Vaksinasi November 21

Nama Puskesmas/Fasyankes/Pos : PKM GADINGREJO
Kabupaten/Kota : PASURUAN
Provinsi : JAWA TIMUR
Tanggal Pelaksanaan : 01 NOVEMBER 2021
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No No. Registrasi NIK Nama Penerima Vaksin Umur ok Alamat No. Hp Merek Vaksin Tanggal Tanggal
Umur Pemberian No. Batch Pemberian No. Batch
Vaksinasi Vaksinasi
INDUK
1 P-4V8C9HSU 3575011406000003 RAKHMAT AGUNG MAULANA 21 UMUM JL SLAMET RIYADI 1/4 SEBANI 8574227116 ASTRAZENECA 01/11/2021 A1063
2 P-6DU8VVXP 3575010107970033 LUKMANUL KHAQIM 24 UMUM JL HANGTUAH 4/3 GADINGREJO 8135797103 ASTRAZENECA 01/11/2021 A1063
3 P-2RD27IEJ 3575014507950003 NUR WARISA 26 UMUM JL HANGTUAH 6/4 GADINGREJO 8585568358 ASTRAZENECA 11 January 2021 A1063
4 P-5G7OXE43 3575010107920046 HARIYANTO 29 UMUM JL BANDA 5/2 GADINGREJO 8199760521 ASTRAZENECA 11 January 2021 A1063
5 P-6TXC3S5O 3575014101890010 AMINAH 32 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRAZENECA 11 January 2021 A1063
6 P-988PLQJ4 3514160604870002 NUR YAHYA 34 UMUM DUSUN ASEM JAJAR 8233525013 ASTRAZENECA 11 January 2021 A1063
7 P-5RIHSVFP 3575014107860130 LATIFAH 35 UMUM TAMBAAN 5/3 8775522303 ASTRAZENECA 11 January 2021 A1063
8 P-9CEMEJ8L 3514074910860001 JAHROTUL MUKRIMAH 35 UMUM PERUM NUANSA CANDI PERMAI 8564948860 ASTRAZENECA 11 January 2021 A1063
9 P-4V6CE8Z2 3514071504830002 M. SULAIMAN 38 UMUM JL HALMAHERA 2/3 GADINGREJO 8389215800 ASTRAZENECA 11 January 2021 A1063
10 P-98BDJ5X0 3514161705800004 KHUSNAN 41 UMUM MULYOREJO 2/6 KRATON 8190303644 ASTRAZENECA 11 January 2021 A1063
11 P-99GJ7XVV 3314042811790006 SUGIARTO 42 UMUM MUNGGURAN SRAGEN 8778138350 ASTRAZENECA 11 January 2021 A1063
12 P-98XELLQK 3575014608780001 SITI CHOTIMAH 43 UMUM JL SLAMET RIYADI 2/1 8311539710 ASTRAZENECA 11 January 2021 A1063
13 P-997QSYEW 3527036304780007 KARTIKA APRILIA 43 UMUM PERUM NUANSA CANDI PERMAI 8138085210 ASTRAZENECA 11 January 2021 A1063
14 P-6KIXS6IC 3575014306760001 NUR SALAMAH 45 UMUM JL HANGTUAH 1/3 GADINGREJO 8311452629 ASTRAZENECA 01/11/2021 A1063
15 P-44I66627 3575015604740002 LULUK MUKARROMAH 47 UMUM JL SLAMET RIYADI 1/4 SEBANI 8123092023 ASTRAZENECA 11 January 2021 A1063
16 P-5KP35QBH 3575016705770002 DEWI RUSMINI 47 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRAZENECA 01/11/2021 A1063
17 P-5ZW5J0LV 3575014107740038 LAILATUL MUKAROMAH 47 UMUM JL HANGTUAH 4/3 GADINGREJO 8975573032 ASTRAZENECA 11 January 2021 A1063
18 P-7CBD7OQJ 3575010107690103 SUPRAYITNO 52 RENTAN JL BANDA 4/2 GADINGREJO 8113777705 ASTRAZENECA 11 January 2021 A1063
19 P-99BOUVP0 3575015406670001 RINI IDAYATI 54 RENTAN KARANGKETUG 1/3 8133444790 ASTRAZENECA 11 January 2021 A1063
20 P-5AF26GHL 3575015809620001 SITI JENAB 59 RENTAN JL SLAMET RIYADI 3/3 GENTONG 8778541126 ASTRAZENECA 11 January 2021 A1063
21 Q-000L4BNJ 3575012112020002 HIPNI HERMAWAN 19 UMUM SEBANI 3/1 8153652151 ASTRAZENECA 05/08/2021 ABY1911 01/11/2021 A1063
22 Q-000LCE3M 3575010209890001 SONI RAKHMADI PAMUNGKAS 32 UMUM GADINGREJO RT 2 RW 2 8573290584 ASTRAZENECA 06/08/2021 ABY1911 01/11/2021 A1063
23 Q-000LJ4DA 3575014712700001 UMI KULSUM 51 RENTAN JL SLAMET RIYADI 4/2 GADINGREJO 8789559060 ASTRAZENECA 07/08/2021 ABY1911 01/11/2021 A1063
24 Z-0008NMN4 3514211003570001 M TAMIM 64 LANSIA JL BANDA GG. CEMPAKA NO.99 8122699136 ASTRAZENECA 06/08/2021 ABY1911 01/11/2021 A1063
25 P-9I8CITR3 3514182209090001 M. RIZKI AKMAL 12 REMAJA JL URIP SUMOHARJO 3/8 BUKIR 8880596387 BIOFARMA 01/11/2021 202108178F
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
26 P-9L28Y362 3527032006050002 AFIF MUHAMMAD DARMAWAN 16 REMAJA PERUM NUANSA CANDI PERMAI 1 Blok A-24 P 8123684386 BIOFARMA 01/11/2021 202108178F
27 P-7111HIXR 3575015210960003 PUTRI NURU SARI 25 UMUM JL HALMAHERA 5/6 GADINGREJO 8585277322 BIOFARMA 01/11/2021 202108178F
28 P-7K6Y1PCJ 3575014107900006 PUTRI WAHYUNING GUSTI 31 UMUM JL SLAMET RIYADI 1/1 8135955954 BIOFARMA 01/11/2021 202108178F
29 P-9D3P8WED 6408185112880002 MARIA ULFA 33 UMUM JL MANGGA SEGOY MAKMUR 8113777705 BIOFARMA 01/11/2021 202108178F
30 S-2C1EC2D9 3575032808540001 SUDIRMAN 67 LANSIA JL. SALAK III/A4 NO. 13, JAWA TIMUR, KOTA 8223319647 BIOFARMA 01/11/2021 202108178F
31 Q-001EXMC2 3575012208090002 CANDRA RAMADANI NUGROHO 12 REMAJA Jl. Anyelir Raya no 47 Gading Permai PASURUAN 8872808736 BIOFARMA 03/10/2021 202108172F 01/11/2021 202108178F
32 K-0001ZC87 3514191207090001 AKHMAD MUKHTAR KHOZIN 12 REMAJA Perum Gading Permai GG Anyelir 5 no. 6 PASUR 8525867374 BIOFARMA 03/10/2021 202108172F 01/11/2021 202108178F
33 Q-000RTTPC 3575012402080002 FAHRI MUKHAMMAD ZIDAN 13 REMAJA JL BANDA RT02/RW02 GADINGREJO 8580835511 BIOFARMA 31/08/2021 24202321 01/11/2021 202108178F
34 Q-001851QT 3575015105050001 KHUSNUL KHOTIMAH 16 REMAJA JL. HALAMHERA GG 9 KEL GADINGREJO 8385785694 BIOFARMA 04/10/2021 202108172N 01/11/2021 202108178F
35 Q-001F7JZH 3575012005050001 PIRMAN MAULANA 16 REMAJA JL. HALMAHERA GG. XI - GADINGREJO 8965498331 BIOFARMA 04/10/2021 202108154G 01/11/2021 202108178F
36 Q-0017JRM8 3514114301010002 DEWI PURWANTI 20 UMUM jl banda gadingrejo 8580635680 BIOFARMA 02/10/2021 202108154G 01/11/2021 202108178F
37 Q-000UEU69 3575015105990002 ANISATUL KHOIRIYAH 22 UMUM JL GATOT SUBROTO 1/7 BUKIR 8190893462 BIOFARMA 07/09/2021 2021071371 01/11/2021 202108178F
38 Q-00168LMI 3514140104980004 MUHAMMAD MUSLIM 23 UMUM JL GRIYA KAUMAN BANGIL 8570745531 BIOFARMA 30/09/2021 202108154G 01/11/2021 202108178F
39 Q-001837GT 3509114803930002 ELAFATUL ROHMAH 28 UMUM PERUM NUANSA CANDI II 003/007 PETAHUNAN 8525817771 BIOFARMA 04/10/2021 202108154G 01/11/2021 202108178F
40 Q-000ZZH26 3514161111920003 NANANG KOSIM 29 UMUM JL. BANDA 004/002 GADINGREJO, PASURUHAN 8314764760 BIOFARMA 18/09/2021 202108144G 01/11/2021 202108178F
41 Q-0018168P 3575035705890002 RITA MONIKA 32 UMUM JL ANJASMORO 006/006 BUGUL LOR 8223399104 BIOFARMA 04/10/2021 202108154G 01/11/2021 202108178F
42 Q-0018168V 3514174404880001 IVA ACHDIANI 33 UMUM DS PANDEAN 001/001 PLERET 8533492800 BIOFARMA 04/10/2021 202108154G 01/11/2021 202108178F
43 Q-000ENTZO 3575015202830003 MASNUNA 38 UMUM JL BANDA GG TERATAI GADINGREJO 8581669737 BIOFARMA 15/07/2021 24202321 01/11/2021 202108178F
44 Q-001F70RF 3575014107820150 SULIHA 39 UMUM JL HALMAHERA GG. XI 5/5 - GADINGREJO 8965498331 BIOFARMA 04/10/2021 202108154G 01/11/2021 202108178F
45 Q-000ENU09 3575011301800001 ABD. ROKHIM 41 UMUM JL BANDA GG TERATAI GADINGREJO 8581669737 BIOFARMA 15/07/2021 24200421 G 01/11/2021 202108178F
46 Q-001722YE 3575011611800002 ABDUL SYAKUR 41 UMUM JL HALMAHERA 8786160941 BIOFARMA 01/10/2021 202108154G 01/11/2021 202108178F
47 Q-000RTTI8 3575015307790003 SUSANTI 42 UMUM JL BANDA 2/2 GADINGREJO 8580835511 BIOFARMA 31/08/2021 24202321 01/11/2021 202108178F
48 Q-000N86Y1 3514161010760006 SAMIDI 45 UMUM GAMBIRAN 004/002 GAMBIR KUNING 8523184277 BIOFARMA 15/08/2021 24003521 N 01/11/2021 202108178F
49 Q-00171YOR 3575014107760124 SOLICHAH 45 UMUM GADINGREJO 3/3 8560658609 BIOFARMA 01/10/2021 202108154G 01/11/2021 202108178F
50 Q-000RI8JG 3575010312760001 MASYUDI 45 UMUM JL BANDA GG DAHLIA 8585812776 BIOFARMA 30/08/2021 24202221 G 01/11/2021 202108178F
51 Q-0014C0ZX 3527032808750003 AGUS WAHYUDI 46 UMUM PERUM NUANSA CANDI PERMAI 1 BLOK A 24 8525871620 BIOFARMA 27/09/2021 24202321 01/11/2021 202108178F
52 Q-000JJ8RG 3514145812730001 FENTY ROSYIDAH 48 UMUM JL. GRIYA KAUMAN JL. SEPAT NO.731 8775620757 BIOFARMA 26/07/2021 24201421 01/11/2021 202108178F
53 Q-00154CLF 3575010107660025 SUDARMAJI 55 RENTAN GENTONG 1/5 8510077634 BIOFARMA 28/09/2021 202108154G 01/11/2021 202108178F
54 Q-000RNTN6 3575010207650003 KARNO ARIANTO 56 RENTAN JL IRIAN JAYA GG ANGGREK PASURUAN. 8199940811 BIOFARMA 31/08/2021 24202321 01/11/2021 202108178F
55 Z-000BY6YE 3578145708580003 SUGIARTI 63 LANSIA PERUM PAKAL RESIDENCE PAKAL SURABAYA 8533527382 BIOFARMA 02/10/2021 202108154G 01/11/2021 202108178F
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
56 Z-000BY702 3578140112560001 SISWANTO 65 LANSIA PAKAL RESIDENCE B20 RT05/RW03 SURABAYA 8581543165 BIOFARMA 02/10/2021 202108154G 01/11/2021 202108178F
PUSTU BUKIR
1 Q-001A7QL0 3575010808760002 M. HIDAYAT 45 UMUM Bukir RT01 RW02 81216914833 CoronaVac 04/10/2021 202108154G 01/11/2021 202108178F
2 K-0001R2RE 3514053004930007 ANDI LIYAS BASTIYAR 28 UMUM jl.urip sumoharjo, Gadingrejo, KOTA PASURUAN, 82332115981 CoronaVac 04/10/2021 202108154G 01/11/2021 202108178F
3 Q-000X7P3P 3575011512040002 AKHMAD NAWAWI 17 REMAJA Jalan Gatot Subroto RT 3 RW 6 82152262382 CoronaVac 13/09/2021 202108118H 01/11/2021 202108178F
4 Z-000B4LGA 3575014101420008 PONIRA 79 LANSIA SEBANI RT 2 / 5 8113777705 CoronaVac 20/09/2021 202108118H 01/11/2021 202108178F
Mengetahui Pasuruan, 01-11-2021

Kepala UPT Puskesmas Gadingrejo Admin Vaksinasi
drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Umur Pemberian No. Batch Pemberian
Batch
Vaksinasi Vaksinasi
INDUK
1 P-ADCQJF5R 3575026804030002 LATIFAH DIVA 18 UMUM JL HALMAHERA RT02/RW03 GADINGREJO 8113777705 Astra Zeneca 02/11/2021 A10B3
2 P-ADW14IZL 3575014602020002 AISAH 19 UMUM JL HALMAHERA GADINGREJO 8969959661 Astra Zeneca 02/11/2021 A10B3
3 P-AGIBS2GZ 3575011406000005 M. FAJAR MAULUDIN 21 UMUM JL SLAMET RIYADI 1/2 8383377383 Astra Zeneca 02/11/2021 A10B3
4 P-AFYO6HZU 3575010107990037 M. NASIH SIBLI 22 UMUM JL HANG TUAH GADINGREJO 8113777705 Astra Zeneca 02/11/2021 A10B3
5 P-AFOUDKO6 3575011406990001 SAIFUL HUDA 22 UMUM JL HANGTUAH GADINGREJO 8967885815 Astra Zeneca 02/11/2021 A10B3
6 P-7ZQQFWXS 3575016111970004 MAGHFIROH 24 UMUM JL BANDA 4/2 GADINGREJO 8383882115 Astra Zeneca 02/11/2021 A10B3
7 P-8BA7Z5HP 3575012901950002 ABDUL ROKHIM 26 UMUM JL SLAMET RIYADI RT03/04 8953662449 Astra Zeneca 02/11/2021 A10B3
8 P-AIIROTR7 3575017003940003 LUTFIAH 27 UMUM JL HALMAHERA GADINGREJO 8560775230 Astra Zeneca 02/11/2021 A10B3
9 P-ADSBIFN7 3575011610900004 MUHAMMAD MAULUDIN 31 UMUM JL GATOT SUBROTO BUKIR 8575507355 Astra Zeneca 02/11/2021 A10B3
10 P-7J3RWWRM 3575010107900054 EKO PRASTIYO 31 UMUM JL HANGTUAH GADINGREJO 8958010413 Astra Zeneca 02/11/2021 A10B3
11 P-98XXUE2J 3514184410870001 RANI LINDAWATI 34 UMUM JL URIP SUMOHARJO RT03/RW08 8880596387 Astra Zeneca 02/11/2021 A10B3
12 P-AHD7YA0A 3514050411870004 MOH. IMRON 34 UMUM NGANTUNGAN PASERPAN 8121270797 Astra Zeneca 02/11/2021 A10B3
13 P-ADISTERR 3514162808860004 M. MUAMAR 35 UMUM GUMENG KALIREJO 8113777705 Astra Zeneca 02/11/2021 A10B3
14 P-ADLESWUY 3575012401860001 ABDUL KHAMID 35 UMUM JL IRIAN JAYA GADINGREJO 8581509048 Astra Zeneca 02/11/2021 A10B3
15 P-ADD0SHHZ 3575014703840003 SURIYA 37 UMUM JL HALMAHERA GADINGREJO 8113777705 Astra Zeneca 02/11/2021 A10B3
16 P-AGR7C3LZ 3578175601840001 RESIA BAREK OPEN 37 UMUM TANAH MERAH KENJERAN 8564906443 Astra Zeneca 02/11/2021 A10B3
17 P-AI819QB7 3514060112830002 MOH.NASIKIN 38 UMUM BELANG KEJAYAN 8560775230 Astra Zeneca 02/11/2021 A10B3
18 P-AHZ63NSQ 3575010811810004 ANDRI W. 40 UMUM JL HALMAHERA IX GADINGREJO 8560775230 Astra Zeneca 02/11/2021 A10B3
19 P-62BWYCIK 3575014107800126 MAF ULA 42 UMUM JL HANG TUAH GADINGREJO 8113777705 Astra Zeneca 02/11/2021 A10B3
20 P-8NMF7DZP 3575015501700001 YAMUNA 51 RENTAN JL SLAMET RIYADI SEBANI 8953662449 Astra Zeneca 02/11/2021 A10B3
21 P-AE72GH2L 3575010107630064 SUPAAT 58 RENTAN JL GATOT SUBROTO BUKIR 8575507355 Astra Zeneca 02/11/2021 A10B3
22 Q-000LBGQZ 3575016410970002 LILIK MUSHAROFAH 24 UMUM GADINGREJO RT 2 RW 2 8560819551 Astra Zeneca 06/08/2021 ABY1911 02/11/2021 A10B3
23 Q-000B16M9 3575035009820006 MASRUROH 39 UMUM JL JEND S PARMAN 8133383355 Astra Zeneca 03/07/2021 ABY1911 02/11/2021 A10B3
24 Q-000K01K7 3575013007760002 MOCH. SOLEH 45 UMUM JL IRIAN JAYA GG ANGGREK 8133328296 Astra Zeneca 29/07/2021 ABY1911 02/11/2021 A10B3
25 Q-000LIH8F 3575011005650003 SUPARDI 56 RENTAN JL BANDA GG DAHLIA 3/2 8965265719 Astra Zeneca 07/08/2021 ABY1911 02/11/2021 A10B3
26 Q-000UMUZM 3575011008070001 ACHMAD MARIO FERDIANSYAH 14 REMAJA JL.KYAI SEPUH GANG 3 GADINGREJO PASURU 8880503661 Biofarma 07/09/2021 2021071371 02/11/2021 202108178F
27 Q-00187VB0 3575011308070002 ALFA FIKRI AFIXENA 14 REMAJA JL HALMAHERA 8591859467 Biofarma 04/10/2021 202108154G 02/11/2021 202108178F
28 Q-0017VGD1 3575044905060001 FIRLY WARDHANI 15 REMAJA APARTEMEN PANTAI MAS LANTAI 5/18/B II, 4 8384657663 Biofarma 03/10/2021 202108172F 02/11/2021 202108178F
29 Q-0018EHNM 3575012411060004 MUKHAMMAD ALI MUFLIKH 15 REMAJA JL NGAGLIK RT06/RW02 GADINGREJO 8312279829 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 Q-00170CIQ 3575017012040001 MUSRIFAH 17 REMAJA JL HANGTUA 4/3 GADINGREJO 8113777705 Biofarma 01/10/2021 202108154G 02/11/2021 202108178F
31 Q-000U0TKM 3575015205030003 WAHDANIYAH 18 UMUM JL BANDA 5/2 GADINGREJO 8384766971 Biofarma 06/09/2021 2021071371 02/11/2021 202108178F
32 Q-00155ANX 3575016203960002 LISA DWI FATIMAH 25 UMUM KELURAHAN GENTONG 8585211152 Biofarma 28/09/2021 202108154G 02/11/2021 202108178F
33 Z-000BNAIE 3575017012950001 NORA SYAFIRA 26 UMUM GENTONG 2/4 8125932804 Biofarma 28/09/2021 202108154G 02/11/2021 202108178F
34 Q-0012FNFX 3575014101870026 DEWI ANITA 34 UMUM JL HALMAHERA 002/003 8113777705 Biofarma 23/09/2021 202108123H 02/11/2021 202108178F
35 Q-0018DB7M 3575015606860006 ZULAIKHA 35 UMUM JL HANGTUAH 3/3 8820095071 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
36 Q-0015TDGT 3575015006850002 SATUMI 36 UMUM JL HANGTUAH 2 RT04/RW03 GADINGREJO 8594343060 Biofarma 29/09/2021 202108154G 02/11/2021 202108178F
37 Q-00187UQX 3575014510840003 MUSLICHA 37 UMUM JL HALMAHERA 8113777705 Biofarma 04/10/2021 202108154G 02/11/2021 202108178F
38 Q-0016A9Y0 3575015912830001 DARMIATI 38 UMUM JL BANDA 4/2 GADINGREJO 8575571558 Biofarma 30/09/2021 202108154G 02/11/2021 202108178F
39 Q-0018I8QA 3575014512820001 KHUSNUL MUAROFAH 39 UMUM JL SLAMET RIADI 003/003 GENTONG 8214349257 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
40 Q-0018GX1F 3575015511780002 PUDJI RAHAYU 43 UMUM JL HASANUDIN IX NO 53 RT01/RW07 KARANGA 8963507550 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
41 Q-0017JQ0E 3575014311730001 JUARIYAH 48 UMUM JL KYAI SEPUH GENTONG 8968376960 Biofarma 02/10/2021 202108154G 02/11/2021 202108178F
42 Q-000U13FA 3575016002700001 SOLICHAH 51 RENTAN JL SLAMET RIYADI 1/1 GENTONG 8113777705 Biofarma 06/09/2021 2021071371 02/11/2021 202108178F
43 Q-0009I7KB 3575037006650007 YANTIN YUNIARDINA 56 RENTAN PERUMAHAN KARYA BAKTI BLOK B. NO. 16 8223319647 Biofarma 29/06/2021 24003521 02/11/2021 202108178F
44 Q-0018F706 3575014506610002 DJUKAISI 59 RENTAN JL SLAMET RIADI 003/003 GENTONG 8968766298 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
45 Q-0018GIL2 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 Biofarma 05/10/2021 202108154G 02/11/2021 202108178F
46 Z-000BNAOU 3575027011580002 AISYAH AL TWAY 63 LANSIA JL PUCANGAN 3/4 PURWOREJO 8785271310 Biofarma 28/09/2021 202108154G 02/11/2021 202108178F
47 Z-000BNM65 3575024504450004 MAHANI AMBAR 76 LANSIA JL MARGO UTOMO 4/3 PURWOREJO 8213030335 Biofarma 28/09/2021 202108154G 02/11/2021 202108178F
48 P-ADF3R9KC 3575016304880002 ARBIAN APRILIA 33 UMUM JL SLAMET RIYADI GENTONG 8222838880 Biofarma 02/11/2021 202108178F
49 P-AH2J2XV1 3575010107700122 MOBIN 51 RENTAN JL HANGTUAH 1/4 GADINGREJO 8113777705 Biofarma 02/11/2021 202108178F
50 S-49E62A2F 3575014101610030 SUPIYANI 61 LANSIA JL HALMAHERA TAMBA'AN 8113777705 Biofarma 02/11/2021 202108178F
51 S-37921FFC 3575014801580001 TATIK WIBAWATI 63 LANSIA JL SLAMET RIADI GENTONG 8133133777 Biofarma 02/11/2021 202108178F
52 S-C6C56326 3575011502540001 ARWI 67 LANSIA JL HANGTUAH GADINGREJO 8113777705 Biofarma 02/11/2021 202108178F
53 S-7EB27AA5 3575012209610001 H. ABDULLAH SODIQ 60 LANSIA JL MENARA NO 16 1/8 GENTONG 8133348105 Biofarma 02/11/2021 202108178F
1 Q-0013CCTO 3575011503880001 EDI PURNOMO 33 UMUM JL GATOT SUBROTO 85855608197 CoronaVac 24/09/2021 202108154G 02/11/2021 202108178F
2 Q-00185107 3575015712870001 DEWI NAFISAH 34 UMUM JL URIP SUMOHARJO 89530910101 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
3 Z-000C13JS 3575014107570025 FATA BASAMA 64 LANSIA jl urip sumoharjo 89530910101 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
4 Q-00185122 3575015005930002 MUNAWARO 28 UMUM BUKIR RT 2 RW 6 8311804699 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
5 Q-001850YX 3575015111020001 NUR SAFINA ROMADHONA 19 UMUM JL GATOT SUBROTO 88217914329 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
6 Q-001850YR 3575014905700001 NURYATI 51 RENTAN JL GATOT SUBROTO 88217914329 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
PUSTU SEBANI
1 Q-00188KH3 3575011111850001 AKHMAD ARIFIN 36 UMUM JL SLAMET RIYADI 8968779558 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
2 Q-00187V0B 3575014908880006 ANITA SARI 33 UMUM JL SLAMET RIYADI 8239729404 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
3 Q-00187V33 3575014412860004 NUR AZIZAH 35 UMUM JL SLAMET RIYADI 8523229094 CoronaVac 04/10/2021 202108154G 02/11/2021 202108178F
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
4 Q-0018HOVI 3575010208840001 SAMSUL ARIFIN 37 UMUM JL. SIMPANG SLAMET RIYADI 3/1 SEBANI 8533870512 CoronaVac 05/10/2021 202108154G 02/11/2021 202108178F
PUSTU GADINGREJO & GENTONG
1 Q-00171IH0 : 3527046710890004 TOYYIBEH 32 UMUM JL HANGTUAH 1/4 GADINGREJO 8113777770 BIOFARMA 01/10/2021 202108154G 02/11/2021 202108178F
2 Q-000U3LJ7 : 3575014803940001 LAILATUL FITRIYAH 27 UMUM JL HALMAHERA 4/5 GADINGREJO 8126580014 BIOFARMA 06/09/2021 2021071371 02/11/2021 202108178F
3 Q-00116XOY : 3575016110830003 DINA ARI NURTI 38 UMUM KARYA BAKTI 3/8 8123245504 BIOFARMA 21/09/2021 202108118H 02/11/2021 202108178F
4 Q-001734FQ : 3575016409820005 SITI ANISAH 39 UMUM JL KYAI SEPUH 001/005 8810268037 BIOFARMA 01/10/2021 202108154G 02/11/2021 202108178F
5 Q-001CR7W6 : 3575014107850004 KHOLIFAH 36 UMUM JL KYAI SEPUH 002/005 GENTONG 8573395350 BIOFARMA 30/09/2021 202108154G 02/11/2021 202108178F
6 Z-000C39CO : 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 05/10/2021 202108154G 02/11/2021 202108178F
7 Q-0018ELD3 : 3514206708730001 SUKAEMI 48 UMUM DS KRAWAN 001/004 KEDAWUNG WETAN 8580669268 BIOFARMA 05/10/2021 202108154G 02/11/2021 202108178F
8 Q-001COSK2 : 3305206305890003 SARMINI 32 UMUM JL HASANUDIN 38 002/005 KARANGANYAR 8138082314 BIOFARMA 30/09/2021 202108154G 02/11/2021 202108178F
9 Q-001CR8BO : 3575016409810002 NURANI EKA NUFIANDARI 40 UMUM JL DARMOYUDO UTAMA 001/001 PURWOREJO 8554903305 BIOFARMA 30/09/2021 202108154G 02/11/2021 202108178F
10 Q-0018I8LA : 3575011001940002 AKHMAD BAIDOWI 27 UMUM JL SLAMET RIADI 003/003 GENTONG 8978396481 BIOFARMA 05/10/2021 202108154G 02/11/2021 202108178F
11 Q-001526X4 : 3575016504760002 SUNAEMI 45 UMUM JL. SLAMET RIYADI GENTONG 8133222731 BIOFARMA 28/09/2021 202108154G 02/11/2021 202108178F
12 Q-001734D1 : 3575012503740001 SAIMUN 47 UMUM JL KYAI SEPUH 001/005 GENTONG 8573011561 BIOFARMA 01/10/2021 202108154G 02/11/2021 202108178F


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
INDUK
1 P-44HGVE59 : 3514204502880001 NIEKE ARDIANA WIBAWANTI 33 UMUM MAGERSARI 1/4 KEDAWUNG KULON GRATI 8158618229 BIOFARMA 03/11/2021 202108178F
2 P-B8TEOXI7 : 3575016608990006 ALFIATUS SHOLIKHA 22 UMUM NGAGLIK 6/2 GADINGREJO 8213229945 BIOFARMA 03/11/2021 202108178F
3 P-3XLQTMU1 : 3575016704940002 RETNO PUJI LESTARI 27 UMUM PERUM CITRA CANDI PERMAI BLOK E-33 KAR 8578575111 BIOFARMA 03/11/2021 202108178F
4 P-4ZMJDXUO : 3575016004070001 SASKIA DWI MAULIDIYAH 14 REMAJA JL SLAMET RIYADI 1/2 8383210124 BIOFARMA 03/11/2021 202108178F
5 Q-000RG6E8 : 3575015705060006 LILIAN FARRA BILLAH 15 REMAJA JL HALMAHERA 3/3 GADINGREJO 8224587417 BIOFARMA 30/08/2021 24202221 03/11/2021 202108178F
6 K-0001ZV2S : 3575011503050001 VINCENTIUS GIOVANNI SAPUTRA 16 REMAJA Perumahan gading permai anyelir 3 no 15, Gadi 8124920673 BIOFARMA 04/10/2021 202108172F 03/11/2021 202108178F
7 Q-00187TOD : 3575010107920031 MACHMUD 29 UMUM jl hangtuah 8113777705 BIOFARMA 04/10/2021 202108154G 03/11/2021 202108178F
8 Q-000TZ8MR : 3575015010770012 KUSMIATI 44 UMUM JL BANDA 3/2 GADINGREJO 8113777770 BIOFARMA 06/09/2021 2021071371 03/11/2021 202108178F
9 Q-001929O8 : 3575010403670001 MUSTOFA HUDA 54 RENTAN JL SLAMET RIADI 003/003 GENTONG 8786697250 BIOFARMA 06/10/2021 202108154G 03/11/2021 202108178F
10 Q-0018YOQ3 : 3513144310940003 FAIQOTUL HIKMAH 27 UMUM PERUM LUMBUNG PADI NO.85 004/001 SEBANI 8523086521 BIOFARMA 06/10/2021 202108154G 03/11/2021 202108178F
11 Q-0014YKA4 : 3575014202020003 LAILI AL-FITRA 19 UMUM JL. SLA RT 2 RW 4 GENTONGMET RIYADI 8781542528 BIOFARMA 28/09/2021 202108154G 03/11/2021 202108178F
12 Q-0018YF0K : 3575016311030002 LAYLA RIMADHANI 18 UMUM JL SLAMET RIYADI 8783707834 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
13 Q-0015QRTX : 3575017108880002 NURUL BADRIYA 33 UMUM JL BANDA RT04/RW02 GADINGREJO 8123582712 BIOFARMA 29/09/2021 202108154G 03/11/2021 202108178F
14 Q-000UYM17 : 3575014101030002 KHOIRIYAH 18 UMUM JL HALMAHERA GADINGREJO 8956061904 BIOFARMA 08/09/2021 2021071371 03/11/2021 202108178F
15 Q-0016IPOT : 3575010111650004 PRIYO YUDO BAROTO 56 RENTAN JL KYAI SEPUH 8523515653 BIOFARMA 30/09/2021 202108154G 03/11/2021 202108178F
16 Q-001935RQ : 3575017105900001 SULASTRI 31 UMUM SEBANI GADINGREJO 8580423605 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
17 Q-0015GN7E : 3575016907030002 PUTRI NABILATUS SA'ADAH 18 UMUM SEBANI GADINGREJO 8580688271 BIOFARMA 28/09/2021 202108154G 03/11/2021 202108178F
18 Q-0018RU8C : 3514140411040003 MUHAMMAD SAHRONI 17 UMUM KALUR SARI 8384165746 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
19 Q-0017ICIV : 3575014409960002 TOIFA 25 UMUM JL HANGTUAH VI 8113777705 BIOFARMA 02/10/2021 202108154G 03/11/2021 202108178F
20 Q-0018SFWS : 3575020707060003 MOCHAMAD SUCHEL 15 REMAJA JL LAKS MARTADINATA 4/8 8383457848 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
21 Q-0016F2ZZ : 3575015702730001 MUNTI'AH 48 UMUM JL SLAMET TIYADI 17 GENTONG 8133031956 BIOFARMA 30/09/2021 202108154G 03/11/2021 202108178F
22 Q-0018TP51 : 3575015304040002 MUSYAWAROH 17 UMUM JL HANGTUAH GG 6 8312524861 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
23 Q-0016H31G : 3575010207950001 MUHAMAD FARIED BUDIMAN 26 UMUM JL KYAI SEPUH 2/1 GADINGREJO 8312027260 BIOFARMA 30/09/2021 202108154G 03/11/2021 202108178F
24 Z-000CQPIZ : 3514065405990001 SITI MUQIMAH 22 UMUM Dsn jambangan rtrw015005 Ketangi rejo Kejayan 8133016010 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
25 Q-0018S37V : 3575014809930002 ALFIYAH 28 UMUM JL HANGTUAH GADINGREJO 8778524390 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
26 Q-000VY382 : 3575011808950004 MUHAMMAD NUR KHOLIS 26 UMUM JL BANDA 3/3 GADINGREJO 8575579376 BIOFARMA 10/09/2021 202108118H 03/11/2021 202108178F
27 P-4R6LIEWI : 3514165306820006 NASICHAH 39 UMUM JL HANGTUAH 4/3 GADINGREJO 8123408980 ASTRA ZENECA 03/11/2021 A1063
28 P-7SEGUZPI : 3575014604840002 APRIN HANDAYANI 37 UMUM JL SLAMET RIYADI 3/4 SEBANI 8523203417 ASTRA ZENECA 03/11/2021 A1063
29 P-8H7QMVBY : 3575016412850004 NUR HIDAYATI 36 UMUM JL MULYOREJO 1/6 SEBANI 8233894733 ASTRA ZENECA 03/11/2021 A1063
30 P-ASGPF6TH : 3575014605720003 ANISAH 49 UMUM JL HANGTUAH 3/3 GADINGREJO 8564566797 ASTRA ZENECA 03/11/2021 A1063
31 P-B9B15MCT : 3575014311760002 ASIA 45 UMUM JL HANGTUAH 3/4 GADINGREJO 8113777705 ASTRA ZENECA 03/11/2021 A1063
32 P-BA0WOYDH : 3575014809670001 KHAMIDAH 54 RENTAN GADINGREJO 8564946016 ASTRA ZENECA 03/11/2021 A1063
33 P-BAEE0ECR : 3575030708980001 BAYU FARDIANSYAH 23 UMUM JL RA KARTINI BANGILAN 8223262562 ASTRA ZENECA 03/11/2021 A1063
34 P-0BY6X2AG : 3575010107940031 SAMSUL ARIFIN 28 UMUM JL HANG TUAH 2/3 GADINGREJO 8573300432 ASTRA ZENECA 03/11/2021 A1063
35 P-68CJ5HRE : 3575011601000001 TEDDY PUTRA FIRDIANSYAH 21 UMUM JL SLAMET RIYADI 8313265667 ASTRA ZENECA 03/11/2021 A1063
36 P-4GYKQP3J : 3514164207820011 SUROYA 39 UMUM JL HANGTUAH 4/3 GADINGREJO 8123408980 ASTRA ZENECA 03/11/2021 A1063
37 P-8TUF8OOB : 3514160406860003 MOH.TAUFIK 35 UMUM JL HALMAHERA GADINGREJO 8953960005 ASTRA ZENECA 03/11/2021 A1063
38 P-9WH6ZUO1 : 3575016303950002 KOMARIA 26 UMUM JL HALMAHERA 6/4 GADINGREJO 8951567662 ASTRA ZENECA 03/11/2021 A1063
39 P-B3OFZILW : 3575014609880005 KURNIA 33 UMUM JL KYAI SEPUH 1/6 GENTONG 8880565133 ASTRA ZENECA 03/11/2021 A1063
40 P-B8XZN9NP : 3575010809850001 MOHAMAD SU'UD 36 UMUM JL SLAMET RIYADI 2/2 GENTONG 8523333478 ASTRA ZENECA 03/11/2021 A1063
41 P-B9FOORVH : 3575034404960004 INDAH RIANTI 25 UMUM JL HANGTUAH 3/4 GADINGREJO 8784604049 ASTRA ZENECA 03/11/2021 A1063
42 P-BA4ICTDM : 3575014408730001 HAYANAH 48 UMUM JL HANGTUAH GADINGREJO 8155699274 ASTRA ZENECA 03/11/2021 A1063
43 P-BAB0VQ13 : 3575014312930003 KHOFIFA 28 UMUM JL HALMAHERA 2/3 GADINGREJO 8953960005 ASTRA ZENECA 03/11/2021 A1063
44 P-BB1AIZPO : 3514245206910002 PONASRI 30 UMUM JL SLAMET RIYADI 8233563243 ASTRA ZENECA 03/11/2021 A1063
45 P-BAVWQKIG : 3575010807990004 MOCHAMAD ANDY WAHYULIANTO 22 UMUM JL SLAMET RIYADI 3/5 SEBANI 8570563551 ASTRA ZENECA 03/11/2021 A1063
46 Q-000K3QH6 : 3575012412760001 SUKOCO 45 UMUM JL GATOT SUBROTO 8123389261 ASTRA ZENECA 29/07/2021 ABY1911 03/11/2021 A1063
47 Q-000K4DQ3 : 3575016008010002 DIANA SARI AGUSTININGSIH 20 UMUM JL GATOT SUBROTO bukir 8135787312 ASTRA ZENECA 29/07/2021 ABY1911 03/11/2021 A1063
48 Q-000LIEON : 3575016308710001 SITI MARIYAM 50 RENTAN JL GATOT SUBROTO 1/7 BUKIR 8123467867 ASTRA ZENECA 07/08/2021 ABY1911 03/11/2021 A1063
49 P-0SK06KDM : 3575014107690099 HASANAH 52 RENTAN JL HANGTUAH 8133536474 ASTRA ZENECA 05/10/2021 ABY1312 03/11/2021 A1063
50 Q-000LIB5B : 3575016509010001 NURUL SINTIYAH 20 UMUM JL GATOT SUBROTO 1/7 BUKIR 8135876967 ASTRA ZENECA 07/08/2021 ABY1911 03/11/2021 A1063
PUSTU SEBANI & GENTONG
1 Q-00154SNY : 3575014909010002 HANIFIAH 20 UMUM GENTONG 1/5 8571196530 BIOFARMA 28/09/2021 202108154G 03/11/2021 202108178F
2 Q-001557WV : 3575014812750003 SITI HINDUN 46 UMUM KELURAHAN GENTONG 8810367658 BIOFARMA 28/09/2021 202108154G 03/11/2021 202108178F
3 Q-0017JBPA : 3575013105810001 JAINUL ARIFIN 40 UMUM JL KYAI SEPUH GENTONG 8810268037 BIOFARMA 02/10/2021 202108154G 03/11/2021 202108178F
4 Q-001733MW : 3575015111650002 SALIYAH 56 RENTAN JL KYAI SEPUH 001/005 GENTONG 8133411941 BIOFARMA 01/10/2021 202108154G 03/11/2021 202108178F
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
5 Z-000AY6NK : 3575014505590002 ALFIYAH 62 LANSIA JL KYAI SEPUH 1/6 GENTONG 8122148563 BIOFARMA 17/09/2021 202108118H 03/11/2021 202108178F
6 Q-0018Z0YG : 3575014507850002 YULIASTUTIK 36 UMUM JL KYAI SEPUH 002/005 GENTONG 8969986171 BIOFARMA 06/10/2021 202108154G 03/11/2021 202108178F
7 Q-00187V99 : 3575016210630001 AMINAH 58 RENTAN JL SLAMET RIYADI 8213141124 BIOFARMA 04/10/2021 202108154G 03/11/2021 202108178F
8 Q-0019386H : 3575014107680007 SULASTRI 56 RENTAN JL SLAMET RIYADI 8951373263 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
9 Q-00193BN9 : 3514131201830004 MUHAMMAD IKHWAN 38 UMUM SEBANI GADINGREJO 8533825277 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F
10 Q-00192OWF : 3575012707870001 MOCHAMAD SUHADA 34 UMUM JL SLAMET RIYADI 8951373263 BIOFARMA 06/10/2021 202108172F 03/11/2021 202108178F


