DAFTAR NAMA TENAGA KESEHATAN DI FASILITAS PELAYANAN

KESEHATAN PUSKESMAS JRANGOAN YANG MENDAPATKAN

VAKSINASI DOSIS 3 (BOOSTER) TAHAP 1

No. Nama NIK

1 H. Misnari, SKM.M.Mkes 3527030112670006
2 Sustyanto, S.Kep.Ns 3527051302680002
3 Mas'ud Arifin, S.Kep.Ns 3527031011910009
4 Moh. Nawawi 3527050107880655
5 Mubtadi 3527050104840005
6 Noer Imamah, Amd.Kep 3527035706800013
7 Titin Isnaidi, Amd.Kep 3527036911840004
8 Tri Mardika Ningsih, Amd.Gz 3527035808820012
9 Nasiyatul Aisiyah, Amd.Kep 3527036403843420
10 Devita Pramola Sari, Amd.Keb 3527034105863641
11 Aida Fitriana, S.Tr.Keb 3527036204910003
12 Silvia Ayu Octavia Muniroh, Amd.Keb 3527036510880008
13 Ida Maftuhah, Amd.Keb 3527036811930004
14 Chusnul Hotimah, S.Tr.Keb 3527035101890002
15 dr. Maria Ulfah 3527036504870007
16 Qomariyah 3527054205930008
17 Firda Alfisyahraputri, Amd.Gz 3527036602970003
18 Samsul, Amd.Kep 3527122003930000
19 Siti Nurul Kamariyah, S.Kep.Ns 3527034706792802
20 Maisaroh, S.ST 3527054708740003
21 Hani Prihandini, Amd.Keb 3527036607850009
22 Anis Zamrotin Nisa, S.ST 3527056405770001
23 Harvin Hunainah, S.ST 3527035504840004
24 Nice Undine, S.Tr.Keb 3527036110870001
25 St. Muhibbatun Nisa, S.Tr.Keb 3527036903860005
26 St. Subaida Iya, S.Kep.Ns 3527057001820006
27 Sochifatul Lutfah, Amd.Kep 3527036510830001
28 Abdul Matin Abrom, S.Kep.Ns 3527932703900007
29 Isa Nurul Hasanah, Amd.Kep 3527025803850002
30 Nunung Sholeka, S.Tr.Keb 3527037001850013
31 Edy Suhartono, S.Kep.Ns 3528041412790003
32 Nurul Cholifah, S.ST 3527035001920003
33 Moh. Subhan, Amd.Kep 3527031510800005
34 Islahul Ummah, Amd.Keb 3527036812920001
35 Aslikatul Mahmudah, S.Tr.Keb 3527036809910004
36 Misaroh, Amd.Keb 3527045207880023
37 dr. Nora Febrina 3527035102850010
38 Ida Pariani, S.ST 3527057003780002
39 Tri Yuniarti, Amd.Kep 3527074806810001
40 Moh. Ismail, S.Kep.Ns 3527030607710010
41 Maghfirotus Safitri, Amd. AK 3515065604940002
42 Ihwan Hariyanto, Amd.Kep 3527032810800001
43 Uswatun Hasanah, Amd.Keb 3527035909920002
44 Yudi Sufianto, Amd.Kep 3527030604910005
45 Septin Komalasari,S.Tr.Keb 3527025909920003
46 Deasy Arliyana Majid, S.Tr.Keb 3527034207880000
47 Lailatul Jannah 3527036705880000
48 Tri Oktafiyanti, Amd.Keb 3527034510883910
49 Meriana Candra Eka 3527055804820000
50 Rika Amalia Saputri 3527035701990000
51 Mujibur Rido 3527031607980000
52 Emilia Ibtisam Hasin 3527036808930000
53 Ikhlas Sabariman 3528040302890001
54 drg. Dian 352611570850001
55 dr. Hilmi Ainul Yaqin Syah 3526092009880005
56 Laila Afifah, S.ST 3527036209904135
57 Hari Sandy Mahardikca 3527053008870002
58 Isna Nur Baiti, S.Tr.Keb 3527035901940002
59 Iswatun Hasanah, Amd.Keb 3527035808950004
60 Mery Puspita Hadi, S.Tr.Keb 3527034905850011
61 Nur Agustini 3527015808930001
62 Hari Pujiawati 3527134907930001
HATAN DI FASILITAS PELAYANAN
ANGOAN YANG MENDAPATKAN
3 (BOOSTER) TAHAP 1

