Lampiran Data Pegawai BPJS

DAFTAR PESERTA PER ENTITAS
RSUD CIMACAN
PERIODE BULAN-11-TAHUN-2022
NO. NOMOR KARTU NIK NPP

1 0000042100874 3203100303000021 -
2 0000055669443 3203010508920004 -
3 0000053184611 3217075905930003 -
4 0002434777727 3203112303180002 -
5 0000058113865 3203065906940008 -
6 0000058124665 3203196206930002 -
7 0000058661526 3203284303910002 -
8 0002198017124 3203282501170002 -
9 0003093541233 3203133107210001 -
10 0000058853259 3203041502970004 -
11 0000061972525 3203136707980003 0
12 0000061973008 3203010105930010 0
13 0000061977936 3203075209940013 -
14 0003086384624 3203072101210005 -
15 0000061979567 3203281011990007 -
16 0000061993181 3203047108940004 -
17 0002769607934 3203044804190001 -
18 0000061998142 3203283012900002 -
19 0000062003979 3203280105820013 -
20 0000062011495 3203022608940007 -
21 0002423280025 3203035511940009 -
22 0002921863994 3203023010190003 -
23 0000062015804 3203016804960022 0
24 0000062052366 3203040304980013 000000
25 0003268780659 3203044512200002 000000
26 0000062059094 3203134907990011 0
27 0000062066136 3203131502950016 -
28 0001660008161 3203086909950002 -
29 0002914019829 3203130307190005 -
30 0002914019897 3203132706170002 -
31 0000062081526 3203121211950001 -
32 0003293854672 3203126807220001 -
33 0000062083023 3203130707990004 -
34 0000062097388 3203010809920005 02
35 0002092634897 3203105711160001 02
36 0000062116975 3203036505990010 00
37 0000062200811 3203112001980013 0
38 0000062204174 3203135609910009 -
39 0002476888389 3203130307130002 -
40 0003082539688 3203131305210001 -
41 0000062219283 3203171603910005 -
42 0000062244448 3203014904990010 -
43 0003300654227 3201361012210059 -
44 0000062258488 3203177103920002 -
45 0000062264158 3203016911930008 0
46 0000062273564 3203111502940001 -
47 0000062357174 3203116408940006 -
48 0002941648852 3203115807170001 -
49 0003295868128 3203112809220002 -
50 0000062278176 3203010312950010 409
51 0000062295693 3203090707960009 385
52 0000062309136 3203100308960008 -
53 0000062317607 3203071405920005 -
54 0000062335844 3203074609960006 0
55 0000062378526 3203221210950007 0
56 0002927085502 3213306809920003 0
57 0003003731875 3213304901120001 0
58 0003119751404 3203302406210001 0
59 0000062379911 3203011409990002 0
60 0000062383555 3203051701960001 0
61 0000062391813 3203010901920006 -
62 0002765367112 3201246809920001 -
63 0002765367189 3203011805170002 -
64 0000062662645 3203016701880012 -
65 0000062700783 3203136908970004 199708292022000868
66 0000062703145 3203014402970010 -
67 0000062703865 3203012911940012 -
68 0000062706273 3203013105910016 -
69 0000062708455 3203012908960004 -
70 0000062709298 3203115711950001 -
71 0003052235654 3203285509200001 -
72 0000062709592 3203011703940015 -
73 0003130365161 3203014111200003 -
74 0000062719143 3203075009980008 0
75 0000062721404 3203076607960005 -
76 0000062723542 3203074710940010 -
77 0002764011609 3203075005190004 -
78 0000069942622 3205101902980003 -
79 0000164516398 3203016411990005 0
80 0000167233307 3203011103970011 cimacan
81 0000167961407 3203015806950005 -
82 0000170413119 3203145603910001 -
83 0000171502457 3203285607990003 -
84 0000173555111 3203280605960002 -
85 0000194107443 3203082701920001 -
86 0002765361598 3203034308940007 -
87 0002765361857 3203035009160001 -
88 0000195227919 3203011512950008 -
89 0002525833337 3203044805990001 -
90 0000199047071 3203106008920005 rsc
91 0003005297853 3203106509180001 rsc
92 0000199611652 3203287108940001 -
93 0000199611854 3203285910960001 -
94 0000201362038 3203016104990001 -
95 0000201712893 3203014509920008 -
96 0000202017688 3673055702790001 -
97 0000203434244 3203286604010009 -
98 0000208248063 6302120309920001 -
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100 0000208892597 3203074606950017 -
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102 0002921520385 3203075502200005 -
103 0000211247414 3206224308000003 -
104 0000401091682 3203322002980002 -
105 0000403409619 3203042812950006 -
106 0000404846976 3203316002970001 -
107 0000406514823 3203110206900008 -
108 0000406622801 3203100312990016 -
109 0002765369373 3203285704000002 -
110 0002942338847 3203281005190001 -
111 0000407721205 3203101409970007 380
112 0000407991508 3203133105910001 -
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120 0000408652457 3203132905990005 -
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123 0000539743241 3305065607680002 -
124 0000539744411 3305060510040001 -
125 0000977338809 3203170708980009 000000
126 0001002645281 3203106805010002 -
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128 0002393007287 3203100310880017 -
129 0002910900971 3203100912190002 -
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133 0001082240425 3203282807910004 -
134 0001097480889 3203211108940003 -
135 0003110069518 3203036401950005 -
136 0003131170029 3203010906210011 -
137 0001105862038 3203105903940004 -

138 0003129654677 3203100203160006 -
139 0001105961409 3203106309990003 -

140 0001106142603 3203136608960005 0
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151 0003106493829 3203107008210003 -
152 0001196663387 3203284306980008 -
153 0001265516954 3203041007950012 -
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155 0001266348137 3203285710940001 -
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157 0001268688003 3203042402980008 374
158 0001268712426 3203046006950010 -
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160 0001269427959 3203016006980013 -
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162 0001282417209 3203142309930004 -
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167 0001302226266 3203136705890004 -
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169 0002765135002 3203132205140003 -
170 0003258719032 3203136307210003 -
171 0001371993693 3203100302870020 ci
172 0001381374167 3203142912890002 -
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174 0002914041521 3203060403190002 -
175 0002914041622 3203062607150001 -
176 0001388413271 3203245203970008 -
177 0001389007708 3203106605750008 0615
178 0001969296164 3276020607670004 0615
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180 0001969297762 3203106106080005 0615
181 0001969298583 3203102007140001 0615
182 0001392716362 3203283108940004 00
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184 0003293873706 3203036405970002 0
185 0003130323827 3203045001220001 0
186 0001425939873 3203030612970006 0
187 0001429064256 3203281012010002 -
188 0001434582347 3203106107970003 -
189 0001453740682 3203075508950010 rsc
190 0003109706414 3203075711210003 rsc
191 0001459660779 3203281611020010 200211092022000849
192 0001461560804 3201254405980004 -
193 0001465476423 3203281807850008 -
194 0001470255748 3203010912890013 -
195 0002216218094 3203017011960011 -
196 0002914026568 3203016008190003 -
197 0001518204835 3204341802970004 0
198 0001522283174 3203074212930010 -
199 0001522672301 3203016406940014 -
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201 0001523186425 3203285909020006 -

202 0001603294841 3203284211990005 -
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222 0003274972661 3217056401180001 -
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235 0001729276582 3203130502800002 -
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269 0003293958835 3203025702220001 -
270 0001847764078 3203134601830006 rsc
271 0001847763448 3203130503780010 rsc
272 0002935032671 3203136302100004 rsc
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301 0000062250941 3203076708920003 -
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NAMA HUB. KELUARGA TGL. LAHIR TMT
RIZWAN TAUFIK PESERTA 03/03/2000 01/01/2020
RIFKY MAULANA KHABIR PESERTA 05/08/1992 01/01/2020
FITRI NURAINI ISTRI 19/05/1993 01/01/2020
JIDAN PAWAJADAHU KHABIR ANAK 23/03/2018 01/01/2020
YUNITA PUSPITASARI PESERTA 19/06/1994 01/01/2020
HENHEN HERLINA PESERTA 22/06/1993 01/06/2019
PIPIT RIANTINI,SKM PESERTA 03/03/1991 01/10/2019
FAIREL ALFAIZ ARSENIO KURNIA ANAK 25/01/2017 01/10/2019
fairuza elfatih dwi kurnia ANAK 31/07/2021 01/10/2019
SOFWAN FAUZY PESERTA 15/02/1997 01/01/2020
KRIS INDRIYANTI MAULANI PESERTA 27/07/1998 01/04/2021
RIZAL REINALDI PESERTA 01/05/1993 01/01/2022
SINDHIA SARI SEFTIA NURROHMAN PESERTA 12/09/1994 01/01/2020
BAYI NYONYA SINDHIA SARI SEFTIA NURROHMAN ANAK 10/06/2021 01/01/2020
JAMALUDIN PESERTA 10/11/1999 01/01/2020

