Puskesmas / RS :Puskesmas TIRIS

DUSUN: MANGGIS DESA TIRIS

No NIK Nama

1 3513074101690000 MISNA
2 3513074704980003 JUMAATI
3 3513074107580024 JUMIANTI.
4 3513074107780017 BUNI
5 3513074107800032 MANI
6 3513075603790003 SUTIK
7 3513075012590001 AKMA
8 3513070107870107 TOHAR
9 3513070107680021 MISRO
10 3513074111880001 WASI'A
11 3513074107830713 SATIK
12 3513070107720439 USMAN
13 3513070107870506 MARSO
14 3513074107910445 SUMATRI
15 3513070208870003 MISLAM
16 3513070506800005 SALIM
17 3513074107830789 PAIDA
18 3513076107880001 SAIDA
19 3513071809820001 HERMANTO
20 3513074107850745 NITI
21 3513074911980002 LULUK
22 3513070107780015 SAWI
23 3513074208870003 MISRI
24 3513074107800014 JUMANI
25 3513071007500004 MISDAN SUMARYA
26 3513070107700381 TUMO
27 3513070307770001 SALE
28 3513071502940002 SUKRI
29 3513070107720001 KUS
30 3513070107770015 ADI
31 3513074107680862 RUHA
32 3513074107650008 ASTI
33 3513075303660001 SARINAH
34 351301808860003 TAUFIK HIDAYATULLAH
35 3513074107600012 MISNI
36 3513074107810005 MISRI
37 3513074510860002 SUNARMI
38 3513075004810004 SAMI
39 3513075605830004 SUMIATI
40 3513074608640001 READI / P
41 3513075006010002 SULASTRI
42 3513074409990001 ENDANG
43 3513074107660153 NISI
44 3513075305780003 SULAIHA
45 3513070410770001 ADI
46 3513070106760001 ROSIDI
47 3513074107820096 NIMA
48 3513074107460277 SATI
49 3513074605790002 EM
50 3513074107990150 JUMANI
51 3513074107620134 TOYAMI
52 3513074107780045 JUMARI
53 3513074408890003 SATRI
54 3513074206760003 SUTI
55 3513070107760104 HASAN
56 3513071710830003 ASMAD
57 3513070107480100 ABDULLA
58 3513074107500007 JUMI.
59 3513074107920448 AMI
60 3513075209920003 MUSLIMAH
61 351307010766050 KASIMAN
62 3513074107740007 ARMI
63 3513076007900003 IMROATUS SOLEHA
64 3513074107770107 MIS
65 3513074107600013 NINTI
66 3513074402820006 SITI ASIYA
67 3513074102010001 NURMALA SATIMA
68 3513070107810504 ATRO
69 3513076609690001 HARTATIK
70 3513075807810003 TUNI
71 3513070107640092 SATUN MISWA
72 3513070107840095 SUMAI
73 3513074107760024 ASNATI
74 35130701900004 LIHIN
75 3513070107690504 MISLI
76 3513075304570002 SARINA
77 3513070507900001 SUL FAEDI
78 3513074107780031 JUMANI
79 3513074511020002 SRI WAHYUNI
80 3513075803980001 HOSNIAH
81 3513070605870002 KUSMAN FELANI
82 3513081210850001 AHMAD FAUSI
83 3513070708940001 TOSAN
84 3513076106780003 AYEM
85 3513074204810006 NARSI
86 3513074712890001 BUNI
87 3513070805860002 SUTAR
88 3513074107690085 TUNI
89 3513074107870519 ANI
90 3513072107450001 ENDIN SASMITO
91 3513076807860001 MARNI
92 3513074107790542 SANI
93 3513075208870004 SIPAK
94 3513075308940001 INDAH WATI
95 3513074107690049 TORIMA
96 3513074107760031 TUTIK
97 3513074101790001 PAIDA
98 351305802760003 MISNA
99 3513074107780832 SANATI
100 3513074303940003 SITTI AISAH

3513074107830798
129
130
 Alamat Instansi

MANGGIS 19/04
MANGGIS 18/06
MANGGIS 18/04
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/06
JAMBUAN 18/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 18/04
MANGGIS 18/04
MANGGIS 22/04
MANGGIS 20/04
MANGGIS 21/04
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/04
MANGGIS 18/05
MANGGIS 19/04
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/04
JAMBUAN 14/03
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/05
MANGGIS 20/04
MANGGIS 19/04
MANGGIS 20/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/04
MANGGIS 18/05
MANGGIS 20/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 20/04
JAMBUAN 14/03
JAMBUAN 14/03
MANGGIS 19/04
MANGGIS 20/04
MANGGIS 19/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 21/04
MANGGIS 19/04
MANGGIS 19/06
MANGGIS 19/06
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/05
MANGGIS 20/04
MANGGIS 20/05
MANGGIS 18/04
MANGGIS 18/04
MANGGIS 20/04
JAMBUAN 14/03
MANGGIS 18/04
MANGGIS 21/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 22/05
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/05
MANGGIS 21/04
MANGGIS 21/04
MANGGIS 19/04
MANGGIS 18/04
MANGGIS 18/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/04
MANGGIS 22/04
MANGGIS 22/04
MANGGIS 18/04
MANGGIS 22/04
MANGGIS 18/04
MANGGIS 19/06
MANGGIS 20/05

MANGGIS 18/4
kelompok vaksinasi (nakes, single/multi
Dosis 1 Dosis 2
pelayan publik, lansia) dose

11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 15-Oct-21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 29-Sep-21
11-Jun-21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 9/29/2021
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21 9/29/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 10/15/2021
11-Jun-21 9/29/2021
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21/AZ
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 9 JULI 21
11-Jun-21 10/15/2021
11-Jun-21 9 JULI 21
11-Jun-21
11-Jun-21 9 JULI 21
11-Jun-21

10/15/2021
single/multi Masuk Pcare
Keterangan
dose (Ya/Tidak)
=
SUDAH VAKSIN DOS 2 15-10-21
YANG BELUM VAKSIN DOSIS 2 25 ORG
Puskesmas / RS :Puskesmas TIRIS
DUSUN : TIMUR SUNGAI DESA TIRIS

No NIK Nama

1 3513074112770000 SAMINA
2 3513074107540040 SUCI WARMI
3 3513070107300030 TORIMAN P.DARNA
4 3513074107780009 MISWA
5 3513070107870494 MOH.SANTOSO
6 3513070107621027 MU'IN
7 3513071807580001 SAIFUL
8 3513075105500004 NIMA
9 3513077012620001 TUNA
10 3513076304890001 FINI INDRAWATI
11 3513075802960001 MEGA IRAWATI
12 3509234107830230 NUR LELA
13 3513071310950006 KHOIRUL ACHMAD SHOLEH
14 3513072407010001 ADITYA PUTRA PRASETYA
15 3513072001830002 ZAINUDIN
16 3513070705860004 MOH.FADILLA ERWANTO
17 3513076910980002 ROSALINA WIJAYANTI
18 3513070508920003 ULIFAH
19 3513075012970003 WAHYU NURUL ISTIQOMAH
20 3513072406710002 MIARSO
21 3513070107600016 MA'AT
22 3513074107680013 ASMI
23 3517011301890002 MOH.ANAS ZAMROZY
24 3513074107400349 ROKAYATUN
25 3513073103860002 MUHAMMAD HOSNAN
26 3513074207750001 NUR HAYATI
27 3513074912810001 YENI RAHMAWATI
28 3513075010650001 ZUMROTUS SHOLIHAH
29 3513071810870002 EKO HENDRIYANTO
30 3513070107720039 SLAMET
31 3513074107650018 MINA
32 3513071106620004 TOSARI
33 3513074411810001 HARLINI
34 3315171907850002 JOKO DWI SANTOSO
35 3513074101000014 MELINYA INDAH RAMADHANI
36 3513075105010002 DEBI FANISA
37 3513070702850001 SUHARTONO
38 3513074304810004 INDA YUSTIFA
39 3513072110020001 PANJI AHMAD BAHTIAR
40 3513075604740002 NUR HIDAYATI
41 3513073101030001 MUHAMMAD ANGKY KURNIA
42 3513075712400001 RUSMINIYATI
43 3513070107670078 SUDI
44 3509034207910004 JAUHAROTUL KAMALIAH
45 3513070104750005 MALI
46 3513074107730014 BUNA
47 3513074107550359 MISNI
48 3513095706940001 IIN PUSPITA DEWI
49 3513076004720001 SANA
50 3513074107620059 ERNA KISMIATI
51 3513074107750397 JUMA'ATI
52 3513070107760545 KUSNADIYANTO
53 3513074107830170 ARSIA
54 3513074107550043 HASIA
55 3513076707830003 SAMA
56 3513076509880002 INDAYATI
57 3513074107410204 ARIS
58 3513074107460076 SATRI
59 3513070305560001 NUR HAMID
60 3513072707580001 ANANG BUDI PRASETYO
61 3513074107620126 YULIATI NINGSIH
62 3513070508410001 MARWI
63 3513074107590054 MURNIATI
64 3513070107480341 SATO
65 3513070107490015 MALIDIN P.CIPTO
66 3513075406740002 WIWIK ASTUTIK
67 3513072507700002 BUDIYONO
68 3513070704650004 ACH.SUMARNOTO
69 3513075007740004 WIWIK KASIYATI
70 3513074107520038 SITI
71 3513075612820003 RUKMIATI
72 3513075503840007 HOLIPA
73 3513076609630002 DEVIS HARI WIDI ASTUTI
74 3513076811600001 PONI RAWATI
75 3513076010780002 MARWATI
76 3513074201680003 RAHMI
77 3513074808740002 HINDA WARTI
129
130
DOSIS 1 : TGL 17-05-DOSIS 2 : TGL 10-08-21

Alamat Instansi

TIMUR SUNGAI 008/002

TAMAN 002/001
TIMUR SUNGAI 010/002
TIMUR SUNGAI 010/002
TIMUR SUNGAI 009/003
TIMUR SUNGAI 009/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 010/002
TIMUR SUNGAI 010/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/003
TIMUR SUNGAI 009/002
KRAJAN 005/001
KRAJAN 005/001
TAMAN 001/001
KRAJAN 001/001
TIMUR SUNGAI 010/002
TIMUR SUNGAI 008/002
JAMBUAN 017/004
TIMUR SUNGAI 009/003
TIMUR SUNGAI 009/003
KRAJAN 004/001
KRAJAN 001/001
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TAMAN 001/001
KRAJAN 004/001
TAMAN 001/001
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 009/002
KRAJAN 005/002
TIMUR SUNGAI 009/003
TIMUR SUNGAI 009/003
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 010/002
TAMAN 003/001
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 010/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TAMAN 002/001
TIMUR SUNGAI
TIMUR SUNGAI 009/002
TIMUR SUNGAI 012/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 008/002
TIMUR SUNGAI 012/002
KRAJAN 005/001
KRAJAN 005/001'
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 009/002
TIMUR SUNGAI 010/002
KRAJAN 004/001
TIMUR SUNGAI 008/003
TIMUR SUNGAI 009/002
TIMUR SUNGAI 008/002
KRAJAN 005/001
KRAJAN 004/001
TIMUR SUNGAI 008/002
TIMUR SUNGAI 009/002
TAMAN 001/001
KRAJAN 005/001
TIMUR SUNGAI 009/002
KRAJAN 001/001
TIMUR SUNGAI 008/002
kelompok vaksinasi (nakes, single/multi
Dosis 1 Dosis 2
pelayan publik, lansia) dose

