R1 Yankb

1.
Petugas Entri
Data
REGISTER PELAYANAN KB R/I/KB/20
Lembar 1
1 2 3 4 5 V
3 6 7 4 0 2 2 0 7 Bulan : 2022
NAMA FASKES/ BPM BIDAN NURLIS 7 8 9 10 11 12
:
JARINGAN/JEJARING Kode Provinsi Kode No. Register Faskes No. Jaringan/
Kabupaten/ Jejaring Faskes
Kota
PESERTA KB JENIS TINDAKAN Kasus PENGGUNAAN SUMBER ALOKON

(Kode) (Kode) ASURANSI
PELAYANAN BERGERAK
STATUS PESERTA KB
INFORMED CONSENT
PASCA KEGUGURAN
PASCA PERSALINAN
ISTRI
BPJS KESEHATAN
NO. TANGGAL ALAMAT NO. HANDPHONE
PEMASANGAN
PENCABUTAN
PENCABUTAN
KEGAGALAN
PEMBERIAN/
KOMPLIKASI
NAMA SUAMI
OPERATIF/
LAINNYA
TANGGAL
MANDIRI
NIK (NOMOR INDUK KEPENDUDUKAN) NAMA
BERAT
LAHIR
(Kode)
TIDAK
APBN
APBD
DAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
18-September-
1 01-June-2022 AAN 3 6 7 4 0 6 5 8 0 9 8 4 0 0 0 2 SITI KOMARIYAH PAMULANG 3 1 0 0 1 0 0 1 0 0 1 0
1984
2 01-June-2022 AAY 3 6 7 4 0 6 4 3 0 4 9 2 0 0 0 7 SELVI 04-March-1992 PAMULANG 2 1 0 0 1 0 0 1 0 0 1 0
21-October-1988
3 01-June-2022 ANDRI 3 6 7 4 0 6 4 6 1 1 0 0 0 0 0 6 RINA KEDAUNG 2 1 0 0 1 0 0 1 0 0 1 0
20-August-1999
4 01-June-2022 BAYU 3 6 7 4 0 4 6 0 0 8 9 9 0 0 0 3 ROSALIA KEDAUNG 089535869238 3 1 0 0 1 0 0 1 0 0 1 1
07-October-1986
5 01-June-2022 HERI 3 6 7 4 0 6 4 7 1 0 8 6 0 0 0 3 ANISA JL. OTISTA RAYA 085718562094 2 1 0 0 1 0 0 1 0 0 1 0
26-September-
6 01-June-2022 MASRI 3 6 7 4 0 6 2 8 8 0 1 9 1 0 0 0 INDAH JL. ARYA PUTRA 0819947472441 3 1 0 0 1 0 0 1 0 0 1 0
1990
7 01-June-2022 RANU 3 6 7 4 0 6 5 3 0 7 8 3 0 0 0 7 FITRIYANI 13-July-1983 SARANA 08571970838 2 1 0 0 1 0 0 1 0 0 1 0
14-February-
8 01-June-2022 REGI 3 6 7 4 0 2 5 4 0 2 9 1 0 0 0 7 SINTA JL. SURYA MAKMUR 085778807921 3 1 0 0 1 0 0 1 0 0 1 0
1991
9 01-June-2022 RIRI 3 6 0 3 1 2 4 7 0 2 9 4 0 0 0 7 MONICA 26-March-1988 007/004 3 1 0 0 1 0 0 1 0 0 1 0
30-September-
10 01-June-2022 SUHERI 3 6 7 4 0 6 7 1 0 3 8 5 5 0 0 1 HERMAYANTI KEDAUNG 085803858806 3 1 0 0 1 0 0 1 0 0 1 0
1985
15-September-
11 01-June-2022 SYARIF 3 6 7 1 0 8 6 1 0 9 8 2 0 0 0 6 SAROH GG. H BETONG 08171777817 3 1 0 0 1 0 0 1 0 0 1 0
1981
05-January-
12 02-June-2022 ADE 3 6 7 4 0 6 4 1 0 5 9 2 0 0 0 7 ANISA SASAK 087741118952 2 1 0 0 1 0 0 1 0 0 1 0
19992
13 02-June-2022 ALDI 3 6 7 4 0 6 5 4 0 5 7 9 0 0 0 6 ANNA 14-May-1979 PARKOS 2 1 0 0 1 0 0 1 0 0 1 0
14 02-June-2022 IRFAN 3 2 0 2 0 4 4 9 0 6 0 0 0 0 0 5 LINA 09-June-2000 JOMBANG 081806367086 1 1 0 0 1 0 0 1 0 0 1 0
30-September-
15 02-June-2022 RICI 3 6 7 4 0 6 2 8 8 0 1 9 1 0 0 1 INDAH 009/019 088808901356 3 1 0 0 1 0 0 1 0 0 1 0
1991
11-August-1992
16 03-June-2022 ALI 1 2 0 7 3 3 5 1 0 8 9 2 0 0 0 2 TRIA JL. M DARUSSALAM 085781720261 3 1 0 0 1 0 0 1 0 0 1 0
17 03-June-2022 ARYA 3 6 7 4 0 6 5 9 0 1 9 0 0 0 0 3 LIA 13-March-1988 BULAK WANGI III 081310509469 3 1 0 0 1 0 0 1 0 0 1 0
18 03-June-2022 ARYANTO 3 2 7 6 0 3 6 5 0 6 8 4 0 0 0 4 SRI 14-May-1987 JL SURYA MULYA 3 1 0 0 1 0 0 1 0 0 1 0
19 03-June-2022 CHANAN 3 3 2 7 0 7 4 1 1 2 7 6 0 0 0 1 DEWI 05-May-1988 JOMBANG 3 1 0 0 1 0 0 1 0 0 1 0
20 03-June-2022 DAWVIN 3 6 7 4 0 4 4 6 0 6 9 8 0 0 1 2 AULIA 06-June-1998 JL.S. MAKMUR 085813093886 2 1 0 0 1 0 0 1 0 0 1 0
21 03-June-2022 GUNTUR 3 1 7 5 0 7 6 8 0 5 7 9 0 0 0 6 LISA 01-June-1988 ASRAMA BRIMOB 2 1 0 0 1 0 0 1 0 0 1 0
16-January-1981
22 03-June-2022 HAMAMI 3 6 7 4 0 6 4 5 0 6 7 8 0 0 1 3 SITI AMINAH JL. S. MULYA 3 1 0 0 1 0 0 1 0 0 1 0
23-January-1981
23 03-June-2022 HERI 3 6 7 4 0 6 4 1 1 0 7 9 0 0 1 1 RITA JL. SURYA MAKMUR 085710168853 2 1 0 0 1 0 0 1 0 0 1 0
15-August-1981
24 03-June-2022 MARDI 3 6 7 4 0 6 6 2 1 0 7 4 0 0 0 4 LARNI JL. S MANDIRI 3 1 0 0 1 0 0 1 0 0 1 0
25 03-June-2022 SOHIB 3 6 7 4 0 6 6 7 0 5 8 7 0 0 0 5 FITRI 11-April-1983 KEDAUNG 087772547676 3 0 0 0 0 0 1 0 0 1 0
16-November-
26 04-June-2022 APOY 3 6 7 4 0 6 6 7 0 5 7 3 0 0 1 2 YANTI SERUA INDAH 1 1 0 0 1 0 0 1 0 0 1 0
1991
27 04-June-2022 CAHYANTO 3 6 7 4 0 6 4 5 0 6 7 9 0 0 0 2 MULYAH 05-June-1979 JL. KAVLING 2 2 1 0 0 1 0 0 1 0 0 1 0

28 04-June-2022 EEP 3 6 7 4 0 4 5 1 0 4 9 0 0 0 0 5 RISA 19-March-1991 KEDAUNG 089524580604 1 1 0 0 1 0 0 1 0 0 1 0
05-October-1995
29 04-June-2022 EKA 3 6 7 4 0 6 4 3 0 5 9 1 0 0 1 3 DWI KEDAUNG 089613485274 3 1 0 0 1 0 0 1 0 0 1 0
26-November-
30 04-June-2022 JAIMAN 3 6 7 4 0 6 5 4 0 5 7 6 0 0 1 2 DINI KP BULAK 087772408098 1 1 0 0 1 0 0 1 0 0 1 0
1988
31 04-June-2022 PIYAN 3 6 0 3 2 5 4 4 0 4 7 2 0 0 0 5 OLIV 04-April-1979 PARKOS 081906398687 3 1 0 0 1 0 0 1 0 0 1 0
06-September-
32 04-June-2022 VICKY 3 6 7 4 0 6 4 6 0 9 7 4 0 0 0 3 NURHA PONDOK LABU 3 1 0 0 1 0 0 1 0 0 1 0
1974
26-August-1997
33 05-June-2022 FAJRI 3 6 7 2 0 6 4 6 1 1 0 0 0 0 1 1 AYU JL. SURYA MAKMUR 087804315815 3 1 0 0 1 0 0 1 0 0 1 0
12-November-
34 05-June-2022 IBNU 3 6 7 4 0 6 6 7 0 3 9 2 0 0 0 1 EKA CIPUTAT 08787772739 2 1 0 0 1 0 0 1 0 0 1 0
1993
35 05-June-2022 ROBI 3 6 7 4 0 6 6 4 0 6 9 2 0 0 0 6 ROSDIANA 22-July-1985 JL. PARKOS 2 1 0 0 1 0 0 1 0 0 1 0
36 05-June-2022 YATNA 3 6 0 3 2 5 4 9 0 7 8 3 0 0 0 3 SITI SOFIYAH 29-May-1995 GG SARANA 085881300403 1 1 0 0 1 0 0 1 0 0 1 0
37 05-June-2022 ZIKRULLOH 3 6 7 4 0 6 4 8 0 3 7 3 0 0 0 9 LIZAH 08-March-1973 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
30-December-
38 06-June-2022 ARDIANSYA 3 6 7 4 0 6 7 0 1 1 8 1 0 0 0 2 MAY KEDAUNG 085711361522 2 1 0 0 1 0 0 1 0 0 1 0
1981
31-October-1988
39 06-June-2022 ASEP 3 6 7 4 0 6 7 1 1 0 8 8 0 0 0 7 FIKA KP SAWAH 3 1 0 0 1 0 0 1 0 0 1 0
17-October-1973
40 06-June-2022 NURHOLIS 3 6 7 4 0 6 5 7 1 0 7 3 0 0 0 7 MARDIAH KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
41 06-June-2022 RUDI 3 6 7 4 0 6 6 5 0 4 7 4 0 0 0 3 MIRA 21-May-1993 KEDAUNG 085694567503 3 1 0 0 1 0 0 1 0 0 1 0
42 06-June-2022 SARIF 3 6 7 4 0 6 5 2 0 7 0 5 0 0 1 5 ANIK 12-July-1985 GG. BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
06-January-1994
43 06-June-2022 SUKIRNO 3 2 0 6 0 5 4 5 0 4 9 4 0 0 0 2 IWAH JL. SAHID 089539599626 3 1 0 0 1 0 0 1 0 0 1 0
44 15-June-2022 ADE ARDIANSAH 3 2 0 8 2 2 6 6 0 5 9 4 0 0 0 1 DINI NURWANTI SAPUTRI 26-May-1994 JLN KAV KEUANGAN 3 1 0 0 1 0 0 1 0 0 1 1
26-November-
45 15-June-2022 HERI FIRMASYAH 3 2 0 6 1 8 6 0 0 7 9 1 0 0 0 8 NITA JLN. ARIA PUTRA 3 1 0 0 1 0 0 1 0 0 1 1
1995
13-February-
46 15-June-2022 SURYONO 3 6 7 4 0 6 5 3 0 2 8 2 0 0 1 7 HARYATI KP BULAK TIMUR 1 1 0 0 1 0 0 1 0 0 1 1
1982
18-August-1982
47 15-June-2022 SYAH RIDWAN 3 6 7 4 0 6 5 0 0 8 8 2 0 0 0 5 LIDA WATI KP.BULAK BARAT 1 1 0 0 1 0 0 1 0 0 1 1
JL MASJID DARUSSALAM RT10 RW

48 15-June-2022 UJANG 3 6 7 4 0 6 4 3 0 3 7 4 0 0 0 1 LENI MARLINA 03-March-1974 3 1 0 0 1 0 0 1 0 0 1 1
11 KEDAUNG PAMULANG
02-December-
49 15-June-2022 WAHYUDI 3 6 7 4 0 6 4 2 1 2 8 8 0 0 0 4 DESIALIANI JL KAV KEUANGAN 2 3 1 0 0 1 0 0 1 0 0 1 1
1988
01-August-2022
50 Dudi 3 2 7 6 0 4 6 3 0 5 8 9 0 0 0 4 Lusi 23-May-1989 Jl kavling 1 085691705553 3 1 0 0 1 0 0 1 0 0 1 1
01-August-2022 02-September-
51 Fajriansyah 3 6 7 2 0 3 4 2 0 9 9 1 0 0 0 1 Tia Serua 083807982952 3 1 0 0 1 0 0 1 0 0 1 1
1987
01-August-2022
52 Rudi 3 4 0 3 0 8 4 1 0 4 9 2 0 0 0 1 Safitri 01-April-1992 GG wahid 081586144315 3 1 0 0 1 0 0 1 0 0 1 1
53 Sarif 3 2 7 6 0 9 4 1 0 9 8 4 0 0 0 1 Anik Jl bakti 087870525412 3 1 0 0 1 0 0 1 0 0 1 1
1982
02-August-2022
54 IRMANSYAH 3 6 7 4 0 4 6 6 0 5 8 3 0 0 0 3 ERLITA 26-May-1983 KEDAUNG 08515695706 3 1 0 0 1 0 0 1 0 0 1 0
02-August-2022 02-February-
55 RASI 3 6 7 4 0 4 4 2 0 2 9 9 0 0 1 0 TASYA JL. OSTITA RAYA 088212518805 3 1 0 0 1 0 0 1 0 0 1 0
1999
03-August-2022
56 Alsen 3 6 7 4 0 5 6 7 0 3 9 3 0 0 0 3 Disca 27-March-1993 Pisangan 089519915179 3 1 0 0 1 0 0 1 0 0 1 1
03-August-2022 04-January-1991
57 Asep 3 6 7 4 0 4 4 4 0 4 9 1 0 0 1 0 Fika Kp. sawah 081906378079 3 1 0 0 1 0 0 1 0 0 1 1
03-August-2022
58 Bima 3 6 7 4 0 4 6 6 0 6 8 6 0 0 0 1 Ayu 26-June-1986 Jl suka makmur 087786966815 3 1 0 0 1 0 0 1 0 0 1 1
59 CITRA SANJAYA 3 6 7 4 0 6 5 9 0 1 8 7 0 0 1 5 IIS SUMIATI JL. KAV KEUANGAN GG H. KUMING 08171956884 2 0 0 0 1 0 0 1 0 0 1 1
03-August-2022
60 Mamat 3 6 7 4 0 4 5 0 0 7 9 6 0 0 1 1 Yuli 10-July-1990 Ciputat 0895703601702 3 1 0 0 1 0 0 1 0 0 1 1
03-August-2022 17-August-1987
61 Tomi 3 6 7 4 0 4 5 7 0 8 8 7 0 0 1 0 Nurlita Kp Parung benying 085817009451 3 1 0 0 1 0 0 1 0 0 1 1
04-August-2022 22-November-
62 ADITIA 1 5 7 1 0 7 5 4 0 7 9 5 0 0 0 1 KHAIRUNNISA KEDAUNG 081286878275 3 1 0 0 1 0 0 1 0 0 1 0
1991
04-August-2022 21-October-1988
63 ANDRI 3 6 7 4 0 6 2 1 1 0 8 8 0 0 0 6 HERLINAH KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
64 DEWANGGA 3 1 7 3 0 7 4 8 0 8 8 7 0 0 0 1 SHELLA EMPANG SARI 3 1 0 0 1 0 0 1 0 0 1 0
65 Hendrik 1 2 8 8 0 1 4 3 1 1 9 0 0 0 0 2 Murti Jl. Surya Makmur 08380465344 3 1 0 0 1 0 0 1 0 0 1 0
1990
05-August-2022
66 AEP 3 6 7 4 0 6 4 2 0 1 8 7 0 0 0 1 DIANA 26-March-1987 JL. SWADAYA 08592128930 3 1 0 0 1 0 0 1 0 0 1 0
05-August-2022
67 ARDIYANSYAH 3 6 7 4 0 6 4 2 0 3 9 3 0 0 0 8 MAISUM 08-May-1993 KEDAUNG 085711361522 3 1 0 0 1 0 0 1 0 0 1 0
05-August-2022
68 BENI 3 6 7 4 0 6 5 2 0 4 8 8 0 0 0 8 IMA 27-July-1994 GG MUJAHID 087762456092 3 1 0 0 1 0 0 1 0 0 1 0
69 BUSTANI 3 6 7 4 0 6 6 9 0 4 8 7 0 0 1 7 RHAMADANI JL JAMUR 3 1 0 0 1 0 0 1 0 0 1 0
70 DADANG 3 6 7 4 0 6 4 5 0 2 8 7 0 0 0 7 DWI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
71 HAMAMI 3 6 7 4 0 6 5 0 0 3 8 7 0 0 0 7 SITI AMINAH GG SWADAYA 3 1 0 0 1 0 0 1 0 0 1 0
05-August-2022 18-December-
72 HOIRUL ANWAR 3 6 0 2 0 4 5 8 1 2 9 1 0 0 0 1 DASNIAWATI JL MUSHOLLA ANNUR 2 1 0 0 1 0 0 1 0 0 1 0
1992
05-August-2022
73 KISWANTO 3 6 7 4 0 4 4 6 0 7 8 3 0 0 0 3 JUARIYAH 10-June-1983 KP JOMBANG 3 1 0 0 1 0 0 1 0 0 1 0
74 MADI 3 6 7 4 0 6 5 8 1 1 7 8 0 0 1 3 DAHLIA JL. SUKA MAKMUR 08528979275 3 1 0 0 1 0 0 1 0 0 1 0
75 MULYANTORO 3 6 7 4 0 6 5 8 0 9 7 6 0 0 0 4 RIRIN ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1976
76 RIANTO 3 6 7 4 0 6 5 1 0 1 9 6 0 0 1 2 WIDIANAH PAMULANG 085712548462 3 1 0 0 1 0 0 1 0 0 1 0
77 SAFEUL 3 6 7 4 0 6 5 5 0 2 7 3 0 0 0 3 TATIK JL ARYA PUTRA 081288749256 3 1 0 0 1 0 0 1 0 0 1 0
1983
78 SUNARDI 3 6 7 4 0 3 6 5 0 2 8 3 0 0 0 2 NUNI CIPUTAT 0857219153 3 1 0 0 1 0 0 1 0 0 1 0
1983
05-August-2022 ZAINUDIN
79 3 6 7 4 0 6 4 4 0 5 8 5 0 0 1 3 HOMSATI 04-May-1987 JALAN. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
SEMBIRING
06-August-2022
80 ALAMSYAH 1 8 7 1 1 2 4 6 0 6 8 8 0 0 0 5 NURDIANA 16-June-1988 JL. H KUNING 083690150983 3 1 0 0 1 0 0 1 0 0 1 0
81 EKA 3 6 7 4 0 6 4 5 1 0 9 5 1 0 0 0 DWI KEDAUNG 089613485274 3 1 0 0 1 0 0 1 0 0 1 0
1995
82 ROY 3 1 0 1 0 2 5 0 0 1 9 2 0 0 0 1 MULYANTI JL. SUKA MAKMUR 082129779814 3 1 0 0 1 0 1 0 0 0 1 0
06-August-2022
83 SUTARMAN 3 3 1 8 0 2 4 3 0 3 8 6 0 0 0 2 SITI 03-March-1986 KAVLING 083842441861 3 1 0 0 1 0 0 1 0 0 1 0
84 TEDY 3 6 7 4 0 6 4 2 0 8 8 6 0 0 0 4 DWI ASTUTI JL LURAH KEL PD BENDA 085718080841 3 1 0 0 1 0 0 1 0 0 1 0
85 TOPIK 3 6 7 4 0 6 4 6 0 5 8 0 0 0 2 0 DASIMAH PAMULANG PERMAI 083841462682 3 1 0 0 1 0 0 1 0 0 1 0
1999
86 ABDUL 3 2 7 6 0 5 5 8 0 5 8 4 0 0 0 8 MARLIAN JL KAVLING 081383553813 3 1 0 0 1 0 0 1 0 0 1 0
87 ALI 3 6 7 4 0 6 5 5 1 2 8 2 0 0 0 5 NINA JL. BERINGIN I 085899897206 3 1 0 0 1 0 0 1 0 0 1 0
1982
07-August-2022
88 EVI 3 6 7 4 0 6 5 3 0 2 7 3 0 0 0 4 FIFI 21-May-1986 JL SARANA INDAH 08129669977 3 1 0 0 1 0 0 1 0 0 1 0
89 IANDUNG 3 4 0 4 0 6 5 1 0 2 8 7 0 0 0 1 RENA JL. H TARIP 3 1 0 0 1 0 0 1 0 0 1 0
1987
07-August-2022
90 JAGAT 3 6 7 4 0 6 5 3 0 5 8 2 0 0 0 5 SITI SOLEHA 16-April-1996 JL. B BARAT 081314509889 3 1 0 0 1 0 0 1 0 0 1 0
07-August-2022
91 MAHDI 3 6 7 4 0 6 5 5 0 5 8 4 0 0 0 6 CINDY 24-March-1998 KEDAUNG 087883986898 3 1 0 0 1 0 0 1 0 0 1 0
92 MUSLIM 3 6 7 4 0 4 5 1 1 2 3 2 0 0 0 3 DESI CIPUTAT 081317754843 3 1 0 0 1 0 0 1 0 0 1 0
1993
93 USMAN 3 6 7 4 0 6 6 2 1 1 8 2 0 0 1 1 MEGI JL ELANG 3 1 0 0 1 0 0 1 0 0 1 0
07-August-2022
94 YATNA 3 6 7 4 0 1 7 0 0 7 9 3 0 0 0 4 SITI JURIAH 29-May-1995 SARANA 085881300463 3 1 0 0 1 0 0 1 0 0 1 0
07-August-2022
95 ZERULOH 3 1 7 4 0 5 6 2 0 4 8 9 0 0 0 3 LIZA 22-April-1989 JL. KAVLING 08780827798 3 1 0 0 1 0 0 1 0 0 1 0
96 AHMAD 3 6 7 4 0 4 5 3 0 8 0 0 0 0 0 3 NANDA CENDRAWASIH 0895803220120 3 1 0 0 1 0 0 1 0 0 1 0
97 ILHAM 3 6 7 4 0 6 6 6 0 7 7 6 0 0 0 1 LEONITA JL SURYA MAKMUR 081413268327 3 1 0 0 1 0 0 1 0 0 1 0
98 JAENUDIN 3 2 0 1 0 7 6 1 1 8 7 0 0 0 0 6 RELIANA SUKA DAMAI 3 1 0 0 1 0 0 1 0 0 1 0
1987
08-August-2022
99 LUKMAN 3 6 7 4 0 6 4 1 0 6 7 3 0 0 1 3 BADRIAH 11-June-1973 JL GUNUNG JAYA 3 1 0 0 1 0 0 1 0 0 1 0
08-August-2022
100 RAGIL 3 6 7 4 0 6 6 1 0 7 8 6 0 0 1 0 RUMI 21-July-1986 CRYSTAL PAMULANG A 10 081804723299 3 1 0 0 1 0 0 1 0 0 1 0
09-August-2022
101 FIRMAN 3 1 7 4 0 9 4 2 0 7 9 2 0 0 0 2 PUJIANAH 02-July-1992 JL NURUL IMAN 088212795649 3 1 0 0 1 0 0 1 0 0 1 0
102 IWAN 3 3 2 3 0 4 7 1 0 1 8 3 0 0 0 2 SRI JL. KAVLING 089605360126 3 1 0 0 1 0 0 1 0 0 1 0
09-August-2022
103 JAMALUDIN 3 6 7 4 0 6 4 9 0 1 7 7 0 0 0 4 ROHAYATI 04-May-1991 JL. KAVLING 081380994637 3 1 0 0 1 0 0 1 0 0 1 0
104 MARWIH 3 6 7 4 0 6 4 4 0 0 1 8 4 0 0 1 RATIH KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
1984
09-August-2022
105 RAHMAT 3 6 7 4 0 6 5 6 0 5 9 1 0 0 0 1 LILIS 16-May-1991 JL H KUNING 081905941704 3 1 0 0 1 0 0 1 0 0 1 0
106 SANDI 3 6 7 4 0 5 5 4 1 2 4 6 0 0 0 3 DESI KEDAUNG 087888714760 3 1 0 0 1 0 0 1 0 0 1 0
1996
107 ABDUL 3 6 7 4 0 6 4 4 0 8 9 8 0 0 1 2 AMELIA JL DR SETIA BUDI GG SUKUN 1 0858177393321 3 1 0 0 1 0 0 1 0 0 1 0
108 ARDI 3 1 7 4 0 0 4 5 0 8 6 8 0 0 0 7 EKA KEDAUNG 087788770020 3 1 0 0 1 0 0 1 0 0 1 0
1984
109 AZHAR 3 2 7 6 1 1 4 3 1 2 9 4 0 0 0 4 DEVI JL.BERINGIN 08988473886 3 1 0 0 1 0 0 1 0 0 1 0
1994
11-August-2022
110 FAHRUL 3 2 7 6 0 2 5 8 0 4 9 3 0 0 0 2 SUCI 03-May-1993 JL. M DARUSSALAM 085782641202 3 1 0 0 1 0 0 1 0 0 1 0
111 IZAL 3 6 7 4 0 6 5 2 0 5 8 0 0 0 0 5 SULIS KP BULAK TIMUR 089566693413 3 1 0 0 1 0 0 1 0 0 1 0
2001
112 LEPI 3 6 7 4 8 4 6 7 0 6 8 4 0 0 0 8 YUNI JL SUKA MAKMUR 3 1 0 0 1 0 0 1 0 0 1 0
113 RENALDI 3 6 7 4 0 6 4 6 1 2 9 9 0 0 0 6 DEA PAMPER 1 B 38/26 088213173933 3 1 0 0 1 0 0 1 0 0 1 0
1982
114 ARMONO 3 6 7 4 0 4 5 5 0 8 9 3 0 0 0 2 FANI GG SINDUR 3 1 0 0 1 0 0 1 0 0 1 0
12-August-2022
115 DAUS 3 6 7 4 0 6 4 6 0 5 9 5 0 0 0 4 RISUA 06-May-1995 JL KAVLING 085718844911 3 1 0 0 1 0 0 1 0 0 1 0
116 DAYAT 3 6 7 4 0 6 4 5 0 5 7 6 0 0 0 2 NENI PAMULANG BARAT 08964629395 3 1 0 0 1 0 0 1 0 0 1 0
1982
117 IR NAKISTAN 3 1 7 3 0 8 4 6 0 9 7 5 0 0 0 1 TISA JL.H.SALEH RT.04/02 3 1 0 0 1 0 0 1 0 0 1 0
1975
118 WIRADINATA 1 8 0 2 2 1 5 9 0 9 9 5 0 0 0 1 MILA JL KAVLING KEUANGAN 081270355356 3 1 0 0 1 0 0 1 0 0 1 0
1995
13-August-2022
119 IWAN 3 5 2 3 0 3 6 4 0 3 9 8 0 0 0 1 SUCIATI 24-March-1998 TAMAN KEDAUNG 085891666700 3 1 0 0 1 0 0 1 0 0 1 0
120 JOKO 3 6 7 4 0 6 5 0 1 2 8 2 0 0 0 8 KOMSATUN KEDAUNG 08211291167 3 1 0 0 1 0 0 1 0 0 1 0
1982
13-August-2022
121 MASRI 3 1 7 3 0 5 4 7 0 4 7 6 0 0 1 4 ROPIAH 06-March-1979 KEDAUNG 089647583707 3 1 0 0 1 0 0 1 0 0 1 0
122 RIADI 3 6 7 4 0 6 5 1 0 9 9 4 0 0 0 1 SINTA JL MASJID DARUSSALAM 085218138093 3 1 0 0 1 0 0 1 0 0 1 0
1988
14-August-2022
123 AGUS 3 6 7 4 0 6 5 4 0 7 7 5 0 0 0 1 HARMILAH 17-April-1974 JL. KAVLING 087826749516 3 1 0 0 1 0 0 1 0 0 1 0
14-August-2022
124 ARIF 3 1 7 4 0 5 5 2 0 9 7 7 0 0 0 7 INDAH 27-May-1990 ARIA PUTRI 98787009796 3 1 0 0 1 0 0 1 0 0 1 0
125 ARIF 3 6 7 4 0 6 6 2 0 4 8 2 0 0 0 4 RENATA JL. KAVLING 089637881932 3 1 0 0 1 0 0 1 0 0 1 0
2000
14-August-2022
126 BENI 3 6 7 4 0 6 4 4 0 4 8 8 0 0 0 7 SITI 03-March-1991 JL MUSYAWARAH 081211203440 3 1 0 0 1 0 0 1 0 0 1 0
14-August-2022
127 FERI 3 6 7 4 0 4 4 2 0 6 9 5 0 0 0 8 LUVI 02-June-1995 JL SURYA MAKMUR 085892208642 3 1 0 0 1 0 0 1 0 0 1 0
14-August-2022 JALAN CEMARA 1 RT 001 RW 001