ARNISA NUR KOMALASARI PESERTA 31/08/1994 01/07/2019
FREYA SAFFA ALLEA ANAK 08/04/2019 01/07/2019
ARI SETIA BUDI PERMANA PESERTA 30/12/1990 01/06/2020
DEDI SETIAWAN PESERTA 01/05/1982 01/06/2019
M RHEYNALDI LUTHFI ZEIN PESERTA 26/08/1994 01/01/2020
SISKA SILVIA ANDRIANI ISTRI 15/11/1994 01/01/2020
MUHAMMAD HARRY PUTRA LUTHFI ZEIN ANAK 30/10/2019 01/01/2020
RISKA SITI AMATUNISA PESERTA 28/04/1996 01/04/2021
Muhammad MUFTI PESERTA 03/04/1998 01/12/2020
HUSNA AWALIAH ANAK 05/12/2020 01/12/2020
ANGGIE KRISNAWANTI PRAYITNO PESERTA 09/07/1999 01/04/2021
FEBI MUHAMAD RAMDAN PESERTA 15/02/1995 01/01/2020
NEUIS SEPTIANAH ISTRI 29/09/1995 01/01/2020
M DZIKRI AL MUSTAFA RAMDAN ANAK 03/07/2019 01/01/2020
M. DZIKRA AL MUSYAFFA RAMDAN ANAK 27/06/2017 01/01/2020
EDDO AHMAD FAUZI PESERTA 12/11/1995 01/10/2022
ARUMI MAFAZA FAUZIYAH ANAK 28/07/2022 01/10/2022
ADI MAULANA WAHYU PERMANA PESERTA 07/07/1999 01/01/2022
SALMAN FIRMANSYAH PESERTA 08/09/1992 01/12/2016
MUKHBILLA FIRMANSYAH ANAK 17/11/2016 01/12/2016
RISKA DWI MEILAWATI PESERTA 25/05/1999 01/01/2022
LUTHFI FIRDAUS PESERTA 20/01/1998 01/04/2021
FARRAH AYU LESTARI PESERTA 16/09/1991 01/01/2020
MOCH GIO GALIH AL-GHIFARY ANAK 03/07/2013 01/01/2020
MOCH GYAN ALHANAN ANAK 15/05/2021 01/01/2020
KAKANG PERMANA SAPUTRA PESERTA 16/03/1991 01/06/2019
ANNISA FUJI LESTARI PESERTA 09/04/1997 01/06/2019
BAYI NYONYA ANNISA FUJI LESTARI ANAK 23/10/2022 01/06/2019
NURUL FAUZIAH PESERTA 31/03/1992 01/06/2019

NURJANAH PESERTA 29/11/1993 01/04/2021
AAL HAMZAH PESERTA 15/02/1994 01/06/2019
USWATUN HASANAH ISTRI 24/08/1994 01/06/2019
WARDA NAVISHA AWALIYAH ANAK 18/07/2017 01/06/2019
MUHAMMAD NAUFAL AN NAJMIE ANAK 28/09/2022 01/06/2019
RIZKI ANUGERAH ILHAMI PESERTA 13/12/1995 01/05/2022
EKA PUTERA PRATAMA PESERTA 07/07/1996 01/01/2022
MUHAMMAD AKBAR FAWZI PESERTA 03/08/1996 01/01/2020
MOHAMMAD ABDU ROHMAN PESERTA 14/05/1992 01/06/2019
PUTRI AMALIA SUKMAN PESERTA 06/09/1996 01/04/2021
ARFAN YUSTIAN DULIMAN PESERTA 12/10/1995 01/04/2021
FIKROTUS SHAHAH ISTRI 28/09/1992 01/04/2021
ZAKIYA ALIFANNISA ANAK 09/01/2012 01/04/2021
muhammad khalid yusuf ANAK 24/06/2021 01/04/2021
ALGI MAULANA PESERTA 14/09/1999 01/01/2022
ELGA HAZBI ALFARIQI PESERTA 17/01/1996 01/04/2021
RIZKI JANUAR PESERTA 09/01/1992 01/06/2019
RAHMAWATI ISTRI 28/09/1992 01/06/2019
MUHAMMAD AL FATIH PUTERA RIZKI ANAK 18/05/2017 01/06/2019
NENENG SITI NURJANAH PESERTA 27/01/1988 01/10/2022
SANTI RATNA SARI PESERTA 29/08/1997 01/11/2022
FINA FALISTA PESERTA 04/02/1997 01/06/2020
DONI SAPUTRA PESERTA 29/11/1994 01/01/2020
FREDYAWAN SRI NOVIANTO PESERTA 31/05/1991 01/01/2020
MUHAMAD YUVIE GIFARI ATI RAMA PESERTA 29/08/1996 01/06/2019
YULIYANTI PESERTA 17/11/1995 01/01/2020
KIRANA SEPTIA SALSABILA ANAK 15/09/2020 01/01/2020
PURNAMA PUTRA PESERTA 17/03/1994 01/01/2020
eliza salma aziza ANAK 01/11/2020 01/01/2020
SOFFIA SEFTIARI PESERTA 10/09/1998 01/04/2021
NIDA SITI NURHIDAYAH PESERTA 26/07/1996 01/01/2020
MIMA AMALIA PESERTA 07/10/1994 01/01/2020
KANAYA RAMADHANI MALIKI ANAK 10/05/2019 01/01/2020
ERI ADI PURNAMA PESERTA 19/02/1998 01/11/2022
RIMA FATIMAH ZAHRA PESERTA 24/11/1998 01/04/2021
MUHAMMAD EKA NUGRAHA PESERTA 11/03/1997 01/06/2020
ELVINA LISTRIANSYAH PESERTA 18/06/1995 01/06/2019
DINI AGUNG WIDIAWATI PESERTA 16/03/1991 01/01/2022
NADIA NURMAYANTI PESERTA 16/07/1999 01/02/2020
DIKA ANDRIA NURSALAM PESERTA 06/05/1996 01/06/2019
SUPRAYOGA PAMUNGKAS PESERTA 27/01/1992 01/06/2019
LILIS SURYANI ISTRI 03/08/1994 01/06/2019
ANNISA SHILVIA RUSMAN ANAK 10/09/2016 01/06/2019
FACHRI PRASETYA PESERTA 15/12/1995 01/06/2019
NURANI SILVIYA ANDREAN ISTRI 08/05/1999 01/06/2019
AGUSTINA WIJAYANTI PESERTA 20/08/1992 01/06/2020
SAFFANAH SYAHLA SETIAWAN ANAK 25/09/2018 01/06/2020
NYIMAS SINGGIH SRI NURTANTI PESERTA 31/08/1994 01/02/2020
NYIMAS KWARTIANTI SRI NUGRAHA INI PESERTA 19/10/1996 01/06/2019
AJENG SHAFIRA AFRIYANTI PESERTA 21/04/1999 01/01/2022
RAHMAWATI RUBI AWWALIAH PESERTA 05/09/1992 01/06/2019
ENENG ULFI FAUZIAH PESERTA 17/02/1979 01/01/2020
NIRA PACHIRA APRIANI PESERTA 26/04/2001 01/01/2020
SEPTIA BUDI PRIANA PESERTA 03/09/1992 01/01/2020
SYAHFA SITI MAYASTARI PESERTA 11/07/1998 01/04/2021
MUTIARANI YAZID PESERTA 06/06/1995 01/01/2020
MAULUDI WIJAYA KUSUMA SUAMI 29/07/1997 01/01/2020
MAURA ADZRAALEA KUSUMA ANAK 15/02/2020 01/01/2020
IRMA MIR'ATUL HASANAH PESERTA 03/08/2000 01/11/2022
ANDRI IRAWAN PESERTA 20/02/1998 01/01/2022
DEDE GAGAH PESERTA 28/12/1995 01/01/2022
NUR IRYANTI PESERTA 20/02/1997 01/01/2022
DADAN SURYANA PESERTA 02/06/1990 01/01/2020
MUHAMAD ARSALUDIN PESERTA 03/12/1999 01/06/2019
SITI ROHAENI ISTRI 17/04/2000 01/06/2019
MUHAMMAD FARSYA AL-FATIH ANAK 10/05/2019 01/06/2019
MIMING RISALAM PESERTA 14/09/1997 01/10/2021
AHMAD HERIAWAN PESERTA 31/05/1991 01/01/2020
DIMAH HAIFAH ISTRI 13/03/1994 01/01/2020
FATIHA HUSNA RAMADANI ANAK 08/05/2019 01/01/2020
SARIFATUL HUDA RAHAYU PESERTA 18/06/1998 01/01/2020
NOVIA KHOIRUN NISSA PESERTA 09/11/1999 01/01/2022
JULIA NURGITANIA PESERTA 12/07/1992 01/06/2019
FIRZAN AZHAR MUAZZAM ANAK 14/06/2021 01/06/2019
AHMAD JUNAEDI PESERTA 06/04/2001 01/01/2022
YUSMAN MULYAWAN PESERTA 29/05/1999 01/06/2019
SITI AMINAH PESERTA 25/02/1993 01/01/2020
MUHAMMAD DANESH YUSUF LESMANA ANAK 08/06/2018 01/01/2020
SUKAESIH PESERTA 16/07/1968 01/06/2019
MUHAMAD RIZKI AL AMIN ANAK 05/10/2004 01/06/2019
GARNIS PESERTA 07/08/1998 01/12/2020
RATU SAGARA PUTRI PESERTA 28/05/2001 01/01/2022
SYANI CAHYANI PRATIWI PESERTA 04/09/1996 01/06/2019
ADITIA SAPUTRA SUAMI 03/10/1988 01/06/2019
ALKHALIFI KAUTSARRAZKY SAFFARAZ ANAK 09/12/2019 01/06/2019
ANGGA NUGRAHA PESERTA 14/07/1992 01/01/2020
LUH MADE KUSUMADEWI ISTRI 01/01/1997 01/01/2020
M. DZIKRI ANDHANU NUGRAHA ANAK 11/09/2018 01/01/2020
BINTARA WIDI YULIANTO PESERTA 28/07/1991 01/04/2020
BUDIMAN PRASETYO PESERTA 11/08/1994 01/06/2020
SUSANTI ISTRI 24/01/1995 01/06/2020
BAYI NYONYA SUSANTI ANAK 08/01/2022 01/06/2020
HANDIKA DWI MARYATI PESERTA 19/03/1994 01/06/2019