Tanggal Vaksinasi
Jabatan No. HP
Dosis 2
Kepala Puskesmas 087750422444 13/02/2021 1 1
Perawat 082338998830 05/03/2021
Perawat 081913591352 15/02/2021 1 1
Petugas IT 082335985743 26/02/2021 1
Sopir Ambulance 081934600111 27/02/2021 1
Perawat 087750018319 13/02/2021 1 1
Perawat 081937313887 15/02/2021 1 1
Petugas Gizi 085257770311 27/02/2021 1
Perawat 087849851221 27/02/2021 1
Bidan 081357032602 15/02/2021 1 1
Bidan 081944094043 03/03/2021
Bidan 085607104839 22/06/2021
Bidan 082337731328 09/03/2021
Bidan 087806876114 15/02/2021 1 1
Dokter Umum 085230639467 13/02/2021 1 1
Bidan 085259101991 13/02/2021 1 1
Petugas Gizi 087755896916 02/03/2021
Perawat 087750726057 16/02/2021 1 2
Perawat 087849701480 15/02/2021 1 1
Bidan 081703406336 15/02/2021 1 1
Bidan 087880005522 24/02/2021 1 2
Bidan 085230253230 05/03/2021
Bidan 085235772003 26/02/2021 1
Bidan 087852933281 15/02/2021 1 1
Bidan 081703323947 15/02/2021 1 1
Perawat 082338371992 16/02/2021 1 2
Perawat 085232673462 15/02/2021 1 1
Perawat 082332523699 15/02/2021 1 1
Perawat 082336068827 27/02/2021 1
Bidan 082338133823 27/02/2021 1
Perawat 085130369687 27/02/2021 1
Bidan 087803277799 16/02/2021 1 2
Perawat 082338000558 16/02/2021 1 2
Bidan 081939336553 02/03/2021
Bidan 085231501703 16/02/2021 1 2
Bidan 087761408345 16/02/2021 2
Dokter Umum 08121789241 22/06/2021
Bidan 081398120487 24/06/2021
Perawat 087750850569 08/07/2021
Perawat 085235258949 16/02/2021 2
Analis Kesehatan 07752794040 24/02/2021 2
Perawat 08179380445 24/02/2021
Bidan 085204233663 26/02/2021
Perawat 087750223434 15/02/2021 2
Bidan 087736999990 27/02/2021
Bidan 081330530030 02/03/2021
Kesling 085231946383 27/02/2021
Bidan 081939133393 27/02/2021
Bendahara 081331362389 23/03/2021
Analis Kesehatan 082359250880 24/02/2021 2
Analis Kesehatan 085232706170 24/02/2021
Bendahara 082333377446 22/03/2021
Perawat 82332917333 27/02/2021
Dokter Gigi 085234368525 18/05/2021
Dokter Umum 082331177703 27/02/2021
Bidan 081903277778 27/02/2021
Perawat 082301095888 26/02/2021
Bidan 085230190972 16/02/2021 2
Bidan 082337011275 03/06/2021
Bidan 087702111100 02/03/2021
Bidan 082333377446 16/02/2021 2
Bidan 081933163397 16/02/2021 2

Sampang, 05 Agustus 2021

Kepala UPTD. Puskesmas Jrangoan

(Misnari, SKM,M.MKes)
NIP. 19671201 198803 1 008
 DAFTAR NAMA TENAGA KESEHATAN DI FASILITAS PELAYANAN
KESEHATAN PUSKESMAS JRANGOAN YANG MENDAPATKAN
VAKSINASI DOSIS 3 (BOOSTER) TAHAP 1

