New - Form Pencatatan Manual Faskes Dan Laporan Rekapitulasi Vaksinasi COVID-19 - 28april

Nama Puskesmas/Fasyankes/Pos
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
7
8
10
11
12
13
14
15
16
17
18
19
20
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
P-5ERDYH7B
46
P-5F83FKGY
47
S-46B60C85
48
S-82C1BBEC
49
S-3A742A02
50
S-EF148E7E
51
S-2E06D41F
52
S-A67485F0
53
S-1267128F
54
S-D2CD212C
55
S-88075494
56
S-9D37EB84
57
S-31B34DFA
58
S-A6FCACAB
59
S-5982033C
60
S-8184E2DB
61
62
63
S-A5C880A0
64
S-34E151C0
65
S-30B80A87
66
S-45C2244E
67
68
69 S-C5CA365F
70
71
72 P-68P68JJO
73 P-6XXXXKZV
74
75
76
77
78
79
80 P-696FI3UI
81
82
83
84 P-6A3TXWMP
85
86
87
88 : P-6AKJCSD4
89
90
91
92
NIK
5315046612680000'
5315043112670009'
5315044202951001'
5315042707880001'
5315043112660009'
5315047112671001'
5315045308670001'
5315041003740002'
5315045606670002'
5315040511620002'
5315034104910001'
5310032110900002'
5310134102910002'
5315044101950004'
5315066507900004'
5315042512790003'
5315046609020004'
5315042611730001'
5315041310670002'
5310130704875502'
5315042805771001'
5302021404860002'
5315040407881001'
5315041011920002'
5315042904800002'
531'504209900007'
5315045505850004'
5315045007880005'
5308202109900001'
5315052806830006'
5315032504910002'
5315045112861001'
5315043006730001'
5315041601781001'
5315041405670002'
5108062007890006'
5315056207890002'
5315046111911002'
5315046302950003'
5310122808890001'
5315042101820003'
53150247088810001
5315041012830006
5315042210890001
5315044410950002
5315045508840002
5315046703680002
5315043112641002
5315026808820003
5315045205660001
5315045708900003
5315046805820005
5315040208660002
5315042801840001
5315033103880001
5315045312800001
5315052004820001
5315035110850001
5315045803740003
5315064109920001
5315042012911001
5315042208820002
5315040904871001
53150725129200003
5310062501940005
5310123105900006
5315047112691001'
5315040308770002'
5315047112680007'
5315051412870002'
5315040911840002
5315044105931001
5315030606900004
5315043107931001'
5315041702840003'
5315041108830001'
5315041509661001'
5315046611941001'
5315042807700001'
5315046602940002
5315045703970001'
5315045110920001'
531505671880002'
5315042202970009
5315040912670001'
5315040906880002'
5315045305860001'
'5315047103960006'
531594311263008'
5315042802850002'
5315042810870005
5310034808900001
: WERANG
: MANGGARAI BARAT
: NTT
: Selasa, 27/04/2021
Jenis
Nama Penerima Vaksin Pekerjaan*
Kelamin
SITI FATIMA ERI P GURU
MUHAMAD SUDIRMAN L GURU
YULIANA ELVI P GURU
NASARIUS SELSUS SALOMON L GURU
DAMASIUS HAMAT L GURU
ANASTHASIA NIMUNG P GURU
THERESIA NIJUM' P GURU

KANISIUS KEMUDI L
LUTGARDIS JERIA P
STEFANUS SEM L
STEFINA AFRINI BAHAGIA P
GREGORIUS UNGGAR L GURU
NATALIA SARINA P GURU
SRI RAHAYU IDNRIYATI P GURU
SITI HASNI P GURU
YUSUF ARMANSAH L GURU
ANGELINA ARIYANTI SANI P ASISTEN GURU
ERIKSON MEDI MALO L GURU
ANTONIUS BANGGUR L GURU
KORDIANUS RUDIN L GURU
YOSEF HAMSU L GURU
DAMEANUS AMBUT L GURU
FRANSISKUS JUANG L GURU
LEO AGUNG SUTOMO L GURU

SILVESTER SUHANDI L GURU
ADRIANUS JENARU L GURU
BENEDIKTA HINDA L
SITI NURYANTI P
ANTONIUS AMPU L
MU'AMMAR QADRI L
VIRGILIUS BUDIMAN L
VEROIKA ERNI P
TARSISIUS ENJA L
GASPAR SENABAN L
BONEFASIUS DANDUT L
BERNABAS BIO L
SITI NURBAYA P
KATARINA NASKO P
FELISITAS ELSADIANA P
ATANALIA JEHAMU L
FERDINANDUS DARI L
MARIA S NGANTAK P GURU
YOHANES RONAL L GURU
MARSELLUS KARNO L GURU
FLAVIANA INTAN P GURU
MARIA GOO P GURU
AVELINA YUDETI P GURU
L GURU
PETRUS JEHANA
YASINTA SEDIA P GURU
P GURU
PETRONELA LUSIA NGAMPU
P GURU
RINI KUSTIAWATI
P GURU
Maria Yasinta Buana
MARSELINUS MASEH L GURU
L GURU
FLORIANUS PUJI
FLORIANUS CEKA L GURU
YOVITA DAMUL P GURU
L GURU
IWAN KURNIAWAN
P GURU
HILDEGARDIS IRMA
VERONIKA NIAT P GURU
MARIA MARGARETA ANUNG P GURU
DOMINIKUS MUKESE L GURU
FRANSISKUS MELKIOR L GURU
WALTERIUS HANDUR L GURU
HERIBERTUS NATANAEL NATA L GURU
PAULUS LELE L GURU
AFRIDUS MASRI JAMU P GURU
AGNES LAMUN P GURU
BLASIUS OFAN L GURU
ANASTASIA ASIM P GURU
YOHANES HASAN L GURU
BIAKSI L GURU
YUSTINA MELINDA P GURU
FRANSISKUS YOLANTO LIPUR L GURU
ARFID MUSTARAM L
STEFANUS PEDO L
AGUSTINUS LEVEN L
AHMAD KAISAR L
LIVANI IBITALEN P GURU
ROFINUS ANDI L GURU
MARIA SASRIAYU PERMAI P GURU
YOSEFINA KARLIN HIBUR P GURU
NURFA JEMINA P GURU
YULIANA SARLIN P GURU
PETRUS PARMUS KARDUS L GURU
YOHANES DON BOSCO L GURU
PRIMUS HENDRA L GURU
IMELDA MARIYANI P GURU
MARIA VELOMENA BETI P GURU
MUHAMAD MASIR L GURU
ONSWALDUS ALAMSAH L GURU
ADRIANUS JEHADAN L GURU
MARIA GORETI NANUR P GURU

FORMAT PENCATAT
TINGKAT PUSK
Umur
Tanggal Lahir Kelompok Umur
(18 sd ≥ 60 tahun)
26/12/1968 52 46-59
31/12/1967 53 46-59
02/02/1995 26 18-30
27/07/1988 33 31-45
31/12/1966 54 46-59
31/12/1967 57 46-59
13/08/1967 53 46-59
03/10/1974 46 46-59
16/06/1967 54 46-59
11/05/1962 59 46-59
04/01/1991 30 18-30
21/10/1990 30 18-30
02/01/1991 30 18-30
01/01/1995 26 18-30
25/07/1990 30 18-30
25/12/1979 42 31-45
26/09/2002 18 18-30
26/11/1973 48 46-59
13/10/1967 48 46-59
04/07/1987 34 31-45
28/05/1977 44 31-45
14/04/1986 34 31-45
07/04/1988 32 31-45
11/10/1992 28 18-30
29/04/1980 41 31-45
26/09/1990 30 18-30
15/05/1985 36 31-45
07/10/1988 31 31-45
21/09/1990 30 18-30
28/06/1983 38 31-45
25/04/1991 30 18-30
12/11/1986 34 31-45
30/06/1973 48 46-59
16/01/1978 43 31-45
14/05/1967 54 46-59
20/07/1989 32 31-45
22/07/1989 31 31-45
21/11/1991 30 18-30
23/02/1995 26 18-30
28/08/1989 32 31-45
21/01/1982 38 31-45
07/08/1981 41 31-45
10/12/1983 38 31-45
22/10/1989 32 31-45
04/10/1995 26 18-30
15/08/1984 37 31-45
27/03/1968 54 46-59
31/12/1964 57 46-59
23/06/1982 40 31-45
30/05/1966 56 46-59
17/08/1990 31 31-45
28/05/1982 40 31-45
02/08/1966 56 46-59
28/01/1984 38 31-45
31/03/1988 34 31-45
13/12/1980 41 31-45
20/04/1982 40 31-45
11/10/1985 36 31-45
18/03/1974 48 46-59
01/09/1992 29 18-30
20/12/1991 30 18-30
22/08/1982 39 31-45
09/04/1987 35 31-45
25/12/1992 29 18-30
25/01/1994 28 18-30
31/05/1990 32 31-45
31/12/1969 52 46-59
08/03/1977 45 31-45
31/12/1966 53 46-59
14/12/1987 33 31-45
11/09/1984 37 31-45
01/0501993 28 18-30
06/06/1990 32 31-45
31/07/1993 28 18-30
17/02/1984 37 31-45
08/11/1983 38 31-45
15/09/1966 54 46-59
26/11/1994 27 18-30
28/07/1970 50 46-59
26/02/1994 27 18-30
17/03/1997 24 18-30
22/10/1994 26 18-30
27/01/1988 33 31-45
22/02/1997 24 18-30
12/09/1967 54 46-59
06/09/1988 33 31-45
13/05/1986 35 31-45
31/03/1996 25 18-30
31/12/1963 58 46-59
28/02/1985 36 31-45
28/10/1987 34 31-45
08/08/1990 30 18-30
FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI
Alamat
INDRONG
KOTA TADO
WAE MUNTING
PUSUT
TADO LONGGE
INDRONG
INDRONG
NAMPAR
INDRONG
INDRONG
TEONG TODA
TEOG TODA
NUNANG
NAMPAR
NAMPAR
NAMPAR
GENGGO
TEONG TODA
TEONG TODA
TEONG TODA
INDRONG
INDRONG
MBODONG
NUNANG
NOA
NAMPAR
PUSUT
NAMPAR
WAE NAHI
WAE MATA
NAMO, LEMBOR SELATAN
MELO
KOTA TADO
TADO LONGGE
TENDA
WERANG
WERANG
TEONG TODA
TEONG TODA
TEONG TODA
LANGKA RT 02 02 GOLO MANTING
LANDO RT 02/01 DS. GOLO MANTING
KOTA TADO RT 04 RW 02 DS. GOLO LELENG
RU'A RT 4/02 GOLO MANTING
DASAK DS. WAE SANO
DASAK DS. WAE SANO
TAAL DS. WAE SANO
RAMBANG DS. GOLO KEMPO
WERANG DS. GOLO MBU
LEHENG DS. GOLO SENGANG
GENGGO DS. GOLO MBU
KACA RT 01 RW 01 DS. GOLO TANTONG KEC. MBELILING
WERANG DS. GOLO MBU
RANGAT DS. WAE LOLOS
REHAK DS. POCO GOLO KEMPO
REHAK RT 09/05 DS. POCO GOLO KEMPO