MASYARAKAT UMUM 17-05-2021

MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 HAMIL
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021
MASYARAKAT UMUM 17-05-2021 10/8/2021
single/multi Masuk Pcare
Keterangan
dose (Ya/Tidak)

ASTRAZENECA
YG BLM DOSIS 2 : 35 ORG
Puskesmas / RS :Puskesmas TIRIS

No NIK Nama Alamat

1 3513072403910000 SYAMSUL ARIFIN TUNGGENGAN 25/06

2 351306101900004 SITI SUSANTI TIMUR SUNGAI
3 3513114107970092 HAYATUN NOPUS TAMAN
4 3513072605960002 RIHZA MAHDANI TAMAN
5 3513074808880006 SUNARTI TUNGGANGAN 25/5-TIRIS
 kelompok
single/
vaksinasi (nakes,
Instansi Dosis 1 multi Dosis 2
pelayan publik,
dose
lansia)
GAN 25/06 22-5-21
22-5-21
22-5-21 SUDAH
22-5-21 SUDAH
GAN 25/5-TIRIS 22-5-21 16-8-21
 Masuk
single/
Pcare
multi Keterangan
(Ya/Tida
dose
k)
Puskesmas / RS :Puskesmas TIRIS

No NIK Nama Alamat Instansi

1 3513074702760000 BEBUN TUNGGENGAN 24/05

2 3513072203990002 USAMMAH ALADIN TUNGGENGAN
3 3513074107780222 SARI TUNGGENGAN
4 3513074107580138 SARNI TIRIS
5 3510180807840005 MIFTAKUS SAIFULLTAMAN
6 3513076303930001 HALIMATUS SYA'DI TUNGGENGAN 24/05
7 3513074107680205 NITI TUNGGENGAN 24/05
8 3513074107520499 JUMANI TUNGGENGAN 24/05
9 3513074106920002 ZEM TUNGGENGAN 24/05
10 3513072404870004 ABDUL AZIZ TUNGGENGAN 24/05
 kelompok Masuk
single/ single/
vaksinasi (nakes, Pcare
Dosis 1 multi Dosis 2 multi
pelayan publik, (Ya/Tida
dose dose
lansia) k)
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
28-6-21 26-7-21
Keterangan
 DAFTAR SASARAN/PENERIMA VAKSIN COVID-19
PUSKESMAS TIRIS 2021
DESA TIRIS

NO NAMA NIK TTL

1 HASAN "3513074202360001 8/2/1988

2 PAING "3513070211830002 11/2/1983
3 SUGIONO "3513071409980001 9/14/1998
4 MISRO "3513070107750511 5/7/1980
5 ERIT "3513070904750003 4/9/1975
6 EMAT "3513070107430329 7/1/1943
7 IDAWATI "3513074510930001 10/5/1993
8 FARIDA "3513076109020001 8/18/2001
9 BUSAH "3513070107160661 7/1/1976
10 SAMU "351307010690022 7/1/1969
11 SANAH "3513071209770001 9/12/1977
12 NASIR "3513071708820005 8/17/1982
13 ABDUL HALIK "3513072407760002 4/9/1976
14 SAMAN "3513070107630001 7/1/1963
15 SUNARTI "3513074107740005 7/1/1974
16 SHOLEHA "3513075706960003 6/17/1996
17 DIDIK KURNIAWAN "3513070107000162 10/26/1998
18 ENDIN "3213070702560001 2/7/1956
19 TONI "3513075212790003 12/12/1979
20 SAPI'I "3513071008740004 8/10/1974
21 SITI AMINAH "3513074107970001 7/1/1997
22 HANIFA "3513074607990003 7/6/1999
23 JATIM "3513075301730001 1/13/1973
24 TOHE "3513070107660028 7/1/1966
25 SAMI "3513076104820003 4/21/1982
26 ABD AZIZ "3513072410920001 10/24/1992
27 NAZE "351307010620122 7/1/1962
28 MUSLIMAH "3513075608960003 8/16/1996
29 SUMIATI "351307610780000 7/21/1980
30 MAINA "3513074107830790 7/1/1983
31 SATIK "3513074104800003 4/1/1980
32 YULIATI "3513074107800605 7/1/1980
33 SLAMET "3513071202960001 3/3/1990
34 SIMA B SUTI "3513074101700006 1/1/1970
35 ENDANG SRI WAHYUNI "3513075203040004 2/4/1993
36 WATI "3513074107820527 7/1/1982
37 SAMI "3513074107940378 7/1/1994
38 MISNI "3513076105960003 1/1/2000
39 NIPA "3513074605860003 7/1/1987
40 TORINI "3513074107680020 7/1/1968
41 SARU "3513070107760146 7/1/1976
42
43
44
45
46
47
48 MISNA 3513074101690001 1/1/1996
49 SUL FAEDI 3513070507900000
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
RAN/PENERIMA VAKSIN COVID-19
USKESMAS TIRIS 2021

ALAMAT DOSIS 1 DOSIS 2 KETERANGAN

MANGGIS 19/4 7/9/2021 10/15/2021
MANGGIS 18/4 7/9/2021
MANGGIS 19/05 7/9/2021
MANGGIS 22/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/05 7/9/2021 9/29/2021
MANGGIS 19/05 7/9/2021 10/15/2021
MANGGIS 19/05 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021
MANGGIS 19/04 7/9/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/05 7/9/2021 9/29/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 9/29/2021
TLOGOSARI 07/03 7/9/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 18/04 7/9/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021
MANGGIS 11/03 7/9/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 18/04 7/9/2021 10/15/2021
MANGGIS 21/04 7/9/2021 10/12/2021
MANGGIS 21/04 7/9/2021 10/12/2021
MANGGIS 21/04 7/9/2021 10/12/2021
MANGGIS 19/05 7/9/2021
MANGGIS 21/05 7/9/2021 10/12/2021
MANGGIS 19/05 7/9/2021
MANGGIS 20/04 7/9/2021 10/15/2021 YANG BLM DOSIS 2 11 ORG
MANGGIS 19/05 7/9/2021 10/15/2021
MANGGIS 19/05 7/9/2021
MANGGIS 20/05 7/9/2021 10/15/2021
MANGGIS 19/04 7/9/2021 10/15/2021
MANGGIS 19/05 7/9/2021 10/15/2021

###
MANGGIS 19/4 10/15/2021
MANGGIS 19/4 10/15/2021
Puskesmas / RS :Puskesmas TIRIS
DUSUN : TIMUR SUNGAI DESA TIRIS

No NIK Nama

1 35130757077700000 SIH RAHAYU

2 3513074107860728 SURYANI
3 3513071803860002 PUJIONO
4 3513074105540003 WARTI NINGSIH
5 3513074108950001 IKHFI ULIT TAUFIQOH
6 3513075510680003 SARI
7 3513075803520002 SALMA
8 3513074107580046 SURYATI
9 3513074107680058 JUMA'ATI
10 3513084601840005 RUSMIATI
11 351307611700001 PUSPITA NINGSIH
12 3513075706990003 INDAHWATI SHOLEHA
13 3513074502940002 FIKA WULANDARI
14 3513074505780005 ERMAWATI
15 3513074808750001 DARMAWATI
16 3513072701900002 SABAR
17 3513074107490054 BUSIA
18 3513074107720390 MANI
19 3513074102880004 USWATUN HASANAH
20 3513070107860565 RUDIANTO
21 3513075012900007 HOLIFAH
22 3513075705790002 HARIYATI
23 3513070107720085 MISRU
24 3513071211790003 YANTO
25 3513071009610002 KUSBAIN
26 351374107740106 SIA
27 3513074905950001 HALIMATUS SA'DIYAH
28 3513074107560038 BUYA
29 3513076403960003 USLIFATUL JANNAH
30 3513071512860002 USMAN
31 3513075412880003 USWATUN HASANAH
32 3513074107460028 MISRI
33 3513070510600003 AS'AT
34 3513076610780002 MUKMINA
35 3513070107790474 HERUL
36 3513074107740469 MISNA
37 3513074107780035 SIMA
38 3513070602600003 SAWI
39 3513070608900004 KOSNO
40 3513074405930004 MELISA AVINA BIRO
41 3513070107460043 NAPI
42 3513072510840005 SAMIN
43 3513071712710002 SATIMAN
44 3513074107640357 SAMA
45 3513070508920003 ULIFAH
46 3513072707580001 ANANG BUDI PRASETYO
47 3513076406870003 LENI AMIYATI
48 3513071810870002 EKO HENDRIYANTO
49 3513075602480001 ASMANI
50 3513072611980004 ISHAK
51 3513080809980001 SUTIKNO
52 3513070509730002 SUYATNO
53 3513074107780249 SAMA
54 3513074810720001 SENIA
55 3513074107830732 RIRIN
56 3513070410800001 RUDIANTO
57 3513070307940001 MUHAMMAD
58 3513074107660501 MARYAM
59 3513071610790002 MOH.HASMAN
60 3513072008740001 DERI
61 3513070108020012 MUH.ILHAM
62 3513074405890005 JUHAIRIYAH
63 3513074107720468 HARTATIK
64 3513071608880001 BAGUS KOMARULLAH
65 3513076666010001 NUR HALIMA
DOSIS 1 : TGL 10-08-DOSIS 2 :
kelompok vaksinasi
Alamat Instansi (nakes, pelayan publik,
lansia)