BAYI NYONYA HANDIKA DWI MARYATI ANAK 01/01/2022 01/06/2019
EVY SETYORINI PESERTA 20/09/1999 01/10/2022

ANISA DWI PRATIWI PESERTA 26/08/1996 01/04/2021
ENKA MIRA ANDIKA PESERTA 08/03/1995 01/01/2022
RATNA SITI FATIMAH PESERTA 19/12/1997 01/04/2021
NOVIANI KUSBIANTI PESERTA 21/11/1995 01/06/2019
MUHAMMAD BAGUS PRAYOGO ANAK 27/11/2020 01/06/2019
YAYAH HUDARIAH, AMD.KEP PESERTA 06/10/1982 01/01/2020
HAIKAL RAMDHANI AL FIKRY ANAK 21/10/2006 01/01/2020
SYEHA UM'MAH FAJRIAH ANAK 22/12/2010 01/01/2020
SITI SALMA NURHAMIDAH PESERTA 07/05/2000 01/01/2020
AMI RAHMAT PESERTA 28/11/1996 01/01/2022
NENG DINNY ISMARSANNY PESERTA 24/01/1996 01/06/2019
CLARISSA ALARICE JASRIN ANAK 30/08/2021 01/06/2019
AJENG RAHAYU PUTRI PESERTA 03/06/1998 01/01/2020
INDRI TRIMO FARDIANA PESERTA 10/07/1995 01/01/2020
NENG HILDA APRIYANTI ISTRI 07/04/1994 01/01/2020
GITA OKTAVIA PESERTA 17/10/1994 01/06/2019
MUHAMMAD SYAFIQ PRATAMA ANAK 09/06/2020 01/06/2019
IRFAN PESERTA 24/02/1998 01/01/2022
ERIKA PUTRI LINDA PESERTA 20/06/1995 01/01/2022
MUHAMMAD ANDIKA RAMDHAN PRATAMA ANAK 19/04/2021 01/01/2022
ROHANIATY WIDYA PASHA PESERTA 20/06/1998 01/01/2022
SITI MARIAM PESERTA 06/02/1998 01/01/2020
CHAERUL TRI SAPUTRA PESERTA 23/09/1993 01/01/2020
RISKA PUSPITA DEWI ISTRI 22/05/1993 01/01/2020
CHARISTHA AULIA PUTRI ANAK 09/02/2021 01/01/2020
IIS NURHAYATI PESERTA 07/03/1989 01/06/2020
RISVI M IKTIFAR SUAMI 21/05/1988 01/06/2020
NURUL HASANAH PESERTA 27/05/1989 01/06/2019
ARKAAN ERIZALLY MUSADAD ANAK 09/11/2017 01/06/2019
SAKHA RASYIQUL MUSADAD ANAK 22/05/2014 01/06/2019
HAWA RAFIFA ALESHA MUSADAD ANAK 23/07/2021 01/06/2019
ARY SUNJAYA PESERTA 03/02/1987 01/01/2022
SOEGHIH NURIMAN PESERTA 29/12/1989 01/01/2020
ATI HERAWATI ISTRI 15/05/1991 01/01/2020
M FAISAL NURIMAN ANAK 04/03/2019 01/01/2020
SUCI FITRIA KHOERUNISA ANAK 26/07/2015 01/01/2020
FITRIANI RAHMANI PESERTA 12/03/1997 01/06/2019
BETTY ROVINA NASRUN PESERTA 26/05/1975 01/09/2020
M. SAID SUAMI 06/07/1967 01/09/2020
SELA AZZAHRA PUTRI SYAHRIZAL ANAK 01/10/2004 01/09/2020
ZIYAN TARRA PUTRI SYAHRIZAL ANAK 21/06/2008 01/09/2020
safaraz akma fadhil ramadhan ANAK 20/07/2014 01/09/2020
ATIP SUSANTO PESERTA 31/08/1994 01/07/2021
RIRI ASNARI PESERTA 17/03/1996 01/04/2021
DIAN KEKEY ISTRI 24/05/1997 01/04/2021
ELISYA DANIA NUR ASNARI TISUDRA ANAK 10/01/2022 01/04/2021
HASMA DIAN TAUFIK PESERTA 06/12/1997 01/04/2021
M.RAKA ILHAM SAPUTRA PESERTA 10/12/2001 01/01/2022
RIA FAZRIA JULIANTI SUKIR PESERTA 21/07/1997 01/01/2022
SHINTA MAULINA PERTIWI PESERTA 15/08/1995 01/06/2020
humaira shahia suryakusumah ANAK 17/11/2021 01/06/2020
MUHAMAD ZAKI PESERTA 16/11/2002 01/11/2022
MEIKE PUTRI HANDOKO PESERTA 04/05/1998 01/01/2020
RAHMAT RISMAWAN PESERTA 18/07/1985 01/01/2020
DIKI NUGRAHA PESERTA 09/12/1989 01/01/2020
WIDYA PURWADIANTI ISTRI 30/11/1996 01/01/2020
SHAFA ZAKIYAH NUGRAHA ANAK 20/08/2019 01/01/2020
SYAHRUL HARDIANA PESERTA 18/02/1997 01/04/2021
DESTARI MUTIARA HANDANI PESERTA 02/12/1993 01/06/2019
DITA SINTIA PESERTA 24/06/1994 01/01/2020
BAYI NYONYA DITA SINTIA ANAK 22/07/2022 01/01/2020
SEPRILA MAHARANI PESERTA 19/09/2002 01/01/2022

