PUSKESMAS : PAGADUNGAN

No No. Ticket NIK

P-A8I93RIO 3601254609750001

P-B2QDD2MP 3601250408000002

P-A685ZJAL 3601255107790003

P-CETEHQ1Z 3601222806860001

P-CG84AQ7Q 3601256008740001
3601256011650001
P-C4FNV1SC

P-BRGTNSC6 3601251103710001

P-A61Q68K4 3601251903850001
P-1AO0TS1Y 3601251204850002

P-2VZ4SS4X 3601252206660001

P-AYRFQNAT 3201306704960003

P-FAWF0X3J 3601254105910004

P-F1XD2J1C 3601251205780001

P-DKITJWKT 3601251008770003

P-DGTHQLKV 360125090570002

P-DTC2XAMJ 3601252005850002

P-DVRPYEZT 3601252501910001

S-CAB90669 3601250506600001

P-AS7DAH5F 3601255305000002

P-FBAS285J 3601254707890001

P-6SF1PN5Z 3602150212950002
P-FBNSLNFJ 3601254103780001

P-FB32PXFO 3601254108660001

S-7F24835A 3601254205590003

P-FBU8W2QX 3601254302790004

P-FCIJE242 3601253006830002

P-FCAAFZNS 3601250407750002

P-FC0QCLOQ 3601251212780001

P-FC3KUTWH 3601340103940002

S-6B03FF99 3601251110570001

P-FC4ZD8BG 3601254505650001

P-FBYP1ILH 3601254407830001

P-FBS2W6QV 3601251306850001

P-FD5EAZA6 3601251207030002
P-FCEZAYS0 3601250107810084

P-FDA9ABFA 3601255604700002

P-FDA9ABFA 3601255604700002

P-DITYS1F5 3601254708720002

P-FETJ2498 3601156008780002

P-FDE8TDGD 3601255706860001

P-FGFCOYVF 3601253108000001

P-FGPSELD6 7371095409770005

P-FFTRK9XB 3601250312880001

P-FG2T628D 3601256005730001

P-FENO1HTU 3601255906840001

P-FE8FSDHO 3601251004730004

P-FERQL7EW 3601254107950103
P-FE6Y4EXF 3601255010980002

P-FHJ7YCUL 3601254805810002

P-FHMVPOMX 3601252306900001

Q-0015UEYB 3601252707020002

P-FHUSDCOC 3601255506930002

P-FI0SZKB7 360125550576000

P-FHGHWAJI 3601251204930004

S-FF0FEE5F 3601255009520002

P-FJAITI98 3601252507790001

P-FIVUN9LE 3601251008000001

P-FIULMX77 3601250107750010

Q-0015SKY6 3601254101720002

P-FIYDHRWS 3601254310030002
P-FHN692WA 3601250107700004

P-FHSWB22D 3601250208880003

P-FH0MADY0 3601250308960001

Y-0134QDMW 3601252407950004

P-FHD1QQ9B 3601250107610040

P-FD0LPGEF 3601250107400030

P-FH4EAOLI 3601250107620050

P-FH15ZQ9Z 3601250302700003

S-07AAF040 3601255707490026

S-07AAF040 3601255707490001

P-FHFNXF70 3601254707780001

P-FHB25PIH 3601250107770020

P-FHFR2PE0 3601255401610001
S-2FA05ECB 3601250107370002

S-3CCE0ECC 3601251206540002

P-FF4R3V4N 3601251205790005

P-FF9CNQA2 3601251910030001

P-FLN2RAV1 3602046508790001

P-FMOUTAA0 3601255004610001

S-C74A65B0 3601255009650002
P-FN53S5KX
3601254107710040

P-FN89M7RZ 3601254406750004
P-FN8Z0RFM
1871055007760008

P-FNLGW6TK 3601254503910002

P-FMX0BC5Y 3601255207620001

P-FN62FM3K 3601254502930001
P-FN3RQGBD 3601256803660001

