PKM GUNUNG

SUGIH

PESERTA KB

NO. TANGGAL ISTRI

NAMA SUAMI
NIK (NOMOR INDUK KEPENDUDUKAN) NAM

1 2 3 4 5

1 1/3/2022 HERI SANTOSO 1 8 0 2 0 4 6 6 0 3 8 7 0 0 0 1 SITI MARDIANA

2 1/3/2022 ARDIYANTO 1 8 0 7 1 3 6 5 0 8 9 7 0 0 0 1 IKA NURJANAH
3 1/3/2022 ANDRIANSYAH 1 8 0 2 0 7 4 6 0 2 8 4 0 0 1 4 KIKI PRANASARI
4 1/3/2022 SARPUDIN. S.SOS 1 8 0 2 0 4 1 2 0 7 7 6 0 0 0 6 YULIANTI NILAWA
5 1/4/2022 DWI DARMA IRAWAN 1 8 0 2 0 7 4 1 1 2 8 4 0 0 0 3 INA YUSWITA
6 1/4/2022 YONI KURNIAWAN 1 8 0 2 0 4 5 5 0 9 9 2 0 0 0 3 NURUL KHOSIDAH
7 1/4/2022 AHMAD HANIBULLAH 1 8 0 2 1 4 6 6 0 9 8 8 0 0 0 1 NIA RIANI SARI
8 1/4/2022 AHMAD MABARUN 1 8 0 7 1 3 6 8 0 6 9 7 0 0 0 1 NURYA RAGA UTA
9 1/4/2022 FAISOL TANJUNG 1 8 0 2 0 4 6 7 1 0 8 9 0 0 0 2 NORMA SEPTRIAN
10 1/5/2022 DANDI SAPUTRA 1 8 0 2 2 1 4 2 0 6 0 2 0 0 0 1 PITRI
11 1/5/2022 VIKI SUHENDRA 1 8 0 2 2 1 5 6 0 2 0 1 0 0 0 3 FINDI AYUNI
12 1/5/2022 FATKHU ROHMAN 1 8 0 2 2 1 5 4 0 5 8 5 0 0 0 2 ISTIYANI
13 1/5/2022 ANDIKA SETIAWAN 1 8 0 2 1 6 7 0 0 9 9 3 0 0 0 6 EKA YULIYANTI
14 1/6/2022 SUHAIDI 1 8 0 2 1 9 4 8 0 7 8 8 0 0 0 3 LIA ANITA
15 1/6/2022 ALIO ISRANDI 1 8 0 2 0 7 5 0 0 4 9 7 0 0 0 3 WIKE SUGIANTI
16 1/6/2022 YONI KURNIAWAN 1 8 0 2 0 4 5 5 0 9 9 2 0 0 0 3 NURUL KHOSIDAH
17 1/6/2022 SLAMET ANDRIANTO 3 3 1 8 1 5 6 1 1 1 8 9 0 0 0 1 NOVI SETYANING
18 1/7/2022 ARIS SUSANTO 1 8 0 2 1 1 4 2 0 7 8 9 0 0 0 5 YATINI
19 1/7/2022 JOKO SUSANTO 1 8 0 2 1 5 4 4 0 4 9 3 0 0 0 3 MARIYANI
20 1/7/2022 YAYAN KUSWANDI 1 8 0 2 1 5 4 3 0 7 9 2 0 0 0 2 NUR FITRIYANA
21 1/7/2022 YOGA TAMA 1 8 0 2 1 4 0 6 0 1 9 ###4 0 0 0 1
22 1/7/2022 SAHRONI 1 8 0 2 0 7 6 3 0 2 9 1 0 0 0 3 NURWANI SARI
23 1/10/2022 SUGIYANTO 1 8 0 2 0 7 4 6 0 6 0 2 0 0 0 2 FITRI AYU WANDI
24 1/10/2022 SAM SUDIN 1 8 0 2 1 6 5 2 0 2 8 5 0 0 0 6 WIWIK WINARSIH
25 1/10/2022 SURYADI RAHMADAN 1 8 0 2 1 4 5 8 0 3 9 3 0 0 0 3 ENDANG FITRIAN
26 1/10/2022 EDI MARYANTO 1 8 0 2 1 4 5 6 0 7 8 6 0 0 0 6 PAINI
