1.

Petugas Entri
Data
REGISTER PELAYANAN KB R/I/KB/20
Lembar 1

1 2 3 4 5 V
6 3 0 6 0 1 8 Bulan : 2023
NAMA FASKES/ PUSKESMAS WASAH 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

1 14-Jun-2023 BASERAN 6 3 0 6 0 6 5 0 0 5 7 2 0 0 0 2 KUSTANIAH 10-May-1972 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

M. FARID
2 14-Jun-2023 6 3 0 5 0 6 5 3 0 3 9 1 0 0 0 1 YULIANI 13-Mar-1991 JL. WASAH HULU 1 0 1 0 6 1 0 0 1 0 0 0
NASRUDDIN

3 14-Jun-2023 NOR HADIME 6 3 0 6 0 6 6 4 0 8 9 2 0 0 0 1 MAULIDA HAYATI 24-Apr-1992 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

MUHAMMAD JL BAYUR MUARA

4 14-Jun-2023 6 3 0 6 0 6 6 0 1 2 8 7 0 0 0 2 JAMYATI 10-Dec-1987 3 1 0 0 1 1 0 0 1 0 0 0
ARSYAD PANTAI ULIN

5 14-Jun-2023 YUSRAN FAUZI 6 3 0 6 0 6 6 2 0 6 7 8 0 0 0 1 MASAMAH 22-Jun-1978 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

6 14-Jun-2023 WAHYUNI 6 3 0 6 0 6 5 0 0 8 7 9 0 0 0 3 ASMIAH 10-Aug-1979 JALAN BALAIMAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

7 14-Jun-2023 ABD SALIM MA'RUF 6 3 0 6 0 6 5 6 0 3 9 5 0 0 0 1 RUSDIANA 08-Mar-1989 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

8 14-Jun-2023 GAZALI RAHMAN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 HIKMAH MAULIDA 27-Jun-1993 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

MUHAMMAD JL BAYUR MUARA

9 14-Jun-2023 6 3 0 6 0 6 4 5 0 2 9 2 0 0 0 3 MARIANI 05-Feb-1992 3 1 0 0 1 1 0 0 1 0 0 0
RIZALDI PANTAI ULIN

10 14-Jun-2023 MULYADI 6 3 0 6 0 7 4 1 0 1 9 3 0 0 0 5 MARIANTI 01-Jan-1993 JL. WASAH HULU 3 0 0 0 6 1 0 0 1 0 0 0

11 14-Jun-2023 SOGIANOR 6 3 0 6 9 6 5 3 0 2 7 8 0 0 0 1 NORASIAH 13-Feb-1978 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

12 14-Jun-2023 M YAMANI 6 3 0 6 0 6 4 3 0 6 7 2 0 0 0 2 SITI NORAIDA SANTI 06-Mar-1972 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0

13 14-Jun-2023 DARKASI 6 3 0 6 0 6 4 1 0 7 7 2 0 0 7 4 MARIAH 01-Jul-1972 SUNGAI HANYAR 3 0 0 0 6 1 0 0 1 0 0 0

14 14-Jun-2023 RUDI ANSHARI 6 3 0 6 0 5 4 8 0 3 8 3 0 0 0 4 LURINA NELTIE 08-Mar-1983 WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

15 14-Jun-2023 AYYATURRAHMAN 6 3 0 6 0 6 5 0 1 0 8 9 0 0 0 2 AINUN LATIFAH 10-Oct-1989 JL. PAMUJAAN 3 1 0 0 2 1 0 0 1 0 0 0

JL BAYUR MUARA
16 14-Jun-2023 KUSMULIADY JAYA 6 3 0 6 0 6 6 1 0 3 8 8 0 0 0 2 ERMA 21-Mar-1988 3 1 0 0 1 1 0 0 1 0 0 0
PANTAI ULIN

17 14-Jun-2023 M SYARKANI 6 3 0 4 1 3 7 0 0 1 9 2 0 0 0 2 JUBAIDAH 24-Dec-1994 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

18 14-Jun-2023 SYARIFUDIN 6 3 0 6 0 6 4 1 0 3 9 6 0 0 0 1 DAHLIATI 03-Oct-1996 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

19 14-Jun-2023 MUHAMMAD HANAFI 6 3 0 6 0 6 5 5 0 1 9 8 0 0 0 2 SITI MAIMUNAH 15-Jan-1998 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

20 14-Jun-2023 NOVIARRAHMAN 6 3 7 1 0 2 4 9 1 1 9 8 0 0 0 2 RINANTI LIANA SARI 11-Sep-1998 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0

21 14-Jun-2023 WARDIANSYAH 6 3 0 6 0 6 7 1 0 1 8 6 0 0 0 4 SITI ALIAH 31-Jan-1986 JL. WH 3 0 0 0 4 1 0 0 1 0 0 0

22 14-Jun-2023 BAHRUDIN 6 3 0 6 0 6 4 3 0 9 8 7 0 0 0 2 RISNA 03-Sep-1987 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

23 14-Jun-2023 HAMDANI 6 3 0 6 0 6 6 5 0 1 8 4 0 0 0 1 MAHRITA HARIANI 25-Jan-1984 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

24 14-Jun-2023 SAIPUL ANWAR 6 3 0 6 0 4 4 1 0 7 9 1 0 0 8 2 ERLINA 04-Jun-1991 JL. WASAH HULU 1 0 1 0 4 1 0 0 1 0 0 0

25 14-Jun-2023 JUNIANTO 6 3 0 6 0 6 4 8 1 2 9 0 0 0 0 1 SITI MARIA 08-Dec-1990 JL. W. HULU 1 0 0 0 2 1 0 0 1 0 0 0

26 14-Jun-2023 SAHIBUL BAHRI 6 3 0 6 0 6 8 4 1 1 9 1 0 0 0 2 RIHLATUL HAIRIAH 24-Nov-1991 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