P-FNVI3B2K 3601251909780001

P-FMWACR25 3601254507610001
P-FNTRXLJV
3601255710040003

P-FN8926Q9 36012549108100001

P-FNZ0SWVR 36012559039000001

P-FNBE4XCH 31730643106900009

P-FO0SXNOE 3601256008880004

S-E5F5972E 3601254107950040

P-FNYK83MM 3601255203920005

P-FNWBT4OL 3601254501850003

P-FNUKW4YI 3601255011970001

P-FOI1N4TI 3601254107680080
P-FOFQNJ1O 3601254107690010

P-FP0GBPRT 3601255604720001

P-FOFLWFA9 3601254107950070
S-2330C91B
3601255012630001

tP-FOJNLUPV 3601256802630001

P-FNHKGBFY 3601256702880003

P-FLO1NMZQ 3601254107590010

P-FLFSY57P 3601256602980001

P-FLKWBNAO 3601255002650001

P-FLC7MW0U 3601254707820000

P-FLNAGBTX 3601256210880001

P-FLHRYNUL 3601254602900005

S-15979419 3601251203530001
P-FNWWCD2E 3601250912990002

P-FNFT3KML 3601255105800005

P-FPIQWSLH 3601250407000005

P-FOJLCUOE 3601255207640001

P-FOTZEQ0I 3601254107760050

P-FN2IGDWP 3601255212630001

P-FOG03QG3 3601254807880001

P-FNEBP23Q 3601255004790002

P-FNBTEJE5 3601254709770000

P-FNEFCDTQ 3601054707970003
P-FNCXETFD
3601254804730001

P-FMV7VDMC 3601256008770003

P-FQ2COB9C 3601334910670004
P-FOC2NBC2 3601254507680001
P-FNUYOFX6
3601336801820001

P-FOFDER8O 3601254401790001

S-C67E557C 36012552055700213

P-FODXSDIQ 3601256105850002

P-FLL0VPME 3601255508850001

P-FLLPDVRG 3601254505900001
P-FQW9OAMN
3601256302750002

P-FR8JB5R4 3601254212820001

S-2DCE0CB2 3601250107560005

P-FRAVMYFU 3601255304670002

P-FQMRWTIG 3601251808010002

Q-000DLKDO 3601255806810003
P-FRA62FV2 3601251309710001
P-FRCJ9LW0
3601256401930000

P-FRDVGC26 3601254805730004
P-FS00Z1QA
3601256002720000

P-FS00Z1QA 3601256002720001
P-FRWHQ3BR
3175104908060002

P-FSI0ZZUY 3601254711720001

Y-0131HOYZ 3173065806800010

P-FS5YJEF0 3601214107020020

P-FREOC4D7 3601255409800062

P-FRUHYQW3 3602015607820004

P-FRQJN04L 3601251204720001

Y-0131S38H 3173026007820010
S-9415503A 3601220308840002

P-FRM6Z5I7 3601254511830003
P-FRJ5XRSF
3601256501600001

P-FRK75DQJ 3601254310850003
P-FS5ZHFNQ
3601254708920001

P-FRMMOKD8 3601337001000000
P-FQZZRSO6
3601210812000000

P-FQZZRSO6 36012108120000701

S-E4DEADBE 3601254402630001

P-FR54DWQ2 3601250502790001

P-FR7JKV1A 3601250803650001

P-BMTANQI4 3573015211850001

P-FRNSWUAB 3601254604920003
P-FRNT9DDB 3601254107910090

P-FRVNRLA7 3601252311740002
P-FROHHFZO 3601256006810001
P-FSD5VHI0 3601250603010011
P-FPIDZ7LK 3601250107900070
P-FPI8HJ1T 3601251712960002
P-FQK7FET7 3601190403840001
P-FRAKKYE1 3601251207870001
P-FPQN9UIX 3601255005780002
P-COL0C0EH
3601253105060003
P-FT7UTE9P 3601255202040001
 LAPORAN NAMA-NAMA P
PUSKESMAS PAGADUNG

