021607070003 085273887675
161 DEPO DESTRIO 11/9/2006 Daspetah 1708020911060001 085273887675
162 DIMAS RAMON DANUARTA 7/8/2007 Pungguk Meranti 1708020807070002 085273887675
163 DIRGA ARDIYANSYAH 8/21/2006 Bumi Sari 1708022108060002 085273887675
164 DWI LESTARI 9/11/2007 Ujan Mas 1708025109070002 085273887675
165 EMA FATIMA 3/22/2007 Suro Lembak 1708026203070001 085273887675
166 FADHILLAH JULIO A. 7/12/2007 Curup 1702091207070002 085273887675 DUKCAPIL
167 FAIZAL 5/3/2006 Ujan Mas 1708020306050002 085273887675 IZIN
168 IMAS 4/1/2007 Suro Lembak 1708024104070001 085273887675
169 ISLAMIA 2/2/2007 suro Muncar 1708024202070001 085273887675
170 KRISTON ERLANGGA 085273887675 IZIN
171 LOLA AGUSTIA 8/15/2007 Suro Baru 1708025508070003 085273887675 DUKCAPIL
172 M. ANDREYAN SAPUTRA 8/28/2007 Meranti Jaya 1708022807070001 085273887675
173 M. BAGAS ABI FERNANDO 1/21/2007 Bumi Sari 1708022101070001 085273887675
174 MEZI YULIANTI 5/7/2007 Suro Baru 1708024705070001 085273887675
175 PINARKI PARISTA PRATAMA 6/23/2006 Ujan Mas 1708022306060002 085273887675 IZIN
176 PUTRI NABILA 11/14/2006 suro Muncar 1708025411060001 085273887675
177 RAFLY KHAIRUL RIZAL 10/7/2006 Pungguk Meranti 1708020710060001 085273887675 IZIN
178 REHAN PRANATA 12/15/2006 Ujan Mas 1708021512060001 085273887675
179 RIRIN ANDITA 8/7/2007 suro Muncar 1708024708070004 085273887675
180 RISKI RAMADANI 9/25/2007 suro Muncar 1708026509070001 085273887675
181 SINTA FRANSISKA 5/13/2007 Suro Lembak 1708025305070001 085273887675
182 SUTI MURHASTUTI 6/7/2006 Pekalongan 1708024706060001 085273887675
183 TIA ANGGRAINI 5/25/2007 Meranti Jaya 1708025505070002 085273887675 DUKCAPIL
184 ZACKY ANGGARA 12/2/2006 Suro Lembak 1708020212060001 085273887675
185 JUWANDA PERMANA 7/9/2009 PUNGGUK MERANTI 1708020907090001 082279685776
WAHYU ANTONI REBA SURO MUNCAR 1708022608080003 085273875149
ALFIANSYAH 9/9/2009 Ujan mas Atas 1708020909090001 089634249539
MUHAMAD AGUSTIAN F 8/25/2008 kepahiang 1708022508080001 089634249539
AZALIA CARISSA PUTRI 1/10/2009 Pekalongan 1708025001090001 089634249539
DEWA DWI ANDIKA 12 Mei 2007 Daspetah 1708021205070002 081373473116
LENI SURYANI PULO GETO 1708055012790002 089608613664 1
SUKEMI 10/9/1992 TALANG BENIH 1702090910920001 082279746630 1
WULANDARI PINAHAVIVA SURO ILIR 1708024404090001 089634249539
HADIUS INTAN NIRWANA 1/15/1960 JALAN BARU, CURUP 1702095501600001 081273951842 1
SUHERI 12/8/1955 JALAN BARU, CURUP 1702090812550001 081273951842 1

186
187
2 0 1 1 0 0 0 0 0 2 0
JUMLAH
4 2 0
REKAPITULASI HARIAN VAKSINASI COVID 19
20 OKTOBER 2021

MODERNA SINOVAC MODERNA


DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA JUMLAH
PENDIDIK

PENDIDIK

M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
M.UMUM

M.UMUM

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
PUBLIK

LANSIA

PUBLIK
SB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0
0 0 0 0 0 0 0
0 0
UPT P

NO NAMA TGL LAHIR ALAMAT

1 JUWANDA PERMANA 7/9/2009 PUNGGUK MERANTI


2 WAHYU ANTONI REBA SURO MUNCAR
3 ALFIANSYAH 9/9/2009 Ujan mas Atas
4 MUHAMAD AGUSTIAN F 8/25/2008 kepahiang
5 AZALIA CARISSA PUTRI 1/10/2009 Pekalongan
6 DEWA DWI ANDIKA 12 Mei 2007 Daspetah
7 LENI SURYANI PULO GETO
8 SUKEMI 10/9/1992 TALANG BENIH
9 WULANDARI PINAHAVIVA SURO ILIR
10 ADEO LESMANA 12-02-2005 PUNGGUK MERANTI
11 AISAH OKTARIA 20-10-2007 SURO BARU
12 ANDIKA SANJAYA 03-06-2007 UJAN MAS ATAS
13 CANDRA GILANG SAPUTR 10-03-2006 CUGUNG LALANG
14 DEKO AFRIANDA 25-04-2007 PUNGGUK MERANTI
15 DIKTA RIAZI SATRIYA 20-05-2007 UJAN MAS ATAS
16 DWI KURNIATI 06-02-2006 PEKALONGAN
17 ERWAN SETIAWAN 19-11-2006 PUNGGUK MERANTI
18 FELINZA TAZKIYA 27-07-2007 UJAN MAS ATAS
19 FERI FRASETYO 12-11-2006 UJAN MAS ATAS
20 GILANG 2/19/2005 CUGUNG LALANG
21 IQBAL PRAYODI 28-03-2007 UJAN MAS ATAS
22 NEKA UTARI 25-09-2004 SURO MUNCAR
23 NUR MASYITAH 14-03-2007 SURO BARU
24 PADIL ADI JAYA KUSUMA 17-02-2007 SURO MUNCAR
25 PUTRI SURIATI 30-05-2005 BUMI SARI
26 REZKI RAMADANI 15-10-2005 UJAN MAS ATAS
27 RIYANTI SUSANTI 13-06-2007 BUMI SARI
28 SINTA ROSDIANTI 09-09-2006 SURO LEMBAK
29 SITI MELATI ASA'DIAH 18-05-2007 SURO ILIR
30 TIRA PUSPITA SARI 18-05-2006 SURO ILIR
31 WIWIN JULIANTI 21-07-2007 SURO MUNCAR
32 ZAHRA DWI MAHARANI 19--01-2007 BUMI SARI
33 AZHARI ALWI 30-04-2007 SUKA RAJA (R/L)
34 AZI DWI KURNIAWAN 01-04-2007 PUNGGUK MERANTI
35 DEDE ANGGARA PUTRA 26-01-2006 PUNGGUK MERANTI
36 DELISA 29-09-2007 CUGUNG LALANG
37 DIMAS AJI PRANATA 10-11-2008 UJAN MAS ATAS
38 INTAN DWI PUTRI 20-10-2007 PULO GETO
39 FADLI FIRMANSYAH 26-11-2007 UJAN MAS
40 FERDI SANTOSO 20-03-2008 SURO MUNCAR
41 JONA MARIO AKBAR 23-03-2007 SURO BARU
42 JULIO OLIVIA MAJEVI 26-07-2006 PEKALONGAN
43 MILAN RAJA DANUARTA 13-05-2007 SURO BARU
44 MUTIARA HATI SAPITRI 06-11-2006 SURO LEMBAK
45 NADIN RAHMADANI 24-09-2008 SURO ILIR
46 OKTA VIARAHMA DANI 04-10-2006 UJAN MAS BAWAH
47 RADITYA 5/22/2006 UJAN MAS ATAS
48 RASTI DWI ANDINI 14-12-2007 SURO MUNVCAR
49 REZA ADELA 28-09-2007 UJAN MAS
50 AFRISA 23-03-2006 SURO MUNCAR
51 AHMAD DAFI DIANSAH 25-08-2007 BUMI SARI
52 ALAN DEMO PUTRA PUNGGUK MERANTI
53 ARDIANSYAH REGI P. 10-01-2007 SURO BARU
54 DELA RELITA 27-08-2007 SURO LEMBAK
55 DITA YOLANDA 11-07-2004 CUGUNG LALANG
56 DWI PUTRI RAHMA 12-06-2007 PEKALONGAN
57 ELSA VEROLITA 20-08-2007 BUMI SARI
58 INDA LESTARI 12-12-2006 SURO MUNCAR
59 MELISA ARIYANTI 28-06-2006 PUNGGUK MERANTI
60 NAILA VERISIA 25-03-2007 BUMI SARI
61 NOVA ELIZA 01-05-2007 SURO ILIR
62 PEMBER PRATAMA 10-11-2006 UJAN MAS
63 ROBI SUGARA 23-03-2007 SURO BARU
64 SISIL NADIN CANDRA 21-08-2007 SURO ILIR
65 TIYA ANITA 12/11/2006 UJAN MAS ATAS
66 YULIO SAPERDI 25-04-2006 PUNGGUK MERANTI
67 ADRIAN 03/01/2005 SURO MUNCAR
68 ANISA ALFITRA 19/12/2006 SURO BARU
69 CINTIA AGUSTINA 7/8/2007 UJAN MAS ATAS
70 DAFFA ARIANSYAH 11/1/2007 PUNGGUK MERANTI
71 DWI ANDINI LESTARI 18/12/2006 SURO ILIR
72 ENGGA ANGGARA 12/09/2006 UJAN MAS ATAS
73 EZI RADITIA PRATAMA 31/03/2007 PUNGGUK MERANTI
74 FRENDI JUNANDI 11/06/2007 UJAN MAS ATAS
75 IMEL DIANA 30/05/2007 UJAN MAS ATAS
76 JOVITA AGUSTINA 15/08/2007 PUNGGUK MERANTI
77 MARTA YUDHA 11/03/2006 BUMI SARI
78 MUHAMAD ZAKI SETIAWA 23/08/2007 BUMI SARI
79 NADIA 19/01/2008 SURO BARU
80 REKAL DEAN ADE PUTRA 16/08/2006 SURO MUNCAR
81 REVAN DWI SAPUTRA 17/07/2007 BUMI SARI
82 ROSNA WATI 29/04/2007 SURO LEMBAK
83 SATRIA ALPAJRI 23/12/2005 SURO MUNCAR
84 SELI OKTA VITRIA 07/03/2007 UJAN MAS ATAS
85 SELMA AZHARI 10/08/2007 SURO ILIR
86 SEPTI JANG SAKTI 27/02/2007 UJAN MAS BAWAH
87 TIO ARDANI 17/03/2007 PUNGGUK MERANTI
88 WAHYU NURDIANWAR 1/5/2005 CUGUNG LALANG
89 AGUNG TRIO PUTRA PRA 05-02-2007 BUMI SARI
90 AMELIA ANGGRAINI 18-10-2006 PUNGGUK MERANTI
91 ANDREAN DEVANDRA 24-02-2007 SURO MUNCAR
92 DEPRIYANSYAH 01-05-2007 PEKALONGAN
93 DWI PUTRI ANGERAINI 20-07-2007 UJAN MAS
94 FRISKO ADETIO 10-06-2007 UJAN MAS
95 GITA YOLANDA '14-08-2007 UJAN MAS
96 ILHAM PRATAMA 01-01-2007 SURO MUNCAR
97 JONA EFANDI 02-09-2006 UJAN MAS
98 MARCEL REFKOSMAJAYA 08-08-2007 CUGUNG LALANG
99 MARIO OSCAR DS BUMI SARI
100 MARSYA AMANDA. A 08-04-2006 UJAN MAS
101 MUHAMMAD ALFIQRY 15-10'2005 BUMI SARI
102 NOVIA RENSISKA 26-11-2006 UJAN MAS
103 RAHMAD FEBRI SYAH PU 09-02-2007 UJAN MAS
104 RAMANDA 06-02-2006 UJAN MAS
105 REKI SANJAYA 16-07-2007 SURO MUNCAR
106 REPALIA 02-06-2007 SURO BARU
107 RISKI PUTRI 10-07-2007 UJAN MAS
108 SEPTI TRILIA BELA A. 12-09-2006 TANJUNG ALAM
109 SUCI RAMADANI 23-09-2006 PEKALONGAN
110 WINSI PUTRI 23-03-2007 SURO MUNCAR
111 YUDHA MUHAMAT AGUNG 03-05-2004 PUNGGUK MERANTI
112 ANDIKA PRANATA 18-07-2007 SURO MUNCAR
113 ANISA MELANDA 23-05-2007 SURO MUNCAR
114 DANDY WIJAYA 01-12-2006 PEKALONGAN
115 DANIL ADE PUTRA 24-07-2006 MERANTI JAYA
116 DECA AULIA 11-01-2008 UJAN MAS ATAS
117 DOVAL RISKI KARLES 23-07-2007 UJAN MAS ATAS
118 FAUZAN EFENDI 05-01-2007 BUMI SARI
119 FEBI ARIYANTI 22-02-2007 UJAN MAS ATAS
120 FLENALDO SYAQLI F. 11-07-2007 PUNGGUK MERANTI
121 GUSTIANTARA IRAWAN 12-08-2007 SURO MUNCAR
122 INTAN SADEWO 16-02-2007 SURO ILIR
123 KEPIN 29-06-2006 SURO MUNCAR
124 MAREMUR 07-04-2007 PUNGGUK BERINGANG
125 MEILA CAHYA PANIA 08-05-2007 PEKALONGAN
126 NANA RAHMAYANI 27-09-2007 SURO ILIR
127 NASWA ZIZAR ARIFAH 10-09-2007 PEKALONGAN
128 NAYLA FAIZATUL KHUSN 10-11-2007 BUMI SARI
129 OKTARI RAMADEYANTI 22-10-2007 MERANTI JAYA
130 RIKI SAPUTRA 03-02-2007 UJAN MAS
131 RIRIN RENALDI 26-06-2006 UJAN MAS
132 TARA FEBI DWIYANTI 22-02-2006 PEKALONGAN
133 TIARA LESTARI 28-12-2007 SURO BARU
134 ZAKIA SALSABILA 29-06-2007 BUMI SARI
135 AGIM NASTIAR 4/29/2006 suro Muncar
136 AISYAH TRI AFRILIA 4/20/2006 Meranti Jaya
137 ANDI JULIAN SAPUTRA 7/16/2006 Bumi Sari
138 DEPO DESTRIO 11/9/2006 Daspetah
139 DIMAS RAMON DANUART 7/8/2007 Pungguk Meranti
140 DIRGA ARDIYANSYAH 8/21/2006 Bumi Sari
141 DWI LESTARI 9/11/2007 Ujan Mas
142 EMA FATIMA 3/22/2007 Suro Lembak
143 IMAS 4/1/2007 Suro Lembak
144 ISLAMIA 2/2/2007 suro Muncar
145 M. ANDREYAN SAPUTRA 8/28/2007 Meranti Jaya
146 M. BAGAS ABI FERNANDO 1/21/2007 Bumi Sari
147 MEZI YULIANTI 5/7/2007 Suro Baru
148 PUTRI NABILA 11/14/2006 suro Muncar
149 REHAN PRANATA 12/15/2006 Ujan Mas
150 RIRIN ANDITA 8/7/2007 suro Muncar
151 RISKI RAMADANI 9/25/2007 suro Muncar
152 SINTA FRANSISKA 5/13/2007 Suro Lembak
153 SUTI MURHASTUTI 6/7/2006 Pekalongan
154 ZACKY ANGGARA 12/2/2006 Suro Lembak
155 HADIUS INTAN NIRWANA 1/15/1960 JALAN BARU, CURUP
156 SUHERI 12/8/1955 JALAN BARU, CURUP
157 WATI 7/1/1967 SIMPANG KOTA BINGIN
158 Ermansia 4/20/1966 Suro baru
159 Ahmad Kurniadi 11/16/1995 Curup Utara
160 Iqbal fati 8/14/2005 Daspetah 2
161 Febri Ardianzah 2/19/2005 Pelangkian
162 Widya Gunasanti 7/18/2006 Ujan mas atas
163 Sutri 2/2/1979 Ujan mas atas
164 Winda susanti 4/5/1990 Suro baru
165 Yurma Yunita 5/16/1990 Daspetah 1
166 Reka Susanti 7/4/1986 P. Beringang
167 Arsanto 10/24/1983 Desa Teladan
168 Sutiman Bogor baru
169 Nursinta purnama 12/8/2001 Ujan mas atas
170 Eva Indra Wati 5/5/1979 Durian depun
171 Narti 7/1/1959 Ujan mas atas
172 Ramaya kartik1 7/1/1975 Suro baru
173 Dilviani 10/12/1990 Suro baru
174 Febantika 2/28/1990 Daspetah
175 Mikael sinaga 10/11/1973 kepahiang
176 Enda yulita 2/10/1995 kelobak
177 Lidya wisi astuti 1/26/1993 curup tengah
178 Peli anggraini 4/15/1991 Daspetah
179 Dessy M 12/15/1981 curup tengah
180 Hasnayani 5/28/1981 curup tengah
181 Saropil 8/14/1978 curup tengah
182 Leni larasati 7/1/1980 Ujan mas atas
183 Resa susanti 12/12/1999 daspetah
184 Jayanti 6/13/1988 Suro baru
185 Hamiri andra 7/13/1979 Suro baru
186 Beka oktavia 10/8/1989 Ujan mas atas
187 Silvia ekananda 6/5/1996 Curup tengah
188 Ila wati 1/1/1976 Ujan mas atas
189 Kaharudin 7/26/1984 merigi keindang
190 Sarifatul aini 2/20/1975 Suro Lembak
191 Nova eliza 2/2/1987 benteng
192 Kartini wilis 7/5/1985 Ujan mas atas
193 Reka Julita 2/11/1992 Ujan mas atas
194 Sinta Apriantika 2/27/1982 Daspetah II
195 Dedi Irawan 10/28/1993 Suro Muncar
196 maulida khairani 4/21/2005 Pungguk Beringang
197 wawan triono 8/8/1988 Suro Muncar
198 husnaini 6/18/1981 suro baru
199 siti asma 7/6/1955 Ujan mas atas
200 reda wati 7/1/1988 Ujan mas atas
201 mahyudin 10/9/1968 Ujan mas atas
202 Kuriana 13/07/1070 Suro baru
203 Peramli 7/1/1971 Ujan mas atas
204 Suryati 3/6/1967 Ujan mas atas
205 Damuya 12/1/1943 Ujan mas atas
206 Cantika Wulandari 7/22/1993 Suro Lembak
207 Erni Surtati 10/6/1967 Suro Lembak
208 Rudi Antoni 9/1/1981 Ujan mas atas
209 Sunarti Hartati 7/27/1970 Suro baru
210 Risma agustin 8/15/1995 Suro baru
211 Tianzi agustin 8/12/2003 Rimbo pengadang
212 Sri Sulasmi 5/5/1975 Suro baru
213 Rita Safitri 7/1/1979 Ujan mas atas
214 Putri hani 4/25/1981 Suro baru
215 Anan 01/0/1948 Tanjung Alam

JUMLAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
27 OKTOBER 2021

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
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2 1 10 1 150 0 0 7
164 9
215
MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK
LDREMSINO1
SMREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
DPTREMSINO1
LDMUSINO1
LDPENSINO1
SIREMSINO1
LDREMSINO1
SBREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
SMREMSINO1
SBREMSINO1
SMREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
SLREMSINO1
SIREMSINO1
SIREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
SMREMSINO1
SBREMSINO1
LDREMSINO1
SBREMSINO1
SLREMSINO1
SIREMSINO1
UMBREMSINO1
UMAREMSINO1
SMREMSINO1
UMAREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
SLREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
SIREMSINO1
UMAREMSINO1
SBREMSINO1
SIREMSINO1
UMAREMSINO1
LDREMSINO1
SMREMSINO1
SBREMSINO1
UMAREMSINO1
LDREMSINO1
SIREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
SMREMSINO1
LDREMSINO1
SLREMSINO1
SMREMSINO1
UMAREMSINO1
SIREMSINO1
UMBREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
UMAREMSINO1
1 SMREMSINO2
1 UMAREMSINO2
LDREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
UMAREMSINO1
SMREMSINO1
SBREMSINO1
UMAREMSINO1
LDREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
SMREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
UMAREMSINO1
LDREMSINO1
SMREMSINO1
SIREMSINO1
SMREMSINO1
PBREMSINO1
LDREMSINO1
SIREMSINO1
LDREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
UMAREMSINO1
LDREMSINO1
SBREMSINO1
LDREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
DPTREMSINO1
LDREMSINO1
LDREMSINO1
UMAREMSINO1
SLREMSINO1
SLREMSINO1
SMREMSINO1
LDREMSINO1
LDREMSINO1
SBREMSINO1
SMREMSINO1
UMAREMSINO1
SMREMSINO1
SMREMSINO1
SLREMSINO1
LDREMSINO1
SLREMSINO1
LDMUSINO1
LDMUSINO1
LDMUSINO1
1 SBLANMODER1
1 LDMUMODER1
DPT2MUSINO1
LDMUSINO1
UMAMUSINO1
1 UMAMUMODER1
1 SBMUMODER1
1 DPTMUMODER1
PBMUSINO2
1 LDPUBMODER1
1 LDPENMODER2
1 UMAMUMODER1
LDMUSINO2
UMAMUSINO2
1 SBMUMODER1
1 SBMUMODER1
1 DPTMUMODER2
1 LDPENMODER1
1 LDPENMODER2
1 LDPENMODER1
DPTPUBSINO1
1 LDPENMODER2
1 LDPENMODER2
1 LDPUBMODER2
1 UMAMUMODER1
DPTMUSINO1
1 SBMUMODER1
1 SBMUMODER1
1 UMAMUMODER2
LDMUSINO1
1 UMAMUMODER1
1 LDMUMODER2
1 SLMUMODER2
LDMUSINO2
UMAMUSINO2
UMAMUSINO2
1 DPT2MUMODER2
1 SMMUMODER1
PBMUSINO1
1 SMMUMODER1
1 SBMUMODER1
1 UMALANMODER1
1 UMAMUMODER1
1 UMAMUMODER1
1 SBMUMODER1
UMALANSINO1
1 UMAMUMODER2
UMALANSINO1
SLMUSINO2
1 SLMUSINO2
1 UMAMUMODER1
1 SBMUMODER1
1 SBMUMODER1
1 LDMUMODER2
1 SBMUMODER1
1 UMAMUMODER1
1 SBMUMODER1
1 LDLANMODER2
0 2 2 1 25 2 1 1 6 4
9 30 12
REKAPITULASI HARIAN VAKSINASI COVID 19
27 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SB 0 0 0 0 11 0 0 0 0 0 1 0 11 0 0 0 0 0
SM 0 0 0 0 23 0 0 0 0 1 0 0 2 0 0 0 0 0
SI 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 8 0 0 2 0 0 0 0 0 0 0 0 1 0
UMA 2 0 1 0 33 0 0 3 0 1 1 0 8 0 0 0 2 0
UMB 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0
DPT 0 1 1 0 2 0 0 0 0 0 0 0 1 0 0 0 1 0
DPT2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
LD 0 0 6 1 60 0 0 2 0 0 0 1 1 2 1 1 2 4
JUMLAH 2 1 10 1 150 0 0 8 0 2 2 1 23 2 1 1 7 4
174
JUMLAH

23
26
10
11
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UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
1 ALFINKI 07/02/2009 DASPETAH 1708020702090001 085268404438 1
2 ANISA AL MAGFIRA 04/03/2008 DASPETAH II 1708024403080002 085268404438 1
3 DEWINTA DEWA DARU 03/05/2009 UJAN MAS 1708024305090001 085268404438 1
4 DIKA ANGGARA 11/12/2008 DASPETAH 1708021112080001 085268404438 1
5 KEYLA OKTAVIA 17/10/2008 DASPETAH II 1708025710850001 085268404438 1
6 MELZA ANGGRAINI 25/07/2008 DASPETAH II 1708026507080002 085268404438 1
7 SILVA DWI ANDIRA 26/02/2008 DASPETAH 1708026602080001 085268404438 1
8 ABDAL ZAHIR ALI SALAM 30/10/2008 DASPETAH II 1708023001080001 085378884847 1
9 ANDINI KRISTIANA 29/01/2009 DASPETAH 1708026901090001 085378884847 1
10 ANINDIA NABILA PUTRI 16/07/2008 DASPETAH II 1771035607080003 085378884847 1
11 ARGA PRIYA WANTO 11/05/2009 DASPETAH II 1708021105090001 085378884847 1
12 M. HAIKAL ALFARUQ 28/09/2008 DASPETAH II 1708022809080001 085378884847 1
13 ANDIKA PUTRA PRATAMA 1/08/2008 PUNGGUK BERINGANG 1708021508080001 085268013283 1
14 CECEP RAMA SEPTIAWA 20/0/2008 DASPETAH II 1708022606080009 085268013283 1
15 SASKIA NADIA META 0/10/2008 DASPETAH II 1708024610080001 085268013283 1
16 SELVI CAHAYA LESTARI 10/29/2009 DASPETAH 1708026910090002 085268013283 1
17 ADI ALHADI 18/01/2007 PUNGGUK BERINGANG 1708021801060001 082371150488 1
18 ADITYA BINTANG RAMAD 0/09/2008 DASPETAH 1708020509080002 082371150488 1
19 ANGGUN MARSYAHFILA 09/07/2008 DASPETAH II 1708044907080003 082371150488 1
20 APRIANSYAH 01/04/2007 DASPETAH 1708020104070001 082371150488 1
21 CELSI APRILIANI 18/04/2008 KELOBAK 1708045804080001 082371150488 1
22 DELA NANDA 09/06/2008 DASPETAH II 1708025206060001 082371150488 1
23 DINTA INDRIANI 14/09/20008 DASPETAH 1708025409080002 082371150488 1
24 DWI ZASKIA 25/02/2008 DASPETAH II 1708026502080001 082371150488 1
25 HELEN LINTANG PRATIWI 11/01/2008 DASPETAH 1708025101080003 082371150488 1
26 IMEL SUSANTI 04/05/2008 DASPETAH II 1708024405080003 082371150488 1
27 MITZI ARKA LENGGA 15/01/2008 DASPETAH II 1708021501080002 082371150488 1
28 NATYA MAHARANI 0/09/2007 DASPETAH II 1708024509070001 082371150488 1
29 NIKO HARJA 05/05/2008 DASPETAH II 1708020505080002 082371150488 1
30 POPI MELINDA PUSPITA 08/08/2008 DASPETAH II 1708024808080002 082371150488 1
31 PIKRI APRIYANSAH 22/11/2007 DASPETAH 1708022211070001 082371150488 1
32 RATIH PURWASIH 16/11/2008 DASPETAH 1708025611080001 082371150488 1
33 RIKI PANJAITAN 28/11/2008 DASPETAH II 1708022801080002 082371150488 1
34 ADI PRANATA 27/12/2006 DASPETAH II 1708022712060003 081373664060 1
35 ANISA RISKI SAHBILA 29/08/2009 DASPETAH 1708026908070001 081373664060 1
36 ANTONI SAPUTRA 10/08/2006 DASPETAH 1708020807070001 081373664060 1
37 DIKO ASTREA 03/12/2007 DASPETAH II 1708020312070001 081373664060 1
38 FENTI CITRA 10/10/2008 DASPETAH II 1708025010080004 081373664060 1
39 KESI FEBRIANI 26/02/2008 DASPETAH 1708026602080002 081373664060 1
40 KEYSIA DELONAH 25/03/2008 DASPETAH II 1708020405080001 081373664060 1
41 RAKA WIJAYA 17/12/2008 DASPETAH 1708021712080001 081373664060 1
42 RASTI APRIANTI 01/04/2008 DASPETAH II 1708024104080002 081373664060 1
43 REYHADI 05/03/2008 DASPETAH II 1708020503080001 081373664060 1
44 REYO PRANATA 17/06/2007 DASPETAH 1708021706070004 081373664060 1
45 YESI RISKI AYU 02/02/2008 DASPETAH 1708024202080001 081373664060 1
46 LILIS SELVIA MELINDA 28/05/2007 UJAN MAS 1702226805070001 081373664060 1
47 SINTA DIANDRI 28/08/2008 DASPETAH 1708026706040001 081373664060 1
48 ALDENO ALONSO KENED 21/04/2007 DASPETAH 1708022104070001 085268553665 1
49 FINA KRISTIANA 09/11/2006 DASPETAH 1708024911060003 085268553665 1
50 JENI YUNIANSI 08/06/2006 DASPETAH 1708024806060001 085268553665 1
51 PANJI PRANATA 30/10/2007 DASPETAH 1708023010070001 085268553665 1
52 RAMA 25/09/2006 PUNGGUK BERINGANG 1708022509060001 085268553665 1
53 REMONDO SUSILO CAND 06/05/2005 DASPETAH 1708020605050001 085268553665 1
54 RIO RAHMAT ILAHI 25/05/2006 DASPETAH II 1708022505060002 085268553665 1
55 RONALDI 10/12/2006 DASPETAH II 1708021012060002 085268553665 1
56 AHMAD NAJIB 4/4/2007 DASPETAH II 1708020404070002 08994222937 1
57 BAHRI GUNAWAN 17/04/2006 DASPETAH 1708021704060001 08994222937 1
58 DAWIA SRI VIA VANESA 26/08/2007 DASPETAH II 1708046608070001 08994222937 1
59 DIRLI PARENSA 02/12/2007 DASPETAH 1708020212070002 08994222937 1
60 EDWIN ORLANDO 19/05/2007 DASPETAH 1708021905070001 08994222937 1
61 ELO DWI SAPUTRA 28/12/2006 PUNGGUK BERINGANG 1709052305070001 08994222937 1
62 HATOYA ALPARENZA 23/0/2007 PUNGGUK BERINGANG 1708022305070001 08994222937 1
63 LEKSI MAHYENI 15/04/2005 PUNGGUK BERINGANG 1708025604050001 08994222937 1
64 LIYA AUDINA 11/07/2007 PUNGGUK BERINGANG 1708025107070002 08994222937 1
65 NABILA 1/05/2007 DASPETAH 1708025605070001 08994222937 1
66 RINDI ANTIKA 27/04/2007 DASPETAH 1708026704070001 08994222937 1
67 RARA RISKI ISLAMI 23/11/2007 DASPETAH 1708026301070001 08994222937 1
68 WICHA KARO LINZAH 17/08/2006 DASPETAH 1708025708060001 08994222937 1
69 SINTIYA PEBI SONETA 10/28/2008 DASPETAH 1708026810080001 085268404438 1
70 RIKA AYU ANDINI 2/16/2007 DASPETAH 1708025602070001 085268404438 1
71 AGUNG SATRIA 12/18/2008 DASPETAH 2 1708021812080002 085268404438 1
72 YONANDA 1/12/2009 DASPETAH 1708025201090001 081373664060 1
73 JONA AGUSTIN 8/17/2006 DASPETAH 1708025806100001 085268553665 1
74 FEBRI SANJAYA 6/9/2005 DASPETAH 1708025112050001 08994222937 1
75 MEYLANEE 5/5/2007 DASPETAH 1708024505070002 08994222937 1
76 ROY JORDY 8/4/2006 DASPETAH 1708020408060002 08994222937 1
77 SENO 9/11/2007 DASPETAH 1708021109070001 08994222937 1
78 MUHAMMAD NABIL RAMA 9/21/2007 DASPETAH 1708022109070001 08994222937 1
79 ALDO WIRANATA 2/12/2007 DASPETAH 1708021702070001 08994222937 1
80 ARIEL DWIANTO 6/20/2008 DASPETAH 1708022006080001 08994222937 1
81 JESEN 6/26/2006 DASPETAH 1708022606060005 08994222937 1
82 DIO SUGANDA 7/3/2007 DASPETAH 2 1708020307070003 08994222937 1
83 ANIS MARSELLA 07-01-2003 UJAN MAS ATAS 1708024701030001 081272722939 1
84 ANJELITA ANJAS FADILA 30-10-2004 DASPETAH 1708027010040002 081272722939 1
85 Ansi Marda Lova 25-09-2004 Daspetah II 1708022509040002 081272722939 1
86 Bunga Afriyanti 21-04-2006 Pungguk Beringang 1708026104050001 081272722939 1
87 Depi Susiyanti 10-11-2003 Daspetah II 1708025011030003 081272722939 1
88 Devita Nanda Ria 07-05-2002 Pungguk Beringang 1708024705020003 081272722939 1
89 DIAH PERMATA SARI 31-07-2004 PAGAR GUNUNG 1708025205040002 081272722939 1
90 Enja Efrisan Yudika 14-04-2004 Daspetah II 1708021404040003 081272722939 1
91 FELLA MONICA 26-07-2006 Jambu - Lubuk Unen Km 6 1709076202060001 081272722939 1
92 Hesti Vlorika 29-06-2006 Daspetah II 1708026906060003 081272722939 1
93 INDAH PUTRI GAYATRI 12-02-2003 PELANGKIAN 1708015202030003 081272722939 1
94 Iwan Saputra 25-07-2004 Daspetah II 1708022507040001 081272722939 1
95 LESTARIA 14-02-2005 Daspetah 1708025402050002 081272722939 1
96 LOUNDRI MASPELLA 30-07-2004 daspetah 1708027006040001 081272722939 1
97 M. ADRIL 04-02-2006 Jl. Raya Curup Kepahiang 1708020402060002 081272722939 1
98 M. Rizki Parenza 02-06-2006 Daspetah II 1708020206060002 081272722939 1
99 MARISA 08-09-2004 Daspetah II 1708024809040001 081272722939 1
100 OKTA SUGARA 27-09-2005 Daspetah II 1708022709050002 081272722939 1
101 SUCI RIZKI NORAMASARI 17-11-2002 DESA KEPAHIANG 1708040107030043 081272722939 1
102 Sulistia Ningsih 23-01-2004 Jl. Raya Curup Kepahiang 1708026310040001 081272722939 1
103 TANTO PRANATA 03-02-2004 Daspetah II 1708020302040002 081272722939 1
104 Titi Ayu Wandira 20-11-2002 Jl. Raya Curup Kepahiang 1708026011020005 081272722939 1
105 Tri Rahayu 30-01-2005 Daspetah 1708027001050002 081272722939 1
106 YULITA PUSPITASARI 30-12-2003 Plta Musi 1709087012030001 081272722939 1
107 NOVI KURNIAWAN 28-04-2005 Daspetah II 1708026804050002 081272722939 1
108 ELVI SAHARA 26-08-2004 UJAN MAS ATAS 1708026608040002 081272722939 1
109 EVI SUHENI TITI 07-0302003 PAGAR GUNUNG 1708044601040001 081272722939 1
110 ANI SAFITRI 10-07-1970 SURO BARU 1708021002700001 085266137594 1
111 SUKMAYATI 04-03-1970 DASPETAH 1708024403700005 082372910650 1
112 NELI NANAGKARA 01-07-1953 DASPETAH 1708020107530114 081367539251 1
113 SIDARIA 01-07-1956 DASPETAH 1708024107560034 082371093822 1
114 SUKINI 01-07-1973 DASPETAH 2 1708020107730265 085269806083 1
115 RETINA 13-09-2007 DASPETAH 1708021309070002 082372910650 1
116 ANDRI FELANI 17-04-1964 SURO LEMBAK 1708021704640005 085669613001 1
117 FIRDAUS 04-12-1980 DASPETAH 1708024412800003 081240761355 1
118 NOVIA SYLVIANI TAMPU 29-07-1976 DASPETAH 1708026907760003 081367539251 1
119 RATONO 27-03-1973 PUUNGGUK BERINGANG 1708022703730001 081240761355 1
120 MEYLINDA TRIMAYENI 26-01-1976 DASPETAH 1708026601760002 081367539251 1
121 DEDI HARJO 07-09-1986 UJAN MAS ATAS 1708054107890007 085609557036 1
122 CANDRA DEDI 03-07-1989 UJAN MAS ATAS 1708024307890001 081367539251 1
123 LILI 04-07-1995 UJAN MAS ATAS 1708024503990004 082282007401 1
124 FETI ARYASI 17-04-1987 UJAN MAS ATAS 3205091704870001 085357254445 1
125 SURYA 12-10-1979 UJAN MAS ATAS 1708025210790002 085669943169 1
126 SANDI 10-06-1986 SURO BARU 1708025006860006 085357521617 1
127 HAI RUMANI 11-11-1966 UJAN MAS ATAS 1708021111660001 081367539251 1
128 YURSILA WATI 03-10-1979 SURO BARU 1708024310790003 08117311487 1
129 YOSI SUSANTI 12-03-2000 UJAN MAS ATAS 1708025203990002 085809928023 1
130 SITTI SALEHA 27-08-2000 DASPETAH II 1708026708000001 0857790074 1
131 MARYATI 04-11-1991 SURO BARU 1708024411910003 082374660013 1
132 SUSMITA 17-01-1982 SURO BARU 1708025701820001 08316713405 1
133 UMAYA 14-10-1986 UJAN MAS ATAS 1708025410860001 085384642226 1
134 ELFI SUKAISIH 01-01-1977 UJAN MAS ATAS 1708024101770003 085709513539 1
135 SPINGKU BERJAYA 14-09-2000 UJAN MAS ATAS 1708025409000001 085709513537 1
136 PONIAH 13-05-1985 UJAN MAS ATAS 1708025305850002 082379480993 1
137 VIDELA OLIVIA 13-07-1990 SURO BARU 1708025307900002 082372388780 1
138 MUHADI 12-04-1983 SURO BARU 1708025204830005 081367539251 1
139 LETI NINGSIH 30-04-1959 UJAN MAS ATAS 1708027004590001 085892834366 1
140 YASMI ZONA 01-07-1970 UJAN MAS ATAS 1708024107700126 081367539251 1
141 DIANA MEILITA 08-10-1977 UJAN MAS ATAS 1708024810770003 089520380901 1
142 TIKA KARTIKA DEWI 01-07-1975 UJAN MAS ATAS 1708024107750135 085892834360 1
143 HENI ARIES 19-09-1985 SURO ILIR 1708025909850001 082373553720 1
144 HALIMA 09-12-1983 CURUP TENGAH 1702194912830001 081272722939 1
145 1 19-2-1986 SUNGAI SERUT 1771081902860003 1
146 TITI MARLENA 17-04-1980 PULOGETO 170805570480004 1
147 MARIANA 01-09-1979 SURO ILIR 1611020506730004 082373553720 1
148 SUPINA 03-11-1981 DASPETAH 1708021111810001 085279641980 1
149 LENI JAYA 08-03-1978 UJAN MAS ATAS 1708024803780005 082379480993 1
150 ZAINAL ABIDIN 08-11-1994 SURO BARU 1708024811940002 08153838066 1
151 GITA MARDIANA 01-07-1956 UJAN MAS ATAS 1708024107560036 081367539251 1
152 NADYA LAILA SARI 27-08-1994 UJAN MAS ATAS 1708022708940001 085273127449 1
153 MESI HARTATI 08-06-1997 UJAN MAS ATAS 1708020806690001 083172996378 1
154 HERUNA RESTIANI 20-04-1974 MERANTI JAYA 1708026004740001 085669613001 1
155 KA RAHMAN 13-01-1979 UJAN MAS ATAS 1708025301790001 081367539251 1
156 REGI HAMSYAH 06-06-1994 DASPETAH 1708044505950002 085273118796 1
157 NURHAYATI 11-03-1965 UJAN MAS ATAS 1708025103650001 081367539251 1
158 HAFDI YANTONI 04-08-1988 PUNGGUK BERINGANG 1708024408880001 0895636554026 1
159 RESA MARLENI 20-01-1988 PUNGGUK BERINGANG 1708025010880002 085384642226 1
160 VESTI MERINDA 01-07-1988 UJAN MAS ATAS 1708024107880080 085758010879 1
161 RIANTA YOHANES 17-11-1960 PUNGGUK BERINGANG 1708025711600002 081367539251 1
162 AYU SAFITRI 10-05-1979 SURO MUNCAR 1708025005790003 081367539251 1
163 SITI MARLIA 12-04-1983 SURO MUNCAR 1702185204830002 085709930024 1
164 PEPY DWI SANTA 04-03-2009 PEKALONGAN 1708024403090002 085709930024 1
165 FITRI WAHYUNI 14-08-1976 DASPETAH 1708021408760001 082376315457 1
166 IIN SULIANI 12-03-1986 BELUMAI 1708025203860005 081367539251 1
167 ELIS WIDIA 03-07-1982 SURI ILIR 1708024307820003 081375582999 1
168 PIKE ANITA 10-05-1992 SURO LEMBAK 1708025005920008 085758010879 1
169 AMRAN SYAFII 09-03-1990 SURO MUNCAR 1708024903900002 085758010879 1
170 INDRI YANI OKTAPIANO 03-03-1993 UJAN MAS BAWAH 1708024303930001 085758010879 1
171 NUR PAUSI 08-08-1973 UJAN MAS BAWAH 1771074808730003 082269436709 1
172 RIRIN HERLINDA 15-01-1982 SURO BARU 1708025501820002 1
173 MELTA ANJELINA 09-09-1995 DASPETAH 1708024909950001 085268407670 1
174 RATIH INDRAWATI 09-09-1995 UJAN MAS ATAS 1708024909950002 085268407670 1
175 LINDA PUTRI 09-12-1966 SURO BARU 1708024912660001 081367539251 1
176 TAMRIN 10-11-1984 SURO MUNCAR 1708025011840007 085839724361 1
177 MADE DESI HANDAYANI 26-01-1986 SURO BARU 1708026601860001 085839724361 1
178 SUHANA YUNITA 01-07-1984 DASPETAH II 1708024187840135 081367539251 1
179 NURYEM 02-03-1987 PUNGGUK BERINGANG 1708020203870002 085268407676 1
180 MIMI TRIANDARTI 03-07-1995 SURO LEMBAK 1708024307950002 085383634752 1
181 ERNAWATI 25-12-2000 UJAN MAS ATAS 1708026512010001 083176138605 1
182 PAINO 11-05-1993 UJAN MAS BAWAH 1708025105930002 081278761498 1
183 JAYANTI MURNI 01-07-1974 UJAN MAS BAWAH 1708020403750002 082280061611 1
184 DESI RAHAYU 02-02-1991 UJAN MAS BAWAH 1708020201910003 081278462409 1
185 RADIATAN 01-07-1978 UJAN MAS BAWAH 1708024512810002 082280061611 1
186 JONI 06-11-1972 SURO MUNCAR 1708020611720001 082377695469 1
187 SINTA SUSIANTI 17-06-1986 PUNGGUK BERINGANG 1708025706860001 085382723237 1
188 WISE PARTILA 26-12-2005 UJAN MAS BAWAH 1708026712040001 083802972457 1
189 YESI WIDIA SARI 11-04-2006 SURO MUNCAR 1708021204060001 085664939712 1
190 RAPINA 26-02-1999 UJAN MAS ATAS 1708026602990001 08281729057 1
191 SABARYATI 11-11-1994 SURO MUNCAR 1708025111940001 0838910481 1
192 ZAINUL RAHMAN 01-11-1974 UJAN MAS BAWAH 1708024111740002 082375197564 1
193 NURUL 01-02-1992 UJAN MAS BAWAH 1708024902920004 082155417571 1
194 ROLIAH 30-04-1997 SURO MUNCAR 1708056612980001 082297745730 1
195 ERMA DEWI 07-03-1992 SURO MUNCAR 1702074703920003 0812719930057 1
196 HETTI MARIATI 02-22-1990 UJAN MAS ATAS 1702094211900001 0857988378188 1
197 JULITA 25-02-1992 PUNGGUK BERINGANG 1708026502920001 083187163516 1
198 ANGGUN PUTRA GUNAW28-09-1971 SURO BARU 1708022809710001 082373387707 1
199 GUSTI SARTIKA 26-10-2003 SURO ILIR 1708026610030001 085789431826 1
200 LISA SUSYANTI 01-10-1977 UJAN MAS ATAS 1708024110770001 085709431826 1
201 EMI YATI 04-03-1997 SURO MUNCAR 1708024403970001 089560962074 1
202 ZELVI YOLANDA 27-07-2007 SURO MUNCAR 1708026707070001 082289105278 1
203 AYU MANDALA SARI 06-08-1993 UJAN MAS ATAS 1708024608910001 08583100928 1
204 INDAH SUMARNI 28-06-1982 DASPETAH 1708026806820003 085222075996 1
205 KASMIA WATI 04-02-19979 DASPETAH 1708020707820003 081367539251 1
206 RITA 22-12-1991 DASPETAH 2 1708026212910002 087808497622 1
207 ANI REKA PERA 10-01-1987 UJAN MAS ATAS 1708025001870003 082220945539 1
208 ROPIA 02-05-1994 DASPETAH 1708024205940001 081278962447 1
209 ANITA ANDRIANI 07-08-1964 TEBAT MONOK 1708024708640001 081367539251 1
210 WIDIYA 11-03-1986 SURO ILIR 1708025103860002 085788249759 1
211 NAZARWAN 14-11-1992 PACET 3204365411920002 081532565917 1
212 NICOLAS 20-04-1978 PUNGGUK BERINGANG 1708026004780001 085769916817 1
213 EWENG 18-07-1963 KEPAHIANG 1708021807630003 085273119278 1
214 MEZI PURWATI 05-11-1991 SURO LEMBAK 1708024511910002 0829171424919 1
215 RAHMI 08-07-1987 SURO LEMBAK 1708024808870002 0859171424919 1
216 ASWI NAINI 12-02-1976 SURO MUNCAR 1708021202760001 085839339175 1
217 YAHYA WATI 03-10-1996 DASPETAH 1708024310960001 085809644172 1
218 ROHANA 22-10-1991 SURO LEMBAK 1708026210880004 082175890162 1
219 SUARTI 06-07-1993 UJAN MAS BAWAH 1708024607930004 1
220 SRI SULATRI 01-07-1955 UJAN MAS BAWAH 1708024107550065 081367539251 1
221 KASNILA WATI 03-10-1970 UJAN MAS ATAS 1708024310700001 0859171528970 1
222 SUMRATUL AINI 29-12-1956 SURO LEMBAK 1708022912560003 081367539251 1
223 LISMAYANA 20-07-1958 UJAN MAS ATAS 1708024207580001 081367539251 1
224 JAUZIA RAHIM 10-07-1982 UJAN MAS ATAS 1708024807820001 081367539251 1
225 ELMI YATI 01-09-1988 UJAN MAS ATAS 170802410988001 081367539251 1
226 MARLIN APANDI 01-01-1978 UJAN MAS ATAS 1708024102740004 081367539251 1
227 HELMI NAHERA 01-07-1988 UJAN MAS ATAS 1708024107880001 082377425138 1
228 DEDI IRAWAN 17-11-2002 SUMBER HARTA 1708021711020001 082281463950 1
229 PERSI JUANDA 05-09-2001 UJAN MAS ATAS 1708024509010001 0895610018607 1
230 RANDI PRANATA 23-07-1989 UJAN MAS ATAS 1708026307890003 085783533180 1
231 ARENA SUSANTI 24-04-1975 UJAN MAS ATAS 1708026904750001 0895617065537 1
232 YOSI 27-07-2001 UJAN MAS ATAS 1708026707010001 0895617065537 1
233 JULFI SISWANTO 07-07-1994 PUNGGUK BERINGANG 1708024707940003 081367539251 1
234 ROHANA 30-04-1974 PUNGGUK BERINGANG 1708027004740001 081367539251 1
235 SUMINI 21-07-1975 UJAN MAS ATAS 1708025201740003 081367539251 1
236 SOPYAN EFFENDI 02-12-1970 CURUP TENGAH 170802412700002 082275361076 1
237 RAMON DANI 03-03-1978 UJAN MAS ATAS 1708024303780001 081367539251 1
238 SHEZA KARISMA 10-05-1975 DASPETAH 1708025005750006 081279664187 1
239 LEMIDING 01-05-2005 PUNGUK BERINGANG 1708020105050002 082183491139 1
240 NURYANTO SURO BARU 1
241 ONNA DASPETAH 1
242 NABILAH DASPETAH 1
243 SAIFUL BASIR DASPETAH 1
244 SAMSINA DASPETAH 1
245 RODI HARTONO DASPETAH 2 1
246 AFRSA DIYO LANDA DASPETAH 1
247 NANSI DASPETAH 1
248 USMAN JUNAIDI DASPETAH 1
249 M DEWO DASPETAH 1
250 RENI DASPETAH 1
251 RELIANA DASPETAH 1
252 DEKI ALIANSYAH UJAN MAS BAWAH 1
253 YANTI DASPETAH 1
254 FAUZIAH DASPETAH 1
255 FERA SUSANTI UJAN MAS ATAS 1
256 MUHAMMAD JOHARI PUNGGUK BERINGANG 1
257 USMAN JUNAIDI SURO LEMBAK 1
258 HERTA UJAN MAS BAWAH 1
259 SARWANI SURO LEMBAK 1
260 RUSLI EFFENDI UJAN MAS ATAS 1
261 PUTRI SORAYA UJAN MAS ATAS 1
262 ETI SUSANTI UJAN MAS ATAS 1
263 AHMAD HENDRA UJAN MAS ATAS 1
264 SAINUDIN 10-02-1959 UJAN MAS ATAS 1
265 MUDA 12-12-1976 DASPETAH 1
266 WISDA UJAN MAS ATAS 1
267 LENI ANITA DASPETAH 1
268 INDRI MASPELA DASPETAH 1
269 HELMI JUWITA SURO BARU 1
270 SAINURI UJAN MAS ATAS 1
271 RATNA JUITA SURO BARU 1
272 PIPIN RISKI UJAN MAS ATAS 1
273 JULIA HATI UJAN MAS ATAS 1
274 EVI JULITA UJAN MAS ATAS 1
275 YULIANA UJAN MAS ATAS 1
276 RHEIZA AFRIANTO 25-04-2003 UJAN MAS ATAS 1
277 HEDI DIANA 19-01-1992 UJN MAS ATAS 1
278 YOSI ERMALENA 20-06-1988 TEBAT MONOK 1
279 ERWIN HERMAWAN 06-05-1986 CURUP 1
280 RENDI DASPETAH 2 1
281 SITI NURBAYA 16-04-1984 UJAN MAS ATAS 1
282 JUSMA UJAN MAS ATAS 1
283 ARPANDI 01-07-1965 SURO BARU 1
284 YUYUN PAGAR GUNUNG 1
285 LINDA PUSPITASARI SURO LEMBAK 1
286 RATNA SURO BARU 1
287 NELA NIASARI PULOGETO 1
288 KURNIAWATI UJAN MAS ATAS 1
289 FITRIA FIRMAN CURUP 1
290 ERNA YUNIARTI UJAN MAS ATAS 1
291 BOBI UTOMO SURO BARU 1
292 EKA SUSIANTI UJAN MAS ATAS 1
293 SULIS DASPETAH 1
294 RENA SAHARA SURO MUNCAR 1
295 ROMLAH SURO BARU 1
296 USTIA UJAN MAS BAWAH 1
297 TITIN MARLENI SURO LEMBAK 1
298 YESI PANCA RITA UJAN MAS ATAS 1
299 YETA MAHERNA UJAN MAS ATAS 1
300 KHAIRIL FIKRI DASPETAH 1
301 DEWI UJAN MAS ATAS 1
302 JAILANI SURO BARU 1
303 SAIBUL UJAN MAS ATAS 1
304 ERWINDA MENTARI UJAN MAS ATAS 1
305 RENI UJAN MAS ATAS 1
306 DESI HERLISA PUNGGUK BERINGANG 1
307 KARMILA PUNGGUK BERINGANG 1
308 HERAWATI SURO BARU 1
309 ELIYA UJAN MAS ATAS 1
310 KASMABOTI DASPETAH 1 1
3 1 141 4 111 0 0 22 0 0 1 0 16 1 0 1 8 1
JUMLAH
260 22 18 10
FK6858
202108165i

NO NAMA TGL LAHIR ALAMAT

1 KASMABOTI DASPETAH
2 LEKA SUSIANA 9/30/1984 DASPETAH
3 RIFALDO PUTRA ANUGRAH 6/5/2008 DASPETAH
4 ELIZA DASPETAH
5 RINTA RINDA 1/3/1980 DASPETAH
6 HEDI DIANA 7/1/1990 DASPETAH
7 NURANI 5/10/1969 DASPETAH
8 INDRA WANI 9/12/1951 DASPETAH
9 SUBIHANI 10/20/1950 DASPETAH
10 DAYA MURNI 8/20/1976 DASPETAH
11 TUTI KARNELI 12/12/1984 DASPETAH
12 NUR AZIZA DASPETAH
13 MARIANA DASPETAH
14 LAILATUL ASMA DASPETAH
15 ANITA TRIYANA 7/4/1975 DASPETAH
16 LILI ZAIZAL 5/5/1973 DASPETAH
17 KARTIKA WATI 9/7/1977 DASPETAH
18 MALNA 6/3/1954 DASPETAH
19 TUTI CAHAYA 6/5/1975 DASPETAH
20 HERMANSYAH 5/22/1955 DASPETAH
21 SELVI TIANA ROSA 2/18/2001 DASPETAH
22 LENA 7/7/1978 DASPETAH
23 HERIANA 3/20/1966 DASPETAH
24 DESI RATNA SARI 12/12/1996 DASPETAH
25 A. MUIS 5/1/1952 DASPETAH
26 ROHANI 6/14/1976 DASPETAH
27 NINI 10/15/1982 DASPETAH
28 MALIA WATI 1/1/1986 DASPETAH
29 WANI DALELA 1/1/1974 DASPETAH
30 ANDAYONI 4/12/1990 DASPETAH
31 WIDIA WATI 3/7/1979 DASPETAH
32 FRESI SUSANTI 8/18/2004 DASPETAH
33 STEPANI 5/22/2004 DASPETAH
34 TRI ANITA 7/5/1977 DASPETAH
35 HELMIA 7/20/1980 DASPETAH
36 STEBI SUPRIYANTI 11/9/2006 DASPETAH
37 YULISAR SUPIANTI 7/25/1969 DASPETAH
38 MURI 7/1/1955 DASPETAH
39 DARMIANA 1/1/1986 DASPETAH
40 HELEN SISKA METARIA 8/21/2007 DASPETAH
41 REKA RISMA 4/12/2008 DASPETAH
42 FITRIA MARETI 3/3/1999 DASPETAH
43 METRO SUHARDI 7/7/1998 CURUP UTARA
44 SUDIRMAN 7/15/1958 DASPETAH
45 SUDARMAN 3/2/1976 DASPETAH
46 MILHANA 7/19/1968 DASPETAH
47 DOSI ARYANTI 11/25/1989 DASPETAH
48 MULIYA 1/21/1964 DASPETAH
49 MARLENA BAITI 2/20/1979 DASPETAH
50 PAREDA 10/1/1978 DASPETAH
RIKI 51 VERA KRISTIANA 5/12/1979 DASPETAH
52 LINDA SUPRIANTI 8/12/1989 DASPETAH
53 HABIBA 11/8/1962 DASPETAH
54 MARMINA 7/1/1961 DASPETAH
55 SADARIA 8/18/1958 DASPETAH
56 FENI ANITA 4/13/1987 DASPETAH
57 HERMAN TODI 4/30/1970 DASPETAH
58 RINI PUSPITA SARI 8/2/1974 DASPETAH
59 ASMAWI 3/15/1965 DASPETAH
60 REKA SURYANI 5/4/1983 DASPETAH
61 JALALUDIN 5/10/1959 DASPETAH
62 TITI SUMARNI 12/3/1976 DASPETAH
63 MUKLIS 12/20/1966 DASPETAH
64 SUMARLIN JAYA 8/10/1984 DASPETAH
65 NAINI WARNA 12/10/1966 DASPETAH
66 ERNAWATI 7/1/1968 DASPETAH
67 JUMAN 4/17/1965 DASPETAH
68 LAMIA 4/9/1985 DASPETAH
69 UPIK MARYATI 7/9/1967 DASPETAH
70 DARWIS HAMZAH 2/13/1971 DASPETAH
71 PALEL 4/21/1974 DASPETAH
72 SAMSIDAR YATI 7/17/1956 DASPETAH
73 ERYUDANILA 7/25/1963 DASPETAH
74 INUN JARIA 2/2/1964 DASPETAH
75 MARSEL STEVEN 7/25/2007 DASPETAH
76 SRI HARTATI 5/15/1991 DASPETAH
77 SUMIATI 6/28/1970 PG BERINGANG
78 LISWAN 2/10/1970 DASPETAH
79 SLAMAINA 7/15/1944 DASPETAH
80 VIVI KUSTILAWATI 11/10/1990 DASPETAH
81 HENDRI WIJAYA 7/10/1973 DASPETAH
82 ISKANDAR 7/1/1948 DASPETAH
83 NOVA SUGIYARTO 12/1/1987 DASPETAH
84 ANGGUN MARTIA SARI 3/22/1990 DASPETAH
85 HAMDA 4/7/1975 DASPETAH
86 POPI 2/10/1990 DASPETAH
87 DODI ARIANTO 5/30/1994 DASPETAH
88 AMINA 9/20/1970 DASPETAH
89 MARLENA 4/2/1986 DASPETAH
90 ERNI HAYATI 6/21/1970 DASPETAH
91 DEDI ROMANSA SUMANDI 6/7/1996 DASPETAH
92 LINDA PUTRI 11/4/1984 DASPETAH
93 SUKIR 7/1/1968 DASPETAH
94 NENGSI MEILAN 2/9/1998 DASPETAH
95 ELLY SUPRIYANTI 12/1/1960 DASPETAH
96 HERMANSYAH 2/1/1954 DASPETAH
97 MENI ENJELINA 9/20/2002 DASPETAH
98 AMIR HAMZAH 5/10/1960 DASPETAH
99 CAHAYA MURNI 7/10/1966 DASPETAH
100 PATIMA DAYOT 11/11/1960 DASPETAH
REKA 101 ZAINAL APANDI 1/1/1968 DASPETAH
102 BUKHORI 9/1/1970 DASPETAH
103 LIS MULYANA 7/16/1977 DASPETAH
104 MAHDALENA 8/10/1976 DASPETAH
105 HERMAWATI 7/1/1960 DASPETAH
106 YENNI 12/25/1983 DASPETAH
107 SYAHRIAL 12/10/1974 DASPETAH
108 DEDI DARMADI 6/23/1981 DASPETAH
109 ASMAWATI 4/22/1967 DASPETAH
110 NURUL SUHAIMI 7/15/1984 DASPETAH
111 MEDI PRANATA 5/2/1993 DASPETAH
112 DEVI NOVASARI 10/2/1988 DASPETAH
113 MARZUKI 4/21/1965 DASPETAH
114 MADE YULIANA 2/1/1989 DASPETAH
115 RISNAWATI 7/12/1983 DASPETAH
116 SARIPUL 5/4/1981 DASPETAH
117 RIAN IMELDA 10/11/1987 DASPETAH
118 YUSLAIMA 12/12/1962 DASPETAH
119 SUKARMI 10/15/1984 DASPETAH
120 RAHINI 11/12/1977 DASPETAH
121 YOVI INDAH LESTARI 11/8/1997 DASPETAH
122 SISKA MAYA SARI 5/8/1992 DASPETAH
123 DEVI LESTARI 7/14/1998 DASPETAH
124 AMIR MARDANI 1/24/1995 DASPETAH
125 ISMAEL 11/10/1953 DASPETAH
REMAJA MENIKAH 126 DINI PUTRI ROSA 9/20/2005 DASPETAH
127 EPI SUPRIYA 3/4/1983 DASPETAH
128 ENA KURNIANTI 2/4/1983 DASPETAH
129 RINDU HATI 3/20/1961 DASPETAH
130 RIS MAINI 2/28/1979 DASPETAH
131 WIMBI CITRA LESTARI 1/22/2002 DASPETAH
132 UMI AMINA 5/7/1948 DASPETAH
133 MARIANA 4/20/1973 DASPETAH
134 KARNILAWATI 7/13/1974 DASPETAH
135 RAMIA SUSILAWATI 7/1/1982 DASPETAH
136 KURNIA 10/15/1973 DASPETAH
137 DAMIRI 3/10/1958 DASPETAH
138 REVI 2/24/1991 DASPETAH
139 DEVI DIANA 12/10/1984 DASPETAH
140 SINAR WANI 10/28/1968 DASPETAH
141 HADIJAH MULYATI 8/7/1970 DASPETAH
142 SINARYA 4/10/1972 DASPETAH
143 SALAMIA 5/10/1958 DASPETAH
144 SUAI'BA 1/12/1957 DASPETAH
145 SAROJA SAPITRI 1/26/1998 DASPETAH
146 SARNEDI 3/15/1971 DASPETAH
147 RAHINI 6/10/2021 DASPETAH
148 EDI YANSAH 1/1/1954 DASPETAH
149 SARIFA AINI 6/5/1977 DASPETAH
150 DARMAWAN 8/26/1969 DASPETAH
151 WILDA ARMELLIA 4/7/1999 DASPETAH
152 SAPAR GINTA 10/17/1968 DASPETAH
153 SUCI 8/7/1972 DASPETAH
154 KARTINI 11/12/1964 DASPETAH
155 WINATA 12/12/1955 DASPETAH
156 SAMSINA 1/10/1963 DASPETAH
157 DEWI INDRAWATI 5/4/1977 DASPETAH
158 CONEDI 1/12/1970 DASPETAH
159 NABILA RAHMAWATI 10/6/2005 DASPETAH
160 MULYADI 5/5/1977 DASPETAH
161 ANNA ARYANTI 12/11/1985 DASPETAH
162 TITIN SUMARNI 2/4/1987 DASPETAH
163 AMRI 5/10/1963 DASPETAH
164 GUNTUR ALAM 5/20/1969 DASPETAH
165 NURBAISA 10/15/1944 DASPETAH
166 NYA 1/21/1969 DASPETAH
167 IDAMAN HATI 6/20/1973 DASPETAH
168 ECI SOPIA NENGSI 11/24/2000 DASPETAH
169 GUSTI ARIANTO 8/20/1987 DASPETAH
170 JUSMA WATI 8/5/1976 DASPETAH
171 RIZKI ARYANTI 4/22/2003 DASPETAH
172 PAJARINA 2/17/1963 DASPETAH
173 YANTI 7/1/1987 DASPETAH
174 LINDA 12/12/1991 DASPETAH
175 UBAT ATI 5/10/1966 DASPETAH
176 RISTA LIAN SARI 10/22/1995 DASPETAH
177 LIZA ARMIKA 5/19/1996 DASPETAH
178 SUSILAWATI 4/14/1982 DASPETAH
179 HERI YANTO 7/6/1967 DASPETAH
180 ILIS SUNARTI 4/11/1970 DASPETAH
181 ROSI YANTI 4/12/1986 DASPETAH
182 YAHYA 10/5/1942 DASPETAH
183 TATI HERAWATI 1/7/1971 DASPETAH
184 AISYAH 7/1/1955 DASPETAH
185 LILI SURYANI 10/21/1968 DASPETAH
186 RODI ASWAR 2/1/1975 DASPETAH
187 BAHERAN MUSLIM 11/20/1968 DASPETAH
188 KANJENG RANA DEWI 7/7/1996 DASPETAH
189 ALI USMAN 3/5/1966 DASPETAH
190 LENI MARLENA 7/11/1990 DASPETAH
191 SUMI SUSANTI 11/20/1971 DASPETAH
192 MARDIANA 12/11/1981 DASPETAH
193 NURHARTONO 12/12/1964 DASPETAH
194 ASMAWI 7/1/1969 DASPETAH
195 IBNU HASIM 7/1/1953 DASPETAH
196 SOPIAN 8/7/1975 DASPETAH
197 SUNARYO 9/6/1970 DASPETAH
198 NURHAYATI 9/20/1974 DASPETAH
199 TABRI 10/2/1971 DASPETAH
200 LETI SERIYANI 3/12/1994 DASPETAH
201 MARSI KUSMIATI 3/22/1990 DASPETAH
202 BUSTAMIN 10/15/1975 DASPETAH
203 IWAH NIHA 7/1/1960 DASPETAH
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
JUMLAH

TUNDA 1 EVI 8/12/1973 DASPETAH


TUNDA 6 RITA HERANI 8/6/1994 DASPETAH
51 MARSI KUSMIATI 3/22/1990 DASPETAH
65 BUSTAMIN 10/15/1975 DASPETAH
144 IWAH NIHA 7/1/1960 DASPETAH
TUNDA 152 TITIN SUMARNI 9/28/1976 DASPETAH
202 AMINA 5/12/1978 DASPETAH
203 RAMSAH 11/25/1952 DASPETAH
TUNDA 208 TURI ASIA 10/25/1976 DASPETAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
01 NOVEMBER 2021

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK
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M.UMUM

DOSIS 2
PENDIDIK

REMAJA

1
1
1
1
LANSIA

PUBLIK

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DOSIS 1

M.UMUM

PENDIDIK
PFIZER

LANSIA

PUBLIK
DOSIS 2

M.UMUM

PENDIDIK
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1

1
1
1

1
1

1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1

1
1

1
1
1
1
1

1
1
1
1
1
1
1

1
1

1
1
1

1
1
10 0 0 19 0 140 0 0 0 0 0
13 159 0

310

1
1
1
1
1
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
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PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH

0
0
0
0
0
0
0
0
0
0
0
FK6858 UPT P
20210816

NO NAMA TGL LAHIR ALAMAT

1 PIK SUMARNO 3/19/1988 PUNGGUK BERINGA


2 TITIN 6/15/1986
3 SARDI ARYANDA 6/25/1990
4 RESI ARYA 8/12/1987
5 TODI 11/25/1981
6 KARTINI 6/8/1989
7 SUKMA 5/12/1965
8 ROS MADALENA 10/25/1977
9 LISA NOPITASARI 12/6/1987
10 AZWAR 4/30/1970
11 ROPI ANDESTA 3/24/1995
12 BUYUNG KANEDI 21-8-77
13 KRISTIAN HADI NATA 5/5/1985
14 HAJUN MUSLI 6/5/1984
15 MULA WARMAN 10/14/1976
16 REKO ANDI SAPUTRA 5/3/1990
17 FITRIAN ELIZA 5/10/1983
18 EVA EFRIANTI 10/5/1972
19 RAMYATUL ASMANI 11/16/1971
20 UMI ASMA 11/20/1956
21 WINDA LESTARI 1/6/2003
22 LENTI SANIA 12/29/1971
23 RUMSIANA 2/10/1978
24 MARLIN 2/11/1985
25 HELMI EKAWATI 11/24/1987
26 RADIA YOT 9/20/1971
27 KASMAWANENGSI 8/1/1972
28 UCI INDARTI 11/15/1990
29 YESI HARYANTI 8/8/1994
30 ARYANTI 12/15/1984
31 MARIANA ASTUTI 5/23/1991
32 EDI SATIJO 8/17/1970
33 JAGOK SAPUTRA 12/6/2001
34 PIAK 3/9/1960
35 HESTI PRANSISCA 4/22/1989
36 YOGA GUNTARA 6/16/2003
37 SURYA 5/10/1972
38 LESTARI 9/2/1979
39 CHINDY LALA 1/20/2002
40 DARWIN JAYA 3/4/1978
41 REPA LOKA 12/1/2007
42 INDA 10/10/2007
43 RAPIT 5/10/1974
44 SUNARTI 1/5/1977
45 MAL 7/1/1962
46 ARSI 9/10/1998
47 BAMBANG S 8/29/2003
48 SUNU BANA 10/11/1938
RIKI 49 IMRON SUPRIANTO 6/17/1982
50 PARIDA SUSANTI 3/26/1986
51 DARWIN ISKANDAR 1/1/1988
52 SARTIKA 9/16/1993
53 RADIUS FRAYOTI 2/10/1996
54 DEVI DIANA 12/29/1991
55 ANI PUTRI ANITA 11/11/1990
56 SUTAN 12/17/1991
57 LISA 8/11/1990
58 BAHTIAR 7/25/1976
59 NOVELIA 10/15/1998
60 SUSILAWATI 7/6/1980
61 MUSTAPA 4/20/1955
62 JALALUDIN 7/1/1958
63 HERLIS ASI YANTI 2/5/1991
64 KARPIN 11/12/1982
65 SALMINA 12/18/1977
66 LAILATUL JANNA 1/13/1991
67 NETI 8/5/1980
68 DESI GUNAWAN 12/14/1983
69 NURANI 1/1/1984
70 TOMI 2/10/1990
71 YOGI PRANATA 5/31/2000
72 MANTU 3/29/1984
73 RALASATI 10/10/2000
74 RUI HASINAH 5/5/1955
75 LINA MUSMANI 7/27/1988
76 SUNIAR BAITA 12/15/1967
BELUM D 77 JULIO F 7/10/1997
78 CAROLINA S 10/5/2001
79 ALPIAN SISWANTO 6/23/1979
80 SIKE PARA DEPA 10/3/1998
81 RISKA AZISTA 1/2/2000
82 EGI SISGIARDI 1/2/1991
83 REZA NOVITA 1/30/1997
84 REVI ARYANTO 5/1/2000
85 PUTRI SELVI 4/2/2000
86 ESNI PERAWATI 6/30/1995
87 ADOT 7/1/1943
88 BUDIMAN PRANATA 7/1/1992
89 SAIDIL BAHRI 6/27/1962
90 RISKA HELMINA 12/10/1986
91 REKA SUKAISI 12/1/1983
92 DARVIN 5/12/1984
93 EVA 2/24/1985
94 AL HIJAR 11/29/1990
95 RIZAL EFENDI 5/15/1989
96 LESTI MARDIANA 2/1/2000
REKA 97 YOSI ANA 2/6/1989
98 NOVA SUSANTI 5/25/1978
99 RISNA SUSANTI 11/10/1990
100 TITIN HAYANTI 1/1/1990
101 DESI SUSANTI 5/14/1983
102 DESI 1/28/1991
103 GITA ANDRIANI 4/12/1994
104 RENO INDARSO 6/13/1994
105 NORMA YUNITA 9/10/1990
106 JONI HERMANSA 1/1/1979
107 FARUK ALFERO 5/5/1992
108 RIYA APRIDA 4/18/1997
109 DEPA BLIZINZKI 12/22/1995
110 RONA PRAMUDIKA 8/28/2004
111 JENDI KRISTIANI 10/29/1983
112 SAMSUL BAHRI 9/9/2000
113 DIANA MARYANA 8/4/1987
114 SISI ARYANI 12/11/1998
115 ENI LESTARI 7/20/1980
116 SIGEN 9/2/2008
117 RUSMAN TAJUDIN 12/15/1975
118 RATNI 2/11/1982
119 MEGAWATI 6/20/1983
120 SRI NOVITA SARI 3/1/1991
REMAJA 121 YOKA TAMPATI 12/2/1994
122 IWAN SWANDI 9/9/1997
123 DARMAWANSYAH 6/16/1986
124 MALIK 8/4/1995
125 JONI BAROKAH 6/11/1994
126 YULIA 4/10/1997
127 REDO 6/17/1984
128 SRI HARTATI 11/4/1973
129 ELVI HARTATI 7/27/1979
130 HAIRUL AMSA 7/16/1985
131 HENDRI 7/9/1986
132 ERI SUSANTO 7/17/1975
133 PERI ARIANTO 10/29/1989
134 TOPO ARIANTOSI 10/17/1990
135 BAMBANG KARTODI 8/8/1975
136 ARAFIK SUSIANTONI 5/4/1983
137 RAK INTAN ANISA 4/1/2009
138 SAHERA 2/12/1960
139 MUHAMMAD RIZAL ARIFI 3/4/1995
140 MUHAMMAD SANUSI 11/23/1978
141 IBNU HOLIK 5/25/1968
142 LUKMAN SAHDI 9/16/1972
143 BUDIONO 3/17/1980
144 KARTAWIJAYA 11/7/1973
145 AMINA 12/9/1971
146 REPI ARYANTI 9/9/2000
147 MANSIR 12/5/1984
148 RANDI PRANATA 5/19/1994
149 SOPIAN SANUSI 5/8/1982
150 ANDES PUTRA 3/13/1989
151 LISMAN 12/18/1951
152 RANTI SELVIANA 8/5/1999
153 ROSI 3/9/1988
154 RAMA DANI 12/12/1982
155 AMIR HAMZA 4/2/1979
156 E. ZAMZAMI 9/3/1983
157 ARPAN 10/18/1991
158 PAIDI 6/15/1963
159 HIKMATUN
166 SUSI 5/25/1985
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
JUMLAH

TUNDA 20 MILA ASWI 7/12/1976


67 SUSI 5/25/1985
114 AMINA 5/12/1978
TUNDA 132 LELA 9/7/1968
TUNDA 55 SINAR HAYATI 11/10/1963
34 RATNA WATI 5/20/1959
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
02 NOVEMBER 2021

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK
1708021903880001 085384827643
1708025506860001 081367539251
1708042505900006 082177210141
1708025208870004 081367539251
1708022511810001 085383877603
1708024806890001 081367539251
1708025205650001 081367539251 1
1708026510770002 081367539251
1708024612870001 081367539251 1
1708020711710002 085267079702 1
1708012403950002 081271303585
1708022108770005 085369044056
1708020505850007 085789125783
1708020506840001
1708021410760001 081276625602 1
1708020305900003 085709127475
1708025005830002
1708024510720003 085269898608
1708025611710001 085243241965
1708026011560001 085384932720 1
1708024601030001 082278246590 1
1708026912710001 085664758674 1
1708025002780005 081272187357
1708025102850001 082376840787 1
1708026411870001 081367539251 1
1708026009710002 081367539251
1708024906730003 085664949415 1
1708025511900001 085841575928
1708024808940002 081367539251
1708025512840001 081367539251 1
1708026305910002 082371602333
1708021708700004 081271351913
1708022109000001 081367539251
1708024903600001 081367539251
1708026204890001 082178968588 1
1708021606030001 081367539251
1708021505720001 082175342259 1
1708024107770095 081367539251 1
1708026001020001 081367746803 1
1708020403780001 081367539251 1
1708024112070001 081367539251 1
1708025010070004 082376840787 1
1708021005740001 082282597207 1
1708026907760001 081367539251 1
1708024107620001 081367539251 1
1708025009840004 081367539251 1
1708020604040004 083182438740 1
1708025110380001 081367539251 1
1708021706820003 081367539251 1
1708026602860001 081367539251 1
1708050101880002 081333501504 1
1708045609930002 081372996458 1
1708021002960001 081367539251 1
1708026912910001 081367539251 1
1708025111900001 085709152685 1
1708021712900001 085669433261 1
1708025108900001 085788186210 1
1708022507760001 1
1708025510980002 082377565443 1
1708024607800003 085384288319 1
1708022004550001 082317171850 1
1708020107580140 081367539251 1
1708024502910001 085783501891 1
1708021211820001 081272625630 1
1708025812770001 081367539251 1
1708025301910002 081367539251 1
1708024508800006 085664757926 1
1708021412830002 082374402069 1
1708024101840006 082374402069 1
1708023011800001 082376840923 1
1708023105000002 081367539251 1
1708023011800001 082376840923 1
1708025010000005 1
1708024505550002 081367539251 1
1708046707880007 081367539251 1
1708027006680001 081367539251 1
1708022008980001 08578864478 1
1708024510010001 082377965016 1
1708022308790001 082289822385 1
1708024310980003 081367539251 1
1702184201000002 081367539251 1
1708021201910003 082182051740 1
1708027001970001 081367539251 1
1708020105000003 081367539251 1
1708024204000003 081367539251 1
1708027006950005 081367539251 1
1708020107430002 081367539251 1
1708020107920059 081274321134 1
1708022706620001 081367539251 1
1708025412860001 082307663765 1
1708025412860001 082307663765 1
1708021205840002 082312171858 1
1708036402850002 082375361599 1
1708022911900002 081367539251 1
1708021505890002 082281178028 1
1708024102000002 085839209227 1
1708024401890001 081367539251 1
1708026505780006 085609427566 1
1708025011900003 085766869332 1
1708024101910001 082376308611 1
1708026606830001 081367539251 1
1708026801910001 085768359445 1
1708025204920002 1
1708020101940002 081367539251 1
1708025009900002 081367539251 1
1708020101790011 085268752663 1
1708020505920002 085764426303 1
1708045804970001 085788856299 1
1708026212950001 1
1708022808040001 1
1708022910930001 082184170188 1
1708020909000002 081367539251 1
1708024408870001 081367539251 1
1708025112980001 08579658568 1
1708025712800001 081632238554 1
1708020209080001 081367539251 1
1708021512750003 081272187357 1
1708025102820001 081367539251 1
1708026006820001 081367539251 1
1708024103910003 1
1708040112940001 1
1708020909970008 1
1708021606860002 1
1708021606860002 1
1708021904940001 1
1708025004970001 1
1708021706840002 1
1708024411730002 081367539251 1
1708026707790002 081369204783 1
1708021607850001 1
1708020907860001 1
1708021707750003 081367539251 1
1708022010890002 081367539251 1
1708021710900001 081367539251 1
1708020808760001 081367539251 1
1708020405830001 081367539251 1
1708024104090001 081367539251 1
1708025202600001 081367539251 1
1702180403950001 081367539251 1
1708022311780001 081367539251
1708022505680001 081367539251 1
1708021609720002 081367539251 1
1708021004840001 081367539251 1
1708020711730001 081367539251 1
1708024912710002 081367539251 1
1708014909000002 081367539251 1
1708020512840001 081367539251 1
1708020503960001 081367539251 1
1708020805820003 081367539251 1
1708021303890001 081367539251 1
1708021812510001 081367539251 1
1708014508990001 081367539251 1
1708024903880002 081367539251 1
1708022510820002 081367539251 1
1708020204780002 081367539251 1
1708022706830001 1
1708021810880001 081367539251 1
1708021506530001 081367539251 1

1708026505850005 081367539251 1
10 0 116 0 6 2 0 0
134 2
160

PB 10 0 116 0 6 2 0 0
PUSKES 2 0 84 2 3
UMB 26 86 0 4 1 0
38 0 286 2 13 2 1 0
341 7
1708025207760001 081367539251
1708026505850005 081367539251
1708025205780007
1708024709680003
1708025011630001 081367539251 1
1708027005590001 081367539251
M.UMUM

DOSIS 2
PENDIDIK

REMAJA

LANSIA

PUBLIK

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DOSIS 1

M.UMUM

PENDIDIK
PFIZER

LANSIA

PUBLIK
DOSIS 2

M.UMUM

PENDIDIK
1

1
2 0 0 0 0 24 0 0 0 0 0
2 24 0

310
2 0 0 0 0 24 0
4
0 0 0 0 0 0 0
6 0 0 0 0 24 0 372
24 174 348
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH

0
0
0
0
0
0
0
0
0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
03 NOVEMBER 2021

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM
HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
1 MURIANA 7/1/1956 SURO ILIR 1708024107560045 081367539251 1
2 ULIA 7/1/1968 SURO ILIR 1708024107680233 081367539251 1
3 TINTIN SUMARNI 3/23/1997 SURO ILIR 1708026303970001 085840936204 1
4 RITA SURYANI 1/1/1983 SURO ILIR 1708024101830006 081367539251 1
5 ASRIL 4/21/1956 SURO ILIR 1708022104560001 081367539251 1
6 JUMSUSI 1/7/1978 SURO ILIR 1708024701780002 1
7 MAHARANI NOPITASARI 12/25/1999 SURO ILIR 1771016512990002 1
8 RUSDI ISKANDAR DINATA 11/8/1975 SURO ILIR 1708022111950002 1
9 JUMIA LAILI 6/3/1976 SURO ILIR 1708024306760001 1
10 MIRNAWATI 7/16/1990 SURO ILIR 1708025607900002 1
11 DESI MARYANI 2/10/1987 SURO ILIR 1708025002870001 1
12 YULISTRI 8/30/1983 SURO ILIR 1708027008830001 1
13 ILI MURNI 2/10/1969 SURO ILIR 1708025002690003 1
14 PUTRIANA 12/12/1972 SURO ILIR 1708025212720006 1
15 NURHAYATI 2/15/1959 SURO ILIR 1708025502590001 1
16 AMIR AMSA 4/3/1960 SURO ILIR 1708020403600001 1
17 IDA ROYANI 10/7/1985 SURO ILIR 1708024710850003 1
18 M. SIDIK 7/1/1962 SURO ILIR 1708020107620072 1
19 ASMAWATI 4/22/1979 SURO ILIR 1708026204790001 1
20 SISMASANTI 10/4/1986 SURO ILIR 1708024604820003 1
21 AHMAD WIRA WIJAYA 11/12/1986 SURO ILIR 1708020207850001 1
22 PESI HERILISA 5/18/1991 SURO ILIR 1708025805810001 1
23 ETI SUMARNI 7/26/1980 SURO ILIR 1708026607800001 1
24 KAMISAH 3/7/1985 SURO ILIR 1708024703850001 1
25 SURYATI 7/1/1967 SURO ILIR 1708054107670014 081367539251 1
26 HARYONO 3/12/1989 SURO ILIR 1708021203890002 083172844763 1
27 TITI RISKI 2/10/1999 SURO ILIR 1708025002990004 081367539251 1
28 ELI SURYANI 6/12/1975 SURO ILIR 1708025206750002 081367539251 1
29 RIA ANJELINA 6/8/1991 SURO ILIR 1708024806910002 081367539251 1
30 SELVI SULISTIA NENGSI 7/6/2000 SURO ILIR 1708024607020002 083163820171 1
31 MISRIWATI 8/7/1965 SURO ILIR 1708024708650006 081367539251 1
32 SITI YANI 7/5/1975 SURO ILIR 1708024507750005 081367539251 1
33 KARMILA WATI 8/10/1975 SURO ILIR 1708025808750001 081367539251 1
34 RANI 11/18/2002 SURO ILIR 1708025811020001 085789127670 1
35 BAITI 4/5/1983 SURO ILIR 1708024504830004 081367539251 1
36 DARIA 6/10/1969 SURO ILIR 1708025006690005 081367539251 1
37 ELYANA 4/10/1995 SURO ILIR 1708025004950001 081367539251 1
38 DORA KIKI HARYANTI 7/25/1991 SURO ILIR 1708026507910003 081367539251 1
39 KIKI PUSPITA SARI 4/9/1991 SURO ILIR 1702114904910002 081367539251 1
40 ASWAN SUDIRMAN 7/16/1972 SURO ILIR 1708021607720001 085874005438 1
41 DANAR YOHANES PUTRA 1/31/1994 SURO ILIR 1708023101940001 0895344251047 1
42 BETI SORAYA 12/5/1996 SURO ILIR 1708024512960002 085789114604 1
43 LILI SUMARNI 3/10/1970 SURO ILIR 1708025003700008 081367539251 1
44 YATI 5/10/1975 SURO ILIR 1708024510750001 089530288178 1
45 DILUSNAWATI 8/1/1970 SURO ILIR 1708024108700001 081367539251 1
46 MEROSI 5/15/1989 SURO ILIR 1708021505890004 082387331027 1
47 JUNIARTI 6/3/1990 SURO ILIR 1708024306900001 089524208310 1
48 SABANDI 8/7/1981 SURO ILIR 1708020708810002 082177989696 1
49 SAIDIL MAKMUR 4/5/1960 SURO ILIR 1708020504600001 081367539251 1
50 TARMIN 3/9/1972 SURO ILIR 1702180903720002 085788061981 1
51 SANIA 6/11/1964 SURO ILIR 1708025106640001 081367539251 1
52 SUHERNI 4/17/1981 SURO ILIR 1702185704810001 085788061981 1
53 SULASMI 11/10/1958 SURO ILIR 1702095011580002 081367539251 1
54 ERI KARSIH 6/12/1953 SURO ILIR 1708025206530002 081367539251 1
55 JAHINA 1/7/1965 SURO ILIR 1708024701650001 081367539251 1
56 SUMIATI 5/10/1994 SURO ILIR 1708025005940003 083188864561 1
57 RISKA HENDI DIANA 12/11/1999 SURO ILIR 1708025112990001 081271914676 1
58 MARLENA 7/1/1965 SURO ILIR 1708054107650020 081367539251 1
59 IDA RAYANI 6/13/1980 SURO ILIR 1708025306800001 081367539251 1
60 SURYATI 10/9/1977 SURO ILIR 1708024910770002 081367539251 1
61 MUHAMMAD ALI 11/14/1985 SURO ILIR 1708021411850001 085269821371 1
62 DESI RATNASARI 2/4/1988 SURO ILIR 1708024402880001 081367539251 1
63 IDAR YANI 12/12/1968 SURO ILIR 1708025212680002 081367539251 1
64 ASMAWI 11/25/1962 SURO ILIR 1708022511620004 081367539251 1
65 JUNIATI 6/11/1982 SURO ILIR 1708025106820003 081367539251 1
66 BOBY ALEXANDRA 1/10/1997 SURO ILIR 1708071001970005 089501806770 1
67 PUTRA IRAWAN 11/13/1987 SURO ILIR 1708025701860002 085788609776 1
68 AZWAR NADI 1/8/1995 SURO ILIR 1708020801950001 081367539251 1
69 DIAN FITRIANA 3/8/1999 SURO ILIR 1708024803990003 089628903171 1
70 WIDIA WATI 5/16/1998 SURO ILIR 1708025605980001 085841445099 1
71 RISTON TONCE 5/23/1983 SURO ILIR 1708052305830001 082374228528 1
72 WINDRI PUSPITASARI 11/8/2001 SURO ILIR 1702174811010001 083173366051 1
73 M.YAKUP 5/4/1954 SURO ILIR 1708020405540001 1
74 SURIYATI 5/4/1972 SURO ILIR 1702174405730001 083173366051 1
75 KIKI SANTI MUSTIKA 4/8/1990 SURO ILIR 1708024804900002 083167890766 1
76 NENI TRIANA 11/16/1983 SURO ILIR 1708025611830003 081367539251 1
77 MUJIONO 11/8/1980 SURO ILIR 1708020811800003 087783344078 1
78 SUHARTINI 7/1/1970 SURO ILIR 1708024107700109 082371271609 1
79 NYAIK SUNDARI 12/12/2004 SURO ILIR 1708025212040004 081367539251 1
80 ADE OKTARIA SAPUTRA 10/19/1996 SURO ILIR 1708021910960001 085268432446 1
81 PUTRA IRAWAN 10/27/1995 SURO ILIR 17908022710950004 1
82 INDAYANI 10/28/1998 SURO ILIR 1708026701980001 0859171429325 1
83 REJA ANDRE BASTIAN 12/29/2000 SURO ILIR 1708022912000005 1
84 FAIZAL 4/7/1968 SURO ILIR 1708020704680004 085266270944 1
85 REZA UTAMI 7/7/1998 SURO ILIR 1708024707980001 083177513727 1
86 ILHAM FIRDAUS 12/1/2003 SURO ILIR 1708020112030001 081367539251 1
87 RAHMAD AGUSTIAN 8/21/2002 SURO ILIR 1708022108020001 083173777840 1
88 ALEN 7/5/1974 SURO ILIR 1708020507740001 081278935284 1
89 JARNI WATI 3/6/1974 SURO ILIR 1708024603740003 081367539251 1
90 SUMYATI 4/7/1995 SURO ILIR 1708024704950003 082177026080 1
91 ASMARA DEWI 11/27/1970 SURO ILIR 1708026711700001 1
92 HELMI AKSA 5/21/1971 SURO ILIR 1708022105710001 085266880636 1
93 EDWIN ANTONIO 9/23/1995 SURO ILIR 1708022309950001 1
94 MEDI DAVID SUSANTO 5/3/1996 SURO ILIR 1708020305960001 1
95 ERSIH ANGGRAINI 2/10/2001 SURO ILIR 1708025002010001 0895604936070 1
96 JAUWITA 9/6/1995 SURO ILIR 1708024609950001 083166209077 1
97 BURHAN 11/11/1960 SURO ILIR 1708021111600003 1
98 MIFTAHUL JANNAH 10/13/2006 SURO ILIR 1708025310060001 1
99 EKO PATRIO 1/1/2001 SURO ILIR 1708020101010003 1
100 MEILAN 5/16/1990 SURO ILIR 1702195605900001 083175986368 1
101 RUDI HARTONO 4/12/1965 SURO ILIR 1702171204650003 081367539251 1
102 AHMAD BADAWI 10/12/1968 SURO ILIR 1708021210680004 1
103 ARLENI ELIA NENGSIH 9/20/1984 SURO ILIR 1708024107870106 081367151782 1
104 RISKI RAMADANI 12/14/1999 SURO ILIR 1708021412940003 1
105 MAHARANI 2/6/2002 SURO ILIR 1708024503990003 1
106 BETRAN RIPALDO 10/6/2002 SURO ILIR 1708020710020002 1
107 UPIK 2/3/1956 SURO ILIR 1708024302560002 1

1 0 5 0 2 5 5 1 32 0 1 6 0 49 0 0 0 0 0
13 39 55
107
FK6858 UPT PUSKESMAS RAWAT INAP UJAN MAS
20210816 VAKSINASI COVID-19
04 NOVEMBER 2021
DESA SURO MUNCAR

PFIZER SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM
HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
HAMIL
1 RIA NOPITA SARI 10/13/1992 SURO MUNCAR 1708025310920002 085841577174 1
2 LILI JAYANTI 11/20/1990 SURO MUNCAR 1708026011900001 081367539251 1
3 RISMA DEWI 6/12/1987 SURO MUNCAR 1708024107940059 081367539251 1
4 MIRNA WATI 11/2/1995 SURO MUNCAR 1708024211950003 081367539251 1
5 MARLIN KARMILAWATI 4/14/1990 SURO MUNCAR 1708025404900002 085767154736 1
6 DARWANTI 1/16/1992 SURO MUNCAR 1771055901920001 08954202895 1
7 SUSILA RUMIYATI 10/16/1990 SURO MUNCAR 1700218561090003 081367539251 1
8 DESI ARIANI 12/31/1984 SURO MUNCAR 1708027112840001 085279278290 1
9 KARMILA SUSANTI 1/5/1975 SURO MUNCAR 1708024501750001 081367539251 1
10 BAMBANG IRAWAN 1/21/1987 SURO MUNCAR 1708020201870001 085788363017 1
11 SUDIRMAN 5/15/1971 SURO MUNCAR 1708021505710001 085832950302 1
12 IRSAN JANI 5/1/1992 SURO MUNCAR 1708021105920002 08995737142 1
13 ANDI SAHRONI 12/17/1991 SURO MUNCAR 1708021712910002 083867236121 1
14 NURLELA 6/4/1960 SURO MUNCAR 1708024406600001 081367539251 1
15 JEPRI OKTARIA 10/4/1997 SURO MUNCAR 1708020410970003 081367539251 1
16 ALI KURIP 7/1/1958 SURO MUNCAR 1708020107580131 081367539251 1
17 WARISMA 7/1/1989 SURO MUNCAR 1708024107890087 082278861737 1
18 JAHANI 3/9/1979 SURO MUNCAR 1708020903790001 081367539251 1
19 EKA MANDA SARI 1/14/1990 SURO MUNCAR 1708025401900003 085279019095 1
20 TITIN SUMARNI 11/10/1974 SURO MUNCAR 1708025011740002 081367539251 1
21 SAINUL 4/3/1976 SURO MUNCAR 1708020304760001 081367539251 1
22 SUJIYATI 6/5/1989 SURO MUNCAR 1708024506890003 085789127720 1
23 SIA 7/1/1948 SURO MUNCAR 1708024107480036 081367539251 1
24 BAHYA 7/1/1953 SURO MUNCAR 1708024107530117 081367539251 1
25 YEFRI OKY 10/30/1995 SURO MUNCAR 1604247010950001 085384492624 1
26 NINA MARYANA 6/13/1989 SURO MUNCAR 1708025306890001 081271562216 1
27 RUMI 8/1/1990 SURO MUNCAR 1708024108900004 081367539251 1
28 MARI 7/1/1983 SURO MUNCAR 1708024107830159 081367539251 1
29 NURMALA 9/8/1991 SURO MUNCAR 1702186508910001 081367539251 1
30 SUSMANELI 12/6/1987 SURO MUNCAR 1708024612870004 081367539251 1
31 RUSMINI 3/20/1959 SURO MUNCAR 1708026003590001 081367539251 1
32 REZA APRIANTI 4/12/1999 SURO MUNCAR 1708025204020001 08982544044 1
33 SINTA PERMATA 5/6/1994 SURO MUNCAR 1708024612870004 08982544044 1
34 DALINA 4/25/1961 SURO MUNCAR 1708026504610001 081367539251 1
35 MARDESI 4/18/1972 SURO MUNCAR 1708025804720001 085896232839 1
36 VETI LIDIA 5/29/1998 SURO MUNCAR 1708026905980001 082281341412 1
37 MELITA FIDIA 5/8/1993 SURO MUNCAR 1708024805930002 082281341412 1
38 JUM'AINI 1/17/1990 SURO MUNCAR 1708025701900001 081367539251 1
39 SARNIAWAN 7/1/1979 SURO MUNCAR 1708020107790104 081367539251 1
40 DESI ARISANDI 12/5/1984 SURO MUNCAR 1708024512840002 081367539251 1
41 MARYONO 3/29/1983 SURO MUNCAR 1708022903830002 085279019095 1
42 RINA FLORETA 12/5/1995 SURO MUNCAR 1708024512950001 081367539251 1
43 LENI 6/9/1986 SURO MUNCAR 1708024906820003 081367539251 1
44 MELI SUNANRTI 10/10/1984 SURO MUNCAR 1708025010830001 081367539251 1
45 BAMBANG IRAWAN 4/17/1990 SURO MUNCAR 1708021704900002 085664758390 1
46 JUMIATI 2/7/1982 SURO MUNCAR 1708044702820002 081367539251 1
47 RESITA NOVRIANTI 11/19/1994 SURO MUNCAR 1708025911940001 081367539251 1
48 WINCI NURJANNAH 5/9/2002 SURO MUNCAR 1708024905020002 081367539251 1
49 DALEHA 12/20/1991 SURO MUNCAR 1708022012910004 085832950281 1
50 MUHADI 5/4/1983 SURO MUNCAR 1708020405830004 085832950281 1
51 RITA MELISA 5/5/2000 SURO MUNCAR 1708024505000001 08995932891 1
52 YORI PUSPITA 7/5/1995 SURO MUNCAR 1708024507950001 08995932891 1
53 EVA PUSPITA 6/6/1987 SURO MUNCAR 1708024301830002 081367539251 1
54 YESNI ARIYANTI 2/11/1997 SURO MUNCAR 1702184107000009 081367539251 1
55 HENGKI SAPARINGGA 7/2/1998 SURO MUNCAR 1708020207980003 085758612278 1
56 RAMLI 7/1/1955 SURO MUNCAR 1708020107550038 081367539251 1
57 AMELIA APRIANI 4/4/2000 SURO MUNCAR 1708024404080004 081367539251 1
58 INDRA HERIADI 7/19/1977 SURO MUNCAR 1702181907770001 085377535314 1
59 KARMILA WATI 4/4/1982 SURO MUNCAR 1708020404820001 081367539251 1
60 ERNA WATI 6/7/1971 SURO MUNCAR 1708024706800002 081367539251 1
61 SUWARNO 5/6/1964 SURO MUNCAR 1708020605640002 085896514138 1
62 CAHAYA SUMARNI 11/10/1983 SURO MUNCAR 1708025011830001 085213786503 1
63 ROSMALA DEWI 4/4/1987 SURO MUNCAR 1708024404870002 081367539251 1
64 KOMALA 10/21/1970 SURO MUNCAR 1708026110700002 081367539251 1
65 ANI RABANIAH 6/16/1986 SURO MUNCAR 1708025606860002 081367539251 1
66 RABANI 4/10/1989 SURO MUNCAR 1771085004890002 082175628300 1
67 BENTAR PRAPASTA 3/13/1988 SURO MUNCAR 1771081303880003 082175628300 1
68 TARMIDI 3/1/1969 SURO MUNCAR 1708020103690001 081367539251 1
69 NURIADI 5/12/1986 SURO MUNCAR 1708021205820001 081367539251 1
70 IDA WATI 3/1/1945 SURO MUNCAR 1708024103450002 081367539251 1
71 RAMA ADIATNA 11/2/2001 SURO MUNCAR 1708020211010004 08995932904 1
72 YUDI SUPRIATNA 10/5/1977 SURO MUNCAR 1708020510770001 081367539251 1
73 ARPENSASI 3/18/1986 SURO MUNCAR 1708021803860001 1
74 YENTI 7/21/1988 SURO MUNCAR 1702196107880003 1
75 SUBANIA 8/16/1970 SURO MUNCAR 1708025608700001 1
76 HENDRO WIDODO 5/9/1990 SURO MUNCAR 1708020905900001 1
77 YUNITA RISANDI 6/12/1989 SURO MUNCAR 1708025206890001 1
78 SOPIAN EPENDI 12/12/1970 SURO MUNCAR 1708021212700006 1
79 YENI AYU PITA SARI 4/22/1995 SURO MUNCAR 1708026504950004 1
80 SEPRI HARYADI 9/11/1990 SURO MUNCAR 1708021109900001 1
81 DESI ASNA MARLIANA 1/23/1992 SURO MUNCAR 1708046301920001 1
82 AZWAR ANAS 12/18/1986 SURO MUNCAR 1708021812860001 1
83 PAULUS ISKANDAR 7/18/1963 SURO MUNCAR 1708020207700003 1
84 DIKI PUTRA 4/6/1992 SURO MUNCAR 1708080604920001 1
85 BILASIN 1/2/1967 SURO MUNCAR 1708020201670002 1
86 DONI RISWAN SAPUTRA 7/22/1993 SURO MUNCAR 1708022707930001 1
87 RANDI SAPUTRA 2/16/1996 SURO MUNCAR 1708021402960003 1
88 AYU WULANDARI 12/12/2000 SURO MUNCAR 1708025212000002 1
89 DEDI DAMHARI 7/20/1981 SURO MUNCAR 1708022007810001 1
90 KARYAWATI 6/5/1980 SURO MUNCAR 1708024506800005 085769735129 1
91 SUSMIYANA 7/28/1980 SURO MUNCAR 1708026807800001 081367539251 1
92 ANA REVIKA 8/18/1995 SURO MUNCAR 1708055808950004 08995737142 1
93 MAUYA 7/1/1953 SURO MUNCAR 1708024107530115 081367539251 1
94 UMI SUMRA 7/1/1945 SURO MUNCAR 1708024107450021 081367539251 1
95 NURAINI 9/15/1967 SURO MUNCAR 1708025509670002 081367539251 1
96 NI LUH REMBUN 7/1/1964 SURO MUNCAR 1708025207670001 081367539251 1
97 ZAINURIA 5/16/1969 SURO MUNCAR 1708025605690001 081367539251 1
98 DARNA WANI SURO MUNCAR 1708024207650003 081367539251 1
99 HERMAN JAYA 3/7/1980 SURO MUNCAR 1708020703800003 081367539251 1
100 HANAPI 9/12/1976 SURO MUNCAR 1708021209760001 081367539251 1
101 YOSI NOVIANTI 12/10/1978 SURO MUNCAR 1708025012780002 081367539251 1
102 YANTI 3/1/1993 SURO MUNCAR 1708024103890001 081367539251 1
103 MIKE 11/5/1998 SURO MUNCAR 1708024511980001 081367539251 1
104 YOKI 11/8/1986 SURO MUNCAR 1708020612810001 081367539251 1
105 SRI SUSANTI 7/1/1980 SURO MUNCAR 1708024107800157 081367539251 1
106 DESI HARYATI SURO MUNCAR 1
107 PURNAWIRAWAN 7/10/1977 SURO MUNCAR 1708021007770002 081367539251 1
108 RESI SUSANTI SURO MUNCAR 1
109 MIRWAN 7/1/1978 SURO MUNCAR 1708020107780203 081367539251 1
110 EVA SUSANTI 9/23/1994 SURO MUNCAR 1708026811940002 081367539251 1
10 0 71 0 1 0 0 0 0 0 0 0 0 9 0 2 0 0 17 0
82 0 11 17
110
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA JUMLAH

M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FK6858 UPT P
20210816

NO NAMA TGL LAHIR ALAMAT

1 ACENG SURAHMAN 3/3/1980 UJAN MAS ATAS


2 AWALUDIN 10/7/1972 UJAN MAS ATAS
3 DESI YANA 8/1/1980 UJAN MAS ATAS
4 NYAIK 9/4/1973 UJAN MAS ATAS
5 EMA KARISMA 5/2/1997 UJAN MAS ATAS
6 DAHLIA WATI 7/1/1964 UJAN MAS ATAS
7 DESI ARITA 7/15/1996 UJAN MAS ATAS
8 HADIJAH 7/1/1962 UJAN MAS ATAS
9 NOVIA ARIESTI 5/21/1992 UJAN MAS ATAS
10 MARGIANTO 7/1/1977 UJAN MAS ATAS
11 PUTRI MULYANA 5/11/1977 UJAN MAS ATAS
12 MILA WATI 2/15/1984 UJAN MAS ATAS
DUKCAPI 13 MISRA WATI 5/7/1989 UJAN MAS ATAS
14 WAHIMA 1/25/1966 UJAN MAS ATAS
15 ASMARA 10/17/1958 UJAN MAS ATAS
16 DESI RATNASARI 11/4/1994 DS DASPETAH
17 ABDUL AZIS 9/19/1957 KELOBAK
18 ANDO DIYO BAGITE 1/14/2003 UJAN MAS ATAS
19 BAHARONI 9/25/1969 UJAN MAS ATAS
20 ALFIAN TONI 3/11/1978 UJAN MAS ATAS
21 ADI JAGAD 6/10/2002 SURO BARU
22 PUTRI TRIA ANDINI 7/10/2003 UJAN MAS ATAS
23 WIDIA AGUSTINA A 8/3/1999 UJAN MAS ATAS
24 NUR BAKRI 7/6/1974 UJAN MAS ATAS
25 YESI F 1/20/1998 UJAN MAS ATAS
26 ROSDALENI 2/14/1983 UJAN MAS ATAS
27 SAHARA 2/5/1972 UJAN MAS ATAS
28 EVAMA DALENA 4/12/1975 UJAN MAS ATAS
29 SISWANTONI 7/25/1985 UJAN MAS ATAS
30 SINTA LIA A 10/5/1997 UJAN MAS ATAS
31 SURYATI 2/16/1976 UJAN MAS ATAS
32 RESKI ANGGARA 6/14/1996 UJAN MAS ATAS
33 NYIMAS MILYA S 10/5/1999 UJAN MAS ATAS
34 SUPARMAN 7/11/1975 UJAN MAS ATAS
35 DEWI MURNI 6/8/1970 UJAN MAS ATAS
36 ANDI ANWAR 1/2/1992 UJAN MAS ATAS
37 YURIANA 9/7/1986 UJAN MAS ATAS
38 M. UMAR USMAN 7/1/1955 UJAN MAS ATAS
39 ANGGI PRANATA 8/29/1991 UJAN MAS ATAS
40 RESI WINDASARI 8/20/1997 UJAN MAS ATAS
41 ERNI YANTI 5/2/1986 UJAN MAS ATAS
42 DEWI 7/1/1964 UJAN MAS ATAS
TUNDA 43 SUMI HATI 7/1/1965 UJAN MAS ATAS
44 HENI P 9/3/1999 UJAN MAS ATAS
45 ERWIN SUPRI 11/24/1999 UJAN MAS ATAS
46 RITA HARTATI 4/12/1981 UJAN MAS ATAS
47 SUGIONO 5/27/1990 UJAN MAS ATAS
48 DEVI ANJELITA 9/4/2002 UJAN MAS ATAS
49 MURDIONO 3/10/1990 UJAN MAS ATAS
50 IQBAL AL FAREZI 2/17/2009 UJAN MAS ATAS
51 R SUWONO 12/15/1966 UJAN MAS ATAS
52 PIONANDA S 9/1/1997 UJAN MAS ATAS
53 ROSNI 7/7/1975 UJAN MAS ATAS
54 TRI 3/10/1989 UJAN MAS ATAS
55 MAWARIDA 7/7/1970 UJAN MAS ATAS
56 KARMILA 4/1/1984 UJAN MAS ATAS
57 RAMADAN 11/10/1980 UJAN MAS ATAS
58 ERNA 10/10/1983 UJAN MAS ATAS
59 BIBA A 7/2/1968 UJAN MAS ATAS
60 DARMAWANSYAH 8/9/1985 UJAN MAS ATAS
61 MARSUNA 7/1/1968 UJAN MAS ATAS
62 ALDI GIOFANI\ 6/18/2000 UJAN MAS ATAS
TUNDA 63 NURHAPIA 4/10/1968 UJAN MAS ATAS
64 SUMARNI 5/18/1965 UJAN MAS ATAS
65 AJIMNA 7/16/1948 UJAN MAS ATAS
66 NURLENTI 8/15/1975 UJAN MAS ATAS
67 KASMA BUTI 12/11/1967 UJAN MAS ATAS
68 NUR KASILAINI 2/11/1979 UJAN MAS ATAS
69 ILA BUNAYA 7/1/1945 UJAN MAS ATAS
70 JONDI N 1/1/1982 UJAN MAS ATAS
71 MARLINA 8/28/1983 UJAN MAS ATAS
72 SUCI NENGSI 9/6/1970 UJAN MAS BAWAH
73 SURI RAHAYU 4/4/1981 UJAN MAS ATAS
74 OLIS S 9/9/2000 DS DASPETAH
75 KARLINA 7/10/1998 UJAN MAS ATAS
76 TOPIK HIDAYAT 12/20/1991 UJAN MAS ATAS
77 DESRIAN SARI 3/5/1990 SURO ILIR
78 HERAWATI 1/1/1985 UJAN MAS ATAS
79 JULIADI S 7/3/1998 SURO ILIR
80 HEPIRIANI 5/10/1980 UJAN MAS ATAS
81 RISMAN 2/19/2001 UJAN MAS ATAS
82 SUSYANTI 7/23/1988 UJAN MAS ATAS
83 MUN HAYATI 7/1/1975 UJAN MAS ATAS
84 JULITA 6/20/1997 UJAN MAS ATAS
85 ZARKAWI 5/4/1981 UJAN MAS ATAS
86 RAMA 9/22/2000 UJAN MAS ATAS
87 LUSI SUSANTI 5/20/1999 UJAN MAS ATAS
88 UCI 9/8/1978 UJAN MAS ATAS
89 BAYA NATI 6/8/1971 UJAN MAS ATAS
90 LENTIANA 12/5/1983 UJAN MAS ATAS
91 RITA 9/10/1972 UJAN MAS ATAS
92 MERI SUSYANTI 9/27/1978 UJAN MAS ATAS
93 CIK INI 6/13/1975 UJAN MAS ATAS
94 LENI MARLENA 1/10/1983 UJAN MAS ATAS
95 BARI'A 7/1/1951 UJAN MAS ATAS
96 REDI ARIANTO 12/14/2003 DASPETAH
97 NENGSIH 7/12/1988 SURO MUNCAR
98 BAITI 7/1/1974 UJAN MAS ATAS
99 HERNI WIDIA 6/18/2000 UJAN MAS ATAS
100 AJI JANG JAYA 12/5/2004 UJAN MAS ATAS
101 SUSI YANTI 7/1/1986 UJAN MAS ATAS
102 SAMSUL BAHRI 7/1/1974 UJAN MAS ATAS
103 LESA WULAN 6/20/2001 UJAN MAS BAWAH
104 SIKIN 7/11/1968 UJAN MAS ATAS
105 NADYA ANDESTI 8/20/2004 UJAN MAS ATAS
106 ROSITA 12/25/1987 UJAN MAS ATAS
107 EVA SUSANTI 10/10/1978 UJAN MAS ATAS
108 ROSIDA IBRAHIM 7/3/1978 UJAN MAS ATAS
109 EFRI SUSANTI 4/26/2003 UJAN MAS ATAS
110 SUFIYAN 8/6/1970 UJAN MAS ATAS
111 ARI AFRIADI 9/17/2001 UJAN MAS ATAS
112 JONI PRANATA 6/20/2006 UJAN MAS BAWAH
113 ULANDARI 8/12/2002 UJAN MAS ATAS
114 MUSTAFA 12/7/1968 UJAN MAS ATAS
95 CICI ENDANG 3/4/1997 UJAN MAS ATAS
96 ABDUL QODIR 3/16/1970 UJAN MAS ATAS
97 DASWATI 2/1/1960 UJAN MAS ATAS
98 SUKU RIA 7/1/1954 UJAN MAS ATAS
99 BOBI IRAWAN 8/17/1992 UJAN MAS ATAS
100 MARJAN SAURI 11/5/1979 UJAN MAS ATAS
101 KURMAYANI 7/10/1985 UJAN MAS ATAS
102 ARPAN 3/1/1969 UJAN MAS ATAS
103 JUMILA 7/13/1972 UJAN MAS ATAS
104 ALDIN SUMANTRI 8/1/1973 UJAN MAS ATAS
105 RISKI PRANSISKO 5/12/2002 UJAN MAS ATAS
106 PEBIO OKTARINA 10/26/2008 UJAN MAS ATAS
107 PATMAWATI 2/10/1962 UJAN MAS ATAS
108 YUHELMINAH 7/5/1972 UJAN MAS ATAS
109 ETIKA P 12/14/1999 UJAN MAS ATAS
110 FENNI SUMARNI 8/17/1984 UJAN MAS ATAS
111 INA 7/1/1963 UJAN MAS ATAS
112 SUSI SUSANTI 1/24/2001 UJAN MAS ATAS
113 MARDANA 12/21/1958 UJAN MAS ATAS
114 SUMARDI 7/6/1978 UJAN MAS ATAS
115 MIRA YULIKA 6/25/1988 UJAN MAS ATAS
116 ARI LUSIAH 8/12/1986 UJAN MAS ATAS
117 RODIA 7/1/1980 UJAN MAS ATAS
118 UPIK SATINI 5/3/1975 UJAN MAS ATAS
119 ROYANTI 5/19/1980 UJAN MAS ATAS
120 EKA MARINDA 4/7/1993 UJAN MAS ATAS
121 DEKA ANGGRAINI 12/2/1997 UJAN MAS ATAS
122 AISAH A 1/18/1986 UJAN MAS ATAS
123 NURJANA 10/15/1977 UJAN MAS ATAS
124 IRPAN 10/1/2006 UJAN MAS ATAS
ANGGA F 5/25/1989 UJAN MAS ATAS
RENI HAFISAH 12/2/1987 UJAN MAS ATAS

110
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
06 NOVEMBER 2021
KANTOR CAMAT

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

M.UMUM
HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK
1708020303800001 085764228894 1
1708020710720003 081367539251 1
1708024108880002 081367539251 1
1708024409730001 081367539251 1
1708024107640091 085658315079 1
1708024205770002 085658315079 1
1708025507960001 085896915068 1
1708024107620060 085658315079 1
1702194107920054 081367539251 1
1708020107770133 081367539251 1
1708025105770001 081367539251 1
1708025502840005 081367539251
1708024208920004 081367539251
1708026501660001 081367539251
1708025710580002 085758568460 1
1708024411940002 085785688466 1
1708021909570002 085268039742 1
1708021401030002 085758728834 1
1708022509690002 085357705088 1
1708021103780001 085368660531 1
1708021006020001 082371273057 1
1702095007030004 083174163429 1
1708024308990001 083857683231 1
1708020607740001 081367539251 1
1708026901980001 085783358521 1
1708025402830003 081367539251 1
1708024502720001 085783358521 1
1708025204750008 081367539251 1
1708022507850004 085841602107 1
1708024510990001 081375946238 1
1708025602760001 081367539251 1
1708021406980001 081275511320 1
1708024510990004 082377881828 1
1708021107750001 085764157742 1
1708024806700001 081367539251 1
1708020201920004 085279022940 1
1708085507870001 081367539251 1
1708020107550053 081367539251 1
1708022908910001 081367539251 1
1708026008970001 085896283471 1
1708024205880001 081367539251 1
1708024107640088 081367539251 1
1708024107650130 081367539251 1
1708014309990002 085764935813 1
1708022411990003 081367539251 1
1708025204810002 085764935813 1
1708022705900003 082171164054 1
1708024409020001 085832949064 1
1708021003900003 085783434924 1
1708021702090002 085783434924 1
1708021512660003 081367539251 1
1708024109970001 083148416720 1
1708024707750001 083148416720 1
1708025003890007 085788857895 1
1708024707700002 081367539251 1
1708024104840002 081367539251 1
1708021011800005 081367539251 1
1708025010830002 085862097298 1
1708024207680002 081367539251 1
1708020908850002 081367539251 1
1708034107680379 081367539251 1
1708021806000002 081367539251 1
1708025004680002 081367539251 1
1708025805650001 081367539251 1
1708021607480001 081367539251 1
1708025508750002 081367539251 1
1708025112670004 081367539251 1
1708025102750001 081367539251 1
1708024107450031 081367539251 1
1708021406840001 085839712681 1
1605126808830003 085766603820 1
1708024609700002 081367539251 1
1708024404810004 081367539251 1
1708024909000005 082372980992 1
1708025007980002 082372980992 1
1708022012910003 081367539251 1
1708024503900001 082152038420 1
1708024101850002 081367539251 1
1708020307980002 0895360755126 1
1708025005800002 081367539251 1
1708021902010001 1
1708025503880001 081367539251 1
1708024107750144 081367539251 1
1708026006970001 081367539251 1
1708020405810007 081367539251 1
1708022209000001 083162466105 1
1708046005990002 085709934179 1
1708024809780001 081367539251 1
1708024806710001 081367539251 1
1708024512830002 081367539251 1
1708025009720002 1
1708026709780003 081367539251 1
1708025306750002 081367539251 1
1708025001830002 081367539251 1
1708021209630001 081367539251 1
1708021412030004 085709640467 1
1708025207880002 085377593559 1
1708024107740105 081367539251 1
1708025806000002 085377214685 1
1708020512040004 085709349089 1
1708025211770003 081367539251 1
1708021110740003 081367539251 1
1708026006010001 085758507453 1
1708021108660001 081367002162 1
1708026008040002
1708026512870002 081367539251 1
1708025010780008 081367539251
1708024307780001 081367539251 1
1708026604030001 085709080467 1
1708020608700001 081367539251 1
1708021012910002 082299652771 1
1708022006060002 081367539251 1
1708025208020001 081367539251 1
1708020712680001 085267882281
1702184403970003 081367539251 1
1708021603730001 081367539251 1
1708024102600001 081367539251 1
1708020107590001 081367539251 1
1708021708920002 081367539251 1
1708020511790001 081367539251 1
1708025007850004 081367539251 1
1708020103690002 081367539251 1
1708025307720001 081367539251 1
1708020108730001 085609443400 1
1708021205020003 082181426588 1
1708026610080002 081367539251 1
1708025002620001 081274780772 1
1708024507720003 081367539251 1
1708025412990003 081367539251 1
1705025708840002 085832241586 1
1708024107630176 081367539251 1
1708026401010001 081367539251 1
1708022112580001 081367539251 1
1708020607780004 085832948316 1
1708026506880001 085832241585 1
1708025208860004 081367539251 1
1708024107800163 085832241585 1
1708024305750001 081367539251 1
1708025905800002 081367539251 1
1702194704930002 081367539251 1
1708075202970002 081367539251 1
1708025801860002 083803305548 1
1708025510770001 081367539251 1
1708020110060001 081367539251 1
1709052505890002 082386479831 1
1708026305850001 082377900258 1

10 1 118 0 9 0 0 0 2
138 3
141
DOSIS 2
PENDIDIK

REMAJA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

HAMIL
PFIZER

LANSIA

PUBLIK
DOSIS 2

M.UMUM

PENDIDIK
1
0 1 0 0 0 0 0 0 0 0 0
3 0 0
141
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA
M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH

0
0
0
0
0
0
0
0
0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
08 NOVEMBER 2021
DESA DASPETAH

PFIZER SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM
HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
HAMIL
1 IMILIA CONTESA 11/20/1993 DASPETAH 1708046211940002 085758113917 1
2 ASMI 1/3/1979 1708024301790001 085382723241 1
3 SUCI HATI 12/21/1963 1708025212630005 085380134282 1
4 AFRIZAL 4/27/1971 1708042704710001 082307646067 1
5 DESI ANA 4/13/1985 1702095304850002 085269396949 1
6 SAHABUDIN 3/28/1972 1708022803720001 081279620054 1
7 ERNI YOSNITA 7/20/1974 1708026007740003 081367539251 1
8 ERNI YOSNITA 8/12/1984 1708025208840001 081367539251 1
9 WAHAYA 4/6/1963 1708024604630001 1
10 AYUN SUNDARI 5/8/1998 1708024805980003 081279085619 1
11 LUK CANDRI 12/10/1992 1708025012920004 081367539251 1
12 SURI 11/20/1962 1708026011620001 081367539251 1
13 BAHARUDIN 9/29/2001 1708022909010001 081367539251 1
14 SUDIRMAN 2/17/1980 1708021702800004 081367539251 1
15 LENTIS SUHAILA 2/22/1978 1708026202780001 081367539251 1
16 DEWI SARTIKA 1/10/1979 1708025001790001 1
17 BETARIA SONATA 11/2/1984 1708027112840002 081367539251 1
18 BENI SUSANTI 4/10/1984 1708025004840006 081367539251 1
19 ERLAN SUHERI 6/5/1971 1708020506710002 1
20 SAHAK 1/15/1958 1708021501580001 1
21 JAMALUDIN 1/30/1956 1708023001560001 081367539251 1
22 LELI KASITA 11/11/1985 1708055111850002 081367539251 1
23 ARDIANSYAH 3/3/1990 1708020303900007 081367539251 1
24 REMA ARYANTI 6/27/1993 1708026706930005 081367539251 1
25 ARISNAWATI 4/24/1972 1708026404720002 081367539251 1
26 SURYANTI 8/10/1985 1708025008850001 081367539251 1
27 ABDULLAH 4/13/1966 1708021304660003 081367539251 1
28 SUWANDI 4/15/1962 1708021504620002 081367539251 1
29 EVI 8/12/1973 1708025208730003 1
30 LISMAHI DAYA 5/9/1980 1708024905800002 1
31 MARIATI 9/21/2001 1708026109010003 1
32 BUSTARI 11/26/1988 1708022611880002 1
33 DONA RISANTI 6/27/1993 1708026706930004 1
34 ADLI PAIRUS 1/11/2008 1708021101080002 1
35 TITIN SUTRA ANDORI 6/7/1986 1708024706860001 1
36 SELVI DIANA 6/24/2000 1708026406000001 081367539251 1
37 NOPITA SARI 11/18/1991 1708025811910003 081367539251 1
38 LENTRI 9/18/1982 1708024102860001 081367539251 1
39 PUJI ANTI 10/15/1986 1708025510860002 081367539251 1
40 EMILIA CONTESA 8/20/1982 1708026008820002 081367539251 1
41 ROSMI 11/11/1967 1708025111670001 081367539251 1
42 ILHAMZAH KURNIAWAN 10/30/1995 1708023010950003 1
43 EVI SARI YANTI 7/1/1965 1708024107650128 1
44 MARDALENA 7/19/1979 1708025907790001 1
45 LESNI SARTIKA 9/22/1983 1708026209830002 1
46 ANITA 7/2/1974 1708024207740001 081273407091 1
47 HELPA NENGSI 11/19/2002 1708025911020003 1
48 SENALDO 2/18/1998 1708021802980001 081367539251 1
49 YULIUS SUMARTONI 11/30/2006 1708023011060001 081367539251 1
50 ERNAINI 5/10/1967 1708025005670001 081367539251 1
51 WELI KURNIA 7/9/1985 1708024907850002 081367539251 1
52 ARIYO ARYANTO 12/11/2001 1708025112010005 081367539251 1
53 SALEHA 11/3/1974 1708024311740001 081367539251 1
54 KIKI IKE PRATIWI 8/25/1997 1708026508970001 081367539251 1
55 LAURA CYNTIA BELLA 9/1/2006 1708024109060004 085384920491 1
56 DIOSI EKA PUTRA 4/17/1977 1708021704770004 1
57 DALIAH 10/8/1968 1708024810680001 081367539251 1
58 SINAR 12/5/1980 1708024512800002 081367539251 1
59 INDAR PAJRI 7/9/1972 1708020701730003 081367539251 1
60 ARI SETIAWAN 6/23/2004 1708042306040001 081367539251 1
61 YOLANDA 6/4/2008 1708024406080002 081367539251 1
62 TARMIN HAROM 4/6/1980 1708020604800002 085366837100 1
63 RESI ANDESTA 3/9/1994 1708024903940003 081274791833 1
64 NORMA 3/10/1964 1708025003640001 1
65 MARZUKI 7/1/1971 1708021212700001 082362544713 1
66 EKO CANDRA 6/9/1987 1708020906870001 1
67 ROSNI PONITA SARI 11/11/1978 1708045111780003 1
68 ZENDRANI 5/1/1976 1708022907790003 1
69 MEDIA SURYANI 11/17/1989 1708025711890001 1
70 YENI SUSIANTI 9/9/1998 1708024909980001 1
71 DEWI EFRIAYNI 6/3/1982 1708024306820001 1
72 HASANA 11/16/1969 1708025611690001 1
73 EVA NOVITASARI 10/20/1991 1708026810910003 1
74 PRIMA ARI SANJAYA 9/26/2008 1708042609080001 1
75 MEGAWATI 12/11/1974 1708015112740001 082371455552 1
76 OVY PRADETI 10/25/1996 1708026510960001 1
77 TITANIA FAULA 7/10/1998 1708025007980001 082279684194 1
78 FESA ARIANTI 8/30/2000 1708027008000001 085840935892 1
79 YUSNAINI 9/8/1978 1708024908780004 082269384688 1
80 JESIKA ANGGI 12/23/2004 1708026309040004 081316524142 1
81 SUDIRMAN RUS 1708020111580002 1
82 RAHINA WANI 3/16/1978 1708025603780001 1
83 RAENA WATI 4/25/1964 1708025503610001 1
84 KANEDI 1/27/1963 1708022701630003 1
85 RESTI FRANSISCA 1/6/1993 1708024601930001 1
86 AINI 1/27/1944 1708022701440001 1
87 MULYADI 3/15/1985 1702161503850002 1
88 HAMID 1/22/1955 1708022201550001 082180341449 1
89 FEDRIANSYAH 2/5/1988 1708020502880001 1
90 RISKA YUNITA 9/29/1990 1708026909900002 1
91 MULYA KARNA 11/13/1977 1708025311770002 085609413988 1
92 JUNAIDI 10/14/1968 1708021410680001 1
93 GUNTUR PRANATA 3/3/1997 1708020303970003 1
94 HENDRI MIARKOSE 2/13/1994 1708021302940003 081271024969 1
95 DAMSA 10/10/1974 1708021010740005 082269384561 1
96 SUARTI 6/27/1969 1708026706690002 1
97 SEMARANG JAYA 7/2/1977 1708020207770001 085208986218 1
98 ERLAN PURNAMA 9/10/1983 1708021009830001 0823717449003 1
99 JUSIR AR 7/7/1962 1708020707620003 081366534737 1
100 JELITA HARIANTI 6/23/1998 17021663069800001 1
101 TITI ARIANTI 11/28/1992 1708026811920001 082261861323 1
102 DAM MARIYA WATI 3/6/1973 1708024603730001 085267123853 1
103 YENI MARLIANA 1/4/1988 1708024401880001 082382471395 1
104 SAIPUL 6/17/1962 1708021706620001 082379102986 1
105 SRI ERLINA 1/23/1981 1708026301810002 085378204654 1
106 SUSILAWATI 8/1/1979 1708025212630002 1
107 HANAPIA 12/4/1954 1708020412540001 082280506698 1
108 SENDI PRANATA 5/12/2006 1708021205060002 081274780775 1
109 AWALUDIN 10/10/1950 1708021010500008 1
110 SUMARTULANI 1/3/1961 1708024301610001 1
111 ZAINAL ABIDIN 12/19/1987 1708020107870078 085382471395 1
112 LEDIANA MATULESI 7/1/1990 1708024107910073 082280922133 1
113 FITTAHUL JANNA 10/10/1982 1708025010820004 085609640166 1
114 ALEK DARWANDI 12/11/1986 1708021112860001 082280922133 1
115 SANIA 9/10/1981 1708025009810001 1
116 KINUT 7/1/1963 1708024107630160 1
117 AHMAD TARMIJI 1/13/1979 3207181301790002 1
118 SAKILA WATI 8/25/1973 1708026508730001 1
119 ELDA RAYATI 4/12/1980 1708025204800003 1
120 DERI INTAN PRATIWI 11/8/2002 170802481020001 1
121 ANJLI BERA ATIKA 9/15/2003 1708024111030001 1
122 AGNES RENIKA 9/27/2003 1708026708030002 1
123 SYAFEI 1708022003560002 1
106
107
108
109
110
9 0 95 0 8 2 0 0 0 0 0 0 0 0 0 0 1 0 8 0
114 0 0 9
123
FK6858 UP
202108165i

NO NAMA TGL LAHIR ALAMAT

1 LILI KARYANI 7/1/1983 SURO ILIR


2 KASINA 11/10/1980 SURO ILIR
3 ERMITA SARI 10/25/1996 SURO ILIR
4 DINARIA ANGGARA 2/15/2000 SURO ILIR
5 REPA PINDI JULIANTI 7/7/2004 SURO ILIR
6 LESI SUSANTI 11/21/2000 SURO ILIR
7 MEDIA 12/5/1998 SURO ILIR
8 PRENGKI JUNETA ASRI 9/9/1997 SURO ILIR
9 ARI MANSYAH 6/1/1995 SURO ILIR
10 ADE CANRA 10/6/1995 SURO ILIR
11 MULYADI 7/1/1967 SURO ILIR
12 MEGA DARLENA 8/22/1973 SURO ILIR
13 ROBY SETIAWAN 10/28/1990 SURO ILIR
14 WENDI SAPUTRA 8/8/1973 SURO ILIR
15 ADI SOFYAN 5/1/1982 SURO ILIR
16 SITIN SUMARNI 3/10/1982 SURO ILIR
17 JARNI 11/1/1984 SURO ILIR
18 RODI HARTONO 7/1/1995 SURO ILIR
19 PORIYAL 8/8/1990 SURO ILIR
20 ANTONI 7/17/1957 SURO ILIR
21 TUIP 7/1/1960 SURO ILIR
22 RIDUAN GUNAWAN 7/17/1991 SURO ILIR
23 ANTON WIJAYA 1/18/1998 SURO ILIR
24 TOPAN HIDAYAT 9/21/1979 SURO ILIR
25 HENDRA CIPTA 8/14/1987 SURO ILIR
26 SUBARI 3/2/1952 SURO ILIR
27 INDRI NOVITA SARI 11/18/2004 SURO ILIR
28 DEPI KUSMAWATIA 3/7/1983 SURO ILIR
29 MARIANA 9/6/1980 SURO ILIR
30 FATMI 6/26/1994 SURO ILIR
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
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
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
106
107
108
109
110
8 NETRA HERIYANI 5/14/1974 SURO ILIR
2 SAMSIAR 8/18/1976 SURO ILIR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
10 NOVEMBER 2021
DESA DASPETAH

PFIZER
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM

M.UMUM
HAMIL
LANSIA

PUBLIK

LANSIA

PUBLIK
1708024107830164 081367539251 1
1708025011800005 081367539251 1
1708026610960004 085379104684 1
1708025501000002 082372601035 1
1708024707040002 085758769787 1
1708026111000001 081266666383 1
1708024512980001 082250429728 1
1702180909970002 081367539251 1
1708021504950003
1708042110950003
1708020107670064 081373441070 1
1708024107760122 085709170862 1
1771022810910003 0895603588932 1
1702180808730002 081367539251 1
1708020105820004
1708026303740002
1708024111840002
1708020107850162 082281215377 1
1708020808900004 081367539251 1
1708051707570002 085273308977 1
1708020107600094 081367539251 1
1708021707910003
1708021801980001
1708022109790002 085377217737 1
1708021408870006
1708020203520001 081367539251 1
1708025811040001 0895360774382 1
1708024703830003 0895360774382 1
1708024609800002
1708026606940002 081367539251 1
3 0 16 0 2 0 0 0 0
21 0
30
1708025405740001 081367539251 1
1708025808760001 081367539251 1
DOSIS 2
PENDIDIK

REMAJA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

HAMIL
SINOVAC

LANSIA

PUBLIK

1
1
1
1
1
1
1
1
DOSIS 2

M.UMUM

1
PENDIDIK
0 0 0 0 0 0 0 0 0 9 0
0 0 9
30
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
DESA
M.UMUM

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH

0
0
0
0
0
0
0
0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
11 NOVEMBER 2021
DESA SURO MUNCAR

SINOVAC PFIZER MODERNA SINOPHARM


DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL
1 RITA PUTRI 1/25/1965 SURO MUNCAR 1708026501650001 081367539251 1
2 SUMINI 2/6/1977 SURO MUNCAR 1708024602770002 081367539251 1
3 RINDI HATI 6/7/1960 SURO MUNCAR 1708024706600001 081367539251 1
4 EVI PUTRI 7/4/1982 SURO MUNCAR 1708024407820001 081367539251 1
5 YUSMA WANI 3/1/1965 SURO MUNCAR 1708024103650002 081367539251 1
6 TAHER 6/8/1950 SURO MUNCAR 1708020806500004 081367539251 1
7 HASANUSI 7/17/1974 SURO MUNCAR 1708021707740002 081367539251 1
8 HERPAN EFENDI 1/6/1986 SURO MUNCAR 1708020601860003 081367539251 1
9 RENA SUSANTI 8/13/1990 SURO MUNCAR 1708025308900002 081367539251 1
10 ALI USMAN 10/29/1961 SURO MUNCAR 1708022910610001 081367539251 1
11 APANDI 2/7/1974 SURO MUNCAR 1708020702780003 081367539251 1
12 BAMBANG IRAWAN 4/24/1987 SURO MUNCAR 1709012404870001 081367539251 1
13 ABASRI 7/1/1977 SURO MUNCAR 1708020107770134 081367539251 1
14 HAWA KINI 11/4/1980 SURO MUNCAR 1708024411800003 081367539251 1
15 RETA MANDA SARI 3/13/1998 SURO MUNCAR 1708025003980004 081367539251 1
16 YANTI HARMELIS 2/9/1984 SURO MUNCAR 1708054902840001 081367539251 1
17 DASNAYANTI 6/9/1975 SURO MUNCAR 1708024906750002 081367539251 1
18 DONA FRANSISKA 6/19/1998 SURO MUNCAR 1708025906980001 081367539251 1
19 ROHANA 4/7/1973 SURO MUNCAR 1708024704730001 081367539251 1
20 DELTI LESTARI 6/6/1998 SURO MUNCAR 1708024606980001 081367539251 1
21 HENDRO 3/1/1988 SURO MUNCAR 1708020103880001 081367539251 1
22 YANTI PUSPITA SARI 12/12/1995 SURO MUNCAR 1708025212950003 081367539251 1
23 ANGGA SAPUTRA 6/9/2000 SURO MUNCAR 1708020906000004 081367539251 1
24 HARTA DINATA 5/5/1973 SURO MUNCAR 1708020505730006 081367539251 1
25 SABANIA SAHRA 3/7/1983 SURO MUNCAR 1708024703830002 081367539251 1
26 EZI SISWANTO 9/1/1983 SURO MUNCAR 1708020109830002 081367539251 1
27 MAYA GITA P 9/17/2000 SURO MUNCAR 1708056705000001 081367539251 1
28 RISMA DEWI 3/2/1983 SURO MUNCAR 1708024203830003 081367539251 1
29 ABDUL KASIM 10/1/1956 SURO MUNCAR 1708020110560001 081367539251 1
30 MIRNAWATI 7/1/1990 SURO MUNCAR 1708024107900090 081367539251 1
31 RAMSIANA 3/2/1983 SURO MUNCAR 1708024203830002 081367539251 1
32 RENI OKTAVIA 10/23/1997 SURO MUNCAR 1702196310970001 082373375845 1
33 ELVI LESTARI 7/6/1984 SURO MUNCAR 1708024607840001 081367539251 1
34 SUNARTO 4/14/1992 SURO MUNCAR 1708021406920004 082373375845 1
35 WELI SUSANTI 4/2/1982 SURO MUNCAR 1708024204820002 081367539251 1
36 SAIBUL BASRI 3/1/1989 SURO MUNCAR 1708020103890003 089530848667 1
37 YASIT HARIS 4/25/1981 SURO MUNCAR 1708022504810002 081367539251 1
38 KASMA JELITA 7/10/1992 SURO MUNCAR 1708025007920002 081367539251 1
39 ELNA WATI 8/24/1980 SURO MUNCAR 1708026408800001 081367539251 1
40 ETI HERLINDA 7/1/1982 SURO MUNCAR 1708024107820130 081367539251 1
41 WILDA 12/5/1986 SURO MUNCAR 1708024512860002 081367539251 1
42 ELPA 12/22/1979 SURO MUNCAR 1708026212790002 081367539251 1
43 ASMARA 3/9/1968 SURO MUNCAR 1708024903680001 081367539251 1
44 SINARYANI 7/14/1969 SURO MUNCAR 1708025407690001 081367539251 1
45 SURYANI 12/12/1981 SURO MUNCAR 1708025212810002 081367539251 1
46 SARIPAH 7/1/1975 SURO MUNCAR 1708024107790103 081367539251 1
47 RINA ARYANTI 12/10/1995 SURO MUNCAR 1708025012950002 081367539251 1
48 INDRA MARZUKI 7/13/1987 SURO MUNCAR 1708021307870001 081367539251 1
49 SARTIKA 1/5/1995 SURO MUNCAR 1708044501950001 081367539251 1
50 METI EPRIANI 7/9/1996 SURO MUNCAR 1708024907960002 081367539251 1
51 SAPRUDIN 8/8/1990 SURO MUNCAR 1708020808800003 081367539251 1
52 YANITA 4/8/1983 SURO MUNCAR 1708024804830002 081367539251 1
53 SERPI AYU 9/4/2001 SURO MUNCAR 1708024412010001 081367539251 1
54 NURLELA 4/17/1985 SURO MUNCAR 1708025704750001 081367539251 1
55 NURCAYA DEWI 3/1/1970 SURO MUNCAR 1708024103700002 081367539251 1
56 HARIMA MLATI 9/3/1967 SURO MUNCAR 1708024309670002 081367539251 1
57 BUYUNG SUDI 7/1/1967 SURO MUNCAR 1708020107670069 081367539251 1
58 OTO SUHENDRI 10/25/1999 SURO MUNCAR 1708022510990001 081367539251 1
59 SAIPIN JOHAN 1/2/1980 SURO MUNCAR 1708020201800001 081367539251 1
60 M. NASIR 7/27/1979 SURO MUNCAR 1708022707790001 081367539251 1
61 HENGKY ADE PUTRA 6/29/1998 SURO MUNCAR 1708022906980002 081367539251 1
62 KASMIATI 7/1/1981 SURO MUNCAR 1708024107810106 081367539251 1
63 JULI SUTRA 8/13/1992 SURO MUNCAR 1708041308920002 081367539251 1
64 MUTOHAR 2/12/1995 SURO MUNCAR 1708021202950004 081367539251 1
65 DARWIN KAMIDAR 10/30/1960 SURO MUNCAR 1708023010600001 081367539251 1
66 BETI SUSANTI 7/1/1991 SURO MUNCAR 1708024107910095 081367539251 1
67 PELIPUR HATI 12/11/1967 SURO MUNCAR 1708025112670003 081367539251 1
68 BAMBANG IRAWAN 1/8/1994 SURO MUNCAR 1708020801940003 081367539251 1
69 UMI NATUN 7/4/1971 SURO MUNCAR 1708024407710001 081367539251 1
70 VIONAN IKAMUILIAH 12/23/2000 SURO MUNCAR 1708022312000001 081367539251 1
71 ARTIS MIMBAR 10/15/1986 SURO MUNCAR 1708021510860003 081367539251 1
72 URIANA 2/10/1965 SURO MUNCAR 1708025002650001 081367539251 1
73 DORA PARANITA 4/28/1996 SURO MUNCAR 1708026804960003 081367539251 1
74 NETI 9/21/1982 SURO MUNCAR 1708026109820001 081367539251 1
75 ANISA LESTARI 8/14/2006 SURO MUNCAR 1708025408060001 081367539251 1
76 REZA YOLANDA 4/3/1993 SURO MUNCAR 1708024304930002 081367539251 1
77 SUMI 10/8/1970 SURO MUNCAR 1708024810700005 081367539251 1
78 SEPTI ALPIYONITA 12/18/2003 SURO MUNCAR 1708025812030001 081367539251 1
79 EDI HERMANSYAH 10/30/1991 SURO MUNCAR 1708023010880001 081367539251 1
80 HERI ASNAWI 3/1/1983 SURO MUNCAR 1708020103830001 081367539251 1
81 BAYU / BARIA 6/3/1948 SURO MUNCAR 1708024306480001 081367539251 1
82 AIWANI IDRIS 8/18/1960 SURO MUNCAR 1708021808600001 081367539251 1
83 RICA DESMI LESTARI 1/14/2003 SURO MUNCAR 1708055401030001 081367539251 1
84 ADE PUTRA 11/26/1995 SURO MUNCAR 1708022611950003 081367539251 1
85 M. SHOLEH 2/8/1993 SURO MUNCAR 1708020506930001 081367539251 1
86 FERRI ANDIKA 6/19/2004 SURO MUNCAR 1708021906040001 081367539251 1
87 VERA LENSI 4/3/1986 SURO MUNCAR 1771084304860002 081367539251 1
88 DIANA NOVITA SARI 7/24/1999 SURO MUNCAR 1708026303990003 081367539251 1
89 YANTI SAPITRI 8/5/1998 SURO MUNCAR 1708024508980001 081367539251 1
90 NURANI 7/1/1960 SURO MUNCAR 1708020107600089 081367539251 1
91 DENI FANSURI 10/1/1987 SURO MUNCAR 1702180110870001 081367539251 1
92 HAMDANI 8/17/1970 SURO MUNCAR 1708021708700005 081367539251 1
93 BAHARUDIN 4/3/1986 SURO MUNCAR 1708020304860005 081367539251 1
94 SUAIBA GANI 7/1/1965 SURO MUNCAR 1708024107650131 081367539251 1
95 SURIYATI 5/4/1964 SURO MUNCAR 1708024405640001 081367539251 1
96 ROH 7/1/1963 SURO MUNCAR 1708024107630151 1
97 PATRI 8/2/1973 SURO MUNCAR 1708024208730001 1
98 MARWAN 1/1/1975 SURO MUNCAR 1702182606720002 1
99 YUSPA 4/1/1963 SURO MUNCAR 1708024504640002 1
100 ALDI NANDA PRATAMA 12/25/2004 SURO MUNCAR 1708022552040003 1
101 JUMILA 12/20/1990 SURO MUNCAR 1708026012900003 1
102 SUKARNO 6/10/1969 SURO MUNCAR 1708021006690001 1
103 RAPINA 7/1/1953 SURO MUNCAR 1708024107530116 1
104 MARYANI 3/7/1955 SURO MUNCAR 1708024703550001 1
105 CENDRA WANI 6/5/1983 SURO MUNCAR 1708024506830005 1
106 ADE PUTRA 5/6/1998 SURO MUNCAR 1708020605980001 1
107 RAWINA 7/1/1964 SURO MUNCAR 1708024107640089 1
108 NURLELA 1/4/1980 SURO MUNCAR 1708024401800001 081367539251 1
109 TITIN SUMARNI 6/1/1974 SURO MUNCAR 1708024106740001 081367539251 1
110 ROBI YULIANSYA 7/14/1991 SURO MUNCAR 1708051407910001 081367539251 1
111 ARI FERNANDO 3/16/1993 SURO MUNCAR 1708050103930002 081367539251 1
112 SISWAN TARMIZI 2/17/1986 SURO MUNCAR 1708021702860001 081367539251 1
113 LUSIANA 6/10/1985 SURO MUNCAR 1708025006850003 081367539251 1
114 HELMAHERA 7/1/1982 SURO MUNCAR 1708024107820115 1
115 OKTAPIA ALIMATUSAKDIA 10/29/1993 SURO MUNCAR 1702196910930002 081367539251 1
116 RUSPA 1/2/1970 SURO MUNCAR 1708024201700002 081367539251 1
117 YENI SATRIANI 3/28/2004 SURO MUNCAR 1708026003040001 081367539251 1
118 SUPARNA 4/10/1962 SURO MUNCAR 1708021004620002 081367539251 1
119 DENI 3/18/2000 SURO MUNCAR 1708021803000005 081367539251 1
120 ROBI'A 7/16/2007 SURO MUNCAR 1702185607070003 081367539251 1
121 SIDAR JAYA 7/30/1985 SURO MUNCAR 1708025708780003 081367539251 1
122 AGUSTIAN DARI 8/14/2001 SURO MUNCAR 1708021408010001 081367539251 1
123 HERMANSYAH 6/15/1981 SURO MUNCAR 1708021506810001 081367539251 1
0 0 0 0 0 0 1 0 0 9 0 1 8 0 0 96 0 4 0 0 0 0 0 0 0 0 0 4 0 0
0 11 108 0 0 4
123
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
12 NOVEMBER 2021
DESA DASPETAH 1 DAN 2