TIMUR SUNGAI 9/3 MASYARAKAT UMUM

KRAJAN 1/1 MASYARAKAT UMUM
KRAJAN 3/1 MASYARAKAT UMUM
KRAJAN 6/1 MASYARAKAT UMUM
KRAJAN 2/1 MASYARAKAT UMUM
TUNGGANGAN 23/5 MASYARAKAT UMUM
KRAJAN 21/1 MASYARAKAT UMUM
KRAJAN 2/1 MASYARAKAT UMUM
KRAJAN 2/1 MASYARAKAT UMUM
SUMBER DUREN 3/1 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
SUMBER LELE 1/1 MASYARAKAT UMUM
TIMUR SUNGAI 8/2 MASYARAKAT UMUM
TIMUR SUNGAI 8/2 MASYARAKAT UMUM
KRAJAN 6/1 MASYARAKAT UMUM
TIMUR SUNGAI 11/3 MASYARAKAT UMUM
KRAJAN 5/1 MASYARAKAT UMUM
TIMUR SUNGAI 12/3 MASYARAKAT UMUM
TIMUR SUNGAI 12/3 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
TIMUR SUNGAI 11/3 MASYARAKAT UMUM
MANGGISAN 22/4 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
MANGGIS 22/4 MASYARAKAT UMUM
TUNGGENGAN 26/5 MASYARAKAT UMUM
MANGGISAN 19/4 MASYARAKAT UMUM
LAWANG KEDATON 13/4 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
TUNGGANGAN 23/5 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TUNGGANGAN 23/5 MASYARAKAT UMUM
TUNGGANGAN 29/6 MASYARAKAT UMUM
TUNGGANGAN 29/6 MASYARAKAT UMUM
TUNGGANGAN 29/6 MASYARAKAT UMUM
LAWANG KEDATON 14/5 MASYARAKAT UMUM
TUNGGANGAN 23/5 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
TIMUR SUNGAI 11/3 MASYARAKAT UMUM
TIMUR SUNGAI 10/2 MASYARAKAT UMUM
KRAJAN 5/1 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
TAMAN 1/1 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
JAMBUAN 15/3 MASYARAKAT UMUM
JAMBUAN 15/4 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TIMUR SUNGAI 11/3 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TUNGGANGAN 29/5 MASYARAKAT UMUM
KRAJAN 4/2 MASYARAKAT UMUM
JAMBUAN 15/3 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
TIMUR SUNGAI 9/3 MASYARAKAT UMUM
TIMUR SUNGAI 8/3 MASYARAKAT UMUM
TUNGGANGAN 25/5 MASYARAKAT UMUM
KRAJAN 3/1 MASYARAKAT UMUM
KRAJAN 2/1 MASYARAKAT UMUM
LALANGAN 9/4 MASYARAKAT UMUM
 Masuk
single/ single/
Pcare
Dosis 1 multi Dosis 2 multi
(Ya/Tidak
dose dose
)
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
10/8/2021
 Keterangan

ASTRAZENECA
DOSIS 1 SINOVAC,TAPI DIVAKSIN AZ
DOSIS 1 SINOVAC,TAPI DIVAKSIN AZ
DESA : TIRIS

NO NAMA NIK TTL ALAMAT

1 AMI 3513075905800002 5/19/1980 TUNGGANGAN 24/05-TIRIS
2 NUR HASAN 3513071706940004 6/17/1994 TUNGGANGAN 25/05-TIRIS
3 M.KHOUZEN 3513070107930532 2/11/1990 JAMBUAN 13/04 - TIRIS
DOSIS 1 DOSIS 2 KETERANGAN
8/16/2021
8/16/2021
8/16/2021
DESA : TIRIS

NO NAMA NIK TTL ALAMAT

1 ASNI 3513074107500066 7/1/1950 TIRIS 24/05
2 TITIN NAWARO W3513075612940002 12/16/1994 TUNGGANGAN 23/4 TIRIS
3 HODIJAH 3513076007950001 7/20/1995 TIRIS 24/05
DOSIS 1 DOSIS 2 KETERANGAN
7/15/2021
7/15/2021
7/15/2021
DESA : TIRIS

NO NAMA NIK TTL ALAMAT

1 HASAN 3513070107830504 1/7/1983 TUNGGANGAN 24/6, TIRIS
 DOSIS 1 DOSIS 2 KETERANGAN
26/7/2021
No NIK Nama Alamat

1 3513071505900005ZAENAB TIRIS
2 3513073107830001 DEDI TRICAHYONO TIRIS
3 3513075301980001 MILA DEWI ROMADHONI TIRIS
4 3513075005720002 SILAWATI TIRIS
5 3513071010770004 SADIKIN TIRIS
6 3513073011950001 SUPRIYANTO TIRIS
7 3513070103670006 MISTUR TIRIS
8 3513070809720002 MUKARDI TIRIS
9 3513071212630001 AJUN SUPRIANTO TIRIS, DSN TIMUR SUNGAN
10 3513071105530001 SUPARMAN DUSUN KRAJAN
11 3513074107660011 IYA TIRIS
12 3513070408820003 ASNAWI TIRIS
3513074612960003 SITI MARYAM TIRIS
3513074306950003 SITI FATIMAH TIRIS
3513075705820002 BUNAWATI TIRIS
3513074102930002 ENDANG ESTAURINA TIRIS
3513074808880003 NITIK HARYATI TIRIS
3513077006000001 PUTRI HERLISA TIRIS
3513075111010004 RESIANA PUTRI TIRIS
3513074402970001 FITRIYATUL HASANATIRIS
3513075502950001 NURSIDA HASANAH TIRIS
3513077008000004 SITI ROMLA TIRIS
3513075205770003 BUNA TIRIS
3513074107820520 SANIMA TIRIS
3513074303940003 SITI AISYAH TIRIS
3513075210910006 SITI AISAH TIRIS
3513076212550002 SRI HARTINI TIRIS
3513074407010002 INDANA IZZA ZUHRIATIRIS
3513076612780001 WIDAYATI TIRIS
331307040590005 RAHMAT ANSORI TIRIS
3513075605960004 LUTHFI NUR INDAH S TIRIS
3513071701820001 ALIF BUDI RAHMAN TIRIS
3513072503640001 AKHMAD TIRIS
3513071308740002 JOKO NUGROHO TIRIS
3513074507720004 SITI MARIYAM TIRIS
3513075002910001 FEBRIYANTI DIAN KUSUMA TIRIS
3513070504710001
ABD SALIM TIRIS
3513071604640003
SUNARDI TIRIS
3513071810790002 MUHAMMAD HASAN FAUSI TIRIS
3513070507730002 SALIM TIRIS
3513071604770004 SAMSURI TIRIS
3513072603800002 BADRUL MUNIR TIRIS
3513070408820003 ASNAWI DUSUN TIMUR SUNGAI
3513071407800001
MOCH. HUSEN MANSYUR TIRIS
3513070405880003 SOLEHUDIN TIRIS
3513071908630002 SUPRAPTO TIRIS
3513071611650001 BOENGKUS SOEPARTHONO TIRIS
3513080506690003 NIDIN KRUCIL
3513075705700001
SITI SUWATI TIRIS
3508105805850010 TIKA YUDHA EKA HERIYANI LUMAJANG
 kelompok
single/
vaksinasi (nakes,
Instansi Dosis 1 multi
pelayan publik,
dose
lansia)
SD TIRIS TUNGGAN PELAYAN PUBL26/3/2021
CS PONDOK SEHAT PELAYAN PUBLIK 27-Mar-21
PHL POLSEK TIRIS PELAYAN PUBLIK 27-Mar-21
PEDAGANG PASAR PEDAGANG PASAR 27-Mar-21
MI MIFTAHUL HUDA TENAGA PENDIDIK 27-Mar-21
MI IHYAUL ISLAM TENAGA PENDIDIK 27-Mar-21
PEDAGANG PASAR PEDAGANG PASAR 27-Mar-21
MI IHYAUL ISLAM TIRIS TENAGA PENDIDIK 27-Mar-21
SD RANUAGAUNG 2 TENAGA PENDIDIK 29-Mar-21
PEDAGANG PELAYAN PUBLIK 29-Mar-21
CALON JAMAAH HAJI CJI 29-Mar-21
PERANGKAT DESA TIRIPELAYAN PUBLIK 2-Mar-21
SD ALHIDAYAH TENAGA PENDIDI15/4/2021 10
SDN ROTO 2 TENAGA PENDIDI15/4/2021 10.01
KADER TIRIS KADER 15/4/2021 10.03
KADER TIRIS KADER 15/4/2021 10.07
KADER TIRIS KADER 15/4/2021 10.05
KADER KADER 15/4/2021 10.24
KADER KADER 15/4/2021 10.31
KADER KADER 15/4/2021 10.4
KADER KADER 15/4/2021 10.44
KADER KADER 15/4/2021 10.47
KADER KADER 15/4/2021 10.52
KADER KADER 15/4/2021 10.53
KADER KADER 15/4/2021 11.3
SMPI SABIUL HASAN TENAGA PENDIDI 19/4/2021 8.56
LANSIA LANSIA 26/4/2027 9.03
MAHASISWA MAHASISWA 26/4/2028 10.09
PKK PELAYAN PUBLIK 26/4/2030 10.18
PDAM PELAYAN PUBLIK 26/4/21 10.23
GURU SMA UNGGULAN 26/04/21 10.25
STAFF KEC Yan Publik 01/03/2021 multi dose
POL PP Yan Publik 01/03/2021 multi dose
STAFF KEC Yan Publik 01/03/2021 multi dose
STAFF KEC Yan Publik 01/03/2021 multi dose
SMPN 1 TIRIS GURU 02/03/2021 multi dose

KADES 02/03/2021 multi dose

SDN 1 ANDUNGSARI GURU 02/03/2021 multi dose

PERANGKAT DESA 02/03/2021 multi dose
PERANGKAT DESA 02/03/2021 multi dose
PERANGKAT DESA 02/03/2021 multi dose
PERANGKAT DESA 02/03/2021 multi dose
PERANGKAT DESA Yan Publik 02/03/2021 multi dose

PERANGKAT DESA Yan Publik 02/03/2021 multi dose

SMPN 1 TIRIS GURU 02/03/2021 multi dose
SDN RANUAGUNG 3 Yan Publik 02/03/2021 multi dose
SMPN 1 TIRIS GURU 02/03/2021 multi dose
SDN 3 TIRIS GURU 02/03/2021 multi dose

SDN 1 TIRIS GURU 02/03/2021 multi dose

SDN 3 TIRIS GURU 02/03/2021 multi dose
 Masuk
single/
Pcare
Dosis 2 multi Keterangan
(Ya/Tida
dose
k)
12/4/2021
12/4/2021
26/4/2021
26/4/2021
12/4/2021

26/4/2021
12/4/2021
12/4/2021
26/04/21
12/4/2021
3-Apr-21
19/5/21
19/5/21
24/5/21