YENI NOVIYAWATI PESERTA 02/11/1999 01/06/2019
JUNIARTO ADITAMA PESERTA 03/06/1994 01/06/2019
MUHAMAD AJI NURDIN PESERTA 24/01/1994 01/01/2020
ARIES BUDIMAN PESERTA 09/07/1986 01/01/2022
Rina Rosmawati ISTRI 21/06/1989 01/01/2022
AKIFFA LUBNASAKHI BUDIMAN ANAK 11/08/2014 01/01/2022
ALFAREZEL MIYAZSAKHI BUDIMAN ANAK 18/12/2019 01/01/2022
AYU LESTARI PESERTA 12/06/1989 01/06/2019
ARIE GINA ARIZA PESERTA 30/09/1996 01/01/2020
MUHAMMAD ELRUMI ALSHAD SUAMI 09/12/2019 01/01/2020
EVI LIANA PESERTA 04/12/1989 01/06/2019
RAHMAT ZAFAR SIDIK SUAMI 10/05/1986 01/06/2019
MUHAMMAD ARIYAN ARRAFI'I ANAK 10/11/2011 01/06/2019
MUHAMMAD FIKRI ANAK 06/12/2019 01/06/2019
TETY SEPTIANINGSIH PESERTA 08/02/1986 01/01/2020
DEWI ANGGRAENI PESERTA 27/07/1992 01/01/2020
WAHYU FEBRI SANDI SUAMI 24/02/1990 01/01/2020
ARVINO FAEYZA ANGGRIANO ANAK 10/09/2017 01/01/2020
UJANG CECE PESERTA 14/08/1988 01/01/2020
WAFA ISTRI 28/05/1995 01/01/2020
GINA LATIFATUL MUNAWAROH ANAK 24/01/2018 01/01/2020
WAHYU PESERTA 23/07/1990 01/01/2020
SITI ERIA SUKAERIAH PESERTA 08/08/1995 01/07/2019
KYNADITYA LITUHAYU ANAK 02/11/2021 01/07/2019
YULITA PRIHANDINI PESERTA 02/07/1990 01/01/2020
DEDE SUTRISNO PESERTA 13/08/1984 01/06/2019
KOMARIAH ISTRI 24/04/1989 01/06/2019
DIAL JABAR FIRMANSYAH ANAK 04/05/2011 01/06/2019
MITHA MARISA ROSWITA PESERTA 25/10/1998 01/01/2022
LIDYA AGUSTINA PESERTA 07/08/1995 01/11/2019
REDY EGIYANTO PESERTA 21/09/1991 01/06/2019
MUHAMMAD HAFIZH ALFAREZI ANAK 17/07/2017 01/06/2019
ANNE RATNASARI PESERTA 14/01/1992 01/06/2019
DEDE ABDILAH PESERTA 05/02/1980 01/01/2020
DEWI ASTUTI ISTRI 17/08/1985 01/01/2020
AJENG NUR SOLEHAH ANAK 21/07/2009 01/01/2020
ADAM RASYIDI ANAK 10/09/2017 01/01/2020
siti hawa syakila ANAK 04/01/2021 01/01/2020
DEDI HAMZAH PESERTA 25/02/1980 01/12/2019
IRA RAMIANI ISTRI 14/06/1986 01/12/2019
ZIHAN AZAHRA ANAK 25/01/2006 01/12/2019
MUHAMMAD HAKAM HAMZAH ANAK 29/04/2021 01/12/2019
WINA FATIRAHMA FATIMAH PESERTA 10/07/1996 01/01/2020
hanna jennaira aisyah ANAK 31/05/2021 01/01/2020
AZIS MUSTOPA PESERTA 09/01/1995 01/06/2019
ASEP DIDIN PESERTA 09/11/1981 01/06/2020
ASEP SAEPUL LUTFI PESERTA 29/03/1988 01/06/2019
ENTIN KARTINI ISTRI 13/07/1992 01/06/2019
SRI RATNA PURNAMA ANAK 14/10/2011 01/06/2019
ARIF RAHMANUDIN PESERTA 19/10/1995 01/01/2020
YENTI MULYANTI PESERTA 10/12/1981 01/06/2019
SOFFIE SEFTIANI PESERTA 10/09/1998 01/01/2022
RISTA DYAH YULIANA PRASETYANINGTYAS PESERTA 27/07/1987 01/01/2020
MAWAR SUCI AGUSTINA PESERTA 12/08/1997 01/01/2020
WIDIARTI PESERTA 28/08/1997 01/06/2019
SITI ZAETUN PESERTA 15/05/1976 01/12/2016
CECEP MAMUN SUAMI 02/07/1981 01/12/2016
SALWA AMANDA NOVI SHAH ANAK 28/02/2004 01/12/2016
DESILAWATI PESERTA 20/12/1987 01/06/2019
ARUMI SHIDQIA NUGRAHA ANAK 12/07/2020 01/06/2019
SARAH SYAFRINA PESERTA 05/07/1996 01/01/2020
AFRIDA YENNY, A.MK PESERTA 14/04/1978 01/12/2016
RUDI CANDRA SUAMI 02/11/1986 01/12/2016
DAFRIL CANDRA ANAK 01/12/2015 01/12/2016
DERRI AMARILA HANDANI PESERTA 26/01/1992 01/01/2020
NENG LISDAYANTI ISTRI 22/05/1997 01/01/2020
MUHAMMAD ALFIANSYAH FEBRIAN ANAK 01/02/2016 01/01/2020
KAYLA PUTRI HANDANI ANAK 17/02/2022 01/01/2020
RATIH WARDANI PESERTA 06/01/1984 01/06/2020
NANDANG SUTEDI SUAMI 05/03/1978 01/06/2020
DWI NURRIZKY ANAK 23/02/2010 01/06/2020
RESTU FAUZIYAH RAHAYU SULAEMAN PESERTA 17/12/1997 01/04/2021
RAHMAT RUSWANDI PESERTA 06/07/1987 01/01/2020
NAIRA FATIMAH PUTRI ANAK 07/08/2015 01/01/2020
MEGA WATI PESERTA 06/09/1993 01/02/2020
FADILLA APRIYANTI PESERTA 02/04/2002 01/10/2022
DESI SUSANTI PESERTA 28/02/1977 01/12/2016
HENDRI ANTONI SUAMI 17/09/1981 01/12/2016
yaqdhan rakha assaid ANAK 10/08/2015 01/12/2016
IDA DAMAYANTI PESERTA 20/09/1979 01/06/2019
SALWA RANISYA ANAK 13/09/2011 01/06/2019
IRMAWATI ROSADI PESERTA 04/04/1992 01/01/2020
PANDU NUGRAHA SUAMI 28/02/1991 01/01/2020
RIMA PERMATASARI SUDRAJAT PESERTA 16/12/1996 01/06/2019
muhammad pahlepi kurnia ANAK 26/05/2021 01/06/2019
RITA ROSWITA PESERTA 31/01/1995 01/01/2020
MUHAMMAD ADY RUSMANA SUAMI 13/03/1995 01/01/2020
NABILA PUTRI ARETHA ANAK 15/07/2021 01/01/2020
SOAIDAH PESERTA 02/03/1987 01/01/2020
SUKIRMAN SUAMI 10/05/1985 01/01/2020
SAFANA AULIA PUTRI ANAK 26/08/2012 01/01/2020
M ALBY LUTHFY RAHMANI ANAK 21/02/2016 01/01/2020
RAIHANI VANESCHA LIMITA PESERTA 04/05/2001 01/01/2020
YUSRIYANDI KURNIAWAN PESERTA 20/08/1998 01/01/2020
DEDE PURI PURWANDI PESERTA 24/08/1991 01/01/2020
RINI NURAENI DEWI PESERTA 29/04/1990 01/06/2019
REYNAN ADYA FARSHAD ANAK 03/08/2016 01/06/2019
BAYI NYONYA RINI NURAENI DEWI ANAK 06/07/2021 01/06/2019
HADRI SAPAAT PESERTA 08/05/1994 01/01/2020

GITA LARAS SRIWANDANI ISTRI 27/08/1992 01/01/2020
DINA MARYAM QURATUAINI ANAK 19/03/2018 01/01/2020
M. ZHAFRAN ALFARIZKI ANAK 27/07/2020 01/01/2020
SANTY PESERTA 17/02/1998 01/04/2021
LUKI MURDANI PESERTA 27/11/1990 01/06/2020
ARIYANI ISTRI 05/08/1993 01/06/2020
BAYI NYONYA ARIYANI ANAK 09/09/2022 01/06/2020
NENG RENI ANGGRAENI PESERTA 21/05/1989 01/01/2020

MUHAMMAD GHANY AR-RAZZAQ ANAK 23/11/2018 01/01/2020
GILANG PRATAMA PESERTA 26/08/1997 01/01/2020
DELLA NURSEPTIANI PESERTA 06/09/1997 01/10/2022
ANDI SUPANDI PESERTA 02/05/1993 01/06/2019
IWAN SETIAWAN PESERTA 31/12/1978 01/06/2019
MUHAMMAD REZA SETIAWAN ANAK 04/06/2002 01/06/2019
JUSRI SATIA PESERTA 29/09/1997 01/01/2020
VINA HANDIKA PRATIWI PESERTA 06/02/1998 01/01/2022
MUHAMAD ARIF RAHMAN PESERTA 05/02/1999 01/01/2022
DICKY AHMAD RUHIYAT PESERTA 01/08/1995 01/06/2019
CEP RAHMAT PESERTA 05/06/1981 01/01/2020
REDDY RAMADHAN PESERTA 17/02/1996 01/06/2019
Hera Djunaedi ISTRI 17/02/1997 01/06/2019
MUHAMMAD RAFFA AL FARIZQI ANAK 05/04/2020 01/06/2019
DIKI DWI KURNIA PESERTA 12/05/1992 01/12/2019
YANE SUKMAWATI PESERTA 11/01/1982 01/12/2016
KAHLA HAYFADIYA ADZANIAR RAMDANI ANAK 01/03/2010 01/12/2016
MOCHAMAD SULTHON ZHYLANZAMI RAMDANI ANAK 29/09/2006 01/12/2016
RESTU RESDIAN PESERTA 05/01/1986 01/12/2016
RINI YUDIANTI ISTRI 01/09/1985 01/12/2016
MUHAMMAD HABIBI NAUFAL ARASYID ANAK 20/10/2007 01/12/2016
MUHAMMAD WABIL TAMAM ASSADIQ ANAK 21/10/2014 01/12/2016
DEDE SOPIAN PESERTA 30/12/1973 01/12/2016
RUHYAT TAUFIK PESERTA 14/12/1983 01/12/2016
SARI WIJI ASTUTI ISTRI 29/01/1990 01/12/2016
M.HIBAN FIKRI FATHILLAH ANAK 14/04/2012 01/12/2016
MUHAMMAD ABYAN AL-FAEYZA ANAK 28/03/2019 01/12/2016
NENI KURAESIN PESERTA 05/09/1979 01/12/2016
E NURYAMAN SUAMI 08/12/1968 01/12/2016
kamila rahmawati ANAK 18/03/2012 01/12/2016
TANU PRANATA ANAK 09/12/2015 01/12/2016
SUPRAPTO PESERTA 18/02/1964 01/12/2016
SITI SOLIHAT ISTRI 30/06/1973 01/12/2016
MAWAR TREY ASTUTI ANAK 11/06/2006 01/12/2016
AGUS SAMSUDIN PESERTA 01/09/1977 01/12/2016
M. BILKIS A. P ANAK 04/04/2009 01/12/2016
MUHAMAD SYABAN ALGINAN ANAK 17/05/2017 01/12/2016
ERNA WATI PESERTA 08/08/1985 01/01/2020
AE DAELANI PESERTA 13/11/1982 01/12/2016
NANIH ISTRI 10/10/1985 01/12/2016
MUHAMAD DIVA MAULANA ANAK 31/08/2004 01/12/2016
SITI NUR AGISNA ANAK 17/12/2019 01/12/2016
SITI SAKINAH ANAK 05/02/2015 01/12/2016
SADILI PESERTA 28/01/1990 01/12/2016
NURAENI ISTRI 30/10/1993 01/12/2016
SALSA NABILA ULFATUNNISA ANAK 19/05/2014 01/12/2016
M ALBYAN MALIK BAASITH ANAK 12/09/2017 01/12/2016
AYI JAMILAH PESERTA 10/05/1978 01/12/2016
NYANYANG SUPYAN SUAMI 24/06/1977 01/12/2016
INTAN SITI NURJANAH ANAK 10/03/2013 01/12/2016
BAYI NYONYA AYI JAMILAH ANAK 06/08/2021 01/12/2016
DEWI ELIYANTI PESERTA 03/09/1981 01/12/2016