128 HANDOKO 3 6 7 4 0 6 4 1 1 0 7 9 0 0 1 1 RITA 28-March-1987 0895347361016 3 1 0 0 1 0 0 1 0 0 1 0
PAMULANG BARAT
14-August-2022
129 RIZULI 3 6 7 4 0 6 4 8 0 6 9 3 0 0 0 1 DELA 08-June-1993 MASJID DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
130 ZIURI 3 6 7 4 0 6 6 1 0 6 7 7 0 0 0 3 RISA JL. KAVLING 083804751602 3 1 0 0 1 0 0 1 0 0 1 0
1994
131 ARIS 3 6 7 4 0 6 6 0 1 0 8 2 0 0 1 9 ETI KEDAUNG 087771439041 3 1 0 0 1 0 0 1 0 0 1 0
15-August-2022
132 GUNAWAN 3 6 0 3 2 5 6 4 0 2 8 8 0 0 0 1 RIA 08-March-1990 PAMULANG BARAT 085710509021 3 1 0 0 1 0 0 1 0 0 1 0
133 M. SOLEHUDIN 3 6 7 4 0 4 0 0 1 2 7 4 0 0 0 1 ANI SOFIYANI H. ELANG 08137779664 3 1 0 0 1 0 0 1 0 0 1 0
16-August-2022
134 ARIS 3 2 7 6 0 3 6 7 0 1 8 9 0 0 0 4 LISA 27-April-1982 TABANAS 085716231409 3 1 0 0 1 0 0 1 0 0 1 0
135 M. SUBUR 3 2 0 4 4 9 0 1 0 1 8 6 0 0 0 2 RISMA PD. PUCUNG INDAH 3 1 0 0 1 0 0 1 0 0 1 0
1971
16-August-2022
136 MUTHOLOB 3 2 0 7 1 5 5 8 0 5 7 3 0 0 0 3 MIMIN 18-May-1973 JL AMAL BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
137 NIKO 3 6 7 4 0 6 5 2 0 5 8 9 0 0 0 3 SINTIA JL. RAJAWALI 3 1 0 0 1 0 0 1 0 0 1 0
16-August-2022
138 RAHUL 3 6 7 4 0 5 6 6 0 4 8 2 0 0 1 0 DISYANA 08-May-1986 MASJID DARUSSALAM 081808023856 3 1 0 0 1 0 0 1 0 0 1 0
16-August-2022
139 RIO 3 2 0 1 1 4 6 3 0 6 8 5 0 0 0 4 MIA 04-July-1983 JL KAVLING 08571802264 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
140 ADE SURYA 3 4 7 4 0 6 5 8 0 4 9 2 0 0 0 4 RISKA 18-April-1992 JL. S MULYA 0819060466292 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
141 AHMAD 3 3 1 7 1 4 6 0 0 5 9 2 0 0 0 7 RISMA PUTRI 20-May-1992 KEDAUNG 083899369069 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
142 HASYIM 3 3 0 1 0 9 5 7 0 7 8 7 0 0 0 1 FATONAH 17-July-1987 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
143 M NUR 3 2 0 6 3 8 6 7 0 9 9 4 0 0 0 1 RINI JL KAVLING 3 1 0 0 1 0 0 1 0 0 1 0
1994
17-August-2022
144 ROMI 3 6 7 4 0 6 4 1 0 1 7 8 0 0 0 2 ANISA 08-July-1999 BEKASI 3 1 0 0 1 0 0 1 0 0 1 0
145 Endy 3 5 7 8 2 3 5 3 0 1 8 8 0 0 0 1 Madu Parkos 08992136199 3 1 0 0 1 0 0 1 0 0 1 0
18-August-2022
146 Imam 3 2 0 3 2 5 4 6 0 9 9 4 0 0 0 4 SUSI 03-March-1993 Kedaung 08771387884 3 1 0 0 1 0 0 1 0 0 1 0
147 Redi 3 2 7 6 0 3 6 5 0 8 9 0 0 0 0 3 RESTI Kedaung 0881888340 3 1 0 0 1 0 0 1 0 0 1 0
19-August-2022
148 IMAM 1 5 0 1 0 2 5 8 0 7 8 1 0 0 0 4 ZUBAIDAH 18-July-1981 JL SURYA MAKMUR 085211686779 3 1 0 0 1 0 0 1 0 0 1 0
19-August-2022
149 MUDIANTO 3 6 7 4 0 6 6 6 0 1 9 5 0 0 0 4 INTAN 16-May-1994 JL.SURYA MAKMUR 085700990682 3 1 0 0 1 0 0 1 0 0 1 0
19-August-2022
150 WAWAN 3 2 0 1 3 5 5 6 0 5 0 1 0 0 0 3 KULSUM 05-March-1976 PAMPER 1 A 53/13 08211117506 3 1 0 0 1 0 0 1 0 0 1 0
151 ERWIN 3 6 7 4 0 6 6 7 1 1 7 4 0 0 1 2 SATI JL MASJID DARUSSALAM 0858849495529 3 1 0 0 1 0 0 1 0 0 1 0
152 FAHRI 3 6 7 4 0 5 6 3 0 9 8 7 0 0 0 3 RANI CIPUTAT 085814023929 3 1 0 0 1 0 0 1 0 0 1 0
1993
20-August-2022
153 SULAIMAN 3 6 7 4 0 3 4 1 0 7 7 8 0 0 1 7 SULISTIANI 30-April-1977 JL. SUMA MAKMUR 3 1 0 0 1 0 0 1 0 0 1 0
154 USMAN 3 1 7 4 0 6 5 1 0 5 8 9 0 0 0 8 RIADANTI KEDAUNG 088801359368 3 1 0 0 1 0 0 1 0 0 1 0
1987
21-August-2022
155 ARDIYANSYAH 3 1 7 4 0 5 7 0 0 6 8 6 0 0 1 3 FITRI 24-March-1998 PARKOS 085710481023 3 1 0 0 1 0 0 1 0 0 1 0
21-August-2022
156 FERI 3 2 0 2 2 9 0 1 0 1 8 6 0 0 0 1 RISMA 24-March-1998 KEDAUNG 082114434646 3 1 0 0 1 0 0 1 0 0 1 0
157 HENDRI 3 6 7 4 0 6 4 7 0 9 8 7 0 0 1 1 PIPIT MASJID DARUSSALAM 2 1 0 0 1 0 0 1 0 0 1 0
1987
158 YUDA 3 6 7 4 1 1 3 4 5 1 0 9 1 0 0 0 NURHAYATI JL. SUKA MAKMUR 3 1 0 0 1 0 0 1 0 0 1 0
159 BAYU 3 6 7 4 0 4 6 0 0 8 9 9 0 0 0 3 ROS PAMULANG BARAT 089535869318 3 1 0 0 1 0 0 1 0 0 1 0
160 DAVID 6 1 0 1 1 9 5 3 0 4 8 7 0 0 0 2 NADIA ARIA PUTRA 082381838810 3 1 0 0 1 0 0 1 0 0 1 0
22-August-2022
161 HERI 3 6 7 4 0 6 5 5 0 6 8 3 0 0 1 0 LICI 15-June-1983 KP BULAK 082211629497 3 1 0 0 1 0 0 1 0 0 1 0
162 MUTAR 3 6 7 4 0 6 6 5 0 1 8 3 0 0 0 7 FINDA KEDAUNG 0815866685 3 1 0 0 1 0 0 1 0 0 1 0
163 RIBUT 3 6 7 4 0 6 6 6 0 9 7 1 0 0 0 1 DEVI JL. S MULYA 082213008131 3 1 0 0 1 0 0 1 0 0 1 0
1992
22-August-2022
164 SOFIAN 3 6 7 4 6 6 7 1 0 1 9 6 0 0 0 2 FAUZIAH 31-May-1990 SASAK TINGGI 081298434693 3 1 0 0 1 0 0 1 0 0 1 0
165 SUGENG 3 4 0 1 1 1 4 1 0 8 8 2 0 0 0 2 DWI PAMULANG BARAT 083812801792 3 1 0 0 1 0 0 1 0 0 1 0
23-August-2022
166 AKSEL 3 2 7 6 1 1 4 9 0 4 9 8 0 0 0 2 NURWA 10-July-1983 KEDAUNG 085788509629 2 1 0 0 1 0 0 1 0 0 1 0
23-August-2022
167 YUSUF 3 6 7 4 0 6 6 6 0 6 9 8 0 0 1 2 SITI ROHAYA 21-April-1990 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
168 AHMAAD 3 6 7 4 0 6 6 1 1 1 8 9 0 0 0 2 NOVA JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1989
169 FARHAN 3 6 7 4 0 6 4 4 0 8 9 2 0 0 0 6 RISMA ARYA PUTRA 085718534753 3 1 0 0 1 0 0 1 0 0 1 0
170 RICI 1 6 1 0 0 8 7 0 0 9 9 0 0 0 0 5 INDAH GG. H THAIB 088808901336 3 1 0 0 1 0 0 1 0 0 1 0
1991
25-August-2022
171 YUSUF 3 6 7 4 0 6 5 0 1 0 8 2 0 0 0 3 HERMA 18-May-1991 GG. ELANG 3 1 0 0 1 0 0 1 0 0 1 0
26-August-2022
172 DUDI 3 2 7 6 0 4 6 3 0 5 8 9 0 0 0 7 LUSI 23-May-1989 KAVLING 085691705553 3 1 0 0 1 0 0 1 0 0 1 0
26-August-2022
173 OMAN 3 6 7 4 0 6 5 8 0 8 7 5 0 0 0 7 TIA 03-April-1996 JL KEMUNING 1 081318445987 3 1 0 0 1 0 0 1 0 0 1 0
174 RESTU 3 3 2 7 0 9 4 7 0 2 9 1 0 0 0 7 ANISA JL. LAGOS 0895385645586 2 1 0 0 1 0 0 1 0 0 1 0
2000
26-August-2022
175 SUPARNO 3 6 7 4 0 6 5 7 0 4 8 6 0 0 0 7 UCI 16-March-1981 JL SUDAN UJUNG 081293809293 3 1 0 0 1 0 0 1 0 0 1 0
176 TOMI 3 6 7 4 0 6 5 7 1 0 7 6 0 0 0 3 ISTIRONAN JL. SURYA MAKMUR 08575525960 3 1 0 0 1 0 0 1 0 0 1 0
1989
27-August-2022
177 ARIF 3 6 7 4 0 6 7 1 0 3 9 4 0 0 0 7 PUPUT 01-April-1994 KEDAUNG 082180426011 3 1 0 0 1 0 0 1 0 0 1 0
178 ENDANG 3 6 7 4 0 4 4 7 0 6 8 1 0 0 0 2 ITA CIPUTAT 08213336866 3 1 0 0 1 0 0 1 0 0 1 0
179 HERI 3 6 7 4 0 4 6 4 0 2 8 6 0 0 0 1 TANISA JL OTSITA RAYA 085718562094 3 1 0 0 1 0 0 1 0 0 1 0
27-August-2022
180 SUPRIYANTO 3 3 1 2 1 2 6 7 0 4 9 3 0 0 0 1 URHASANAH 14-April-1988 GG MUSYAWARAH 08816178077 3 1 0 0 1 0 0 1 0 0 1 0
27-August-2022 24-November- PAMULANG PERMAI 2 BLOK F 7 NO