27 14-Jun-2023 MAWARDI 6 3 0 6 0 6 6 6 0 6 8 2 0 0 0 2 HUSWIDAH 26-Jun-1982 WASAH TENGAH 3 0 0 0 4 1 0 0 1 0 0 0

28 14-Jun-2023 RUDI 6 3 0 6 0 6 5 2 0 9 9 4 0 0 0 1 NORJANAH 12-Sep-1994 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

29 14-Jun-2023 M RAYHAN MAULIDI 6 3 0 6 0 6 6 5 0 5 0 4 0 0 0 1 NORMALINA 25-May-2004 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

30 14-Jun-2023 MARHAN 6 3 0 6 0 6 4 1 0 7 7 2 0 0 7 5 JUMAINUR 01-Jul-1972 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

31 14-Jun-2023 SALBANI 6 3 0 6 0 6 6 1 0 4 8 9 0 0 0 1 ALFI RAHMAH 21-Apr-1989 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

32 14-Jun-2023 MUHAMMAD 6 3 0 6 0 6 5 0 0 1 7 3 0 0 0 3 JABAIDAH 10-Jan-1973 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

33 14-Jun-2023 SULAIMAN 6 3 0 6 0 6 5 4 1 1 7 7 0 0 0 1 RATNAWATI 14-Nov-1977 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

34 14-Jun-2023 M HERIYADI 6 3 0 6 0 6 7 1 0 1 7 8 0 0 0 2 ANDRIYANI 31-Jan-1978 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

35 14-Jun-2023 ABDUL MUTALIB 6 3 0 6 0 5 6 0 0 4 9 1 0 0 0 1 ANISA 20-Jun-1991 JL.MANGAMOL 3 0 0 0 4 1 0 0 1 0 0 0

36 14-Jun-2023 RUSMAN 6 3 0 6 0 6 5 0 0 8 7 9 0 0 0 1 JAMILAH 10-May-1979 JL.SEBERANG 3 1 0 0 8 1 0 0 1 0 0 0

37 14-Jun-2023 NORHANSYAH 6 3 0 6 0 6 4 1 0 7 7 7 0 0 5 7 NORHILALIAH 01-Jul-1974 PANTAI ULIN 3 0 0 0 6 1 0 0 1 0 0 0

38 14-Jun-2023 ABDUR RASYID 6 2 0 3 0 3 5 4 0 5 8 2 0 0 0 4 JAMILAH 14-May-1982 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
39 14-Jun-2023 SURIYADI 6 3 0 6 9 6 5 4 0 8 8 5 0 0 0 1 MARNIDAH 14-Aug-1985 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

40 14-Jun-2023 YAMANI 6 3 0 6 0 6 4 5 0 9 8 3 0 0 0 1 MARNI ERLIYANI 05-Sep-1983 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

41 14-Jun-2023 ANSYARI SALEH 6 3 0 6 0 6 6 3 0 5 8 8 0 0 0 1 ERMA WATI 23-May-1988 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

42 14-Jun-2023 FAHRURAJI 6 3 0 6 0 6 4 8 0 8 8 7 0 0 0 1 RASIDAH IKRIMAH 08-Aug-1987 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

43 14-Jun-2023 A. RIDHANI 6 3 0 6 0 7 4 5 0 5 9 7 0 0 0 5 NORHALIMAH 08-Jun-1997 JL. W. HULU 3 1 0 0 2 1 0 0 1 0 0 0

44 14-Jun-2023 M. MAHYUNI 6 3 0 6 0 6 5 4 0 9 8 6 0 0 0 1 RUSDIANA 24-Sep-1986 JL. TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

45 14-Jun-2023 SYAHRUL 6 3 0 6 0 6 4 3 0 6 9 0 0 0 0 1 DEWI PARAMITA 03-Jun-1990 JL BAYUR MUARA PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

46 14-Jun-2023 HANI 6 3 0 6 0 6 4 1 0 7 7 2 0 0 7 8 DANIL 01-Jul-1972 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

47 14-Jun-2023 PAHRURRAZI 6 3 0 6 0 6 5 5 0 5 8 3 0 0 0 1 RINI RAHMI 15-May-1983 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

48 14-Jun-2023 SYAIFULLAH 6 3 0 6 0 6 4 3 1 2 7 8 0 0 0 2 RAMDANIAH 03-Dec-1978 JL BAYUR MUARA PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

49 14-Jun-2023 ALIANSYAH 6 3 0 6 0 6 4 5 0 6 7 6 0 0 0 1 HAMDANAH 05-Jun-1976 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

50 14-Jun-2023 HUMAIDI 6 3 0 5 0 5 4 3 0 6 8 9 0 0 0 1 SUMAYATI 03-Jun-1989 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

51 14-Jun-2023 ASRANI 6 3 0 4 0 3 6 7 0 9 7 5 0 0 0 1 SITI RAUDAH 27-Sep-1975 JL. WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

52 14-Jun-2023 SURYADI 6 3 0 5 1 1 7 0 1 2 8 7 0 0 0 1 MISBAH 30-Dec-1987 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

53 14-Jun-2023 YUSRANSYAH 6 3 0 6 0 6 5 7 0 7 7 1 0 0 0 1 HAMSIAH 17-Jul-1971 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

54 14-Jun-2023 M ZAKIR 6 3 0 3 0 3 4 4 0 5 9 2 0 0 0 3 ELLY MEYDA 04-May-1992 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

