FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19

TINGKAT PUSKESMAS / FASYANKES / POS VAKSINASI

Nama Fasyankes : Puskesmas Kelingi IV/C

Provinsi : Sumatera Selatan
Kabupaten : Musi Rawas
Kecamatan : Megang Sakti
Desa : SP.6 Marga Puspita

Komorbid TD
No Nama JK NIK Umur Ket
Ya Tidak (mmHg)
1 Darinah P 1605124107760006 46 √ 110/70 Dosis 2
2 Kasni L 1605124505640001 58 √ 140/90 Dosis 2
3 Sukarmi P 1605124412480001 74 √ 160/100 Dosis 3
4 Redi L 1605125304590001 63 √ 170/100 Dosis 3
5 Saniyem P 1605125911480001 74 √ 140/90 Dosis 3
6 Mandah P 1605124107550075 67 √ 120/70 Dosis 3
7 Turinah P 1605124107550016 67 √ 150/90 Dosis 2
8 Turini P 1605126309830001 39 √ 120/80 Dosis 3
9 Kusmiati P 1605125206850007 37 √ 120/70 Dosis 2
10 Satini P 1605125002610004 61 √ 110/70 Dosis 2
11 Endang Firdaus L 1605122507800003 42 √ 140/90 Dosis 2
12 Supiyanto L 1605122190160001 62 √ 130/80 Dosis 3
13 Jumai L 1605120107480002 74 √ 160/100 Dosis 3
14 Nadiyanto L 1605120105880002 34 √ 120/70 Dosis 3
15 Haryani P 1605014707930001 29 √ 110/70 Dosis 3
16 Iin P 1605125808610001 61 √ 160/100 Dosis 3
17 Sadinem P 1605125707520001 70 √ 180/110 Dosis 3
18 Syamsiah P 1605124304790002 43 √ 110/70 Dosis 3
19 Edi Sutrisno L 1605121808740004 48 √ 110/70 Dosis 3
20 Liya Rindiani P 1605125306970001 25 √ 110/70 Dosis 3
21 Rio Prayoga Adi L 1605120406010006 21 √ 110/70 Dosis 3
22 Dwi Puji Utami P 1605124912880002 34 √ 120/70 Dosis 3
23 Sukarti P 1605124107590050 63 √ 170/100 Dosis 3
24 Selamat L 1605122004800001 42 √ 120/70 Dosis 3
25 Hasnawi L 1605120107520030 70 √ 100/60 Dosis 2
26 Ngatini P 1605125009880004 34 √ 120/70 Dosis 3
27 Surani P 1605125511800001 42 √ 120/70 Dosis 3
28 Zaenal Arifin L 1605121409770001 45 √ 120/80 Dosis 3
29 Suwartini P 1605125204760001 46 √ 120/70 Dosis 3
30 Calem P 1605125709560001 66 √ 120/70 Dosis 3
31 Sutri P 1605125008830003 39 √ 120/80 Dosis 3
32 Firman L 1505121304660003 56 √ 140/90 Dosis 2
33 Gitoyo L 1605122208830002 39 √ 120/70 Dosis 3
34 Ayi Yusep Sumirat L 1605142103510002 71 √ 140/90 Dosis 3
35 Lilis Sumiati P 1605144205630002 59 √ 160/100 Dosis 3
36 Kartini P 1605126102800003 42 √ 120/80 Dosis 3
37 Sumiati P 1605124107790005 43 √ 110/70 Dosis 3
38 Rio Septa Pradana L 1605122908030003 19 √ 100/60 Dosis 3
39 Nunung P 1605120303730004 49 √ 140/90 Dosis 3
40 Setyo Utoyo L 1605122411550001 67 √ 120/80 Dosis 3
41 Sarimin L 1605120401510004 71 √ 130/80 Dosis 3
42 Partini P 1605126410740001 48 √ 170/100 Dosis 3
43 Sumari L 1605121909690002 53 √ 100/60 Dosis 3