WERANG DS. GOLO MBU
PAREK DS. SANO NGGOANG
RU'A DS. GOLO MANTING
GENGGO RT 03 RW 02 DS. GOLO MBU
ASRAMA ST KLAUS WERANG DS. GOLO NDARING
TEONG TODA DS. GOLO NDARING
BOKAK RANGGA
TAAL
RAMBANG
MATA WAE
COMPANG
RUA
TAAL
MBODONG
TAAL
P/ KALO
B. RANGGA
TENDA
TAAL
REHAK
REHAK
DALENG
RANGAT
COMPANG
RAMBANG
B. RANGGA
COMPANG
MBODONG
WERANG
WERANG
WATU WANGKA
TEONGTODA
LAKSANAAN VAKSINASI COVID-19
/FASYANKES/POS VAKSINASI
Kepesertaan BPJS (tulis 'Ya' pada kolom yang sesuai)
No. Hp
BPJS PBI BPJS Non PBI
081339898021' V
082236734937' V
081235023345' V
082266016589' V
081236405011' V
0852384430156' V
081237796215' V
081238775856' V
081238752133' V
08124617697' V
081238805890'
081236048744' V
081296570723' V
081237 323 825 V
082146084784'
082144627903' V V
081284624812 V
081353606986' V
081328339162' V
082266351698' V
081338648602' V
082236777414' V
082237311120' V
081338634447' V
085238997060 V
082144793103' V
081236206311' V
081339899476 V
082147724311
081237460460' V
081238185675' V
081338212829'
085253556611' V
081353437351' V
081337069417 V
082146613382' V
082147009203' V
085242664829' V
081239435403' V
081232748722' V
081331623146 V
081239381185 YA
085847992193 YA
0 YA
082144838890 YA
082147906953
081237087034 YA
081291467193 YA
082146044913 YA
YA
081246019898
085738173141 YA
081246134306 YA
085253141311 YA
082236053577
081217502470 YA
082235933357 YA
082147324501 YA
082147187553 YA
YA
081246871975 YA
082339592390 YA
081239591503 YA
081338281004 YA
082144768491
085253717725 YA
082235916898
85253202519 V
081236610241' V
081339876879' V
081237171793' V
082338799871' V
081239851087' V
081236090884' V
081353478388' V
082145036708' V
082145018352'
085338224326 V
081236223827' V
081238638115' V
082341391596' V
081337269700' V
081237078411' V
082236276231' V
081236805398' V
082237208558' V
082236105660' V
082123796990' V
082142240484 V
082341257529 V
082336915987 V
a' pada kolom yang sesuai)
Tanggal Screening Nama/Jenis/Merek Vaksin***
Non Anggota
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
V 27/04/2021
27/04/2021
27/04/2021
27/04/2021
V 27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
V 27/04/2021
27/04/2021
27/04/2021
V 27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
YA 27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021 SINOVAC
27/04/2021
YA 27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
V 27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
27/04/2021
Dosis I
Tanggal Pemberian
No. Batch No. Serial
Vaksinasi
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
1/27/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
(Ditunda/Tidak Diberikan/Lanjut)
HT
HAMIL
RIWAYAT HEPATITID DALAM PENGOBATAN, FLU 2 HARI

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
1
S-93BF2968
2
S-65E5789D
3 P-2K3LBJ13
4
P-2KMTRR0M
5
S-623F2D2F
6
P-2KTUF3D5
7
S-05BF4FA9
8 P-2KVR01L3
9
S-0525D4DF
10
S-7A76023F
11
S-D619CAD3
12
S-DCC9DEB4
13
S-94A15743
14
P-2L2U1MCD
15
S-793805ED
16
S-9E699A81
17
P-2LGZ97TX
18
S-43A86AA7
19
S-B6A70529
20
S-0787DB4F
21
S-632F3184
22
P-2LIVMRD5
23
S-23F7E991
24
S-74F754BF
25
S-6EC750E7
26
S-F6C9F862
27 P-2LLSN0DU
28
S-3139787F
29
S-910696EB
30
S-DC48C72A
31
S-2A7148AA
32
S-E71CCF33
33 S-6F74B409
34 P-2LRB833I
35 P-2LSANNZR
36
S-A3F5E112
37
S-3FE0C6D8
38
S-2AA1B718
39
40
41 P-8PLCMH1J
42
43
44
45 P-2LX4LS3L
46
47
48
49
50
51 P-2LYINPCS
52
53
54
55
56
57 P-2M1D7ECY
58 P-2M5WQXBM
59
60
61
62
63 P-2MARVSLU
64
65
66
67
68
69
70 P-2ME0F9C1
71
72
73
74
75 P-2MIQ59KJ
76
77
78 P-2MKUMEOX
79 P-2MNBZ3VY
80
81
82 P-2MUKCR52
83
84 P-2N1LKB7T
85
86
87
88 P-2N926QMS
89 P-2NERPKR8
90 P-2NK3X8HO
91
92
93
94
95 P-2NUNR8HX
96 P-2O96HVOL
97 P-2OHZ5Z0J
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113 P-2PGDM7H9
Keterangan
* Pekerjaan dikelompokkan menjadi:
A = Petugas Medis dan Non Medis di Fasilitas Pelayanan Kesehatan
B = Petugas pelayanan publik yang berhadapan langsung dengan masyarakat
C = Administrator Pemerintahan
D = Lainnya
E = Tidak Bekerja
NIK
5315046612910003
5315041805880004
5315043008930005
5315045106010002
5315046007841001
5315046712670003
5315045512660002
5371021610910005
5315044909820001
5315047112661001
5315040202850002
5315065207920002
5310035509901001
5315041511740004
5315040405900003
5315042410920004
5315046809010003
5315044907850003
5315046411900003
5301220201920004
5315043112651002
5315030503960001
5315043101860002
5315065205910002
5315044611960004
5315044705871001
5310156007930001
5315055407810001
5315040404850003
5315030109870006
5315047101790001
5206024610891002
5315062205750001
5315044507800004
5315015905970005
5315042107750002
5315041111871001
5315040904810004
5315046612680000'
5315043112670009'
5315044202951001'
5315042707880001'
5315043112660009'
5315047112671001'
5315045308670001
5315041003740002
5315045606670002'
5315040511620002'
5315034104910001'
5310032110900002'
5310134102910002
5315044101950004'
5315066507900004'
5315042512790003'
5315046609020004'
5315042611730001'
5315041310670002
5310130704875502
5315042805771001'
5302021404860002'
5315040407881001'
5315041011920002'
5315042904800002
531'504209900007'
5315045505850004'
5315045007880005'
5308202109900001'
5315052806830006'
5315032504910002'
5315045112861001
5315043006730001'
5315041601781001'
5315041405670002'
5108062007890006'
5315056207890002
5315046111911002'
5315046302950003'
5310122808890001
5315042101820003
5315040803671001
5315042705840004
3515041910680001
5315065404860001
5315035303830003
531504590470004
5315045403740001
7318292211870001
5315041410890001
5315065405010002
5315034610020001
5371041212910003
5371020412830001
5315032207770002
5315101005900001
53151042008700001
53151046910790003
5315045212960003
5315031311800003
5315050403800001
53150502905951001
3302135706910005
5315041109630002
5315050905901001
5315045303960006
5315045601920003
5315041804930002
5315015309900002
5310065601930001
8203095212891001
5319050607870001
5310030811900002
5315046602960000
5319031903900001
litas Pelayanan Kesehatan

dapan langsung dengan masyarakat
Kelompok Umur:
18-30
31-45
46-59
≥ 60 tahun
Total
Pekerjaan:
A
B
C
D
E
Total
: WERANG
: MANGGARAI BARAT
: NTT
: Rabu, 28 April 2021
Jenis
Nama Penerima Vaksin Pekerjaan*
Kelamin
SITI SERIFA P GURU
YOHANES S SUNARDI L GURU
HIRONIMUS HARDI CAPUR L GURU
BERNADETA JENI P GURU
THERESIA DALIMA P GURU
YOHANA SOFIA LIUN P GURU
P GURU
DORTHEA SARTIKA
YOHANES ROY PUTRA UBA L GR

P GURU
RAHMAWATI RUNI
P GURU
SENIMA
L GURU
YOHANES PANDU
SERAFINA ALMEIDA ROSY P GURU
P GURU
MARIA ELVIRA
HERIBERTUS HANE L GURU
SILVANUS VIDIMAN L GURU
L GURU
MARIANUS TAMAN
P GURU
AGUSTINA ONCI
P GURU
NURAENI SITI HAMDIAH
P GURU
MARIA FLORIANA BAYA
DEMI YANWARD NAIOES L GURU
MUHAMAT SEHUDIN L GURU
IGNASIUS A PUTRA L GURU
FRANSISKUS BURMAMORA L GURU
Maria Rolinsia Alfionita P GURU
DESI RATNA SARI P GURU
Korina Mensiana Lernia P GURU

PETRONELA JAIMUN P GUURU
ANDI MINERVAH P GURU
HERMANTO L GURU
SAIFUL SARIFUDIN L GURU
GONSAGINA MENSIYANI P GURU
NURWASILAH P GURU
FALENRIANUS TANDI L GURU
MARIA KARTIKA DERITA P GURU
KLEMENTINI P RANA P GURU
L GURU
Bonifasius Ubur
L GURU
Martinus Ola Rain
L GURU
Makarius Primairson Dhadjo
SITI FATIMA ERI P GURU
MUHAMAD SUDIRMAN L GURU
YULIANA ELVI P GURU
NASARIUS SELSUS SALOMON L GURU
DAMASIUS HAMAT L GURU
ANASTHASIA NIMUNG P GURU

THERESIA NIJUM' P GURU
KANISIUS KEMUDI L
LUTGARDIS JERIA P
STEFANUS SEM L
STEFINA AFRINI BAHAGIA P
GREGORIUS UNGGAR L GURU
NATALIA SARINA P GURU
SRI RAHAYU IDNRIYATI P GURU
SITI HASNI P GURU
YUSUF ARMANSAH L GURU
ANGELINA ARIYANTI SANI P ASISTEN GURU
ERIKSON MEDI MALO L GURU
ANTONIUS BANGGUR L GURU
KORDIANUS RUDIN L GURU
YOSEF HAMSU L GURU
DAMEANUS AMBUT L GURU
FRANSISKUS JUANG L GURU
LEO AGUNG SUTOMO L GURU

SILVESTER SUHANDI L GURU
ADRIANUS JENARU L GURU
BENEDIKTA HINDA L
SITI NURYANTI P
ANTONIUS AMPU L
MU'AMMAR QADRI L
VIRGILIUS BUDIMAN L
VEROIKA ERNI P
TARSISIUS ENJA L
GASPAR SENABAN L
BONEFASIUS DANDUT L
BERNABAS BIO L
SITI NURBAYA P
KATARINA NASKO P
FELISITAS ELSADIANA P
ATANALIA JEHAMU L
FERDINANDUS DARI L
Yohanes Baptista Birman L GURU