No. NIK Nama Jabatan

1 3527030112670006 H. Misnari, SKM.M.Mkes Kepala Puskesmas
2 3527031011910009 Mas'ud Arifin, S.Kep.Ns Perawat
3 3527035706800013 Noer Imamah, Amd.Kep Perawat
4 3527036911840004 Titin Isnaidi, Amd.Kep Perawat
5 3527034105863641 Devita Pramola Sari, Amd.Keb Bidan
6 3527035101890002 Chusnul Hotimah, S.Tr.Keb Bidan
7 3527036504870007 dr. Maria Ulfah Dokter Umum
8 3527054205930008 Qomariyah Bidan
9 3527122003930000 Samsul, Amd.Kep Perawat
10 3527034706792802 Siti Nurul Kamariyah, S.Kep.Ns Perawat
11 3527054708740003 Maisaroh, S.ST Bidan
12 3527036607850009 Hani Prihandini, Amd.Keb Bidan
13 3527036110870001 Nice Undine, S.Tr.Keb Bidan
14 3527036903860005 St. Muhibbatun Nisa, S.Tr.Keb Bidan
15 3527057001820006 St. Subaida Iya, S.Kep.Ns Perawat
16 3527036510830001 Sochifatul Lutfah, Amd.Kep Perawat
17 3527932703900007 Abdul Matin Abrom, S.Kep.Ns Perawat
18 3527035001920003 Nurul Cholifah, S.ST Bidan
19 3527031510800005 Moh. Subhan, Amd.Kep Perawat
20 3527036809910004 Aslikatul Mahmudah, S.Tr.Keb Bidan
21 3527045207880023 Misaroh, Amd.Keb Bidan
22 3527030607710010 Moh. Ismail, S.Kep.Ns Perawat
23 3515065604940002 Maghfirotus Safitri, Amd. AK Analis Kesehatan
24 3527030604910005 Yudi Sufianto, Amd.Kep Perawat
25 3527035701990000 Rika Amalia Saputri Analis Kesehatan
26 3527035901940002 Isna Nur Baiti, S.Tr.Keb Bidan
27 3527015808930001 Nur Agustini Bidan
28 3527134907930001 Hari Pujiawati Bidan

Sampang, 05 Agust
Kepala UPTD. Puskesm

(Misnari, SKM,M.
NIP. 19671201 1988
ITAS PELAYANAN
MENDAPATKAN
HAP 1

Tanggal
No. HP
Vaksinasi Dosis 2
087750422444 13/02/2021 1
081913591352 15/02/2021 1
087750018319 13/02/2021 1
081937313887 15/02/2021 1
081357032602 15/02/2021 1
087806876114 15/02/2021 1
085230639467 13/02/2021 1
085259101991 13/02/2021 1
087750726057 16/02/2021 2
087849701480 15/02/2021 1
081703406336 15/02/2021 1
087880005522 24/02/2021 2
087852933281 15/02/2021 1
081703323947 15/02/2021 1
082338371992 16/02/2021 2
085232673462 15/02/2021 1
082332523699 15/02/2021 1
087803277799 16/02/2021 2
082338000558 16/02/2021 2
085231501703 16/02/2021 2
087761408345 16/02/2021 2
085235258949 16/02/2021 2
07752794040 24/02/2021 2
087750223434 15/02/2021 2
082359250880 24/02/2021 2
085230190972 16/02/2021 2
082333377446 16/02/2021 2
081933163397 16/02/2021 2

Sampang, 05 Agustus 2021

Kepala UPTD. Puskesmas Jrangoan

(Misnari, SKM,M.MKes)
NIP. 19671201 198803 1 008
 DAFTAR NAMA TENAGA KESEHATAN DI FASILITAS PELA
KESEHATAN PUSKESMAS JRANGOAN YANG MENDAPA
VAKSINASI DOSIS 3 (BOOSTER) TAHAP 1