27 1/10/2022 ZAINURI 1 8 0 2 0 4 6 1 0 9 8 7 0 0 0 8 ROSDIANA
28 1/10/2022 MUCHLISIN 1 8 0 3 0 5 6 3 0 8 8 9 0 0 0 1 SUPRIHATIN
29 1/10/2022 MURAD 1 8 0 2 0 4 6 7 0 7 9 9 0 0 0 7 JUNAIYAH
30 1/10/2022 ANSORI 1 8 0 2 0 7 5 9 0 9 9 7 0 0 0 8 CEMILIA SAFITRI
31 1/10/2022 SANUSI 1 8 0 2 0 4 4 6 0 7 8 4 0 0 0 4 YULIANA
32 1/10/2022 TUKIRAN 1 8 0 2 0 4 5 5 1 2 8 ###0 0 0 0 1 SUTARMI
33 1/10/2022 SUPRI ADI 1 8 0 2 0 4 5 8 0 8 9 1 0 0 0 5 RENI WATI
34 1/11/2022 BAMBANG RUSWANTO 1 8 0 2 0 4 5 0 0 1 8 6 0 0 1 2 MUJI LESTARI
35 1/11/2022 ROHEDI 1 8 0 2 0 4 6 6 0 5 9 2 0 0 0 7 MIFTAHUL KHOIR
36 1/11/2022 SUWANTO 1 8 0 2 0 4 6 2 1 1 8 0 0 0 0 3 MARSIATI
37 1/11/2022 M.SAAT 1 8 0 2 0 4 5 5 1 2 7 8 0 0 0 3 HERMA WATI
38 1/11/2022 SARING 1 8 0 2 0 4 0 3 1 1 7 7 0 0 0 7 KARISEM
39 1/11/2022 RUDI BASTIYAN 1 8 0 2 0 4 5 4 0 8 8 5 0 0 0 8 HAPIPAH
40 1/11/2022 MISWAN FAUZI 1 8 0 2 0 4 6 6 0 2 9 ###4 0 0 0 0 NOVA SARI
41 1/12/2022 AGUS 1 8 0 2 0 8 5 1 0 8 7 9 0 0 0 1 DIANA SEPTIANA
42 1/12/2022 IWAN ANSORI 1 8 0 2 0 4 4 8 1 2 9 4 0 0 0 2 DESI MALA SARI
43 1/12/2022 BEDY SUMARNO 1 8 0 2 0 4 6 4 0 4 8 4 0 0 0 4 NITA VERINA
44 1/12/2022 EDWAR A KARIM 1 8 0 2 0 5 4 0 7 8 4 0 0 0 0 2 EPIYANA
45 1/12/2022 WASIYO 1 8 0 2 0 4 4 5 0 1 7 9 0 0 0 5 BISWATI
46 1/13/2022 SUPRAPTO 1 8 0 2 0 4 6 3 0 5 8 2 0 0 0 2 TITIS ROHAYATI
47 1/13/2022 SIPAN PRAYUDI 1 8 0 2 0 4 4 8 0 7 1 5 0 0 0 3 SRI WINARTI
48 1/13/2022 GUNARTO 1 8 0 2 0 4 5 6 0 9 8 0 0 0 0 3 SUMARMI
49 1/13/2022 AHMAT 1 8 0 2 0 4 5X 0 0 2 8 8 0 0 1 0 IDA WATI
50 1/13/2022 JEPRI SEPTA RIYANSAH 1 8 0 2 0 4 4 7 0 1 9 6 0 0 0 1 RENI BUSTI
51 1/13/2022 DWI HERMAWAN 1 8 0 2 1 5 5 6 0 7 8 9 0 0 0 1 PUJI LESTARI
52 1/13/2022 EDO EDWARD 1 6 0 2 1 3 4 3 3 1 1 8 8 0 0 3 RINI KUSWINDAR
53 1/14/2022 TASLIM 1 8 0 2 0 4 6 6 0 7 7 0 0 0 0 2 SRI UTAMI
54 1/14/2022 SUTAR 1 8 0 2 1 4 4 9 0 2 8 6 0 0 0 1 SUTARSIH
55 1/14/2022 AHMAD SULAIMAN 1 8 0 2 1 5 4 3 0 6 0 1 0 0 0 1 NENENG