SINOVAC PFIZER ASTRA MODERNA


DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL
1 HENGKI TARNANDO 4/24/1994 DASPETAH 2 1708021610940001 082289102550 1
2 BAHERMANSA 9/1/1968 DASPETAH 2 170802010650032 1
3 HARIANTONI 8/27/1981 DASPETAH 2 1708022708810001 1
4 ROHATI FRANSISKA 9/10/1996 DASPETAH 2 1708025009960002 1
5 IRSAN 6/24/1970 DASPETAH 2 1708032406700002 1
6 HENI 8/7/1979 DASPETAH 2 17080221708790002 1
7 ANDI CANDRA 1/17/1990 DASPETAH 2 1708021403900001 1
8 HARTONO ARBI 7/6/1985 DASPETAH 2 1708020607850002 1
9 ENDERWIS 7/12/1976 DASPETAH 2 1708021207670001 1
10 SIA 1/7/1980 DASPETAH 1708024701800003 1
11 JUNAIDI 7/5/1977 DASPETAH 2 1708020507770003 1
12 ARJAN SUBARIO NAIDI 10/15/1972 DASPETAH 2 1708031510720001 1
13 ADI SAPUTRA 4/18/2002 DASPETAH 2 1708021804020001 1
14 ELI KURNIA 2/1/1963 DASPETAH 2 1708024102630004 1
15 SITI SALEHA 6/12/1967 DASPETAH 2 1708025206670001 1
16 DARMA ASIA 7/1/1950 DASPETAH 1708024107500033 1
17 M. NASIR 8/7/1963 DASPETAH 2 1708020708630001 1
18 RISAN 12/12/1969 DASPETAH 1708021212690008 1
19 ADON PRASTIO 6/17/1970 DASPETAH 2 1708021706700001 1
20 LOSARI ANJELINA 7/26/1995 DASPETAH 2 1708026607950001 1
21 SRI WARTATI 6/16/1978 DASPETAH 2 1708025606780007 1
22 NIRWANA 7/1/1977 DASPETAH 2 1708020101650004 1
23 SAKUAN 1/1/1965 DASPETAH 2 1708020101650004 1
24 SARIPUDIN 9/7/1987 DASPETAH 2 1708020709870003 1
25 SRI 10/15/1974 DASPETAH 2 1708025510740001 1
26 DIPTA LESTARI 8/17/2007 DASPETAH 1708025708070001 1
27 RENA OKTARIA 10/2/2008 DASPETAH 2 1708029210080001 1
28 MULYANI 3/12/1976 DASPETAH 1708025203760001 1
29 DEDI 12/11/1986 DASPETAH 1602091112860003 1
30 FATIMAH TULZUHRO 5/16/2004 DASPETAH 2 1708025605040001 1
31 SUHERMAN 4/19/1971 DASPETAH 2 1708021904710001 1
32 LONA LOSINTA 11/30/1999 DASPETAH 2 1708027011990003 1
33 ADITIA KUSUMA 10/22/2003 DASPETAH 2 1708022210030001 1
34 REMI PUSPITA SARI 7/6/1989 DASPETAH 2 1708024607890001 1
35 RIANDI 9/8/1998 DASPETAH 2 1708020809980001 1
36 ROSMAWATI 8/12/1974 DASPETAH 2 1708025208740001 1
37 IDRIS 12/8/1970 DASPETAH 1708020812700004 1
38 SURNA 6/15/1974 DASPETAH 1708025506740001 1
39 LINDA PUSPITA 10/20/1980 DASPETAH 1708026010800001 1
40 MARLIS ANTONI 3/20/1987 DASPETAH 1708022003870002 1
41 BENI GUSTIANA 7/24/1994 DASPETAH 2 1708022407940001 1
42 DAILA 6/6/1981 DASPETAH 1708024606810011 1
43 ANISA 1/29/1984 DASPETAH 1708026901840001 1
44 WINARTI 7/15/1982 DASPETAH 2 1708025507820001 1
45 YUSUP HAMDANI 12/11/1979 DASPETAH 1708021112790004 1
46 HERMAN 3/12/1971 DASPETAH 2 1708021203710004 1
47 IRAWAN EFENDI 7/14/1985 DASPETAH 1708021407850001 1
48 HERMANSYAH 6/4/1974 DASPETAH 2 1708020406740001 1
49 HERMAN TONI 3/15/1974 DASPETAH 1708021503740002 1
50 MUNAWAROH 7/25/1979 DASPETAH 1708026507790001 1
51 ALFIAN SUHENDRA 8/12/2004 DASPETAH 1708021208040002 1
52 SELVI MUTIARA 6/1/2004 DASPETAH 1708024106040002 1
53 NOPIANSYAH 1/1/1985 DASPETAH 1708020101850005 1
54 LINDA KUMALA SARI 4/20/2000 DASPETAH 2 1708026004000004 1
55 JUMI ARLISA 6/15/1990 DASPETAH 1708025506900002 1
56 FERO WANTO ALAMSYAH 5/30/2005 DASPETAH 1708023005050001 1
57 ENDANG SAPUTRA 1/10/1999 DASPETAH 2 1708021001990001 1
58 IRHAM JUNAIDI 10/15/1987 DASPETAH 1708021510870005 1
59 ARIEL PERDO PRAYETNO 3/15/2006 DASPETAH 1708021503060001 1
60 NETI 6/5/1983 DASPETAH 1708024506830008 1
61 SYOPIANDI 12/10/1977 DASPETAH 1708021012770006 1
62 RAPIKA SASTRA WIJAYA 12/16/1996 DASPETAH 2 170802162960001 1
63 MARWAN 1/16/1963 DASPETAH 1708021601630001 1
64 ROSI PUSPITA SARI 10/10/1988 DASPETAH 2 1708045010880009 1
65 YANTI SAHARA 3/3/2000 DASPETAH 1708024303000001 1
66 EMI KURNIAWATI 2/20/1968 DASPETAH 2 1708026002680003 1
67 RUMIA ASMAWATI 10/20/1967 DASPETAH 1708026010670002 1
68 DWI PUSPITA SARI 11/18/1994 DASPETAH 2 1708045811940002 1
69 CANDRA IRAWAN 9/13/1998 DASPETAH 2 1708025304980001 1
70 YANDI PUTRA SENSA 2/2/2006 DASPETAH 1708020202060004 1
71 DAPIT REJANG PUTRA 3/11/1971 DASPETAH 2 1708021103710001 1
72 KARNA BUDI 6/20/1968 DASPETAH 2 1708022006680002 1
73 JON SINADA 12/2/1967 DASPETAH 2 1708020212670001 1
74 ARIPIN 1/5/1964 DASPETAH 2 1708020501640001 1
75 ADEWAR ALI 7/5/1992 DASPETAH 2 1707030507921001 1
76 NINI SURYANTI 7/1/1979 DASPETAH 2 1708024107790113 1
77 SWI BATUL ISLAMIA 9/17/1999 DASPETAH 1708025709990001 1
78 RIKI SUSANTO 10/17/1989 DASPETAH 1708021710890002 1
79 ARTI AMINA 7/6/1972 DASPETAH 2 1708024607720001 1
80 DESI 6/12/1999 DASPETAH 1708025206940001 1
81 MILA HARTATI 7/10/1993 DASPETAH 1708025007930002 1
82 SANTI ALEKA 10/27/1988 DASPETAH 2 1708025610900001 1
83 IMRON JUNAIDI 9/4/1979 DASPETAH 2 1708020409790001 1
84 NETI RISMA DEWI 11/9/1989 DASPETAH 2 1708024911890001 1
85 IRFAN 7/10/1999 DASPETAH 2 1708021007990004 1
86 YANTI MAHESA 8/28/1998 DASPETAH 1702186808980002 1
87 ROLIMURANDES 12/9/1981 DASPETAH 2 1708020912810002 1
88 DELLO MOREA 7/14/2005 DASPETAH 1708021407050003 1
89 RUDI LOVIAN SYAH 3/1/1973 DASPETAH 170217018730001 1
90 HERI TONI 8/1/1989 DASPETAH 2 1708020108890001 1
91 WENI EFRIYANTI 2/10/1982 DASPETAH 1708025002820005 1
92 YANTI PAREDA 3/28/1990 PG BERINGANG 1708026803900002 1
93 ALPIAN JAWI 7/30/1973 DASPETAH 2 1708023007730001 1
94 MARTIAN SAPUTRA 1/10/2007 DASPETAH 1708021001070002 1
95 TIARA INDA AYU PUTRI 6/13/2008 DASPETAH 2 1708025306080001 1
96 LAUDIA SINTA BELA 11/7/2008 DASPETAH 2 1708024711080001 1
97 BUNGA DELVITA 2/15/2009 DASPETAH 2 1708025502090001 1
98 WINDRI 4/13/2000 DASPETAH 1708025304000001 1
99 MEYCAN 9/29/2009 DASPETAH 2 1708026909090001 1
100 TANTI BAHERA 11/9/1988 DASPETAH 1708024911880002 1
101 DONI CANDRA 9/25/1991 DASPETAH 2 1708022509910001 1
102 LIS 7/1/1979 DASPETAH 2 1708024107790118 1
103 PANJI LARASATI 1/31/1996 DASPETAH 2 1708027101960007 1
104 YENSI MISA ADE RELIA 5/29/2003 DASPETAH 2 1708026905030001 1
105 HENDRI JAYA 7/17/1989 DASPETAH 1708021707890001 1
106 RADA ARGIANTO 1/8/2002 DASPETAH 1708020801020006 1
107 UMARSALEH 8/8/1984 DASPETAH 1 1708020808840003 1
108 AMIRIL MUKMIN 1/10/1971 DASPETAH 2 1708021001710002 1
109 ARYAN TANI 8/10/1984 DASPETAH 2 1708021008840002 1
0 0 0 0 0 0 0 0 0 8 0 0 0 0 1 5 0 15 0 0 0 0 0 0 1 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 8 21 0 80 0
109
NO NAMA TGL LAHIR ALAMAT

1 RIDUAN 7/1/1951 PG BERINGANG


2 LUDIN 6/19/1938 PG BERINGANG
3 NILAWATI 12/10/1979
4 PERENGKI 3/10/2005
5 MARYANI 6/4/1986
6 DINA AGUSTINA 8/20/1997
7 ERMA YUNITA 9/14/1986
8 ROSMA 8/29/1966
9 EDO PERNANDO 12/6/1994
10 JUNAIDI 6/25/1969
11 PUTRA 8/14/1992
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
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
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
UPT PUSKE

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM
NAKES

NAKES
LANSIA

PUBLIK

LANSIA

PUBLIK
BUMIL
1708020107530115 081367539251
1708021906380001
1708024107760107
1708021003030001
1708024406860007
1708026008970002
1708025409860003 082289717074
1708026908660001
1708020612940003 082178786968
1708022506690003
1708021408920001
0 0 0 0 0 0 0 0
0 0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
16 NOVEMBER 2021
DESA PG BERINGANG

PFIZER
DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1
PENDIDIK

PENDIDIK

PENDIDIK
REMAJA
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
BUMIL

BUMIL

BUMIL
1
1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 11
11
BUMIL

1
1
1
1
1
1
1
1
1
M.UMUM

DOSIS 1
PENDIDIK

REMAJA
ASTRA

LANSIA

PUBLIK

BUMIL

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA

PUBLIK

BUMIL

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOPHARM

PUBLIK
DOSIS 2
0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0
REKAPITULASI HARIAN VAKSINA
28 OKTOBER 2021

HARM SINOVAC
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK
DESA
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK
BUMIL

SM 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0
DPT2 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0
0 0 0 0
0
ULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

C MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM
REMAJA

LANSIA

PUBLIK

LANSIA

0 0 0 0 0 0 0 PUBLIK
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
NO NAMA TGL LAHIR ALAMAT

1 ELSA MAYORI 1/12/2000 SURO ILIR


2 ELI PURNAMA SARI 9/10/1998 SURO ILIR
3 AURA YOLANDA 1/29/2005 SURO ILIR
4 EKA PURNAMA SARI 4/9/2000 SURO ILIR
5 HAMDAN MAHYUDI 10/10/1966 SURO ILIR
6 SUHARYANTO 1/1/1990 SURO ILIR
7 ANGGITA RENATA SARI 8/19/2000 SURO ILIR
8 PITRI SUSANTI 5/18/1997 SURO ILIR
9 RIA NOVITA SARI 5/21/2003 SURO ILIR
10 HENRI GUNAWAN 2/2/1995 SURO ILIR
11 LENI KARLENA 7/28/1990 SURO ILIR
12 SURYONO 11/4/1982 SURO ILIR
13 ROMI 5/10/1985 SURO ILIR
14 REKI HENDRAWAN 6/8/1985 SURO ILIR
15 UJANG SISWOYO 6/30/1977 SURO ILIR
16 RABIUL AKSI 4/8/1976 SURO ILIR
17 RIO ADEDO 9/1/1999 SURO ILIR
18 RIDUAN 6/25/1977 SURO ILIR
19 HERMAN JAYADI 4/10/1979 SURO ILIR
20 RARA NATALIA 12/23/1998 SURO ILIR
21 WIDHI REKSA 11/1/1994 SURO ILIR
22 WIWIK 10/8/1975 SURO ILIR
24 LIBERO 11/25/1993 SURO ILIR
25 HARDIANTO 2/21/2003 SURO ILIR
26 CHRISTINA 3/1/1992 SURO ILIR
27 CANDRA GUNAWAN 7/14/1991 SURO ILIR
28
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
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
UPT PU

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

REMAJA
NIK NO HP

M.UMUM
NAKES

NAKES
LANSIA

PUBLIK

LANSIA
BUMIL
1708025201000001 083177164779
1708025009880005 082279683804
1708026901050002 085764941874
1708024904000001 083145049476
170802590800001 085837312979
1708020101900008
1708025908000001 089524207389
1708045805970001 0831877160277
1708026105030001 0831877160277
1708020202950003 085925122768
1702116807900001 082310572453
1708020411820001 0895428434499
1708021005850006
1708020806850005 085383155148
1702190107820074 08117311487
1708020804760001
1708022109990002
1708022506770001
1708021004790001
1708026312980002
1702090111940001
1708024810740002
1702062511930002
1708022102030002
1702174103920002
1708021407910004
0 0 0 0 0 0 0
0 6
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
17 NOVEMBER 2021
DESA SURO ILIR

VAC PFIZER
DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
REMAJA
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
BUMIL

BUMIL

BUMIL
1

1
1
1
1
1

1
1

1
0 0 6 0 0 0 0 0 2 0 1 0 0 0 0 0 0
6 3 0
26
LANSIA

PUBLIK

BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM DOSIS 1

PENDIDIK

REMAJA
ASTRA

LANSIA

PUBLIK

BUMIL

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA

PUBLIK

BUMIL

M.UMUM
DOSIS 1

PENDIDIK
SINOPHARM
0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0
17
26
REKAPITULAS

SINOPHARM SINOVAC
S1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
M.UMUM DESA

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK
BUMIL

SM 0 0 0 0
UMA 0 0 0 0
PB 0 0 0 0
DPT 0 0 0 0
DPT2 0 0 0 0
LD 0 0 0 0
0 0 0 0 0 0 0
0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
18 NOVEMBER 2021
DESA SURO MUNCAR

SINOVAC PFIZER ASTRA SINOPHARM


DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL
1 SANTI SUSILAWATI 6/11/2005 SURO MUNCAR 1708025106050001 085709769534 1
2 LESTARI YOLANDA 6/26/1998 SURO MUNCAR 1708026606980006 081367539251 1
3 SUNARIO 7/14/1990 SURO MUNCAR 1708021407900001 089518863954 1
4 FICTORI DARMA P 5/29/1999 SURO MUNCAR 1708022905990001 081367539251 1
5 MARDON SITOMPUL 1/20/1987 SURO MUNCAR 1708022001870001 081367539251 1
6 ELVI SUKAISIH 12/20/1979 SURO MUNCAR 1708024107820099 081367539251 1
7 RITA NOVAYANTI 11/18/1990 SURO MUNCAR 1708025811900001 085789481145 1
8 BAMBANG IRAWAN 8/5/1985 SURO MUNCAR 1708020508850002 081367539251 1
9 DEKI EFRISA 9/20/2008 SURO MUNCAR 1708022009060001 081367539251 1
10 DIMAS SAPUTRA 7/7/2007 SURO MUNCAR 1708050208050001 085769612589 1
11 RATI PURWASIH 6/5/1992 SURO MUNCAR 1707055203920002 1
12 BAMBANG IRAWAN 3/15/1970 SURO MUNCAR 1708021503700001 1
13 DENDI WIRANTO 10/10/1998 SURO MUNCAR 1708021010980006 1
14 RENO SUTRA PUTRA 8/29/2005 SURO MUNCAR 1708022908050003 081367539251 1
15 MERI ULANDARI 5/25/1998 SURO MUNCAR 1708024505980004 082374029337 1
16 YANA 3/1/1980 SURO MUNCAR 1708024103800001 082374029337 1
17 MAHYUDIN 10/25/1950 SURO MUNCAR 1708022510500002 081367539251 1
18 SANARIA 7/1/1968 SURO MUNCAR 1708024107680191 081367539251 1
19 ENDAH LESTARI 2/2/1998 SURO MUNCAR 1708024202980002 081367539251 1
20 HERI SURYADI 10/21/1974 SURO MUNCAR 1708022110740002 081367539251 1
21 PILA YATI 2/7/1994 SURO MUNCAR 1708054702940003 081367539251 1
22 KATIA 2/10/1971 SURO MUNCAR 1708025002710003 081367539251 1
23 SUNARDI 9/9/1990 SURO MUNCAR 1708020909900002 081367539251 1
24 AHMAD SUGIANTO 12/17/2003 SURO MUNCAR 1708021712030001 08985996481 1
25 SUDARMONO 8/6/1988 SURO MUNCAR 1708020808880011 081367539251 1
26 PERI SAPUTRA 12/15/1995 SURO MUNCAR 1708021512950003 1
27 ARPAN 12/12/1963 SURO MUNCAR 1708021212630001 085377712548 1
28 KRISTINA NINGSIH 6/24/2004 SURO MUNCAR 1708026406040001 089629108639 1
29 REPI APRIANSYAH 5/4/2002 SURO MUNCAR 1708020405020001 081367539251 1
30 ELLADI 2/5/1981 SURO MUNCAR 1708020502810003 085269998926 1
31 AGUS MIARTI 8/7/1965 SURO MUNCAR 1708024708650008 081369147361 1
32 DALYATUL AINI 7/1/1968 SURO MUNCAR 1708024107680255 081367539251 1
33 ABU BAKAR SIDIK 8/1/1951 SURO MUNCAR 1708020108510001 081367539251 1
34 ANSONI 11/10/1991 SURO MUNCAR 1708021011910005 1
35 ARAB SAUDI 7/9/1983 SURO MUNCAR 1708020907830002 1
36 SALASA INDRA JAYA 8/2/2005 SURO MUNCAR 1708020208050001 1
37 ITA MARLENA 6/10/1983 SURO MUNCAR 1708025006830003 1
38 SITI FATIMAH 10/3/1991 SURO MUNCAR 1702184310920001 1
39
40
41
42
0 0 1 0 0 0 0 0 0 6 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
1 6 6 0 23 2
38
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
20 NOVEMBER 2021
KANTOR CAMAT

SINOVAC PFIZER ASTRA SINOPHARM


DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NO NAMA TGL LAHIR ALAMAT NIK NO HP

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL

BUMIL
1 ERWIN SAHYUDA 7/11/1969 DASPETAH 2 1708021107690001 1
2 SAPON GUMANTRI 12/7/1964 UJAN MAS ATAS 1708020712640002 1
3 BAMBANG SUMANTRI 1/4/1993 UJAN MAS ATAS 1708020401930001 1
4 SAUPI 5/8/1983 UJAN MAS ATAS 1708021608780001 1
5 SYAFUAN 9/28/1968 UJAN MAS ATAS 1708022809680001 1
6 SALMA WATI 10/3/1963 UJAN MAS ATAS 1708024310630002 1
7 ERNA WATI 5/5/1963 UJAN MAS ATAS 1708024505630001 1
8 ANYA 7/1/1960 UJAN MAS ATAS 1708024107600095 1
9 INA WATI 7/5/1959 DASPETAH 2 1708024507590001 1
10 YES ASRIN 10/26/1972 SURO LEMBAK 1708042610720001 1
11 EDI 5/18/1992 UJAN MAS ATAS 1708022505920003 1
12 ALDI ALPIANOSA 3/13/1996 UJAN MAS ATAS 1708021303960007 1
13 NURBAITI 3/21/1977 UJAN MAS ATAS 1708026103770001 1
14 HADI SUMANTO 3/9/1979 BUMI SARI 1708020903790004 1
15 KURNIA ESA 2/7/2003 UJAN MAS ATAS 1708024702030001 1
16 NUR ASIA 4/15/1959 UJAN MAS ATAS 1708025504590001 1
17 SARIMAH 1/2/1959 UJAN MAS ATAS 1708024201590001 1
18 GERI ANGGARA 7/9/1999 UJAN MAS ATAS 1708020907990001 1
19 HERAWATI 7/1/1974 UJAN MAS ATAS 1708024107740117 1
20 DARMADI M 7/1/1971 UJAN MAS ATAS 1708020107710091 1
21 EDI SAPUTRA 1/9/1995 UJAN MAS ATAS 1708021504950002 1
22 MEZITA SUNDAR 1/10/1998 DASPETAH 1708025001980001 1
23 SINTA DIANA 1/19/1992 UJAN MAS ATAS 1708025901920003 1
24 ROBITA YASMAN 10/28/1989 UJAN MAS ATAS 1702162810890001 1
25 SAPARUDIN 9/11/1969 UJAN MAS ATAS 1708021109690001 1
26 EZA MUHAMMAD FADILLA 1/5/2009 UJAN MAS ATAS 1708026112130001 1
27 ARIANTI 4/7/1988 UJAN MAS ATAS 1708024704880001 1
28 A. BASRI 11/15/1962 UJAN MAS ATAS 1708020203670001 1
29 SUGIYANA 2/1/1993 UJAN MAS ATAS 1708020102930002 1
30 ROMI 8/24/1996 UJAN MAS ATAS 1708026408960001 1
31 JULYAN PRANATA 7/27/1994 KELOBAK, KEPAHIAN1708022607940002 1
32 RIZA 8/7/1987 UJAN MAS ATAS 1708024708870004 1
33 IRA HASANAH 6/24/1997 BERMANI ULU 1702246406970001 1
34 EKO ZASTRA WINATA 1/12/1997 BERMANI ULU 1708021701970004 1
35 DARMAWANI 7/1/1963 UJAN MAS ATAS 1708024107630177 1
36 NURLELA SARI 10/25/2001 SURO MUNCAR 1708026510010003 1
37 SAHADAN ARBI 12/29/1981 UJAN MAS ATAS 1708022912810001 1
38 SYOPIAN EFENDI 7/1/1966 UJAN MAS ATAS 1708020107660097 1
39 NOVITA SARI 3/11/1999 UJAN MAS ATAS 1708025103990001 1
40 NGAIDI 1/24/1988 UJAN MAS ATAS 1708022401880001 1
41 SUPARMAN 12/11/1978 UJAN MAS ATAS 1708021112780001 1
42 RAMDAN PANSI 12/25/2000 UJAN MAS ATAS 1708022512000004 1
43 HERMANTO 5/17/1982 UJAN MAS ATAS 1708021705820003 1
44 JAPARUDIN 7/1/1962 UJAN MAS ATAS 1708020107620077 1
45 ERLINA NENGSI 7/4/1984 UJAN MAS ATAS 1708024407840005 1
46 JOKO 2/1/1989 UJAN MAS ATAS 1708020102890002 1
47 MISDA 7/1/1986 UJAN MAS ATAS 1708024107860142 1
48 VINGKI PEBRI YANTI 2/17/2003 UJAN MAS ATAS 1708025702030003 1
49 RESI MARYANI 10/11/1985 DUSUN KEPAHIANG 1771085110850003 1
50 PIRSON 4/7/1985 UJAN MAS ATAS 1708020704850001 1
51 SANDI PRANATA 3/3/1997 UJAN MAS ATAS 1708020303970004 1
52 HERI KOPRI 8/29/1984 UJAN MAS ATAS 1708022908840001 1
53 WAHYU ADI UTAMA 4/29/2002 UJAN MAS ATAS 1708022908840001 1
54 DIPATI BASU DEWA 3/6/2002 UJAN MAS BAWAH 1708020603020003 1
55 YOGI APRIANSYAH 8/29/2002 UJAN MAS ATAS 1708022908020002 1
56 ISWARI AKBAR 12/6/1987 UJAN MAS ATAS 1708020612870002 1
57 AGUNG SUBPRIADI 6/5/1999 UJAN MAS ATAS 1708020506990005 1
58 RENI CAHRIA 5/5/1995 UJAN MAS ATAS 1708026001940002 1
59 RATNA JUWITA 11/28/1985 AIR PUTIH LAMA 1702096811850002 1
60 BENI MASHUDI 1/19/1986 UJAN MAS ATAS 1708021901860004 1
61 ISNAENI HASANAH 4/23/1993 LAHAT 1604106304930012 1
62 HASAN MANALO 12/10/1964 UJAN MAS ATAS 1708021412640001 1
63 ARWAN ANSORI 12/5/1975 UJAN MAS ATAS 1708023012750001 1
64 JARNI 7/1/1975 UJAN MAS ATAS 1708024107750134 1
65 EDI MUKTAR 7/17/1989 UJAN MAS ATAS 1708021707890003 1
66 MITAN 12/31/1983 UJAN MAS ATAS 1708027112830003 1
67 SUBAGYO 12/10/1978 UJAN MAS ATAS 1708021012780004 1
68 EKA KARJAYA 4/25/1985 UJAN MAS ATAS 1708026604850004 1
69 DARMAN 5/2/1969 UJAN MAS ATAS 1708020205690001 1
70 SELVI WAHYUNI 9/13/1999 DASPETAH 1708045309990004 1
71 BURHAN 6/1/1962 UJAN MAS ATAS 1708020106620001 1
72 SRI BAYUMI 5/4/1980 UJAN MAS BAWAH 1708024405800006 1
73 PUSPITA SARI 6/13/1988 UJAN MAS ATAS 1708025306880001 1
74 ZANDIKA BERIANSA 11/25/2002 UJAN MAS ATAS 1708022511020002 1
75 JAUHARI 6/6/1999 UJAN MAS BAWAH 1708020606990002 1
76 MEGI 6/6/1980 MERIGI 1708050606800002 1
77 SANDI SANTANA 9/27/1999 UJAN MAS ATAS 1708022709990001 1
78 YOKA DAVIKA 12/15/2000 UJAN MAS ATAS 1708021512000001 1
79 RODIMAN 5/4/1983 UJAN MAS ATAS 1708020405830005 1
80 ARI ARDIANSYAH 12/30/1987 UJAN MAS ATAS 1708043012870002 1
81 ANGGA SAPUTRA 12/2/2006 UJAN MAS ATAS 1708020212060004 1
82 ARDANA SAMITRA 11/29/2006 UJAN MAS ATAS 1708022911060005 1
83 MIFTAHUL MASHUDA 7/27/2001 UJAN MAS ATAS 1708022707010001 1
84 ARIF KURNIAWAN 11/30/2000 UJAN MAS ATAS 1708023011000001 1
85 FADILAH B. 8/14/1996 UJAN MAS ATAS 1708025408960001 1
86 SUCI MURNI 5/14/1981 UJAN MAS ATAS 1708025405810001 1
87 SUPRIONO 11/8/2003 UJAN MAS BAWAH 1708020811030002 085767866515 1
88 REVO WINOTO 9/23/2009 UJAN MAS BAWAH 1708022309090002 085348510199 1
89 KAMSIA 12/3/1975 UJAN MAS ATAS 1708024312750001 1
0 0 0 0 3 0 0 0 0 3 0 0 0 0 0 5 0 1 0 0 0 0 0 0 5 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 3 6 0 77 0
89
NO NAMA TGL LAHIR ALAMAT

1 SUPIAN JAYADI 10/11/1998 DASPETAH


2 BEN SINAR JUKI 6/1/1960 DASPETAH
3 DARWIS 7/1/1979 DASPETAH
4 ALPIN 4/17/1980 DASPETAH
5 ASWANDI 7/1/1969 DASPETAH
6 RAHMAT JUNAIDI 5/24/2007 DASPETAH
7 JULIANA 7/17/1995 DASPETAH
8 RESA SILVIAN 11/23/1999 DASPETAH
9 MUHAMAD ARDIYANTO 12/12/2002 DASPETAH
10 RAHMAT JUNAIDI 7/5/1996 DASPETAH
11 HENI SUSIANTI 4/23/1987 DASPETAH
12 MADA ANSARI 9/4/2004 DASPETAH
13 YUDA ANDIKA 4/19/1997 DASPETAH
14 SARI YANTI 10/21/1992 DASPETAH
15 ILUS YANTI 10/27/1973 DASPETAH
16 ESI PRATIWI 10/10/1993 DASPETAH
17 RANDA GUSTIAN 12/20/1993 DASPETAH
18 DEKI TERNANDO 1/8/1997 DASPETAH
19 LAILATUL BAITI 8/22/1973 DASPETAH
20 ABENG 8/22/1973 DASPETAH
21 EGI SAPUTRA 5/15/1998 DASPETAH
22 RESTA 6/2/2005 DASPETAH
23 AMIR HAMZA 12/13/1970 DASPETAH
24 ZUM RAMLI 2/10/1965 DASPETAH
25 LOVA KAROLIN 7/12/2001 DASPETAH
26 NOFRI YANTI 10/5/1990 DASPETAH
27 DAWIYA MARSELANTI 5/5/2003 DASPETAH
28 SUWANDI 12/1/1955 DASPETAH
29 SUMANTRI 2/16/1976 DASPETAH
30 KEYCA KIRANA 5/5/2008 DASPETAH
31 ANDIKA PUTRA 12/11/1990 DASPETAH
32 DAHLIAN 8/17/1970 DASPETAH
33 LETI BESWANTI 11/14/1984 DASPETAH
34 LESTI MALISA 11/23/1998 DASPETAH
35 TRI AGUSTINA 8/25/2002 DASPETAH
36 M. FAHRUL ROZI 3/10/2003 DASPETAH
37 IRAWAN 7/25/1984 DASPETAH
38 TITIN SUMARNI 9/28/1976 DASPETAH
39 ASAN 12/10/1951 DASPETAH
40 WIRA PURWANTO 9/12/2003 DASPETAH
41 AMINATUL W 12/27/1968 DASPETAH
42 YARNI 9/29/1975 DASPETAH
43 SUSI BERINDA 1/5/1975 DASPETAH
44 HERI PRASETYA 1/23/1999 DASPETAH
45 RUSTAM TARMISI 10/25/2000 DASPETAH
46 INAL HASIRIN 5/12/2000 DASPETAH
47 RAYA HATI 1/7/1978 DASPETAH
48 SHINTA BELA 7/21/1995 DASPETAH
49 MINUR HAYATI 5/15/1972 DASPETAH
50 VEVI 11/18/2000 DASPETAH
51 SUKAISI 1/12/1981 DASPETAH
52 HERNAWAN 9/1/1974 DASPETAH
53 SINTA LIA 9/10/2000 DASPETAH
54 GUSTIAN ERIYON PANULI 11/11/1992 DASPETAH
55 SRI MAWARNI 3/9/1978 DASPETAH
56 SAWALIN 7/4/1978 DASPETAH
57 ARI PRANATA A 10/1/1995 DASPETAH
58 MAT USIN 6/22/1947 DASPETAH
59 SUHARYADI 11/15/1971 DASPETAH
60 RAJU FHIDI 12/8/2003 DASPETAH
61 MELAN MELANTI 1/12/2004 DASPETAH
62 ASMAWATI 1/15/1960 DASPETAH
63 MAMAN WIJAYA 6/27/2005 DASPETAH
64 YOYON APRIZAL 4/14/1982 DASPETAH
65 JOKO SAPUTRA 3/6/1993 DASPETAH
66 MARIANA 10/10/1978 DASPETAH
67 JONI SAPUTRA 10/3/2003 DASPETAH
68 RODI HARDIANTO 11/10/1991 DASPETAH
69 ERNI SUSILA 8/8/1977 DASPETAH
70 ELI KURNIA 3/13/1978 DASPETAH
71 RESIANA 8/7/1991 DASPETAH
72 TUTIAN JULIANA 4/10/1973 DASPETAH
73 JUNAIDI 10/28/1969 DASPETAH
74 MARI'A 3/13/1953 DASPETAH
75 KEPIN PERMANA 2/2/2003 DASPETAH
76 SUARTI 9/7/1957 DASPETAH
77 DEVINCA 4/14/1999 DASPETAH
78 VIOLA EKA UTAMI 1/18/2009 DASPETAH
79 ANTON 12/26/1979 DASPETAH
80 YUNI ARIA 3/10/1965 DASPETAH
81 ANDES RAMADHAN 12/28/1998 DASPETAH
82 RATNING GATI 3/30/1988 DASPETAH
83 AMINA DAYATI 7/1/1973 DASPETAH
84 ANTON SUJARWO 4/14/1984 DASPETAH
85 TIKA NOPELA 8/1/2000 DASPETAH
86 EKA SUSTIN LOVIA 4/6/1977 DASPETAH
87 JELLI MASKAR FRANSISK 4/24/2001 DASPETAH
88 UPIK SADIA 1/5/1981 DASPETAH
89 INDAR MIYA 4/6/1976 DASPETAH
90 ARPAN BUKRI 9/9/1975 DASPETAH
91 ARPAN JAYA 4/10/1973 DASPETAH
92 RIAN SAMARGUNDA 9/27/1994 DASPETAH
93 LUSPITA PANDEMI 3/8/2000 DASPETAH
94 EDO FERDIANSYAH 6/26/1999 DASPETAH
95 WINDRA 7/1/1983 DASPETAH
96 DARMITA 4/14/1999 DASPETAH
97 HERLINA 9/22/1997 DASPETAH
98 BEKA KURNIATI 7/23/1974 DASPETAH
99 UJANG ANWAR 8/10/1959 DASPETAH
100 WABINO 3/26/2001 DASPETAH
101 ABI OKTO ROBBI 10/10/1995 DASPETAH
102 TUTI MARIANA 4/8/1969 DASPETAH
103 ILI SAHROH 11/25/1971 DASPETAH
104 MUKMINAH 5/25/1975 DASPETAH
105 LENSI HARYANTI 12/23/2003 DASPETAH
106 MEGI SAPUTRA 9/28/1999 DASPETAH
107 SIPAINA 1/10/1949 DASPETAH
108 AYU LESTARI 7/6/2001 DASPETAH
109 YOGI SAPUTRA 6/8/1994 DASPETAH
110 BAMBANG SUPRIADI 8/12/1986 DASPETAH
111 AWEN DERI 1/21/2000 DASPETAH
112 YOSIANA 7/6/1979 DASPETAH
113 ZUBAINA 11/11/1970 DASPETAH
114 SUPIYA 2/20/1983 DASPETAH
115 RAMDAN 4/18/1971 DASPETAH
116 ASIAWATI 6/26/1968 DASPETAH
117 HENDRA 2/15/1980 DASPETAH
118 EKO PURNOMO 5/5/1987 DASPETAH
119 VIRA OKTA 10/1/1997 DASPETAH
120 AGUSTIAN BASTARI 8/16/1996 DASPETAH
121 IWEN OKTAYOLANDA 10/27/1998 DASPETAH
LESI MARDIAYANA 8/30/2008 DASPETAH
SUMI JAMILA 9/10/1973 DASPETAH
ALFIAN 9/21/1999 DASPETAH
DADANG WAHYUDI 1/11/1991 DASPETAH
SAMSUDIN 1/12/1973 DASPETAH
SULASTRI 12/12/1967 DASPETAH
TENI AYU 9/17/2003 DASPETAH
NAKIP 12/5/1954 DASPETAH
MURSI 3/23/1983 DASPETAH
WAGIYANTI 7/6/1973 DASPETAH
KARTODI 7/7/1977 DASPETAH
ANANI APRISA 4/14/2007 DASPETAH
ENI DESMITA 3/28/2007 DASPETAH
HAMBALI 7/17/1971 DASPETAH
ARI AGI PRASETYO 8/28/1993 DASPETAH
UJANG SAIRIN 4/30/1963 DASPETAH
JAWADI 9/25/1969 DASPETAH
HARTATI SUMARNI 5/1/1983 DASPETAH
INDRI PERMATASARI 2/29/1996 DASPETAH
SUSILAWATI 10/6/1982 DASPETAH
TUTI MARIANA 1/19/1993 DASPETAH
SUKARDI 7/1/1956 DASPETAH
REDA SANTI 12/1/1989 DASPETAH
HERMAN TONI 9/6/1970 DASPETAH
HERU PINOSA 11/23/1987 DASPETAH
FARTI ROSMAINI 7/11/1982 DASPETAH

83
84
85
86
87
88
89

60 TRI MARLENA 11/10/1984 PG BERINGANG


MERIGI
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
22 NOVEMBER 2021
DESA DASPETAH

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL
1708021110980004
1708020106690002
1708020107790003
1708021704800003
1708020107690126
1708020501960002
1708025707950001
1708026311990001
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1708022908920001
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1708021011910003
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1708024708910001
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1708024107730196
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1708020107830146
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1708022311870001
1708025107820002

0 0 0 0 0 0 0 0 0 7 0 0 0 0 1 0 0
0 7 11

1708025011840007 1
DOSIS 1

1
1
1
REMAJA
LANSIA

PFIZER
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA

1
LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA

LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1

10 0 0 0 0 0 0 10 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 128 0
146
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
DESA

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
SM 0 0 0 0 0 0 0 0 0 0 0 0 0
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0
PB 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0
LD 0 0 0 0 0 0 0 0 0 0 0 0 0
NASI COVID 19
1

MODERNA
DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK
JUMLAH
M.UMUM
LANSIA

PUBLIK

0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
NO NAMA TGL LAHIR ALAMAT

1 BEN SINAR JUKI 6/1/1960 DASPETAH


2 ALPIN 4/17/1980 DASPETAH
3 MUHAMAD ARDIYANTO 12/12/2002 DASPETAH
4 MADA ANSARI 9/17/1974 DASPETAH
5 SARI YANTI 10/21/1992 DASPETAH
6 ILUS YANTI 10/27/1973 DASPETAH
7 ESI PRATIWI 10/10/1993 DASPETAH
8 RANDA GUSTIAN 12/20/1993 DASPETAH
9 DEKI TERNANDO 1/8/1997 DASPETAH
10 LOVA KAROLIN 7/12/2001 DASPETAH
11 SUMANTRI 2/16/1976 DASPETAH
12 IRAWAN 7/25/1984 DASPETAH
13 TITIN SUMARNI 9/28/1976 DASPETAH
14 ASAN 12/10/1951 DASPETAH
15 WIRA PURWANTO 9/12/2003 DASPETAH
16 AMINATUL W 12/27/1968 DASPETAH
17 YARNI 9/29/1975 DASPETAH
18 MARIANA 10/10/1978 DASPETAH
19 JONI SAPUTRA 10/3/2003 DASPETAH
20 RODI HARDIANTO 11/10/1991 DASPETAH
resi 21 ERNI SUSILA 8/8/1977 DASPETAH
22 ELI KURNIA 3/13/1978 DASPETAH
23 RESIANA 8/7/1991 DASPETAH
24 TUTIAN JULIANA 4/10/1973 DASPETAH
25 JUNAIDI 10/28/1969 DASPETAH
26 MARI'A 3/13/1953 DASPETAH
27 SISI BERINDA 1/5/1975 DASPETAH
28 RUSTAM TARMISI 10/25/2000 DASPETAH
29 VIOLA EKA UTAMI 1/18/2009 DASPETAH
30 HERI PRASETYA 1/23/1999 DASPETAH
31 RAYA HATI 1/7/1978 DASPETAH
32 SHINTA BELA 7/21/1995 DASPETAH
33 MINUR HAYATI 5/15/1972 DASPETAH
34 VEVI DEVI TALIA 11/18/2000 DASPETAH
35 SUKAISI 1/12/1981 DASPETAH
36 HERNAWAN 9/1/1974 DASPETAH
37 SINTA LIA 9/10/2000 DASPETAH
38 JELLI MASKAR FRANSISK 4/24/2001 DASPETAH
39 UPIK SADIA 1/5/1981 DASPETAH
40 INDAR MIYA 4/6/1976 DASPETAH
41 ARPAN BUKRI 9/9/1975 DASPETAH
42 ANTON 12/26/1979 DASPETAH
43 SUHARYADI 11/15/1971 DASPETAH
44 YUNI ARIA 3/10/1965 DASPETAH
45 ANDES RAMADHAN 12/28/1998 DASPETAH
46 RATNING GATI 3/30/1988 DASPETAH
47 KEPIN PERMANA 2/2/2003 DASPETAH
48 SUARTI 9/7/1957 DASPETAH
49 DEVINCA 4/14/1999 DASPETAH
50 ABENG 8/22/1973 DASPETAH
51 LAILATUL BAITI 8/22/1973 DASPETAH
52 ARI PRANATA A 10/1/1995 DASPETAH
53 JOKO SAPUTRA 3/6/1993 DASPETAH
54 YOYON APRIZAL 4/14/1982 DASPETAH
55 MAMAN WIJAYA 6/27/2005 DASPETAH
56 ASMAWATI 1/15/1960 DASPETAH
57 MELAN MELANTI 1/12/2004 DASPETAH
58 INAL HASIRIN 5/12/2000 DASPETAH
59 RAJU FHIDI 12/8/2003 DASPETAH
60 M. FAHRUL ROZI 3/10/2003 DASPETAH
reka 61 ABENG 8/22/1973 DASPETAH
62 LAILATUL BAITI 8/22/1973 DASPETAH
63 SAWALIN 7/4/1978 DASPETAH
64 SRI MAWARNI 3/9/1978 DASPETAH
65 GUSTIAN ERIYON PANULI 11/11/1992 DASPETAH
66 AMINA DAYATI 7/1/1973 DASPETAH
67 WABINO 3/26/2001 DASPETAH
68 UJANG ANWAR 8/10/1959 DASPETAH
69 BEKA KURNIATI 7/23/1974 DASPETAH
70 HERLINA 9/22/1997 DASPETAH
71 DARMITA 4/14/1999 DASPETAH
72 ANTON SUJARWO 4/14/1984 DASPETAH
73 TIKA NOPELA 8/1/2000 DASPETAH
74 EKA SUSTIN LOVIA 4/6/1977 DASPETAH
75 WINDRA 7/1/1983 DASPETAH
76 LUSPITA PANDEMI 3/8/2000 DASPETAH
77 TUTI MARIANA 4/8/1969 DASPETAH
78 ABI OKTO ROBBI 10/10/1995 DASPETAH
79 ILI SAHROH 11/25/1971 DASPETAH
80 MUKMINAH 5/25/1975 DASPETAH
81 LENSI HARYANTI 12/23/2003 DASPETAH
82 MEGI SAPUTRA 9/28/1999 DASPETAH
83 ZUBAINA 11/11/1970 DASPETAH
84 AYU LESTARI 7/6/2001 DASPETAH
85 RIAN SAMARGUNDA 9/27/1994 DASPETAH
86 YOGI SAPUTRA 6/8/1994 DASPETAH
87 BAMBANG SUPRIADI 8/12/1986 DASPETAH
88 AWEN DERI 1/21/2000 DASPETAH
89 RAMDAN 4/18/1971 DASPETAH
90 EDO FERDIANSYAH 6/26/1999 DASPETAH
ari 91 SUPIYA 2/20/1983 DASPETAH
92 ARPAN JAYA 4/10/1973 DASPETAH
93 HENDRA 2/15/1980 DASPETAH
94 EKO PURNOMO 5/5/1987 DASPETAH
95 AGUSTIAN BASTARI 8/16/1996 DASPETAH
96 IWEN OKTAYOLANDA 10/27/1998 DASPETAH
97 LESI MARDIAYANA 8/30/2008 DASPETAH
98 SUMI JAMILA 9/10/1973 DASPETAH
99 ALFIAN 9/21/1999 DASPETAH
100 VIRA OKTA 10/1/1997 DASPETAH
101 SAMSUDIN 1/12/1973 DASPETAH
102 DADANG WAHYUDI 1/11/1991 DASPETAH
103 MAT USIN 6/22/1947 DASPETAH
104 SIPAINA 1/10/1949 DASPETAH
105 ASIAWATI 6/26/1968 DASPETAH
106 SULASTRI 12/12/1967 DASPETAH
107 YOSIANA 7/6/1979 DASPETAH
108 TENI AYU 9/17/2003 DASPETAH
109 WAGIYANTI 7/6/1973 DASPETAH
110 KARTODI 7/7/1977 DASPETAH
111 TRI AGUSTINA 8/25/2002 DASPETAH
112 ENI DESMITA 3/28/2007 DASPETAH
113 HAMBALI 7/17/1971 DASPETAH
114 UJANG SAIRIN 4/30/1963 DASPETAH
115 JAWADI 9/25/1969 DASPETAH
116 ARI AGI PRASETYO 8/28/1993 DASPETAH
117 MURSI 3/23/1983 DASPETAH
118 INDRI PERMATASARI 2/29/1996 DASPETAH
119 HARTATI SUMARNI 5/1/1983 DASPETAH
120 SUSILAWATI 10/6/1982 DASPETAH
121 TUTI MARIANA 1/19/1993 DASPETAH
122 SUKARDI 7/1/1956 DASPETAH
123 REDA SANTI 12/1/1989 DASPETAH
124 HERMAN TONI 9/6/1970 DASPETAH
125 HERU PINOSA 11/23/1987 DASPETAH
126 NOFRI YANTI 10/5/1990 DASPETAH
127 FARTI ROSMAINI 7/11/1982 DASPETAH
128 ANDINI APRISA 4/14/2007 DASPETAH

MERIGI
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
22 NOVEMBER 2021
DESA DASPETAH

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM

M.UMUM
NAKES

NAKES

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
BUMIL

BUMIL

BUMIL
1708020106690002
1708021704800003
1708021712020001
1708025709740001
1708026110920001
1708026710730002
1708045010930006 1
1708022012930005
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1708026809760002
1708021012510001
1708021209030003
1708022712680003
1708026909750001
1708025010780004
1708020310030001
1708021011910003
1708024808770002 SUDAH ENTRI 30 OKTOBER DI AIR BINTUHAN
1708025303780006
1708024708910001
1708025004730002
1708022810690002
1708025304530002
1708024501750002
1708022510000005
1708025801090001 1
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1708022706050001 1
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1708021205000002
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1708021003030005
1708022805710001
1708026208730001
1708020502790001
1708024903780002 DUKCAPIL
1708022908920001
1708024107730196
1708022603010001
1708021008590001
1708026307740001
1708026209970001 1
1708025404990002
1708021404840001
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1708020107830146
1708024803000001 DUKCAPIL 1
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1708021804710001
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1708021502800004 1
1708020505870001
1708021608960004 DUKCAPIL
1708026710980001
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1708025009730003
1708042109990002
1708024110990001
1708021201730002
1708021101910004
1708022206470001
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1702186508020001 1
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1708021707710002
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1708022808930004 1
1708022303830002
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1708024105830001
1708024610820002
1708025901930002 1
1708020107560030 DUKCAPIL
1708024112890001
1708020609700001
1708022311870001
1708024510900003 1
1708025107820002
1708045404070001 1
0 0 0 0 0 0 0 0 0 7 0 0 0 0 3 8 0 7
0 7 18
LANSIA

PFIZER
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA

1
1
LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA

LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
1
1

1
1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1

1
1
1
1
1

0 0 0 0 0 0 8 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 103 0
128
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
DESA

M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
UMA 0 0 0 0 0 0 0 0 0 0 0 0 0
DPT 0 0 0 0 0 0 0 0 0 0 0 0 0
NASI COVID 19
1

MODERNA
DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

JUMLAH
M.UMUM
LANSIA

PUBLIK

0 0 0 0 0 0
0 0 0 0 0 0
NO NAMA TGL LAHIR ALAMAT

1 KODIR HIDAYAT 7/17/1986 SURO MUNCAR


2 RUBIAH 3/1/1958 BUMI SARI
3 SARNO 3/1/1954 BUMI SARI
4 ADITIA WIGUNA 5/2/1979 SURO BALI
5 ASNI 7/1/1972 UJAN MAS ATAS
6 PUTRI YANI 6/30/1993 BUMI SARI
7 TUMINI 8/5/1962 BUMI SARI
8 PONINTEN 7/12/1962 BUMI SARI
9 SITI SAKDIYAH 12/26/1977 BUMI SARI
10 HJ. WILIANI 2/22/1957 UJAN MAS ATAS
11 HARJULI YANTI 7/1/1979 UJAN MAS ATAS
12 NASIR NAJEMI 2/24/1967 UJAN MAS ATAS
13 SUDIRMAN 10/10/1976 UJAN MAS ATAS
14 SATIYEM 12/13/1961 UJAN MAS ATAS
15 EKO WAHYUDI 6/9/1978 SURO BARU
16 INDRA 5/17/1981 UJAN MAS ATAS
17 MAIKEM 3/9/1949 BUMI SARI
18 MARLENA 7/7/1970 BUMI SARI
19 BULYA AINI 9/5/1999 UJAN MAS ATAS
20 MARSIP 7/1/1954 SURO MUNCAR
21 NOVA SAPUTRA 4/8/1995 UJAN MAS ATAS
22 RAHANI 6/12/1976 UJAN MAS ATAS
23 SAIDI 3/1/1974 SURO ILIR
24 SUPRIADI 8/7/1967 BUMI SARI
25 JONI ANSORI 10/8/1978 UJAN MAS ATAS
26 MEGI SAMUDRA 8/1/1997 UJAN MAS ATAS
27 BAULI 3/7/1990 UJAN MAS ATAS
28 FITRIA PISALENA 2/2/1996 UJAN MAS ATAS
29 MULYADI 7/1/1990 UJAN MAS ATAS
30 HERMANTO 4/12/1979 UJAN MAS BAWAH
31 TRISKA 12/19/1991 UJAN MAS ATAS
32 LENSI DIANA 6/10/1984 UJAN MAS ATAS
33 DEWI SUSANTI 7/1/1979 UJAN MAS ATAS
34 ARIPAN JUNAIDI 9/2/1982 UJAN MAS ATAS
35 YERSI MARSITA 12/14/1989 UJAN MAS ATAS
36 ADELIA PUTRI HADI 8/20/2006 PG MERANTI
37 NETI HERAWATI 7/1/1976 DS SURO ILIR
38 JUSNA WATI 11/10/1978 UJAN MAS ATAS
39 J.O NANDO 6/14/2001 UJAN MAS ATAS
40 LEGIATI 7/15/1983 SURO BARU
41 KHUSNUL KHATIMAH 5/28/2006 SURO ILIR
42 SUSILAWATI 7/2/1977 UJAN MAS BAWAH
43 KURNIASIH 10/16/1958 CIMANGGIS
44 NELI LESTARI 5/5/1985 UJAN MAS ATAS
45 ALPIN MAHENDRA JAYA 12/16/2001 UJAN MAS BAWAH
46 SARINA 2/3/1958 UJAN MAS ATAS
47 MARIYANI 12/12/1988 UJAN MAS ATAS
48 ANTON SUPRIADI 4/6/1989 WATAS MARGA CUR
49 NURLAILI 6/10/1984 DASPETAH
50 DARWIN 1/18/1973 DASPETAH
51 ABU SOPYAN 11/15/1996 UJAN MAS BAWAH
52 PUTU NALIE 2/3/1968 SURO BALI
53 LESI ANDRIYANI 1/9/2001 SURO ILIR
54 JAALNAWATI 7/1/1970 UJAN MAS ATAS
55 AKIB 4/24/1967 UJAN MAS BAWAH
56 MISYADI BUMI SARI
57 PUTRI CAHAYA DASPETAH 2
58 SAYUTI 5/29/1966 PG BERINGANG
59 EVI KURNIA WATI 8/11/1976 DASPETAH
60 EDI HARYANTO 6/6/1981 UJAN MAS ATAS
61 FIKRI RAMADANI ADITIA 12/13/2000 UJAN MAS ATAS
62 RIKI SUBAKJA 1/25/2006 UJAN MAS BAWAH
63 UMI KALSUM 7/28/1981 UJAN MAS ATAS
64 SELLI VERONIKA 9/10/2002 UJAN MAS ATAS
65 RIAN AGUSTORI 8/29/1992 UJAN MAS BAWAH
66 BUDI YANTO 8/25/1974 SURO ILIR
67 AMELIA OKTARINA 1/10/1994 UJAN MAS ATAS
68 TITIN HERAWATI 5/31/1988 PG MERANTI
69 ENDANG IRAWAN 11/14/1989 UJAN MAS ATAS
70 PUTI AMELIA 6/25/2007 UJAN MAS ATAS
71 SUPIAH 7/1/1960 SURO MUNCAR
72 SITI ROHANI 6/6/1996 SURO MUNCAR
73 ANGGRITA SALSA BILA 5/10/2008 SURO MUNCAR
74 ARSI NANDA 7/1/1974 UJAN MAS ATAS
75 DEDI DARMADI DASPETAH
76 RUSLINA MANALU 12/13/1985 UJAN MAS BAWAH
77 YOYON SURYAWAN 11/9/1988 UJAN MAS ATAS
78 YUSMAWATI 3/2/1973 UJAN MAS ATAS
79 RATNA JUWITA 4/25/1987 SURO MUNCAR
80 RENI 4/6/1989 UJAN MAS BAWAH
81 OMSYAWATI 7/1/1971 UJAN MAS ATAS
82 SUSLINDA 7/16/1988 UJAN MAS ATAS
83 JAMES BOND 1/1/1975 UJAN MAS BAWAH
84 WENI PUTRI ANI 5/28/2003 PG BERINGANG
85 RITA ARIANI 2/11/1987 UJAN MAS ATAS
86 HENDRIK UJAN MAS ATAS
87 ASNILAWATI 3/10/1970 UJAN MAS ATAS
88 WAWAN TRIONO 8/8/1988 SURO MUNCAR
89 EFENDI 3/1/1962 UJAN MAS ATAS
90 PADRI 1/10/1980 PG BERINGANG
91 BENAWATI 7/8/1972 PG BERINGANG
92 MELATI MESTIKA 6/13/2004 PULOGETO
93 YOYON ANSORI 7/5/1989 PG BERINGANG
94 NANDO SAPUTRA 5/4/2001 PULOGETO
95 ZULKARNAIN 7/4/1964 PG BERINGANG
96 HASAHUDIN 5/3/1968 PG BERINGANG
97 DARMALINDA 1/1/1999 PG BERINGANG
98 AGUSTIANTO 8/11/1995 PG BERINGANG
99 AHMAD PUDIN 10/25/1981 PG BERINGANG
100 ARYA SUGARA 1/2/1995 PG BERINGANG
101 ASNAWATI 3/9/1968 PG BERINGANG
102 DENI ISWAN BERLANDA 7/11/1992 PULOGETO
103 ANGGA SAPUTRA 6/20/1997 PULOGETO
104 KIKI ANISA CITRA 4/5/2001 PULOGETO
105 AMRATULLAH 7/1/1979 DASPETAH
106 SAHRONI 5/11/1970 PG BERINGANG
107 JONI PUTRA 1/1/1983 PG BERINGANG
108 AYU TRI LOPA 7/27/1995 PG BERINGANG
109 RISKI ANGGRAINI 6/3/2007 CURUP
110 RISKA ANGGRAINI 6/3/2007 CURUP
111 KARTINI 10/15/1955 DASPETAH
112 SASMITA MAHARANI 1/10/1986 PG BERINGANG
113 AJI SUKMO SAPUTRA 12/16/1995 PG BERINGANG
114 HAMDAN JUNAIDI 4/10/1982 PG BERINGANG
115 BENO ARYANTO 3/17/2008 PG BERINGANG
MERIGI
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
23 NOVEMBER 2021
KANTOR CAMAT

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
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1708024107780175
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1708025207620002
1708026612770001
1708026202570001
1708024107790139
1702090107670020
1708021010790007
1708025312610001
1708050906780001
1708020107800142
1708024309490001
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1708024509990004
1708020107540038
1708020604950001
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1708024107700128 1
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1708022905660001
1708025108760001
1708020606810001
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0 0 0 0 0 0 0 1 0 8 0 1 1 0 0 1
0 10 16
T
021
D-19

1
1
1
DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA

1
LANSIA
MODERNA

PUBLIK

1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK
REMAJA

1
1
1

LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
DOSIS 1
SI
1
1

1
1
1

1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

12 0 2 0 0 0 2 0 0 0 0 0 0 0 1 0 13 0 0 5 0 0 64 0 0 0 0 0 0 0 0 0
16 2 14 69
115
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA

DPT
UMA
DESA

0
0

LANSIA
0
0

PUBLIK
0
0

M.UMUM
DOSIS 1

0
0

PENDIDIK

REMAJA
0
0
0
0

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
1
1
1
1

0 0 0 0 0 1 0 0 1 0 2
4
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
NO NAMA TGL LAHIR ALAMAT

1 ANDI SAPUTRA 10/5/1980 SURO MUNCAR


2 SERI SULASTRI 9/29/2001 SURO MUNCAR
3 RIKI ARDIANSYAH 12/19/1988 SURO MUNCAR
4 AZWAR IRAWAN 5/4/1996 SURO MUNCAR
5 MUKTAR LUBIS 4/5/1976 SURO MUNCAR
6 TUNUK 7/1/1970 SURO MUNCAR
7 CIKMAN 10/11/1957 SURO MUNCAR
8 ARIZAL 11/9/1992 SURO MUNCAR
9 NOVI SUSANTI 7/5/1990 SURO MUNCAR
10 SARNUBI 6/9/1951 SURO MUNCAR
11 LINDA 6/7/1998 SURO MUNCAR
12 ANITA SARI 8/27/1997 SURO MUNCAR
13 RENA YENSI 6/14/1999 SURO MUNCAR
14 YUSNA DELI 8/7/1965 SURO MUNCAR
15 DARMAWANSYAH 2/6/1987 SURO MUNCAR
16 MANIA 3/25/1952 SURO MUNCAR
17 DARYANA 7/1/1965 SURO MUNCAR
18 PASWAN JAYA 7/2/1966 SURO MUNCAR
19 NODI WIJAYA 11/19/1987 SURO MUNCAR
20 ZUBAIDA 8/16/1998 SURO MUNCAR
21 ROB PAISAL 2/27/2000 SURO MUNCAR
22 WAWAN 3/1/1995 SURO MUNCAR
23 MAHYUDIN 6/1/1963 SURO MUNCAR
24 ROMI 11/4/1988 SURO MUNCAR
25 SUHARDI 7/1/1967 SURO MUNCAR
26 RATNA WATI 5/15/1968 SURO MUNCAR
27 ISKANDAR 8/7/1977 SURO MUNCAR
28 ZAINAL 7/12/1980 SURO MUNCAR
29 ASWAN EFENDI 2/5/1969 SURO MUNCAR
30 BUYAMIN 12/6/1980 SURO MUNCAR
31 EDI SULAIMAN 5/7/1981 SURO MUNCAR
32 ROBI HARTONO 8/4/1992 SURO MUNCAR
33 DIMAS VINO FERNANDO 7/14/2007 SURO MUNCAR
34 ABU NAWAS 4/21/1952 SURO MUNCAR
35 DORI IRAWAN 1/23/2001 SURO MUNCAR
36 RISKITO 8/6/2000 KESAMBE LAMA
37 HENI WIDIA SARI 8/3/1990 SURO MUNCAR
38 REKA WATI 11/18/1983 SURO MUNCAR
39 AHMAD SOPIAN 7/26/1957 SURO MUNCAR
40 ABU HANIPA 12/9/1969 SURO MUNCAR
41 NOVELIDIA 2/16/1998 SURO MUNCAR
42 INDRA HERIADI 7/19/1977 SURO MUNCAR
43 SARPANI 3/10/1973 SURO MUNCAR
44 INDA LESTARI 2/15/2003 SURO MUNCAR
45 ROSMAYULI 4/1/1970 SURO MUNCAR
46 MARLENA 7/28/1980 SURO MUNCAR
47 NENI NURHAYATI 6/29/1993 SURO MUNCAR
48 RADE PURBA 2/20/1993 SURO MUNCAR
49 HERMAN JONO 7/21/1974 SURO MUNCAR
50 ANGGI 7/1/2002 SURO MUNCAR
51 SALDI 9/3/2003 SURO MUNCAR
52 SAIPUL 3/12/1978 SURO MUNCAR
53 SANDI ADI PUTRA 6/7/2002 SURO MUNCAR
54 RIA SARTIKA 3/23/1992 SURO MUNCAR
55 COCON WAHYUDIN 7/12/1982 SURO MUNCAR
56 MALYATI 7/5/1971 SURO MUNCAR
57 JOHAN SUMANTRI 6/7/2002 SURO MUNCAR
58 RIAN SAPUTRA 7/4/1999 SURO MUNCAR
59 SA'ADIA 2/13/1961 SURO MUNCAR
60 MAINA 7/1/1962 SURO MUNCAR
61 YUSDA 10/2/1978 SURO MUNCAR
62 ANI SAPITRI 2/18/1998 SURO MUNCAR
63 DEVI YANTI 1/27/1985 SURO MUNCAR
64 IBNU HAJAR 1/8/1978 SURO MUNCAR
65 SUKARNAWATI 11/15/1986 SURO MUNCAR
66 SUDIHATI 7/5/1977 SURO MUNCAR
67 SOLEKAN 8/19/1974 SURO MUNCAR
68 MARIANA 10/25/1962 SURO MUNCAR
69 DEDI 5/17/1980 SURO MUNCAR
70 NENTRI 8/12/1983 SURO MUNCAR
71 SETIA BUDI 12/1/1981 SURO MUNCAR
72 KELING SUPARTA 12/3/1968 SURO MUNCAR
73 ZAINAL IMRON 3/14/1977 SURO MUNCAR
74 KARTINA SURO MUNCAR
75 SURYADI SURO MUNCAR
76 ANGGITA PRIATNA 9/29/2002 SURO MUNCAR
77 AGUS MAWAR 8/10/1983 SURO MUNCAR
78 FIDIA HANDAYANI 6/28/1984 SURO MUNCAR
25 KASTURI 6/5/1974 SURO MUNCAR
51 BURSAN 11/20/1980 SURO MUNCAR
64 RESI 12/24/1979 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
25 NOVEMBER 2021
DESA SURO MUNCAR

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
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0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
0 30

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021
D-19

CAR

DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK

1
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA

1
1
1
1

LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
DOSIS 1
SI
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

27 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 43 0 0 0 0 0 0 0 0 0
30 0 48
78

1
1
1
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
0 0 0 0 0 0 0 0 0 0 0
0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
NO NAMA TGL LAHIR ALAMAT