181 YOFI 3 6 7 4 0 6 4 1 0 8 8 4 0 0 0 2 LISNA 085773251270 3 1 0 0 1 0 0 1 0 0 1 0
1989 8
28-August-2022
182 CHANAN 3 6 7 4 0 6 7 0 0 8 9 5 0 0 0 2 DEBBY 05-June-1988 JOMBANG 081585434459 3 1 0 0 1 0 0 1 0 0 1 0
28-August-2022
183 EDDY DAMHUDIE 3 6 7 4 0 6 5 2 0 5 7 4 0 0 0 7 MUNIMAH 22-March-1981 JL.LAMTORO RT 02/O16 088101118535 3 1 0 0 1 0 0 1 0 0 1 0
28-August-2022
184 FAISAL 3 6 7 4 0 6 6 5 0 6 9 4 0 0 0 2 SITI SOLEHA 25-June-1994 NURUL IMAN 088223900322 3 1 0 0 1 0 0 1 0 0 1 0
28-August-2022
185 KURNIAWAN 3 6 7 4 0 6 4 2 1 1 7 2 0 0 1 0 SALIYAH 17-July-1998 GG LANGGAR 0895352523779 3 1 0 0 1 0 0 1 0 0 1 0
186 M. ZAMIL 3 6 7 4 0 4 4 6 1 1 7 7 0 0 0 1 NOVI GG MADRASAH 085714404917 3 1 0 0 1 0 0 1 0 0 1 0
1977
187 SANDI 3 6 7 4 0 1 5 2 0 2 9 0 0 0 0 2 DEWI JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1990
188 WIDI 3 2 0 4 2 5 6 8 1 0 7 8 0 0 0 1 SITI FATIMAH KP SAWAH 3 1 0 0 1 0 0 1 0 0 1 0
189 AZMI 3 6 7 4 0 6 5 6 1 2 8 5 0 0 0 4 NILA PAMULANG BARAT 3 1 0 0 1 0 0 1 0 0 1 0
14-August-1988
190 01-June-2022 ARIF 3 6 7 4 0 6 5 2 1 2 7 5 0 0 0 1 INAH JL MASJID DARUSSALAM 081398281771 3 1 0 0 2 0 0 1 0 0 1 0
10-November-
191 01-June-2022 BARI 3 6 7 4 0 6 4 1 0 1 8 3 0 0 0 2 RISKA JOMBANG 1 1 0 0 2 0 0 1 0 0 1 0
1997
01-September-
192 01-June-2022 DWI 3 6 7 4 0 6 5 2 0 6 9 0 0 0 1 2 HEPI JL. SURYA MULYA I 3 1 0 0 2 0 0 1 0 0 1 0
1997
193 01-June-2022 RADEN 3 6 7 4 0 6 4 4 0 8 8 7 0 0 0 3 SELVI 08-April-1987 JL PARKOS 2 1 0 0 2 0 0 1 0 0 1 0
02-September-
194 01-June-2022 RIYANTO 3 1 7 1 0 4 4 6 0 9 7 5 0 0 0 5 TIA KEDAUNG 2 1 0 0 2 0 0 1 0 0 1 0
1994
195 01-June-2022 SUGATO 3 6 7 4 0 6 6 9 0 5 7 1 0 0 0 9 GITA RAHAYU 29-May-1971 JL MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0
26-November-
196 02-June-2022 AHMAD 3 6 7 4 0 6 5 0 1 1 9 2 0 0 0 9 NOVI JL. ARYA PUTRA 2 1 0 0 2 0 0 1 0 0 1 0
1989
25-November-
197 02-June-2022 RIAN 3 6 7 4 0 6 6 8 0 9 8 8 0 0 0 1 DIAN JL. SURYA MAKMUR 1 1 0 0 2 0 0 1 0 0 1 0
1987
25-December-
198 02-June-2022 RULI 3 2 0 2 0 8 5 0 0 3 8 1 0 0 0 7 LENI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1990
19-September-
199 03-June-2022 ANDI 1 2 0 6 1 6 5 2 0 6 8 9 0 0 0 1 DIAH KEDAUNG 0895358484072 3 1 0 0 2 0 0 1 0 0 1 0
1988
02-February-
200 03-June-2022 GUNAWAN 3 6 7 4 0 1 4 2 0 2 0 0 0 0 0 4 FIRLI JL GURAME III 0895358484072 2 1 0 0 2 0 0 1 0 0 1 0
2000
201 03-June-2022 KOMAR 3 6 7 4 0 6 5 2 0 1 9 6 0 0 0 3 MARIAM 11-May-1998 SASAK TINGGI 083140723175 1 1 0 0 2 0 0 1 0 0 1 0
202 03-June-2022 LINDA 3 3 7 4 0 6 4 5 0 5 9 7 0 0 0 8 ELIN 05-May-1997 JL. H MAUNG 089668234014 2 1 0 0 2 0 0 1 0 0 1 0
23-September-
203 03-June-2022 WILDAN 3 6 7 4 0 6 5 2 0 7 9 3 0 0 0 6 ADE KEDAUNG 082260208019 3 1 0 0 2 0 0 1 0 0 1 0
1994
ADAM CHOLID
204 04-June-2022 3 1 7 4 0 5 4 2 0 5 9 2 0 0 0 3 HERNITA 02-May-1992 KP. BULAK TIMUR 2 1 0 0 2 0 0 1 0 0 1 0
PRAWIRA
19-February-
205 05-June-2022 FERDIYAN 3 3 2 8 0 7 4 4 0 7 8 3 0 0 0 1 MIA JL. KAVLING KEUANGAN 3 1 0 0 2 0 0 1 0 0 1 0
1981
21-December-
206 05-June-2022 JALALUDIN 3 6 7 4 0 6 6 1 1 2 7 9 0 0 0 1 PARYANTI KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
1979
16-February-
207 05-June-2022 SUGITO 3 6 7 4 0 6 4 1 0 6 6 3 0 0 0 2 WIJIANTI JL. SURYA MAKMUR 2 1 0 0 2 0 0 1 0 0 1 0
1975
09-August-1979
208 15-June-2022 ABDUL SOMAD 3 6 7 4 0 6 4 9 0 8 7 9 0 0 0 5 RAHMAWATI JL.PALA RAYA RT002/001 1 1 0 0 2 0 0 1 1 0 0 1
209 15-June-2022 AHMAD JAZULI 3 6 7 4 0 6 6 1 0 3 8 8 0 0 0 7 YENI MAYSAROH 21-March-1988 JL KAV KEUANGAN 1 1 0 0 2 0 0 1 1 0 0 1
21-August-1974
210 15-June-2022 AMAN PRAMAD 3 6 7 4 0 6 6 1 0 8 7 4 0 0 1 3 NURHAYATI JL KAV KEUANGAN 1 1 0 0 2 0 0 1 1 0 0 1
211 15-June-2022 HASAN BASRI 3 6 7 4 0 6 4 3 0 4 7 0 0 0 1 1 ROSINTA WATI 03-April-1970 JL. HAJI KUMING 2 3 1 0 0 2 0 0 1 1 0 0 1
01-January-1977
212 15-June-2022 RANTO LUBIS 3 6 7 4 0 6 4 1 0 1 7 7 0 0 1 2 RENY RINA MEGAWATI JL KAV KEUANGAN 3 1 0 0 2 0 0 1 1 0 0 1
213 15-June-2022 ROSID 3 1 7 4 1 0 5 3 0 5 7 3 0 0 0 1 MEILINDA SUSANTI 13-May-1973 KP. BULAK TIMUR 3 1 0 0 2 0 0 1 1 0 0 1
214 15-June-2022 SUPRIYANTO 3 6 7 4 0 6 7 1 0 7 7 7 0 0 0 6 WULANDARI 30-July-1977 KP BULAK TIMUR 1 1 0 0 2 0 0 1 1 0 0 1
JL. MUSHOLLA ANNUR, KEDAUNG,

215 15-June-2022 ZAKARIA 3 6 7 4 0 6 4 5 0 6 7 3 0 0 2 6 HARYANIH 05-June-1973 1 1 0 0 2 0 0 1 1 0 0 1
CIPUTAT
01-August-2022
216 Ahmad 3 6 7 4 0 6 4 9 0 5 9 1 0 0 0 6 Elis 09-June-1992 Jalan kedaung 085820239676 3 1 0 0 2 0 0 1 0 0 1 1
01-August-2022
217 Bilal 3 6 7 4 0 6 6 7 0 7 9 4 0 0 0 7 Triana 26-July-1994 Kedaung 085971702969 3 1 0 0 2 0 0 1 0 0 1 1
01-August-2022
218 Eno 3 3 2 7 0 9 4 7 0 7 8 7 0 0 0 9 Susi 07-July-1987 Suka mulya 085946170298 3 1 0 0 2 0 0 1 0 0 1 1
01-August-2022
219 Firman 3 6 7 4 0 4 4 4 0 5 9 7 0 0 0 2 Siska 04-May-1997 Sawah baru 089506702302 1 1 0 0 2 0 0 1 0 0 1 1
04-August-2022
220 HARIS 3 6 7 1 1 1 5 9 0 4 9 0 0 0 0 2 APRIL 08-April-1999 JL. MASJID AN-NUR 087770226572 3 1 0 0 2 0 0 1 0 0 1 0
04-August-2022
221 MAULANA 3 6 7 4 0 6 4 6 0 4 8 5 0 0 1 6 SARTIWI 06-April-1985 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
222 DANI 3 6 7 4 0 6 6 4 0 1 9 6 0 0 0 1 RATNA EYANG AGUNG 0882955213 3 1 0 0 2 0 0 1 0 0 1 0
05-August-2022
223 FEBRY 3 6 7 4 0 6 4 8 0 9 7 6 0 0 0 3 SELFANI 12-July-1994 KP GUNUNG 085717633285 3 1 0 0 2 0 0 1 0 0 1 0
224 RIFAI 3 3 2 8 1 0 6 4 0 3 8 6 0 0 0 4 MAYANG JL. H UMING 3 1 0 0 2 0 0 1 0 0 1 0
225 TAUFIK 3 6 7 4 0 6 5 3 0 9 7 3 0 0 0 3 MUNIROH PAMULANG BARAT 0895636751637 3 1 0 0 2 0 0 1 0 0 1 0
1980
10-August-2022
226 DEDE 3 6 7 4 0 6 6 0 0 6 7 7 0 0 0 1 ERNA 03-May-1987 KEDAUNG 087775158977 3 1 0 0 2 0 0 1 0 0 1 0
10-August-2022
227 FAISAL 3 6 7 4 0 6 5 6 0 4 8 2 0 0 0 2 DINA 11-July-1996 JLAN SURYA MAKMUR 08963651113 3 1 0 0 2 0 0 1 0 0 1 0
228 SUCIPTO 3 3 2 8 0 9 6 0 1 1 9 1 0 0 0 3 LINA GG SWADAYA 081805401901 3 1 0 0 2 0 0 1 0 0 1 0
1995
229 HARIS 3 6 0 3 1 2 4 7 0 2 9 4 0 0 0 7 MONICA JL GADUNG RAYA 0895604000090 1 1 0 0 2 0 0 1 0 0 1 0
1995
12-August-2022
230 M. SYAFIIH 3 6 7 4 0 6 5 5 0 3 8 3 0 0 0 7 SUNARTI 15-March-1983 JL KAVLING KEUANGAN 085694885373 1 1 0 0 2 0 0 1 0 0 1 0
14-August-2022
231 DANIAN 3 6 7 4 0 6 6 8 0 8 7 5 0 0 1 1 TRISNIASIH 27-April-1986 JL. PARKOS 3 1 0 0 2 0 0 1 0 0 1 0
14-August-2022
232 HADI 3 1 7 4 0 5 5 0 0 1 7 7 0 0 0 7 NINING 25-April-1974 JL. H NATONG 081286632121 3 1 0 0 2 0 0 1 0 0 1 0
14-August-2022
233 KRISANTO 3 6 7 4 0 6 5 5 0 9 8 1 0 0 0 5 MAESAROH 26-July-1990 SERUA INDAH 0895410342392 3 1 0 0 2 0 0 1 0 0 1 0
234 WARIMIN 3 1 7 3 0 2 4 2 0 9 8 9 0 0 0 2 MELLANO TABANAS UJUNG 081905942199 3 1 0 0 2 0 0 1 0 0 1 0
1989
235 WISMANTO 3 6 7 4 0 5 4 9 0 1 7 7 0 0 1 0 ROHAYATI JL. ELANG 3 1 0 0 2 0 0 1 0 0 1 0
15-August-2022
236 ANTON 3 6 7 4 0 6 6 1 0 6 7 7 0 0 0 8 SULIASIH 21-June-1977 ARIA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
237 IBRAHIM 3 6 7 4 0 6 4 5 1 1 9 9 0 0 0 2 ELSA GG. WAHID 3 1 0 0 2 0 0 1 0 0 1 0
1996
238 INDRA 3 6 7 4 0 6 4 6 1 1 0 0 0 0 0 6 AYU JL. KAVLING 089514060255 3 1 0 0 2 0 0 1 0 0 1 0
16-August-2022
239 WIDIANTO 3 6 7 4 0 6 4 9 0 3 9 7 0 0 0 1 MELA 09-March-1997 H. GADUNG 089626139997 3 1 0 0 2 0 0 1 0 0 1 0
240 RIDWAN 3 6 7 4 0 6 4 1 0 3 8 3 0 0 1 0 NUR AZIZAH KP GUNUNG 088211595089 3 1 0 0 2 0 0 1 0 0 1 0
241 HOLONGAN 3 4 0 6 0 1 5 0 0 9 7 5 0 0 0 8 NURMATI JL. KAVLING 082166811595 3 1 0 0 2 0 0 1 0 0 1 0
1987
21-August-2022
242 RITMATISUM 3 6 7 4 0 6 4 4 0 2 7 7 0 0 0 3 SUPRIYATIN 11-April-1973 SERUA 3 1 0 0 2 0 0 1 0 0 1 0
22-August-2022
243 AFRIZON 3 6 7 4 0 6 2 7 0 2 1 8 0 0 4 7 DESI 26-June-1998 GG SWADAYA 0812898899 3 1 0 0 2 0 0 1 0 0 1 0
22-August-2022
244 ASMUNI 3 6 7 4 0 6 4 3 0 2 6 3 0 0 0 1 SITI SUPRAMAH 04-April-1986 MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0
245 DILA 3 6 7 4 0 6 5 1 0 9 7 6 0 0 0 2 DWI JL. S MULYA 3 1 0 0 2 0 0 1 0 0 1 0
1997
22-August-2022
246 IHSAN 3 6 7 4 0 6 5 1 0 1 8 6 0 0 0 2 MAULANI IHSAN 11-July-1995 MASJID DARUSSALAM 0881615251 3 1 0 0 2 0 0 1 0 0 1 0
22-August-2022
247 TONO 3 3 1 8 0 1 6 5 0 7 8 9 0 0 0 2 MUDIYANTI 24-July-1989 JL AT TAUHID 3 1 0 0 2 0 0 1 0 0 1 0
248 UDIN 3 6 7 4 0 6 6 2 1 0 8 4 0 0 1 1 RENI JL. H UMING 08569488545 3 1 0 0 2 0 0 1 0 0 1 0
1990
24-August-2022
249 RIAN 3 6 7 4 0 6 4 5 0 5 9 7 0 0 0 8 ELIN 05-May-1997 JL. H MAUNG 089668234614 3 1 0 0 2 0 0 1 0 0 1 0
250 ALDI 3 6 7 4 0 6 6 8 0 3 8 3 0 0 0 7 ANA JL. PARKOS 3 1 0 0 2 0 0 1 0 0 1 0
1983
25-August-2022
251 YUSUF 3 3 2 7 1 2 6 1 0 4 9 8 0 0 0 4 NURUL 21-April-1998 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
252 ADI 3 6 7 4 0 6 6 1 0 4 8 3 0 0 2 3 DEWI KOMPLEK THE PARK 3 1 0 0 2 0 0 1 0 0 1 0
1988
27-August-2022
253 HADI 3 1 7 1 0 3 5 0 0 3 7 9 0 0 0 2 TITIN 10-March-1979 JL MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0
254 RIO 3 4 7 4 0 6 5 5 0 9 9 9 0 0 0 5 SILVIA JLH. REAN 081584594505 3 1 0 0 2 0 0 1 0 0 1 0
1999
255 ZIKRI 3 6 7 4 0 4 6 0 0 1 7 6 0 0 0 7 ANA JL. SUKA MAKMUR 087885132873 3 1 0 0 2 0 0 1 0 0 1 0
28-August-2022
256 SIGIT 3 6 0 3 2 5 5 3 0 3 8 0 0 0 0 3 MONI 27-May-1978 KEDAUNG 081286145840 3 1 0 0 2 0 0 1 0 0 1 0
257 01-June-2022 GARILES 3 6 7 4 0 6 5 2 0 6 8 0 0 0 0 4 GINA 08-July-1989 JL NASABAH 5 082116600235 1 1 0 0 3 0 0 1 0 0 1 0
11-December-
258 02-June-2022 DIMAS 3 6 7 4 0 6 6 1 1 1 8 9 0 0 1 1 NATALI GG. PINANG 0895380501800 3 1 0 0 3 0 0 1 0 0 1 0
20001
03-February-
259 02-June-2022 HERI 3 1 7 4 0 8 4 3 0 2 7 3 0 0 0 3 LUSI GG MUSYAWARAH 2 1 0 0 3 0 0 1 0 0 1 0
1973
260 04-June-2022 MULYADI 3 6 7 4 0 6 6 5 0 7 7 6 0 0 0 3 TETI 25-July-1976 JALAN MUJAER 3 1 0 0 3 0 0 1 0 0 1 0
14-January-2000
261 05-June-2022 BAHARUDIN 3 6 7 4 0 4 4 0 2 9 2 0 0 0 0 5 FIELGA KEDAUNG 085717580669 3 1 0 0 3 0 0 1 0 0 1 0
262 05-June-2022 INDRA 3 6 7 4 0 6 4 2 0 1 8 7 0 0 0 1 DIAN 28-July-1992 JL. ANNABAWI 083890096516 1 1 0 0 3 0 0 1 0 0 1 0
263 05-June-2022 TATANG 3 2 0 2 2 2 6 3 0 5 9 8 0 0 0 3 METI 23-May-1998 JL. SERUA BABAKAN 085862883501 2 1 0 0 3 0 0 1 0 0 1 0
264 06-June-2022 AROFIQ 3 6 7 4 0 6 4 6 0 7 8 1 0 0 0 7 MALIYAH 06-July-1981 JL. KALI ASEM 082114008445 3 1 0 0 3 0 0 1 0 0 1 0
06-December-
265 06-June-2022 FURQON 3 6 7 4 0 6 6 1 0 3 8 4 0 0 0 2 LIA AMELIA VILA PAMULANG 08954377082 3 1 0 0 3 0 0 1 0 0 1 0
2001
266 06-June-2022 MULYADI 3 1 7 4 0 7 4 1 0 3 8 4 0 0 0 6 MITA 01-March-1984 KEDAUNG 2 1 0 0 3 0 0 1 0 0 1 0
267 06-June-2022 MUNAJIR 3 6 7 4 0 6 4 5 0 6 8 8 0 0 0 7 ELA 05-June-1988 JL. KAVLING KEUANGAN 089580324865 2 1 0 0 3 0 0 1 0 0 1 0
268 06-June-2022 RIRI 3 6 7 4 0 6 4 6 0 4 8 4 0 0 2 2 SIVA 06-April-1984 Kedaung 2 1 0 0 3 0 0 1 0 0 1 0
08-August-1974
269 06-June-2022 SUGIO 3 6 7 4 4 0 6 4 6 0 8 7 4 0 0 0 YANI JL. KAVLING 3 1 0 0 3 0 0 1 0 0 1 0
270 06-June-2022 SUNARTO 3 6 7 4 0 6 5 5 0 6 8 4 0 0 1 0 JUMIATI 04-May-1973 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
271 06-June-2022 TIO 3 6 7 4 0 6 5 6 0 6 9 5 0 0 1 3 RLISA 16-June-1995 JL KAVLING KEUANGAN II 087786760548 3 1 0 0 3 0 0 1 0 0 1 0
272 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 DIAH 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
273 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 MEILANI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
274 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NIRANDA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
01-December-
275 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NITA KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 1
1994
276 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NURHAYATI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
277 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RENI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
278 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RISKA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
279 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
280 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI MASITOH 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
281 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI S 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
282 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 TIA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
283 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 UNA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
284 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 WULAN 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
285 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 YULI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0
01-December-
286 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 AMELIA BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
1994
287 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ARY 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
288 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 DETI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
289 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ELSA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
290 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FIRLI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
291 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FITRIYANI 01-July-1985 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
292 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 HERNNITA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
293 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 IPAH 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

294 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 LUSI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
295 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 MARIAM 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
296 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NISA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
297 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 OLI 01-July-1995 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
298 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 PUAN 01-July-1995 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
299 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RARA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
300 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RIKA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
301 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
01-January-7994
302 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 TETI BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
303 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 YANA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
304 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ZAHRA 01-July-1995 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0
02-August-2022 06-August-1987 JL SWADAYA RT 005 RW 015