56 1/14/2022 AGUS RIYONO 1 8 0 2 1 4 5 0 2 9 8 0 0 0 0 1 ANITA
57 1/14/2022 DWI SETIYONO 1 8 0 2 0 4 4 5 0 6 9 1 0 0 0 5 ANA
58 1/15/2022 ANDIKA EFENDI 1 8 0 2 0 7 6 4 1 1 8 8 0 0 0 4 DARMI
59 1/17/2022 RANGGA UMBARA 1 8 0 2 1 7 2 0 0 5 8 7 0 0 0 1 MAYA ANGKA SAR
60 1/17/2022 TEGOH SANTOSO 1 8 0 2 2 1 5 2 0 4 8 5 0 0 0 5 SULASMI
61 1/17/2022 TOBINGAN 1 8 0 2 1 5 5 5 0 9 8 9 0 0 0 1 LEGIYEM
62 1/17/2022 SUMADI 1 8 0 2 1 5 4 8 0 3 8 0 0 0 0 2 MUJIYATI
63 1/17/2022 SUWANDI 1 8 0 2 0 4 5 7 0 3 8 1 0 0 0 3 SUMARTI
64 1/17/2022 PARIYAN 1 8 0 2 1 5 4 4 0 3 6 3 0 0 0 1 PARYATI
65 1/17/2022 ARPAN WIJAYA 1 8 1 2 0 1 5 8 1 1 9 9 0 0 0 8 MELIANA NOVELA
66 1/17/2022 MISNAN 1 8 0 6 2 7 4 9 1 0 9 ###0 0 0 0 1 SITI LESTARI
67 1/17/2022 MAT JAHRI 1 8 0 8 1 2 5 9 0 7 9 2 0 0 0 2 NIRWANTI
68 1/17/2022 MASHUDI 1 8 0 8 1 1 5 5 0 6 9 5 0 0 0 3 YULIANA
69 1/17/2022 ABDULLAH BIN ARIF SPMSI 1 8 0 2 0 7 5 5 1 0 8 9 0 0 0 6 LINDA OKTAVIAN
70 1/17/2022 IWAN SUNOKO 1 8 1 2 0 1 5 5 0 9 9 2 0 0 1 0 NUR AINI
71 1/17/2022 ASEP SAPUTRA 1 8 0 5 1 2 4 8 0 5 9 2 0 0 0 4 TRIANI
72 1/18/2022 SUPRIYANTO 1 8 0 8 1 2 4 7 0 7 9 2 0 0 0 1 RIYANTI
73 1/18/2022 M.ALI 1 8 0 7 1 3 0 8 0 1 9 1 0 0 1 1 ERDALIA
74 1/18/2022 AGUS SUPRIADI 1 8 0 8 1 2 5 4 0 5 9 0 0 0 0 4 ITA PUSPITA SARI
75 1/18/2022 BASUKI 1 8 1 1 0 5 4 6 0 6 7 9 0 0 0 2 MISEM
76 1/19/2022 JAHRI EPENDI 1 8 0 2 2 1 5 3 1 0 8 7 0 0 0 4 OKTAVIA
77 1/19/2022 TONI WAHYUDI 1 8 0 2 1 5 1 0 4 9 6 0 0 0 0 3 VIVI ROSSYANA
78 1/19/2022 HARUDI 1 8 0 2 0 4 1 3 0 7 8 7 0 0 0 4 MARYANA
79 1/19/2022 RIZKI FAHRIZA 1 8 0 2 0 4 4 8 0 7 9 1 0 0 0 4
80 1/19/2022 MANSYUR 1 8 0 2 0 4 4 7 0 4 8 3 0 0 0 3
81 1/19/2022 ANWAR 1 8 0 2 0 4 4 3 0 5 8 1 0 0 0 8
82 1/20/2022 ANGGA SAPUTRA 1 8 0 2 0 4 4 5 0 7 9 8 0 0 0 6
83 1/20/2022 BUDI SANTOSO 1 8 0 2 0 4 4 3 0 4 8 1 0 0 0 5
84 1/20/2022 ALMUARIP 1 8 0 2 0 4 4 7 0 9 8 2 0 0 0 4
85 1/20/2022 ENDAR SAPUTRA 1 8 0 2 0 4 5 2 0 4 8 7 0 0 0 8
86 1/21/2022 IWAN SURYADI 1 8 0 2 0 4 6 9 1 1 8 1 0 0 0 3