MUHAMAD AZZKA ANAK 12/03/2009 01/12/2016
MUHAMMAD AZZAM ANAK 16/12/2016 01/12/2016
JAYADI PESERTA 06/09/1983 01/06/2019
IDA FARIDA PESERTA 24/05/1977 01/12/2016
RENI MELYAWATI, S.PD PESERTA 12/05/1975 01/12/2016
DADANG MUHIDIN SUAMI 20/06/1975 01/12/2016
SHENI BADRA INAYAH ANAK 23/05/2005 01/12/2016
INAYA AZMI ATHIFA ANAK 26/08/2013 01/12/2016
DEDE SURYANA PESERTA 22/06/1987 01/04/2021
MELINDA YOAN ISTRI 21/05/1990 01/04/2021
ASKA MAULIDA KIRANA ANAK 22/02/2010 01/04/2021
M. ARSHAKA ABDUL HANAN ANAK 04/09/2018 01/04/2021
OGI SAPUTRA PESERTA 12/08/1995 01/06/2019
DELA NURFITRIANI FAIZIN ISTRI 08/03/1995 01/06/2019
NAUFAL ALI NURSYAFIQ ANAK 16/05/2019 01/06/2019
QORYNATUSHALIHAH PESERTA 07/01/1995 01/01/2020
BAYI NYONYA QORYNATUSHALIHAH ANAK 26/08/2021 01/01/2020
RIKA SELVIA MEISINTA PESERTA 10/05/1998 01/06/2019

FAISAL ARBIANSYAH SURYANA PESERTA 05/10/1997 01/06/2019
SITI IMAT ROHIMAT PESERTA 26/02/1994 01/01/2020
EIYNA NILIYYA SUBAGJA ANAK 14/01/2019 01/01/2020
SACHRUL AWALUDIN PESERTA 25/01/1999 01/01/2022
ANITA PESERTA 11/03/1996 01/01/2020
LIVI ASTRINA PESERTA 19/10/1998 01/04/2021
NURUL SURYANI SAYAGA PESERTA 04/10/1994 01/01/2020
RIFKI FAUZI PESERTA 20/03/1994 01/01/2022
ALDI RIVALDY PESERTA 19/05/1998 01/01/2022
ANNISA KURNIAWATI PESERTA 22/11/1991 01/01/2020
SILVIA SETIAWATI PESERTA 08/05/1999 01/01/2020
LENA NOVIANTI TAMBUNAN PESERTA 02/11/1998 01/04/2021
LAMIA APRIANI PESERTA 25/04/1994 01/06/2019
NARUNI KIVARA AZKADINA ANAK 14/11/2017 01/06/2019
USEP GUNAWAN PESERTA 16/04/1984 01/01/2022
AI RUSTIANINGSIH ISTRI 26/08/1986 01/01/2022
SAFIRRA NUR LATIFAH ANAK 05/02/2010 01/01/2022
ASEP HENDAR PERMANA PESERTA 10/07/1987 01/06/2019
SITI MARIANI ULFAH ISTRI 09/09/1994 01/06/2019
ALFARIZQI M AKBAR ALFARISH ANAK 10/11/2017 01/06/2019
ARZAN M MIGHPAR ANAK 23/08/2020 01/06/2019
WIJI PAKSA SETIANI PESERTA 30/12/1993 01/06/2019
NUR ALIP PESERTA 20/09/2000 01/04/2021
HERI PESERTA 13/06/1979 01/06/2019
NANI LATIFAH ISTRI 15/08/1980 01/06/2019
MUHAMMAD RIDWAN NURROHMAN ANAK 14/01/2006 01/06/2019
RIFDA NURAINI ANAK 29/06/2013 01/06/2019
RAIHANA SYARIFA ANAK 13/10/2019 01/06/2019
RISMAN HENDRAWAN PESERTA 20/05/1994 01/04/2021
DIKI HERMAWAN TOHA PESERTA 19/03/1997 01/01/2020
VINA SELFIANY PESERTA 04/06/1994 01/01/2020
ARINA DIRA ANJANI ANAK 30/12/2020 01/01/2020
PURWANTI BUDI ASEH PESERTA 05/07/1987 01/06/2019
NAESWARI NISAKA KHUMAIRA ANAK 26/11/2017 01/06/2019
JENAL ABIDIN PESERTA 18/08/1988 01/01/2020
RIZKY ERSHAN GUNAWAN PESERTA 05/03/1998 01/01/2022
RATIH WARDANI PESERTA 06/01/1983 01/10/2021
NUR MATIAS PESERTA 22/07/1994 01/01/2020
ADITIA AGUSTIAN PESERTA 16/08/1999 01/06/2019
SITI HERAWATI ISTRI 10/11/2001 01/06/2019
NAZRA SHABIRA HILYAWATI ANAK 27/12/2021 01/06/2019
INDRIYANI SURYA PRATAMA PESERTA 21/02/2000 01/11/2019
BAYI NYONYA INDRIYANI SURYA PRATAMA ANAK 05/09/2022 01/11/2019
SITI SAHDIYANTI MUZRIYAH PESERTA 22/07/1996 01/01/2020

INDAH NURMAWARSARI PESERTA 02/10/1998 01/06/2020
AHMAD JAELANI PESERTA 11/01/1996 01/09/2021
ANGGIS SUNDAENI PESERTA 09/10/1996 01/06/2019
SITI NURHASANAH PESERTA 25/01/2000 01/01/2020
MELIAWATI PESERTA 26/05/1994 01/01/2020
BAYI NYONYA MELIAWATI ANAK 21/03/2021 01/01/2020
RISKA YULIANTI PESERTA 23/07/1992 01/06/2019

SOMANTRI WIJENA PESERTA 11/05/1986 01/01/2020
MAYA SYARIFAH ADAWIYAH PESERTA 26/04/1988 01/01/2020
MEISA TRIRIZKIA PESERTA 15/05/2000 01/11/2022
SITI RUKOYAH PESERTA 30/06/1989 01/07/2019
DADAN RUKIANA SUAMI 11/03/1986 01/07/2019
MUHAMMAD ATHARIZ ALBI ASWARI ANAK 08/05/2014 01/07/2019
MUHAMMAD ARRAFI AULIAN ASHARI ANAK 04/04/2018 01/07/2019
TATANG SUHERMAN PESERTA 01/03/1960 01/01/2020
MIMIK KARMILA ISTRI 07/04/1963 01/01/2020
RIA DURIYATUL HASANAH PESERTA 11/11/1994 01/06/2019
BAYI NYONYA RIA DURIYATUL HASANAH ANAK 12/09/2021 01/06/2019
MOCHAMMAD FARHAN RANGKUTI PESERTA 10/11/1997 01/01/2020