305 DUDUNG DUHRON 3 6 7 4 0 6 4 6 0 8 8 7 0 0 0 4 TINA NURAIDA 3 1 0 0 3 0 0 1 0 0 1 0
KEDAUNG PAMULANG
02-August-2022
306 JAENI 3 6 7 4 0 6 5 3 0 4 8 3 0 0 1 8 SITI JUBAEDAH 14-March-1983 KEDAUNG 083904303171 3 1 0 0 3 0 0 1 0 0 1 0
307 MASREN DUDUNG 3 6 7 4 0 6 6 0 0 7 9 5 0 0 1 5 RISMAWATI CIPUTAT 0821108467992 3 1 0 0 3 0 0 1 0 0 1 0
1988
308 AGUNG 3 6 7 4 0 6 4 6 0 1 8 9 0 0 0 7 WULANSARI JL H NURLEAN RT 01/03 NO 131 3 1 0 0 3 0 0 1 0 0 1 0
2002
309 ALDI 3 6 7 4 0 6 6 3 1 0 9 0 0 0 0 4 LINDA LIDIAWATI KEDAUNG 08585830013 3 1 0 0 3 0 0 1 0 0 1 0
310 FARNUDIN 3 6 7 4 0 6 4 6 0 5 8 7 0 0 1 6 ERA JL. SWADAYA 083876880727 3 1 0 0 3 0 0 1 0 0 1 0
311 FIRDAUS 3 6 7 4 0 6 6 1 0 8 8 8 0 0 0 4 FAUZIAH JL, SWADYA 3 1 0 0 3 0 0 1 0 0 1 0
06-August-2022
312 HAIKAL 3 6 7 4 0 6 5 0 0 4 8 4 0 0 0 8 NURAINI 18-April-1999 JL PUSAT PASAR MEDAN 087815499079 3 1 0 0 3 0 0 1 0 0 1 0
313 NUNU 3 2 7 5 0 9 6 7 0 3 8 6 0 0 0 6 NUR BAMBU APUS 085774324700 3 1 0 0 3 0 0 1 0 0 1 0
1993
07-August-2022
314 ATANG 3 1 7 4 0 6 4 9 0 7 7 7 0 0 0 5 LINA 09-July-1977 KEDAUNG 083813670883 3 1 0 0 3 0 0 1 0 0 1 0
315 RIAN 3 3 2 7 0 6 4 1 0 9 9 1 0 0 0 7 SEPTI JL. MUSYAWARAH 081285246669 3 1 0 0 3 0 0 1 0 0 1 0
1991
316 FAJAR 3 6 7 4 0 6 4 2 0 7 2 0 0 0 0 5 ARSILAH PAMULANG 083871604440 3 1 0 0 3 0 0 1 0 0 1 0
317 FARHAN 3 6 7 4 0 6 6 0 1 2 7 4 0 0 1 0 ANI JL.KAVLING 081387638131 3 1 0 0 3 0 0 1 0 0 1 0
1994
318 RIYADI 3 6 7 4 0 6 4 5 0 7 7 7 0 0 0 4 SITI KHODIJAH KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
319 SUPRIATNA 3 6 7 4 0 4 6 8 0 8 9 0 0 0 0 8 FIFI CIPUTAT 083879495586 3 1 0 0 3 0 0 1 0 0 1 0
08-August-2022
320 SUYANTO 3 3 1 4 1 7 5 2 0 4 8 5 0 0 1 0 MUKAROMAH 12-April-1985 JL. NUSA INDAH 081213254064 3 1 0 0 3 0 0 1 0 0 1 0
321 UMAR 3 3 1 3 0 6 4 9 1 0 0 0 0 0 0 4 SARAH PARKOS 087741199820 3 1 0 0 3 0 0 1 0 0 1 0
322 YAYAN 3 6 7 4 0 6 6 1 0 5 7 8 0 0 0 3 SITI MARYAM SERUA INDAH 081906522912 3 1 0 0 3 0 0 1 0 0 1 0
1990
323 MALIK 3 6 7 4 0 6 6 0 0 7 8 3 0 0 0 2 OVITA JL. M ANNUR 089514327545 3 1 0 0 3 0 0 1 0 0 1 0
1998
11-August-2022
324 HARDIAN 3 6 7 4 0 4 6 8 0 3 0 1 0 0 0 1 SULIS 28-March-2001 JL. SURYA MAKMUR 089652416762 3 1 0 0 3 0 0 1 0 0 1 0
325 RUDI 3 1 7 2 0 4 4 2 0 2 8 4 1 0 0 2 LUNA KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
1984
326 TATANG 3 6 7 4 0 6 4 3 0 3 7 9 0 0 0 4 DEWI KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
1995
13-August-2022
327 EKO 3 6 7 4 0 6 4 4 0 8 9 2 0 0 0 6 PUTRI 07-March-2000 KEDAUNG 085714593279 3 1 0 0 3 0 0 1 0 0 1 0
328 YONO 3 5 2 1 1 1 4 8 0 8 8 8 0 0 0 5 LILIS SASAK TINGGI 089503627326 3 1 0 0 3 0 0 1 0 0 1 0
14-August-2022
329 PARUMUN 3 1 7 1 0 4 4 6 0 9 7 5 0 0 0 5 MUTIA 08-May-1975 KALIJIGER 3 1 0 0 3 0 0 1 0 0 1 0
16-August-2022
330 ANWAR 3 6 0 3 2 5 4 1 0 1 7 4 0 0 0 0 AISYAH 24-April-1980 JLN KAVLING 085217736517 3 1 0 0 3 0 0 1 0 0 1 0
331 HADI 3 2 1 5 0 8 4 1 0 1 7 8 0 0 0 6 ELIS JL. MASJID ATTAUHID 0878714960 3 1 0 0 3 0 0 1 0 0 1 0
1985
16-August-2022
332 JAKA 3 6 7 4 0 1 4 6 1 2 0 0 0 0 0 6 SYIFA 29-July-1998 JL M. DARUSAALAM 082114940297 3 1 0 0 3 0 0 1 0 0 1 0
333 JONI 3 6 7 4 0 6 5 0 0 7 8 7 0 0 0 8 LIA KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
1990
334 MAULANA 3 6 7 4 0 6 5 0 0 5 8 9 0 0 0 5 SRI GG. H KUMING 3 1 0 0 3 0 0 1 0 0 1 0
335 PURYANTO 3 1 7 4 0 6 6 2 1 2 7 5 0 0 0 1 SUNDANI JL. M DARUSSALAM 3 1 0 0 3 0 0 1 0 0 1 0
1991
18-August-2022
336 Ainal 3 6 7 4 0 6 4 9 0 5 9 4 0 0 1 2 MEYDIANA 30-May-1994 Jombang 3 1 0 0 3 0 0 1 0 0 1 0
337 Ali 3 6 7 4 0 6 4 2 0 1 8 7 0 0 0 1 Dian PAMULANG 3 1 0 0 3 0 0 1 0 0 1 0
338 Deni 3 6 7 4 0 6 6 4 0 2 8 0 0 0 0 3 RATNA Kp. Bulak 08962201591 3 1 0 0 3 0 0 1 0 0 1 0
339 Liswanto 3 6 0 3 1 6 4 6 0 9 9 5 0 0 0 1 CICI Kedaung 3 1 0 0 3 0 0 1 0 0 1 0
340 M. Irsan 3 6 7 4 0 5 7 0 0 1 0 0 0 0 0 7 MELINA Kp. Utan 08828891602 3 1 0 0 3 0 0 1 0 0 1 0
341 Nur rifai 3 6 7 4 0 6 4 1 1 2 8 4 0 0 1 3 DEDE Kavling 087889875768 3 1 0 0 3 0 0 1 0 0 1 0
1984
342 Zuli 3 6 7 4 0 6 5 3 0 4 7 5 0 0 0 8 Deswawita Kedaung 083812571819 3 1 0 0 3 0 0 1 0 0 1 0
1991
343 ALVIAN 3 6 7 4 0 6 4 5 0 9 7 9 0 0 1 3 MALA EYANG AGUNG 085925283715 3 1 0 0 3 0 0 1 0 0 1 0
344 ADI 3 6 0 3 2 5 4 9 0 7 8 3 0 0 0 3 SOFI PAMULANG BARAT 08589159748 3 1 0 0 3 0 0 1 0 0 1 0
1993
21-August-2022
345 PURWANTO 3 6 0 3 2 5 5 2 0 3 5 3 0 0 0 2 RUNAH 11-March-1953 JL. MASJID DARUSSALAM 3 1 0 0 3 0 0 1 0 0 1 0
346 SYARIF 3 6 7 4 0 6 6 6 0 0 5 8 7 0 0 1 HANDAYANI JL SURYA MAKUR 08569591206 3 1 0 0 3 0 0 1 0 0 1 0
1999
347 ANDREYANSYAH 3 6 7 4 0 6 4 3 1 2 7 2 0 0 2 3 SAGITA JOMBANG 089636639199 3 1 0 0 3 0 0 1 0 0 1 0
348 DIMAS 3 0 0 2 2 6 4 1 0 1 8 4 0 0 0 1 NATALI GG PINANG 3 1 0 0 3 0 0 1 0 0 1 0
2001
349 INDRA 3 6 7 4 0 6 6 0 1 0 9 1 0 0 0 4 WITA SERUA INDAH 08777479968 3 1 0 0 3 0 0 1 0 0 1 0
350 MAJA 3 6 7 4 0 6 4 8 0 6 8 8 0 0 1 0 SURYANAH ASRAMA BRIMOB 082325002992 3 1 0 0 3 0 0 1 0 0 1 0
22-August-2022
351 RADEN 3 6 7 4 0 6 5 9 0 3 7 8 0 0 0 3 SRI 04-June-1979 JL PARKOS 3 1 0 0 3 0 0 1 0 0 1 0
352 SIRAJUDIN 3 6 7 4 0 6 4 4 0 4 8 7 0 0 0 4 FATONAH GUNUNG SINDUR 082340772451 3 1 0 0 3 0 0 1 0 0 1 0
1993
353 BAHARUDIN 3 6 7 4 0 4 4 0 2 9 2 0 0 0 0 5 FIELGA KEDAUNG 085717580669 3 1 0 0 3 0 0 1 0 0 1 0
23-August-2022
354 HARYANTO 3 6 7 4 0 6 5 4 0 5 8 7 0 0 0 7 SITI HAYATI 14-May-1987 JL. SURYA MULYA 3 1 0 0 3 0 0 1 0 0 1 0
355 RENALDI 3 6 7 4 0 4 5 0 6 0 9 9 1 0 0 4 TIA JL CEMARA 2 RT2/01 PAM BAR 083893773432 3 1 0 0 3 0 0 1 0 0 1 0
1991
23-August-2022
356 TOMI 3 3 2 9 0 7 5 2 0 3 7 3 0 0 0 1 RINA 02-March-1973 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
26-August-2022
357 ADE AHMAD 3 6 7 4 0 6 7 1 0 3 9 8 0 0 1 0 DIAN 31-March-1998 PAMULANG BARAT 0895619912453 3 1 0 0 3 0 0 1 0 0 1 0
26-August-2022
358 DADY 3 6 7 4 0 6 4 3 0 4 8 3 0 0 0 4 LINA 15-May-1976 KEDAUNG 085782599247 3 1 0 0 3 0 0 1 0 0 1 0
26-August-2022
359 INDRA 3 6 7 4 0 6 6 7 1 1 9 0 0 0 0 5 DIAN 26-July-1992 JL SETIA KAWAN 083890096516 3 1 0 0 3 0 0 1 0 0 1 0
27-August-2022
360 JASIMUR 3 6 7 4 0 6 6 3 0 6 8 0 0 0 0 2 MARSINI 23-June-1976 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
361 WEMPI 3 6 7 4 0 6 4 7 1 2 8 8 0 0 1 3 DESI KP BULAK JAYA 085947232471 3 1 0 0 3 0 0 1 0 0 1 0
1994
28-August-2022
362 AHMAD 3 6 7 4 0 6 4 9 0 5 9 1 0 0 0 7 ELIS 09-June-1992 KEDAUANG 08582023967 3 1 0 0 3 0 0 1 0 0 1 0
363 INDRA 3 6 7 4 0 3 5 7 0 8 9 2 0 0 0 6 MURIA KEDAUNG 083895290499 3 1 0 0 3 0 0 1 0 0 1 0
364 RUDI 3 6 7 4 0 6 4 2 0 6 7 5 0 0 0 7 LILIS KAVLING II 087884027931 3 1 0 0 3 0 0 1 0 0 1 0
1975
28-August-2022
365 SUGITO 3 6 7 4 0 6 6 3 0 1 8 2 0 0 1 0 YUMI 23-March-1981 RT 04 RW 01 3 1 0 0 3 0 0 1 0 0 1 0
28-August-2022
366 TIO 3 6 7 4 0 6 5 6 0 6 9 5 0 0 1 3 ANISA 16-June-1995 JL KAVLING II 087786760548 3 1 0 0 3 0 0 1 0 0 1 0
367 WASTUN 3 6 7 4 0 4 4 6 0 3 8 2 0 0 0 3 MARSIH KAVLING 081574229020 3 1 0 0 3 0 0 1 0 0 1 0
368 JUMARSONO 3 6 7 4 0 6 4 6 0 8 7 9 0 0 1 5 KARTINI SERUA PONCOL 08571819893 3 1 0 0 3 0 0 1 0 0 1 0
1985
09-December-
369 03-June-2022 ABDUL 3 6 7 4 0 4 4 9 1 0 9 4 0 0 0 2 UKTI JL.S. INDAH 089562774889 3 0 0 0 0 0 1 0 0 1 0
1994
24-September-
370 01-June-2022 GUNAWAN 3 1 7 3 0 7 5 5 0 6 8 8 0 0 0 6 TARI JL ARYA PUTRA 2 0 0 0 0 0 1 0 0 1 0
1983
371 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NENENG 01-July-1985 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
13-August-2000
372 15-June-2022 AHMAD SYAFEIH 3 6 7 4 0 4 5 3 0 8 0 0 0 0 0 3 NIRANDA AURELLIA SAWAH BARU 1 1 0 0 8 0 0 1 1 0 0 1
373 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 AJENG 01-July-1994 BENDA BARU 1 1 0 0 9 1 0 0 1 0 0 0
02-August-2022
374 M. SOLEHUDIN 3 1 7 4 0 5 4 5 0 6 7 9 0 0 2 2 DECCA 29-May-1988 JL. SURYA MAKMUR 082122322902 3 1 0 0 9 0 0 1 0 0 1 0
1) Keterangan Kode
STATUS PESERTA KB KODE JENIS ALOKON (Diisi Pada Jenis Tindakan dan Kasus)
1 : Peserta KB Baru 3 : Peserta KB Ulangan 1 : Suntikan 1 Bulanan 3 : Suntikan 3 Bulanan 5 : Pil Progestin 7 : Implan 1 Batang 9 : IUD 11 : Tubektomi
2 : Peserta KB Ganti 4 : Komplikasi 2 : Suntikan 3 Bulanan 4 : Pil Kombinasi 6 : Kondom 8 : Implan 2 Batang 10 : Vasektomi
2) SELAIN STATUS PESERTA KB, JENIS TINDAKAN DAN KASUS DIISI TANDA CENTANG (V)
1. Petugas Entri Lamp.R/I/KB/20
Data LAMPIRAN R/I/KB/20 Lembar 12
1 2 3 4 5 6
3 6 7 4 0 2 2 0 7 Bulan : 2022
NAMA FASKES/ BPM BIDAN NURLIS 7 V 9 10 11 12
:
Kota
RINGKASAN HASIL PELAYANAN KB
PESERTA KB BARU (PB) PESERTA KB ULANGAN PELAYANAN KASUS
PEMBERIAN
PEMBERIAN INFORMED PB DAN KESERTAAN JKN INFORMED CONSENT
METODE
NO. CONSENT (Untuk Peserta KB
KONTRASEPSI
(Untuk PB) PB PASCA PB PASCA Ulangan) PELAYANAN ULANG KOMPLIKASI BERAT
GANTI CARA PENCABUTAN KEGAGALAN
PERSALINAN KEGUGURAN
PB JKN PB NON JKN TOTAL PB
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
2 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
3 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
4 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
5 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
6 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
7 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
8 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
9 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
10 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
11 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
12 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
13 SUNTIKAN 0 0 0 0 0 0 1 1 0 0 0 0
14 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
15 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
16 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
17 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
18 PIL 0 0 0 0 0 0 0 1 0 0 0 0
19 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
20 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
21 SUNTIKAN 0 0 0 0 0 0 1 1 0 0 0 0
22 IUD 0 0 0 0 0 0 1 0 1 0 0 0
JUMLAH 55 35 0 35 0 0 314 31 287 0 0 0
,
Pimpinan Faskes KB/Jaringan/Jejaring*
( .................................................................................................)
NIP/NRP
* Coret yang tidak perlu
1. Petugas Entri
Data
REGISTER PELAYANAN KB R/I/KB/20
Lembar 13
1 2 3 4 5 V
3 6 7 4 0 2 2 0 9 Bulan : 2022
NAMA FASKES/ BPM BIDAN WATIMENAH 7 8 9 10 11 12
:
Kota
PESERTA KB JENIS TINDAKAN Kasus PENGGUNAAN SUMBER ALOKON

(Kode) (Kode) ASURANSI
PELAYANAN BERGERAK
STATUS PESERTA KB
INFORMED CONSENT
PASCA KEGUGURAN
PASCA PERSALINAN
ISTRI
BPJS KESEHATAN
NO. TANGGAL ALAMAT NO. HANDPHONE
PEMASANGAN
PENCABUTAN
PENCABUTAN
KEGAGALAN
PEMBERIAN/
KOMPLIKASI
NAMA SUAMI
OPERATIF/
LAINNYA
TANGGAL
MANDIRI
NIK (NOMOR INDUK KEPENDUDUKAN) NAMA
BERAT
LAHIR
(Kode)
TIDAK
APBN
APBD
DAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
09-November-
375 01-June-2022 ABDUL MUJIB 3 6 7 4 0 6 4 9 1 1 8 6 0 0 0 3 WENI GUSMITA JLN.ARIA PUTRA RT 010/019 1 1 0 0 1 0 0 1 0 0 1 1
1986
03-August-1973
376 01-June-2022 M. RUJI 3 6 7 4 0 6 4 3 0 8 7 3 0 0 1 0 MURNIATI JL. ARIA PUTRA GG H BETONG 1 1 0 0 1 0 0 1 0 0 1 1
02-November-
377 01-June-2022 SAMSODIN 3 2 0 1 1 1 4 2 1 1 8 9 0 0 0 5 NOVITASARI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 1
1989
JL. ARIA PUTRA, GG. SWADAYA, RT
378 15-June-2022 ABDUL HADI 3 1 7 3 0 7 6 6 0 6 9 2 0 0 0 9 SITI FATIMAH 26-June-1992 1 1 0 0 1 0 0 1 0 0 1 1
012/010. KEDAUNG - PAMULANG -
20-December-
379 15-June-2022 ABDUL HAFIZ 3 6 7 4 0 6 6 0 1 2 9 2 0 0 1 7 DEBBY RAHAYU PURI PAMULANG BLOK H3/28 3 1 0 0 1 0 0 1 0 0 1 1
1992
380 15-June-2022 ACHMADI 3 2 0 8 2 1 4 2 0 3 9 3 0 0 0 3 SRI AYU FITRIANI 02-March-1995 JL KAV KEUANGAN 2 3 1 0 0 1 0 0 1 0 0 1 1
AGUNG ANRIA 23-October-1988

381 15-June-2022 3 6 7 4 0 6 6 3 1 0 8 8 0 0 0 2 MIRNAWATI JL. ARIA PUTRA RT 006 RW 015 3 1 0 0 1 0 0 1 0 0 1 1
PUTRA
382 15-June-2022 AGUNG NUR IMAN 3 3 0 1 0 5 4 8 0 3 9 3 0 0 0 5 NIKE NURJANAH 08-March-1993 KEDAUNG 1 1 0 0 1 0 0 1 0 0 1 1
JL. MASJID DARUSSALAM RT 003

383 15-June-2022 AHMAD SUBHI 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 AISYAH 09-March-1985 1 1 0 0 1 0 0 1 0 0 1 1
RW 015 KEDAUNG
384 15-June-2022 ANDI 3 6 7 4 0 6 4 4 0 7 8 4 0 0 0 1 YULIANTI RISMA DEWI 04-July-1984 H TAIP 3 1 0 0 1 0 0 1 0 0 1 1
385 15-June-2022 ANDIE 3 6 7 4 0 6 5 0 0 3 8 0 0 0 0 5 SISIE 10-March-1980 JL TABANAS RAYA I 3 1 0 0 1 0 0 1 0 0 1 1
05-August-1987
386 15-June-2022 ANDRI 3 6 7 4 0 6 4 5 0 8 8 7 0 0 0 9 MUNAWAROH JLN. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 1
18-November- JL TANAH KUSIR KEBAYORAN LAMA

387 15-June-2022 AZHARI 3 1 7 4 0 5 5 8 1 1 7 9 0 0 0 3 IIS KURNIAWATI 3 1 0 0 1 0 0 1 0 0 1 1
1979 JAKARTA SELATAN
15-February- JL.OTISTA RAYA GG. H. MAUNG RT.
388 15-June-2022 BAYU SYAHPUTRA 3 6 7 4 0 6 5 5 0 2 9 3 0 0 0 4 SOPIAH 1 1 0 0 1 0 0 1 0 0 1 1
1993 009/018
JLN, KH DEWANTARA RT 002 RW 04
389 15-June-2022 CAHYAWAN 3 6 7 4 0 4 6 0 0 6 8 9 0 0 0 6 GITA PAVITA RENATA 20-June-1989 3 1 0 0 1 0 0 1 0 0 1 1
CIPUTAT
JLN.H.USMAN RT 001/008 CIPUTAT
390 15-June-2022 DASIMAN 3 6 7 4 0 4 4 7 0 3 7 9 0 0 1 2 SITI FATIMAH 07-March-1979 3 1 0 0 1 0 0 1 0 0 1 1
15411
JL TABANAS IV NO 8 KEDAUNG
391 15-June-2022 DEDE SURYANTO 1 8 0 1 1 3 5 5 0 4 9 0 0 0 1 0 AMINAH FITRIANI 15-April-1990 1 1 0 0 1 0 0 1 0 0 1 1
PAMULANG
10-January-1975
392 15-June-2022 DEDY MULYADI 3 6 7 4 0 6 5 0 0 1 7 6 0 0 0 9 SMI NENISIH JL.OTISTA 1 1 0 0 1 0 0 1 0 0 1 1
30-October-1993 JL KEMANDORAN KEDAUNG

393 15-June-2022 DENI FIRMANSYAH 3 6 7 4 0 6 7 0 1 0 9 3 0 0 0 8 ASTRIDA 1 1 0 0 1 0 0 1 0 0 1 1
PAMULANG TANGSEL
28-August-1956
394 15-June-2022 DUDUNG 3 6 7 4 0 6 6 9 0 8 5 6 0 0 0 2 ATIKAH KEDAUNG RT 003/005 1 1 0 0 1 0 0 1 0 0 1 1
05-August-1977 JL. ARIA PUTRA, GG. WAHID, RT

395 15-June-2022 ERMAN 3 6 7 4 0 4 4 5 0 8 7 7 0 0 1 1 WILNA 1 1 0 0 1 0 0 1 0 0 1 1
012/010, KEDAUNG - PAMULANG -
12-February-
396 15-June-2022 FAUZI 3 1 7 4 0 5 5 2 0 2 7 8 0 0 1 3 ADALATUR RAHMANIAH KAMP RAWA 1 1 0 0 1 0 0 1 0 0 1 1
1978
22-December- PONDOK BENDA INDAH BLOK S1
397 15-June-2022 HAGI TRI UTAMA 3 6 7 4 0 6 6 2 1 2 9 7 0 0 1 0 TIARA LESTARI 1 1 0 0 1 0 0 1 0 0 1 1
1997 NO.8
HENDRA PRASETIYO.
398 15-June-2022 3 6 7 4 0 4 6 5 0 4 9 3 0 0 0 2 APTIS ANENDRASARI 25-April-1993 JL SUKA MANDIR 1 1 0 0 1 0 0 1 0 0 1 1
S
399 15-June-2022 Heri 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Mutia 01-June-1996 Kedaung 0 1 1 0 0 1 0 0 1 0 0 1 1
400 15-June-2022 HERMAN 3 6 7 4 0 5 5 8 0 5 8 7 0 0 0 2 MASNAWATI 18-May-1987 JL MUJAIR 6 3 1 0 0 1 0 0 1 0 0 1 1
12-December-
401 15-June-2022 HERMAWAN 3 6 7 4 0 6 5 2 1 2 9 0 0 0 0 6 RINA JLN.ARIA PUTRA RT 010/019 1 1 0 0 1 0 0 1 0 0 1 1
1990
19-January-1993
402 15-June-2022 IRWANSYAH 3 6 7 4 0 6 5 9 0 1 9 3 0 0 1 0 MUR INDAH SARI JL KAV KEUANGAN 3 1 0 0 1 0 0 1 0 0 1 1
403 15-June-2022 IRWANSYAH 3 6 7 4 0 6 6 0 0 7 8 0 0 0 1 1 DEDE SUSILAWATI 20-July-1980 JL.KAV KEUANGAN GG SANIP 3 1 0 0 1 0 0 1 0 0 1 1
404 15-June-2022 JAJANG SUHERMAN 3 6 7 4 0 6 5 0 0 4 7 3 0 0 0 9 SITI SAMSIAH 10-April-1973 BAMBU APUS 3 1 0 0 1 0 0 1 0 0 1 1
KRISTANA 07-December-
405 15-June-2022 3 6 7 4 0 4 4 7 1 2 7 8 0 0 0 1 THERESIA PARWATI VILLA JOMBANG BARU RT002/014 3 1 0 0 1 0 0 1 0 0 1 1
KURNIANTA 1978
03-February- TAMAN KEDAUNG
406 15-June-2022 MASRIL 3 6 0 5 2 5 4 7 0 2 5 7 0 0 0 2 EVANITA TAHER 1 1 0 0 1 0 0 1 0 0 1 1
1957 JL.MELATI 8 A9 NO.11
JL ARIA PUTRA GG BAKTI RT 006
407 15-June-2022 MEGI PRATAMA 3 6 7 4 0 6 6 2 0 4 9 1 0 0 0 7 IKA PUSPITASARI 22-April-1991 1 1 0 0 1 0 0 1 0 0 1 1
RW 015
KP. KEDAUNG RT003/003 SERUA
408 15-June-2022 MOHAMAD PURJAYA 3 6 7 4 0 4 5 7 0 7 8 3 1 0 0 1 DIAN YULIANA 17-July-1983 1 1 0 0 1 0 0 1 0 0 1 1
INDAH
03-August-1973
409 15-June-2022 M. RUJI 3 6 7 4 0 6 4 3 0 8 7 3 0 0 1 0 MURNIATI JL. ARIA PUTRA GG H BETONG 1 1 0 0 1 0 0 1 0 0 1 1
03-August-1991
410 15-June-2022 MUSTAQIM 3 6 7 4 0 6 4 3 0 8 9 1 0 0 0 8 YUNI WINDASARI JALAN ARIA PUTRA GG H BETONG 3 1 0 0 1 0 0 1 0 0 1 1
30-January-1973
411 15-June-2022 OPIE MARLINA 3 6 7 4 0 6 7 0 0 1 7 3 0 0 0 6 YULIA TAMAN KEDAUNG BLOK A6 NO06 3 1 0 0 1 0 0 1 0 0 1 1
412 15-June-2022 Reno 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Desi 01-June-1998 Kedaung 0 3 1 0 0 1 0 0 1 0 0 1 1
30-September-
413 15-June-2022 RIKI KARDO 1 6 1 0 0 8 7 0 0 9 9 0 0 0 0 5 INDAH PUTRI UTAMI KEDAUNG 1 1 0 0 1 0 0 1 0 0 1 1
1990
19-November- JL MASJID DARUSSALAM RT 05 RW
414 15-June-2022 ROBBY SANJAYA 3 6 7 4 0 6 5 9 1 1 8 8 0 0 0 3 WINARSIH 1 1 0 0 1 0 0 1 0 0 1 1
1988 014 KEDAUNG PAMULANG TANG
02-November-
415 15-June-2022 SAMSODIN 3 2 0 1 1 1 4 2 1 1 8 9 0 0 0 5 NOVITASARI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 1
1989
08-December- JL MASJID DARUSALAM RT 003/014
416 15-June-2022 SLAMET HARYANTO 3 6 7 4 0 6 4 8 1 2 8 2 0 0 1 7 FITRIA NINGSIH 1 1 0 0 1 0 0 1 0 0 1 1
1982 KEDAUNG PAMULANG TANGSEL
05-February-
417 15-June-2022 SUDAMA AR 3 6 7 4 0 6 1 4 0 1 8 6 0 0 0 1 FANDI ADISTIRA GG.NANGKA KEDAUNG PAMULANG 3 1 0 0 1 0 0 1 0 0 1 1
1990
418 15-June-2022 SUMARDI 3 6 7 4 0 6 5 2 0 6 7 5 0 0 2 3 TITIN YENI 12-June-1975 KP. BULAK TIMUR 3 1 0 0 1 0 0 1 0 0 1 1
10-October-1978
419 15-June-2022 SUPRIYADI 3 6 7 4 0 6 5 0 0 7 7 8 0 0 0 2 YULIYANTI JL KAV KEUANGAN 2 RT 009/001 1 1 0 0 1 0 0 1 0 0 1 1
16-February-
420 15-June-2022 TARMUJI 3 6 7 4 0 6 5 6 0 2 7 5 0 0 0 9 TASANI KP BULAK BARAT 0 3 1 0 0 1 0 0 1 0 0 1 1
1975
421 15-June-2022 TARTO 3 6 7 4 0 6 6 1 0 5 7 5 0 0 0 8 YENI HERAWATI 21-May-1975 JL ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 1
TENGKU 04-November- JL.MASJID DARUSSALAM RT.03 RW