87 1/21/2022 DANIEL IRAWAN 1 8 0 2 1 4 6 6 0 7 8 5 0 0 0 2
88 1/21/2022 EKO PRATIKO 1 8 0 2 0 7 5 0 1 0 9 2 0 0 0 6
89 1/21/2022 JAUHARI 1 8 0 2 2 3 4 5 0 4 8 3 0 0 0 2
 90 1/21/2022 K.AL ANSORI 1 8 0 2 0 4 6 8 0 2 9 6 0 0 0 2
91 1/21/2022 KHOIRUL 1 8 0 2 0 4 5 8 0 9 9 2 0 0 0 3
92 1/21/2022 SUHARNO 1 8 0 2 0 4 5 7 0 5 9 0 0 0 0 1
93 1/21/2022 MEDY WIJAYA 1 8 0 2 0 4 6 0 1 2 9 4 0 0 0 4
94 1/22/2022 SARENGAT 1 8 0 2 0 4 4 9 1 0 8 6 0 0 0 1
95 1/22/2022 ANGGRO BAKTI 1 8 0 2 0 4 4 9 1 0 8 4 0 0 0 4
96 1/24/2022 SETIADI 1 8 0 2 0 4 5 0 0 7 8 9 0 0 0 6
97 1/24/2022 EDI SAMSURI 1 8 0 2 0 4 4 6 0 5 8 0 0 0 0 5
98 1/24/2022 DEDI SETIAWAN 1 8 0 2 2 3 4 2 0 1 9 8 0 0 0 3
99 1/24/2022 MEDY WIJAYA 1 8 0 2 2 3 4 2 0 1 9 8 0 0 0 4
100 1/24/2022 SUNYOTO 1 8 0 2 0 4 5 0 1 0 8 4 0 0 1 0
101 1/25/2022 AGUS SECIPTO 1 8 0 2 2 3 5 6 0 4 9 5 0 0 0 2
102 1/25/2022 M. KHAIDAR 1 8 0 2 0 4 4 9 1 0 8 6 0 0 0 1
103 1/25/2022 SUJARNO 1 8 0 2 0 4 5 6 0 6 7 7 0 0 0 2
104 1/25/2022 WAHID YAMIN 1 8 0 2 2 3 4 2 0 1 9 8 0 0 0 3
105 1/26/2022 ABDUL ISMAIL 1 8 0 2 1 5 4 4 0 3 6 3 0 0 0 1
106 1/26/2022 SUGIMIN 1 8 0 2 0 4 5 2 0 4 5 8 0 0 0 6
107 1/26/2022 MARDI 1 8 0 2 2 3 4 8 0 9 9 1 0 0 0 3
108 1/26/2022 SUTIKNO 1 8 0 2 0 4 4 3 0 4 8 1 0 0 0 5
109 1/26/2022 M.MA ARUF 1 8 0 2 0 4 5 0 0 7 8 9 0 0 0 6
110 1/27/2022 RUDI HARTONO 1 8 0 7 1 3 4 1 1 0 8 7 0 0 0 2
111 1/27/2022 WIYONO 1 8 0 2 1 5 4 4 0 3 6 3 0 0 0 1
112 1/27/2022 RENDI ADITA 1 8 0 7 3 5 8 1 1 9 8 0 0 0 0 2
113 1/28/2022 TONI SAPUTRA 1 8 0 2 0 4 5 2 0 4 5 8 0 0 0 6
114 1/28/2022 AHMAD ABADI 1 8 0 2 2 3 4 8 0 9 9 1 0 0 0 3
115 1/28/2022 DODI AS 1 8 0 7 2 1 4 5 1 1 9 7 0 0 0 1
116 1/28/2022 SUMARNO 1 8 0 2 0 4 6 9 0 6 9 4 0 0 0 3
117 1/28/2022 A. MADE D.S 1 8 0 2 0 4 6 4 0 6 7 9 0 0 0 3
118 1/29/2022 SYARIFUDIN 1 8 0 2 0 4 6 2 0 5 9 9 0 0 0 1
119 1/29/2022 ANGGA HAROSA 1 8 0 9 0 3 5 9 0 9 9 6 0 0 0 6
120 1/29/2022 ANDRE SATRIA 1 8 0 2 0 7 6 7 1 1 9 2 0 0 0 5
 8 0 2 1 5