28/5/21
3/6/2021
24/5/21

24/5/21
28/5/21
24/5/21
24/5/21

19/6/21
28/5/21
28/5/21
3 JUNI 21
28/5/21
15/03/2021

15/03/2021
15/03/2021
16/03/2021

16/03/2021

16/03/2021
16/03/2021
16/03/2021
16/03/2021
16/03/2021
3/4/2021

16/03/2021
17/03/2021
18/03/2021
16/03/2021
16/03/2021

16/03/2021
16/03/2021
 REKAP VAKSINASI PKM TIRIS
LOKASI : KECAMATAN TIRIS
DOSIS 1: 18 AZ
DOSIS 2 : 47 SINOVAC

NO NIK NAMA ALAMAT TTL DOSIS 1

1 3513074107600073 PILIN WAHYUNINGSIH KRAJAN 2/1, TIRIS 1/Jul/1960 6/22/2021
2 3513074107740562 BEBUN TIMUR SUNGAI 10/2, TI 1/Jul/1974 6/22/2021
3 3513070606530001 NUNUNG HERNOWO KRAJAN 4/1, TIRIS 6/Jun/1953 6/22/2021
4 3513075805770002 NIA TIMUR SUNGAI 10/2, TI 18/May/1977 6/22/2021
5 3513075812640001 MIWAH PRIHATINGSIH KRAJAN 4/2, TIRIS 18/Dec/1964 6/22/2021
6 3513074107690004 TUMI KRAJAN 1/1, TIRIS 1/Jul/1969 6/22/2021
7 3513074107540055 SUAMA KRAJAN 5/1, TIRIS 1/Jul/1954 6/22/2021
8 3513070402580001 BUGI TIRIS 5/1, TIRIS 4/Feb/1958 6/22/2021
9 3513152907810001 HADI MAIMUN MANGGISAN 22/04, TIR 29/Jul/1981 6/22/2021
10 3513074109790002 ASI ASIH SUSANTI KRAJAN 2/1, TIRIS 1/Sep/1979 6/22/2021
11 3513074612010001 WIDAYANTI MANGGI 22/4, TIRIS 5/Jul/1996 6/22/2021
12 3513070107570018 MULYONO KRAJAN 4/2, TIRIS 1/Jul/1957 6/22/2021
13 3513076106830003 NUR HAMISA KRAJAN 5/1, TIRIS 21/Jun/1983 6/22/2021
14 3513070107640105 IMAM SUTAJI KRAJAN 3/1, TIRIS 1/Jul/1964 6/22/2021
15 3513076603810001 SITI ATIKAH KRAJAN 6/1, TIRIS 26/Mar/1981 6/22/2021
16 3513074705020002 FAIZATUL ZAHRO JANNKRAJAN 6/2, TIRIS 7/May/2002 6/22/2021
17 3513071908020003 MUCHAMMAD PUTRA TAMAN 5/1, TIRIS 19/Sep/2002 6/22/2021
18 3513074107770006 ASMIATI KRAJAN1/1, TIRIS 1/Jul/1977 6/22/2021
19 3513074107420184 SAWATI KRAJAN 7/1, TIRIS 1/Jul/1941 6/22/2021
20 3513070403760004 SAIFUL KRAJAN 7/1, TIRIS 4/Mar/1978 6/22/2021
21 3513076001590002 SUNDARI KRAJAN 1/1, TIRIS 20/Jan/1959 6/22/2021
22 3513074107950028 SRI AGUSTIN AMALIA TAMAN 3/1, TIRIS 6/Aug/1995 6/22/2021
23 3513075306710002 LILIS SUSILOWATI TAMAN 2/1, TIRIS 13/Jun/1971 6/22/2021
24 3513070107740011 ANTON EFENDI JAMBUAN 13/3, TIRIS 1/Jul/1974 7/24/2021
25 3513071206770002 SHOLEHUDDIN KRAJAN 7/1, TIRIS 12/Jun/1977 7/24/2021
26 3513070808000002 FAISOL AKBAR TIMUR SUNGAI 12/3, TI 8/Aug/2000 7/24/2021
27 3513071807000003 M. AKHSAN AL AHDAFI KRAJAN 6/1, TIRIS 24/Aug/2000 7/24/2021
28 3513070508730002 HARTONO KRAJAN 1/1, TIRIS 5/Aug/1973 7/24/2021
NASI PKM TIRIS

DOSIS 2 KET
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
7/24/2021 LENGKAP SINO
AZ
AZ
AZ
AZ
AZ
LOKASI : PUSKESMAS TIRIS
NO NIK NAMA ALAMAT TTL KELOMPOK JENIS VAKSIN
1 3513072809020003 MOH. DIKI ARYANAN TAMAN 3/1, TIRI 9/28/2002 MASY UMUMAZ
DOSIS 1 DOSIS 2 KET
8/3/2021
NO NIK NAMA TTL ALAMAT KELOMPOK
1 35130'70107620120 MISTARI 7/1/1982 TIMUR SUNGAI 12/2MASYARAK
2 3513074107890520 ANISA 9/13/1982 TIMUR SUNGAI 12/MASYARAK
DOSIS 1 DOSIS 2 KET
7/14/2021
7/14/2021
No NIK Nama

1 3513070107960110AHMAD FAISOL
2 3513070412820000UNTUNG
3 3513072606060000YUSRON ABDILLAH
4 3513075609050000SEPTIYA QORROTA'AYUN
5 3513075104060000NABILA MAULIDA
6 3513075508770000AWILDA RISTA
7 3513074803050000LISA HIDAYAH
 kelompok
vaksinasi (nakes,
Alamat Instansi Dosis 1
pelayan publik,
lansia)

Tunggangan,26/06,tiris Masyarakat umum 21-07-2021

Tunggangan,26/5,Tiris Masyarakat umum 21-07-2021
Tiris,2/1,Tiris Remaja 21-07-2021
Tiris,5/2,Tiris Remaja 21-07-2021
Timur sungai,12/2,Tiris Remaja 21-07-2021
Krajan,5/2,Tiris Remaja 21-07-2021
Timur sungai,8/3,Tiris Remaja 21-07-2021
 Masuk
single/ single/
Pcare
multi Dosis 2 multi Keterangan
(Ya/Tida
dose dose
k)

AZ
AZ
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
No NIK Nama

1 3513071606070002 TRI BAGUS AGUNG GUMELAR

2 3513070705080002 M ISHAK
3 3513071712040003 ARIELLA ADIKA ADIYADMA
4 3513070601080005 MUHAMMAD ROMLI WIDODO
5 3513073110080002 FERGIE OKTA PRADANA
6 3513074712060004 SAVIRA NURAINI
7 351324275790 SITI ROMLA
8 3513074301060003 MEADINE MAR'ATUS.S
9 3513075909060002 AYU PUJI CAHYANI
 kelompok vaksinasi
Alamat Instansi (nakes, pelayan publik,
lansia)

DSN KRAJAN 07/01 DESA TIRIS SMP REMAJA

KRAJAN 01/01 DESA TIRIS REMAJA
KRAJAN 07/01 DESA TIRIS REMAJA
KRAJAN 01/01 DESA TIRIS REMAJA
KRAJAN 07/01 DESA TIRIS REMAJA
KRAJAN 02/01 DESA TIRIS REMAJA
JAMBUAN 13/03 DESA TIRIS MASYARAKAT UMUM
TIMUR SUNGAI 8/3 DESA TIRIS MASYARAKAT UMUM
TIMUR SUNGAI 8/2 DESA TIRIS REMAJA
 Masuk
single/ single/
Pcare
Dosis 1 multi Dosis 2 multi Keterangan
(Ya/Tida
dose dose
k)
22-07-2021 2
22-07-2021
22-07-2021
22-07-2021
22-07-2021
22-07-2021
22-07-2021
22-07-2021
22-07-2021
eterangan
No NIK Nama

1 ### DIDID TRI KUNCORO

2 3.513074108E+15 SUMARMI
3 3.51307541E+15 SITI ASROFA
4 3.513074711E+15 MISRI
5 3.513074108E+15 HANISA
6 3.513070305E+15 AHMAD JUNAIDI
7 3.513074702E+15 YANTI
8 3.513074107E+15 TIMA
9 3.513070108E+15 BUNA'IN
10 3.51307171E+15 DARMINTO
11 3.513076307E+15 MARYANI
12 3.513074108E+15 PATIMA
13 3.513074108E+15 RUHINA
14 3.51307561E+15 WATI
15 3.513071913E+15 KASWORO
16 3.513070108E+15 RA'IS
17 3.513074111E+15 ALFIA RUKMINIATI
18 '351307010789099 SALIM
19 3.513075207E+15 ARSAI
20 3.513071012E+15 BUSRI
21 3.513070108E+15 MISTAT
22 3.513075009E+15 ANDI
23 3.513074108E+15 SUPRI
24 3.513074511E+15 DWI NUR LESTARI
25 3.513070806E+15 SHODIQIN
 kelompok vaksinasi (nakes,
Alamat JENIS VAKSIN
pelayan publik, lansia)

SEGARAN AGUNG 12/04 RA SINOVAC MASYARAKAT UMUM

TIRIS 03/01 TIRIS SINOVAC MASYARAKAT UMUM
DSN KRAJAN 07/01 TIRIS SINOVAC MASYARAKAT UMUM
DSN TIRIS 07/01 TIRIS SINOVAC MASYARAKAT UMUM
TIMUR SUNGAI 10/02 TIRIS SINOVAC MASYARAKAT UMUM
DSN KRAJAN 02/01 WEDUSA SINOVAC MASYARAKAT UMUM
NANGKAAN 13/05 AS SINOVAC MASYARAKAT UMUM
TIMUR SUNGAI 10/02 TIRIS SINOVAC MASYARAKAT UMUM
TIRIS 10/02 TIRIS SINOVAC MASYARAKAT UMUM
DSN TAMAN 03/01 TIRIS SINOVAC MASYARAKAT UMUM
TIRIS 10/02 TIRIS SINOVAC MASYARAKAT UMUM
TIRIS 3/1 TIRIS SINOVAC MASYARAKAT UMUM
TIRIS 3/1 TIRIS SINOVAC MASYARAKAT UMUM
KRAJAN 03/01 TIRIS SINOVAC MASYARAKAT UMUM
KRAJAN 07/01 TIRIS SINOVAC MASYARAKAT UMUM
TIRIS 03/01 TIRIS SINOVAC MASYARAKAT UMUM
KRAJAN 2/1 TIRIS SINOVAC MASYARAKAT UMUM
MANGGIS 22/4 TIRIS SINOVAC MASYARAKAT UMUM
PARAS 01/04 SEGARAN SINOVAC MASYARAKAT UMUM
JAMBUAN 15/03 TIRIS SINOVAC MASYARAKAT UMUM
TUNGGANGAN 25/5, TIRIS SINOVAC MASYARAKAT UMUM
MANGGIS 22/5 TIRIS ASTRA MASYARAKAT UMUM
MANGGIS 22/ 04 TIRIS ASTRA MASYARAKAT UMUM
DSN TAMAN 03/01 TIRIS ASTRA MASYARAKAT UMUM
TAMAN 3/1,TIRIS ASTRA PRA LANSIA
 single/
Dosis 1 multi Dosis 2 Keterangan
dose
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
3 JULI 2021 31-07-202 LENGKAP
31-7-2021
31-07-2021
31-07-2021
31-07-2021
31-07-2021
No NIK Nama