422 15-June-2022 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 YULIANI 3 1 0 0 1 0 0 1 0 0 1 1
MUHAMMAD IRFAN 1986 015 KEDAUNG
JL MASJID DARUSSALAM RT
423 15-June-2022 YUDI WAHYUDI 3 1 7 2 0 2 4 5 0 6 8 4 0 0 1 1 SATRIANA RAHMAWATI 05-June-1984 3 1 0 0 1 0 0 1 0 0 1 1
003/014 KEDAUNG PAMULANG
JL. KAV KEUANGAN II GG. ABDUL
424 15-June-2022 ZAINAL ARIFIN 3 6 7 4 0 6 4 5 0 6 7 4 0 0 0 5 EKAWATI 05-June-1974 3 1 0 0 1 0 0 1 0 0 1 1
AZIZ
01-August-2022
425 ABDUL 3 6 7 4 0 6 4 6 0 2 7 3 0 0 0 9 SUNARTI 02-June-1973 GG RAMBUTAN 3 1 0 0 1 0 0 1 0 0 1 0
426 AHMAD 3 6 7 4 0 6 4 7 0 3 5 8 0 0 0 5 KOSNIAH GG SWADAYA 3 1 0 0 1 0 0 1 0 0 1 0
1959
427 ARIF 3 6 7 4 0 6 5 2 1 1 8 7 0 0 0 8 NOVIYANTI SUSUK TINGGI 3 1 0 0 1 0 0 1 0 0 1 0
1987
428 AWIN 3 6 7 4 0 6 6 4 0 2 9 0 0 0 0 7 ITA GG. H TARIP 3 1 0 0 1 0 0 1 0 0 1 0
1986
429 DONI 3 6 7 4 0 6 4 3 0 9 9 3 0 0 0 6 SETIYANI JL GURAME 3 1 0 0 1 0 0 1 0 0 1 0
1993
01-August-2022
430 HERYANDI 3 1 7 4 0 6 7 0 0 4 8 5 0 0 0 8 EKA 30-April-1985 PAMULANG 3 1 0 0 1 0 0 1 0 0 1 0
431 M. ALWIH 3 6 7 4 0 6 6 3 1 2 8 4 0 0 0 4 SAVIAH GG PINANG 3 1 0 0 1 0 0 1 0 0 1 0
1984
01-August-2022
432 RONI 3 3 2 4 1 6 4 7 0 7 9 0 0 0 0 1 DIAN 07-July-1990 SERUA IDAH 3 1 0 0 1 0 0 1 0 0 1 0
433 SUYANTO 1 6 7 1 0 2 1 0 1 0 9 2 0 0 3 0 OKTAVIA SERUA INDAH 3 1 0 0 1 0 0 1 0 0 1 0
02-August-2022
434 BUDI 3 4 0 3 0 5 4 9 0 3 8 3 0 0 0 5 RINI 17-March-1983 BAMBU APUS 3 1 0 0 1 0 0 1 0 0 1 0
02-August-2022
435 CAIRUN 3 6 7 4 0 6 4 3 0 5 6 7 0 0 0 2 SANIH 03-May-1976 GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
436 MEGI 3 6 7 4 0 6 5 4 0 1 7 9 0 0 0 4 IKA GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
02-August-2022
437 SENTRI 3 6 0 3 2 5 4 7 0 4 7 4 0 0 0 2 RANI 07-April-1974 GG NANGKA 3 1 0 0 1 0 0 1 0 0 1 0
02-August-2022
438 SUGIANTO 3 6 7 4 0 6 5 4 0 3 7 7 0 0 0 3 UMMU 14-March-1977 KP CILALULUNG 3 1 0 0 1 0 0 1 0 0 1 0
03-August-2022
439 DANIL 3 6 0 3 2 3 5 7 0 3 9 4 0 0 0 1 FITRIANA 17-March-1994 JL. MASJID DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
440 ELMI 3 6 7 4 0 6 4 7 1 1 8 1 0 0 0 8 ASMIATI JL ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1981
441 ENDANG 3 6 7 4 0 6 6 5 0 8 8 2 0 0 0 4 YETI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
442 IRWAN 3 6 7 4 0 6 4 6 1 1 9 2 0 0 1 9 NOVI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
1992
03-August-2022
443 UNTUNG 3 6 7 4 0 6 5 6 0 3 7 8 0 0 1 1 MULYATI 22-March-1978 JL ARYA PUTRA 1 1 0 0 1 0 0 1 0 0 1 0
444 DENI 3 6 7 4 0 6 5 8 0 9 9 5 0 0 0 3 ASTRI SASAK TINGGI 3 1 0 0 1 0 0 1 0 0 1 0
1995
04-August-2022 25-November- JL. ARIA PUTRA NO 47 GG.
445 DUDDY SUDARMADJI 3 6 7 4 0 6 6 5 1 1 7 4 0 0 0 9 UMI HARNI 3 1 0 0 1 0 0 1 0 0 1 0
1974 MUSHOLAH RT 006 RW 015
04-August-2022
446 HERMAWAN 3 3 2 9 0 7 5 2 0 3 7 3 0 0 0 1 RINA 02-March-1973 JL. ARYA PUTRA 1 1 0 0 1 0 0 1 0 0 1 0
04-August-2022
447 NANDA 3 6 7 4 0 6 5 7 0 4 9 1 0 0 0 9 FITRI 17-April-1991 GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
04-August-2022
448 NANDAR 3 6 7 4 0 6 5 3 0 4 7 5 0 0 0 8 WITA 13-April-1975 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
449 PUTUT 3 6 7 4 0 6 7 0 0 8 8 3 0 0 0 3 TUTI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
450 SARWANTO 3 0 0 2 2 6 6 4 1 2 8 0 0 0 0 1 MURNI GG MAUNG 3 1 0 0 1 0 0 1 0 0 1 0
1980
451 IMRON 3 6 7 4 0 6 5 1 1 1 8 6 0 0 0 8 SITI JL. H TARIP 3 1 0 0 1 0 0 1 0 0 1 0
1986
452 REZA 3 6 7 4 0 9 4 1 1 0 9 0 0 0 2 0 DEWI JLN PILAR 3 1 0 0 1 0 0 1 0 0 1 0
05-August-2022
453 RUDI 3 2 7 9 0 2 6 7 0 4 9 7 0 0 0 1 AAS 27-April-1997 TAMAN KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
06-August-2022 22-December- PONDOK BENDA INDAH BLOK S1

454 HAGI TRI UTAMA 3 6 7 4 0 6 6 2 1 2 9 7 0 0 1 0 TIARA LESTARI 3 1 0 0 1 0 0 1 0 0 1 0
1997 NO.8
06-August-2022
455 HENDRA 3 5 2 2 1 1 6 9 0 5 8 5 0 0 0 1 TAMI 29-May-1985 SERUA INDAH 3 1 0 0 1 0 0 1 0 0 1 0
456 PURWONO 3 6 7 4 0 6 5 7 0 9 8 4 0 0 0 1 ROHMAWATI JL. M DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
1984
457 RASMIN 3 6 7 4 0 6 4 9 0 1 7 7 0 0 0 4 ROHAYATI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
458 DAYAT 3 6 7 4 0 6 5 0 1 0 8 3 0 0 1 0 IMAS JL. H TARIP 3 1 0 0 1 0 0 1 0 0 1 0
07-August-2022
459 MUHDI 3 6 7 4 0 6 4 5 0 5 8 5 0 0 1 6 RINA 05-May-1985 JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
460 MUZAR 3 2 0 8 1 1 4 7 1 0 7 9 0 0 0 1 RINA JL. ARYA PUTRA 1 1 0 0 1 0 0 1 0 0 1 0
07-August-2022
461 SUKIMAN 3 6 7 4 0 6 5 1 0 4 9 1 0 0 0 5 WIDIA 11-April-1991 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
462 FUAD 3 6 7 4 0 6 6 5 1 1 8 5 0 0 0 4 ERIN JL ARYA PUTRA 1 1 0 0 1 0 0 1 0 0 1 0
1985
08-August-2022
463 GUNTUR 3 6 7 4 0 6 5 0 0 5 8 0 0 0 1 8 KARNI 10-May-1980 JL. H TARIP 3 1 0 0 1 0 0 1 0 0 1 0
464 NURYADI 3 6 7 4 0 6 6 8 0 8 8 5 0 0 0 7 NURHALIMAH CIPAYUNG 3 1 0 0 1 0 0 1 0 0 1 0
465 SAKIMAN 3 6 7 4 0 6 4 1 0 1 8 5 0 0 1 8 METI TAMAN KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
08-August-2022
466 YOGI 3 6 7 4 0 6 4 4 0 8 9 2 0 0 0 6 PUTRI 08-April-1992 SERUA INDAH 3 1 0 0 1 0 0 1 0 0 1 0
467 FIRUNAH 3 6 7 4 0 6 5 0 1 0 7 3 0 0 0 1 SALMA PASAR KAMBING 3 1 0 0 1 0 0 1 0 0 1 0
09-August-2022
468 HANDAYANA 3 6 7 4 0 6 4 2 0 7 7 8 0 0 0 1 MIRA 02-July-1978 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
09-August-2022
469 HENDRI 3 6 7 4 0 6 6 6 0 6 9 6 0 0 1 2 DESNIARTI 26-June-1996 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
09-August-2022
470 IWAN 3 6 0 3 2 3 5 7 0 7 7 5 0 0 0 3 IIS 17-July-1975 KP. SAWAH 3 1 0 0 1 0 0 1 0 0 1 0
471 ROHMAN 3 6 7 4 0 6 5 7 1 0 7 3 0 0 0 7 DIAH KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
472 ZULKILFI 3 3 2 9 1 7 4 1 0 6 8 1 0 0 1 4 MASNAH BAMBU APUS 3 1 0 0 1 0 0 1 0 0 1 0
1981
473 M. HASAN 3 6 7 4 0 6 5 2 0 5 9 1 0 0 0 5 PUTRI BAMBU APUS 3 1 0 0 1 0 0 1 0 0 1 1
1991
474 TASORI 3 2 0 7 0 2 5 1 1 2 8 8 0 0 0 2 NURHALIMAH GG NANGKA 1 1 0 0 1 0 0 1 0 0 1 0
1988
475 TRISNA 3 6 7 4 0 6 6 8 1 0 7 6 0 0 1 1 HAVI TAMAN KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
476 BENDI 3 6 7 4 0 6 6 9 0 9 8 3 1 0 0 2 NURFAIDAH JL. H TARIP 1 1 0 0 1 0 0 1 0 0 1 0
1983
477 MOH. SURAH 3 5 7 8 0 8 6 0 1 0 8 1 0 0 0 1 NURFAIZA KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
11-August-2022
478 MUSAWIR 3 6 7 4 0 6 4 4 0 5 8 1 0 0 0 6 ROHINI 04-May-1981 JL. KEMANDORAN 3 1 0 0 1 0 0 1 0 0 1 0
11-August-2022
479 SUAIDI 3 6 7 4 0 6 6 8 0 4 7 6 0 0 0 2 NURHASANAH 28-April-1976 GG. H DAHLAN 3 1 0 0 1 0 0 1 0 0 1 0
12-August-2022
480 IDRIS 3 2 7 4 0 4 4 6 0 4 9 8 0 0 0 3 SINDI 06-April-1998 GANG MASJID DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 1
12-August-2022
481 SLAMET 3 6 7 4 0 6 4 4 0 4 8 6 0 0 0 7 INDAH 04-April-1986 JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
482 DEDI 3 1 7 4 0 7 5 4 1 1 8 9 0 0 0 8 NOVI CIPUTAT 3 1 0 0 1 0 0 1 0 0 1 0
1989
483 JEPRI 3 6 7 4 0 6 6 3 0 1 8 9 0 0 0 1 MONA KEDAUNG 1 1 0 0 1 0 0 1 0 0 1 0
13-August-2022 NURDIANSYAH, SE, 10-February-