Nama Penerima Vaksin JK

een suhaenah L

ANGGI SETIAWAN  L

SAANAH  P

JUHERI  P

NENI NURHAYATI  P

ETI SUHAETI  P

APIPI L

PURWIDODO L
M. ANAS L

EPEN SUPENDI L

NENI HERMAWATI  P

ADE ANTARIAH  P

ALIYUDIN L

SARIP HIDAYAT L

ASEP PAYUMI L

JUHERI  L

SAMAN  L

TB EDI HUMAEDI L

SUTIANC KHAERUZKIAH L

LINDA P

APANG SUHENDI L
MISEM P

RUKIAH P

JENAB L

IIS P

eko l

yayan suryani l

WALIM  L

AHMAD YANI  L

ASEP L

DEDE ROSITA P

YANTI P

JOHARIAH P

M IMDAD ABDILAH L
SARUDIN L

AAS HERAWATI  P

SALBIAH P

SITI KHODIJAH  P

MASLIAH  P

MURTI P

RADEN SOFYAN MOULADI HL

FITRIANI S P

CECEP SUPRIYADI L

MARIAM  P

AISAH  P

SAPRI L

ERAH IHTIFANI P
ASIH P

NENI L

HADI SUPRIADI L

MUHAMMAD NIKO ZULIANSYAH L

NURSINAH  P

YAYAH  P

ASAN  L

KUSNI L

KAMSARUDIN L

RUHIYAT L

MUHAMMAD ALI L

AMNAH P

ADHARI P
ANDA SUHANDA  L

SUTISNA L

ANGGA PERMANA L

KAMSARI  L

NAWAWI L

UMAR L

ROHADI  L

SUNAWIRI L

SAMSIAH  P

DEDE IRFAN L

SITI ROHMAH  P

SUANDI  L

SUHAELIMAH P
NURDIN  L

KAMJAH L

NURJAYA L

AJAT MUAZAT L

IIN JULIANTI P

NINGRUM P

ENUNG P

SENI  P

MAMAH P

ZAINAB P

ROSITA  P

ERUM P

NITA JUANITA P
MARNAH  P

SUNA  L

MARSONAH P

IRNA AULIA  P

SRI AYU MARYATI  P

URNIASIH  P

SITI HAERIAH  P

IIS P

YANI ANDRIYANI P

MASNI P

AAH UMIYATI P

JUHENI  L

ENUNG  P
MAEMUNAH P

AMAH P

LENI P

SURTINAH RT P

MASNAH P

ELAWATI P

ASMARIAH  P

UMAMAH ASTIYAH  P

ASKAH P

ANI  P

TITI MUDIARTI  P

SITI ANISA  P

MURDI  L
SEPTIAN HADI PRANA L

SUKMIYATI L

IRSAN L

TATI SULASTRI P

RUMSANAH  P

ENUNG NURHASANAH P

JUMSIAH P

AAS ASNAWATI P

HENI P

DEDE YETI P

UMINAH P

SITI P

SANAH P
KARTINI P

UTIAWATI P

UUN P

JUNENGSIH P

EEN ERNA P

IAH PARIHAH P

IHAH MAFTUHAH P

ETI P

JUNARIAH  P

ENJAS SUHAEDI L

ATITI P

MUHAMMAD HAMDI L

HELI SUSIDAH  P
NURYADI  L

OOM P

MASITOH P

SUJIAH/JIAH P

DULHAK L

GHEFIRA NUR FATIMAH P

IYAH  P

NINING.S P

MITA CAHMITA P

SITI RAHMAWATI P

NENGSIH P

SANURI L

DEWI SUSILAWATI P
BUDI SANJAYA L

YANA MULYANA  P

YAYAH ROHAYAH  P

IRAH RAHMAWATI P

DEVI P

ROIYAH P

MUHAMMAD FIKRI L

SURTI P

INAH  P

JAJA MIHARJA L

IHROM MUHATIR L

RHONAL L

ANI SUHARTINI P
MAEMANAH P

YUDI EFENDI L
ULKIAH P
TOPIK HIDAYAT L
OYON P
RIKI RIADI  L
SOLIHIN L
KUDIMI L
RUMSANI P

M. DIMAS FATURROHMANL
NASHA NURFADILAH P
ORAN NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2
SKESMAS PAGADUNGAN

Um
ur
(18- Kelomp
Pekerjaan*
59 ok Umur
tahu
n)