ISTRI ALAMAT

TANGGAL
NAMA LAHIR

5 6 7

SITI MARDIANA 3/26/1987 SRIWALUYO I RT/RW 015/006 BUYUT ILIR

IKA NURJANAH 8/25/1997 DS.2 PUTRA BUYUT RT/RW 004/002
KIKI PRANASARI 2/6/1984 JL.MOJOPAHIT LK IV RT/RW 003/001
YULIANTI NILAWATI 12 07 1976 GUNUNG SUGIH RAYA RT/RW 001/005
INA YUSWITA 12/1/1984 LINGKUNGAN II RT/RW 011/002
NURUL KHOSIDAH 9/15/1992 SRIWALUYO I RT/RW 015/006 GUNUNG SUGIH
NIA RIANI SARI 9/26/1988 DUSUN III RT/RW 009/003 WATES
NURYA RAGA UTAMI 6/26/1997 LINGKUNGAN II BARU RT/RW 001/002 GUNUNG SUGIH RAYA
NORMA SEPTRIANA 10/27/1989 GUNUNG SUGIH RAYA RT/RW 003/003
PITRI 6/2/2000 GUNUNG RAYA RT/RW 001/001 KECAMATAN PUBIAN
FINDI AYUNI 2/16/2001 BUMI SAKTI RT/RW 026/009
ISTIYANI 5/14/1985 PURWASARI RT/RW 003/001
EKA YULIYANTI 30-0901993 SULUSUBAN RT/RW 035/008
LIA ANITA 7/8/1988 SEGALA MIDER RT/RW 001 /001 PUBIAN
WIKE SUGIANTI 10 04 1997 DUSUN II RT/RW 002/004 TERBANGGI BESAR
NURUL KHOSIDAH 9/15/1992 SRIWALUYO I RT/RW 016/006 GUNUNG SUGIH
NOVI SETYANINGSIH 11/21/1989 DUSUN V SIDO BANGUN RT/RW 018/005
YATINI 7/2/1989 PAJAR MATAPAM RT/RW 024/007
MARIYANI 4/4/1993 DUSUN WONOREJO RT/RW 017/005
NUR FITRIYANA 7/26/1992 DUSUN II RT/RW 007/002 BEKRI
TUTI ALAWIYAH 4/22/1994 DUSUN VIII SUKA JAWA RT/RW 007/010
NURWANI SARI 2/23/1991 NEGERI RATU RT/RW 001/001
FITRI AYU WANDIRA 6/6/2002 DUSUN II RT/RW 007/002 BEKRI
WIWIK WINARSIH 2/12/1985 GAYA SAKTI RT/RW 009/002
ENDANG FITRIANI 3/18/1993 DUSUN II TULUK KAKAN RT/RW 003/002
PAINI 7/16/1986 DUSUN III SUKAJAWA 028/004
ROSDIANA 9/21/1987 LINGKUNGAN I RT/RW 003/001
SUPRIHATIN 8/23/1989 DUSUN SRI WALUYO I RT/RW 017/006
JUNAIYAH 7/27/1999 DUSUN I INDUK RT/RW 002/-
CEMILIA SAFITRI 2/19/1997 DUSUN I RT/RW 003/001 BUYUT ILIR
YULIANA 7/6/1984 DUSUN II TELUK DALEM RT/RW 002/001
SUTARMI 12/15/1980 DUSUN V BANGUN SARI I RT/RW 003/001
RENI WATI 8/18/1991 DUSUN VI BANGUN SARI II RT/RW 003/001
MUJI LESTARI 1/10/1986 DUSUN V BANGUN SARI I RT/RW 004/001
MIFTAHUL KHOIRIAH 5/26/1992 LINGKUNGAN II RT/RW 006/-
MARSIATI 11/22/1980 DUSUN VI PUTRA BUYUT
HERMA WATI 12/15/1978 DUSUN 3 SUNDAY
KARISEM 11/8/1978 DUSUN V BANGUN SARI
HAPIPAH 8/14/1985 DUSUN I RT/RW 001/001 BUYUT UDIK