55 14-Jun-2023 AGUS SALIM 6 3 0 6 0 6 6 1 1 1 8 8 0 0 0 1 HASMI 21-Nov-1988 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

56 14-Jun-2023 SAMSUL BAHRI 6 3 0 6 0 6 7 0 0 9 7 7 0 0 0 1 NORHAYATI 30-Sep-1977 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

57 14-Jun-2023 A KHAIRUN SHALEH 6 3 0 6 0 1 6 5 0 1 0 0 0 0 0 2 AL INSANIAH MIFTAHUL 25-Jan-2000 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

58 14-Jun-2023 SARBAINI 6 3 0 6 0 6 4 1 0 4 8 3 0 0 0 5 MARLINI 01-Apr-1983 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

59 14-Jun-2023 HARYANTO 6 3 0 6 0 5 5 2 0 4 7 7 0 0 0 3 YULIANI 12-Apr-1977 JL. WASAH HULU 1 1 1 0 8 1 0 0 1 0 0 0

60 14-Jun-2023 FAHRI 6 3 0 6 0 5 6 6 0 1 8 4 0 0 0 1 SRI WAHYUNI 26-Jan-1984 JL.MANGAMOL 3 1 0 0 1 1 0 0 1 0 0 0

61 14-Jun-2023 IBRAHIM 6 3 0 6 1 3 4 1 0 7 7 7 0 0 2 4 HALIMAH 07-Jan-1977 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

62 14-Jun-2023 AHMAD MUSLEH 6 3 0 6 0 6 5 3 0 7 7 8 0 0 0 3 RADATUL ADAWIAH 13-Jul-1978 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

63 14-Jun-2023 HAIRIL MUCHLIS 6 3 0 6 0 6 5 3 0 3 6 5 0 0 0 2 SITI NONI 13-Mar-1965 JL. WASAH HULU 1 0 0 0 6 1 0 0 1 0 0 0

64 14-Jun-2023 SARIADANI 6 3 0 6 0 6 6 5 0 5 8 5 0 0 0 4 NINI RAHMIANI 25-May-1980 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

65 14-Jun-2023 MARJUKI 6 3 0 6 0 6 4 2 0 1 8 1 0 0 0 1 FATIMAH 02-Jan-1981 JL.TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

66 14-Jun-2023 MUHAMMAD AMIN 6 3 0 3 1 3 6 6 0 7 8 3 0 0 0 1 ILA WATI 26-Jul-1983 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

67 14-Jun-2023 M ARSYAD 6 3 0 6 0 6 4 1 0 7 7 7 0 0 6 2 JUBAIDAH 01-Jul-1977 SUNGAI HANYAR 3 0 0 0 6 1 0 0 1 0 0 0

68 14-Jun-2023 AHMAD RIDANI 6 3 0 6 0 6 4 7 0 8 9 9 0 0 0 1 RAIHANAH 07-Aug-1999 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

69 14-Jun-2023 EDY MASDIANOR 6 3 0 6 0 6 6 6 0 3 8 5 0 0 0 1 SAADAH 20-Mar-1985 JL BAYUR MUARA 1 0 1 0 8 1 0 0 1 0 0 0

70 14-Jun-2023 IRIANSYAH 6 3 0 6 0 6 6 8 0 3 9 1 0 0 0 1 SARTIKA 28-Mar-1991 JL BAYUR MUARA PANTAI ULIN 3 1 0 0 1 1 0 0 1 0 0 0

71 14-Jun-2023 ROMANSI 6 3 0 6 0 6 7 0 0 1 6 5 0 0 0 1 RATNA FARIDAH 30-Jan-1985 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0

72 14-Jun-2023 GAZALI RAHMAN 6 3 0 6 0 6 4 5 0 7 7 1 0 0 0 2 JALIPAH 05-Jul-1971 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

73 14-Jun-2023 SAIFUL TAHZANI 6 3 0 6 0 2 6 5 1 0 8 7 0 0 0 2 SRI MAULIDA RAHMI 25-Oct-1987 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

74 14-Jun-2023 DANA 6 3 0 6 0 6 4 5 0 6 8 6 0 0 0 2 ISTUTI IRIANI 05-Jun-1986 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

75 14-Jun-2023 BASERAN 6 3 0 6 0 6 4 1 0 7 8 0 0 0 4 3 HAMIDAH 01-Jul-1980 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

76 14-Jun-2023 SAMAN 6 3 0 6 0 6 6 2 1 2 7 5 0 0 0 1 SAIDAH MASRUFAH 22-Dec-1975 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

77 14-Jun-2023 SYAIFULAH 6 3 0 6 0 6 5 6 0 5 7 9 0 0 0 1 HAMSIAH 16-May-1979 JL.SEBERANG 1 1 0 0 8 1 0 0 1 0 0 0

78 14-Jun-2023 FATHURRAHMAN 6 3 0 6 0 6 6 7 1 1 8 2 0 0 0 1 MUSLIMAH 27-Feb-1982 JL. WASAH HULU 1 0 1 0 6 1 0 0 1 0 0 0

79 14-Jun-2023 SYARFANI 6 3 0 6 0 5 6 0 1 2 8 3 0 0 0 5 MULIANA 20-Dec-1983 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

80 14-Jun-2023 ALI PULLAH 6 3 0 6 0 6 4 1 0 7 7 8 0 0 5 5 MASLIAN 01-Jul-1978 JALAN BALAIMAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

81 14-Jun-2023 ABDUR RAHMAN 6 3 0 6 0 6 4 3 0 2 9 2 0 0 0 2 SALASIAH 03-Feb-1992 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