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
INDUK & PUSTU SEBANI

1 P-835PWTKU : 3575016104030002 AMIRA 18 UMUM JL KARYA BAKTI P 15 GENTONG 8786160971 BIOFARMA 04/11/2021 202108178F
2 P-C4Q6WUJN : 3573016301920003 JANEY LETA DEBORA 29 UMUM JL SADEWONO 4 BLIMBING 8123453457 BIOFARMA 04/11/2021 202108178F
3 P-C5KX0BLQ : 3575015210050001 YULI JULAILI 16 REMAJA JL HALMAHERA GADINGREJO 8223038564 BIOFARMA 04/11/2021 202108178F
4 Q-0018YQSE : 3575032701090002 ALDIANSYAH 12 REMAJA JL HANGTUAH 8776597766 BIOFARMA 06/10/2021 202108172F 04/11/2021 202108178F
5 Q-0019PUUK : 3575014609070001 MAYADA ALYA PUSPITA 14 REMAJA JL SLAMET RIADI 002/003 GENTONG 8223236588 BIOFARMA 07/10/2021 202108172F 04/11/2021 202108178F
6 Q-0019OH61 : 3514182505880003 M.ATOK ILLAH 33 UMUM JL SLAMET RIADI 002/003 GENTONG 8213188101 BIOFARMA 07/10/2021 202108172F 04/11/2021 202108178F
7 Q-0019LUN6 : 3575016012930001 IRA NUR AFIYA 28 UMUM JL SLAMET RIADI 002/003 GENTONG 8213188101 BIOFARMA 07/10/2021 202108172F 04/11/2021 202108178F
8 Q-000V0MHP : 3575012007710003 AS'AD 53 RENTAN JL HANGTUAH 1/3 GADINGREJO 8113777705 BIOFARMA 08/09/2021 2021071371 04/11/2021 202108178F
9 Q-000RCEB0 : 3575015907700004 SULAIYAH 53 RENTAN JL HANG TUA 1/3 GADINGREJO 8190303648 BIOFARMA 30/08/2021 24202221 04/11/2021 202108178F
10 Q-0002EH3N : 3514165308840003 SITI LUTFIAH 36 UMUM MUNENG RT 003 RW 004 BENDUNGAN KRATON 838484603 BIOFARMA 14/06/2021 24002621 04/11/2021 202108178F
11 Q-000RNO8K : 3514152812950001 NURUL HUDA 26 UMUM DSN KETAPAN 1/8 PEKOREN REMBANG 8560813477 BIOFARMA 31/08/2021 24202321 04/11/2021 202108178F
12 Q-000VXY00 : 3575014803010002 PUTRI FAUZIAH 20 UMUM JL HALMAHERA 3/5 GADINGREJO 8880505477 BIOFARMA 10/09/2021 202108118H 04/11/2021 202108178F
13 P-A05TEA7O : 3575014102650001 SUISMIATI 56 RENTAN SEBANI, JAWA TIMUR, KOTA PASURUAN, GADI 8895583827 ASTRA ZENECA 04/11/2021 A1063
14 P-52R9Y1Q8 : 3575010808770003 SOLEHUDIN 44 UMUM JL HANGTUAH 3/5 GADINGREJO 8113777705 ASTRA ZENECA 04/11/2021 A1063
15 P-5EVNN54Q : 3575015406860001 IRNA 35 UMUM JL HALMAHERA XI GADINGREJO 8575543941 ASTRA ZENECA 04/11/2021 A1063
16 P-635U5ABV : 3575016007810003 FIRDIANA YULIANI 40 UMUM JL HALMAHERA 1/4 GADINGREJO 8223429690 ASTRA ZENECA 04/11/2021 A1063
17 P-5QAXL337 : 3575010107810164 HERI PURWANTO 40 UMUM JL HALMAHERA GADINGREJO 8316039338 ASTRA ZENECA 04/11/2021 A1063
18 P-6E8409LP : 3575010402790001 MOCHAMMAD FAISOL 42 UMUM JL HALMAHERA 2/5 GADINGREJO 8113777705 ASTRA ZENECA 04/11/2021 A1063
19 P-74CVSG0H : 3575010209760004 TEGUH SUSILO 45 UMUM JL HALMAHERA 5/5 GADINGREJO 8383363477 ASTRA ZENECA 04/11/2021 A1063
20 P-98WCURLT : 3575014604950001 NOR JANNAH 26 UMUM JL HALMAHERA 4/5 GADINGREJO 8573522044 ASTRA ZENECA 04/11/2021 A1063
21 P-A823ZO8J : 3514160109990003 MUHAMMAD ATTIRIL ARDANI 22 UMUM JL HANGTUAH 4/3 GADINGREJO 8123444764 ASTRA ZENECA 04/11/2021 A1063
22 P-ALIDSJRQ : 3575022111790001 EKO HARI BASUKI 42 UMUM JL RADEN PATAH GENTONG 8578524782 ASTRA ZENECA 04/11/2021 A1063
23 P-C0DVLFFT : 3575014102000001 KHUSNUL KHOTIMAH 21 UMUM JL HALMAHERA GADINGREJO 8577237745 ASTRA ZENECA 04/11/2021 A1063
24 P-C4HDXCR9 : 3575011503010005 ZAID ABDUL HAFID 20 UMUM BUKIR 2/2 BUKIR 8958090499 ASTRA ZENECA 04/11/2021 A1063
25 P-C4L72UTC : 3575015306890003 SITI CHOLILAH 32 UMUM BUKIR GADINGREJO 8953040092 ASTRA ZENECA 04/11/2021 A1063
26 P-C4Y8XB5A : 3575011904880004 EKA DWI APRILIYANTO 33 UMUM JL SADEWONO 4 BLIMBING 8123453457 ASTRA ZENECA 04/11/2021 A1063
27 P-C57VJRO2 : 3575010107750042 ALI MUHSIN 46 UMUM SEKARGADUNG 8579275066 ASTRA ZENECA 04/11/2021 A1063
28 P-C5FVHWVQ : 3575010102750003 SU'UDI 46 UMUM JL HALMAHERA GADINGREJO 8786455339 ASTRA ZENECA 04/11/2021 A1063
29 P-C5RDLGMJ : 3575016105020005 FIRDATUS SINTYA 19 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8983909097 ASTRA ZENECA 04/11/2021 A1063
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
30 P-C606KJV4 : 3575015605960003 INDRI KOMARIA 25 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8579171510 ASTRA ZENECA 04/11/2021 A1063
31 P-C6F6WICJ : 3575010506950004 HARIYANTO 26 UMUM JL HALMAHERA 1/5 GADINGREJO 8810260462 ASTRA ZENECA 04/11/2021 A1063
32 P-0UEZVLVP : 3575014302790003 NUR FADILAH 42 UMUM JL HALMAHERA 2/5 GADINGREJO 8951572441 ASTRA ZENECA 04/11/2021 A1063
33 P-7NIL1PCS : 3575015902780001 VIKRIA SHOFIYAH 43 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 04/11/2021 A1063
34 P-91JGA3KC : 3575016203940002 KHISBIYA 27 UMUM JL KYAI SEPUH 1/5 GENTONG 8573190666 ASTRA ZENECA 04/11/2021 A1063
35 P-C7ERAL9E : 3575024409640001 SAMINEM 57 RENTAN JL KYAI SEPUH 1/6 GENTONG 8113777705 ASTRA ZENECA 04/11/2021 A1063
36 Q-000LC7BO : 3575025705760007 DEWI NUR SUGIYATI 45 UMUM GENTONG RT 3 RW 5 8215794200 ASTRA ZENECA 06/08/2021 ABY1911 04/11/2021 A1063
37 P-CA8KDQ5Y : 3575037005800002 JAZILAH ROCHMAH 41 UMUM JL HALMAHERA 4/5 GADINGREJO 8565555342 ASTRA ZENECA 04/11/2021 A1063
38 P-C94X2FNA : 3575012907950001 FATCHUR ROCHMAN 26 UMUM JL KYAI SEPUH 1/5 GENTONG 8577554349 ASTRA ZENECA 04/11/2021 A1063
39 P-CATL00FV : 3575010107720048 ACHMAD ZAINI 48 UMUM JL HALMAHERA 5/5 GADINGREJO 8780359293 ASTRA ZENECA 04/11/2021 A1063
40 P-C9YGP79Q : 3575011801990001 ZANUAR KURNIAWAN EFENDI 25 UMUM JL GATOT SUBROTO 5/7 BUKIR 8822804206 ASTRA ZENECA 04/11/2021 A1063
41 P-CB8Z5D6Y : 3575025102960002 MUTMAINAH 25 UMUM JL IRIAN JAYA GADINGREJO 8953292601 ASTRA ZENECA 04/11/2021 A1063
42 P-CEWJUNHN : 3575016207860001 TITIK SUHARTI 35 UMUM jl banda 5/2 gadingrejo 8124925404 ASTRA ZENECA 04/11/2021 A1063
43 P-CAG50RON : 3575011209950002 ABDURRAHMAN WAHID 26 UMUM JL HANGTUAH 1/3 GADINGREJO 8781068005 ASTRA ZENECA 04/11/2021 A1063
44 P-CHFIGVVV : 3575036309890004 RATNAWATI ANGGRAENI 33 UMUM jl halmahera gadingrejo 8510466111 ASTRA ZENECA 04/11/2021 A1063
45 P-CHLSIWIK : 3575025306730003 LAILATUS SA'ADAH 48 UMUM jl kh ahmad dahlan v/43 8510128951 ASTRA ZENECA 04/11/2021 A1063
46 P-CHS6TTRQ : 3514186303790003 DJUMATUL FATIKHAN 42 UMUM jl gajah mada 18 8510050263 ASTRA ZENECA 04/11/2021 A1063
47 P-CHY5K2F0 : 3575032806860002 MUHAMMAD MAKSUM 35 UMUM jl gajah madah 18 8575515103 ASTRA ZENECA 04/11/2021 A1063
48 P-PS8DLLBQ : 3575014101830004 JAMILAH 38 UMUM JL BANDA 5/2 GADINGREJO 8897111865 ASTRA ZENECA 04/11/2021 A1063
49 P-CEARJDIB : 3575013006080006 MOHAMMAD FIKRI FERDIANSYAH 13 REMAJA JL BANDA GADINGREJO 8113777705 BIOFARMA 04/11/2021 202108178F
50 Q-000VZTH7 : 3575011104060001 WAHYU HIDAYAH 15 REMAJA JL BANDA 5/2 GADINGREJO 8770479383 BIOFARMA 10/09/2021 202108118H 04/11/2021 202108178F
51 Z-000BQ8D8 : 3575012106880001 ACHMAD NAJIB 33 UMUM JL. SLAMET RIYADI RT 002 RW 003 SEBANI G 8510384441 BIOFARMA 29/09/2021 202108167I 04/11/2021 202108178F
52 Q-000UL5N2 : 3575015302090002 SILVIA HASAN 12 REMAJA JL SLAMET RIYADI RT 02 RW 03 SEBANI 8311075426 BIOFARMA 07/09/2021 202108118H 04/11/2021 202108178F
53 Q-0018I6LA : 3575014102010001 SARIFATUL FITRIYAH 20 UMUM SEBANI GADINGREJO 8564992623 BIOFARMA 05/10/2021 202108154G 04/11/2021 202108178F
54 Q-000V51GC : 3514185910060003 DINI OKTOPRADITA RAMADHANI 15 REMAJA SEBANI KEL. SEBANI 8570616539 BIOFARMA 08/09/2021 202108118H 04/11/2021 202108178F
### PUSTU BUKIR
1 Q-0018511D 3575013012670001 BUNYANI 55 RENTAN BUKIR GADINGREJO 85791239700 CoronaVac 04/10/2021 202108154G 04/11/2021 202108178F
2 Q-00192758 3575025307950001 ANGGRAENI MARDIANTI 26 UMUM JL URIP SUMOHARJO RT 3 RW 3 82234717261 CoronaVac 04/10/2021 202108178F 04/11/2021 202108178F
3 Q-0018I7XI 3575010408050001 MUKHAMAD TEGAR ARDIANSYAH P 16 REMAJA bukir 2/5 gadingrejo 81233510881 CoronaVac 05/10/2021 202108154G 04/11/2021 202108178F
4 Q-0019MQ9E 3575016109090001 ISNAINI YOVITA SYAFITRI 12 REMAJA bukir 2/1 bukir 895396072142 CoronaVac 07/10/2021 202108172F 04/11/2021 202108178F
5 Q-00191F0O 3575012907930001 M. LUTFI MARDI CAHYO 28 UMUM JL URIP SUMOHARJO RT 2 RW 2 89699322329 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
6 Q-0019VHRB 3575010210640001 SUKAEDI 52 RENTAN JL URIP SUMOHARJO 82230911708 CoronaVac 07/10/2021 202108172F 04/11/2021 202108178F
7 Q-00192K76 3514160209900002 KHOIRON 31 UMUM JL URIP SUMOHARJO 8385879484 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
8 Q-00192YN1 3575015102920001 ALFIYAH FARISSONA 29 UMUM JL URIP SUMOHARJO 82229992629 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
9 Q-00192DK1 3575010406800004 MUKTAR 41 UMUM RW MONGINSIDI 85731211880 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
10 Z-000CAR6L 3575016202560001 SRI SUPRIHATIN 65 LANSIA JL URIP SUMOHARJO 89654983318 CoronaVac 07/10/2021 202108172F 04/11/2021 202108178F
11 Q-0019DS05 3575010107820030 MOKHAMAD CHAIRUDIN 39 UMUM jl gatot subroto 3/7 bukir 82132604011 CoronaVac 07/10/2021 202108172F 04/11/2021 202108178F
12 Q-0018I7QD 3575013005700001 CHAMBALI 51 RENTAN BUKIR 2/6 GADINGREJO 85797474847 CoronaVac 05/10/2021 202108154G 04/11/2021 202108178F
13 P-BAFM5V1Y 3575026912900001 RUQOIYAH 31 UMUM JL GATOT SUBROTO 3/7 BUKIR 85607311189 CoronaVac 04/11/2021 202108178F
14 Q-00185112 3575010309870001 PRASETYA ARI WIBOWO 34 UMUM JL URIP SUMOHARJO 82234210769 CoronaVac 04/10/2021 202108154G 04/11/2021 202108178F
15 Q-00188KXZ 3575010404900002 MUKHAMMAD ARIF ROMA DHONA 31 UMUM JL URIP SUMOHARJO 859175461665 CoronaVac 04/10/2021 202108154G 04/11/2021 202108178F
16 Q-001937QV 3575012311780001 JOKO NURSIYO 43 UMUM JL GATOT SUBROTO 83834601328 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
17 Q-00192JH4 3575015004730004 NUR KHASANAH 48 UMUM JL GATOT SUBROTO 83834601341 CoronaVac 06/10/2021 202108172F 04/11/2021 202108178F
18 P-CIAI0FB2 3575014505740002 MULIANA 47 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 81338145453 CoronaVac 04/11/2021 202108178F


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-31C8W1FT : 3575010505720002 AKHMAD 49 UMUM JL. HANG TUAH GG 4 GADINGREJO KOTA PAS 8533530442 ASTRA ZENECA 05/11/2021 A10B3
2 P-8N0F0A5G : 3575011010670005 MUKHAMMAD ABDUL MANAN 54 RENTAN GENTONG RT 001 RW 006 8575502698 ASTRA ZENECA 05/11/2021 A10B3
3 P-9HVDWHYU : 3575014607740004 NINIK SETIYOWATI 47 UMUM JL. HALMAHERA GG IX PASURUAN 8233511234 ASTRA ZENECA 05/11/2021 A10B3
4 P-AEZE5U6L : 3575016301030002 NURIL FIRDAUSY 18 UMUM JL. HALMAHERA GG IX PASURUAN 8233511234 ASTRA ZENECA 05/11/2021 A10B3
5 P-APMFKHDO : 3575016912890003 KHUNAINAH 31 UMUM JL. HANGTUAH RT 002 RW 003 PASURUAN 8384681525 ASTRA ZENECA 05/11/2021 A10B3
6 P-C1TXI6YO : 3575011003950002 SAMHAJI 29 UMUM JL. BANDA GG TERATAI PASURUAN 8318570382 ASTRA ZENECA 05/11/2021 A10B3
7 P-CWLYUEQA : 3575010701860004 M. AFANDI 35 UMUM JL. GATOT SUBROTO GG 1 PASURUAN 8578425211 ASTRA ZENECA 05/11/2021 A10B3
8 P-CX6KGH0B : 3575014808910002 SWADIA SEJUK 32 UMUM JL. BANDA GG MAWAR PASURUAN 8829336323 ASTRA ZENECA 05/11/2021 A10B3
9 P-CXCI5ZGA : 3573045206880006 IKA SETYARINI 33 UMUM JL. GENTONG GG 6 PASURUAN 8313241744 ASTRA ZENECA 05/11/2021 A10B3
10 P-CXHLBZBS : 3575010405870001 MOHAMAD ADI SUYITNO 34 UMUM GENTONG GG 5 PASURUAN 8313241744 ASTRA ZENECA 05/11/2021 A10B3
11 P-CXO456AA : 3575013011870002 IMAN MAULA 34 UMUM JL. JENDRAL S. PARMAN PASURUAN 8133555829 ASTRA ZENECA 05/11/2021 A10B3
12 P-LW8PGZYP : 3575014403840001 SAIMAH 38 UMUM JL HALMAHERA 2/5 GADINGREJO 8560643483 ASTRA ZENECA 05/11/2021 A10B3
13 P-26D8KJQQ : 3575013012030001 ALAMUL HUDA 18 UMUM JL. HALMAHERA GG 9 PASURUAN 8383426612 ASTRA ZENECA 05/11/2021 A10B3
14 P-2I2AFOST : 3575010507760002 MUNAWIR 45 UMUM JL. HANGTUAH RT 4 RW 4 PASURUAN 8113777705 ASTRA ZENECA 05/11/2021 A10B3
15 P-5R713BCL : 3575010107840179 M. JUFRI 34 UMUM JL. HANGTUAH RT 004 RW 004 PASURUAN 8113777705 ASTRA ZENECA 05/11/2021 A10B3
16 P-7HXN0TE6 : 3575011707920003 ABD GHOFUR 29 UMUM JL. HANG TUAH 8113777705 ASTRA ZENECA 05/11/2021 A10B3
17 P-8I6TJFA7 : 3575010604800002 MUSTOFAH 41 UMUM JL. HANG TUAH 8113777705 ASTRA ZENECA 05/11/2021 A10B3
18 P-9C8T1XOA : 3575010802960007 FEBRI ARI PRASETIAWAN 25 UMUM JL. HANG TUAH 8585059743 ASTRA ZENECA 05/11/2021 A10B3
19 P-AGLTR1EV : 3575013103690001 UMAR 52 RENTAN JL. HALMAHERA 8113777705 ASTRA ZENECA 05/11/2021 A10B3
20 P-B2IFIBVM : 3514176103870005 YANIK SUPANESTU 34 UMUM KRAPYAKREJO 8214274417 ASTRA ZENECA 05/11/2021 A10B3
21 P-BLRHF17A : 3575010509030001 ACHMAD CHOIRUL ANWAR 18 UMUM JL. IRIAN JAYA 8113777705 ASTRA ZENECA 05/11/2021 A10B3
22 P-C54UPFOL : 3575016503790001 NANIK PURWANTI 42 UMUM JL. SLAMET RIADI 8233103754 ASTRA ZENECA 05/11/2021 A10B3
23 P-CKIAYA4Z : 3575010107750018 NYAMIN 47 UMUM JL. SLAMET RIADI 8123574468 ASTRA ZENECA 05/11/2021 A10B3
24 P-CZAEEYMQ : 3575015908700001 TIMYATI KHOTIMAH 51 RENTAN JL. KYAI SEPUH 8956321700 ASTRA ZENECA 05/11/2021 A10B3
25 P-CZLMVISI : 3575011105780002 KARSIMAN 44 UMUM JL. SLAMET RIYADI SEBANI 8222802804 ASTRA ZENECA 05/11/2021 A10B3
26 P-CZXVWEDH : 3575010507820007 TEGUH TRIANA 39 UMUM SEBANI RT 03 RW 03 PASURUAN 8581522290 ASTRA ZENECA 05/11/2021 A10B3
27 P-D08ADGGU : 3575010306690002 ICHWANUDIN 52 RENTAN JL. SLAMET RIYADI SEBANI 8951599116 ASTRA ZENECA 05/11/2021 A10B3
28 P-D0FPOVQC : 3575011708790003 MOH. MUKHDOR 42 UMUM JL. HALMAHERA GG 9 PASURUAN 8384846339 ASTRA ZENECA 05/11/2021 A10B3
29 P-D0MQZGF4 : 3575012710840002 MARDA OKTAWIJAYA 37 UMUM JL. SLAMET RIYADI SEBANI 8135876610 ASTRA ZENECA 05/11/2021 A10B3
30 P-D0U38Y4C : 3575010107690092 SOLICHIN 52 RENTAN SEBANI RT 3 RW 3 PASURUAN 8113777705 ASTRA ZENECA 05/11/2021 A10B3
31 P-D30UONSL : 3575012305000001 MOCH. ALI SOFYAN 26 UMUM JL URIPSUMOHARJO 8885192445 ASTRA ZENECA 05/11/2021 A10B3
32 P-D3N7C42F : 6105135109960001 SEFTIANI 25 UMUM CITRA CANDI E11 8123266992 ASTRA ZENECA 05/11/2021 A10B3
33 Q-000LIX9I : 3575015912000001 MAZIA KHILWA IMANI 21 UMUM JL GATOT SUBROTO GG 8 BUKIR 8989777849 ASTRA ZENECA 07/08/2021 ABY1911 05/11/2021 A10B3
34 Q-000LJ9I6 : 3575011912020001 WAHYU ANANG MA'RUF 19 UMUM JL GATOT SUBROTO 4/7 GADINGREJO 8213990483 ASTRA ZENECA 0:00:00 ABY1911 05/11/2021 A10B3
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 Q-000LC7GJ : 3575024805010004 FATIMATUZ ZAHRO 20 UMUM GENTONG RT 6 RE 7 8155389714 ASTRA ZENECA 06/08/2021 ABY1911 05/11/2021 A10B3
36 Q-000LC5HK : 3575024909760002 NURUL HIDAYATI 45 UMUM GENTONG RT 6 RW 7 8193705780 ASTRA ZENECA 06/08/2021 ABY1911 05/11/2021 A10B3
37 S-D739ACD7 : 3575022807570001 YOYOK HERI SUCIPTO 64 LANSIA PONDOK SURYA KENCANA III D3 8133341287 BIOFARMA 05/11/2021 24007021
38 P-CYBVT14F : 1607105703960002 RIAWATI 25 UMUM JL. BANDA GG DAHLIA PASURUAN 8199491077 BIOFARMA 05/11/2021 24007021
39 P-CYHEY8TA : 3514226701920002 ROBIATUL ADAWIYAH 29 UMUM JL. BANDA GG DAHLIA PASURUAN 8574678063 BIOFARMA 05/11/2021 24007021
40 Q-000UFGKI : 3575010505990003 MOCHAMAD FAJAR 22 UMUM JL BANDA 5/2 GADINGREJO 8123428872 BIOFARMA 07/09/2021 2021071371 05/11/2021 24007021
41 Z-000CAZW6 : 3575016104430001 LISA SUPARSIAH 78 LANSIA PERUM KARYA BAKTI B 16 8223319647 BIOFARMA 08/10/2021 202108172F 05/11/2021 24007021
42 Q-0019ZOQJ : 3575011011740006 MOCHAMAT SLAMET 47 UMUM JL SLAMET RIYADI 8510229997 BIOFARMA 08/10/2021 202108172F 05/11/2021 24007021
43 Q-000U3OAH : 3514055203800001 SUTARLIN 41 UMUM JL HANG TUA 3/4 GADINGREJO 8132861596 BIOFARMA 06/09/2021 2021071371 05/11/2021 24007021
44 Q-000CHU9Q : 3575012407750002 MOHAMMAD SLAMET 46 UMUM JL SLAMET RIYADI 8233103754 BIOFARMA 08/07/2021 24200421 05/11/2021 24007021
45 Q-001A03O1 : 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 BIOFARMA 08/10/2021 202108172F 05/11/2021 24007021
46 Q-0019JWL8 : 3575016801830002 RINI KRISTIANA 38 UMUM JL SLAMET RIADI 3/1 SEBANI 8585277861 BIOFARMA 07/10/2021 202108172F 05/11/2021 24007021
### PUSTU BUKIR
1 Q-00192POO 3575012003890002 NUR HUDA 32 UMUM BUKIR PASURUAN 8581672221 CoronaVac 06/10/2021 202108172F 05/11/2021 24007021
2 Q-001A6DZ0 3575014506900004 KHUSWATUN KHASANAH 31 UMUM JL. Gatot Subroto RT05 RW07 - Bukir 83149281479 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
3 Q-001A6GME 3515130508890008 BAGUS SUSILA YUWANA 32 UMUM JL. Gatot Subroto RT05 RW07 - Bukir 83149281479 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
4 P-CYBH1R29 3575025610910001 AYU ZAHROTUL KHUSNIA 30 UMUM JL. URIP SUMOHARJO 3/8 - BUKIR 85899400560 CoronaVac 05/11/2021 24007021
5 Q-001939QZ 3575010311790001 MUHAMMAD MUNIR 42 UMUM JL GATOT SUBROTO 8113777705 CoronaVac 06/10/2021 202108172F 05/11/2021 24007021
6 Q-001A6TCJ 3575015804890003 ARIS LIA ROMDONI 32 UMUM JL. KH. Hasyim Asy'ari RT02 RW04 - Bakalan 85755536365 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
7 Q-001A6ZN2 3575016912810001 MULIKHA 40 UMUM JL. RW Mongosidi Gg Panca Warna RT01 RW01 - 85259118564 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
8 Q-001A6U14 3575015507760001 RINIL MACHMUDAH 45 UMUM JL. Urip Sumoharjo RT01 RW03 - Bukir 85975290680 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
9 Q-001A7DCO 3575015505090001 ARDIANA EKA PUTRI 12 REMAJA JL URIP SUMOHARJO 85975290680 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021
10 Q-001A6EO0 3575016210890004 SITI MASRUKHAH 32 UMUM JL. Gatot Subroto RT01 RW 05 - Bukir 85704204034 CoronaVac 08/10/2021 202108172F 05/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
### INDUK
1 P-9NQ983FA : 3575012605040002 MOCHAMAD ALI RIDHO 17 UMUM JL HANGTUAH RT03/03 GADINGREJO 8969945349 BIOFARMA 06/11/2021 24007021
2 P-7PK8PT0L : 3575016308080005 ZAHRA ALYATUNNISA' 13 REMAJA JL HANGTUAH RT03/RW03 GADINGREJO 8969956542 BIOFARMA 06/11/2021 24007021
3 P-8UKCTVL7 : 3575010109040004 MUKHAMAD RISKI FIRMANSHA 17 UMUM JL BANDA GG MAWAR GADINGREJO 8180620427 BIOFARMA 06/11/2021 24007021
4 Z-000CD3MK : 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
5 Z-000CB1VR : 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 BIOFARMA 08/10/2021 202108172F 06/11/2021 24007021
6 Q-001AGHC2 : 3575014211660002 SUHARTINI 55 RENTAN JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8133501055 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
7 P-0CFEGLHF : 3575016404090001 LINTANG APRILIA SAPUTRI 12 REMAJA JL KYAI SEPUH 2/6 GENTONG 8575547301 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
8 Q-001AK846 : 3575015205060004 DIAN SAFITRI 15 REMAJA JL. HANGTUAH GG 2 RT 01 RW 03 8574843854 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
9 Q-001AK1WI : 3575014905060002 ALFIRA REZA MAULIDIYA 15 REMAJA Jl. Halmahera rt 03 rw 05 Kelurahan Gadingrejo 8138394922 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
10 Q-001AITNN : 3575011208050004 EVA WULANDARI 16 REMAJA Jl. Hangtuah rt 04 rw 02 8533493401 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
11 Q-001AK7W5 : 3575011702090002 ACHMAD SAIFUL ANWAR 12 REMAJA JL. HANGTUAH RT 4 RW 4, GADINGREJO 8574535730 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
12 Q-001AJ29W : 3575024611860001 ARDIYAH PRATIWI 35 UMUM Jl. KH Ahmad Dahlan Gg 15 No. 1 rt 005 rw 005 8215777965 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
13 Q-001AKGAF : 3575016504050004 FIDROTUL MAULIDIA 16 REMAJA JL. HALMAHERA Gg. V/69, PANGGUNGREJO, 8581527337 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
14 Q-001AHJKD : 3514125306990001 YUYUN INDAH WATI 22 UMUM WINONG GEMPOL 8953969315 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
15 Q-001AK1HJ : 3575016106060002 ILFI NURDIANA 15 REMAJA Jl. Halmahera Gg 7 rt 01 rw 05 kelurahan Gadingre 8776329761 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
16 Q-001AKDDI : 3575014510060005 SAKINATUL FITRIAH 15 REMAJA JL. HALMAHERA GG 9 RT 01 RW 05 8593126895 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
17 Q-001AKPSI : 3575014104720003 SA'IDAH 49 UMUM JL SLAMET RIYADI 8523303301 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
18 Q-001AK82G : 3514160807080003 MUHAMMAD IWANUR ROHMAN 13 REMAJA KEBONSAWAH, RT 4 RW 7, KALIREJO, PASURU 8590311873 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
19 Q-001AJVJV : 3514161304060004 MUHAMMAD YUSRIL MAHENDRA 15 REMAJA KEBONSAWAH, RT 3 RW 7, KALIREJO, PASURU 8311450857 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
20 Q-001AJW5X : 3575011705080003 AFIF RISKI 13 REMAJA JL. HALMAHERA GG 9 RT 05 RW 05 8135992299 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
21 Q-001AJXX8 : 3575012911050002 MUKHAMMAD SAMSUL MUBARROK 16 REMAJA JL. HANGTUAH GG 4 RT 02 RW 04 8573025475 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
22 Q-001AKE7G : 3575012704060005 M. SUKRON HABIBI 15 REMAJA HL. HANGTUAH GG 4 RT 02 RW 04 8383105817 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
23 Q-001AKLVM : 3575012807050001 WAFIK SUBADHA 16 REMAJA JL. HANGTUAH GG 4 RT 02 RW 04 8233066572 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
24 Q-001AK6LX : 3575010105060001 MUHAMMAD ALI FIKRI 15 REMAJA JL. HALMAHERA Gg. 9, GADINGREJO, PASURU 8389851023 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
25 Q-001ANOQ2 : 3575010101600011 MOH. AMIN 59 RENTAN JL SLAMET RIYADI 8311541103 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
26 Q-001AJ7CA : 3575015204050003 RANI RAHMAWATI 16 REMAJA Jl. Halmahera rt 04 rw 03 Kelurahan Tambaan 8214130146 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
27 Q-001AJ5WH : 3575016505070006 NURUL BAHRIYA 14 REMAJA Jl. Halmahera Gg. IX 8313949405 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
28 N-00001KV9 : 3575015709890001 KHOLFIAH 32 UMUM JL GATOT SUBROTO 5/2 PETAHUNAN 8233467133 BIOFARMA 07/10/2021 202108172F 06/11/2021 24007021
29 Q-001AJYKE : 3575015702070002 WARSITA SARI 14 REMAJA Jl. Hangtuah rt 04 rw 04 Kelurahan Gadingrejo 8312515641 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
30 Q-001AKKGO : 3514165112070001 LAILATUL ILMIYAH 14 REMAJA KEBON SAWAH, RT 4 RW 1, KALIREJO, PASUR 8384849048 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
31 Q-001AIYI4 : 3575014806070003 ADIFA NOFITA 14 REMAJA Jl. Hangtuah Gg 4 rt 02 rw 04 8823188386 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
32 Q-001AKBUJ : 3514164611070003 FITRI NOLATUL HOLIYA 14 REMAJA KEBONSAWAH RT 02 RW 07 8314095417 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
33 Q-001AHWUW : 3575036406750001 HAFSAH WAHYUNI 46 UMUM JL IMAM BONJOL BUGUL LOR 8510083170 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
34 Q-001AK61B : 3575034612830003 SUTINAH 38 UMUM JL LETJEN SUTOYO MANDARANREJO 8880879578 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
35 Q-001AEXSR : 3575030505750006 MOHAMAD MUSLIMIN 46 UMUM JL MT HARYONO 2/5 BUGUL LOR 8225709995 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
36 Q-001AIYJM : 3575031412060001 MUKHAMMAD DIMAS RUR 15 REMAJA gadingrejo rt 004 rw 002 8311441425 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
37 Q-0013MDR8 : 3575015501070001 HANIFAH 14 REMAJA JL HANGTUAH 2/3 GADINGREJO 8113777705 BIOFARMA 25/09/2021 202108154G 06/11/2021 24007021
38 Q-000ZG6RJ : 3525131111070004 RASYA DHAFAH PRATAMA 14 REMAJA JL. ADE IRMA SURYANI NO.1 SEBANI 8233449752 BIOFARMA 17/09/2021 202108118H 06/11/2021 24007021
39 Q-0018I7QL : 3575010107650053 BUNARI 56 RENTAN BUKIR 5/7 GADINGREJO 8574921135 BIOFARMA 05/10/2021 202108154G 06/11/2021 24007021
40 Q-000ZCJ1H : 3525130711070001 ARVINO LUQMANUL HAKIM 14 REMAJA JL. ADE IRMA SURYANI NO.1 SEBANI 8123100529 BIOFARMA 17/09/2021 202108118H 06/11/2021 24007021
41 Q-000ZG2QR : 3514142112070001 MUHAMMAD RIF`AN 14 REMAJA JL. ADE IRMA SURYANI NO.1 SEBANI 8121684683 BIOFARMA 17/09/2021 202108118H 06/11/2021 24007021
42 Q-001AJGGW : 3575016809910001 UCIK SETYARINI 30 UMUM JL. Gatot Subroto RT03 RW05 - Bukir 8950801319 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
43 Q-001AKI72 : 3514195410990006 DEWI ASTUTIK 22 UMUM JL. Gatot Subroto RT03 RW05 - Bukir 8133671758 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
44 Q-001A77A9 : 3575012506710001 CIPTO PRAYITNO 50 RENTAN Bukir RT01 RW07 8233483560 BIOFARMA 08/10/2021 202108172F 06/11/2021 24007021
45 Q-001AMYQR : 3514164610910001 UMI AMINAH 30 UMUM TUNGGAAN I 001/004 KRATON 8564992400 BIOFARMA 09/10/2021 202108178F 06/11/2021 24007021
46 Q-001AJC30 : 3575016709900001 KHUSNUL KHOTIMAH 31 UMUM JL. Slamet Riyadi RT01 RW06 - Sebani 8952336276 BIOFARMA 09/10/2021 202108172F 06/11/2021 24007021
47 Q-001A02SV : 3575015503900001 IDA ARIANI 31 UMUM JL SLAMET RIYADI 8779408251 BIOFARMA 08/10/2021 202108172F 06/11/2021 24007021
48 Q-000MZMC8 : 3575010312720002 KURNIADI 49 UMUM JL URIP SUMOHARJO 2/3 8123481785 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
49 Z-00095WE0 : 3575012103850002 Solihin 36 UMUM 8218792171 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
50 Q-000MYL27 : 3514170511930001 YUNINDO NOFIANTO 28 UMUM JL RAYA PLERET 1/3 8135941999 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
51 Q-000MYL1Y : 3514150810600001 SUWITO 53 RENTAN KRAJAN 2/5 REMBANG 8223264834 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
52 Q-000MZMBX : 3528060309940006 FATHOROSI 27 UMUM BUGIH PAMEKASAN 8770171313 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
53 Q-000MYQNK : 3575016012770002 SITI KHOTIJAH 44 UMUM JL URIP SUMOHARHO 3/3 BUKIR 8193848073 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
54 Q-000MYQN6 : 3575015502890002 NAFI'AH 32 UMUM JL URIP SUMOHARJO 2/3 8570886352 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
55 Q-000MZMCJ : 3575012512820001 AKHMAD HARIONI 39 UMUM JL URIP SUMOHARJO 2/3 BUKIR 8578886352 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
56 Q-000N0A9T : 3575021412780001 ACHMAD SUWANDI 43 UMUM JL PANGLIMA SUDIRMAN 16 8213979978 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
57 Q-000MYQN0 : 3575015004940002 LAILATUL FITRIYAH 27 UMUM JL GATOT SUBROTO 1/3 8581669745 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
58 Q-000MZMCE : 3575011511960003 ULFATUL NIZAK 25 UMUM JL IRIAN JAYA 2/2 8589555805 ASTRA ZENECA 14/08/2021 ABY1911 06/11/2021 A10B3
59 Q-000K41VG : 3575011709000001 ERLANGGA RIZKY PUTRA 21 UMUM JL BANDA, gadingrejo 8572602728 ASTRA ZENECA 29/07/2021 ABY1911 06/11/2021 A10B3
60 Q-0013ZI6U : 3515030207880006 M. FARIDZ HIDAYAT 33 UMUM WANGKAL KREMBUNG 6/3 8525921222 BIOFARMA 25/09/2021 202108154G 06/11/2021 24007021
61 P-DRJJNUCY : 3575016610880003 LIYANA 33 UMUM JL HALMAHERA GG 9 8585123280 BIOFARMA 06/11/2021 24007021
62 P-DSG5BG6B : 3575014806920005 RATNA NINGRUM 29 UMUM JL HALMAHERA GG9 8213267142 BIOFARMA 06/11/2021 24007021
63 P-DS8KS65V : 3575017007890003 MUTMAINAH 32 UMUM JL HALMAHERA GG 9 8585502555 BIOFARMA 06/11/2021 24007021
64 P-DSCBXTON : 3575014505900004 PUTRI SITI NAFISAH 31 UMUM JL HALMAHERA GG 9 8133642944 BIOFARMA 06/11/2021 24007021

Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 Q-000MYQMK 3575014508020001 Nafisatul Laila 19 UMUM Jl Urip Sumoharjo 2/3 Bukir 8135903947 ASTRAZENECA 14/08/2021 ABY1911 08/11/2021 A10B3
2 K-0000JKED 3575015207000002 RINA HIDAYAT 21 UMUM JL HANG TUA 2/3 GADINGREJO 8385276139 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
3 Q-000K44IQ 3575014505990004 SYAFINA IMANIA 22 UMUM JL SLAMET RIADI sebani 8565502472 ASTRAZENECA 29/07/2021 ABY1911 08/11/2021 A10B3
4 K-0000JDG8 3575015611980003 FARIDATUL LINA AINUR ROSIDAH 23 UMUM ASRAMA 8214568760 ASTRAZENECA 15/08/2021 210056 08/11/2021 A10B3
5 Q-000NCM7L 3575011207670001 SOKHEH 23 UMUM JL SLAMET RIYADI GG 14 2/4 GENTONG 8384809899 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
6 Q-000NBZ7C 3514041007970001 AHMAD TAUFIQ 24 UMUM JL BANDA 6/2 GADINGREJO 8123429057 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
7 Q-000NCR3V 3575016409950001 NOVI SULISTIYANINGSIH 25 UMUM JL SLAMET RIYADI 2/1 SEBANI 8573191321 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
8 Q-000NCJZ0 3575016105950001 DWI NUR ARIZAH 26 UMUM JL SLAMET RIYADI 2/4 GENTONG 8587717199 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
9 Z-00095OZ2 3306087004940003 RAHMAWATI 27 UMUM BLEBER 1/2 8564036070 ASTRAZENECA 14/08/2021 ABY1911 08/11/2021 A10B3
10 Q-000NCJRG 3575015211930001 DIAH AYU HARIANI 28 UMUM JL SLAMET RIYADI GG 14 2/4 8579117357 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
11 Q-000NIU4N 3575010507920001 MUHAMMAD RIZKY UTOMO 29 UMUM JL GATOT SUBROTO 1/6 BUKIR 8960595131 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
12 Q-000NDGKQ 3574031309890002 ALEX ADIT CANDRA WIJAYA 32 UMUM JL SLAMET RIYADI 2/4 GG 15 GENTONG 8224594063 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
13 Q-000NCMBI 3519076611890002 NANIK NOVITASARI 32 UMUM JL SLAMET RIYADI 4/2 SEBANI 8953184714 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
14 Q-000NCVY1 3575012208840004 ABDUL KARIM 37 UMUM JL SLAMET RIYADI 2/4 SEBANI 8233388762 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
15 Q-000NDGQN 3575014508800003 FARIDA 39 UMUM JL SLAMET RIYADI 2/3 SEBANI 8113777705 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
16 Q-000NGUPA 3575015311790002 SUMARMI 42 UMUM JL SLAMET RIYADI 2/4 GENTONG 8315940261 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
17 Q-000NDGCW 3575020408770001 EMIL RUTAMADJI 44 UMUM JL GATOT SUBROTO 5/7 BUKIR 8564927602 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
18 Q-000PVCSP 3516064405730003 ANISAH 48 UMUM PERUM NUANSA CANDI I BLOCK A/38 8133288235 ASTRAZENECA 26/08/2021 PV4670 08/11/2021 A10B3
19 Q-000NEEXL 3575011309710001 KARIYANTO 50 RENTAN JL URIP SUMOHARJO 1/2 BUKIR 8311758791 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
20 Q-000NDKFE 3575012305700001 SUWARDI 51 RENTAN JL KYAI SEPUH 3/1 GADINGREJO 8533576892 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
21 Q-000MYQNC 3575016010730002 CHANIPAH 53 RENTAN JL IRIAN JAYA 2/3 8510566411 ASTRAZENECA 14/08/2021 ABY1911 08/11/2021 A10B3
22 Q-000NCLUF 3575010803700001 MUHAIMIN 56 RENTAN JL SLAMET RIYADI 2/4 GENTONG 8523339352 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
23 Q-000NBZU6 3575014101620017 SUKARTI 59 RENTAN JL KYAI SEPUH IV 3/1 GADINGREJO 8572602728 ASTRAZENECA 16/08/2021 ABY1911 08/11/2021 A10B3
24 P-6SJOMHB2 3575010111020004 MUKHAMAD RIZKI 19 UMUM JL HALMAHERA RT02/RW03 GADINGREJO 8578429803 ASTRAZENECA 08/11/2021 A10B3
25 P-A6TAISAI 3575016812000001 LAILATUL FITRI 21 UMUM JL SLAMET RIADI GENTONG 8385199397 ASTRAZENECA 08/11/2021 A10B3
26 P-C60MN2PP 3575014801000001 NIHAYATI SA'DEYAH 21 UMUM JL KYAI SEPUH RT01/RW06 GENTONG 8968377023 ASTRAZENECA 08/11/2021 A10B3
27 P-9T6RFNTE 3575015212980001 SITI MUSLIKHA 23 UMUM JL HANGTUAH GADINGREJO 8574834395 ASTRAZENECA 08/11/2021 A10B3
28 P-E9Y29XDR 3575011802980001 KHOLIS AKBAR 23 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRAZENECA 08/11/2021 A10B3
29 P-E5MI9MG4 3575014107970044 SOFIYAH 24 UMUM JL HANGTUAH GADINGREJO 8211306862 ASTRAZENECA 08/11/2021 A10B3
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 P-BHAL0YKH 3514164306940002 VITRIA HANI 27 UMUM JL HALMAHERA GADINGREJO 8121200822 ASTRAZENECA 08/11/2021 A10B3
31 P-EAEJ9VUI 3575016807930002 MERINA NUR CAHYANI 27 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRAZENECA 08/11/2021 A10B3
32 P-BSGX5J2I 3575012404930001 M. APRILIAN S. 28 UMUM JL SLAMET RIYADI SEBANI 8579142317 ASTRAZENECA 08/11/2021 A10B3
33 P-7MOY0MQJ 3514121310920002 SAYFUL ANWAR 29 UMUM JL HALMAHERA RT05/RW05 GADINGREJO 8585046642 ASTRAZENECA 08/11/2021 A10B3
34 P-8JLRS0QS 3575016104920001 MARFUA 29 UMUM JL HANGTUAH RT04/RW04 GADINGREJO 8213219075 ASTRAZENECA 08/11/2021 A10B3
35 P-4CT9Q27Z 3514164605890001 SALMA 31 UMUM JL IRIAN JAYA NO2 GADINGREJO 8953649453 ASTRAZENECA 08/11/2021 A10B3
36 P-E5CLCZU4 3575016303900004 MIFTACHUL JANNAH 31 UMUM JL HANGTUAH GADINGREJO 8816985984 ASTRAZENECA 08/11/2021 A10B3
37 P-E3J0DT7Y 3578106708870003 MUSLIHA 34 UMUM JL KYAI SEPUH GADINGREJO 8560452755 ASTRAZENECA 08/11/2021 A10B3
38 P-D34D83SQ 3575010911850003 ABDUL HAFID 36 UMUM JL HALMAHERA GADINGREJO 8121200822 ASTRAZENECA 08/11/2021 A10B3
39 P-0H89MACA 3575014107830148 KHUMAIYAH 38 UMUM JL HANGTUAH RT03/RW04 GADINGREJO 8113777705 ASTRAZENECA 08/11/2021 A10B3
40 P-CD5Y5DVD 3575010611800002 SUPRIYADI 39 UMUM GADINGREJO 3/4 85855976384 ASTRAZENECA 08/11/2021 A10B3
41 P-E4FZA99O 3575011309810003 PUJI SANTOSO 40 UMUM JL KYAI SEPUH GADINGREJO 8560452755 ASTRAZENECA 08/11/2021 A10B3
42 P-E5UODMB3 3575012205800002 MOKH. TAMRIN 41 UMUM JL KAMPUNG TENGAH ASEMBAGUS 8123349293 ASTRAZENECA 08/11/2021 A10B3
43 P-E7JNWGEO 3575014101780022 ULUL ARKHAMI 43 UMUM BUKIR 3/1 PASURUAN 8953091060 ASTRAZENECA 08/11/2021 A10B3
44 P-E8464CMD 3575012212740001 M. GUFRON 47 UMUM JL URIP SUMOHARJO BUKIR 8113777705 ASTRAZENECA 08/11/2021 A10B3
45 P-9HAUOEKN 3575015906720001 MUJAROH 49 UMUM JL KYAI SEPUH GENTONG 8510065233 ASTRAZENECA 08/11/2021 A10B3
46 P-5AEXXHR2 3575015203750001 CHAULA 50 RENTAN JL HANGTUAH RT03/RW04 GADINGREJO 8387963360 ASTRAZENECA 08/11/2021 A10B3
47 P-E7QVD7FU 3575011701710001 MUHAMMAD IKHSAN 50 RENTAN JL URIP SUMOHARJO BUKIR 8525791020 ASTRAZENECA 08/11/2021 A10B3
48 P-E4YFMK4W 3575011409690002 MOH. SALIM 52 RENTAN JL KYAI SEPUH GADINGREJO 8585132168 ASTRAZENECA 08/11/2021 A10B3
49 Q-001B69YN 3575015511080002 BELLA RACHMAWATI 13 REMAJA JL IRIAN JAYA 4/1 GADINGREJO 8595171312 BIOFARMA 11/10/2021 2021081 08/11/2021 2400702
50 Q-001AEXUR 3575032404040001 MOCHAMAD ALI FIKRI 17 UMUM JL MT HARYONO 2/5 BUGUL LOR 8773784163 BIOFARMA 09/10/2021 2021081 08/11/2021 2400702
51 K-000158VB 3507105205960001 ISMIATI FITRI 25 UMUM JL KYAI SEPUH 2/6 GENTONG 8593255305 BIOFARMA 08/09/2021 2021071 08/11/2021 2400702
52 Z-000CG7DS 3514160710900008 MUHAMMAD SHOLAHUDIN 31 UMUM DSN. JOPATI 012/004 KETANGIREJO 8575530230 BIOFARMA 11/10/2021 2021081 08/11/2021 2400702
53 Q-000VY6QH 3514122010890003 RIZAL MUBAROK 32 UMUM DSN NGINGAS 1/7 GEMPOL 8585637695 BIOFARMA 10/09/2021 2021081 08/11/2021 2400702
54 Q-000UHND5 3575011606720001 MATOHIR 33 UMUM JL HALMAHERA 3/5 GADINGREJO 8133126086 BIOFARMA 07/09/2021 2021071 08/11/2021 2400702
55 Q-0002FKMW 3575014201700002 CHASILAH 51 RENTAN BUKIR RT RW 8575500835 BIOFARMA 14/06/2021 VAKSIN 08/11/2021 2400702
56 Q-000VLT4T 3575014107700064 MARDIYAH 51 RENTAN JL HALMAHERA 2/3 GADINGREJO 8383479893 BIOFARMA 09/09/2021 2021081 08/11/2021 2400702
57 Q-001ANZ1W 3575011612670001 MUKHAMMAD SOLEH 54 RENTAN JL SLAMET RIYADI 8133342397 BIOFARMA 09/10/2021 2021081 08/11/2021 2400702
58 Q-000S5YUG 3575010502610001 SLAMET BAGONG 60 LANSIA JL SLAMET RIYADI 8384160774 BIOFARMA 01/09/2021 2021071 08/11/2021 2400702
59 Z-000CG3WC 3575010805560001 MUDJIONO 70 LANSIA JL SLAMET RIYADI 1/1 8113777705 BIOFARMA 11/10/2021 2021081 08/11/2021 2400702
60 P-E341BBL1 3514177012050001 AINUL NISAK 16 REMAJA JL PARAS REJO DUSUN PENULUPAN 8233103557 BIOFARMA 08/11/2021 2400702
61 P-1OG07VZ3 3575011604040005 MOCH. WAHYU APRIANTO 17 UMUM JL HANGTUAH GADINGREJO 830125136 BIOFARMA 08/11/2021 2400702
62 P-2RVSYOZJ 3575016211040001 RIYYADHUL BADI'AH 17 UMUM JL URIP SUMOHARJO BUKIR 8133329909 BIOFARMA 08/11/2021 2400702
63 P-E92GTQW8 3575034608970003 IFTAKHUL JANNAH 24 UMUM JL HANGTUAH GADINGREJO 8113777705 BIOFARMA 08/11/2021 2400702
64 P-831LJHTD 3575014107940056 RETNO AMBARSARI 27 UMUM JL HALMAHERA RT05/RW05 GADINGREJO 8585046642 BIOFARMA 08/11/2021 2400702
65 P-AVS5RGNP 3508105307940003 RHIZKY CLAODIA ARISTA 27 UMUM JL URIP SUMOHARJO RT02/RW02 BUKIR 8953970052 BIOFARMA 08/11/2021 2400702
66 P-E8Q3HF8Z 3575014811940001 AMALIATUS SOLIKHAH 27 UMUM JL HANGTUAH GADINGREJO 8212446750 BIOFARMA 08/11/2021 2400702
67 P-EAOS5CFW 3575014110960003 ANA 27 UMUM JL HALMAHERA GADINGREJO 8113777705 BIOFARMA 08/11/2021 2400702
68 P-AFFFPMC4 3514166409950001 HOLIDAH 33 UMUM JL HALMAHERA GG II GADINGREJO 8121200822 BIOFARMA 08/11/2021 2400702
SDN BUKIR
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
1 P-DBRRP10O 3575011610080001 MUCHAMMAD RISKYAN ADITYA 13 REMAJA Jl. Slamet Riyadi 8214371319 CoronaVac 08/11/2021 240007021
2 P-DBTUBXZ4 3575022107090002 ABDURRAKHMAN KHOLID 12 REMAJA Jl. Margo Taruno 8384805000 CoronaVac 08/11/2021 240007021
3 P-5YKAXD31 3575026808090001 AULIA AJENG PRATIWI 12 REMAJA Jl. Margo Taruno 8125922111 CoronaVac 08/11/2021 24007021 G
4 P-DBWGFCKZ 3514176207090001 ASTI VERONICA 12 REMAJA Penulupan – Pohjentrek 8135861128 CoronaVac 08/11/2021 240007021
5 P-DBXYNT1F 3575010608090001 AKHDAN RIDHA HABIBI 12 REMAJA Perum Graha Indah M. 4 8233290777 CoronaVac 08/11/2021 240007021
6 P-DBZI2QZP 3575012403090001 ABDUR RAHMAN ABADI 12 REMAJA Jl. Gatot Subroto 8952338896 CoronaVac 08/11/2021 240007021
7 P-DC19984C 3575015108090002 AGUSTIA SUKMANI AJENG 12 REMAJA Perum Nuansa Candi B-28 8224577541 CoronaVac 08/11/2021 240007021
8 P-DC2M2EMB 3575016603090003 HANUM MAULIDIYAH 12 REMAJA Jl. Gatot Subroto 8385454813 CoronaVac 08/11/2021 240007021
9 P-M7LDDMX7 3575021207090001 IMAM JAZULY 12 REMAJA Jl. R. W Monginsidi 8384523144 CoronaVac 08/11/2021 240007021
10 P-DC53NEL6 3575022207090002 MUKHAMAD AKMAL SYUKRI ALDAFI 12 REMAJA Jl. Margo Taruno 8155698867 CoronaVac 08/11/2021 240007021
11 P-DC6CBI2G 3575022906090002 MUHAMMAD ADRIAN SASONGKO 12 REMAJA Jl. R.W Monginsidi 8214139662 CoronaVac 08/11/2021 240007021
12 P-DCFOG1CE 3575020104090002 MOCHAMAD APRYANDIKA FACHRUD 12 REMAJA Jl. R.W Monginsidi 8383319351 CoronaVac 08/11/2021 240007021
13 P-DCGIKXOE 3575015708090001 RIZKY NUR ANDINI 12 REMAJA Jl. Gatot Subroto 8953960053 CoronaVac 08/11/2021 240007021
14 P-DCR9SSPQ 3575014904090001 ZAKIYAH AFRILIA 12 REMAJA Jl. Urip Sumoharjo 8135903310 CoronaVac 08/11/2021 240007021
15 P-DCS2FUJ5 3575012907070001 MUKHAMAD IQBAL PRANAYUDHA 14 REMAJA Sebani GADINGREJO 8958112803 CoronaVac 08/11/2021 240007021
16 P-8ZZ16NB0 3575021307080003 AKHMAD ZIDAN ZULKIFLI 13 REMAJA Jln. Urip Sumoharjo 8574681497 CoronaVac 08/11/2021 240007021
17 P-95PWHWSN 3575022308090001 BINTANG RAMADHAN NADHIF WIB 12 REMAJA Jln. Pangsud 8822604754 CoronaVac 08/11/2021 240007021
18 P-DCXSZRMJ 3575010605090001 WILDAN MUBAROK 12 REMAJA Jln Mulyorejo Sebani 8214308992 CoronaVac 08/11/2021 240007021
19 P-DCYS6EOH 3575020509080003 AKHMAD RAMADHAN 13 REMAJA Jl. Indagiri 8953381314 CoronaVac 08/11/2021 240007021
20 P-8NQPNXQG 3575024808090001 AINI RACHMAWATI 12 REMAJA Jl. Margo Taruno 8385774456 CoronaVac 08/11/2021 240007021
21 P-DD2NK4PF 3514175808090002 DWI WARDA NUR SEFILA 12 REMAJA Jl. Margo Taruno No. 22 8222808384 CoronaVac 08/11/2021 240007021
22 P-DD5LL8GB 3575020704090003 DIMAS ANANTA 12 REMAJA Jl. Margo Taruno 8573012473 CoronaVac 08/11/2021 240007021
23 P-DD6K2ORK 3575025210090003 KEYLA BILQIS AULIFIA PUTRI 12 REMAJA Jl. Margo Taruno 8573103263 CoronaVac 08/11/2021 240007021
24 P-DD9HDUAD 3575011312080002 MUKHAMMAD ROIKHAN 13 REMAJA BUKIR GADINGREJO 8133452582 CoronaVac 08/11/2021 240007021
25 P-DDBXNOAJ 3575012304090001 MUHAMMAD FARIS APRILIYONO 12 REMAJA Jl. Margo Taruno 8525759702 CoronaVac 08/11/2021 240007021
26 P-DDCPZSBK 3575020605090003 MUHAMMAD SALMAN AL FARISI 12 REMAJA Sutojayan KEBONAGUNG 8810365487 CoronaVac 08/11/2021 240007021
27 P-DDDTFQD9 3575025603090003 NAJWATUL NABILLAH 12 REMAJA Jl. Urip Sumoharjo 8123425992 CoronaVac 08/11/2021 240007021
28 P-DDF1WPKF 3575027006090002 OLIVIA RENI 12 REMAJA Jl. Margo Taruno 8233511595 CoronaVac 08/11/2021 240007021
29 P-DDJ86U9V 3575024307090001 ZAKIATUN NAFISAH 12 REMAJA Jl. Margo Taruno 8213173131 CoronaVac 08/11/2021 240007021
30 P-DDKL5SBJ 3578051001090004 ACHMAD BAGUS RESYA YANUAR 12 REMAJA Pandegiling 1/22 8588802248 CoronaVac 08/11/2021 240007021
31 P-9AJ19YW2 3575010508090001 BAGUS IBRAHIM 12 REMAJA Jl. Urip Sumoharjo 8969959316 CoronaVac 08/11/2021 240007021
32 P-9BTKXBZ5 3575016402090001 ELMADINATUR ROFIAH 12 REMAJA Jl. Gatot Subroto 8312245032 CoronaVac 08/11/2021 240007021
33 P-DDRNQY4A 3575011707090001 FAJAR DARMA KUSUMA 12 REMAJA Jl. Gatot Subroto 8880537448 CoronaVac 08/11/2021 240007021
34 P-DDULCS8Q 3575011704090003 M. ANDIKA PRATANA 12 REMAJA Jl. Urip Sumoharjo 8573191285 CoronaVac 08/11/2021 240007021
35 P-DDW5O3V6 3575011906090001 MUHAMMAD FARIS NOVANDI HART 12 REMAJA Perum Tanah Mas Blok B-11 8214349186 CoronaVac 08/11/2021 240007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
36 P-DDX4VWDH 3575011108090001 MUKHAMMAD ABIDIN GOLIB 12 REMAJA Jl. Gatot Subroto 8224162103 CoronaVac 08/11/2021 240007021
37 P-9DBJSNO5 3575010710090003 MUKHAMAD ARIF FARDIANSYAH 12 REMAJA Jl. Urip Sumoharjo 8523026054 CoronaVac 08/11/2021 240007021
38 P-9EOMSEB7 3575012502090001 NUGROHO FAIRUS PRAMANA PUTR 12 REMAJA Jl. Gatot Subroto 8121650186 CoronaVac 08/11/2021 240007021
39 P-DE6J4DT6 3514176306090003 NUR VITA INDAH SARI 12 REMAJA Dusun Penulupan 8383377355 CoronaVac 08/11/2021 240007021
40 P-DE7QI3IE 3575026210090001 YASMINE SAFA CACA MARWADA 12 REMAJA Jl. Erlangga Selatan 8590375196 CoronaVac 08/11/2021 240007021
41 P-DE9D7K5M 3514131908090003 M. RIZAL AL - MUKARROM 12 REMAJA Grogolan PASURUAN 8139362014 CoronaVac 08/11/2021 240007021
42 Z-000AFD4P 3575015901870001 KHOTITIK WATININGSIH 34 UMUM BUKIR. RT 02 / RW 01 . KEL . GADING REJO 8961440138 CoronaVac 08/09/2021 2140103 08/11/2021 240007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
### INDUK
1 S-2FF0C61D : 3575010107550031 AS'ARI 69 LANSIA JL SLAMET RIYADI GENTONG 8961741817 BIOFARMA 09/11/2021 24007021
2 Y-0000960N : 3575025110960001 SITI KOMARIA TIKA MAHARANI 25 UMUM JL LAKS MARTADINATA RT 002 RW 008 NGE 8221035759 BIOFARMA 09/11/2021 24007021
3 P-2SLRDAZD : 3575015605050003 LAILI INAYAH 16 REMAJA SEBANI RT02/RW05 SEBANI 8596434497 BIOFARMA 09/11/2021 24007021
4 Q-001BGY5B : 3575014104930001 MUSRIFAH 28 UMUM JL BANDA GADINGREJO 8223311929 BIOFARMA 12/10/2021 202108172F 09/11/2021 24007021
5 Q-001BHHAS : 3575014610060001 LYSSA NUR RAMADHANY 15 REMAJA PERUM KRATON INDAH 8578118659 BIOFARMA 12/10/2021 202108172F 09/11/2021 24007021
6 Q-001BITOU : 3575012703070002 TONTON SUSANTO 14 REMAJA JL HALMAHERA GG9 8578092035 BIOFARMA 12/10/2021 202108172F 09/11/2021 24007021
7 Z-000CILTH : 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 BIOFARMA 12/10/2021 202108172F 09/11/2021 24007021
8 Q-001A6VA0 : 3575014909090002 RIZKIA AMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 BIOFARMA 08/10/2021 202108172F 09/11/2021 24007021
9 Q-001A30DA : 3575014909090001 RIZKA KAMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 BIOFARMA 08/10/2021 202108172F 09/11/2021 24007021
10 P-EOONMSBT : 3575012805050001 MUHAMMAD FARHAN SAPUTRA 16 REMAJA JL HALMAHERA GG9 RT03/RW05 GADINGREJO 8132517204 BIOFARMA 09/11/2021 24007021
11 P-8GIOGXIC : 3575011006920003 JUNAIDI 29 UMUM JL HANGTUAH 2 8113777705 ASTRA ZENECA 09/11/2021 A1063
12 P-BFWE6494 : 3575010908850002 YUSUF 36 UMUM JL HALMAHERA GG 9 818324348 ASTRA ZENECA 09/11/2021 A1063
13 P-8QGBZ4T3 : 3575010905010007 MOCH. KHOIRUL 20 UMUM JL HALMAHERA GG9 GADINGREJO 8585583626 ASTRA ZENECA 09/11/2021 A1063
14 P-A7SDWGLE : 3575037007740001 SITI NURWIDAYATI 47 UMUM JL PATIMURA NO 128 BUGUL KIDUL RT 05 RW 0 8193971150 ASTRA ZENECA 09/11/2021 A1063
15 P-BWJ31EL9 : 3575014107880132 AYUK 33 UMUM JL HALMAHERA GG 9 818324348 ASTRA ZENECA 09/11/2021 A1063
16 P-9N6ACUDB : 3575012810010001 HERU PRASETIAWAN 20 UMUM JL BANDA RT05/RW02 GADINGREJO 8575574212 ASTRA ZENECA 09/11/2021 A1063
17 P-BZRLETFN : 3575012204850003 HAKI PRIYANTO 36 UMUM JL SLAMET RIYADI GENTONG 8585277857 ASTRA ZENECA 09/11/2021 A1063
18 P-8XT7IZC0 : 3575014307810004 IRNA 40 UMUM JL HANGTUAH 2 8113777705 ASTRA ZENECA 09/11/2021 A1063
19 P-CDUWPQXI : 3575010107850036 SLAMET RIYADI 36 UMUM JL HASANUDIN VII 8967012297 ASTRA ZENECA 09/11/2021 A1063
20 P-CWZX5CVK : 3575011411920001 MOHAMMAD FIRMAN MAULANA 29 UMUM JL SLAMET RIYADI 8564896301 ASTRA ZENECA 09/11/2021 A1063
21 P-D9BABISG : 3508171512940003 DEBI DIAN PRATIWI 27 UMUM PERSIL NYEORAN 8570768327 ASTRA ZENECA 09/11/2021 A1063
22 P-EAOZVYZT : 3575010107980052 ROBIATUL AWALIYA 23 UMUM JL HALMAHERA RT02/RW03 GADINGREJO 8570706844 ASTRA ZENECA 09/11/2021 A1063
23 P-EM3W7YCP : 3575016512740001 ALFIAH 47 UMUM JL HANGTUAH RT02/RW04 GADINGREJO 8113777705 ASTRA ZENECA 09/11/2021 A1063
24 P-D6IMZPQF : 3575015805770007 NUNIK 44 UMUM JL GATOT SUBROTO GG 8 BUKIR 8312245032 ASTRA ZENECA 09/11/2021 A1063
25 P-EM7HYX1B : 3575011709750001 SOLICHIN 46 UMUM JL KYAI SEPUH RT01/RW05 GENTONG 8510065233 ASTRA ZENECA 09/11/2021 A1063
26 P-0V3WU2TN : 3575015211880002 MUSLIKHAH 33 UMUM JL HANGTUAH 2/4 GADINGREJO 8113777705 ASTRA ZENECA 09/11/2021 A1063
27 P-5PPGIW63 : 3514165402990008 SITI FATMAWATI 22 UMUM JL HANGTUAH RT04/RW01 TAMBAAN 8113777705 ASTRA ZENECA 09/11/2021 A1063
28 P-57ZBRKNU : 3575015201770001 URIFAH 44 UMUM JL KYAI SEPUH GENTONG 8113777705 ASTRA ZENECA 09/11/2021 A1063
29 P-2NO3M06H : 3575016212680001 SITI KHODIJAH 53 RENTAN JL KYAI SEPUH GG 21 GENTONG 8113777705 ASTRA ZENECA 09/11/2021 A1063
30 P-EPGUQEIQ : 3575014704900001 LAILIA AINUN HIDAYATI 31 UMUM JL KYAI SEPUH GG 19 RT02/RW05 GENTONG 8564954747 ASTRA ZENECA 09/11/2021 A1063
31 P-EPRUABNX : 3575014808920001 KIPTIYAH 29 UMUM JL HALMAHERA RT05/RW05 GADINGREJO 8382355319 ASTRA ZENECA 09/11/2021 A1063
32 P-EQ4N547C : 3514166611010003 KHUROTUL AINI 20 UMUM KEBON SAWAH KALIREJO KRATON 8382417584 ASTRA ZENECA 09/11/2021 A1063
33 P-EQEYO7PU : 3575016711940004 ILMIATUL ROFI'AH 27 UMUM JL HALMAHERA RT05/RW05 GADINGREJO 8312336786 ASTRA ZENECA 09/11/2021 A1063
34 Q-000NEEPB : 3575015703010003 MAYA INDAH SATYAWATI 20 UMUM SLMAET RIYADI 2/2 SEBANI 8132500422 ASTRA ZENECA 16/08/2021 ABY1911 09/11/2021 A1063
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 Q-000NE6IH : 3575011701010001 MOHAMMAD RISQI DWI NUGROHO 20 UMUM JL MULYOREJO 3/6 SEBANI 8967886867 ASTRA ZENECA 16/08/2021 ABY1911 09/11/2021 A1063
36 Q-000N0AYI : 3575031809860001 MUHAMAD HAFID 34 UMUM JL HALMAHERA 8510566411 ASTRA ZENECA 14/08/2021 ABY1911 09/11/2021 A1063
37 Q-000K4893 : 3575016005000002 SOFIATUL KHUSNIA 21 UMUM JL URIP SUMOHARJO 8573139070 ASTRA ZENECA 29/07/2021 ABY1911 09/11/2021 A1063
38 Z-00099AYI : 3575010107840077 HERI SUTIKNO 37 UMUM DSN TAWAR 3/1 GONDANG 8573051898 ASTRA ZENECA 16/08/2021 ABY1911 09/11/2021 A1063
39 P-ETRPS6ZI : 3575015407920002 CICI AMALIA 29 UMUM J; BANDA GG MAWAR 8573030844 ASTRA ZENECA 09/11/2021 A1063
40 P-EU5K53KQ : 3575014212830003 JULAIKA 38 UMUM JL BANDA GG MAWAR 8573139636 ASTRA ZENECA 09/11/2021 A1063
41 P-EWMFROT4 : 3575015402770001 YULIATIN 44 UMUM JL BANDA GG MAWAR 8124925404 ASTRA ZENECA 09/11/2021 A1063
42 P-EX09AK6L : 3575014107800128 YUNIANAH 41 UMUM JL BANDA GG MAWAR 8585227204 ASTRA ZENECA 09/11/2021 A1063
### SD TRAJENG
1 P-4Q44EK9S 3575014907090003 SERLIE ANGGRAENI TAUFIQ 12 REMAJA JL. HALMAHERA X 8822600800 BIOFARMA 09/11/2021 24007021
2 P-E8YT60WY 3575014804090001 ASMA'UL KHUSNA 12 REMAJA JL. HANGTUAH GG 9 8822664957 BIOFARMA 09/11/2021 24007021
3 P-ENHPCS1P 3575012505090002 MUHAMMAD UMAR AIMAR 12 REMAJA JL. HALMAHERA IXB 8967874534 BIOFARMA 09/11/2021 24007021
4 P-EM5Q1BP5 3575042209090001 CHANDRA PRATAMA 12 REMAJA JL. HALMAHERA 13 8384665276 BIOFARMA 09/11/2021 24007021
5 P-2ZJ817TG 3575013005090001 MUHAMMAD RAFI 12 REMAJA JL. HALMAHERA IX 8233149555 BIOFARMA 09/11/2021 24007021
6 P-V2YFVDKV 3575016704080001 MIYAH KARIMAH 13 REMAJA JL. HANGTUAH GG 9 8573131034 BIOFARMA 09/11/2021 24007021
7 P-1XYWKP6B 3575014403090002 NURIN NISAIL JAMILAH 12 REMAJA JL. HALMAHERA X 8564908908 BIOFARMA 09/11/2021 24007021
8 P-EJG0TLO2 3575015106090003 AULIA ALFIATUL KHASANAH 12 REMAJA JL. HALMAHERA XX/34 8123119022 BIOFARMA 09/11/2021 24007021
9 P-EWHEOS98 3575014107100008 ROFIAH 13 REMAJA JL. HALMAHERA 8313259429 BIOFARMA 09/11/2021 24007021
10 P-EOA04FHW 3575012809090001 DWI PUTRA AFANDI 12 REMAJA JL. HANGTUAH 8898962363 BIOFARMA 09/11/2021 24007021
11 P-EOGPHUEC 3575015704090005 FIRDA MAULIDIYA 12 REMAJA JL. HALMAHERA 8953505467 BIOFARMA 09/11/2021 24007021
12 P-EOLPERXG 3575011607090005 IMAM GHOJALI 12 REMAJA JL. HALMAHERA GG 9 8772120607 BIOFARMA 09/11/2021 24007021
13 P-EOQOGKWK 3575015612080001 ISNAYA AZARA ARIFIANI 13 REMAJA APARTEMEN PANTAI 8318566237 BIOFARMA 09/11/2021 24007021
14 P-EP4QEAOM 3575014202090001 LAILATUL WULAN SAFARA 12 REMAJA JL. HANGTUAH 8313806085 BIOFARMA 09/11/2021 24007021
15 P-EPF6HBP5 3575010106060007 MUCHAMMAD NURUL YAKIN 12 REMAJA JL. HALMAHERA 8311945597 BIOFARMA 09/11/2021 24007021
16 P-EPAGVTR3 3575010909090003 M. MUJIB 12 REMAJA JL. HALMAHERA 8135747214 BIOFARMA 09/11/2021 24007021
17 P-8REXYJWP 3575012506090001 MUHAMMAD AFRAND IZZUDDIN 12 REMAJA JL. HALMAHERA GG 9 8953390378 BIOFARMA 09/11/2021 24007021
18 P-9LLRDYDE 3575014401080003 NUR AJIZAH 13 REMAJA JL. HALMAHERA XI 8135765036 BIOFARMA 09/11/2021 24007021
19 P-BOTEPB1H 3575014509090002 NURUL IFADAH 12 REMAJA JL. HANGTUAH 8573858344 BIOFARMA 09/11/2021 24007021
20 P-EXVGA6CK 3575014407090003 ALFA RISKA 12 REMAJA APARTEMEN PANTAI MAS 8573062509 BIOFARMA 09/11/2021 24007021
21 P-EPR6YJIZ 3575010204090003 ACHMAD ZAHIR 12 REMAJA JL. HALMAHERA 8340848020 BIOFARMA 09/11/2021 24007021
22 P-EQAMYFCR 3575012702090002 MUCHAMMAD MAULUDIN ISMAEL 12 REMAJA RUSUNAWA 1/4 8384561573 BIOFARMA 09/11/2021 24007021
23 P-PZSS0GVN 3575030905080002 MUHAMMAD IRFAN HAKIM 13 REMAJA BUGUL KIDUL PASURUAN 8133458936 BIOFARMA 09/11/2021 24007021
24 P-EYPY4M6U 3575010107070002 YUSRIL ILMAN 14 REMAJA JL. HALMAHERA 8311569042 BIOFARMA 09/11/2021 24007021
25 P-EYY5DGGJ 3575011006090002 MUCHAMMAD LUTFI 12 REMAJA JL. HALMAHERA 8575568243 BIOFARMA 09/11/2021 24007021
26 P-EZ3FEUFO 3575012301090001 MUCHAMMAD IQBAL WAHYUDI 12 REMAJA JL. HALMAHERA 8810272397 BIOFARMA 09/11/2021 24007021
27 P-EZA77XLS 3575011406090001 SOFIYAN 12 REMAJA HANGTUAH 1/4 8311068954 BIOFARMA 09/11/2021 24007021
28 P-EZEHM7HH 3575014102070003 HIKMATUL AMELIA 13 REMAJA HANGTUAH 1/4 8199967913 BIOFARMA 09/11/2021 24007021
29 P-EZJ90JEU 3575012403090003 FARIL MAULANA 12 REMAJA HANGTUAH 3/3 8384610053 BIOFARMA 09/11/2021 24007021
30 P-EZO9LHDW 3575011212080001 DIAN FIRMANSYAH 13 REMAJA JL. HALMAHERA 8384610053 BIOFARMA 09/11/2021 24007021
31 P-EZSDMILL 3575016408090001 NADIA VERLITA RAMADHANI 12 REMAJA JL. HALMAHERA 8596233353 BIOFARMA 09/11/2021 24007021
32 P-9M4KIK2U 3575011207090002 ALI FARKHAN 12 REMAJA Jl. Hangtuah Rt.003 Rw.004 Gadingrejo 8121774644 BIOFARMA 09/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
33 P-9L7QTGBI 3515041804090003 AHMAD IKSAN MAULANA 12 REMAJA Jl. Halmahera Gg XI Rt.005 Rw.008 Gadingrejo 8585093691 BIOFARMA 09/11/2021 24007021
34 P-9NEVYENC 3575014703080001 DIANA SAFIRAH 13 REMAJA JL. HALMAHERA 8385108422 BIOFARMA 09/11/2021 24007021
35 P-F0DMLQI0 3575011609090002 FARHAN RAMADHAN CHALIM 12 REMAJA HANGTUAH 4/2 8515654516 BIOFARMA 09/11/2021 24007021
36 P-F0J1PNBK 3575012407090003 MOCHAMMAD EMIL ALFARIDHO 12 REMAJA JL. HALMAHERA 8233672786 BIOFARMA 09/11/2021 24007021
37 P-F0MT1CHJ 3575013009090001 MUKHAMAD SAIROZI 12 REMAJA HANGTUAH 3/4 8383004340 BIOFARMA 09/11/2021 24007021
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
### INDUK
1 S-14E5DE2A 3575010107600064 PITONG 61 LANSIA JL PADAT RAYA BARU GELANG KUSAN HILIR 8113777705 BIOFARMA 10/11/2021 24007021
2 P-FBR32DKL 3573014101600023 LULUK KHODUBIYAH 57 RENTAN JL KYAI SEPUH N0 21 RT01/RW06 GENTONG 8113777705 BIOFARMA 10/11/2021 202108178F
3 P-0WMM4OMS 3575016510060004 FITRIA SABILA ROSADA 15 REMAJA JL IRIAN JAYA 27 GADINGREJO 8776691204 BIOFARMA 10/11/2021 24007021
4 P-FKHRGZVR 3514162209840001 CHOLIL 37 UMUM KEBONSAWAH PASURUAN 8773645653 BIOFARMA 10/11/2021 24007021
5 Z-000CLBVC 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 BIOFARMA 13/10/2021 202108172F 10/11/2021 24007021
6 Q-000HZJFW 3575011008900002 MOCH. ROCHMAN 31 UMUM JL HANGTUAH G. V 8225730266 BIOFARMA 17/07/2021 24201621 10/11/2021 24007021
7 Q-00193PXF 3575013003960002 KATON SUPRAYUGI 25 UMUM JL SLAMET RIYADI 8786610172 BIOFARMA 06/10/2021 202108172F 10/11/2021 24007021
8 Z-000B92NU 3575010910510001 MOCH. AMALI ZAIN 70 LANSIA JL URIP SUMOHARJO RT 3 RW 1 BUKIR 8113777705 BIOFARMA 22/09/2021 202108154G 10/11/2021 24007021
9 Q-000BAE58 3514166904910002 ANJAR WULANSARI 30 UMUM JL GATOT SUBROTO 8224775494 BIOFARMA 05/07/2021 24003521 G 10/11/2021 24007021
10 Q-001731H5 3575014910050003 NIA RAMADHANI 16 REMAJA JL HALMAHERA 3/5 GADINGREJO 8318524416 BIOFARMA 01/10/2021 202108154G 10/11/2021 24007021
11 Q-001701HA 3575015012060001 FAIZAH 15 REMAJA JL HALMAHERA 3/5 GADINGREJO 8318524416 BIOFARMA 01/10/2021 202108154G 10/11/2021 24007021
12 Q-001A6Y6Y 3575011804890001 FATKHUR ROKHMAN 32 UMUM Bukir RT01 RW05 8523020115 BIOFARMA 08/10/2021 202108172F 10/11/2021 24007021
13 Q-0017LXNQ 3575026205940003 MIA AMALIA 27 UMUM JL DIPONEGORO . KEL KEBONSARI . RT 03 / RW 8123298123 BIOFARMA 02/10/2021 2021081671 10/11/2021 24007021
14 Q-0017LZK8 3514196008950002 NURUL MAULIYAH 26 UMUM JL DIPONEGORO . KEL KEBONSARI . RT 03 / RW 8574677780 BIOFARMA 02/10/2021 2021081671 10/11/2021 202108172F
15 Q-000EU1U9 3575014710880002 IMROATUL MUFIDAH 33 UMUM JL KH ACHMAD DAHLAN 110 8787590141 BIOFARMA 15/07/2021 202108178F 10/11/2021 24007021
16 Q-001AIKOM 3575035109970002 NINDYA WAHYUWI CAHYANINGRUM 24 UMUM JL DR WAHIDIN S HUSODO IV / 28 8223348731 BIOFARMA 09/10/2021 202108172F 10/11/2021 24007021
17 P-7BX13J8E 3575015407820006 DEWI KURNIAWATI 39 UMUM JL SLAMET RIYADI RT01/RW05 GENTONG 8135732818 ASTRA ZENECA 10/11/2021 A1063
18 P-45TMXO0J 3575010206900002 MOKH. MUSLIK 31 UMUM DUSUN RUKEM RT01/RW04 SUNGKULON POHJ 8315375317 ASTRA ZENECA 10/11/2021 A1063
19 P-0AQQJYVI 3575010607740005 MOCH ANSORI 47 UMUM JL IRIAN JAYA NO 27 GADINGREJO 8776691204 ASTRA ZENECA 10/11/2021 A1063
20 P-EQPHNBEP 3575015608760002 NASIFAH 45 UMUM JL. SLAMET RIYADI KEL. SEBANI GADINGREJO 8564523695 ASTRA ZENECA 10/11/2021 A1063
21 P-7SN24GCU 3507106509870004 SEBTIANA 34 UMUM SEBANI RT01/RW06 SEBANI 8233120591 ASTRA ZENECA 10/11/2021 A1063
22 P-A620UYN1 3575014706910002 MUTMAINAH 30 UMUM MENANGAS WETAN GRATI 8581543667 ASTRA ZENECA 10/11/2021 A1063
23 P-AESD9FSR 3575014501680001 SAKIYAH 53 RENTAN JL KYAI SEPUH RT01/RW06 GENTONG 8560839181 ASTRA ZENECA 10/11/2021 A1063
24 P-APWQAQAP 3575011005980001 RACHMAT MAIHAQI ANDRIANSYAH 23 UMUM JL KYAI SEPUH GG 20 GENTONG 8810262519 ASTRA ZENECA 10/11/2021 A1063
25 P-BDT5O7MO 3575015909880001 WINDY AYU LESTARI 33 UMUM JL SLAMET RIYADI RT02/RW04 GENTONG 8887123213 ASTRA ZENECA 10/11/2021 A1063
26 P-BQD97HA0 3575034107830112 NASIFAH 39 UMUM DOROPAYUNG SEKARGADUNG POHJENTREK 8123294064 ASTRA ZENECA 10/11/2021 A1063
27 P-BXM8NQHK 3575010106020002 MOH. SAFII 19 UMUM JL HALMAHERA RT05/RW05 GADINGREJO 8123294064 ASTRA ZENECA 10/11/2021 A1063
28 P-COPLOGRX 3575016108870001 LILIS SURYANI 35 UMUM JL GATOT SUBROTO BUKIR 8821754553 ASTRA ZENECA 10/11/2021 A1063
29 P-0QEYEKUR 3575024107880002 TRIVINA DAMAYANTI 35 UMUM JL GATOT SUBROTO BUKIR 8562403688 ASTRA ZENECA 10/11/2021 A1063
30 P-FBIACWYF 3514146812830001 SITI KHALIMATUS SADEYAH 38 UMUM JL KYAI SEPUH RT02/RW05 GENTONG 8523072500 ASTRA ZENECA 10/11/2021 A1063
31 Q-000NMFWR 3514147110020001 ANANDA RAHMASTARI RIZKI A 19 UMUM JL MANGGIS DERMO BANGIL 8953383991 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
32 Q-000NSM7P 3575011503770001 M.MUSIK 43 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8133437837 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
33 Q-000NSM5J 3575014503790001 WIWIK RAHAYUNINGSIH 42 UMUM JL GATOT SUBROTO BUKIR 8533061506 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
34 Q-000NSLB0 3575014507760001 ASLICHAH 45 UMUM JL URIP SUMOHARJO 8969965741 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
35 Q-000NSKXX 3575010801610001 NGADIONO 60 LANSIA JL IRIAN JAYA 2/2 8133688826 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
36 Q-000NSLBA 3575015602790005 LULUK FAIZAH 42 UMUM JL URIP SUMOHARJO 1/2 GADINGREJO 8113777705 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
37 Q-000NMCGT 3575011210640001 SUHERMAN 57 RENTAN JL GATOT SUBROTO 3/4 GADINGREJO 8222813235 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
38 Q-000NSCQA 3514180402870001 MOCHAMAT NUR ROCHIM 34 UMUM JL GATOT SUBROTO 2/7 GADINGREJO 8968804289 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
39 Q-000NSCHP 3575011409810001 ARIF FADILAH 42 UMUM BUKIR 3/7 GADINGREJO 8533453059 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
40 Q-000NSE2I 3575012109020002 MUHAMMAD FAHMI 19 UMUM JL URIP SUMOHARJO 1/2 GADINGREJO 8161598391 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
41 Q-000NSCEG 3575013101020001 ZUFAR ABDUL GHOFAR 19 UMUM BUKIR 2/2 GADINGREJO 8969962398 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
42 Q-000NSN7G 3575012007840002 NANANG HARIANTO 37 UMUM JL GATOT SUBROTO 2/4 GADINGREJO 8125973857 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
43 Q-000NSO7D 3575011303760002 MUKHAMAD HUFRON 45 UMUM JL GATOT SUBROTO 1/3 GADINGREJO 8560808967 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
44 Q-000NSL8S 3575015408790002 YULIATI 42 UMUM JL GATOT SUBROTO 5/7 GADINGREJO 8383136320 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
45 Q-000NSLAQ 3575014803000001 ANGGRAENI WASIAH 21 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8981308263 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
46 Q-000NSL0D 3575016508920001 RATNA EKA WATI 29 UMUM JL IRIAN JAYA 2/2 8573755434 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
47 Q-000NSOHO 3575010510820003 AKHMAD KUSAINI 39 UMUM JL GATOT SUBROTO BUKIR 8578435426 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
48 Q-000NSOGV 3575014207860003 NUR KHOLIS SETYANINGSIH 35 UMUM JL GATOT SUBROTO 1/7 GADINGREJO 8569555106 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
49 Q-000NSOUT 3575016611960002 DEWI MASITA MABRURO 25 UMUM JL GATOT SUBROTO 3/4 8954004780 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
50 Q-000NSM5D 3575014105720001 SUMINI 45 UMUM JL GATOT SUBROTO 05/07 GADINGREJO 8132875374 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
51 Q-000NSNS4 3575015211770001 SITI ROMLAH 44 UMUM JL GATOT SUBROTO 3/4 GADINGREJO 8969962869 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
52 Q-000NSOWO 3514202812890004 FRENGKI 32 UMUM JL GATOT SUBROTO 3/4 GADINGREJO 8954004780 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
53 Q-000NSNPQ 3575010105650002 M. MA'RUF 56 RENTAN JL GATOT SUBROTO 3/4 GADINGREJO 8969962869 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
54 Q-000NSMPM 3575014203790001 SITI AMINAH 42 UMUM JL IRIAN JAYA GADINGREJO 8213256348 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
55 Q-000NSOY6 3575017004990001 MAISAROH DWI WAHYUNI 22 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8574833749 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
56 Q-000NSKYZ 3575014407990002 RASIO DWI MURPY 22 UMUM JL IRIAN JAYA 2/2 8574639980 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
57 Q-000NSLTE 3575016905990003 RATNA JUWITA 22 UMUM JL IRIAN JAYA N0.24 8132849174 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
58 Q-000NSOSF 3575010910000001 MUCHAMMAD IQBAL FIRMANSYAH 21 UMUM JL GATOT SUBROTO 1/5 GADINGREJO 8573012527 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
59 Q-000NSOKA 3575011504930002 MUKHAMAD SUBADAR 28 UMUM JL URIP SUMOHARJO BUKIR 8969953634 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
60 Q-000NSOLI 3575027101000003 KHOLIFATUR ROSIDAH 21 UMUM WIROGUNAN 3/4 8961639985 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
61 Q-000NSM96 3514174906900002 IRMA NUR HALIMAH 31 UMUM JL GATOT SUBROTO 1/4 8223022453 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
62 Q-000NSOGS 3575015205000004 AINUN NAZILLAH 21 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8953363980 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
63 Q-000NSOMG 3575016803030003 NOVITA WULANDARI 19 UMUM JL GATOT SUBROTO 3/5 8968095862 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
64 Q-000NSDD5 3575017006930001 SUROYATUL MAGHFIROH 28 UMUM BUKIR 2/3 GADINGREJO 8222819414 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
65 Q-000NSKWA 3575014604650002 EVA JUBAEDAH 55 RENTAN JL HANGTUAH GADINGREJO 8383383144 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
66 Q-000NSOC3 3575025003960001 KHOIRUL BARIYAH 25 UMUM JL HANGTUAH 4/2 GADINGREJO 8383383144 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
67 Q-000NSCL4 3575012706740001 DAHLAN 47 UMUM JL URIP SUMOHARJO 2/1 GADINGREJO 8233549449 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
68 Q-000NSCNZ 3575015412850001 WULAN SARI 36 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8593225256 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
69 Q-000NSNC2 3575011505770006 ALI MUSTOFA 44 UMUM JL GATOT SUBROTO 8956139779 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
70 Q-000NSB4W 3575015710760001 ANIK SUNDARI 45 UMUM BUKIR RT 2 RW 4 8958052099 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
71 Q-000NSN7K 3575016404820001 SISWATININGSIH 39 UMUM JL GATOT SUBROTO 8956139779 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
72 Q-000NM9QW 3575011909020003 ACHMAD SUHAD 19 UMUM JL BANDA GADINGREJO 8383513183 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
73 Q-000NSOYT 3514121410910005 GUNAWAN 30 UMUM JL GATOT SUBROTO 3/4 GADINGREJO 8578416000 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
74 Q-000NSNIF 3575034312020002 SAMMATUL FITRIYAH 19 UMUM JL HOS COKROAMINOTO 8585573892 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
75 Q-000NSMJJ 3575015002000005 EVI LUTFIYANI 21 UMUM JL SLAMET RIYADI SEBANI GADINGREJO 8383327721 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
76 Q-000MZMC2 3575010308810004 BEYU ISMAIL 40 UMUM PERUM KARYA BAKTI D1 8218238144 ASTRA ZENECA 14/08/2021 ABY1911 10/11/2021 A1063
77 Q-000MZMCO 3575012608900001 RIZAL AFDILLAH 31 UMUM JL SLAMET RIYADI 2/4 8223659616 ASTRA ZENECA 14/08/2021 ABY1911 10/11/2021 A1063
78 Z-0009D192 3524172301870001 MOCHAMAD SHOLEH 34 UMUM JL BANDA GADINGREJO 8122021977 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
79 Q-000NSD5K 3575015610950003 SITA NINGRUM 26 UMUM JL URIP SUMOHARJO 1/2 GADINGREJO 8194971266 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
80 Q-000NSD7F 3575015701770001 SUWARNI 44 UMUM JL URIP SUMOHARJO BUKIR 8953172278 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
81 Q-000NSC0D 3575015609020004 ILVI NUR DIANA 19 UMUM BUKIR 2/6 GADINGREJO 8225728129 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
82 Q-000MZMCT 3575013112720001 SUTRISNO 49 UMUM BUKIR 3/3 GADINGREJO 8967885621 ASTRA ZENECA 14/08/2021 ABY1911 10/11/2021 A1063
83 Q-000MYQN4 3575015207860001 MISTAMAH 35 UMUM BUKIR 3/3 GADINGREJO 8967885621 ASTRA ZENECA 14/08/2021 ABY1911 10/11/2021 A1063
84 Q-000NSO1C 3575014803910001 NUR AINI 30 UMUM JL URIP SUMOHARJO 1/3 GADINGREJO 8578524756 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
85 Q-000NSCNL 3575012604750001 IHWAN PARYOGO 42 UMUM JL GATOT SUBROTO BUKIR 8533104445 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
86 Q-000NSNTA 3575012304780001 NURIL KHADIS 43 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8958030175 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
87 Q-000NSCC2 3575010202850006 M0CHAMAD ERDIANSYAH 36 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8953081100 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
88 Q-000NSONB 3575020106880004 MAMAN FIRMANTO 33 UMUM JL GATOT SUBROTO BUKIR 8953091008 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
89 Q-000NSOR9 3575011807740001 IMRON HAMZAH 47 UMUM JL GTOT SUBROTO BUKIR 8958052100 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
90 Q-000NSDE2 3575012803890003 BAYUARGAWAN 32 UMUM JL URIP SUMOHARJO 1/2 GADINGREJO 8951595411 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
91 Q-000NSD52 3575010106020003 PURNOMO MAS NUR DIRJO 19 UMUM BUKIR GADINGREJO 8999425279 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
92 Q-000NMS6G 3575014107850043 RUCHANAH 36 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8224401999 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
93 Q-000NSNBD 3575012111970001 MUKHAMAD FARID ANDIKA 24 UMUM JL URIP SUMOHARJO 1/1 8124619328 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
94 Q-000NSNXM 3575016112750001 HARIYASTUTI 46 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8969954268 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
95 Q-000NSME1 3575015202780003 DIAH TRIYANI 43 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8953981586 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
96 Q-000NSNTQ 3575012508680002 ISMAIL 53 RENTAN JL GATOT SUBROTO 1/5 GADINGREJO 8969954268 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
97 Q-000NSMAT 3575010303760003 AGUS BUDIONO 45 UMUM JL GATOT SUBROTO 2/4 8589567891 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
98 Q-000NSMCB 3575014107800024 MUNIFAH 41 UMUM JL URIP SUMOHARJO BUKIR 8585023050 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
99 Q-000NSOJD 3575012607990004 IZZUDIN ABDUL AZIZ 22 UMUM BUKIR 2/2 GADINGREJO 8953879033 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
100 Z-0009D19B 3575015802900001 YUNI INDAH LESTARI 31 UMUM JL BANDA 3/2 GADINGREJO 8578493666 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
101 Z-0009D1AZ 3514155708920002 HABIBATUL JANNAH 29 UMUM JL SLAMET RIYADI GENTONG GADINGREJO 8585578428 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
102 Q-000ODACV 3575011411010001 AKHMAD ZAKY 20 UMUM JL URIP SUMOHARJO 8958019797 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
103 Q-000NSNCJ 3575012309000001 ACHMAD ROFIQ 21 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8786351588 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
104 Q-000NSERK 3575010305830001 FIRDAUS SUCAHYONO 38 UMUM JL HANGTUAH 4/3 GADINGREJO 8564972292 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
105 Q-000NSM1M 3575011503730001 MUHAMMAD YUSUF 48 UMUM BUKIR 3/5 GADINGREJO 8532057117 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
106 Q-000NSN5U 3575010908730001 MUKLAS 48 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8385346227 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
107 Q-000NSDL9 3575011410770001 SUPRIADI 44 UMUM JL GATOT SUBROTO 2/6 GADINGREJO 8786458926 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
108 Q-000NSDJZ 3575010505800003 SUPRIYADI 41 UMUM JL GATOT SUBROTO 3/6 GADINGREJO 8223427222 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
109 Q-000NSCCU 3575015407030001 NABILA KURNIA QURROTA A'YUN 18 UMUM JL URIP SUMOHARJO 3/2 GADINGREJO 8953385137 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
110 Q-000NSGCE 3575011507030001 MUHAMMAD SYAUQUL MUHIBBI 18 UMUM JL GATOT SUBROTO 3/6 GADINGREJO 8213980275 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
111 Q-000NMI2G 3507102309850001 ZAINUL ARIFIN 36 UMUM JL GATOT SUBROTO 2/6 GADINGREJO 8385620007 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
112 Q-000NSJLF 3575016411920002 LILIK WAHYUNINGSIH 32 UMUM JL GATOT SUBROTO 8385620007 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
113 Q-000NMG0R 3515104712950002 ILAILIL INDRIANI 26 UMUM PERUM LUMBUNG PADI 89 SEBANI 8214003327 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
114 Q-000NSNDL 3575015111790001 SHOLIHAH 42 UMUM JL GATOT SUBROTO 1/5 8785718304 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
115 Q-000NSOOJ 3575010210990002 MOKHAMAD ARIF HIDAYATULLOH 22 UMUM JL GATOT SUBROTO BUKIR GADINGREJO 8785718304 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
116 Q-000NSECO 3575017112960005 INE ANDRIANI ESTIARI 25 UMUM JL URIP SUMOHARJO 2/1 GADINGREJO 8121746936 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
117 Z-0009D1D3 6471044906790005 NINIK SUHARTINI 42 UMUM JLURIP SUMOHARJO BUKIR GADINGREJO 8223062797 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
118 Q-000NSJFX 3514166505810065 DENOK SURYATI 40 UMUM JL SLAMET RIYADI GADINGREJO SEBANI 8121675596 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
119 Q-000NSJK5 3575014409910003 RIZKY AMALLINA 30 UMUM SEBANI 4/1 GADINGREJO 8233528493 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
120 Q-000NSLU3 3575012201760001 LILIK SUPRIYANTI 45 UMUM BUKIR 2/2 GADINGREJO 8385339571 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
121 Q-000NSL6E 3575012701930004 TRYAN WAHYU FIRMANSYAH 28 UMUM PERUM KARYA BAKTI 2/7 GADINGREJO 8123450679 ASTRA ZENECA 18/08/2021 ABY1911 10/11/2021 A1063
122 Q-000NSDPN 3575012311970001 MOCHAMMAD LUKMAN HAKIM 24 UMUM JL GATOT SUBROTO 5/7 GADINGREJO 8951595653 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
123 Q-000NSDXG 3575012506000001 SYAHRUL ALAMSYAH 21 UMUM JL BANDA GADINGREJO 8222927156 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
124 Q-000NMP59 7602014302920001 AMALIA ANDYNI ALMUtTASIM 29 UMUM JL SLAMET RIYADI,SEBANI 8574976411 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063
125 Q-000NSDE8 3575011404030008 ANDRIS ETIABUDI 18 UMUM JL URIP SUMOHARJO 1/2 GADINGREJO 8999425385 ASTRA ZENECA 18/08/2021 210050 10/11/2021 A1063