484 3 6 7 4 0 6 4 2 1 0 8 6 0 0 0 5 RANIYATI GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
SE 1986
13-August-2022
485 RAHMAT 3 2 0 2 0 8 5 0 0 3 8 1 0 0 0 7 LENI 10-March-1981 PAMULANG 3 1 0 0 1 0 0 1 0 0 1 0
486 SAHIDAN 3 6 7 4 0 4 5 6 0 8 7 9 0 0 0 5 YENI GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
487 SAMSUL 3 6 7 4 0 6 4 6 0 8 7 7 0 0 0 8 NARIYAH GG BETONG 3 1 0 0 1 0 0 1 0 0 1 0
488 SUPARNO 3 6 7 4 0 6 6 2 0 1 7 7 0 0 0 5 IIN KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
489 SURYANA 3 6 7 4 0 4 6 9 0 9 9 0 0 0 0 6 SITI DAHLIA GG. H DAHLAN 3 1 0 0 1 0 0 1 0 0 1 0
1990
13-August-2022
490 SUTARNO 3 6 7 4 0 6 5 3 0 3 8 8 0 0 0 4 FAUZIAH 13-March-1988 GG NANGKA 3 1 0 0 1 0 0 1 0 0 1 0
13-August-2022
491 UNDA 3 2 0 3 1 5 5 5 0 5 8 4 0 0 0 2 RATIH 15-May-1984 JLN ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
492 DIANTO 3 6 7 4 0 4 5 1 1 1 9 1 0 0 0 1 NOVITASARI JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1991
14-August-2022
493 JONI 3 6 7 4 0 6 5 5 0 5 8 8 0 0 0 1 DIAN 15-May-1988 GG RAMBUTAN 1 1 0 0 1 0 0 1 0 0 1 0
494 SUSILO 3 6 7 4 0 4 4 1 0 7 9 4 0 0 0 1 YUYUN GG BETONG 3 1 0 0 1 0 0 1 0 0 1 0
495 HERI 3 6 7 4 0 6 6 6 1 0 8 0 0 0 1 6 NURAINI 009/009 3 1 0 0 1 0 0 1 0 0 1 0
15-August-2022
496 MUNAJI 3 6 7 4 0 6 4 8 0 7 7 5 0 0 1 4 PUJI 08-July-1975 JL MELATI 3 1 0 0 1 0 0 1 0 0 1 1
497 AHMAD 3 1 7 1 0 1 4 7 0 2 4 4 0 0 0 1 VERLI KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
1974
16-August-2022
498 RENO 3 2 0 2 0 4 4 9 0 6 0 0 0 0 0 5 DESI PRATIWI 09-June-2000 GG H MAUNG 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
499 AHMAD 3 6 7 4 0 6 6 1 0 4 7 7 0 0 0 6 NURKOMARAH 21-April-1977 CIPUTAT 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
500 ARIF 3 6 7 4 0 6 4 7 0 7 7 7 0 0 1 3 YUNI 07-July-1977 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
17-August-2022
501 FAHRURIZAL 3 6 7 4 0 6 6 2 0 3 9 1 0 0 0 1 DEWI 22-March-1991 GG SWADAYA 3 1 0 0 1 0 0 1 0 0 1 0
502 HARIVI 3 6 7 4 0 6 6 1 1 0 9 0 0 0 0 1 DEWI CIMANGGIS 3 1 0 0 1 0 0 1 0 0 1 0
503 SUMARDI 3 6 7 4 0 6 4 3 0 2 8 4 0 0 1 0 SITI MUHLISOH GG NANGKA 3 1 0 0 1 0 0 1 0 0 1 0
1984
504 NURIYANTO 3 6 7 4 0 6 4 8 0 1 8 2 0 0 1 4 MUJIANTI JLN. ARYA PUTRA 2 1 0 0 1 0 0 1 0 0 1 0
18-August-2022
505 RAUSTAKIM 3 6 7 4 0 6 6 6 0 6 7 7 0 0 0 6 YUNI 26-June-1977 GG BETONG 3 1 0 0 1 0 0 1 0 0 1 0
18-August-2022
506 WARTO 3 6 7 4 4 6 4 3 0 7 8 0 0 0 0 9 FATIMAH 03-July-1980 JL MELIA RECIDENCE 3 1 0 0 1 0 0 1 0 0 1 0
507 Ali 3 6 7 4 0 6 4 8 1 2 8 7 0 0 1 3 ULFA GG nangka 3 1 0 0 1 0 0 1 0 0 1 0
1987
508 Dodi 3 6 7 4 0 6 5 9 0 8 8 1 0 0 0 5 IKE HANDAYANI Kedaung 3 1 0 0 0 0 1 0 0 1 0
509 Masad 3 6 7 4 0 4 5 7 0 2 9 5 0 0 0 7 NURUL JL Arya Putra 3 1 0 0 1 0 0 1 0 0 1 0
1995
19-August-2022
510 Opik 3 3 7 6 0 4 4 1 0 5 8 7 0 0 0 6 Puji 01-June-1987 GANG HAJI MUNTIRI 3 1 0 0 1 0 0 1 0 0 1 0
511 Rufi 3 6 7 4 0 6 6 4 1 0 8 4 0 0 0 7 RANITA Kedaung 3 1 0 0 1 0 0 1 0 0 1 0
512 Sahir 3 6 7 4 0 6 6 8 1 0 8 8 0 0 1 0 ASIYAH JL kemamdoran 3 1 0 0 1 0 0 1 0 0 1 0
513 Sudirman 3 5 2 9 1 6 5 2 0 8 9 3 0 0 0 4 SITI NAILIYAH Cimanggis 3 1 0 0 1 0 0 1 0 0 1 0
20-August-2022
514 ADIT 3 6 7 4 0 6 5 9 0 5 7 5 0 0 0 2 FIRA 19-May-1975 GG . GURAME III 1 1 0 0 1 0 0 1 0 0 1 0
515 MARYANTO 3 6 7 4 0 6 6 8 0 8 9 2 0 0 1 8 MEGA TABANAS 3 1 0 0 1 0 0 1 0 0 1 0
20-August-2022
516 NURHAYADI 3 5 0 1 0 7 5 3 0 6 8 9 0 0 0 1 MASITOH 13-June-1989 JLN MASJID AL AMIN 3 1 0 0 1 0 0 1 0 0 1 0
517 NURYAN 3 3 0 8 2 0 5 2 1 1 7 5 0 0 0 2 MESIATI GG NANGKA 3 1 0 0 1 0 0 1 0 0 1 0
1975
518 RIDHO 3 6 7 4 0 4 4 8 1 0 8 3 0 0 0 8 INDAH CIPUTAT 3 1 0 0 1 0 0 1 0 0 1 0
519 SAJONO 3 3 2 7 0 7 4 1 1 2 7 6 0 0 0 1 IRMA PAMULANG 3 1 0 0 1 0 0 1 0 0 1 0
1976
20-August-2022
520 SUDIMA 3 6 7 4 0 6 5 0 0 6 7 4 0 0 1 1 YUNI 10-June-1974 GG PINANG 3 1 0 0 1 0 0 1 0 0 1 0
521 SULISTONO 3 6 7 4 0 6 4 7 0 9 8 2 0 0 0 4 ANA GG PINANG 3 1 0 0 1 0 0 1 0 0 1 0
1982
22-August-2022
522 AIDRUS 3 1 7 4 0 7 5 7 0 7 8 4 0 0 0 6 NURMALA 17-July-1984 DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
523 AMDIA 3 1 7 4 0 5 6 3 1 2 9 4 0 0 0 2 DESI GG. MASJID DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
1984
524 DEDE 3 6 7 4 0 6 7 0 0 8 7 4 0 0 0 4 NYAI GG BETONG 3 1 0 0 1 0 0 1 0 0 1 0
525 DEDI 3 6 7 4 0 4 0 0 1 0 8 3 0 0 0 1 IMAS GG NANGKA 3 1 0 0 1 0 0 1 0 0 1 0
526 DENI 3 6 7 4 0 6 5 4 0 1 8 8 0 0 0 3 MAYA SOFA SERUA 3 1 0 0 1 0 0 1 0 0 1 0
22-August-2022
527 IHTIAN 3 6 7 4 0 6 6 7 0 8 6 8 0 0 0 1 RAHMA 27-June-1988 GG. H BETONG 3 1 0 0 1 0 0 1 0 0 1 0
528 IZAL 3 6 7 4 0 6 6 8 0 9 8 8 0 0 0 1 DIAN PAMULANG 3 1 0 0 1 0 0 1 0 0 1 0
1988
22-August-2022
529 JUJUR 3 6 7 4 0 6 4 1 0 1 7 4 0 0 1 8 AAN 10-June-1982 GG. H BETONG 3 1 0 0 1 0 0 1 0 0 1 0
22-August-2022
530 LUKMAN 3 6 7 1 1 3 6 1 0 7 8 1 0 0 0 4 DIAN 21-July-1981 CIPUTAT 3 1 0 0 1 0 0 1 0 0 1 0
531 RIKI 3 1 7 3 0 8 5 2 1 2 8 3 0 0 0 7 AYU KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
1983
22-August-2022
532 RIZI 3 6 7 4 0 6 4 6 0 8 8 0 0 0 0 8 KUSNAWATI 09-June-1980 JL. KAYU PUTIH 3 1 0 0 1 0 0 1 0 0 1 0
23-August-2022
533 AHMAD 3 2 7 6 0 4 5 0 0 4 8 6 0 0 0 5 KOSNIAH 10-April-1986 GG SWADAYA 1 1 0 0 1 0 0 1 0 0 1 0
534 BAMS 3 6 7 4 0 6 4 9 0 8 8 0 0 0 0 1 ATIKA SUCIATI KP BULAK 3 1 0 0 1 0 0 1 0 0 1 0
535 BOWO 3 6 7 4 0 7 5 0 0 9 8 0 0 0 0 2 SOLIHAH JL. KEMANDORAN 3 1 0 0 1 0 0 1 0 0 1 0
1980
536 SANDI 3 6 7 4 0 6 4 9 0 2 9 5 0 0 1 0 SARAH GG TK BUNGA 3 1 0 0 1 0 0 1 0 0 1 0
1995
25-August-2022
537 UNTUNG 3 3 2 4 0 1 5 0 0 3 8 2 0 0 0 2 MULYATI 10-March-1982 JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
538 YANTO 3 1 7 4 0 5 6 1 1 0 9 4 1 0 0 2 OKTAVIA SERUA INDAH 1 1 0 0 1 0 0 1 0 0 1 0
539 ABDUL 3 6 7 4 0 1 4 7 0 1 8 6 0 0 3 4 ATIKAH GG SWADAYA 1 1 0 0 1 0 0 1 0 0 1 0
540 AWIH 3 6 7 4 0 6 6 1 0 2 7 7 0 0 1 0 ITA GG. H TARIP 1 1 0 0 1 0 0 1 0 0 1 0
1977
541 MAHDI 3 6 7 4 0 5 4 1 1 1 8 2 0 0 0 2 SHALI GG. M DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
1982
27-August-2022
542 ABDUL GHANI 3 6 7 4 0 6 5 3 0 6 7 8 0 0 0 1 SUNARTI 13-June-1978 GG RAMBUTAN 1 1 0 0 1 0 0 1 0 0 1 0
27-August-2022
543 JEDI 3 6 7 4 0 6 6 0 0 4 8 8 0 0 0 7 DEVI 20-April-1988 GG PINANG 3 1 0 0 1 0 0 1 0 0 1 0
544 SHERMAN 3 6 7 4 0 6 4 2 1 1 8 4 0 0 0 8 RINA JL ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
1984
28-August-2022
545 BULE 3 1 7 3 0 7 6 2 0 6 8 5 0 0 0 9 RINI 20-June-1985 GURAME 3 1 0 0 1 0 0 1 0 0 1 0
546 HERI 3 6 7 4 0 6 6 7 0 8 9 0 0 0 0 1 IRAWATI GG. H MAUNG 3 1 0 0 1 0 0 1 0 0 1 0
547 ISKANDAR 3 6 7 4 0 6 4 4 1 1 7 2 0 0 0 1 NURLAILA SASAK TINGGI 3 1 0 0 1 0 0 1 0 0 1 0
1972
548 MOHWAGENI 3 3 2 9 0 4 6 5 1 1 9 2 0 0 0 5 CATUR BAMBU APUS 3 1 0 0 1 0 0 1 0 0 1 0
1992
28-August-2022
549 NANDA 3 6 7 4 0 6 0 7 0 4 9 1 0 0 0 1 FITRI 17-April-1991 GG BAKTI 3 1 0 0 1 0 0 1 0 0 1 0
550 DANI 3 2 0 6 0 8 5 9 1 0 9 0 0 0 0 2 PIPIT PITNAWATI JL. M DARUSSALAM 3 1 0 0 1 0 0 1 0 0 1 0
551 ENDNAG 3 6 7 4 0 4 0 5 0 8 8 2 0 0 0 3 YETI 009/003 3 1 0 0 1 0 0 1 0 0 1 0
552 RIAN 3 6 7 4 0 6 6 3 0 8 7 7 0 0 0 2 SRI JL. ARYA PUTRA 3 1 0 0 1 0 0 1 0 0 1 0
553 ENDANG 3 6 7 4 0 6 7 0 0 8 9 5 0 0 0 2 DEWI JL KEMANDORAN 3 1 0 0 1 0 0 1 0 0 1 0
554 FAUZI 3 6 7 4 0 6 6 6 0 1 8 3 0 0 0 2 DEDEH SWADAYA 1 1 0 0 1 0 0 1 0 0 1 0
555 RUSMANA 3 6 7 4 0 6 4 6 1 0 7 6 0 0 1 6 NONIH KEDAUNG 1 1 0 0 1 0 0 1 0 0 1 0
556 ARIF 1 8 0 9 0 6 4 3 0 9 9 0 0 0 0 6 NOVITA SARI SASAK TINGGI 1 1 0 0 1 0 0 1 0 0 1 0
1990
31-August-2022
557 WADI 3 6 7 4 0 6 4 5 0 6 7 5 0 0 0 4 RINI 05-June-1975 JL. KEMANDORAN 1 1 0 0 1 0 0 1 0 0 1 0
31-August-2022
558 YUSUF 3 5 2 0 4 0 6 9 0 5 8 5 0 0 0 1 SITI 29-May-1985 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0
21-September-
559 01-June-2022 CEPI BURHANUDIN 3 6 7 4 0 6 6 1 0 9 7 7 0 0 0 7 PITRIAH ARIA PUTRA 3 1 0 0 2 0 0 1 1 0 0 1
1977
DIDI MUHAMAD 17-October-1994 JL.ARIA PUTRA GG.H.BETONG
560 01-June-2022 3 3 1 0 1 7 5 7 1 0 9 4 0 0 0 4 HARIYATI 3 1 0 0 2 0 0 1 1 0 0 1
SELAMET KEDAUNG PAMULANG
08-February-
561 01-June-2022 EDI 3 6 7 4 0 6 4 8 0 2 7 8 0 0 0 9 IDA FARIDA JL.MASJID DARUSSALAM 3 1 0 0 2 0 0 1 1 0 0 1
1978
08-February- JL.MASJID DARUSSALAM
562 01-June-2022 FAIZUN 3 6 7 4 0 6 4 8 0 2 8 8 0 0 0 7 LISNAWATI 3 1 0 0 2 0 0 1 1 0 0 1
1988 RT004/RW015
30-January-1983
563 01-June-2022 HENDRA GUNAWAN 3 6 7 4 0 4 4 7 0 6 8 3 0 0 0 7 SITI ROHAYATI JL.SUKA MANDIRI 3 1 0 0 2 0 0 1 1 0 0 1
28-September- JL OTISTA GG SAKTI RT 09/09

564 01-June-2022 IBNU SUWARDI 3 1 7 4 0 4 6 8 0 9 8 8 0 0 0 4 DIAH NURYANI 1 1 0 0 2 0 0 1 1 0 0 1
1988 KEDAUNG
565 01-June-2022 IBRAHIM 3 6 7 4 0 6 4 1 0 4 7 7 0 0 0 2 JURIAH 01-April-1977 JL ARYA PUTRA KEDAUNG 3 1 0 0 2 0 0 1 1 0 0 1
UTOMO HARI JL KEMANDORAN 4 KEDAUNG

566 01-June-2022 3 6 7 4 0 6 6 3 0 6 8 6 0 0 1 1 MEGA SEPRIANTI 25-May-1986 1 1 0 0 2 0 0 1 1 0 0 1
SULISTYO PAMULANG TANG SEL
JL.MASJID DARUSALAM RT 010/011
567 01-June-2022 YEETENDRA 3 1 7 2 0 6 6 2 0 7 7 9 0 0 0 2 TATI SUGIHARTANTI 22-July-1979 3 1 0 0 2 0 0 1 1 0 0 1
KEDAUNG PAMULANG
568 15-June-2022 ABD.ROHMAN 3 6 7 4 0 6 7 0 0 7 8 0 0 0 0 7 NENENG AULIYA 30-July-1980 JLN ARIA PUTRA RT010 RW 019 3 1 0 0 2 0 0 1 1 0 0 1
19-October-1994
569 15-June-2022 ABDUL MAJID 3 2 0 6 0 7 5 6 0 2 9 3 0 0 0 4 FITRIA HENTI KEDAUNG PAMULANG 3 1 0 0 2 0 0 1 1 0 0 1
13-September-
570 15-June-2022 ACHMAD FIRDAUS 3 6 7 4 0 6 5 3 0 9 8 6 0 0 0 1 SINTA CHAFIFANI KP.BULAK BARAT NO.26 3 1 0 0 2 0 0 1 1 0 0 1
1986
571 15-June-2022 Aemin nurdin 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Lia 01-June-2003 Jl. Mujair 0 3 1 0 0 2 0 0 1 1 0 0 1
AGUNG 10-September-
572 15-June-2022 3 6 7 4 0 3 5 0 0 9 9 8 0 0 0 5 NURMALA JLN KAV KEUANGAN 3 1 0 0 2 0 0 1 1 0 0 1
FATURACHMAN 1998
29-November-
573 15-June-2022 AHMAD SYARIF 3 6 7 4 0 6 6 9 1 1 8 7 0 0 0 2 MEGA NOVIANTI JL GURAME 3 1 1 0 0 2 0 0 1 1 0 0 1
1987
15-December-
574 15-June-2022 AIRUDIN 3 6 7 4 0 4 5 5 1 2 7 5 0 0 1 0 RITA NOVITA 003/009 CIPAYUNG 1 1 0 0 2 0 0 1 1 0 0 1
1975
11-December-
575 15-June-2022 ARFIAN FAHRI 3 1 7 4 0 5 5 1 1 2 9 1 0 0 0 6 INDAH PRESTIKA KEDAUNG 1 1 0 0 2 0 0 1 1 0 0 1
1991
30-November-
576 15-June-2022 ARIF HIDAYATULLOH 3 6 7 4 0 6 7 0 1 1 8 5 0 0 0 5 NOVIYANTI JLN DEPARTEMEN AGAMA 3 1 0 0 2 0 0 1 1 0 0 1
1985
577 15-June-2022 ARJONI 3 6 7 4 0 6 4 4 0 6 7 8 0 0 0 8 YULIYANTI 04-June-1978 JLN. ARYA PUTRA 0 3 1 0 0 2 0 0 1 1 0 0 1
26-November- JL. MADJID DARUSSALAM RT 05 RW

578 15-June-2022 ASMAWI 3 6 7 4 0 6 6 6 1 1 7 2 0 0 0 2 HENNY ALFIANI 3 1 0 0 2 0 0 1 1 0 0 1
1972 014. KEDAUNG . PAMULANG
579 15-June-2022 AWAN 3 6 0 1 0 4 4 2 0 6 8 9 6 0 0 3 SURNAH 07-June-1995 KP BULAK 0 1 1 0 0 2 0 0 1 1 0 0 1
JL KAMPUNG BULAK TIMUR RT007

580 15-June-2022 BAYU SETYAWAN 3 2 1 5 2 6 4 1 0 5 8 2 0 0 0 5 NURSEHA 01-May-1982 1 1 0 0 2 0 0 1 1 0 0 1
RW004 KEDAUNG PAMULANG
04-August-1974
581 15-June-2022 BUDI SYAFRUDIN 3 1 7 4 0 6 4 4 0 8 7 4 0 0 1 6 RINI SETYOWATI CILANDAK , JAKARTA SELATAN 1 1 0 0 2 0 0 1 1 0 0 1
21-September-
582 15-June-2022 CEPI BURHANUDIN 3 6 7 4 0 6 6 1 0 9 7 7 0 0 0 7 PITRIAH ARIA PUTRA 3 1 0 0 2 0 0 1 1 0 0 1
1977
19-January-1987
583 15-June-2022 CITRA SANJAYA 3 6 7 4 0 6 5 9 0 1 8 7 0 0 1 5 IIS SUMIATI JL. KAV KEUANGAN GG H. KUMING 1 1 0 0 2 0 0 1 1 0 0 1
584 15-June-2022 DIDIK MAULANA 3 1 7 4 0 4 5 9 0 6 9 9 0 0 0 3 PUTRI ORIZA SAVITA 19-June-1999 KP BULAK TIMUR 1 1 0 0 2 0 0 1 0 0 1 1
585 15-June-2022 DION RASYID GHANI 3 6 7 4 0 6 6 0 0 6 8 6 0 0 1 3 YUNI RATNASARI 20-June-1986 SARANA INDAH PERMAI RT 1 3 1 0 0 2 0 0 1 1 0 0 1
25-November- JL. ARIA PUTRA NO 47 GG.

586 15-June-2022 DUDDY SUDARMADJI 3 6 7 4 0 6 6 5 1 1 7 4 0 0 0 9 UMI HARNI 1 1 0 0 2 0 0 1 1 0 0 1
1974 MUSHOLAH RT 006 RW 015
17-September-
587 15-June-2022 DWIYANTO 3 6 7 4 0 6 5 7 0 9 8 4 0 0 1 3 SUSANA KEDAUNG RT 004/020 3 1 0 0 2 0 0 1 1 0 0 1
1984
05-November- JL MASJID DARUSALM RT 003/014
588 15-June-2022 ENTIS SUTISNA 3 6 7 4 0 6 4 5 1 1 8 4 0 0 1 3 SITI MAISAROH 1 1 0 0 2 0 0 1 1 0 0 1
1984 KEDAUNG PAMULANG
04-October-1988
589 15-June-2022 ESTU DWI NOVIKA 3 6 7 4 0 4 4 4 1 0 8 8 0 0 0 5 DEWI OKTAVIA SERUA INDAH 1 1 0 0 2 0 0 1 1 0 0 1
08-January-1982
590 15-June-2022 FENDI 3 6 7 4 0 6 4 8 0 1 8 2 0 0 1 2 NELLY ELIDA KEDAUNG RT 001/016 0 3 1 0 0 2 0 0 1 1 0 0 1
FENDI SETYA
591 15-June-2022 3 2 7 5 0 4 7 0 0 4 9 1 0 0 2 2 MELIANI SANTI 30-April-1991 JLN.ARIA PUTRA RT 010/019 1 1 0 0 2 0 0 1 1 0 0 1
HANDIKA
JL. KESADARAN II GG. SABAR
592 15-June-2022 FERDIAN 3 2 7 6 0 3 7 1 0 5 9 2 0 0 1 0 DESI SUSANTI 31-May-1992 3 1 0 0 2 0 0 1 1 0 0 1
PONDOK PETIR
593 15-June-2022 Hadi 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Tatik 01-June-1982 Masjid darussalam 0 3 1 0 0 2 0 0 1 1 0 0 1
594 15-June-2022 HASANUDIN 3 6 7 4 0 6 5 5 0 5 8 5 0 0 1 3 ADE ROSITA 15-May-1985 JL H TAIP KEDAUNG 0 3 1 0 0 2 0 0 1 1 0 0 1
30-January-1983
595 15-June-2022 HENDRA GUNAWAN 3 6 7 4 0 4 4 7 0 6 8 3 0 0 0 7 SITI ROHAYATI JL.SUKA MANDIRI 3 1 0 0 2 0 0 1 1 0 0 1
03-September-
596 15-June-2022 HENDRA SETIAWAN 3 6 7 4 0 6 4 3 0 9 9 0 0 0 0 3 ROSSY RUSTIANI TAMAN KEDAUNG C2/11 3 1 0 0 2 0 0 1 1 0 0 1
1990
597 15-June-2022 HILMI KARIM S AG 3 6 7 4 0 6 4 5 0 5 7 3 0 0 3 1 NURJANAH 05-May-1973 KEDAUNG 1 1 0 0 2 0 0 1 1 0 0 1
12-November-
598 15-June-2022 IBNU NOVIANSYAH 3 6 7 4 0 6 5 1 1 2 9 3 0 0 0 6 EKA BUDI RAHAYU JLN IR H JUANDA 3 1 0 0 2 0 0 1 1 0 0 1
1993
28-September- JL OTISTA GG SAKTI RT 09/09
599 15-June-2022 IBNU SUWARDI 3 1 7 4 0 4 6 8 0 9 8 8 0 0 0 4 DIAH NURYANI 1 1 0 0 2 0 0 1 1 0 0 1
1988 KEDAUNG
600 15-June-2022 IBRAHIM 3 6 7 4 0 6 4 1 0 4 7 7 0 0 0 2 JURIAH 01-April-1977 JL ARYA PUTRA KEDAUNG 3 1 0 0 2 0 0 1 1 0 0 1
26-November-
601 15-June-2022 IRWAN DADANG K. 3 6 7 4 0 6 6 6 1 1 9 1 0 0 1 0 NOVI SELFIANI JL. ARIA PUTRA NO. 17 1 1 0 0 2 0 0 1 1 0 0 1
1991
602 15-June-2022 Jurdi 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Rina 01-June-1994 Jl. Betong 0 3 1 0 0 2 0 0 1 1 0 0 1
603 15-June-2022 KAHFI SETIAWAN 3 6 7 4 0 6 5 4 0 4 9 1 0 0 1 4 YULI YANTI 14-April-1991 JL.MUJAIR 3 1 0 0 2 0 0 1 1 0 0 1
20-August-1989
604 15-June-2022 KUSWANTORO 3 3 2 7 0 6 6 0 0 6 8 9 0 0 0 7 DANINGSIH JLN. ARYA PUTRA 3 1 0 0 2 0 0 1 1 0 0 1
NAZAR REZA 08-August-1985

605 15-June-2022 3 6 7 4 0 6 4 8 0 8 8 5 0 0 1 0 RINA AGUSTINI JLN.ARIA PUTRA RT 010/019 1 1 0 0 2 0 0 1 1 0 0 1
FAHLEVI
INTEN KUMALA
606 15-June-2022 NURDIN SETIAWAN 3 6 7 4 0 6 4 5 0 6 8 5 0 0 1 7 06-June-1985 JL H TAIP KEDAUNG PAMULANG 3 1 0 0 2 0 0 1 1 0 0 1
PUSPITASARI
31-December-
607 15-June-2022 NURUDIN 3 3 2 7 0 6 7 1 1 2 8 8 0 0 0 4 SUSIATI KEDAUNG 3 1 0 0 2 0 0 1 1 0 0 1
1988
608 15-June-2022 PANJI SUHENDAR 3 6 7 4 0 6 4 3 0 3 9 2 0 0 1 3 NUR KOMARIAH 13-March-1992 JLN . ARYA PUTRA 3 1 0 0 2 0 0 1 1 0 0 1
JL PERINTIS BAWAH RT008/012

609 15-June-2022 PARDIANTO 3 6 7 4 0 6 6 7 0 7 7 3 0 0 0 3 T.MINIATUN 27-July-1973 1 1 0 0 2 0 0 1 1 0 0 1
KEDAUNG
26-September-
610 15-June-2022 RAHMUDIN 3 6 7 4 0 6 6 0 0 9 7 2 0 0 0 5 DWI YANTI JL ARIA PUTRA GG H BETONG 1 1 0 0 2 0 0 1 1 0 0 1
1972
AGNES SILVIA 15-August-1988 JL KAV. KEUANGAN VII CLUSTER
611 15-June-2022 RAINHARD TARIGAN 1 2 7 1 2 1 5 5 0 8 8 8 0 0 0 2 3 1 0 0 2 0 0 1 1 0 0 1
PERANGINANGIN NO. 5
25-December-
612 15-June-2022 RAKI KIRANA 3 6 7 1 1 2 6 5 1 2 7 9 0 0 0 1 INDRAWASIH JL. ARIA PUTRA RT 006 RW 015 1 1 0 0 2 0 0 1 1 0 0 1
1979
30-October-1983
613 15-June-2022 RIZAL GUNTORO 3 2 0 1 0 1 7 0 1 0 8 3 0 0 1 2 NURLAILA JL ARIA PUTRA 3 1 0 0 2 0 0 1 1 0 0 1
26-September- JLN.KEMANDORAN 4 KEDAUNG

614 15-June-2022 ROBIYANA 3 6 7 4 0 6 6 6 0 9 9 3 0 0 0 2 TRI WAHYUNI 1 1 0 0 2 0 0 1 1 0 0 1
1993 TANGSEL
615 15-June-2022 ROKIB 3 6 7 4 0 6 6 4 0 4 7 8 0 0 1 0 RISKA 24-April-1978 JLN.ARIA PUTRA RT 010/019 1 1 0 0 2 0 0 1 1 0 0 1
13-August-1979
616 15-June-2022 RUKADI 3 6 7 4 0 6 5 3 0 8 7 9 0 0 0 7 ANIS SUSMIATI TAMAN KEDAUNG BLOK A6 NO 14 0 3 1 0 0 2 0 0 1 1 0 0 1
617 15-June-2022 Sakha 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Manwiyah 01-June-1979 Jl. Kemandoran 0 3 1 0 0 2 0 0 1 1 0 0 1
03-August-1974
618 15-June-2022 SALIMUN 3 6 7 4 0 6 4 3 0 8 7 4 0 0 0 9 KHAIDIARTI JL BULAK WANGI 2 1 1 0 0 2 0 0 1 1 0 0 1
619 15-June-2022 Sandi 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Sarah 01-June-1996 O 0 1 1 0 0 2 0 0 1 1 0 0 1
SARIMIN EKO 03-December- JL. ARIA PUTRA, GG. WAHID. RT