1 3513071204060005 M IMAM MAULANA ISHAK

2 3513076306030002 HABIBATUR RAHMANIYA
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
 kelompo
k
vaksinasi
Alamat Instansi (nakes, Dosis 1
pelayan
publik,
lansia)

JAMBUAN 13/3 TIRIS PUBLIK 08 JULI 21

TIMUR SUNGAI 8/2 TIRIS PUBLIK 08 JULI 21
 Masuk
single/ single/
Pcare
multi Dosis 2 multi Keterangan
(Ya/Tida
dose dose
k)
Puskesmas / RS :Puskesmas TIRIS

No NIK Nama

1 3513070406070001 MOH HASAN

2 3513071111050001 ALVIN MAULANA IBRAHIM
3 3513070404030002 MOCH IRQISANDI MAULANA
4 3513072111030003 BINTANG PRATAMA YOLANDA
5 3513070808040003 IFANI DWI CAHYANTO
6 3513070106040002 M IQBAL FIRDAUS
7 3513070512050002 MUHAMMAD RONI
8 3513071304050003 MOCH AZKA TSALZADY LUBIS
9 3513074202030002 FITRIA ULANDARI
10 3513070909760001 MUHAMAD ROMLI
11 ABILGA FEBRI ROMANSYAH
25
26
27
28
29
30
31
32
33
34
35
129
130
 Alamat

DSN JAMBUAN 13/03 TIRIS

DSN JAMBUAN 15/04 TIRIS
DSN TIMUR SUNGAI 08/02 TIRIS
DSN KRAJAN 06/01 TIRIS
DSN TAMAN 01/01 TIRIS
DSN TAMAN 02/01 TIRIS
DSN TAMAN 01/01 TIRIS
DSN TIMUR SUNGAI 08/02 TIRIS
DSN KRAJAN 4/1 TRS
KRAJAN 06/01 TIRIS
DSN KRAJAN 01/01 TIRIS
 kelompok vaksinasi (nakes,
Instansi
pelayan publik, lansia)

PKM TIRIS REMAJA

PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS REMAJA
PKM TIRIS MASYRAKAT UMUM
PKM TIRIS REMAJA
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
24-07-2021
Keterangan
Puskesmas / RS :Puskesmas TIRIS
KANTOR DESA TIRIS

No NIK Nama

1 3513076011850003 SAMA
2 3513072009020004 MOHAMMAD YESEK
3 3513074205820002 NIMA
4 3513074102740002 MISNI
5 3513076909680003 MARYAMI
6 3513076805830002 HOSNA FATIMA
7 3513071706820004 JULIANTO
8 3513076611800001 SITI HASANAH
9 3513075802970002 HIMAMI HAFSAWATI
10 3513070606770001 MOHAMMMAD
11 3513075208730003 SULAMI
12 3513075406570001 SUNARMI
13 3513070107710075 MATSARI
14 3513074107780026 IDA IRIANI
15 3513074107790015 MURTINI
16 3513076507800001 SRI YANA
17 3513071509650001 HASAN
18 3513070107620140 NURAHMAN
19 3513076509880002 INDAYATI
20 3513070107720039 SLAMET
21
129
130
 kelompok
vaksinasi (nakes,
Alamat Instansi Dosis 1
pelayan publik,
lansia)

TIMUR SUNGAI 11/02 21-Sep-21

TIMUR SUNGAI 11/02 21-Sep-21
TIMUR SUNGAI 10/02 21-Sep-21
TIMUR SUNGAI 09/02 21-Sep-21
TAMAN 03/01 21-Sep-21
TIMUR SUNGAI 10/02 21-Sep-21
TIMUR SUNGAI 10/02 21-Sep-21
TIMUR SUNGAI 10/02 21-Sep-21
TAMAN 01/01 21-Sep-21
TIMUR SUNGAI 09/02 21-Sep-21
TIMUR SUNGAI 11/02 21-Sep-21
TIMUR SUNGAI 11/02 21-Sep-21
TIMUR SUNGAI 10/02 21-Sep-21
TIMUR SUNGAI 09/02 21-Sep-21
TIMUR SUNGAI 09/02 21-Sep-21
TIMUR SUNGAI 09/02 21-Sep-21
TIMUR SUNGAI 01/01 21-Sep-21
KRAJAN 01/01 21-Sep-21
TIMUR SUNGAI 08/02
TIMUR SUNGAI 09/02
single/multi single/multi Masuk Pcare
Dosis 2
dose dose (Ya/Tidak)

21-Sep-21 lengkap
21-Sep-21 lengkap
14-12-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS

No NIK Nama

1 "3513070112980000 SUBAHTIYAR INDRA

26
27
28
29
30
31
32
33
34
35
129
130
 Alamat Instansi

TAMAN 1/1
kelompok vaksinasi (nakes, single/multi
Dosis 1 Dosis 2
pelayan publik, lansia) dose

9/21/2021
 single/multi Masuk Pcare
Keterangan
dose (Ya/Tidak)

lengkap
Puskesmas / RS :Puskesmas TIRIS

No NIK Nama

1 3513070108720005 ARI
129
130
 Alamat Instansi

TIMUR SUNGAI 09/03

kelompok vaksinasi (nakes, single/multi
Dosis 1 Dosis 2
pelayan publik, lansia) dose

9/21/2021
single/multi Masuk Pcare
Keterangan
dose (Ya/Tidak)

LENGKAP
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:JAMBUAN

No NIK Nama

1 "3513072509050000 MUHAMMAD ALDI

2 "3513074205050002 RISKA
3 "3513075309060003 FATIMATUL HASANAH
4 "3513075303060003 AMANDA TIYA MUSAHRO
5
6
7
8
9
10
11
25
26
27
28
29
30
31
32
33
34
35
129
130
 kelompok vaksinasi (nakes,
Alamat Instansi
pelayan publik, lansia)

JAMBUAN 15/04
JAMBUAN 15/03
JAMBUAN 14/04
JAMBUAN 14/04
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

22-Sep-21

20-10-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
JAMBUAN

No NIK Nama

1 3513074107620101 ASMA
2 3513074107840568 SANI
3 3513076701670003 PRA'I
4 3513071902750002 WARNO
5 3513070107660029 READI
6 3513076008000006 HASANAH
7 3513074107670039 SITIANI
8 3513074909990001 HARIRA
9 3513074107630067 SENI
10 3513075310900002 SAMI
11 3513072101750001 BAKAR
12 3513074107860615 NIMA
13 3513074107960464 NISI
14 3513075404880001 SUMRIAH
15 3513075203970007 USWATUN HASANAH
16 3513070107600101 MAUN
17 3513074101030011 NISA SAFITRI
18 3513075012990005 INDAH NINGSIH
19 3513076207030003 SITI AISAH
20 3513074107750018 HARTINA
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
129
130
 kelompok vaksinasi
Alamat Instansi (nakes, pelayan
publik, lansia)

JAMBUAN 15/3
JAMBUAN 15/3
JAMBUAN 13/03
JAMBUAN 13/04
JAMBUAN 14/03
JAMBUAN 15/03
JAMBUAN 13/03
JAMBUAN 13/04
JAMBUAN 13/03
JAMBUAN 14/03
JAMBUAN 13/03
JAMBUAN 15/4
JAMBUAN 15/03
JAMBUAN 14/03
JAMBUAN 15/03
JAMBUAN 15/03
JAMBUAN 14/04
JAMBUAN 14/04
JAMBUAN 14/04
JAMBUAN 13/03
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
22-Sep-21
9/22/2021 lengkap
15-12-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
KRAJAN/PONKESDES

No NIK Nama

1 3513075904000001 SUMARWATI NINGSIH

2 3513075810010001 INDAH YATUL MANGROFA
3 3513070107610009 ADNAN
4 3513074111940001 LINDA RATNA SARI
5 3513074107010009 SAROH
6 3513074708900004 SUNDARI
7 3513074107680035 BUNI
8 3513070701000001 MUHAMMAD ILYAS
9 3513070107800796 SATO
10 3513075010990005 RANI RAHMAWATI
11 3513071602930001 AHMAD SYABAN RIJZALI
12 3513074805030003 CUCUN NOVITA SARI
13 3513075412920001 ROFITA NUR KOMARIA
14 3513072605960002 RIHZA MAHDANI
15 3513114107970092 HAYATUN NOPUS
16 3513075311820001 ALFIYAH
17 3513076408920002 TITIN SULAIHA
18
19
20
21
22
23
24
25
26
27
28
29
30
129
130
 kelompok
vaksinasi (nakes,
Alamat Instansi
pelayan publik,
lansia)

KRAJAN 4/2
KRAJAN RANUANGGUNG 02/18
CURAH PAKIS 12/05 JANGKANG
CURAH PAKIS 12/05 JANGKANG
CURAH PAKIS 12/05 JANGKANG
CURAH PAKIS 12/05 JANGKANG
TEMPORAN 09/03 ANDUNGSARI
KRAJAN 03/01 RANUAGUNG
MANGGIS 20/04 TIRIS
KRAJAN 04/01 TIRIS
KRAJAN 06/01 TIRIS
WEDUSAN TIMUR 11/04
TIMUR SUNGAI 09/02
TAMAN 02/01 TIRIS
TAMAN 02/01 TIRIS
KRAJAN 03/01
KRAJAN 03/01
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
9/25/2021 lengkap
9/25/2021 lengkap
25-Sep-21
25-Sep-21

18-12-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
MANGGIS

No NIK Nama

1 3513071306930002 MUHAMMAD MALI

2 3513074104850007 JUMA'A
3 3513070602470001 FUKAT
4 3513070107800819 MA'AT
5 3513071710790003 TOYO
6 3513071408960003 NITO
7 3513074208030003 SITI AMINA
8 3513076406950003 RIRIN DAWATI
9 3513074107560425 SATINA
10 3513074710010002 JUMRATI
11 3513074107720155 TURINA
12 35130727008940004 RIYANTO
13 3513075104030006 FATILA
14 3513074107960009 ROSMIATI
15 3513075108990003 FATIMAH
16 3513075809000005 LINDA SARI
17 3513070107640111 SARI
18 3513070107980155 ISMAIL
19 3513074107020005 HALIMATUS SADIYAH
20
21
22
23
24
25
26
27
28
29
30
129
130
 kelompok vaksinasi (nakes,
Alamat Instansi
pelayan publik, lansia)

MANGGIS 18/04
MANGGIS 20/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 20/05
MANGGIS 19/05
MANGGIS 20/04
MANGGIS 20/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/05
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/04
MANGGIS 19/05
MANGGIS 18/04
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