AMADIUS AMAL L GURU
FABIANUS SUPANDI L GURU
ELISABET IDA P GURU
EVIRITA IRA P GURU
ANASTASIA YUDITHA TEA P GURU
MELANIA RIJA P GURU
YOHANRS RUDI HARTONO L GURU
PASKALIS GODENANSIUS L GURU
YUSTINA ALFINA GENINDA P GURU
MARGARETA SUSANTI P ASISTEN GURU
AVENTINUS EVENDI L GURU
YOHANES PAKE PANI L GURU
THEOFILUS URJI GAMBUR L GURU
VIKTORIUS HARIDONO L GURU
YOHANES DON BOSKO L GURU
EMILINDA SURYATI ELVI P GURU
HAJIJA P GURU
JAIDIN L GURU
MAKSIMUS JERUBU L GURU
TAUFIK AKHIDAYAH L GURU
SRIATIN RAHAYU P GURU
BONEFASIUS BARUK L GURU
ANSELMUS ALMA L GURU
FADMI NIRMALASARI MASIR P GURU
SITI NURBAYA HATIMA P GURU
VINSENSIUS KASIANUS L GURU
YUSTINA NELAM P GURU
MARIA AYU FATIMA P GURU
Delivanti Sibu P GURU
FIDELIS SARONG L GURU
FREDERIKUS SILVESTER MUJUR L GURU
ANTONIA E OSIN P GURU
HARSENSIUS PATENMUT L GURU
***Merek Vaksin
A = Sinovac
B = Lainnya (Mohon disebutkan jenis vaksin yang diterima Puskesmas/Faskes)
elompok Umur: Kepesertaan BPJS
13 BPJS PBI
16 BPJS Non PBI
12 Non Anggota
0
41 Total
Pekerjaan: Pemberian Dosis
0 Dosis 1
0 Dosis 2
0 Total
0
0
0
FORMAT PENCAT
TINGKAT PU
Umur
Tanggal Lahir Kelompok Umur
(18 sd ≥ 60 tahun)
26/12/1991 30 18-30
18/05/1988 34 31-45
30/08/1993 28 18-30
11/06/1991 31 31-45
20/07/1984 38 31-45
27/12/1968 53 46-59
15/12/1966 55 46-59
16/10/1991 30 18-30
09/09/1982 39 31-45
31/12/1966 55 46-59
02/02/1985 37 31-45
02/02/1985 37 31-45
15/09/1990 31 31-45
15/11/1974 47 46-59
04/05/1990 32 31-45
24/10/1992 29 18-30
28/08/2001 20 18-30
09/07/1985 37 31-45
24/11/1990 31 31-45
02/01/1992 30 18-30
31/12/1965 56 46-59
05/03/1996 26 18-30
29/08/1981 40 31-45
12/05/1991 31 31-45
06/11/1996 25 18-30
07/05/1987 35 31-45
20/07/1993 29 18-30
14/07/1981 41 31-45
04/04/1985 37 31-45
01/09/1987 34 31-45
31/01/1979 43 31-45
06/10/1989 32 31-45
22/05/1975 47 46-59
05/07/1980 42 31-45
19/05/1997 25 18-30
21/07/1975 47 46-59
11/11/1987 34 31-45
09/04/1981 41 31-45
26/12/1968 52 46-59
31/12/1967 53 46-59
02/02/1995 26 18-30
27/07/1988 33 31-45
31/12/1966 54 46-59
31/12/1967 57 46-59
13/08/1967 53 46-59
03/10/1974 46 46-59
16/06/1967 54 46-59
11/05/1962 59 46-59
04/01/1991 30 18-30
21/10/1990 30 18-30
02/01/1991 30 18-30
01/01/1995 26 18-30
25/07/1990 30 18-30
25/12/1979 42 31-45
26/09/2002 18 18-30
26/11/1973 48 46-59
13/10/1967 48 46-59
04/07/1987 34 31-45
28/05/1977 44 31-45
14/04/1986 34 31-45
07/04/1988 32 31-45
11/10/1992 28 18-30
29/04/1980 41 31-45
26/09/1990 30 18-30
15/05/1985 36 31-45
07/10/1988 31 31-45
21/09/1990 30 18-30
28/06/1983 38 31-45
25/04/1991 30 18-30
12/11/1986 34 31-45
30/06/1973 48 46-59
16/01/1978 43 31-45
14/05/1967 54 46-59
20/07/1989 32 31-45
22/07/1989 31 31-45
21/11/1991 30 18-30
23/02/1995 26 18-30
28/08/1989 32 31-45
21/01/1982 38 31-45
03/08/1967 54 46-59
27/05/1984 37 31-45
19/10/1968 53 46-59
15/04/1986 35 31-45
13/03/1983 38 31-45
19/04/1974 47 46-59
14/03/1974 47 46-59
22/11/1987 34 31-45
14/10/1989 30 18-30
14/05/2001 19 18-30
10/06/2002 20 18-30
12/12/1991 30 18-30
12/04/1988 34 31-45
22/07/1977 44 31-45
05/10/1990 31 31-45
20/08/1970 50 46-59
29/10/1979 41 31-45
27/12/1996 24 18-30
13/11/1980 41 31-45
03/04/1980 41 31-45
29/05/1995 26 18-30
17/06/1991 30 18-30
09/11/1963 58 46-59
05/09/1990 30 18-30
13/03/1996 25 18-30
16/01/1992 29 18-30
18/04/1993 28 18-30
13/09/1990 30 18-30
16/01/1993 28 18-30
12/12/1989 30 18-30
07/06/1987 34 31-45
11/08/1990 30 18-30
26/02/1996 25 18-30
118/11/1996 25 18-30
0
0
0
0
0
FORMAT PENCATATAN PELAKSANAAN VAKSINASI CO
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINA
Alamat
NDIRI DS. NAMPAR MACING
NARA DS. WATU GALANG KEC. MBELILING
NAMPAR MACING DS. GOLO LELENG
WAE MUNTING DS. NAMPAR MACING (SDN TONDONG LAMBA)
DUSUN REHAK DS. GOLO KEMPO KEC. SANO NGGOANG
INDRONG DS. GOLO LELENG
DAHOT DS. NAMPAR MACING

LOKONG DS. PULAU N UNCUNG
COWANG ANAK DS. SANO NGGOANG
GENGGO DS. GOLO MBU
NUNANG DS. WAE SANO
REHAK DS. POCO GOLO KRMPO
NUNANG DS. WAE SANO
KOTA TADO INDRONG DS. GOLO LELENG
KOTA TADO INDRONG DS. GOLO LELENG
PAMPA DS. WAE WAKO
NAMPAR DS. GOLO LELENG / SMAN 1 NGGOANG
PUSUT DS. NAMPAR MACING
KACA DS. GOLO TANTANG KEC MBELILING
DANGE DS. NAMPAR MACING

KACA DS. GOLO TANTANG KEC MBELILING
KOTA TADO DS. GOLO LELENG
WATU LENDO RT 001 RW 001 DS. SIRU KEC LEMBOR
WERANG
WERANG
INDRONG
KOTA TADO
WAE MUNTING
PUSUT
TADO LONGGE
INDRONG
INDRONG
NAMPAR
INDRONG
INDRONG
TEONG TODA
TEOG TODA
NUNANG
NAMPAR
NAMPAR
NAMPAR
GENGGO
TEONG TODA
TEONG TODA
TEONG TODA
INDRONG
INDRONG
MBODONG
NUNANG
NOA
NAMPAR
PUSUT
NAMPAR
WAE NAHI
WAE MATA
NAMO, LEMBOR SELATAN
MELO
KOTA TADO
TADO LONGGE
TENDA
WERANG
WERANG
TEONG TODA
TEONG TODA
TEONG TODA
PUSUT
INDRONG
INDRONG
INDRONG
KOTA TADO
TEONG TODA
TA,AL
RANGAT WAE LOLOS
REKAS
TEONG TODA
TEONG TODA
INDRONG
NUNANG
INDRONG
NUNANG
DAHOT
DAHOT
RAHAK
INDRONG
INDRONG
INDRONG
INDRONG
PUSUT
WERANG
WERANG
WERANG
WERANG
WERANG
WERANG
WERANG
TEONG TODA
TEONG TODA
TEONG TODA
TEONG TODA
Pekerjaan
A
B
C
D
E
Total
AKSANAAN VAKSINASI COVID-19
FASYANKES/POS VAKSINASI
No. Hp
082144532300 1
082237888480 YA
081353088396 YA
082145953754 YA
081236230002 YA
082144519842 YA
081393741465 YA
081390614956
YA
081262441771
081238036685 YA
082196444645 YA
082196444645 YA
082236102958 YA
081246643932 YA
081340300672 YA
082139222384 YA
081352283657
081353266893 YA
081246491103 YA
085239017256 YA
081236696051 YA
081353104451 YA
081225124103 YA
085333739827 YA
YA
085339133475
082237368990
081339128821
081339861407 YA
082247051034 YA
081339833416 YA
081338245214 YA
081239822388 YA
082146977824 YA
082231429885 YA
085328983135 YA
082146631128 YA
082145287256 YA
081237262345 YA
081339898021' V
082236734937' V
081235023345' V
082266016589' V
081236405011' V
0852384430156' V
081237796215 V
081238775856' V
081238752133' V
08124617697' V
081238805890'
081236048744' V
081296570723 V
081237 323 825 V
082146084784'
082144627903' V V
081284624812 V
081353606986' V
081328339162 V
082266351698 V
081338648602' V
082236777414' V
082237311120' V
081338634447' V
085238997060 V
082144793103' V
081236206311' V
081339899476 V
082147724311
081237460460' V
081238185675' V
081338212829'
085253556611' V
081353437351' V
081337069417 V
082146613382' V
082147009203 V
085242664829' V
081239435403' V
081232748722 V
081331623146 V
081337633077 V
082247947635 V
081311999122 V
08133910651 V
081236106956 V
085239116292 V
082144900998 V
081338291332 V
081239420339 V
081338662839 V
082 197 634 902 V
082342147450 V
081338479537 V
081353294891 V
085255376407 V
081239450912 V
082187974154 V
082 341 922 698 V
082 237 614 441 V

08123752244 V
081337470770 V
085211786123 V
082145609097 V
082 236 196 799 V
081293507573 V
082359197610 V
085247696027 V
085340788528 V
082237313762 V
08211290750 V
081353176883 V
085337317844 V
081239565476 V
085 338 396 328 V

n
0
0
0
0
0
0
Non Anggota
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
4/28/2021 SINOVAC
27/04/2021
27/04/2021
V
V
V
V
Dosis I
Tanggal Pemberian
Vaksinasi
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
4/28/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
1
S-C0409DD1
2
S-1D4FB08F
3
S-16A1D0CA
4
S-1EFA7189
5
S-395F436D
6
P-84ZSG4HO
7
S-B3FD6EDF
8
P-862GQAMF
9
P-86U7GSQ7
10
P-88VKICQP
11
S-1BFBAD85
12
S-7A106ED2
13
S-13E9E5FC
14
S-D02D03A5
15 S-56EBC040
16
S-F6C43C6E
17
S-FB64A8E2
18
S-C055CB52
19
P-8D5LNCJL
20
P-89L5T578
21
S-62FD471D
22
P-8A65YYD5
23
S-D17E54E6
24
P-8NWRH6YB
25
26
27
28
29
P-8Q3G0VSO
30
31
P-8QT4KJNM
32
P-8R7VQNND
33
34
35
36
37
38
39
40
41
42
43
44
45
46
P-8RTFGGUY
47
P-8SO06F03
48
P-8T1IIIK1
49
50
51
52
53
54
55
56
P-9BXLBR58
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
S-B5A01756
87
88
S-8C83A1CA
89
S-7DADA179
90
S-BE21D297
91
S-F198D9A5
92
Y-000051X1
93
94
S-A93D5CBD
95
S-BA22E289
96
S-BBC5306A
97
S-5402BADD
98
S-2255B9E2
99
100
101
102
103
104
manual
pcare
TUNDA (TPK)
total
NIK
5315037011900001
5315043112640011
5315043004660003
5315043112651003
5315046812700001
5315045806770001
5315043112640012
5315042811880002
5315010305960006
5315036109950001
5315040107660068
5315041105920001
5315042510760003
5310110203880003
5315046911910004
5315043112650010
5315042312640002
5315040107900047
5315044305770002
5315046312820002
5315040603820002
5315044107880047
5315043006930002
5315045010960003
53100347059007
5315046004950004'
3524140101880027'
5206115604921003'
5315054703920002'
5315045710960002'
5315041009640004'
5315044911681001'
5315042405830001'
5315040107660089'
5315045803740003'
5315044702841001'
5315042104670001'
5310121205910005'
5315044106891001'
5315045207680002'
5315041810640002'
5315043012630004'
5315040805620001'
5315040311930003'
5310131401912501'
5315044306871001
53150460097500004
5315042207890002
5315041209650001
5315040507900001
5315044312851001
5315045307840004
5310034603880002
5310141103860001
5315042210710001
5315041908960003
5315041908960003
5315041604831001
5315045901930001
5315046507690004
5315041112860001
5315045504901001
5315036505830004
5315045401940001
5315043112691001
53150425706670002
5315042210710001
5315040108801001
5315043112890002
7371020106720008
5315041001730001
5315042609640001
5315037108910001
5315042403740002
5315041208810002
5315042510820002
5315043112740003
5315040605670003
5315044705740002
5315042203791001
5315043112700004
5315050510900004
5315040912980008
5315040510640001
5315041203570001
'5315044107550087
'5315046604700002
'5315044107500129
'5301102503930005
'5315040107460073
'5315040112410001
'5315040107530087
'5315046006620001
'5315044107540096
'5315042504520001
'5315044107510063
'5315044107550086
'5315044107450153
5319024306900002
5310057112630002
5310142408100933
531040107560090
53150409106640004
5315045607841001
22
82
4
104
: WERANG
: MANGGARAI BARAT
: NTT
: KAMIS, 29 APRIL 2021
Nama Penerima Vaksin Jenis Kelamin
P
Yosefina Gamung
L
YOHANES BABTISTA ISAKAR
L
Antonius Aden
L
SERAFINUS MADIN
P
VINSENSIA GADIS
PAULA JENDIA P
P
ABDUL KADIR
MUHAMAD SUHARDUN L
FRANSISKUS ASISI HARTO ADI L
SITI ARPIAN P
L
Usman
L
Eduardus Sariman, S. Pd
L
Christophorus Yos
L
Agustinus Mao
ANGELIA BERNADETA HAYATI P
Jeman L
MUHAMAD BAHALI L
L
Ferdinandus Yufensi
P
MARIA LOVIA MAINA
P
MARGARETHA LIA
Ambrosius Buhan L
P
FITRIYANI NININGSIH RAYA
L
MUHAMAD ASMAN
P
NURJILA
DIONISIA NURTI NAHUS P
NASTILDE KURNIAWATI DORSI P
JAFRUDDIN L
NURWAHIDAH P
VILISITAS MARIAN ANUR P
HERONITA ELFRIDA MARKONA P
AGUSTINUS JAMU L
HANUS P
FERDINANDUS SEMADRIS L
BINATUS SARDAP L
VERONIKA NIAT P
SITI MELTI P
URBANUS JASA L
YOHANES SADI MANTU L
SITI VENIDARTI P
NURHAYATI SELIMA P
SUDIR MUHAMAD L
IDRIS HANU L
VALENTINUS JAMIN L
HUBERTUS NENGKA L
MAKSIMILIANUS ERVELIN L
MELANIA MAI P
EUSTACHIA YOSEPHINA P
MUH. SUHARDI L
YOHANES HABAT L
SAPRUDIN HARDI L
TERESIA SURIYANTI P
ERMELINDA DETRIN P
LUSIA JAIMUN P
MAKSIMUS NGAMBU L
MUHAMMAD MUSTAJIK L
HERI SUSANTO BAKHTIAR L
IGNASIUS S.A. JANDU L
YOHANES FERDINANUS HASBUN L