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-ELI1FMIL 3575015602620001 ARIFAH 60 LANSIA JL SLAMET RIYADI 8113777705 CoronaVac 11/11/2021 202108187F
2 P-DMGUHO4L 3575016212890002 HAFSAH 32 UMUM JL HALMAHERA GADINGREJO 8774328141 CoronaVac 11/11/2021 24001021
3 P-G1AZZ871 3575014305080004 DWI KHOIRUNNISA 13 REMAJA JL IRIAN JAYA GG ANGGREK 8573018387 CoronaVac 11/11/2021 24001021
4 P-G1IAQHKO 3575015006060003 SAFIRA NUR LAILINA 15 REMAJA JL IRIANJAYA GG ANGGREK 8161598567 CoronaVac 11/11/2021 24001021
5 Z-000CG7O5 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/10/2021 202108172F 11/11/2021 202108172F
6 P-02SP6CBD 3514161001710003 MARKHAN 50 RENTAN JL. BANDA GADINGREJO 8133417404 ASTRA ZENECA 11/11/2021 A1094
7 P-DCTFOMCH 3575015706720002 SALAMAH 49 UMUM JL HANGTUAH 1/4 GADINGREJO 8113777705 ASTRA ZENECA 11/11/2021 A1094
8 P-E3RGJM0S 3575014107860117 ASMAUL CHUSNAH 35 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 11/11/2021 A1094
9 P-FTPN4AXU 3575015010750005 HASANAH 46 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRA ZENECA 11/11/2021 A1094
10 P-FTUGOTZ3 3575012504800003 SUPIYAN 41 UMUM JL SLAMET RIYADI GG 8 GENTONG 8573190691 ASTRA ZENECA 11/11/2021 A1094
11 P-F0OOW1JY 3575010601850002 IWAN HARIYANTO 36 UMUM JL BANDA GADINGREJO 8113777705 ASTRA ZENECA 11/11/2021 A1094
12 P-FUFXWPRI 3575010506850001 M. HARIS 36 UMUM JL HANGTUAH RT 4 RW 4 GADINGREJO 8125077258 ASTRA ZENECA 11/11/2021 A1094
13 P-CHZFJE4W 3575011007900002 SULAIMAN 31 UMUM JL HANGTUAH NO 4 GADINGREJO 8113777705 ASTRA ZENECA 11/11/2021 A1094
14 P-FXGUQG03 3575010311720002 SAROJI 49 UMUM JL SLAMET RIYADI 8523893558 ASTRA ZENECA 11/11/2021 A1094
15 P-FY7K4LDI 3575010107800215 KHOIRUL ANAM 41 UMUM GADINGREJO 8586571389 ASTRA ZENECA 11/11/2021 A1094
16 Q-000NWTZP 3575012004030002 YUSACH MAULANA 18 UMUM JL SLAMET RIYADI 1/1 GENTONG 8785516557 CoronaVac 19/08/2021 210050 11/11/2021 A1063
17 Q-000NWSC0 3575020506950005 YUNIAR KURNIAWAN PUTRA 26 UMUM JL SLMAET RIYADI 1/1 GENTONG 8575539069 CoronaVac 19/08/2021 210050 11/11/2021 A1063
18 Q-000NWFK9 3575010510690001 SIAMIN 52 RENTAN JL SLAMET RIYADI 1/1 GENTONG 8223477927 CoronaVac 19/08/2021 210050 11/11/2021 A1063
19 Q-000NWE6Y 3575014909790001 NURUL JANNAH 42 UMUM JL SLAMET RIYADI 1/1 GENTONG 8223761050 CoronaVac 19/08/2021 210050 11/11/2021 A1063
20 Q-000NWU0O 3575010910020002 MUHAMMAD ANANG MA'RUF 19 UMUM JL SLAMET RIADI GENTONG 8953363954 CoronaVac 19/08/2021 210050 11/11/2021 A1063
21 Q-000NVOUB 3575034610840001 DWI WIJIASTUTI 37 UMUM PERUM KBKA BLOK E12 3/8 GENTONG 8575502886 CoronaVac 19/08/2021 210050 11/11/2021 A1063
22 Q-000NVRIO 3515132406850012 CHITA RISTIANTO 36 UMUM TAWANGSARI 9/2 SIDOARJO 8214376221 CoronaVac 19/08/2021 210050 11/11/2021 A1063
23 Q-000NVRJC 3575015010790002 ELIS PURWATI 42 UMUM JL SLAMET RIYADI 1/1 GENTONG 8953219830 CoronaVac 19/08/2021 210050 11/11/2021 A1063
24 Q-000NVPPI 3575011001750001 ABD.KHALIM 49 UMUM JL SLAMET RIYADI 1/1 GENTONG 8953219830 CoronaVac 19/08/2021 210050 11/11/2021 A1063
25 Q-000NVY7K 3575014512900001 SITI ZULAIKHAH 31 UMUM JL SLAMET RIYADI 1/1 GENTONG 8956011332 CoronaVac 19/08/2021 210050 11/11/2021 A1063
26 Q-000NVND8 3575010808620001 AGUS SUGIANTORO 59 RENTAN GENTONG RT 1 RW 1 817339861 CoronaVac 19/08/2021 210050 11/11/2021 A1063
27 Q-000NXKDD 3508216406840001 SIYAMAH 37 UMUM MLAGI 7/3 KARANGKETUG 8128641454 CoronaVac 19/08/2021 210050 11/11/2021 A1063
28 Q-000NVX2R 3575016802810001 LULUK ILMIAH 40 UMUM JL SLAMET RIYADI 1/1 GENTONG 8575562705 CoronaVac 19/08/2021 210050 11/11/2021 A1063
29 Q-000NVYUA 3575016905820003 RIBUT 39 UMUM JL SLAMET RIYADI 1/1 GENTONG 8573203013 CoronaVac 19/08/2021 210050 11/11/2021 A1063
30 Q-000NVNOZ 3575011907020001 MOCHAMMAD FARIS YULIANTO 19 UMUM JL GATOT SUBROTO 3/4 BUKIR 8135903975 CoronaVac 19/08/2021 210050 11/11/2021 A1063
31 Q-000NWZ7Q 3514184310920001 KISWANTI 29 UMUM JL SLAMET RIYADI 3/4 SEBANI 8560806063 CoronaVac 19/08/2021 210050 11/11/2021 A1063
32 Q-000NW1HT 3575013009820001 MOH CHUSAINI 39 UMUM JL SLAMET RIYADI 1/1 GENTONG 8113777705 CoronaVac 19/08/2021 210050 11/11/2021 A1063
33 Q-000NYT6L 3575016207020003 ROSA YULIANA PUTRI 19 UMUM JL BANDA 4/2 GADINGREJO 8574586953 CoronaVac 19/08/2021 210050 11/11/2021 A1063
34 Q-000NWHZ7 3575011212000002 ANGGA PRATAMA 21 UMUM JL SLAMET RIYADI 1/1 GENTONG 8133271854 CoronaVac 19/08/2021 210050 11/11/2021 A1063
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 Q-000NWFKN 3575012404680002 MOCHAMAD SUSILO 53 RENTAN JL SLAMET RIYADI 1/1 GENTONG 8383328087 CoronaVac 19/08/2021 210050 11/11/2021 A1063
36 Q-000NW0GC 3575016012000001 ASMIATUL RAMADANTI 21 UMUM JL SLAMET RIYADI 1/1 GENTONG 8553696312 CoronaVac 19/08/2021 210050 11/11/2021 A1063
37 Q-000NW6JE 3575014404720002 AKHATIK 49 UMUM JL SLAMET RIYADI 1/1 GENTONG 8553696312 CoronaVac 19/08/2021 210050 11/11/2021 A1063
38 Q-000NYP7V 3320052012990002 DIDIN SETIAWAN 22 UMUM JL SLAMET RIYADI 4/2 SEBANI 8232973765 CoronaVac 19/08/2021 210050 11/11/2021 A1063
39 Q-000NVPBK 3575014405780001 NUR KHAMIDAH 43 UMUM JL GATOT SUBROTO 3/5 BUKIR 8573203107 CoronaVac 19/08/2021 210050 11/11/2021 A1063
40 K-0000L0V2 3575011608000004 MUKHAMMAD SALMAN ALFARIZI 21 UMUM JL HANGTUAH GANG 4 2/4 GADINGREJO 8954005604 CoronaVac 18/08/2021 210050 11/11/2021 A1094
41 Q-000NSCVD 3575010910000003 M. FUAD 21 UMUM JL HANGTUAH GADINGREJO 8135836746 CoronaVac 18/08/2021 210050 11/11/2021 A1094
42 Q-000NVOHR 3575013006710001 M ALI ZAINAL ABIDIN 50 RENTAN JL GATOT SUBROTO 3/5 BUKIR 8573203107 CoronaVac 19/08/2021 210050 11/11/2021 A1094
43 Q-000NYN4E 3575010404980001 ARNAZ ANDRI PRAMANA 23 UMUM JL SLAMET RIYADI 4/2 SEBANI 8235710752 CoronaVac 19/08/2021 210050 11/11/2021 A1094
44 Z-0009DY5N 3575012703510001 BUDI SULISTIYA 65 LANSIA JL. KARYA BHAKTI BLOK N / NO.20 8113777705 CoronaVac 19/08/2021 210050 11/11/2021 A1094
45 Q-000NSEHI 3514096611980004 KANITA ISNANI ASADIYAH 23 UMUM JL WAHIDIN 9/3 PURWOREJO 8317678150 CoronaVac 18/08/2021 210050 11/11/2021 A1094
46 Q-000NVTJU 3575012904860002 NUR SUPRIANTO 35 UMUM JL KYAI SEPUH 1/6 GENTONG 8224577543 CoronaVac 19/08/2021 210050 11/11/2021 A1094
47 Q-000NWU5Q 3575016302960002 REVA NURIL RACHMA 25 UMUM JL SINONGGO 1/1 GADINGREJO 8122157615 CoronaVac 19/08/2021 210050 11/11/2021 A1094
48 Q-000NSC2Y 3575011510780007 MUKHAMAD HASAN 43 UMUM BUKIR GADINGREJO 8952336239 CoronaVac 18/08/2021 210050 11/11/2021 A1094
49 Q-000MYL1S 3514140908780005 MOCH RISZA HIMMAWAN 43 UMUM JL URIP SUMOHARJO 2/3 BUKIR 8213115555 CoronaVac 14/08/2021 ABY1911 11/11/2021 A1094
50 Q-000NWPIP 3575010807000002 ARIF MARDIANSYAH 21 UMUM JL SLAMET RIYADI 2/1 GENTONG 8384863845 CoronaVac 19/08/2021 210050 11/11/2021 A1094
51 Q-000NSBXK 3514146309830002 NUR ITA FATMAWATI 38 UMUM JL URIP SUMOHARJO 2/3 GADINGREJO 8191720008 CoronaVac 18/08/2021 210050 11/11/2021 A1094
52 Q-000NSBZZ 3575016309770001 ANIK FITRIAWATI 44 UMUM JL URIP SUMOHARJO BUKIR 8998777325 CoronaVac 18/08/2021 210050 11/11/2021 A1094
53 Q-000NVN1G 3575015308880001 KIKI CHUSNIA 33 UMUM JL SLAMET RIYADI 2/3 SEBANI 8384846080 CoronaVac 19/08/2021 210050 11/11/2021 A1094
SDI HIDAYATUL MUBTADI'IN
1 P-DTO9T1LJ 3575011403090001 ABI SUGARA 12 REMAJA Jl.Slamet Riyadi No.18 8313623096 CoronaVac 11/11/2021 240007021
2 P-EAMMJT97 3575012607090002 AHMAD NAJIB 12 REMAJA Jl. Urip Sumoharjo No.18 8214339165 CoronaVac 11/11/2021 240007021
3 P-EUVZW1G7 3575011609090001 AHMAD ZIDNI RAMDAN MUBAROK 12 REMAJA Jl. Slamet Riyadi 8525924454 CoronaVac 11/11/2021 240007021
4 P-FTR4LJQG 3575024306090001 ANNISA DWI ADI PUTRI 12 REMAJA Jl. KH. Ahmad Dahlan No.52 8124686646 CoronaVac 11/11/2021 240007021
5 P-FTTZLN13 3575017105090001 AULIA KAYYISAH NABILAH 12 REMAJA Jl. Slamet Riyadi No.16 8574964360 CoronaVac 11/11/2021 240007021
6 P-FTV8UXD2 3575015410090006 AULIA NIKMATUL KHABIBAH 12 REMAJA Jl. Slamet Riyadi 8779408251 CoronaVac 11/11/2021 240007021
7 P-FTZNW9TA 3575010310090002 BRILIANT CAHYA RIZQI 12 REMAJA Bukir Kec Gadingrejo 8570758009 CoronaVac 11/11/2021 240007021
8 P-FU1NVEH9 3575015806090001 BUNGA AYU LESTARI 12 REMAJA Jl. Slamet Riyadi 8967702249 CoronaVac 11/11/2021 240007021
9 P-FU4PW4ON 3575014207090001 DAVINA PUTRIANA ANSHORY 12 REMAJA Jl. Hasanudin Gg.XI 8139174823 CoronaVac 11/11/2021 240007021
10 P-FU8XSYGF 3514172211080001 FAKHRIR ROZAQI 13 REMAJA Jl. Slamet Riyadi 8968745706 CoronaVac 11/11/2021 240007021
11 P-FUHGQRMU 3575024209090003 KEYSHA TSABITA AS'SHAFA QUINN 12 REMAJA Jl. Kebon Jaya No.32 8122559811 CoronaVac 11/11/2021 240007021
12 P-FULM56EF 3575012608090005 M. FARHAN ADITYA 12 REMAJA Jl. Slamet Riyadi 8573088690 CoronaVac 11/11/2021 240007021
13 P-FV0KIHSZ 3575010206080002 MOKHAMAD FERDIANSYAH 13 REMAJA Jl.Slamet Riyadi 8573210270 CoronaVac 11/11/2021 240007021
14 P-FV91XKVI 3575041406090001 MUHAMMAD JA'FAR SHODIQ 12 REMAJA Jl.Kolonel Sugiono 8784952735 CoronaVac 11/11/2021 240007021
15 P-FVCPS0OD 3575022106090001 MUKHAMMAD AMIR ROIHAN 12 REMAJA Jl. Jambangan 2/7 8510261092 CoronaVac 11/11/2021 240007021
16 P-0CGA1ATT 3514186508090001 NURUL FITROTUL AULIAH 12 REMAJA Karang Sentul II 8123362347 CoronaVac 11/11/2021 240007021
17 P-1AGMOOBW 3575014607090001 QONITA WAHYU DANIYAH 12 REMAJA Jl. Jolondriyo 8135704232 CoronaVac 11/11/2021 240007021
18 P-FVDYJN8W 3575020410090002 MUKHAMMAD JASIR NASRULLAH 12 REMAJA Jl. Slamet Riyadi 818871005 CoronaVac 11/11/2021 240007021
19 P-2UJ3HNO6 3575024910090003 RAYSA ADZRA ANDHARA KHUDSHI 12 REMAJA Perum. Karya Bhakti Kencana Asri 8227711444 CoronaVac 11/11/2021 240007021
20 P-10M6EHUY 3575025609090002 SABRINA AZZAHRA 12 REMAJA Gayaman pasuruan 8564920120 CoronaVac 11/11/2021 240007021
21 P-20VO1LG5 3575010109090001 SEPTIAN HADI RAMDHANI 12 REMAJA Jl. Slamet Riyadi 8565571132 CoronaVac 11/11/2021 240007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
22 P-0X8XQ37M 3575014909090004 SITI AISYAH 12 REMAJA Jl. Slamet Riyadi 8213974067 CoronaVac 11/11/2021 240007021
23 P-3U4Q9SX9 3514142508090001 UMAR AHMAD SALIM ROMADHON 12 REMAJA Jl. Slamet Riyadi No.44 8384651101 CoronaVac 11/11/2021 240007021
24 P-46MXTBSU 3575011502090002 WIAAM RAFA NAAFI 12 REMAJA Jl. Kyai Sepuh No.48 8223403472 CoronaVac 11/11/2021 240007021
25 P-4LJLI0A6 3575026202090001 YASMIN MUMTAZ 12 REMAJA Jl. Margo Taruno No.67 8574564549 CoronaVac 11/11/2021 240007021
26 P-4XXRL3X4 3575015111090002 ZAHRA SALSABILA 12 REMAJA Jl. Slamet Riyadi Gg.4 8585084757 CoronaVac 11/11/2021 240007021
27 P-G33AUHAU 3575010907090001 MUHAMMAD RAJAA PRANATA 12 REMAJA Jl. Slamet Riyadi Gentong 8215038844 CoronaVac 11/11/2021 240007021
28 P-FLFIBR72 3575012109090003 AKHMAD ALVIN AL-FIROSYI 12 REMAJA Jl. Slamet Riyadi 8573302089 CoronaVac 11/11/2021 240007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-GIZEVCV9 : 3575024501920005 SAFIRA NUR 29 UMUM jl hangtuah gadingrejo 8122881980 BIOFARMA 12/11/2021 24007021
2 P-GKIAKPBE : 3575014107870115 SUWARNI 34 UMUM jl banda 5/2 gadingrejo 8810275729 BIOFARMA 12/11/2021 24007021
3 P-GK75UOHF : 3509100110850003 AHMAD SAHAWI 36 UMUM dusun krajan kidul 8525942848 BIOFARMA 12/11/2021 24007021
4 Q-0011F97C : 3514154805880003 WIWIK WINARTI 33 UMUM PWEKOREN REMBANG 8123397897 BIOFARMA 21/09/2021 2021081551 12/11/2021 24007021
5 Q-00117SRQ : 3514146806880002 IKA WAHYUNI KURNIASARI 33 UMUM KALIANYAR BANGIL 8233066488 BIOFARMA 21/09/2021 2021081551 12/11/2021 24007021
6 Q-001A3048 : 3575012103650001 SUWANDI 56 RENTAN JL SLAMET RIYADI 813777705 BIOFARMA 08/10/2021 202108172F 12/11/2021 24007021
7 Q-001CJW6W : 3575044712860001 SITI NURHASANAH 35 UMUM JL. KOMODOR YOS SUDARSO 40/50 8000000000 BIOFARMA 13/10/2021 202108143H 12/11/2021 24007021
8 Z-6B6C39FD : 3575014303530002 SUWARTI 68 LANSIA JL IRIAN JAYA 8232240409 BIOFARMA 11/05/2021 24001821 12/11/2021 24007021
9 Q-000E8OI0 : 3575016002780001 SRI RAHAYU 43 UMUM JL HASANUDIN I / 27 8510186628 BIOFARMA 10/07/2021 24200421 12/11/2021 24007021
10 Q-000I09EV : 3514116001700001 SUMILAH 51 RENTAN MACANAN, PETUNGSARI, KEC. PANDAAN KAB 8224446050 BIOFARMA 17/07/2021 24200421 12/11/2021 24007021
11 Q-001AN6AJ : 3509102308020001 ALI ZAENAL ABIDIN AL HABSYIE 19 UMUM DUSUN KEBONSARI 8213106575 BIOFARMA 09/10/2021 202108172F 12/11/2021 24007021
12 S-0645E5C5 : 3575012808600001 IR R AGUS SUPRIANTO 61 LANSIA JL. KARYA BAKTI BLOK G/7 - ASTRA ZENECA 12/11/2021 A1094
13 P-8ZE67PIF : 3575011708630002 AGUS SUPRIHATIN 58 RENTAN jl hangtuah gadingrejo 8123684392 ASTRA ZENECA 12/11/2021 A1094
14 P-8HUB6L3C : 3575010101820022 RAHMADHAN 39 UMUM jl slamet riyadi gg.4 8123684392 ASTRA ZENECA 12/11/2021 A1094
15 P-9N7KNMZX : 3575022609820002 HARI PRASONGKO 39 UMUM jl hangtuah gadingrejo 8222802356 ASTRA ZENECA 12/11/2021 A1094
16 P-DWB45OET : 3575015005820004 YUNI JUBAIDAH 39 UMUM jl hangtuah gadingrejo 8113777705 ASTRA ZENECA 12/11/2021 A1094
17 P-EOP1ZJOR : 3575011205770003 M. MUNIR 46 UMUM jl hangtuah gadingrejo 8113777705 ASTRA ZENECA 12/11/2021 A1094
18 P-F7F7RLCH : 3575024106670003 CHUSAIMAH 54 RENTAN jl hangtuah 13 e 8233173178 ASTRA ZENECA 12/11/2021 A1094
19 P-GG1K2XPS : 3575011504680004 OO ROSIDIN 53 RENTAN jl halmahera 5/5 gadingrejo 8113777705 ASTRA ZENECA 12/11/2021 A1094
20 P-FZ9AFAPF : 3575012907700001 MOCH. YUSUF 51 RENTAN gadingrejo 8113777705 ASTRA ZENECA 12/11/2021 A1094
21 P-GIT5AVYD : 3575016211730002 SITI ROMLAH 48 UMUM jl letjen soeprapto 8312210407 ASTRA ZENECA 12/11/2021 A1094
22 P-EL4MXYAH : 3514184606810008 SUNAIMI 40 UMUM MOJOSARI 1/3 GONDANG WETAN 8123363210 ASTRA ZENECA 12/11/2021 A1094
23 P-6FNBXH82 : 3575014609960001 ANGGI KURNIA 25 UMUM bukir gadingrejo 8574622524 ASTRA ZENECA 12/11/2021 A1094
24 P-7JLBTGX0 : 3514051711920001 NUR YAQIN 29 UMUM bukir gadingrejo 8573210834 ASTRA ZENECA 12/11/2021 A1094
25 P-5AECZBEF : 3575010504850002 KHOIRON 36 UMUM jl hangtuah 1/4 gadingrejo 8384513279 ASTRA ZENECA 12/11/2021 A1094
26 P-4066IWA7 : 3575014107910093 FATHONAH 30 UMUM jl hangtuah 1/4 gadingrejo 8345132790 ASTRA ZENECA 12/11/2021 A1094
27 P-B4TPNSAI : 3575015304920006 SRI WAHYUNIH 29 UMUM jl halmahera gg.9 8589557964 ASTRA ZENECA 12/11/2021 A1094
28 P-DLZ7NXH0 : 3575011706880002 MUKHID MURTADO 33 UMUM jl halmahera gadingrejo 8233511863 ASTRA ZENECA 12/11/2021 A1094
29 P-GJM1CMJZ : 3575014209800002 SITI SUNARTI 41 UMUM jl halmahera gadingrejo 8389416927 ASTRA ZENECA 12/11/2021 A1094
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 P-GJIANLWF : 3575011212720008 BUDIONO 49 UMUM jl halmahera gadingrejo 8384416927 ASTRA ZENECA 12/11/2021 A1094
31 P-GJ75HUYE : 3575024702770004 SUERLIN 44 UMUM joyogrand ruko malang 8195440348 ASTRA ZENECA 12/11/2021 A1094
32 P-GLS16ILE : 3575011808850001 AGUS SAFUAN HADI 36 UMUM krajan ngantungan pasrepan 8233064964 ASTRA ZENECA 12/11/2021 A1094
33 P-GLJP3XZ6 : 3575010107860117 M. ABDUL HAFIT 35 UMUM hl halmahera gadingrejo 8113777705 ASTRA ZENECA 12/11/2021 A1094
34 Q-000O78L9 : 3575014107900114 ISNAINI 31 UMUM JL HAKMAHERA GADINGREJO 8786160941 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
35 Q-000O814L : 3575012003720002 SOLIKIN 49 UMUM JL URIP SUMOHARJO BUKIR 8956302740 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
36 Q-000O6OMN : 3575010302860001 HERU PURNOMO 35 UMUM JL BANDA GADINGREJO 8788787018 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
37 Q-000O7CTA : 3575014106870004 CITRA FITRIA RAKHMAH 34 UMUM JL SINONGGO GADINGREJO 8125921872 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
38 Q-000O7K9G : 3508071603890003 HERRI KISWANTO 32 UMUM JL SINONGGO GADINGREJO 8125921870 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
39 Q-000B0CXQ : 3575031207750002 MOCH SYAFI'I 46 UMUM JL JEND S PARMAN RT 1 RW 1 PANGGUNGREJ 881100000 ASTRA ZENECA 03/07/2021 ABY1911 12/11/2021 A1094
40 Q-000R6S7X : 3575035610000002 SAILA FAHMI 21 UMUM JL JEND S PARM RT 001 RW 001 PANGGUNGR 8883692165 ASTRA ZENECA 29/08/2021 A1042 12/11/2021 A1094
41 Q-000K26U8 : 3575016306720002 UMIANI 49 UMUM JL KYAI SEPUH NO 1.GADING REJO.PASURUAN 8123109960 ASTRA ZENECA 29/07/2021 ABY1911 12/11/2021 A1094
42 Q-000O6PCX : 3575012707640001 ARIFIN HIDAYAT 57 RENTAN JL SININGGO GADINGREJO 8133463408 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
43 Q-000O6VFB : 3514144807820002 MIMIN AQUARINI 39 UMUM JL KYAI SEPUH GADINGREJO 8223350909 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
44 Q-000O8HXL : 3575010510720001 MUHAMMAD RIDWAN 49 UMUM JL SLAMET RIYADI GG 13 8785698946 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
45 Q-000O8KBE : 3575011507750001 MUFLIHA 46 UMUM JL SLAMET RIYADI GG 13 8785947227 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
46 Q-000O8LGD : 3575014504990001 UMNIATUL FADHILAH 22 UMUM JL SLAMET RIYADI GENTONG GADINGREJO 8581565955 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
47 Q-000O6OOH : 3575013011680003 MOH MUNIP 53 RENTAN JL BANDA GADINGREJO 8578456137 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
48 Q-000O7NNG : 3575016909980001 SITI MUFIDAH 23 UMUM JL BANDA GADINGREJO 8589549952 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
49 Q-000O9XB2 : 3575011704780003 MOH HADIONO 43 UMUM JL SLAMET RIYADI SEBANI 8570811912 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
50 Q-000O6X9A : 3575010105780004 TAKIM SUTIKNO 43 UMUM JL KYAI SEPUH GADING 8383313767 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
51 K-0000NE6T : 3575014102950003 YANTI PUJI LESTARI 26 UMUM JL BANDA GG KAMBOJA GADINGREJO 8578412226 ASTRA ZENECA 20/08/2021 K00A4 12/11/2021 A1094
52 Q-000OFYWG : 3575016311760002 ZUBAIDAH 45 UMUM JL BANDA GG DAHLIA 66 GADINGREJO 8953040590 ASTRA ZENECA 20/08/2021 K00A4 12/11/2021 A1094
53 Q-000O9XGX : 3575015609810001 MUZAYANAH 40 UMUM JL SLAMET RIYADI GENTONG GADINGREJO 8560683773 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
54 Q-000O9WR3 : 3575011607870001 SAMITO HADI 34 UMUM JL BANDA GANG DAHLIA 8523434358 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
55 Q-000O8IXQ : 3575014204840002 WIJI ASTUTIK 37 UMUM JL SLAMET RIYADI 8113777705 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
56 Q-000O8LMS : 3575010412820002 M MACHFUDI 39 UMUM JL SLAMET RIYADI BUKIR GADINGREJO 8533444484 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
57 Q-000O8EF1 : 3575014204770003 SUHARTINI 44 UMUM JL BANDA GG DAHLIA 8579143926 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
58 Q-000O9WUS : 3575015805880001 YAYUK HIDAYATI 33 UMUM JL BANDA GADINGREJO 8523434358 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
59 Q-000AVL4O : 3575012104010003 M. NU'MAN AL GHIFARI 20 UMUM JL URIP SUMOHARJO RT 2 RW 3 BUKIR 8969969162 ASTRA ZENECA 03/07/2021 ABY1911 12/11/2021 A1094
60 Q-000NX0VA : 3575014506030001 YUNIETHA FIRDAUS SAFIRAH 18 UMUM JL SLAMET RIYADI 5/2 SEBANI 8575544951 ASTRA ZENECA 19/08/2021 210050 12/11/2021 A1094
61 Q-000O8KAG : 3575014105030001 MEI PUTRI ANJANI 18 UMUM JL SLAMET RIYADI 8385022569 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
62 Q-000O8FWC : 3575014107860062 YULI SUKIANI 35 UMUM JL BANDA GADINGREJO 8525844877 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
63 Q-000O8FXY : 3575015506880001 SITI FATIMATUS ZAHRO 33 UMUM JL BANDA GADINGREJO 8573370140 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
64 Q-000O8FXR : 3575014107750102 SUNARTI 44 UMUM JL BANDA GG DAHLIA 8573395252 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
65 Q-000O6Q6U : 3514184505860001 LINA YUNIARTI 35 UMUM JL KYAI SEPUH GADING 8384867938 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
66 Q-000O8EEV : 3575011909790007 SAIFUL ANWAR 42 UMUM JL URIP SUMOHARJO 8133034993 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
67 Q-000O8HX9 : 3575012807030001 MUHAMMAD RIZKY ARIFIAN FIRDAU 18 UMUM JL SLAMET RIYADI 8822829806 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
68 Q-000O8IXX : 3575012104010001 MUHAMMAD BACHRUL YASAK ARIFI 20 UMUM GENTONG RT 03 RW 03 8585560820 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
69 Q-000O8O4N : 3575014803820003 ANA FARIDA 39 UMUM JL SLAMET RIYADI 8139465087 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
70 Q-000O8CWL : 3517186506860002 ANITA 35 UMUM JL URIP SUMOHARJO BUKIR 8133034993 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
71 Q-000O88FS : 3575015412720001 SULASTRI 49 UMUM JL SLAMET RIYADI SEBANI 8956270695 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
72 Q-000O86XN : 3575015307010002 RISMA ELVANIA 20 UMUM JL SLAMET RIADI 8956270695 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
73 Q-000O8LH6 : 3575012510840001 ACHMAD SUYUDI 37 UMUM JL BANDA GADINGREJO 8313265003 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
74 Q-000O7ZR0 : 3575014506770003 MUSTIPAH 44 UMUM JL GATOT SUBROTO BUKIR 8580642678 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
75 Q-000O7MEW : 3575015106780003 KHUSNIDAH 44 UMUM JL URIP SUMOHARJO BUKIR 8958042002 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
76 Q-000O7DXT : 3575010808720002 SUHARTO 49 UMUM JL URIP SUMOHARJO BUKIR 8958042002 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
77 Q-000O8EF2 : 3575011603000003 INDRA HADI KUSUMO 21 UMUM JL TENGKU UMAR SEBANI GADINGREJO 8136249277 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
78 Q-000O7OI3 : 3575012107930001 TEGUH IMANSYAH 28 UMUM JL HALMAHERA GADINGREJO 8570438340 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
79 Q-000O7APL : 3575017105980002 AFRISTA AGFARIZQYANTI JANATU 23 UMUM JL SINONGGO GADINGREJO 8223263027 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
80 Q-000O7VW7 : 3575011312000003 RENGGA DWI RAMADANI 21 UMUM JL KYAI SEPUH GENTONG GADINGREJO 8953266908 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
81 Q-000O8N8Z : 3515184712960004 NUR REZA WULANDARI 25 UMUM PATEGUHAN 002/004 8132538900 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
82 Q-000O8CW8 : 3575012812960005 MUHAMMAD RAFI SAIFUDIN 25 UMUM JL SLAMET RIYADI 8138189951 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
83 Q-000O7NN6 : 3575012406900002 MUKHAMMAD AJI 31 UMUM JL GATOT SUBROTO BUKIR 8523167897 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
84 Q-000O9XN9 : 3575011010970001 REZA PERMANA 24 UMUM BUKIR RT 01 RW 08 8953384056 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
85Q-000O9X46 : 3575010102750001 PUJI SETIAWAN 46 UMUM BUKIR RT 01 RW 08 8953091070 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
86Q-000O9WX0 : 3575014101790023 DEWI KHASANAH 42 UMUM BUKIR RT 03 RW 02 8969954442 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
87Q-000O9Y02 : 3575015507730004 IMAMAH 48 UMUM JL GATOT SUBROTO BUKIR 8775437869 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
88Q-000O6NZA : 3575010503790003 AKHMAD SUBAIRI 42 UMUM JL BANDA GADINGREJO 8133430079 ASTRA ZENECA 20/08/2021 210050 12/11/2021 A1094
SDN GADING 1
1 P-FISNGIZT 3514050108090004 MUCHAMMAD ADITIYA RAMADHANI 12 REMAJA Jl. Hangtuah RT/RW:03/04 Gadingrejo 8132861596 CoronaVac 12/11/2021 240007021
2 P-FIUN2EUP 3575013107090001 AFGAN DWI NOVAL CHAQI 12 REMAJA Jl. Irian Jaya RT/RW: 03/02 Gadingrejo 8570756185 CoronaVac 12/11/2021 240007021
3 P-FIWB1ITW 3575016606090001 AIS KHUMAIROH 12 REMAJA Jl Banda RT/RW: 04/02 8581532266 CoronaVac 12/11/2021 240007021
4 P-FIYAN6FL 3575010909090002 BAYU RAMADHANY 12 REMAJA Jl. Irian Jaya No. 11 Karanganyar 8191744215 CoronaVac 12/11/2021 240007021
5 P-FIZTMS9U 3514165810090002 KAILA NURIS SALAMAH 12 REMAJA Gumeng RT/RW: 02/06 Kraton 8385198762 CoronaVac 12/11/2021 240007021
6 P-FJ5BHN5E 3575012906090003 MUCHAMMAD RIZKI 12 REMAJA Jl. Akhmad Yani RT/RW: 04/01 Gadingrejo 8155399179 CoronaVac 12/11/2021 240007021
7 P-JAANBPLF 3575012810090004 MUHAMAD MAULANA LABIB AL-AMIR 12 REMAJA Jl. Banda Gg Dahlia RT/RW: 03/02 8135378735 CoronaVac 12/11/2021 240007021
8 P-FJDV8DNC 3575013003080003 MUHAMMAD ALIEF FIRDAUS 13 REMAJA Jl. Banda RT/RW: 04/02 8575503479 CoronaVac 12/11/2021 240007021
9 P-FJFDCVE7 3575015706090001 NISA NUR FAUZIAH 12 REMAJA Jl. Hangtuah II RT/RW: 04/03 8123273918 CoronaVac 12/11/2021 240007021
10 P-FJH748B5 3575016903090002 YAYIN AMELIA 12 REMAJA Jl. Irian Jaya No. 27 RT/RW: 01/06 8953950493 CoronaVac 12/11/2021 240007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
11 P-FJIRPIDC 3575016807090001 YULI AMALIA 12 REMAJA Jl. Banda No. 12 RT/RW: 03/02 8581541938 CoronaVac 12/11/2021 240007021
12 P-FJKFMZM9 3575011605090001 YAZID AL BUSTOMI 12 REMAJA Jl. Halmahera Apartemen Pantai 8586570420 CoronaVac 12/11/2021 240007021
13 P-FJMM0ML0 3575015008090002 ADINDA BAYU DWIYANTI 12 REMAJA Jl. Irian Jaya Gg Anggrek RT/RW: 01/02 8560709452 CoronaVac 12/11/2021 240007021
14 P-FJO4XJ1M 3575010502090002 FATCHUL ULUM 12 REMAJA Jl. Irian jaya No. 21 Karanganyar 8191744215 CoronaVac 12/11/2021 240007021
15 P-FJP8IT5D 3575010909090001 FIRDAUS RAMADHANY 12 REMAJA Jl. Irian Jaya No. 11 Karanganyar 8191744215 CoronaVac 12/11/2021 240007021
16 P-FJQLSXS6 3507314108090001 ILMI SOFIAWATI 12 REMAJA Jl. Irian Jaya Gg. Anggrek RT/RW: 02/02 8580713925 CoronaVac 12/11/2021 240007021
17 P-FJURANEP 3514145608090001 MIFTAKHUL JANNAH 12 REMAJA Jl. Banda No.92 Gadingrejo 8135902429 CoronaVac 12/11/2021 240007021
18 P-FK4BP37V 3575012004090001 MUKHAMAT UMAR FARUK 12 REMAJA Ngaglik RT/RW: 06/02 Gadingrejo 8385102645 CoronaVac 12/11/2021 240007021
19 P-FK6NX4MD 3575012607090004 MOKHAMMAD IBNU ROHMAN 12 REMAJA Jl. Banda RT/RW: 03/02 Gadingrejo 8123544652 CoronaVac 12/11/2021 240007021
20 P-FJSM0GG3 3514226504080002 KAYLATUL ZAHRA 13 REMAJA Dsn Kisik RT/RW: 02/04 Kalirejo, Kraton 8777465387 CoronaVac 12/11/2021 240007021
21 P-FK933XX1 3575013103090001 MUHAMMAD AL FARIZI FADLY SAVE 12 REMAJA Jl. Irian Jaya RT/RW: 02/02 Gadingrejo 8384897083 CoronaVac 12/11/2021 240007021
22 P-FKAP6ATD 3575012607090001 MUKHAMAD RIDHO PRATAMA 12 REMAJA Jl Irian Jaya RT/RW: 02/02 Gadingrejo 8138056738 CoronaVac 12/11/2021 240007021
23 P-FKDAFATA 3575015009090001 NUR LAILI 12 REMAJA Jl. A. Yani No. 62 RT/RW: 04/01 Gadingrejo 8133270605 CoronaVac 12/11/2021 240007021
24 P-FKEQS6KP 3575016709090001 ZASKIA AULIA SAFITRI 12 REMAJA Jl. Irian Jaya Gg. Anggrek RT/RW: 0102 Gadingrej 8157545018 CoronaVac 12/11/2021 240007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-B1IDGJL4 3575012412770001 SUHADAK 44 UMUM JL SLAMET RIYADI 1/1 SEBANI 8199651499 ASTRA ZENECA 13/11/2021 A1067
2 P-BMDL5ZSD 3575014407780005 IRMA WIDIASTUTI 43 UMUM JL HALMAHERA 5/5 GADINGREJO 8213315291 ASTRA ZENECA 13/11/2021 A1067
3 P-BBPV6WJV 3575012703790003 MOH MUKHLAS 42 UMUM JL SLAMET RIYADI SEBANI 8523203417 ASTRA ZENECA 13/11/2021 A1067
4 P-CMJYLYCY 3575016808970002 SITI FATIMAH 25 UMUM JL HANGTUAH 3/4 GADINGREJO 8595443954 ASTRA ZENECA 13/11/2021 A1067
5 P-D4EDQ9JL 3575014106880001 LUTFIYATU ZAHRO 33 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRA ZENECA 13/11/2021 A1067
6 P-EADFYEEB 3575015803010001 AMILIA KARTIKA 20 UMUM JL URIP SUMOHARJO BUKIR 8956166499 ASTRA ZENECA 13/11/2021 A1067
7 P-DXUSI5QY 3575014605800002 SOLICHAH 41 UMUM GADINGREJO 8113777705 ASTRA ZENECA 13/11/2021 A1067