82 14-Jun-2023 FAUZI RAMADANI 6 3 0 7 0 7 6 5 1 0 8 9 0 0 0 1 SITI KHADIJAH 25-Oct-1989 WASAH HULU 1 0 1 0 2 1 0 0 1 0 0 0

83 14-Jun-2023 BARDAINI 6 3 0 6 0 6 5 1 0 4 8 4 0 0 0 2 RASIDAH 11-Apr-1984 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

84 14-Jun-2023 DEWIN ALGIFARI 6 3 0 6 0 5 7 0 1 2 8 3 0 0 0 3 RIDHA DWIYANA 30-Dec-1983 JL. THOBA 1 0 1 0 2 1 0 0 1 0 0 0

85 14-Jun-2023 SYAHRUDDIN 6 3 0 6 0 6 4 2 0 1 7 5 0 0 0 1 HAIRINA 02-Jan-1975 JL. WASAH HULU 1 0 0 0 6 1 0 0 1 0 0 0

86 14-Jun-2023 IWAN FAUZI 6 3 0 6 0 6 5 6 0 7 9 6 0 0 0 1 NURUL MUNA 16-Jul-1996 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

87 14-Jun-2023 AHMAD KUSASI 6 3 0 6 0 6 5 7 0 2 7 2 0 0 0 2 FARIDAH 02-Jul-1972 SUNGAI HANYAR 3 0 0 0 6 1 0 0 1 0 0 0

88 14-Jun-2023 M. KARTA 6 3 0 6 0 6 4 3 0 1 8 2 0 0 0 2 HERLINAWATI 03-Jan-1982 JL. W. HULU 3 1 0 0 2 1 0 0 1 0 0 0

89 14-Jun-2023 MAHDIANSYAH 6 3 0 7 0 5 6 1 0 8 8 7 0 0 0 1 NORHATIMAH 21-Aug-1987 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

90 14-Jun-2023 HILYAS 6 3 0 6 0 6 4 4 1 2 7 7 0 0 0 2 SITI ATIYAH 15-Apr-1977 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

91 14-Jun-2023 SAHRUNI 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 IDAH 01-Jul-1972 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

M RAHMADENI
92 14-Jun-2023 6 3 7 1 0 1 6 6 0 6 9 2 0 0 0 4 INTAN PERTIWI 26-Aug-1992 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0
HAKIM

93 14-Jun-2023 GAJALI RAHMAN 6 3 0 6 0 6 7 0 0 1 9 1 0 0 0 1 MELISA 30-Jan-1991 Wasah Hulu RT 4 1 0 0 0 2 1 0 0 1 0 0 0

94 14-Jun-2023 ABDURRAHMAN 6 3 0 6 0 6 4 2 1 0 6 2 0 0 0 1 MASLINA 02-Oct-1962 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

95 14-Jun-2023 ABDURRAHIM 6 3 0 6 0 8 7 1 1 2 7 8 0 0 0 3 TSANAWIYAH 31-Dec-1978 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

96 14-Jun-2023 NURIPANSAH 6 3 0 6 0 6 5 3 0 1 8 6 0 0 0 2 LAMIDAH 13-Jan-1986 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

97 14-Jun-2023 AHMAD FITRIADI 6 3 0 6 0 6 6 1 1 2 9 0 0 0 0 3 LILY SUHARNI 30-Jan-1980 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

98 14-Jun-2023 NORDIAN 6 3 0 6 0 6 5 4 1 0 7 1 0 0 0 2 SITI NORINTANIAH 14-Oct-1971 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

99 14-Jun-2023 HUSNI 6 3 0 6 0 3 6 0 0 3 9 5 0 0 0 1 RABIATUL ADAWIYAH 20-Mar-1996 JALAN BALAI MAS PANTAI ULIN 1 1 1 0 9 1 0 0 1 0 0 0

100 14-Jun-2023 RUSTAN 6 3 0 6 0 6 5 3 1 0 7 4 0 0 0 2 MARFUAH 13-Oct-1974 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

101 14-Jun-2023 LUTFI RAHMI 6 3 0 6 0 6 5 5 1 0 7 3 0 0 0 1 YULINA 15-Oct-1973 JL. WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

102 14-Jun-2023 RUSDI 6 3 0 5 1 0 6 3 0 8 8 0 0 0 0 1 SITI AISYAH 23-Aug-1980 JL PANGGUPAU 3 1 0 0 2 1 0 0 1 0 0 0

103 14-Jun-2023 MUKLIH 6 3 0 6 0 6 4 6 1 1 7 1 0 0 0 1 AMNAH 12-Mar-1973 JL MANGAMOL 1 1 1 0 8 1 0 0 1 0 0 0

104 14-Jun-2023 HASAN BASRI 6 3 0 6 0 6 6 0 0 8 8 6 0 0 0 2 YULIANA 20-Aug-1986 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

105 14-Jun-2023 BAKHRAM 6 3 0 6 0 6 6 7 0 9 8 3 0 0 0 1 SRI MARTINI 27-Sep-1981 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

106 14-Jun-2023 RIDUAN 6 3 0 6 0 6 4 1 0 7 7 7 0 1 0 1 ASWATI 01-Jul-1977 JL.TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

107 14-Jun-2023 ARBAN SULAIMAN 6 3 0 6 0 6 4 1 0 7 7 9 0 0 3 2 MASNIAH 01-Jul-1979 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

108 14-Jun-2023 RIADI SUPATMI 6 3 0 6 0 6 6 8 0 5 7 7 0 0 0 2 NORMALINA 28-May-1977 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

109 14-Jun-2023 M ARSYAD 6 3 0 6 0 6 5 6 0 5 7 7 0 0 0 1 SARFIAH 16-May-1977 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