P
EMERENSIANA HADIA
REINELDIS MARNI P
AHMAD ABUK L
LUSIANA JUMANTI P
FATIMA P
MIN RIA P
YOHANES SUDIRMAN L
LUTGARDIS NIGA P
YUSTINUS Y. SUHADISMAN L
ÁGUSTINUS RAISON L
Supardi Bung L
L
MIRU
BUDIMAN L
L
SIPRIANUS SIMEON
YASINTA SULASTI RUDIN L
SALESIUS SADIR L
FLORIANUS FERDISON L
Robertus Randu L
ANSELMUS MUSTAHIL L
LAURENSIUS LARUNG L
MARIA MAGDALENA ASNI L
MARSIANUS Y.A.POA L
GASPAR TAMPUL L
PATRISIUS YANUARIUS SALASA L
APOLONARIS BRUNO STIRMAN L
YOHANES HARUNG L
L
LEONARDUS LANGGU
BERNADETA LINA P
MARIA YOVITA JERVIA P
ROSALIA HAYA P
L
SATBER DUPLIMAR BENU
YULIANA SELINA P
L
BERNADUS NADUS
LUKAS MAHIN L
MARIA DIJA P
MARIA IJO P
PETRUS ANDI L
MARIA DELIMA P
P
MARIA THERESIA ADUL
P
VERONIKA GANUM
MELIANA GANUT P
KATARINA IMAT P
HUBERTUS LAGUS L
THEODORUS TEO L
DONATUS JARUT L
YULIANA MAMU P
lansia
pertanian
peternakan
pol pp
bkkbn
NAKES
PEGAWAI KECAMATAN
PELAKU USAHA
PTPK
TOTAL
FOR
Umur
Pekerjaan* Tanggal Lahir
(18 sd ≥ 60 tahun)
GURU 31/11/1990 #VALUE!
GURU 31/12/1964 57
GURU 30/04/1966 56
GURU 31/12/1965 56
GURU 28/12/1970 51
GURU 18/06/1977 45
GURU 31/12/1964 57
GURU 28/11/1988 33
GURU 03/05/1996 26
GURU 21/09/1995 26
GURU 01/07/1966 56
GURU 11/02/1992 30
GURU 25/10/1976 45
GURU 02/03/1988 34
GURU 29/11/1991 30
GURU 31/12/1965 56
GURU 31/12/1964 57
GURU 17/12/1985 36
GURU 03/05/1977 45
GURU 23/12/1982 39
GURU 06/03/1982 40
GURU 23/12/1990 31
GURU 18/02/1993 29
GURU 10/10/1996 25
05/07/1990 30
20/04/1995 26
33
16/4/1992 29
03/07/1992 29
17/10/1996 24
09/10/1964 56
10/09/1968 53
24/5/1983 37
31/12/1966 55
18/3/1974 47
17/2/1984 37
21/4/1967 55
05/12/1991 30
06/01/1989 31
07/12/1968 53
18/10/1964 57
30/12/1963 57
05/08/1962 59
11/03/1993 28
14/1/1991 29
06/03/1987 33
20/9/1975 45
22/7/1989 31
09/12/1965 56
07/05/1990 31
12/03/1985 36
13/7/1984 37
03/06/1988 33
PTPK 03/11/1986 35
GURU 22/10/1971 50
GURU 19/08/1996 23
ASISTEN GURU 12/01/2000 20
GURU 16/04/1983 38
GURU 19/01/1993 28
GURU 25/07/1969 52
GURU 12/11/1986 35
GURU 15/04/1990 30
GURU 25/05/1983 37
GURU 14/011/1994 27
GURU 31/12/1969 52
GURU 17/06/1967 54
GURU 19/10/1968 52
GURU 08/01/1980 40
GURU 31-12-1989 32
GURU 06/01/1972 48
GURU 01/10/1973 48
GURU 56
26/09/1964
GURU 31/08/1991 30
GURU 24/03/1974 47
PEGAWAI KECAMATAN 08/12/1981 39

GURU 25/10/1982 39
POL PP 31/12/1974 47
PEGAWAI KECAMATAN 05/06/1967 53
PEGAWAIPOL PP 05/07/1974 47
BKKBN 22/03/1979 42
PETERNAKAN 31/12/1970 51
DOKTER HWN 01/05/1990 30
PETERNAKAN 09/12/1998 23
GURU 56
10/05/1964
LANSIA 03/12/1957 64
LANSIA 07/01/1955 66
PERTANIAN 26/04/1970 51
LANSIA 07/01/1950 71
GURU 25/03/1993 28
LANSIA 07/01/1946 75
LANSIA 12/01/1941 70
LANSIA 07/01/1953 68
LANSIA 20/06/1962 59
LANSIA 07/01/1954 67
LANSIA 25/04/1952 69
LANSIA 07/01/1951 60
LANSIA 07/01/1955 66
LANSIA 07/01/1945 76
PELAYAN PUBLIK/PTPK 07/03/1991 30
LANSIA 07/10/1955 66
LANSIA 07/01/1956 65
GURU 16/07/1984 36
14
1
3
2
1
2
2
1
74
100
FORMAT PENCATATAN PELAKSANAAN VAK
TINGKAT PUSKESMAS/FASYANKES/POS
Kelompok Umur Alamat
#VALUE! LOKONG
46-59 WAE RACANG
46-59 PAKU DS. GOLO MANTING
46-59 LANDO DS. GOLO MANTING
46-59 CERENG DS. GOLO SENGANG
31-45 LOKONG DS. PULAU NUNCUNG
46-59 WAE RACANG DS. MATA WAE

31-45 ANGKOR DS. MATA WAE
18-30 NGGOANG DS. SANO NGGOANG
18-30 NAGA DS. MATA WAE
46-59 WAE RACANG DS. MATA WAE
18-30 WATU WANGKA DS. GOLO NDARING
31-45 KANDANG DS. PULAU NUNCUNG
31-45 NDENGO DS. WAE LOLOS
31-45 MBODONG DS. GOLO KONDENG
31-45 MBODONG DS. GOLO KONDNEG
31-45 NDAJOT DS. MATA WAE
18-30 BOKAK RANGGA DS. SANO NGGOANG

18-30 TEONG TODA
18-30 LOKONG
31-45 CERENG
18-30 LEHENG
18-30 CERENG
18-30 CERENG
46-59 LOKONG
46-59 CERENG
31-45 NGGOANG
46-59 CERENG
46-59 WERANG
31-45 WAE RACAG
46-59 KANDANG
18-30 KANDANG
31-45 NAGA
46-59 NAGA
46-59 WAE RACANG

46-59 METANGGA
46-59 NAGA
18-30 GOLO MANTING
18-30 SANO NGGOANG
31-45 RUA
31-45 DALENG
31-45 CERENG
46-59 LOKONG
31-45 NAGA
31-45 WERANG
31-45 WERANG
31-45 TEONG TODA
31-45 TEONG TODA
`46-59 LEHENG
18-30 NAGA
18-30 TEONG TODA
31-45 WERAANG
18-30 CEREMBA
46-59 CERENG
31-45 WAE RACANG
18-30 P. NUNCUNG
31-45 NAGA
18-30 NAGA
46-59 NAGA
46-59 NAMPR MACING
46-59 BOKAK RANGGA
31-45 NDAJOT
31-45 CERENG
46-59 NAGA
46-59 NAGA
46-59 BOKAK RANGGA
18-30 PINGGONG
46-59 TEONG TODA
31-45 WERANG
31-45 TEONG TODA
46-59 TEMBEL
46-59 WERANG
46-59 WERANG
31-45 WERANG
46-59 NAMPR MACING
18-30 LABUAN BAJO
18-30 NAMPAR MACING
46-59 METANGGA
46-60 GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
LOKONG DS. PULAU NUNCUNG
GENGGO DS. GOLO MBU
WERANG DS. GOLO MBU
GENGGO DS. GOLO MBU

GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
WERANG DS. GOLO MBU
WERANG DS. GOLO MBU
WERANG DS. GOLO MBU
TEONG TODA, DS. GL. NDARING
GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
SMPN 2 SANO NGGOANG

