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N0 MR/MRS NAME PLACE DATE /M/D/Y PASSPORT NO

1 MRS JUMAIYAH MALANG 2/14/1960 C7967440


2 MRS SUPRIATI MALANG 7/12/1977 C6213826
3 MR. WAGIMAN MALANG 8/1/1972 C8314267
4 MRS SULIKAH MALANG 8/8/1978 AU438000
5 MR MISNADI MALANG 8/4/1972 C7967444
6 MRS MAR'ATUS SOLICHA MALANG 1/13/1983 C7967442
7 MR BONADI MALANG 9/19/1985 C7967451
8 MRS TUKINEM MALANG 1/20/1966 C7967445
9 MRS MOCH UBAIDILLAH MALANG 4/20/1982 C9528739
10 MRS YAYUK INDAWATI MALANG 12/8/1980 C9528740
11 MR PURNOMO MALANG 3/7/1961
12 MRS NANIK KUSTIANIK SOENARDI MALANG 8/15/1963 C6423564
13 MRS SULISTIONO MALANG 1/1/1962 C7967823
14 MRS SUWATI MALANG 1/1/1967 C7967822
16 MRS ABD.SHOMAD BANGIL 6/16/1954
17 SHOHIBAH BANGIL 4/16/1964
18 SUKARTONO BANGIL 4/21/1964
19 FAUZAH BANGIL 8/17/1961
20 NELSON SIBEUEA BANGIL 9/27/1972
21 NUR SYAFAAH BANGIL 7/26/1972
22 CHOIRIYAH BANGIL 11/1/1959
23 SUBAIKAH MALANG 19/011979 C7967447
24 SUPARTI MALANG 3/11/1961 C7967441
25 SENO MALANG 1/22/1959 C7967446
26 BUYARI ARIFIN MALANG 5/20/1954 C7967439
27 RUSMANTO MALANG 4/14/1975 C7967443
28 MARLAN MALANG 10/10/1956 C7967824
29 KASEMI MALANG 3/27/1965 C7967825
30 KARTINI MALANG 1/1/1964 C7967821
31 RASIYEM MALANG 9/10/1965 C6427479
32 SARIAH MALANG 3/10/1946 C9527667
33 SUNARLIK MALANG 4/26/1972 C9527668
34 ABDUL QOWI MALANG 11/7/1973
35 SYAFAAH MALANG 6/15/1982
36 SUKI MALANG 6/19/1964 C7967452
37
38
39
40
PLACE OF ISSUE ISSUED M/D/Y EXPIRED M/D/Y RELATIONSHOP SPONSOR
MALANG 11/11/2021 11/11/2026 IBU
MALANG 7/2/2020 7/2/2025 ANAK 1
MALANG 4/16/2022 4/10/2027 SUAMI
MALANG 9/19/2018 9/19/2023 ISTRI 4
MALANG 11/11/2021 11/11/2026 SUAMI
MALANG 11/11/2021 11/11/2026 ISTRI 6
MALANG 11/12/2021 11/12/2026 SUAMI
MALANG 11/11/2021 11/11/2026 ISTRI 8
MALANG 6/23/2022 6/23/2027 SUAMI
MALANG 6/23/2022 6/23/2027 ISTRI 10
MALANG SUAMI
MALANG 1/24/2020 1/24/2025 ISTRI 12
MALANG 7/30/2021 7/30/2026 SUAMI
MALANG 7/30/2021 7/30/2026 ISTRI 14
SUAMI
ISTRI 16
SUAMI
ISTRI 18
SUAMI
ISTRI 20
WOG
MALANG 11/11/2021 11/11/2026 WOG
MALANG 11/11/2021 11/11/2026 WOG
MALANG 11/11/2021 11/11/2026 SINGLE
MALANG 11/11/2021 11/11/2026 SINGLE
MALANG 11/11/2021 11/11/2026 SINGLE
MALANG 7/30/2021 7/30/2026 SUAMI
MALANG 7/30/2021 7/30/2026 ISTRI
MALANG 7/30/2021 7/30/2026 WOG
MALANG 2/27/2020 2/27/2025 WOG
MALANG 6/15/2022 6/15/2027 WOG
MALANG 6/15/2022 6/15/2027 WOG
MALANG SUAMI
MALANG ISTRI 34
MALANG 11/19/2021 11/19/2026 SINGLE
NAMA MUHRAM NIK ALAMAT LENGKAP
3507055402600001 DSN.KAMPUNG SELANG,BATURETNO
JUMAIYAH 3507055207780007 DSN PANGGUNGSARI,BATURETNO
3507050108720015 DSN PANGGUNGSARI,BATURETNO
WAGIMAN 3507054708780011 DSN PANGGUNGSARI,BATURETNO
3507050408720001 DSN PANGGUNGSARI,BATURETNO
MISNADI 3507057101810006 DSN PANGGUNGSARI,BATURETNO
3507051909650001 DSN PANGGUNGSARI,BATURETNO
BONADI 3507056001660007 DSN PANGGUNGSARI,BATURETNO
35070162004820001 TUMPANG
MOCH UBAIDILLAH 3507164812800002 TUMPANG
3573040703610002 JL.JANTI BARAT SUKUN
PURNOMO 3573045508630002 JL.JANTI BARAT SUKUN
3507050101610149 DSN.KAMPUNG SELANG,BATURETNO
SULISTIONO 3507054101670159 DSN.KAMPUNG SELANG,BATURETNO
3514141606500004 JL.DR.SUTOMO,DERMO BANGIL
ABD.SHOMAD 3514145604640002 JL.DR.SUTOMO,DERMO BANGIL
3514142104640003 JL.DR.SUTOMO,DERMO BANGIL
SUKARTONO 3514145708610002 JL.DR.SUTOMO,DERMO BANGIL
3514142709720002 JL.DR.SUTOMO,DERMO BANGIL
NELSON SIBEUEA 3514146607720001 JL.DR.SUTOMO,DERMO BANGIL
3514144111590012 JL.DR.SUTOMO,DERMO BANGIL
3573055901790009 JL.KEDAWUNG IX/56 ,TULUSREJO
3507055103610001 DSN PANGGUNGSARI,BATURETNO
3507052201590001 DSN PANGGUNGSARI,BATURETNO
3507052005540003 DSN PANGGUNGSARI,BATURETNO
3507051404750002 DSN PANGGUNGSARI,BATURETNO
35070291010560003 DSN PUTAT,SEGARAN GEDANGAN
3507056703650002 DSN BALIREJO SRIMULYO
3507054101540004 DSN.KAMPUNG SELANG,BATURETNO