44 Joko Riyanto L 1605120202620003 60 √ 130/90 Dosis 3
45 Ning Helia Nora P 1605124801700001 52 √ 140/90 Dosis 3
46 Fuji Sudaryanto L 1605122505650001 57 √ 140/90 Dosis 3
47 Tuminah P 1605124902800003 42 √ 110/70 Dosis 3
48 Rohman L 1605121010770003 45 √ 130/80 Dosis 3
49 Tarisih P 1605125303730001 49 √ 130/80 Dosis 3
50 Harun L 1605121811690001 53 √ 150/90 Dosis 3
51 Siti Musriah P 1504046301890001 33 √ 130/80 Dosis 3
52 Fuji Sugiharto L 1605121101700002 52 √ 120/70 Dosis 3
53 Rahmi P 1605125511540001 68 √ 170/100 Dosis 3
54 Sardik L 1605122311610001 61 √ 110/70 Dosis 3
55 Kharisma Fidinni P 1605125701020001 20 √ 110/70 Dosis 3
56 Nining Nuryanti P 1605125106880003 34 √ 140/70 Dosis 3
57 Sugiyem P 1605124710680003 54 √ 120/80 Dosis 3
58 Fatni P 1605124905780001 44 √ 120/80 Dosis 3
59 Waginem P 1695124107690001 53 √ 160/100 Dosis 3
60 Mariyam P 1605126210850002 37 √ 130/80 Dosis 3
61 Dulun L 1605121804780000 44 √ 130/80 Dosis 3
62 Surni L 1605125006770002 45 √ 120/80 Dosis 3
63 Umi Nafiah P 1605127001640001 58 √ 170/100 Dosis 3
64 Sumini P 1605125307750002 47 √ 140/90 Dosis 3
65 Marlinawati P 1605124304760002 46 √ 140/90 Dosis 3
66 Sumirah P 1605125412740001 48 √ 120/70 Dosis 3
67 Suwarno L 1605121205670004 55 √ 110/70 Dosis 2
68 Rusmiati P 1605124107840001 38 √ 100/60 Dosis 3
69 Pania P 1605124107880099 34 √ 110/70 Dosis 3
70 Sudirman L 1605121703790001 43 √ 120/80 Dosis 3
71 Asanah P 1605205705870001 35 √ 100/60 Dosis 3
72 Ros Dewi P 1605125608820004 40 √ 130/70 Dosis 3
73 Khodijah P 1605125404560004 66 √ 130/80 Dosis 2
74 Atik P 1605121111520001 70 √ 140/90 Dosis 3
75 Sarni L 1605125505620001 60 √ 170/100 Dosis 3
 76 Madi L 1605120707570004 65 √ 130/90 Dosis 3
77 Bagus Setiawan L 1605122406860001 36 √ 100/60 Dosis 3
78 Rina Masning P 1605126211850003 37 √ 120/70 Dosis 2
79 Setiawan L 1605120710830003 39 √ 120/80 Dosis 3
80 Isnaini L 1605126801910002 31 √ 120/70 Dosis 3
81 Pantes L 1605122011620001 60 √ 120/80 Dosis 3
82 Enjun Junalah P 1605125606860004 36 √ 120/80 Dosis 3
83 Sugiyo L 1605120510730003 49 √ 110/70 Dosis 3
84 Ecih P 1605126008710001 51 √ 120/80 Dosis 3
85 Wulan Sartika P 1605124207900003 43 √ 100/60 Dosis 3
86 Septiana P 1605125709960002 26 √ 120/80 Dosis 3
87 Sugiyem P 1605127007760001 46 √ 100/60 Dosis 3
88 Dwi Yanto L 1605120601710003 51 √ 120/80 Dosis 3
89 Lasono L 1605122304800003 42 √ 130/80 Dosis 3
90 Murtafiah P 1605121670890001 33 √ 110/70 Dosis 3
91 Sumirah P 1605124107640001 58 √ 140/80 Dosis 3
92 Sarimin L 1605121108650003 57 √ 120/70 Dosis 3