masya.umum 46

masya.umum 21

masya.umum 42

masya.umum 33

masya.umum 47

masya.umum 56

masya.umum 40

masya.umum 36
masya.umum 36

masya.umum 55

masya.umum 40

masya.umum 30

masya.umum 43

masya.umum 45

masya.umum 42

masya.umum 41

masya.umum 30

masya.umum 51

masya.umum 21

masya.umum 32

masya.umum 30
masya.umum 43

masya.umum 55

LANSIA 62

masya.umum 42

masya.umum 33

masya.umum 46

masya.umum 43

masya.umum 27

LANSIA 64

masya.umum 56

masya.umum 38

masya.umum 36

masya.umum 18
masya.umum 40

masya.umum 41

masya.umum 49

masya.umum 49

masya.umum 40

masya.umum 35

masya.umum 21

masya.umum 44

masya.umum 53

masya.umum 48

masya.umum 34

masya.umum 49

masya.umum 26
masya.umum 23

masya.umum 40

masya.umum 29

masya.umum 19

masya.umum 28

masya.umum 45

masya.umum 28

LANSIA 69

MAsya.umum 42

masya.umum 20

masya.umum 46

masya.umum 57

masya.umum 18
masya.umum 49

MAsya.umum 33

masya.umum 25

masya.umum 26

masya.umum 50

masya.umum 53

masya.umum 59

masya.umum 41

LANSIA 62

masya.umum 24

masya.umum 38

masya.umum 44

masya.umum 50
LANSIA 74

LANSIA 67

masya.umum 42

masya.umum 18

masya.umum 42

masya.umum 54

LANSIA 64

masya.umum 49

Masya.umum 46

masya.umum 45

Masya.umum 30

Masya.umum 59

Masya.umum 28
Masya.umum 55

masya.umum 31

Masya.umum 69

masya.umum 18

Masya.umum 39

masya.umum 25

masya.umum 52

masya.umum 33

masya.umum 26

masya.umum 29

masya.umum 35

Masya.umum24

MASYA.UMUM 59
MASYA.UMUM 41

MASYA.UMUM 58

MASYA.UMUM 26

MASYA.UMUM 41

MASYA.UMUM 58

MASYA.UMUM 33

MASYA.UMUM 57

MASYA.UMUM 28

MASYA.UMUM 55

MSAYA.UMUM 38

MASYA.UMUM 33

REMAJA 15

LANSIA 65
MASYA.UMUM 22

MASYA.UMUM 33

MASYA.UMUM 21

MASYA.UMUM 56

MASYA.UMUM 53

MASYA.UMUM 58

MASYA.UMUM 33

MASYA.UMUM 42

MASYA.UMUM 44

MASYA.UMUM 24

MASY.UMUM 48

MASYA.UMUM 35

MASYA.UMUM 27
MASYA.UMUM 41

MASYA.UMUM 38

MASYA.UMUM 42

LANSIA 64

MAUK 36

MASYA.UMUM 36

MASYA.UMUM 31

MASYA.UMUM 44

MASYA.UMUM 59

LANSIA 65

MASYA.UMUM 45

MASYA.UMUM 20

MASYA.UMUM 39
MASYA.UMUM 40

MASYA.UMUM 28

MASYA.UMUM 48

MASYA.UMUM 58

LANSIA 62

REMAJA 15

MASYA.UMUM 49

MASYA,UMUM 31

MASYA.UMUM 21

MASYA,UMUM 31

MASYA.UMUM 38

MASYA,UMUM 49

MASYA.UMUM 39
MASYA.UMUM 27

MASYA.UMUM 28

MASYA.UMUM 49

MASYA.UMUM 25

MASYA.UMUM 27

MASYA.UMUM 37

MASYA.UMUM 21

MASYA.UMUM 40

MASYA.UMUM 58

MASYA.UMUM 42

MASYA.UMUM 45

MASYA.UMUM 36

MASYA.UMUM 39
MASYA.UMUM 30

MASYA.UMUM 47
MASYA.UMUM 30
MASYA.UMUM 32
MASYA.UMUM 31
MAASYA.UMUM 25
MASYA.UMUM 37
MASYA.UMUM 34
MASY.UMUM 45

REMAJA 15
REMAJA 15
A VAKSIN DOSIS 1 DAN 2

INSTANSI Alamat

kp sampora

kp juhut

kp canggoang

kp ciodeng

kp kaduberem

kp karangtanjung

KP JUHUT

KP NAGARA
PAGADUNGAN

KP MAUK

KP PETIR

KP PAANGASIH

kp canggoang

KADULIMUS

KP JUHUT