8 P-EKE7RGP0 3575012508870004 FATKHUR ROKHMAN 34 UMUM JL SLAMET RIYADI GENTONG 8951926411 ASTRA ZENECA 13/11/2021 A1067
9 P-1HDWJM36 3501094912860001 SUYANTI 35 UMUM JL HANGTUAH GADINGREJO 8311941567 ASTRA ZENECA 13/11/2021 A1067
10 P-BXJUFTZ0 3575022912620002 ACHMAD RIVAI 59 RENTAN PERUM PONDOK SURYA KENCANA GENTONG 8510029072 ASTRA ZENECA 13/11/2021 A1067
11 Q-000OED4J 3575021110710002 ADI MULYONO 50 RENTAN TAMAN ASRI WIROGUNAN 8579097154 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
12 Q-000ODPGE 3514124112990002 INDAH PUSPITASARI 22 UMUM GEMPOL JOYO 2/3 GEMPOL 8983832808 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
13 Q-000NSJGT 3575010808010001 QUDSI FAIZAL AZIZ 20 UMUM SEBANI 3/5 GADINGREJO 8585278147 ASTRA ZENECA 18/08/2021 ABY1911 Ga 13/11/2021 A1094
14 Q-000OQKIM 3575011406870004 MOHAMMAD ANWAR 34 UMUM JL NGAGLIK GADINGREJO 8385192392 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
15 Q-000OPQTA 3575014107700103 SARPIA 51 RENTAN JL BANDA GADINGREJO 8585691607 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
16 Q-000OQKIS 3514165503960002 SITI AMINAH 25 UMUM JL BANDA GADINGREJO 8570615937 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
17 Q-000ODSFM 3575015206750004 LULUK HERAWATI 46 UMUM PERUM KRATON INDAH E2/20 2/4 KARANG KE 8319399731 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
18 Q-000ODTNS 3575017103990003 REFYNIKA MARCHA PUTRI PRIYATNA 22 UMUM PERUM KRATON INDAH E2/20 2/4 KARANG KE 8573326042 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
19 Q-000OPRJA 3575014107670102 KHASIYATUN 54 RENTAN JL BANDA GG MAWAR RW 02 RT 006 8384668206 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
20 Z-0009HTJ9 3575012712560001 SUTRISNO 63 LANSIA JL BANDA 3/2 GADINGREJO 8213920994 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
21 Q-000OPT8D 3575015406630001 LILIK INDRAWATI 58 RENTAN JL SINONGGO GADINGREJO 8523518681 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
22 Q-000ODOEB 3575011303660003 AGUS SUPRIYATNO 55 RENTAN PERUM KRATON INDAH E2/20 2/4 KARANG KE 8121733160 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
23 Q-000O6ZQK 3575013010760001 IWAN HARIONO 45 UMUM JL A YANI KARANG KETUG 8133022007 ASTRA ZENECA 20/08/2021 210050 13/11/2021 A1094
24 Q-000LBVNO 3575010606720001 MULYO HARTO 49 UMUM SEBANI RT 1 RW 3 8113777705 ASTRA ZENECA 06/08/2021 ABY1911 13/11/2021 A1094
25 Q-000OF9T3 3575010307750004 MUKHAMMAD MUKHTAR 46 UMUM JL HANGTUA 1/3 GADINGREJO 8785686655 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
26 Q-000OF7MJ 3575015102860002 LAILIL MUKHAROMAH 35 UMUM JL HANGTUAH GG 2 GADINGREJO 8523273875 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
27 Q-000OEWVY 3575010107800210 SAPARI 31 UMUM GADINGREJO RT 02 RW 02 8573655724 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
28 Q-000OESSU 3575012305740002 MOCH SUYATNO 47 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8135921809 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
29 Q-000OEGW3 3575010109740002 BASORI 47 UMUM JL IRIAN JAYA GG ANGGREK 8575545758 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
30 Q-000ODL0H 3575010708670001 SUCIPTO 54 RENTAN JL GATOT SUBROTO 3/7 BUKIR 8510186406 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
31 Q-000ODLUF 3575015507750001 SURIFAH 46 UMUM JL GATOT SUBROTO 3/7 BUKIR 8510186406 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
32 Q-000OFTXQ 3578040311830002 JINOVIN MINTARNO TITO, S.Psi. 38 UMUM TEUKU UMAR SEBANI 8564516351 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
33 Q-000OFPYU 3575025305870006 WAHYU UTAMI 34 UMUM JL. TEUKU UMAR SEBANI 8224585701 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1094
34 Q-000OQZ7I 3575010109910002 MAULUDIA 30 UMUM JL HANGTUAH GADINGREJO 8128454572 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1094
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 Q-000O9Y2U 3514164906030001 FADILAH NUR LAILY 18 UMUM GADINGREJO RT 3 RW 2 8135905540 ASTRA ZENECA 20/08/2021 210050 13/11/2021 A1094
36 Q-000OEHWL 3575016411700002 NURUL JANNAH 51 RENTAN JL IRIN JAYA 1/2 GADINGREJO 8123360442 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
37 Q-000OF5O0 3575014107890117 NUFAT 32 UMUM JL HANG TUA 3/4 GADINGREJO 8313494401 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
38 Q-000OD5N2 3575016008940001 MAULIDATUN NAFISAH 27 UMUM JL SLAMET RIYADI 3/3 GENTONG 8385240493 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
39 Q-000OPKN1 3514044708950001 ISWANTINI 26 UMUM jl selamet riyadi SEBANI 8214584737 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
40 Q-000OFC6I 3575016904720001 SRI RAHAYU 49 UMUM JL SLAMET RIYADI 2/3 GENTONG 8133370978 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
41 Q-000OFIP5 3575011703990001 AHMAD FAHRI SIRADZ 22 UMUM GENTONG RT 02 RW 03 8133370978 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
42 Q-000OPP7O 3575010910960001 DWI ROBBY PRASETYO 25 UMUM SEBANI RT 1 RW 3 8574945603 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
43 Q-000OFC7L 3575012507740001 CHOIRUL SOLEH 47 UMUM GENTONG RT 02 RW 03 8155392446 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
44 Q-000OF9T5 3575016105780001 SUMILAH 43 UMUM JL SLAMET RIADI GENTONG 8155392446 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
45 Q-000OPJQZ 3575016403900001 SITI FATIMAH 31 UMUM JL SLAMET RIYADI SEBANI 8786504087 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
46 Q-000OD5N5 3575010410930002 HARIS LISMANTO 28 UMUM JL SLAMET RIYADI 3/3 GENTONG 8585278661 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
47 Q-000OQHPF 3575012708670003 SOCHIB 56 RENTAN JL BANDA GADINGREJO 8113777705 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
48 Q-001CR85G 3575015506820004 LILIK SUTAMI 39 UMUM JL SLAMET RIYADI SEBANI 8570726266 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
49 Q-000ODHQF 3575015211720002 CHOTIJAH 49 UMUM JL GATOT SUBROTO 3/7 BUKIR 8383323521 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
50 Q-000ODJT6 3575016802850004 TRI MULYANINGTYAS SETYORINI 36 UMUM JL GATOT SUBROTO 3/7 BUKIR 8132644450 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
51 Q-000OFDT4 3575014504840001 SITI ASMARA 37 UMUM JL SLAMET RIYADI 2/1 GENTONG 8161553992 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
52 Q-000OQOZX 3575016704900002 HUSNUL KHOTIMAH 31 UMUM JL HANGTUAH GADINGREJO 8537710472 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
53 Q-000OR1RW 3514145106810003 NUR AINI 38 UMUM JL HANGTUAH GADINGREJO 8574824696 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
54 Q-000OQTZG 3575015407740003 RETNO YULIATI 47 UMUM JL HALMAHERA GADINGREJO 8223466304 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
55 Q-000O8CWD 3575010606760007 SULTONIL KARIM 45 UMUM JL SLAMET RIYADI SEBANI GADINGREJO 8775677196 ASTRA ZENECA 20/08/2021 210050 13/11/2021 A1067
56 Q-000OEZFM 3575011409020003 IQBAL FAIZAL RAFLI 19 UMUM SEBANI RT 01 RW 01 8570728746 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
57 Q-000OFKRF 3575014101810020 ROHMAH 40 UMUM JL HANGTUA 1/3 GADINGREJO 8788288038 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
58 Q-000OFC78 3575011407020003 RAFIUT DAROJAD 19 UMUM JL HANGTUAH II 8788288038 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
59 Q-000NSC99 3514161210910004 AINUL NA'IM 31 UMUM JL URIP SUMOHARJO 1/3 GADINGREJO 8585523055 ASTRA ZENECA 18/08/2021 210050 13/11/2021 A1067
60 Q-000OFIP8 3575022412740003 ZAINUL ARIFIN 47 UMUM JL SLAMET RIYADI 1/1 SEBANI 8577816000 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
61 Q-000OFIF1 3575012108800006 DWI SANTOSO 41 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8565586393 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
62 Q-000NDKDO 3575014211710001 SUMIATI 50 RENTAN JL KYAI SEPUH 3/1 GADINGREJO 8213991298 ASTRA ZENECA 16/08/2021 ABY1911 13/11/2021 A1067
63 Q-000OEKZX 3575016305710003 INDIANA 50 RENTAN JL IRIAN JAYA GG ANGGREK 8123360442 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
64 Q-000OFVCR 3575011604020001 MUHAMMAD WAHYU 19 UMUM JL SLAMET RIYADI 2/1 GENTONG 8515506774 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
65 Q-000OER2Y 3575011406660003 WARJITO 55 RENTAN JL IRIAN JAYA GG ANGGREK 8123360442 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
66 Q-000OEST2 3575014908800001 HANIK SRI WAHYUNI 41 UMUM JL KYAI SEPUH GG.3 8214032370 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
67 Q-000OF3G9 3575014402700001 ROMELA 50 RENTAN GADINGREJO RT 03 RW 01 8214032370 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
68 Q-000OF1BB 3575013009990006 SEPTIAN BAYU KHARISMA 22 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8214032370 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
69 Q-000OG1CK 3575014504790001 APRIYANTI 42 UMUM JL BANDA / KENONGO NO. 73 GADINGREJO 8883072109 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
70 Q-000OPPX7 3575021112640004 SUSIANTO 57 RENTAN JN SLAMET RIYADI SEBANI 8214077639 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
71 Q-000ODLTN 3575016808850002 CAHYO PALUPI YOHANDATI 36 UMUM JL GATOT SUBROTO 3/7 BUKIR 8123187575 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
72 Q-000OF5Q6 3575011103790001 SLAMET ASKIN 42 UMUM JL HANGTUAH GADINGREJO 8312515639 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
73 Q-000OPKZM 3575011006960002 M. AMIRUDIN 25 UMUM JL BANDA GADINGREJO 8578521131 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
74 Q-000ODL0Z 3575014404930002 AFITRI DEWI 28 UMUM JL GATOT SUBROTO 1/7 BUKIR 8575514780 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
75 Q-000OQHPA 3575012701010003 ARI NUR RIZQI 20 UMUM JL MULYO REJO SEBANI GADINGREJO 8575546205 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
76 Q-000O6YYL 3575016207710001 SAICHAH 50 RENTAN JL GATOT SUBROTO 8585079979 ASTRA ZENECA 20/08/2021 210050 13/11/2021 A1067
77 Q-000O6W8T 3575017103020001 DHIA LAILATUL FAIZAH 19 UMUM JL. GATOT SUBROTO BUKIR 8564943263 ASTRA ZENECA 20/08/2021 210050 13/11/2021 A1067
78 Q-000K3K3K 3575016503750001 CHUSNIYAH 46 UMUM JL IRIAN JAYA / ANGGREK gadingrejo 8214181887 ASTRA ZENECA 29/07/2021 ABY1911 13/11/2021 A1067
79 Q-000OEJSG 3575014107730062 SUSI YULIANI 48 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8133448644 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
80 Q-000OQ9CZ 3575011405770004 MUSTAKIM 41 UMUM JL BANDA GADINGREJO 8113777705 ASTRA ZENECA 23/08/2021 K004A 13/11/2021 A1067
81 Q-000OFXKR 3575016106820001 KHUSNUL KHOLILAH 39 UMUM JL SLAMET RIYADI 1/1 SEBANI 8226442428 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
82 Q-000B02H8 3575012302960001 RAHMAT SUYUDI AKBAR 25 UMUM JL IRIAN JAYA NO 2 RT 1 RW 2 GADINGREJO 8123247260 ASTRA ZENECA 03/07/2021 ABY1911 13/11/2021 A1067
83 Q-000OD4ZX 3575016001810001 ANIS QOMARIYAH 40 UMUM JL KYAI SEPUH GG 21 GENTONG 8383153774 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
84 Q-000OEST0 3575012410770001 YASA 44 UMUM GADINGREJO RT 01 RW 02 8784600131 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
85 Q-000OESRO 3575010303030003 MOCH FATCHIMAKNUF 18 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8125940361 ASTRA ZENECA 21/08/2021 K004A 13/11/2021 A1067
86 P-FUFN9J26 3575025010090001 JOCELLYN CARISSA AMMAR 12 REMAJA Jl. Margo Taruno 8311103066 CoronaVac 13/11/2021 24007021
87 P-GH25BYCJ 3575012105070003 M. DIMAS IRWANSYA 14 REMAJA JL HANGTUAH GADING 8533657382 CoronaVac 13/11/2021 24007021
88 P-H07RKLYJ 3575010111730003 M. DJUMA'ARI 47 UMUM JL HANGTUAH GG 4 8578568041 CoronaVac 13/11/2021 24007021
89 P-H16C2AI7 3575015205860002 SHOFIYAH 35 UMUM JL HANGTUAH 4/4 8580710622 CoronaVac 13/11/2021 24007021
90 Q-001EA2SJ 3575012610080001 DIMASLIKHAN 13 REMAJA jl gatot subroto 2/5 SEBANI 8214192013 CoronaVac 16/10/2021 C202106115 13/11/2021 24007021
91 Q-001EA7ZM 3575015206040001 CINDY DWI NOVITASARI 17 REMAJA JL SLAMET RIYADI 2/1 GENTONG 8585278784 CoronaVac 16/10/2021 C202106115 13/11/2021 24007021
92 K-00013CNS 3575011508080002 MUKHAMAD DIMAS ARDIANSYAH 13 REMAJA JL GATOT SUBROTO 3/2 BUKIR 8385712552 CoronaVac 06/09/2021 2021071371 13/11/2021 24007021
93 Q-0012BBPS 3575016911980002 MAMLUATUR ROHMAH 23 UMUM GADINGREJO-PASURUAN 8314430168 CoronaVac 22/09/2021 24202821 13/11/2021 24007021
SD GADING 2
1 P-2BEZTNRF 3514164307090003 CINTIA CHOBSO 12 REMAJA GUMENG RT 03 / RW 06 KALIREJO KRATON 8823429026 CoronaVac 13/11/2021 240007021
2 P-2DEI6NAC 3514166906090001 MAYA HILDA INAYATI 12 REMAJA KEBON SAWAH RT 01 / RT 07 KALIREJO KRAT 8782600848 CoronaVac 13/11/2021 240007021
3 P-2EJRT4N2 3575016705090001 NURISSUBKHI WAHYUNI 12 REMAJA JL. BANDA Gg. TERATAI RT 04 / RW 02 GADIN 8510085214 CoronaVac 13/11/2021 240007021
4 P-2EXDVUG9 3575014103090001 ATIQ QONITA MAULUDIYAH 12 REMAJA JL. Gg. HANGTUAH RT 04 / RW 03 GADINGREJO 8123551314 CoronaVac 13/11/2021 240007021
5 P-2FF7GQUV 3514162807090004 MUHAMMAD AFANDI 12 REMAJA GUMENG RT 03 / RW 06 KALIREJO KRATON 8319716187 CoronaVac 13/11/2021 240007021
6 P-2GAYKPDP 3514165609090004 FITRIYAH 12 REMAJA GUMENG RT 02 / RW 06 KALIREJO KRATON 8384610013 CoronaVac 13/11/2021 240007021
7 P-2GNALLWO 3575010304090001 MUCHAMMAD FAHRUL RIZAL 12 REMAJA JL. BANDA RT 06 / RW 02 GADINGREJO 8383363360 CoronaVac 13/11/2021 240007021
8 P-2I74GLT5 3514161909090005 M. SALMAN RAMADHAN 12 REMAJA GUMENG RT 02 / RW 06 KALIREJO KRATON 8382404162 CoronaVac 13/11/2021 240007021
9 P-2KAB943K 3514165505090003 ANDINI AMALIA 12 REMAJA GUMENG RT 01 / RW 06 KALIREJO KRATON 8318524448 CoronaVac 13/11/2021 240007021
10 P-2IRZN3HL 3514161309090003 A.NASYRIL MA'SUM 12 REMAJA GUMENG RT 03 / RW 06 KALIREJO KRATON 8113777705 CoronaVac 13/11/2021 240007021
11 P-2KKYG70W 3514161710090006 ROCHMATAL LIL ALAMIN 12 REMAJA GUMENG RT 01 / RW 06 KALIREJO KRATON 8135902257 CoronaVac 13/11/2021 240007021
12 P-A8HA7OEM 3514162610090006 M. FIKRI NAILUR ROKMAH 12 REMAJA Dusun Kebon Sawah Kalirejo Kraton 8311450823 CoronaVac 13/11/2021 240007021
13 P-DCL7MMHU 3514161701090002 ACHMAD NOR AQSO 12 REMAJA Kebonsawah Kraton 8384165494 CoronaVac 13/11/2021 240007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-HCHXJL35 3575014304950003 OLIVIA WANISAK 25 UMUM PERUM NUANSA CANDI 2 / H8 8222186003 CoronaVac 15/11/2021 24007021
2 Q-001F0TWL 3575014205090003 MELISA SOFIA WARDANI 12 REMAJA JL. URIP SUMOHARJO 2/3 - BUKIR 8575536935 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
3 Q-001F2Q8R 3514172603860001 AGUS SISWANTO 35 UMUM WARUNG DOWO SELATAN 8225721823 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
4 Q-001F9UBJ 3575014302790004 SITI AMINAH 42 UMUM JL HALMAHERA 8578001203 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
5 Q-001F9DJE 3514125105890002 NURMALA SARI 32 UMUM JL HALMAHERA 8574958258 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
6 Q-001FBAAL 3575010506990002 ACHMAD CHUMAIDI 22 UMUM JL HALMAHERA XI 8953661484 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
7 Q-001FCDPS 3514201008850003 PONADI 36 UMUM BUNTALAN PASURUAN 8574931950 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
8 Q-001FD2VA 3575015011910001 KRISTININGRUM 30 UMUM BUNTALAN PASURUAN 8574931950 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
9 Z-000CYPLA 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 CoronaVac 18/10/2021 C202106115 15/11/2021 24007021
10 Q-00155FF9 3575011112080001 JAZULI NUR ALIF ACHMAD HAMKA 13 REMAJA JL. HANGTUA GG.4 RT 03 RW 04 GADINGREJO 8383479869 CoronaVac 28/09/2021 202108154G 15/11/2021 24007021
11 Q-0017JKTU 3575014801820005 LATIFAH 39 UMUM JL HALMAHERA NO.18 8785907657 CoronaVac 02/10/2021 202108154G 15/11/2021 24007021
12 P-GX1LQQVV 3575016711720001 CHOLIFAH 49 UMUM JL HANGTUAH 5/4 GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
13 P-GX49CFAK 3510165401030006 SITI NURJANAH 18 UMUM JL HANGTUAH 1/4 GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
14 P-4NLBUKIQ 3575010705830001 MUCHAMAT SOFIYAN 38 UMUM JL SLAMET RIYADI 1/1 8575576666 ASTRA ZENECA 15/11/2021 A1067
15 P-55OPHGLN 3575015403750002 HARTINI 46 UMUM JL BANDA 3/2 GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
16 P-5JL7HM1E 3575036208850003 AGUSTIN WAHYU UTARI 36 UMUM PERUM KARYA BAKTI BLOK B GENTONG 8523676676 ASTRA ZENECA 15/11/2021 A1067
17 P-5ONUHIDW 3575011010980001 A SAIFUL ARIFIN 23 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
18 P-5VGJXGIQ 3575036312850003 KHUSNUL KHOTIMAH 36 UMUM JL HANGTUAH 1/3 GADINGREJO 8573330051 ASTRA ZENECA 15/11/2021 A1067
19 P-6MU0B218 3575014107960072 FATIMAH 25 UMUM JL HANGTUAHN GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
20 P-6R8X43PT 3514011705860001 SULAIMAN 35 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8223284737 ASTRA ZENECA 15/11/2021 A1067
21 P-78ZUX0AV 3575016707960002 ISMANIYAH NENGSE 25 UMUM JL HANGTUAH GADINGREJO 8311746421 ASTRA ZENECA 15/11/2021 A1067
22 P-7IA7S5E9 3575030107860152 SIONO 35 UMUM JL MT HARYONO MANDARAN 8190303648 ASTRA ZENECA 15/11/2021 A1067
23 P-CPX013H0 3505160210730002 MUHAMAD SUYATNO 48 UMUM BUKIR 1 / 6 8773214483 ASTRA ZENECA 15/11/2021 A1067
24 P-814S132R 3575011506020006 IZAM SAPUTRA 19 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8585268177 ASTRA ZENECA 15/11/2021 A1067
25 P-4KB2XLI4 3575010708770002 AGUS SUBIANTO 44 UMUM JL BANDA 3/2 GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
26 P-8OQIH9SN 3575014804950003 FITRIA 26 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
27 P-8TU0PO18 3575010107980095 MUCHAMMAD NUR CHOLIS 23 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
28 P-AXJBN5WS 3575012406000004 HERU LISMANTO 21 UMUM JL HALMAHERA 8231344332 ASTRA ZENECA 15/11/2021 A1067
29 P-91P17MEV 3575016304990001 MUFAS SARO 22 UMUM JL SLAMET RIYADI 8574843555 ASTRA ZENECA 15/11/2021 A1067
30 P-471GPNJH 3575014505820007 MAISAROH 39 UMUM JL HALMAHERA GADINGREJO 8575541139 ASTRA ZENECA 15/11/2021 A1067
31 P-9TY9ALAZ 3575016009860001 SITI MARDEYAH 35 UMUM JL HANGTUAH GADINGREJO 8383479869 ASTRA ZENECA 15/11/2021 A1067
32 P-97ODZVVN 3575011305030004 M. IQBALUDDIN 18 UMUM JL HALMAHERA 5/5 GADINGREJO 8988750815 ASTRA ZENECA 15/11/2021 A1067
33 P-DKMIGR3Z 3575016703990001 DEVINA ADININGSIH 22 UMUM KARANG KETUG 8923170798 ASTRA ZENECA 15/11/2021 A1067
34 P-DEK5OO41 3575011509930002 MUKHAMAD ARIF 28 UMUM KETUG MLAGI 6/3 KARANG KETUG 8961264280 ASTRA ZENECA 15/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 P-C6LERCFL 3575016310880003 NUR LAILA 33 UMUM JL HANGTUAH GADINGREJO 8384763056 ASTRA ZENECA 15/11/2021 A1067
36 P-F314K5VH 3575014112670001 SITI FATIMAH 54 RENTAN JL HALMAHERA 1/5 GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
37 P-BZGIFSKH 3575014508680001 TITIK AGUSTIYAH 53 RENTAN JL SLAMET RIYADI 8785177070 ASTRA ZENECA 15/11/2021 A1067
38 P-CEABORGH 3575014212890002 NUR CHOLISAH 32 UMUM JL HANGTUAH GADINGREJO 8383513282 ASTRA ZENECA 15/11/2021 A1067
39 P-CHMRYLRV 3575020404870003 BAYU HARIYANTO 35 UMUM JL AIRLANGGA 8223332222 ASTRA ZENECA 15/11/2021 A1067
40 P-DQHESYGG 3575017003820004 YUSI KURNIAWATI 39 UMUM JL KYAI SEPUH 8229393357 ASTRA ZENECA 15/11/2021 A1067
41 P-E6HJZDJA 3575025008860003 ISMAWATI 35 UMUM JL HANGTUAH GADINGREJO 8823045471 ASTRA ZENECA 15/11/2021 A1067
42 P-EE9DROAX 3575014606940002 NUR ALIYAH 27 UMUM JL HANGTUAH GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
43 P-FAL03ES6 3575014107760043 CHABIBAH 45 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 15/11/2021 A1067
44 Q-000OF1LF 3575014710770006 ISMIATI 44 UMUM GADINGREJO RT 03 RW 01 8214032370 ASTRA ZENECA 21/08/2021 K004A 15/11/2021 A1067
45 Q-000OQTY5 3575016804950002 NUR KASANAH . 26 UMUM JL HANGTUAH GADINGREJO 8213874006 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
46 Q-000OROLH 3575014107750085 JUWARIA 46 UMUM JL HANGTUAH GADINGREJO 8968384114 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
47 Q-000OS5R5 3575014209890001 UMROTUS SOLIHAH 32 UMUM JL HANGTUAH GADINGREJO 8585024628 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
48 Q-000OTJNT 3575015709810002 SATUKHAH 41 UMUM JL BANDA GG TERATAI 8373312187 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
49 Q-000ORHMY 3575014402710001 CHASANAH 50 RENTAN JL HANGTUAH GADINGREJO 8880505476 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
50 Q-000O7AJ1 3575010107620061 SYAFII 59 RENTAN JL BANDA GADINGREJO 8810363242 ASTRA ZENECA 20/08/2021 210050 Gad 15/11/2021 A1067
51 Q-000OQP01 3575017010030001 SOFIYA LAJUBAH 18 UMUM JL HANGTUAH GADINGREJO 8385772315 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
52 Q-000ORZ6I 3575015511700004 SUUDAH 51 RENTAN JL HANGTUAH GADINGREJO 8574843854 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
53 Q-000ORDUZ 3575014107750057 MUCHAIYAH 46 UMUM JL HANGTUAH GADINGREJO 8125950660 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
54 Q-000OQHPO 3575014505880002 HASANAH 33 UMUM JL HANGTUAH GADINGREJO 8233103504 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
55 Q-000OQKJC 3575012012790004 IMAM GHOZALI 42 UMUM JL HANGTUAH GADINGREJO 8233103504 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
56 Q-000OT6FV 3575016310820004 SALAMI . 39 UMUM JL BANDA GADINGREJO 8113777705 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
57 Q-000OT6EW 3575015804780001 HAYUMI 43 UMUM JL BANDA GG TERATAI 8113777770 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
58 Q-000O7AAT 3514160605940002 SAIFUL ROHMAN 27 UMUM JL BANDA GADINGREJO 8816061806 ASTRA ZENECA 20/08/2021 210050 Gad 15/11/2021 A1067
59 Q-000ORDWO 3575015404800003 CHAMIDAH 41 UMUM JL HANGTUAH GADINGREJO 8575511992 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
60 Q-000OROKP 3575011706010001 IKHWAN 21 UMUM JL HANGTUAH GADINGREJO 8575511992 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
61 Q-000OT6CR 3575014504810001 PURWOGATI 40 UMUM JL SLAMET RIYADI SEBANI 8770327884 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
62 Q-000NVY81 3575016812880002 SURYANINGTYAS PERTIWI 33 UMUM RANDUSARI 3/5 GADINGREJO 8574538930 ASTRA ZENECA 19/08/2021 210050 Gad 15/11/2021 A1067
63 Q-000ORQOZ 3575014101880015 JUWARIYAH 33 UMUM JL HANGTUAH II GADINGREJO 8510668444 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
64 Q-000OT5XE 3575011310970002 MUCHAMAD YUSTANDI 24 UMUM JL SLAMET RIYADI SEBANI 8810379985 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
65 Q-000OQWNW 3575012503980005 KHARIS AFANDI 23 UMUM JL HANGTUAH GADINGREJO 8190823374 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
66 Q-000ORWEQ 3575011303790005 MUHAMMAD JUFRI 42 UMUM JL HANGTUAH II GADINGREJO 8510668444 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
67 Q-000OS1G2 3575014811780001 HJ. NOR HALIMAH 40 UMUM JL HANGTUAH GADINGREJO 8786676373 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
68 Q-000ORQDC 3575014107750088 SITI MARIYAM 46 UMUM JL HANGTUAH GADINGREJO 8775006181 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
69 Q-000OSNC9 3575010101010002 MUHAMMAD FARIZ DWITANTO 20 UMUM JL TEUKU UMAR SEBANI 8789561018 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
70 Z-0009JIYB 3575011408560001 AGUS MULYONO 65 LANSIA JL KARYA BAKTI GENTONG 8510284382 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
71 Q-000ORK77 3575010101930003 M. HUFRON 28 UMUM JL HANGTUAH GADINGREJO 8578461559 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
72 Q-000ORDVE 3575035705940004 UYUNUL KHOIROH 27 UMUM JL HANGTUAH GADINGREJO 8578461559 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
73 Q-000OTJQM 3575015202000002 ANGGUN MONALISA 20 UMUM JL SLAMET RIYADI SEBANI 8383798397 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
74 Q-000ORHN7 3575014612810002 KARTINI 40 UMUM JL HANGTUAH GADINGREJO 8578461559 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
75 Q-000ORHMP 3575011101880002 IMAM WAHYUDI 33 UMUM JL HANGTUAH II GADINGREJO 8585056257 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
76 Q-000OTJQR 3575014704980003 AROFA WIDYA ANDRIANI 23 UMUM JL SLAMET RIYADI GADINGREJO 8584898742 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
77 Q-000NSMD9 3575016202010002 LAILA DIAN FARIDA 20 UMUM JL URIP SUMOHARJO 2/1 GADINGREJO 8953370163 ASTRA ZENECA 18/08/2021 210050 Gad 15/11/2021 A1067
78 Q-000OSK6I 3575010101750027 SLAMET RIYADI 46 UMUM JL SLAMET RIYADI GADINGREJO 8573189018 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
79 Q-000OT0ZH 3575010202010002 MOCH. KHAFID 20 UMUM jl hangtuah gadingrejo 8980184286 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
80 Q-000O814M 3575011307720002 M MAS,UD 49 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8191342261 ASTRA ZENECA 20/08/2021 210050 Gad 15/11/2021 A1067
81 Q-000ORZ56 3575014411700002 QOSIDAH 44 UMUM JL HANGTUAH GADINGREJO 8775476225 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
82 Q-000ORQEA 3575011010020004 NAUFAKUR ROCHMAN 19 UMUM JL HANGTUAH VI GADINGREJO 8533630445 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
83 Q-000ORKDO 3575010704730001 M. MUNIR SYAHIDIN 48 UMUM JL HANGTUAH GADINGREJO 8775476225 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
84 Q-000K4ALV 3575010208930002 ACH NAWAWI AFANDI 28 UMUM JL URIP SUMOHARJO 20 BUKIR 8123152809 ASTRA ZENECA 29/07/2021 ABY1911 15/11/2021 A1067
85 Q-000OSR5D 3575010801030004 SUDIRMAN 18 UMUM JL HANGTUAH GADINGREJO 8384729048 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
86 Q-000OROLT 3575016802820003 JULAICHA 39 UMUM JL HANGTUAH GADINGREJO 8968384114 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
87 Q-000ORQE0 3575012110810003 IMAM SU'UDI 39 UMUM JL HANGTUAH GADINGREJO 8968384114 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
88 Q-000ORK95 3575025301870002 SITI RAKHMAWATI 34 UMUM JL HANGTUAG GADINGREJO 8968384114 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
89 Q-000ORWE9 3575011508660004 HANNAN 54 RENTAN JL HANGTUAH GADINGREJO 8968384114 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
90 Q-000OTDBR 3575013101950002 MUHAMMAD RUBI MULYONO 26 UMUM JL GATOT SUBROTO BUKIR 8525775112 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
91 Q-000OS3VY 3575015111800003 NUNING TRILESTARI 41 UMUM JL KYAI SEPUH GADINGREJO 8233698279 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
92 Q-000OS3U7 3575014710740002 CHOLIFAH 47 UMUM JL BANDA GADINGREJO 8133203883 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
93 Q-000OTDBJ 3575015506850006 FITRIYAH 36 UMUM JL HANGTUAH GADINGREJO 8125947030 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
94 Q-000ORU0U 3575012305750002 M. CHOTIP 42 UMUM JL HANGTUAH 4/3 GADINGREJO 8125947030 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067
95 Q-000NSDAR 3575015411020001 RENI TRIANA SARI 19 UMUM JL GATOT SUBROTO 2/4 GADINGREJO 8995948458 ASTRA ZENECA 18/08/2021 Z10050 Gad 15/11/2021 A1067
96 Q-000ORZ7F 3575012506880004 IMAM SUYUTI 33 UMUM JL HALMAHERA GADINGREJO 8523182887 ASTRA ZENECA 23/08/2021 K004A 15/11/2021 A1067