VIVI SETYA INRAWATI PESERTA 11/06/1996 01/01/2022
AMY RUBIYANTI PESERTA 08/01/1986 01/06/2020
ABDUL MAJID SUAMI 16/08/1980 01/06/2020
MUHAMMAD ZAKARIA ANAK 22/04/2011 01/06/2020
NUR SIFA AIDAH ANAK 07/05/2003 01/06/2020
RUBBY AGNIA SUGANDA ANAK 29/08/2018 01/06/2020
LARAS NURUL FITRI PESERTA 02/02/1997 01/01/2020
MUHAMMAD RAFFI PRATAMA ANAK 19/10/2018 01/01/2020
WANDA EKA PUSPITA PESERTA 09/03/2000 01/01/2020
SYIPA HARDIYANTI PESERTA 09/03/1997 01/04/2021
FAISAL FIRMANSYAH PESERTA 04/04/1998 01/01/2022
BARJAH ALAMSYAH PESERTA 03/09/1988 01/01/2020
ENENG RESTIANATA PESERTA 05/12/1992 01/01/2022
MUTI SEPTIANI PESERTA 15/10/2002 01/01/2022
MUHAMMAD ARYA PESERTA 03/03/2003 01/01/2022
SAWALUDIN PESERTA 20/02/1998 01/01/2022
ENAH BT. OKING PESERTA 16/02/1956 01/06/2019
ACHMAD SOPIAN SYORI PESERTA 16/10/1990 01/01/2020
MERITA RUSDIASTUTI ISTRI 18/03/1994 01/01/2020
ALEXA GHAITSA ACHMAD ANAK 23/12/2018 01/01/2020
IRMA AFRIANI HANAFI PESERTA 21/01/1996 01/06/2019
SHALSHADILA FAUJIAH PESERTA 01/03/1999 01/04/2021
CEP RIAN PESERTA 01/08/1998 01/11/2022
R.REKSA BUANA ANDREAN PESERTA 19/01/1997 01/01/2020
ALYA DEWI PESERTA 22/05/1999 01/01/2022
ARDI KURNIAWAN PESERTA 15/04/1987 01/06/2019
RANY HERLINA ISTRI 30/12/1988 01/06/2019
HANIFAH HAFSAH NUR RASYIDA ANAK 03/08/2016 01/06/2019
BAYI NYONYA RANY HERLINA ANAK 12/06/2022 01/06/2019
DAVID KUSNADI PESERTA 10/08/1985 01/06/2019

NENG WULAN SURYANDANI ISTRI 11/11/1997 01/06/2019
DENDI MAULANA PESERTA 05/09/1994 01/06/2019
SITI APRIANI ISTRI 01/04/1997 01/06/2019
ALMA ANINDITA MAULANA ANAK 16/03/2018 01/06/2019
LUKMAN HANAPI S. PESERTA 17/09/1996 01/06/2019
RANTI MARLIANA ISTRI 26/06/1995 01/06/2019
ADZKIA KHANZA RAMADHANI ANAK 30/05/2017 01/06/2019
M ANDRI MAULANA PESERTA 06/10/1991 01/06/2019
EVA MUZDALIFAH ISTRI 02/01/1996 01/06/2019
ARKANA IRSYAD MAULANA ANAK 23/02/2020 01/06/2019
DANU GUNAWAN PESERTA 28/07/1998 01/06/2019
ENI ANGGRAENI PESERTA 07/12/1994 01/06/2019
JUNIATI MAGDALENA M PESERTA 10/06/1995 01/06/2019
UTIS SUMARTIN PESERTA 19/06/1983 01/06/2019
FUJI NUR KEMALADEVI PESERTA 22/02/1993 01/06/2019
ANDIKA DHANIARDY SUAMI 08/08/1982 01/06/2019
NADI PESERTA 28/03/1985 01/11/2022
ANDINI ISTRI 06/08/2000 01/11/2022
NADIRA SABILA ANAK 04/09/2021 01/11/2022
CHITRA AYU SILVIANA PESERTA 02/05/1992 01/06/2019
DEDE RIAN PESERTA 23/01/1995 01/06/2019
HANA SRESTHA SARI PESERTA 11/02/1995 01/06/2019
chaska d indra laksana ANAK 02/09/2020 01/06/2019
NIA APRIYANTI PESERTA 09/04/1996 01/06/2019
ROMI INDRA SURYADI PESERTA 09/09/1995 01/06/2019
ASEP MULYADI PESERTA 27/12/1985 01/06/2019
SITI MASLIHAT ISTRI 22/02/1992 01/06/2019
AIRA SYAPA NURASTI ANAK 02/07/2012 01/06/2019
BILQIS PUTRI MULYADI ANAK 20/12/2019 01/06/2019
MUHAMMAD SAEFUL BASRI PESERTA 02/04/1996 01/06/2019
ADHYRA ABIMANYU SUKMANA PESERTA 11/12/1998 01/06/2019
ALPAN PADILAH PESERTA 15/09/1996 01/06/2019
PANJI GUGAH BHASKARA PESERTA 22/07/1986 01/06/2019
ANGGA NUGRAHA SADELI PESERTA 22/09/1990 01/06/2019
BADEN ISKANDAR PESERTA 06/08/1979 01/06/2019
NOVIYANTI ISTRI 14/11/1989 01/06/2019
MUHAMAD NAUVAL ISKANDAR ANAK 11/11/2006 01/06/2019
MUHAMAD NAZRIEL MAULANA ISKANDAR ANAK 25/09/2011 01/06/2019
DADAN GUNAWAN PESERTA 01/01/1980 01/06/2019
MUHAMMAD JULIAN ANAK 29/07/2014 01/06/2019
IMAS NURPADILAH PESERTA 09/09/1984 01/06/2019
ROBI CAHYADI SUAMI 10/01/1978 01/06/2019
NABILA CAHYA PUTRI ANAK 30/05/2005 01/06/2019
NAURA RUBY RAMADHANI ANAK 07/08/2012 01/06/2019
IWAN SETIAWAN PESERTA 20/05/1981 01/06/2019
ANISA P. SETIAWAN ISTRI 06/02/1991 01/06/2019
KIKI ANDRIAN PESERTA 19/08/1993 01/06/2019
FITRIA PURNAMA PESERTA 23/10/1994 01/06/2019
NIA KURNIA PESERTA 29/02/1996 01/06/2019
WANDI SUPRIATNA PESERTA 06/06/1991 01/06/2019
FIRDA RIAH ISTRI 18/01/1996 01/06/2019
IZZATUNISA SALSABILA SUPRIATNA ANAK 21/07/2017 01/06/2019
MOCH IRVAN PRATAMA SIDIK PESERTA 06/04/1998 01/06/2019
SALMA RAFI AFSARI PESERTA 05/05/1996 01/06/2019
SITI HODIJAH PESERTA 02/09/1956 01/06/2019
IBON KARNITA SUAMI 16/05/1946 01/06/2019
MELLYZA NUR OKTAVIRA PESERTA 14/10/1996 01/06/2019
ADITA RAHMAN PESERTA 06/08/1995 01/06/2019
AYU FHAUZIAH PESERTA 06/10/1996 01/06/2019
RAMADAN PERMADI SUAMI 27/03/1992 01/06/2019
calief danish ramadan ANAK 31/03/2021 01/06/2019
GIARA NOVALDI PESERTA 04/11/1994 01/06/2019
HARNITA SITI ALAYA PESERTA 30/07/1999 01/06/2019
NANDANG PESERTA 07/12/1993 01/06/2019
SITI ALAM TORAJA WINDA PERNIAN PESERTA 23/07/1993 01/06/2019
SUHENDAR PESERTA 14/08/1996 01/06/2019
MUHAMAD RAMDANI PESERTA 31/10/1999 01/06/2019
MUHAMAD MUHLIS NOOR JAMIL PESERTA 02/03/1994 01/01/2020
SITI NURHAYATI PESERTA 05/07/1990 01/06/2019
M. SAEPUL FADILAH PESERTA 24/07/1997 01/06/2019
DEDEN KARMANA SAPUTRA PESERTA 25/06/2000 01/04/2021
SAEPUDIN PESERTA 07/05/1985 01/01/2020
ERLINA ISTRI 06/06/1996 01/01/2020
MUHAMMAD AL DZIKRI MAULANA ANAK 11/02/2016 01/01/2020
MIRA NURSEHA PESERTA 07/02/1997 01/01/2022
FANY FATIMAH PESERTA 02/08/1996 01/01/2020
DEVINA RAHMA PESERTA 05/10/2001 01/01/2022
ANDRI RAHMAT PESERTA 14/06/1985 01/01/2020
DEDE SITI AISYAH ISTRI 16/08/1992 01/01/2020
SITI ALISA MAULIDA ANAK 20/03/2011 01/01/2020
AIYRA ANDRIANA OKTAVIA ANAK 25/10/2014 01/01/2020
AYU LESTARI LUMBAN RAJA PESERTA 10/09/1992 01/01/2020
ANGGI SUARNI PUTRI PESERTA 26/01/1993 01/01/2020
MUHAMMAD ARGY SETYA ANAK 20/05/2016 01/01/2020
MUHAMMAD ARSALAN SETYA ANAK 16/07/2019 01/01/2020
HADI YUSUF PESERTA 08/08/1986 01/01/2020
SUAEBAH ISTRI 01/02/1990 01/01/2020
MUHAMMAD ARI HADIANSYAH ANAK 08/02/2010 01/01/2020
AURA SUCI RAMADHANI ANAK 18/07/2013 01/01/2020
MUHAMMAD ARIEL YUSUF ANAK 01/11/2019 01/01/2020
MELCHI ANDHIKA RAMA PESERTA 12/12/1984 01/01/2020
IRMA DEVI KURNIA ISTRI 18/03/1988 01/01/2020
FAEYZA ARSAKHA YUSUF MAHARDIKA ANAK 22/09/2014 01/01/2020
DESY AMBAR RUKMAWATI PESERTA 08/12/1991 01/01/2020
SAIRA MAHREEN LABIIBAH SUKRONI ANAK 06/02/2017 01/01/2020
NINA MARYANA PESERTA 06/06/1995 01/01/2020
FITRI NURUL SUCI PESERTA 02/08/1994 01/01/2020
UKAH PESERTA 01/01/1959 01/01/2020
RAY ROBI GINANJAR PESERTA 15/05/1991 01/01/2020
RAYSA MUTIA HEVIANA ANAK 29/09/2017 01/01/2020
YOPI MELASARI PESERTA 22/06/1995 01/01/2022
JODI PRANATA PESERTA 27/07/1997 01/01/2020
DEUIS NURAENI PESERTA 11/07/1994 01/01/2020
FATHAM NAAFIAN SUAMI 05/04/1992 01/01/2020
NAZWA ZAHSY SALSABILA NAAFIAN ANAK 29/01/2018 01/01/2020
MUHAMMAD RAYHAN ALFIANSYAH ANAK 31/10/2020 01/01/2020
ACEP HILMAN PESERTA 25/02/1996 01/01/2020
UMI SALMAH MULYAWATI PESERTA 28/07/1997 01/01/2020
SANDI PRABIDA PESERTA 19/07/1991 01/01/2020
ZAENU DAHLAN PESERTA 07/08/1977 01/01/2020
LIA YULIANA ISTRI 25/01/1985 01/01/2020
M ILHAM FAQIH AL GHIFARI ANAK 26/06/2014 01/01/2020
BAYI NYONYA LIA YULIANA ANAK 18/09/2021 01/01/2020
ISMI AZIZATUNNISA PESERTA 04/05/2000 01/01/2020