KP KADUKUPA

KP SUKALIMAS

KOTAMANIK

KARANGTANJUNG

KP KOTAMANIK

KP CIGADUNG
KP PABUARAN

KP JAMI

KP SUKALIMAS

kp canggoang

kp kadulimus

kp kaduberem

KP KUMPAY

KP MAUK JUHUT

CIKIRAY

PASIRRANDU

CANGGOANG

KADUTUNGGUL

KOMP SMU
KP KADULIMUS

KADUTUNGGUL

KP PASIR KASO

KP KADUBEREM

KP PABUARAN

KP KADUKUPA

KOMP AMBULEUIT

JL H KALLA NO 3A

KP JUHUT

KADUTUNGGUL

KADUTUNGGUL

kp canggoang

KP SANIM
KOTAMANIK

KP KADUKUPA

JL TIRTANDA

KP KALAHANG

KADULIMUS

KP MAUK

KP CINYURUP

KP CINYURUP

SUKALIMAS

KADUKUPA

KALAHANG

LEBAKSEREUH

KADUSALAK
KP JAMI

NAGARA

KP KALAHANG

KP KALAHANG

KP CIODENG

KARANGTANJUNG

CIODENG

KP JAMI

KALAHANG

KOMP AMBULEUIT

KP CATIHAN

KADU LOLO

KP AMBULEUIT
PASIRKACAPI

PASIRKACAPI

KP CANGGOANG

KP SUKALIMAS

KP PASIRKACAPI

KP CIKIRAY

KADUBEREM

KADULIMUS

KP BABAKAN MASJID

KARANGTANJUNG

KP CINYURUP

CIGULUDUG

PASIRHAUR
KP MAUK

KP CINYURUP

SUKALIMAS

KP JATI

KP KALAHANG

CIKIRAY GIRANG

PASIRRANDU

KP JAMBU

KERONCONG PERMAI

KP CINYURUP

KP CANGGOANG

CINYURUP

CANGGOANG
KADUTUNGGUL

CIPAPAIS

KP CINYURUP

CIKIRAY

CINYURUP

PAILAN

KADUTUNGGUL

CIKIRAI GIRANG

KALAHANG

MAUK

CILIANG

BABAKAN MASJID

BALANGENDONG
KADUMANTUNG

BARINGKUNG

LEBAKSEREUH

CIKIRAY

SUKALIMAS

KADUPERENG

KADUKUPA

CANGGOANG

MAUK MANGKUBUMI

KP KADUBEREM

CANGGOANG

PABUARAN

SANIM
PAILAN

NANGGERANG

CIPAPAIS

LEBAKSEREUH

KP MAUK

KALAHANG

CILIANG

LEBAKSEREUH

PASIRPUTRI

PASIRHAUR

PASIRPUTRI

SUKALIMAS

KADUSUMBUL
PASIRHAUR

PASIRPUTRI

PASIRPUTRI

KP SUKAASIH

KP CALINCING

JL AMD LINTAS TIMUR SYEH

KADEPER

BAMBU LARANGAN

KADUPESING

KARANGTANJUNG

SINDANG KERAMAT

CANGGOANG

JL ANYAR
CINYURUP

PASIRHAUR

PABRIK

CATIHAN

KP KADUMANTUNG

KP CIPACUNG

CICADAS

KP MAUK

CUNGKEDANG

KP KADUSALAK

KOTAMANIK

CUNGKEDANG

NANGGERANG
CANGGOANG

PABRIK
KP AMBULUEIT
KP CANGGOANG
CINYURUP
CANGGOANG
NAGARA
CUNGKEDANG
KP JUHUT

KP. MAUK
KARANGINDAH
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang
sesuai)

No. Hp BPJS BPJS Non

PBI Non PBI Anggota

87805663629

83872348238

82113212365

85817090661

81280523

81908359639

83893168500

85281149343
 81218136903

85960358285
0895613176075
2

89637612350

85281210815

81328433765

83139571940

83819828127

82113245276

85216213586

89538515613

83819334610

88213533831
838151835316

81318706030

85718201029

82299284147

81807223090

85774960491

893519471

81291504199

8191129805

8596143917

85211683584

81224424360

8989637990
 85210346341

87773237948

88289573416

857177237424

87871775218

859303874133

89650596536

85212505352

895803213917

89502057330

81380786206

85213905367

81380798049
83892653536

81218613887

83841226222

8951333188

838626720

8563298370

87811536558

81321031055

85281720165

81574718388