29-Sep-21

22-12-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:MANGGISAN

No NIK Nama

1 3513074107060115 MISNA
2 3513074310050004 M.SAHE
3 3513075802090002 SULIS
4 3513075108040004 TITA
5 3513074103050003 FIRDAUS SHOLEHA
6
7
8
9
10
11
12
13
14
15
16
17
129
130
 Alamat Instansi

MANGGIS 20/05
MANGGIS 20/04
MANGGIS 20/05
MANGGIS 20/04
MANGGIS 20/04
kelompok vaksinasi (nakes, single/multi
Dosis 1 Dosis 2
pelayan publik, lansia) dose

29-Sep-21
29-Sep-21
29-Sep-21
29-Sep-21
29-Sep-21

27-10-21
single/multi Masuk Pcare
Keterangan
dose (Ya/Tidak)
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:JAMBUAN PK.PARI

No NIK Nama

1 3513074103000000 LILIS
2 3513070107710468 DULLA
3 3513074107470026 SUPIK
4 3513070107810009 BRAHIM HARSONO
5 3513076209580001 NARJI
6 3513071205990004 MUHER
7 3513071711700001 AMA
8 3513071811000002 MUHAMMAD FAESOL
9 3513075006840004 AMINA
10 3513070107900115 SAMSUL
11 3413070507920004 MUSTAKIM
12 3513071009990003 DARUS SALAM
13 3513075410020002 ROFI'A SARI
14 3513075801990001 JUMIYATI
15 3513074107750036 SITTI
16 3513075012850001 HOLIPA
17 3513074102680001 NIPA
18 3513074107840017 SUNARMI
19 3513076707920001 RUS
20 3513074107730184 MISWATI
21 3513074605940002 UWEN
22 3513074506920004 SURATI
23 3513070107850623 SIPUL
24 3513074107740068 SARI
25 3513076101810003 SITI
26 3513074107720401 MARYAMA
27 3513074107680732 MISRI
28 3513074107650042 ROKAYA
29 3513070107770006 IDIANTO
30 '3513072110630002 MISTARI
31 3513074107630078 JUMAINA
32 3513070107650016 SUMU
33 3513070206030001 MOH.EFENDI
34 3513071401950003 AGUSTONO
35 3513075402830001 SUKAISI
36 3513080107720007 SUNARI
37 3513076202720001 MARYAM
38 3513076208700003 ANI
39 3513074208830002 SITI MARYAM
40 3513074105730005 JATIM
41 3513076006770001 SULAIHA
42 3513084107760008 SARIJA
43 3513076009790005 NIA
44 3513071607660001 ADIM
45 3513074107750479 MARYAMI
46 3513071402000001 M.HANIP
47 3513075311070002 NUR AISAH
48 3513074402060003 DELA CITRA
49 3513074107780007 ERNA
50
51 3513072507900002 ABDUR RAHMAN WAHID
52 3513076609690001 HARTATIK
129
130
 kelompok
vaksinasi (nakes,
Alamat Instansi Dosis 1
pelayan publik,
lansia)

JAMBUAN 13/3 AZ 4-10-21

JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 15/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
ANDUNGMINIAN 2/5 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
MANGGIS 22/4 AZ 4-10-21
MANGGIS 22/4 AZ 4-10-21
MANGGIS 22/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 15/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 15/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 15/3 AZ 4-10-21
JAMBUAN 14/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 14/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/4 AZ 4-10-21
JAMBUAN 13/4 AZ 4-10-21
JAMBUAN 14/3 AZ 4-10-21
JAMBUAN 14/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 15/3 AZ 4-10-21
JAMBUAN 14/3 AZ 4-10-21
JAMBUAN 14/4 AZ 4-10-21
JAMBUAN 14/3 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 13/4 AZ 4-10-21
JAMBUAN 13/3 AZ 4-10-21
JAMBUAN 14/4 REMAJA SN 4-10-21
JAMBUAN 13/4 REMAJA SN 4-10-21
JAMBUAN 13/3 UMUM 'SN 4-10-21

JAMBUAN 13/3 UMUM

JAMBUAN 14/3 UMUM
single/multi single/multi Masuk Pcare
Dosis 2
dose dose (Ya/Tidak)
SN 4-10-21 LENGKAP
SN 4-10-21 LENGKAP

AZ 27-12-21
SN 2-11-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:TUNGGENGAN PK.SALIM KE 2

No NIK Nama

1 3513074207910002 ANI
2 3513074107830837 NAWIYEH
3 3513074107800130 SALATI
4 3513074107480070 MISTEN
5 3513075604880001 SANI
6 3513074102890003 ASIYA
7 3513074107870368 NISA
8 3513074107740515 BEBUN
9 3513074107890596 HOTIJA
10 3513074107420220 MA'INA
11 3513074107590032 MISNATI
12 3513075206980003 UMMIHIMATUL HASANAH
13 3513070107960086 SAMUD
14 '3513070207630002 BUSAR
15 3513074107890530 HABIBA
16 3513074107710041 SALIMA
17 3513074611950001 ASNI
18 3513070203920002 SISWANTO
19 3513070107770421 EDI
20 351307401550003 DURAHMAN
21 3513070107680820 MISTO
22 3513070107520083 NISA
23 3513074107830189 TORIYA
24 3513076705850001 SITI AISAH
25 3513074107810588 MURTI
26 3513074107820105 FATIMA
27 3513074107760759 ASNI
28 3513074107530541 BUNIS
29 3513070107720010 ATIM
30 3513074107850703 TONI
31 3513075207930003 SITI SOLEHA
32 3513074311710001 SUYATI
33 3513074107530104 TIAMA
34 3513074107910491 MARYAMI
35 3513074107780206 RAMLA
36 3513074107860078 TIMAI
37 3513071311980003 MAHMUD
38 3513076010800004 NIPA
39 3513076402990003 ROSIDAH
40 3513070609880001 ISMAIL
41 3513071308950003 SAMSUL ARIFIN
42 3513075205010004 SENNI
43 3513074107600162 NARTI
44 3513070304900003 SUWARDI
45 3513074107780835 MANING
46 3513071911040003 MOH.YESIN
47 3513070107670427 NISAT
48 3513074507810001 TIMA
129
130
 kelompok vaksinasi
Alamat Instansi (nakes, pelayan publik,
lansia)
TUNGGANGAN 24/5
TUNGGANGAN 24/5
TUNGGANGAN 27/5
TUNGGANGAN 29/5
KOMALANG 5/2
TUNGGANGAN 23/5
TUNGGANGAN 24/5
TUNGGANGAN 24/5
TUNGGANGAN 24/5
TUNGGANGAN 27/5
TUNGGANGAN 26/5
TUNGGANGAN 27/6
TUNGGANGAN 26/6
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 28/5
TUNGGANGAN 29/5
TUNGGANGAN 29/6
TUNGGANGAN 27/6
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 27/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 28/5
TUNGGANGAN 27/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 26/5
TUNGGANGAN 24/5
TUNGGANGAN 28/5
TUNGGANGAN 29/5
MANGGIS 21/4
TUNGGANGAN 29/6
TUNGGANGAN 29/5
TUNGGANGAN 29/3
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 29/5
TUNGGANGAN 27/6 BUMIL
TUNGGANGAN 29/6 REMAJA
TUNGGANGAN 29/5 UMUM
TUNGGANGAN 29/5 UMUM
 single/multi single/multi Masuk Pcare
Dosis 1 Dosis 2
dose dose (Ya/Tidak)

AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
 AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
AZ 5-10-21
SN 5-10-21 BUMIL
SN 5-10-21
SN 5-10-21
SN 5-10-21

AZ 28-12-21
SN 3-11-21
Keterangan
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:KANTOR DESA

No NIK Nama

1 3513076606990002 ROFIKA DEWI

2 3513075304940003 SITI AMINA
3 3513074112770003 SAMINA
4 351076010780002 MARWATI
5 3509031107910004 IMAM WAHYUDI
6 3513074107790464 YANI
7 3513074107680864 BUNI
8 3513070506750002 SUMARDI
9 351307430480006 RASIAH
10 3513074107830180 RAI
11 3513075502730002 SULAMAH
12 3513075808980001 KIKI MONALISA
13 3513085405000002 NURUL SINTAWATI
14 3513074107910443 TORIYA
15 3513076306010001 YULIANA SAFARA
16 3513072311950002 ZAINULLAH
17 3513076811910004 NUVIM NURAINI
18 3513074107710378 SATI
19 3513075906870002 LASMINI
20 3513074107720023 SITI RAMLA
21 3513074107850654 NINGSIH WAHYU MAULANA
22 3513074201800003 BUSRI
23 3513070306670004 SUDANTO
24 3513070408790002 NIMAN
25 3513074107750110 JUMA'ATI
26 3513074107730170 TILA
27 3574042108790009 HARIS AGUSTIAN
28 3513076107810002 HOTIJAH
29 3513070107780136 LEHAN
30 3513074112680002 HARTIAMI
31 3513074707870007 TITIK ARMINI
32 3513074601930003 SUMIYATI
33 3513074105740001 ASNI
34 3513075206900005 SITI MUSRIFA
35 3513076104970010 ISNAINI APRILIA
36 3513076807030002 KRISTIN SEKAR SARI
37 3513071406950002 LUTFI
38 351074511810001 SARINI
39 3513070105950003 SOLIHIN
40 3513074112680002 HARTIAMI
41 3513074107790412 HATIJA
42 3513070107710405 SATIMAN
43 3513074703820008 YUNI ASTUTIK
44 3513076710670001 ATI
45 3513074208750002 PURWANTI
46 3513071807970002 M.HOLIL
47 3513074107820496 UMMATUS ZUHRO
48 3513070107900023 SAMA ADIANZAH
49 3513070107960487 MOH.SIPUL
50 3513071312830001 SANEMAN
51 3513072103740002 EMAN
52 3513070306930004 MUHAMMAT DUL HASAN
53 3513074107660051 PAIDAH
54 3513070107630051 NIRAN
55 3513070303830001 WAGIJU PRIYANTO
56 3513071503020001 KACONG
57 3513075607750001 FATIMAH
58 3513075709990002 LULUK ILMAKNUN
59 3513070507000006 ANDIKA
60 3513074107650100 JAMILA
61 3513074107950070 SARI ASTUTIK
129
130
 kelompok vaksinasi (nakes,
Alamat Instansi
pelayan publik, lansia)