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Kelomp Dosis I Dosis 2

No.
Batch
INDUK Vaksinasi Vaksinasi
1 P-6HU7YVOH 3575014101940007 MUSALMAH 27 UMUM JL HANGTUAH GADINGREJO 8113777705 CoronaVac 16/11/2021 24007021
2 P-5NDUATYH 3575016410090003 CHELSEA NIKITA MAHARANI 12 REMAJA jl gatot subroto 8967702243 CoronaVac 16/11/2021 24007021
3 P-4RBRLE8U 3575012904050001 M. ARIFIN 16 REMAJA SEBANI GADINGREJO 8387606735 CoronaVac 16/11/2021 24007021
4 S-5A7BA830 3575010107500083 M.THOYYIB 71 LANSIA jl hangtuah gadingrejo 8113777705 CoronaVac 16/11/2021 24007021
5 P-34ILVU98 3518145009960002 RANI NUR WULANDARI 25 UMUM jl slamet riyadi sebani 8218238129 CoronaVac 16/11/2021 24007021
6 P-7D6SJJ9H 3575015604060002 MURIDATUS SHOLIKHA 15 REMAJA gadengrejo 8113777705 CoronaVac 16/11/2021 24007021
7 P-DRLRNH12 3575015508080002 NURUL AINI 13 REMAJA gadengrejo 8113777705 CoronaVac 16/11/2021 24007021
8 P-BJII5J5E 3575012811060001 MUHAMMAD REGA 15 REMAJA JL UIRIAN JAYA I RT 01 RW 06 KARANGANYAR 8573298095 CoronaVac 16/11/2021 24007021
9 P-HQLTEHQM 3575010212610001 SOKIBUL HAJAR 60 LANSIA jl halmahera gadingrejo 8113777705 CoronaVac 16/11/2021 24007021
10 P-4MHVJFR2 3575012904090002 MUHAMMAD FARDHAN 12 REMAJA JL IRIAN JAYA I NO.64 RT 01 RW 06 KARANGA 8525844274 CoronaVac 16/11/2021 24007021
11 Q-001FW299 5107040312870002 NANANG KOSIM 34 UMUM DUSUN SUMUR WARU RT 04 RW 02 SUMBERA 8585637032 CoronaVac 19/10/2021 202108154G 16/11/2021 24007021
12 Z-000A210F 3575011707580001 SUHADI 63 LANSIA JL HANGTUAH 4/4 GADINGREJO 8213963665 CoronaVac 31/08/2021 24202321 G 16/11/2021 24007021
13 Q-000RSJXK 3575014107650090 ASIYATUN 56 RENTAN JL HANGTUAH RT04 RW04 GADINGREJO 8775522247 CoronaVac 31/08/2021 24202321 G 16/11/2021 24007021
14 Q-001FX3Z8 3575032512670002 HERU SUKARIYADI 54 RENTAN JL.IMAM BONJOL BUGUL LOR 8233552764 CoronaVac 19/10/2021 c202106115 16/11/2021 24007021
15 Q-0008JBUW 3575016709760004 WINARNI 45 UMUM BUKIR rt2vrw6 8233707108 CoronaVac 26/06/2021 24200821 16/11/2021 24007021
16 Q-0008IY3L 3575011104730003 A. SOFYAN HADI 48 UMUM BUKIR rt 2 rw6 8233707108 CoronaVac 26/06/2021 24200281 16/11/2021 24007021
17 Q-001F0NRL 3575012303740001 M. ALI MA'SUM 47 UMUM JL KYAI SEPUH 002/005 8233107175 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
18 Q-001FJ3O7 3575011905080001 AKHMAD MAULANA 13 REMAJA JL HALMAHERA GADINGREJO 8560778047 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
19 Q-000A52K9 3575014704900003 AYU ANGGITA WULANSARI 31 UMUM JL. SUKARNO HATTA ZIPUR 10, JAWA TIMUR, 8575499436 CoronaVac 01/07/2021 24003921 16/11/2021 24007021
20 Q-001EZG4V 3575014506850002 TUTIK FAUZIA 36 UMUM JL. GATOT SUBROTO 3/7 - BUKIR 8223278952 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
21 Q-001FK4O2 3575015107070003 LAILY NUR WULANDARI 14 REMAJA JL KYAI SEPUH 001/005 GENTONG 8573011561 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
22 K-0001V8E3 3514154512960001 WAHYU TRI CAHYANTI 25 UMUM PEKOREN REMBANG 1/5 8224473957 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
23 K-0001V7RV 3514150606890002 BUDI SANTOSO 32 UMUM Pekoren, Rembang, KAB. PASURUAN, Jawa Timu 8575588957 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
24 Q-001FX45Q 3514070808870007 SAIFULLOH 34 UMUM DUSUN KARANGPOH KLUWUT 8593664361 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
25 Q-000E9B50 3575010809900001 DIMAS RACHMAN SUHAIMI 31 UMUM JL SLAMET RIYADI 8133338057 CoronaVac 10/07/2021 24200421 16/11/2021 24007021
26 Q-001FJ23A 3575011901060003 FERDINAN NUR AULIA 15 REMAJA JL IRIAN JAYA GADINGREJO 8132639649 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
27 Q-001F0S93 3575011608950001 MUHAMAD MISBACHUL MUNIR 26 UMUM JL KYAI SEPUH 002/005 8314651883 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
28 Q-001FT789 3575016411630001 MUDJAYANAH 58 RENTAN JL. SLAMET RIYADI 2/4 - SEBANI 8573011560 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
29 Q-001FW4S8 3514145504750002 IDA MULYANTI 46 UMUM JL DUYUNG 35 BANGIL 8570417052 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
30 Q-000TEP88 3575017005820001 ANDAYANI 39 UMUM JL ANYELIR RAYA PERUM GADING PERMAI 8135992919 CoronaVac 04/09/2021 2021071371 16/11/2021 24007021
31 Q-001FW2TO 3575016912040002 WARDATUL MUNIROH 17 REMAJA JL. HANGTUAH II, 04/03, GADINGREJO 8315375086 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
32 Q-001FVZNI 3514142703700002 GUNARNO 51 RENTAN JL MANGGA GG IKAN MAS RT 5 RW 2 8523038373 CoronaVac 19/10/2021 C202106115 16/11/2021 24007021
33 P-461GNHXV 3575011903630001 ANWAR MUSTOFA 58 RENTAN JL SLAMET RIYADI 1/1 8113777705 ASTRA ZENECA 16/11/2021 A1067
34 P-4HSLIIQ0 3575010107780167 SUKANDAR 43 UMUM JL BANDA GG TERATAI 05 8384682956 ASTRA ZENECA 16/11/2021 A1067
35 P-4WDN6DBG 3514172108840002 BUKHORI 37 UMUM DSN SUNGI SELATAN 8579029337 ASTRA ZENECA 16/11/2021 A1067
36 P-E26IKNRI 3575010107760138 SAERI 45 UMUM JL HANTUAH 3/3 GADINGREJO 8121115850 ASTRA ZENECA 16/11/2021 A1067
37 P-9509YE54 3202406006900003 ANISAH 31 UMUM jl irian jaya gadingrejo 8580643064 ASTRA ZENECA 16/11/2021 A1067
No.
Batch
38 P-9NJK7RQF 3575015210680003 KHUMAIYAH 54 RENTAN jl selamet riyadi 8585201986 ASTRA ZENECA Vaksinasi
16/11/2021 A1067 Vaksinasi
39 P-B4OPCVNA 3575014107810101 NUR KHAULAH 44 UMUM jl hangtuah gadingrejo 8113777705 ASTRA ZENECA 16/11/2021 A1067
40 P-BH5PUHDB 3575035208780005 SITI CHODIJAH 39 UMUM jl halmahera gadingrejo 8113777705 ASTRA ZENECA 16/11/2021 A1067
41 P-CCOCJN1O 3575015305970006 DINA PUSPITA 24 UMUM jl banda 6/2 gadingrejo 8113777705 ASTRA ZENECA 16/11/2021 A1067
42 P-E2XEVPGO 3575012411600001 TORIK MULYADI 60 LANSIA jl slamet riyadi 2/4 gentong 8781542528 ASTRA ZENECA 16/11/2021 A1067
43 P-EO3ZID2I 3575012710640002 ABD. KADIR 58 RENTAN jl slamet riyadi 1/2 gentong 8585201986 ASTRA ZENECA 16/11/2021 A1067
44 P-083J9OYM 3575011010720003 NUR SALIM 49 UMUM jl haang tuah gadingrejo 8113777705 ASTRA ZENECA 16/11/2021 A1067
45 P-G5CW7WAJ 3575010107800131 IMAM MAHDI 41 UMUM jl halmahera gadingrejo 8135333100 ASTRA ZENECA 16/11/2021 A1067
46 P-GQ70NS4T 3575017009890002 MARIA ULFA 32 UMUM jl halmahera gadingrejo 8135333100 ASTRA ZENECA 16/11/2021 A1067
47 P-A4YOY9UC 3575012102630001 NUR WAKHID 58 RENTAN jl kyai sepuh gentong 8145604484 ASTRA ZENECA 16/11/2021 A1067
48 P-AO55MICO 3575015508650001 ZAINAB 56 RENTAN jl kyai sepuh gentong 8564198664 ASTRA ZENECA 16/11/2021 A1067
49 P-D2AHVHZR 3575014107820127 SUMAIYA 39 UMUM jl slamet riyadi 2/4 gentong 8781542528 ASTRA ZENECA 16/11/2021 A1067
50 Q-000OZTS9 3575011807030001 DAVIES SATRIA PUTRO WAHYUDI 18 UMUM JL KYAI SEPUH GENTONG 8819585707 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
51 Q-000P09RQ 3575015903880002 SHINTA EKA PHISESA 33 UMUM PERUM GRAHA INDAH BLOK I 52 8135954218 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
52 Q-000OTH6M 3575011009840003 BUDIYONO 37 UMUM JL IRIANJAYA GADINGREJO 8580251140 ASTRA ZENECA 23/08/2021 K004A 16/11/2021 A1067
53 Q-000OZXZH 3575014107880114 SUMIATI 33 UMUM JL BANDA GADINGREJO 8384682956 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
54 Q-000P0EYL 3575017006000002 PUTRI AYU NUR RAHMAWATI 21 UMUM JL KYAI SEPUH GADINGREJO 8219918137 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
55 Q-000P1677 3575014107760104 SAIDAH 45 UMUM JL HANGTUAH 4/3 GADINGREJO 8121728006 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
56 Q-000P07WU 3575015212860004 FIRDATIH 35 UMUM JL BANDA GADINGREJO 8135378735 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
57 Q-000P0XRH 3575015508780006 AGUS SULISTINAH 43 UMUM JL SOEKARNO HATTA GADINGREJO 8533492095 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
58 Q-000P0VCY 3575011411000003 YUDHA RIZKYANA 21 UMUM JL SOEKARNO HATTA ZIPUR 6/1 GADINGREJO 8969967655 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
59 Q-000P0G9V 3575012004870003 MUCHAMAD MAHKRUS 34 UMUM JL BANDA GADINGREJO 8385312934 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
60 Q-000P0IBM 3575010107930085 MUCHAMAD SUBEKHAN 28 UMUM JL BANDA GADINGREJO 8585982508 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
61 Q-000P0BTE 3575016301990001 FITRI ANDRI LESTARI 22 UMUM JL BANDA GADINGREJO 8383153295 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
62 K-0000NDFN 3575015910960002 AFISAH SUNANI 25 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8133452488 ASTRA ZENECA 20/08/2021 210050 16/11/2021 A1067
63 Q-000P0ZOB 3575016508750003 KHANIFAH 38 UMUM JL SLAMET RIYADI GADINGREJO 8953410052 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
64 Q-000K83ZG 3575013008820002 AGUS HARIYONO 39 UMUM JL. IRIAN JAYA GG ANGGREK 8383353353 ASTRA ZENECA 30/07/2021 ABX2795 16/11/2021 A1067
65 Q-000ZQGEG 3575011611960001 ROY CHRISNA SUHANDA 25 UMUM jl sinonggo 1/1 gadingrejo 8573028789 ASTRA ZENECA 18/09/2021 A1050 16/11/2021 A1067
66 Q-000P0BU6 3575010101640017 YASIN 57 RENTAN JL IRIAN JAYA GADINGREJO 8113777705 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
67 Q-000P0LP8 3575010307880005 AKHMAD MANSUR 33 UMUM JL KYAI SEPUH GADINGREJO 8810276792 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
68 Q-000P0AKP 3575027007010002 AINUN SUKMA MELATI PUTRI 20 UMUM JL SLAMET RIYADI GENTONG 8570616400 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
69 Q-000P05QI 3575014107860124 KHORY ISHAYATI 35 UMUM JL JEND A. YANI GADINGREJO 8214584800 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
70 Q-000P0SN2 3575015611990001 VENY NOVIANA 22 UMUM JL KYAI SEPUH GADINGREJO 8969959415 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
71 Q-000P0VDA 3514162306870003 FARIS MAHMUD 34 UMUM JL IRIAN JAYA GADINGREJO 8384854449 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
72 Q-000P0ICJ 3575016602760001 ALFIYAH 45 UMUM JL KYAI SEPUH GADINGREJO 8312908454 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
73 Q-000P3D1O 3575015808810003 LAILATUL FITRIYAH 40 UMUM ASRAMA YON ZIPUR GADINGREJO 8580878956 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
74 Q-000P3JIM 3575010704780005 ARIES SUGENG DEDIYANTO 43 UMUM JL KYAI SEPUH GADINGREJO 8123336545 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
75 Q-000P3J7D 3575016712810003 HARIANTI 40 UMUM JL KYAI SEPUH GADINGREJO 8123336545 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
76 Q-000OZV5Z 3509052506010002 DWI CAHYO SAPUTRO 20 UMUM JL SLAMET RIYADI GENTONG 8385056258 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
77 Q-000P04AG 3509056506750004 TITIK IRFATUL AROFAH 46 UMUM JL SLAMET RIYADI GENTONG 8778802561 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
78 Q-000OZTSC 3509050703690002 MULYONO 52 RENTAN JL SLAMET RIYADI GENTONG 8585592944 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
79 Q-000P1KXB 3575012912760003 KUSWIANTO 45 UMUM JL HANGTUAH GADINGREJO 8123582723 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
80 Q-000P167G 3575011103020002 MOCH RIFAI 19 UMUM JL HANGTUAH 3/3 8384854580 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
81 Q-000OSDVZ 3575012407000005 ABDUL RACHMAN 21 UMUM JL HANGTUAH II GADINGREJO 8573343943 ASTRA ZENECA 23/08/2021 K004A 16/11/2021 A1067
No.
Batch
82 Z-0009L4U6 3575016507990001 NURUL ALFIN 22 UMUM jl slamet riyadi SEBANI 8570424269 ASTRA ZENECA Vaksinasi
24/08/2021 K004A Vaksinasi
16/11/2021 A1067
83 Q-000OQMV2 3575014905960004 USWATUN CHASANA 25 UMUM JL BANDA GADINGREJO 8787070165 ASTRA ZENECA 23/08/2021 K004A 16/11/2021 A1067
84 Q-000P0UHV 3575014205790001 SYAMSIAH 42 UMUM JL SOEKARNO HATTA ZIPUR 10 , JAWA TIMUR, 8123322254 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
85 K-0000P9RD 3575020112030006 AHMAD ZANUAR AZIZ 19 UMUM JL KH ACHMAD DAHLAN POHJENTREK 8953878268 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
86 Q-000OFMUS 3575016810790005 SITI AMINAH 45 UMUM JL HALMAHERA 5/5 GADINGREJO 8180558160 ASTRA ZENECA 21/08/2021 K004A 16/11/2021 A1067
87 Q-000P0ICT 3575015903990004 LIA AGUSTINA 22 UMUM JL HALMAHERA GADINGREJO 8585068831 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
88 Q-000P0KAY 3575010404000003 MAULANA ISKAK 21 UMUM JL HALMAHERA GADINGREJO 8585068835 ASTRA ZENECA 24/08/2021 A1024 16/11/2021 A1067
89 K-0000P3WL 3575014103700002 DARIYAH 51 RENTAN ASRAMA YONZIPUR GADINGREJO 8233225859 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
90 K-0000P3WK 3575011106650001 ABDUROSID 56 RENTAN ASRAMA YONZIPUR GADINGREJO 8214092104 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
91 Q-000P3QV4 3575016603990003 NAHLA FAUZIYAH 22 UMUM JL. IRIAN JAYA GG ANGGREK, GADINGREJO 1/ 8577449353 ASTRA ZENECA 24/08/2021 210050 16/11/2021 A1067
92 Q-000P13EF 3575010909750007 TRI BUSONO HERMAWAN 46 UMUM JL SLAMET RIYADI GADINGREJO 8222896009 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
93 Q-000P1EG2 3575014107930037 JULAEKHA 28 UMUM GADINGREJO 8113777705 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
94 Q-000P02NA 3575016804760001 MUZDALIFA 46 UMUM jl slamet riyadi GENTONG 8523620722 ASTRA ZENECA 24/08/2021 K004A 16/11/2021 A1067
### PUSTU BUKIR
1 Q-001F0SDG 3575014505800007 IMA HIDAYATI 41 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 88805036591 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
2 Q-00137DG4 3575017012760001 KRISTIN 45 UMUM BUKIR 005/007 81259042624 CoronaVac 24/09/2021 202108123H 16/11/2021 24007021
3 Q-001F0SSX 3575011003960002 MOCHAMMAD DANI ISMAIL 25 UMUM JL. GATOT SUBROTO 5/7 - BUKIR 82131089651 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
4 Q-001F0TCO 3575011209770004 MOTOHHIRIN 44 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 85334614944 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
5 Q-001F0SOK 3575011710760002 SLAMET HARYADI 45 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 82330247148 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
6 Q-001F0NHV 3575010907850002 MOCHAMMAD SAICHU 36 UMUM JL. GATOT SUBROTO 2/7 - BUKIR 82331038813 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
7 Q-001F0RMK 3575011212820001 SELAMET SALIM 39 UMUM JL.RADEN PATAH GG. PRAMUKA 7/5 - PURWO 83830472839 CoronaVac 18/10/2021 C202106115 16/11/2021 24007021
8 Z-000CACJN 3575013112590002 AMARI 62 LANSIA Bukir RT03 RW02 81333110339 CoronaVac 08/10/2021 202108172F 16/11/2021 24007021
9 Q-0013CE9Z 3514076711990001 IDA FITRIA LAILATUN NIKMAH 22 UMUM BUKIR GADINGREJO 85815422487 CoronaVac 24/09/2021 202108154G 16/11/2021 24007021
10 Q-000UMSFT 3575011309070002 MUHAMMAD GUNTUR RAMADHANI A 14 UMUM BUKIR KEC. GADINGREJO 82228111979 CoronaVac 07/09/2021 202108118H 16/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 Z-00017G45 3575016112560001 SUMARMI 65 LANSIA JL KYAI SEPUH, 8113777705 CoronaVac 22/06/2021 24002621 17/11/2021 24007021
2 Z-000D1D7I 3575014101540011 SUPATMI 67 LANSIA JL. HALMAHERA 23 / 22 8213141562 CoronaVac 19/10/2021 C202106115 17/11/2021 24007021
3 Q-001FVPFU 3515075010090001 KEISYA ANINDYA CAHYONO 12 REMAJA SEPANDE RT 002 RW 001 8133301963 CoronaVac 19/10/2021 C202106115 17/11/2021 24007021
4 P-4GWAQB8E 3514166605860001 NURUL OKTAFIA 35 UMUM JL HANGTUAH GADINGREJO 8214167154 ASTRA ZENECA 17/11/2021 A1067
5 P-4M40B0WS 3575011205850004 SOLICHAN 36 UMUM JL HALMAHERA 6/4 GADINGREJO 8313907973 ASTRA ZENECA 17/11/2021 A1067
6 P-4Z2II48K 3575016309000003 SITI MUTIMATUL LAILI 21 UMUM JL IRIAN JAYA GG ANGGREK NO 2 8953267442 ASTRA ZENECA 17/11/2021 A1067
7 P-6AC449PW 3575015106820001 NUR AENI 39 UMUM JL SLAMET RIYADI GENTONG 8213990832 ASTRA ZENECA 17/11/2021 A1067
8 Q-000PBSLN 3514161009720003 ABDUL HAKIP 49 UMUM WRINGIN 1/3 GADINGREJO 8128149956 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
9 Q-000PC2H3 3575015407000002 LEGINA JULIYANTI 21 UMUM JL KYAI SEPUH 3/4 GADINGREJO 8573278478 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
10 Q-000PCMAA 3575014406780007 FIVA MUSFIA 43 UMUM JL BANDA 4/2 GADINGREJO 8113777705 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
11 Q-000PCKVD 3575011610980002 MOCH FANDY PRATAMA. 23 UMUM JL BANDA 4/2 GADINGREJO 8384513581 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
12 Q-000PC0CC 3575014706820004 NURUL AINI 39 UMUM JL KYAI SEPUH 2/1 GADINGREJO 8566768403 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
13 Q-000PCAXL 3514132307990003 SHOLEH MAHMUD 22 UMUM JL BANDA 2/2 GADINGREJO 8383192330 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
14 Q-000P13DX 3575014407780004 SULAMI 43 UMUM BUKIR 2/2 GADINGREJO 8778501273 ASTRA ZENECA 24/08/2021 A1024 17/11/2021 A1067
15 Q-000PC2I6 3575011209720003 ACHMAD RIFA'I 49 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8580642909 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
16 Q-000PC2IC 3575011801030002 FIRMAN MAULANA 18 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8573081744 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
17 Q-000PCS59 3575011610970001 MUKHAMAD NUR KHAKIM 24 UMUM JL IRIAN JAYA 3/2 GADINGREJO 8573327014 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
18 Q-000PCVNK 3575012208820001 SUDIONO 39 UMUM JL IRIAN JAYA 3/2 GADINGREJO 8523573420 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
19 Q-000PD1XJ 3575014403840005 TRI MUSLIKA 37 UMUM JL IRIAN JAYA 3/2 GADINGREJO 8573084711 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
20 Z-0009MI3Z 3575020512780004 Elvy Rachmawati 43 UMUM Perum Taman asri Jl.Murai Bali Blok EE No.12 RT 8125990588 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
21 Q-000P3485 3575011012850003 SANDI 36 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 24/08/2021 K004A 17/11/2021 A1067
22 Z-0009MOPR 3515075606750005 WAHYU SHINTA HANDAYANI 46 UMUM JL. CIPINANG MUARA NO. 27 RT 5 RW 4 KEL. 8135760146 ASTRA ZENECA 25/08/2021 ABX2795 17/11/2021 A1067
23 Q-000PC5S9 3575012909910001 SOFYAN HADI SAPUTRA 30 UMUM JL SLAMET RIYADI 3/4 GADINGREJO 8135703292 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
24 K-0000PX48 3575014107880125 NUR BAIDA 33 UMUM Jl.Banda, Gg.Mawar 8218792171 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
25 Q-000PCMAI 3575014507980001 NUR MAULIDIYAH 25 UMUM JL BANDA 5/3 GADINGREJO 8776251856 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
26 Q-000PDKCX 3175024202841001 KRISTINA 37 UMUM JL BANDA 5/2 GADINGREJO 8213993881 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
27 Q-000PCTF7 3575011005030002 M. JAELANI 18 UMUM JL BANDA 5/2 GADINGREJO 8533099915 ASTRA ZENECA 25/08/2021 K004A 17/11/2021 A1067
MI MIFTAKHUL HUDA
1 P-9CDDWTEP 3575042802090001 MUHAMMAD SOFIYAN 12 REMAJA JL IRIAN JAYA NO. 33 RT 1 RW 6 KEL KARA 8573073603 BIOFARMA 17/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
2 P-B3XMT1D3 3575011504090004 MUKHAMAD ALI RIDHO 12 REMAJA JL. BANDA GADINGREJO 8585026007 BIOFARMA 17/11/2021 24007021
3 P-BFU8BOT4 3575012604080003 MOHAMMAD FARREL TRI ADI 13 REMAJA JL KYAI SEPUH GENTONG 8964705660 BIOFARMA 17/11/2021 24007021
4 P-EI529M3B 3575015410090001 ZAHROTUL KAMILIA 12 REMAJA JL IRIAN JAYA GADINGREJO 8129614260 BIOFARMA 17/11/2021 24007021
5 P-CL0BCJ3V 3575011510090001 ZAMROTA AJI PANGESTU 12 REMAJA JL KYAI SEPUH GENTONG 8129614260 BIOFARMA 17/11/2021 24007021
6 P-CSE8WR1N 3575014905090007 ZASKYA NOR JAHIRA 12 REMAJA JL IRIAN JAYA GADINGREJO 8573852211 BIOFARMA 17/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-D1WO4YU6 3575010804990001 ISLAKHUL RIZAL 22 UMUM jl banda 5/2 gading 8573117886 ASTRA ZENECA 18/11/2021 A1067
2 P-E98BKHBI 3575016503970003 IDA KHURNIA 24 UMUM jl hangtuah 1/4 8560724563 ASTRA ZENECA 18/11/2021 A1067
3 P-GT1LCL56 3575010506960003 M. MUKHTAR 24 UMUM jl hangtuah 8575509902 ASTRA ZENECA 18/11/2021 A1067
4 P-INJMJOT3 3575037112960002 FIA MAIMUNAH 25 UMUM jl halmahera 8789940386 ASTRA ZENECA 18/11/2021 A1067
5 P-97096L4D 3515084301950001 EKA HASANAH ARIYATI 26 UMUM jl gatot subroto 5/7 bukir 8978100667 ASTRA ZENECA 18/11/2021 A1067
6 P-GCLV7H7Q 3575015103950004 DEWI AZIZAH 26 UMUM jl hangtuah 8585046689 ASTRA ZENECA 18/11/2021 A1067
7 P-EPAIPEQD 3575015912920001 SITI NAFISAH 29 UMUM jl hangtuah 2/3 gadingrejo 8770332740 ASTRA ZENECA 18/11/2021 A1067
8 P-EH4V6W1T 3311052109870001 MULYADI 34 UMUM jl hangtuah 2/3 gadingrejo 8770332740 ASTRA ZENECA 18/11/2021 A1067
9 P-7KVFC0EU 3514214606860003 MISRI 35 UMUM wotgalih - nguling 8233627801 ASTRA ZENECA 18/11/2021 A1067
10 P-G4GH4ROS 3575015605860003 LATIFAH 35 UMUM dsn penawangan bukir 8953363989 ASTRA ZENECA 18/11/2021 A1067
11 P-5ZURQ1AC 3575015507830002 RENI YULIATI FITRIANA 38 UMUM BUKIR PASURUAN 8554677332 ASTRA ZENECA 18/11/2021 A1067
12 P-HAHTV0HO 3575016311830005 NOVI ANDRIANA 38 UMUM jl gatot subroto 3/7 bukir 8523339142 ASTRA ZENECA 18/11/2021 A1067
13 P-ILZQNR67 3575015012820012 SUMAN FAATI 39 UMUM jl halmahera 8113777705 ASTRA ZENECA 18/11/2021 A1067
14 P-HNLI22HI 3575015810800002 CHUSNA 41 UMUM jl hangtuah 8313217628 ASTRA ZENECA 18/11/2021 A1067
15 P-FT72VK1T 3575017005760002 SITI MAIMUNAH 45 UMUM jl urip sumoharjo bukir 8953363989 ASTRA ZENECA 18/11/2021 A1067
16 P-C8VJQ5FA 3575014107740096 SOFIYAH 47 UMUM jl.hangtuah 1/4 gadingrejo 8560724563 ASTRA ZENECA 18/11/2021 A1067
17 P-H1ZU8HHU 3575012008720001 SAIFUL 50 RENTAN jl hangtuah 8529053056 ASTRA ZENECA 18/11/2021 A1067
18 Q-000PV6WA 3575011305030003 MOHAMMAD DAVA MAULANA 18 UMUM jl gatot subroto 1/4 bukir 8135901288 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
19 Q-000PUKK8 3575015112020003 MIFTAHUL JANNAH 19 UMUM JL BANDA 5/2 GADINGREJO 8133122269 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
20 Q-000PD9OJ 3575034507020002 FRIELLA PUTRI NURMALASARI 19 UMUM PERUM PESONA CANDI PERMAI 3 7/7 8951472287 ASTRA ZENECA 25/08/2021 K004A 18/11/2021 A1067
21 Q-000PUPDA 3575015108010004 ULIN NUHA 20 UMUM JL HANGTUAH 1/3 GADINGREJO 8953374268 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
22 Q-000PUOWJ 3575012111000004 MUCHAMMAD NAUFAL FIRMAN HID 21 UMUM JL URIP SUMOHARJO 2/2 BUKIR 8961740482 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
23 Q-000PW9XC 3575010101000001 SUTIYO MAS AZIZ 21 UMUM jl gatot subroto 5/7 bukir 8956302587 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
24 Q-000PV0X8 3575010808990002 SITI MASFUFAH 22 UMUM JL BANDA 3/3 GADINGREJO 8312515640 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
25 Q-000PS958 3575011403980001 KHUMAEDI 22 UMUM JL HANGTUAH 1/3 GADINGREJO 8123408212 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
26 Q-000PWF8U 3575010209990002 DIMAS WAHYU SEPTIAN 22 UMUM JL BANDA 3/2 GADINGREJO 8212439353 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
27 K-0000RNW7 3575012203980002 BUDHI HARTOYO 23 UMUM JL BANDA 3/2 GADINGREJO 8233591704 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
28 Q-000PTUY4 3575016607980001 NUR MUKHLISA 23 UMUM JL KYAI SEPUH GENTONG 8880380231 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
29 Q-000P4IAX 3575015408970001 EVY AYUNINGTYAS 24 UMUM JL SLAMET RIYADI 2/3 GADINGREJO 8585522477 ASTRA ZENECA 24/08/2021 K004A 18/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 Q-000PSCR6 3575015105970001 SITI AISAH 24 UMUM JL GATOT SUBROTO BUKIR 8953485137 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
31 Q-000PUJ2B 3575015711990001 SINTAFIAH 24 UMUM JL HANGTUAH 1/3 GADINGREJO 8951595615 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
32 Q-000PTZ1L 3507145809970001 GITA AYU DWI PERTIWI 24 UMUM PERUM LUMBUNG PADI SEBANI 8122255189 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
33 Q-000PW2BS 3575017012970001 KARIMAH RUWANDA 24 UMUM JL SULAWESI GG 3 PASURUAN 8883217351 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
34 Q-000NSD8V 3575014507970004 SAIFUL RIZAL 24 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8574827885 ASTRA ZENECA 18/08/2021 210050 18/11/2021 A1067
35 Q-000PTYWJ 3575012211960001 PRASETYO ARYO YUDHANTO 25 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8785686013 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
36 Q-000PVI80 3575012410990002 M. SYUFYAN LUTFI 25 UMUM JL BANDA 4/2 GADINGREJO 8573918453 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
37 Q-000LM8XG 3204134804950002 PIPIT ISMAWANTI APRILIA 26 UMUM JL. HANGTUAH RT03 RW05 PASURUAN 8966543795 ASTRA ZENECA 07/08/2021 210056 DKK 18/11/2021 A1067
38 N-00000WSQ 3575014104950004 Ratna Priscillia Angelina 26 UMUM JL RW MANGONSIDI KAV 21 KEBONAGUNG 8122270128 ASTRA ZENECA 16/08/2021 ABY1911 18/11/2021 A1067
39 Q-000PVVOG 3575015903950002 MARSIYA 26 UMUM JL GATOT SUBROTO 4/7 BUKIR 8570486488 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
40 Q-000PV71H 3575010906950001 DEDEN SYEFIRA RISYAF 26 UMUM BUKIR 1/4 GADINGREJO 8950960876 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
41 Q-000PUK75 3514206108940002 SITI MAISYAROH 27 UMUM JL HANGTUAH 1/3 GADINGREJO 8311740423 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
42 Q-000PWA4N 3575014412940002 AINUL KHARIR 27 UMUM jl hangtuah 2/3 Gadingrejo 8770295596 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
43 Q-000PUXHX 3575010708920003 M. AHMUD MUSLIM 29 UMUM JL SEBANI 1/6 SEBANI 8574904885 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
44 Q-000OZXYJ 3514165809920002 ROBIKATUL ADAWIYAH 29 UMUM JL NGAGLIK GADINGREJO 8383451866 ASTRA ZENECA 24/08/2021 K004A 18/11/2021 A1067
45 Q-000PSGH6 3575015611920002 ROSIDAH 29 UMUM JL GATOT SUBROTO BUKIR 8383323521 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
46 Q-000PSQ3M 3575012207920001 KHOIRUL FAJAR 29 UMUM jl gatot subroto sebani 8122223877 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
47 Q-000PUR1G 3575011507920002 MISBAKHUL HUDA 29 UMUM JL HANGTUAH 1/3 GADINGREJO 8311740423 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
48 Q-000PUH50 3575014107940035 SULIS 30 UMUM JL BANDA 5/2 GADINGREJO 8180626393 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
49 Q-000PCOJI 3575011011900003 M. MAS AMAK 31 UMUM JL HALMAHERA 1/5 GADINGREJO 8132677929 ASTRA ZENECA 25/08/2021 K004A 18/11/2021 A1067
50 Q-000NSOES 3575016305910001 WILUTAMA 31 UMUM JL URIP SUMOHARJO BUKIR 8384752888 ASTRA ZENECA 18/08/2021 210050 18/11/2021 A1067
51 Q-000PUC6W 3575014406890002 FARIDA 32 UMUM JL HANGTUAH 1/3 GADINGREJO 8571587467 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
52 Q-000OZZCY 3575010107890046 MUCHAMMAD MUSA 32 UMUM NGAGLIK PASURUAN 8383451866 ASTRA ZENECA 24/08/2021 K004A 18/11/2021 A1067
53 Q-000PULHV 3514050101890006 JANWAR WAHYUDI 32 UMUM JL BANDA 5/2 GADINGREJO 8383273734 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
54 Q-000O6NZH 3575016011880002 NUR KHASANAH 33 UMUM JL BANDA GADINGREJO 8788787018 ASTRA ZENECA 20/08/2021 210050 18/11/2021 A1067
55 Q-000PTUXO 3514084508870005 SITI FATMAWATI 34 UMUM JL RADEN PATAH 1/5 GENTONG 8155462978 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
56 Q-000NSODV 3514162206870002 JUNAEDI 35 UMUM JL URIP SUMOHARJO 3/3 GADINGREJO 8384642073 ASTRA ZENECA 18/08/2021 210050 18/11/2021 A1067
57 Q-000PSLAE 3575022309860002 MUHAMMAD NAWAWI 35 UMUM JL GATOT SUBROTO BUKIR 8383327596 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
58 Q-000PUV81 3575016509860001 SULIS SETIYOWATI 35 UMUM JL SLAMET RIYADI GG.13 GENTONG 8575533735 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
59 Q-000PU1CP 3575015905850002 MEILAH 36 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8565586393 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
60 Q-000PU2U5 3575010903850003 M. JATIM 36 UMUM JL HANGTUAH 1/3 GADINGREJO 8777211103 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
61 Q-000P3AM0 3575014101840016 NUR CHASANAH 37 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 24/08/2021 K004A 18/11/2021 A1067
62 Q-000OPRM7 3575010307840002 SAMSUL HADI 37 UMUM JL BANDA GADINGREJO 8133665511 ASTRA ZENECA 23/08/2021 K004A 18/11/2021 A1067
63 Q-000PU0CW 3203221505840007 ABDUK ROCHMAN 37 UMUM JL KYAI SEPUH 1/6 GENTONG 8591896884 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
64 Q-000PTSXI 3575015203830005 NUR ASIYAH 38 UMUM JL BANDA GADINGREJO 8585086776 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
65 Q-000PVNJZ 3575010107820194 HOLIK 39 UMUM JL BANDA GADINGREJO 8533578694 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
66 Q-000PS9P2 3575012012820001 HERIYANTO 39 UMUM lumbung padi Sebani 8581155189 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
67 Q-000PWA8X 3575011103800001 TUGIMAN 41 UMUM jl banda 3/2 Gadingrejo 8787651396 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
68 Q-000PU4JM 3575014507830001 MALICHAH 41 UMUM JL HANGTUAH 4/3 GADINGREJO 8384656090 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
69 Q-000PC55O 3575016503820004 HARTATIK 43 UMUM JL BANDA GADINGREJO 8776251856 ASTRA ZENECA 25/08/2021 K004A 18/11/2021 A1067
70 Q-000PUJ8I 3575014804780001 SOLIKHAH 43 UMUM JL HANGTUAH 1/3 GADINGREJO 8953374268 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
71 Q-000PTU7E 3575015909780002 SUMARNI 43 UMUM JL HANGTUAH GADINGREJO 8786697283 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
72 Q-000PUYAA 3575015511780003 NOFI FEBRIYANI 43 UMUM JL GATOT SUBROTO 1/4 BUKIR 8573132529 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
73 Q-000PV5RA 3575014107770084 CHANIFAH 44 UMUM JL BANDA GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
74 Q-000PV6M5 3575015403770001 KHANIFAH 44 UMUM JL HANGTUAH 2/4 GADINGREJO 8784618289 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
75 Q-000PVEPD 3575016709760003 SANTI SUPRIYATIN 45 UMUM JL SLAMET RIYADI 4/2 8233192344 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
76 Q-000PW175 3575016005760002 SAMINI 45 UMUM JL BANDA 5/2 GADINGREJO 8384763075 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
77 Q-000PUCME 3575010107750105 M. MUKSIN 45 UMUM GADINGREJO 1/3 8383323889 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
78 Q-000PTYE2 3575011706750002 MOCH. MANSUR 46 UMUM JL BANDA 3/2 GADINGREJO 8574803007 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
79 Q-000PVYN4 3509084107750765 YULIATIN 46 UMUM GENTONG GADINGREJO 8193693621 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
80 Q-000PUGFQ 3575014101720017 USWATUL KASANAH 49 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
81 Q-000PV65X 3575014107720073 SUMARYATI 49 UMUM JL BANDA 4/2 GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
82 Q-000P02NL 3575015704710002 MUTMAINAH 50 RENTAN JL SLAMET RIYADI GENTONG 8953948464 ASTRA ZENECA 24/08/2021 K004A 18/11/2021 A1067
83 Q-000PUCHV 3575015504710001 PONIYEM 50 RENTAN jl banda gadingrejo 8113777705 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
84 Q-000PVFVJ 3575014101660026 KARTININGSIH 52 RENTAN JL BANDA 4/2 GADINGREJO 8573918453 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
85 Q-000PUJOR 3575016809690002 TAMIMAH 52 RENTAN JL HANGTUAH GADINGREJO 8311740423 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
86 Q-000PUP8X 3514096603680001 LULUK MASLUKHA 53 RENTAN DUSUN PALANG 1/3 SUKOREJO 8214014803 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
87 Q-000PUI78 3575016703690003 CHOMSATUN 53 RENTAN JL HANGTUAH 3/3 GADINGREJO 8233436714 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
88 Z-0009PK4F 3575021210670002 BUDI SUWASONO 54 RENTAN JL ERLANGGA 8/5 PURWOREJO 8123082777 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
89 Q-000PUK1R 3529017112660010 SATUMI 55 RENTAN JL HANGTUAH GADINGREJO 8785014663 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
90 Z-0009PN8P 3575011705660001 ROHMAN 55 RENTAN JL BANDA 4/2 GADINGREJO 8810264264 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
91 Q-000PUK0Z 3575014405690001 KHOLIFAH 56 RENTAN JL BANDA 5/2 GADINGREJO 8133122269 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
92 Q-000PULGS 3575014107730040 DJUMAATI 56 RENTAN JL BANDA GADINGREJO 8776251856 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
93 Q-000PURHQ 3575014107650076 SA'DIYAH 56 RENTAN JL HANGTUAH 4/3 GADINGREJO 8384656090 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
94 Q-000PW2QF 3575011203650003 ZAINUDDIN 56 RENTAN JL HANGTUAH 1/3 GADINGREJO 8953648128 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
95 Q-000PVY43 3575014107630088 WAGINEM 58 RENTAN JL BANDA 5/2 GADINGREJO 8384763075 ASTRA ZENECA 26/08/2021 PV46700 18/11/2021 A1067
96 Q-000OTPME 3575010107620072 MOCH. CHUSAIRI 59 RENTAN JL BANDA GADINGREJO 8123081747 ASTRA ZENECA 23/08/2021 K004A 18/11/2021 A1067
97 Q-001GCBUQ 3575014210090001 ANGELA AURELLIA PUTRI 12 REMAJA JL KYAI SEPUH 3/18 GADINGREJO 8578524729 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
98 Q-001G9893 3575011810080002 MUHAMMAD ALIF MUFLIKH 13 REMAJA JL GATOT SUBROTO BUKIR GADINGREJO 8822199197 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021 G
99 Q-001G99GF 3575012301080001 MUKHAMAD RISWAN BAWAFI 13 REMAJA SEBANI - GADING REJO 8225728317 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
100 K-0000EGMC 3575010802060001 MOCHAMMAD AJI SAPUTRA 15 REMAJA JL GATOT SUBROTO 3/6 BUKIR 8953352419 CoronaVac 05/08/2021 24004621 18/11/2021 24007021
101 Q-001GO016 3575012106050001 MUHAMMAD ROBBY RAHMADANI 16 REMAJA JL. GATOT SUBROTO 1/6 - BUKIR 8121736716 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
102 Q-001FLBXF 3575014609030001 SALWA AISYAH SILVARATIH 18 UMUM JL ALAMANDA GADINGREJO 8133118059 CoronaVac 19/10/2021 C202106115 18/11/2021 24007021
103 Q-000SNTL0 3575013101030003 M. JUNAIDI 18 UMUM JL BANDA 5/2 GADINGREJO 8578525841 CoronaVac 02/09/2021 2021071371 18/11/2021 24007021
104 Q-000SNS6R 3575010711020001 M. PUTRA RAMADANI 19 UMUM JL BANDA 5/2 GADINGREJO 8580714425 CoronaVac 02/09/2021 2021071371 18/11/2021 24007021
105 Q-0017KA19 3575012507000005 MOCHAMAD BAHARUDDIN FIRMANS 21 UMUM SEBANI 1/4 8953970716 CoronaVac 02/10/2021 202108154G 18/11/2021 24007021
106 Q-001GF32L 3575034107960026 NIKMATUL HASANAH 25 UMUM JL. Komodor Yos Sudarso 1/4 - Mandaranrejo 8580646142 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
107 Q-0017200N 3575014203890002 HUSNUL KHOTIMAH 32 UMUM JL HALMAHERA 8133689565 CoronaVac 01/10/2021 202108154G 18/11/2021 24007021
108 Q-001G9R4E 3575026104880002 NURYANTI 33 UMUM JL SLAMET RIADI 003/003 GENTONG 8585299542 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
109 Q-000RT0TQ 3575014707850004 MASLUKHAH 36 UMUM JL HANGTUAH RT 04 RW03 GADINGREJO 8214227516 CoronaVac 31/08/2021 24202321 G 18/11/2021 24007021
110 Q-00171W7D 3575011612840001 IMAM BAIDLAWI 38 UMUM JL HANGTUAH 8133689565 CoronaVac 01/10/2021 202108154G 18/11/2021 24007021
111 Q-001GE8PF 3575014806760003 ANISAH AMI 45 UMUM JL SLAMET RIYADI 002/004 GENTONG 8193621577 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
112 Q-001GOT3K 3575015908760004 BUNANTI 45 UMUM Jl mulyorejo 8533040818 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
113 Q-000RT2AU 3575014507700003 ROCHIMAH 51 RENTAN JL HANGTUAH II RT04/RW 03 GADINGREJO 8214227516 CoronaVac 31/08/2021 24202321 G 18/11/2021 24007021
114 Q-001681OV 3575014107670081 DJUMAANAH 55 RENTAN JL BANDA 4/2 GADINGREJO 8113777705 CoronaVac 30/09/2021 202108154G 18/11/2021 24007021
115 Q-001FBMJ2 3575015510650002 SUHAIMI 56 RENTAN JL HALMAHERA 8585086883 CoronaVac 18/10/2021 C202106115 18/11/2021 24007021
116 Q-001FXMG2 3575012309640002 SYAFI I 57 RENTAN JL. SLAMET RIADI, GENTONG GADING REJO 8127562171 CoronaVac 19/10/2021 202108154G 18/11/2021 24007021
117 Z-000D50D5 3575015102600001 SUHARTIK 61 LANSIA JL. GATOT SUBROTO 2/7 - BUKIR 8969958264 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
118 Z-0001AUJL 3575014505590003 NADIFAH 62 LANSIA JL BANDA GG MAWAR - CoronaVac 23/06/2021 24002621 18/11/2021 24007021
119 Z-0001B1IG 3575010107580065 SUTRISNO 63 LANSIA JL BANDA GG MAWAR - CoronaVac 23/06/2021 24002621 18/11/2021 24007021
120 Z-000D4UVE 3575011110580002 SUNARIYO 65 LANSIA JL SLAMET RIYADI 003/003 GENTONG 8575537795 CoronaVac 21/10/2021 C202106115 18/11/2021 24007021
121 P-FNHMU8OB 3575011003090002 MOCH. FIRDAUS 12 REMAJA jl halmahera 8234204711 CoronaVac 18/11/2021 24007021
122 P-CXRC82DJ 3575014902050002 KHUSNUL KHOTIMAH 16 REMAJA jl hangtuah 8594343504 CoronaVac 18/11/2021 24007021
123 P-DXBF6YXL 3575010107050018 NAVA ARDI ANSYAH 16 REMAJA jl banda 5/2 gadingrejo 8113777705 CoronaVac 18/11/2021 24007021
124 P-DX5RLJKO 3575014801050002 SITI HAMIDAH 16 REMAJA jl halmahera 8773645524 CoronaVac 18/11/2021 24007021
125 P-IOCW8PH9 3509080112040002 ARIES 17 REMAJA jl kyai sepuh 8311452631 CoronaVac 18/11/2021 24007021
126 P-INPTWLPO 3575014908940001 EVI NUR MAULIDIYAH 27 UMUM jl kyai sepuh 8967884986 CoronaVac 18/11/2021 24007021
127 P-IPP5PXDM 3575014107910001 SITI AMINAH 29 UMUM jl slamet riyadi 1/1 sebani 8121746109 CoronaVac 18/11/2021 24007021
128 S-04D6413E 3575014101590012 SULISWATI 62 LANSIA jl timor timur 3/1 gadingrejo 8113777705 CoronaVac 18/11/2021 24007021

Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-13SWDSYI 3575017101980001 UNSIA 24 UMUM JL IRIAN JAYA GG ANGGREK 8199919592 CoronaVac 19/11/2021 24007021
2 P-6889ZIOX 3575012308040001 FAISAL ADJI PRASETYO 17 REMAJA JL IRIAN JAYA 8224567843 CoronaVac 19/11/2021 24007021
3 Q-001GTWBC 3575015909090001 YENITA FITRI SEPTIASA 12 REMAJA JL URIP SUMOHARJO 3/8 BUKIR 8311450636 CoronaVac 22/10/2021 C202106115 19/11/2021 24007021
4 Z-000AX7RQ 3575014107600110 SITI CHOLISAH 61 LANSIA JL HANGTUAH GG 4 8312515640 CoronaVac 16/09/2021 202108118H 19/11/2021 24007021
5 Q-001GUFA0 3575016111850004 SUCI INDRAWATI 36 UMUM JL SLAMET RIYADI 003/003 GENTONG 8575537795 CoronaVac 22/10/2021 C212106115 19/11/2021 24007021
6 Q-000I9IPM 3575012906990001 MOHAMAD DIMAS MAHENDRA 22 UMUM JL SLAMET RIYADI RT01/RW06 SEBANI 8785068824 CoronaVac 19/07/2021 24200421 19/11/2021 24007021
7 Q-000S22UB 3578174505850007 IKA HERLINA 36 UMUM POGOT 6/36-J 8125943558 CoronaVac 01/09/2021 24202521 19/11/2021 24007021
8 Q-0018I7S8 3514132010050003 REVI JIHAD FISABILILLAH 16 REMAJA JL TENGIRI I/407 BENDOMUNGAL 8214091580 CoronaVac 05/10/2021 202108172F 19/11/2021 24007021
9 Q-000S7HME 3575014903780002 FARIDA 43 UMUM JL HANGTUAH 4/3 GADINGREJO 8788714964 CoronaVac 01/09/2021 2021071371 19/11/2021 24007021
10 Q-000HUULY 3575020908910001 AGUS SUPRIADI 30 UMUM JL. SLAMET RIYADI 8578588937 CoronaVac 17/07/2021 24200421 19/11/2021 24007021
11 K-00023K44 3575011507990001 RISWANTO 22 UMUM jl Slamet Riadi , Gadingrejo, KOTA PASURUAN, J 8585202789 CoronaVac 09/10/2021 202108172F 19/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-2OU4WPQ7 3514124209000002 ERVINA SHOFWATUL QOLBIYAH 21 UMUM jl urip sumoharjo bukir 8311769097 CoronaVac 20/11/2021 24007021
2 Q-001G9YMH 3575011906050001 MOCH. RAYHAN DWI HADIANSYAH 16 REMAJA JL BANDA GADINGREJO 8967023261 CoronaVac 21/10/2021 C202106115 20/11/2021 24007021
3 Q-001FOQP4 3575021702820005 AHMAD EFENDI 39 UMUM JL. SLAMET RIYADI - SEBANI 8525886312 CoronaVac 19/10/2021 C202106115 20/11/2021 24007021
4 Q-001FITI5 3575015111040003 FITRIA AMALIA 17 REMAJA JL HALMAHERA XI GADINGREJO 8579178913 CoronaVac 19/10/2021 C202106115 20/11/2021 24007021
5 Q-001EYWZC 3575014205050003 KUSNUL KHOTIMAH 16 REMAJA JL HANGTUAH IV 8528085541 CoronaVac 18/10/2021 C202106115 20/11/2021 24007021
6 Z-000D70Q4 3575010101560009 ENTIN SURYADI 65 LANSIA JL SLAMET RIYADI 1/3 GENTONG 8113777705 CoronaVac 22/10/2021 C202106115 20/11/2021 24007021
7 Q-0010QQHE 3575011910060004 ANDI IRAWAN 15 REMAJA jl hangtuah 1/3 gadingrejo 8233103290 CoronaVac 21/09/2021 202108118H 20/11/2021 24007021
8 Q-001H9Y3Q 3575011703070003 MOCH. RIZQI ALFIANSYAH 14 REMAJA JL HANGTUAH 2/3 GADINGREJO 8523613284 CoronaVac 23/10/2021 C202106115 20/11/2021 24007021
9 Q-001HES0U 3575014107730112 JUMAATI 48 UMUM JL HANGTUAH 8113777705 CoronaVac 21/10/2021 C202106115 20/11/2021 24007021
10 Q-001GWZD8 3575012805910001 FATKHAN ZAINURI 30 UMUM JL KYAI SEPUH 001/005 8560704747 CoronaVac 22/10/2021 C202106115 20/11/2021 24007021
11 Q-001GXUF5 3575014508890001 IDA RAKHMAWATI 32 UMUM JL KYAI SEPUH 001/005 GENTONG 8560704747 CoronaVac 22/10/2021 C212106115 20/11/2021 24007021
12 P-2S2GLQZ9 3575010911970003 ILHAM HAKIM 24 UMUM jl hangtuah 1/4 gadingrejo 8113777705 ASTRA ZENECA 20/11/2021 A1067
13 P-2V99O6TQ 3575010107730147 SULAIMAN 48 UMUM jl hangtuah gadingrejo 8113777705 ASTRA ZENECA 20/11/2021 A1067
14 P-3C9Y2523 3575010207990002 MUKHAMMAD AGUNG LAKSONO 22 UMUM jl slamet riyadi 3/3 gentong 8155493899 ASTRA ZENECA 20/11/2021 A1067
15 P-5BDRJDZI 3575014208960001 EMILDA FAUZIATUL UMROH 24 UMUM jl urip sumohrjo 2/1 bukir 8313434705 ASTRA ZENECA 20/11/2021 A1067
16 Q-000ORTTM 3575014107020041 LIZA ROVANIA 19 UMUM JL HANGTUAH GADINGREJO 8125077260 ASTRA ZENECA 23/08/2021 K004A 20/11/2021 A1067
17 Q-000QAT2Z 3575013006830003 SUBANDI 38 UMUM JL HANGTUAH RW 3 RT 3 GADINGREJO 8814375004 ASTRA ZENECA 28/08/2021 PV46700 20/11/2021 A1067
18 Q-000O70TU 3514160309940001 KHOIRUL ANAM 27 UMUM JL URIP SUMOHARJO BUKIR 8313434705 ASTRA ZENECA 20/08/2021 210050 20/11/2021 A1067
19 Q-000QAUEQ 3575014103840003 CHOTIMAH 37 UMUM JL HANGTUAH RT 1 RW 3 GADINGREJO 8223260711 ASTRA ZENECA 28/08/2021 PV46700 20/11/2021 A1067
20 Q-000N0MK8 3575025805790001 EMY HARIATI 42 UMUM KRAPYAKREJO 6/7 8523337110 ASTRA ZENECA 14/08/2021 210050 20/11/2021 A1067
21 Q-000N0MJV 3575022308020001 MOCHAMAD ABDILLAH CHUSNUN 19 UMUM KRAPYAKREJO RT 6 RW 7 8223020864 ASTRA ZENECA 14/08/2021 210050 20/11/2021 A1067
22 Z-0009S02O 3514134812860002 FITRA RAHIM 35 UMUM DUSUN GERSIKAN RT 1 RW 1 KEDUNGRINGIN B 8573600288 ASTRA ZENECA 28/08/2021 PV46700 20/11/2021 A1067


Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003

Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
INDUK
1 K-0000PAYN 3510132211950001 PAULUS WIJAYA SURYADI 26 UMUM JL. BAJANG RATU NO. 47 8229555675 ASTRA ZENECA 24/08/2021 K004A 22/11/2021 A1067
2 Q-000NDQTJ 3526111008850001 MOHAMMAD MUFIED 36 UMUM PERUM LUMBUNG PADI NO 43 4/1 SEBANI 8113306048 ASTRA ZENECA 16/08/2021 ABY1911 22/11/2021 A1067
3 Q-000P05QE 3575010703830006 KHUZAINI 38 UMUM JL BANDA GADINGREJO 8213966201 ASTRA ZENECA 24/08/2021 A1024 22/11/2021 A1067
4 Q-000QARGJ 3575014107820055 NUR KHASANAH 39 UMUM JL BANDA RT 5 RW 2 GADINGREJO 8113777705 ASTRA ZENECA 28/08/2021 PV46700 22/11/2021 A1067
5 Q-000PUI11 3575015711820002 KHUSNUL HOTIMAH 39 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 22/11/2021 A1067
6 Q-000PUVP6 3575015102660001 JUMIATI 55 RENTAN JL GATOT SUBROTO BUKIR 8580713793 ASTRA ZENECA 26/08/2021 PV46700 22/11/2021 A1067
7 Q-000P2V68 3575010708630002 IKSAN BISRI 58 RENTAN JL IRIAN JAYA 2/3 GADINGREJO 8113777705 ASTRA ZENECA 24/08/2021 K004A 22/11/2021 A1067
8 P-BNGAS89Z 3575010302020002 NUR CHOLES FEBRIANTO 19 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 22/11/2021 A1067
9 P-ARUFIJ5T 3575012208000001 ACHMAD ARIS 21 UMUM JL SLAMET RIYADI 2/3 GENTONG 8316404285 ASTRA ZENECA 22/11/2021 A1067
10 P-9VOFVBM0 3575012408990002 MOCH CHARIS 22 UMUM JL BANDA GG TERATAI GADINGREJO 8880522833 ASTRA ZENECA 22/11/2021 A1067
11 P-AZIEE6JH 3575012108990002 JUNAIDI 22 UMUM JL SLAMET RIYADI 2/1 GENTONG 8951339555 ASTRA ZENECA 22/11/2021 A1067
12 P-FWNB5FZO 3575011610980001 SAMSUL ARIFIN 23 UMUM JL SLAMET RIYADI 8384296073 ASTRA ZENECA 22/11/2021 A1067
13 J-0006K5H4 3575011604980001 MUKHAMAD ALFIAN DARMAWAN 23 UMUM JL GATOT SUBROTO BUKIR 8967904848 ASTRA ZENECA 22/11/2021 A1067
14 P-9F1C4KSU 3507204108970004 INTAN MAULIDATUR RIZQIYAH 24 UMUM JL GATOT SUBROTO 2/5 SEBANI 8823091804 ASTRA ZENECA 22/11/2021 A1067
15 P-G2ZIWFXC 3575012905920001 KHOIRUL ANWAR 29 UMUM JL HANGTUAH 1/3 GADINGREJO 8573251908 ASTRA ZENECA 22/11/2021 A1067
16 P-8XH2N5GX 3575010705880003 ABDUL ROCHMAN 33 UMUM JL HANGTUAH 3/4 GADINGREJO 8311196200 ASTRA ZENECA 22/11/2021 A1067
17 P-FQTZEIBY 3575010701860002 MOKHAMAD SOLIKHIN 35 UMUM JL BANDA 3/2 GADINGREJO 8383057170 ASTRA ZENECA 22/11/2021 A1067
18 P-8JQKD7ET 3575016807830001 SULISTYO WANDENI 38 UMUM JL URIP SUMOHARJO 1/2 BUKIR 8233398058 ASTRA ZENECA 22/11/2021 A1067
19 P-G6ZJII11 3575016504780003 ST. KHOTIJAH 43 UMUM JL BANDA 3/3 GADINGREJO 8574843858 ASTRA ZENECA 22/11/2021 A1067
20 P-F6E507VE 3575011205740002 WILDAN ABDUL HAFID SYEBAN 47 UMUM JL PUNTA DEWA 2/8 GENTONG 8121640200 ASTRA ZENECA 22/11/2021 A1067
21 P-B1ALZO06 3575010804690003 ABDUL GOFUR 52 RENTAN JL AYANI 5/1 GADINGREJO 8574923926 ASTRA ZENECA 22/11/2021 A1067
22 P-FCVGFK8M 3575014208660002 CHUNDARIYANI 55 RENTAN JL BANDA 3/2 GADINGREJO 8383057170 ASTRA ZENECA 22/11/2021 A1067
23 P-23GIC75C 3575012305630003 MIHARTO 58 RENTAN JL KYAI SEPUH GADINGREJO 8576717689 ASTRA ZENECA 22/11/2021 A1067
24 P-FLWTHNGB 3575015211630001 LILIK HARIATI 58 RENTAN JL BANDA 3/2 GADINGREJO 8383057170 ASTRA ZENECA 22/11/2021 A1067
25 P-A615MWCM 3507200101070001 M. NABIL AZMI ALMAS 14 REMAJA JL GATOT SUBROTO SEBANI 8823091804 CoronaVac 22/11/2021 24007021
26 Q-001IAD08 3575044308060001 WULANDARI 15 REMAJA JL. HANGTUAH 3/2 - GADINGREJO 8315326331 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
27 Q-001I82EJ 3575011407030002 M. REZA EKA JULIANTO 18 UMUM JL. HALMAHERA 5/5 - GADINGREJO 8583801208 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
28 Q-000S7HE3 3575011402010001 ANDI CAHYO UTOMO 20 UMUM GADINGREJO RT 4 RW 1 8523632667 CoronaVac 01/09/2021 2021071371 22/11/2021 24007021
29 Q-0012FY8O 3514234507990002 SITI ZAHRO 21 UMUM JL. BANDA GG MAWAR 006/002 DS. GADINGR 8589350251 CoronaVac 23/09/2021 202108154G 22/11/2021 24007021
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
30 Q-001I0JAU 3575015809000002 LAILA ALIEF MAULIDIA HERKAMTO 21 UMUM JL SLAMET RIYADI 3/4 SEBANI 8113777705 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
31 Q-0008IY5V 3575011708000002 TOMI HERMANSYAH 21 UMUM JL SLAMET RIADI NO 8311472481 CoronaVac 26/06/2021 24200821 22/11/2021 24007021
32 Q-000I9O0V 3575012007950004 ROSIDI 26 UMUM JL BANDA GG MAWAR 8570862500 CoronaVac 19/07/2021 24200421 22/11/2021 24007021
33 Q-001I0JBY 3575010603940001 AKHMAD LUTFI 27 UMUM JL KYAI SEPUH 2/5 8956153902 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
34 Q-001HFOII 3575015909930001 IIN KURNIAWATI 28 UMUM JL HALMAHERA 8123627407 CoronaVac 21/10/2021 C202106115 22/11/2021 24007021
35 Q-001HZU6I 3575015208900003 NUR AZIZAH 31 UMUM JL HALMAHERA GADINGREJO 8823862724 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
36 Q-001HEY5R 3575030405850002 MUHAMMAD HUSEIN 33 UMUM JL HALMAHERA 8123627407 CoronaVac 21/10/2021 C202106115 22/11/2021 24007021
37 Q-000NFJUF 3575015004870001 SUAIBAH 34 UMUM KARANGKETUG 8383217192 CoronaVac 16/08/2021 24202221 22/11/2021 24007021
38 K-0001WYZC 3575031103860001 NGAHADI 36 UMUM JL HALMAHERA GADINGREJO 8575458872 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
39 Q-000NFK0C 3575012208840001 ILHAM YUSUF 37 UMUM KARANGKETUG 8384178047 CoronaVac 16/08/2021 24202221 22/11/2021 24007021
40 Q-000R97NW 3575010109830003 ABDUL KARIM 38 UMUM JL HANG TUA 1/3 GADINGREJO 8384665838 CoronaVac 30/08/2021 24202221 G 22/11/2021 24007021
41 Q-0016E5W0 3575022703820006 MOKHAMAT TOYIB 39 UMUM JL SLAMET RIYADI 2/6 SEBANI 8533913619 CoronaVac 30/09/2021 202108154G 22/11/2021 24007021
42 Q-001HEF3Z 3575012608820002 DJUMA'ALI 39 UMUM JL HALMAHERA 8315326339 CoronaVac 21/10/2021 C202106115 22/11/2021 24007021
43 Q-001JE9DT 3575011107820005 SUMANTRI 39 UMUM HALMAHERA 5/5 8570757110 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
44 Q-001JEAYX 3575015001800004 NUR LAILA 41 UMUM HALMAHERA 5/5 8383319753 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
45 Q-001I8Y2D 3575011001800006 M. IDHAM HURI 41 UMUM JL. HALMAHERA 5/5 - GADINGREJO 8583801208 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
46 Q-001IXQY5 3575020707800007 CHOIRUL HUDA 41 UMUM SEBANI RT02 RW04 8121705214 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
47 Q-001IXHKR 3575010404770001 SUJA'I 42 UMUM JL. SLAMET RIYADI 3/2 - SEBANI 8565555376 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
48 P-3AVW3M00 3575011007790004 ZAINUL ARIFIN 42 UMUM HALMAHERA 2/5 8113777705 CoronaVac 26/10/2021 C202106115 22/11/2021 24007021
49 Q-001I32SH 3514160411750002 ZAINI 46 UMUM MUNENG BENDUNGAN 8384846035 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
50 Q-001I2G3P 3575015708740007 KHAMIDAH 47 UMUM JL SLAMET RIYADI 3/4 SEBANI 8123492962 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
51 Q-001JCDX3 3575014107740056 RATNASARI 47 UMUM HALMAHERA 4/5 8113777705 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
52 Q-001KT2F0 3575014107740084 MAIMUNAH 47 UMUM HALMAHERA 1/5 8113777705 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
53 Q-001JD49V 3575010107720068 M. ALI 49 UMUM HALMAHERA 4/5 8125240151 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
54 Q-001IXJDF 3513105401710002 MUAMILAH 50 RENTAN SEBANI RT02 RW06 8213107963 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
55 Q-001I2L3D 3575012012700001 CHOLIB 51 RENTAN JL HANGTUAH 6/4 GADINGREJO 8311109898 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
56 Q-001IXFWP 3575014209630003 MARIYAH ULFAH 52 RENTAN JL GATOT SUBROTO 1/4 - SEBANI 8113777705 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
57 Q-001IAC0S 3575015204680002 NAIMA 53 RENTAN JL HALMAHERA 3/5 - GADINGREJO 8315326331 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
58 Q-001HWMJN 3575014306680001 RUQOIYAH 53 RENTAN JL SLAMET RIYADI 002/001 GENTONG 8523653984 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
59 Q-001F3IOT 3514161512650005 SUTIYON 56 RENTAN GUMENG 003/006 KALIREJO KRATON 8224565954 CoronaVac 18/10/2021 202108146H 22/11/2021 24007021
60 Q-000BIG9X 3575010110620001 SUBANDI 59 RENTAN JL URIP SUMOHARJO 8224565182 CoronaVac 05/07/2021 24003521 22/11/2021 24007021
61 Q-001HX40C 3575010202610001 ABDUL GHOFUR 59 RENTAN JL SLAMET RIYADI 002/001 GENTONG 8523653984 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
62 Z-000DJ861 3575010101580036 SAURIP 63 LANSIA JL SLAMET RIYADI 8213926648 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
63 Z-0007FB7A 3575014107560061 RUSMIATIN 65 LANSIA JL HALMAHERA 66 XI GADINGREJO 8113777705 CoronaVac 16/07/2021 24200421 22/11/2021 24007021
PUSTU BUKIR
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
1 Q-001GNHUY 3575012204980001 MUCLASON 23 UMUM JL. GATOT SUBROTO 1/7 - BUKIR 83117056414 CoronaVac 21/10/2021 C202106115 22/11/2021 202108178F
2 Q-001H3YYE 3575016810910005 MUFIDAH 30 UMUM JL. URIP SUMOHARJO 1/8 - BUKIR 89682298706 CoronaVac 23/10/2021 C202106115 22/11/2021 24007021
3 Q-001HV15M 3575015711900001 ULUM MAISAROH 31 UMUM JL. GATOT SUBROTO 1/7 - BUKIR 89699207084 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
4 Q-001HL880 3575020501870001 YEYEN JANUARI SETYOBUDI 34 UMUM JL. GATOT SUBROTO 2/6 - BUKIR 85757570775 CoronaVac 23/10/2021 C202106115 22/11/2021 24007021
5 Q-001HWJHO 3575016708820001 MAULINAWATI 39 UMUM JL. GATOT SUBROTO 1/2 - BUKIR 83848320117 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
6 Q-001EZXDN 3575015006790007 SITI HINDUN 42 UMUM JL URIP SUMOHARJO BUKIR 85334944082 CoronaVac 18/10/2021 C202106115 22/11/2021 24007021
7 Q-001EZBVP 3575015505760007 MIMA NUR ZAKIYAH 45 UMUM JL URIP SUMOHARJO RW 01 RT 003 BUKIR 89699436878 CoronaVac 18/10/2021 C202106115 22/11/2021 24007021
8 Q-001HKQDW 3575015504760001 SUPATMI 45 UMUM JL. GATOT SUBROTO 2/7 - BUKIR 81259470733 CoronaVac 23/10/2021 C202106115 22/11/2021 24007021
9 Q-001HV1L1 3575014701720001 KHOWILAH 49 UMUM JL. GATOT SUBROTO 1/7 - BUKIR 89699207084 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
10 Q-001HLCYR 3575015202710002 DAIPAH 53 RENTAN JL. GATOT SUBROTO 5/7 - BUKIR 89654983318 CoronaVac 23/10/2021 C202106115 22/11/2021 202108178F
11 Q-0017HUDQ 3575015005680003 ST. CHOTIDJAH 53 RENTAN JL. GATOT SUBROTO BUKIR 8113777705 CoronaVac 02/10/2021 202108154G 22/11/2021 24007021
12 Z-000E5JQH 3575015411570001 MUSTIKA EMY 64 LANSIA BUKIR RT01/RW02 8999434951 CoronaVac 25/10/2021 C202106115 22/11/2021 24007021
13 Z-000B1HUC 3575016403440001 TASNI 77 LANSIA JL URIP SUMOHARJO 89654983318 CoronaVac 18/10/2021 C202106115 22/11/2021 24007021
14 S-DB2B4DFE 3575010505520001 AMIR 67 LANSIA JL. GATOT SUBROTO 4/7 - BUKIR 85258411968 CoronaVac 22/11/2021 24007021
15 P-JJSTQWKM 3575011505750008 SUHARTONO 45 UMUM JL. GATOT SUBROTO R03 RW07 - BUKIR 87851079348 CoronaVac 22/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-39WX4GMU 3514070505950003 MUHAMMAD LUQMAN HAKIM 26 UMUM jl hangtuah 2/4 gadingrejo 8113777705 ASTRA ZENECA 23/11/2021 A1067
2 P-45BR82BM 3575014107910096 PONIRAH 30 UMUM jl halmahera 2/3 gadingrejo 8113777705 ASTRA ZENECA 23/11/2021 A1067
3 P-APFCYLV2 3575011101870001 ABDUL ROKHMAN 34 UMUM jl kyai sepuh 1/5 gentong 8573663948 ASTRA ZENECA 23/11/2021 A1067
4 P-64HT4VQV 3575010508830001 ABDUL ROSID 38 UMUM JL KYAI SEPUH GG. 21 8383153774 ASTRA ZENECA 23/11/2021 A1067
5 P-9UJ0F04G 3575012701810003 MULYONO 40 UMUM jl gatot subroto 1/7 bukir 8223483753 ASTRA ZENECA 23/11/2021 A1067
6 P-548L86LF 3575015705810002 MUFAD 40 UMUM JL HALMAHERA 1/5 GADINGREJO 8235247860 ASTRA ZENECA 23/11/2021 A1067
7 P-CTPOZMUP 3575014107830100 SITI MUNAWAROH 40 UMUM JL HALMAHERA 3/5 GADINGREJO 8113777705 ASTRA ZENECA 23/11/2021 A1067
8 P-8VVA7R6Q 3575012012720003 MOCH.LUKMANUDIN 49 UMUM PERUM NUANSA CANDI 1 NO 45 8223338760 ASTRA ZENECA 23/11/2021 A1067
9 P-2PP7V2XC 3575011105710001 IMRON HASAN JAJULI 50 RENTAN JL HANGTUAH 3/4 GADINGREJO 8113777705 ASTRA ZENECA 23/11/2021 A1067
10 P-4HPGKWPK 3575015211690001 SUJARWATI 54 RENTAN jl slamet riyadi 1/2 gentong 8113777705 ASTRA ZENECA 23/11/2021 A1067
11 P-5APP3LI4 3403022506650003 SUGIYANTO 56 RENTAN jl maluku 1/4 trajeng 8113777705 ASTRA ZENECA 23/11/2021 A1067
12 P-4NA35SFQ 3575015307640001 FATIMAH 57 RENTAN JL SLAMET RIYADI 8564999766 ASTRA ZENECA 23/11/2021 A1067
13 Q-000K41VD 3575016011850003 RIZKY RAVITA SUWARNO 36 UMUM JL SLAMET RIADI GG 7 GENTONG 8223050777 ASTRA ZENECA 29/07/2021 ABY1911 23/11/2021 A1067
14 Q-000K4AL3 3575010204910001 PRIYO PRASTIKKO 30 UMUM JL SLAMET RIYADI, JAWA TIMUR, KOTA PASU 8383383381 ASTRA ZENECA 29/07/2021 ABY1911 23/11/2021 A1067
15 Q-000QAWBS 3575015007790006 MAIMUNAH 42 UMUM JL HANGTUAH RT 1 RW 3 GADINGREJO 8383111623 ASTRA ZENECA 28/08/2021 PV46700 23/11/2021 A1067
16 Q-000NSETH 3575012006750001 M TAUFIK 46 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8233385044 ASTRA ZENECA 18/08/2021 210050 23/11/2021 A1067
17 Q-000O9XPY 3575011110020001 MUHAMMAD ABDUL HAMID 19 UMUM JL SLAMET RIYADI SEBANI 8123753617 ASTRA ZENECA 20/08/2021 210050 23/11/2021 A1067
18 Q-000O9XOF 3575012512020001 MOCHAMAD ICHWAN ABDILLAH 19 UMUM SEBANI GADINGREJO 8953258376 ASTRA ZENECA 20/08/2021 210050 23/11/2021 A1067
19 Q-000L3MUZ 3514072412840001 BUHARI 37 UMUM BUKIR R 1 RW 8 8123458548 ASTRA ZENECA 05/08/2021 ABY1911 23/11/2021 A1067
20 Q-000QAUE2 3575016309890001 LULUK IMAMA 32 UMUM JL HANGTUAH RT 1 RW 3 GADINGREJO 8191816586 ASTRA ZENECA 28/08/2021 PV46700 23/11/2021 A1067
21 Q-000PUG11 3575015007790002 SUGIATI 42 UMUM JL HANGTUAH 1/3 GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 23/11/2021 A1067
22 Q-000XG6YQ 3575014502030002 MIFTAKHUL JANNAH 18 UMUM JL HANGTUAH GG 2 01/03 GADINGREJO 8581541920 ASTRA ZENECA 14/09/2021 A1050 23/11/2021 A1067
23 Q-000PV3RS 3575014101770027 KHAYATI 45 UMUM JL BANDA 5/2 GADINGREJO 8113777705 ASTRA ZENECA 26/08/2021 PV46700 23/11/2021 A1067
24 Q-000NSEET 3575012007750002 SUPRATMAN 46 UMUM JL BANDA 5/2 GADINGREJO 8235170775 ASTRA ZENECA 18/08/2021 210050 23/11/2021 A1067
25 Q-000PV383 3575011404990003 SALAMUN 22 UMUM JL BANDA 5/2 GADINGREJO 8214075214 ASTRA ZENECA 26/08/2021 PV46700 23/11/2021 A1067
26 P-3C2RM5OQ 3575016809090001 BILGIS ABIGAIL ALDA 12 REMAJA JL IRIAN JAYA GG ANGREK 8121765948 CoronaVac 23/11/2021 24007021
27 P-EBUUDQMW 3575011401060002 ULUL ABSOR 15 REMAJA JL HANGTUAH 2 GADINGREJO 8113777705 CoronaVac 23/11/2021 24007021
28 S-A0817949 3575011010600006 SUGIANTO 62 LANSIA jl halmahera 2/3 gadingrejo 8113777705 CoronaVac 23/11/2021 24007021
29 Q-001HGOPN 3575016005060005 KHOIRUN NISAH 15 REMAJA GENTONG RT 02 RW 05 GADINGREJO 8810264214 CoronaVac 23/10/2021 C202106115 23/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 Q-001HEUN5 3575016305060002 UKHTUNA FIRDA 15 REMAJA RT 001 RW 001 8121795428 CoronaVac 23/10/2021 C202106115 23/11/2021 24007021
31 Q-001OFHBI 3575015910040002 SURYA DEWI MAHARANI 17 REMAJA JL IRIAN JAYA I / 57 RT 01 RW RW 06 KARANG 8383598719 CoronaVac 26/10/2021 202108154G 23/11/2021 24007021
32 Q-000Z404T 3575012709020001 MAULANA FARDIANSYAH 18 UMUM JL SLAMET RIYADI 2/3 GENTONG 8384606494 CoronaVac 17/09/2021 202108118H 23/11/2021 24007021
33 Q-001JKGQY 7271032704930007 MOCH. BUKHORI 27 UMUM GAMBIRAN DESA GAMBIR KUNING KEC.KRATO 8575557662 CoronaVac 24/09/2021 202108154G 23/11/2021 24007021
34 Q-001IX1PP 3514171001900003 ABDUL MAJID 31 UMUM SEBANI RT02 RW01 8123982101 CoronaVac 25/10/2021 C202106115 23/11/2021 24007021
35 Q-001IJO7H 3514176203910001 MAISAROH 31 UMUM JL. GATOT SUBROTO 1/7 - BUKIR 8233483560 CoronaVac 26/10/2021 C202106115 23/11/2021 24007021
36 Q-001IWXU1 3575010306900002 FATKHUR ROZY 31 UMUM JL. SLAMET RIYADI 4/2 - SEBANI 8125961299 CoronaVac 26/10/2021 C202106115 23/11/2021 24007021
37 Q-001OFHA9 3575014206870001 DWI YUNI SUHARTINI 34 UMUM JL IRIAN JAYA I / 58 RT 01 RW 06 KARANGANY 8233380334 CoronaVac 26/10/2021 202108154G 23/11/2021 24007021
38 Q-001GMC3J 3523084104860005 MURTI 34 UMUM SEBANI PASURUAN 8113577770 CoronaVac 21/10/2021 C202106115 23/11/2021 24007021
39 Q-001BHJN1 3575014712870004 KHUSNUL KHOTIMAH 34 UMUM JL HANGTUA 3/3 8810270084 CoronaVac 12/10/2021 202108172F 23/11/2021 24007021
40 Q-001FN028 3575015603830006 ROKHAYATIK 38 UMUM JL SIMPANG SLAMET RIYADI 01/02 SEBANI GA 8223478213 CoronaVac 19/10/2021 C202106115 23/11/2021 24007021
41 Q-001IJVQ1 3575025704760001 MASLUKHA 45 UMUM JL LAKS MARTADINATA MAYANGAN 8123398077 CoronaVac 26/10/2021 C202106115 23/11/2021 24007021
42 Q-001JBM9C 3510174808750002 RITA RUSIYANTI 46 UMUM HALMAHERA 3/5 8113777705 CoronaVac 25/10/2021 C202106115 23/11/2021 24007021
43 Q-0012HJ1E 3575016008670003 SAUDAH 54 RENTAN JL HALMAHERA 3/5 GADINGREJO 8113777705 CoronaVac 23/09/2021 202108123H 23/11/2021 24007021
44 Q-0018VFV3 3520134107590045 MARINAH 62 LANSIA DS. KAUMAN RT 03/02 8133320610 CoronaVac 06/10/2021 202108172 23/11/2021 24007021
45 Z-0000ICFO 3575011408590001 SUROYO 62 LANSIA JL GATOT SUBROTO - CoronaVac 14/06/2021 24002621 23/11/2021 24007021
46 Z-000E5JQB 3575014505620001 ELIS YULIASTUTIK 63 LANSIA PERUM KARYA BAKTI / GENTONG 8214012660 CoronaVac 25/10/2021 C202106115 23/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
INDUK
1 P-CQMIJ03G 3575012107010005 FAISOL 20 UMUM JL HANGTUAH 2/4 GADINGREJO 8383374819 ASTRA ZENECA 24/11/2021 A1067
2 P-HWK3K4KZ 3575011807010003 ACH SYAHRUL 20 UMUM JL HALMAHERA GADINGREJO 8128460639 ASTRA ZENECA 24/11/2021 A1067
3 P-DW7AMRQU 3575010107970037 MOCH SOLEH 24 UMUM JL IRIAN JAYA GADINGREJO 8133998337 ASTRA ZENECA 24/11/2021 A1067
4 P-9SYXRZP0 3575012805960005 MOCHAMAD RAFI 25 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
5 P-B9KBRT7F 3575010111950004 YOGI PRASETYO NUGROHO 26 UMUM JL GATOT SUBROTO 2/6 BUKIR 8125984730 ASTRA ZENECA 24/11/2021 A1067
6 P-AKJ8U0WC 3575010602900001 LUTFI 31 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
7 P-4TUUCVSX 3575011503890002 EKO WALUYO 32 UMUM SEBANI 1/6 8125924492 ASTRA ZENECA 24/11/2021 A1067
8 P-6D7QCMIQ 3575032811890002 MUKHAMAD NASRIL 32 UMUM JL HANGTUAH GADINGREJO 8314095031 ASTRA ZENECA 24/11/2021 A1067
9 P-9EOH5O8Y 3575012512890007 IMRON ROSYADI 33 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
10 P-DDS6LN0K 3575015809840001 NIKMATUL ULA 37 UMUM JL HANGTUAH 2/4 GADINGREJO 8533658423 ASTRA ZENECA 24/11/2021 A1067
11 P-F6UUMWTQ 3575010904820005 AKHMAD 39 UMUM JL IRIAN JAYA GADINGREJO 8133328295 ASTRA ZENECA 24/11/2021 A1067
12 P-8TBJQ43X 3575010107790064 SALMAN 42 UMUM JL HANGTUAG 1/4 GADINGREJO 8135953043 ASTRA ZENECA 24/11/2021 A1067
13 P-BH31CHXX 3575014601790005 YENI NARTI 42 UMUM JL SLAMET RIYADI 3/5 8191643504 ASTRA ZENECA 24/11/2021 A1067
14 P-0O4RTDL8 3575010306790001 ANANG ACHMADI 42 UMUM JL KALIMANTAN XII / 23 TRAJENG 8214473707 ASTRA ZENECA 24/11/2021 A1067
15 P-FYAVO2KC 3575014405730008 MARDIYAH 45 UMUM JL HANGTUAH 2/4 GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
16 P-BR9LYHJ0 3575015004750002 SITI FAUZAH 46 UMUM SEBANI 3/5 8585026027 ASTRA ZENECA 24/11/2021 A1067
17 P-AEXCVIF2 3575010107730112 SULAIMAN 48 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
18 P-FFPWRD7L 3575011402720001 YUSUP 49 UMUM JL BANDA 2/2 GADINGREJO 8133689405 ASTRA ZENECA 24/11/2021 A1067
19 P-8HNPW7F3 3575010710710002 ALIMAN 51 RENTAN JL HANGTUAH 5/4 GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
20 S-41CFC2BA 3575014210700001 SUMIATI 55 RENTAN JL SLAMET RIYADI 3/5 SEBANI 8585026027 ASTRA ZENECA 24/11/2021 A1067
21 P-A3H9TV4R 3575014107610056 RIFAATIL CHOIRIYAH 60 LANSIA JL HALMAHERA 6/4 GADINGREJO 8113777705 ASTRA ZENECA 24/11/2021 A1067
22 Q-000PSLTK 3514152703030002 MUHAMMAD FERI PRASNANDA 18 UMUM NGANGLANG 3/1 REMBANG 8968828380 ASTRA ZENECA 26/08/2021 PV46700 24/11/2021 A1067
23 Q-000Q1H0R 3575017012700002 ROFI'AH 51 RENTAN JL HALMAHERA 8123039541 ASTRA ZENECA 27/08/2021 PV46700 24/11/2021 A1067
24 Q-000NSL0V 3575010311960003 AKHMAD NAJIB 25 UMUM JL IRIAN JAYA GADINGREJO 8579187102 ASTRA ZENECA 18/08/2021 ABY1911 24/11/2021 A1067
25 Q-001J1IIF 3575012008070002 MOCHAMMAD RISQI FACHRUDIN 14 REMAJA JL. GATOT SUBROTO 3/5 - BUKIR 8572746486 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
26 Q-001HCHFN 3575016904070001 PUTRIAN NAURA AISYHANDA 14 REMAJA JL. SLAMET RIYADI SEBANI GADINGREJO 8133984757 CoronaVac 23/10/2021 C202106115 24/11/2021 24007021 G
27 Q-001J3TZI 3575016608050004 PUTRI SALSABILLA 16 REMAJA JL HANGTUAH 1/4 GADINGREJO 8135953043 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
28 Q-001J3OKQ 3575011606990003 SULTON 22 UMUM JL HANGTUAH 3/3 GADINGREJO 8885900311 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
29 Q-001J1II5 3575014912880002 MUTIMATUS ZAHRO 33 UMUM BUKIR RT03 RW05 8572746486 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
30 Q-001JC8VO 3575015512870002 RINTA SARI 34 UMUM SEBANI GADINGREJO 8123006431 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
31 Q-000VKF25 3575014501770001 MUNAWAROH 44 UMUM JL BANDA 4/3 GADINGREJO 8810257970 CoronaVac 09/09/2021 202108118H 24/11/2021 24007021 G
32 Q-001J3S9N 3575010607740001 MOCH. ROCHIM 47 UMUM JL. GATOT SUBROTO 3/5 - BUKIR 8953970040 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
33 Q-001J1EVP 3575012512730001 SUWADI 48 UMUM BUKIR RT RT03 RW05 8572746486 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
34 Q-001JBXQQ 3575015804630001 MARCHUMAH 58 RENTAN SEBANI 2/6 8128894312 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G
35 Q-001JBWZP 3575011603630001 SUNANDAR 58 RENTAN SEBANI 2/6 8128894312 CoronaVac 27/10/2021 C202106115 24/11/2021 24007021 G


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
INDUK
1 P-5BMXDPQ4 3575010406990001 MOCHAMMAD IKBAL 22 UMUM JL HALMAHERA GG 9 8133779899 ASTRA ZENECA 25/11/2021 A1067
2 P-DLGVHLCS 3514165212970001 LILIS KARLINA 23 UMUM JL HANGTUAH 1/3 GADINGREJO 8523012016 ASTRA ZENECA 25/11/2021 A1067
3 P-DFIU7FWK 3575010502870002 AGUNG CAHYONO 34 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8113777705 ASTRA ZENECA 25/11/2021 A1067
4 P-24189VV0 3575016104790001 CHOLILAH 42 UMUM JL HALMAHERA RT01/RW05 GADINGREJO 8133779899 ASTRA ZENECA 25/11/2021 A1067
5 P-A8OX0VFI 3575010107770096 CHUMAIDI 44 UMUM GADINGREJO 8113777705 ASTRA ZENECA 25/11/2021 A1067
6 P-7O85L1FL 3575014510760005 SALAMA 45 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8233270503 ASTRA ZENECA 25/11/2021 A1067
7 P-8GEBMDEF 3575011504750002 HANI PURWANTOKO 46 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8233270503 ASTRA ZENECA 25/11/2021 A1067
8 P-MHZYFKWQ 3575014405710003 SAYUTI 50 RENTAN jl hangtuah 3/3 GADINGREJO 8113777705 ASTRA ZENECA 25/11/2021 A1067
9 P-HKOE4161 3575014401690001 ROFI'AH 52 RENTAN JL MALUKU 1/2 TRAJENG 8113777705 ASTRA ZENECA 25/11/2021 A1067
10 P-CCB0T1UA 3575011210640002 MOCH HALLI 57 RENTAN JL HANGTUAH 2/4 GADINGREJO 8113777705 ASTRA ZENECA 25/11/2021 A1067
11 Q-0014GZBX 3514170401950002 ACHMAD SUKRI 26 UMUM KISIK 3/4 KALIREJO 8383384828 ASTRA ZENECA 27/09/2021 317710P 25/11/2021 A1067
12 Q-000OFGDL 3575012201030001 NUR FAJAR AMINULLAH 18 UMUM JL SLAMET RIADI 8953384393 ASTRA ZENECA 21/08/2021 K004A 25/11/2021 A1067
13 P-34NVQSJM 3575014906090002 INTAN NUR LAILI 12 REMAJA JL. KYAI SEPUH RT.001/006 KELURAHAN GE 8213529933 CoronaVac 29/10/2021 202108178F 25/11/2021 24007021
14 Q-001OE0XJ 3509061111080008 SAFARAZ AKMA FADIL 13 REMAJA Jl Ade Irma Suryani No 1 kel. Sebani Kec. Gadingr 8389729261 CoronaVac 26/10/2021 C202106115 25/11/2021 24007021
15 Q-001JTK9B 3575036310060002 SAFITRI RATNA UTAMI 15 REMAJA JL HALMAHERA RT01/RW05 TAMBAAN 8310525032 CoronaVac 28/10/2021 202108178F 25/11/2021 24007021
16 Q-001JTK9H 3575034909040001 NURI ALWANI 17 REMAJA JL HALMAHERA RT01/RW05 TAMBAAN 8822623789 CoronaVac 28/10/2021 202108178F 25/11/2021 24007021
17 Q-001JMQU5 3524246002020003 PUTRI ASMAUL KHOIROH 19 UMUM JL TENGKU UMAR RT03/RW01 SEBANI 8573087358 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
18 P-63PLPAFM 3575016512990001 INAS 22 UMUM PERUM KARYA BAKTI 4/7 GENTONG 8880365574 CoronaVac 29/10/2021 202108178F 25/11/2021 24007021
19 Q-001GORS9 3575012206710001 MUHAMMAD KHAFID 50 RENTAN Jl mulyorejo 8533040818 CoronaVac 21/10/2021 C202106115 25/11/2021 24007021
20 P-A20WUESX 3575010102060005 MOHAMMAD DZAKY WIDARMA LATE 15 REMAJA GADINGREJO 8233330008 CoronaVac 25/11/2021 24007021
21 S-04965B81 3575020703370001 ABDUL KARIM MUHAMMAD 84 LANSIA JL MARGO UTOMO NO 18 8179317001 CoronaVac 25/11/2021 24007021
PUSTU BUKIR
1 Q-001J4LBT 3575011804090001 PAMUNGKAS WAHYU DIONO 12 REMAJA JL. GATOT SUBROTO 3/5 - BUKIR 89699427450 CoronaVac 27/10/2021 C202106115 25/11/2021 24007021
2 Q-001GVBLP 3575012901080002 SATRIA BAGUS NUGROHO ARIANTO 13 REMAJA JL GATOT SUBROTO BUKIR 82158327055 CoronaVac 22/10/2021 C202106115 25/11/2021 24007021
3 Q-001HVPJH 3575015209000002 CHOIROTUN NISA' 21 UMUM JL. GATOT SUBROTO 1/6 - BUKIR 88298138241 CoronaVac 25/10/2021 C202106115 25/11/2021 24007021
4 Q-001J4JVZ 3575016910000003 RISKA NOVITA SARI 21 UMUM JL. GATOT SUBROTO 2/4 - BUKIR 82228597938 CoronaVac 27/10/2021 C202106115 25/11/2021 24007021
5 Q-001JMTWG 3575016503990001 NUNGKI SUKMAWATI 22 UMUM JL. PANG. SUDIRMAN GG. III 1/5 - KEBONAGUN 89699427450 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
6 Q-001J9C4Z 3575015901980001 LIANA AMALIA 23 UMUM SARIREJO 4/2 - ARJOSARI 881036219354 CoronaVac 27/10/2021 C202106115 25/11/2021 24007021
7 Q-001OFHAF 3575014504940002 YUNI KHASANA 27 UMUM JL. URIP SUMOHARJO 1/2 - BUKIR 82234146086 CoronaVac 26/10/2021 C202106115 25/11/2021 24007021
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
8 Q-001H3YXI 3575014706930001 AYU LESTARI 28 UMUM JL. GATOT SUBROTO - BUKIR 82359156543 CoronaVac 22/10/2021 C202106115 25/11/2021 202108178F
9 Q-001J1QLN 3514204104910001 ANITA PURNAMASARI 30 UMUM JL. URIP SUMOHARJO 3/2 - BUKIR 85648959313 CoronaVac 27/10/2021 C202106115 25/11/2021 24007021
10 Q-001JMWSD 3514182807880001 M.ABDI SOLEH 33 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 85259378115 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
11 Q-001JNGGA 3575011705870003 EKO WIRIYANTO 34 UMUM JL GATOT SUBROTO 5/7 - BUKIR 8814918656 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
12 Q-001JNGMA 3575026408870003 SITI HARIYANTI 34 UMUM JL GATOT SUBROTO 5/7 - BUKIR 8814918656 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
13 Q-001F2VN1 3575014909830001 EVI KRISTANTI 38 UMUM JL. URIP SUMOHARJO 1/3 - BUKIR 82142680774 CoronaVac 18/10/2021 C202106115 25/11/2021 24007021
14 Q-001OFHBC 3575015502810001 ANITA SETIYARINI 40 UMUM DSN PENAWANGAN 1/2 - BUKIR 89678755383 CoronaVac 26/10/2021 C202106115 25/11/2021 24007021
15 Q-001JOLP5 3575010205800001 MUHAMMAD SAIFUL 41 UMUM JL. GATOT SUBROTO 2/7 - BUKIR 8557293962 CoronaVac 28/10/2021 C202106115 25/11/2021 202108178F
16 Q-001OFHBW 3575017006780001 ATIM UMAMI 43 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 89508086376 CoronaVac 26/10/2021 C202106115 25/11/2021 24007021
17 Q-001JN0O3 3575011206770002 SUNARTO 44 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 82232585496 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
18 Q-001JTQ0I 3575016606780001 SAROFAH 44 UMUM JL. URIP SUMOHARJO 2/8 - BUKIR 895630274043 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
19 Q-001J4JYH 3575014109760003 SUGIYANTI 45 UMUM JL. GATOT SUBROTO 2/4 - BUKIR 82131074524 CoronaVac 27/10/2021 C202106115 25/11/2021 24007021
20 Q-001JTQCI 3575014102750002 KHOSIAH 46 UMUM JL. GATOT SUBROTO 3/4 - BUKIR 85733282961 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
21 Q-000N82Q2 3575012909750001 BUDI ARIANTO 46 UMUM Jl. Gatot Subroto 001/006 Bukir Gadingrejo Kab. P 81234727055 CoronaVac 15/08/2021 24201621 25/11/2021 24007021
22 Q-001JSA8B 3575011505640002 SLAMET 57 RENTAN JL URIP SUMOHARJO 895630274043 CoronaVac 28/10/2021 C202106115 25/11/2021 24007021
23 P-DE23OKZ0 3575010408090002 MOCHAMMAD WILDAN ROZAQ 12 REMAJA Jl. Gatot Subroto 88231337817 CoronaVac 25/11/2021 24007021
24 P-HTQBSXRW 3575014512990002 ICA NURMASITA 22 UMUM JL. GATOT SUBROTO 5/7 - BUKIR 83846241751 CoronaVac 25/11/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-PMGUZWUR 3202406512080002 DINI PERMATA SARI 13 REMAJA JL. IRIAN JAYA GG. ANGGREK RT.2 RT.2 GADI 8314268363 CoronaVac 27/11/2021 24007021
2 P-491E5UV7 3575015908040002 JIYADATUL ROHMANIA 17 REMAJA JL HALMAHERA RT05/RW 05 GADINGREJO 8775587151 CoronaVac 27/11/2021 24007021
3 P-3VSP5X0V 3575015510940003 SANIA 27 UMUM JL HANGTUAH GG2 01/03 GADINGREJO 8578425211 CoronaVac 27/11/2021 24007021
4 P-BVNTST6B 3575033010830004 MUHAMMAD JUNAIDI 38 UMUM JL MT HARYONO PANGGUNGREJO 8126580014 CoronaVac 27/11/2021 24007021
5 P-BR2DJUP2 3514040101820032 AHMAD FAISOL 39 UMUM DSN WERINGIN LUMBANG 8573253950 CoronaVac 27/11/2021 24007021
6 P-74WGKF40 3514204508700002 AMIN TUTIK 51 RENTAN KRAWAN KEDAWUNG WETAN 8383340426 CoronaVac 27/11/2021 24007021
7 S-AB55D7B0 3514163006600012 MOCH. IMRON 61 LANSIA bendungan kraton 8133415252 CoronaVac 27/11/2021 24007021
8 S-F035ECA0 3575011703580001 SUKIRMAN 62 LANSIA jl slamet riyadi 1/2 gentong 8113777705 CoronaVac 27/11/2021 24007021
9 Q-001JTS8F 3575011304080001 SAFIRA AL MAGHFIROH 13 REMAJA JL HANGTUAH GADINGREJO 8319274744 CoronaVac 28/10/2021 202108178F 27/11/2021 24007021
10 Q-001JCJHI 3514161507070025 M.IFAN SYAHPUTRA 14 REMAJA HALMAHERA 5/5 8574904898 CoronaVac 25/10/2021 C202106115 27/11/2021 24007021
11 Q-001KRQQF 3575011509060001 M. BAKHRUDDIN IKHYA' 15 REMAJA GADING PASURUAN 8224549051 CoronaVac 30/10/2021 202108178F 27/11/2021 24007021
12 Q-00181DGX 3575015710050001 NIA MAYSAROH OKTAVIA 16 REMAJA JL. IRIAN JAYA GG ANGGREK RT 1 RW 2 KEL 8573043104 CoronaVac 04/10/2021 202108172N 27/11/2021 24007021
13 Q-001KRYNL 3575011508050004 AGUS SIGIT CAHYONO 16 REMAJA JL GATOT SUBROTO PETAHUNAN 8953258377 CoronaVac 30/10/2021 202108178F 27/11/2021 24007021
14 Q-001KS1T7 3575012012050004 M. ARDHAN ALAMSYAH 16 REMAJA JL SLAMET RIYADI SEBANI 8311943081 CoronaVac 30/10/2021 202108178F 27/11/2021 24007021
15 Q-001HFSYK 3514166601020024 MUSLIKHAH 19 UMUM JL HALMAHERA 8585812129 CoronaVac 21/10/2021 C202106115 27/11/2021 24007021
16 Q-001FBMUE 3575010107850134 M. FAUZAN 36 UMUM JL HALMAHERA 8585983073 CoronaVac 18/10/2021 C202106115 27/11/2021 24007021
17 Q-001GYP4B 3575014607830003 ISTY QOMARIYAH 38 UMUM JL SLAMET RIYADI 8581522290 CoronaVac 22/10/2021 C202106115 27/11/2021 24007021
18 Q-001J29OR 3575015708830002 SOFI HIDAYATI 38 UMUM JL HANGTUAH 1/4 GADINGREJO 8314778820 CoronaVac 27/10/2021 C202106115 27/11/2021 24007021
19 Q-E9FB8ED3 3515131508820004 HERI PURWANTO 39 UMUM DSN. SAMBIBULU TAMAN KAB. SIDOARJO 8533440403 CoronaVac 30/03/2021 24000221 27/11/2021 24007021
20 Q-001H0XIO 3575015205800001 SRI WAHYUNI 41 UMUM JL SLAMET RIYADI 8123574468 CoronaVac 22/10/2021 C202106115 27/11/2021 24007021
21 Q-001IAPKG 3575014107720063 SUAENI 49 UMUM JL. HANGTUAH GG.4 2/4 - GADINGREJO 8311557898 CoronaVac 25/10/2021 C202106115 27/11/2021 24007021
22 Z-000CCZ75 3575014101570005 YANAH 64 LANSIA JL SLAMET RIADI GG 13 - CoronaVac 09/10/2021 202108172F 27/11/2021 24007021
23 P-88ZV6MOX 3575012012000001 ABDUL GHONI 21 UMUM JL HALMAHERA 1/5 GADINGREJO 8113777705 ASTRA ZENECA 27/11/2021 A1067
24 P-7OUAA52P 3575010208980004 HARIYONO 23 UMUM JL HALMAHERA 01/05 GADINGREJO 8113777705 ASTRA ZENECA 27/11/2021 A1067
25 S-6E39C224 3575012609950003 AKHMAD SIDDIQ 26 UMUM JL HALMAHERA 01/05 GADINGREJO 8123391912 ASTRA ZENECA 27/11/2021 A1067
26 P-63MDEF8J 3575014201940001 SILVIYANTI 27 UMUM JL GATOT SUBROTO 4/6 KARANGKETUG 8579617329 ASTRA ZENECA 27/11/2021 A1067
27 P-7UZGAA9U 3575014107940111 HINDUN 27 UMUM JL BANDA 5/2 GADINGREJO 8385057036 ASTRA ZENECA 27/11/2021 A1067
28 P-3VV3TG3Z 3575014107930097 NOVITA IRIANTI 28 UMUM jl hangtuah 1/3 gadingrejo 8113777705 ASTRA ZENECA 27/11/2021 A1067
29 P-5E3JR643 3575036006930001 NUR WAHYUNI 28 UMUM JL HANGTUAH GG. 02 8581666630 ASTRA ZENECA 27/11/2021 A1067
30 P-8GIPO4FW 3575015912930003 SITI NURJANNAH 28 UMUM JL HALMAHERA GADINGREJO 8191840022 ASTRA ZENECA 27/11/2021 A1067
31 P-5IUFTSWM 3575011107910001 NURIL ANWAR 30 UMUM JL SLAMET RIYADI 03/05 SEBANI 8579617329 ASTRA ZENECA 27/11/2021 A1067
32 P-4MKSLRIU 1102035707870004 HAIRAWATI 34 UMUM jl slamet riyadi 1/1 gentong 8121661573 ASTRA ZENECA 27/11/2021 A1067
33 P-7LTHB6GX 3575015309860006 MUCH. SAICHU 35 UMUM GADINGREJO 8113777705 ASTRA ZENECA 27/11/2021 A1067
34 P-3PRII122 3575014107870099 ROMELAH 37 UMUM jl hangtuah 1/4 gadingrejo 8113777705 ASTRA ZENECA 27/11/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
35 P-4YBRG4H4 3575014107840146 KUSNAH 37 UMUM jl halmahera 4/5 gadingrejo 8113777705 ASTRA ZENECA 27/11/2021 A1067
36 P-60Z7YMK7 3575015411810002 SALAMAH 40 UMUM JL HALMAHERA GG9 GADINGREJO 8113777705 ASTRA ZENECA 27/11/2021 A1067
37 P-5WYGDAY6 3575011006770001 MISTAR 43 UMUM JL HALMAHERA GADINGREJO 8113777705 ASTRA ZENECA 27/11/2021 A1067
38 P-45V4JWST 1102031104670001 SATUDIN 54 RENTAN jl slamet riyadi 1/1 gentong 8121661573 ASTRA ZENECA 27/11/2021 A1067
39 P-WSIKHEWN 3575016911660001 REJEKI NENGSIH 55 RENTAN RT 3 RW 5 SEBANI 822457543 ASTRA ZENECA 27/11/2021 A1067
40 Q-000Q1O98 3575012009020003 AKHMAD TRI ANGGA 19 UMUM JL HANG TUA 1/3 GADINGREJO 8381881122 ASTRA ZENECA 27/08/2021 PV46700 27/11/2021 A1067
41 Q-000OD5BW 3575015110000003 TUCHFATISSANIYAH 21 UMUM JL GATOT SUBROTO 2/6 BUKIR 8222895981 ASTRA ZENECA 21/08/2021 K004A 27/11/2021 A1067
42 Q-000OI86P 3514202211950003 JOHAN PRASETIYO 26 UMUM KRAWAN RT/RW 007/004 GRATI 8383340426 ASTRA ZENECA 21/08/2021 D005A 27/11/2021 A1067
43 Q-000NSNOT 3575010104940007 AKHMAD INDRAJID 27 UMUM JL MULYOREJO SEBANI GADINGREJO 8573069888 ASTRA ZENECA 18/08/2021 210050 27/11/2021 A1067
44 Z-0009D67Z 3509166705890013 SITI KOMARIAH FITRI 32 UMUM JL MULYOREJO 3/6 GADINGREJO 8134182860 ASTRA ZENECA 18/08/2021 210050 27/11/2021 A1067
45 P-7I0J7PBH 3575010107930101 MUHAMMAD MUNIR 28 UMUM JL BANDA GADINGREJO 8385057036 ASTRA ZENECA 30/10/2021 A1063 27/11/2021 A1067
46 Q-000PUZWV 3575016609010001 INDAH KARIMATUS SAIDAH 20 UMUM JL GATOT SUBROTO 2/6 BUKIR 8191817272 ASTRA ZENECA 26/08/2021 PV46700 27/11/2021 A1067