LAKSANAAN VAKSINASI COVID-19
/FASYANKES/POS VAKSINASI
No. Hp
081338534079 YA
081329783148 YA
082146605825 YA
082146084018 YA
085857675136 YA
081238150973 YA
081338425844 YA
082189118495 YA
082236733857
082144895501 YA
085237164061 YA
082147240858 YA
081339858802 YA
085237431527 /081543170902
082339877317 YA
085739564276 YA
082144207233 YA
082146200865
081339543251 YA
081226597338 YA
081239428354 YA
081337320481 YA
081237587418 YA
085239128660 YA
081236556245' V
0822235113913 V
082341518876'
085335140955' V
085796358641' V
081236269054' V
085857675106'
081337269976' V
082359261516' V
081246291194' V
081238149647' V
081236933549' V
081246255895' V
085792638845'
082144358278' V
081337087586' V
085337680948' V
085858763107' V
085333601540'
081338290065
081337704464
081246232677 V
085792229373
085237962488 V
081239343167
081246327662 V
082146517392 V
081236706138 V
081339118972
- V
082339053387
082145671823 V
081337925530
081241587070 V
082144097945 V
081239524801
081246255895 V
081237511864 V
081236060955 V
081339802236 V
081338662988 V
081353528154 V
081236655294
085857675143 V
082339781442
085857824269
081238083542 V
082342306200
081339306765 V
082145417887
081236578021 V
082145816886 V
082134975534 V
081236046873 V
081236570613 V
'085253925605 V
0853239562534 V
081296576378 V
081339812474 V
YA
082111073140
YA
'081237018878 YA
0 YA
'082324292607 YA
0 YA
'081238383783 YA
0 YA
YA
0 YA
0 YA
0 YA
0 YA
08139732095
081236608368 YA
081236608368
081337057764 YA
085239228672 YA
081338038006 YA
Non Anggota
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
4/29/2021 SINOVAC
V
V
V
V
V
V
YA
YA
YA
Dosis I
Tanggal Pemberian
Vaksinasi
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
4/29/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
1
S-0240BC52
2
P-6OGKN9OP
3
S-32B3E22E
4
S-671867DF
5
S-D6F269D7
6
S-7DA1F14B
7
S-34A0CD3B
8
P-6S7A0NN7
9
S-99321711
10
S-0319CDBA
11
S-0EDCDBC4
12
S-FD2A1ED0
13 S-C11A39A4
14
P-6V8C5387
15
N-E0431305
16
S-F0A674D8
17
Y-000051Y7
18
P-77AOJ6P7
19 S-57527F90
20
S-821F016D
21
S-55C483B8
22
P-7CH0NA6F
23
P-7FI8JWAZ
24
S-119DDD74
25
S-98FD8A22
26
S-FF2A45C3
27
S-012F0FF8
28
S-BDA38907
29
S-E46AFB4C
30
S-8920849F
31
S-F1BFD87D
32
S-BAE1527D
33 S-AE543170
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
P-7WMGS3C4
66
P-854Z2H68
67
68
P-8BDWB3N9
69
70
71
72
73
74
75
76
77
78
79
80
81
82
MANUAL
PCARE
TOTAL
BATAL
VAKSIN
TPK
NAKES
BATAL (GURU)
APARAT DESA
TOTAL
NIK
5315034605880002
5315045505920003
5315046711920002
5315041807790003
5310144704890001
5315042711730002
5315047005770001
5315041701870002
5315046501930002
5315041311910001
5315034907820001
5315071409690001
5315044404930002
5315045007700001
5315046903890001
5315034105900007
5315050803830002
5315045104730003
5315064104850001
5315042201921001
5315042004921001
5315045611830001
5315045802691001
5315044107741002
5315042811800001
3506121504890005
5315062808840003
5315043112660013
5315043112660010
5315042802920001
5315042604880001
5315040206940001
5315032804890001
5315041802750001
5315042102870001
5315041408770001
5315046002880003
5315040405930002
5315040107670522
5315040908770001
5315042302690002
5315042704680001
5315041108830001
5315041807890003
5315047110881001
5315036308840004
5315040807850003
5315045606920001
5315041207910001
5315040809861001
5315041309850002
5315032612800001
5315042501940002
5315044612910003
5310050102930006
5315054306890001
5315041707720007
5315041609860004
5315046802930002
5315045708780005
5315043011830004
5315045504950002
5315042103650002
5315043112660009
5315060507870002
5315035204870004
5315043012650003
5310175611890001
5315036810920004
5315041705880001
5315004410793026
531504180788007
5315041231640010
5315041501950002
5315032404860009
5315042311951001
5315040306750003
5315042307800001
5315042506710002
5315041417110001
5315042304890002
5315040107730072
23
58
81
1
80
64
1
1
15
81
: WERANG
: MANGGARAI BARAT
: NTT
: JUMAT, 30 APRIL 2021
P
ANTONIA SAVIA JUMAIDA BELIT
P
MARSELINA NAUM
P
Etheltredis Dadores
L
YUSUF GAFUR
P
YOANA ANITA ARVI
L
ABDUL SUDIN, S. AG
P
Setia Nurjaya
ANTONIUS HANI L
ANASTASIA SINCE P
L
YOHANES ANDRIONO HAMU
P
TERESIA FLORIDA
L
Sylvester Muan
P
ARWIAN ASTUTI
P
NURAENI S. SOS
P
Siti Nurhayati
P
Maria Alviani Gibun
L
YOHANES HABU
P
THEOLOSIA MARIA KLAUDIA SEDIA
P
ISABELA INTAN
L
SALAHUDIN AL TONDONG
L
Marianus Paskasitus Jehana
P
SITI HAMIDA RUDIN
P
VERONIKA VIBERNA
P
SITI NURFATMAH
L
Muhammad Malik S
L
Benny Isayoga Kristyowidi
L
Agustinus Andi
SEBASTIANUS PIRTO L
L
RAHMAD FUDIN
FERNANDES CANDRA L
L
Antonius Duar
L
ALMUHARAM MASCUR
L
IVAN SUDARMI ADIN
BONEFASIUS PANTAR L
MUHAMAD SAPRI L
ZAKARIAS SON L
SITI SANAFIA P
FLORIANUS DARWIN L
FRANSISIKUS NURDIN L
VINSENSIUS NABON L
TADEUS TAMAT L
ARNOLDUS AGAR L
AGUSTINUS LEVEN L
HERIBERTUS RIASWAN L
VIKTORIA MELODI P
BERNADETA JEMINA P
AGUSTINUS ANGGU L
MARIA ERMELINDA DALULNG P
MUHAMAD HARYONO L
BONEFATURA PON ARJU L
YPHANES H. TUTI L
ROMANUS TUHU L
METODIUS NALI L
SITI NASMI YANTI P
SAVERIUS GALVRANI L
DAHLIA P
BONEVATURA MULAWARMAN L
DIDIMUS SANDRA L
OVOTA GETI HADINAR P
DONATA AWING P
AVENTINUS VENTUS
FRANSISKA PASKALINA AYU P

VINSENSIUS JOGO L
DAMASUS HAMAT L
PIUS ONDENG L
MARGARETA MURJIATI P
ANDREAS BOLE L
TANTIANA J. MIMUNG P
NUR ASFAH P
ROBERTUS TONI L
SITI SARTIKA DEWI P
KANISIUS JADI L
IGNASIUS IMPUN L
ARIFIN RASIDIN KADU L
ABU HURAIRAH M. SUNDI L
RIKardus felisitas L
ALFONSUS SAMAN L
ANSELMUS HERY L
WIHELMUS PHILIPUS SULENSI L
VINSENSIUS EDENSI L
GEORGIUS GERSON L
SAVERIUS SEHABUN L
GURU (SILVESTER)
GURU 06/05/1988
GURU 15/05/1992
GURU 27/11/1992
GURU 18/07/1979
GURU 07/04/1989
GURU 27/11/1973
GURU 30/05/1977
GURU 17/01/1987
GURU 25/01/1993
GURU 13/11/1991
GURU 09/07/1982
GURU 14/09/1969
GURU 04/04/1993
GURU 10/07/1970
NAKES PENYINTAS 29/03/1989
GURU 01/05/1990
GURU 08/03/1983
GURU 11/04/1973
GURU 01/04/1985
GURU 22/01/1992
GURU 20/04/1992
GURU 16/11/1983
GURU 07/06/1976
GURU 01/07/1974
GURU 28/11/1980
GURU 15/04/1989
GURU 28/08/1984
GURU 31/12/1966
GURU 31/12/1966
GURU 29/01/1992
GURU 26/04/1988
GURU 02/04/1994
GURU 28/04/1989
PERANGKAT DESA GOLO KONDENG 18/02/1975
KETUA RT DS. GOLO KONDENG 01/07/1967
KETUA RT DS. GOLO KONDENG 23/02/1969
PERANG DS. GOLO NDARING 28/04/1969
08/11/1983
18/7/1989
31/10/1988
23/10/1984
07/08/1985
16/6/1992
07/12/1991
09/08/1986
13/9/1985
26/12/1980
25/1/1994
12/06/1991
02/01/1993
06/03/1989
17/7/1972
16/9/1986
28/2/1993
17/8/1978
31/11
15/4/1995
21/3/1965
31/12/1966
30/5/1987
04/12/1987
30/12/1965
16/11/1989
28/10/1998
17/5/1988
15/1/1993
18/7/1988
31/12/1964
15/1/1995
24/4/1986
23/11/1995
Staff DESA 07/03/1975


FORMAT PENCATATAN P
TINGKAT PUSKESMA
Umur
Kelompok Umur
(18 sd ≥ 60 tahun)
34 31-45
30 18-30
29 18-30
43 31-45
33 31-45
48 46-59
45 31-45
35 31-45
29 18-30
30 18-30
40 31-45
52 46-59
29 18-30
52 46-59
33 31-45
32 31-45
39 31-45
49 46-59
37 31-45
30 18-30
30 18-30
38 31-45
46 46-59
48 46-59
41 31-45
33 31-45
37 31-45
55 46-59
55 46-59
30 18-30
34 31-45
28 18-30
33 31-45
47 46-59
35 31-45
44 31-45
34 31-45
29 18-30
55 46-59
45 31-45
53 46-59
53 46-59
38 31-45
32 31-45
33 31-45
37 31-45
36 31-45
28 18-30
30 18-30
34 31-45
36 31-45
40 31-45
26 18-30
30 18-30
28 18-30
32 31-45
49 46-59
35 31-45
28 18-30
42 31-45
37 31-45
26 18-30
56 46-59
55 46-59
33 31-45
33 31-45
56 46-59
31 31-45
28 18-30
32 31-45
28 18-30
32 31-45
56 46-59
26 18-30
34 31-45
25 18-30
45 31-45
40 31-45
50 46-59
49 46-59
31 31-45
47 46-59
FORMAT PENCATATAN PELAKSANAAN VAKSINASI C
TINGKAT PUSKESMAS/FASYANKES/POS VAKSIN
Alamat
PONCENG KALO DS. WAE SANO
NUNANG, DS. WAE SANO
NDAJOT DS. MATA WAE
WER4ANG DS. GOLO MBU
WERANG DS. GOLO MBU
LANDO DS. GOLO MSNTING
LANDO RT 002 RW 001 DS. GOLO MANTING
CEREMBA DS. GOLO SENGANG

GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
KOMPLEKS SMPN 4 SANO NGGOANG DS. GOLO LELENG
KOMPLEKS SMPN 4 SANO NGGOANG DS. GOLO LELENG
NDAJOT DS. MATA WAE
GENGGO DS. GOLO MBU
GENGGO DS. GOLO MBU
NAGA DS. MATA WAE
MBODONG DS. GOLO KONDENG
ANGKOR DS. MATA WAE
NAGA DS. MATA WAE
NAGA DS. MATA WAE