T.SUNGAI 12/3
T.SUNGAI 11/2
T.SUNGAI 8/2
T.SUNGAI 9/2
KRAJAN 11/4 ALKANDANG
T.SUNGAI 10/2
T.SUNGAI 10/2
PONDO KLAKA 1/1 RACEK
T.SUNGAI 12/2
T.SUNGAI 12/2
T.SUNGAI 8/2
T.SUNGAI 12/3
T.SUNGAI 12/3
T.SUNGAI 11/2
T.SUNGAI 12/3
T.SUNGAI 11/2
T.SUNGAI 11/2
T.SUNGAI 11/2
T.SUNGAI 11/3
T.SUNGAI 11/2
T.SUNGAI 11/2
KEDUNG KOKAP 2/2 SEGARAN
KRAJAN 4/2
T.SUNGAI 11/2
T.SUNGAI 11/3
T.SUNGAI 11/3
T.SUNGAI 12/3
T.SUNGAI 11/2
T.SUNGAI 12/2
KRAJAN 4/1
T.SUNGAI 11/3
T.SUNGAI 10/2
T.SUNGAI 11/2
T.SUNGAI 11/2
T.SUNGAI 10/2
T.SUNGAI 12/3
AGUNG 11/4 RANUAGUNG
T.SUNGAI 11/2
T.SUNGAI 11/2
KRAJAN 4/1
KRAJAN 3/1
T.SUNGAI 12/2
T.SUNGAI 10/2
T.SUNGAI 12/2
T.SUNGAI 12/2
KRAJAN 1/1 RANUAGUNG
T.SUNGAI 11/2
T.SUNGAI 11/2
T.SUNGAI 12/3
T.SUNGAI 11/2
T.SUNGAI 12/2
T.SUNGAI 12/2
TAMAN 1/1
PAOKECIK 6/3
TAMAN 1/1
TAMAN 1/1
T.SUNGAI 10/2
T.SUNGAI 8/2
KRAJAN 1/1 ANDUNGSARI
T.SUNGAI 11/2
T.SUNGAI 12/3
 single/
single/multi Masuk Pcare
Dosis 1 Dosis 2 multi
dose (Ya/Tidak)
dose
13-Oct-21

AZ DOSIS 2
AZ DOSIS 2
AZ DOSIS 2
SN DOSIS 2
SN DOSIS 2
SN DOSIS 2
SN DOSIS 2
SN DOSIS 2
SN DOSIS 2
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21
13-Oct-21

AZ 5-1-22
Keterangan
Puskesmas / RS :Puskesmas TIRIS
TEMPAT: KEBUNAN

No NIK Nama Alamat

1 3513074811860002 SULASTRI MANGGIS 22/4

2 3513071605900004 HOLIL MANGGIS 2/5
3 3513075710960001 SAHRUNIATI MANGGIS 22/5
4 3513070107640092 SATUN MISWA MANGGIS 21/4
5 3513074511020002 SRI WAHYUNI MANGGIS 22/5
6 3513071708050006 SAENOL ANGWAR MANGGIS 21/4
7 351307076050002 SAMSUL ARIFIN MANGGIS 21/4
8 3513071406040003 MUHAMMAD HUSYAIN MANGGIS 22/4
9 3513075012040003 FITRIYA NINGSEH MANGGIS 21/5
10 3513075212030003 SITI FATIMA MANGGIS 22/4
11 3513074107740564 SUSILA MANGGIS 22/4
12 3513076605990003 ROHIMA MANGGIS 22/5
13 3513081007890003 ABDULLAH MANGGIS 22/5
14 3513074107780790 MARYAMI MANGGIS 22/4
15 3513070107580586 EJU P.RAHIM MANGGIS 21/5
16 3513070107890696 IDAWATI MANGGIS 22/4
17 35313074107800605 YULIATI MANGGIS 21/4
18 3513074101700006 SIMA B.SUTI MANGGIS 21/5
19 3513074107830790 MAINA MANGGIS 21/4
20 3513074104800003 SATIK MANGGIS 21/4
21 3513075806670001 SIA MANGGIS 22/4
22 3513075070800004 UNAINI MANGGIS 21/4
23 3513075105700002 MUNA MANGGIS 22/4
24 3513074107790081 PUSRI MANGGIS 22/4
25 3513074107800607 SITI HASANAH MANGGIS 22/4
26 3513075904650002 SALEHA MANGGIS 22/4
27 3513074602830004 ERNAWATI MANGGIS 22/4
28 3513072403900001 NANANG MANGGIS 22/5
29 3513070107880133 MU'IS MANGGIS 22/4
30 3513076504770003 SALAMA MANGGIS 22/4
31 3513076410890001 ERNAWATI MANGGIS 21/5
32 3513070703030003 RIKO TAMPOTI MANGGIS 21/4
33 3513074103630003 SAMIA MANGGIS 21/4
34 3513074101000002 ITI FATIMA MANGGIS 21/4
35 '3513070511720001 ASAN MANGGIS 22/4
36 3513074107920438 SRI WAHYUNI MANGGIS 20/4
37 '3513075806030004 MALA MANGGIS 21/4
38 3513072208910002 HOLIL MANGGIS 18/4
39 3513070107810035 ASMA MANGGIS 20/05
40 3513070107850700 PANDI MANGGIS 22/4
41 3513074107800089 RUSMIATI MANGGIS 22/5
42 3513073009000002 PAISOL ROHMAN MANGGIS 22/5
43 3513070708030003 M.MUNIP MANGGIS 22/5
44 3513070710910001 SUGI MANGGIS 22/4
45 3513070107530417 BAKAR MANGGIS 22/4
46 3513075204730004 SOM B.TILA MANGGIS 22/4
47 3513074107900572 ASIA MANGGIS 22/4
48 3513070107700099 TOLI MANGGIS 22/4
49 3513070107690454 SUYIT P.TILA MANGGIS 22/4
50 3513070107780185 SU MANGGIS 21/4
129
130
 kelompok
vaksinasi (nakes, single/multi
Instansi Dosis 1 Dosis 2
pelayan publik, dose
lansia)
SN 12-10-21
SN 12-10-21
SN 12-10-21
SN 12-10-21
SN 12-10-21
REMAJA SN 12-10-21
REMAJA SN 12-10-21
REMAJA SN 12-10-21
REMAJA SN 12-10-21
REMAJA SN 12-10-21
SN 12-10-21
SN 12-10-21
SN 12-10-21
SN 12-10-21
SN 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
DOSIS 2 AZ
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21
AZ 12-10-21

1/4/2022
single/
Masuk Pcare
multi Keterangan
(Ya/Tidak)
dose
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:MANGGISAN

No NIK Nama Alamat

1 3513076102850002 SUMIATI MANGGIS 19/5

2 3513074106910005 ASTUTIK MANGGIS 19/5
3 3513070107630029 NALI MANGGIS 18/4
4 3513070107010420 ABDUL RAZAK MANGGIS 18/5
5 3513070602890001 KASIM MANGGIS 19/4
6 3513070107900058 KUSNADI MANGGIS 19/4
7 3513081108980003 AMAN MANGGIS 12/3 KRUCIL
8 3513070107560131 MAKI MANGGIS 19/5
9 3513074107700116 NIPA MANGGIS 19/5
10 3513074701650004 HOLIPA MANGGIS 18/4
11 3513070107890698 MUHAMMAD MANGGIS 18/4
12 3513071002710001 RAHEM MANGGIS 18/4
13 3513070107830645 MADIN MANGGIS 20/4
14 3513070107000170 RAHIM MANGGIS 20/4
15 3513070107900007 AGUS MANGGIS 19/5
16 3513070102020001 SHOLEHUDDIN MANGGIS 18/4
17 3513074107790048 NISI MANGGIS 18/5
18 3513074107960167 SULIHA MANGGIS 20/4
19 3513074802000003 TITIN MANGGIS 18/5
20 3513075908990003 SITI FATIMATUS Z. MANGGIS 20/5
21 3513074107020013 SAMIATI MANGGIS 19/5
22 3513076012000001 NUR HALIMA MANGGIS 19/4
23 3513074107020291 BUNI MANGGIS 18/4
24 3513074107510005 BUSATI MANGGIS 19/4
25 351307680690001 RIRIN MANGGIS 18/5
26 3513072011020001 EKO SAPUTRO MANGGIS 19/5
27 3513074107570020 SATI MANGGIS 18/4
28 3513074107500114 BUSIA SIRTO MANGGIS 19/5
29 3513074107000150 MISRI MANGGIS 19/4
30 3513074107000431 SITI FATIMA KOMALANG 7/2
31 3513076104770003 NUR SITI HALIMAH MANGGIS 18/4
32 3513075209000004 ILAWATI MANGGIS 18/4
33 3513074107600642 GULUH MANGGIS 20/4
34 3513070107960182 NISAN MANGGIS 20/5
35 3513070107780050 BUDI MANGGIS 18/5
36 35130708020004 AHMAD HADI MANGGIS 19/4
37 3513071017960052 EKO SAPUTRO MANGGIS 18/5
38 3513070912880004 MOH.SALIM MANGGIS 20/4
39 3513070107700023 SAHRI MANGGIS 19/4
40 3513076805690001 SATIMA MANGGIS 18/4
41 3513071708000003 MUSTAKIM MANGGIS 18/5
42 3513070107880027 BEBUN MANGGIS 18/4
43 3513070107410013 ESEL SIRTO MANGGIS 19/5
44 3513074107880506 NIMA MANGGIS 18/4
45 3513075405830003 MUZEYYENAH MANGGIS 21/4
46 3513070107810452 AGUS SALEM MANGGIS 21/4
47 3513071210760003 NAWI MANGGIS 19/4
48 3513070405980001 SANEMAN MANGGIS 19/4
49 3513072607830001 EPA MANGGIS 19/4
50 3513070107840483 SUNARI MANGGIS 18/4
51 3513070606000005 MOH.LUTFI JAMBUAN 14/4
52 3513070107810457 BASAR MANGGIS 18/4
53 3513066706970001 NURMALA MANGGIS 18/4
54 3513070107030053 ABDUL HAKIM MANGGIS 20/4
55 3513074107960146 LIPYANA MANGGIS 19/4
56 3513070107830018 MISTU MANGGIS 18/4
57 3513075108380001 MISNA MANGGIS 19/4
58 3513070107710476 SALE MANGGIS 19/4
59 3513070107790373 MISNARI MANGGIS 20/4
60 3513074107900512 JUMRATI MANGGIS 18/5
61 3513070107750108 MAI P.YASIN MANGGIS 20/4
62 3513070107930028 MOHAMAD HOLIS MANGGIS 18/4
63 3513075603870003 SAMIATI MANGGIS 20/4
64 3513075505030002 ROMLA TUNGGENGAN 29/5
65 3513074107680089 SARI MANGGIS 18/4
66 3513074107570019 MISRI MANGGIS 18/4
67 3513074107590015 HAYATI MANGGIS 18/5
68 3513071709860003 BUNADI MANGGIS 19/5
69 3513070107920014 MUHAMAD MANGGIS 19/4
70 3513070107880028 SUGIANTO MANGGIS 18/5
71 3513076009750004 BUNI MANGGIS 18/5
72 3513070703080003 NURUL ISLAM MANGGIS 19/5
73 3513071706070005 SAHRONI MANGGIS 19/4
74 3513074902070002 SITI AMINA MANGGIS 19/5
75 3513075809090001 FITRIA MANGGIS 19/5
76 3513075106080004 FIRDA MANGGIS 19/4
77 3513075003090001 NABILA MANGGIS 19/4
78 3513074805090001 HANDAYANI MANGGIS 19/5
79 3513070409090001 ABDU ROHMAN MANGGIS 18/4
80 3513070306920001 SALIM MANGGIS 18/4
81 3513070101060001 ABDUL ROHIM MANGGIS 19/5
82 3513070107041253 MUHAMMAD YANTO MANGGIS 18/4
83 3513070104020001 MOH.KUSNO MANGGIS 18/5
84 3513072506060003 M.IPAN MANGGIS 19/5
85 3513074405090001 HALIMATUS SA'DIYAH MANGGIS 18/4
86 3513070208050001 MAHRUS SHOLEH MANGGIS 18/5
87 3513075311060004 SAFITRI MANGGIS 20/4
88 3513074101030002 SUTRIA MANGGIS 18/5
89 3513071403050001 AHMAD SULAIMAN F.S MANGGIS 18/5
90 3513070207060001 SOLIHIN MANGGIS 19/5
91 3513071906060002 RAHMAT SOLEH MANGGIS 18/4
92 3513070103060001 AGUS MANGGIS 18/5
93 3513075805080002 LIANA MANGGIS 20/4
94 3513075703040001 RIKA MANGGIS 19/5
95 3513070504080004 JUNAEDI MANGGIS 19/5
96 3513075912080004 SELFI KARISMA PUTRI MANGGIS 18/5
97 3513070104060003 M.SIDIQ MANGGIS 18/4
98 3513076201070001 DIANA ALFIAH MANGGIS 19/4
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
 kelompok
vaksinasi
single/
(nakes, single/
Instansi Dosis 1 multi Dosis 2
pelayan multi dose
dose
publik,
lansia)
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
/3 KRUCIL AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
 AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
AZ 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
REMAJA SN 15-10-21
SN BUMIL 15-10-21
AZ 7-1-21
SN 15-11-21
Masuk Pcare
Keterangan
(Ya/Tidak)
Puskesmas / RS :Puskesmas TIRIS
TEMPAT: KANTOR DESA

