L ‘3207352312150001

ABI FATONI Tasikmalaya 23-12-2015 Entin

L ‘3278090411150001
ADIARAPA ALPARIZKI Tasikmalaya 04-11-2015 Ai Mini
ALIKA AFSHEEN MYESHA P ‘3278034405160002
RINALDY Tasikmalaya 04-05-2016 Radi Gusmawati

ARKA MUHAMAD RIPAL AL L ‘3278092609160002

PARIZI Tasikmalaya 26-09-2016 Yuni Sri Wahyuni

P ‘3278094808160001
AZMYA SABIA NASIRA Tasikmalaya 08-08-2016 Sri Herlin
P ‘3278096402160002
BELLA ASMARINI KURNIA Tasikmalaya 24-02-2016 Rini Kusmarani
P ‘3278096602170002
FIRZA AKHWATUL IJABAH Tasikmalaya 27-06-2013 Iit Farida
L ‘3306121008160001 Rd Ajeng Ratu
HAIRAZ MEIZAN SIDHIATAMA Tasikmalaya 10-08-2016 Anggraeni
L ‘3278022701160002
IKHSAN NUGRAHA SULAIMAN Tasikmalaya 27-01-2016 Santi Purnamasari
L ‘3278092705160004
JILI YERVANT NURABQARI Tasikmalaya 27-05-2016 Anny Nuraeny
P ‘3278096106210001
LARISSA TITIAN PUTRI Tasikmalaya 27-04-2016 Neti Sumiati
MUHAMMAD LUTHFI SAKHI L ‘3279022204160001
ZAIDAN Tasikmalaya 22-04-2016 Meri Krisnawanti

P ‘3278095901160001
NAILA SITI ZAHRA Tasikmalaya 19-01-2016 Rik Rik Rodiah
P ‘3278094701160003
NIKEISHA MICHAELA BACHTIAR Tasikmalaya 07-01-2016 Tina Winarti
P ‘3278035408160003
NISA NURAULIA SHAFA Tasikmalaya 14-08-2016 Lia Yuliyati

RESMAIRA AISYAH ZAHRA P ‘3278044904160001

SONAPORTA Tasikmalaya 09-04-2016 Delina

L ‘3278092702170001
RIZKI FEBRIAN Tasikmalaya 27-02-2017 Ecin
P ‘3278095708160006
SHALHA HURRIYYATUL MUNA Tasikmalaya 17-08-2016 Kiki Wakiah

P ‘3278094305180003
ADINDA GENDHIS RAHMAJI Tasikmalaya 03-05-2018 Ulfah

L ‘3278090811170002 Nida Anhopia,S.Pd

ADSKHAN IRFANUL MUMTAZ Tasikmalaya 08-11-2017

L ‘3278102405170003
AFABIAN GIBRAN ASHARI Tasikmalaya 24-05-2017

L ‘3278090805180001
AKHTAR ALFARIZKI Tasikmalaya 08-05-2018

FACHRA BISMA DARMAWANGSA L ‘3278090712170002

Tasikmalaya 07-12-2017

P ‘3278096501190003
HANBIN AYESHA RANIA Tasikmalaya 25-01-2019

P ‘3278024703180002
KHAIRA ALMEERA SHAKILA Tasikmalaya 07-03-2018
 L ‘3278010108170002
KHALIF MUHAMMAD SYAUQI Tasikmalaya 01-08-2017

MOCHAMMAD RAMADHAN L ‘3278091806170004

TSANI PUTRA Tasikmalaya 18-06-2017

L ‘3278091611160003
MUHAMMAD IKRAR ALGIFARI Tasikmalaya 16-11-2016

MUHAMMAD REVAN L ‘3278092405170003

FAUZAN Tasikmalaya 24-05-2017

L ‘3278091710170001
NATHAN OKTARIAN PUTRA Tasikmalaya 17-10-2017

P ‘3278024706170001
QINARA AYUDIA RAMADANI Tasikmalaya 17-10-2017

L ‘3278022808170001
RAFARDHAN TEMA ATHALA Tasikmalaya 28-08-2017
 B
Entin Herdianto Setiarasa RT.001 RW.003 Khodijah
B
Ai Mini Andi Yusup Pamijahan RT.002 RW.007 Khodijah
B
Radi Gusmawati Bambang Adi Renaldy JL. RSU Cikalang Tawang Khodijah