No. NIK Nama Jabatan

1 3527030112670006 H. Misnari, SKM.M.Mkes Kepala Puskesmas
2 3527031011910009 Mas'ud Arifin, S.Kep.Ns Perawat
3 3527035706800013 Noer Imamah, Amd.Kep Perawat
4 3527036911840004 Titin Isnaidi, Amd.Kep Perawat
5 3527034105863641 Devita Pramola Sari, Amd.Keb Bidan
6 3527035101890002 Chusnul Hotimah, S.Tr.Keb Bidan
7 3527036504870007 dr. Maria Ulfah Dokter Umum
8 3527054205930008 Qomariyah Bidan
9 3527122003930000 Samsul, Amd.Kep Perawat
10 3527034706792802 Siti Nurul Kamariyah, S.Kep.Ns Perawat
11 3527054708740003 Maisaroh, S.ST Bidan
12 3527036607850009 Hani Prihandini, Amd.Keb Bidan
13 3527036110870001 Nice Undine, S.Tr.Keb Bidan
14 3527036903860005 St. Muhibbatun Nisa, S.Tr.Keb Bidan
15 3527057001820006 St. Subaida Iya, S.Kep.Ns Perawat
16 3527036510830001 Sochifatul Lutfah, Amd.Kep Perawat
17 3527932703900007 Abdul Matin Abrom, S.Kep.Ns Perawat
18 3527035001920003 Nurul Cholifah, S.ST Bidan
19 3527031510800005 Moh. Subhan, Amd.Kep Perawat
20 3527036809910004 Aslikatul Mahmudah, S.Tr.Keb Bidan
21 3527045207880023 Misaroh, Amd.Keb Bidan
22 3527030607710010 Moh. Ismail, S.Kep.Ns Perawat
23 3515065604940002 Maghfirotus Safitri, Amd. AK Analis Kesehatan
24 3527030604910005 Yudi Sufianto, Amd.Kep Perawat
25 3527035701990000 Rika Amalia Saputri Analis Kesehatan
26 3527035901940002 Isna Nur Baiti, S.Tr.Keb Bidan
27 3527015808930001 Nur Agustini Bidan
28 3527134907930001 Hari Pujiawati Bidan
AN DI FASILITAS PELAYANAN
OAN YANG MENDAPATKAN
OOSTER) TAHAP 1

Tanggal Rencana Vaksinasi

No. HP
Vaksinasi Dosis 2 Dosis 3 (Booster)
087750422444 13/02/2021 12/08/2021 1
081913591352 15/02/2021 12/08/2021 1
087750018319 13/02/2021 12/08/2021 1
081937313887 15/02/2021 12/08/2021 1
081357032602 15/02/2021 12/08/2021 1
087806876114 15/02/2021 12/08/2021 1
085230639467 13/02/2021 12/08/2021 1
085259101991 13/02/2021 12/08/2021 1
087750726057 16/02/2021 13/08/2021 2
087849701480 15/02/2021 12/08/2021 1
081703406336 15/02/2021 12/08/2021 1
087880005522 24/02/2021 13/08/2021 2
087852933281 15/02/2021 12/08/2021 1
081703323947 15/02/2021 12/08/2021 1
082338371992 16/02/2021 13/08/2021 2
085232673462 15/02/2021 12/08/2021 1
082332523699 15/02/2021 12/08/2021 1
087803277799 16/02/2021 13/08/2021 2
082338000558 16/02/2021 13/08/2021 2
085231501703 16/02/2021 13/08/2021 2
087761408345 16/02/2021 13/08/2021 2
085235258949 16/02/2021 13/08/2021 2
07752794040 24/02/2021 13/08/2021 2
087750223434 15/02/2021 13/08/2021 2
082359250880 24/02/2021 13/08/2021 2
085230190972 16/02/2021 13/08/2021 2
082333377446 16/02/2021 13/08/2021 2
081933163397 16/02/2021 13/08/2021 2

Sampang, 11 Agustus 2021

Kepala UPTD. Puskesmas Jrangoan

(Misnari, SKM,M.MKes)
NIP. 19671201 198803 1 008