110 14-Jun-2023 ABDURRAHMIN 6 3 0 6 0 6 4 1 0 7 8 0 0 0 4 5 MAIMUNAH 13-Mar-1975 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

111 14-Jun-2023 AMIDI 6 3 0 6 0 6 5 4 0 3 7 1 0 0 0 1 MARJANAH 14-Mar-1975 JL.MANGAMOL 3 1 0 0 8 1 0 0 1 0 0 0

112 14-Jun-2023 ABRAR SAUKI 6 3 0 6 0 6 6 3 0 1 0 4 0 0 0 3 NORJANAH 23-Jan-2004 WASAH HILIR 3 0 0 0 4 1 0 0 1 0 0 0

113 14-Jun-2023 ZUBAIDI 6 3 0 6 0 6 5 7 0 4 8 6 0 0 0 3 JAMILAH 07-Apr-1986 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

114 14-Jun-2023 DARSANI 6 3 0 6 0 6 4 1 0 6 9 1 0 0 0 1 NURSIHAT 01-Jun-1991 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

115 14-Jun-2023 MAHRAWI 6 3 0 6 0 6 4 6 8 7 9 0 0 0 0 1 NANA DIANA 06-Aug-1999 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

116 14-Jun-2023 HAMIM 6 3 0 6 0 6 4 1 1 2 7 9 0 0 0 1 MURSIDAH 01-Dec-1979 JL. TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

117 14-Jun-2023 FAULIZAN FITRIADI 6 3 0 6 0 6 4 8 0 9 7 3 0 0 0 1 ISTIQAMAH 08-Sep-1973 PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

118 14-Jun-2023 ZAINAL ARIFIN 6 3 0 6 0 6 4 1 0 7 8 5 0 0 2 0 NORLAILA 01-Jul-1984 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

119 14-Jun-2023 ALPIAN HUSNA 6 3 0 6 0 6 6 2 1 0 9 1 0 0 0 2 KHAIRUNNIDA 22-Oct-1991 JL. WASAH HULU 1 0 1 0 6 1 0 0 1 0 0 0

120 14-Jun-2023 HAFIZIN 6 3 0 6 0 6 6 2 0 1 8 1 0 0 0 1 MUSTIKA 22-Jan-1981 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

121 14-Jun-2023 AIDI 6 3 0 6 0 6 4 5 0 4 8 8 0 0 0 1 IRNAWATI 05-Apr-1988 JALAN BALAIMAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

122 14-Jun-2023 MUHAMMAD NISPI 6 3 0 6 0 6 4 7 0 3 9 6 0 0 0 5 FITRIA NURDA 07-Mar-1996 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

123 14-Jun-2023 MAHMUD KUSAIRI 6 3 0 6 0 6 4 7 0 7 7 5 0 0 0 1 MALASARI 07-Jul-1975 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

124 14-Jun-2023 RAMLAN 6 3 0 6 0 6 5 0 1 0 7 5 0 0 0 4 MASDIANA 10-Oct-1974 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

125 14-Jun-2023 ZAINUDIN 6 3 0 6 0 6 5 0 0 1 9 2 0 0 0 1 ELMAWATI 01-Oct-1992 JL.SEBERANG 1 1 1 0 8 1 0 0 1 0 0 0

126 14-Jun-2023 JAINI 6 3 0 6 0 6 5 1 0 7 7 1 0 0 5 3 SITI AWALIYAH 01-Jul-1971 SUNGAI HANYAR 3 0 0 0 6 1 0 0 1 0 0 0

127 14-Jun-2023 MISRANI 6 3 0 6 0 6 5 3 0 4 7 6 0 0 0 1 MASTAINAH 13-Apr-1976 JL. TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

128 14-Jun-2023 SAFII RAHMAN 6 3 0 6 0 6 4 3 0 7 7 3 0 0 0 2 SITI RAMLAH 03-Jul-1973 JL KANIDAI PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

129 14-Jun-2023 TAUFIQURRAHMAN 6 3 0 6 0 6 6 9 0 7 8 3 0 0 0 2 HIDAYATI RAHMI 19-Sep-1983 JL. W. HULU 1 0 0 0 2 1 0 0 1 0 0 0

130 14-Jun-2023 ZULKARNAIN 6 3 0 6 0 6 6 9 0 3 8 4 0 0 0 1 RISNAWATI 29-Mar-1984 JL.SEBERANG 3 0 0 0 4 1 0 0 1 0 0 0

131 14-Jun-2023 ALFIANUR 6 3 0 6 0 6 4 2 1 1 9 0 0 0 0 1 MAISYARAH 02-Nov-1990 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

132 14-Jun-2023 SYAFRUDIN 6 3 0 6 0 6 4 5 1 2 8 8 0 0 0 3 LIANA MARTINI 05-Dec-1988 JL. TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

133 14-Jun-2023 ARKANI 6 3 0 6 0 6 5 0 0 7 7 4 0 0 0 2 NURHAYATI 10-Jul-1974 JALAN BALAI MAS PANTAI ULIN 1 1 1 0 9 1 0 0 1 0 0 0

134 14-Jun-2023 JUNAIDI 6 3 0 6 0 6 6 7 0 5 7 7 0 0 0 2 MAWARNI 27-May-1977 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

135 14-Jun-2023 SUGIANOR 6 3 0 6 0 6 5 2 0 6 9 3 0 0 0 1 DATE HERLINA 12-Jun-1993 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

136 14-Jun-2023 RAHMAN 6 3 0 6 0 6 5 2 1 0 7 2 0 0 0 1 DARMAH 12-Oct-1978 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