B
Yuni Sri Wahyuni Yogi Yanto Pamijahan RT.002 RW.007 Khodijah

B
Sri Herlin Paino Setiarasa RT.001 RW.003 Khodijah
B
Rini Kusmarani Sona Kurnia Pamijahan RT.002 RW.007 Khodijah
B
Iit Farida Yuyu Sopiudin Setiarasa RT.004 RW.003 Khodijah
Rd Ajeng Ratu B
Anggraeni Aditya Sidiyatama Perum Sukarindik Khodijah

B
Santi Purnamasari Jajang Nurjaman Pamijahan RT.002 RW.007 Khodijah
B
Anny Nuraeny Jajang Nurjaman Setiarasa RT.001 RW.003 Khodijah
B
Neti Sumiati Eko Suryatman Setiarasa RT. 004 RW.003 Khodijah
B
Meri Krisnawanti Adi Yoyo Setaiarasa R.001 RW.003 Khodijah

B
Rik Rik Rodiah Pendi Setiarasa RT.004 RW.003 Khodijah
B
Tina Winarti U.Badruzaman B Setiarasa RT.002 RW.003 Khodijah
Letjen Mashudi Setiaratu B
Lia Yuliyati Uum Bhrul U Cibeureum Khodijah

Ressantika B
Delina Seanaporta Setiarasa RT.002 RW.003 Khodijah

B
Ecin Oyon Pamijahan RT.002 RW.007 Khodijah
B
Kiki Wakiah Badrujaman Setiarasa RT.003 RW.003 Khodijah

Setiarasa RT.001 A
Ulfah Djeri Rahmaji RW.003 Aisyah

Nida Anhopia,S.Pd Sukasari Bungursari Bungursari A

Saepul Uyun,Sag Aisyah

Teguh Mirangga Y, Awiluar Singkup A

Neni Nur Islami S.Pd Purbaratu Aisyah

Pamijahan RT.002 RW.007 A

Herlina Setiawati Deni Nuryadin Aisyah

Setiarasa RT. 002 RW.003 A

Fety Asmawati Fery Haerdyanto, SE Aisyah

Pamijahan RT.002 A
Daniarti, S.PdI Fachryan Arisakti RW.007 Aisyah

Sarah Nuraini,S.Sos Mancogeh Nagarasari Cipedes A

Eris Kaharisman Aisyah
 Cilembang Cilembang A
Desi Maryati Mujahid Al Faruq Cihideung Aisyah

Setiarasa RT.003 A
Rahayu Ratnasari Mochamad Roidiana RW.003 Aisyah

Setiarasa RT.002 RW.003 A

Ida Farida Dedi Supriadi Aisyah

Setiarasa RT.001 A
Rini Romyani Eri Darwin RW.003 Aisyah

Setiarasa RT.004 RW.003 A

Veni Novieanti Rian Kurniawan Aisyah

Mulyasari Sukamanah Cipedes A

Yuni Indriani Odik Wahidin Aisyah

Panunggal Cipedes A
Tina Mardiah Tema Hariawan Cipedes Aisyah
HASIL PEMERIKSAAN KESEHATAN GIGI DAN MULUT DAN TUMB