3573055203460001 JL.SIMPANG PIRANHA ATAS LOWOKWARU


3573056604720005 JL.SIMPANG PIRANHA ATAS LOWOKWARU
3507030711730004 DSN.SUKOSARI,BANTUR
ABDUL QOWI 3507035506820003 DSN.SUKOSARI,BANTUR
3507051906640003 DSN.PANGGUNGREJO,BATURETNO
VAKSIN COVID
DOSIS 2 31 OKTOBER
DOSIS3BELUM VAKSIN SAMA SEKALI
DOSIS 3 VAKSIN BERES
DOSIS 3 22-Sep
DOSIS 3 VAKSIN BERES
DOSIS 3 VAKSIN BERES
DOSIS 3 BERES
DOSIS 3 BERES
DOSIS 3 BERES
DOSIS 3 BERES
BERES
BERES
DOSIS 3 BERES
DOSIS 3 BERES

DOSIS 3 BERES
TUNGGU TIKET 3
DOSIS 3 BERES
DOSIS 3 BERES
DOSIS 3 BERES
KTP TIDAK TERDETEKSI/SALAH
DOSIS 3 BERES
DOSIS 3 BERES

BERES
DOSIS 3 BERES
23 AGUSTUS
20-Sep
BELUM VAKSIN SAMA SEKALI

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