No NIK Nama

1 3513084211000002 SUMIATI
2 3513080906900002 SANIMAN
3 3513075506970001 HOTIMAH
4 3513086408950001 SANATUL QIBTIYAH
5 3513070107600492 NIREN P.JUM
6 3513174207810002 SITI AISYAH
7 3513170107800008 SADI
8 3513085201980002 LISWATUL HASANAH
9 351307120774000 RAPI'I
10 3513070107820539 YUDI
11 3513074201870002 SUMARNI
12 3513075104760001 ANISA
13 3513071406930001 MUHAMMAD SALE
14 3513076904590002 BADRIYA
15 3513075304980001 EKA ANDITA
16 3513070107670029 SUM
17 3513070107460014 MARKATON
18 3513074107900571 ASTUTIK
19 3513071011660002 ASMAD
20 3513075511750002 BUNI
21 3513075006020002 MAULIDATUL HASANAH
22 3513074803690003 SIANA
23 3513070107690100 SATOLI
24 3513071409750001 YUNUS
25 3513074107550359 MISNI
26 3513070107480341 SATO
27 3513071107850004 NIRIN
28 3513075706990003 INDAHWATI SHOLEHA
29 3513074810720001 SENIA
30 3513075001910003 MISTRI
31 3513070107870114 HOLIK
32 3513075111890001 NUR KOMARIA
33 3513076006030003 ALFIATUL LAILI
34 3513074808750001 DARMAWAT
35 3513071610790002 MOH. HOSNAN
36 3513074505780005 ERMAWATI
37 3513074107740106 SIA
38 3513070509730002 SUYATNO
39 3513074107640357 SAMA
40 3513076012010001 KARTIKA MAHARANI
41 3513074107650018 MINA
42 3513076406870003 LENI AMIYATI
43 3513071906420002 SIADI
44 3525063112530002 MISRODI
45 3513072005650001 BEBUN
46 3513071404700001 SUBANDI
47 3513070107670390 NAI
48 3513170102880000 MUHAMMAD HASAN
49 3513071702700001 ASMAT
50 3513074107720144 MARYAM
51 3513070107700668 ASAN
52 3513074604750003 ASRIANI
53 3513072710990002 ISMAIL
54 3513072301950001 Ahmad KACONG ABDULLAH
55 3216100909870001 FIRMAN HIDAYAT
56 3513071010790002 LEMAN KURNIADI
57 3513076802900001 SUCIATI
58 3513072305940003 RIYAN HIDAYAT
59 3513070802020002 MUHAMMAD FAISOL
60 3513070902710001 SIDIK KARYAWANTO
61 3513070506840001 MULUD
62 3513070107680819 SUGIONO
63 3513075412820002 HOSNIA
64 3513074305950001 NURIS SUHARYATI
65 3513071107860002 UMAR HASAN
66 3513075410820002 TUHA WINARSIH
67
 Alamat Instansi

MANDATI 12/4 KALIANAN KRUCIL

PENANG PAEK 20/08 ROTO KRUCIL
JAMBUAN 17/4
TIMUR SUNGAI 12/3
TIMUR SUNGAI 8/2
TUNGGANGAN 23/6
TUNGGANGAN 23/6
TIMUR SUNGAI 10/03
TIMUR SUNGAI 8/2
KRAJAN 6/1
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
JAMBUAN16/3
TIMUR SUNGAI 8/3
ALORAN 8/3 TLOGOSARI
JAMBUAN 13/3
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
KRAJAN 7/1
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 10/2
TIMUR SUNGAI 10/2
TIMUR SUNGAI 8/3
TIMUR SUNGAI 8/3
TIMUR SUNGAI 8/3
TIMUR SUNGAI 8/3
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 8/3
TIMUR SUNGAI 8/2
TIMUR SUNGAI 9/3
KRAJAN 8/2
TUNGGANGAN 26/5
TIMUR SUNGAI 8/3
TIMUR SUNGAI 11/3
TIMUR SUNGAI 10/2
TIMUR SUNGAI 9/2
TIMUR SUNGAI 9/2
TIMUR SUNGAI 8/2
BANGKALAN MADURA DS. CAMPOR
TIMUR SUNGAI 8/2
KRAJAN 6/2
TIMUR SUNGAI 11/2
TIMUR SUNGAI 8/3
TIMUR SUNGAI 11/2
TIMUR SUNGAI 11/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 10/2
TIMUR SUNGAI 11/3
KRAJAN 4/1
KP.PELAUKAN KEC. KARANGBAHAGIA BEKASI
TIMUR SUNGAI 9/3
TIMUR SUNGAI 12/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 11/2
TIMUR SUNGAI 8/2
TIMUR SUNGAI 10/3
TIMUR SUNGAI 11/3
TIMUR SUNGAI 11/2
TIMUR SUNGAI 10/3
TIMUR SUNGAI 9/3
KRAJAN 6/2
 kelompok
vaksinasi
(nakes, single/ single/
Dosis 1 Dosis 2
pelayan multi dose multi dose
publik,
lansia)

BUMIL SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
SN 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
LANSIA AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
LANSIA AZ 5-11-21
LANSIA AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
AZ 5-11-21
LANSIA PFIZER 5-11-21
LANSIA PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
PFIZER 5-11-21
Masuk Pcare (Ya/Tidak) Keterangan
Puskesmas / RS :Puskesmas TIRIS
TEMPAT:MANGGIS

No NIK Nama

1 3513074911070003 SA'ADA
2 3513070107760104 HASAN
3 3513074107060115 MISNA
4 3513074107680024 ASNI
5 3513081404950002 JUNAIDI
6 3513074107720459 MAIMUNA
7 3513075502980001 ROMLA
8 3513074105720002 SUTIK
9 3513074107540259 ASNI
10 3513070104800007 SATIK
11 3513074107840525 JUMAATI
12 3513070103020003 M.MISDI
13 351307410760140 ENDANGWATI
14 3513074204980004 FATIMAH
15 3513070107810509 MANIS
16 3513074110640004 ANI
17 3513074112650000 BUNIA
18 3513070103630001 BURADIN
19 3513071405900004 NIMUN
20 3513074101940002 HOLIFA
21 3513074107780823 MANITI
22 3513077011950002 NUR HASANAH
23 3513070102890001 NURUL HUDA
24 3513085507090003 DEWI SEKARTAJI
25 3513074107950151 SUMIATI
26 3513070107770437 TOHARI
27 3513070102690003 SUARDI
28 3513070107890697 ZAENAL
29 3513070107790420 SURAN
30 3513072508800002 SALE
31 3513074105830001 SUTIMA
32 3513071707640002 MARSIS
33 3513074110580001 SATRI
34 3513071805550002 ASJAR P.SUTI
35 3513070102540001 MOHAMMAD
36 3513074107660463 ATI
37 351307410358001 TUHA
38 351307421050005 PUTRI WAHYUNI
39 3513074610090005 RISE
40 3513070702040004 SUNDARI
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
 kelompok
vaksinasi
Alamat Instansi
(nakes, pelayan
publik, lansia)

MANGGIS 18/5
MANGGIS21/4
MANGGIS 20/5
MANGGIS 18/4
MANGGIS 18/4
MANGGIS 18/4
MANGGIS 22/5
MANGGIS 21/4
MANGGIS 21/4 LANSIA
MANGGIS 21/4 LANSIA
MANGGIS 20/4
MANGGIS 21/4
MANGGIS 20/5
MANGGIS 20/5
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 20/4
MANGGIS 20/5
MANGGIS 21/5
KERTUSOKO,KRJAN KRUCIL
MANGGIS 20/4
MANGGIS 20/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 21/4
MANGGIS 20/5
MANGGIS 21/4
MANGGIS 20/4 LANSIA
MANGGIS 21/4 LANSIA
MANGGIS 21/4 LANSIA
MANGGIS 21/4 LANSIA
MANGGIS 20/4 LANSIA
MANGGIS 21/4 LANSIA
MANGGIS 20/4 REMAJA
MANGGIS 21/4 ANAK
MANGGIS 20/5 ANAK
 DOSIS 1 single/multi dose Dosis 2

SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
SN 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
 PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
PFIZER 4-11-21
single/multi dose Masuk Pcare (Ya/Tidak)
Keterangan