SEKOLAH : TK AL-Khudloriyah

TANGGAL
NO NAMA SISWA NIK
LAHIR
‘3278094305180003
1 ADINDA GENDHIS RAHMAJI 03-05-2018

‘3278090811170002
2 ADSKHAN IRFANUL MUMTAZ 08-11-2017

‘3278102405170003
3 AFABIAN GIBRAN ASHARI 24-05-2017

‘3278090805180001
4 AKHTAR ALFARIZKI 08-05-2018

FACHRA BISMA DARMAWANGSA ‘3278090712170002

5 07-12-2017

‘3278096501190003
6 HANBIN AYESHA RANIA 25-01-2019

‘3278024703180002
7 KHAIRA ALMEERA SHAKILA 07-03-2018

‘3278010108170002
8 KHALIF MUHAMMAD SYAUQI 01-08-2017

MOCHAMMAD RAMADHAN ‘3278091806170004

9 TSANI PUTRA 18-06-2017

‘3278091611160003
10 MUHAMMAD IKRAR ALGIFARI 16-11-2016

MUHAMMAD REVAN ‘3278092405170003

11 FAUZAN 24-05-2017

‘3278091710170001
12 NATHAN OKTARIAN PUTRA 17-10-2017

‘3278024706170001
13 QINARA AYUDIA RAMADANI 17-10-2017

‘3278022808170001
14 RAFARDHAN TEMA ATHALA 28-08-2017

15

16

17

18

19

20
 Mengetahui,
Kepala Puskesmas Bantar

H.TEDY SETYADI , SKM , Msi

NIP. 19740523 199503 1 001
GI DAN MULUT DAN TUMBUH KEMBANG SISWA

HASIL SURVEY
KELA
NAMA ORANGTUA L/P JML
S d e f def-t D M F DMF-T
GIGI
Teguh Mirangga Y, P
S.Pd A
L
Deni Nuryadin
A
L
Fery Haerdyanto, SE
A
L
Fachryan Arisakti
A
L
Eris Kaharisman
A
P
Mujahid Al Faruq
A
P
Mochamad Roidiana
A
L
Dedi Supriadi
A
L
Eri Darwin
A
L
Rian Kurniawan
A
L
Odik Wahidin
A
L
Tema Hariawan
A
P
A
L
A
 STATUS HASIL
BB TB LK KET
GIZI SDIDTK
 Petugas

NIP.
HASIL PEMERIKSAAN KESEHATAN GIGI DAN MULUT DAN TUMB

SEKOLAH : TK AL-Khudloriyah

TANGGAL
NO NAMA SISWA NIK
LAHIR
‘3207352312150001
1 ABI FATONI 23-12-2015

‘3278090411150001
2 ADIARAPA ALPARIZKI 04-11-2015

ALIKA AFSHEEN MYESHA ‘3278034405160002

3 RINALDY 04-05-2016

ARKA MUHAMAD RIPAL AL ‘3278092609160002

4 PARIZI 26-09-2016

‘3278094808160001
5 AZMYA SABIA NASIRA 08-08-2016

‘3278096402160002
6 BELLA ASMARINI KURNIA 24-02-2016

‘3278096602170002
7 FIRZA AKHWATUL IJABAH 27-06-2013

‘3306121008160001
8 HAIRAZ MEIZAN SIDHIATAMA 10-08-2016

‘3278022701160002
9 IKHSAN NUGRAHA SULAIMAN 27-01-2016

‘3278092705160004
10 JILI YERVANT NURABQARI 27-05-2016

‘3278096106210001
11 LARISSA TITIAN PUTRI 27-04-2016

MUHAMMAD LUTHFI SAKHI ‘3279022204160001

12 ZAIDAN 22-04-2016

‘3278095901160001
13 NAILA SITI ZAHRA 19-01-2016

‘3278094701160003
14 NIKEISHA MICHAELA BACHTIAR 07-01-2016

‘3278035408160003
15 NISA NURAULIA SHAFA 14-08-2016

RESMAIRA AISYAH ZAHRA ‘3278044904160001

16 SONAPORTA 09-04-2016

‘3278092702170001
17 RIZKI FEBRIAN 27-02-2017

‘3278095708160006
SHALHA HURRIYYATUL MUNA 17-08-2016
18

19

20
 Mengetahui,
Kepala Puskesmas Bantar

H.TEDY SETYADI , SKM , Msi

NIP. 19740523 199503 1 001
DAN MULUT DAN TUMBUH KEMBANG SISWA

HASIL SURVEY
NAMA ORANGTUA L/P KELAS
d e f def-t D M F
L
Entin
B
L
Ai Mini
B
P
Radi Gusmawati
B
L
Yuni Sri Wahyuni
B
P
Sri Herlin
B
P
Rini Kusmarani
B
P
Iit Farida
B
Rd Ajeng Ratu L
Anggraeni
B
L
Santi Purnamasari
B
L
Anny Nuraeny
B
P
Neti Sumiati
B
L
Meri Krisnawanti
B
P
Rik Rik Rodiah
B
P
Tina Winarti
B
P
Lia Yuliyati
B
P
Delina
B
L
Ecin
B
P
Kiki Wakiah
RVEY HASIL
STATU
BB TB LK SDIDT KET
DMF-T JML GIGI S GIZI
K
 Petugas

NIP.