1 ANRIANA 8/24/1985 DURIAN DEPUN


2 MARHAMA 7/1/1948 SURO MUNCAR
3 AHMAD RIFKI PRATAMA 10/24/2000 UJAN MAS ATAS
4 TRI ADIYANSAH 10/28/1989 UJAN MAS ATAS
5 METAYOSI 6/24/1991 UJAN MAS ATAS
6 MARYATI 12/6/1979 UJAN MAS ATAS
7 ARPANDI 7/1/1975 UJAN MAS ATAS
8 REPIL EKSAN ROMADON 10/17/2005 UJAN MAS ATAS
9 LINDA 9/2/1988 UJAN MAS ATAS
10 BADRI 2/5/1967 UJAN MAS ATAS
11 RIZKI OKTARIA 10/3/2003 SURO MUNCAR
12 BENIDIAN PRANATA 4/4/2008 UJAN MAS ATAS
13 WINARTA 5/11/1984 PG MERANTI
14 ENDANG SUPRIADI 8/9/1980 UJAN MAS ATAS
15 DIA DWI PUTRI 7/30/2000 UJAN MAS ATAS
16 REKI KARDO 11/17/1995 UJAN MAS ATAS
17 DONI AFRIANTO 4/29/1991 SURO LEMBAK
18 RENITA 2/2/1992 UJAN MAS ATAS
19 PUTRA JAYA 12/10/1983 UJAN MAS ATAS
20 HAMDAN 7/27/1978 UJAN MAS ATAS
21 ASMADI 1/20/1973 UJAN MAS ATAS
22 MARLENA SURO ILIR
23 PUTRA JAYA 12/10/1983 UJAN MAS ATAS
24 RISTON TONCE 5/23/1983 UJAN MAS ATAS
25 RIWANTO MUJIONO 6/1/1970 UJAN MAS ATAS
26 JOKO SANTOSO 10/11/1997 UJAN MAS ATAS
27 RATNA REFI 8/2/1992 UJAN MAS ATAS
28 MIKE KUSNAINI 9/10/1999 UJAN MAS BAWAH
29 TUTI RUSIANA 5/12/1974 UJAN MAS ATAS
30 RESTA NOKI 3/30/1999 UJAN MAS ATAS
31 HASINUL ATMI 3/5/1971 DASPETAH 2
32 REPALDO APRIANSAH 8/28/2002 UJAN MAS ATAS
33 GUNAWAN ALPIAN 11/8/2005 UJAN MAS BAWAH
34 ZENA ADE PUTRI 2/23/2007 UJAN MAS ATAS
35 DINDY BUSRANDI 12/7/1990 SUNGAI SERUT, BEN
36 SISWONO 10/21/1993 UJAN MAS ATAS
37 SAPUTRA DARMAWANSA 6/12/2007 UJAN MAS BAWAH
38 ADE IRAWAN 10/12/1995 UJAN MAS ATAS
39 RUDI SUSANTO 1/4/2005 UJAN MAS ATAS
40 SUDI PAJRI 6/10/1990 UJAN MAS ATAS
41 HAMDAN 7/19/1973 UJAN MAS ATAS
42 LILI HERLINA 5/7/1987 UJAN MAS ATAS
43 ROSWAN GUMANTI 7/1/1963 UJAN MAS ATAS
44 M. ISWANDI 6/8/1983 UJAN MAS ATAS
45 HJ WASIAH 7/1/1955 UJAN MAS ATAS
46 WIWIK ROSDIANA 5/23/1982 UJAN MAS ATAS
47 DELI 5/5/1989 DASPETAH 2
48 SYAHRONI 6/12/1985 UJAN MAS ATAS
49 ALPIN ERI ANGGARA 2/27/2003 UJAN MAS BAWAH
50 YOGI RUKANDA 6/1/1999 SURO BARU
51 CAYOT 6/4/1970 UJAN MAS ATAS
52 RISWAN TONI 4/19/2001 UJAN MAS ATAS
53 WENI PITRIYANI 5/9/2003 UJAN MAS ATAS
54 DERIAN KONEDI 1/28/1996 UJAN MAS ATAS
55 SUSILAWATI 4/20/1972 UJAN MAS ATAS
56 MATIUS 9/1/1974 UJAN MAS ATAS
57 ADNAN ANSORI 7/1/1977 UJAN MAS ATAS
58 YANTI 7/1/1986 UJAN MAS ATAS
59 DARN WATI 7/1/1963 UJAN MAS ATAS
60 FITRI HANDAYANI 4/1/1987 UJAN MAS ATAS
61 TARA LESFITA 6/7/2004 UJAN MAS ATAS
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
25 KASTURI 6/5/1974 SURO MUNCAR
51 BURSAN 11/20/1980 SURO MUNCAR
64 RESI 12/24/1979 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
27 NOVEMBER 2021
KANTOR CAMAT

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708016408850001
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1708024167630217
1708024104870001
1708074706040000

0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 61

1708024506740002 0
1708022118000009 08979574300
1708056412790001 081632192279
T
021
D-19

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK

1
1
1
1
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL

1
1
1
1
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
DOSIS 1
SI
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

48 0 7 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 0 0
61

1
1
1
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
0 0 0 0 0 0 0 0 0 0 0
0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
NO NAMA TGL LAHIR ALAMAT

1 DAHLIAN 8/17/1970 DASPETAH


2 TURI ASIA 1/25/1976 DASPETAH
3 JENI 1/21/2000 DASPETAH
4 SUDIRMAN 7/1/1979 DASPETAH
5 JEKI HERLIANSYAH 7/22/1997 DASPETAH
6 NINI ANDIAN SARI 1/6/1998 DASPETAH
7 EDI SAPUTRA 10/5/1988 DASPETAH
8 YULIANTI 7/7/1993 DASPETAH
9 NIRWANA 4/12/1983 DASPETAH
10 NURLELA HAYATI 1/1/1960 DASPETAH
11 DESI RAMADANI 12/18/1999 DASPETAH
12 ERI SUJONO YONO 6/1/1981 DASPETAH
13 MAT ARUP 8/10/1952 DASPETAH
14 ARIA ANITA 7/12/1985 PG BERINGANG
15 RIZKI APRIANSA 2/16/2007 PG BERINGANG
16 MARDALENA 2/5/1991 DASPETAH
17 ADE PERNATA 6/18/1996 DASPETAH
18 ANITA PUSPITASARI 4/14/2004 DASPETAH
19 ANSORI 5/4/1983 DASPETAH
20 CAHAYA MURNI 1/27/1975 DASPETAH
21 SRI DALENA 7/6/1984 DASPETAH
22 PONIRUN 7/7/1979 DASPETAH
23 EPIARIANTI 6/15/1980 DASPETAH
24 PATMI YANTI 4/7/1985 DASPETAH
25 SUPRI MARYADI 3/2/1992 DASPETAH
26 ANDI WIJAYA 10/12/1981 DASPETAH
27 WELI HARTATI 8/24/1985 DASPETAH
28 ROSDIANAH 9/14/1966 DASPETAH
29 WAZIR ALAM 1/4/1971 DASPETAH
30 LENI 11/6/1991 DASPETAH
31 KIRANA LARA SATI 5/4/2009 DASPETAH
32 DARIMUN 8/4/1983 DASPETAH
33 BINTANG NUKRAHA 12/13/2003 DASPETAH
34 RINALDI PAHMI 2/16/1999 DASPETAH
35 DONA 7/16/1985 DASPETAH
36 DOKI AFRI 6/5/1992 DASPETAH
37 SAPRI YANDO 2/1/2003 DASPETAH
38 JENDI GUNAWAN 10/7/1999 DASPETAH
39 INDRA WANI 9/12/1951 DASPETAH
40 RIAN IMELDA 10/11/1987 DASPETAH
41 FAUZIAH 1/26/1976 DASPETAH
42 YANTI 7/29/1976 DASPETAH
43 ANDI ROMADAN 4/20/2003 DASPETAH
44 FETI ARYASI 11/8/1994 DASPETAH
45 MERI SUSANTI 3/18/1994 DASPETAH
46 INDAH SUMARNI 4/30/1974 DASPETAH
47 DEWI INDRAWATI 5/4/1977 DASPETAH
48 MUHADI 8/14/1976 DASPETAH
49 SARIPUL 5/4/1981 DASPETAH
50 REGI HAMSYAH 2/2/1991 DASPETAH
51 CANDRA DEDI 11/3/1981 DASPETAH
52 ABDUL HAMID 5/5/1981 DASPETAH
53 DEVI DIANA 12/10/1984 DASPETAH
54 M. NABIL RAMADHAN 9/21/2007 DASPETAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
29 NOVEMBER 2021
DASPETAH

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708021708700006 085782919065
1708026501760001
1708026101000004
1708020107790122
1708022707970001
1708024601980001
1708020510880001
1708024707930003
1708025204830001
1708024101600003
1708025812990006
1708021907760002
1708021008520001
1708025207850006
1708021602070002
1708024502910002
1708021806960001
1708085404040002
1708020405830001 BELUM DI SKRINING
1708026701750001
1708024607840002
1708020707790008
1708025506800001
1708074704850001
1708020203920001
1708021210810001
1708026408850001
1708045409660002
1708020401710003
1708024611910001
1708025004090001
1708020408830001
1708021312030001
1708021602990001
1708021607850002
1708020506920004
1708020102030001
1708020710990001
1708025209510001
1708025110870003
1708026601760002 1
1708026907760003 1
1708022004030002 1
1708024811940002 1
1708026408890001 1
1708027004740001 1
1708024405770004 1
1708021408760001 1
1708020405810005 1
1708020201910003 1
1708021111810001 1
1708020505810004 1
1708025012840004 1
1708022109070001 1

0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0
14 17
21
19

1
1
1
1
1
1
1
1
1
1
1
DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK

1
1
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA

1
1
LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
DOSIS 1
SI
1
1
1
1

13 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 21 0 0 0 0 0 0 0 0 0
17 0 23
54
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
0 0 0 0 0 0 0 0 0 0 0
0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 DEWAN DWI ANDIKA 5/12/2007 PUNGGUK BERINGA


2 REKA SUKAISI 12/1/1985 PUNGGUK BERINGA
3 DARVIN 5/12/1984 PUNGGUK BERINGA
4 HELMI EKAWATI 11/24/1987 PUNGGUK BERINGA
5 ADOT 7/1/1943 PUNGGUK BERINGA
6 UCI INDARTI 11/15/1990 PUNGGUK BERINGA
7 MARIANA ASTUTI 5/23/1991 PUNGGUK BERINGA
8 YESI HARYANTI 8/8/1994 PUNGGUK BERINGA
9 LISA 8/11/1990 PUNGGUK BERINGA
10 MAI 7/1/1962 PUNGGUK BERINGA
11 NURDIN MUHAMAT RAZA 11/5/1968 PUNGGUK BERINGA
12 AMINA 12/9/1971 PUNGGUK BERINGA
13 ELI ASNAWATI 3/26/1966 PUNGGUK BERINGA
14 YOGI PRANATA 5/31/2000 PUNGGUK BERINGA
15 CENCEN PIDRIANTI 9/24/1986 PUNGGUK BERINGA
16 RAMYATUL ASMANI 11/16/1971 PUNGGUK BERINGA
17 RADIA YOT 9/20/1971 PUNGGUK BERINGA
18 RUMSIANA 2/10/1978 PUNGGUK BERINGA
19 UMI KALSUM 4/25/1964 PUNGGUK BERINGA
20 DEDI ANSORI 3/30/1978 PUNGGUK BERINGA
21 BAMBANG SUTOYO 6/27/1992 PUNGGUK BERINGA
22 IRVANDI 1/6/1996 PUNGGUK BERINGA
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
30 NOVEMBER 2021
PUNGGUK BERINGANG

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708021205070002 081373473116 1
1708024112850002 1
1708021205840002 1
1708026411870001 1
1708020107430002 1
1708025511900001
1708026305910002
1708024808940002
1708025108900001 1
1708024107620001 1
1708020511680002
1708024912710002 1
1702096603660002 1
1708023105000003 1
1708026409860002 08985712090
1708025611710001
1708026009710002
1708025002780005
1708026504640002
1708023003780003
1708022706920004 082281925711
1708020601960002 085266265838

0 0 0 0 0 0 1 0 0 8 0 1 0 0 0 0
10 12
21
19

ANG

1
1
1
1
DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK

12
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA

4 0 0 0 0 0 8 0 0 0 0
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK

22
REMAJA

0
0 0 0 0
LANSIA
MODERNA

PUBLIK

0
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK

0 0 0 0 0 0
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA

0
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
0 0 0 0 0 0 0 0 0 0 LANSIA
DOSIS 1
SI
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA

0
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK

0 0 0 0 0 0 0 0 0 0 0
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 PERI HARDIANSYAH 9/27/1997 SURO ILIR


2 MISTAR YADI 5/20/1990 SURO ILIR
3 ILI SURYANI 1/7/1974 SURO ILIR
4 MUHAMAT ROZALI 12/27/2002 SURO ILIR
5 DARWIN 7/2/1992 SURO ILIR
6 HARTATI 4/14/1991 SURO ILIR
7 JERI ANITA 10/27/1996 SURO ILIR
8 NURUL HUDA 2/9/1988 SURO ILIR
9 RIANTO 6/19/2002 SURO ILIR
10 NGADIKEM 8/2/1959 SURO ILIR
11 NIKEN JUNIATI 6/18/2005 SURO ILIR
12 SUPARSIH 5/6/2004 SURO ILIR
13 HADI MULYA 5/1/1994 SURO ILIR
14 ANDI SAPUTRA 1/15/1993 SURO ILIR
15 ROBYANDI 12/28/1990 SURO ILIR
16 ASWANDI 9/23/1969 SURO ILIR
17 SISKA 3/10/1996 SURO ILIR
18 MARLIN 5/5/1983 SURO ILIR
19 RINO ILHAM 11/2/2009 SURO ILIR
20 DAVA RAHARDI 8/27/2008 SURO ILIR
21 PANDI AFRILIO PUTRA 4/14/1989 SURO ILIR
22 SURLINDA 6/22/1991 SURO ILIR
23 YONA SAPUTRA 11/2/2001 SURO ILIR
24 SALBUDIN 9/8/1963 SURO ILIR
25 KARYO IRAWAN 2/11/1990 SURO ILIR
26
27
28
29
30
31
32
ANITA SARI 7/17/1997 SURO ILIR
17 MELI HARTATI 6/3/1974 SURO ILIR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
01 DESEMBER 2021
SURO ILIR

SINOVAC PFIZER
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708022709970002
1708022005900001
1708024701740001
1708022712020003
1708020207720002 085368665878
1708025404910003
1708026608960001 085269968725
1708024902880001
1708021906020002
1708024208590001
1708025806050002 089526155632
1708024605040001 089530976406
1708020105940003 085709354402
1708021501930003 085279611705
1702182812900001 085382534040
1702182309690002 085382534040
1708025003960001 082186435171
1708020505830003 085367459283
1708020211090002
1708022708080001
1702181404890004
1702186206910003 085382534040
1708020211010003 083157581415
1708020809630002
1708021102920001 089609819459

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 13
1708025707970002 085383634720 1
1702184306740001
21
19

1
1
1
1
1
1
1
1
1
DOSIS 1
M.UMUM AP UJAN MAS
PENDIDIK

13
1
1
1
1
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA

9 0 4 0 0 0 0 0 0 0 0
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA

0
0 0 0 0
LANSIA
MODERNA

PUBLIK

0
M.UMUM
DOSIS 2

PENDIDIK
1 REMAJA
LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA

12
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA

0 0 0 1 0 0 11 0 0 0 0 0 0 0 0 0
LANSIA
DOSIS 1
SI
25

1
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA

0
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK

0 0 0 0 0 0 0 0 0 0 0
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC
DOSIS 2
28 OKTO
REKAPITULASI HARIAN
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 DATIN SUHAIMA 10/18/1982 SURO MUNCAR


2 LINDA HARATTI 2/6/1984 SURO MUNCAR
3 KARTINI 2/3/1976 SURO MUNCAR
4 SITI RIYA 8/12/1965 SURO MUNCAR
5 NELI 2/1/1982 SURO MUNCAR
6 EGO HARYANTO 3/6/2003 SURO MUNCAR
7 DESI RATNA SARI 6/26/1998 SURO MUNCAR
8 BUSTADIR 11/22/1975 SURO MUNCAR
9 HOLING 7/1/1979 SURO MUNCAR
10 SUSILAWATI 4/17/1991 SURO MUNCAR
11 MURNI CAHAYA 5/12/1990 SURO MUNCAR
12 SUKRI JAMIN 10/1/1987 SURO MUNCAR
13 AKTI MULYASARI 8/22/1972 SURO MUNCAR
14 PURNAMA IRAWAN 6/3/1998 SURO MUNCAR
15 LENI YANITA 11/14/1986 SURO MUNCAR
16 SALMA 7/7/1983 SURO MUNCAR
17 RUMI 8/1/1990 SURO MUNCAR
18 MELANI PUTRI 8/11/2001 SURO MUNCAR
19 SITI MARLIA 11/1/1974 SURO MUNCAR
20 MISSITA 4/3/1978 SURO MUNCAR
21 EVA PUSPITA SARI 6/6/1987 SURO MUNCAR
22 AVEROES ARIF 5/21/1994 SURO MUNCAR
23 HADI SUPRAYITONO 5/12/1999 SURO MUNCAR
24 ARYANI 9/20/1986 SURO MUNCAR
25 REKO GUNTARA 5/10/1993 SURO MUNCAR
26 ANSYORI 1/12/1992 SURO MUNCAR
27 PATRIANA 8/11/1983 SURO MUNCAR
28 SANTI JUSTARI 9/10/1988 SURO MUNCAR
29 HIDAYATULAH EFENDI 10/22/2005 SURO MUNCAR
30 RENA SAHARA 9/9/1995 SURO MUNCAR
31 SARI MANTO 10/10/1974 SURO MUNCAR
32 NENGSI 7/5/1979 SURO MUNCAR
33 MARLINA SUSANTI 12/10/1993 SURO MUNCAR
34 ARIANTONI 6/27/1997 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
02 DESEMBER 2021
SURO MUNCAR

SINOVAC PFIZE
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1702195810820002 085384997480
1708024502840001
1708024302860003
1708025208650004
1708024102820003
1708020603030001 088153995611
1708026606980009 085263113892
1708022211750005 081632203321
1708020107790114 081632192279
1708025704910001 085379391007
1708025205900001 089519083387
1708020110780001 08995730707
1708026208720002 085268598118 1
1708020603980001 0895423452174 1
1708025411860001 1
1708024707830005 1
1708024108900004 1
1708025108010001 1
1708024111740002 1
1708024304780001 1
1708024301830002
1771082105940001 082281754029
1708021205990004
1708026009860002 081368447588
1708051005950003 089503189028
1708021001920002 082374574893
1708025108830006 085768722539
1708026205930002 08995730707
1708022210050001 089530972669
1708024909950002 1
1708021010740004 1
1708024507790004 085788365745
1708024207920003 085896473639
1708022706970001 1

0 0 0 0 0 0 0 0 0 11 0 0 0 0 0
11 23
N
AR
2021
VID-19
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DOSIS 1
INAP UJAN MAS
M.UMUM
PENDIDIK

23
1
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL

1
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA

0 21 0 1 0 0 0 1 0 0 0 0
PUBLIK
M.UMUM
DOSIS 1

34
PENDIDIK
REMAJA

0
0 0 0 0
LANSIA
MODERNA

PUBLIK

0
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK

0 0 0 0 0 0
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA

0
LANSIA
ASTRA

PUBLIK
BUMIL

0 0 0 0 0 0 0
M.UMUM
DOSIS 2
A
DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
PENDIDIK DOSIS 1
REMAJA

0
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK

0 0 0 0 0 0 0 0 0 0 0 0 0 0
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
SINOVAC
REKAPITU
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 JARNI 6/30/1975 DASPETAH


2 RUMBIA 4/3/1971 DASPETAH
3 NELI KUTIBA HERA 10/5/1979 DASPETAH
4 INDRIAN OKTARI 10/3/2004 DASPETAH
5 ANDIKA ARIA P 5/25/2001 DASPETAH
6 RAFFLES RAMADANI 12/5/2000 DASPETAH
7 PITRI LESTARI 7/21/1993 DASPETAH
8 PITRIANA HUSNI 7/1/1967 DASPETAH
9 PIRMIN 7/12/1953 DASPETAH
10 INA ASMA 1/17/1955 DASPETAH
11 SOPYAN ANTONI 2/1/1986 DASPETAH
12 LENSIANA 4/20/1987 DASPETAH
13 AMIRUDIN 7/26/1983 DASPETAH
14 ANI KASITA 5/14/1995 DASPETAH
15 SURIB 3/13/1946 DASPETAH
16 JALIL 7/1/1943 DASPETAH
17 EMI SUHARTI 8/17/1980 DASPETAH
18 NELI HERMAWATI 1/20/1963 DASPETAH
19 HENDRI MULYADI 6/2/1984 DASPETAH
20 ADITIO CARLO 12/29/1994 DASPETAH
21 DELAH MARYANAH 8/27/2004 DASPETAH
22 DOHLI MARIYANI 10/3/2005 DASPETAH
24 RUSMANTO 8/16/1960 DASPETAH
25 EDI SABARA 3/1/1974 DASPETAH
26 NURMAINI 12/31/1962 DASPETAH
27 SELI LIA 3/1/1999 DASPETAH
28 CARISA SILVIANA 7/14/2009 DASPETAH
29 ELPI MARLENA 10/9/1978 DASPETAH
30 ROLAN RONALDI 5/18/2003 DASPETAH
31 RISEH ATIRTA 1/19/2001 DASPETAH
32 JEN 8/16/1982 DASPETAH
33 RAHMA 5/25/1955 DASPETAH
34 TARJO TIARA 8/25/2001 DASPETAH
35 LISKA NURANI 11/14/1988 DASPETAH
36 TAUFIK HIDAYAT 5/5/2007 DASPETAH
37 WANGGI APENTRI 6/6/2002 DASPETAH
38 HERMAN SABIRAN 4/20/1975 DASPETAH
39 YOLAN SINEYO 7/10/2000 DASPETAH
40 RANI DIANSI 11/15/2002 DASPETAH
41 WAHAYA 4/6/1963 DASPETAH
42 PALEL 4/21/1974 DASPETAH
43 SUHAIBA 1/12/1957 DASPETAH
44 MULYADI 3/15/1985 DASPETAH
45 MURI 7/1/1955 DASPETAH
46 MULIYA 1/21/1964 DASPETAH
47 MARSI KUSMIATI 3/22/1990 DASPETAH
48 FITRIA MARETI 3/3/1999 DASPETAH
49 INUN JARIA 2/2/1964 DASPETAH
50 RITA RINDA 1/3/1980 DASPETAH
51 REKA SURYANI 5/4/1983 DASPETAH
52 LINDA PUTRI 11/4/1984 DASPETAH
53 WIMBI CITRA LESTARI 1/22/2002 DASPETAH
54 METRO SUHARDI 7/7/1998 CURUP UTARA
55 MAHDALENA 8/10/1976 DASPETAH
56 IWAH NIHA 7/1/1960 DASPETAH
57 MARLENA 4/2/1986 DASPETAH
58 SYAHRIAL 12/10/1974 DASPETAH
59 AISYAH 7/1/1955 DASPETAH
60 IMILIA KONTESA 11/20/1993 DASPETAH
61 DAYA MURNI 8/20/1976 DASPETAH
62 NUR AZIZA 4/3/1979 DASPETAH
63 ANITA TRIYANA 7/4/1975 DASPETAH
64 MARIATI 9/21/2001
65 LAILATUL ASMA 5/11/1967 DASPETAH
66 NOPITA SARI 11/18/1991
67 NURAINI 5/10/1969 DASPETAH
68 SUMIATI 6/28/1970 PG BERINGANG
69 MEDIA SURYANI 11/17/1989 DASPETAH
70 TITIN SUMARNI 2/4/1987 DASPETAH
71 RAHINA WANI 3/16/1978
72 BUSTAMIN 10/15/1975 DASPETAH
73 ROSMI 11/11/1967
74 GUSTI ARIANTO 8/20/1987 DASPETAH
75 SUKIR 7/1/1968 DASPETAH
76 RISNAWATI 7/12/1983 DASPETAH
77 AWALUDIN 10/10/1950
78 VERA KRISTIANA 5/12/1979 DASPETAH
79 RAMIA SUSILAWATI 7/1/1982 DASPETAH
80 EPI SUPRIYA 3/4/1983 DASPETAH
81 ERNI YOSNITA 7/20/1974
82 DAMIRI 3/10/1958 DASPETAH
83 RINI PUSPITA SARI 8/2/1974 DASPETAH
84 EDI YANSAH 1/1/1954 DASPETAH
85 TITI SUMARNI 12/3/1976 DASPETAH
86 ERNAWATI 7/1/1968 DASPETAH
87 ERYUDANILA 7/25/1963 DASPETAH
88 JALALUDIN 5/10/1959 DASPETAH
89 ANNA ARYANTI 12/11/1985 DASPETAH
90 SUSILAWATI 8/23/1974 DASPETAH
91 WILDA ARMELLIA 4/7/1999 DASPETAH
92 DEDI ROMANSA SUMANDI6/7/1996 DASPETAH
93 SRI ERLINA 1/23/1981
94 FITTAHUL JANNA 10/10/1982
95 EKO CANDRA 6/9/1987
96 CONEDI 1/12/1970 DASPETAH
97 SUCI 8/7/1972 DASPETAH
98 NURUL SUHAIMI 7/15/1984 DASPETAH
99 HERMAN TODI 4/30/1970 DASPETAH
100 SINAR WANI 10/28/1968 DASPETAH
101 ARISNAWATI 4/24/1972
102 DOSI ARYANTI 11/25/1989 DASPETAH
103 MAKIYAH DASPETAH
104 SUWANDI DASPETAH

TUNDA 16 PAJARINA 2/17/1963 DASPETAH


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
06 DESEMBER 2021
DASPETAH

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
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12 RESI
12 YUK PIT 2
4 DIAN
28
2 0
24
N 4.0

1708025702630001
AH
ER 2021
OVID-19
BUMIL

1
1
1
M.UMUM

DOSIS 1
AT INAP UJAN MAS

PENDIDIK

1
1
1
1
1
REMAJA
LANSIA PFIZER
PUBLIK
BUMIL

M.UMUM
DOSIS 2

PENDIDIK
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LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
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LANSIA
MODERNA

PUBLIK
M.UMUM
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PENDIDIK
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1
1
1
1
1
1

LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
DOSIS 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
1
1
1
1
1
1
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1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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0 3 0 5 7 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 25 0 0 0 0 0
8 64 0 0 31 0
103

3 5 7 57 6 25 103
1 3 6 1 57 15 85
4 1 22 1 19 47

1 6 0 15 9 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 59 235
24 145 66
4.00
168

4 DOSIS DR PUSKESMAS

72
70

12
58
15
85
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1
REKAPI

SINOVA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 VERA SUSANTI 9/7/1986 UJAN MAS ATAS


2 REZA ADELA 9/28/2007 UJAN MAS ATAS
3 JAYA 2/28/1971 UJAN MAS ATAS
4 PUTRI MULYA 4/6/1963 UJAN MAS ATAS
5 HASRATUL AIDA 7/1/1971 UJAN MAS ATAS
6 ITA KARMITA 8/7/1992 UJAN MAS ATAS
7 VATIMA LESTANI 10/11/1996 SURO MUNCAR
8 KARTINI 10/17/1983 UJAN MAS ATAS
9 MULYAHANA 1/1/1985 UJAN MAS ATAS
10 MESI ARSITA 3/3/1998 UJAN MAS ATAS
11 LENI HERLINA 8/7/1983 UJAN MAS ATAS
12 HARTODI 6/6/1983 UJAN MAS ATAS
13 REVI SARTIKA 4/15/1990 DASPETAH 2
14 TRI 3/10/1989 DASPETAH
15 EMI SUTIARA 7/6/1988 UJAN MAS ATAS
16 KASMA BUTI 12/11/1967 UJAN MAS ATAS
17 SUKURIA 7/1/1959 UJAN MAS ATAS
18 ROMI HARYANI 6/5/1981 UJAN MAS ATAS
19 MUTI ALI 12/3/1979 UJAN MAS ATAS
20 IBNU HAJAR 10/22/1968 UJAN MAS ATAS
21 BAHTIAR 7/1/1963 UJAN MAS ATAS
22 YUSMA WATI 7/1/1965 UJAN MAS ATAS
23 M. UMAR USMAN 7/1/1955 UJAN MAS ATAS
24 ROZI 12/10/1981 UJAN MAS ATAS
25 ENI LESTARI 7/20/1980 PG BERINGANG
26 PIONANDA SOPIANI 9/1/1997 UJAN MAS ATAS
27 EVA SUSANTI 10/10/1978 UJAN MAS ATAS
28 EVA HARTATI 8/3/1985 UJAN MAS ATAS
29 NURLENTI 8/15/1975 UJAN MAS ATAS
30 KURNIA 7/1/1970 UJAN MAS ATAS
31 BETSI SINAR WANI 7/30/1965 DASPETAH
32 WIDIYAWATI 5/26/1977 DASPETAH
33 SURYA 7/1/1956 UJAN MAS ATAS
34 SURIATI 7/2/1956 UJAN MAS ATAS
35 AISA 7/1/1962 UJAN MAS ATAS
36 PRIO NOVANDA 11/10/1994 UJAN MAS ATAS
37 HEPIRIANI 5/10/1980 UJAN MAS ATAS
38 AJIMINA 7/16/1948 UJAN MAS ATAS
39 EMI NURYA 3/1/1998 UJAN MAS ATAS
40 SUMINI 7/6/1979 UJAN MAS ATAS
41 SUSILAWATI 1/5/1991 UJAN MAS ATAS
42 ANGGI 10/22/1992 UJAN MAS ATAS
43 RENI MARYATI 2/12/1987 UJAN MAS ATAS
44 IWAN BUSTARI 5/21/1986 UJAN MAS ATAS
45 BETI SUMINI 12/29/1994 UJAN MAS ATAS
46 LASMI 7/1/1977 UJAN MAS ATAS
47 IQBAL AL VAREZI 2/17/2009 UJAN MAS ATAS
48 ELI SUSANTI 6/12/1990 UJAN MAS ATAS
49 MURDIONO 3/10/1990 UJAN MAS ATAS
50 ERWIN SUPRI 11/24/1999 UJAN MAS ATAS
51 NUR ANITA 10/10/1978 UJAN MAS ATAS
52 MILA WATI 2/15/1984 UJAN MAS ATAS
53 FATIMA TUSSADIA 3/7/1996 UJAN MAS ATAS
54 HENI ARIES 3/3/1993 UJAN MAS ATAS
55 RITA ASIA 6/16/1996 UJAN MAS ATAS
56 SUNARIYO 10/25/1989 DASPETAH
57 ELA FITRIANI 6/28/2002 UJAN MAS ATAS
58 PINGKA 6/12/1993 UJAN MAS ATAS
59 MUHIP 5/13/1967 UJAN MAS ATAS
60 LINDA SUSIANTI 7/17/1987 UJAN MAS ATAS
61 DARWIN 5/12/1983 UJAN MAS ATAS
62 ROSIDA IBRAHIM 7/3/1978 UJAN MAS ATAS
63 LENI ANITA 12/10/1986 UJAN MAS ATAS
64 SUKMA YATI 5/13/1985 UJAN MAS ATAS
65 SAHDI PARYANTA 6/26/1970 UJAN MAS ATAS
66 JULIANA 7/7/1968 UJAN MAS ATAS
67 ROYANTI 5/19/1980 UJAN MAS ATAS
68 FENNY SUMARNI 8/17/1984 UJAN MAS ATAS
69 ARENA YENSI 4/4/1979 UJAN MAS ATAS
70 NOVI MARDIANI 8/8/1978 UJAN MAS ATAS
71 YOSI MARANTIKA 10/3/1995 UJAN MAS ATAS
72 JUMIATUN 7/5/1985 UJAN MAS ATAS
73 NUR KASILAINI 2/11/1979 UJAN MAS ATAS
74 NURANIYA 7/13/1971 UJAN MAS ATAS
75 INA 7/1/1963 UJAN MAS ATAS
76 CUL'A 11/8/1964 UJAN MAS ATAS
77 DASWATI 2/1/1960 UJAN MAS ATAS
78 ERWINDA MENTARI 8/19/1997 UJAN MAS ATAS
79 EKA MARISA 4/25/1990 UJAN MAS ATAS
80 RANGGA SANGJAYA 9/11/2002 UJAN MAS ATAS
81 SINTA LIA ANISA 10/5/1997 UJAN MAS ATAS
82 DEKA ANGGRAINI 12/2/1997 UJAN MAS ATAS
83 SRI LUSIAH 8/12/1968 UJAN MAS ATAS
84 UPIK SATINI 5/3/1975 UJAN MAS ATAS
85 RODIA 7/1/1980 UJAN MAS ATAS
86 WAHYUDI 10/10/1983 UJAN MAS ATAS
87 KARTINA 7/1/1974 UJAN MAS ATAS
88 ARIANI 2/27/1968 UJAN MAS ATAS
89 ARPAN 3/1/1969 UJAN MAS ATAS
90 JUMILA 7/13/1972 UJAN MAS ATAS
91 RIDUAN 3/1/1968 UJAN MAS ATAS
92 MARDANA 12/21/1958 UJAN MAS ATAS
93 REZA NOVI JUWITA 5/5/1994 DASPETAH 2
94 PEBIO OKTARANI 10/26/2008 UJAN MAS ATAS
95 YOSI MARYANA 3/3/1994 UJAN MAS BAWAH
96 BIBA ARIYANI 7/2/1968 UJAN MAS ATAS
97 NETI HERAWATI 7/1/1979 UJAN MAS ATAS
98 FAIZAL 6/3/2005 UJAN MAS ATAS
99 DESI RATNASARI 11/4/1994 DASPETAH
100 TOPI HIDAYAT 12/20/1991 UJAN MAS ATAS
101 ASMARA 10/17/1958 UJAN MAS ATAS
102 MIRA YULIKA 6/25/1988 UJAN MAS ATAS
103 DEWI MURNI 6/8/1970 UJAN MAS ATAS
104 LENTIANA 12/5/1983 UJAN MAS ATAS
105 BAYA NATI 6/8/1971 UJAN MAS ATAS
106 DEVI YANTI 12/17/1994 UJAN MAS ATAS
107 RIA HAYATI 8/18/1990 DASPETAH
108 KIKI NOVITA SARI 2/22/1997 UJAN MAS ATAS
109 ABDUL AZIS 9/19/1957 UJAN MAS ATAS
110 ALDI GIOFANI 6/18/2000 UJAN MAS ATAS
111 DIDI MARTONO 10/12/1991 PG BERINGANG
112 WAHIMA 1/25/1966 UJAN MAS ATAS
113 SRI MAWARNI 8/18/1989 UJAN MAS ATAS
114 NURJANA 10/15/1977 UJAN MAS ATAS
115 HELMI KURNIA WATI 12/27/1987 UJAN MAS ATAS
116 MARSUNA 7/1/1968 UJAN MAS ATAS
117 LIHAN 2/8/1988 UJAN MAS ATAS
118 ELIYAH 2/1/1971 UJAN MAS ATAS
119 ALFIAN TONI 3/11/1978 UJAN MAS ATAS
120 RAMIANA 7/1/1974 UJAN MAS ATAS
121 RUSTAM EPENDI 3/13/1972 UJAN MAS BAWAH
122 SARIFUDIN 7/1/1966 UJAN MAS ATAS
123 WINDI RAHAYU 9/6/2003 UJAN MAS ATAS
124 ROMLI B 2/1/1965 UJAN MAS ATAS
125 HERAWATI 1/1/1985 UJAN MAS ATAS
126 NURCANA WATI 5/17/1974 UJAN MAS ATAS
127 HABIBULLAH 11/30/1997 UJAN MAS ATAS
128 PUJI LESTARI 9/18/1999 DASPETAH 2
129 YOGA PRANANDA 7/1/1997 DASPETAH 2
130 RISKI YANSAR 4/24/1984 SURO LEMBAK
131 DUL HADI 7/27/1971 UJAN MAS ATAS
132 PUTRA DIOBA 10/15/1980 UJAN MAS ATAS
133 RUMBIA 4/3/1976 UJAN MAS ATAS
134 YUNITA ASMARA 6/6/1969 SURO LEMBAK
135 BETA KUSUMO 2/10/1992 UJAN MAS ATAS
136 NELAM SARI 9/2/1989 SURO ILIR
137 YENI HARTATI 7/18/1995 UJAN MAS ATAS
138 TAUFIK HIDAYAT 4/1/1995 DS SURO ILIR
139 LENI MARLENA 1/20/1987 UJAN MAS ATAS
140 AZIZ 8/27/1996 UJAN MAS ATAS
141 RIYO WISODO 8/8/1993 UJAN MAS ATAS
142 RENDRA WIJAYA 1/14/1989 UJAN MAS ATAS
143 IBNU HAJAR 6/7/1973 UJAN MAS ATAS

5 MISGIARTI 8/15/1974 BUMI SARI


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
08 DESEMBER 2021
KANTOR CAMAT

SINOVAC PFIZE
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
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BUMIL

BUMIL

BUMIL
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PUBLIK
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M.UMUM
DOSIS 2

PENDIDIK
REMAJA
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PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
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PUBLIK
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PENDIDIK
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PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0
0 0 0 0 23 0
143

4 DOSIS DR PUSKESMAS

0
0

12
58
15
85
DOSIS 2
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA
SINOVAC
28
REKAPITULASI H
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 AKUAN 6/24/1979 DASPETAH


2 RISAL 11/3/1976 DASPETAH
3 JUMIRA 11/3/1953 DASPETAH
4 AMRAN 1/28/1945 DASPETAH
5 CANDRA ADE PRATAMA 8/1/2000 DASPETAH
6 SUWANDI 12/1/1955 DASPETAH
7 EDO ERLANGGA MAKMU 7/14/1990 DASPETAH
8 NANDA SAYUDA 9/7/1996 DASPETAH
9 RIA IMELDA 8/13/1980 DASPETAH
10 SUWANDI 4/15/1962 DASPETAH
11 DARMAWAN 8/26/1969 DASPETAH
12 DESI ANA 4/13/1985 DASPETAH
13 JAMALUDIN 1/30/1956 DASPETAH
14 SALEHA 11/3/1974 DASPETAH
15 KIKI IKE PRATIWI 8/25/1997 DASPETAH
16 ERNAINI 5/10/1967 DASPETAH
17 AMIR HAMZAH 5/10/1960 DASPETAH
18 PURNAMA 9/1/1968 DASPETAH
19 YENI SUSIANTI 9/9/1998 DASPETAH
20 DENA MARYANA 5/5/1988 DASPETAH
21 PIT TRIAH 9/10/1984 DASPETAH
22 ENA KURNIATI 2/4/1983 DASPETAH
23 ARDIANSYAH 3/3/1990 DASPETAH
24 LENTIS SUHAILA 2/22/1978 DASPETAH
25 RESI ANDESTA 3/9/1994 DASPETAH
26 SAKILA WATI 8/25/1973 DASPETAH
27 DARWIS HAMZAH 2/13/1971 DASPETAH
28 SEMARANG JAYA 7/2/1977 DASPETAH
29 REMA ARYANTI 6/27/1993 DASPETAH
30 DIOSI EKA PUTRA 4/17/1977 DASPETAH
31 DONA RISANTI 6/27/1993 DASPETAH
32 LESNI SARTIKA 9/22/1983 DASPETAH
33 ASMI 1/3/1979 DASPETAH
34 EVI SARI YANTI 7/1/1965 DASPETAH
35 RIS MAINI 2/28/1979 DASPETAH
36 KURNIAWATI 10/8/1997 DASPETAH
37 SUSI PATRI 7/15/1994 DASPETAH
38 TUTIK HARYANI 11/11/1990 DASPETAH
39 IBNU 8/6/1973 DASPETAH
40 RENO SANJAYA 8/23/1998 DASPETAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
13 DESEMBER 2021
DESA DASPETAH

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1708022709810001 085782919065
1708020311760001
1708024311530001
1708022801450001
1708020205990001
1708020112550001
1708021407900002
1708020709960002
1708025308860003
1708021504620002
1708022608690001
1702095304850002 085269396949
1708023001560001
1708024311740001 BLM
1708026508970001 BLM
1708025005670001 BLM
1708021005600001 BLM
1708020109680001
1708024909980001
1708024505880005
1708025009840005
1708024402830001
1708020303900007
1708026202780001
1708024903940003
1708026508730001
1708021302710001 082371093805
1708020207770001 085208986218
1708026706930005
1708021704770004 BLM
1708026706930004 BLM
1708026209830002 BLM
1708024301790001
1708024107650128 BLM
1708026802790001
1708024810970001
1708025507940001
1708025111900002
1708020608730005
1708022308980001
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
ETAH
R 2021
OVID-19
BUMIL
M.UMUM

DOSIS 1
T INAP UJAN MAS

PENDIDIK
REMAJA

1
1
LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
1
1
1

LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
DOSIS 2
1
0 0 0 0 2 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 13 0 0 0 0 0
0 24 0 0 16 0
40
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1
REKAPI

SINOVA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 SALEH 4/2/1969 PG BERINGANG


2 DEDI 11/11/1981 PG BERINGANG
3 EKO SUPRIADI 9/12/1993 PG BERINGANG
4 REKI 9/12/2000 PG BERINGANG
5 WANIT 9/25/1979 PG BERINGANG
6 DJUHARDI 6/6/1999 PG BERINGANG
7 BAMBANG IRAWAN 3/23/1998 PG BERINGANG
8 EKA MARTADINATA 5/5/1987 PG BERINGANG
9 DOKI PUTRA IRAWAN 3/18/1987 PG BERINGANG
10 MUHAMMAD HARUN 2/15/1980 PG BERINGANG
11 ALIANI 8/30/1960 PG BERINGANG
12 RIKA NOVIANTI
13 HENDRI 7/9/1986 PG BERINGANG
14 DELPA BLEZINSKI 12/22/1995 PG BERINGANG
15 ALPIAN TONI 6/27/1972 PG BERINGANG
16 JALALUDIN 7/1/1958 PG BERINGANG
17 RUSMAN TAJUDIN 12/15/1974 PG BERINGANG
18 BAMBANG KATODI 8/8/1976 PG BERINGANG
19 HERLIS ASIYANTI 2/5/1991 PG BERINGANG
20 ALPIAN SISUWANDI 8/23/1979 PG BERINGANG
21 MEGA WATI 6/20/1982 PG BERINGANG
22 CAROLINA SASMITA 10/5/2001 PG BERINGANG
23 LAILATUL JANNA 1/13/1991 PG BERINGANG
24 HENGKI PERANATA 9/14/2003 PG BERINGANG
25 ADI SUTIJO 8/17/1970 PG BERINGANG
26 RENALDO AGUSTIN 8/5/2008 PG BERINGANG
27 TOPO ARIANTOSI 10/17/1990 PG BERINGANG
28 ARAFIK SUSIANTONI 5/4/1983 PG BERINGANG
29 ARIYANTI 12/15/1984 PG BERINGANG
30 JERI APRIANSA 2/13/2003 PG BERINGANG
31 SUNARTI 1/5/1977 PG BERINGANG
32 LESTARI 9/1/1978 PG BERINGANG
33 DARWIN JAYA 3/4/1978 PG BERINGANG
34 ESNI PERAWATI 6/30/1996 PG BERINGANG
35 REDO ANSORI 6/17/1984 PG BERINGANG
36 NOVELIA 10/15/1998 PG BERINGANG
37 SRI NOPITA SARI 3/1/1991 PG BERINGANG
38 DESI 1/28/1991 PG BERINGANG
39 RUL HAZINAH 5/5/1955 PG BERINGANG
40 SURYA 10/10/1972 PG BERINGANG
41 ROZA ANGGRAINI 1/23/2006 PG BERINGANG
42 SUKMA 5/12/1965 PG BERINGANG
43 MULIA WARMAN 10/14/1976 PG BERINGANG
44 UMI ASMA 11/20/1956 PG BERINGANG
45 MARLIN 2/11/1985 PG BERINGANG
46 AMIR HAMZAH 4/2/1978 PG BERINGANG
47 RISKA HELMINA 2/10/1986 PG BERINGANG
48 AL HIJAR 11/29/1990 PG BERINGANG
49 LENI MARLENA 1/10/1983 PG BERINGANG
50 DESI SUSIANTI 5/14/1983 PG BERINGANG
51 SUSILAWATI 7/6/1980 PG BERINGANG
52 SUSI 5/25/1985 PG BERINGANG
53 EVA 2/24/1985 PG BERINGANG
54 ARPAN 10/18/1991 PG BERINGANG
55 ELVI HARTATI 7/27/1979 PG BERINGANG
56 ROHANA 1/5/1979 PG BERINGANG
57 YOSI ANA 2/4/1989 PG BERINGANG
58 GITA ANDRIANY 4/12/1994 PG BERINGANG
59 MANTU 3/29/1984 PG BERINGANG
60 PAIDI 6/15/1953 PG BERINGANG
61 JULPI SISWANTO 7/28/1998 PG BERINGANG
62 LUSI WIDIA SARI 5/5/1991 PG BERINGANG
63 USMAN 12/18/1951 PG BERINGANG
64 ANI PUTRI ANITA 11/11/1990 PG BERINGANG
65 ANDIKA PUTRA PRATAMA8/15/2008 PG BERINGANG
66 RENI HAFISAH 12/2/1987 PG BERINGANG
67 YULIA 4/10/1997 PG BERINGANG
68 ARSI 9/10/1984 PG BERINGANG
69 WINDA LESTARI 1/6/2003 PG BERINGANG
70 RATNI 2/11/1982 PG BERINGANG
71 SISI ARIYANI 12/11/1998 PG BERINGANG
72 MARIANA 1/26/1986 PG BERINGANG
73 RAMA DANI HARIANTA 12/12/1982 PG BERINGANG
74 SUTAN 12/17/1991 PG BERINGANG
75 JONI BAROKA 6/11/1994 PG BERINGANG
76 LENTI SANIA 12/29/1971 PG BERINGANG
77 RONA PRAMUDIKA 8/28/2004 PG BERINGANG
78 LUKMAN SAHDI 9/16/1972 PG BERINGANG
79 SAHERA 2/12/1960 PG BERINGANG
80 KASMABOTI 3/29/1962 PG BERINGANG
81 SUNIAR BAITI 12/15/1965 PG BERINGANG
82 HAIRUL AMSA 7/16/1985 PG BERINGANG
83 IDIL PIRMANSYAH 2/22/2002 PG BERINGANG
84 NOPA SUSANTI 5/25/1979 PG BERINGANG
85 NETI 8/5/1980 PG BERINGANG
86 CHINDY LALA SHOPIANA 1/20/2002 PG BERINGANG
87 RALASATI 10/10/2000 PG BERINGANG
88 JONI PUTRA 9/11/1985 PG BERINGANG
89 EGI SISGIARDI 1/12/1991 PG BERINGANG
90 ROSI 6/20/1984 PG BERINGANG
91 SALMINA 12/18/1977 PG BERINGANG
92 IBNU HOLIK 5/25/1968 PG BERINGANG
93 LEKSI MAHYENI 4/16/2005 PG BERINGANG
94 REVI ARYANTO 5/1/1998 PG BERINGANG
95 JULIO FRANSISKO 7/10/1997 PG BERINGANG
96 SIGEN 9/2/2008 PG BERINGANG
97 JONI HERMANSA 1/1/1979 PG BERINGANG
98 RAK INTAN ASISA 4/1/2009 PG BERINGANG
99 AZWAR 4/30/1970 PG BERINGANG
100 MALIK 8/4/1995 PG BERINGANG
101 RAPIT 5/10/1974 PG BERINGANG
102 JULITA 7/1/1988 PG BERINGANG
103 RISAL EFENDI
104 LINA MUSRIANI

3 SUKMA 10/28/1987 PG BERINGANG


4 SUGIANTO ASWAN 7/21/1974 PG BERINGANG
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
14 DESEMBER 2021
PUNGGUK BERINGANG

SINOVAC PFIZ
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708020204690001 082281495655
1708021111810002
1708021209930001
1708021209000004
1708026509790001
1708020606990001
1708022503890004
1708020505870002
1708021803870001
1708021502800003
1708023008600001

1708020907860001 1
1708026212950001 1
1708022706720001 1
1708020107580140 1
1708021512750003 1
1708020808760001 1
1708024502910001 1
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1708026006820001 1
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1708026707790002 1
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1708024402890001 1
1708025204940002 1
1708022903840001 1
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1708024505910006 1
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1708024107880001 1
1
1

0 0 0 0 0 0 6 0 0 79 0 7 0 0 0 0
0 92 0

RESI 6 0 0 79 0 7 0 0 0 0
PKM 26 8
YUK PIT 8 1 90 7
134 14 0 1 195 0 22 0 0 0 0
232

1702246810870002
1708022107740001
021
D-19

GANG
M.UMUM

DOSIS 1
NAP UJAN MAS
PENDIDIK
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL

M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0
0 0 0 0 12 0
104

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12
2
10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24

1
1
DOSIS 2
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA
SINOVAC
28
REKAPITULASI H
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 259
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 INDRA SANJAYA 9/11/1997 SURO ILIR


2 NURUL IMAN 5/10/1982 SURO ILIR
3 MURYATI 5/10/1953 SURO ILIR
4 NOFITA EKA S 11/14/1986 SURO ILIR
5 ISHAK 4/2/1962 SURO ILIR
6 BAMBANG HERDIANTO 5/13/1995 SURO ILIR
7 SISWATI AMELIA 2/17/1984 SURO ILIR
8 YENITA 3/29/1995 SURO ILIR
9 SUFYANTO 9/21/2002 SURO ILIR
10 ROI MARTEN SAFARI 9/5/1989 SURO ILIR
11 ANSORI 6/4/1984 SURO ILIR
12 AMRAN EPENDI 7/1/1968 SURO ILIR
13 MIRA YANA 11/7/1991 SURO ILIR
14 BAMBANG EFERI 3/2/1993 SURO ILIR
15 DONI ASWAR 4/8/1993 SURO ILIR
16 SRI SEJATI 7/1/1960 SURO ILIR
17 RAHMAD 8/9/1990 SURO ILIR
18 MIRNA HARTATI 4/18/2001 SURO ILIR
19 MAL JUMIA 8/28/1956 SURO ILIR
20 MARWAN ANHAR 12/7/1985 SURO ILIR
21 RAMI ANA 7/9/1985 SURO ILIR
22 SYARIPUDIN 7/7/1975 SURO ILIR
23 SAIDINA YANSI 3/25/1986 SURO ILIR
24 DARIA 6/10/1969 SURO ILIR
25 SUKARNAH 12/23/1974 SURO ILIR
26 INDAH MELATI 1/2/2005 SURO ILIR
27 SARNI BANA 4/24/1969 SURO ILIR
28 BURHAN DAHRI 1/1/1950 SURO ILIR
29 SUSI SUSANTI 10/25/1999 SURO ILIR
30 LILI SUMARNI 4/23/1983 SURO ILIR
31 SISKA WELI 3/13/1987 SURO ILIR
32 JAUWITA 9/6/1995 SURO ILIR
33 NYAIK SUNDARI 12/12/2004 SURO ILIR
34 NOPITA SARI 4/4/1994 SURO ILIR
35 DIMAS 5/6/2006 SURO ILIR
36 JULIADI SETIAWAN 7/3/1998 SURO ILIR
37 RINDIYANI 1/4/2009 SURO ILIR
38 BELA SEBTIANI 9/14/2009 SURO ILIR

TUNDA 4 PURWADI 5/12/1959 SURO ILIR


6 IMAM AL RAID 12/8/2007 SURO ILIR
16 SUDIRMAN 6/2/2000 SURO ILIR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
15 DESEMBER 2021
SURO ILIR

SINOVAC PFIZ
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1708021109970005 08995733003
1708021005820002 085215238510
1708025308580001
1708021411860001 085769132133
1708020204620001
1708021305950001
1708025702840001 089687847300
1708026903950003
1708022109020001
1702160505890002 085268091218
1708020406840001 085269875255
1708020107680242 081356420367
1708024711910001
1708020203930001 081366279199
1708020804920001
1708024107600073
1708020908900002 081274081198
1708025804010002 083136241286
1708026708560001
1708020712860001 089505036530
1708024907850001 1
1708020707750009 1
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1603040605060002 1
1708020307980002 1
1708024401090001 1
1708025409090002 1
0 0 0 0 0 0 1 0 1 13 0 3 0 0 0 0
0 18 0

RESI
PKM
YUK PIT
134 0 0 0 0 0 0 0 0 0 0
0

1708021205560002 085796132133

1708020206020001 08566631343
021
D-19
M.UMUM

DOSIS 1
NAP UJAN MAS
PENDIDIK
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL

M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
1

LANSIA
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 19 0 0 0 0 0 0 0
0 0 0 0 20 0
38

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1
1
1
DOSIS 2
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA
SINOVAC
28
REKAPITULASI H
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 3
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
2021091

NO NAMA TGL LAHIR ALAMAT

1 RENI 10/11/2008 DASPETAH


2 REMONDO SUSILO CAND 06/05/2005 DASPETAH
3 LIYA AUDINA 11/07/2007 PUNGGUK BERINGA
4 WILKI ANJELI 2/27/2009 DASPETAH II
5 ALDO WIRANATA 2/17/2007 DASPETAH
6 ADITYA BINTANG RAMAD 0/09/2008 DASPETAH
7 RAKA WIJAYA 17/12/2008 DASPETAH
8 DEWINTA DEWA DARU 03/05/2009 UJAN MAS
9 SENO 9/11/2007 DASPETAH
10 EDWIN ORLANDO 19/05/2007 DASPETAH
11 KESI FEBRIANI 26/02/2008 DASPETAH
12 CELSI APRILIANI 18/04/2008 KELOBAK
13 NIKO HARJA 05/05/2008 DASPETAH II
14 INGKA KRISTI 2/7/2007 DASPETAH II
15 HELEN LINTANG PRATIWI 11/01/2008 DASPETAH
16 KEYSIA DELONAH 25/03/2008 DASPETAH II
17 JENI YUNIANSI 08/06/2006 DASPETAH
18 SALSA NABILA 11/22/2008 DASPETAH
19 RONALDI 10/12/2006 DASPETAH II
20 RIO RAHMAT ILAHI 25/05/2006 DASPETAH II
21 ANDINI KRISTIANA 29/01/2009 DASPETAH
22 IMEL SUSANTI 04/05/2008 DASPETAH II
23 WICHA KARO LINZAH 17/08/2006 DASPETAH
24 AGUNG SATRIA 12/18/2008 DASPETAH 2
25 RARA RISKI ISLAMI 23/11/2007 DASPETAH
26 M. FAREL 2/4/2009 DASPETAH 2
27 JESEN 6/26/2006 DASPETAH 2
28 ABDAL ZAHIR ALI SALAM 30/10/2008 DASPETAH II
29 ADI PRANATA 27/12/2006 DASPETAH II
30 AHMAD NAJIB 4/4/2007 DASPETAH II
31 ALDENO ALONSO KENED 21/04/2007 DASPETAH
32 HATOYA ALPARENZA 23/0/2007 PUNGGUK BERINGA
33 FEBRI SANJAYA 6/9/2005 DASPETAH
34 REYO PRANATA 17/06/2007 DASPETAH
35 ANISA AL MAGFIRA 04/03/2008 DASPETAH II
36 RIKA AYU ANDINI 2/16/2007 DASPETAH
37 YONANDA 1/12/2009 DASPETAH
38 INDA 10-10--07 PG BERINGANG
39 FINA KRISTIANA 09/11/2006 DASPETAH
40 ANGGUN PUTRA GUNAW28-09-1971 SURO BARU
41 SILFA 2/26/2008 DASPETAH
42 M. HAIKAL ALFARUQ 28/09/2008 DASPETAH II
43 MITZI ARKA LENGGA 15/01/2008 DASPETAH II
44 APRIANSYAH 01/04/2007 DASPETAH
45 LILIES 5/28/2007 UJAN MAS ATAS
46 DWI ZASKIA 25/02/2008 DASPETAH II
47 ANISA RISKI SAHBILA 29/08/2009 DASPETAH
48 ANINDIA NABILA PUTRI 16/07/2008 DASPETAH II
49 REYHADI 05/03/2008 DASPETAH II
50 SINTA SUSIANTI 17-06-1986 PUNGGUK BERINGA
51 STEBI SUPRIYANTI 11/9/2006 DASPETAH
52 RIKI SAPUTRA 8/30/2008 DASPETAH II
53 CECEP RAMA SEPTIAWA 20/0/2008 DASPETAH II
54 MELZA ANGGRAINI 25/07/2008 DASPETAH II
55 YESI RISKI AYU 02/02/2008 DASPETAH
56 DINTA INDRIANI 14/09/20008 DASPETAH
57 ARGA PRIYA WANTO 11/05/2009 DASPETAH II
58 DIKO ASTREA 03/12/2007 DASPETAH II
59 HELEN SISKA METARIA 8/21/2007 DASPETAH
60 POPI MELINDA PUSPITA 08/08/2008 DASPETAH II
61 RATIH PURWASIH 16/11/2008 DASPETAH
62 DELA NANDA 09/06/2008 DASPETAH II
63 JONA AGUSTIN 8/17/2006 DASPETAH
64 BAHRI GUNAWAN 17/04/2006 DASPETAH
65 KEYLA OKTAVIA 17/10/2008 DASPETAH II
66 WIRA KIKI NURAINI 11/9/2008 DASPETAH II
67 ANTONI SAPUTRA 10/08/2006 DASPETAH
68 DIO SUGANDA 7/3/2007 DASPETAH 2
69 PANJI PRANATA 30/10/2007 DASPETAH
70 DIKA ANGGARA 11/12/2008 DASPETAH
71 FENTI CITRA 10/10/2008 DASPETAH II
72 M DEWO 9/13/2007 DASPETAH
73 ARIEL DWIANTO 6/20/2008 DASPETAH
74 RIKI PANJAITAN 28/11/2008 DASPETAH II
75 MARSEL STEVEN 7/25/2007 DASPETAH
76 ELO DWI SAPUTRA 28/12/2006 PUNGGUK BERINGA
77 RINDI ANTIKA 27/04/2007 DASPETAH
78 DAWIA SRI VIA VANESA 26/08/2007 DASPETAH II
79 DIRLI PARENSA 02/12/2007 DASPETAH
80 SASKIA NADIA META 0/10/2008 DASPETAH II
81 NABILA 1/05/2007 DASPETAH
82 NATYA MAHARANI 0/09/2007 DASPETAH II
83 RASTI APRIANTI 01/04/2008 DASPETAH II
84 ALFINGKI
85 ANELIARISA 7/17/1969 PASAR UJUNG, KPH
86 NARA APRIANI 4/28/2007 DASPETAH
87 PIPTA LESTARI 8/17/2007 DASPETAH
88 YULIANA 7/28/2006 DASPETAH
89 SENDI PRANATA 5/12/2006
90 YOLANDA 6/4/2008
91 RENA OKTARIA 10/2/2008 DASPETAH II
92 CITRA AUDIA LORA 5/12/2007 PG BERINGANG
93 CANDANI CHESA UTAMI 12/11/2009 DASPETAH II
94 ADLI PAIRUS 1/11/2008
95 STELA YUNINGSIH 12/20/2006 DASPETAH II
96 ENJEL PERDIANSA 2/13/2009 DASPETAH II
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
17 DESEMBER 2021
SMPN 02 UJAN MAS

SINOVAC PFIZ
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL

BUMIL
1602045110080003 1
1708020605050001 085268553665 1
1708025107070002 08994222937 1
1708026702090001 1
1708021702070001 1
1708020509080002 082371150488 1
1708021712080001 081373664060 1
1708024305090001 085268404438 1
1708021109070001 08994222937 1
1708021905070001 08994222937 1
1708026602080002 081373664060 1
1708045804080001 082371150488 1
1708020505080002 082371150488 1
1708024702070002 1
1708025101080003 082371150488 1
1708020405080001 081373664060 1
1708024806060001 085268553665 1
1708026211080002 1
1708021012060002 085268553665 1
1708022505060002 085268553665 1
1708026901090001 085378884847 1
1708024405080003 082371150488 1
1708025708060001 08994222937 1
1708021812080002 085268404438 1
1708026301070001 08994222937 1
1708020402090001 1
1708022606060005 1
1708023001080001 085378884847 1
1708022712060003 081373664060 1
1708020404070002 08994222937 1
1708022104070001 085268553665 1
1708022305070001 08994222937 1
1708025112050001 08994222937 1
1708021706070004 081373664060 1
1708024403080002 085268404438 1
1708025602070001 085268404438 1
1708025201090001 081373664060 1
1708025010070004 1
1708024911060003 085268553665 1
1708022809710001 082373387707 1
1708026602080001 1
1708022809080001 085378884847 1
1708021501080002 082371150488 1
1708020104070001 082371150488 1
1702226805070001 1
1708026502080001 082371150488 1
1708026908070001 081373664060 1
1771035607080003 085378884847 1
1708020503080001 081373664060 1
1708025706860001 085382723237 1
1708024910060002 1
1708023008080001 1
1708022606080009 085268013283 1
1708026507080002 085268404438 1
1708024202080001 081373664060 1
1708025409080002 082371150488 1
1708021105090001 085378884847 1
1708020312070001 081373664060 1
1708026108090001 1
1708024808080002 082371150488 1
1708025611080001 082371150488 1
1708025206060001 082371150488 1
1708025806100001 085268553665 1
1708021704060001 08994222937 1
1708025710850001 085268404438 1
1708024911080001 1
1708020807070001 081373664060 1
1708020307070003 081373664060 1
1708023010070001 085268553665 1
1708021112080001 085268404438 1
1708025010080004 081373664060 1
1708021309070002 1
1708022006080001 0 1
1708022801080002 082371150488 1
1708042507170001 085268446596 1
1709052305070001 08994222937 1
1708026704070001 08994222937 1
1708046608070001 08994222937 1
1708020212070002 08994222937 1
1708024610080001 085268013283 1
1708025605070001 08994222937 1
1708024509070001 082371150488 1
1708024104080002 081373664060 1
1
1708045707690004 085357039057
1708024910060001
1708025708070001
1708026807060002
1708021205060002 081274780775
1708024406080002 081367539251
1708024210080001
1708025205070001
1708045112090003 085378884877
1708021101080002
1708026012060003 085268553665
1708041302090001 085268553665
0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0
0 84 3

RESI
PKM
YUK PIT
134 0 0 0 0 0 0 0 0 0 0
0
021
MAS
D-19
M.UMUM

DOSIS 1
NAP UJAN MAS
PENDIDIK
REMAJA

PFIZER
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
1
1
1
1
1
1
1
1
1
1
1
1
0 0 3 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 9 0 0 0 0
96

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DOSIS 2
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA
SINOVAC
28
REKAPITULASI H
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 3
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 2 DOSIS 1 DOSIS 2
PENDIDIK