620 15-June-2022 3 6 7 4 0 6 4 3 1 2 9 1 0 0 0 1 DEVI TRI HANDAYANI 3 1 0 0 2 0 0 1 1 0 0 1
PRASETYO 1991 012/010, NO. 5. KEDAUNG -
621 15-June-2022 SUKINO 3 3 2 5 0 3 5 0 0 3 8 9 0 0 0 3 NURJANAH TUN 10-March-1989 JL.SUMBER HIDUP 3 1 0 0 2 0 0 1 1 0 0 1
05-September-
622 15-June-2022 SUPOMO 3 6 7 4 0 6 4 5 0 9 7 6 0 0 1 4 YOLLA KATARINA JL. GURAME III 1 1 0 0 2 0 0 1 1 0 0 1
1976
623 15-June-2022 supriadi 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Umi kulsum 01-June-1998 Gg. Nangka 0 1 1 0 0 2 0 0 1 0 0 1 1
28-September-
624 15-June-2022 SURATNO 3 6 7 4 0 4 6 8 0 9 8 7 0 0 0 1 RATIH PONYATI JL. KARYAWAN 3 1 0 0 2 0 0 1 1 0 0 1
1987
12-December- JL.MUSHOLLA ANNUR, KEDAUNG,
625 15-June-2022 SUWANDI 3 6 7 4 0 6 5 2 1 2 8 3 0 0 2 4 SUMIYATI 1 1 0 0 2 0 0 1 1 0 0 1
1983 PAMULANG
01-February- JLN.KEMANDORAN 4 KEDAUNG
626 15-June-2022 SUYANTO 3 6 7 4 0 6 4 1 0 2 8 3 0 0 0 8 II FADILAH 0 1 1 0 0 2 0 0 1 1 0 0 1
1983 TANGSEL
02-October-1975 JL MASJID DARUSSALAM RT
627 15-June-2022 SUYANTO 3 6 7 4 0 6 4 2 1 0 7 5 0 0 1 2 MULYANAH 1 1 0 0 2 0 0 1 1 0 0 1
003/014 KEDAUNG PAMULANG
09-November-
628 15-June-2022 SYAFRIZAL 3 6 7 4 0 6 4 9 1 1 8 1 0 0 0 7 NOVIANITA JL SWADAYA 3 1 0 0 2 0 0 1 1 0 0 1
1981
UTOMO HARI JL KEMANDORAN 4 KEDAUNG
629 15-June-2022 3 6 7 4 0 6 6 3 0 6 8 6 0 0 1 1 MEGA SEPRIANTI 25-May-1986 1 1 0 0 2 0 0 1 1 0 0 1
SULISTYO PAMULANG TANG SEL
630 15-June-2022 Wahid 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 Tati 01-June-1983 Jl. Arya putra 0 3 1 0 0 2 0 0 1 1 0 0 1
30-December-
631 15-June-2022 WAHYUDI 3 6 7 4 0 5 7 0 1 2 7 7 0 0 0 8 JANATUN JL. ARIA PUTRA RT 006 RW 015 1 1 0 0 2 0 0 1 1 0 0 1
1977
02-December-
632 15-June-2022 WAHYUDI 3 6 7 4 0 6 4 2 1 2 8 8 0 0 0 4 DESIALIANI JL KAV KEUANGAN 2 3 1 0 0 2 0 0 1 1 0 0 1
1988
31-December-
633 15-June-2022 WANTORO 3 2 7 6 0 3 7 1 1 2 8 7 0 0 0 6 TITIK SUNDARI KEDAUNG 1 1 0 0 2 0 0 1 1 0 0 1
1987
634 15-June-2022 YAKIN SYAH 3 6 7 4 0 6 4 2 0 3 7 9 0 0 1 1 SRI PURWATI 02-March-1975 JLN.ARIA PUTRA RT 010/019 1 1 0 0 2 0 0 1 1 0 0 1
JL.MASJID DARUSALAM RT 010/011

635 15-June-2022 YEETENDRA 3 1 7 2 0 6 6 2 0 7 7 9 0 0 0 2 TATI SUGIHARTANTI 22-July-1979 3 1 0 0 2 0 0 1 1 0 0 1
KEDAUNG PAMULANG
JL KEMANDORAN KEDAUNG
636 15-June-2022 ZAINUL MUTTAQIN 3 6 7 4 0 6 4 7 0 6 8 8 0 0 0 1 ATIKAH HANDAYANI 07-June-1988 1 1 0 0 2 0 0 1 1 0 0 1
PAMULANG TANGSEL
01-August-2022
637 ABDULLAH 3 6 7 4 0 6 4 9 0 9 9 0 0 0 0 2 ADE 04-May-1990 CINANGKA 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
638 ADE 3 6 7 4 0 6 6 6 0 5 8 9 0 0 0 4 DITA 26-May-1989 TAMAN KEDAUANG 3 1 0 0 2 0 0 1 0 0 1 0
639 AFRIZAL 3 1 7 4 0 5 7 1 0 8 8 7 0 0 0 9 WAHYUNI GG SWADAYA 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
640 CATUR 3 6 7 4 0 6 5 7 0 4 8 5 0 0 2 2 SRI YATUN 17-April-1985 GG BETONG 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
641 DASUKI 3 6 7 4 0 6 5 5 0 4 8 8 0 0 1 1 SITI HAYATI 15-April-1988 JL ARIA PUTRA KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
642 M. CHOUIRUN 3 6 7 4 0 6 5 0 0 8 7 4 0 0 0 4 FARIDA GG MAUNG 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
643 MIFTAH 3 3 1 2 2 4 4 6 0 4 9 8 0 0 0 1 SINDI 06-April-1998 JL DEWI SATRIKA 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
644 M. SOLEH 3 5 7 4 0 6 6 1 0 3 8 0 0 0 0 8 DWI 21-March-1980 SERUA INDAH 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022
645 NURILAHI 3 6 7 4 0 6 4 3 0 7 8 0 0 0 0 7 FATIMAH 03-July-1980 GG NANGKA 3 1 0 0 2 0 0 1 0 0 1 0
01-August-2022 17-August-1975 JL MASJID DARUSSALAM RT

646 RASIKUN 3 6 7 4 0 6 5 7 0 8 7 5 0 0 0 8 DASINAH 3 1 0 0 2 0 0 1 0 0 1 0
004/014 KEDAUNG
647 ROMDANI 3 6 7 4 0 6 5 9 0 2 7 8 0 0 0 1 YULIANA GG. BETONG 3 1 0 0 2 0 0 1 0 0 1 0
1978
01-August-2022
648 TRISNA 3 1 7 4 0 1 5 4 0 7 9 5 1 0 0 4 DETI 14-July-1995 GG WAHID 3 1 0 0 2 0 0 1 0 0 1 0
649 WANTORO 3 6 0 3 2 2 5 0 1 2 7 9 0 0 0 1 TITIK KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1979
01-August-2022
650 YUDI SAMANTA 1 6 0 5 1 1 4 3 0 6 9 5 0 0 0 2 JUMINAH 03-June-1995 JL KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
651 ARWAN 3 3 0 5 1 8 4 1 0 2 9 5 0 0 0 3 RANTI BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
1995
02-August-2022
652 DEDE 3 6 7 4 0 6 5 0 0 3 8 3 0 0 0 3 MARLINA 10-March-1983 GG. BETONG 3 1 0 0 2 0 0 1 0 0 1 0
653 LUTFI 3 2 0 7 0 2 5 1 1 2 8 8 0 0 0 2 NURHALIMAHU S JL ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
1988
654 MUL 3 6 0 4 1 0 6 5 0 8 8 5 0 1 4 7 NIA PAMULANG 3 1 0 0 2 0 0 1 0 0 1 0
655 NARTAM 3 6 7 4 0 6 5 9 0 9 8 6 0 0 0 2 FARIJAH KEDAUNG 2 1 0 0 2 0 0 1 0 0 1 0
1986
656 NOVI ISKANDAR 3 1 7 3 0 1 6 2 0 8 8 1 0 0 0 4 NURLAILA SASAK TINGGI 3 1 0 0 2 0 0 1 0 0 1 0
02-August-2022
657 SABAR 3 1 7 4 0 0 4 4 0 6 7 5 0 0 0 3 ERNAWATI 04-June-1975 BOJONG SARI 3 1 0 0 2 0 0 1 0 0 1 0
658 SUJAMONO 3 6 7 4 0 6 6 3 0 1 7 4 0 0 0 7 DWI GG BETONG 3 1 0 0 2 0 0 1 0 0 1 0
659 AHMAD 3 3 2 6 1 0 6 2 0 9 8 2 0 0 0 1 SUGINI JL SWADAYA 1 1 0 0 2 0 0 1 0 0 1 0
1982
660 CASNO 3 3 2 6 0 7 6 4 1 1 8 6 0 0 0 2 SRIKOWATI KEDAUNG 2 1 0 0 2 0 0 1 0 0 1 0
1986
661 M. SUGHRI 3 6 7 4 0 6 5 1 0 9 8 7 0 0 0 6 NURHAYATI JL. MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0
1987
662 PURWONO 3 5 2 6 1 5 5 5 1 2 7 2 0 0 0 3 JUMATI GG. H TARIP 3 1 0 0 2 0 0 1 0 0 1 0
1972
663 SUYONO 3 6 7 4 0 6 7 0 1 0 7 4 0 0 0 4 MAINAH GG WAHID 3 1 0 0 2 0 0 1 0 0 1 0
03-August-2022
664 TAUFIK 3 6 7 4 0 6 4 3 0 5 8 7 0 0 1 6 ASTRI 03-May-1987 GG. NANGKA 3 1 0 0 2 0 0 1 0 0 1 0
665 WARDOYO 3 1 7 4 0 5 6 3 1 1 7 7 0 0 0 1 WULANDARI BENDA BARU 3 1 0 0 2 0 0 1 0 0 1 0
1977
666 PURWANTO 3 6 7 4 0 6 4 1 0 1 7 8 0 0 0 2 ANISUNDAVI BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
667 SARDI 3 6 0 3 2 5 6 8 0 6 7 9 0 0 0 3 DEVI JL. BAMBU APUS 1 1 0 0 2 0 0 1 0 0 1 0
04-August-2022
668 TIYAN 3 6 7 4 0 6 5 5 0 6 8 4 0 0 1 0 UMI 15-June-1984 CIPUTAT 3 1 0 0 2 0 0 1 0 0 1 0
669 ZULHAN 3 6 0 3 2 5 5 4 1 2 7 2 0 0 0 2 ELI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1972
670 EDI 3 6 7 4 0 6 6 7 0 1 9 4 0 0 0 7 WINDA PAMULANG 3 1 0 0 2 0 0 1 0 0 1 0
05-August-2022 JL. ARIA PUTRA, GG. WAHID, RT

671 SARTIM 3 3 0 3 0 9 6 1 0 5 9 0 0 0 0 1 KHOTIAH 21-May-1990 3 1 0 0 2 0 0 1 0 0 1 0
012/010. KEDAUNG - PAMULANG -
06-August-2022 30-December- JL ARIA PUTRA KEDAUNG RT 005
672 DADANG PERMANA 3 3 0 4 1 1 7 0 1 2 8 8 0 0 0 2 YUSMIATUN KHASANAH 2 1 0 0 2 0 0 1 0 0 1 0
1988 RW 015
673 DARSIN 3 1 7 1 0 6 6 0 1 1 8 4 0 0 0 5 SUKMANA GG. H DAHIAN 3 1 0 0 2 0 0 1 0 0 1 0
1984
06-August-2022
674 EKO 3 6 7 4 0 6 4 5 0 5 8 3 0 0 0 8 SARI 05-May-1983 CIPAYUNG 3 1 0 0 2 0 0 1 0 0 1 0
07-August-2022
675 RULI 3 6 7 4 0 6 6 6 0 3 9 8 0 0 1 0 NIDIA 25-March-1996 GG BETONG 3 1 0 0 2 0 0 1 0 0 1 0
676 DARTI 3 6 7 4 0 6 5 1 0 2 7 4 0 0 0 9 SOLIHAH KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1974
677 JAINAL ABIDIN 3 6 7 4 0 4 5 1 1 1 8 8 0 0 0 4 NUR KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1988
09-August-2022
678 MUKDI 3 6 7 4 0 6 6 4 0 5 7 8 0 0 0 7 RINI 24-May-1978 JL. ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
679 MUKTI 3 6 7 4 0 6 6 4 0 2 9 0 0 0 0 7 ITA EYANG AGUNG 3 1 0 0 2 0 0 1 0 0 1 0
1986
09-August-2022
680 PARJO 3 6 7 4 0 6 4 1 0 6 7 9 0 0 0 7 KARMILAH 01-June-1979 JL. H TARIP 3 1 0 0 2 0 0 1 0 0 1 0
681 RAMA 3 6 7 4 0 6 6 2 1 0 7 3 0 0 0 1 SUKI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
682 RISKY 3 6 7 4 0 5 7 1 0 1 8 7 0 0 0 1 INTAN GG. BABA AMIR 3 1 0 0 2 0 0 1 0 0 1 0
683 AHMAD 3 6 0 2 1 0 4 4 0 1 8 3 0 0 0 1 JULEHA JL SWADAYA 3 1 0 0 2 0 0 1 0 0 1 0
684 ALEX 3 6 7 4 0 4 0 4 0 2 9 0 0 0 1 1 NITA BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
1986
685 ASNARI 3 6 7 4 0 6 4 6 0 1 9 3 0 0 0 7 SUMIATI GG. WAHID 3 1 0 0 2 0 0 1 0 0 1 0
11-August-2022
686 DEDE 3 6 7 4 0 6 4 8 0 5 7 4 0 0 1 2 NURIDAH 08-May-1974 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
11-August-2022
687 DEDEN 3 6 7 4 0 6 5 2 0 6 8 4 0 0 0 5 UNI 12-June-1984 BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
688 KARTONO 3 3 2 2 0 3 5 7 0 8 7 9 0 0 0 4 ROHATUN BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
11-August-2022
689 MUHAMAD 3 6 7 4 0 6 5 0 0 5 8 9 0 0 0 5 SRI UTAMI 10-May-1989 GG BETONG 3 1 0 0 2 0 0 1 0 0 1 0
690 TARMIN 3 6 7 4 0 6 5 0 0 9 7 3 0 0 0 3 SARTINI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1973
11-August-2022
691 TRIONO 3 6 7 4 0 6 4 7 0 4 8 1 0 0 0 1 HASANAH 07-April-1981 GG PILAR 3 1 0 0 2 0 0 1 0 0 1 0
11-August-2022
692 WANTO 3 6 7 4 0 6 6 6 0 5 7 7 0 0 0 3 LIAH 26-May-1977 GG. H TARIP 3 1 0 0 2 0 0 1 0 0 1 0
12-August-2022
693 JUNAIDI 3 6 7 4 0 6 4 6 0 3 7 9 0 0 0 5 MULYATI 06-March-1979 GG SWADAYA 3 1 0 0 2 0 0 1 0 0 1 0
12-August-2022
694 MASTUR 3 6 7 4 0 6 4 6 0 7 7 7 0 0 1 1 TITI 06-July-1977 MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0
12-August-2022
695 RUSDIMAN 3 2 1 6 0 9 5 8 0 5 9 6 0 0 0 5 ROSA 18-May-1996 BLOK PILAR 3 1 0 0 2 0 0 1 0 0 1 0
696 SUPRIATNA 3 6 7 4 0 6 6 1 1 1 6 0 0 0 0 2 RUMSIAH GG PILAR 3 1 0 0 2 0 0 1 0 0 1 0
1960
697 AJIS 3 6 7 4 0 6 5 8 0 8 7 9 0 0 1 2 NONI JL. KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
698 ALIMAN 3 6 7 4 0 6 4 3 0 2 8 0 0 0 0 4 WARTINI JLN.ARIA PUTRA RT 010/019 3 1 0 0 2 0 0 1 0 0 1 0
1982
699 SUPADI 3 6 7 4 0 4 6 4 7 0 8 7 8 0 0 0 WULAN KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
700 ACENG 3 6 7 4 0 6 4 2 0 1 7 8 0 0 0 3 HALIMAH KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
701 ADE SUHENDI 3 2 7 6 0 6 5 7 1 0 8 5 0 0 0 2 USNAYA JLN.ARIA PUTRA RT 010/019 2 1 0 0 2 0 0 1 0 0 1 0
702 ADNAN 3 2 7 5 1 0 7 1 1 0 9 0 0 0 1 2 FARA JL KEMANDORAN 1 1 0 0 2 0 0 1 0 0 1 0
703 M. QULZAH 3 6 1 4 0 4 6 0 1 0 1 0 0 0 0 5 POPON CIPUTAT 3 1 0 0 2 0 0 1 0 0 1 0
14-August-2022
704 URI 3 1 7 4 0 4 5 4 0 6 7 3 0 0 1 2 ASIH 14-June-1973 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
15-August-2022
705 ABDUL 3 6 7 4 0 6 6 7 0 7 8 0 0 0 0 4 ENIH 27-July-1980 JL SWADAYA 3 1 0 0 2 0 0 1 0 0 1 0
706 BUDI 3 4 0 3 0 2 6 0 1 2 8 8 0 0 0 3 SUMARTINI JL KEMANDORAN 1 1 0 0 2 0 0 1 0 0 1 0
1988
15-August-2022
707 NGADIMIN 3 6 7 4 0 6 4 5 0 5 7 7 0 0 2 6 SURANTI 05-May-1977 JL H TARIP 3 1 0 0 2 0 0 1 0 0 1 0
15-August-2022
708 SOLEHIN 3 6 7 4 0 6 6 4 0 4 8 1 0 0 0 2 ROSA 24-April-1981 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
709 WASITO 3 6 7 4 0 6 6 9 1 0 8 5 0 0 0 6 SRI BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
15-August-2022
710 YOYO 3 6 7 4 0 6 5 6 0 5 7 6 0 0 0 4 ATIK 16-May-1976 SWADAYA 3 1 0 0 2 0 0 1 0 0 1 0
17-August-2022 03-February- JL. OTISTA RAYA GG. H. MAUNG RT.