93 Neliati P 1605125112780002 44 √ 120/80 Dosis 3
94 Meri Feftia Ningsih P 1605125202030002 19 √ 100/60 Dosis 3
95 Desti Wulandari P 1605126012020002 18 √ 90/60 Dosis 3
96 Wahidatul Asfia P 1605125406000001 22 √ 100/60 Dosis 3
97 Shindi Febiyani P 1605125702080001 14 √ 90/60 Dosis 3
98 Yumaini P 1605120612750001 47 √ 130/80 Dosis 3
99 Imas Siti Maesaroh P 1605125007830001 39 √ 120/80 Dosis 3
100 Warniti P 1605126710890001 33 √ 130/80 Dosis 3
101 Siti Maryam P 1605126106770001 45 √ 90/60 Dosis 3
102 Sugeng L 1605122402660002 56 √ 120/80 Dosis 3
103 M. Sugiarto L 1605120101880004 34 √ 120/80 Dosis 3
104 Sulastri P 1605106308910001 31 √ 120/80 Dosis 3
105 Nurul Wakhidah P 1605125507720003 50 √ 170/100 Dosis 3
106 Sri Asih P 1605126505820001 40 √ 130/80 Dosis 2
107 Darno L 1605122512680001 54 √ 130/80 Dosis 3
108 Siti Fuadatul P 1471014101850001 37 √ 130/80 Dosis 3
109 Titik Hidayati P 1605124808880001 34 √ 120/80 Dosis 3
110 M. Alfarizi L 1605122101080001 14 √ 110/70 Dosis 3
111 Jasih L 1208034107530001 69 √ 120/70 Dosis 3
112 Juhiya P 3208030107550010 67 √ 150/80 Dosis 3
113 Sukarman L 1605121712600002 62 √ 130/80 Dosis 3
114 Heru Sukoco L 1605122409740001 48 √ 120/80 Dosis 3
115 Ahmad Anwar L 1605122302030001 19 √ 110/70 Dosis 3
116 Supalianto L 1605120310950001 27 √ 140/80 Dosis 3
117 Fatimah Isma P 1605126308010002 21 √ 120/80 Dosis 3
118 Ponidi L 1605120410510002 71 √ 150/90 Dosis 3
119 Slamet L 1605122505560002 66 √ 150/90 Dosis 3
120 Nova Khorifa P 1605121911910001 31 √ 100/70 Dosis 3
121 Supriyatin L 1605124604800002 42 √ 110/80 Dosis 3
122 Mustahab L 1605121609970005 25 √ 100/60 Dosis 3
123 Meliawan Saika P 1605122408050001 17 √ 120/80 Dosis 3
124 Eka Sri Puji Astuti P 1605124101000091 22 √ 120/70 Dosis 3
125 Siti Khotimah P 1605126608900001 32 √ 110/80 Dosis 3
126 Purwanto L 1605121703880001 34 √ 120/80 Dosis 3
127 Sutarmin L 1605111408700002 52 √ 160/100 Dosis 3
128 Suminah P 1605124107680088 54 √ 120/70 Dosis 3
129 Sumodiono L 1605122704770001 45 √ 170/100 Dosis 3
130 Riyanto L 1605122204830002 39 √ 120/70 Dosis 3
131 Nurhayati P 1605125604930007 29 √ 120/70 Dosis 3
132 Dwi Santoso L 1605121601930001 29 √ 110/70 Dosis 3
133 Anisah P 1605124612910006 31 √ 120/70 Dosis 3
134 Sikin L 1605120110750001 47 √ 120/80 Dosis 3
135 Winem P 1605126708560002 66 √ 170/100 Dosis 3
136 Unis Hamzah P 1471012601810001 41 √ 130/80 Dosis 3

Musi Rawas, 10 Oktober 2022

Mengetahui,
Ka. UPT Puskesmas Kelingi IV/C

dr. Winny Puspitasari

NIP. 198109112010012013