TENDA DS. WATU PANGGAL
SD-SMPN SATAP METANGGA
TONDANG RAJA
WATU WANGKA DS. GOLO NDARING
WERANG DS. GOLO MBU
NDAJOT DS. MATA WAE
PAMPA DS. WAE WAKO
LAMUNG DS. GOLO NDARING
PONCENG KALO
WAKAR
WERANG
WERANG
WERANG
WERANG
NAGA
WERANG
GENGGO
INDRONG
KOTA TADO
NAGA
INDRONG
INDRONG
TADO LONGGE
NAMPAR MACING
INDRONG
INDRONG
NAGA
GENGGO
GENGGO
TADO LONGGE
BAMBOR
INDRONG
TENDA
METANGGA
ANGKOR
DALENG
WERANG
INDRONG
LOKONG
NDAJOT
DS. SIRU
mbodong
MBODONG
MODONG
MBODONG
PINGGONG
LABA
WATU WANGKA
SANAAN VAKSINASI COVID-19
SYANKES/POS VAKSINASI
No. Hp
081246364389 YA
081246871652
081239763372 YA
082145681212 YA
YA
082244730021
082147154158 YA
085857819885 YA
081338446331
082228330132 YA
085334471579
085237299408 YA
085253151725 YA
081338878457 YA
082145816952 YA
081226940409 YA
YA
082145826592
YA
081338324812 YA
081239036473
081339817530 YA
081239524483 YA
082146209509 YA
082340207887 YA
085258272627 YA
082236474422 YA
YA
081236570554
08123783547 YA
085397563133 YA
082145667635 YA
081343807760
081338431263 YA
082146527806 YA
081238601724
081236583961 YA
081237495781 YA
082141272006
0 YA
081226597338 YA
0 YA
0 YA
081353478388 V
081239588116 V
082146266150 V
082232708608 V
081337340385
085339205682 V
081246234829 V
082147541670 V
082146855527 V
082236322788 V
085205792302 V
082144895569 V
181337572163
081236178500 V
081238821007 V
082146513677 V
081239353124
081236533839 V
085847836102
082144222942
081236705028 V
081236405011 V
08523862188
082145222650 V
081239422529 V
081238773417 V
082394435691
085239816642 V
085234367364 V
085238203658 V
081294050347 V
081356778738 V
082341488052 V
081246722293 V
082236758342 V
081353847426
081235616348 V
081393742467 V
082311781632 V
0812 96553998
Non Anggota
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
4/30/2021 SINOVAC
V
V
V
V
Dosis I
Tanggal Pemberian
Vaksinasi
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
DITUNDA KRNA HT
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
1 P-1BRSHJUL
2 P-4FF0OVKT
3
S-C8CB554A
4 P-4GCG4LVF
5
S-FB6F6AD5
6 P-4HAI5VFZ
7
S-472500BC
8
9
S-4F7B2BA9
10
11
S-32DB84F9
12
S-7C5F8078
13
S-1B1E47B2
14
15
16
S-0101AD09
17
18
19
20
21
22
23
24
25
26
S-02D653DB
27
28
29
30
31
S-7F866EC3
32
S-1E2FA35D
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
S-BB13C836
49
S-96717FC4
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
P-1EIFEGD4
98
P-42ORT4AM
99
100
101
P-46XNSYKU
102
103
104
105
P-48GYEF6H
106
P-1IKM0U1R
107
S-72FAD7B4
108
P-1MYW9O7U
109
P-1PPYAIZ4
110
P-1RR9AI0M
111
112
113
114
P-4C7X83Q6
115
P-4CZR12NA
116
P-4DIWF5PM
117
P-4EREH4TB
118
P-4FKMO4K0
119
120
121
122
123
124
P-4HBZS5WN
125
P-4I16M0N6
126
127
P-4JT5HIUW
128
P-4VTQ1TLW
129
P-4WH2UEFO
130
P-4XHMNHDA
131
132
133
134
135
136
137
138
PCARE
MANUAL
TOTAL
BATA
NIK
5315014510720003
5315045909690004
5315014203900002
5315040507710001
5315042908850002
5315045109920001
5315045109920001
5315045512830005
5315040211680003
5315045306920001
5315040311831001
5319052007880003
5315042501820001
5315054803970012
5315046408690005
5315043005881001
5315045610720001
5315041205670002
5315042210890001
5315045406840001
5315041905710001
5315042804840002
5315040804880006
5315040507690001
3275032707770034
5315034808970005
5315046911840001
5315042511830001
5315042004800001
5315045608880003
5315041203850001
5315041207930001
5315046206641001
5315041902930003
5315041903830002
5315043005690003
5315042709820005
5315040908760002
5315041812680001
5315040176000131
5315046609760002
5315040401070006
5315042402990002
5315042312831001
5315042602881001
5315042099760001
5315041806720001
5319024502940002
5315042904630002
5315032009840004
5315045604670002
5315042504790002
5315042004840002
5315044311960004
5315041606650003
5315040407680001
5315040107760085
5315046706920001
5315045703970001
5315041509660006
5315042203640002
5315040906880002
5315040309920002
5315042411930001
5315040111790003
5315043112651002
5315043112651002
5315042805930002
5315044206800004
3275035510810036
5315045012941001
5315046401770001
5303024705920001
5315044311930004
5315045108810002
5315040808680007
5315045807800002
5315042002930001
5315071409690001
5315042304890002
5315041003770001
5315044811810001
5315045007880004
5315045007880004
53151042701721001
5315040608830001
5315041308980001
5315040505620002
5315042503720002
5315041005860001
5315041201630002
5315045508760005
5315040107610066
5315042310711001
5315035707910003
5315041010810001
5315044112850002
5315064306880004
5315040805620001
531504410761005
5315042901630001
5315047101790001
5315047112680007
5315043005830005
5315042208690001
5315040802800004
5315041010810001
5315046304740001
5315044103870003
5315044809790001
5310035110930001
5315101812840001
5319036709870001
5315040904850003
5315040107840065
5315040101910006
5315042709780003
5315041204670001
5315041010810001
5315047004750001
5315040611870003
7371125512910009
9171055103970003
5315045711860001
5315035012930002
5315043107780001
5315040902730001
5315044908720002
5315045011690003
5315040306670003
5315041407790002
5315042607770001
5315040402790001
730608234920011
5315042807660003
5310055506910003
5310055506910003
5315042405740001
59
79
138
8
: WERANG
: MANGGARAI BARAT
: NTT
: SABTU, 01 MEI 2021
P
KRISTINA STIN
P
FRANSISKA HADIAH
P
NURLAILA
L
ANTONIUS PABU
L
MASRIN MUKHTAR UMAR
P
ASTUTI BUNGAWATI
L
YOHANES SUDIRMAN
MARIA MARGARETHA MARNI P

MARSELINUS HERSONI L
P
GENOVEVA SIMUN
L
MUSA
AMBROSIUS SARFUS L
Yohanes Paulus Bion L
P
BEATA HETRI
P
YULIANA YENI
FERDINANDUS WELIMON L
P
MARIA MARGARETA NIMAT
L
DANIEL JEMUDI
L
MARSELUS KARNO
P
BIBIANA DEVI
L
VIKTOR BITRODIS
L
YOSEPH SURIANTO GIAT
L
GREGORIUS SUMARLIN
L
BERTOLOMIUS BARU
L
SILVESTER SURYAMAN
P
NURSIA HABIA
L
MELANIA CICISUTARTI
KONSTANTINUS DION L
L
MONALDUS PIRTA
MARIAMA ERNA P
L
Severinus Vedi
L
PAULINUS NIRMAN
P
CLARA TRI PENI PUTRI
ANSELMUS ARI L
VINSENSIUS VIKTOR L
FERDINANDUS PAPU L
ROBERTUS MANS L
TARSIUS JUAN L
MATIAS HADIP L
ALFONSIUS JALU L
MARIA FATIMA ANIS P
DAMASIUS RIMIN L
VINSENSIUS VARANO L
YOHANES SUHARDI L
EDUARDUS ERVANS L
MIKAEL AGUNG L
ARNOLDUS EMAS BAHAGIA L
LUSIANA NDIWUL P
ANTONIUS AGEN L
LUKAS MANASIAN L
SISILIA NISA P
MARSELINUS GONS SUHARDI NANDI L
DAMIANUS DAMIN L
MERLINDA DAPORES NOVILIA P
RAFAEL LANGKU L
ANSELMUS SU L
ROBERTUS NARUS L
NURSAH ADIAH AHMAD P
YOSEFINA CARLIN HIBUR P
NIKOLAUS MAJU L
ANTONIUS ADI L
PRIMUS HENDRA L
BENI SURATMAN L
ICHSAN L
MAKSIMILIANUS MAGUAN L
MUHAMAD SEHUDIN L
MARSELUS MALA L
WIHELMUS ADI PUTRA L
REGINA ERNI P
MARIA FRANSISKA NURHAYATI P
ANJELA RENI P
HILDA AGNETA P
MELIANA GORETI BOY P
IDA SUSANTI TESUYI P
GEOVEVA GENSI P
STEFANUS SAMAN L
FLORIDA SALESIANA TUWUNG P
ALOYSIUS GONZAGA L
SYLVESTER MUAN L
GEORGIUS GERSON L
SYRILUS FOU L
VERONIKA SAIMAN L
YULIANA ASMIN P
MARIA VIVI SUSANTI DEWI P
FRANSISKUS NIKSON L
ARNOLDUS ANDU L
KANISIUS ARDO L
YOSEF ARDI L
HIRONIMUS HUDIN L
GORDIANUS H. MANJELO L
TITUS TURUK L
MARTA SURIA P
FRANSIKUS MIDIN L
STANISLAUS SANDI L
NURMIYATI P
AYYUB L
AGUSTINA SEDIAN P
ROSALIA YULITA P
VALENTINUS JAMIN L
P
MARTINA NETI
MARSELINUS LAMPUNG P
GONSAGINA MENSIYANI P
P
ANASTASIA ASIM
ALEKSANDER T RUNTU L
ALI ANWAR KURI L
YOSEPH S.J. BARU L
LORENSIUS ALUR L
BERNADETA IJA P
ROFINA NILAM P
MARIA YASINTA SURYANI L
P
Erwin Susanti Banur
Fransiskus Doni L
P
MARIA NENSI
AHMAD SUBIN L
AHMAD DOLA L
DONATUS JEBARU L
VINSENSIUS BASTIAN L
FRANSISKUS ADON L
P
MARIA MAGDALENA MBIMBUS
MARIA MAGDALENA MEDIA P
Mikael Gildus L
THERESIA VIVIYANI N. NUDIL P
VELIANA MBAWUNG P
MARIA FATIMA FLORIDAN P
ERMELINDA RIDAN P
L
STEFANUS ADON
YASMAN NURSALIM L
ROFINA NANUT P
YUSTINA NELI P
L
MARSELINUS JONI
DAVID SALVIUS DEN L
L
FRANSISKUS HARDI
FELISIANUS GAHU L
RIKARDUS JEMADU L
YAKOBUS YAKOB KELEN L
MONALDUS MANSUHANDI L
MARIA JUANA P
L
ARNOLDUS RUDIN
BPD 05/10/1972
GURU 19/09/1964
GURU 30/06/1992
PETANI 05/07/1971
GURU 29/08/1985
GURU 11/09/1992
GURU 27/10/1964
GURU PAUD 05/12/1983

APARAT DESA 02/11/1968
GURU PAUD 13/06/1992
GURU 03/11/1983
GURU 25/04/1990
GURU 25/01/1982
BPD 08/03/1997
APARAT DESA GOLO MBUJ 24/08/1969
GURU 30/05/1988
KADER PKK 16/10/1972
BPD 12/05/1967
GURU 22/10/1989
KADER 14/06/1984
BPD 19/05/1971
BPD 28/04/1984
STAFF DESA WATU PANGGAL 08/04/1988
KETUA RT DS. GOLO MBU 05/07/1969
STAF DESA WATU PANGGAL 27/07/1977
GURU 08/08/1997
STAFF DESA GOLO LELENGH 29/11/1984
LINMAS DESA WATU PANGGAL 25/11/1983
KETUA RT DESA WATU PANGGAL 20/04/1980
BPD 16/08/1988
GURU 12/02/1987
GURU 12/07/1993
GURU 22/06/1964
STAFF DESA WATU PANGGAL 19/02/1993
KETUA RT 08 DESA GOLO LELENG 19/03/1983
KETUA RT 03 DS. NAMPAR MACING 30/05/1969
APARAT DESA NAMPAR MACING 27/09/1982
STAFF DESA NAMPAR MACING 09/08/1976
KETUA RT 18/12/1968
KADER/LANSIA 01/07/1960
KADER 26/09/1976
KETUA RT 04/01/1987
KETUA RT 24/02/1999

STAFF DESA GOLO LELENG 26/02/1988
GURU 05/02/1994
APARAT DESA NAMPAR MACING 29/04/1963
STAFF DESA GOLO LELENG 20/09/1984
KADER 25/04/1979
KEPALA DUSUN NDIRI 20/04/1984
GURU 11/03/1996
GURU 16/6/1965
PETANI 07/04/1968
PETANI 07/01/1975
GURU 27/6/1992
GURU 17/3/1997
PETANI 15/9/1966
GURU 22/3/1964
GURU 06/09/1988
GURU 21/8/1992
GURU 24/11/1993
PEGAWAI 11/01/1979
GURU 31/12/1965
GURU 28/10/1991
GURU 28/5/1993
IRT 15/10/1981
KADER 12/10/1994
PETANI 24/1/1977
KADER 11/02/1993
KADER 18/11/1981
GURU 14/9/1969