NOVA SARI 2/26/1994 DUSUN I RT/RW 003/002
DIANA SEPTIANA 8/11/1979 DUSUN 3 RT/RW 001/001
DESI MALA SARI 12/8/1994 DUSUN 2 RT/RW 001/001
NITA VERINA 24/04/19845 DUSUN 3 RT/RW 001/001
EPIYANA 7/18/1984 DUSUN 3 RT/RW 001/001
BISWATI 4/12/1979 DUSUN 5 RT/RW 001/001
TITIS ROHAYATI 5/23/1983 DUSUN 5 RT/RW 002/001
SRI WINARTI 7/8/1975 DUSUN 5 RT/RW 004/001
SUMARMI 9/16/1980 DUSUN 5 RT/RW 001/001
IDA WATI 2/10/1988 DUSUN 2 RT/TE 002/001
RENI BUSTI 1/7/1996 DUSUN 2 RT/RW 003/001
PUJI LESTARI 7/18/1989 DUSUN 4 RT/RW 006/003
RINI KUSWINDARI 11/3/1988 DUSUN 3 RT/RW 003/001
SRI UTAMI 7/18/1970 LINGKUNGAN 1 GEDONG SARI RT/RW 006/002
SUTARSIH 2/9/1986 DUSUN 8 SUKAJAWA RT/RW 008/003
NENENG 6/3/1991 DUSUN 2 SIDOREJO RT/RW 011/005
ANITA 3/18/1995 DUSUN 4 BUMIJAYA RT/RW 014/003
ANA 6/5/1991 DUSUN 3 MARGOYOSORT/RW 003/-
DARMI 11/24/1988 DUSUN 7 RT/RW 002/007
MAYA ANGKA SARI 5/20/1987 JL UDARA RT/RW 002/002
SULASMI 4/12/1995 BUMI JAYA RT/RW 007/004
LEGIYEM 9/15/1989 DUSUN V SUMBEREJO RT/RW 018/007
MUJIYATI 3/8/1980 BAGUN SARI RT/RW 001/005
SUMARTI 3/17/1981 SRIMULYO RT/RW 001/004
PARYATI 3/4/1963 DUSUN I SIDOREJO RT/RW 003/001
MELIANA NOVELA 11/18/1999 DUSUN 1 RT 001/001
SITI LESTARI 10/9/1990 SIDO MAKMUR RT/RW 003/004
NIRWANTI 7/19/1992 MATARAM RT/RW 004/004
YULIANA 6/15/1995 GISTING JAYA RT/RW 014/004
LINDA OKTAVIANA S.P 10/15/1989 JL BABAKAN LIO RT/RW 002/008
NUR AINI 9/15/1992 PANARAGAN RT/RW 002/012
TRIANI 5/8/1992 MEDA SARI RT/RW 005/005
RIYANTI 7/7/1992 TEGAL MUKTI RT/RW 006/002
ERDALIA 1/2/1992 DUSUN I RT/RW 001/001
ITA PUSPITA SARI 5/14/1990 NEGARA JAYA RT/RW 001/002
MISEM 6/6/1979 DUSUN I MAJOPAHIT RT/RW 011/006
OKTAVIA 10/13/1987 PODO URIP RT/RW 010/004
VIVI ROSSYANA 4/1/1997 DUSUN I MARGOYOSO
MARYANA 7/13/1987 DUSUN I RT/RW 001/001
SUSANTI 7/8/1991 DUSUN IN\ RT/RW 001/001
ELMA SEHA 4/7/1983 DUSUN I RT/RW 003/001
SRI MAWATI 5/3/1981 DUSUN I RT/RW 003/001
MARISKA KIAN MARYANI 7/5/1998 DUSUN I RT/RW 002/001
SURATI 4/3/1981 PAGAR WAJA
MEGA WATI 9/7/1982 DUSUN II RT/RW 011/004
EBETRI 11/10/1984 DUSUN II RT/RW 005/002
ANSRIYANI 11/29/1981 DUSUN II RT/RW 005/002
UNTARI 7/26/1985 DUSUN II RT/RW 001/001