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
32155BA

NO NAMA TGL LAHIR ALAMAT

1 ADING USMAN 2/1/1973 UJAN MAS BAWAH


2 JENDI MINATA 8/18/2002 UJAN MAS ATAS
3 SELAWATI 10/19/2001 UJAN MAS ATAS
4 TUSIYEM 8/17/1973 SURO ILIR
5 EDI SUGIANTO 4/10/1989 SURO LEMBAK
6 SUNARDI 3/7/1976 SURO LEMBAK
7 TETI AS 7/9/1979 SURO LEMBAK
8 AMERUDIN 7/14/1960 SURO LEMBAK
9 LESI KARTIKA 2/28/1997 SURO LEMBAK
10 MULIDAL AHMAD 8/1/1997 SURO LEMBAK
11 NURSIDA 11/21/1968 SURO LEMBAK
12 ALI ADHA 11/16/1972 UJAN MAS ATAS
13 PENDI SAPUTRA 12/9/1997 SURO LEMBAK
14 ZAINAL ABIDIN 7/26/1972 SURO LEMBAK
15 SUAIBA GANI 7/1/1965 SURO MUNCAR
16 TARMIDI 3/1/1969 SURO MUNCAR
17 YUDI SUPRIATNA SURO MUNCAR
18 DALINA 3/25/1961 UJAN MAS ATAS
19 RAMA ADIYATNA 11/2/2001 SURO MUNCAR
20 MEROSI 5/15/1989 SURO ILIR
21 M. NASIR 7/27/1979 SURO MUNCAR
22 HENGKI ADE PUTRA 6/29/1998 SURO MUNCAR
23 SOVIAN ALAM AKBAR 10/10/2002 UJAN MAS ATAS
24 DINGKI ARYANDI 2/23/2003 UJAN MAS ATAS
25 SUDIRMAN RUS 11/1/1958 DASPETAH
26 ABASRI 7/1/1977 SURO MUNCAR
27 SAIPIN JOHAN 1/2/1980 SURO MUNCAR
28 NADIRUL ASHARI 3/8/1972 SURO MUNCAR
29 TITIN SUMARNI 11/4/1971 SURO ILIR
30 KASINA 11/10/1980 SURO ILIR
31 JARNI WATI 2/27/1974 SURO ILIR
32 UMI NATUN 7/4/1971 SURO MUNCAR
33 IDAR YANI 12/12/1968 SURO ILIR
34 DARWIN KAMIDAN 10/30/1960 SURO MUNCAR
35 ELI SURYANI 6/12/1975 SURO ILIR
36 SITI YANI 7/5/1975 SURO ILIR
37 MEGA DARLENA 8/22/1973 SURO ILIR
38 MIRNA WATI 11/2/1995 SURO MUNCAR
39 SUKIRMAN 6/10/1983 DASPETAH
40 ALI USMAN 10/29/1961 SURO MUNCAR
41 KARMILA SUSYANTI 1/5/1975 SURO MUNCAR
42 NELI MARYANI 5/30/1998 SURO ILIR
43 HARIMA MELATI 9/3/1967 SURO MUNCAR
44 RENI OKTAVIA 10/23/1997 SURO MUNCAR
45 SUNARTO 4/14/1992 SURO MUNCAR
46 HELMI AKSA 5/21/1971 SURO ILIR
47 YORI APRIANSYAH 4/6/1980 UJAN MAS ATAS
48 MARWAN 1/1/1980 PG BERINGANG
49 JEPRI OKTARIA 10/4/1997 SURO MUNCAR
50 SARTIKA 5/7/1986 DASPETAH II
51 KOMALA 10/21/1970 SURO MUNCAR
52 RIA ANJELINA 6/8/1991 SURO ILIR
53 SIDAR JAYA 7/30/1985 SURO MUNCAR
54 WIDIA RAMADANI 10/29/2006 UJAN MAS ATAS
55 4/3/1976 SURO MUNCAR
56 DERIAN KONEDI 1/28/1996 UJAN MAS ATAS
57 WENI PITRIYANI 5/9/2003 UJAN MAS ATAS
58 HANAPI 9/12/1976 SURO MUNCAR
59 SUSMIANA 7/28/1980 SURO MUNCAR
60 LILI JAYANTI 11/20/1990 SURO MUNCAR
61 RINDI HATI 6/7/1960 SURO MUNCAR
62 REZA APRIANTI 4/12/1999 SURO MUNCAR
63 MILATI 9/19/1982 PG BERINGANG
64 HARMEN 12/12/1979 PG BERINGANG
65 MARWAN S 10/16/1977 UJAN MAS ATAS
66 ADE PUTRA 11/26/1995 SURO MUNCAR
67 YUSMAWATI 3/2/1973 UJAN MAS ATAS
68 RISAL KUSNADI 2/5/1995 UJAN MAS ATAS
69 RENITA 2/2/1991 UJAN MAS ATAS
70 RABUL SANUSI 5/25/1979 UJAN MAS ATAS
71 YENI 6/9/1997 UJAN MAS BAWAH
72 RIA REKA SARI 3/2/1990 UJAN MAS BAWAH
73 PUTRA IRAWAN 11/13/1987 SURO ILIR
74 BETI SUSANTI 7/1/1991 SURO MUNCAR
75 DESI HARYANTI 10/16/1994 SURO MUNCAR
76 DONI AFRIANTO 4/29/1991 SURO LEMBAK
77 YUSDA ELLIYANI 10/2/1978 SURO MUNCAR
78 ANI SAPITRI 2/18/1998 SURO MUNCAR
79 INDRA MARZUKI 7/13/1987 SURO MUNCAR
80 SEPTI ALPIYONITA 12/18/2003 SURO MUNCAR
81 ASRIL 4/21/1956 SURO ILIR
82 MARLI JUMIATI 7/1/1974 SURO LEMBAK
83 SUHERMANTO 10/7/1988 SURO LEMBAK
84 SINTA RAMAYANA 5/11/1986 UJAN MAS ATAS
85 SUNARDI 3/5/1964 UJAN MAS ATAS
86 KASIMIN 10/21/1978 UJAN MAS ATAS
87 ROHANI 3/1/1977 UJAN MAS ATAS
88 ALI 8/2/1982 UJAN MAS ATAS
89 ENDANG SIRIWIJAYA 10/10/1983 UJAN MAS ATAS
90 RITA MALA 2/1/1992 UJAN MAS ATAS
91 BARIA 6/3/1948 SURO MUNCAR
92 WELI SUSANTI 4/2/1982 SURO MUNCAR
93 KIKI SANTI MUSTIKA 4/8/1990 SURO ILIR
94 ANDRE MERLINDO 3/3/2006 UJAN MAS ATAS
95 REPI LUSPITA 12/10/2000 UJAN MAS BAWAH
96 MAHI 11/12/1962 UJAN MAS ATAS
97 SANIA WATI 11/2/1977 UJAN MAS BAWAH
98 ARI FERNANDO 3/16/1993 SURO MUNCAR
99 SUJIYATI 6/5/1989 SURO MUNCAR
100 TIO GUNAWAN 5/6/2005 UJAN MAS ATAS
101 KARYAWATI 6/5/1980 SURO MUNCAR
102 SARINA WATI 4/13/1976 UJAN MAS ATAS
103 MUHAMAT SAMAN 8/3/1954 UJAN MAS BAWAH
104 RAHMAN Y 9/8/1972 UJAN MAS BAWAH
105 WIRDA SUPIYANTO 3/1/1983 UJAN MAS ATAS
106 RADIA SAHADA 7/12/1986 UJAN MAS BAWAH
107 SANTI DWIYANA UJAN MAS ATAS
108 BINA AGUS
109 PUTRA JAYA 5/10/1980 UJAN MAS BAWAH
110 KRISTIA NINGSIH 6/24/2004 SURO MUNCAR
111 BUDIMAN 3/25/1989 SURO MUNCAR
112 CIK LIA 8/12/1965 UJAN MAS ATAS
113 LENA 3/20/1986 SURO MUNCAR
114 BAGUS SHERIYADI 6/11/2002 SURO LEMBAK
115 DARLIS 4/12/1974 UJAN MAS ATAS
116 SOVIA LORADIA 5/10/2005 UJAN MAS ATAS
117 SAM NAJUA ASOKA 11/10/2009 PG BEIRNGANG
118 NENI SUSILAWATI 10/15/2003 UJAN MAS ATAS
119 IBNU HAJAR 7/1/1977 SURO MUNCAR
120 NOVI APRIYANTIKA 3/23/2000 SURO MUNCAR
121 HAMINA 1/7/1961 UJAN MAS ATAS
122 JAWITA MURNI 4/6/1983 UJAN MAS ATAS
123 DEMI SAPUTRA 3/3/2003 UJAN MAS ATAS
124 MAULIN SAPUTRA 5/3/2003 UJAN MAS ATAS
125 MIFTAKIYAH 3/2/1973 UJAN MAS ATAS
126 ASEP SURAHMAN 8/12/1992 SURO MUNCAR
127 SISI SARTIKA 7/26/1998 UJAN MAS ATAS
128 IRAWATI 1/7/1969 UJAN MAS ATAS
129 MUKTAR AMARULLAH 2/12/1994 UJAN MAS ATAS
130 ASWANDI 1/30/1978 UJAN MAS ATAS
131 SUDIRMAN 2/1/1978 UJAN MAS ATAS
132 SAWALUDIN 4/11/1983 SURO MUNCAR
133 RIA ASTARINA 2/8/1988 DASPETAH II
134 ROSDIANTI TRI MARIAH 12/7/1992 SURO MUNCAR
135 MUHAMMAD PERI PURNA 12/6/1994 UJAN MAS ATAS
136 ANDIKA PRANATA 2/16/1998 UJAN MAS ATAS
137 MUSTIKA PRSETIO 5/12/1976 UJAN MAS ATAS
138 MALINA 12/8/1976 UJAN MAS ATAS
139 CAHAYATULLAILI 3/7/1960 UJAN MAS ATAS
140 BURHAN 12/12/1979 SURO MUNCAR
141 SUPARDI 2/3/1978 SURO MUNCAR
142 EDI SUMANTRI 3/4/1976 UJAN MAS ATAS
143 SURI 3/1/1966 SURO MUNCAR
144 MAINA ASRA 7/1/1975 UJAN MAS ATAS
145 SAKUT 2/2/1992 UJAN MAS ATAS
146 SUMARDIANA 3/6/1987 SURO MUNCAR
147 TAUPIK DIAMTI 7/1/1979 UJAN MAS ATAS
148 SAHRUL EFENDI 2/3/1977 SURO MUNCAR
149 AZWAR MUKMIN 8/8/1973 UJAN MAS ATAS
150 AHMAD EPENDI 5/20/2001 SURO MUNCAR
151 DORI SUSANTO 4/17/1982 UJAN MAS ATAS
152 RABE 4/11/1979 UJAN MAS ATAS
153 REPY ARISKA 11/5/1997 UJAN MAS ATAS
154 MARYUNDI 1/18/1980 SURO ILIR
155 RIDI AR 6/30/1978 UJAN MAS ATAS
156 KARTIKA 7/14/1993 UJAN MAS ATAS
157 ASRAWATI 3/1/1982 UJAN MAS ATAS
158 HAMDAN SANUSI 8/17/1990 UJAN MAS ATAS
159 HERLINA 2/15/1985 UJAN MAS ATAS
160 BUNGA CITRA LESTARI 4/5/2009 SURO MUNCAR
161 MIRA HARTATI 11/2/1992 UJAN MAS ATAS
162 CHELSEA APRILIA 4/24/2007 UJAN MAS ATAS
163 RIAN HIDAYAT 6/24/1978 SURO MUNCAR
164 RENDI 8/4/1994 UJAN MAS ATAS
165 CELSI AUREL LORENSA 12/15/2009 DASPETAH
166 AHMAD BADAWI 3/23/1969 UJAN MAS ATAS
167 KARTINI 7/1/1979 UJAN MAS ATAS
168 WIKE AGUSTINA 8/1/1999 UJAN MAS ATAS
169 ROLIS 10/4/1989 UJAN MAS ATAS
170 SYAIRUL BADRI 11/24/1963 UJAN MAS BAWAH
171 RIKA AMELIA 6/7/1989 UJAN MAS ATAS
172 SEPTA PEBRIANSYAH 9/25/1998 UJAN MAS ATAS
173 HARPANSA 7/1/1970 UJAN MAS ATAS
174 YOPI SANDORA 2/11/1997 SURO MUNCAR
175 MUHAMMAD HERI 10/3/1986 SURO MUNCAR
176 ROBI ASWAR 7/16/1984 UJAN MAS ATAS
177 TIARA ASTUTI 4/16/2004 UJAN MAS ATAS
178 YURNA 7/1/1968 UJAN MAS ATAS
179 SABANDI SUNARIO 7/20/2006 SURO MUNCAR
180 SRI YANTI 7/10/1975 UJAN MAS ATAS
181 MUHARIP 8/28/1978 SURO MUNCAR
182 REPI VEBRIANSYAH 7/1/1993 UJAN MAS ATAS
183 FINDI WIJAYA UJAN MAS ATAS
184 KUSNADI 3/20/1998 UJAN MAS ATAS
185 HAPIS PERNANDO 11/22/2000 SURO MUNCAR
186 LIMUT 5/8/1952 UJAN MAS ATAS
187 YUNITA 7/1/1976 UJAN MAS ATAS
188 DESIYANI MASITO 12/5/1999 UJAN MAS ATAS
189 AKHIRMAN 6/8/1975 UJAN MAS ATAS
190 NELY 7/6/1977 UJAN MAS ATAS
191 YANTI WIBAWATI 9/16/1986 UJAN MAS ATAS
192 UMAYA 11/17/1960 SURO ILIR
193 SISKA LESTARI 2/22/1999 UJAN MAS ATAS
194 RIRIN HERLINDA 3/4/1997 SURO BARU
195 SUSI KARTINA 4/13/1996 UJAN MAS ATAS
196 MERI SUSYANTI 9/27/1978 UJAN MAS ATAS
197 SEPTI BETA MAYANGSAR 9/9/2000 UJAN MAS ATAS
198 HENDRA JAYA 23-3--87 UJAN MAS ATAS
199 YANTI 7/4/2009 UJAN MAS ATAS
200 SUHARNI 10-2--72 UJAN MAS ATAS
201 NETI HERAWATI 5/29/1993 UJAN MAS ATAS
202 DARWIS 8/7/1968 SURO ILIR
203 FITRI NATALIA 11/10/2005 UJAN MAS ATAS
204 MELINDA PUTRI RAHAYU 5/2/2006 UJAN MAS ATAS
205 TARMIZI 4/8/1984 SURO ILIR
206 MIRA WAHYUNI 5/27/2004 DASPETAH
207 NADIA LESTARI 9/20/2005 UJAN MAS ATAS
208 NURUL AMBIYA 3/2/1970 UJAN MAS ATAS
209 SINTA PRATAMI 11/12/2003 UJAN MAS ATAS
210 GUNAWAN 11/16/1973 SURO ILIR
211 KRISTIAN ADI NATA 10/10/2005 UJAN MAS ATAS
212 JAFRI 8/22/1992 UJAN MAS ATAS
213 LILI SURYANTI 5/10/1983 UJAN MAS ATAS
214 SUMIATI 5/10/1994 SURO ILIR
215 ARI YANTO 9/20/2003 DASPETAH
216 SAIRIN 1/12/1982 UJAN MAS ATAS
217 ZAINAL 7/1/1978 UJAN MAS ATAS
218 SUPIYANTO 6/9/1987 UJAN MAS ATAS
219 YHESI YOLANDA 2/9/1993 UJAN MAS ATAS
220 DELA ZAKILA 8/13/2005 DASPETAH II
221 YESI FITRIANA 1/29/1998 UJAN MAS ATAS
222 PRIYANSA 3/11/2003 DASPETAH II
223 SAHARA 2/5/1972 UJAN MAS ATAS
224 MARSEL ADE PIO 4/4/2004 UJAN MAS ATAS
225 RESI SUSANTI 3/17/2006 SURO MUNCAR
226 BAHARUDIN 10/28/1969 UJAN MAS ATAS
227 BASRI DAUD 9/1/1960 SURO ILIR
228 ARINDA PRIYANTI 2/2/2006 UJAN MAS ATAS
229 UPI KARMILA 12/6/1981 UJAN MAS ATAS
230 ADINDA LESTARI 3/6/2003 UJAN MAS ATAS
231 GERI WALDI 8/24/1994 UJAN MAS ATAS
232 HENDRI 7/10/1985 UJAN MAS ATAS
233 YULIA HATI 3/5/1998 UJAN MAS ATAS
234 YESI SUMARNI 8/17/1987 UJAN MAS ATAS
235 SISKA HERAWATI 10/24/2007 UJAN MAS ATAS
236 DIKA RATNA DEWI 7/13/1996 SURO LEMBAK
237 ANGGUN ANGGRAINI 8/10/2009 UJAN MAS ATAS
238 NURHAYATI 1/4/1977 UJAN MAS ATAS
239 DESI ANGGINI PUTRI 12/25/2005 UJAN MAS ATAS
240 DESI SAHARA 8/16/1986 DASPETAH II
241 BELA SARINA OKTIARI 7/9/2005 UJAN MAS ATAS
242 GITA YOLANDA 8/14/2007 UJAN MAS ATAS
243 CENDI REGINA PUTRI 11/28/2008 DASPETAH
244 MILA EMILIA 12/24/2004 DASPETAH
245 AIDIN SUMANTRI 8/1/1973 UJAN MAS ATAS
246 VELA PERONIKA 11/2/2004 PG BERINGANG
247 ELI 7/1/1969 UJAN MAS ATAS
248 PATMA 9/13/1982 UJAN MAS ATAS
249 SUMARLINTON 7/1/1960 UJAN MAS ATAS
250 SUSI AMELIYA 11/20/2000 UJAN MAS ATAS
251 MIMI PUSPITAS SARI 5/21/1996 UJAN MAS ATAS
252 SEPTI LESTARI 9/26/2008 UJAN MAS ATAS
253 CHELSI OLIVIA 11/11/2008 UJAN MAS ATAS
254 SUSYANTI 7/23/1988 UJAN MAS ATAS
255 MUHAMMAD FADILLAH 4/14/2004 UJAN MAS ATAS
256 KAMAL MUKMIN 11/23/1960 UJAN MAS ATAS
257 FEBI ARIYANTI 2/22/2007 UJAN MAS ATAS
258 ANDIKA SANJAYA 6/3/2007 UJAN MAS ATAS
259 YULISA 7/10/1977 UJAN MAS ATAS
260 ELMI YATI 7/4/1970 UJAN MAS ATAS
261 NARISMAWATI 1/9/1982 SURO MUNCAR
262 RIRIN ANDITA 8/7/2007 SURO MUNCAR
263 INDA LESTARI 12/12/2006 SURO MUNCAR
264 SONA SELA NABILA 3/5/2009 UJAN MAS BAWAH
265 HENDRA JAYA 8/8/1988 UJAN MAS ATAS
266 SUCI KARNILA 7/1/1978 UJAN MAS ATAS
267 SINTIAN HAJA AULAH 12/13/2007 UJAN MAS ATAS
268 RISKI PUTRI 7/10/2007 UJAN MAS ATAS
269 ITA YUNANI 12/15/1989 UJAN MAS ATAS
270 SELSI LESTARI 6/8/2008 UJAN MAS ATAS
271 ADETIA 8/3/2001 SURO MUNCAR
272 RIAN HIDAYAT 1/8/2009 UJAN MAS ATAS
273 DELANO OSKARIDO 10/2/2003 UJAN MAS ATAS
274 YEFRI OKY GANESHA 10/30/1995 SURO MUNCAR
275 IDRIS ISKANDAR 2/2/1987 SURO BARU
276 RANDA 9/27/1945 DASPETAH II
277 IDRUS ABDUL SALEH 11/25/1969 SURO MUNCAR
278 LISMAYANA 7/1/1973 UJAN MAS ATAS
279 RENI NOPITA SARI 8/5/2009 UJAN MAS ATAS
280 UJANG ANTOLI 10/21/1963 UJAN MAS ATAS
281 FARHAN AL FIKRI 9/3/2009 SURO MUNCAR
282 JULITA 7/12/2003 SURO MUNCAR
283 PITRI 11/12/2003 SURO ILIR
284 LINDA 5/18/1986 UJAN MAS ATAS
285 NI LUH REMBUN 7/1/1964 SURO MUNCAR
286 SANDI SURO BARU
287 RAYHAN ARYA JOEL 7/27/2007 UJAN MAS ATAS
288 KURMAYANI 7/10/1985 UJAN MAS ATAS
289 SRI SULASMI 5/5/1975 SURO BARU
290 SHINTA 12/6/2001 SURO LEMBAK
291 LINDA PUTRI NENGSIH 6/28/1982 SURO BARU
292 RATNA YULIS 4/28/1982 UJAN MAS ATAS
293 RITA SAPITRI 7/1/1979 UJAN MAS ATAS
294 REPI ARIANTI 12/20/1995 DASPETAH
295 ENDANG PAUZI 1/3/1991 UJAN MAS ATAS
296 DEDI IRAWAN 10/28/1993 SURO MUNCAR
297 PEPI YARMI 5/26/1989 DASPETAH
298 DENA MARYANA 7/5/1992 UJAN MAS BAWAH
299 ELLY ELMA YANTI 2/22/1980 UJAN MAS BAWAH
300 HERMANSYAH 11/10/1995 UJAN MAS ATAS
301 ANTON SUDARWO 3/25/1985 SURO MUNCAR
302 INDRA SAPRI 1/11/1969 SURO MUNCAR
303 MAT ASIN 7/2/1963 UJAN MAS ATAS
304 PUTU YASE 3/20/1974 SURO ILIR
305 MEKO PAHMI ALAMZA 5/26/2001 SURO MUNCAR
306 M. REDO 7/30/1980 SURO MUNCAR
307 MARGONO 7/17/1959 SURO MUNCAR
308 DONI ANSA 8/19/1990 UJAN MAS ATAS
309 AMINULLAZI 3/1/1967 SURO MUNCAR

83 GUNA'IM 2/6/1969 UJAN MAS ATAS


HAPIS PERNANDO 11/22/2000 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
18 DESEMBER 2021
KANTOR CAMAT

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
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1
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0 0 0 0 0 0 5 0 0 64 0 33 0 3 0
0 102 76

1
RESI
PKM
YUK PIT
134 0 0 0 0 0 0 0 0 0
0

1708020602690001
1708022211000001
MAT
R 2021
OVID-19
BUMIL
M.UMUM

DOSIS 1
T INAP UJAN MAS

PENDIDIK
REMAJA

1
1
1
1
LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
DOSIS 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0 66 0 7 7 0 0 100 0 3 0 0 0 0 0 0 0 11 0 0 0 0 0 10 0 0 0 0 0
76 110 0 11 10 0
309
186

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1
1
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
SINOVAC
REKAPITUL
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 3
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
32155BA

NO NAMA TGL LAHIR ALAMAT

1 ASMAWI 12/10/1989 DASPETAH


2 KASRUL AIDIN 8/12/1969 DASPETAH
DUKCAPIL 3 EMI 12/10/1981 DASPETAH
4 HERMAN PRIANSYAH 9/18/2002 DASPETAH
5 SINAR WANI 12/2/1978 DASPETAH
DUKCAPIL 6 ADEL VESA 12/12/2005 DASPETAH
7 SISKA 12/10/2005 DASPETAH
8 RAHMAT JUNAIDI 7/5/1996 DASPETAH
9 KARNELI SUSIANA 5/15/1979 DASPETAH
10 SUHAIMIK 8/20/1968 DASPETAH
11 RISKI ADITIO 1/10/2005 DASPETAH
12 MAHDAL TORI 3/1/1984 DASPETAH
13 SRI DWI BULAN SEJATI 8/31/2004 DASPETAH
14 GATOT ARYANTO 9/10/1995 DASPETAH
15 AMINUDIN 1/8/1952 DASPETAH
16 DENI PERIYANTI 12/6/1992 DASPETAH
HARUSNYO SINOVAC 17 RANGGA PEPRIYANSAH 1/17/2008 DASPETAH
18 ABDULLAH 4/13/1966 DASPETAH
19 LESMIANI 12/28/1984 DASPETAH
20 AYUN SUNDARI 5/8/1998 DASPETAH
21 NORMA 3/10/1964 DASPETAH
22 LEDIANA MUTULESI 7/1/1990 DASPETAH
23 ALEK DARWANDI 12/11/1986 DASPETAH
24 YUSNAINI 9/8/1978 DASPETAH
25 SENALDO DASPETAH
26 SELVI DIANA 6/24/2000 DASPETAH
27 SUMARTULANI 1/3/1961 DASPETAH
28 RUSLI 5/10/1972 DASPETAH
29 PRIMA ARI SANJAJAYA 9/26/2008 DASPETAH
30 ROSNI PONITA SARI 11/11/1978 DASPETAH
31 SURI 11/20/1962 DASPETAH
32 HAMID 1/22/1955 DASPETAH
33 WELI KURNIA DASPETAH
34 SUMI SUSANTI 11/20/1971 DASPETAH
SUDAH VAKSIN 2 TP SALA 35 YULIUS MARTONI 11/30/2006 DASPETAH
36 SUDARMAN 3/2/1976 DASPETAH
37 DWI NADILA 8/1/2006 DASPETAH
38 INDAR FAJRI DASPETAH
39 SURYANTI 8/10/1985 DASPETAH
40 SUDIRMAN 2/17/1980 DASPETAH
41 TARMIN HAROM 4/6/1980 DASPETAH
42 ILHAMZAH KURNIAWAN 10/30/1995 DASPETAH
43 TITI ARIANTI 11/28/1992 DASPETAH
44 PUJI ANTI 10/15/1986 DASPETAH
45 EMILIA CONTESA 8/20/1982 DASPETAH
46 SOPIAN 8/7/1975 DASPETAH
47 WINDY DWI LESTARI 9/24/2000 DASPETAH
48 ERNI YOSNITA DASPETAH
49 JELITA HARIANTI 6/23/1998 DASPETAH
50 GUNTUR PRANATA 3/3/1997 DASPETAH
51 SUARTI 6/27/1969 DASPETAH
52 JESSIKA ANGGI 12/23/2004 DASPETAH
53 RAENA WATI 4/25/1964 DASPETAH
54 MARZUKI 7/1/1971 DASPETAH
55 KANEDI 1/27/1963 DASPETAH
ENTRY 21 HARI LAGI 56 MARDALENA 7/19/1979 DASPETAH
57 ARDIANTO 8/4/2001 DASPETAH
58 HASANA 11/16/1969 DASPETAH
59 SYAFEI DASPETAH
60 LIS MULYANA 7/16/1977 DASPETAH
61 MARZUKI 7/1/1971 DASPETAH
ENTRY 21 HARI LAGI 62 LAURA CYNTIA BELLA 9/1/2006 DASPETAH
63 JAMINA 5/7/1957 PG BERINGANG
64 BUKHORI 9/1/1970 DASPETAH
65 DALIAH DASPETAH
66 RESTI FRANSISCA 1/6/1993 DASPETAH
67 KASMABOTI DASPETAH
68 MARTIAN SAPUTRA 1/10/2007 DASPETAH
69 VIOLA EKA UTAMI 1/18/2009 DASPETAH
70 RIKO ARYANSA 4/23/2009 DASPETAH
71 ANDINI AFRISA 4/14/2007 DASPETAH
72 HENDRI NIARKOSE 2/13/1994 DASPETAH
73 SINARYA 4/10/1972 DASPETAH
74 MULYA KARNA 11/13/1977 DASPETAH
75 TITIN SUTRANDORI 6/7/1986 DASPETAH
76 PAJARNA 2/17/1963 DASPETAH
77 MAHRISAL ANTONI 8/7/1971 DASPETAH
78 OVY PRADETI 10/25/1996
79 TITANIA FAULA 7/10/1998 DASPETAH
80 ALDI RONALDO 1/14/2001 DASPETAH
81 ELIZA DASPETAH
82 LELI KASITA DASPETAH
83 SAPAR GINTA 10/17/1968 DASPETAH
84 SHINTA BELA 7/21/1995 DASPETAH
DUKCAPIL 85 PEBER PEPRIAN 1/26/2009 DASPETAH
DUKCAPIL 86 BERLIAN AJI DWI ANDIKA 12/25/2007 DASPETAH
87 LATI PATURUHHANIA 6/5/1994 PG BERINGANG
88 HANIZAR NAINI 4/12/1994 PG BERINGANG
89 UMI KALSUM 4/25/1964 PG BERINGANG
90 LELA 9/7/1968 PG BERINGANG
91 DIANA NOVITA SARI 4/18/1988 PG BERINGANG
ASTRA 92 DARMA LINDA 1/1/1999 PG BERINGANG
93 LOVA DWI CAHYO 4/27/2005 PG BERINGANG
94 BUYUNG KANEDI 8/21/1977 PG BERINGANG
95 SUHANDAK 5/12/1983
96 SELLY MARCELENA 2/23/2000 PG BERINGANG
97 KARVI 3/14/1981 PG BERINGANG
98 ROSMALA DEWI 9/1/1987
99 DIANA SUSIANTI 4/18/1988 PG BERINGANG
100 KIKI PRASISKA 7/23/1996
101 SELVIA UTARI 10/15/1996 PG BERINGANG
102 RATNA WATI 5/30/1959 PG BERINGANG
103 MELA CUCIANTI 5/25/1978 PG BERINGANG
104 MUHTAR 6/2/1960 PG BERINGANG
105 FARHAN FIRMANSYAH 7/27/2007 PG BERINGANG
106 HERI JARAUL 8/19/1977 PG BERINGANG
107 BETA RIA 2/10/1986 PG BERINGANG
108 KRISTIAN HADI NATA 5/5/1985 PG BERINGANG
109 HAIGA 2/11/1979 PG BERINGANG
110 KORI PRANOTO 11/10/1986 PG BERINGANG
111 BURHAN ISKANDAR 3/13/1986 DASPETAH
112 JENDI GUNAWAN 10/7/1999 DASPETAH
113 SAPRI YANDO 2/1/2003 DASPETAH
114 ERNA YUNITA 1/3/1988 DASPETAH
115 ROSLAN 1/5/1945 DASPETAH
116 GUNUNG 4/3/1968 DASPETAH
117 SUSI 5/10/1983 DASPETAH
118 ERLAN PURNAMA 9/10/1983
119 SARLIS 11/15/1982 DASPETAH
120 ARIO 1/11/1985 DASPETAH
121 SUMIATI 8/12/1982 DASPETAH
122 YOLANDA KYAHAHO 4/18/1999 DASPETAH
123 SUHAISIH OKTALIA 10/13/1993 DASPETAH
124 REKI MARTINA 12/14/1987 DASPETAH
DUKCAPIL 125 MELANDA AURELIA A 5/3/2007 DASPETAH
126 AGSTA ALAMSYAH 8/6/1994 DASPETAH
127 AMRI 8/5/1964 DASPETAH
128 KARMILA 9/22/1993 DASPETAH
129 ASNI 7/17/1973 DASPETAH
130 SANIA 12/1/1962 DASPETAH
DUKCAPIL 131 CINTA DELA AGITA 8/22/2007 DASPETAH
132 SITI 3/7/1963 DASPETAH
133 SUMARNI 8/6/1988 DASPETAH
134 DARWIS 7/1/1979 DASPETAH
135 ICE ERMITA 10/24/2001 DASPETAH
136 DIFA SELIFANISA 7/5/2007 DASPETAH
137 KAIMA 2/2/1940 DASPETAH
138 SAMSIR ALAM 12/10/1943 DASPETAH
139 GATOT KACA 7/27/1986 DASPETAH
140 SAPARUDIN CAPDIN 5/3/1969 DASPETAH
141 KARTILAWATI 5/25/1974 DASPETAH
142 SAMSUL BADAWI 7/1/1963 DASPETAH
143 ELPINA 6/12/1973 DASPETAH
144 MEGI ARIANTO 5/18/2001 DASPETAH
145 LESTI MALISA 11/23/1998 DASPETAH
146 HERMAN JUNAIDI 7/3/1981 DASPETAH
147 LENI MARLENA 12/12/1983 DASPETAH
148 ERI KURNIAWAN 12/28/2000 DASPETAH
149 SOPIKA ALAWIYA 8/3/2001 DASPETAH
150 ROSMANIAR 7/14/1977 DASPETAH
151 RUAIDA 4/20/1945 DASPETAH
152 TARMIZI 12/1/1974 DASPETAH
153 MARYANA
154 MEMES PERTIWI 5/6/2005 DASPETAH
155 NABILA APRILIA 4/2/2007 DASPETAH
156 EVA NOVITASARI 10/20/1991 DASPETAH
157 LARASATI 2/10/2000 DASPETAH
158 NOVRI YANTI 10/5/1990 DASPETAH
159 RESI AYU LESTARI 6/1/2005 DASPETAH
160 RADEN PATA 8/11/1984 DASPETAH
161 SARIA 7/1/1977 DASPETAH
162 SUWI 6/12/1967 DASPETAH
58 163 ERIK GUNAWAN 4/11/1990 DASPETAH
164 TAUSI 7/21/1970 DASPETAH
165 EKA SUSTIN LOVIA 4/6/1997 DASPETAH
166 TUTI DARLESA 1/20/1980 DASPETAH
167 ANAUYA 10/10/1959 DASPETAH
168 NASOHA DASPETAH
169 DAWALA DASPETAH
170 YUNITA DWI CANTIKA 6/1/2007 DASPETAH
171 PARMI 1/16/1979 DASPETAH
172 AHMDA DO'A DASPETAH
173 BETI LESTARI 10/19/1985 DASPETAH
174 ZAINAL 12/12/1976 DASPETAH
175 FENNY CRISTIAN NOPITA 5/8/1996 DASPETAH
176 SUHERMAN 9/29/1980 DASPETAH
177 NUR PADILAH 3/16/2009 PG BERINGANG
178 ROSIDA 8/11/1985 PG BERINGANG
179 ADE ANITA 10/20/1997 PG BERINGANG
180 ELMI DAHRI 5/25/1980 PG BERINGANG
181 FIKRI ADI PRASETYO 12/2/2006 UJAN MAS ATAS
182 MILNA 5/5/1969 PG BERINGANG
183 RIDUAN 8/7/1967 PG BERINGANG
184 YURNI MAHERAWATI 5/10/1987 PG BERINGANG
185 MILA WATI 8/10/1980 PG BERINGANG
186 ANWAR SANUSI 12/6/1964 PG BERINGANG
187 SOPYAN HARDIANTO 10/14/1988 PG BERINGANG
188 PIK SUMARNO 3/19/1988 PG BERINGANG
189 NARSIH SARTIKA 6/9/1990 PG BERINGANG
DUKCAPIL 190 TARMIZI 10/18/1985 PG BERINGANG
191 HENDRI AKSA 12/27/1975 PG BERINGANG
192 KUNIA WATI 11/10/1979 PG BERINGANG
193 REPI CANDRA UJAN MAS ATAS
194 RUDI SANTOSO UJAN MAS ATAS
195 WAHIMAH UJAN MAS ATAS
196 HERMAN UJAN MAS ATAS
197 HENDRA UJAN MAS ATAS
198 DIANA PUSPITA SARI UJAN MAS ATAS
DUKCAPIL 199 NOVRI AGUSTIN UJAN MAS ATAS
200 AYU RISKA AMELIA UJAN MAS ATAS
201 REKA PUTRI UJAN MAS ATAS
202 EKO SUPARDI UJAN MAS ATAS
203 ROKI MARTA UJAN MAS ATAS
204 JERI SAPUTRA UJAN MAS ATAS
205 SUSILA UJAN MAS ATAS
206 EDI HERWANTO UJAN MAS ATAS
207 RIO ANDRIANTO UJAN MAS ATAS
208 PRETY ANISA JULIANTIKA UJAN MAS ATAS
209 JOKO HARYANTO UJAN MAS ATAS
210 RANDI FEBRIANSAH UJAN MAS ATAS
211 FAHRI INDARWAN UJAN MAS ATAS
212 ADITIA PERDANA PATRA UJAN MAS ATAS
213 NILA LESTARI UJAN MAS ATAS
214 ANGGI SAPUTRA UJAN MAS ATAS
215 MELIAN UJAN MAS ATAS
216 ALDO SAPUTRA 1/6/2008 SURO ILIR

83 GUNA'IM 2/6/1969 UJAN MAS ATAS


HAPIS PERNANDO 11/22/2000 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
20 DESEMBER 2021

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1708021012690002
1708021208690005
1708024612830003
1708024212780001
1708024212780001
1708025212050002
1708025012050001
1708020501960002

1708042008680004
1708020602060001
1707010103840006
1708027108040003

1708020801520001 1
1708024612920001
1708021701080001
1708021304660003
1709065607840002
1708024805980003
1708025003640001
1708024107910073
1708021112860001
1708024908780004
1708021802980001
1708026406000001
1708024301610001
1708021005720003
1708042609080001
1708045111780003
1708026011620001
1708022201550001
1708024907850002
1708026011710001
1708023011060001
1708020203760002
1708024108060002
1708020701730003
1708025008850001
1708021702800004
1708020604800002 085366837100
1708023010950003
1708026811920001
1708025510860002
1708026008820002
1708020708750001
1708026409000001
1708025208840001
17021663069800001
1708020303970003
1708026706690002
1708026309040004
1708025503610001
1708021212700001
1708022701630003
1708025907790001
1708020804010002
1708025611690001
1708022003560002
1708025607770002
1708021212700001
1708024109060004
1708024705570001
1708020109700004
1708024810680001
1708024601930001
1708045409780003
1708021001070002
1708025801090001
1708022304090001
1708045404070001
1708021302940003
1708025004720002
1708025311770002
1708024706860001
1708025702630001
1708020708720002
1708026510960001
1708025007980001
1708041401010002
1708024908820001
1708055111850002
1708021710680001
1702196106950003
1708022001090001
1708022612070002
1708024506940002
1708025204940003
1708026504640002
1708024709680003
1708025804880001
1708025011990002
1708022704040002
1708022108770005
1708022512830001
1708026303000003
1708025403810001
1673024109870005
1708025804880001
1708026307960004 082269342594
1708024208980002
1708027005590001
1708026505780004
1708020205600001
1708022707070001
1708021906770001
1708025002860003
1708020505850007
1708025102790001
1708021011860002
1708051303860002
1708020710990001
1708020102030001
1708034301880001
1708020501450002 1
1708024304670003
1708015005830013
1708021009830001
1708025511820002
1708021101850001
1708025208820001
1708025804990002
1708085310930002
1708025412870003
1708024305070001
1708020608940001
1708020508640001
1708025905830001
1708025707730001
1708024112620001
1709030200070002
1708024703630009
1708024808880010
1708020107790103
1707054306010001
1708024507070003
1708024202400001 1
1708021012430001 1
1708022707860004
1708020303690001
1708026505740004
1708020107630185
1708024606730002
1708025805010001
1708026311980004
1708020307810001
1708025212830001
1708022810000001
1708024308010001
1708025407770001
1708026004450001 1
1708020112740004

1708024605050001
1708024204070002
1708026810910003
1708025002000001
1708024510900003
1708024106050002
1708021108840002
1708024107770127
1708021206670003
1708021104900001
1708022107700001
1708064604970001
1708026001800001
1708025010590001 1
1708021507640003
1708025708710001
1708024106070005
1708025601790001
1708022810840001
1708025910850001
1708021212760008
1708024805960003
1708022909800002
1708025603090001
1708025108850002
1708026010970003
1708022505800001
1708020212060006
1708024505690008
1708020708670005
1708025005870004
1708025008800001
1708020612640001
1708021410880003
1708021903880001
1708024906900001
1708021810850003
1708022712750001
1708025011790004
1708020106900002
1708021702930001
1708024107550063
1708020102640002
1708022005980001
1709065612830001
1709020308980002
1709065606020001
1708025410030001
1708021005870002
1708041805930001
1708021508990001
1708025811730002
1708023012730001
1708022408860002
1708025307050003
1708022005870001
1708021702090001
1708020912070002
1708020109080003
1708027007040003
1708021907000001
1708020102820006
1708020601080001
0 0 0 0 0 0 0 0 0 0 0 0 0 6 0
0 0 118

2
RESI
PKM
YUK PIT
134 0 0 0 0 0 0 0 0 0
0

1708020602690001
1708022211000001
R 2021
OVID-19
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM

DOSIS 1
T INAP UJAN MAS

PENDIDIK

1
1
1
1
1
REMAJA

1
1
LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK

1
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
DOSIS 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 90 0 21 6 0 0 81 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 98 0 0 0 0
216
216

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1
1
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
SINOVAC
REKAPITUL
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 3
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
32155BA

NO NAMA TGL LAHIR ALAMAT

1 DIRA ADE SAPUTRA 7/30/2008 SURO MUNCAR


2 NOPRIANSYAH 2/1/2008 SURO MUNCAR
3 REKI SANJAYA 7/16/2007 SURO MUNCAR
4 HABIB FAHRY 3/8/2009 SURO MUNCAR
5 BAHRI 1/1/1960 SURO MUNCAR
6 PADIL ADI JAYA KUSUMA 2/17/2007 SURO MUNCAR
7 DELVI ARYANI 2/18/2005 SURO MUNCAR
8 SUSILAWATI 4/18/1975 SURO MUNCAR
9 ANDREAN DEVANDRA 2/24/2007 SURO MUNCAR
10 MELI SUNARTI 10/10/1984 SURO MUNCAR
11 NESA SUNDARI 1/19/2005 SURO MUNCAR
12 REKAL DEAN ADEPUTRA 8/16/2006 SURO MUNCAR
13 ELNAWATI 8/24/1980 SURO MUNCAR
14 RITA PUTRI 1/25/1965 SURO MUNCAR
15 MURNI CAHAYA 5/12/1990 SURO MUNCAR
16 SARTIKA 1/5/1995 SURO MUNCAR
17 LUSIANA 6/10/1985 SURO MUNCAR
18 ARTIS MIMBAR 10/15/1986 SURO MUNCAR
19 SUPARNA 4/10/1962 SURO MUNCAR
20 PELIPUR HATI 12/11/1967 SURO MUNCAR
21 NENI NURHAYANTI 6/29/1993 SURO MUNCAR
22 HENI WIDIA SARI 8/3/1990 SURO MUNCAR
23 YUSMA WANI 3/1/1965 SURO MUNCAR
24 MAUYA 7/1/1953 SURO MUNCAR
25 NENGSI 7/5/1979 SURO MUNCAR
26 DIMAS VINO FERNANDO 7/14/2007 SURO MUNCAR
27 RAHANA 4/7/1973 SURO MUNCAR
28 ANISA LESTARI 8/14/2006 SURO MUNCAR
29 NETI 9/21/1982 SURO MUNCAR
30 EGO HARYANTO 3/6/2003 SURO MUNCAR
31 ZAINAL IMRON 3/14/1977 SURO MUNCAR
32 MAYA GITA PRATIWI 9/17/2000 SURO MUNCAR
33 SANTI JUSTARI 9/10/1988 SURO MUNCAR
34 REKONI 8/8/1988 SURO MUNCAR
35 HENDRIK OKTANIUS 10/15/1999 SURO MUNCAR
36 MUHAMMAD NASIR 5/3/1971 SURO MUNCAR
37 PARDIMIN 5/12/1956 SURO MUNCAR
38 JUNIAQSA 6/9/1982 SURO MUNCAR
39 SURIF 3/1/1962 SURO MUNCAR
40 YULITA 5/7/1986 SURO MUNCAR
41 JUANDA 4/28/1991 SURO MUNCAR
42 JUSNI 4/1/1985 SURO MUNCAR
43 SRI WAHYUNI 6/6/2000 SURO MUNCAR
44 HENDRI KUSMEDI 5/8/1978 SURO MUNCAR
45 HERI HARYANTO 3/20/1989 SURO MUNCAR
46 IRWAN ISKANDI 7/18/1987 SURO MUNCAR
44
45
46
47
48
49
|

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
23 DESEMBER 2021
SURO MUNCAR

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1702193007080001 1
1708020107080008 1
1708021607070004 1
1708020803090001 1
1708020101600003 1
1708020411080001 1
1708025802050001 1
1708025804750001 1
1708022402070001 1
1708025010830001 1
1708025901050001 1
1708051608060002 1
1708026408800001
1708026501650001
1708025205900001
1708044501950001
1708025006850003
1708021510860003
1708021004620002
1708025112670003
1708026906930001
1708024308900002
1708024103650002
1708024107530115
1708024507790004
1708021407070001
1708024704730001
1708025408060001
1708026109820001
1708020603030001
1708021403770004
1708056705000001
1708026205930002
1708020808880002 08995730707
1708021510990001 08995730707
1708020305710001 08995730707
1708021205560003 08995730707
1708020906820001 08995730707
1708020103620004 08995730707
1708024705860003 08995730707
1708022804910001 08995730707
1708024104850003 08995730707
1708024606000002 08995730707
1702190805780002 08995730707
1708022003890001 08995730707
1708021807870001 08995730707

0 0 0 0 0 0 0 0 0 4 0 8 0 0 0
0 12 0

RESI 4 0 8 0 0 0
PKM 2 50
YUK PIT 2 27 21
134 2 0 0 33 0 79 0 0 0
114

PFIZER
RESI 21 3 18 3
PKM 28 4 24 4
YUK PIT 27 4 23 3

1708024403770004 08995730707
CAR
R 2021
OVID-19
BUMIL
M.UMUM

DOSIS 1
T INAP UJAN MAS

PENDIDIK
REMAJA

1
LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK

1
1
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL

1
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
DOSIS 2
1
1
1
1
1
1
1
1
1
1
1
1

0 0 0 0 1 0 0 18 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 12 0 0 0 0 0
0 21 0 0 13 0
46
21
0 0 0 0 1 0 0 18 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 12
1 4 1 19 3 1 9
1 3 1 21 1 10
1 4 0 5 2 0 0 58 0 6 0 0 0 0 0 0 0 0 0 0 2 0 0 31

1
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
SINOVAC
REKAPITUL
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

3 226
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
32155BA

NO NAMA TGL LAHIR ALAMAT

1 DIRA ADE SAPUTRA 7/30/2008 SURO MUNCAR


2 NOPRIANSYAH 2/1/2008 SURO MUNCAR
3 REKI SANJAYA 7/16/2007 SURO MUNCAR
4 HABIB FAHRY 3/8/2009 SURO MUNCAR
5 BAHRI 1/1/1960 SURO MUNCAR
6 PADIL ADI JAYA KUSUMA 2/17/2007 SURO MUNCAR
7 DELVI ARYANI 2/18/2005 SURO MUNCAR
8 SUSILAWATI 4/18/1975 SURO MUNCAR
9 ANDREAN DEVANDRA 2/24/2007 SURO MUNCAR
10 MELI SUNARTI 10/10/1984 SURO MUNCAR
11 NESA SUNDARI 1/19/2005 SURO MUNCAR
12 REKAL DEAN ADEPUTRA 8/16/2006 SURO MUNCAR
13 ELNAWATI 8/24/1980 SURO MUNCAR
14 RITA PUTRI 1/25/1965 SURO MUNCAR
15 MURNI CAHAYA 5/12/1990 SURO MUNCAR
16 SARTIKA 1/5/1995 SURO MUNCAR
17 LUSIANA 6/10/1985 SURO MUNCAR
18 ARTIS MIMBAR 10/15/1986 SURO MUNCAR
19 SUPARNA 4/10/1962 SURO MUNCAR
20 PELIPUR HATI 12/11/1967 SURO MUNCAR
21 NENI NURHAYANTI 6/29/1993 SURO MUNCAR
22 HENI WIDIA SARI 8/3/1990 SURO MUNCAR
23 YUSMA WANI 3/1/1965 SURO MUNCAR
24 MAUYA 7/1/1953 SURO MUNCAR
25 NENGSI 7/5/1979 SURO MUNCAR
26 DIMAS VINO FERNANDO 7/14/2007 SURO MUNCAR
27 RAHANA 4/7/1973 SURO MUNCAR
28 ANISA LESTARI 8/14/2006 SURO MUNCAR
29 NETI 9/21/1982 SURO MUNCAR
30 EGO HARYANTO 3/6/2003 SURO MUNCAR
31 ZAINAL IMRON 3/14/1977 SURO MUNCAR
32 MAYA GITA PRATIWI 9/17/2000 SURO MUNCAR
33 SANTI JUSTARI 9/10/1988 SURO MUNCAR
34 REKONI 8/8/1988 SURO MUNCAR
35 HENDRIK OKTANIUS 10/15/1999 SURO MUNCAR
36 MUHAMMAD NASIR 5/3/1971 SURO MUNCAR
37 PARDIMIN 5/12/1956 SURO MUNCAR
38 JUNIAQSA 6/9/1982 SURO MUNCAR
39 SURIF 3/1/1962 SURO MUNCAR
40 YULITA 5/7/1986 SURO MUNCAR
41 JUANDA 4/28/1991 SURO MUNCAR
42 JUSNI 4/1/1985 SURO MUNCAR
43 SRI WAHYUNI 6/6/2000 SURO MUNCAR
44 HENDRI KUSMEDI 5/8/1978 SURO MUNCAR
45 HERI HARYANTO 3/20/1989 SURO MUNCAR
46 IRWAN ISKANDI 7/18/1987 SURO MUNCAR
47 RUMILA WANI 01-06-1969 SURO BARU
48 ELIA MARYANI 21-07-1978 SURO BARU
49 ASMAWATI 01-07-1948 SURO BARU
50 DIRNO 10-04-1962 SURO BARU
51 BUDI HARTONO 20-06-1974 SURO BARU
52 SAHRI 01-07-1971 SURO BARU
53 KUMARIAH 09-09-2008 SURO BARU
54 AISAH OKTARIA 20-10-2007 SURO BARU
55 CHLARA WINARTI 02-04-2004 SURO BARU
56 SELPI WAHINA 09-04-2003 SURO BARU
57 MUTIARA PUSPITA 25-02-1999 SURO BARU
58 BAMBANG IRAWAN 02-08-1981 SURO BARU
59 NHABILA AYU SHERLY MASYIT 02-09-2008 SURO BARU
60 TANTI SUMANTI 11-11-1989 SURO BARU
61 INDRA JAYA 04-02-1974 SURO BARU
62 SUDI PUTRA 01-07-1999 SURO BARU
63 IKHSAN ANSORI 12/2/2002 SURO BARU
64 BUDI MARTONI 13-10-1988 SURO BARU
65 BUDI MARTONO 13-10-1988 SURO BARU
66 SUTRISNO 15-08-1993 SURO BARU
67 AFRYANA 25-04-1988 SURO BARU
68 SARI PATMAWATI 05-05-1996 SURO BARU
69 IQBAL MALIKI 01-09-2001 SURO BARU
70 IBRAHIM SALEH 12-12-1988 SURO BARU
71 TANIA APRIANI 03-11-2008 SURO BARU
72 ELIS PURNAMA SARI 15-04-1995 SURO BARU
73 TIARA LESTARI 28-12-2007 SURO BARU
74 SAMSIA 01-07-1955 SURO BARU
75 YUNI IRAWAN 01-05-1988 SURO BARU
76 NOVI HERLINDA 06-07-1979 SURO BARU
77 LESTARINI 18-11-1992 SURO BARU
78 RISKI SAPUTRA 03-08-1997 SURO BARU
79 YUR EFENDI 26-06-1965 SURO BARU
80 SUHARTO AKSA 01-09-1975 SURO BARU
81 ERISMA WULANDARI 04-07-1994 SURO BARU
82 KHEYLA YOFITA SARI 10-08-2008 SURO BARU
83 ANISA ALFITRA 19-12-2006 SURO BARU
84 DUTA ANUGRAH 14-08-2008 SURO BARU
85 DIVA PIOLESI 13-01-2008 SURO BARU
86 DADI HARTONO 05-05-1986 SURO BARU
87 PUTRA SALAM ABDUL FATAH 30-05-2005 SURO BARU
88 NENGSI PERMATA SARI 15-10-1998 SURO BARU
89 PINA 08-09-2005 SURO BARU
90 NIKE YOLANDA 22-12-2002 SURO BARU
91 DEPRIYANTO 15-01-1994 SURO BARU
92 NEKA UTARI 25-09-2004 SURO BARU
93 NURLELAWATI 04-06-1977 SURO BARU
94 AZIZAH FITRI UTAMI 11-12-2007 SURO BARU
95 PERA ARIANTI 05-09-1998 SURO BARU
96 NOPENSI DEWI SENJA 19-11-2000 SURO BARU
97 REZA HAYATI 14-08-1968 SURO BARU
98 JEZI AULIA UJAN MAS ATAS
99 ANGGA ADI PUTRA UJAN MAS ATAS
100 YUSNIDA HERANI UJAN MAS ATAS
101 TRI YANTO UJAN MAS ATAS
102 REFI UJAN MAS ATAS
103 KHAIDIR UJAN MAS ATAS
104 RESI WINDA SARI UJAN MAS ATAS
105 SUNIP UJAN MAS ATAS
106 NURIYATI 01-07-1963 SURO BARU
107 RIYADI 10-01-1996 SURO BARU
108 FADLI FIRMANSYAH 26-11-2007 UJAN MAS ATAS
109 AGUS ANSORI 16-08-1991 SURO BARU
110 MEISA MARSELA SURO BARU
111 LUSTRI MUSTARI SURO BARU
112 IRSAN ILHAM KARIM SURO BARU
113 HETI PURNAMASARI SURO BARU
114 TAUPIK HIDAYAT SURO BARU
115 DEDE PANGABEAN SURO BARU
116 TUGIMAN SURO BARU
117 EDO SAPUTRA SURO BARU
118 KARINA SURO BARU
119 AHMAD AGUSTIAN 18-08-2006 SURO BARU
120 FEBI RAHMAN AL FIKRI 24-12-2007 SURO BARU
121 MILAN RAJA DANUARTA 13-05-2007 SURO BARU
122 DINDA MAROAN 28-03-2008 SURO BARU
123 M DEDE SAFAWI 30-10-2006 SURO BARU
124 HERO KURNIAWAN 29-06-2001 SURO BARU
125 RELESTI MAHARANI 09-01-2008 SURO BARU
126 BAHARUDIN SURO BARU
127 SUTAN SURO BARU
128 REKA UJAN MAS ATAS
129 BUNGA FIRZA 10/30/2008 UMA
130 NOLA SEPTIA P 5/9/2009 UMA
131 RIRIN 4/14/2009 PB
132 SELI OKTA V 3/7/2007 UMA
133 ARSI MELI S 6/4/2008 UMA
134 NORA 12/4/2008 UMA
135 DEA AMANDA 3/16/2000 UMA
136 DWI LESTARI 9/11/2007 UMA
137 RISNA LEPIA 7/18/2009 UMA
138 CINTIA AGUSTINA 8/7/2007 UMA
139 IMEL DIANA 5/30/2007 UMA
140 DOVAL RISKI 7/23/2007 UMA
141 HERNI W 6/18/2000 UJAN MAS BAWAH
142 LESA WULAN 6/20/2001 UJAN MAS BAWAH
143 ALMIYAH 3/4/1977 SURO ILIR
144 ROSULI 6/12/1970 SURO LEMBAK
145 KELARA SINTA 8/28/2007 BUMI
146 AZHAR 4/30/2007 UMA
147 LESI LESTARI 5/6/2003 UMA
148 NADIN R 9/24/2006 SURO ILIR
149 JULIO 7/26/2006 PEKALONGAN
150 DELA ANGGARINI 5/18/2009 PULO GETO
151 WIDIA 9/4/2009 UMA
152 RIYANTI SUSANTI 6/13/2007 BUMI SARI
153 OKTARI R 10/22/2007 MERANTI JAYA
154 NADIA 10/19/2008 SURO BARU
155 INDAH MUSTIKA 8/23/2007 PENGGUK MERANTI
156 SINTA ROSDIANTI 9/9/2006 SUTO LEMBAK
157 TOMI K 11/14/2008 UMA
158 MUHAMMAD ZALI 8/23/2007 BUMI SARI
159 SUSI 5/16/1994 SURO MUNCAR
160 MANI 4/3/1952 UMA
161 LARA ANGGRAWATI 8/16/2002 UMA
162 BADRI 2/5/1967 UMA
163 LENSI H 12/23/2003 DASPETAH
164 LEKSI ELIANTI 8/12/1999 UMA
165 RINTI NOPITA 11/15/2000 UJAN MAS BAWAH
166 DIA DWI 7/30/2000 UMA
167 MISRAWATI 5/7/1989 UMA
168 REKI K 11/17/1995 UMA
169 ADELIA PUTRI 8/20/2006 P. MERANTI
170 HAIYANA 5/11/2005 UJAN MAS BAWAH
171 NOVA ELIZA 5/1/2007 SURO ILIR
172 IMAS 4/1/2007 SURO LEMBAK
173 SISIL NADIN C 8/21/2007 SURO ILIR
174 ROSNA WATI 4/29/2007 SURO LEMBAK
175 RIA RESTI 5/30/1989 UMA
176 SINTA 5/13/2007 SURO LEMBAK
177 FRISKO 6/10/2007 UMA
178 COKI ARIANSYAH 4/29/2008 UMA
179 GYOZHA DINDA 10/13/1999 SURO BARU
180 TRISKA 12/19/1991 UMA
181 SINAR DASPETAH
182 ELVI L 7/6/1984 SURO MUNCAR
183 ELSIH ANNGRAINI 2/10/2001 SURO ILIR
184 ALVIN 4/21/2006 SURO MUNCAR
185 KAROLIN FEB 11/22/2005 SURO MUNCAR
186 SUSILAWATI 4/20/1972 SURO MUNCAR
187 SUWARBIANTO 5/16/1991 BUMI SARI
188 ANDRIANA 8/24/1985 DD
189 SUBARI 3/2/1952 SURO ILIR
190 MUTIARA 6/12/1999 SURO ILIR
191 METAYOSI 6/24/1991 UMA
192 EDO 3/3/2003 SURO ILIR
193 ADELIA TRI 6/20/2005 DASPETAH
194 YUSNIDAR 9/23/1969 SURO BARU
195 DEBI 11/4/2004 SURO ILIR
196 WIWIN 7/21/2007 SURO MUNCAR
197 ANDINI 10/13/2005 DPT 2
198 ZAKIA SALSABILA 6/29/2007 BUMI SARI
199 EFRI SUSANTI 4/24/2005 UMA
200 SINTA APRIZA UMA
201 ADE YUNIARSIH 6/23/2003 SURO BARU
202 RICO 1/6/2002 UMA
203 LATIRAH 9/1/1979 BUMI SARI
204 RAHADI 7/12/1972 BUMI SARI
205 MURIA 8/8/1976 UMA
206 SUKARDI 1/22/2003 SURO MUNCAR
207 SOPIAN ANSORI 12/2/2001 SURO MUNCAR
208 DEKI HERNANDO 2/14/2000 UMA
209 RAFIKA ROFAMITA 9/15/2003 BUMI SARI
210 ANA 01-07-1957 UMA
211 NURLELA 7/4/1984 UMA
212 RISKI ANGGRAINI 6/3/2007 PUNGGUK BERINGANG
213 RISKA ANGGANI 6/3/2007 PUNGGUK BERINGANG
214 DEA MARYANTI 3/15/2006 SURO ILIR
215 DECA 1/11/2008 UMA
|

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
23 DESEMBER 2021
SURO MUNCAR

SINOVAC P
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1702193007080001 1
1708020107080008 1
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1708021004620004
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1708025504990002

1708023112880002
1708022712830001 1

1708026105090001 1
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1
1
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1708026211050001
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1708016408850001
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1708026405910004
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1702194306070004
1702194306070003
1708025503060001 1
1708025101080005 1
0 0 0 0 0 0 2 0 0 33 0 79 0 0 0
0 114 0

RESI 4 0 8 0 0 0
YUK PIT 2 27 21
PKM 2 50

134 2 0 0 33 0 79 0 0 0
114

PFIZER
RESI 21 3 18 3
PKM 23 4 24 4
YUK PIT 22 4 23 3

1708024403770004 08995730707
AR
2021
VID-19
BUMIL
M.UMUM
INAP UJAN MAS

DOSIS 1
PENDIDIK
REMAJA

1
LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK

1
1
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK

1
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
BUMIL
M.UMUM
DOSIS 2
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1

1
1

1
1
1
1
1

1
1

1
1
1

1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
0 0 0 0 2 0 0 58 0 6 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0
0 66 0 0 33 0
215
66
1 0 0 18 0 2 0 0 0 0 0 0 0 0 0 0 1 0 12
21 1 10
1 19 3 1 9

0 0 0 0 2 0 0 58 0 6 0 0 0 0 0 0 0 0 0 0 2 0 31 213

57

1
RA
DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
PENDIDIK DOSIS 1
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
SINOVAC
REKAPITULAS
1
1
0 0 0 0 0 0 0 0 0 0 0 0 0 2
0 2

3 429
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
1 PEBER PEPRIAN 1/26/2009 DASPETAH
2 BERLIAN AJI DWI ANDIKA 12/25/2007 DASPETAH
3 ADEL VESA 12/12/2005 DASPETAH
4 MELANDA AURELIA A 5/3/2007 DASPETAH
5 CINTA DELA AGITA 8/22/2007 DASPETAH
6 TARMIZI 10/18/1985 PG BERINGANG
7 NOVRI AGUSTIN UJAN MAS ATAS
8 EMI 12/10/1981 DASPETAH
9 DEBI VALENTINO 11/4/2004 DPT 2
10 LEO NARDO 1/25/2005
11 APRITIO WIJAYA 4/1/2004 SURO BARU
1708022001090001
1708022612070002
1708025212050002
1708024305070001
1709030200070002
1708021810850003
1709020308980002
1708024612830003
1708024708840001
1708022501050002
1708020104040004
32155BA

NO NAMA TGL LAHIR ALAMAT

1 MURGIANTO 4/5/1970 SURO ILIR


2 ANGGA RISTIAN 11/18/1993 SURO ILIR
3 PURWADI 5/12/1956 SURO ILIR
4 AHMAD BADAWI 10/12/2021 SURO ILIR
5 NETRA HERIYANI 5/14/1974 SURO ILIR
6 WINDRI PUSPITASARI 11/8/2001 SURO ILIR
7 SURYATI 5/4/1972 SURO ILIR
8 KUMSARO 7/10/1976 SURO ILIR
9 INAH 7/1/1964 SURO ILIR
SMP 1 SURO 10 SUMI YATI 4/7/1995 SURO ILIR
11 PERICE AMELIYA 1/5/2009 SURO ILIR
12 SELMA AZHARI 8/10/2007 SURO ILIR
13 FEMRI NUR AZIZAH 11/12/2003 SURO ILIR
14 RIAN EDO SAPUTRA 7/1/1987 SURO ILIR
15 ROPIAH 9/3/1997 SURO ILIR
16 NOVA OKTIA 3/6/1996 SURO ILIR
17 ULIA 7/1/1968 SURO ILIR
18 SAIDIL MAKMUR 4/5/1960 SURO ILIR
19 CIK UDA 5/12/1947 SURO ILIR
20 MURIANA 7/1/1956 SURO ILIR
21 NEMI SASMITA 12/11/1994 SURO ILIR
22 NABILA FEBRIYANTI 12/7/2003 SURO ILIR
23 SUDIRMAN 6/2/2000 SURO ILIR
24 CIKMAN BAHARUDIN 3/23/1965 SURO ILIR
25 PERETI ROMA DENSI 2/9/2003 SURO ILIR
26 KAISAH MARDALENA 4/27/2008 SURO LEMBAK
27 EGI DWI AGUSTIAN 8/13/2006 SURO LEMBAK
28 SUSILA FITRIATI 9/19/1977 SURO LEMBAK
29 KERIN YUNITA SARI 1/11/2008 SURO LEMBAK
30 PIOLA BUNGA LESTARI 5/17/2008 SURO LEMBAK
38 SIDA MULYANI 6/8/1980 SURO ILIR
39 ADE MELANI 10/10/2003 SURO ILIR
40 PENCI CHARLES 2/6/1992 SURO ILIR
41 RINTO ARDIANSYAH 12/20/1991 SURO LEMBAK
42 MERI ANDANI 5/2/1992 SURO LEMBAK
43 DWI ANDINI
44 RISDA 6/18/1993 SURO ILIR
45 SURIYADI 3/25/1984 SURO ILIR
46 ROSWAN GUMANTRI 7/1/1963 UJAN MAS ATAS
47
48
49
50
|

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
29 DESEMBER 2021
SURO ILIR

SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
NAKES
BUMIL

BUMIL
1708020504700003
1708041811930001 082122335466
1708021205560002
1708021210680004
1708025405740001
1702174811010001
1702174405730001
1708025007840002
1708024107640084
1708024704950003 1
1708024501090002 1
1708025008070002 1
1708025211030002 1
1708020107870084 1
1702184209970002
1702225603960001
1708024107680233
1708020504600001
1708025205470001 1
1708024107560045
1708085112940003
1708024702030002
1708020206020001 08566631343
1708022303650015
1708024902030003
1708026704080002
1708021308060002
1708025909770003 1
1708025101080004
1708025705080003 1
1708024806800003
1708025010030007
1708020602920003
1708022012910002
1708054205920001
1708025812060001 1
1708025806930001
1708022503840001 1
1708020107630244

0 0 0 0 0 0 1 0 0 6 0 3 0 0
0 10 8

RESI 1 0 0 6 0 3 0 0
YUK PIT
PKM 3 11

134 1 0 0 9 0 14 0 0
24

PFIZER
RESI 24 3 18 3
PKM 36 4 24 4
YUK PIT 0 4 23 3

1708024403770004 0
LIR
ER 2021
COVID-19
PUBLIK
BUMIL

1
1
1
1
1
1
1
M.UMUM
AT INAP UJAN MAS

DOSIS 1
PENDIDIK

1
REMAJA

1
LANSIA
PFIZER

PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
1

LANSIA
PUBLIK

1
1
1
1

M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA

PUBLIK
DOSIS 2
1

0 0 7 0 1 1 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0
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39
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4 1 1 18 12 1 11 62

0 0 7 0 5 2 0 1 33 0 12 0 0 0 0 0 0 0 0 0 0 2 0 15 101
60

57

###
ASTRA
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
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LANSIA

PUBLIK
DOSIS 1
SINO
REKA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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26 62 2

3 205
24
M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA
SINOVAC
PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
32155BA

NO NAMA TGL LAHIR ALAMAT

1 RASTI DWI ANDINI 12/14/2007 SURO MUNCAR


2 ISLAMIA 2/2/2007 SURO MUNCAR
3 SALSA NOPRIANTI 11/11/2008 SURO MUNCAR
4 RESITA NOVRIANTI 11/19/1994 SURO MUNCAR
5 FUJI FITRI RAHAYU 7/26/2009 SURO MUNCAR
6 SABANIA SAHRA 3/7/1983 SURO MUNCAR
7 SAPRUDIN 8/8/1980 SURO MUNCAR
8 SURYANI 12/12/1981 SURO MUNCAR
9 SINARYANI 7/14/1969 SURO MUNCAR
10 NENTRI 8/12/1983 SURO MUNCAR
11 MARLINA SUSANTI 12/10/1993 SURO MUNCAR
12 ANI RABANIAH 6/16/1986 SURO MUNCAR
13 ARIS MUNANDAR 7/20/1986 SURO MUNCAR
14 WILDA 12/5/1986 SURO MUNCAR
15 VERA LENSI 4/3/1986 SURO MUNCAR
16 EDI HERMANSYAH 10/30/1991 SURO MUNCAR
17 EZI SISWANTO 9/1/1983 SURO MUNCAR
18 JOHAN SUMANTRI 1/18/2007 SURO MUNCAR
19 AMELIA APRIANI 4/4/2008 SURO MUNCAR
20 REKA WATI 11/18/1983 SURO MUNCAR
21 PENI PRATAMA 6/6/2005 SURO MUNCAR
22 HENDRI SUSANTO 4/14/1988 SURO MUNCAR
23 BENTAR PRAPASTA 3/13/1988 SURO MUNCAR
24 RIA SARTIKA 3/23/1992 SURO MUNCAR
25 CANDRA 6/14/2002 SURO MUNCAR
26 SURYADI 8/5/1976 SURO MUNCAR
27 MARGINI 6/22/1995 SURO MUNCAR
28 TITIN 6/1/1974 SURO MUNCAR
29 MARDESI 4/18/1972 SURO MUNCAR
30 DIMAS ARYA 6/17/2009 SURO MUNCAR
31 ROBI YULIANSAH 7/14/1991 SURO MUNCAR
32 SISWAN TARMIZI 2/17/1986 SURO MUNCAR
33
34
35
36
37
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47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
30 DESEMBER 2021
SURO MUNCAR

SINOVAC PF
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA

REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES

NAKES
LANSIA
PUBLIK

LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES
BUMIL

BUMIL
1708025412070001 1
1708024202070001 1
1708025111080001 1
1708025911940001 1
1708026607090001 1
1708024703830002
1708020808800003
1708025212810002
1708025407690001
1708041208830002
1708024207920003
1708025606860002
1708022002860001
1708024512860002
1771084304860002
1708023010880001
1708020109830002
1708021801070001
1708024404080004
1708025811830001
1708020606050002
1708021404880001
1771081303880003
1708026303920001
1708021406020001
1708020508760007
1708026206720002
1708024106740001
1708025804720001
1708021706060001 1
1708051407910001
1708021702860001
0 0 0 0 0 0 0 0 0 1 0 5 0 0 0
0 6 2

RESI 0 0 0 1 0 5 0 0 0
YUK PIT
PKM 3 11

134 0 0 0 4 0 16 0 0 0
20

PFIZER
RESI 24 3 18 3
PKM 36 4 24 4
YUK PIT 0 4 23 3

1708024403770004 0
CAR
R 2021
OVID-19
BUMIL

1
M.UMUM

DOSIS 1
T INAP UJAN MAS

PENDIDIK

1
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LANSIA PFIZER
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
M.UMUM
DOSIS 2

PENDIDIK

1
1
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
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PUBLIK
M.UMUM
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PENDIDIK
REMAJA
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1
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DOSIS 1

PENDIDIK
REMAJA
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0 1 0 1 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0
2 22 0 0 2 0
32
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0 1 0 1 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2

4 1 1 18 12 1 11 62

0 1 0 5 1 0 1 38 0 14 0 0 0 0 0 0 0 0 0 0 1 0 13 94
60

57

###
TRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM DOSIS 1
PENDIDIK
REMAJA
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M.UMUM
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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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3 191
24
REKAPITULASI HARIAN VAKSINASI COVID 19
28 OKTOBER 2021