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
INDUK
1 P-2G0FCIFU 3575011309050001 ISHOMMUDDIN 16 REMAJA GADINGREJO 08133118040 CoronaVac 11/29/2021 24007021
2 S-54E55CD0 3575010906580001 BUASIN 63 LANSIA JL HALMAHERA GG.9 GADINGREJO 08385799205 CoronaVac 11/29/2021 24007021 G
3 P-3NHGAOPV 3514195807980001 VINA AZIZAH 23 UMUM JL SLAMET RIYADI 1/2 SEBANI 08573019565 CoronaVac 11/29/2021 24007021 G
4 S-027CF391 3575011206600001 SANUSI 61 LANSIA JL GATOT SUBROTO 1/4 BUKIR 08113777705 CoronaVac 11/29/2021 24007021 G
5 P-9IGV57TW 3575013007040002 NAUFAL DARMA RAFIF 17 REMAJA GADINGREJO 08233330008 CoronaVac 11/29/2021 24007021 G
6 S-A1DD37E3 3575014408700001 URIPAH 61 LANSIA JL HANGTUAH 6/4 GADINGREJO 08233840147 CoronaVac 11/29/2021 24007021 G
7 P-BSOGPI0H 3575015102070001 AZIJAH 14 REMAJA JL HANGTUAH 6/4 GADINGREJO 08113777705 CoronaVac 11/29/2021 24007021 G
8 P-BZCKWD5B 3575014308070002 FITRIYA AYU LESTARI 14 REMAJA JL HANTUAH 6/4 GADINGREJO 08317002985 CoronaVac 11/29/2021 24007021 G
9 P-C2UE3FO1 3575016105060002 KHUSNUL KHOTIMAH 15 REMAJA HL HANGTUAH 6/4 GADINGREJO 08113777705 CoronaVac 11/29/2021 24007021 G
10 Z-000DSS6H 3575032808540001 SUDIRMAN 67 LANSIA JL. SALAK III/A4 NO. 13, JAWA TIMUR, KOTA 08223319647 CoronaVac 11/1/2021 202108178F 11/29/2021 24007021
11 Q-001JZKTN 3575012610090002 NAZRIEL SATRIA 12 REMAJA JL SLAMET RIYADI 08578435443 CoronaVac 10/28/2021 202108178F 11/29/2021 24007021
12 Q-001HEMC2 3202337103700001 UMI KULSUM 55 RENTAN JL HALMAHERA 08123425909 CoronaVac 10/21/2021 C202106115 11/29/2021 24007021
13 Q-001FTAIH 3575010107030024 MUCHAMMAD ARDIANSYAH PRANA 18 UMUM JL. Slamet Riyadi 1/4 - Sebani 08135807924 CoronaVac 10/19/2021 C202106115 11/29/2021 24007021
14 Q-000XM2HP 3575012105030004 FATHUR ROHMAN 18 UMUM JL HANGTUAH 2/4 GADINGREJO 08385016190 CoronaVac 9/14/2021 202108118H 11/29/2021 24007021
15 Q-001HG15A 3575011607780002 SAMSUL ARIFIN 43 UMUM JL HANGTUAH 08139362020 CoronaVac 10/21/2021 C202106115 11/29/2021 24007021
16 Q-0011E3X0 3514220608940002 ROIS 27 UMUM WATUSALANG 002 / 003 PASINAN LEKOK - PA 08953384226 CoronaVac 9/21/2021 VAKSINASI 11/29/2021 24007021
17 N-00001UPU 3207146501960002 ELA NURKAMILAH 25 UMUM JL WAHIDIN UTARA PETAMANAN 08585051221 CoronaVac 10/30/2021 202108178F 11/29/2021 24007021
18 Q-001FTMD4 3575010112980002 MUCHAMMAD MARDANY PRATAMA 23 UMUM JL. Slamet Riyadi 1/4 -Sebani 08132850925 CoronaVac 10/19/2021 C202106115 11/29/2021 24007021
19 Q-001HCFW3 3575014107900116 SULIHATI 31 UMUM JL HALMAHERA 08113777705 CoronaVac 10/21/2021 C202106115 11/29/2021 24007021
20 Q-000E3SDW 3575016401030001 ARIFATUL RAHMANIA 18 UMUM JL SLAMET RIADI GG 8 GENTONG 08585248087 CoronaVac 7/13/2021 VAKSIN 1, 11/29/2021 24007021
21 Q-001LESL6 3575014107900006 PUTRI WAHYUNING GUSTI 31 UMUM JL SLAMET RIYADI 1/1 08135955954 CoronaVac 11/1/2021 202108178F 11/29/2021 24007021
22 Q-001K61Y3 3575010909830001 AKHMAD SOFYAN 38 UMUM JL SLAMET RIYADI 2/4 - SEBANI 08951925057 CoronaVac 10/26/2021 C202106115 11/29/2021 24007021
23 P-2722SRK6 3575014801950002 SITI MUSRIFAH 26 UMUM JL JEND S PARMAN 08784012136 Astra Zeneca 11/29/2021 A1067
24 P-2CKKZC2Q 3575016510910002 LINA QURROTU AINI 30 UMUM JL HALMAHERA GADINGREJO 08123354744 Astra Zeneca 11/29/2021 A1067
25 P-2DEIPQJ2 3575014107010067 HOIRUN NISAK 20 UMUM JL HANGTUA GG 4 08385771988 Astra Zeneca 11/29/2021 A1067
26 P-2ELY8VWW 3575016503970002 NUR ' AINI 24 UMUM GADINGREJO 08121696744 Astra Zeneca 11/29/2021 A1067
27 P-2EJYD421 3575014306820003 ERNA 39 UMUM JL HALMAHERA 3/5 GADINGREJO 08953950366 Astra Zeneca 11/29/2021 A1067
28 P-2FWVNAVE 3575015611020001 FIRDATUL KHASANA 19 UMUM JL HALMAHERA 3/5 GADINGREJO 08956201225 Astra Zeneca 11/29/2021 A1067
29 P-2I4XFRXD 3575014808780005 FIFTA MARIANA 43 UMUM JL KYAI SEPUH NO. 14 GADINGREJO 08113777705 Astra Zeneca 11/29/2021 A1067
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
30 P-2L3NFFB0 3523112709690001 HERI PURWANTO 52 RENTAN DUSUN SOKO 1/1 SOKOSSARI TUBAN 08135732818 Astra Zeneca 11/29/2021 A1067
31 P-2LX8U82J 3575012509000002 M. ISROFI AZIZI 21 UMUM JL HANGTUAH GG4 08113777705 Astra Zeneca 11/29/2021 A1067
32 P-2PSFL1NH 3575011509000001 ROFIKIL MUZAIDI 21 UMUM JL BANDA 4/2 GADINGREJO 08574873197 Astra Zeneca 11/29/2021 A1067
33 P-2RZ4MIEE 3575016010860002 UMI DARSIAH 35 UMUM JL URIP SUMOHARJO 2/2 BUKIR 08775711329 Astra Zeneca 11/29/2021 A1067
34 P-3R3BMKEC 3575012112920002 ABDUL ROCHIM 29 UMUM JL SLAMET RIYADI 1/2 SEBANI 08589594409 Astra Zeneca 11/29/2021 A1067
35 P-465SZF3F 3575014107770101 SITI MARFU'AH 49 UMUM JL HANGTUAH 6/4 GADINGREJO 08113777705 Astra Zeneca 11/29/2021 A1067
36 P-4RHP6TKA 3575010107750136 M. RUSDI 46 UMUM JL HANGTUAH 2/4 GADINGREJO 08113777705 Astra Zeneca 11/29/2021 A1067
37 P-5VFH0VKX 3575012507910003 HARIYADI 30 UMUM JL IRIAN JAYA 1/2 GADINGREJO 08580333495 Astra Zeneca 11/29/2021 A1067
38 P-63CSPMGH 3575012204980002 MOH. TAUFIK 23 UMUM JL SLAMET RIYADI 3/1 SEBANI 08589568193 Astra Zeneca 11/29/2021 A1067
39 P-A360HDIG 3575010107690009 NUR HASAN 56 RENTAN JL SLAMET RIYADI 3/5 SEBANI 08121795043 Astra Zeneca 11/29/2021 A1067
40 Q-000PUFER 3575015201770002 MACHMUDAH 44 UMUM JL HANGTUAH 4/3 GADINGREJO 08121669674 Astra Zeneca 8/26/2021 PV46700 11/29/2021 A1067
41 Q-000PUEB3 3514160507930002 MUKHAMAD IMRON 28 UMUM JL HANGTUAH 4/3 GADINGREJO 08121669674 Astra Zeneca 8/26/2021 PV46700 11/29/2021 A1067
42 Q-000PUEEP 3575013004020001 MOCH. RODI TAJUDIN 19 UMUM JL HANGTUAH GADINGREJO 08121669674 Astra Zeneca 8/26/2021 PV46700 11/29/2021 A1067
43 Q-000OG23V 3575013107000002 FIKRI RACHMAT PURWOAJI 21 UMUM JL IRIAN JAYA GG ANGGREK GADINGREJO 08585640434 Astra Zeneca 8/20/2021 K00A4 11/29/2021 A1067
44 Q-000QAYLQ 3575011307940001 ANUGRA DWI PRAKOSO 27 UMUM JL SLAMET RIYADI RT 2 RW 4 SEBANI 08573203313 Astra Zeneca 8/28/2021 PV46700 11/29/2021 A1067
45 Q-000NSM0B 3575011412830004 EKO LUDFIYANTO 38 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 08133129838 Astra Zeneca 8/18/2021 ABY1911 11/29/2021 A1067
46 K-0000JJW2 3324076810970001 RIS DIANA KUSUMAWARDANI 24 UMUM SIMBANG RT 7RW 5 BEBENGAN BOJA 08771682515 Astra Zeneca 8/16/2021 ABY1911 11/29/2021 A1067
47 Q-000K3M5X 3575015812940003 NURUL KOMARIYAH 27 UMUM JL IRIAN JAYA NO 2 PASURUAN. 08953274300 Astra Zeneca 7/29/2021 ABY1911 11/29/2021 A1067
SDN SEBANI
1 P-216A690I 3575016301090004 ADELIA SALSABILA 2009-01-23 REMAJA Jl. Slamet Riyadi 3/4 Sebani 08885730814 CoronaVac 11/29/2021 24007021 G
2 P-23AHQGPW 3575014403090001 DAVINA RISTANTI 2009-03-04 REMAJA Jl. Slamet Riyadi 2/5 Sebani 08125946848 CoronaVac 11/29/2021 24007021 G
3 P-23TC2PGG 3575016201090002 FINDI TRI WULANDARI 2009-01-22 REMAJA Jl. Slamet Riyadi 3/5 Sebani 08570713407 CoronaVac 11/29/2021 24007021 G
4 P-29QJX5K1 3575022508090002 IBNU FAHMI DWI NUGROHO 2009-08-25 REMAJA Jl. KH. Achmad Dahlan V/10 4/2 Pohjentrek 08781960682 CoronaVac 11/29/2021 24007021 G
5 P-2AE4LIP3 3575015307090002 JASMINE DARMAYANTI KURNIAWAN 2009-07-13 REMAJA Jl. Slamet Riyadi 1/4 Sebani 08214349257 CoronaVac 11/29/2021 24007021 G
6 P-2B5I3AUZ 3575012611080002 MAULANA NUR IKSAN 2008-11-26 REMAJA Jl. Kyai Sepuh 2/5 Gentong 08775725811 CoronaVac 11/29/2021 24007021 G
7 P-2CDGBKWQ 3575010705070004 MOKHAMMAD FACHRY SYUHADAK 2009-05-07 REMAJA Jl. Slamet Riyadi 1/1 Sebani 08585180303 CoronaVac 11/29/2021 24007021 G
8 P-RROV2WZT 3575011909090002 MUCHAMAD ADITYA SAPUTRA 2009-09-19 REMAJA Sebani 2/6 Sebani 08773214348 CoronaVac 11/29/2021 24007021 G
9 P-2DPCL8IJ 3575010511090001 MUCHAMAD RADITYA ARDIANSYAH 2009-11-05 REMAJA Jl. Slamet Riyadi 4/2 Sebani 08573084157 CoronaVac 11/29/2021 24007021 G
10 P-2EKMDN6M 3575011806090002 MUHAMMAD ADI BAYU WIJAYA PRA 2009-06-18 REMAJA Jl. Slamet Riyadi 3/3 Sebani 08135876610 CoronaVac 11/29/2021 24007021 G
11 P-2FLKUACN 3575012306090001 MUHAMMAD ALFARIDZI 2009-06-23 REMAJA Jl. Slamet Riyadi 2/5 Sebani 08771566902 CoronaVac 11/29/2021 24007021 G
12 P-2H6JAACN 3575011203090003 MUHAMAD RAYHAN FIRDAUS 2009-03-12 REMAJA Jl. Slamet Riyadi 3/6 Sebani 08385157445 CoronaVac 11/29/2021 24007021 G
13 P-2GECMVAN 3575032406090001 MUHAMMAD RAFI EFENDI 2009-06-24 REMAJA Jl. Jend. S. Parman 3/5 Mandaran Rejo 08133220315 CoronaVac 11/29/2021 24007021 G
14 P-2HY82DWA 3575010502090004 MUHAMMAD ZAKARIA 2009-02-05 REMAJA Jl. Slamet Riyadi 2/6 Sebani 08785193367 CoronaVac 11/29/2021 24007021 G
15 P-6YURVWME 3575012404090002 MUKHAMAD AJI MAULANA 2009-04-24 REMAJA Jl. Mulyorejo 2/6 Sebani 08311564350 CoronaVac 11/29/2021 24007021 G
16 P-701EOSBD 3575012010090001 MUKHAMMAD ZAKARIYA 2009-10-20 REMAJA Jl. Slamet Riyadi 2/6 Sebani 08961409775 CoronaVac 11/29/2021 24007021 G
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
17 P-72DOPJGT 3502076308090003 NILA RAHAYU RAMADHANI 2009-08-23 REMAJA Jl. Slamet Riyadi 2/4 Sebani 08578570669 CoronaVac 11/29/2021 24007021 G
18 P-73AKF6UP 3575014104090003 PUTRI AMELIA RISKY 2009-04-01 REMAJA Paras 2/4 Parasrejo 08585637318 CoronaVac 11/29/2021 24007021 G
19 P-73YUL6ON 3575016908090002 SAVIRA RAMADANI 2009-08-29 REMAJA Jl. Slamet Riyadi 2/3 Gentong 08951467791 CoronaVac 11/29/2021 24007021 G
20 P-74XG7CHE 3575012409090003 SURYA BICHILMI 2009-09-24 REMAJA Jl. Slamet Riyadi 1/1 Sebani 08783511454 CoronaVac 11/29/2021 24007021 G
21 P-75SXXW2G 3575010705090001 YAZID AL BUSTOMI 2009-05-07 REMAJA Jl. Mulyorejo 2/6 Sebani 08213107963 CoronaVac 11/29/2021 24007021 G
22 P-3I2ETADN 3575011308080002 MOH. IRFAN SYAH 2008-08-13 REMAJA JL. KYAI SEPUH 2/5 GENTONG 08775725811 CoronaVac 11/29/2021 24007021 G


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
1 Q-000Q0ZH5 3575020808990004 AMIRUL MU'MININ 23 UMUM JL HANGTUAH 08121766417 ASTRA ZENECA 8/27/2021 PV46700 11/30/2021 A1067
2 Q-000OD908 3575031605890002 FIRMAN DWI PRASETYO 32 UMUM JL VETERAN GG 2/ 50 RT 02 RW 01 BUGUL KIDUL 0816553808 ASTRA ZENECA 8/21/2021 210050 11/30/2021 A1067
3 Q-000O9Y8L 3575014811750002 ENDANG BASUKI 46 UMUM JL BANDA GADINGREJO 08570756185 ASTRA ZENECA 8/20/2021 210050 11/30/2021 A1067
4 Q-0018GNUN 3575010107630133 SAHRUL 58 RENTAN JL HANGTUAH RT02/RW04 GADINGREJO 08564646822 ASTRA ZENECA 10/5/2021 ABY1312 11/30/2021 A1067
5 P-467FM1U9 3575010206000002 SAHRUL YUDAPRAMANA 21 UMUM JL BANDA 02/02 GADINGREJO 08573325208 ASTRA ZENECA 11/30/2021 A1067
6 P-AJCECVDB 3575032205000001 M. ARDI MAULANA 21 UMUM JL LETJEN SUTOYO 4/1 MANDARAN 08113777705 ASTRA ZENECA 11/30/2021 A1067
7 P-AXR3PSLC 3575011704980002 RINA APRILIA 23 UMUM JL URIP SUMOHARJO 1/2 BUKIR 08319272582 ASTRA ZENECA 11/30/2021 A1067
8 P-D4PFCSIA 3575011407960002 M. YAZIT 25 UMUM JL HALMAHERA 1/5 GADINGREJO 08113777705 ASTRA ZENECA 11/30/2021 A1067
9 P-C3HHFDOD 3514201504950003 M. HASANUDDIN 26 UMUM KALIPANG KRAJAN 08578526612 ASTRA ZENECA 11/30/2021 A1067
10 P-CDQPRIJK 3575010809920001 IRWANUDIN 29 UMUM JL SLAMET RIYADI 2/4 SEBANI 08113777705 ASTRA ZENECA 11/30/2021 A1067
11 P-3S77JZKX 3575011703900004 M. ISROQ MIKRODHI 31 UMUM JL URIP SUMOHARJO 1/2 BUKIR 08123394313 ASTRA ZENECA 11/30/2021 A1067
12 P-C2BOFAUK 3575014609890002 ROBI'ATUL ADAWIYAH 32 UMUM JL HALMAHERA IX GADINGREJO 08113777705 ASTRA ZENECA 11/30/2021 A1067
13 P-CIAISU2W 3514165801890004 NIMATUL LAILA 32 UMUM JL BANDA 5/2 GADINGREJO 08384610034 ASTRA ZENECA 11/30/2021 A1067
14 P-3MGN2RD5 3575013110860001 AKHMAD ZAINUDDIN 35 UMUM JL SLAMET RIYADI 2/1 GENTONG 08580642685 ASTRA ZENECA 11/30/2021 A1067
15 P-CBME0R86 3575014103800010 MUSLICHAH 36 UMUM JL BANDA 5/2 GADINGREJO 08817952043 ASTRA ZENECA 11/30/2021 A1067
16 P-D27M3S5H 3514041607840004 M.HAMIM 37 UMUM DUSUN KARANG JATI 08226425221 ASTRA ZENECA 11/30/2021 A1067
17 P-DMYT1RKX 3575015102830002 ZUBAIDAH 38 UMUM JL HANGTUAH IV GADINGREJO 08113777705 ASTRA ZENECA 11/30/2021 A1067
18 P-BKSXGSU2 3575010107820114 MUHAMMAD IKHWAN 39 UMUM JL HALMAHERA GADINGREJO 08383400496 ASTRA ZENECA 11/30/2021 A1067
19 P-41395HIS 3575010504820003 MUKHAMMAD HUFRON 39 UMUM JL SLAMET RIYADI 1/3 SEBANI 08383374220 ASTRA ZENECA 11/30/2021 A1067
20 P-5WDCL5AE 3575016506770002 SOLICHATIN 44 UMUM JL HANGTUAG GG2 GADINGREJO 08123273912 ASTRA ZENECA 11/30/2021 A1067
21 P-DTF8RMDA 3575012008770001 AGUS SUGIANTORO 44 UMUM JL IRIAN JAYA GADINGREJO 08585253040 ASTRA ZENECA 11/30/2021 A1067
22 P-9GHWQMVW 3575015909760002 SITI MAISAROH 45 UMUM JL HALMAHERA 3/5 GADINGREJO 08585640465 ASTRA ZENECA 11/30/2021 A1067
23 P-6PIFM1H9 3575011208760002 MUCHAMAD 45 UMUM JL HALMAHERA IX GADINGREJO 08113777705 ASTRA ZENECA 11/30/2021 A1067
24 P-3IDYSSCL 3575010107630130 CHOLILI 58 RENTAN jl hangtuah 5/4 gadingrejo 08113777705 ASTRA ZENECA 11/30/2021 A1067
25 Q-001B3IPF 3575014807090002 ANISA ARISKI 12 REMAJA JL. Urip Sumoharjo RT01 RW02 - Bukir 08311315519 CoronaVac 10/11/2021 202108172F 11/30/2021 24007021
26 Q-001MB1QB 3575016304880002 ARBIAN APRILIA 33 UMUM JL SLAMET RIYADI GENTONG 08222838880 CoronaVac 11/2/2021 202108178F 11/30/2021 24007021
27 Q-000U9T93 3575030407760001 ABD CHALIM 45 UMUM JL LETJEN SUTOYO 1 004/001 MANDARANREJO PASURUAN 08570780767 CoronaVac 9/6/2021 202108144G 11/30/2021 24007021
28 Z-000DV7F6 3575014101610030 SUPIYANI 61 LANSIA JL HALMAHERA TAMBA'AN 08113777705 CoronaVac 11/2/2021 202108178F 11/30/2021 24007021
29 Z-000DV3VP 3575014801580001 TATIK WIBAWATI 63 LANSIA JL SLAMET RIADI GENTONG 08133133777 CoronaVac 11/2/2021 202108178F 11/30/2021 24007021
30 Z-00019HS3 3575012104570003 FATCHUL MUIN 64 LANSIA JL BANDA GG MAWAR - CoronaVac 6/23/2021 24002621 11/30/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
31 Z-000DH79N 3514161009480001 ABD. QOHAR 73 LANSIA KEBONSAWAH 4/7 08123224569 CoronaVac 10/9/2021 202108178 11/30/2021 24007021
32 P-7FJO49B3 3575012706080002 MOHAMMAD RIDHWAN TRIADMAJA 13 REMAJA GADINGREJO 08233330008 CoronaVac 11/30/2021 24007021
33 P-54X73MZ8 3575015001040003 LILLAH AMALIA 17 REMAJA JL URIP SUMOHARJO 01/02 BUKIR 08580642952 CoronaVac 11/30/2021 24007021
34 P-GHYUPLNL 3575017101980004 KHOTIJAH 23 UMUM JL HANGTUAH 4/3 GADINGREJO 08113777705 CoronaVac 11/30/2021 24007021
35 S-6D501AA3 3575014107570075 SUDJIATI 64 LANSIA JL HALMAHERA 1/5 GADINGREJO 08113777705 CoronaVac 11/30/2021 24007021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
2 Z-000E5JQH 3575015411570001 MUSTIKA EMY 64 LANSIA BUKIR RT01/RW02 8999434951 CoronaVac 22/11/2021
3 Z-000CACJN 3575013112590002 AMARI 62 LANSIA Bukir RT03 RW02 81333110339 CoronaVac 16/11/2021
4 Z-000C39CO 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 02/11/2021
5 Q-0018VFV3 3520134107590045 MARINAH 62 LANSIA DS. KAUMAN RT 03/02 8133320610 CoronaVac 23/11/2021
6 Z-000CG7O5 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/11/2021
7 Q-0018GIL2 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 Biofarma 02/11/2021
8 Z-000CD3MK 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 BIOFARMA 06/11/2021
9 Z-0009HTJ9 3575012712560001 SUTRISNO 63 LANSIA JL BANDA 3/2 GADINGREJO 8213920994 ASTRA ZENECA 13/11/2021
10 Z-0001AUJL 3575014505590003 NADIFAH 62 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021
11 Z-0001B1IG 3575010107580065 SUTRISNO 63 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021
12 Z-00019HS3 3575012104570003 FATCHUL MUIN 64 LANSIA JL BANDA GG MAWAR - CoronaVac 11/30/2021
13 Z-0008NMN4 3514211003570001 M TAMIM 64 LANSIA JL BANDA GG. CEMPAKA NO.99 8122699136 ASTRAZENECA 01/11/2021
14 Z-0000ICFO 3575011408590001 SUROYO 62 LANSIA JL GATOT SUBROTO - CoronaVac 23/11/2021
18 Z-000CLBVC 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 BIOFARMA 10/11/2021
21 Z-000CYPLA 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 CoronaVac 15/11/2021
23 Z-000DV7F6 3575014101610030 SUPIYANI 61 LANSIA JL HALMAHERA TAMBA'AN 08113777705 CoronaVac 11/2/2021 202108178F 11/30/2021
25 Z-000A210F 3575011707580001 SUHADI 63 LANSIA JL HANGTUAH 4/4 GADINGREJO 8213963665 CoronaVac 16/11/2021
29 Z-000AX7RQ 3575014107600110 SITI CHOLISAH 61 LANSIA JL HANGTUAH GG 4 8312515640 CoronaVac 19/11/2021
30 Z-6B6C39FD 3575014303530002 SUWARTI 68 LANSIA JL IRIAN JAYA 8232240409 BIOFARMA 12/11/2021
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
31 Q-000NSKXX 3575010801610001 NGADIONO 60 LANSIA JL IRIAN JAYA 2/2 8133688826 ASTRA ZENECA 10/11/2021
32 Z-000CB1VR 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 BIOFARMA 06/11/2021
33 Z-0009JIYB 3575011408560001 AGUS MULYONO 65 LANSIA JL KARYA BAKTI GENTONG 8510284382 ASTRA ZENECA 15/11/2021
34 Q-001A03O1 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 BIOFARMA 05/11/2021
35 Z-000AY6NK 3575014505590002 ALFIYAH 62 LANSIA JL KYAI SEPUH 1/6 GENTONG 8122148563 BIOFARMA 03/11/2021
36 Z-000CILTH 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 BIOFARMA 09/11/2021
37 Z-00017G45 3575016112560001 SUMARMI 65 LANSIA JL KYAI SEPUH, 8113777705 CoronaVac 17/11/2021
38 Z-000BNM65 3575024504450004 MAHANI AMBAR 76 LANSIA JL MARGO UTOMO 4/3 PURWOREJO 8213030335 Biofarma 02/11/2021
41 S-14E5DE2A 3575010107600064 PITONG 61 LANSIA JL PADAT RAYA BARU GELANG KUSAN HILIR KALIMANTAN 8113777705 BIOFARMA 10/11/2021 24007021
42 Z-000BNAOU 3575027011580002 AISYAH AL TWAY 63 LANSIA JL PUCANGAN 3/4 PURWOREJO 8785271310 Biofarma 02/11/2021
43 Z-000DV3VP 3575014801580001 TATIK WIBAWATI 63 LANSIA JL SLAMET RIADI GENTONG 08133133777 CoronaVac 11/2/2021 202108178F 11/30/2021
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
2 Z-000E5JQH 3575015411570001 MUSTIKA EMY 64 LANSIA BUKIR RT01/RW02 8999434951 CoronaVac 22/11/2021 24007021
3 Z-000CACJN 3575013112590002 AMARI 62 LANSIA Bukir RT03 RW02 81333110339 CoronaVac 16/11/2021 24007021
4 Z-000C39CO 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 02/11/2021 202108178F
5 Q-0018VFV3 3520134107590045 MARINAH 62 LANSIA DS. KAUMAN RT 03/02 8133320610 CoronaVac 23/11/2021 24007021
6 Z-000CG7O5 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/11/2021 202108172F
7 Q-0018GIL2 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 Biofarma 02/11/2021 202108178F
8 Z-000CD3MK 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 BIOFARMA 06/11/2021 24007021
9 Z-0009HTJ9 3575012712560001 SUTRISNO 63 LANSIA JL BANDA 3/2 GADINGREJO 8213920994 ASTRA ZENECA 13/11/2021 A1094
10 Z-0001AUJL 3575014505590003 NADIFAH 62 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021 24007021
11 Z-0001B1IG 3575010107580065 SUTRISNO 63 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021 24007021
12 Z-00019HS3 3575012104570003 FATCHUL MUIN 64 LANSIA JL BANDA GG MAWAR - CoronaVac 11/30/2021 24007021
13 Z-0008NMN4 3514211003570001 M TAMIM 64 LANSIA JL BANDA GG. CEMPAKA NO.99 8122699136 ASTRAZENECA 01/11/2021 A1063
14 Z-0000ICFO 3575011408590001 SUROYO 62 LANSIA JL GATOT SUBROTO - CoronaVac 23/11/2021 24007021
18 Z-000CLBVC 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 BIOFARMA 10/11/2021 24007021
21 Z-000CYPLA 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 CoronaVac 15/11/2021 24007021
25 Z-000A210F 3575011707580001 SUHADI 63 LANSIA JL HANGTUAH 4/4 GADINGREJO 8213963665 CoronaVac 16/11/2021 24007021
29 Z-000AX7RQ 3575014107600110 SITI CHOLISAH 61 LANSIA JL HANGTUAH GG 4 8312515640 CoronaVac 19/11/2021 24007021
30 Z-6B6C39FD 3575014303530002 SUWARTI 68 LANSIA JL IRIAN JAYA 8232240409 BIOFARMA 12/11/2021 24007021
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
31 Q-000NSKXX 3575010801610001 NGADIONO 60 LANSIA JL IRIAN JAYA 2/2 8133688826 ASTRA ZENECA 10/11/2021 A1063
32 Z-000CB1VR 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 BIOFARMA 06/11/2021 24007021
33 Z-0009JIYB 3575011408560001 AGUS MULYONO 65 LANSIA JL KARYA BAKTI GENTONG 8510284382 ASTRA ZENECA 15/11/2021 A1067
34 Q-001A03O1 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 BIOFARMA 05/11/2021 24007021
35 Z-000AY6NK 3575014505590002 ALFIYAH 62 LANSIA JL KYAI SEPUH 1/6 GENTONG 8122148563 BIOFARMA 03/11/2021 202108178F
36 Z-000CILTH 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 BIOFARMA 09/11/2021 24007021
37 Z-00017G45 3575016112560001 SUMARMI 65 LANSIA JL KYAI SEPUH, 8113777705 CoronaVac 17/11/2021 24007021
38 Z-000BNM65 3575024504450004 MAHANI AMBAR 76 LANSIA JL MARGO UTOMO 4/3 PURWOREJO 8213030335 Biofarma 02/11/2021 202108178F
42 Z-000BNAOU 3575027011580002 AISYAH AL TWAY 63 LANSIA JL PUCANGAN 3/4 PURWOREJO 8785271310 Biofarma 02/11/2021 202108178F
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
2 Z-000E5JQH 3575015411570001 MUSTIKA EMY 64 LANSIA BUKIR RT01/RW02 8999434951 CoronaVac 22/11/2021
3 Z-000CACJN 3575013112590002 AMARI 62 LANSIA Bukir RT03 RW02 81333110339 CoronaVac 16/11/2021
4 Z-000C39CO 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 02/11/2021
5 Q-0018VFV3 3520134107590045 MARINAH 62 LANSIA DS. KAUMAN RT 03/02 8133320610 CoronaVac 23/11/2021
6 Z-000CG7O5 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/11/2021
7 Q-0018GIL2 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 Biofarma 02/11/2021
8 Z-000CD3MK 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 BIOFARMA 06/11/2021
9 Z-0009HTJ9 3575012712560001 SUTRISNO 63 LANSIA JL BANDA 3/2 GADINGREJO 8213920994 ASTRA ZENECA 13/11/2021
10 Z-0001AUJL 3575014505590003 NADIFAH 62 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021
11 Z-0001B1IG 3575010107580065 SUTRISNO 63 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021
12 Z-00019HS3 3575012104570003 FATCHUL MUIN 64 LANSIA JL BANDA GG MAWAR - CoronaVac 11/30/2021
13 Z-0008NMN4 3514211003570001 M TAMIM 64 LANSIA JL BANDA GG. CEMPAKA NO.99 8122699136 ASTRAZENECA 01/11/2021
14 Z-0000ICFO 3575011408590001 SUROYO 62 LANSIA JL GATOT SUBROTO - CoronaVac 23/11/2021
18 Z-000CLBVC 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 BIOFARMA 10/11/2021
21 Z-000CYPLA 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 CoronaVac 15/11/2021
23 Z-000DV7F6 3575014101610030 SUPIYANI 61 LANSIA JL HALMAHERA TAMBA'AN 08113777705 CoronaVac 11/2/2021 202108178F 11/30/2021
24 Z-000A210F 3575011707580001 SUHADI 63 LANSIA JL HANGTUAH 4/4 GADINGREJO 8213963665 CoronaVac 16/11/2021
28 Z-000AX7RQ 3575014107600110 SITI CHOLISAH 61 LANSIA JL HANGTUAH GG 4 8312515640 CoronaVac 19/11/2021
29 Z-6B6C39FD 3575014303530002 SUWARTI 68 LANSIA JL IRIAN JAYA 8232240409 BIOFARMA 12/11/2021
30 Q-000NSKXX 3575010801610001 NGADIONO 60 LANSIA JL IRIAN JAYA 2/2 8133688826 ASTRA ZENECA 10/11/2021
Dosis I Dosis 2
Kelomp
Vaksinasi Vaksinasi
31 Z-000CB1VR 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 BIOFARMA 06/11/2021
32 Z-0009JIYB 3575011408560001 AGUS MULYONO 65 LANSIA JL KARYA BAKTI GENTONG 8510284382 ASTRA ZENECA 15/11/2021
33 Q-001A03O1 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 BIOFARMA 05/11/2021
34 Z-000AY6NK 3575014505590002 ALFIYAH 62 LANSIA JL KYAI SEPUH 1/6 GENTONG 8122148563 BIOFARMA 03/11/2021
35 Z-000CILTH 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 BIOFARMA 09/11/2021
36 Z-00017G45 3575016112560001 SUMARMI 65 LANSIA JL KYAI SEPUH, 8113777705 CoronaVac 17/11/2021
37 Z-000BNM65 3575024504450004 MAHANI AMBAR 76 LANSIA JL MARGO UTOMO 4/3 PURWOREJO 8213030335 Biofarma 02/11/2021
41 Z-000BNAOU 3575027011580002 AISYAH AL TWAY 63 LANSIA JL PUCANGAN 3/4 PURWOREJO 8785271310 Biofarma 02/11/2021
42 Z-000DV3VP 3575014801580001 TATIK WIBAWATI 63 LANSIA JL SLAMET RIADI GENTONG 08133133777 CoronaVac 11/2/2021 202108178F 11/30/2021
43 Z-000CCZ75 3575014101570005 YANAH 64 LANSIA JL SLAMET RIADI GG 13 - CoronaVac 27/11/2021
Kategori : UMUM
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
2 Z-000E5JQH 3575015411570001 MUSTIKA EMY 64 LANSIA BUKIR RT01/RW02 8999434951 CoronaVac 22/11/2021 24007021
3 Z-000CACJN 3575013112590002 AMARI 62 LANSIA Bukir RT03 RW02 81333110339 CoronaVac 16/11/2021 24007021
4 Z-000C39CO 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 02/11/2021 202108178F
5 Q-0018VFV3 3520134107590045 MARINAH 62 LANSIA DS. KAUMAN RT 03/02 8133320610 CoronaVac 23/11/2021 24007021
6 Z-000CG7O5 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/11/2021 202108172F
7 Q-0018GIL2 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 Biofarma 02/11/2021 202108178F
8 Z-000CD3MK 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 BIOFARMA 06/11/2021 24007021
9 Z-0009HTJ9 3575012712560001 SUTRISNO 63 LANSIA JL BANDA 3/2 GADINGREJO 8213920994 ASTRA ZENECA 13/11/2021 A1094
10 Z-0001AUJL 3575014505590003 NADIFAH 62 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021 24007021
11 Z-0001B1IG 3575010107580065 SUTRISNO 63 LANSIA JL BANDA GG MAWAR - CoronaVac 18/11/2021 24007021
12 Z-00019HS3 3575012104570003 FATCHUL MUIN 64 LANSIA JL BANDA GG MAWAR - CoronaVac 11/30/2021 24007021
13 Z-0008NMN4 3514211003570001 M TAMIM 64 LANSIA JL BANDA GG. CEMPAKA NO.99 8122699136 ASTRAZENECA 01/11/2021 A1063
14 Z-0000ICFO 3575011408590001 SUROYO 62 LANSIA JL GATOT SUBROTO - CoronaVac 23/11/2021 24007021
18 Z-000CLBVC 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 BIOFARMA 10/11/2021 24007021
21 Z-000CYPLA 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 CoronaVac 15/11/2021 24007021
24 Z-000A210F 3575011707580001 SUHADI 63 LANSIA JL HANGTUAH 4/4 GADINGREJO 8213963665 CoronaVac 16/11/2021 24007021
28 Z-000AX7RQ 3575014107600110 SITI CHOLISAH 61 LANSIA JL HANGTUAH GG 4 8312515640 CoronaVac 19/11/2021 24007021
29 Z-6B6C39FD 3575014303530002 SUWARTI 68 LANSIA JL IRIAN JAYA 8232240409 BIOFARMA 12/11/2021 24007021
30 Q-000NSKXX 3575010801610001 NGADIONO 60 LANSIA JL IRIAN JAYA 2/2 8133688826 ASTRA ZENECA 10/11/2021 A1063
Dosis I Dosis 2
Kelomp
No.
Batch
Vaksinasi Vaksinasi
31 Z-000CB1VR 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 BIOFARMA 06/11/2021 24007021
32 Z-0009JIYB 3575011408560001 AGUS MULYONO 65 LANSIA JL KARYA BAKTI GENTONG 8510284382 ASTRA ZENECA 15/11/2021 A1067
33 Q-001A03O1 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 BIOFARMA 05/11/2021 24007021
34 Z-000AY6NK 3575014505590002 ALFIYAH 62 LANSIA JL KYAI SEPUH 1/6 GENTONG 8122148563 BIOFARMA 03/11/2021 202108178F
35 Z-000CILTH 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 BIOFARMA 09/11/2021 24007021
36 Z-00017G45 3575016112560001 SUMARMI 65 LANSIA JL KYAI SEPUH, 8113777705 CoronaVac 17/11/2021 24007021
37 Z-000BNM65 3575024504450004 MAHANI AMBAR 76 LANSIA JL MARGO UTOMO 4/3 PURWOREJO 8213030335 Biofarma 02/11/2021 202108178F
41 Z-000BNAOU 3575027011580002 AISYAH AL TWAY 63 LANSIA JL PUCANGAN 3/4 PURWOREJO 8785271310 Biofarma 02/11/2021 202108178F
43 Z-000CCZ75 3575014101570005 YANAH 64 LANSIA JL SLAMET RIADI GG 13 - CoronaVac 27/11/2021 24007021
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN ANAK-ANAK (6-11 TAHUN) KOTA PASURUAN
PER PUSKESMAS
TARGET CAPAIAN SELISIH KETERANGAN

NO PUSKESMAS %
ANAK-ANAK DOSIS 1 % DOSIS 2 % D1-D2
1 GADINGR 2,454 0.00% #DIV/0! 0 #DIV/0!
2 KARANGK 2,259 0.00% #DIV/0! 0 #DIV/0!
3 SEKARG 3,010 0.00% #DIV/0! 0 #DIV/0!
4 KEBONA 2,828 0.00% #DIV/0! 0 #DIV/0!
5 BUGULKI 3,133 0.00% #DIV/0! 0 #DIV/0!
6 TRAJENG 2,243 0.00% #DIV/0! 0 #DIV/0!
7 KEBONSA 1,916 0.00% #DIV/0! 0 #DIV/0!
8 KANDANG 2,566 0.00% #DIV/0! 0 #DIV/0!
TOTAL 20,409 0 0 0 0 0 0
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN LANSIA KOTA PASURUAN

PER PUSKESMAS
TARGET CAPAIAN SELISIH

NO PUSKESMAS
LANSIA DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGR 1,930 823 42.64% 671 81.53% 4 0.60% 667
2 KARANGK 1,707 0.00% #DIV/0! #DIV/0! 0
3 SEKARG 2,386 0.00% #DIV/0! #DIV/0! 0
4 KEBONA 2,506 0.00% #DIV/0! #DIV/0! 0
5 BUGULKI 2,607 0.00% #DIV/0! #DIV/0! 0
6 TRAJENG 1,710 0.00% #DIV/0! #DIV/0! 0
7 KEBONSA 1,392 0.00% #DIV/0! #DIV/0! 0
8 KANDANG 1,929 0.00% #DIV/0! #DIV/0! 0
TOTAL 16,167 823 0 671 0 4 0 667
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN MASYARAKAT UMUM (18 TAHUN KEATAS) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
MASY. UMUM DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGR 12,206 5310 43.50% 3642 68.59% 67 1.84% 3,575
2 KARANGK 10,757 0.00% #DIV/0! #DIV/0! 0
3 SEKARG 15,856 0.00% #DIV/0! #DIV/0! 0
4 KEBONA 15,382 0.00% #DIV/0! #DIV/0! 0
5 BUGULKI 15,768 0.00% #DIV/0! #DIV/0! 0
6 TRAJENG 10,621 0.00% #DIV/0! #DIV/0! 0
7 KEBONSA 8,702 0.00% #DIV/0! #DIV/0! 0
8 KANDANG 12,074 0.00% #DIV/0! #DIV/0! 0
TOTAL 101,366 5,310 0 3,642 0 67 0 3,575
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN REMAJA (12-17 TAHUN) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
REMAJA DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO 1348 #DIV/0! 1177 87.31% 0.00% 1,177
2 KARANGKETUG #DIV/0! #DIV/0! #DIV/0! 0
3 SEKARGADUNG #DIV/0! #DIV/0! #DIV/0! 0
4 KEBONAGUNG #DIV/0! #DIV/0! #DIV/0! 0
5 BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! 0
6 TRAJENG #DIV/0! #DIV/0! #DIV/0! 0
7 KEBONSARI #DIV/0! #DIV/0! #DIV/0! 0
8 KANDANGSAPI #DIV/0! #DIV/0! #DIV/0! 0
TOTAL 0 1,348 #DIV/0! 1,177 #DIV/0! 0 #DIV/0! 1,177
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN MASYARAKAT RENTAN (50-59 TAHUN) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
MASY RENTAN
DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO 1107 #DIV/0! 867 78.32% 1 0.12% 866
5 BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! 791
7 KEBONSARI #DIV/0! #DIV/0! #DIV/0! 0
8 KANDANGSAPI #DIV/0! #DIV/0! #DIV/0! 0
TOTAL 0 1,107 #DIV/0! 867 #DIV/0! 1 #DIV/0! 866
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN HAMIL KOTA PASURUAN

PER PUSKESMAS

NO PUSKESMAS
MASY RENTAN
DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO #DIV/0! #DIV/0! #DIV/0! 0
5 BUGULKIDUL 59 #DIV/0! 34 57.63% 5 14.71% 791
7 KEBONSARI 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0
8 KANDANGSAPI 3 #DIV/0! 3 100.00% 1 33.33% 2
TOTAL 0 62 #DIV/0! 37 #DIV/0! 6 #DIV/0! 31
PUSKESMAS KEBONSARI UNTUK BUMIL MASUK KE MASYARAKAT UMUM

JANUARI 2021 PEBRUARI 2021 MARET 202
KETERANGAN ANAK ANAK ANAK
DOSIS 1 DOSIS 2 DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF DOSIS 1
RUAN

LANSIA LANSIA LANSIA
%
16675.00% 6 6 1 1 98
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
0
ATAS) KOTA PASURUAN

UMUM UMUM UMUM
%
5335.82% 32 93 125 52 52 629
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
0
TA PASURUAN

REMAJA REMAJA REMAJA
%
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
UN) KOTA PASURUAN

RENTAN RENTAN RENTAN
%
86600.00% 23 23 3 3 181
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
RUAN

IBU HAMIL IBU HAMIL IBU HAMIL
%
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
15820.00%
#DIV/0!
#DIV/0!
200.00%
#DIV/0!
MARET 2021 APRIL 2021 MEI 2021
ANAK ANAK ANAK
KOMULATIF DOSIS 2 KOMULATIF DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF DOSIS 1 KOMULATIF DOSIS 2

LANSIA LANSIA LANSIA
104 6 7 163 267 127 134 34 301 113

UMUM UMUM UMUM
722 440 492 60 782 252 744 170 952 84

RENTAN RENTAN RENTAN
204 139 142 36 240 73 215 38 278 26

2021 JUNI 2021 JULI 2021 AGUSTUS 2021
NAK ANAK ANAK ANAK
2021 JUNI 2021 JULI 2021 AGU

NSIA LANSIA LANSIA
247 324 625 32 279 56 681 250 529 10
2021 JUNI 2021 JULI 2021 AGU

MUM UMUM UMUM
828 227 1179 77 905 1270 2449 239 1144 999
MAJA REMAJA REMAJA REMAJA
257 257 139
2021 JUNI 2021 JULI 2021 AGU

NTAN RENTAN RENTAN R
241 223 501 28 269 237 738 226 495 102

HAMIL IBU HAMIL IBU HAMIL IBU HAMIL
AGUSTUS 2021 SEPTEMBER 2021 OKTOBER 2022
ANAK ANAK ANAK
AGUSTUS 2021 SEPTEMBER 2021

LANSIA LANSIA
691 29 558 4 4 65 756 25 583 0

UMUM UMUM
3448 795 1939 67 67 721 4169 339 2278 0
396 151 151 575 971 176 327 182 1153 756

RENTAN RENTAN
840 99 594 1 1 121 961 47 641 0

BER 2022 NOVEMBER 2022
NAK ANAK
KOMULATIF DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF
OKTOBER 2022 NOVEMBER 2022

LANSIA LANSIA
4 48 804 45 628 0 4 19 823 43

UMUM UMUM
67 764 4933 658 2936 0 67 377 5310 706
MAJA REMAJA
1083 195 1348 94 1177

RENTAN RENTAN
1 99 1060 129 770 0 1 47 1107 97

HAMIL IBU HAMIL
NOVEMBER 2022
LANSIA
KOMULATIF DOSIS 3 KOMULATIF
671 0 4
NOVEMBER 2022
UMUM
3642 0 67
NOVEMBER 2022
RENTAN
867 0 1

Vaksinasi November 21

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Vaksinasi November 21

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Nama Puskesmas/Fasyankes/Pos : PKM GADINGREJO

Mengetahui Pasuruan, 01-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 02-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 03-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

INDUK & PUSTU SEBANI

Mengetahui Pasuruan, 04-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 05-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 06-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 08-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 10-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 11-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 12-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 13-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 15-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Kelomp Dosis I Dosis 2

Mengetahui Pasuruan, 16-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 17-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 18-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 19-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 20-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003

Mengetahui Pasuruan, 22-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 23-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 24-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 25-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 27-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 29-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 30-11-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

TARGET CAPAIAN SELISIH KETERANGAN

LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN LANSIA KOTA PASURUAN

TARGET CAPAIAN SELISIH

TARGET CAPAIAN SELISIH

TARGET CAPAIAN SELISIH

TARGET CAPAIAN SELISIH

LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN HAMIL KOTA PASURUAN

TARGET CAPAIAN SELISIH

PUSKESMAS KEBONSARI UNTUK BUMIL MASUK KE MASYARAKAT UMUM

JANUARI 2021 PEBRUARI 2021 MARET 202