HESTIE ANGGRAENI PESERTA 24/11/1998 01/01/2020
ASTRI YUSTICA PEBRI PESERTA 12/02/1993 01/01/2020
TUTI SARI RATNA DEWI PESERTA 13/09/1983 01/01/2020
SUHENDI SUAMI 10/06/1978 01/01/2020
ST HANA CHAERUNNISA ANAK 06/06/2010 01/01/2020
AGUNG MAULANA RAHMAT PESERTA 15/10/1990 01/01/2020
RENITA ANGGRAENI ISTRI 29/10/1993 01/01/2020
MUHAMMAD HILMI AL YASIR ABDUROZAK PESERTA 11/01/1997 01/01/2020
RUSLAN PESERTA 04/05/1998 01/01/2020
DWISEPTIO LAMALSA PESERTA 11/09/1999 01/01/2020
ANGGI DWI ANDINI PESERTA 27/02/1997 01/01/2020
RANDI FAUZI SUAMI 12/09/1995 01/01/2020
NISCALA YAHYA NATAPRAWIRA ANAK 18/11/2021 01/01/2020
DONI ESAPUTRA PESERTA 27/07/1992 01/02/2020
WINDA MARLIANA ISTRI 15/03/1995 01/02/2020
MUHAMMAD ALDO ALFAIRUZ ANAK 26/09/2016 01/02/2020
ANITA WIJAYA PESERTA 16/02/1998 01/02/2020
REZSA RISANDI NUGRAHA PESERTA 22/09/1998 01/12/2021
RANDI FARHAN PESERTA 13/05/2002 01/01/2022
INDRA ARIESTA ISKANDAR PESERTA 01/07/1992 01/06/2020
TARTUSI PESERTA 21/09/1986 01/06/2020
DINA ISTRI 02/04/1989 01/06/2020
ARYA WIDATAR ANAK 14/11/2012 01/06/2020
ARYO MUHAMAD GOPAR ANAK 14/11/2012 01/06/2020
IBAH bahrudin PESERTA 28/03/1985 01/06/2020
INAYAH ISTRI 14/01/1984 01/06/2020
HERU HERLAMBANG PESERTA 01/05/1996 01/04/2021
MOCHAMAD GIFALDI PESERTA 30/05/2001 01/11/2020
DESTARA ASYANE FAZRIN PESERTA 13/12/2001 01/01/2022
DANDI DARMAWAN PESERTA 16/12/2000 01/04/2021
M ALDI PERMANA PESERTA 07/01/1996 01/04/2021
ABIZARD FARAZ RAUFA ANAK 26/12/2019 01/04/2021
ZAENAL ABIDIN PESERTA 18/08/1999 01/04/2021
ALFIN ANDIKA B PESERTA 23/09/1994 01/04/2021
MAULANA JAMANIL JANAH PESERTA 11/05/1998 01/04/2021
LISNA APRILIA PESERTA 06/04/1997 01/04/2021
RISDA MUTIARASARI PESERTA 26/09/1998 01/04/2021
NUR RACHMANIA SUHENDANG PESERTA 11/06/1995 01/04/2021
IRVAN CAHYADI PESERTA 09/01/2002 01/04/2021
SYAIFUL ARLAN PESERTA 22/10/1994 01/04/2021
Deri Sukardi PESERTA 28/10/2002 01/10/2021
SUHENDAR PESERTA 02/11/1995 01/01/2022
TARI MUSTARI ISTRI 18/01/2001 01/01/2022
BAYI NYONYA TARI MUSTARI ANAK 25/07/2022 01/01/2022
taofik hidayatulloh PESERTA 17/06/1996 01/01/2022

SITI MASITOH PESERTA 05/02/1964 01/01/2022
LINDA KURNIAWATI PESERTA 10/12/1996 01/01/2022
SITI SYIFA NURRIZKY PESERTA 26/08/1998 01/01/2022
Reno Firdaus PESERTA 17/10/1994 01/01/2022
Aji Apriansyah PESERTA 19/04/1997 01/01/2022
M. Ilham Maulana PESERTA 20/10/2003 01/01/2022
Junaedi PESERTA 26/07/1995 01/01/2022
Egi Oktaviandi PESERTA 07/10/1994 01/01/2022
Cecep Khoerul Bachri, A.Md.Kep PESERTA 30/07/1997 01/01/2022
Ilham Zulkifli PESERTA 27/07/1993 01/01/2022
Nandang K PESERTA 22/07/1996 01/01/2022
ANNISA SA'DIAH PESERTA 22/12/2002 01/01/2022
Siti Triana PESERTA 04/11/1995 01/01/2022
Muhamad Ilyas Gimnastiar PESERTA 19/02/2001 01/01/2022
Alya Shakira PESERTA 21/04/1999 01/01/2022
SHIKA SHAFURAMA PESERTA 20/02/1998 01/01/2022
Muhammad Wildan Firdaus PESERTA 27/04/1999 01/01/2022
JAJAT SUDRAJAT PESERTA 12/04/1994 01/01/2022
Cep Wisnu Paruk PESERTA 16/01/1998 01/01/2022
AGUNG MUNAWAR PESERTA 21/08/2001 01/01/2022
IBNU KATSIR MACHBUB PESERTA 09/01/1988 01/05/2022
Robby Fajar Maulana PESERTA 20/01/1994 01/06/2022
ELLYA HERLINAWATI PESERTA 18/11/1998 01/10/2022
DYANAH BILQIS MUJAHIDAH PESERTA 16/11/1997 01/10/2022
MUSTIKA SARI PESERTA 02/03/2000 01/11/2022
Nama Faskes Tingkat I Nama Faskes Gigi STATUS PESERTA IURAN
KLINIK KELUARGA SEHAT AKTIF 134991
CUGENANG AKTIF 134991
CUGENANG AKTIF 0
CUGENANG AKTIF 0
KARANG TENGAH AKTIF 134991
TANGGEUNG AKTIF 134991
POSK 03.10.08 CIANJUR AKTIF 134991
SUKASARI AKTIF 134991
KLINIK ASRI AKTIF 135000
KLINIK CITRA MEDIKA AKTIF 134991