AHMAD GAJALI
137 14-Jun-2023 6 3 0 6 0 6 6 1 0 2 9 3 0 0 0 1 MARIATUL FITRIAYAH 21-Feb-1993 WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0
RAHMAN
JL BAYUR MUARA
138 14-Jun-2023 RUSMADI 6 3 0 6 0 6 6 6 0 5 7 8 0 0 0 1 LINIE MARLINA 26-May-1978 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

139 14-Jun-2023 M RIDUAN 6 3 0 6 0 9 5 1 0 5 8 5 0 0 0 2 RULIA HASNA ELFAH 11-Jun-1985 WASAH TENGAH 1 0 1 0 4 1 0 0 1 0 0 0

140 14-Jun-2023 ABDURRAHMAN 6 3 0 6 9 6 4 7 1 1 7 1 0 0 0 2 RABIBAH 07-Oct-1971 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

141 14-Jun-2023 RADIYANOR 6 3 0 6 0 6 5 6 0 4 9 7 0 0 0 1 RISNA YANTI 16-Apr-1997 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

142 14-Jun-2023 AHMAD ASWADI 6 3 0 6 0 9 6 5 1 2 9 8 0 0 0 1 HASANAH 25-Dec-1998 WASAH HILIR 3 0 0 0 4 1 0 0 1 0 0 0

143 14-Jun-2023 FIRDAUS 6 3 0 6 0 6 6 8 1 1 8 4 0 0 0 1 AINUN RASYIDAH 28-Nov-1984 WASAH TENGAH 3 1 0 0 2 1 0 0 1 0 0 0

144 14-Jun-2023 ABDUL AZIZ 6 3 0 6 0 6 4 6 1 2 7 5 0 0 0 2 NURUL LATIFAH 06-Dec-1975 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

145 14-Jun-2023 ABKARI YAZIDI 6 3 0 5 0 4 4 6 0 6 8 8 0 0 0 1 MILAWATI 06-Jun-1988 JL. W. HULU 3 0 0 0 4 1 0 0 1 0 0 0

146 14-Jun-2023 ZAINAL HAKIM 6 3 0 6 0 6 5 0 0 8 8 0 0 0 0 2 RUSLINA 10-Aug-1980 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

147 14-Jun-2023 MAHYUDIN 6 3 0 6 0 6 4 2 0 4 9 3 0 0 0 1 YULIANI 02-Apr-1993 JL. THOBA 1 0 1 0 4 1 0 0 1 0 0 0

148 14-Jun-2023 MASRANI 6 3 0 6 0 6 4 1 0 7 7 7 0 0 6 4 JAINAH 08-Aug-1977 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

149 14-Jun-2023 JUNIANSYAH 6 3 0 6 0 6 4 5 0 8 8 6 0 0 0 2 RUBAYAH 05-Aug-1986 JL KANIDAI PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

150 14-Jun-2023 GAZALI RAHMAN 6 3 0 6 0 6 6 7 0 3 7 4 0 0 0 1 RAIHANUL JANNAH 27-Mar-1974 JL. PADANG HAUR 1 0 0 0 4 1 0 0 1 0 0 0

151 14-Jun-2023 ERFANSYAH 6 3 0 6 0 2 4 5 0 7 7 2 0 0 0 5 SITI AISYAH 07-Jul-1972 JL PNTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

152 14-Jun-2023 TONY FAHRIZA 6 3 0 6 0 5 7 0 0 8 8 9 0 0 0 1 REZA NOVIANTI 30-Aug-1989 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

153 14-Jun-2023 SAPRUDIN 6 3 0 5 0 9 6 1 0 3 8 5 0 0 0 3 MURNI 21-Mar-1985 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

154 14-Jun-2023 M.PADELI RAHIM 6 3 0 6 0 6 1 8 0 8 8 4 0 0 0 3 HIKMAH ANITA 18-Aug-1984 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

155 14-Jun-2023 ABDUL MUIS 6 3 0 6 0 6 5 1 1 0 7 6 0 0 0 1 MASLINA 11-Oct-1976 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
156 14-Jun-2023 SYAMSUL BAHRI 6 3 0 6 0 6 6 1 0 8 7 1 0 0 0 2 ROHANA 21-Aug-1971 3 1 0 0 1 1 0 0 1 0 0 0
PANTAI ULIN

157 14-Jun-2023 YULI RAHMAN 6 3 0 6 0 6 5 3 0 7 9 0 0 0 0 1 SITI BULKIS 13-Jul-1990 WASAH HILIR 3 0 0 0 4 1 0 0 1 0 0 0

158 14-Jun-2023 M RIFANI 6 3 0 6 0 6 4 7 0 8 7 5 0 0 0 2 SITI KASMAH 07-Aug-1975 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

159 14-Jun-2023 AGUS SETIAWAN 6 3 0 6 0 6 5 3 0 8 8 4 0 0 0 2 MURDINA 13-Aug-1984 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

160 14-Jun-2023 AIDL RAHMAN 6 3 0 6 0 6 5 7 0 9 7 8 0 0 0 3 RISNAWATI 09-Jul-1976 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

161 14-Jun-2023 JAMHURI 6 3 0 6 0 6 4 4 0 5 8 3 0 0 0 5 RUSBAYAH 04-May-1983 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

162 14-Jun-2023 ASLAN 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 FATIMAH 02-Nov-1972 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

163 14-Jun-2023 RUSMADI 6 3 0 6 0 6 6 9 0 6 7 7 0 0 0 1 FAHRINAH 29-Jun-1977 JL.MANGAMOL 3 0 0 0 4 1 0 0 1 0 0 0

MUHAMMAD
164 14-Jun-2023 6 3 0 6 0 6 4 2 0 4 7 7 0 0 0 2 MARAWIAH 02-Apr-1977 JL. TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0
MUKHTAR