LENI FERIYANTI 10/10/1992 DUSUN IV RT/RW 002/007
FITRIANI 4/5/1983 DUSUN GAJAH TIMUR
YOHANA ADE HELIYASWATI 2/28/1996 DUSUN KAUMAN
ANA PRAJU WINATA 9/18/1992 DUSUN SRI LUNGGUH
NURDIYANTI 5/17/1990 DUSUN IV RT/RW 001/001
MISDA 12/20/1994 DUSUN II RT/RW 001/001
PRAPTI 10/9/1986 DUSUN IN\ RT/RW 001/001
NURUL ISTIKOMAH 7/29/1990 SRI LUNGGUH I RT/RW 006/003
SRI WAHYUNI 7/10/1989 DUSUN SRI WALUYO I RT/RW 017/006
SRI ANIK 5/6/1988 GUNUNG ADI RT/RW 002/004
NURHASANAH 1/2/1998 SRIWALUYO I RT/RW 019/009
MISDA 12/20/1994 DUSUN I INDUK II RT/RW 005/002
PONIYEM 10/10/1984 SRI WALUYO I RT/RW 016/006
SITI UMAYAH 4/16/1995 SRI WALUYO I RT/RW 017/006
DEVI NOPITA S 5/17/1990 SRI WALUYO I RT/RW 016/006
SUMARTIYAH 6/16/1977 SRI WALUYO I RT/RW 016/006
JAMIATU ROHMAH 8/27/1986 TULUNG MAS
LISMAWATI 11/22/1989 DUSUN I RT/RW 001/001
WARSI 4/12/1978 DUSUN SRILUNGUH I RT/RW 006/003
SEPTI SUSANTI 9/8/1991 DUSUN SRILUNGUH I RT/RW 006/003
SUTRIKA 4/3/1981 DUSUN SRILUNGUH I RT/RW 006/003
Y.ERMA WATI 7/12/2001 SRIWALUYO I RT/RW 019/009
SUKIYATI 10/1/1987 SRIWALUYO I RT/RW 019/009
ERNAWATI 11/22/1989 SRIWALUYO II RT/RW 0O7/003
SURANTIYAH 11/18/1998 DUSUN I RT/RW 002/001
ZULAIHA 4/12/1990 DUSUN IN\ RT/RW 001/001
DEWI KURNIATI 3/25/1990 SRILUNGUH II
KHAZAH A.A 11/5/1997 DUSUN IN\ RT/RW 001/001
D.DAMAYANTI 6/29/1994 PAGAR WAJA
E. SUPATMI 6/24/1979 SRIWALUYO I RT/RW 019/009
V.DAYU ANGGRAINI 5/22/1999 DUSUN INDUK I RT/RW 003/001
OCHI S YANTI 9/12/1996 DUSUN I RT/RW 003/001
NOVINDA SARI 11/27/1992 DUSUN II RT/RW 005/002
 1 2 3 4 5 6
2022
7 8 9 10 11 12

JENIS TINDAKAN KASUS PENGGUNAAN SUMBER

STATUS PESERTA KB (Kode)
(Kode) (Kode) ASURANSI ALOKON

PELAYANAN BERGERAK
INFORMED CONSENT

PASCA KEGUGURAN
PASCA PERSALINAN

KOMPLIKASI BERAT
OPERATIF/PEMBERIAN/

BPJS KESEHATAN
PENCABUTAN DAN

PENCABUTAN

KEGAGALAN
NO. HANDPHONE

PEMASANGAN

PEMASANGAN

MANDIRI
LAINNYA
TIDAK
APBN
APBD
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 4
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
3 √ 4
3 √ 3
3 √ 3
1 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
1 √ 4
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
3 √ 3
1 √ 3
1 √ 3