711 ADE PRASETIA 3 1 7 4 0 6 4 3 0 2 9 7 0 0 0 1 ADE FITRI 1 1 0 0 2 0 0 1 0 0 1 0
1997 009/018
712 CATUR WASENO 3 6 7 4 0 6 5 9 1 2 8 9 0 0 0 7 LILIS GG WAHID 3 1 0 0 2 0 0 1 0 0 1 0
1989
713 HERU 3 6 7 4 0 6 5 0 1 0 8 2 0 0 0 3 ERMA GG NANGKA 3 1 0 0 2 0 0 1 0 0 1 0
17-August-2022
714 ROBIN 3 2 0 1 1 0 5 9 0 7 9 2 0 0 0 5 FITRI 19-July-1992 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
18-August-2022
715 AMSORI 3 6 7 4 0 6 5 5 0 7 7 6 0 0 1 2 SARNI 15-July-1976 JL ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
18-August-2022
716 EMAN 3 6 7 4 0 6 6 3 0 4 8 4 0 0 1 4 LETA BADARIYAH 23-April-1984 KP. BULAK TIMUR 2 1 0 0 2 0 0 1 0 0 1 0
18-August-2022
717 ERI 3 6 7 4 0 6 4 8 0 5 8 9 0 0 0 3 ATIKA 08-May-1989 JL DEWI SARTIKA 3 1 0 0 2 0 0 1 0 0 1 0
718 SUAIDI 3 1 7 4 0 9 5 0 0 2 8 5 0 0 0 3 RANTI 10/19 3 1 0 0 2 0 0 1 0 0 1 0
1985
719 SUBUR 3 6 7 4 0 6 4 5 0 8 8 5 0 0 1 2 NENENG SERUA INDAH 3 1 0 0 2 0 0 1 0 0 1 0
720 Asep 3 6 7 4 0 6 5 4 0 2 8 1 0 0 0 2 ROHMAWATI GG Betong 3 0 0 0 2 0 0 1 0 0 1 0
1981
721 ANDIKA 3 6 7 4 0 6 6 1 1 2 8 4 0 0 1 1 ANGGUN CIPUTAT 3 1 0 0 2 0 0 1 0 0 1 0
1984
722 MUJIB 3 6 7 4 0 6 5 6 0 2 9 5 0 0 0 2 MUTIA GG. H MAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1995
20-August-2022
723 MUKLIS 3 6 7 4 0 4 5 7 0 6 8 4 0 0 0 2 ANI 17-June-1984 GG.H MAAN 3 1 0 0 2 0 0 1 0 0 1 0
20-August-2022
724 TOHIR 3 6 7 4 0 6 6 1 0 5 6 9 0 0 1 3 ALLATUN 21-May-1969 GG. H BETONG 3 1 0 0 2 0 0 1 0 0 1 0
21-August-2022
725 TENGKUH 3 6 7 4 0 6 4 4 0 4 8 4 0 0 0 7 SEFIA DWI 04-April-1984 GG WAHID 3 1 0 0 2 0 0 1 0 0 1 0
726 WARID 3 6 7 4 0 6 4 1 0 1 7 4 0 0 0 2 TASIH JL. ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
727 HERMAN 3 6 7 4 0 6 6 3 0 8 7 9 0 0 0 3 MONIKA JL. H TARIP 3 1 0 0 2 0 0 1 0 0 1 0
728 ROBI 3 6 7 4 0 6 4 3 0 8 8 1 0 0 0 6 YUNI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
729 TAPSIRUDIN 3 6 7 4 0 6 5 6 0 9 8 8 0 0 1 0 NINDI KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
1988
730 YUDI 3 6 7 4 0 6 4 7 0 2 7 9 0 0 0 3 LILIS NUSA INDAH 3 1 0 0 2 0 0 1 0 0 1 0
1979
731 NASIR 3 2 7 6 0 3 4 9 0 2 8 8 0 0 0 3 DEDE JL ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
1988
24-August-2022
732 aemin 3 6 7 4 0 6 5 3 0 7 8 2 0 0 1 0 lia 13-July-1982 JL. MUJAER 3 1 0 0 2 0 0 1 0 0 1 0
24-August-2022
733 INDRA 3 6 7 4 0 1 5 7 0 1 8 5 0 0 0 3 QOROTAINI 17-June-1985 TABANAS 3 1 0 0 2 0 0 1 0 0 1 0
734 IRWAN 3 5 2 2 0 1 6 6 0 2 9 5 0 0 0 1 TARI JL. KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
1995
24-August-2022
735 ROBI 3 6 7 4 0 6 5 0 0 5 7 9 0 0 0 4 MILA 10-May-1979 PONDOK RANJI 3 1 0 0 2 0 0 1 0 0 1 0
24-August-2022
736 SUMARIN 3 6 7 4 0 6 6 0 0 5 8 0 0 0 1 0 ARNIH 10-May-1980 BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
25-August-2022
737 ROJALI 3 2 7 6 0 3 5 0 0 5 9 1 0 0 0 9 HUSNAH 10-May-1981 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
738 UTOMO 3 6 7 4 0 6 5 5 0 9 8 9 0 0 1 2 MEGAWATI JL. KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
1989
739 YULI 3 6 0 3 1 7 4 9 0 1 8 4 0 0 0 1 TRI WULANDARI GG PILAR 3 1 0 0 2 0 0 1 0 0 1 0
26-August-2022
740 ROBY 3 6 7 4 0 6 7 1 0 7 9 0 0 0 0 6 YULI 31-July-1990 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
28-August-2022
741 HANDOKO 3 6 7 4 0 6 5 5 0 5 8 3 0 0 1 2 TIKAH 15-May-1983 GG BAKTI 3 1 0 0 2 0 0 1 0 0 1 0
742 ASEP 3 6 7 4 0 6 6 8 1 0 9 3 0 0 0 7 SITI JL. ARYA PUTRA 3 1 0 0 2 0 0 1 0 0 1 0
743 SARIF 3 6 7 4 0 6 5 6 0 9 8 8 0 0 0 9 MEGA BAMBU APUS 3 1 0 0 2 0 0 1 0 0 1 0
1988
29-August-2022
744 YANA 3 2 0 2 2 9 0 1 0 1 8 6 0 0 0 1 RISMA 21-April-1986 GG. PILAR 2 1 0 0 2 0 0 1 0 0 1 0
30-August-2022
745 BAYU 3 6 7 4 0 6 5 1 0 5 8 2 0 0 1 0 SOPIAH 11-May-1982 KEDAUNG 3 1 0 0 2 0 0 1 0 0 1 0
746 HABIBI 3 6 7 4 0 6 5 1 1 1 9 1 0 0 0 8 RISKA SASAK TINGGI 1 1 0 0 2 0 0 1 0 0 1 0
1991
31-August-2022
747 DIDIK 3 6 7 4 0 6 4 7 0 4 7 4 0 0 0 2 NURHAYATI 07-April-1974 JL. MASJID DARUSSALAM 1 1 0 0 2 0 0 1 0 0 1 0
748 EDI 3 1 7 4 0 8 4 6 0 9 7 2 0 0 0 6 SRI SULASIH CIMANGGIS 3 1 0 0 2 0 0 1 0 0 1 0
1972
31-August-2022
749 KONTA 3 6 7 4 0 6 4 7 0 4 7 7 0 0 0 1 TARSIA 07-April-1977 JOMBANG BARU 3 1 0 0 2 0 0 1 0 0 1 0
31-August-2022
750 RUSDANI 3 6 7 4 0 6 5 0 0 6 8 4 0 0 0 6 SITI MUNAWAROH 10-June-1984 JL. M. DARUSSALAM 1 1 0 0 2 0 0 1 0 0 1 0
751 SAKA 3 6 7 4 0 6 4 6 0 8 7 4 0 0 0 2 MARIYAM JL. KEMANDORAN 3 1 0 0 2 0 0 1 0 0 1 0
752 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 TALIA 01-July-1995 PAMULANG BARAT 1 1 0 0 3 1 0 0 1 0 0 0
01-August-2022
753 AGUS 3 6 7 4 0 3 5 4 0 4 6 3 0 0 0 4 SARINAH 14-April-1983 JL. ARYA PUTRA 3 1 0 0 3 0 0 1 0 0 1 0
01-August-2022
754 SUMANTORO 3 3 0 5 0 8 6 5 0 5 8 8 0 0 0 1 QODRIYAH 26-June-1988 GG. H TARIP 3 1 0 0 3 0 0 1 0 0 1 0
02-August-2022
755 SAHRONI 3 1 7 3 0 5 6 1 0 5 9 0 0 0 1 0 FATIMAH 21-June-1990 GG WAHID 3 1 0 0 3 0 0 1 0 0 1 0
756 SUKARMA 3 6 7 4 0 6 6 0 0 2 9 5 0 0 0 3 FEBRI JL MASJID DARUSSALAM 1 1 0 0 3 0 0 1 0 0 1 0
1995
08-August-2022
757 SAIPUL 3 3 2 8 0 7 4 4 0 7 8 3 0 0 0 1 AMI 04-July-1983 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
08-August-2022
758 SARIPUDIN 3 2 0 7 1 5 5 8 0 5 7 3 0 0 0 3 MIMIN 18-May-1973 GG SWADAYA 3 1 0 0 3 0 0 1 0 0 1 0
09-August-2022
759 ACHMAD FAISAL 3 6 7 4 0 6 4 8 0 7 8 3 0 0 0 7 RINA 08-July-1983 ARYA PUTRA 3 1 0 0 3 0 0 1 0 0 1 0
09-August-2022
760 BAIDILLAH 3 6 7 4 0 6 6 7 0 6 9 8 0 0 0 2 IDA 27-June-1998 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0
761 DADANG 3 6 7 4 0 6 6 5 0 8 8 2 0 0 0 4 AMEL GANG HAJI DAHLAN 3 1 0 0 3 0 0 1 0 0 1 0
762 Galang 3 6 7 4 0 6 6 7 1 2 9 2 0 0 0 3 SUSI Kedaung 3 1 0 0 3 0 0 1 0 0 1 0
1992
19-August-2022
763 Hudi 3 6 7 4 0 6 6 3 0 4 7 6 0 0 0 8 SURATIH 23-April-1976 GANG Masjid Darussalam 3 1 0 0 3 0 0 1 0 0 1 0
19-August-2022
764 Muji 3 6 7 4 0 6 5 3 0 4 7 3 0 0 0 3 SUGIARTI 24-April-1973 Kedaung 3 1 0 0 3 0 0 1 0 0 1 0
19-August-2022
765 Tomi 3 2 0 6 3 5 4 9 0 4 8 8 0 0 0 1 HARTATI 20-July-1985 GG. H TARIP 3 1 0 0 3 0 0 1 0 0 1 0
24-August-2022
766 SUPRIADI 3 6 7 4 0 6 6 2 0 5 7 9 0 0 0 2 UMI KALSUM 22-May-1979 GG NANGKA 1 1 0 0 3 0 0 1 0 0 1 0
25-August-2022
767 MUHADI 3 6 7 4 0 6 5 0 0 3 8 7 0 0 0 1 ALIYAH 10-March-1980 GG. H DAHLAN 1 1 0 0 3 0 0 1 0 0 1 0
768 SAPRIYANTO 3 6 7 4 0 6 5 9 1 0 7 1 0 0 0 1 HARMAYANTI JL. M. DARUSSALAM 3 1 0 0 3 0 0 1 0 0 1 0
769 YAYAN 3 6 7 4 0 6 5 0 0 2 8 5 0 0 1 5 SITI ATIAH GG GURAME 3 1 0 0 3 0 0 1 0 0 1 0
770 CARIUN 3 1 7 4 0 5 5 2 0 9 7 7 0 0 0 7 SANI GG BAKTI 3 1 0 0 3 0 0 1 0 0 1 0
1977
771 SUBHI 3 2 0 9 0 2 6 1 0 1 9 6 0 0 0 4 AISYAH KEDAUNG 1 1 0 0 3 0 0 1 0 0 1 0
31-August-2022
772 ANAS 3 6 7 4 0 6 5 0 0 5 9 3 0 0 0 3 WULANDARI 10-May-1993 KEDAUNG 1 1 0 0 3 0 0 1 0 0 1 0
773 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 AMELIA SAFITRI 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
774 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FITRI PUSPITASARI 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
775 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NUNI SAFITRI 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
776 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RANI KUSMIATI 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
777 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RITA APRIANAN 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
778 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SABRINA SIMBOLON 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
779 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI AWALIYAH 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
780 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 WINDY FAJAR L 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
781 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 APRIYANTI 01-July-1985 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0

782 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ELVIAH 01-July-1985 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
01-January-7994
783 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FITRI BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
784 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 IID KHODIJAH 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
01-December-
785 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 INE YULIANTI BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
1994
01-December-
786 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 INTAN BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
1994
787 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 LESLY 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
788 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NURHAYATI 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
789 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 PUTRI LARAS P 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
790 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 PUTRI ORIZHA C 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
01-January-7994
791 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RENA BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
792 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SOPIAH 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
793 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SUPRAPTI 01-July-1994 BENDA BARU 1 0 0 0 5 1 0 0 1 0 0 0
794 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 APRIYANTI 01-July-1985 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
795 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 IIS KHODIJAH 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
796 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NURHAYATI 01-June-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 1
797 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 PUTRI LARAS P 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 1
798 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 PUTRI ORIZHA 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 1
799 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RANI 01-July-1994 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
800 17-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RATNA 01-July-1985 PAMULANG BARAT 1 0 0 0 5 1 0 0 1 0 0 0
801 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 EMI 01-July-1994 BENDA BARU 1 0 0 0 6 1 0 0 1 0 0 0
802 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 LINDA 01-July-1994 BENDA BARU 1 0 0 0 6 1 0 0 1 0 0 0
803 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SUSI 01-July-1994 BENDA BARU 1 0 0 0 6 1 0 0 1 0 0 0
MUHAMMAD AZMI 21-January-1974

804 15-June-2022 3 6 7 4 0 6 6 1 0 1 7 4 0 0 0 1 MILA KARMILA JL ARIA PUTRA GG H BETONG 1 1 0 0 9 0 0 1 1 0 0 1
JAWAS
24-August-2022
805 BAHRI 3 6 0 3 2 5 6 2 0 3 8 5 0 0 0 2 YATI 22-March-1985 GG BETONG 3 1 0 0 9 0 0 1 0 0 1 0
806 HASAN 3 6 0 2 1 0 6 5 0 8 8 4 0 0 0 5 WIWI SASAK TINGGI 3 1 0 0 9 0 0 1 0 0 1 0
1) Keterangan Kode
STATUS PESERTA KB KODE JENIS ALOKON (Diisi Pada Jenis Tindakan dan Kasus)
1 : Peserta KB Baru 3 : Peserta KB Ulangan 1 : Suntikan 1 Bulanan 3 : Suntikan 3 Bulanan 5 : Pil Progestin 7 : Implan 1 Batang 9 : IUD 11 : Tubektomi
2 : Peserta KB Ganti 4 : Komplikasi 2 : Suntikan 3 Bulanan 4 : Pil Kombinasi 6 : Kondom 8 : Implan 2 Batang 10 : Vasektomi
2) SELAIN STATUS PESERTA KB, JENIS TINDAKAN DAN KASUS DIISI TANDA CENTANG (V)
1. Petugas Entri Lamp.R/I/KB/20
Data LAMPIRAN R/I/KB/20 Lembar 25
1 2 3 4 5 6
3 6 7 4 0 2 2 0 9 Bulan : 2022
NAMA FASKES/ BPM BIDAN WATIMENAH 7 V 9 10 11 12
:
Kota
RINGKASAN HASIL PELAYANAN KB
PESERTA KB BARU (PB) PESERTA KB ULANGAN PELAYANAN KASUS
PEMBERIAN
PEMBERIAN INFORMED PB DAN KESERTAAN JKN INFORMED CONSENT
METODE
NO. CONSENT (Untuk Peserta KB
KONTRASEPSI
(Untuk PB) PB PASCA PB PASCA Ulangan) PELAYANAN ULANG KOMPLIKASI BERAT
GANTI CARA PENCABUTAN KEGAGALAN
PERSALINAN KEGUGURAN
PB JKN PB NON JKN TOTAL PB
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
2 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
3 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
4 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
5 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
6 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
7 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
8 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
9 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
10 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
11 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
12 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
13 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
14 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
15 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
16 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
17 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
18 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
19 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
20 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0 0
21 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
22 SUNTIKAN 1 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 92 32 0 32 0 0 308 7 302 0 0 0
,
Pimpinan Faskes KB/Jaringan/Jejaring*
( .................................................................................................)
NIP/NRP
* Coret yang tidak perlu

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1.

PESERTA KB JENIS TINDAKAN Kasus PENGGUNAAN SUMBER ALOKON

2 01-June-2022 AAY 3 6 7 4 0 6 4 3 0 4 9 2 0 0 0 7 SELVI 04-March-1992 PAMULANG 2 1 0 0 1 0 0 1 0 0 1 0

7 01-June-2022 RANU 3 6 7 4 0 6 5 3 0 7 8 3 0 0 0 7 FITRIYANI 13-July-1983 SARANA 08571970838 2 1 0 0 1 0 0 1 0 0 1 0

9 01-June-2022 RIRI 3 6 0 3 1 2 4 7 0 2 9 4 0 0 0 7 MONICA 26-March-1988 007/004 3 1 0 0 1 0 0 1 0 0 1 0

13 02-June-2022 ALDI 3 6 7 4 0 6 5 4 0 5 7 9 0 0 0 6 ANNA 14-May-1979 PARKOS 2 1 0 0 1 0 0 1 0 0 1 0

14 02-June-2022 IRFAN 3 2 0 2 0 4 4 9 0 6 0 0 0 0 0 5 LINA 09-June-2000 JOMBANG 081806367086 1 1 0 0 1 0 0 1 0 0 1 0

17 03-June-2022 ARYA 3 6 7 4 0 6 5 9 0 1 9 0 0 0 0 3 LIA 13-March-1988 BULAK WANGI III 081310509469 3 1 0 0 1 0 0 1 0 0 1 0

18 03-June-2022 ARYANTO 3 2 7 6 0 3 6 5 0 6 8 4 0 0 0 4 SRI 14-May-1987 JL SURYA MULYA 3 1 0 0 1 0 0 1 0 0 1 0

19 03-June-2022 CHANAN 3 3 2 7 0 7 4 1 1 2 7 6 0 0 0 1 DEWI 05-May-1988 JOMBANG 3 1 0 0 1 0 0 1 0 0 1 0

20 03-June-2022 DAWVIN 3 6 7 4 0 4 4 6 0 6 9 8 0 0 1 2 AULIA 06-June-1998 JL.S. MAKMUR 085813093886 2 1 0 0 1 0 0 1 0 0 1 0

21 03-June-2022 GUNTUR 3 1 7 5 0 7 6 8 0 5 7 9 0 0 0 6 LISA 01-June-1988 ASRAMA BRIMOB 2 1 0 0 1 0 0 1 0 0 1 0

25 03-June-2022 SOHIB 3 6 7 4 0 6 6 7 0 5 8 7 0 0 0 5 FITRI 11-April-1983 KEDAUNG 087772547676 3 0 0 0 0 0 1 0 0 1 0

27 04-June-2022 CAHYANTO 3 6 7 4 0 6 4 5 0 6 7 9 0 0 0 2 MULYAH 05-June-1979 JL. KAVLING 2 2 1 0 0 1 0 0 1 0 0 1 0

31 04-June-2022 PIYAN 3 6 0 3 2 5 4 4 0 4 7 2 0 0 0 5 OLIV 04-April-1979 PARKOS 081906398687 3 1 0 0 1 0 0 1 0 0 1 0

35 05-June-2022 ROBI 3 6 7 4 0 6 6 4 0 6 9 2 0 0 0 6 ROSDIANA 22-July-1985 JL. PARKOS 2 1 0 0 1 0 0 1 0 0 1 0

36 05-June-2022 YATNA 3 6 0 3 2 5 4 9 0 7 8 3 0 0 0 3 SITI SOFIYAH 29-May-1995 GG SARANA 085881300403 1 1 0 0 1 0 0 1 0 0 1 0

37 05-June-2022 ZIKRULLOH 3 6 7 4 0 6 4 8 0 3 7 3 0 0 0 9 LIZAH 08-March-1973 KEDAUNG 3 1 0 0 1 0 0 1 0 0 1 0

41 06-June-2022 RUDI 3 6 7 4 0 6 6 5 0 4 7 4 0 0 0 3 MIRA 21-May-1993 KEDAUNG 085694567503 3 1 0 0 1 0 0 1 0 0 1 0

42 06-June-2022 SARIF 3 6 7 4 0 6 5 2 0 7 0 5 0 0 1 5 ANIK 12-July-1985 GG. BAKTI 3 1 0 0 1 0 0 1 0 0 1 0

JL MASJID DARUSSALAM RT10 RW

14-August-2022 JALAN CEMARA 1 RT 001 RW 001

27-August-2022 24-November- PAMULANG PERMAI 2 BLOK F 7 NO

193 01-June-2022 RADEN 3 6 7 4 0 6 4 4 0 8 8 7 0 0 0 3 SELVI 08-April-1987 JL PARKOS 2 1 0 0 2 0 0 1 0 0 1 0

195 01-June-2022 SUGATO 3 6 7 4 0 6 6 9 0 5 7 1 0 0 0 9 GITA RAHAYU 29-May-1971 JL MASJID DARUSSALAM 3 1 0 0 2 0 0 1 0 0 1 0

201 03-June-2022 KOMAR 3 6 7 4 0 6 5 2 0 1 9 6 0 0 0 3 MARIAM 11-May-1998 SASAK TINGGI 083140723175 1 1 0 0 2 0 0 1 0 0 1 0

202 03-June-2022 LINDA 3 3 7 4 0 6 4 5 0 5 9 7 0 0 0 8 ELIN 05-May-1997 JL. H MAUNG 089668234014 2 1 0 0 2 0 0 1 0 0 1 0

209 15-June-2022 AHMAD JAZULI 3 6 7 4 0 6 6 1 0 3 8 8 0 0 0 7 YENI MAYSAROH 21-March-1988 JL KAV KEUANGAN 1 1 0 0 2 0 0 1 1 0 0 1

213 15-June-2022 ROSID 3 1 7 4 1 0 5 3 0 5 7 3 0 0 0 1 MEILINDA SUSANTI 13-May-1973 KP. BULAK TIMUR 3 1 0 0 2 0 0 1 1 0 0 1

214 15-June-2022 SUPRIYANTO 3 6 7 4 0 6 7 1 0 7 7 7 0 0 0 6 WULANDARI 30-July-1977 KP BULAK TIMUR 1 1 0 0 2 0 0 1 1 0 0 1

JL. MUSHOLLA ANNUR, KEDAUNG,

257 01-June-2022 GARILES 3 6 7 4 0 6 5 2 0 6 8 0 0 0 0 4 GINA 08-July-1989 JL NASABAH 5 082116600235 1 1 0 0 3 0 0 1 0 0 1 0

260 04-June-2022 MULYADI 3 6 7 4 0 6 6 5 0 7 7 6 0 0 0 3 TETI 25-July-1976 JALAN MUJAER 3 1 0 0 3 0 0 1 0 0 1 0

262 05-June-2022 INDRA 3 6 7 4 0 6 4 2 0 1 8 7 0 0 0 1 DIAN 28-July-1992 JL. ANNABAWI 083890096516 1 1 0 0 3 0 0 1 0 0 1 0

263 05-June-2022 TATANG 3 2 0 2 2 2 6 3 0 5 9 8 0 0 0 3 METI 23-May-1998 JL. SERUA BABAKAN 085862883501 2 1 0 0 3 0 0 1 0 0 1 0

264 06-June-2022 AROFIQ 3 6 7 4 0 6 4 6 0 7 8 1 0 0 0 7 MALIYAH 06-July-1981 JL. KALI ASEM 082114008445 3 1 0 0 3 0 0 1 0 0 1 0

266 06-June-2022 MULYADI 3 1 7 4 0 7 4 1 0 3 8 4 0 0 0 6 MITA 01-March-1984 KEDAUNG 2 1 0 0 3 0 0 1 0 0 1 0

267 06-June-2022 MUNAJIR 3 6 7 4 0 6 4 5 0 6 8 8 0 0 0 7 ELA 05-June-1988 JL. KAVLING KEUANGAN 089580324865 2 1 0 0 3 0 0 1 0 0 1 0

268 06-June-2022 RIRI 3 6 7 4 0 6 4 6 0 4 8 4 0 0 2 2 SIVA 06-April-1984 Kedaung 2 1 0 0 3 0 0 1 0 0 1 0

270 06-June-2022 SUNARTO 3 6 7 4 0 6 5 5 0 6 8 4 0 0 1 0 JUMIATI 04-May-1973 KEDAUNG 3 1 0 0 3 0 0 1 0 0 1 0

271 06-June-2022 TIO 3 6 7 4 0 6 5 6 0 6 9 5 0 0 1 3 RLISA 16-June-1995 JL KAVLING KEUANGAN II 087786760548 3 1 0 0 3 0 0 1 0 0 1 0

272 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 DIAH 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

273 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 MEILANI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

274 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NIRANDA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

276 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NURHAYATI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

277 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RENI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

278 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 RISKA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

279 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

280 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI MASITOH 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

281 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 SITI S 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

282 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 TIA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

283 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 UNA 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

284 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 WULAN 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

285 15-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 YULI 01-July-1994 KEDAUNG 1 1 0 0 3 1 0 0 1 0 0 0

287 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ARY 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

288 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 DETI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

289 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 ELSA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

290 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FIRLI 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

291 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FITRIYANI 01-July-1985 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

292 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 HERNNITA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

293 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 IPAH 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

295 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 MARIAM 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0

296 16-June-2022 NN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 NISA 01-July-1994 BENDA BARU 1 1 0 0 3 1 0 0 1 0 0 0