GURU 03/10/1977
KADER 10/08/1981
GURU 07/10/1988
KADER 14/4/1987
RT 27/1/1972
LINMAS 08/06/1983
KETUA DUSUN 13/8/1999
KEPALA DUSUN 25/3/1972
GURU 05/10/1986
PNS 01/12/1963
RT 23/10/1971
GURU 17-07-1991
GURU 10/10/1981
GURU 12/01/1985
GURU 03/061988
GURU 05/08/1962
GURU 31/12/1961
BPD DS. WT. PANGGAL 29/01/1963
GURU 31/01/1979
GURU 31-12-1968
GURU 30/05/1983
SEKDES GL. MBU 22/08/1969
STAF DESA GL. LELENG 02/08/1980
STAF DESA GL. MBU 07/01/1965
STAF DESA W. PANGGGAL 23/04/1974
STAF DESA W. PANGGGAL 03/01/1987
GURU 10/11/1993
GURU 11/06/1985
GURU PAUD
29/09/1989
9/4/1985
KETUA RT DS. WATU PANGGAL
LINMAS DS. WATU PANGGAL 07/01/1984
KADER DS. WATU PANGGAL 01/01/1991

STAF DESA GL. LELENG 27/09/1978
GURU 25/09/1967
BPD DS. GL. MBU 39/04/1975
GURU 11/06/1987
GURU 15/12/1991
GURU 03/11/1997
KADER DS. GL. LELENG 17/11/1986
GURU PAUD
12/10/1993
PEGAWAI SEKOLAH 31/07/1978
STAF DESA 02/09/1973
KADER POSYANDU 08/09/1972
KETUA RT. DS. GL. LELENG 06/03/1967
BPD DESA GL. LELENG 14/07/1979
KETUA RT. DS. NAMPAR MACIING 26/07/1977
STAF DESA GL.LELENG 02/04/1978
GURU 23/11/1992
BPD DESA GL. LELENG 28/07/1966
KEPALA DESA 16/051978
KEPALA DUSUN DS. NAMPAR MACING 15/06/1991

FORMAT PENCATATAN P
TINGKAT PUSKESMA
Umur
Kelompok Umur
(18 sd ≥ 60 tahun)
49 46-59
57 46-59
30 18-30
51 46-59
36 31-45
29 18-30
57 46-59
38 31-45
53 46-59
30 18-30
38 31-45
32 31-45
40 31-45
25 18-30
52 46-59
34 31-45
49 46-59
55 46-59
32 31-45
38 31-45
51 46-59
38 31-45
34 31-45
53 46-59
45 31-45
25 18-30
37 31-45
38 31-45
42 31-45
33 31-45
35 31-45
29 18-30
58 46-59
29 18-30
39 31-45
53 46-59
39 31-45
46 46-59
53 46-59
62 ≥60
45 31-45
35 31-45
23 18-30
38 31-45
34 31-45
45 31-45
50 46-59
28 18-30
59 46-59
37 31-45
55 46-59
43 31-45
38 31-45
25 18-30
56 46-59
54 46-59
46 46-59
29 18-30
24 18-30
55 46-59
56 46-59
32 31-45
28 18-30
27 18-30
41 31-45
56 46-59
28 18-30
27 18-30
43 31-45
40 31-45
26 18-30
43 31-45
28 18-30
27 18-30
40 31-45
52 46-59
40 31-45
28 18-30
51 46-59
31 31-45
44 31-45
39 31-45
33 31-45
34 31-45
48 46-59
37 31-45
21 18-30
59 46-59
48 46-59
34 31-45
57 46-59
44 31-45
59 46-59
49 46-59
30 18-30
39 31-45
35 31-45
33 31-45
59 46-59
59 46-59
58 46-60
42 31-45
53 46-59
38 31-45
51 46-59
40 31-45
55 46-59
48 46-59
34 31-45
41 31-45
27 18-30
35 31-45
32 31-45
36 31-45
36 31-45
30 18-30
42 31-45
54 46-59
53 46-59
46 46-59
34 31-45
29 18-30
24 18-30
34 31-45
28 31-45
42 31-45
48 46-59
49 46-59
52 46-59
54 46-59
41 31-45
44 31-45
44 31-45
28 18-30
55 46-59
43 31-45
30 18-30
47 46-59
Alamat
PAKU DS. GOLO MANTING
NDAJOT DS. MATA WAE
GALANG DS. GOLO MBU
WERANG DS. GOLO MBU
COMPANG DS. GOLO KEMPO
REHAK DS. POCO GOLO KEMPO

WERANG DS. GOLO MBU
DALENG DS. WATU PANGGAL
NDIRI RT 009 RW 004 DS. NAMPAR MACING
GALANG DS. GOLO MBU
MUNTUNG KEC. MBELILING
GURUNG DS. WATU PANGGAL
WAE MUNTING DS. NAMPAR MACING
GENGGO DS. GOLO MBU
TENDA RT 003 RW 002 DS. WATU PANGGAL
CERENG DS. GOLO SENGANG

NOA DS. GOLO LELENG
NAMPAR DS. GOLO LELENG
KUMBEK RT 01 RW 02 DS. GOLO LELENG
KUMBEK DS. GOLO LELENG
GENGGO DS. GOLO MBU
TADO LONGGE DS. GOLO LELENG
WAE MUNTING DS. NAMPAR MACING

DANGE DS. NAMPAR MACING
BIBANG DS. NAMPAR MACING
NDIRI DS. NAMPAR MACING
PINGGONG
LANDO
PINGGONG
GALANG
PAKU
REHAK
WATU WANGKA
MBODONG
BOKAK RANGGA
NAGA
WERANG
BIBANG
KOTA TADO
RAMBANG
WATU WANGKA
DALENG
TENDA
TENDA
DALENG
GOLO LELENG
DALENG
DANGE
NDIRI
KOTA TADO
KOTA TADO
PUSUT
WATU WANGKA
GALANG
DAHOT
MBODONG
DALENG
WAE MUNTING
GURUNG
KOTA TADO
DAHOT
PUSUT
RAMBANG
KOTA TADO
GOLO LELENG
KOTA TADO
WAE PATENG
WERANG
MBODONG
BOKAK RANGGA
RAMBANG
NAGA
TEONGTODA
GURUNG
GOLO LELENG
RAMBANG
REKAS
WERANG
NAMPAR
WERANG
TENDA
TENDA
WERANG
RAMBANG
RAMBANG
LANDO
DALENG
DALENG
TENDA
PUSUT
WERANG
WERANG
WERANG
LOHA
RAMBANG
DALENG
KOTA TADO
LANGKA
WATU WANGKA
LOHA
DESA GOLO LELENG
KOTA TADO
KOTA TADO
LALANG
NDIRI
GOLO LELENG
TEONGTODA
GOLO LELENG
GOLO LELENG
GOLO LELENG
GOLO LELENG
No. Hp
081338037245 YA
085847866406 YA
081353669943 YA
082145652543 YA
YA
081237720214
082147013902
085253863929 YA
082339791277 YA
082144895703 YA
081239125187 YA
082266841047 YA
081240186649 YA
081237644782 YA
081238849038 YA
081237450773 YA
081338260581 YA
081236996672 YA
082146208820 YA
YA
081398692837 YA
081338063695 YA
085333512540 YA
082145135357 YA
082144903084 YA
081288286393 YA
085333563051 YA
085238866572 YA
YA
081246782264
0 YA
081236425052 YA
081339413300 YA
081338638011 YA
081239216522 YA
082236034870 YA
082298843588 YA
081246150061 YA
081238034549 YA
082147325088 YA
081239916567 YA
081282515073 YA
081353848573 YA
081236075001 YA
082138785812 YA
081239569384 YA
081285854473 YA
082146865236 YA
0852538088691 YA
081337250446 YA
081353264106 YA
081236425476 YA
081338425847 YA
081236924443 YA
082145405376 YA
082340887395 V
085757193393 V
081393749015 V
082145652543 V
081239365278 V
081238638115 V
082144523132 V
081338663498 V
081236805398 V
081237885852
081273488807 V
081337758397 V
081236696051 V
081236442766
082147725256 V
085253826774 V
081236517908 v
081393747076 V
081236126368 V
082340255340 V
081337765820 V
08533323141 V
081238147952 V
081237333843 V
085253151725 V
082311781632 V
082237156016
081238621951 V
081252757025 V
081246056889 V
081338381661 V
081238149125 V
081353844453 V
081337463019 V
081353264690 V
081236705128 V
085238631673 V
082236316592 V
085238868422 V
081245139529 V
081239818239 V
081338663203 V
081236045087 V
085858763107 V
081238770235 V V
081337620858
081338245214 V
082236034985 V
082145223884 V
081236697604 V
082147117074 V
- V
081239422529 V
081282673135
081238537993 V
081337503611
081337503611 V
085338608604
081246233222 V
082112238266 V
082112238266 V
082145673735 V
081215030470 V
081337155802
081236533147 V
082137299587
081337844752 V
081238744584 V
081337487890 V
V
081246227562
V
081239557642
085238631673 V
082138792091 V
081353948573 V
081353948573 V
081353167518 V
081238800894 V
081337782472 V
- V
081246376651 V
082147209199 V
081238880038 V
Non Anggota
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
YA SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
SINOVAC
V
V
V
V
V
V
V
Dosis I
Tanggal Pemberian
Vaksinasi
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
4/30/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
DITUNDA KRNA HT
DITUNDA KARNA SARAF