KLINIK ASRI AKTIF 0
CIPANAS AKTIF 134991
WARUNG KONDANG AKTIF 134991
MUKA AKTIF 135000
SUKASARI AKTIF 0
SUKARESMI AKTIF 135000
MANDE AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
KLINIK NUR ASSYIFA AKTIF 135000
KLINIK NUR ASSYIFA AKTIF 0
KLINIK ASRI AKTIF 0
KLINIK HARAPAN SEHAT AKTIF 135000
NAGRAK AKTIF 135000
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
CARIU AKTIF 134991
CARIU AKTIF 0

H. GUSTI OTWIN ARIONO, DR. AKTIF 135000
DR. PRISKA YUDINA UTAMI SOFWAN AKTIF 0
CUGENANG AKTIF 0
MUKA AKTIF 135000
MUKA AKTIF 135000
KLINIK BINA MEDIKA AKTIF 135000
CUGENANG AKTIF 0
CUGENANG AKTIF 0
CUGENANG AKTIF 0
KLINIK HANIF AKTIF 135000
Klinik Padjadjaran Leles AKTIF 134991
KLINIK KIMIA FARMA AKTIF 134991
CIANJUR KOTA AKTIF 134991
NEGLASARI AKTIF 134991
KLINIK SILOAM AKTIF 134991
KLINIK SILOAM AKTIF 0
CIHERANG AKTIF 135000
KLINIK ASRI AKTIF 0
KADUNGORA AKTIF 135000
HJ. ITA YULIATI, DR. AKTIF 134991
CIBEBER AKTIF 134991
CIBEBER AKTIF 0
CIBEBER AKTIF 0
SUKASARI AKTIF 0
KLINIK KELUARGA AKTIF 134991
KLINIK KIMIA FARMA SELAKOPI AKTIF 135000
CIKALONGKULON AKTIF 135000
BOJONG PICUNG AKTIF 0
KLINIK ASRI AKTIF 0
MANONJAYA AKTIF 135000
GIRIJAYA AKTIF 135000
CIPEUYEUM AKTIF 135000
CIJEDIL AKTIF 134991
SUKANAGALIH AKTIF 134991
SUKANAGALIH AKTIF 0
SUKANAGALIH AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
KLINIK KIMIA FARMA CIPANAS AKTIF 0
CIPANAS AKTIF 0
Buluspesantren II AKTIF 134991
Buluspesantren II AKTIF 0
SUKANAGALIH AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
SINDANGBARANG AKTIF 134991

CIPENDAWA AKTIF 135000

CIPENDAWA AKTIF 0
SUKASARI AKTIF 0
POLRES CIANJUR AKTIF 135000
CIPANAS AKTIF 0
CIPANAS AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
KLINIK CAGAK AKTIF 134991
NARINGGUL AKTIF 134991
dr. Ibnu Syifa AKTIF 134991
MUKA AKTIF 134991
MUKA AKTIF 0
MUKA AKTIF 0

KLINIK BHAKTI SENTOSA AKTIF 135000
KLINIK MUNJUL JAYA AKTIF 0
MEGAMENDUNG AKTIF 134991
MEGAMENDUNG AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CUGENANG drg. Dyah Nugrahani AKTIF 134991
CUGENANG AKTIF 0
CUGENANG AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
MANDE AKTIF 134991
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
MUKA AKTIF 135000
MUKA AKTIF 134991
MUKA AKTIF 0
MUKA AKTIF 134991
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
MANDE AKTIF 134991
CIHERANG AKTIF 135000
KLINIK ASRI AKTIF 0
KLINIK ASRI AKTIF 0
CIPENDAWA AKTIF 0
SUKANAGALIH AKTIF 0
SUKANAGALIH AKTIF 0
PKM JATINANGOR AKTIF 134991
KLINIK ASH-SHIDDIQ CIWALEN AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
KLINIK ALIYYA AKTIF 134991
KLINIK ALIYYA AKTIF 0
KLINIK ASRI AKTIF 0
KLINIK ASRI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0

SUKANAGALIH AKTIF 0
SUKANAGALIH AKTIF 0
SUKANAGALIH AKTIF 0

KLINIK ASRI AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
MUKA AKTIF 134991
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
CIPENDAWA AKTIF 0
CIPENDAWA AKTIF 0
CIPENDAWA AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0

CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CAMPAKA AKTIF 134991

SUKARESMI AKTIF 0
MUKA AKTIF 135000
KLINIK DENKESYAH GARUT AKTIF 135000
SUKARESMI AKTIF 0
CUGENANG AKTIF 0
CUGENANG AKTIF 0
CUGENANG AKTIF 0
KLINIK KELUARGA drg. Minarti AKTIF 135000
CIPANAS AKTIF 0
CIPEUYEUM AKTIF 135000
KEC. CENGKARENG AKTIF 135000
CIPANAS AKTIF 0
CIPANAS AKTIF 0

NAGRAK AKTIF 134991

CILAWU DTP AKTIF 135000
CIPANAS AKTIF 0
MUKA AKTIF 134991

Klinik Siliwangi Kesdam Cimahi AKTIF 0
Klinik Siliwangi Kesdam Cimahi AKTIF 0
GEKBRONG AKTIF 134991

CIPENDAWA AKTIF 0
CIPENDAWA AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
GEKBRONG AKTIF 134991
KLINIK ASRI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
MUKA AKTIF 134991
CIPANAS AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
SUKARESMI AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIRANJANG AKTIF 134991
CIPANAS AKTIF 0
KLINIK MITRA KELUARGA AKTIF 134991
CIRANJANG AKTIF 134991
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIJATI AKTIF 135000
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
SUKARESMI AKTIF 0
CIPANAS AKTIF 0
KLINIK ASRI AKTIF 0
KLINIK ASRI AKTIF 0
KLINIK ASRI AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0

MANDE AKTIF 134991
Klinik TNI AU dr. M. Salamun AKTIF 134991
SUKALUYU AKTIF 0
PERMATA MEDICAL CENTER (JST) AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
CIPANAS AKTIF 0
TIPAR AKTIF 135000
SUKANAGARA AKTIF 135000

KLINIK HANIF AKTIF 135000
AGRABINTA AKTIF 135000
TGL.REGISTRASI NAMA SUB INSTANSI NAMA INSTANSI
30/12/2019 18:00:15 RSUD CIMACAN RSUD CIMACAN















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DAFTAR PESERTA PER ENTITAS

NO. NOMOR KARTU NIK NPP

137 0001105862038 3203105903940004 -

139 0001105961409 3203106309990003 -

201 0001523186425 3203285909020006 -

300 0002069301925 3203170805940007 -

308 0002092631962 3203136105890003 -

360 0002200659603 3203284309810005 83

378 0002221198266 3203155005980006 -

422 0002378607131 3203206207960004 -

429 0002421268479 3203106307920017 -

441 0002460823233 3203011011970002 -

471 0002763024502 3203281008850005 -

585 0002914070398 3203284405000008 -

630 0003109211447 3203171706960009 1

JAMALUDIN PESERTA 10/11/1999 01/01/2020

NURUL FAUZIAH PESERTA 31/03/1992 01/06/2019

HANDIKA DWI MARYATI PESERTA 19/03/1994 01/06/2019

EVY SETYORINI PESERTA 20/09/1999 01/10/2022

SEPRILA MAHARANI PESERTA 19/09/2002 01/01/2022

HADRI SAPAAT PESERTA 08/05/1994 01/01/2020

NENG RENI ANGGRAENI PESERTA 21/05/1989 01/01/2020

DEWI ELIYANTI PESERTA 03/09/1981 01/12/2016

RIKA SELVIA MEISINTA PESERTA 10/05/1998 01/06/2019

SITI SAHDIYANTI MUZRIYAH PESERTA 22/07/1996 01/01/2020

RISKA YULIANTI PESERTA 23/07/1992 01/06/2019

MOCHAMMAD FARHAN RANGKUTI PESERTA 10/11/1997 01/01/2020

DAVID KUSNADI PESERTA 10/08/1985 01/06/2019

ISMI AZIZATUNNISA PESERTA 04/05/2000 01/01/2020

taofik hidayatulloh PESERTA 17/06/1996 01/01/2022

KLINIK KELUARGA SEHAT AKTIF 134991

KLINIK ASRI AKTIF 134991

POSK 03.10.08 CIANJUR AKTIF 134991

CIPENDAWA AKTIF 135000

KLINIK KELUARGA AKTIF 135000

SUKANAGALIH AKTIF 134991

KLINIK ASRI AKTIF 134991

CIPANAS AKTIF 134991

CAMPAKA AKTIF 134991

KLINIK KELUARGA AKTIF 134991

KLINIK KIMIA FARMA CIPANAS AKTIF 134991

MUKA AKTIF 134991

KLINIK KELUARGA AKTIF 134991

CIPANAS AKTIF 134991

SUKANAGARA AKTIF 135000

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- Bayi Harus Menginformasikan Data Nama Bayi (Bukan Bayi Nyonya)

- Bayi Harus Menginformasikan Data Nama Bayi (Bukan Bayi Nyonya)

- Bayi Harus Menginformasikan Data Nama Bayi (Bukan Bayi Nyonya)