165 14-Jun-2023 MIFTAHUR REZKI 6 3 0 6 0 5 6 9 1 1 0 0 0 0 0 4 SITI RAHMAH 29-Nov-2000 JL. BUKHARI 3 0 0 0 4 1 0 0 1 0 0 0

166 14-Jun-2023 RASIDI 6 3 0 6 0 6 4 1 0 7 7 9 0 0 3 4 JAIBAH 01-Jul-1979 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

167 14-Jun-2023 ALI NAPARIN 6 3 0 6 0 6 4 6 0 9 7 7 0 0 0 1 SITI PATIAH 06-Sep-1977 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
168 14-Jun-2023 SUBQI FAHMI 6 3 0 6 0 6 5 9 1 0 9 4 0 0 0 1 NORHAYATI N RILAYLI 19-Oct-1994 3 1 0 0 1 1 0 0 1 0 0 0
PANTAI ULIN

169 14-Jun-2023 RUSDI 6 3 0 6 0 6 5 7 0 7 9 4 0 0 0 1 SITI RAHMAH 17-Jul-1994 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

170 14-Jun-2023 ABDUL WAHAB 6 3 0 6 0 6 4 2 0 8 8 0 0 0 0 1 WAHYUNITA 02-Aug-1983 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

171 14-Jun-2023 KASPUL ANWAR 6 3 0 6 0 6 7 1 1 2 6 6 0 0 0 1 ARINA SAPURAH 31-Dec-1966 JL. WASAH HULU 1 1 0 0 9 1 0 0 1 0 0 0

172 14-Jun-2023 JARHANI 6 3 0 6 0 6 6 1 0 8 7 9 0 0 0 1 SYARIFAH ULYA 21-Aug-1979 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

173 14-Jun-2023 ABDUL WAHID 6 3 0 6 0 6 5 7 1 0 7 4 0 0 0 1 YULIANI FITRIANA 17-Oct-1974 WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

174 14-Jun-2023 HAIDIR SANI 6 3 0 6 0 6 6 4 0 5 8 8 0 0 0 2 SITI MAISARAH 24-May-1988 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

175 14-Jun-2023 RUSDIANSYAH 6 3 0 7 0 1 6 3 0 7 9 3 0 0 0 2 PUTERIANA YULIA 21-Jul-1993 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

176 14-Jun-2023 MUHAMMAD RIZAL 6 3 0 6 0 2 6 5 0 3 8 3 0 0 0 4 KASTANIAH 25-Mar-1983 JL. THOBA 1 0 0 0 2 1 0 0 1 0 0 0

177 14-Jun-2023 ANDRI SAPUTRA 6 3 0 6 0 6 4 7 1 1 9 0 0 0 0 3 AULIDA 17-Nov-1990 JL. ABAU 1 1 1 0 8 1 0 0 1 0 0 0

178 14-Jun-2023 RUDIANSYAH 6 3 0 6 0 2 4 1 0 5 9 2 0 0 0 1 MAILANNIMAH 01-May-1992 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

179 14-Jun-2023 AHMAD RAFII 6 3 0 6 0 6 5 8 0 9 9 0 0 0 0 1 NORSIDA 18-Sep-1990 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

180 14-Jun-2023 A. RISWAN TAUFIK 6 3 0 6 0 6 5 1 0 1 9 5 0 0 0 1 DINA MASLIANA 11-Jan-1995 JL. WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

181 14-Jun-2023 BURHAN 6 3 0 6 0 6 4 2 0 3 8 5 0 0 0 1 MAULIDA 02-Mar-1985 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

182 14-Jun-2023 SALAHUDIN 6 3 0 6 0 6 5 5 1 1 7 3 0 0 0 1 RAIHANAH 15-Nov-1973 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0

183 14-Jun-2023 NASRULLAH 6 3 0 6 0 6 6 4 0 9 7 4 0 0 0 1 RUSMAWARNI 24-Sep-1974 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

184 14-Jun-2023 RUSDI 6 3 0 6 0 6 6 3 1 2 7 5 0 0 0 1 MAIMUNAH 23-Dec-1975 JL.PABRIK 3 1 0 0 1 1 0 0 1 0 0 0

185 14-Jun-2023 SURIANSYAH 6 3 0 6 0 6 4 1 0 7 7 2 0 0 7 7 SALIAH 01-Jul-1972 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

186 14-Jun-2023 AKHMAD SAUKANI 6 3 0 6 0 6 4 8 0 7 8 0 0 0 0 2 ASPIAH 08-Jul-1980 JL. WASAH HULU 1 0 1 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
187 14-Jun-2023 MUHAMMAD HILMI 6 3 0 6 0 6 4 3 0 3 8 0 0 0 0 3 SAMAH 03-Mar-1980 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

188 14-Jun-2023 ZAINODDIN NOOR 6 3 0 6 0 6 6 2 0 3 8 1 0 0 0 3 MASUDAH 12-Mar-1981 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

189 14-Jun-2023 JAMHURI 6 3 0 6 0 6 4 1 0 7 7 6 0 0 5 4 NOR ASIYAH 01-Jul-1976 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

190 14-Jun-2023 ASROFI MUNTAHA 6 3 0 6 0 8 5 3 1 2 8 7 0 0 0 2 NINA LUSIANA 13-Dec-1987 JL. W. HULU 1 0 0 0 2 1 0 0 1 0 0 0

191 14-Jun-2023 KHARUDIN 6 3 0 6 0 6 4 1 0 4 7 6 0 0 0 4 NORHIDAYAH 01-Apr-1976 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