SINOVAC MODERNA
DOSIS 1 DOSIS 2 PENDIDIK DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
JUMLAH
M.UMUM

M.UMUM

M.UMUM
REMAJA

REMAJA
LANSIA

PUBLIK

LANSIA

PUBLIK

LANSIA

PUBLIK
32155BA

NO NAMA TGL LAHIR ALAMAT

1A 1 AJIRNA DWI PERMATA 29-Sep-14 UJAN MAS ATAS


2 AMELIA LEONI RAMADHANI 18-Jun-15 UJAN MAS ATAS
3 ARKA TIAGA DIPIARUPA 15-Nov-14 UJAN MAS ATAS
4 BINTANG DWI PUTRI 30-Jul-14 UJAN MAS ATAS
5 CINTA APRILIA 5-Apr-15 UJAN MAS ATAS
6 DEA SALSABILA 29-Nov-14 UJAN MAS BAWAH
7 DEFIN ALPARIZI 13-Jan-15 UJAN MAS ATAS
8 DESTIANA DEWI NURKHALBY 6-Dec-14 UJAN MAS ATAS
9 DEVIN OKTAVIAN 12-Aug-14 UJAN MAS BAWAH
10 ERINTIA VIRATAMI 25-Feb-15 UJAN MAS ATAS
11 ERISKA DWI CHAIRUNNISA 15-Sep-14 UJAN MAS ATAS
12 FIONA STEFANIE 17-Sep-14 UJAN MAS ATAS
13 JESIKA ALFIRA 7-Nov-14 SURO BARU
14 JULIO RAMADHAN 8-Jul-14 UJAN MAS ATAS
15 LATIFAH DWI PUTRI 19-May-14 UJAN MAS ATAS
16 MIRZHA AULIA BELA 14-Jul-14 UJAN MAS BAWAH
UDAH SKRIN 17 MUHAMMAD RIZKI ALFARIZY 20-Feb-15 UJAN MAS ATAS
18 NAFYA PUTRI MEISYA 5-May-15 UJAN MAS BAWAH
19 NIKO ANJAS SANTARA 13-Oct-14 UJAN MAS ATAS
20 NOVITA SARI 8-Sep-14 UJAN MAS ATAS
21 RIZKY ZEVANO ALVERO 14-Mar-15 UJAN MAS ATAS
22 SINDI AMELIA 25-Dec-14 UJAN MAS BAWAH
23 SPINKI BIGTRI PANA 9-Jan-15 UJAN MAS ATAS
24 VIKO HARGIANTO 5-Jan-14 UJAN MAS BAWAH
25 WAHYU ANUGGRAH 10-Aug-14 UJAN MAS BAWAH
26 ZALFA MIKAILLAH 10-Jan-15 UJAN MAS ATAS
1B 27 ABDUL AZIZ ALGANI 31-Dec-14 UJAN MAS ATAS
28 ABIDZAR AL-GHIFARI AKSA 3-Aug-14 UJAN MAS ATAS
ABIZAR AL-GHIPARI 23-May-15 UJAN MAS BAWAH
AKILAH ANGGRAINI 15-Jul-14 UJAN MAS BAWAH
ALIYANDO SYARIF 20-Oct-14 UJAN MAS BAWAH
ANDRE DIMAS PRAYOGA 2-Aug-13 UJAN MAS BAWAH
ARGA PRISKI DEWANTARA 10-Dec-14 UJAN MAS ATAS
CIKA JEZIKA 22-May-15 UJAN MAS ATAS
DEBI APRILIO 21-Apr-15 UJAN MAS ATAS
FAHMI WIBISONO 31-Jul-14 UJAN MAS ATAS
FARDHAN AKBAR ADITIANSYA 26-Dec-14 UJAN MAS BAWAH
FAUZAN ADITIA 17-Dec-14 UJAN MAS BAWAH
FERO AKIOSI 9-Feb-15 DASPETAH
FHADELIYA MAHARANI 7-Oct-14 UJAN MAS ATAS
GOFAL ALVIANO 1-May-15 UJAN MAS ATAS
KEILA BINTANG CANTIKA 4-Apr-14 UJAN MAS BAWAH
KELVIN RIANSAH 12-Sep-14 UJAN MAS ATAS
KRISTINA BUNGA ADELIA 15-May-15 UJAN MAS ATAS
MAISYARA SALSABILAH 24-Feb-14 UJAN MAS ATAS
MARINKA PUTRI SIOBA 1-Apr-15 PUNGGUK BERINGANG
MEIZA NADILAH 12-May-15 UJAN MAS BAWAH
MELISA ADINDA SARI 20-May-15 UJAN MAS BAWAH
MUHAMAD PARHAN 13-Aug-14 UJAN MAS BAWAH
MUHAMMAD ALIF 31-Aug-14 UJAN MAS ATAS
PANJI YOGA ALIANDO 9-Dec-14 UJAN MAS BAWAH
RISKI ADITIA 17-Apr-15 UJAN MAS BAWAH
VIOLA GISELA QUINZA 1-Sep-14 UJAN MAS ATAS
2A AGUS SANDRILA 30-Aug-14 UJAN MAS ATAS
AGUSTRIA SAPUTRI 24-Aug-13 UJAN MAS ATAS
TDK MASUK ALPIN SAPUTRA 20-Dec-13 UJAN MAS ATAS
ANABEL PARESKI 24-Jan-14 UJAN MAS ATAS
ANDARA LINTANG KIRANA 26-Apr-14 UJAN MAS ATAS
TDK VAKSIN ANGGITA NANDA 4-Jan-14 UJAN MAS BAWAH
BAGAS JHONATANPUTRA MA 4-Jul-14 UJAN MAS ATAS
BULAN PURNAMA 14-Aug-13 UJAN MAS BAWAH
CELSIA OLIPIYA 23-Jun-14 UJAN MAS BAWAH
DEDE OKTA 9-Oct-13 UJAN MAS BAWAH
TDK MASUK ERIK PRATAMA 12-Dec-13 UJAN MAS BAWAH
TDK MASUK FAUZIA PUTRI DEDI 15-Jan-14 DASPETAH II
GARFEL ADEFIO 9-Jul-13 UJAN MAS BAWAH
GILANG TRI ABIZAR 21-Mar-14 UJAN MAS ATAS
TDK MASUK HENGKI 1-Jun-11 UJAN MAS ATAS
KHEYSA AKILA 3-Aug-13 UJAN MAS BAWAH
MICHEL PUTRI LIONZA 26-May-14 UJAN MAS ATAS
NADIRAH MUSLIMAH 7-Jun-14 UJAN MAS ATAS
TDK MASUK RAVA ADITIA SAPUTRA 4-May-14 UJAN MAS BAWAH
REDO RISKI 1-Nov-12 UJAN MAS BAWAH
SELA OKTAVIA 12-Oct-13 UJAN MAS ATAS
SINTA JANEPRA 12-Nov-13 UJAN MAS ATAS
WISNO AJI 29-May-14 UJAN MAS ATAS
TDK MASUK YELSE MELATI 13-Jul-14 UJAN MAS BAWAH
2B ABRAN ANDRIAN 30-May-14 UJAN MAS ATAS
ADELIA AMANDA 8-Dec-13 UJAN MAS BAWAH
AFIQAH ZAHRA 5-Nov-13 UJAN MAS
AMABEL ISDI ALEANO 2-Apr-14 UJAN MAS ATAS
AMELIA MELODI NOVERA 5-Nov-13 UJAN MAS ATAS
ANGGA SARI ABDUL RAZAK 7-May-14 UJAN MAS ATAS
BELA PUSPITA SARI 16-Jun-13 UJAN MAS ATAS
PINDAH DAFFA EXCHEL FEREL 20-Jun-14 UJAN MAS ATAS
EKA SURYANI 12-Feb-14 UJAN MAS BAWAH
FIDELYA UZMA RAFIFA 21-May-14 UJAN MAS ATAS
JULI RHOMADONI 24-Jun-14 UJAN MAS ATAS
KELSI AFRILIA 16-Jul-14 UJAN MAS ATAS
KEYZA PUTRI MAHARANI 9-Mar-12 UJAN MAS BAWAH
LINGGAR ARWANSA 17-Sep-13 UJAN MAS BAWAH
MARTA ERLANGGA 19-Mar-14 UJAN MAS ATAS
MELODI AMELIA 1-Jul-14 UJAN MAS BAWAH
MUHAMMAD ALFAIZ 1-Mar-14 UJAN MAS ATAS
NAUFAL DIMATRI ALVARO 9-Jan-14 UJAN MAS ATAS
NIRMALA SARI 25-Feb-13 UJAN MAS BAWAH
QORIATUL FITRI 21-Dec-13 UJAN MAS ATAS
RAFAH AFRIANSYAH 14-Jun-14 UJAN MAS ATAS
RAMA DWI PUTRA 29-Sep-13 UJAN MAS ATAS
RENA DIANA 12-Aug-13 UJAN MAS ATAS
RESTU HADI SAPUTRA 4-Dec-13 UJAN MAS ATAS
2C AIRAH ZALSAH BILLA 6-Dec-13 UJAN MAS BAWAH
AIRIN BERLIAN 6-Dec-13 UJAN MAS BAWAH
ANDALA OKYO RIFKI 27-Oct-13 UJAN MAS ATAS
ANDIKA SAPUTRA 4-Jun-14 UJAN MAS ATAS
BILKIS NAIKA IRAWAN 17-Mar-14 UJAN MAS ATAS
DESTIAN ERLANGGA 4-Jun-13 UJAN MAS ATAS
DONA LORENZSA 14-Apr-14 UJAN MAS ATAS
DONI LORENZSO 14-Apr-14 UJAN MAS ATAS
INDA PERMATA SARI 4-Apr-14 UJAN MAS BAWAH
IWAN PALES 5-Jul-12 UJAN MAS BAWAH
KASIH PERTIWI 9-Mar-14 UJAN MAS ATAS
LAUREN TRIA BELLA 12-Aug-13 UJAN MAS ATAS
MIA RAMADHANI 18-Jul-14 UJAN MAS ATAS
PRECILAH ADHI LOVA 24-Jun-14 UJAN MAS ATAS
RAVAEL PRATAMA 26-Nov-13 UJAN MAS ATAS
REPI RAMADHANI 29-Jun-14 UJAN MAS ATAS
RESELAHELENDIA 20-Sep-13 UJAN MAS BAWAH
RIKI SUSILO SUGIYANTO 27-Feb-13 UJAN MAS ATAS
RONA DWI ATMAJA 14-Jun-14 UJAN MAS ATAS
SELANDRA 29-Dec-13 UJAN MAS ATAS
SELVIANI DORIANA 23-Sep-13 UJAN MAS ATAS
SINDI ANGRAINI 11-May-14 UJAN MAS ATAS
VIOLA KENIA JUWITA 20-May-14 UJAN MAS BAWAH
YUDA PRATAMA 16-Oct-13 UJAN MAS ATAS
ZAKY RHAMADAN 22-Jul-13 UJAN MAS ATAS
3A ADITIA PUTRA 1/22/2013 PUNGGUK BERINGANG
Aji Saputra 2011-11-06 UJAN MAS ATAS
AL FURQAAN UJAN MAS ATAS
ANGGUN RISKY AYU 5/26/2013 UJAN MAS ATAS
AQILAH PUTRI MAHARANI 5/14/2013 UJAN MAS ATAS
ARENSI DIO LOOVA 12/10/2012 UJAN MAS ATAS
ARINA PRAMUDITA 12/10/2012 UJAN MAS BAWAH
AULYA SAFIRA 1/23/2013 UJAN MAS ATAS
BHELLA AFRIANI 4/30/2013 UJAN MAS ATAS
CINTHYA SHAVA LAKESHA 12/18/2012 UJAN MAS ATAS
FAZA ZAKI ABISAR 5/25/2013 UJAN MAS
FEBIANSYAH 4/16/2013 UJAN MAS ATAS
HAFIZHA ALMIRA 6/2/2013 UJAN MAS ATAS
INDAH LESTARI 7/11/2009 UJAN MAS BAWAH
IQBAL HAFIZ FAHREZI 6/13/2013 UJAN MAS BAWAH
Jaka Andira 2011-09-26
JANWARI ARYA PRASETIA 1/30/2013 UJAN MAS
MEISYA OLIVIA 5/16/2013 UJAN MAS ATAS
PUTRI NAIRA RAHMATULLA 1/12/2013 UJAN MAS ATAS
RAMA TRIOSANJAYA 1/16/2013 UJAN MAS ATAS
REIHAN 2/3/2013 UJAN MAS
SALSA DWINKA ANJANI 7/9/2013 UJAN MAS ATAS
WESLEY SNEIJDER 4/22/2013 UJAN MAS ATAS
WISNU BIGUNA 5/19/2013 UJAN MAS ATAS
REFLES DION FABIO 1-Sep-12 UJAN MAS
3B Alpiansyah 5/30/2012 ujan mas atas
ANDRO WAHYUDI 2/8/2012 UJAN MAS ATAS
ASYIFA SALSABILLAH 1/6/2013 UJAN MAS ATAS
AURA AFIFAH PUTRI 12/29/2012 UJAN MAS ATAS
AZAH ZANETA 4/20/2013 UJAN MAS BAWAH
SN AZEL DWI AVIVA 7/4/2013 UJAN MAS ATAS
BALQIS PUJA ISLAMI 6/20/2013 UJAN MAS BAWAH
FINZY MEIZA VIRGINIA 5/4/2013 UJAN MAS ATAS
HAICKAL ANDREANO 4/4/2013 DASPETAH
HAIKEL SUGIA SAPUTRA 5/15/2013 UJAN MAS ATAS
JEMMY MEDIANSAH 5/26/2013 UJAN MAS BAWAH
KARISA 1/14/2013 DASPETAH
KEYLA PIONITA 9/15/2012 UJAN MAS
MARSEL DARWIN 1/4/2013 UJAN MAS BAWAH
MUHAMMAD ALVINDRA 4/1/2013 UJAN MAS ATAS
NEZA AZZAHRA 9/28/2012 PUNGGUK BERINGANG
PRESILIAN PUTRI 3/29/2013 UJAN MAS ATAS
RAMI WULANSARI 1/16/2013 UJAN MAS ATAS
RARA SATI 10/1/2012 UJAN MAS ATAS
RINO GIBASTIAN 7/7/2012 SURO ILIR
RISAL ASRI 10/4/2012 UJAN MAS ATAS
SANDRINA FITRI 6/9/2013 UJAN MAS ATAS
TRISTAN 11/19/2012 UJAN MAS
VITRA ERLANGGA PRATAMA 5/4/2013 UJAN MAS
MUHAMMAD FIQRI ALGANI 12-Jun-12 UJAN MAS BAWAH
4A ABBY ALDIANO 12/13/2011 KEPAHIANG
ABIB SEBASTIAN FERN 11-Jun-12 KEPAHIANG
ADELIA DINATA 9/16/2012 UJAN MAS ATAS
AUREL AZHENA 12/4/2011 KEPAHIANG
SALAH NAMA DI KKBHYRLI CAPIOLA RAMA 8/30/2011 UJAN MAS
BUNGA CAHYANI 2/27/2012 UJAN MAS ATAS
CHICO ORMANDO 6/17/2012 KEPAHIANG
DELVIN OFHELIA 1/27/2012 UJAN MAS ATAS
DIKA GUSTI RAMADAN 8/20/2011 UJAN MAS ATAS
DIRGA RHICALDO PUTR 12/14/2011 TABA TEBELET
DIRZI SILVANA PUTRI 12/14/2011 TABA TEBELET
ENJEL FRISKILA 5/7/2012 KEPAHIANG
GLEN ALFIANSYAH 6/2/2011 UJAN MAS ATAS
HAFIS APRIYANDI 9/4/2011 KEPAHIANG
IKBAL NAPIOBA 3/23/2012 UJAN MAS ATAS
JAKA PRANATA 3/12/2012 UJAN MAS BAWAH
KARMILA 5/7/2012 UJAN MAS ATAS
LOLITA DELVIANA 12/21/2011 KEPAHIANG
M.SAID AGIL HUSEN A 8/4/2012 KEPAHIANG
MEILANI PUTRI BERLIAN 5/15/2012 PAGAR GUNUNG
MESIN 12/11/2012 KEPAHIANG
MUHAMMAD RIZKI PRA 2010-12-07 UJAN MAS ATAS
PATRA DESTIANO 11/20/2011 UJAN MAS ATAS
RAMADAN SAPUTRA 8/7/2012 KEPAHIANG
RISKI ADEVYO 2/26/2011 DASPETAH
RIZKI ADE PIYO 7/8/2012 KEPAHIANG
SINTIA PUTRI LASTISYA 11/3/2011 KEPAHIANG
SITI RAHMAWANTI 3/25/2012 KEPAHIANG
TAUFIK HIDAYAT 2/23/2012 KEPAHIANG
THAMARA BLEZHINKY 5/15/2012 UJAN MAS BAWAH
4B ADA YAYA SURYANI 1/17/2012 REJANG LEBONG
ADELIA PUTRI 7/24/2011 DASPETAH
ADITIA PRATAMA 1/19/2012 KEPAHIANG
ADO RESKI IYO 2/27/2012 KEPAHIANG
AISYAH DWINOVA 12/16/2011 UJAN MAS ATAS
ALDO WJAKSONO 6/19/2011 UJAN MAS ATAS
APRIANSYAH 4/4/2012
ANDIN SUGARA 8/16/2011 UJAN MAS ATAS
DIANA ANATA 1/1/2012 KEPAHIANG
DIVALDI ADITIYA 5/14/2012 KEPAHIANG
ELAN PRATAMA 11/23/2011 UJAN MAS ATAS
FAUZAN RAJA PRANATA 5/22/2012 KEPAHIANG
FITRI MARYANI 9/5/2011 DASPETAH
HANIFA RACHELIA 3/11/2012 UJAN MAS ATAS
IRFAN SUMANTRI 10/31/2011 UJAN MAS ATAS
M.FADEL DARMAWAN 9/16/2011 REJANG LEBONG
MARSHA DELA AMAND 3/2/2012 DASPETAH
MESA ARAPA 10/3/2012 KEPAHIANG
MUHAMMADA FAHRI AL 2011-10-20 UJAN MAS ATAS
NADIA ANJELINA 8/19/2012 KEPAHIANG
NESA AGNESIA 1/17/2011 KEPAHIANG
PAREL ALISKI 11/21/2011 DASPETAH
RACHEL ERSI 7/10/2012 KEPAHIANG
RASTI AFITRI 10/27/2011 UJAN MAS
REHANDO PRAYOGA 1/29/2012 KEPAHIANG
REVANDO 7/15/2012 KEPAHIANG
SAKIRA OLIVIA 4/2/2012 KEPAHIANG
SELFI ANGGRAINI 9/10/2011 UJAN MAS ATAS
VIOLA BAGITE 8/25/2012 KEPAHIANG
5A ALIZA SARTIKA 2011-04-14 UJAN MAS ATAS
ANANDA BALQIES 2010-11-14 DASPETAH
ANDREAS GUNAWAN 2010-09-21 UJAN MAS ATAS
ARLANGGA SATRIAWAN 2011-01-13 UJAN MAS ATAS
AZRIL ADAM YUSUF 2011-04-14 KEPAHIANG
BIMA AGRESIA TRARASIA 2011-06-26 PUNGGUK BERINGAN
BINTANG JAMASTA 2011-01-31 UJAN MAS
CLAUDYA 2012-05-01 UJAN MAS ATAS
GITA PERMATA SARI 2010-10-27 PAGAR GUNUNG
HIKMATUL RAHMA WATI 2011-08-03 UJAN MAS BAWAH
IRPAN SAPUTRA 2010-12-12 UJAN MAS ATAS
KEFIN SASMITA 2011-04-10 UJAN MAS ATAS
KLARA REGISTA PUTRI 2010-08-04 KEPAHIANG
KOKA YOBA 2011-06-08 UJAN MAS ATAS
LAURA SHAKIRA 2012-05-12 UJAN MAS BAWAH
MISEL GABRELA 2011-05-30 KEPAHIANG
NABILA AFRILIA VITA 2011-04-11 UJAN MAS ATAS
NIKITA ANJELI FINTALOKA 2012-01-28 UJAN MAS BAWAH
OZIL DEVISCA 2011-06-09 UJAN MAS ATAS
RATU FELICIA 2010-12-26 DUSUN KEPAHIANG
REFANA VAREZHA 2012-09-22 SURO LEMBAK
REPANDO ADE PIO 6/12/2009 UJAN MAS ATAS
RISKI ARGA ANUGRAH 2012-06-15 UJAN MAS ATAS
RISKI HARLIYANTO 2012-04-09 PEKALONGAN
RISKI KURNIAWAN 2012-01-22 UJAN MAS ATAS
SESIL CLARA ADELIA 2010-12-15 UJAN MAS BAWAH
SUSAN SINORA 2012-09-08 UJAN MAS ATAS
TANIA ALIPIA 2011-04-16 KEPAHIANG
TIARA INTAN SUTHREE 2011-03-30 DASPETAH
TIARA YOLANDA 2010-10-10 UJAN MAS BAWAH
WINDI ULANDARI 2/4/2011 KEPAHIANG
5B Adelia Giovani 2011-07-27 BANDUNG BARAT
Agus Ramdansah 2011-08-11 UJAN MAS BAWAH
Alpin Aditia 2010-05-17 SURO LEMBAK
Amelia Fransiska 2011-04-12 UJAN MAS ATAS
Amira Khairunnisa 2011-03-30 REJANG LEBONG
Aprilia Salsabila 2011-04-11 UJAN MAS ATAS
Arga Saputra 2011-08-02 UJAN MAS BAWAH
Aulia Zahra Putri 2011-03-23 UJAN MAS ATAS
Aurel Ziva Anugrah 2011-03-14 KEPAHIANG
Azrul Muhammad Yusuf 2011-03-14 KEPAHIANG
Bagas Khotibul Umam 2011-07-28 UJAN MAS ATAS
Deca Sasmita 2011-06-26 UJAN MAS BAWAH
Enjelita Filiani 2011-03-24 UJAN MAS ATAS
Evlin Indah Kirana 2011-05-17 UJAN MAS ATAS
Fadel Aditia 2011-02-04 UJAN MAS ATAS
Fatrah Aka Abdullah 2010-10-10 UJAN MAS
Marcel Aditia 2011-05-09 UJAN MAS ATAS
Mareza Purnama Sari 2011-03-21 UJAN MAS ATAS
Mijen Adepio 2010-11-15 UJAN MAS ATAS
Nikola Ananta 2011-12-28 KEPAHIANG
Rangga Saputra 2011-03-10 KEPAHIANG
Repi Aryanti Lestari Putri 2011-03-09 UJAN MAS ATAS
Resi Wolanda 2009-05-26 UJAN MAS
Revaldi Naufal Oktriansyah 2011-10-06 DURIAN DEPUN
Satrio Pratama 2011-01-23 PUNGGUK MERANTI
Tara Ramandika 2010-08-12 UJAN MAS ATAS
Zindra Alzeo Degopal 2011-05-10 UJAN MAS ATAS
RANDI WIJAYA 7/26/2010 UJAN MAS ATAS
6A ADE AIDIL PITRA 10/13/2007 UJAN MAS ATAS
AGUNG NAZZRIL ALFA REZI 10/26/2010 UJAN MAS BAWAH
AHMAD DARUL 6/25/2010 UJAN MAS ATAS
AMANDA FIORENSIA 11/17/2009 UJAN MAS ATAS
BAGUS AJI SATRIA 5/1/2010 UJAN MAS ATAS
BINTANG AULIA PUTRI 6/11/2010 UJAN MAS ATAS
CARLES ADETIA 3/20/2010 UJAN MAS BAWAH
DERA CANDRA WINATA 4/2/2010 PELANGKIAN
ERMA MARSELA
FIRZI ALFARICHI
IMELDA SINTIA FITRI 9/20/2010 UJAN MAS BAWAH
INDAH PURNAMA SARI 10/30/2009 UJAN MAS ATAS
JENI PEBRIYANTI 1/26/2010 KEPAHIANG
KEIZIA MAHARANI PUTRI 5/2/2010 JAMBI
LESA SUSANTI 24-122009 UJAN MAS
MAICEL ZERO 4/20/2010 UJAN MAS ATAS
MUHAMMAD AIDIL AKBAR 6/5/2009 UJAN MAS
MUHAMMAD ILHAM ARYA 12/2/2009 UJAN MAS ATAS
NOVELIA SANDRA PRATIWI 11/21/2009 UJAN MAS ATAS
PADILLAH 5/1/2010 UJAN MAS BAWAH
PANJI GUSTI WIJAYA 8/16/2009 CURUP
RAKA MEISAPUTRA 5/26/2010 UJAN MAS ATAS
REHAN ALDINATA 8/13/2010 UJAN MAS BAWAH
REHAN ALFAREZI 8/20/2009 UJAN MAS
SEPTI FITRIA AMBARWATI 9/26/2009 UJAN MAS
tarmizi
TASYA ADETIA LOKA 7/22/2010 UJAN MAS ATAS
YOGA DARMAWAN
ZAKI KRISTIAN 5/23/2010 KEPAHIANG
6B ADITYA ALFAHSA 4/3/2010 DASPETAH
ARIL PRANATA 9/25/2009 UJAN MAS BAWAH
BELA MANORI 3/16/2010 UJAN MAS ATAS
BINTANG OKTAVIA 7/23/2010 UJAN MAS BAWAH
BUNGA FATHIA LESTARI 12/28/2010 UJAN MAS ATAS
CINTA KIRANA 4/8/2010 UJAN MAS BAWAH
ILHAM PRAYOGA 3/15/2006 UJAN MAS BAWAH
JEFRI ANUGRA HIDAYAT 7/1/2010 DASPETAH
JENNI SASMIKA 7/18/2010 KEPAHIANG
KESA NABILA 6/16/2010 UJAN MAS ATAS
KESI AULIA 8/1/2009 UJAN MAS BAWAH
LIDIA 9/6/2009 UJAN MAS ATAS
MEISARA 5/12/2010 UJAN MAS
NABILA SOFIA 2/25/2009 UJAN MAS ATAS
NADIA FITRI 9/19/2009 UJAN MAS BAWAH
NOPRAN PRAYOGA 9/29/2010 UJAN MAS ATAS
PEMA NIKO SAPUTRA 1/24/2010 UJAN MAS ATAS
PERDIAN ADINATA 2008-06-12 UJAN MAS BAWAH
REDO SAPITRA 9/23/2009 UJAN MAS
SEGI PRAYOGA 8/2/2009 UJAN MAS
SEMI PRANATA 3/22/2010 UJAN MAS ATAS
SUMIA APRILIYA 4/16/2007 CURUP
TIA SARI 10/3/2009 UJAN MAS BAWAH
VELZI RAMADANI 9/3/2009 DASPETAH
YONA RAHMA AYU 11/27/2009 UJAN MAS
YOSRI YOSITA 2/22/2010 UJAN MAS BAWAH
RANDA GUNAWAN SUGIANSA 11/18/2009 UJAN MAS ATAS
RIZKI ADE PIYO SINE 4/29/2010 UJAN MAS ATAS
ANDINI PUSPITASARI 7/25/2010 UJAN MAS ATAS
6C PRENGKI ADI PRATAMA 11/5/2009 UJAN MAS ATAS
ALDI TIO PRATAMA 5/27/2010 SURO ILIR
AMANDA KRISTA LOVANI 8/16/2010 KEPAHIANG
AMELIA RAMADANI 9/9/2008 CURUP
ARMANSA PARHAN AGUSTIN 8/7/2008 UJAN MAS ATAS
ARYA ANUGRA SAPUTRA 4/17/2010 UJAN MAS ATAS
AULIA RAHMADANI 8/20/2010 UJAN MAS ATAS
Darrell Zakhwan Suyitno Putro 2010-05-15 SEMARANG
DORA OKTARINA 10/10/2009 UJAN MAS ATAS
FADIL VADILA 8/31/2010 UJAN MAS
FITRAH YOBA OKTAVIO 10/1/2009 DASPETAH
FRETI INDAH AURELIA 6/14/2010 UJAN MAS
INDAH OKTAVIA PUTRI 10/23/2009 UJAN MAS ATAS
IQBAL AL-SOBRI 6/4/2010 UJAN MAS
KEYLIN AHLAL MARGARETA. P 9/18/2010 UJAN MAS ATAS
MEYCHA WILIARDHY 12/16/2009 DURIAN DEPUN
MIFTAHUL NINDI HAIRUNISA 11/21/2009 UJAN MAS ATAS
NINDI AULIA 8/11/2010 UJAN MAS ATAS
OCHA PUTRI ANSORI 11/21/2010 UJAN MAS ATAS
PAREL 1/2/2010 KEPAHIANG
REGINA PUTRI DIOPA 7/14/2010 UJAN MAS ATAS
SOPI LUTPIA 5/15/2010 UJAN MAS
WULAN JELITA 5/5/2010 SURO ILIR
YANTI 7/4/2009 CURUP
YOLAN VIONA 2/20/2010 UJAN MAS BAWAH
REHAN ALDINATA 2010-08-13 UJAN MAS BAWAH
YOGA NOPITASARI 4/27/2010 UJAN MAS ATAS

29
30
31
32
33
34
35
36
37
|

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
05 JANUARI 2022
SD 06 UMB

SINOVAC
DOSIS 1 DOSIS 2 DOSIS

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
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LANSIA
PUBLIK
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NAKES
BUMIL

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1708024403770004 0
6 UMB
ARI 2022
I COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
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PUBLIK
BUMIL
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PENDIDIK
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36

57

1
###
ASTRA
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M.UMUM

DOSIS 2
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LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
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LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
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R

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26 62 2

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PUBLIK

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REMAJA

LANSIA
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PUBLIK

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PENDIDIK

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LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
32155BA

NO NAMA TGL LAHIR ALAMAT

1A 1 AJIRNA DWI PERMATA 29-Sep-14 UJAN MAS ATAS


2 AMELIA LEONI RAMADHANI 18-Jun-15 UJAN MAS ATAS
3 ARKA TIAGA DIPIARUPA 15-Nov-14 UJAN MAS ATAS
4 BINTANG DWI PUTRI 30-Jul-14 UJAN MAS ATAS
5 CINTA APRILIA 5-Apr-15 UJAN MAS ATAS
6 DEA SALSABILA 29-Nov-14 UJAN MAS BAWAH
7 DESTIANA DEWI NURKHALBY 6-Dec-14 UJAN MAS ATAS
8 DEVIN OKTAVIAN 12-Aug-14 UJAN MAS BAWAH
9 FIONA STEFANIE 17-Sep-14 UJAN MAS ATAS
10 JESIKA ALFIRA 7-Nov-14 SURO BARU
11 JULIO RAMADHAN 8-Jul-14 UJAN MAS ATAS
12 LATIFAH DWI PUTRI 19-May-14 UJAN MAS ATAS
13 NIKO ANJAS SANTARA 13-Oct-14 UJAN MAS ATAS
14 NOVITA SARI 8-Sep-14 UJAN MAS ATAS
15 RIZKY ZEVANO ALVERO 14-Mar-15 UJAN MAS ATAS
16 SPINKI BIGTRI PANA 9-Jan-15 UJAN MAS ATAS
17 VIKO HARGIANTO 5-Jan-14 UJAN MAS BAWAH
18 WAHYU ANUGGRAH 10-Aug-14 UJAN MAS BAWAH
19 ZALFA MIKAILLAH 10-Jan-15 UJAN MAS ATAS
1B 20 ABDUL AZIZ ALGANI 31-Dec-14 UJAN MAS ATAS
21 ABIDZAR AL-GHIFARI AKSA 3-Aug-14 UJAN MAS ATAS
22 ABIZAR AL-GHIPARI 23-May-15 UJAN MAS BAWAH
23 AKILAH ANGGRAINI 15-Jul-14 UJAN MAS BAWAH
24 ALIYANDO SYARIF 20-Oct-14 UJAN MAS BAWAH
25 ANDRE DIMAS PRAYOGA 2-Aug-13 UJAN MAS BAWAH
26 CIKA JEZIKA 22-May-15 UJAN MAS ATAS
27 FAHMI WIBISONO 31-Jul-14 UJAN MAS ATAS
28 FARDHAN AKBAR ADITIANSYA 26-Dec-14 UJAN MAS BAWAH
29 FAUZAN ADITIA 17-Dec-14 UJAN MAS BAWAH
30 FERO AKIOSI 9-Feb-15 DASPETAH
31 FHADELIYA MAHARANI 7-Oct-14 UJAN MAS ATAS
32 KEILA BINTANG CANTIKA 4-Apr-14 UJAN MAS BAWAH
33 MARINKA PUTRI SIOBA 1-Apr-15 PUNGGUK BERINGANG
34 MELISA ADINDA SARI 20-May-15 UJAN MAS BAWAH
35 MUHAMAD PARHAN 13-Aug-14 UJAN MAS BAWAH
36 MUHAMMAD ALIF 31-Aug-14 UJAN MAS ATAS
37 PANJI YOGA ALIANDO 9-Dec-14 UJAN MAS BAWAH
38 RISKI ADITIA 17-Apr-15 UJAN MAS BAWAH
39 VIOLA GISELA QUINZA 1-Sep-14 UJAN MAS ATAS
2A 40 AGUS SANDRILA 30-Aug-14 UJAN MAS ATAS
41 AGUSTRIA SAPUTRI 24-Aug-13 UJAN MAS ATAS
42 ALVIN SAPUTRA
43 ANABEL PARESKI 24-Jan-14 UJAN MAS ATAS
44 ANDARA LINTANG KIRANA 26-Apr-14 UJAN MAS ATAS
45 BAGAS JHONATANPUTRA MA 4-Jul-14 UJAN MAS ATAS
46 BULAN PURNAMA 14-Aug-13 UJAN MAS BAWAH
47 CELSIA OLIPIYA 23-Jun-14 UJAN MAS BAWAH
48 DEDE OKTA 9-Oct-13 UJAN MAS BAWAH
49 GARFEL ADEFIO 9-Jul-13 UJAN MAS BAWAH
50 GILANG TRI ABIZAR 21-Mar-14 UJAN MAS ATAS
51 KHEYSA AKILA 3-Aug-13 UJAN MAS BAWAH
52 MICHEL PUTRI LIONZA 26-May-14 UJAN MAS ATAS
53 NADIRAH MUSLIMAH 7-Jun-14 UJAN MAS ATAS
54 REDO RISKI 1-Nov-12 UJAN MAS BAWAH
55 SELA OKTAVIA 12-Oct-13 UJAN MAS ATAS
56 SINTA JANEPRA 12-Nov-13 UJAN MAS ATAS
57 WISNO AJI 29-May-14 UJAN MAS ATAS
2B 58 ADELIA AMANDA 8-Dec-13 UJAN MAS BAWAH
59 AFIQAH ZAHRA 5-Nov-13 UJAN MAS
60 AMABEL ISDI ALEANO 2-Apr-14 UJAN MAS ATAS
61 AMELIA MELODI NOVERA 5-Nov-13 UJAN MAS ATAS
62 ANGGA SARI ABDUL RAZAK 7-May-14 UJAN MAS ATAS
63 BELA PUSPITA SARI 16-Jun-13 UJAN MAS ATAS
64 EKA SURYANI 12-Feb-14 UJAN MAS BAWAH
65 FIDELYA UZMA RAFIFA 21-May-14 UJAN MAS ATAS
66 JULI RHOMADONI 24-Jun-14 UJAN MAS ATAS
67 KELSI AFRILIA 16-Jul-14 UJAN MAS ATAS
68 KEYZA PUTRI MAHARANI 9-Mar-12 UJAN MAS BAWAH
69 MARTA ERLANGGA 19-Mar-14 UJAN MAS ATAS
70 MELODI AMELIA 1-Jul-14 UJAN MAS BAWAH
71 MUHAMMAD ALFAIZ 1-Mar-14 UJAN MAS ATAS
72 NAUFAL DIMATRI ALVARO 9-Jan-14 UJAN MAS ATAS
73 NIRMALA SARI 25-Feb-13 UJAN MAS BAWAH
74 QORIATUL FITRI 21-Dec-13 UJAN MAS ATAS
75 RAFAH AFRIANSYAH 14-Jun-14 UJAN MAS ATAS
76 RAMA DWI PUTRA 29-Sep-13 UJAN MAS ATAS
77 RENA DIANA 12-Aug-13 UJAN MAS ATAS
2C 78 ANDALA OKYO RIFKI 27-Oct-13 UJAN MAS ATAS
79 BILKIS NAIKA IRAWAN 17-Mar-14 UJAN MAS ATAS
80 DONA LORENZSA 14-Apr-14 UJAN MAS ATAS
81 DONI LORENZSO 14-Apr-14 UJAN MAS ATAS
82 INDA PERMATA SARI 4-Apr-14 UJAN MAS BAWAH
83 IWAN PALES 5-Jul-12 UJAN MAS BAWAH
84 LAUREN TRIA BELLA 12-Aug-13 UJAN MAS ATAS
85 MIA RAMADHANI 18-Jul-14 UJAN MAS ATAS
86 PRECILAH ADHI LOVA 24-Jun-14 UJAN MAS ATAS
87 RAVAEL PRATAMA 26-Nov-13 UJAN MAS ATAS
88 RESELAHELENDIA 20-Sep-13 UJAN MAS BAWAH
89 SELANDRA 29-Dec-13 UJAN MAS ATAS
90 VIOLA KENIA JUWITA 20-May-14 UJAN MAS BAWAH
91 YUDA PRATAMA 16-Oct-13 UJAN MAS ATAS
92 ZAKY RHAMADAN 22-Jul-13 UJAN MAS ATAS
3A 93 ADITIA PUTRA 1/22/2013 PUNGGUK BERINGANG
94 ANGGUN RISKY AYU 5/26/2013 UJAN MAS ATAS
95 AQILAH PUTRI MAHARANI 5/14/2013 UJAN MAS ATAS
96 ARENSI DIO LOOVA 12/10/2012 UJAN MAS ATAS
97 ARINA PRAMUDITA 12/10/2012 UJAN MAS BAWAH
98 AULYA SAFIRA 1/23/2013 UJAN MAS ATAS
99 BHELLA AFRIANI 4/30/2013 UJAN MAS ATAS
100 FAZA ZAKI ABISAR 5/25/2013 UJAN MAS
101 FEBIANSYAH 4/16/2013 UJAN MAS ATAS
102 HAFIZHA ALMIRA 6/2/2013 UJAN MAS ATAS
103 INDAH LESTARI 7/11/2009 UJAN MAS BAWAH
104 IQBAL HAFIZ FAHREZI 6/13/2013 UJAN MAS BAWAH
105 Jaka Andira 2011-09-26
106 PUTRI NAIRA RAHMATULLA 1/12/2013 UJAN MAS ATAS
107 REIHAN 2/3/2013 UJAN MAS
108 SALSA DWINKA ANJANI 7/9/2013 UJAN MAS ATAS
109 WESLEY SNEIJDER 4/22/2013 UJAN MAS ATAS
110 WISNU BIGUNA 5/19/2013 UJAN MAS ATAS
111 REFLES DION FABIO 1-Sep-12 UJAN MAS
112 ALPIANSYAH
3B 113 AURA AFIFAH PUTRI 12/29/2012 UJAN MAS ATAS
114 AZAH ZANETA 4/20/2013 UJAN MAS BAWAH
SN 115 AZEL DWI AVIVA 7/4/2013 UJAN MAS ATAS
116 BALQIS PUJA ISLAMI 6/20/2013 UJAN MAS BAWAH
117 FINZY MEIZA VIRGINIA 5/4/2013 UJAN MAS ATAS
118 KARISA 1/14/2013 DASPETAH
119 KEYLA PIONITA 9/15/2012 UJAN MAS
120 MUHAMMAD ALVINDRA 4/1/2013 UJAN MAS ATAS
121 NEZA AZZAHRA 9/28/2012 PUNGGUK BERINGANG
122 PRESILIAN PUTRI 3/29/2013 UJAN MAS ATAS
123 RAMI WULANSARI 1/16/2013 UJAN MAS ATAS
124 RARA SATI 10/1/2012 UJAN MAS ATAS
125 RINO GIBASTIAN 7/7/2012 SURO ILIR
126 RISAL ASRI 10/4/2012 UJAN MAS ATAS
127 SANDRINA FITRI 6/9/2013 UJAN MAS ATAS
128 TRISTAN 11/19/2012 UJAN MAS
129 VITRA ERLANGGA PRATAMA 5/4/2013 UJAN MAS
130 MUHAMMAD FIQRI ALGANI 12-Jun-12 UJAN MAS BAWAH
4A 131 ABBY ALDIANO 12/13/2011 KEPAHIANG
132 ABIB SEBASTIAN FERN 11-Jun-12 KEPAHIANG
133 ADELIA DINATA 9/16/2012 UJAN MAS ATAS
134 AUREL AZHENA 12/4/2011 KEPAHIANG
SALAH NAMA 135 BHYRLI CAPIOLA RAMA 8/30/2011 UJAN MAS
136 BUNGA CAHYANI 2/27/2012 UJAN MAS ATAS
137 CHICO ORMANDO 6/17/2012 KEPAHIANG
138 DELVIN OFHELIA 1/27/2012 UJAN MAS ATAS
139 DIKA GUSTI RAMADAN 8/20/2011 UJAN MAS ATAS
140 ENJEL FRISKILA 5/7/2012 KEPAHIANG
141 GLEN ALFIANSYAH 6/2/2011 UJAN MAS ATAS
142 HAFIS APRIYANDI 9/4/2011 KEPAHIANG
143 IKBAL NAPIOBA 3/23/2012 UJAN MAS ATAS
144 JAKA PRANATA 3/12/2012 UJAN MAS BAWAH
145 KARMILA 5/7/2012 UJAN MAS ATAS
146 LOLITA DELVIANA 12/21/2011 KEPAHIANG
147 M.SAID AGIL HUSEN A 8/4/2012 KEPAHIANG
148 MESIN 12/11/2012 KEPAHIANG
149 MUHAMMAD RIZKI PRA 2010-12-07 UJAN MAS ATAS
150 PATRA DESTIANO 11/20/2011 UJAN MAS ATAS
151 RAMADAN SAPUTRA 8/7/2012 KEPAHIANG
152 RIZKI ADE PIYO 7/8/2012 KEPAHIANG
153 SINTIA PUTRI LASTISYA 11/3/2011 KEPAHIANG
154 SITI RAHMAWANTI 3/25/2012 KEPAHIANG
155 TAUFIK HIDAYAT 2/23/2012 KEPAHIANG
156 THAMARA BLEZHINKY 5/15/2012 UJAN MAS BAWAH
4B 157 ADA YAYA SURYANI 1/17/2012 REJANG LEBONG
158 ADELIA PUTRI 7/24/2011 DASPETAH
159 ADITIA PRATAMA 1/19/2012 KEPAHIANG
160 ADO RESKI IYO 2/27/2012 KEPAHIANG
161 AISYAH DWINOVA 12/16/2011 UJAN MAS ATAS
162 ALDO WJAKSONO 6/19/2011 UJAN MAS ATAS
163 APRIANSYAH 4/4/2012
164 DIANA ANATA 1/1/2012 KEPAHIANG
165 DIVALDI ADITIYA 5/14/2012 KEPAHIANG
166 ELAN PRATAMA 11/23/2011 UJAN MAS ATAS
167 FAUZAN RAJA PRANATA 5/22/2012 KEPAHIANG
168 FITRI MARYANI 9/5/2011 DASPETAH
169 HANIFA RACHELIA 3/11/2012 UJAN MAS ATAS
170 IRFAN SUMANTRI 10/31/2011 UJAN MAS ATAS
171 M.FADEL DARMAWAN 9/16/2011 REJANG LEBONG
172 MARSHA DELA AMAND 3/2/2012 DASPETAH
173 MESA ARAPA 10/3/2012 KEPAHIANG
174 MUHAMMADA FAHRI AL 2011-10-20 UJAN MAS ATAS
175 NADIA ANJELINA 8/19/2012 KEPAHIANG
176 NESA AGNESIA 1/17/2011 KEPAHIANG
177 PAREL ALISKI 11/21/2011 DASPETAH
178 RACHEL ERSI 7/10/2012 KEPAHIANG
179 RASTI AFITRI 10/27/2011 UJAN MAS
180 REHANDO PRAYOGA 1/29/2012 KEPAHIANG
181 REVANDO 7/15/2012 KEPAHIANG
182 SAKIRA OLIVIA 4/2/2012 KEPAHIANG
183 SELFI ANGGRAINI 9/10/2011 UJAN MAS ATAS
184 VIOLA BAGITE 8/25/2012 KEPAHIANG
5A 185 ALIZA SARTIKA 2011-04-14 UJAN MAS ATAS
186 ANANDA BALQIES 2010-11-14 DASPETAH
187 ANDREAS GUNAWAN 2010-09-21 UJAN MAS ATAS
188 ARLANGGA SATRIAWAN 2011-01-13 UJAN MAS ATAS
189 AZRIL ADAM YUSUF 2011-04-14 KEPAHIANG
190 BINTANG JAMASTA 2011-01-31 UJAN MAS
191 CLAUDYA 2012-05-01 UJAN MAS ATAS
192 HIKMATUL RAHMA WATI 2011-08-03 UJAN MAS BAWAH
193 IRPAN SAPUTRA 2010-12-12 UJAN MAS ATAS
194 KEFIN SASMITA 2011-04-10 UJAN MAS ATAS
195 KLARA REGISTA PUTRI 2010-08-04 KEPAHIANG
196 KOKA YOBA 2011-06-08 UJAN MAS ATAS
197 LAURA SHAKIRA 2012-05-12 UJAN MAS BAWAH
198 MISEL GABRELA 2011-05-30 KEPAHIANG
199 NIKITA ANJELI FINTALOKA 2012-01-28 UJAN MAS BAWAH
200 OZIL DEVISCA 2011-06-09 UJAN MAS ATAS
201 RATU FELICIA 2010-12-26 DUSUN KEPAHIANG
202 REPANDO ADE PIO 6/12/2009 UJAN MAS ATAS
203 RISKI ARGA ANUGRAH 2012-06-15 UJAN MAS ATAS
204 RISKI HARLIYANTO 2012-04-09 PEKALONGAN
205 RISKI KURNIAWAN 2012-01-22 UJAN MAS ATAS
206 SESIL CLARA ADELIA 2010-12-15 UJAN MAS BAWAH
207 SUSAN SINORA 2012-09-08 UJAN MAS ATAS
208 TANIA ALIPIA 2011-04-16 KEPAHIANG
209 TIARA INTAN SUTHREE 2011-03-30 DASPETAH
210 TIARA YOLANDA 2010-10-10 UJAN MAS BAWAH
211 WINDI ULANDARI 2/4/2011 KEPAHIANG
5B 212 Adelia Giovani 2011-07-27 BANDUNG BARAT
213 Agus Ramdansah 2011-08-11 UJAN MAS BAWAH
214 Alpin Aditia 2010-05-17 SURO LEMBAK
215 Amelia Fransiska 2011-04-12 UJAN MAS ATAS
216 Aprilia Salsabila 2011-04-11 UJAN MAS ATAS
217 Arga Saputra 2011-08-02 UJAN MAS BAWAH
218 Aulia Zahra Putri 2011-03-23 UJAN MAS ATAS
219 Aurel Ziva Anugrah 2011-03-14 KEPAHIANG
220 Azrul Muhammad Yusuf 2011-03-14 KEPAHIANG
221 Bagas Khotibul Umam 2011-07-28 UJAN MAS ATAS
222 Deca Sasmita 2011-06-26 UJAN MAS BAWAH
223 Enjelita Filiani 2011-03-24 UJAN MAS ATAS
224 Evlin Indah Kirana 2011-05-17 UJAN MAS ATAS
225 Fadel Aditia 2011-02-04 UJAN MAS ATAS
226 Fatrah Aka Abdullah 2010-10-10 UJAN MAS
227 Marcel Aditia 2011-05-09 UJAN MAS ATAS
228 Mareza Purnama Sari 2011-03-21 UJAN MAS ATAS
229 Mijen Adepio 2010-11-15 UJAN MAS ATAS
230 Nikola Ananta 2011-12-28 KEPAHIANG
231 Rangga Saputra 2011-03-10 KEPAHIANG
232 Repi Aryanti Lestari Putri 2011-03-09 UJAN MAS ATAS
233 Resi Wolanda 2009-05-26 UJAN MAS
234 Revaldi Naufal Oktriansyah 2011-10-06 DURIAN DEPUN
235 Satrio Pratama 2011-01-23 PUNGGUK MERANTI
236 Tara Ramandika 2010-08-12 UJAN MAS ATAS
237 Zindra Alzeo Degopal 2011-05-10 UJAN MAS ATAS
238 RANDI WIJAYA 7/26/2010 UJAN MAS ATAS
6A 239 AGUNG NAZZRIL ALFA REZI 10/26/2010 UJAN MAS BAWAH
240 AHMAD DARUL 6/25/2010 UJAN MAS ATAS
241 AMANDA FIORENSIA 11/17/2009 UJAN MAS ATAS
242 BAGUS AJI SATRIA 5/1/2010 UJAN MAS ATAS
243 BINTANG AULIA PUTRI 6/11/2010 UJAN MAS ATAS
244 CARLES ADETIA 3/20/2010 UJAN MAS BAWAH
245 DERA CANDRA WINATA 4/2/2010 PELANGKIAN
246 ERMA MARSELA
247 FIRZI ALFARICHI
248 IMELDA SINTIA FITRI 9/20/2010 UJAN MAS BAWAH
249 INDAH PURNAMA SARI 10/30/2009 UJAN MAS ATAS
250 JENI PEBRIYANTI 1/26/2010 KEPAHIANG
251 KEIZIA MAHARANI PUTRI 5/2/2010 JAMBI
252 LESA SUSANTI 24-122009 UJAN MAS
253 MAICEL ZERO 4/20/2010 UJAN MAS ATAS
254 MUHAMMAD ILHAM ARYA 12/2/2009 UJAN MAS ATAS
255 NOVELIA SANDRA PRATIWI 11/21/2009 UJAN MAS ATAS
256 PADILLAH 5/1/2010 UJAN MAS BAWAH
257 PANJI GUSTI WIJAYA 8/16/2009 CURUP
258 RAKA MEISAPUTRA 5/26/2010 UJAN MAS ATAS
259 SEPTI FITRIA AMBARWATI 9/26/2009 UJAN MAS
260 tarmizi
261 TASYA ADETIA LOKA 7/22/2010 UJAN MAS ATAS
262 YOGA DARMAWAN
263 ZAKI KRISTIAN 5/23/2010 KEPAHIANG
6B 264 ADITYA ALFAHSA 4/3/2010 DASPETAH
265 ARIL PRANATA 9/25/2009 UJAN MAS BAWAH
266 BELA MANORI 3/16/2010 UJAN MAS ATAS
267 BINTANG OKTAVIA 7/23/2010 UJAN MAS BAWAH
268 BUNGA FATHIA LESTARI 12/28/2010 UJAN MAS ATAS
269 CINTA KIRANA 4/8/2010 UJAN MAS BAWAH
270 JEFRI ANUGRA HIDAYAT 7/1/2010 DASPETAH
271 JENNI SASMIKA 7/18/2010 KEPAHIANG
272 KESA NABILA 6/16/2010 UJAN MAS ATAS
273 KESI AULIA 8/1/2009 UJAN MAS BAWAH
274 LIDIA 9/6/2009 UJAN MAS ATAS
275 MEISARA 5/12/2010 UJAN MAS
276 NABILA SOFIA 2/25/2009 UJAN MAS ATAS
277 NADIA FITRI 9/19/2009 UJAN MAS BAWAH
278 NOPRAN PRAYOGA 9/29/2010 UJAN MAS ATAS
279 PEMA NIKO SAPUTRA 1/24/2010 UJAN MAS ATAS
280 REDO SAPITRA 9/23/2009 UJAN MAS
281 SEGI PRAYOGA 8/2/2009 UJAN MAS
282 SEMI PRANATA 3/22/2010 UJAN MAS ATAS
283 TIA SARI 10/3/2009 UJAN MAS BAWAH
284 VELZI RAMADANI 9/3/2009 DASPETAH
285 YONA RAHMA AYU 11/27/2009 UJAN MAS
286 YOSRI YOSITA 2/22/2010 UJAN MAS BAWAH
287 RANDA GUNAWAN SUGIANSA 11/18/2009 UJAN MAS ATAS
288 RIZKI ADE PIYO SINE 4/29/2010 UJAN MAS ATAS
289 ANDINI PUSPITASARI 7/25/2010 UJAN MAS ATAS
6C 290 PRENGKI ADI PRATAMA 11/5/2009 UJAN MAS ATAS
291 ALDI TIO PRATAMA 5/27/2010 SURO ILIR
292 AMANDA KRISTA LOVANI 8/16/2010 KEPAHIANG
293 AMELIA RAMADANI 9/9/2008 CURUP
294 ARMANSA PARHAN AGUSTIN 8/7/2008 UJAN MAS ATAS
295 ARYA ANUGRA SAPUTRA 4/17/2010 UJAN MAS ATAS
296 AULIA RAHMADANI 8/20/2010 UJAN MAS ATAS
297 Darrell Zakhwan Suyitno Putro 2010-05-15 SEMARANG
298 DORA OKTARINA 10/10/2009 UJAN MAS ATAS
299 FADIL VADILA 8/31/2010 UJAN MAS
300 FITRAH YOBA OKTAVIO 10/1/2009 DASPETAH
301 FRETI INDAH AURELIA 6/14/2010 UJAN MAS
302 INDAH OKTAVIA PUTRI 10/23/2009 UJAN MAS ATAS
303 IQBAL AL-SOBRI 6/4/2010 UJAN MAS
304 KEYLIN AHLAL MARGARETA. P 9/18/2010 UJAN MAS ATAS
305 MEYCHA WILIARDHY 12/16/2009 DURIAN DEPUN
306 MIFTAHUL NINDI HAIRUNISA 11/21/2009 UJAN MAS ATAS
307 NINDI AULIA 8/11/2010 UJAN MAS ATAS
308 OCHA PUTRI ANSORI 11/21/2010 UJAN MAS ATAS
309 PAREL 1/2/2010 KEPAHIANG
310 REGINA PUTRI DIOPA 7/14/2010 UJAN MAS ATAS
311 SOPI LUTPIA 5/15/2010 UJAN MAS
312 WULAN JELITA 5/5/2010 SURO ILIR
313 YOLAN VIONA 2/20/2010 UJAN MAS BAWAH
314 REHAN ALDINATA 2010-08-13 UJAN MAS BAWAH
315 YOGA NOPITASARI 4/27/2010 UJAN MAS ATAS
37
|
47 CAHAYA MURNI 3/4/1977 SURO MUNCAR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
05 JANUARI 2022
SD 06 UMB

SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

BUMIL
ANAK
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134 0 0 0 3 0 11 0
14

PFIZER
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1708024403770004 #REF!
UMB
ARI 2022
COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA
DOSIS 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
314
0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 1 1 18 12 1 11 62

0 0 0 0 0 4 1 0 1 18 0 12 0 0 0 0 0 0 0 0 0 0 1 0 11 62
36

57
1

###
ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK
DOSIS 1
REK

SINO
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

26 62 2

3 127
0
M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA SINOVAC
PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
32155BA

NO NAMA TGL LAHIR ALAMAT

1A 1 AFIQA DYOBA 1/5/2015 DASPETAH II


2 ARDIANSYAH 2/20/2015 DASPETAH
3 EZA FRAYOGA 5/25/2015 DASPETAH II
4 FEBIAN ANGGARA 8/11/2014 DASPETAH
5 FRISKO AGUSTIN 8/20/2014 DASPETAH II
6 hendro Satria 6/8/2014 DASPETAH II
7 INTAN DEA VALENSA 12/26/2014 DASPETAH II
8 KENZO PREDIANSYAH 1/24/2015 DASPETAH II
9 LIDIYA ABI AZZAHRI 10/16/2014 DASPETAH II
10 MUHAMMAD FADILLA 1/4/2015 DASPETAH II
11 Muhammad Febian Fernanda 9/13/2014 PG BERINGANG
12 Rangg Pramasta 5/12/2015 DASPETAH II
13 TARIO TERNANDO 10/22/2014 DASPETAH II
14 VIOLA ADELPHA JUNIARSI 6/3/2015 DASPETAH II
15 Warsi Supriadi 3/20/2014 DASPETAH
16 ZALFA CARRISA IRAWAN 4/13/2015 DASPETAH II
1A 17 AGNESIA NURHAYANA 2/18/2015 DASPETAH II
18 ANDITA VITALIA 3/9/2015 DASPETAH II
19 DEFAN RIFKY ANGGARA 5/22/2015 DASPETAH II
20 FARERA NINGRAT 1/5/2015 DASPETAH II
21 IQRA DIRGA ALKAFI JOSA 3/13/2015 DASPETAH II
22 Kristi Maha Dewi 7/9/2015 DASPETAH II
23 LEO ALFAIZI 3/15/2015 DASPETAH II
24 MUHAMAD AL GIFRAN 2/21/2015 DASPETAH II
25 MUHAMMAD ALFIANDO 2/18/2015 DASPETAH II
26 Natasya Afri Diani 4/2/2014 DASPETAH II
27 NIKOLAH ARGA PRATAMA 9/25/2014 DASPETAH II
28 Nino Orlando Arsenio 8/18/2015 DASPETAH II
29 PITA LOKA 2/17/2015 DASPETAH II
30 RENDI HARYANSA 12/20/2014 DASPETAH II
31 Satria Wijaya 1/2/2014 DASPETAH II
32 SIREN ARSELIN 7/3/2015 DASPETAH II
33 YOKA PRATAMA 10/30/2014 DASPETAH II
2A 34 ZASKIA ADELIA 19-Sep-13 DASPETAH
35 MUHAMMAD AZZA AL JIBRAN 26-Jan-14 DASPETAH II
36 VELONIKA FITRIANI 28-Jul-14 DASPETAH II
37 DEDE HERLINO 2-Jun-14 PG BERINGANG
38 ANIZA ZAHRATUL AULIA 27-Oct-13 PG BERINGANG
39 HAIKAL AJI PRASETYO 9-Oct-13 DASPETAH II
40 MAHADIKA 7-Sep-13 UJAN MAS ATAS
41 YUDA YOSIBA 15-Apr-15 DASPETAH II
42 KELVIN LEONIL 13-Mar-14 DASPETAH
43 JUWITA PERMATA SARI 24-May-14 DASPETAH II
2B 56 ALVIZ DIA ALPARO SAPUTRA 15-Jul-14 DASPETAH II
57 ALAN DENTA MAULANA 30-Aug-14 DASPETAH II
58 ALPARO BASTIAN EFENDI 31-Jul-14 DASPETAH II
59 AHMAD HABIBI 27-Jul-14 DASPETAH II
60 CLAUDIA ASIFA 26-Jul-14 DASPETAH II
61 DIMAS AKBAR PRANATA 13-Jul-14 PG BERINGANG
62 HARTA DWI SATRIA 4-Jan-14 DASPETAH II
63 KENZO ALPARO 9-Jul-14 DASPETAH
64 MUHAMMAD WILLIAM GEOFF 4-Jul-14 PG BERINGANG
65 NAUFAL AZKA ALDRIC 29-Oct-13 DASPETAH II
66 RIZKI PADILA 25-Feb-14 DASPETAH II
67 RESTI 29-Aug-13 DASPETAH II
68 SHOFI ALILA MARGARETA 20-Mar-14 DASPETAH II
69 TONATAN RAFQIH WAHYUDI 20 NOVEMBER 2014PG BERINGANG
70 ZALZAH NUROHHIMA 25-Jul-14 DASPETAH II
71 ZAYRDAN OKTA PIDURA 3-Oct-14 DASPETAH II
72 MUHAMMAD SUDIBIO CARLO 20-May-13 DASPETAH II
3A 73 AHMAD ARI 25-Jul-12 DASPETAH II
74 ALPIN ADITIA
75 AGIL WINARNO 27-Jan-13 DASPETAH II
76 DIKA RISKI JAWIDA 9-Nov-13 DASPETAH
77 EZA APRIANDA 4-Apr-13 PG BERINGANG
78 ARPANDI
79 HERLANDI
80 HAFIZA FITRISARI 31-Oct-12 DASPETAH
81 KEILA PUTRI 4-Sep-12 DASPETAH II
82 M. FERZIAL VAGIAN 4-Mar-13 PG BERINGANG
83 NEPILSA 3-May-12 DASPETAH II
84 NANDO REVALDO 8-Nov-12 DASPETAH II
85 REGINA PUTRI 9-Feb-16 DASPETAH II
86 SEPTI MARDIANA 5-May-13 DASPETAH II
87 TIARA AQILA 17-Jan-13 DASPETAH II
88 THANIA ANGGELA 7-Aug-13 DASPETAH
89 M. ANUGRAH ADETIO
3B 90 AZLOVE FLOREN ALVARESTU
91 NATHANIA ADELPHA PLORENZ 4-Jul-12 DASPETAH II
92 JENI DINOVA ALDIANO
93 ADE RISKI PEBRIANSA
94 YELSE 4/10/2013 DASPETAH II
95 PADIL ADRIAN
96 JIAN PRISTIAN WIJAYA
97 ANGGI
98 AYZIRAH 10/10/2013 DASPETAH II
99 ZELI LOVITAH 11/23/2012 DASPETAH II
100 RISEL CLARST NISY
101 PETARIA YUNITA 3/2/2012 DASPETAH II
102 ADIDTIO 11/27/2012 DASPETAH II
103 FHAHRI ERLANGGA 6/2/2013 DASPETAH II
104 EGA JULIAN SAPUTRA 7/12/2012 PG BERINGANG
4A 105 AFRILIA 4/18/2012 DASPETAH II
106 AGUSTIAN RENO RAMADHAN 8/26/2011 PG BERINGANG
107 ANGGUN SALSA JUWITA 6/3/2012 DASPETAH II
108 ARDAS
109 Arjuna 4/18/2011 DASPETAH II
110 AZWAL AFRIYANDO
111 BELLA AMELIA
112 GIO ARDIANSAH
113 Indah Lestari 11/7/2011 DASPETAH
114 JHESTIN SYAPIRA 1/21/2012 DASPETAH II
115 KEISA OLIFIA 7/20/2012 DASPETAH II
116 KESYA AUREL 1/31/2012 DASPETAH II
117 KEVIN ALEXSYAH
118 NARTA MAZAR ALJARIA DASPETAH
119 Melinda Anggraini 12/28/2011 DASPETAH
120 MUHAMMAD DEWA JAYA VR 1/1/2012 DASPETAH II
121 MUHAMMAD PIKKRI 9/22/2011 DASPETAH II
122 Olyn Dwi Bintari 7/18/2012 DASPETAH
123 PRAN APRILLAH DIO BAGITE 4/12/2012 DASPETAH II
124 PRATAMA MIRLAN SAPUTRA 11/9/2011 DASPETAH II
125 Raditia Nabiarda 7/12/2010 DASPETAH II
126 Riyan Rivaldi 5/13/2012 DASPETAH
127 Viola Jerika
128 ZEREN ANGINE NADIVA 2/7/2012 PG BERINGANG
129 ZILIAN ALVHARES 5/26/2012 DASPETAH II
130 EKO PRAYETNO
131 LOREN DESPITA ATIKA YOLANDA
132 ALIFA DZAKKIYAH 4-Oct-11 PG BERINGANG
133 KEYSHA SALSABILLA 6/24/2011 DASPETAH
134 GEA ANANDA SUGARA 8/27/2012 UJAN MAS ATAS
5A 135 Afrilio Lion Junior 12/29/2011 DASPETAH II
136 Agus Mandala Yuda 8/17/2010 DASPETAH II
137 Ari Yunita 6/30/2011 DASPETAH II
138 Chinta Laura Sonata
139 Damar Panduwinata
140 Fegi Oktari Franssiska 10/10/2010 UJAN MAS BAWAH
141 Haikal Pratama 11/23/2012 DASPETAH II
142 Inda Sumardio 6/7/2012 DASPETAH II
143 Jiran Patan Anugrah 4/25/2011 DASPETAH II
144 marfel
145 marpel
146 Meiriza Aulia Diva
147 Melati Ramadani 9/1/2010 DASPETAH II
148 Nando Adetio 2/11/2011 DASPETAH II
149 Rangga Renaldo 2010-08-10 DASPETAH II
150 Rani Dwi Futri
151 Rava Putra Zakaria
152 Rere Jevita Nata 11/6/2010 DASPETAH II
153 Reyen Karensi 4/16/2011 DASPETAH
154 Rindiani Putri Hapiza 2/24/2011 DASPETAH II
155 Riski Candra 2/4/2011 DASPETAH II
156 Yunita Sartika 5/21/2017 DASPETAH II
5B 157 Aji Rahmad Saputra
158 Akram Abyan Daffa 6/2/2011 PG BERINGANG
159 Azim Riski Ramadan
160 Aziz Wahyu Romadhan 8/19/2011 DASPETAH II
161 Dela Arianti 7/25/2010 DASPETAH II
162 Delpino Ahmad Wahyudi
163 Diki Ahmat
164 Enjel Putri Olivio 1/2/2011 PG BERINGANG
165 Farel Alex Sander
166 Keisya piona almaira 9/8/2011 DASPETAH
167 Marda Yola Tilatul Azza 3/28/2011 DASPETAH II
168 Marsanda Tria Meka 8/20/2010 DASPETAH II
169 Niko Anugrah 5/13/2011 DASPETAH II
170 Okta Olivia 5/10/2011 DASPETAH II
171 Pandi Aggara
172 Pandu Gandaro 12/6/2010 PG BERINGANG
173 Patia Esi Susiyanti 1/31/2011 DASPETAH II
174 Rafa Leon Dimitri Sudarwo 2011-01-24 DASPETAH
175 Regil Juniansa 6/18/2010 DASPETAH II
176 NADIYA SULASTRI 11/14/2010 DASPETAH II
177 HELSEN PUTRA 11/23/2007 DASPETAH II
6A 178 AHMAD AKBAR 12/10/2009 DASPETAH II
179 ANGGI SAPUTRA
180 ANJELINA 7/14/2010 DASPETAH
181 ARJUNA 5/8/2010 DASPETAH II
182 ARVEL DELOVE 4/8/2010 DASPETAH
183 ALIF MUBAROKAH 3/8/2010 DASPETAH II
184 DINASTI AURA .R 3/20/2010 DASPETAH II
185 DIKA MARKOSE
186 DEBI ALES SULISTIO 2009-07-28 DASPETAH
187 DOLLI CHAROLIN 2010-08-05 DASPETAH II
188 ENGGEL ARIVO 2010-07-13 DASPETAH II
189 FAUZAN RAMADHAN 2008-09-06 DASPETAH II
190 HERLI YUNITA SARI
191 HAZIZAH 2010-05-05 DASPETAH II
192 ICA PADILA .HS 2010-07-02 DASPETAH II
193 INTAN RENALDO 2010-04-16 DASPETAH II
194 LIA PUSPITA
195 LEAN RUMELITA 2010-07-12 DASPETAH II
196 MARCELA C.F 2010-02-19 DASPETAH II
197 MAURIN JEITA LIA 2010-01-10 DASPETAH
198 MEICAN
199 NADILA SAPIRA RIZKI 2010-03-24 DASPETAH
200 NADIA SESILIA .H 6/26/2010 DASPETAH II
201 NANDO APRILIO 2010-04-27 DASPETAH II
202 RAHMAD DANI 7/10/2010 DASPETAH II
203 RIDHO RICARDO 2009-05-10 PG BERINGANG
204 SEPTA RAMADANI
205 SILVI CLAUDIA MENTARI 2010-06-09 DASPETAH II
206 JACKI ARAS HABIBI 2009-11-02 DASPETAH II
6B 207 1. Aisyah Ashashafah 2010-04-17 DASPETAH II
208 2. Andin Juni Astari
209 3. Anggun Ramadani 2010-08-23 DASPETAH
210 4. Audy Gres Oktaviani 2010-10-03 DASPETAH
211 5. Bayu Sastra
212 6. Ezi Dwi Arianti
213 7. Firzi Olivia 4/15/2010 DASPETAH
214 8. Farhan Avatar
215 9. Gea Flanela 6/2/2010 DASPETAH II
216 10. Habibi Kusumo Utomo 2/6/2010 DASPETAH II
217 11.Lorenza 2/10/2010 UJAN MAS ATAS
218 12. Lorenza Rafi Quin 8/8/2010 DASPETAH II
219 13.Medio Rangga
220 14. M. Farhan 11/18/2009 PG BERINGANG
221 15. Meizy
222 16. Nara Hesta Gustian
223 17. Rangga Rifaldo 1/12/2009 PG BERINGANG
224 18. Rahmad Bayu Nanda
225 19. Rifki Oktavianus 10/26/2010 DASPETAH
226 20. Riski Purnama 5/21/2009 DASPETAH
227 21. Tiara Julianti 6/3/2010 DASPETAH II
228 22 Untung Ardeba Dio 7/27/2008 DASPETAH II
229 23. Vinza Fitria 9/15/2010 DASPETAH
230 24. Yoni Yolanda
231 25 Yohanes
232 26. Zaski Dwi Marica
233 CINTA PUSPITA SARI 4/14/2010 PG BERINGANG
37
|

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
06 JANUARI 2022
SD 01 DPT

SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

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M.UMUM
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LANSIA
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1708024403770004 #REF!
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ARI 2022
COVID-19
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M.UMUM

DOSIS 1
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PUBLIK
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PENDIDIK
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PENDIDIK
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36