85718170328

87718916747

85795308428
 85774960481

85810874168

895402647815

81293452404

83894424601
81234565768

83878644013

81284306601

857181692428

8979837465

87709996803

882897240635

81311396373
 8998212042

85694237871

87773481579

83110835442

85280939732

0870809085144

87882569212

8386934579

85939270289

82111714437

85273625870

83878801525

82246747427
87874714866

83814114681

81316838653

83892282317

85311644801

8781820588

83890402034

8571931735

83814118613

82269894061

81218156977

8112462811

82112151755
81224543590

83891226552

81380152847

8129315972

81286273752

83841399206

8588375664

85212492893

8789536613

87776891623

85771919495

83107270818

82136696010
85777853136

8161062506

83890121031

85215465573

83861319258

81908816501

81287322108

81218613887

8226984061

83801998184

81286112471

83109659755

81311275676
83114658528

83892174693

87741637586

87773611041

81212871239

81911298895

83892711002

87772592525

83871897003

82320565983

83805996614

8131015303

85892625034
85711034861

83874952724

89893759991

83806658818

83841353518

83819334649

83811445104

85161667206

8128026435

8979789826

85966316704

81287724828

8989650956
81398243089

85894825536

81311819016

85718234626

83800628503

83107986267

81280850450

8177602739

81318033187

83179662445

83813484163

87781068163

8979757182
81292984994

89531719562
85776466833
81315535116
8212828393
81380798481
82113260584
81290192965
85282061579

83127225467
812195613
 Dosis I

Merek Tanggal Tanggal

Vaksin*** Screening Pemberian
Vaksinasi

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

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sinovac 10/11/2021 10/11/2021

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sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 10/11/2021 10/11/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

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sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021
sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 11/10/2021

sinovac 11/10/2021 23/22/032
Dosis I Dosis 2

Tanggal
Pemberia No.
No. Batch No seri
n Batch
Vaksinasi

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021
24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021
24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021

24005021
 24005021

24005021

202108154G

202108154G

24005021

202108154G

202108154G

202108154G

24005021

24005021

24005021

202108154G

24005021
202108254G

202108154G

202108254G

202108154G

202108254G

24005021

202108254G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G
202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G
202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