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
8
9
10
11
12
13
14
15
16
17
18
19
20
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
LEONI
TOTAL
MANUAL
PCARE
TOTAL
LANSIA
KUA
TOTAL
BATAL
HT
ASMA
DIVAKSIN
NIK
5315040907520001
5315042409531001
5315040107570099
5315046006510001
5315040106560002
5315046109520001
5315044107570110
5315040301600004
5315040107500113
5315040402531001
5315043112450001
5315044111420001
5315044107480092
5315040107450094
5315040107580111
5315040107560087
5315040605520001
5315044301500001
5315040107470097
5315040107600098
5315043112660007
5315042312550002
5315045509590001
5315045908580001
5315044107490066
5315044107510075
5315044107550093
5315040107580130
5315040107440049
5315044107520121
5315044107470093
5315044107600196
5315040402590001
5315040107600151
5315044101620001
5315040107500118
5315044107550078
5315044107430072
5315041311550001
5315040107530093
5315044107610092
5315044107590113
5315042303590001
5315041307550001
5315044101570001
5315045010580001
5315040107530062
5315045607610001
5315040406580001
5315044107400087
5315044305450001
5315042004520002
5315041607440001
5315045205470002
5315040404520002
5315044107430078
65
10
55
121
120
1
121
6
5
11
110
: WERANG
: MANGGARAI BARAT
: NTT
: SENIN, 03 MEI 2021
Nama Penerima Vaksin
Jenis Kelamin
USMAN USU L
YOHANES HAMIS L
DAMIANUS DAU L
THERESIA NAYA P
STANISLAUS CALON L
IRMINA MARIA SITIMAN P
THERESIA SAIRA P
YOSEPH UBUN L
TEODORUS HANDE L
GABRIEL KABUN L
DATUT ALOYSIUS L
MARTINA BAWAS P
LUSIA LULUS P
HENDRIKUS KISMAN L
TOBIAS BAMBUT L
BERNADUS BAS L
ANTONIUS ALO L
MARIA MAGDALENA NGAJIM P
YOAKIM SATUAN L
ABDUL BARU L
DUL HAMID L
PETRUS JEHALA L
KATARINA SIN P
THERESIA SETIA P
BERNADETA HAISA P
MARIA MINU P
THERESIA DAMAS P
HERMAN HAMAT L
GALUS GARIS L
MARIA MMUEN P
MARIA RIMIS P
ANASTASIA ANUM P
AGUS SALIM L
YULIUS JUNI L
THERESIA ANUS P
TARSISIUS RALI L
MARIA MENE P
ANASTASIA NIA P
TOMAS HABI L
AGUSTINUS HAMBUT L
EMILLIA SEMILA P
MARIA JAUNG P
SERVATIUS SENAMAN L
DARIUS DULI L
VELOMENA WETIA P
MARTHA NGANUR P
LAURENSIUS NASUR L
LUSIA LIAM P
STEFANUS SELAMAT L
SISILIA NIAM P
YUSTINA SAMAT P
BERTOLOMEUS AGUS L
ALOYSIUS JERAMU L
MARIA I DIAN P
KAROLUS KAMAR L
ROFINUS HAMBUR L
VISTIN
56 121
4 14
52 107
LANSIA 09/07/1952
LANSIA 9/24/1952
LANSIA 7/1/1957
LANSIA 6/20/1951
LANSIA 6/1/1956
LANSIA 9/21/1952
LANSIA 7/1/1957
LANSIA 1/3/1960
LANSIA 7/1/1950
LANSIA 2/4/1953
LANSIA 12/31/1945
LANSIA 11/1/1945
LANSIA 7/1/1948
LANSIA 7/1/1945
LANSIA 7/1/1958
LANSIA 7/1/1956
LANSIA 5/6/1952
LANSIA 1/3/1950
LANSIA 7/1/1947
LANSIA 7/1/1960
KUA 12/31/1966
LANSIA 12/23/1955
LANSIA 9/15/1959
LANSIA 8/19/1958
LANSIA 7/1/1949
LANSIA 7/1/1951
LANSIA 7/1/1955
LANSIA 7/1/1958
LANSIA 7/1/1944
LANSIA 7/1/1952
LANSIA 7/1/1947
LANSIA 7/1/1960
LANSIA 2/4/1959
LANSIA 7/1/1960
LANSIA 1/1/1962
LANSIA 7/1/1950
LANSIA 7/1/1955
LANSIA 7/1/1943
LANSIA 11/13/1955
LANSIA 7/1/1953
LANSIA 7/1/1961
LANSIA 7/1/1959
LANSIA 3/23/1959
LANSIA 7/13/1955
LANSIA 1/1/1957
LANSIA 10/10/1958
LANSIA 7/1/1953
LANSIA 7/16/1961
LANSIA 6/4/1958
LANSIA 7/1/1940
LANSIA 5/3/1945
LANSIA 4/20/1952
LANSIA 7/16/1944
LANSIA 5/12/1947
LANSIA 4/4/1952
LANSIA 7/1/1943
11/18/1952
FORMAT PENCATATAN P
TINGKAT PUSKESMA
Umur
Kelompok Umur
(18 sd ≥ 60 tahun)
70 ≥60
69 ≥60
65 ≥60
71 ≥60
66 ≥60
69 ≥60
65 ≥60
62 ≥60
72 ≥60
69 ≥60
76 ≥60
76 ≥60
74 ≥60
77 ≥60
64 ≥60
66 ≥60
70 ≥60
72 ≥60
75 ≥60
62 ≥60
55 46-59
66 ≥60
62 ≥60
63 ≥60
73 ≥60
71 ≥60
67 ≥60
64 ≥60
78 ≥60
70 ≥60
75 ≥60
62 ≥60
63 ≥60
62 ≥60
60 ≥60
72 ≥60
67 ≥60
79 ≥60
66 ≥60
69 ≥60
61 ≥60
63 ≥60
63 ≥60
67 ≥60
65 ≥60
63 ≥60
69 ≥60
61 ≥60
64 ≥60
82 ≥60
77 ≥60
70 ≥60
78 ≥60
75 ≥60
70 ≥60
79 ≥60
69 ≥60
Alamat
DS. GOLO MANTING

DS. GOLO MANTING
LANDO DS. GOLO MANTING
PAKU DS. GOLO MANTING
NAGA DS. MATA WAE
WERANG DS. GOLO MBU
NUNANG DS. WAE SANO
TAAL DS. WAE SANO
KANDANG DS. PULAU NUNCUNG

TAAL DS. WAE SANO
TAAL DS. WAE SANO
TAAL DS. WAE SANO
TAAL DS. WAE SANO
DASAK DS. WAE SANO
DS. GOLO MANTING
NUNANG DS. WAE SANO

DS. GOLO KEMPO
LOHA DS. GOLO MBU
LOKONG DS. PULAU NUNCUNG
DS. PULAU NUNCUNG
NAGA DS. MATA WAE

No. Hp
081238643283 YA
YA
0
YA
0
YA
0
YA
082138777583
YA
082340022814
YA
0
YA
0
YA
0
YA
0
YA
082340022814
YA
0
YA
0
YA
082144257958
YA
0
YA
0
YA
YA
08123871277
YA
0
YA
081237452792
YA
081337470514
YA
082144057577
YA
YA
081236718863
YA
0
YA
0
YA
0
YA
081225123941
YA
0
YA
0
YA
0
YA
0
YA
0
YA
081231173707
YA
081237406736
YA
0
YA
0
YA
0
YA
0
YA
0
YA
0
YA
0
YA
081238035578
YA
0
YA
0
YA
0823406559937
YA
081236077973
YA
0
YA
0
YA
0
YA
0
YA
081338877901
YA
0
YA
0
YA
081237832794
YA
0
Non Anggota
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
Dosis I
Tanggal Pemberian
Vaksinasi
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
8
9
10
11
12
13
14
15
16
17
18
19
20
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
NIK
5315040107550071
5315045307600002
5315040107570090
5315044107600173
5315041608700002
: WERANG
: MANGGARAI BARAT
: NTT
: SENIN, 03 MEI 2021
Nama Penerima Vaksin
Jenis Kelamin
HUBERTUS HASAN L
KATARINA SENIMAN P
TEODORUS ROTE L
VERONIKA LAJU P
ABDUL KADIR L
LANSIA 01/07/1955
LANSIA 7/13/1960
LANSIA 7/1/1957
LANSIA 7/1/1960
LANSIA 8/16/1970
LANSIA 9/21/1952
LANSIA 7/1/1957
LANSIA 1/3/1960
LANSIA 7/1/1950
LANSIA 2/4/1953
LANSIA 12/31/1945
LANSIA 11/1/1945
LANSIA 7/1/1948
LANSIA 7/1/1945
LANSIA 7/1/1958
LANSIA 7/1/1956
LANSIA 5/6/1952
LANSIA 1/3/1950
LANSIA 7/1/1947
LANSIA 7/1/1960
KUA 12/31/1966
LANSIA 12/23/1955
LANSIA 9/15/1959
LANSIA 8/19/1958
LANSIA 7/1/1949
LANSIA 7/1/1951
LANSIA 7/1/1955
LANSIA 7/1/1958
LANSIA 7/1/1944
LANSIA 7/1/1952
LANSIA 7/1/1947
LANSIA 7/1/1960
LANSIA 2/4/1959
LANSIA 7/1/1960
LANSIA 1/1/1962
LANSIA 7/1/1950
LANSIA 7/1/1955
LANSIA 7/1/1943
LANSIA 11/13/1955
LANSIA 7/1/1953
LANSIA 7/1/1961
LANSIA 7/1/1959
LANSIA 3/23/1959
LANSIA 7/13/1955
LANSIA 1/1/1957
LANSIA 10/10/1958
LANSIA 7/1/1953
LANSIA 7/16/1961
LANSIA 6/4/1958
LANSIA 7/1/1940
LANSIA 5/3/1945
LANSIA 4/20/1952
LANSIA 7/16/1944
LANSIA 5/12/1947
LANSIA 4/4/1952
LANSIA 7/1/1943
11/18/1952
FORMAT PENCATATAN P
TINGKAT PUSKESMA
Umur
Kelompok Umur
(18 sd ≥ 60 tahun)
67 ≥60
62 ≥60
65 ≥60
62 ≥60
51 46-59
69 ≥60
65 ≥60
62 ≥60
72 ≥60
69 ≥60
76 ≥60
76 ≥60
74 ≥60
77 ≥60
64 ≥60
66 ≥60
70 ≥60
72 ≥60
75 ≥60
62 ≥60
55 46-59
66 ≥60
62 ≥60
63 ≥60
73 ≥60
71 ≥60
67 ≥60
64 ≥60
78 ≥60
70 ≥60
75 ≥60
62 ≥60
63 ≥60
62 ≥60
60 ≥60
72 ≥60
67 ≥60
79 ≥60
66 ≥60
69 ≥60
61 ≥60
63 ≥60
63 ≥60
67 ≥60
65 ≥60
63 ≥60
69 ≥60
61 ≥60
64 ≥60
82 ≥60
77 ≥60
70 ≥60
78 ≥60
75 ≥60
70 ≥60
79 ≥60
69 ≥60
Alamat
WERANG
No. Hp
0 YA
YA
0
YA
0
YA
081375105625
YA
081238845183
Non Anggota
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
5/3/2021 SINOVAC
Dosis I
Tanggal Pemberian
Vaksinasi
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
5/3/2021
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Dosis 2
Tanggal Pemberian
Vaksinasi
Keterangan

New - Form Pencatatan Manual Faskes Dan Laporan Rekapitulasi Vaksinasi COVID-19 - 28april

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New - Form Pencatatan Manual Faskes Dan Laporan Rekapitulasi Vaksinasi COVID-19 - 28april

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Nama Puskesmas/Fasyankes/Pos

SITI FATIMA ERI P GURU

MUHAMAD SUDIRMAN L GURU

YULIANA ELVI P GURU

NASARIUS SELSUS SALOMON L GURU

DAMASIUS HAMAT L GURU

ANASTHASIA NIMUNG P GURU

THERESIA NIJUM' P GURU

STEFINA AFRINI BAHAGIA P

GREGORIUS UNGGAR L GURU

NATALIA SARINA P GURU

SRI RAHAYU IDNRIYATI P GURU

SITI HASNI P GURU

YUSUF ARMANSAH L GURU

ANGELINA ARIYANTI SANI P ASISTEN GURU

ERIKSON MEDI MALO L GURU

ANTONIUS BANGGUR L GURU

KORDIANUS RUDIN L GURU

YOSEF HAMSU L GURU

DAMEANUS AMBUT L GURU

FRANSISKUS JUANG L GURU

LEO AGUNG SUTOMO L GURU

ADRIANUS JENARU L GURU

YOHANES RONAL L GURU

MARSELLUS KARNO L GURU

FLAVIANA INTAN P GURU

MARIA GOO P GURU

AVELINA YUDETI P GURU

YASINTA SEDIA P GURU

MARSELINUS MASEH L GURU

FLORIANUS CEKA L GURU

YOVITA DAMUL P GURU

MARIA MARGARETA ANUNG P GURU

DOMINIKUS MUKESE L GURU

FRANSISKUS MELKIOR L GURU

WALTERIUS HANDUR L GURU

HERIBERTUS NATANAEL NATA L GURU

PAULUS LELE L GURU

AFRIDUS MASRI JAMU P GURU

AGNES LAMUN P GURU

BLASIUS OFAN L GURU

ANASTASIA ASIM P GURU

YOHANES HASAN L GURU

YUSTINA MELINDA P GURU

FRANSISKUS YOLANTO LIPUR L GURU

LIVANI IBITALEN P GURU

ROFINUS ANDI L GURU

MARIA SASRIAYU PERMAI P GURU

YOSEFINA KARLIN HIBUR P GURU

NURFA JEMINA P GURU

YULIANA SARLIN P GURU

PETRUS PARMUS KARDUS L GURU

YOHANES DON BOSCO L GURU

PRIMUS HENDRA L GURU

IMELDA MARIYANI P GURU

MARIA VELOMENA BETI P GURU

MUHAMAD MASIR L GURU

ONSWALDUS ALAMSAH L GURU

ADRIANUS JEHADAN L GURU

MARIA GORETI NANUR P GURU

NAMO, LEMBOR SELATAN

LANDO RT 02/01 DS. GOLO MANTING