57

###
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26 62 2

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28 OKTOBER 2021

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NO NAMA TGL LAHIR ALAMAT

1 ARJUNA ARYA W. 2/16/2009 UJAN MAS ATAS


2 BAYU AZMI 11/28/2008 SURO BARU
3 MARSEL ANGGARA 6/23/2008 PG BERINGANG
4 M. FAHRI ALFAREZA 5/6/2009 SURO ILIR
5 PAREL 12/26/2007 UJAN MAS ATAS
6 RANDI WAHYU P. 3/30/2009 SURO LEMBAK
7 RETIKA YERSILIA 1/1/2009 DASPETAH
8 Exgi Triansa 30-02-2009 Meranti Jaya 
9 Muhammad Daichan 2/23/2009 Suro Lembak
10 Siti Khairun Nisa 8/15/2009 Meranti Jaya
11 Taufik Saputra 4/15/2008 Bumi Sari
12 BUNGA DWI APRIANI WESKUST, KEPAHIA
13 GEDE OKTARIYANE 10/7/2009 Suro Bali
14 INKA CYNTHIA AINNISA 1/28/2009 Bumi Sari
15 JERRI FEBRIAN ARIFIN 2/6/2009 Ujan Mas Atas
16 MARSYAH ENJELA 3/9/2009 Suro Ilir
17 R.J. AL HAFIZT 12/6/2008 Daspetah
18 ALFIANSYAH 9/9/2009 Ujan mas Atas
19 ALVIS QODIRUSAPUTRA 10/22/2008 SURO BARU
20 CINDY ALFI ANINGSIH 3/22/2009 Curup
21 DIOBA TYO BERMANO 1/19/2007 Ujan mas Atas
22 FAZA CRISTIAN DYNATA 3/10/2009 Meranti jaya
23 MUHAMAD AGUSTIAN F 8/25/2008 kepahiang
24 NYOMAN FANNY YURIKE 8/2/2009 Suro bali
25 WAYAN KARINA PUTRI 8/24/2009 kepahiang
26 WULANDARI PINAHAVIVA SURO ILIR
27 ARIF HIDAYATULLAH 11/26/2007 Suro Muncar
28 ARIL PUTRA 12/6/2008 Cugung Lalang
29 RAFLIARZENDO MELDI 7/6/2008 Rejang Lebong
30 RAKA SAPUTRA 2/2/2008 Suro Baru
31 STEVEN 10/31/2008 Daspetah
32 FAHRI ARDIANSYAH 1/7/2009 BUKIT BARISAN
33 OBAMA 1/20/2009 UJAN MAS ATAS
34 PADILA ADITIA 6/26/2009 UJAN MAS BAWAH
35 SIGIT OKTA PENUS 7/14/2009 SURO ILIR
36 YENI ISDIYANTI 3/5/1990 BUMI SARI
37 ANDRIAN OCAVIANSYAH 27-10-2008 GALANG
38 M. AL IKLAS 28-08-2008 TERTIK
39 PUJA KURNIASIH 03-08-2008 BATU BANDUNG
40 DESTI VIANANTA 19 - 12 - 2007 SURO ILIR
41 DWI SATRIO 01 - 09 - 2007 JL. ISKANDAR ONG
42 FAREL 14 - 12 - 2007 KEL. UJAN MAS ATAS
43 SARIFAH 08 - 02 - 2008 KEL. UJAN MAS ATAS
44 DENA MARSELA 28 - 08 - 2006 UJAN MAS ATAS
45 MUHAMMAD MUSLIM 24 - 06 - 2007 PUNGGUK MERANTI
46 PERI ARYANTO 6/30/2006 UJAN MAS ATAS
47 PIKI SATRIO 15 - 07 - 2008 UJAN MAS ATAS
48 RISKI PURNOMO UJAN MAS ATAS
49 WAHYU ANTONI REBA SURO MUNCAR
50 ADE RENALDI 16-06-2008 UJAN MAS ATAS
51 M. FAREN AGUSTIN 04-08-2007 UJAN MAS ATAS
52 RISKI ADITIA 10-07-2007 UJAN MAS ATAS
53 CHENI RAMADANI 06 Oktober 2007 Ujan Mas Atas
54 KEZIA AULIA 04 Desember 2007Ujan Mas Atas
55 RAHMAT RISKI 06 Juni 2008 Suro Ilir
56 SELA SEPRIANI RAMADAN09 September 200Bumi Sari
57 TEDI RAMADAN 19 September 200Suro Ilir
58 YOGA PANGESTU 27 Oktober 2007 Meranti Jaya
59 IBRA RIBERY 20 Maret 2008 Bumi Sari
60 CHELSYE OLIVIA ERYADI4/30/2008 Ujan mas Atas
61 FAHRY AL AKBARY. H 7/4/2008 Pulo Geto
62 FAUZAN MAULANA 10/15/2006 Ujan mas Atas
63 KEVIN PAGASTA 7/15/2008 Suro Lembak
64 LUCKY RORIAND 1/21/2008 Ujan mas Atas
65 RINALDO 7/3/2007 Cugung lalang
66 AZI DWI KURNIAWAN 01-04-2007 PUNGGUK MERANTI
67 DEDE ANGGARA PUTRA 26-01-2006 PUNGGUK MERANTI
68 DIMAS AJI PRANATA 10-11-2008 UJAN MAS ATAS
69 FERDI SANTOSO 20-03-2008 SURO MUNCAR
70 JONA MARIO AKBAR 23-03-2007 SURO BARU
71 ARDIANSYAH REGI P. 10-01-2007 SURO BARU
72 ROBI SUGARA 23-03-2007 SURO BARU
73 ALAN DEMO PUTRA PUNGGUK MERANTI
74 AHMAD DAFI DIANSAH 25-08-2007 BUMI SARI
75 EZI RADITIA PRATAMA 31/03/2007 PUNGGUK MERANTI
76 SEPTI JANG SAKTI 27/02/2007 UJAN MAS BAWAH
77 WAHYU NURDIANWAR 1/5/2005 CUGUNG LALANG
78 FLENALDO SYAQLI F. 11-07-2007 PUNGGUK MERANTI
79 MAREMUR 07-04-2007 PUNGGUK BERINGA
80 NANA RAHMAYANI 27-09-2007 SURO ILIR
81 ANGGA SAPUTRA 02-12-2008 UJAN MAS ATAS
82 ANDI JULIAN SAPUTRA 7/16/2006 Bumi Sari
83 DIRGA ARDIYANSYAH 8/21/2006 Bumi Sari
84 M. BAGAS ABI FERNANDO1/21/2007 Bumi Sari
85 MEZI YULIANTI 5/7/2007 Suro Baru
86 REHAN PRANATA 12/15/2006 Ujan Mas
87 ZACKY ANGGARA 12/2/2006 Suro Lembak
88 DIOSI HIKMA BAGITE 6/16/2006 Ujan mas Atas
89 DEO PERNANDO 05/05/2006 UJAN MAS ATAS
90 FIRZI ALFARICHI
91 SUHIDIN 4/14/1965 SURO BARU
92 ISYE YULISTA 7/20/1984 SURO BARU
93 GUSTI ERWANTO 8/5/1968 SURO BARU
94 AZRIL PRASTYO 1/24/2010 SURO BARU
95 ALFARIZI FARDHAN ARIYO
96 FAHRI AKBAR 9/16/2010 SURO L,EMBAK
97 ZASKIA AULIA PRATAMA Ujan mas Atas
98 KEVINDO GARCIA Suro Lembak
99 M. FARHAN EL JUNDI SURO BARU
100 YUKE ADITYA Ujan mas Atas
101 Viona 12/20/2008 Ujan Mas Atas
102 Putra Jaya 6/13/2008 Suro Muncar
103 FAHRI ALFARADO 8/7/2008 SURO BARU
104 TORA SANDYEGO KEPAHIANG
105 ALFIANSYAH 9/9/2009 Ujan mas Atas
106 DWI NOVITA SARI 11/1/2009 Suro Baru
107 BETA NOPIA 11/29/2009 SURO BARU
108 RENDI ADE LEGITO 12/5/2008 SURO ILIR
109 DAPA RAHARDI
110 ANDIKA PRATAMA 6/10/2008 SURO BARU
111 YULIO SAPERDI 25-04-2006 PUNGGUK MERANTI
112 FADHILLAH JULIO A. 7/12/2007 Curup
113 MUHAMMAD IKBAL 20-11-2007 BUMI SARI
114 DAFFA ADYASAKHA 11/4/2013 SURO BARU
115 SAKIA MELINDA
116 SASKIA MAHARANI
UPT PUSKESMAS RAWAT INAP UJAN MA
VAKSINASI COVID-19
08 JANUARI 2022
SMP 1 SURO BARU

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

BUMIL

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0 0 0 0 0 1 8 0 0 0 0 0 4 91
9 95

RESI 0 0 0 0 4 91
YUK PIT
104 PKM 3 11

134 0 0 0 3 4 ###
109

PFIZER
RESI 12 3 18
PKM 36 4 24
YUK PIT 0 4 23
UARI 2022
SURO BARU
ASI COVID-19
NAKES
LANSIA
PUBLIK
BUMIL
AWAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA
1
1
1
1

1
1
1
1
1
1
1
1

0 0 0 0 0 0 9 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 3 0 0 0
116
12
0 0 0 0 0 0 9 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0

4 1 1 18 12 1 11 62

0 0 0 0 0 0 13 1 0 1 18 0 15 0 0 0 0 0 0 0 0 0 0 1 0 11 169
48

57

3
4
3
###
LANSIA

ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA
DOSIS 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

62 26 62 2

169 3 341
12
PUBLIK

M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
NO NAMA TGL LAHIR ALAMAT

1 1 ABID AKILA PRANAJAYA 10/12/2014 SURO ILIR


2 ARNOL OKTE SELFANO 10/27/2014 SURO ILIR
3 MUHAMMAD GHALI IQBAL 4/18/2015 SURO ILIR
4 NOVITA LESTARI 9/12/2014 SURO ILIR
5 WAHYU RIFKI ANUGRAH 1/30/2015 SURO ILIR
6 WIRA YUDHA 2/28/2015 SURO ILIR
2 7 ADINDA KIRANA 10/28/2013 SURO ILIR
8 ANGGUN PERMATA SARI 8/23/2013 SURO ILIR
9 CALLISTA SAFA HAURA 9/26/2013 SURO ILIR
10 ECA TAMARA CINTA 1/19/2014 SURO ILIR
11 GEO DEVAL PUTRA PERDANA 10/14/2013 SURO ILIR
12 HIKMA SABRI KURNIAWAN 3/23/2014 SURO ILIR
13 KLARA APRILIA 4/5/2014 SURO ILIR
14 MARSYA NATALIA 2/25/2014 SURO ILIR
15 RAYA DWITA 1/2/2014 SURO ILIR
16 VITIYEN DWIKA MALINI 12/26/2013 SURO ILIR
17 ZAFA JANUARI SAPUTRI 1/30/2014 SURO ILIR
18 ZASKIA NURHIDAYA 10/16/2013 SURO ILIR
19 AMOZA SISILIA PUTRI 6/24/2013 SURO ILIR
20 ANDINI PUTRI LESTARI 4/21/2013 SURO ILIR
21 ANGGA PRAMAH 7/2/2012 SURO ILIR
22 ANITA FEBRIANTI 2/20/2013 SURO ILIR
23 ARIFKI RAHMAT JULIANSYAH 7/11/2012 SURO ILIR
24 FARHAN AL IKHSAN 3/31/2013 SURO ILIR
25 IKSAN FIRMANSYAH 1/19/2013 SURO ILIR
26 IZKHA LISTY DWI TARI 4/27/2013 SURO ILIR
27 KINARA FEBRIANI 2/24/2013 SURO ILIR
28 MARCELO ARIANSYAH 3/27/2013 SURO ILIR
29 MARZEL DWI NICOLA 6/17/2013 SURO ILIR
30 MUHAMMAD DIMAS ANGGAR 3/20/2013 SURO ILIR
31 NATASYA AMELIA 3/8/2013 SURO ILIR
32 SASKIA ANITA 8/29/2013 SURO ILIR
4 33 AFIKA ANGGRAINI 15 MEI 2012 SURO ILIR
34 ANUGERAH ISMAIL 23 AGUSTUS 2012 SURO ILIR
35 APRILIA HARTINA 01 APRIL 2012 SURO ILIR
36 ARJUN PUTRA PRATAMA 1-Jun-12 SURO ILIR
37 ARVEL RADITYA 04 Juni 2011 SURO ILIR
38 DIMAS SANJAYA 02 APRIL 2012 SURO ILIR
39 FATIA APRIYANTI 11 APRIL 2012 SURO ILIR
40 IKBAL ALFARIZI 15-Dec-11 SURO ILIR
41 KEYLA OKTARIA 11 OKTOBER 2012 SURO ILIR
42 NESA APRILIA 30-Apr-11 SURO ILIR
43 NESA FEBRIYANTI 25-Feb-12 SURO ILIR
44 RAISYA AZIS AREZA 06 DESEMBER 2011 SURO ILIR
45 REYHAN ARJUNA PUTRA 1-Jun-12 SURO ILIR
46 RISKI DWI RAMADHANI HAIRU 22 JULI 2012 SURO ILIR
47 SAHROTUS SITA 11-Jul-12 SURO ILIR
48 YONITA AULIA MERZI 08 JUNI 2012 SURO ILIR
49 ZAKIRA ENJELITA 24 MEI 2012 SURO ILIR
50 RANGGA MARDI YOWANDA 1-Jun-12 SURO ILIR
5 51 BINTANG BRATAMA 6 OKTOBER 2011 SURO ILIR
52 CHEYZIA PUTRI PIANI 7 FEBRUARI 2011 SURO ILIR
53 DANU 19 Januari 2010 SURO ILIR
54 DAVID ALFIANSYAH 15 OKTOBER 2011 SURO ILIR
55 DECA APRIANI 14 APRIL 2011 SURO ILIR
56 DEDE ROKAYAH 29 DESEMBER 2011 SURO ILIR
57 IRMA 29 DESEMBER 2011 SURO ILIR
58 M. AL HAMMER 17 NOVEMBER 2011 SURO ILIR
59 NIKO FAHREZA 18 JANUARI 2011 SURO ILIR
60 RANGGA ABDI JAYA 13 APRIL 2011 SURO ILIR
61 RENDY MARTIN 24 April 2010 SURO ILIR
62 RENSA PRAMUJA 16 SEPTEMBER 2011 SURO ILIR
63 RESI DIVA APRIKA 18 APRIL 2011 SURO ILIR
64 RISKI APRIANSAH 23 APRIL 2012 SURO ILIR
65 RISKI BADIO 6 NOVEMBER 2010 SURO ILIR
66 SINTA ARDIA BELA 4 MEI 2011 SURO ILIR
6 67 ADIL ARJUNA PUTRA MARSUKI 27 Juni 2010 SURO ILIR
68 AIDA BUNGA HERAWATI 8 September 2010 SURO ILIR
69 BUDIO HARTONO 22 Januari 2010 SURO ILIR
70 CANDRA LIKA PATRA 23 Mei 2010 SURO ILIR
71 CELSI ARMADANI 15 Mei 2010 SURO ILIR
72 DETI JULIANI 22 Juli 2010 SURO ILIR
73 DINDA SULASTRI 30 Agustus 2010 SURO ILIR
74 FACHRY GUNAWAN 28 Desember 2009 SURO ILIR
75 FEBIOLA ADIA MECA 4 Februari 2010 SURO ILIR
76 GEBI APRILIA PUTRI 9 April 2010 SURO ILIR
77 GITA SEPTIANA 18 September 2010 SURO ILIR
78 IMELDA ARIANTI 30 Mei 2010 SURO ILIR
79 JESEN PANGESTU 27 Maret 2010 SURO ILIR
80 JESSICA FEBBY RAHAYU 20 Januari 2010 SURO ILIR
81 MEIZA DWI APRILIA 30 April 2010 SURO ILIR
82 MELSI 27 Maret 2010 SURO ILIR
83 NAZRIL ILHAM HAIRULLAH 29 November 2010 SURO ILIR
84 PUPUT ULANDARI 3 Mei 2010 SURO ILIR
85 QUINZA RADISTI 21 Maret 2010 SURO ILIR
86 ROSIAN ROSADI 8 Juni 2010 SURO ILIR
87 TIARA 7-Sep-09 SURO ILIR
88 WIKA FEBRIANTI 19 Februari 2011 SURO ILIR
89 WIDIYA 1/10/1984 SURO ILIR
90 M. DUTA NOVRIANSYAH UJAN MAS BAWAH

42 DEVI MARISYAH 3/26/2013


70 JULIAN ARGA 21-Jun-12
79 TRISTAN GIANOBA 10 OKTOBER 2012
3 FAIRUZ HUMAIROH PAREJA 2/18/2015 SURO ILIR
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
10 JANUARI 2022
SD 09 SURO ILIR

SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

BUMIL
ANAK
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0 0 0 0 0 0 89 0 0 0 0 1 0 0 0
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90

1708026603130001 TUNDA 1
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RO ILIR
ARI 2022
COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA
DOSIS 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
90
0
0 0 0 0 0 0

1 11 12

0 0 0 1 0 11 12

###
ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA

PUBLIK
DOSIS 1
REK

SINO
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

26 62 2

3 27
0
M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA SINOVAC
PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
NO NAMA TGL LAHIR ALAMAT

1 1 ABYANSHA PRATAMA 9/18/2014 SURO MUNCAR


2 AISYAH AFIFAH LUBIS 1/8/2015 SURO MUNCAR
3 ARGA ANUGRAH 4/11/2015 SURO MUNCAR
4 DEVA ALFIRA 10/3/2014 SURO MUNCAR
5 DYLARA EGINA 6/7/2015 SURO MUNCAR
6 JIHAN ANDINI PUTRI 12/19/2014 SURO MUNCAR
7 KARTIKA RUKIAH LEST 3/14/2015 SURO MUNCAR
8 LESTARI RAMADANI 7/12/2014 SURO MUNCAR
9 MIFTHA HURAHMA 7/20/2014 SURO MUNCAR
10 MUHAMMAD ILHAN ALF 4/17/2015 SURO MUNCAR
11 MUH. JHEREL AL HAFU 2/21/2015 SURO MUNCAR
12 NAILA FIDELYA ARKAN 1/29/2015 SURO MUNCAR
13 PATRA ANUGRAH PRA 7/7/2015 SURO MUNCAR
14 REJA RIRZY ROMADHA 7/11/2013 SURO BARU
15 ROHMA PUTRA ROBIAN 7/23/2014 SURO MUNCAR
16 SIFA SALSABILA 10/5/2014 SURO MUNCAR
17 VAREL MARIO 4/9/2015 SURO MUNCAR
2 18 ABI MUHAMAD AKBAR 1/16/2014 SURO MUNCAR
19 ALPIYAN JAYOBA PRA 12/10/2013 SURO MUNCAR
20 ANJAS APRILIO 12/30/2013 SURO MUNCAR
21 ARA VIA SALSA 3/17/2014 SURO MUNCAR
22 BARA ARGA PRANATA 4/15/2014 SURO MUNCAR
23 DIANDRA TRI ELIDA 12/13/2013 SURO MUNCAR
24 FEBIAN PANDU WINATA 4/29/2014 SURO MUNCAR
25 GIO REPISTA 4/11/2014 SURO MUNCAR
26 HAZIYAH AFIAH 10/29/2013 SURO MUNCAR
27 JUNIOR RAMADANU 6/30/2014 SURO MUNCAR
28 KURNIA WATI 6/13/2014 SURO MUNCAR
29 LUTFI QIANOVALEN 2/11/2014 SURO MUNCAR
30 MARSEL ADE PUTRA 4/11/2014 SURO MUNCAR
31 MEISYA NADHIRA LEVI 4/26/2014 SURO MUNCAR
32 MUHAMMAD FARHAN 3/5/2014 SURO MUNCAR
33 NINDIRA ANGELIA PUTR 16-Jan-14 SURO MUNCAR
34 PEDO SAPUTRA 3/20/2014 SURO MUNCAR
35 RAFAEL 6/9/2014 SURO MUNCAR
36 RAFAEL ASKA FERNAN 2/26/2014 SURO MUNCAR
37 RAHMADI 24-Nov-13 SURO MUNCAR
38 RENDI MUHAMMAD AZK 12/10/2013 SURO MUNCAR
39 ZAHRA SALSABILA 11-Oct-13 SURO MUNCAR
40 ZIAN RISKI MARETA 4-Mar-14 SURO MUNCAR
41 ZAHDAN PUTRA FERN 6/3/2014 SURO MUNCAR
3 42 AKBAR ROMADAN AL H 18-Jul-13 SURO MUNCAR
43 ATILA FEBRI 2/4/2013 SURO MUNCAR
44 DANA ARIFKY 2-Jun-13 SURO MUNCAR
45 DELFINE AL ZAKKI 5/18/2013 SURO MUNCAR
46 DINDA OLIVIA 11/30/2012 SURO MUNCAR
47 FARHAN DWI PUTRA 26-Dec-12 SURO MUNCAR
48 FICKI ANGKA PRATAMA 8/14/2013 SURO MUNCAR
49 FRISKY DAPUTRA PRA 4/7/2013 SURO MUNCAR
50 MIRNA 4/28/2013 SURO MUNCAR
51 MUHAMMAD HADI P 5/15/2013 SURO MUNCAR
52 MUHAMMAD SHOLEHA 12/18/2012 SURO MUNCAR
53 MUHAMMAD DAPA 9/12/2012 SURO MUNCAR
54 YOBA ANUGRAH 7/24/2013 SURO MUNCAR
55 PERNI AZA INAYA 24-Mar-14 SURO MUNCAR
56 RICKO RAMONZA 2/26/2013 SURO MUNCAR
57 RISKI LARENDRA SAPU 8/8/2012 SURO MUNCAR
58 RISKI RAHMAT ADITYA 12/20/2012 SURO MUNCAR
59 RIZTI CINTA ILAHI 11/10/2012 SURO MUNCAR
60 QWAMARA FIRRIZKY 4/3/2014 SURO MUNCAR
4 61 AZIZAH SABARA 16-Sep-12 SURO MUNCAR
62 ALITA SAFIRA 6/25/2011 SURO MUNCAR
63 DERBI ACHMAD ZAMZA 5/7/2012 SURO MUNCAR
64 DIMAS HADI WIJAYA 5/22/2012 SURO MUNCAR
65 DIYEGO ARMIKI 7/11/2012 SURO MUNCAR
66 DITA DWI RAMADHANI 8/5/2012 SURO MUNCAR
67 FAUZAN MUPID 9/4/2011 SURO MUNCAR
68 KELPIN APRIANSYAH 6/28/2012 SURO MUNCAR
69 MARSEL ANANDA PRA 6/3/2012 SURO MUNCAR
70 PEBI CANTIKA 5/22/2013 SURO MUNCAR
71 PUTRI AYU LESTARI 12/9/2011 SURO MUNCAR
72 RAFAEL ALLFICRI 6/8/2011 SURO MUNCAR
73 RANGGA VIRMANSYAH 5/26/2015 SURO MUNCAR
74 RISKI RENALDO 4/30/2011 SURO MUNCAR
75 RIZKY ADE PUTRA ANS 12/9/2011 SURO MUNCAR
76 SRI WULANDARI 11/16/2011 SURO MUNCAR
77 SUPIRA 1/3/2012 SURO MUNCAR
78 ZANI PRATAMA 10/12/2011 SURO MUNCAR
79 ZAKARIA PUTRA 7/6/2012 SURO MUNCAR
5 80 ADITIA PIKI PRANATA 7/18/2011 SURO MUNCAR
81 ARYA WIRANATA 2/14/2011 SURO MUNCAR
82 AIRIN ANJAYNI 7/30/2011 SURO MUNCAR
83 ARGA JAYOBAH 7-Dec-10 SURO MUNCAR
84 CINCIN PRANESA 6/13/2011 SURO MUNCAR
85 GEA RIYE RAMADANI 7/31/2011 SURO MUNCAR
86 IQBAL PUTRA KKURNI 10/11/2010 SURO MUNCAR
87 MARSEL PUTRA PRATA 9/19/2011 SURO MUNCAR
88 NADIA FITRIA 5/20/2011 SURO MUNCAR
89 NASTASYAH SINTIA BE 11/13/2010 SURO MUNCAR
90 NESA DELIA PUTRI 8/30/2011 SURO MUNCAR
91 NOPITA SARI 1/8/2009 SURO MUNCAR
92 PATIYA BELITA 3/29/2011 SURO MUNCAR
93 RAGIL JUNI SADEWO 6/5/2011 SURO MUNCAR
94 ROBIATUL JUNI SADEW 4/13/2011 SURO MUNCAR
95 REDO ASHARI 10/8/2010 SURO MUNCAR
96 TOMI MUHAMMAD AKB 10/5/2010 SURO MUNCAR
97 RENDI MUHAMMAD AZK 11/28/2010 SURO MUNCAR
98 RENDRA WINATA 6/18/2011 SURO MUNCAR
99 WINDA LESTARI 4/13/2011 SURO MUNCAR
100 VIRA AGRA SAKINA 3/8/2011 SURO MUNCAR
6 101 ANDREA DWI PUTRA 5/26/2010 SURO MUNCAR
102 DIONA APRIANSA 4/4/2010 SURO MUNCAR
103 FARLAN ANDRIANSYA 5/28/2010 SURO MUNCAR
104 MHOZI SAQYLA NINDRI 8/2/2010 SURO MUNCAR
105 MELATI OLIPIA 8/12/2010 SURO MUNCAR
106 MEDIYA AMANDA 7/23/2010 SURO MUNCAR
107 NARA AFRIANI 7/20/2011 SURO MUNCAR
108 PUTRA 12/1/2009 SURO MUNCAR
109 RANI AULIA DWI PUTRI 6/13/2010 SURO MUNCAR
110 REHAN AFRIYANSA 4/10/2010 SURO MUNCAR
111 CHELSIA OLYVIA 12/30/2009 SURO MUNCAR
112 RENO FADLIANSYAH 3/21/2009 SURO MUNCAR
113 SINTIA PUTRI 10/6/2009 SURO MUNCAR
114 SEPTI RAMADANI 9/8/2009 SURO MUNCAR
115 TARI RAMADANI 7/26/2010 SURO MUNCAR
116 YOLAN APRIANSYAH 10/27/2009 SURO MUNCAR
117 YELA OKTARIA 12/29/2009 SURO MUNCAR
118 JONI 2/12/1976 SURO MUNCAR
TDK MASUK 4 ARSA BIANTARA 3/25/2015 SURO MUNCAR
TDK MASUK 11 MUHAMMAD DEFRIZAL 12/12/2014 SURO MUNCAR
MENOLAK\ 29 JESSIKA HUMMAIRAH 1/20/2014 SURO MUNCAR
64 NURUL IKSHAN 1/17/2013 SURO MUNCAR
85 APRIL RISWAN SAPUTR 4/5/2009 SURO MUNCAR
98 PEBY DWI PRANATA 10/30/2011 SURO MUNCAR
105 RHEYHAN ZAKHY AGU 8/15/2011 SURO MUNCAR
109 ADE RESKI KITOPIO 3/7/2010 SURO MUNCAR
111 DIKO RORENZA 7/30/2010 SURO MUNCAR

117
UPT PUSKESMAS RAWAT INAP UJAN MA
VAKSINASI COVID-19
11 JANUARI 2022
SD 10 SURO MUNCAR

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

BUMIL

BUMIL
ANAK
1708021809140001 1
1708024801150002 1
1708021104150002 1
1708024310140001 1
1708024706150001 1
1708025912140002 1
1708025403150001 1
1708025207140001 1
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1702181104140001 1
1708026910130001 1
1607103006140007 1
1708025306140001 1
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1708025110130001 1
1708020403140002 1
1708020306140001 1
1708021807130001 1
1708020402130001 1
1708020206130003 1
1708025805130001 1
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1708022612120001 1
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1708021812120001 1
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1708022407130001 1
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1708022602130001 1
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1708021110100001 1
1503031909110005 1503030912130009 1
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1771084803110001 1
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0 0 0 0 0 0 117 0 0 0 0 1 0 0
117 1

118
1708022503150002 1
1708021212140002 1
170802600140001 1
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1708020504090001 1708022904090034 1
1708023010110002 1
1708021508110001 1
1708020703100001 1
1708023007100002 1
UARI 2022
ASI COVID-19
NAKES

RO MUNCAR
LANSIA
PUBLIK
BUMIL
AWAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
118
0
0 0 0 0 0 0

1 11 12

0 0 0 1 0 11 12
LANSIA

ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA
DOSIS 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

12 26 62 2

12 3 27
0
PUBLIK

M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
NO NAMA TGL LAHIR ALAMAT

KLS 1 1 ABYANSHA PRATAMA 9/18/2014 SURO MUNCAR


2 AISYAH AFIFAH LUBIS 1/8/2015 SURO MUNCAR
3 ARGA ANUGRAH 4/11/2015 SURO MUNCAR
4 DEVA ALFIRA 10/3/2014 SURO MUNCAR
5 DYLARA EGINA 6/7/2015 SURO MUNCAR
6 JIHAN ANDINI PUTRI 12/19/2014 SURO MUNCAR
7 KARTIKA RUKIAH LESTARI 3/14/2015 SURO MUNCAR
8 LESTARI RAMADANI 7/12/2014 SURO MUNCAR
9 MIFTHA HURAHMA 7/20/2014 SURO MUNCAR
10 MUHAMMAD ILHAN ALFARO 4/17/2015 SURO MUNCAR
TUNDA 11 MUH. JHEREL AL HAFUZH 2/21/2015 SURO MUNCAR
TUNDA 12 NAILA FIDELYA ARKANA 1/29/2015 SURO MUNCAR
13 PATRA ANUGRAH PRATAM 7/7/2015 SURO MUNCAR
14 REJA RIRZY ROMADHAN 7/11/2013 SURO BARU
15 ROHMA PUTRA ROBIANSY 7/23/2014 SURO MUNCAR
16 SIFA SALSABILA 10/5/2014 SURO MUNCAR
17 VAREL MARIO 4/9/2015 SURO MUNCAR
KLS 2 18 ABI MUHAMAD AKBAR 1/16/2014 SURO MUNCAR
19 ALPIYAN JAYOBA PRATAM 12/10/2013 SURO MUNCAR
20 ANJAS APRILIO 12/30/2013 SURO MUNCAR
21 ARA VIA SALSA 3/17/2014 SURO MUNCAR
22 BARA ARGA PRANATA 4/15/2014 SURO MUNCAR
23 DIANDRA TRI ELIDA 12/13/2013 SURO MUNCAR
24 FEBIAN PANDU WINATA 4/29/2014 SURO MUNCAR
25 GIO REPISTA 4/11/2014 SURO MUNCAR
26 HAZIYAH AFIAH 10/29/2013 SURO MUNCAR
27 JUNIOR RAMADANU 6/30/2014 SURO MUNCAR
28 KURNIA WATI 6/13/2014 SURO MUNCAR
29 LUTFI QIANOVALEN 2/11/2014 SURO MUNCAR
30 MARSEL ADE PUTRA 4/11/2014 SURO MUNCAR
31 MEISYA NADHIRA LEVINA 4/26/2014 SURO MUNCAR
32 MUHAMMAD FARHAN 3/5/2014 SURO MUNCAR
33 NINDIRA ANGELIA PUTRI 16-Jan-14 SURO MUNCAR
34 PEDO SAPUTRA 3/20/2014 SURO MUNCAR
35 RAFAEL 6/9/2014 SURO MUNCAR
36 RAFAEL ASKA FERNANDO 2/26/2014 SURO MUNCAR
37 RAHMADI 24-Nov-13 SURO MUNCAR
38 RENDI MUHAMMAD AZKA 12/10/2013 SURO MUNCAR
39 ZAHRA SALSABILA 11-Oct-13 SURO MUNCAR
40 ZIAN RISKI MARETA 4-Mar-14 SURO MUNCAR
41 ZAHDAN PUTRA FERNAND 6/3/2014 SURO MUNCAR
KLS 3 42 AKBAR ROMADAN AL HAKI 18-Jul-13 SURO MUNCAR
43 ATILA FEBRI 2/4/2013 SURO MUNCAR
44 DANA ARIFKY 2-Jun-13 SURO MUNCAR
45 DELFINE AL ZAKKI 5/18/2013 SURO MUNCAR
46 DINDA OLIVIA 11/30/2012 SURO MUNCAR
47 FARHAN DWI PUTRA 26-Dec-12 SURO MUNCAR
48 FICKI ANGKA PRATAMA 8/14/2013 SURO MUNCAR
49 FRISKY DAPUTRA PRATAM 4/7/2013 SURO MUNCAR
50 MIRNA 4/28/2013 SURO MUNCAR
51 MUHAMMAD HADI P 5/15/2013 SURO MUNCAR
52 MUHAMMAD SHOLEHAN 12/18/2012 SURO MUNCAR
53 MUHAMMAD DAPA 9/12/2012 SURO MUNCAR
54 YOBA ANUGRAH 7/24/2013 SURO MUNCAR
55 PERNI AZA INAYA 24-Mar-14 SURO MUNCAR
56 RICKO RAMONZA 2/26/2013 SURO MUNCAR
57 RISKI LARENDRA SAPUTR 8/8/2012 SURO MUNCAR
58 RISKI RAHMAT ADITYA 12/20/2012 SURO MUNCAR
59 RIZTI CINTA ILAHI 11/10/2012 SURO MUNCAR
60 QAMARA FIRRIZKY 4/3/2014 SURO MUNCAR
KLS 4 61 AZIZAH SABARA 16-Sep-12 SURO MUNCAR
62 ALITA SAFIRA 6/25/2011 SURO MUNCAR
63 DERBI ACHMAD ZAMZAMI 5/7/2012 SURO MUNCAR
64 DIMAS HADI WIJAYA 5/22/2012 SURO MUNCAR
65 DIYEGO ARMIKI 7/11/2012 SURO MUNCAR
66 DITA DWI RAMADHANI 8/5/2012 SURO MUNCAR
67 FAUZAN MUPID 9/4/2011 SURO MUNCAR
68 KELPIN APRIANSYAH 6/28/2012 SURO MUNCAR
69 MARSEL ANANDA PRATAM 6/3/2012 SURO MUNCAR
70 PEBI CANTIKA 5/22/2013 SURO MUNCAR
71 PUTRI AYU LESTARI 12/9/2011 SURO MUNCAR
72 RAFAEL ALLFICRI 6/8/2011 SURO MUNCAR
73 RANGGA VIRMANSYAH 5/26/2015 SURO MUNCAR
74 RISKI RENALDO 4/30/2011 SURO MUNCAR
75 RIZKY ADE PUTRA ANSORI 12/9/2011 SURO MUNCAR
76 SRI WULANDARI 11/16/2011 SURO MUNCAR
77 SUPIRA 1/3/2012 SURO MUNCAR
78 ZANI PRATAMA 10/12/2011 SURO MUNCAR
79 ZAKARIA PUTRA 7/6/2012 SURO MUNCAR
KLS 5 80 ADITIA PIKI PRANATA 7/18/2011 SURO MUNCAR
81 ARYA WIRANATA 2/14/2011 SURO MUNCAR
82 AIRIN ANJAYNI 7/30/2011 SURO MUNCAR
83 ARGA JAYOBAH 7-Dec-10 SURO MUNCAR
84 CINCIN PRANESA 6/13/2011 SURO MUNCAR
85 GEA RIYE RAMADANI 7/31/2011 SURO MUNCAR
86 IQBAL PUTRA KKURNIAWA 10/11/2010 SURO MUNCAR
TDK TERDFT 87 MARSEL PUTRA PRATAMA 9/19/2011 SURO MUNCAR
88 NADIA FITRIA 5/20/2011 SURO MUNCAR
TIDK TERDF 89 NASTASYAH SINTIA BELA 11/13/2010 SURO MUNCAR
90 NESA DELIA PUTRI 8/30/2011 SURO MUNCAR
91 NOPITA SARI 1/8/2009 SURO MUNCAR
92 PATIYA BELITA 3/29/2011 SURO MUNCAR
93 RAGIL JUNI SADEWO 6/5/2011 SURO MUNCAR
94 ROBIATUL JUNI SADEWO 4/13/2011 SURO MUNCAR
95 REDO ASHARI 10/8/2010 SURO MUNCAR
96 TOMI MUHAMMAD AKBAR 10/5/2010 SURO MUNCAR
97 RENDI MUHAMMAD AZKA 11/28/2010 SURO MUNCAR
98 RENDRA WINATA 6/18/2011 SURO MUNCAR
99 WINDA LESTARI 4/13/2011 SURO MUNCAR
100 VIRA AGRA SAKINA 3/8/2011 SURO MUNCAR
TDK TERDFT 101 RHEYHAN ZAKHY AGUSTO 8/15/2011 SURO MUNCAR
KLS 6 102 ANDREA DWI PUTRA 5/26/2010 SURO MUNCAR
103 DIONA APRIANSA 4/4/2010 SURO MUNCAR
104 FARLAN ANDRIANSYA 5/28/2010 SURO MUNCAR
105 MHOZI SAQYLA NINDRI 8/2/2010 SURO MUNCAR
106 MELATI OLIPIA 8/12/2010 SURO MUNCAR
107 MEDIYA AMANDA 7/23/2010 SURO MUNCAR
108 NARA AFRIANI 7/20/2011 SURO MUNCAR
109 PUTRA 12/1/2009 SURO MUNCAR
110 RANI AULIA DWI PUTRI 6/13/2010 SURO MUNCAR
111 REHAN AFRIYANSA 4/10/2010 SURO MUNCAR
112 CHELSIA OLYVIA 12/30/2009 SURO MUNCAR
113 RENO FADLIANSYAH 3/21/2009 SURO MUNCAR
114 SINTIA PUTRI 10/6/2009 SURO MUNCAR
115 SEPTI RAMADANI 9/8/2009 SURO MUNCAR
116 TARI RAMADANI 7/26/2010 SURO MUNCAR
117 YOLAN APRIANSYAH 10/27/2009 SURO MUNCAR
118 YELA OKTARIA 12/29/2009 SURO MUNCAR
119 ADE RESKY KITOPIO 3/7/2007 SURO MUNCAR
120 DIKO RORENZA 7/30/2010 SURO MUNCAR
121 YUKE ADITYA 2/9/2013 UJAN MASATAS
TDK MASUK 4 ARSA BIANTARA 3/25/2015 SURO MUNCAR
TDK MASUK 11 MUHAMMAD DEFRIZAL 12/12/2014 SURO MUNCAR
MENOLAK\ 29 JESSIKA HUMMAIRAH 1/20/2014 SURO MUNCAR
64 NURUL IKSHAN 1/17/2013 SURO MUNCAR
85 APRIL RISWAN SAPUTRA 4/5/2009 SURO MUNCAR
98 PEBY DWI PRANATA 10/30/2011 SURO MUNCAR
109 ADE RESKI KITOPIO 3/7/2010 SURO MUNCAR
111 DIKO RORENZA 7/30/2010 SURO MUNCAR

117
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
11 JANUARI 2022
SD 10 SURO MUNCAR

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

BUMIL

BUMIL
ANAK
1708021809140001 1
1708024801150002 1
1708021104150002
1708024310140001 1
1708024706150001 1
1708025912140002 1
1708025403150001 1
1708025207140001 1
1702196007140001 1
1708021704150002 1
1708022102150001
1708026901150001
1708020707150002
1708021107130001 1
1708022307140001 1
1708024510140001
1708020904150001 1
1708021601140001 1
1708021012130001 1
1708023012130001 1
1771085703140001 1
1708021504140002 1
1708025312130001 1
1708022904140001 1
1702181104140001 1
1708026910130001 1
1607103006140007 1
1708025306140001 1
1708021102140001 1
1708021106140001 1
1708026604140001
1708020503140001 1
1708025601140001 1
1708022003140002 1
1708020906140001 1
1708022602140001 1
1708022411130001
1708021012130002 1
1708025110130001 1
1708020403140002 1
1708020306140001 1
1708021807130001 1
1708020402130001 1
1708020206130003 1
1708025805130001 1
1708027011120001 1
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1708026804130001 1
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1708021812120001 1
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1708022407130001 1
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1708022602130001
1708020808120001 1
1702092012120001 1
1708025011120001 1
1708020304130001 1
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1708026506110002 1
1708020705120001 1
1708022205120002 1
1708021107120001 1
1708024508120001 1
1708020409110001
1708022806120001 1
1708020306120002 1
1708026208130001 1
1708024912110001 1
1708020806110002 1
1708022605120004 1
1708023004110001 1
1708020912110001 1
1708025611110001 1
1702184301120001 1
1708025107150001 1
1708020607120001 1708021003180002 1
1708021807110001 1
1708021402110001 1
1708027007110001 1
1708020712100001 1
1708025306110001 1
1708027107110002 1
1708021110100001
1503031909110005 1503030912130009 1
1708027005110002 1
1708025311100001 1708021401090204 1
1708027008110001 1
1708024801090001 1
1708026903110001 1
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1708025304110001 1
1708020810100001 1
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1708025304110002 1
1771084803110001 1
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1708022605100002 1
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1708026307100003 1
1708026607110001 1
1708020112090002 1
1708055306100001
1708021004100001 1
1708027012090001 1
1708022103090001 1
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1708026607100001 1
1708042710090001 1
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1708020703100001 1
1708023007100002 1
1702190902130000 1
0 0 0 0 0 0 1 0 0 0 0 0 9 100
1 109

110
1708022503150002 1
1708021212140002 1
170802600140001 1
1708021701130001 1
1708020504090001 1708022904090034 1
1708023010110002 1
1708020703100001 1
1708023007100002 1
ARI 2022
SI COVID-19

O MUNCAR
NAKES
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
110
0
0 0 0 0 0 0

1 11 12
0 0 0 1 0 11 12
LANSIA

ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

12 26 62 2
12 3 27
0
NO NAMA TGL LAHIR ALAMAT

1A 1 RASELIA HUMAIRAH 5/12/2015 DASPETAH


2 ZASKIA HARIYANTI 11/17/2014 DASPETAH
3 ZILKY DANUARTA 6/6/2015 PG BERINGANG
4 MUHAMMAD AZIS AL FA 12/19/2014
5 HAFIZAH SHEZA ALYA 7/29/2015
6 DILSI AULIA 5/28/2015 DASPETAH
7 RAZIA ANUGRAH 2/8/2016 PG BERINGANG
8 AHMAD TAUFIQ 5/6/2015 PG BERINGANG
9 NIKEN ANJANI 12/2/2014 PG BERINGANG
10 YANTI 12/15/2013 PG BERINGANG
11 RIDO HIDAYAT 5/31/2015 DASPETAH
12 BILLY SAPUTRA 12/5/2014 PG BERINGANG
1B 13 ADELIA 9/8/2014 DASPETAH
14 NABILA SYAFITRI 7/18/2015 DASPETAH
15 FEBRI ADRIANSYAH 3/27/2015 PG BERINGANG
16 ZAHRA AFRILIA 4/12/2015 UJAN MAS BAWAH
17 RIVALDO 5/5/2015 DASPETAH II
18 MUHAMMAD DZAKI ALM 2/4/2015 DASPETAH
19 AKBAR GIBRAN ALVAR 7/27/2015 DASPETAH
20 FAZLI GAVIN RAMADHA 7/5/2014 DASPETAH
21 TOMAS ALFA EDISON 9/4/2014 PG BERINGANG
22 DENIS BA'ADILLAH 1/30/2014 DASPETAH
23 RESTI SULISTIA 12/6/2014 DASPETAH II
24 ALFARO FRENDIKA 7/5/2015 DASPETAH
25 MARZA AULIA TUZZOL 1/11/2015 DASPETAH
26 RIPANDO SAPUTRO 8/8/2014 DASPETAH
27 NADIRA AULIA SONATA 4/21/2015 PG BERINGANG
28 AQILA NAHDA RAFAND 9/16/2014 DASPETAH II
29 RESTA KAMAYA SARI 8/27/2014 DASPETAH
30 KEYLA DIOPA AZARA 3/19/2015 DASPETAH
31 YUNITA ENJELINA 11/12/2014 DASPETAH
2A 32 SEPTA GALAS FERNAN 8/19/2013 DASPETAH
33 CENS ANDRAINI 11/13/2013 DASPETAH II
34 YUDA RAMADHAN 7/22/2013 DASPETAH
35 SALSABILA FEBRIANI 3/26/2014 DASPETAH
36 ADE FINA RASTI 3/27/2014 DASPETAH
37 AYU DEWI 3-Feb-13 DASPETAH
38 SUTAN MUHAMMAD PAI 8/12/2014 DASPETAH
39 BILQIS SAFIRA MADON 3/31/2014 PG BERINGANG
40 AKBAR SENO PATI 1/27/2014 PG BERINGANG
41 AQILLAH SHEKA AZAH 4/22/2014 DASPETAH
42 ARIL SUGIARTO 3-Oct-13 DASPETAH
43 ALDOH ALVARO 9/7/2013 DASPETAH
44 MUHAMMAD PADIL LO 10/17/2013 DASPETAH II
45 AFGAN ANUGRAH 22-Feb-14 DASPETAH
46 NOVRA DINATA 11/3/2013 DASPETAH
47 ANDIKA 4/30/2012 DASPETAH
48 ANDRA PUTRA ALMAEN 31-Dec-13 DASPETAH II
49 LARA SATIH 9/26/2014 PG BERINGANG
50 ZAKI RAMADHAN 7/23/2013 PG BERINGANG
51 LOVIS NAFOLIUS 4/19/2014 DASPETAH
52 ARGA RAMDHAN 7/23/2014 DASPETAH II
53 EFRI DWI ANGGRAINI 11/10/2013 DASPETAH
54 ANGGI SRI SUMARNI 6/24/2012 DASPETAH
55 TYO PUTRA BUDI PRA 2/27/2014 DASPETAH
56 FAUZIYAH IZZATUNNIS 10-Feb-14 DASPETAH
2C 57 ALINDA 5/7/2014 PG BERINGANG
58 PADILLAH RAHMADANI 8/4/2013 DASPETAH
59 IVANK FABIAN RAMADA 7/12/2013 DASPETAH II
60 DIOBA MUHAMMAD ALRI 16-Mar-14 DASPETAH II
61 SAKHA ADISATYA ATAL 5/7/2014 DASPETAH
62 FLORA FERONICA 1/25/2015 DASPETAH
63 CHARLES PRANATA 11/14/2013 DASPETAH
64 CARLES DIRHAM FEBRI 2/2/2014 DASPETAH II
65 RAHEL OKTO SARAMA 10/21/2013 DASPETAH
66 IKBAL FAUZAN DIANPA 4/26/2014 DASPETAH
67 ENJELLINA 6/21/2014 DASPETAH
3A 68 ALFIN KAYRO AGUSTIA 5/26/2013 PG BERINGANG
69 ANUGRAH RAFA FADIL 11/18/2012 DASPETAH
70 INTAN PERMATA SARI 11/12/2012 PG BERINGANG
71 MUHAMMAD RIFAEL DO 2/16/2013 PG BERINGANG
72 MUHAMMAD LEANDRO 4/25/2013 DASPPETAH
73 RIA FITRIA 2/3/2013 DASPETAH
74 TARA ABABIL 6/29/2012 DASPETAH
75 VINA NOVITA SARI 10/23/2013 DASPETAH
76 KHELZA FANY ABIFA M 10/23/2013 DASPETAH
77 NANDA SATRIA 1/18/2013 DASPETAH
3B 78 ARAFAH FATRIATUL AK 1/3/2013 DASPETAH
79 PRISILIA UILANDARI 2/15/2013 DASPETAH
80 DWI INGGA AFRILIA 3/6/2013 DASPETAH
81 LESI MARCELIA 27-Jun-13 DASPETAH
82 AMIRA NATASYA 4/15/2012 DASPETAH
83 RAFFA AFRIANSYAH 4/16/2013 DASPETAH
84 DECKO PRASETYO 11/30/2012 DASPETAH
85 TIYANSI HERLINA 6/27/2012 PG BERINGANG
86 BELA BIANKA KINARA 5/11/2013 DASPETAH
87 GHITA KHEYREN PATT 8/5/2013 DASPETAH
88 DEYGO MARSELO 6/18/2013 PG BERINGANG
89 REFIN ARDIANSYAH 10/6/2011 DASPETAH
3C 90 KRISTI VIONA 8/30/2013 DASPETAH
91 ZASKIA TANI APUTRI 10/8/2012 PG BERINGANG
92 NABILLA OKTAVIAN NIS 11/2/2013 DASPETAH II
93 ANGGEL HAJALIA 11/12/2012 PG BERINGANG
94 AGUNG WAHYI HIDAYA 1/13/2013 DASPETAH II
95 AURELIN BELFANIA 6/8/2013 DASPETAH
96 AZI JANUARDI 1/19/2012 DASPETAH II
97 SELVI SANTIKA SARI 5/13/2013 DASPETAH
98 GALEH NUGROHO 2/2/2013 SURO LEMBAK
99 KHEIRA HADZAL YAUUM 4/2/2013 DASPETAH
100 ANGGA WIJAYA 11/4/2011 UJAN MAS ATAS
101 AMANDA AYU PRATIWI 4/23/2013 DASPETAH
102 THORIQ FHADILLA ALF 4/5/2013 DASPETAH
103 ELFREDO RENALDO 7/20/2012 DASPETAH
104 DENIS DIANTARA 5/10/2011 PG BERINGANG
105 RASYAH NABILA 11/12/2012 DASPETAH
4B 106 FEBRIAN SAKINA 2/1/2012 PG BERINGANG
107 ALIF PAHREJA 11/8/2012 DASPETAH
108 ABDAL RAMADHAN 7/19/2012 DASPETAH
109 AKBAR ALGHI FAHRY 9/4/2012 DASPETAH II
110 TIARA 3/27/2013 DASPETAH
111 NAULI TUFFAHATI HAR 12/12/2011 DASPETAH
112 SIREN DWI ARIYANTI 9/18/2012 DASPETAH
113 MUHAMMAD AJIS AL P 2/22/2012 DASPETAH
114 DAFIZAH ANATASYYAH 7/7/2011 DASPETAH II
115 DIKA 2/19/2013 DASPETAH
116 FALENTA DWI APRILIA 4/17/2012 PG BERINGANG
117 TARA FEBYOLA 4/16/2012 DASPETAH
118 JESIKA SAKINA 9/19/2012 DASPETAH II
119 GISELA NATASYA PUTR 10/4/2012 DASPETAH
120 MEZZY AURELYA ANDJ 5/9/2012 PG BERINGANG
121 AZIZAH BIBIT SOEHAR 1/10/2013 DASPETAH
122 REBI ADIZAH ARKANA 1/14/2012 DASPETAH
123 WIDIA LESTARI 6/7/2012 DASPETAH
124 VALIANT ZAKY 31--3-12 DASPETAH II
125 FREISYA ALYA PUTRI 5/18/2012 DASPETAH
126 CHIKO ARTA SANJAYA 1/12/2012 DASPETAH
127 JENDI ARIANDY 4/11/2012 PG BERINGANG
128 PANCA PRANATA 9/17/2010 DASPETAH
129 DWI MARKELA 2/22/2011 DASPPETAH
130 FAHRI AL HADY 3/12/2012 PG BERINGANG
131 FEBRI 2/17/2012 DASPETAH
132 RAHELTA JULIYANTI 12/1/7011 DASPETAH
133 ASYIFHA SYAHRIAL 5/31/2012 DASPETAH
134 MIRANDO ARDIANSYAH 2/9/2012 DASPETAH II
135 ERICA ELIYANA 10/24/2012 DASPETAH
136 LODRIK 5/22/2012 PG BERINGANG
137 RAISA TUL JANNA 6/17/2012 DASPETAH II
138 SEFTIAN PRATAMA 9/26/2012 DASPETAH
139 SANIA AURILIA 5/20/2012 DASPETAH II
140 DEMIAN GENKUBA DIOS 9/27/2011 DASPETAH
141 MUHAMMAD ADLI ALFAR 4/4/2012 DASPETAH
4C 142 RISSKHY APRIANDO A 3/29/2013 DASPETAH
143 RASYID MUBARAK 1/3/2013 DASPETAH
144 NUGI ARGA ANUGRA 7/24/2012 DASPETAH II
145 NADILAM ALKIANE 2/29/2012 DASPETAH II
146 MUHAMMAD AKBAR DWI 6/15/2012 PG BERINGANG
147 MIRZAN PRATAMA RA 8/6/2012 DASPETAH
148 MAYZEL VIZELA VILY 6/14/2012 DASPETAH
149 DIAN MUSTIKA 11/29/2011 DASPETAH
150 DESTIANA MUTIARA 12/19/2011 PG BERINGANG
151 AURA DWI VALENTINE 2/7/2012 DASPETAH II
152 DEA LOVA DWI NATALI 6/10/2012 DASPETAH
153 NADIN AFRIANTI 8/14/2011 DASPETAH
154 ALQEANO JULLYAN AN 8/21/2012 DASPETAH II
155 MEYZYA AURORA SUT 3/12/2012 DASPETAH
156 RELTA AYU PANGESTU 3/15/2012 DASPETAH
157 PARENDRA 9/16/2012 DASPETAH
158 NUGI ANUGRAH 3/21/2012 DASPETAH
159 RATI PUSPITA SARI 11/14/2011 DASPETAH II
5A 160 JESICA REGINA PUTRI 10/5/2011 DASPETAH
161 ERLIN NATANIA SAKITA 4/26/2011 DASPETAH
162 AYU OKTAVIA 11/29/2011 DASPETAH
163 FEBRIIAN 5/29/2011 PG BERINGANG
164 ANDIKA PUTRA PRATA 6/13/2008 DASPETAH
165 DENADA 4/16/2011 DASPETAH
166 ARTA AULIYA 3/13/2011 PG BERINGANG
167 ERMA ADIJA VENO 6/24/2010 DASPETAH II
168 ARTA DAVA WIJAYA 10/30/2011 DASAPETAH
169 SAHIRA ANINDITA 7/3/2011 DASPETAH
170 ANDRI WINATA 8/19/2011 PG BERINGANG
171 SEPTA 3/11/2011 PG BERINGANG
172 NAJWA AZZAHRA 7/26/2011 PG BERINGANG
173 AGIT RAGIL PRATAMA 6/16/2011 DASPETAH
174 ABI YUDA RAMADHAN 8/4/2011 DASPETAH
175 OKTA NAZERO 10/8/2009 DASPETAH
176 ULAN RAYA 8/30/2011 PG BERINGANG
177 DEDI ANGGARA 2/13/2010 DASPETAH
5B 178 ACHA MAHARANI 3/21/2011 PG BERINGANG
179 AMASYA DEWA ALFIRA 5/5/2011 DASPETAH
180 ARIL PRASATIYO 2/3/2010 DASPETAH
181 CHELSI OLIVIA 9/16/2011 DASPETAH
182 DAFA ALFARO 12/13/2011 DASPETAH
183 ADIL PRATAMA 11/12/2011 PG BERINGANG
184 ILHAM KURNIAWAN 5/15/2011 DASPETAH
185 GISEL QWINZI OKTAVIA 10/22/2011 DASPETAH
186 KHEISYA ANGGRAINI 10/6/2011 DASPETAH
187 LORENSI CAPELA 1/15/2011 PG BERINGANG
188 NAJIB TIO ALBARIQ 4/23/2011 PG BERINGANG
189 FADIL ADHA 11/28/2009 PG BERINGANG
190 FELITA HATI 1/13/2011 PG BERINGANG
191 RAKA ADITIA 10/31/2011 DASPETAH
192 SEPTA MAURIN 9/25/2011 PG BERINGANG
193 VITA DWI SEPTIA 9/11/2011 DASPETAH
6A 194 ADE RELIN GUSTINI 8/7/2009 DASPETAH
195 APRILIA NABILA 4/28/2010 PG BERINGANG
196 ANGGA SAPUTRA 9/19/2009 DASPETAH
197 AYU SAFITRI 10/25/2010 DASPETAH
198 BIANKA AURORA 9/20/2009 DASPETAH
199 DEFRIL ADITIO 6/13/2010 DASPETAH II
200 DIO PERO HESA 7/22/2010 DASPETAH II
201 ENJEL SUTIYAWATI 1/3/2010 DASPETAH
202 FINO SAPUTRA 7/27/2009 DASPETAH
203 JUL HARYANTO 11/7/2008 DASPETAH
204 LEO PRATAMA 9/15/2010 PG BERINGANG
205 LIRA ANJANI 1/22/2011 DASPETAH
206 MARSEL 1/10/2010 DASPETAH
207 MUHAMMAD RAFEL 7/2/2010 DASPETAH
208 OKTA TALIA 10/7/2010 DAS\PETAH
209 RAFLI ANGGARA 6/7/2010 DASPETAH
210 SAFIRA AZAHRA 10/16/2010 DASPETAH
211 RASYAH ABDILLA 4/25/2010 DASPETAH
212 SAPKI SAPIRA 4/5/2010 DASPETAH
213 WARSI DEVA 2/12/2010 DASPETAH
6B 214 AKILLA ADITYA 9/20/2010 DASPETAH II
215 RISA MAWARNI 11/26/2007 PG BERINGANG
216 RIFKI PEBIYANSA 11/4/2009 DASAPETAH
217 REPAL DIOBAGITE 4/11/2011 PG BERINGANG
218 PEBI YANTOSI 3/11/2010 DASPETAH
219 NADYA DHARMA LESTA 5/12/2010 DASPETAH
220 MUHAMMAD RIZKY SIN 6/18/2010 DASPETAH
221 MELATI FEBRIYANI 2/1/2010 PG BERINGANG
222 JONA JULIANTONI 8/14/2010 DASPETAH
223 JOKO SUPRIADI 3/23/2009 DASPETAH
224 GUSTIANA RAMADANI 8/12/2010 PG BERINGANG
225 GERRI AMARSIL PRAT 3/27/2010 PG BERINGANG
226 FICKO 4/2/2010 DASPETAH
227 DIA PITA HESA 7/22/2010 DASPETAH II
228 ANDIKA PRATAMA 6/23/2009 DASPETAH
229 VINGKI DWI AMORA 6/18/2010 DASPETAH
230 RENITA 4/3/2010 PG BERINGANG
231 WIZY APRILIA 4/30/2010 DASPETAH
232 MUHAMMAD REHAN 10/25/2010 PG BERINGANG
233 MUHAMMAD ALIF AUFA 7/12/2010 DASPETAH
234 IKBAL DWI SAPUTRA 2/25/2010 PG BERINGANG
235 HAFIZAH BINTANGN B 12/2/2009 PG BERINGANG
236 PEBRI 2/15/2010 PG BERINGANG
237 AZZA TAZIA FADILAH 9/23/2010 DASPETAH
238 ARIL ANGGARA 4/16/2009 DASPETAH II
239 DEVITA SARI 6/26/2010 DASPETAH
240 LORINDA
241 FINA NAILATUL IZZAH 2/17/2010 DASPETAH
14 OCTA PRANATA 10/10/2014 PG BERINGANG
236 TASIA ALSIPA 11/4/2009 UJAN MAS BAWAH
221 ELA YUPITA 7/21/2010 DASPETAH
213 AYU PEZA LESTARI 7/30/2010 DASPETAH
195 ZAKILA BALQIS 3/4/2011 DASPETAH
157 NISYA TRI FEBBY INDR 1/29/2012 DASPETAH II
135 SAPIRA APIPA RAHMA 5/10/2012 PG BERINGANG
129 PITO PRANSISKO 4/7/2012 PG BERINGANG
86 RISKI PARIANSYAH 2/13/2013 DASPETAH
74 RIFKY AZKA PRATAMA 7/17/2014 PG BERINGANG
48 HEN IPUSPITASARI 14-Jun-13 DASPETAH
51 ARINI 23-Jul-12 PG BERINGANG
2C 65 DELSI AYU NINGTIAS 7/8/2014 PG BERINGANG
69 ADITYA 3/13/2013 DASPETAH
71 SILFA ASIKA 7/29/2014 DASPETAH
25 NAWRAH 12/27/2014 DASPETAH II
41 DAFA AFRI 1/16/2013 DASPETAH
5 DIVA LORENZOE 4/14/2015 DASPETAH
35 YUNITA ENJELINA 11/12/2014 DASPETAH
13 RESTI ANJANI PUTRI 8/27/2014 DASPETAH
172 RIDHO ALFIANSYAH 8/21/2011 DASPETAH
168 ZILVIA ANNISA PUTRI 11/2/2011 DASPETAH
UPT PUSKESMAS RAWAT INAP UJAN MAS
VAKSINASI COVID-19
13 JANUARI 2022
MIN 04 DASPETAH

SINOVAC
DOSIS 1 DOSIS 2 DOSIS 1

PENDIDIK

PENDIDIK
REMAJA
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

BUMIL
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ARI 2022
SPETAH
COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
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DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
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LANSIA
ASTRA
DOSIS 2
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M.UMUM

DOSIS 2
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PUBLIK
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M.UMUM
DOSIS 1

PENDIDIK
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LANSIA
PUBLIK
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BUMIL
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M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA SINOVAC
PUBLIK