24005021

202108154G
202108154G

202108154G

202108154G

202108154G

24005021

202108154G

24005021

202108154G

24005021

202108154G

202108154G

202108154G

202108154G
202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

204005021

202108154G

202108154G

202108154G

202108154G
202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G
202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

202108154G

2400521

202108154G

202108154G

202108154G

24005021
202108154G

24005021

24005021

202108154G

202108154G

202108154G

24005021

24005021

24005021

24005021

24005021

24005021

24005021
 24005021

24005021

24005021

24005021

24005021

24005021

24005021

2021081641

202108154G

202108154G

202108154G

202108154G

24005021
 24005021

24005021
24005021
202108154G
202108154G
202108154G
202108154G
202108154G
24005021

202108154G
24005021
 KET
No
Seri
 PUSKESMAS : PAGADUNGAN

No No. Ticket NIK Nama Penerima Vaksin

P-HLX0OT82 3601251208080001 ADRIAN

P-HLV73YUA 3601255508890002 ZAKIAH ULPAH
P-HLSKKOR2 3601250107930077 SUHENDRA
P-HLOPTCVX 3601250107660046 ASIM
P-HLDXVBJP 3601250107920101 UCEP SUPENDI
Y-01316SBN 3173021304810006 JUBER 
S-3EF2943A 3601250107630099 MADROMI 
P-HLXB37MY 3601254107920044 ULFAH 
P-HLUNDSUW 3601252202990003 HOLIF
P-HLTXFDOV 3601254202970003 UGI WAHYUNI
P-HHA6CHPO 3601250107760050 SAMUDI 
P-HH3N67FF 3601254609720002 OOM KOMARIAH 
Q-0009WP9W 3601250808960056 MUHAMAD HAMDANI 
P-HGOOIC49 3601254205040002 MILA SARI 
P-HGJ62OXA 3601224807930003 ENCUN SUNAINI 
P-HGBBPNW8 3601254503020001 MARISA 
P-HG0DTIRA 3601255709970003 ASIH ANGGRAYENI 
Q-001DW23Y 3601255001810002 JUMSI
P-HFI8K91F 3601254107820041 MULYATI 
P-HFBN5ZEI 3601254711840001 METI 
P-HF20JUK8 3601254504700003 ANISAH
Q-001DZEMZ 3601254107750035 OLIDAH 
P-HEL9JDTJ 3601254909990002 ETIN SRIMULYANI
P-HDLR1UM7 3601254207860002 ULPAH 
P-HDD4U6SJ 3601254107960078 MALEHA 
P-HJUFKEVA 3601250903000002 ALWI SIHAB
P-HFPQ7N9C 3601254904030002 EHA
P-HE41RCU5 3602154302960001 TITIN ISMAWATI 
P-HKEPL4K8 3601254807780003 duriah
P-HK8Y6LYG 3604270106850002 IIP
P-HKC39GXM 3601256709700002 UWAR
P-HJXGWP3L 3172011410821001 JUMHANI
P-HE7K4KOD 3601254107560014 MENI
P-HMGJKM60 3601252206050001 UMAM FAIZ PADILAH 
P-HDGRVI75 3601255202740001 IROH DOHAYATI 
S-0FDB57F7 3604016404540501 MUSLINAH 
P-HDT0SO70 3601255807880001 DESI WULANDARI
P-HDYD7GCY 3601215411900001 OYAH
P-HK9NQF1D 3601252801050002 MOHAMAD ADI HARIRI 
PUSKESMAS PAGADUNGAN

