DAFTAR NAMA YANG DI VAKSINASI

TANGGAL, 19 OKTOBER 2021

NO NIK NAMA LENGKAP USIA ALAMAT NO HP TANGGAL VAKSIN DOSIS

1 3211100404980005 TESHA 24 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 085322433229 10/19/2021 1
2 3212200105690002 TARDI 53 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 085793361284 10/19/2021 1
3 3212202112630001 MANON JAYA 58 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
4 3212205501740001 RATIAH 48 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
5 3212201905770002 KAMALI 45 Rt 003 Rw 002 Jumbleng - Losarang - Indramayu 083824240561 10/19/2021 1
6 3212200708610002 IJAH RABUN 60 Rt 004 Rw 004 Jumbleng - Losarang - Indramayu - 10/19/2021 1
7 3212204708650001 WATI 56 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
8 3212200306610003 INDRIYANTO 60 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 082125133216 10/19/2021 1
9 3212205006740007 TATI SUGIARTI 47 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
10 3212200611690002 SUNADI 52 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
11 32122041089210001 TIARA EKA W 29 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
12 3212204404010002 DAENI 21 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
13 3212205010760005 RATEM 45 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
14 3212200411900001 TONO 31 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
15 3212204407810001 RASINIH 40 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 081131523486 10/19/2021 1
16 3212210705860008 SUBANDI 36 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
17 3212203112980002 EKO P 23 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 083100737514 10/19/2021 1
18 3212204808750003 SUHAEMI 46 Rt 004 Rw 003 Jumbleng - Losarang - Indramayu 083100737514 10/19/2021 1
19 3212202408760003 RASIDI 45 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 085321719302 10/19/2021 1
20 3212205406650002 DARKINI 56 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 087718715000 10/19/2021 1
21 3212205608790003 SUSANA 42 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
22 3212204706760004 MEGAWATI 45 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
23 3212206105740002 DARSINIH 48 Rt 004 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
24 3212210807800003 NURYANTO 41 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
25 3212204607790002 YANTI 42 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 082117675143 10/19/2021 1
26 3212205003640004 DARINAH 58 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
27 3212205207930003 SRI RAHAYU 28 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
28 3212201811860002 SUNARYO 35 Rt 008 Rw 003 Jangga - Losarang - Indramayu 10/19/2021 1
29 3212200207720001 MUALI 49 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 082318281306 10/19/2021 1
30 3212205102710002 DARNIAH 51 Rt 004 Rw 003 Jumbleng - Losarang - Indramayu 10/19/2021 1
31 3212205812730003 SUHAETI 48 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 10/19/2021 1
32 3212204709630006 CASKINAH 58 Rt 004 Rw 003 Jumbleng - Losarang - Indramayu 10/19/2021 1
33 3212201103610001 KAYIM 61 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 082317639670 10/19/2021 1
34 3212201206670002 DULADI 54 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu - 10/19/2021 1
35 3212201405000001 DANI 22 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 082129289533 10/19/2021 1
36 3212206208040002 ERLINAH 17 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 081372578340 10/19/2021 1
37 3212204038700003 KANIAH 49 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu - 10/19/2021 1
38 3212204700400002 YEYEN 82 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 08979684264 10/19/2021 1
39 3212200404000010 M. AGUNG 22 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
40 3212204904860002 CASTEM 36 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
41 3212204208750001 SUMARNI 46 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
42 3212204303750003 KURNIYAH 47 Rt 005 Rw 003 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
43 3212200906720001 CARYADI 49 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
44 3212202206610001 SULEMAN 60 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
45 3212204109040002 RIYA R 17 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
46 3212201204780004 CARMA 44 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
47 3212202505740002 KARNADI 47 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
48 3212201303700002 RASWAN 52 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
49 321220140410002 ROSANTO 12 Rt 004 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
50 3212204812780002 TARSINA 43 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
51 3212205804940001 NURCAINI 28 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
52 3212204803730004 WARSINI 49 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
53 3212200604680003 RASMA 54 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
54 32122047007000001 MONIKA 52 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
55 32131055068900001 MULYYANI 32 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
56 3212200307610003 DASPAN 60 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
57 3212205403650002 SUENIH 57 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
58 3212201305760001 TOFIK 46 Rt 008 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
59 321226705840003 CASTINI 77 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
60 3212205603630004 NENI SURYANI 59 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
61 3212205208800007 TUMINAH 41 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
62 3212201812040001 ABU SOPYAN 17 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
63 3212260604920001 BURHANUDIN B 30 Rt 002 Rw 002 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
64 3212201903820004 UJIDANUJI 40 Rt 011 Rw 003 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
65 3212206403690001 SURATMI 53 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
66 3212240703950002 RONO 27 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
67 3212204707770002 ROIDAH 44 Rt 008 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
68 32122100808670001 KADIROH 29 Rt 008 Rw 002 Dukuh Jeruk - KarangAmpel - Indramayu 089603105736 10/19/2021 1
69 3212206110830002 TITIN SUMARNI 38 Rt 002 Rw 002 KOJA - JAKARTA TIMUR 089603105736 10/19/2021 1
70 3212181905830003 ROSID 39 Rt 002 Rw 002 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
71 3212204402060003 SOFI 16 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
72 3212206703970003 SISKA MARSELA 25 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
73 3212205011690004 KARINAH 52 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
74 3212200107880084 CASMENI 33 Rt 007 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
75 3212201109760001 CARWAN 45 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
76 3212202002710001 CASGI 51 Rt 010 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
77 3212200308740003 TARYONO 47 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
78 3212200612730002 WARTONO 48 Rt 001 Rw 003 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
79 3212202204570001 SURDARMA 65 Rt 008 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
80 1116051008830002 SULIMIN 38 ACEH - 089603105736 10/19/2021 1
81 3212205009550002 WASKINIH 66 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
82 3212202212920004 WAWAN 29 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 1
83 321225302950003 RANI 69 Rt 010 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
84 3212201306860003 CARYADI 35 BANDUNG 089603105736 10/19/2021 1
85 3212200101940005 NAHRUL 28 Rt 010 Rw 003 Jangga - Losarang - Indramayu 089603105736 10/19/2021 1
86 3212200609750002 SARKIM 46 Rt 002 Rw 002 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
87 3212202411010004 FITO 20 Rt 005 Rw 003 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
88 3212206807950001 JULOIANA 26 Rt 002 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
89 3212202010980005 EKO 23 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
90 3212064203930006 EKA KURNIAWATI 29 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
91 3212202008880004 SUMARJA 33 Rt 005 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
92 321220251880002 ARIS 40 Rt 004 Rw 002 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
93 33250510860002 MAFUDIN 15 Rt 001 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
94 3212206605000004 MELA 21 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
95 3212200404000011 ALDI 22 Rt 004 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
96 321220460570004 KARTILEM 52 Rt 005 Rw 003 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2
97 3212201804980002 DEDE 24 Rt 003 Rw 004 Jumbleng - Losarang - Indramayu 089603105736 10/19/2021 2

Indramayu, 19 Oktober 2021

KEPALA PUSKESMAS CEMARA

dr. DIAN LARASATI

NIP. 19750606 200501 2 006