M.UMUM
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PENDIDIK

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LANSIA
28 OKTOBER 2021

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PENDIDIK
JUMLAH
32155BA

NO NAMA TGL LAHIR ALAMAT

KLS 1A 1 AJIRNA DWI PERMATA 29-Sep-14 UJAN MAS ATAS


2 AMELIA LEONI RAMADHANI 18-Jun-15 UJAN MAS ATAS
3 ARKA TIAGA DIPIARUPA 15-Nov-14 UJAN MAS ATAS
4 BINTANG DWI PUTRI 30-Jul-14 UJAN MAS ATAS
5 CINTA APRILIA 5-Apr-15 UJAN MAS ATAS
6 DEA SALSABILA 29-Nov-14 UJAN MAS BAWAH
7 DESTIANA DEWI NURKHALBY 6-Dec-14 UJAN MAS ATAS
8 DEVIN OKTAVIAN 12-Aug-14 UJAN MAS BAWAH
9 FIONA STEFANIE 17-Sep-14 UJAN MAS ATAS
10 JESIKA ALFIRA 7-Nov-14 SURO BARU
11 JULIO RAMADHAN 8-Jul-14 UJAN MAS ATAS
12 LATIFAH DWI PUTRI 19-May-14 UJAN MAS ATAS
13 NIKO ANJAS SANTARA 13-Oct-14 UJAN MAS ATAS
14 NOVITA SARI 8-Sep-14 UJAN MAS ATAS
15 RIZKY ZEVANO ALVERO 14-Mar-15 UJAN MAS ATAS
16 SPINKI BIGTRI PANA 9-Jan-15 UJAN MAS ATAS
17 VIKO HARGIANTO 5-Jan-14 UJAN MAS BAWAH
18 WAHYU ANUGGRAH 10-Aug-14 UJAN MAS BAWAH
19 ZALFA MIKAILLAH 10-Jan-15 UJAN MAS ATAS
V1 20 MIRZA AULIA 16-Jul-14 UJAN MAS ATAS
V1 21 DEFIN ALFARIZI 13-Jan-15 UJAN MAS ATAS
V1 22 M. RIZKI ALFARIZI 20-Feb-15 UJAN MAS ATAS
V1 23 ERISKA DWI CHAIRUNNISA 15-Sep-14 UJAN MAS ATAS
V1 24 DEBI APRILIO 21-Apr-15 UJAN MAS ATAS
V1 25 MEIZANADILAH 12-May-15 UJAN MAS ATAS
26 ERINTIA VIRATAMI 25-Feb-15 UJAN MAS ATAS
27 NAFYA PUTRI MEISYA 5-May-15 UJAN MAS ATAS
KLS 1B 28 ABDUL AZIZ ALGANI 31-Dec-14 UJAN MAS ATAS
29 ABIDZAR AL-GHIFARI AKSA 3-Aug-14 UJAN MAS ATAS
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31 AKILAH ANGGRAINI 15-Jul-14 UJAN MAS BAWAH
32 ALIYANDO SYARIF 20-Oct-14 UJAN MAS BAWAH
33 ANDRE DIMAS PRAYOGA 2-Aug-13 UJAN MAS BAWAH
34 CIKA JEZIKA 22-May-15 UJAN MAS ATAS
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36 FARDHAN AKBAR ADITIANSYA 26-Dec-14 UJAN MAS BAWAH
37 FAUZAN ADITIA 17-Dec-14 UJAN MAS BAWAH
38 FERO AKIOSI 9-Feb-15 DASPETAH
39 FHADELIYA MAHARANI 7-Oct-14 UJAN MAS ATAS
40 KEILA BINTANG CANTIKA 4-Apr-14 UJAN MAS BAWAH
41 MARINKA PUTRI SIOBA 1-Apr-15 PUNGGUK BERINGANG
42 MELISA ADINDA SARI 20-May-15 UJAN MAS BAWAH
43 MUHAMAD PARHAN 13-Aug-14 UJAN MAS BAWAH
44 MUHAMMAD ALIF 31-Aug-14 UJAN MAS ATAS
45 PANJI YOGA ALIANDO 9-Dec-14 UJAN MAS BAWAH
46 RISKI ADITIA 17-Apr-15 UJAN MAS BAWAH
47 VIOLA GISELA QUINZA 1-Sep-14 UJAN MAS ATAS
48 KALVIN RIANSAH 12-Sep-14
49 KRISTINA BUNGA ADEL 15-May-14
V1 50 ARGAPRISKI DEWANTARA 10-Dec-14
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52 AGUSTRIA SAPUTRI 24-Aug-13 UJAN MAS ATAS
53 ALVIN SAPUTRA 20-Dec-13
54 ANABEL PARESKI 24-Jan-14 UJAN MAS ATAS
55 ANDARA LINTANG KIRANA 26-Apr-14 UJAN MAS ATAS
56 BAGAS JHONATANPUTRA MA 4-Jul-14 UJAN MAS ATAS
57 BULAN PURNAMA 14-Aug-13 UJAN MAS BAWAH
58 CELSIA OLIPIYA 23-Jun-14 UJAN MAS BAWAH
59 DEDE OKTA 9-Oct-13 UJAN MAS BAWAH
60 GARFEL ADEFIO 9-Jul-13 UJAN MAS BAWAH
61 GILANG TRI ABIZAR 21-Mar-14 UJAN MAS ATAS
62 KHEYSA AKILA 3-Aug-13 UJAN MAS BAWAH
63 MICHEL PUTRI LIONZA 26-May-14 UJAN MAS ATAS
64 NADIRAH MUSLIMAH 7-Jun-14 UJAN MAS ATAS
65 REDO RISKI 1-Nov-12 UJAN MAS BAWAH
66 SELA OKTAVIA 12-Oct-13 UJAN MAS ATAS
67 SINTA JANEPRA 12-Nov-13 UJAN MAS ATAS
68 WISNO AJI 29-May-14 UJAN MAS ATAS
V1 69 HENGKI 1-Jun-11 UJAN MAS ATAS
V1 70 YELSE MELATI 13-Jul-14 UJAN MAS ATAS
KLS 2B 71 ADELIA AMANDA 8-Dec-13 UJAN MAS BAWAH
72 AFIQAH ZAHRA 5-Nov-13 UJAN MAS
73 AMABEL ISDI ALEANO 2-Apr-14 UJAN MAS ATAS
74 AMELIA MELODI NOVERA 5-Nov-13 UJAN MAS ATAS
75 ANGGA SARI ABDUL RAZAK 7-May-14 UJAN MAS ATAS
76 BELA PUSPITA SARI 16-Jun-13 UJAN MAS ATAS
77 EKA SURYANI 12-Feb-14 UJAN MAS BAWAH
78 FIDELYA UZMA RAFIFA 21-May-14 UJAN MAS ATAS
79 JULI RHOMADONI 24-Jun-14 UJAN MAS ATAS
80 KELSI AFRILIA 16-Jul-14 UJAN MAS ATAS
81 KEYZA PUTRI MAHARANI 9-Mar-12 UJAN MAS BAWAH
82 MARTA ERLANGGA 19-Mar-14 UJAN MAS ATAS
83 MELODI AMELIA 1-Jul-14 UJAN MAS BAWAH
84 MUHAMMAD ALFAIZ 1-Mar-14 UJAN MAS ATAS
85 NAUFAL DIMATRI ALVARO 9-Jan-14 UJAN MAS ATAS
86 NIRMALA SARI 25-Feb-13 UJAN MAS BAWAH
87 QORIATUL FITRI 21-Dec-13 UJAN MAS ATAS
88 RAFAH AFRIANSYAH 14-Jun-14 UJAN MAS ATAS
89 RAMA DWI PUTRA 29-Sep-13 UJAN MAS ATAS
90 RENA DIANA 12-Aug-13 UJAN MAS ATAS
KLS 2C 91 ANDALA OKYO RIFKI 27-Oct-13 UJAN MAS ATAS
92 BILKIS NAIKA IRAWAN 17-Mar-14 UJAN MAS ATAS
93 DONA LORENZSA 14-Apr-14 UJAN MAS ATAS
94 DONI LORENZSO 14-Apr-14 UJAN MAS ATAS
95 INDA PERMATA SARI 4-Apr-14 UJAN MAS BAWAH
96 IWAN PALES 5-Jul-12 UJAN MAS BAWAH
97 LAUREN TRIA BELLA 12-Aug-13 UJAN MAS ATAS
98 MIA RAMADHANI 18-Jul-14 UJAN MAS ATAS
99 PRECILAH ADHI LOVA 24-Jun-14 UJAN MAS ATAS
100 RAVAEL PRATAMA 26-Nov-13 UJAN MAS ATAS
101 RESELAHELENDIA 20-Sep-13 UJAN MAS BAWAH
102 SELANDRA 29-Dec-13 UJAN MAS ATAS
103 VIOLA KENIA JUWITA 20-May-14 UJAN MAS BAWAH
104 YUDA PRATAMA 16-Oct-13 UJAN MAS ATAS
105 ZAKY RHAMADAN 22-Jul-13 UJAN MAS ATAS
106 SELVIAN DORIANA 23-Sep-13 UJAN MAS ATAS
107 DESTIAN ERLANGGA 4-Jun-13 UJAN MAS ATAS
V1 108 AIRIN BERLIAN 6-Dec-13 UJAN MAS ATAS
V1 109 RIKI SUSILO S 27-Feb-13 UJAN MAS ATAS
V1 110 RENO DWI ATMAJA 19-Jun-14 UJAN MAS ATAS
V1 111 SINDI ANGGREINI 11-May-14 UJAN MAS ATAS
V1 112 REPI RAMADHANI 29-Jun-14 UJAN MAS ATAS
KLS 3A 113 ADITIA PUTRA 1/22/2013 PUNGGUK BERINGANG
114 ANGGUN RISKY AYU 5/26/2013 UJAN MAS ATAS
115 AQILAH PUTRI MAHARANI 5/14/2013 UJAN MAS ATAS
116 ARENSI DIO LOOVA 12/10/2012 UJAN MAS ATAS
117 ARINA PRAMUDITA 12/10/2012 UJAN MAS BAWAH
118 AULYA SAFIRA 1/23/2013 UJAN MAS ATAS
119 BHELLA AFRIANI 4/30/2013 UJAN MAS ATAS
120 FAZA ZAKI ABISAR 5/25/2013 UJAN MAS
121 FEBIANSYAH 4/16/2013 UJAN MAS ATAS
122 HAFIZHA ALMIRA 6/2/2013 UJAN MAS ATAS
123 INDAH LESTARI 7/11/2009 UJAN MAS BAWAH
124 IQBAL HAFIZ FAHREZI 6/13/2013 UJAN MAS BAWAH
125 Jaka Andira 2011-09-26
126 PUTRI NAIRA RAHMATULLA 1/12/2013 UJAN MAS ATAS
127 REIHAN 2/3/2013 UJAN MAS
128 SALSA DWINKA ANJANI 7/9/2013 UJAN MAS ATAS
129 WESLEY SNEIJDER 4/22/2013 UJAN MAS ATAS
130 WISNU BIGUNA 5/19/2013 UJAN MAS ATAS
131 REFLES DION FABIO 1-Sep-12 UJAN MAS
132 ALPIANSYAH UJAN MAS
133 CINTHYA SHAVA L 18-Dec-12 UJAN MAS
134 AJI SAOUTRA 6-Nov-11 UJAN MAS
135 RAMA TRIO 16-Jan-13 UJAN MAS
136 ASYIFA SALSABILLAH 6-Jan-13 UJAN MAS
KLS 3B 137 AURA AFIFAH PUTRI 12/29/2012 UJAN MAS ATAS
138 AZAH ZANETA 4/20/2013 UJAN MAS BAWAH
139 AZEL DWI AVIVA 7/4/2013 UJAN MAS ATAS
140 BALQIS PUJA ISLAMI 6/20/2013 UJAN MAS BAWAH
141 FINZY MEIZA VIRGINIA 5/4/2013 UJAN MAS ATAS
142 KARISA 1/14/2013 DASPETAH
143 KEYLA PIONITA 9/15/2012 UJAN MAS
144 MUHAMMAD ALVINDRA 4/1/2013 UJAN MAS ATAS
145 NEZA AZZAHRA 9/28/2012 PUNGGUK BERINGANG
146 PRESILIAN PUTRI 3/29/2013 UJAN MAS ATAS
147 RAMI WULANSARI 1/16/2013 UJAN MAS ATAS
148 RARA SATI 10/1/2012 UJAN MAS ATAS
149 RINO GIBASTIAN 7/7/2012 SURO ILIR
150 RISAL ASRI 10/4/2012 UJAN MAS ATAS
151 SANDRINA FITRI 6/9/2013 UJAN MAS ATAS
152 TRISTAN 11/19/2012 UJAN MAS
153 VITRA ERLANGGA PRATAMA 5/4/2013 UJAN MAS
154 MUHAMMAD FIQRI ALGANI 12-Jun-12 UJAN MAS BAWAH
V1 155 MARSEL DARWIN 4-Dec-19 UJAN MAS BAWAH
V1 156 HAIKEL SUGIA S 15-May-13 UJAN MAS ATAS
V1 157 HAICKAL ANDREANO 4-Apr-13 DASPETAH
KLS 4A 158 ABBY ALDIANO 12/13/2011 KEPAHIANG
159 ABIB SEBASTIAN FERNANDO 11-Jun-12 KEPAHIANG
160 ADELIA DINATA 9/16/2012 UJAN MAS ATAS
161 AUREL AZHENA 12/4/2011 KEPAHIANG
SALAH NAMA D 162 BHYRLI CAPIOLA RAMADANI 8/30/2011 UJAN MAS
163 BUNGA CAHYANI 2/27/2012 UJAN MAS ATAS
164 CHICO ORMANDO 6/17/2012 KEPAHIANG
165 DELVIN OFHELIA 1/27/2012 UJAN MAS ATAS
166 DIKA GUSTI RAMADAN 8/20/2011 UJAN MAS ATAS
167 ENJEL FRISKILA 5/7/2012 KEPAHIANG
168 GLEN ALFIANSYAH 6/2/2011 UJAN MAS ATAS
169 HAFIS APRIYANDI 9/4/2011 KEPAHIANG
170 IKBAL NAPIOBA 3/23/2012 UJAN MAS ATAS
171 JAKA PRANATA 3/12/2012 UJAN MAS BAWAH
172 KARMILA 5/7/2012 UJAN MAS ATAS
173 LOLITA DELVIANA 12/21/2011 KEPAHIANG
174 M.SAID AGIL HUSEN AL MUN 8/4/2012 KEPAHIANG
175 MESIN 12/11/2012 KEPAHIANG
176 MUHAMMAD RIZKI PRANATA 2010-12-07 UJAN MAS ATAS
177 PATRA DESTIANO 11/20/2011 UJAN MAS ATAS
178 RAMADAN SAPUTRA 8/7/2012 KEPAHIANG
179 RIZKI ADE PIYO 7/8/2012 KEPAHIANG
180 SINTIA PUTRI LASTISYA 11/3/2011 KEPAHIANG
181 SITI RAHMAWANTI 3/25/2012 KEPAHIANG
182 TAUFIK HIDAYAT 2/23/2012 KEPAHIANG
183 THAMARA BLEZHINKY 5/15/2012 UJAN MAS BAWAH
V1 184 DIRGA RHICALDO 12/14/2011 TABA TEBELET
V1 185 DIRZI SILVANA P 12/14/2011 TABA TEBELET
KLS 4B 186 ADA YAYA SURYANI 1/17/2012 REJANG LEBONG
187 ADELIA PUTRI 7/24/2011 DASPETAH
188 ADITIA PRATAMA 1/19/2012 KEPAHIANG
189 ADO RESKI IYO 2/27/2012 KEPAHIANG
190 AISYAH DWINOVA 12/16/2011 UJAN MAS ATAS
191 ALDO WJAKSONO 6/19/2011 UJAN MAS ATAS
192 APRIANSYAH 4/4/2012
193 DIANA ANATA 1/1/2012 KEPAHIANG
194 DIVALDI ADITIYA 5/14/2012 KEPAHIANG
195 ELAN PRATAMA 11/23/2011 UJAN MAS ATAS
196 FAUZAN RAJA PRANATA 5/22/2012 KEPAHIANG
197 FITRI MARYANI 9/5/2011 DASPETAH
198 HANIFA RACHELIA 3/11/2012 UJAN MAS ATAS
199 IRFAN SUMANTRI 10/31/2011 UJAN MAS ATAS
200 M.FADEL DARMAWAN 9/16/2011 REJANG LEBONG
201 MARSHA DELA AMANDA 3/2/2012 DASPETAH
202 MESA ARAPA 10/3/2012 KEPAHIANG
203 MUHAMMADA FAHRI ALFARE 2011-10-20 UJAN MAS ATAS
204 NADIA ANJELINA 8/19/2012 KEPAHIANG
205 NESA AGNESIA 1/17/2011 KEPAHIANG
206 PAREL ALISKI 11/21/2011 DASPETAH
207 RACHEL ERSI 7/10/2012 KEPAHIANG
208 RASTI AFITRI 10/27/2011 UJAN MAS
209 REHANDO PRAYOGA 1/29/2012 KEPAHIANG
210 REVANDO 7/15/2012 KEPAHIANG
211 SAKIRA OLIVIA 4/2/2012 KEPAHIANG
212 SELFI ANGGRAINI 9/10/2011 UJAN MAS ATAS
213 VIOLA BAGITE 8/25/2012 KEPAHIANG
214 RIVALDI ADITIYA
215 ANDIN SUGARA 8/16/2011 UJAN MAS ATAS
KLS 5A 216 ALIZA SARTIKA 2011-04-14 UJAN MAS ATAS
217 ANANDA BALQIES 2010-11-14 DASPETAH
218 ANDREAS GUNAWAN 2010-09-21 UJAN MAS ATAS
219 ARLANGGA SATRIAWAN 2011-01-13 UJAN MAS ATAS
220 AZRIL ADAM YUSUF 2011-04-14 KEPAHIANG
221 BINTANG JAMASTA 2011-01-31 UJAN MAS
222 CLAUDYA 2012-05-01 UJAN MAS ATAS
223 HIKMATUL RAHMA WATI 2011-08-03 UJAN MAS BAWAH
224 IRPAN SAPUTRA 2010-12-12 UJAN MAS ATAS
225 KEFIN SASMITA 2011-04-10 UJAN MAS ATAS
226 KLARA REGISTA PUTRI 2010-08-04 KEPAHIANG
227 KOKA YOBA 2011-06-08 UJAN MAS ATAS
228 LAURA SHAKIRA 2012-05-12 UJAN MAS BAWAH
229 MISEL GABRELA 2011-05-30 KEPAHIANG
230 NIKITA ANJELI FINTALOKA 2012-01-28 UJAN MAS BAWAH
231 OZIL DEVISCA 2011-06-09 UJAN MAS ATAS
232 RATU FELICIA 2010-12-26 DUSUN KEPAHIANG
233 REPANDO ADE PIO 6/12/2009 UJAN MAS ATAS
234 RISKI ARGA ANUGRAH 2012-06-15 UJAN MAS ATAS
235 RISQI HARLIYANTO 2012-04-09 PEKALONGAN
236 RISKI KURNIAWAN 2012-01-22 UJAN MAS ATAS
237 SESIL CLARA ADELIA 2010-12-15 UJAN MAS BAWAH
238 SUSAN SINORA 2012-09-08 UJAN MAS ATAS
239 TANIA ALIPIA 2011-04-16 KEPAHIANG
240 TIARA INTAN SUTHREE 2011-03-30 DASPETAH
241 TIARA YOLANDA 2010-10-10 UJAN MAS BAWAH
242 WINDI ULANDARI 2/4/2011 KEPAHIANG
V1 243 BIMA AGRESIA 6/26/2011 UJAN MAS BAWAH
KLS 5B 244 Adelia Giovani 2011-07-27 BANDUNG BARAT
245 Agus Ramdansah 2011-08-11 UJAN MAS BAWAH
246 Alpin Aditia 2010-05-17 SURO LEMBAK
247 Amelia Fransiska 2011-04-12 UJAN MAS ATAS
248 Aprilia Salsabila 2011-04-11 UJAN MAS ATAS
249 Arga Saputra 2011-08-02 UJAN MAS BAWAH
250 Aulia Zahra Putri 2011-03-23 UJAN MAS ATAS
251 Aurel Ziva Anugrah 2011-03-14 KEPAHIANG
252 Azrul Muhammad Yusuf 2011-03-14 KEPAHIANG
253 Bagas Khotibul Umam 2011-07-28 UJAN MAS ATAS
254 Deca Sasmita 2011-06-26 UJAN MAS BAWAH
255 Enjelita Filiani 2011-03-24 UJAN MAS ATAS
256 Evlin Indah Kirana 2011-05-17 UJAN MAS ATAS
257 Fadel Aditia 2011-02-04 UJAN MAS ATAS
258 Fatrah Aka Abdullah 2010-10-10 UJAN MAS
259 Marcel Aditia 2011-05-09 UJAN MAS ATAS
260 Mareza Purnama Sari 2011-03-21 UJAN MAS ATAS
261 Mijen Adepio 2010-11-15 UJAN MAS ATAS
262 Nikola Ananta 2011-12-28 KEPAHIANG
263 Rangga Saputra 2011-03-10 KEPAHIANG
264 Repi Aryanti Lestari Putri 2011-03-09 UJAN MAS ATAS
265 Resi Wolanda 2009-05-26 UJAN MAS
266 Revaldi Naufal Oktriansyah 2011-10-06 DURIAN DEPUN
267 Satrio Pratama 2011-01-23 PUNGGUK MERANTI
268 Tara Ramandika 2010-08-12 UJAN MAS ATAS
269 Zindra Alzeo Degopal 2011-05-10 UJAN MAS ATAS
270 RANDI WIJAYA 7/26/2010 UJAN MAS ATAS
271 AFREL OKI MEISANDI 5/17/2010
272 AMIRA KHAIRUNNISA 3/30/2011
KLS 6A 273 AGUNG NAZZRIL ALFA REZI 10/26/2010 UJAN MAS BAWAH
274 AHMAD DARUL 6/25/2010 UJAN MAS ATAS
275 AMANDA FIORENSIA 11/17/2009 UJAN MAS ATAS
276 BAGUS AJI SATRIA 5/1/2010 UJAN MAS ATAS
277 BINTANG AULIA PUTRI 6/11/2010 UJAN MAS ATAS
278 CARLES ADETIA 3/20/2010 UJAN MAS BAWAH
279 DERA CANDRA WINATA 4/2/2010 PELANGKIAN
280 ERMA MARSELA
281 FIRZI ALFARICHI
282 IMELDA SINTIA FITRI 9/20/2010 UJAN MAS BAWAH
283 INDAH PURNAMA SARI 10/30/2009 UJAN MAS ATAS
284 JENI PEBRIYANTI 1/26/2010 KEPAHIANG
285 KEIZIA MAHARANI PUTRI 5/2/2010 JAMBI
286 LESA SUSANTI 24-122009 UJAN MAS
287 MAICEL ZERO 4/20/2010 UJAN MAS ATAS
288 MUHAMMAD ILHAM ARYA 12/2/2009 UJAN MAS ATAS
289 NOVELIA SANDRA PRATIWI 11/21/2009 UJAN MAS ATAS
290 PADILLAH 5/1/2010 UJAN MAS BAWAH
291 PANJI GUSTI WIJAYA 8/16/2009 CURUP
292 RAKA MEISAPUTRA 5/26/2010 UJAN MAS ATAS
293 SEPTI FITRIA AMBARWATI 9/26/2009 UJAN MAS
294 tarmizi
295 TASYA ADETIA LOKA 7/22/2010 UJAN MAS ATAS
296 YOGA DARMAWAN
297 ZAKI KRISTIAN 5/23/2010 KEPAHIANG
KLS 6B 298 ADITYA ALFAHSA 4/3/2010 DASPETAH
299 ARIL PRANATA 9/25/2009 UJAN MAS BAWAH
300 BELA MANORI 3/16/2010 UJAN MAS ATAS
301 BINTANG OKTAVIA 7/23/2010 UJAN MAS BAWAH
302 BUNGA FATHIA LESTARI 12/28/2010 UJAN MAS ATAS
303 CINTA KIRANA 4/8/2010 UJAN MAS BAWAH
304 JEFRI ANUGRA HIDAYAT 7/1/2010 DASPETAH
305 JENNI SASMIKA 7/18/2010 KEPAHIANG
306 KESA NABILA 6/16/2010 UJAN MAS ATAS
307 KESI AULIA 8/1/2009 UJAN MAS BAWAH
308 LIDIA 9/6/2009 UJAN MAS ATAS
309 MEISARA 5/12/2010 UJAN MAS
310 NABILA SOFIA 2/25/2009 UJAN MAS ATAS
311 NADIA FITRI 9/19/2009 UJAN MAS BAWAH
312 NOPRAN PRAYOGA 9/29/2010 UJAN MAS ATAS
313 PEMA NIKO SAPUTRA 1/24/2010 UJAN MAS ATAS
314 REDO SAPITRA 9/23/2009 UJAN MAS
315 SEGI PRAYOGA 8/2/2009 UJAN MAS
316 SEMI PRANATA 3/22/2010 UJAN MAS ATAS
317 TIA SARI 10/3/2009 UJAN MAS BAWAH
318 VELZI RAMADANI 9/3/2009 DASPETAH
319 YONA RAHMA AYU 11/27/2009 UJAN MAS
320 YOSRI YOSITA 2/22/2010 UJAN MAS BAWAH
321 RANDA GUNAWAN SUGIANSA 11/18/2009 UJAN MAS ATAS
322 RIZKI ADE PIYO SINE 4/29/2010 UJAN MAS ATAS
323 ANDINI PUSPITASARI 7/25/2010 UJAN MAS ATAS
V1 324 PERDIAN 6/12/2008
6C 325 PRENGKI ADI PRATAMA 11/5/2009 UJAN MAS ATAS
326 ALDI TIO PRATAMA 5/27/2010 SURO ILIR
327 AMANDA KRISTA LOVANI 8/16/2010 KEPAHIANG
328 AMELIA RAMADANI 9/9/2008 CURUP
329 ARMANSA PARHAN AGUSTIN 8/7/2008 UJAN MAS ATAS
330 ARYA ANUGRA SAPUTRA 4/17/2010 UJAN MAS ATAS
331 AULIA RAHMADANI 8/20/2010 UJAN MAS ATAS
332 Darrell Zakhwan Suyitno Putro 2010-05-15 SEMARANG
333 DORA OKTARINA 10/10/2009 UJAN MAS ATAS
334 FADIL VADILA 8/31/2010 UJAN MAS
335 FITRAH YOBA OKTAVIO 10/1/2009 DASPETAH
336 FRETI INDAH AURELIA 6/14/2010 UJAN MAS
337 INDAH OKTAVIA PUTRI 10/23/2009 UJAN MAS ATAS
338 IQBAL AL-SOBRI 6/4/2010 UJAN MAS
339 KEYLIN AHLAL MARGARETA. P 9/18/2010 UJAN MAS ATAS
340 MEYCHA WILIARDHY 12/16/2009 DURIAN DEPUN
341 MIFTAHUL NINDI HAIRUNISA 11/21/2009 UJAN MAS ATAS
342 NINDI AULIA 8/11/2010 UJAN MAS ATAS
343 OCHA PUTRI ANSORI 11/21/2010 UJAN MAS ATAS
344 PAREL 1/2/2010 KEPAHIANG
345 REGINA PUTRI DIOPA 7/14/2010 UJAN MAS ATAS
346 SOPI LUTPIA 5/15/2010 UJAN MAS
347 WULAN JELITA 5/5/2010 SURO ILIR
348 YOLAN VIONA 2/20/2010 UJAN MAS BAWAH
349 REHAN ALDINATA 2010-08-13 UJAN MAS BAWAH
350 YOGA NOPITASARI 4/27/2010 UJAN MAS ATAS
351 FIDIAN ORANAKA 10/31/1978 AIR PUTIH
352 KEYCA KIRANA 5/5/2008 DASPETAH
353 RAKA ERLANDO D.M 3/11/2012 UMA
354 AKENO KAZIM (dr.ken) KEPAHIANG
|

21 DOSIS 1
311 DOSIS 2
332 TOTAL YANG DI SUNTIK

47 CAHAYA MURNI 3/4/1977 SURO MUNCAR


UPT PUSKESMAS RAWAT INAP UJAN MA
VAKSINASI COVID-19
05 JANUARI 2022
SD 06 UMB

SINOVAC
DOSIS 1 DOSIS 2
NIK NO HP

REMAJA
M.UMUM

M.UMUM
PENDIDIK

PENDIDIK
NAKES

ANAK
REMAJA
LANSIA

LANSIA
PUBLIK

PUBLIK
BUMIL

BUMIL
NAKES

ANAK
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1
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1
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0 0 0 0 21 0 0 0 0 0 1 1 309
21 311

1708024403770004 #REF!
6 UMB
UARI 2022
SI COVID-19
NAKES
LANSIA
PUBLIK
BUMIL
AWAT INAP UJAN MAS

DOSIS 1
M.UMUM
PENDIDIK
REMAJA
PFIZER

LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
ASTRA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
332
0

###
LANSIA

ASTRA
PUBLIK
BUMIL

DOSIS 2
M.UMUM
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
SINOPHARM

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA
DOSIS 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

26 62 2

3 3
0
PUBLIK

M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
NO NAMA TGL LAHIR ALAMAT

KLS 1A 1 RASELIA HUMAIRAH 5/12/2015 DASPETAH


2 ZASKIA HARIYANTI 11/17/2014 DASPETAH
3 ZILKY DANUARTA 6/6/2015 PG BERINGANG
4 MUHAMMAD AZIS AL FA 12/19/2014
5 HAFIZAH SHEZA ALYA 7/29/2015
6 DILSI AULIA 5/28/2015 DASPETAH
7 RAZIA ANUGRAH 2/8/2016 PG BERINGANG
8 AHMAD TAUFIQ 5/6/2015 PG BERINGANG
9 NIKEN ANJANI 12/2/2014 PG BERINGANG
10 YANTI 12/15/2013 PG BERINGANG
11 RIDO HIDAYAT 5/31/2015 DASPETAH
12 BILLY SAPUTRA 12/5/2014 PG BERINGANG
13 KEYLA DIOPA AZARA 3/19/2015 DASPETAH
KLS 1B 14 ADELIA 9/8/2014 DASPETAH
15 NABILA SYAFITRI 7/18/2015 DASPETAH
16 FEBRI ADRIANSYAH 3/27/2015 PG BERINGANG
17 ZAHRA AFRILIA 4/12/2015 UJAN MAS BAWAH
18 RIVALDO 5/5/2015 DASPETAH II
19 MUHAMMAD DZAKI ALM 2/4/2015 DASPETAH
20 AKBAR GIBRAN ALVAR 7/27/2015 DASPETAH
21 FAZLI GAVIN RAMADHA 7/5/2014 DASPETAH
22 TOMAS ALFA EDISON 9/4/2014 PG BERINGANG
23 DENIS BA'ADILLAH 1/30/2014 DASPETAH
24 RESTI SULISTIA 12/6/2014 DASPETAH II
25 ALFARO FRENDIKA 7/5/2015 DASPETAH
26 MARZA AULIA TUZZOL 1/11/2015 DASPETAH
27 RIPANDO SAPUTRO 8/8/2014 DASPETAH
28 NADIRA AULIA SONATA 4/21/2015 PG BERINGANG
29 AQILA NAHDA RAFAND 9/16/2014 DASPETAH II
30 RESTA KAMAYA SARI 8/27/2014 DASPETAH
V1 31 NAWRAH 12/27/2014 DASPETAH II
32 YUNITA ENJELINA 11/12/2014 DASPETAH
V1 33 VEFANIA DASPETAH
KLS 2A 34 SEPTA GALAS FERNAN 8/19/2013 DASPETAH
35 CENS ANDRAINI 11/13/2013 DASPETAH II
36 YUDA RAMADHAN 7/22/2013 DASPETAH
37 SALSABILA FEBRIANI 3/26/2014 DASPETAH
38 ADE FINA RASTI 3/27/2014 DASPETAH
39 AYU DEWI 3-Feb-13 DASPETAH
40 SUTAN MUHAMMAD PAI 8/12/2014 DASPETAH
41 BILQIS SAFIRA MADON 3/31/2014 PG BERINGANG
42 AKBAR SENO PATI 1/27/2014 PG BERINGANG
KLS 2B 43 AQILLAH SHEKA AZAH 4/22/2014 DASPETAH
44 ARIL SUGIARTO 3-Oct-13 DASPETAH
45 ALDOH ALVARO 9/7/2013 DASPETAH
46 MUHAMMAD PADIL LO 10/17/2013 DASPETAH II
47 AFGAN ANUGRAH 22-Feb-14 DASPETAH
48 NOVRA DINATA 11/3/2013 DASPETAH
49 ANDIKA 4/30/2012 DASPETAH
50 ANDRA PUTRA ALMAEN 31-Dec-13 DASPETAH II
51 LARA SATIH 9/26/2014 PG BERINGANG
52 ZAKI RAMADHAN 7/23/2013 PG BERINGANG
53 LOVIS NAFOLIUS 4/19/2014 DASPETAH
54 ARGA RAMDHAN 7/23/2014 DASPETAH II
55 EFRI DWI ANGGRAINI 11/10/2013 DASPETAH
56 ANGGI SRI SUMARNI 6/24/2012 DASPETAH
57 TYO PUTRA BUDI PRA 2/27/2014 DASPETAH
58 FAUZIYAH IZZATUNNIS 10-Feb-14 DASPETAH
V1 59 FEBRI YANTO DASPETAH
V1 60 ICHA DESVIANTI 30-Dec-13 DASPETAH
V1 61 ARINI 23-Jul-12 DASPETAH
V1 62 PELISA PRATAMA 16-Jan-14 DASPETAH
KLS 2C 63 ALINDA 5/7/2014 PG BERINGANG
64 PADILLAH RAHMADANI 8/4/2013 DASPETAH
65 IVANK FABIAN RAMADA 7/12/2013 DASPETAH II
66 DIOBA MUHAMMAD ALRI 16-Mar-14 DASPETAH II
67 SAKHA ADISATYA ATAL 5/7/2014 DASPETAH
68 FLORA FERONICA 1/25/2015 DASPETAH
69 CHARLES PRANATA 11/14/2013 DASPETAH
70 CARLES DIRHAM FEBRI 2/2/2014 DASPETAH II
71 RAHEL OKTO SARAMA 10/21/2013 DASPETAH
72 IKBAL FAUZAN DIANPA 4/26/2014 DASPETAH
73 ENJELLINA 6/21/2014 DASPETAH
V1 74 MOZA ZALIKA DASPETAH
KLS 3A 75 ALFIN KAYRO AGUSTIA 5/26/2013 PG BERINGANG
76 ANUGRAH RAFA FADIL 11/18/2012 DASPETAH
77 INTAN PERMATA SARI 11/12/2012 PG BERINGANG
78 MUHAMMAD RIFAEL DO 2/16/2013 PG BERINGANG
79 MUHAMMAD LEANDRO 4/25/2013 DASPPETAH
80 RIA FITRIA 2/3/2013 DASPETAH
81 TARA ABABIL 6/29/2012 DASPETAH
82 VINA NOVITA SARI 10/23/2013 DASPETAH
83 KHELZA FANY ABIFA M 10/23/2013 DASPETAH
V1 84 SUNDARI 5/25/2013 DASPETAH
V1 85 YUDA AZIA 11/8/2012 DASPETAH
V1 86 ZEIN SEPTIAN 9/4/2013 DASPETAH
V1 87 INGKAH ENJEL PUTRI 3/23/2013 DASPETAH
KLS 3B 88 NANDA SATRIA 1/18/2013 DASPETAH
89 ARAFAH FATRIATUL AK 1/3/2013 DASPETAH
90 PRISILIA UILANDARI 2/15/2013 DASPETAH
91 DWI INGGA AFRILIA 3/6/2013 DASPETAH
92 LESI MARCELIA 27-Jun-13 DASPETAH
93 AMIRA NATASYA 4/15/2012 DASPETAH
94 RAFFA AFRIANSYAH 4/16/2013 DASPETAH
95 DECKO PRASETYO 11/30/2012 DASPETAH
96 TIYANSI HERLINA 6/27/2012 PG BERINGANG
97 BELA BIANKA KINARA 5/11/2013 DASPETAH
98 GHITA KHEYREN PATT 8/5/2013 DASPETAH
99 DEYGO MARSELO 6/18/2013 PG BERINGANG
100 REFIN ARDIANSYAH 10/6/2011 DASPETAH
KLS 3C 101 KRISTI VIONA 8/30/2013 DASPETAH
102 ZASKIA TANI APUTRI 10/8/2012 PG BERINGANG
103 NABILLA OKTAVIAN NIS 11/2/2013 DASPETAH II
104 ANGGEL HAJALIA 11/12/2012 PG BERINGANG
105 AGUNG WAHYI HIDAYA 1/13/2013 DASPETAH II
106 AURELIN BELFANIA 6/8/2013 DASPETAH
107 AZI JANUARDI 1/19/2012 DASPETAH II
108 SELVI SANTIKA SARI 5/13/2013 DASPETAH
109 GALEH NUGROHO 2/2/2013 SURO LEMBAK
110 KHEIRA HADZAL YAUUM 4/2/2013 DASPETAH
111 ANGGA WIJAYA 11/4/2011 UJAN MAS ATAS
112 AMANDA AYU PRATIWI 4/23/2013 DASPETAH
113 THORIQ FHADILLA ALF 4/5/2013 DASPETAH
114 ELFREDO RENALDO 7/20/2012 DASPETAH
115 DENIS DIANTARA 5/10/2011 PG BERINGANG
116 RASYAH NABILA 11/12/2012 DASPETAH
KLS 4B 117 FEBRIAN SAKINA 2/1/2012 PG BERINGANG
118 ALIF PAHREJA 11/8/2012 DASPETAH
119 ABDAL RAMADHAN 7/19/2012 DASPETAH
120 AKBAR ALGHI FAHRY 9/4/2012 DASPETAH II
121 TIARA 3/27/2013 DASPETAH
122 NAULI TUFFAHATI HAR 12/12/2011 DASPETAH
123 SIREN DWI ARIYANTI 9/18/2012 DASPETAH
124 MUHAMMAD AJIS AL P 2/22/2012 DASPETAH
125 DAFIZAH ANATASYYAH 7/7/2011 DASPETAH II
126 DIKA 2/19/2013 DASPETAH
127 FALENTA DWI APRILIA 4/17/2012 PG BERINGANG
128 TARA FEBYOLA 4/16/2012 DASPETAH
129 JESIKA SAKINA 9/19/2012 DASPETAH II
130 GISELA NATASYA PUTR 10/4/2012 DASPETAH
131 MEZZY AURELYA ANDJ 5/9/2012 PG BERINGANG
132 AZIZAH BIBIT SOEHAR 1/10/2013 DASPETAH
133 REBI ADIZAH ARKANA 1/14/2012 DASPETAH
134 WIDIA LESTARI 6/7/2012 DASPETAH
135 VALIANT ZAKY 31--3-12 DASPETAH II
136 FREISYA ALYA PUTRI 5/18/2012 DASPETAH
137 CHIKO ARTA SANJAYA 1/12/2012 DASPETAH
KLS 4A 138 JENDI ARIANDY 4/11/2012 PG BERINGANG
139 PANCA PRANATA 9/17/2010 DASPETAH
140 DWI MARKELA 2/22/2011 DASPPETAH
141 FAHRI AL HADY 3/12/2012 PG BERINGANG
142 FEBRI 2/17/2012 DASPETAH
143 RAHELTA JULIYANTI 12/1/7011 DASPETAH
144 ASYIFHA SYAHRIAL 5/31/2012 DASPETAH
145 MIRANDO ARDIANSYAH 2/9/2012 DASPETAH II
146 ERICA ELIYANA 10/24/2012 DASPETAH
147 LODRIK 5/22/2012 PG BERINGANG
148 RAISA TUL JANNA 6/17/2012 DASPETAH II
149 SEFTIAN PRATAMA 9/26/2012 DASPETAH
150 SANIA AURILIA 5/20/2012 DASPETAH II
151 DEMIAN GENKUBA DIOS 9/27/2011 DASPETAH
152 MUHAMMAD ADLI ALFAR 4/4/2012 DASPETAH
153 LAISA TUL JANNA 6/17/2012
154 NISYA TRI FEBBY INDR 1/29/2012 DASPETAH II
KLS 4C 155 RISSKHY APRIANDO A 3/29/2013 DASPETAH
156 RASYID MUBARAK 1/3/2013 DASPETAH
157 NUGI ARGA ANUGRA 7/24/2012 DASPETAH II
158 NADILAM ALKIANE 2/29/2012 DASPETAH II
159 MUHAMMAD AKBAR DWI 6/15/2012 PG BERINGANG
160 MIRZAN PRATAMA RA 8/6/2012 DASPETAH
161 MAYZEL VIZELA VILY 6/14/2012 DASPETAH
162 DIAN MUSTIKA 11/29/2011 DASPETAH
163 DESTIANA MUTIARA 12/19/2011 PG BERINGANG
164 AURA DWI VALENTINE 2/7/2012 DASPETAH II
165 DEA LOVA DWI NATALI 6/10/2012 DASPETAH
166 NADIN AFRIANTI 8/14/2011 DASPETAH
167 ALQEANO JULLYAN AN 8/21/2012 DASPETAH II
168 MEYZYA AURORA SUT 3/12/2012 DASPETAH
169 RELTA AYU PANGESTU 3/15/2012 DASPETAH
170 PARENDRA 9/16/2012 DASPETAH
171 NUGI ANUGRAH 3/21/2012 DASPETAH
172 RATI PUSPITA SARI 11/14/2011 DASPETAH II
173 ZILVIA ANNISA PUTRI 11/2/2011 DASPETAH
KLS 5A 174 JESICA REGINA PUTRI 10/5/2011 DASPETAH
175 ERLIN NATANIA SAKITA 4/26/2011 DASPETAH
176 AYU OKTAVIA 11/29/2011 DASPETAH
177 FEBRIIAN 5/29/2011 PG BERINGANG
178 ANDIKA PUTRA PRATA 6/13/2008 DASPETAH
179 DENADA 4/16/2011 DASPETAH
180 ARTA AULIYA 3/13/2011 PG BERINGANG
181 ERMA ADIJA VENO 6/24/2010 DASPETAH II
182 ARTA DAVA WIJAYA 10/30/2011 DASAPETAH
183 SAHIRA ANINDITA 7/3/2011 DASPETAH
184 ANDRI WINATA 8/19/2011 PG BERINGANG
185 SEPTA 3/11/2011 PG BERINGANG
186 NAJWA AZZAHRA 7/26/2011 PG BERINGANG
187 AGIT RAGIL PRATAMA 6/16/2011 DASPETAH
188 ABI YUDA RAMADHAN 8/4/2011 DASPETAH
189 OKTA NAZERO 10/8/2009 DASPETAH
190 ULAN RAYA 8/30/2011 PG BERINGANG
191 DEDI ANGGARA 2/13/2010 DASPETAH
KLS 5B 192 ACHA MAHARANI 3/21/2011 PG BERINGANG
193 AMASYA DEWA ALFIRA 5/5/2011 DASPETAH
194 ARIL PRASATIYO 2/3/2010 DASPETAH
195 CHELSI OLIVIA 9/16/2011 DASPETAH
196 DAFA ALFARO 12/13/2011 DASPETAH
197 ADIL PRATAMA 11/12/2011 PG BERINGANG
198 ILHAM KURNIAWAN 5/15/2011 DASPETAH
199 GISEL QWINZI OKTAVIA 10/22/2011 DASPETAH
200 KHEISYA ANGGRAINI 10/6/2011 DASPETAH
201 LORENSI CAPELA 1/15/2011 PG BERINGANG
202 NAJIB TIO ALBARIQ 4/23/2011 PG BERINGANG
203 FADIL ADHA 11/28/2009 PG BERINGANG
204 FELITA HATI 1/13/2011 PG BERINGANG
205 RAKA ADITIA 10/31/2011 DASPETAH
206 SEPTA MAURIN 9/25/2011 PG BERINGANG
207 VITA DWI SEPTIA 9/11/2011 DASPETAH
V1 208 KEVIN MUHAMMAD PAD 6/15/2010
V1 209 AYU PEZA LESTARI 7/30/2010
V1 210 DWI AFRILIA FRANSISK 4/22/2011
KLS 6A 211 ADE RELIN GUSTINI 8/7/2009 DASPETAH
212 APRILIA NABILA 4/28/2010 PG BERINGANG
213 ANGGA SAPUTRA 9/19/2009 DASPETAH
214 AYU SAFITRI 10/25/2010 DASPETAH
215 BIANKA AURORA 9/20/2009 DASPETAH
216 DEFRIL ADITIO 6/13/2010 DASPETAH II
217 DIO PERO HESA 7/22/2010 DASPETAH II
218 ENJEL SUTIYAWATI 1/3/2010 DASPETAH
219 FINO SAPUTRA 7/27/2009 DASPETAH
220 JUL HARYANTO 11/7/2008 DASPETAH
221 LEO PRATAMA 9/15/2010 PG BERINGANG
222 LIRA ANJANI 1/22/2011 DASPETAH
223 MARSEL 1/10/2010 DASPETAH
224 MUHAMMAD RAFEL 7/2/2010 DASPETAH
225 OKTA TALIA 10/7/2010 DAS\PETAH
226 RAFLI ANGGARA 6/7/2010 DASPETAH
227 SAFIRA AZAHRA 10/16/2010 DASPETAH
228 RASYAH ABDILLA 4/25/2010 DASPETAH
229 SAPKI SAPIRA 4/5/2010 DASPETAH
230 WARSI DEVA 2/12/2010 DASPETAH
V1 231 ELA YUPITA 7/21/2010 DASPETAH
KLS 6B 232 AKILLA ADITYA 9/20/2010 DASPETAH II
233 RISkA MAWARNI 11/26/2007 PG BERINGANG
234 RIFKI PEBIYANSA 11/4/2009 DASAPETAH
235 REPAL DIOBAGITE 4/11/2011 PG BERINGANG
236 PEBI YANTOSI 3/11/2010 DASPETAH
237 NADYA DHARMA LESTA 5/12/2010 DASPETAH
238 MUHAMMAD RIZKY SIN 6/18/2010 DASPETAH
239 MELATI FEBRIYANI 2/1/2010 PG BERINGANG
240 JONA JULIANTONI 8/14/2010 DASPETAH
241 JOKO SUPRIADI 3/23/2009 DASPETAH
242 GUSTIANA RAMADANI 8/12/2010 PG BERINGANG
243 GERRI AMARSIL PRAT 3/27/2010 PG BERINGANG
244 FICKO 4/2/2010 DASPETAH
245 DIA PITA HESA 7/22/2010 DASPETAH II
246 ANDIKA PRATAMA 6/23/2009 DASPETAH
247 VINGKI DWI AMORA 6/18/2010 DASPETAH
248 RENITA 4/3/2010 PG BERINGANG
249 WIZY APRILIA 4/30/2010 DASPETAH
250 MUHAMMAD REHAN 10/25/2010 PG BERINGANG
251 MUHAMMAD ALIF AUFA 7/12/2010 DASPETAH
252 IKBAL DWI SAPUTRA 2/25/2010 PG BERINGANG
253 HAFIZAH BINTANGN B 12/2/2009 PG BERINGANG
254 PEBRI 2/15/2010 PG BERINGANG
255 AZZA TAZIA FADILAH 9/23/2010 DASPETAH
256 ARIL ANGGARA 4/16/2009 DASPETAH II
257 DEVITA SARI 6/26/2010 DASPETAH
258 LORINDA
259 FINA NAILATUL IZZAH 2/17/2010 DASPETAH
260 DENISA DIBA
261 NAURA KHAIRIYAH 12/10/2011 PADANG LEKAT

1-3 = 98 + 4-6=
TUNDA 11
TIDAK ADA
V1 15
V2 225
TOTAL YG DISUNTIK 240

14 OCTA PRANATA 10/10/2014 PG BERINGANG


236 TASIA ALSIPA 11/4/2009 UJAN MAS BAWAH
213 AYU PEZA LESTARI 7/30/2010 DASPETAH
195 ZAKILA BALQIS 3/4/2011 DASPETAH
135 SAPIRA APIPA RAHMA 5/10/2012 PG BERINGANG
129 PITO PRANSISKO 4/7/2012 PG BERINGANG
86 RISKI PARIANSYAH 2/13/2013 DASPETAH
74 RIFKY AZKA PRATAMA 7/17/2014 PG BERINGANG
48 HEN IPUSPITASARI 14-Jun-13 DASPETAH
51 ARINI 23-Jul-12 PG BERINGANG
2C 65 DELSI AYU NINGTIAS 7/8/2014 PG BERINGANG
69 ADITYA 3/13/2013 DASPETAH
71 SILFA ASIKA 7/29/2014 DASPETAH
41 DAFA AFRI 1/16/2013 DASPETAH
5 DIVA LORENZOE 4/14/2015 DASPETAH
35 YUNITA ENJELINA 11/12/2014 DASPETAH
13 RESTI ANJANI PUTRI 8/27/2014 DASPETAH
172 RIDHO ALFIANSYAH 8/21/2011 DASPETAH
UPT PUSKESMAS RAWAT INAP UJAN M
VAKSINASI COVID-19
16-Feb-22
MIN 04 DASPETAH

SINOVAC
DOSIS 1 DOSIS 2

PENDIDIK

PENDIDIK
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA

REMAJA
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

BUMIL

BUMIL
ANAK
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1708025211120001
1708020102120002
1708020811120003
1708021907120002
1708020409120001
1708025102100001
1708055212110001
1708025809120001
1708022202120002
1708024707110001
1708021902130001
1708025704120001
1708025604120001
1708025909120001
1708024410120001
1708044905120001
1708025001130001
1708021401120001
1708024706120001
1708023103120002 SUDAH DIENTRY DI CG LALANG
1611034507140004
1708021201120001
1708021104120001
1708021709100002
1708024911060002
1708021203120002
1708041702120001
1708025207110002 1708026901120001
1708027105120001
1708020902120001
1708026411120001
1708022205120002
1708025706120001
1708022609120001
1708026006120001
1708022709110001
1708020404120002
1708025706120001
1708026901120001
1708022903130001
1708040301130002
1708022407120001
1708026902120001
1708021506120001
1708020608120001
1708025406120001
1708026911110002
1708025912110001
1708024702120002
1708025006120001
1708025408110001
1708022108120001
1708025203120002
1708021503120001
1708021609120001
1708022103120001
1708026411110002
1708024211110001
1708024510110002
1709066604110001
1708026911110001
1708022905110001
1708021003070002 1
1708025604110002
1708025303110001
1708026406100001
1708023010110001
1708024307110001
1708021908110001
1708027008130003
1708026607110001
1708021606110001
1708020408110002
1708020810090001 1
1708027008110002
1708021302100001
1708026103110001
1708024505110001
1709030302100002
1708025609110002
1708021312110002
1708021211110002
1708021505110001
1708026210110001
1708024610110001
1708025501110001
1708022304110001
1708022811090001 1
1708025301110001
1708043110110002
1708026509110001
1708075109110001
1708021506100001 1
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1708026610100001
1708026609090003 1
1708021306100001
1708026207100002
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1708022707090001 1
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1708021609100002
1708026201110001
1708021001100001
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1708025610100001
1708042504100002
1708024504100002
1708025202100001
1708026107100002 1
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1708021104110001
1708021403100001
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1708021806100001
1708026104050001
1708021406100002
1708022303090002 1
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1708022306090003 1
1708025806100001
1708024304100001
1708027004100003
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1708021207100001
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1708024212090002
1708025502100002
1708026309100002
1709021604090001 1
1708026606100005

1708025702100001
1708026101100001
1708045012110001
0 0 0 0 0 0 15 0 0 0 0 0 0 13
15 225
240

1708021010140002 1
1708024411090001 1
1708027007100001 1
1708044403110001 1
1708025005120001 1
1708020704120001 1
1708021302130001 1
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1708025406130001 1
1708026307120001 1
1708024807140001 1
1708021303130001 1
1708026907140001 1
1708021601130001 1
1708021404150001 1
1708025211140001 1
1708026708140002 1
1708022108110001 1
OSIS 2
16-Feb-22
ANAK

04 DASPETAH

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
SINASI COVID-19
NAKES
LANSIA
PUBLIK
BUMIL
AS RAWAT INAP UJAN MAS

M.UMUM DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1
ASTRA
1
1
1
1

1
1

1
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1

1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1

1
1
1
1

1
1
1
1
1
1

1
1

1
1

1
212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
225 0 0 0 0 0
240
0
DOSIS 1
PENDIDIK
REMAJA
LANSIA

ASTRA
PUBLIK
BUMIL
M.UMUM DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0
0
NO NAMA TGL LAHIR ALAMAT

KLS 1 A 1 ANNISA ZAHABIYA A 3/16/2015 UMA


2 BELLA VIOLITA A 9/15/2015 UMA
3 DINO ADRIAN 11/1/2014 SURO LEMBAK
4 DIVA AMZAR F 3/14/2014 UMA
5 FAREL SUNRYO A 5/7/2015 UMA
6 FATIN ZAININA 5/16/2016 UMA
7 GRESIA PUTRI ANGGRAINI 8/26/2015 UMA
8 M. ZAFRAN DIANDI 10/15/2014 UMA
9 MADU KUSUSMA 2/6/2015 UMA
10 MONIKA MEILINDA I 5/12/2015 UMA
11 M. ASA PRAMUDITA 12/29/2014 UMA
12 NAJWA H 6/23/2015 UMA
13 NASRI YANTI 12/12/2014 UMA
14 RAISYA ALIFA 7/3/2014 UMA
15 RAMA FADILAH 10/10/2015 UMA
16 JAHRA LUTFIAH 1/9/2015 UMA
17 GEBRAL RISKI A 4/26/2015 UMA
18 SALSABILA PUTRI A 5/25/2015 SURO BARU
KLS 1B 19 SALSABILA BILQIS 5/25/2015 UMA
20 ZAHRA DWI P 12/14/2024 UMA
21 SUTRIVI RAHAYU NINGSI 3/27/2015 UMA
22 ADELIA DWI A 8/23/2014 SURO LEMBAK
23 OKTA ZIKRI F 10/10/2014 UMA
24 PATRA ANUGRAH 7/7/2015 SURO MUNCAR
25 AUREL FEBIOLA 12/9/2014 UMA
26 RISKI DWI S 4/20/2015 UMA
27 OCA VELENSIA 1/22/2015 UMA
28 SAYYAF TAQY 2/14/2015 UMA
29 M. KENZO KARBLA 11/20/2014 UMA
30 CIRHA LORENZO 3/16/2015 UMA
31 JESYCA WULANDARI 11/4/2014 UMA
32 RAKEL FADILA 11/14/2014 UJAN MAS BAWAH
33 DAFFA SAPUTRA 5/11/2015 UMA
34 SASIKIRANA 12/26/2011 UMA
35 M. AMIN GIANT B 1/15/2012 UMA
36 ABID AQILA B 11/04/2011 UMA
37 ELYSIA SAFA H 13-Jun-15 SURO LEMBAK
KLS 2A 38 MAKAELLA ILMI NAFISHA 1/21/2014 SURO LEMBAK
39 DESWITA MAHARANI 6/6/2013 SURO LEMBAK
40 FIKKY M. ILHAM 8/15/2014 UMA
41 IZRAQIL F 17-Apr-14 UMA
42 RESTU HADI S 12/4/2013 UMA
43 SYAH REJANG K 30-Oct-13 UMA
44 JULIANSYAH R 2-Jul-14 UMA
45 YUSUB JUEENRI 1/21/2014 UMA
46 RISKY RAHNAD 23-Feb-14 UMA
47 RISKON SALASA 4/28/2014 UMA
48 DAFFA EXCHEL 20-Jun-14 UMA
49 GLANG DIRGA 8/15/2014 UMA
50 MEZI ANGELIANSYAH 5/23/2014 UMA
51 VICKO SUBIANTO 15-Dec-13 UMA
52 ULFA EKA 8/28/2014 UMA
53 REPAN S 7/21/2014 UMA
54 ZIFAN A 5/7/2014 UMA
55 TRI AKBAR A 1/26/2014 UMA
56 BELA JUNITA 6/25/2014 UMA
57 ALFIAN NOVAREAL 11/19/2013 UMA
58 SALSABILAH A 4/29/2014 UMA
59 FELI 15-Dec-13 UMA
60 SRI WAHYUNI 5/20/2012 UMA
KLS 2B 61 BAGAZ PRATAMA 5/22/2013 SURO LEMBAK
62 AGI S 8/26/2014 UMA
63 DEYA A 6/9/2014 UMA
64 RAMA DWI 7/9/2014 UMA
65 SHISI F 22-Aug-14 UMA
66 BAGUS RAGIL 3/29/2014 UMA
67 RAKA S 7/31/2014 UMA
68 PAREL O 4/10/2013 SURO LEMBAK
69 BIMA OZI 5/23/2014 PB
70 FEBY F 11/11/2013 UMA
71 SABRINA DWI N 8/7/2014 UMA
72 EFRAN 11/28/2013 UMA
73 PANCA W 6/26/2014 UMA
74 DAFA A 6/7/2014 UMA
75 KAROLIN VERONIKA 9/22/2013 UMA
76 M. ZAVIN 11/15/2013 UMA
77 SUCI MAHARANI 7/10/2014 UMA
78 KENJI RAKA DWI
79 ZAHRA SAGITA
80 ANNISA AZARA
KLS 3B 81 STEVEN VBAYU 7/18/2013 UMA
82 AHMAD F 12/9/2012 UMA
83 ANISA DERMISTA 11/27/2012 UMA
84 DIOSI ANGGUN 01-05-13 UMA
85 FIKRI P 4/18/2013 UMA
86 HERLAMBANG 4/10/2013 UMA
87 JESIKA PUTRI H 6/24/2013 UMA
88 RAFKI SAUTRA R 23-Aug-12 SURO LEMBAK
89 MIFTAHUL K 10/6/2013 UMA
90 RIKY A 4/29/2013 UMA
91 SEPTI SINTIA B 9/30/2013 UMA
92 NADILA ANATASIA 12/4/2012 T. DALAM
KLS 3A 93 AZIZ KIANO P 3/30/2013 UMA
94 DEA AULI 7/1/2013 UMA
95 ANGGUN S 8/13/2013 UMA
96 KELVIN APRILIO 6/21/2012 UMA
97 CIPTA H 11/3/2011 SURO LEMBAK
98 PUTU ZAKY R 7/8/2013 SURO LEMBAK
99 CHELLO GLASIO 11/24/2012 SURO LEMBAK
100 ANGGUN PUTRA 10/31/2011 UMA
101 ANISA SYAPUTRA 5/3/2013 UMA
102 DISTI APRILIA A 4/3/2013 UMA
103 M HAFIZ A 3/12/2013 UMA
KLS 4A 104 REKA ADELIA 4/6/2012 UMA
105 DIKA RANGGA S 8/4/2008 UMA
106 M. REYHAN 2/16/2012 UMA
107 REFALDO SETIWAN 3/18/2012 UMA
108 M. NIZAM P 7/13/2012 UMA
109 HAIDAR AL DARY 7/30/2012 UMA
110 HEMILZA AKBAR P 8/26/2012 UMA
111 NIKO M ILHAM 12/13/2010 UJAN MAS BAWAH
112 SAKINA NOPITA SARI 3/7/2012 UMA
113 YUNITA F 6/26/2012 UMA
114 IMELSA GIMESTI P 10/10/2011 UMA
KLS 4B 115 AQILA MEIZELA 5/7/2012 UMA
116 TASYA R 7/18/2012 UMA
117 NEKEYSA ALFADILLAH 5/7/2012 SURO LEMBAK
118 JESIKA DWIANI 1/4/2012 SURO LEMBAK
119 BAMBANG IRAWAN 12/8/2011 UMA
120 RAMA ANDREAM S 8/1/2011 UMA
121 RIVALDO 9/29/2011 UMA
122 ADITYA DWI E 3/8/2012 UMA
123 PELIZA D 11/17/2012 SURO LEMBAK
124 FIKA PRISILIA 6/28/2012 SURO LEMBAK
125 AGUNG SATRIA 1/26/2012 UMA
126 PUTRIA SUCI R 8/4/2011 UMA
127 NANDA ALIFA 10/15/2012 UMA
128 SALSABILA KHUSNUL 4/13/2012 UMA
KLS 5 129 SANTIKA RUSADI 3/12/2015 P. BETUNG
130 RAHMAN IBRAHIM 5/25/2010 UMA
131 ANNISA BUNGA 6/27/2011 UMA
132 OCA NOVIYTA SARI 5/25/2011 UMA
133 JAKA ANUGRAH 5/5/2011 UMA
134 NUR AISH E 11/13/2011 UMA
135 VIEOLA DHEA R 12/23/2009 UMA
136 RADIT APRIANSA 4/25/2011 SURO LEMBAK
137 ZICKI P 3/24/2011 UMA
138 FAKHRI PUTRI P 8/13/2011 UMA
139 ALIFIN MAHESA 3/28/2011 UMA
140 AGUNG OKTA P 10/11/2010 UMA
141 LIO AGUSTIN 8/6/2010 UMA
142 GESSIA OKTAPIA 3/4/2011 UMA
143 IRFAN BADRI 3/2/2011 UMA
144 VARIS BAYU SUGARA

42 DEVI MARISYAH 3/26/2013


70 JULIAN ARGA 21-Jun-12
79 TRISTAN GIANOBA 10 OKTOBER 2012
3 FAIRUZ HUMAIROH PAREJA 2/18/2015 SURO ILIR
UPT PUSKESMAS RAWAT INAP UJAN MA
VAKSINASI COVID-19
10 JANUARI 2022
SD 09 SURO ILIR

SINOVAC
DOSIS 1 DOSIS 2 DOSIS

PENDIDIK

PENDIDIK
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA

ANAK
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

BUMIL
ANAK
1708055603150001 1
1708025509150002 1
1708020111140002 1
1708021403140002 1
1708020705150001 1
3201115605140001 1
1708026608150001 1
1771091510140002 1
1708024602150003 1
1708025205150004 1
1708022912140001 1
1708026306150002 1
1708025212140001 1
1708024307140002 1
1708021010150001 1
1708024901150002 1
1708022604150002 1
1303046505150002 DUKCAPIL 1
1709026505150001 1
1708026412140001 1
1708026703150001 1
170802630810001 1
1708021010140001 1
1708020707150002 1
1708024912140002 1
1708022004150001 1
1708026201150001 1
1707121402120001 1
1708022011140001 1
1708025603150001 1
1708024411140001 1
1708025411140001 1
1708021105150001 1
1708026612110001 1
1708021501120001 1
1708021104150001 1
1708025306150001 1
1702096101140001 1
1708020606200001 1
1708021508140001 1
1708021704140003 1
1708020412130001 1
1707103010130001 1
1708020207140001 1
1708022101140001 1
1708022302140001 1
1708022804140001 1
170802200614001 1
1708041508140001 1
1708026205140003 1
1708022512130001 1
1708026808140002 1
1708022107140001 1
1708024705140001 1
1708022601140002 1
1708026506140001 1
1708021911130002 1
1708026904140001 1
708025512130001 1
1806036004120001 1
1702182205130002 1
1708022608140002 1
1708024906140001 1
1708020907140003 1
1708026208140002 1
1708022903140001 1
1708023107140001 1
1708021004130001 1
1708022305140001 DUKCAPIL 1
1708025111130001 1
1708024708140001 1
1708022811130001
17080226016140001 1
1708020706140001 1
1708026209130001 1
1708021511130002 1
1708025007140001 1
1
1
DUKCAPIL 1
1708021807130002 1
1708020912120001 1
1708026711120001 1
1708024105130001 1
1708021804130000 1
1708021004130003 1
1708026406130001 1
1708022308120001 1
1708024607130001 1
1708022904130001 1
1708027009130001 1
170218441220002 1
1708023003130001 1
1708024107130001 1
1708025308130001 1
1708022106120004 1
1708020311110002 1
1708020807130001 1
1708022412120001 1
1708023110110002 1
1702194305130001 1
1708022304130004 1
1708031203130001 1
1708024604120001 1
1708050408080001 1
1708021602120001 1
1708021803120001 1
1708021307120001 1
1702193007120001 1
1708022608120002 1
1708021312100002 1
1708024703120001 1
1708026606120001 1
1708025010110002 1
1611074705120002 1
1708025807120002 1
1708024705120002 1
1708024401120001 1
1708020812110001 1
1708020108110001 1
1708022909110001 1
1708020803120001 1
1708025711120001 1
1708026806120001 1
1708022601120001 1
1708024408110001 1
1708025510120001 1
1703235304120001 1
1709035203110004 1
1708022050100001 1
1708026706110002 1
1708026505110001 1
1708020505110001 1
1702245311110002 1
1771066312090003 1
1709032504110001 1
1708022403110001 1
1708021308110001 1
1708022803110001 1
1708041110100001 1
1708020608100001 1
1708024403110001 1
1708020203110001 1
1
0 0 0 0 0 0 9 0 0 0 0 0 0 134 0
9 134 0

143

1708026603130001 TUNDA 1
1708022106120002 TUNDA 1
1708021010120002 TUNDA 1
1708025802150001 1
URO ILIR
ARI 2022
COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
PENDIDIK
REMAJA
LANSIA
PFIZER

PUBLIK
BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
ASTRA
DOSIS 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
143
0
0 0 0 0 0 0

1 11 12

0 0 0 1 0 11 12

###
ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
PUBLIK
SINOPHARM

BUMIL
M.UMUM
DOSIS 2

PENDIDIK
REMAJA
DESA

LANSIA
DOSIS 1
R

S
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0

26 62 2

3 27
0
PUBLIK

M.UMUM

DOSIS 1
PENDIDIK

REMAJA

LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
JUMLAH
NO NAMA TGL LAHIR ALAMAT

1 ANTON WIJAYA 7/1/2000 SM


2 RENO 9/21/1999 SM
3 SURI SUHANA 5/17/1964 SM
4 DOKI 7/6/1996 SM
5 SELI PUSPITA SARI 12/2/2001 SM
6 TOMI SAPUTRA 12/29/2003 SM
7 MARSIP 7/1/1954 SM
8 EDI PUTRA 3/3/1997 SM
9 JUWTA MARTATI 4/12/1989 SM
10 RIDWAN SAPI'I 8/15/1984 SM
11 DEVI YANTI 1/27/1985 SM
12 SANNARIA 7/1/1968 SM
13 SURIF 3/1/1962 SM'
14 SADAR MUSMIN 3/7/1979 SM
15 M.DEFRIZAL 12/12/2014 SM
16 SUARDI 7/1/1952 SM
17 NGATMINI 7/1/1965 SM
18 RISWAN KANEDI 2/17/1977 SM
19 DESI NURLIA 7/9/1995 SM
20 JAURIA 9/21/1961 SM
21 DENI HARDIANTO 2/14/1997 SM
22 ENDAH LESTARI 2/2/1998 SM
23 AHMAD SOPIAN 7/26/1957 SM
24 HENDRI KUSMEDI 5/8/1978 SM
25 LINNDA 6/7/1998 SM
26 SUPIAH 7/1/1960 SM
27 DARYANA 7/1/1965 SM
28 AFRIZAL 11/9/1992 SM
29 NELI 2/1/1982 SM
30 BURHAN 12/12/1977 SM
31 SUBANDI 7/20/2006 SM
32 ANGGRITA SALSA 5/10/2008 SM
33 RANI AULIA 6/13/2010 SM
34 USMAN 4/15/1982 SM
35 HERI ASNAWI 3/1/1983 SM
36 SUJONO 10-Apr-82 SM
37 ARIYA JUMAT 11-Nov-93 SM
38 KAMSIA HERAWATI 12/31/1899 SM
39 RANDI PUTRA 4/4/2007 SM
40 NADIA 7/15/2007 SM
41 ZONI EFRIANSYAH 11-Sep-97 SM
42 LIANDI DWI PUTRA 6/28/2002 SM
43 CANDRA IRAWANN 19-May-92 SM
44 YOKI 6-Dec-81 SM
45 EDI MULYADI 7/1/1994 SM
46 FEMAS NAYAKA 8-May-05 SM
47 RISMA DEWI 7/1/1994 SM
48 DEBY 18-Jun-01 SM
49 DIMAS A 3/10/2006 SM
50 KARNELI 4/3/1984 SM
51 HENDRIK 21-Jun-86 SM
52 MISDARMAWAN 1/4/1975 SM
53 KARYADI 8/12/1994 SM
54 FAJAR PUTRA 6/26/2005 SM
55 SEBNAR 10/7/1998 SM
56 COCON WAHYUDIN 7/12/1982 SM
57 SUPRIADI 11/10/1979 SM
58 SUTIYEM 1/8/1961 SM
59 WAGITO 2-Jul-86 SM
60 MUZLIHAN 6/8/2001 SM
61 ABU HHANIFA 12/9/1969 SM
62 HERI SURYADI 10/21/1974 SM
63 DAVIS ADE 9/27/1993 SM
64 MARGINI 22-06-72 SM

66

15 10
63 28
1 34
35
UPT PUSKESMAS RAWAT INAP U
VAKSINASI COVID-19
10 JANUARI 2022
SD 09 SURO ILIR

SINOVAC
DOSIS 1 DOSIS 2 DOSIS

PENDIDIK

PENDIDIK
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA

REMAJA

ANAK
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

ANAK
1708020107000087
1708022109990001
1708025705640001
1708022002960002
1708024212010001
1708022912030001 1
1708020107540038
1708020303970002
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1708020107520035
1708024107650126
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1702092806020003
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1708026206720002

0 0 0 0 0 0 1 0 0 0 0 5 0 0 0
1 5 22

6
3
LANSIA
PUBLIK

SD 09 SURO ILIR
BUMIL 10 JANUARI 2022
AKSINASI COVID-19

1
1
1
1
1
1
1
1
1
1
1
1
1
1
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M.UMUM

DOSIS 1
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LANSIA
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PUBLIK
BUMIL

1
1
1
1
1
1
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M.UMUM
DOSIS 2

PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
DOSIS 1

PENDIDIK
REMAJA
LANSIA
MODERNA

PUBLIK
M.UMUM
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PENDIDIK
REMAJA
LANSIA
PUBLIK
M.UMUM
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PENDIDIK
REMAJA
LANSIA
ASTRA
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1
1
1
1
1
1
1
1
1
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1
1
1
1
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0 0 0 19 0 3 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 1 0 0
22 9 0 0 11 16
64
31
0 0 0 0 0 10

1 11 12

0 0 0 1 0 21 22
###
PUBLIK
BUMIL

1
1
1
1
1
1
1
1
1
1
1
1
ASTRA
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
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PUBLIK
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REMAJA
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PUBLIK
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0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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26 62 2

3 47
31
DESA
LANSIA

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK

REMAJA

LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK
DOSIS 2
19

DERNA
DOSIS 2
PENDIDIK

JUMLAH
M.UMUM
NO NAMA TGL LAHIR ALAMAT

KLS 1 A 1 AQILLA ANAZZAHRA 7/11/2014 SURO BARU


2 AHMAD SIDKI KHAIRULA 7/9/2015 DESA SURO BARU
3 FANESTA ALYA SYAFITRI 7/7/2014 SURO BARU
KELAS 2 4 ABIL ZAKI 9/6/2013 SURO BARU
5 MUHAMMAD AGUSTIAN 8/23/2013 SURO BARU
6 MUHAMMAD ILHAM 2/26/2014 SURO BARU
7 MUHAMMAD ALFA REZO 2/28/2014 SURO BARU
8 HALIVA RAMADANI 8/3/2013 SURO BARU
9 HANA KHAIRUN NISA 3/19/2014 SURO BARU
DIEGO ANUGRAH
7/26/2014
10 RHAMADAN SURO BARU
11 KENZAHFITRA UTAMA 1/19/2014 SURO BARU
12 CELSY FITRI DAYANTI 8/11/2013 SURO BARU
13 SUCI LESTARI 4/15/2014
14 CERLI SEPTIAN S 11/13/2013
15 RANSI ARIBAH 10/2/2013
16 MUHAMMAD FAKHRIY 10/19/2014
17 TAUFIK IMANSYAH 2/19/2012
18 PUJI PURNAMA 7/17/2012
19 YUSUP YUDIS BASTIAN 8/25/2012
20 AFIFAH PUTRI 10/8/2012
21 SALWA INARA 2/26/2013
22 JEMMY MEDIANSYAH 5/26/2013
23 AYU APRILIA 4/11/2013
24 BAGAZTRY WIBAWA 4/12/2013
25 RARA OKTAVIA 10/14/2012
26 DAPA DWI PANNGA 10/30/2012
27 DIOBA ADE RIZKI 4/27/2012
28 JENI VERLITA 5/29/2021
29 BIMA ARYA 9/11/2011
30 AREL SAPUTRA 7/14/2012
31 DENDY AULIAN 6/21/2011
32 FITRA RAMADANI 8/29/2011
33 DWIKA YUDISTIRA 5/31/2012
34 PERDEYAN REKAYASAH 10/7/2011
35 GHEA PUTRI 7/31/2011
36 DIONA DEWA REJA 18-Mar-11
37 MUHAMMAD ALFINO A 26-Feb-11
38 ANDINI NOPELLIYA 11/14/2011
39 AKBAR 2/4/2011
40 MUHAMMAD REHAN 6/23/2009
41 NENGSI 1-Mar-09
42 DERA MARSELA 3/28/2011
43 SAGITA 8-Oct-09
44 ERNI APRIANITA 29-Apr-09
45 SYIFA REGINA 9/13/2011
46 MUHAMMAD ILHAM ALFARES 7-Jul-11
47 AZKIA LIDIANA 12/4/2010
48 LIRA FITRI 9-Sep-10
49 RANGGA AIDITYA 9/15/2010
50 SEPTA MARDALENA 9/25/2010
51 REZA AKSA 27-Jul-10
52 FADIL ILHAMSYAH 5/27/2010
53 ASYIFA ADHANI 11/19/2010
54 SANIA SARTIKA 8/17/2010
55 PHATIYA RAMADANI 8/11/2010
56 WIKA YULIA 12/1/2010
57 REFA SALSABILA 10/8/2010
58 AKBAR RAPSANJANI 6/7/2010
59 KIANO IVAN 27-Feb-10
60 GEOVANY SATRIA 1/31/2010
61 DHEBY ZHAKY 5/11/2010
62 RULLY KURNIAWAN 12/22/2008
63 FELLY DESTYANTI 12/16/2009
64 AKBAR AL ALLAMIN 10/3/2010
65 ALDI IKHSAN 5-Oct-09
66 ANDIKA PRATAMA 5/8/2009
UPT PUSKESMAS RAWAT INAP UJAN MA
VAKSINASI COVID-19
10 JANUARI 2022
SD 09 SURO ILIR

SINOVAC
DOSIS 1 DOSIS 2 DOSIS

PENDIDIK

PENDIDIK
NIK NO HP

M.UMUM

M.UMUM
NAKES
REMAJA

REMAJA

ANAK
LANSIA
PUBLIK

LANSIA
PUBLIK
NAKES

NAKES
BUMIL

ANAK
1708025107140001 1
1708020907150001 1
1708024707140001 1
1708020609130001 1
1708022308130001 1
1708022602140003 1
1708022802140001 1
1708024308130002 1
1708025903140001 1
1771082607140001
1
1708021901140001 1
1708025108130002 1
1708025504140001 1
1708021311130001 1
1708020210130001 1
1708021902140001 1
1708021902120001 1
1708025707120001 1
1708022508120001 1
1708024810120001 1
1708026602130001 1
1708022605130001 1
1708025104130001 1
1708021204130001 1
1708025410120001 1
1708023010120001 1
1708022704120003 1
1708026905120004 1
1708021109110001 1
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1708020805090003 1
0 0 0 0 0 0 0 0 0 0 8 0 0 58 0
0 66 0

66
URO ILIR
ARI 2022
COVID-19
LANSIA
PUBLIK
BUMIL
WAT INAP UJAN MAS

M.UMUM

DOSIS 1
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BUMIL
M.UMUM
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M.UMUM
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REMAJA
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M.UMUM
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REMAJA
LANSIA
PUBLIK
M.UMUM
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PENDIDIK
REMAJA
LANSIA
ASTRA
DOSIS 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
66
0
0 0 0 0 0 0

1 11 12

0 0 0 1 0 11 12
###
ASTRA
PUBLIK
BUMIL
M.UMUM

DOSIS 2
PENDIDIK
REMAJA
LANSIA
PUBLIK
BUMIL
M.UMUM
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R

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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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26 62 2

3 27
0
PUBLIK

M.UMUM

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PENDIDIK

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LANSIA
SINOVAC

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK

REMAJA

LANSIA
28 OKTOBER 2021

PUBLIK

M.UMUM
DOSIS 1

PENDIDIK
REKAPITULASI HARIAN VAKSINASI COVID 19

LANSIA
MODERNA

PUBLIK

M.UMUM
DOSIS 2

PENDIDIK
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