Umur Kelompok
JK Pekerjaan* INSTANSI Alamat
(18-59 tahun) Umur

L REMAJA 13 KADU SALAK

P MASYA.UMUM 32 KADU LIMUS
L MASYA.UMUM 28 CANGGOANG
L MASYA.UMUM 55 KADU LIMUS
L MASYA.UMUM 29 KADU SALAK
L MASYA.UMUM 40 JL nyer juhut
L LANSIA 63 canggoang
P MASYA.UMUM 29 KADU LIMUS
L MASYA.UMUM 22 CANGGOANG
L MASYA.UMUM 24 KADU SALAK
L MASYA.UMUM 42 CANGGOANG
P MASYA.UMUM 45 KADU LIMUS
L MASYA.UMUM 25 CANGGOANG
P MASYA.UMUM 17 CANGGOANG
P MASYA.UMUM 28 KADU SALAK
P MASYA.UMUM 56 KADU SALAK
P MASYA.UMUM 24 JUHUT
P MASYA.UMUM 40 CANGGOANG
P MASYA.UMUM 39 CANGGOANG
P MASYA.UMUM 37 JUHUT
P MASYA.UMUM 41 CANGGOANG
P MASYA.UMUM 49 KADU LIMUS
P MASYA.UMUM 32 KADU SALAK
P MASYA.UMUM 35 CANGGOANG
P MASYA.UMUM 25 CANGGOANG
L MASYA.UMUM 21 KADU SALAK
P MASYA.UMUM 18 CANGGOANG
p MASYA.UMUM 24 CANGGOANG
P MASYA.UMUM 39 CANGGOANG
L MASYA.UMUM 37 KP ANYAR
L MASYA.UMUM 41 KADUSALAK
L MASYA.UMUM 39 CANGGOANG
P MASYA.UMUM 59 CANGGOANG
L REMAJA 14 KADU SALAK
P MASYA.UMUM 47 KADU SALAK
P LANSIA 67 KOTA BARU
P MASYA.UMUM 33 KP MAUK
P MASYA.UMUM 29 CANGGOANG
L REMAJA 16 KADU LIMUS
 Kepesertaan BPJS (tulis 'Ya' pada kolom yang
sesuai)
Tanggal
No. Hp Merek Vaksin***
BPJS PBI BPJS Non PBI Non Anggota Screening

81387103564 SINOVAC 15/11/2021

87782694595 SINOVAC 15/11/2021
87788086308 SINOVAC 15/11/2021
85691438410 SINOVAC 15/11/2021
81284897207 SINOVAC 15/11/2021
81317669602 SINOVAC 15/11/2021
82113212365 SINOVAC 15/11/2021
81219668835 SINOVAC 15/11/2021
82113212365 SINOVAC 15/11/2021
81381132244 SINOVAC 15/11/2021
86211663415 SINOVAC 15/11/2021
82136645622 SINOVAC 15/11/2021
83877394913 SINOVAC 15/11/2021
81381940839 SINOVAC 15/11/2021
81242700185 SINOVAC 15/11/2021
81398491965 SINOVAC 15/11/2021
88715444760 SINOVAC 15/11/2021
83813307227 SINOVAC 15/11/2021
81280527655 SINOVAC 15/11/2021
8871544760 SINOVAC 15/11/2021
81317136957 SINOVAC 15/11/2021
87873893817 SINOVAC 15/11/2021
82136689572 SINOVAC 15/11/2021
81213182527 SINOVAC 15/11/2021
81385141923 SINOVAC 15/11/2021
82188698349 SINOVAC 15/11/2021
81276416386 SINOVAC 15/11/2021
81270447302 SINOVAC 15/11/2021
87788086308 SINOVAC 15/11/2021
81295320800 SINOVAC 15/11/2021
81298789125 SINOVAC 15/11/2021
82298885447 SINOVAC 15/11/2021
81276416386 SINOVAC 15/11/2021
8316682007 SINOVAC 15/11/2021
81316756463 SINOVAC 15/11/2021
82122164527 SINOVAC 15/11/2021
85779059417 SINOVAC 15/11/2021
82149018899 SINOVAC 15/11/2021
81296542288 SINOVAC 11/15/2021
 Dosis I Dosis 2

Tanggal Tanggal KET

Pemberian No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi Vaksinasi

11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
2021091741 11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021081641
11/15/2021 2021091741
11/15/2021 2021081641
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741
11/15/2021 2021091741