192 14-Jun-2023 MUHNI 6 3 0 6 0 6 5 3 0 3 7 4 0 0 0 3 MASNUN 13-Mar-1974 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

ANWRUL
193 14-Jun-2023 6 3 0 6 0 6 4 1 0 7 8 2 0 0 4 4 MASKANAH 01-Jul-1982 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0
HIDAYULLAH

194 14-Jun-2023 M. AMIN 6 3 1 0 1 0 5 5 0 8 9 5 0 0 0 2 MAULIDI SANTI 15-Aug-1995 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
195 14-Jun-2023 WAHYU BUDINI 6 3 0 6 0 6 5 2 0 7 9 4 0 0 0 1 SITI KHADIJAH 12-Jul-1994 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

196 14-Jun-2023 AMBERI 6 3 0 6 0 6 6 4 1 0 7 5 0 0 0 1 MASMURAH 24-Oct-1974 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

ZAINUZ SALAM
197 14-Jun-2023 6 3 0 6 0 6 4 5 0 8 8 8 0 0 0 2 MUFLIHAH MIZLAH 05-Aug-1988 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0
MARUF

198 14-Jun-2023 SURIANSYAH 6 3 0 6 0 6 5 0 1 1 7 3 0 0 0 2 NURJANNAH 10-Nov-1973 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

199 14-Jun-2023 JAZULI 6 3 0 6 0 6 4 1 0 7 7 7 0 1 0 6 NORHANI 01-Jul-1977 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

200 14-Jun-2023 MAHMUD RASYID 6 3 0 6 0 6 4 4 0 2 7 7 0 0 0 3 RITNAWATI 15-Mar-1977 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

201 14-Jun-2023 MUKHYAR ARIFIN 6 3 0 6 0 6 6 5 2 0 7 8 5 0 0 0 FITERIANA 12-Jul-1985 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

MUHAMMAD
202 14-Jun-2023 6 3 0 6 0 6 5 8 0 9 9 4 0 0 0 2 SYIFA AMALIA 18-Sep-1994 AMPARAYA 3 1 0 0 1 1 0 0 1 0 0 0
RAHMADANI

203 14-Jun-2023 M. KHAIRIL AKHYAR 6 3 7 1 0 3 6 6 0 9 9 5 0 0 1 1 FATIMAH 26-Sep-1995 JL. WH 1 0 0 0 4 1 0 0 1 0 0 0

204 14-Jun-2023 IRFANI 6 3 0 6 0 6 5 5 0 7 9 2 0 0 0 2 RISNAWATI 15-Jul-1992 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

205 14-Jun-2023 RIZAL SAIDI 6 3 0 6 0 6 5 7 0 6 8 9 0 0 0 4 ISNANIAH 17-Jun-1989 JL. W. HULU 3 0 0 0 4 1 0 0 1 0 0 0

206 14-Jun-2023 GAZALI RAHMAN 6 3 0 6 0 6 6 4 0 1 7 7 0 0 0 2 NORLAILA FATRIANI 24-Jan-1977 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

207 14-Jun-2023 jasman 6 3 0 6 0 6 4 7 0 3 8 2 0 0 0 2 mahliana 09-Sep-1999 pantai ulin 1 1 1 0 8 1 0 0 1 0 0 0

208 14-Jun-2023 SAHRIL ANWAR 6 3 0 6 0 6 4 1 0 7 7 7 0 1 1 0 MARLINA 01-Jul-1977 JL.TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

209 14-Jun-2023 KHAIRUDIN 6 3 0 6 0 6 5 0 0 9 7 3 0 0 0 4 NORSANIAH 10-Sep-1973 JL. BUKHARI WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

210 14-Jun-2023 FAUJI 6 3 0 6 0 6 4 2 1 2 8 8 0 0 0 1 SITI PATIMAH 02-Dec-1988 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

211 14-Jun-2023 AHMAD SAPAWI 6 3 0 6 0 6 4 1 0 6 8 3 0 0 0 2 UMI KULSUM 01-Jun-1983 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

212 14-Jun-2023 IKRA LUTFIANADI 6 3 0 6 0 6 5 3 1 1 9 9 0 0 0 3 MAHRINA 13-Nov-1999 JL. MUNDAR 3 1 0 0 2 1 0 0 1 0 0 0

JL BAYUR MUARA
213 14-Jun-2023 ZIKRI 6 3 0 6 0 6 4 5 0 6 7 4 0 0 0 3 FITRIATI 05-Jun-1974 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

214 14-Jun-2023 mahmuddinoor 6 3 0 6 0 6 5 1 0 5 7 4 0 0 0 2 NORIZATIL HASANAH 05-Nov-1974 pantai ulin 3 0 0 0 4 1 0 0 1 0 0 0

215 14-Jun-2023 USMAN 6 3 0 6 0 6 4 6 1 0 7 1 0 0 0 1 ERNA WATI 06-Oct-1971 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

216 14-Jun-2023 MAULIDI FAHMI 6 3 7 2 0 2 5 2 1 2 9 2 0 0 0 5 EMA DAMAYANTI 30-Apr-1992 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

217 14-Jun-2023 SAHMAN 6 3 0 6 0 6 4 1 0 7 8 2 0 0 4 3 HAIRUN NISA 01-Jul-1982 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0
218 14-Jun-2023 NAWAWI 6 3 0 6 0 6 6 1 0 3 7 5 0 0 0 3 RABIATUL AULIAH 13-Feb-1976 JALAN BALAIMAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

219 14-Jun-2023 HARDI HARIADI 6 3 0 6 0 6 5 4 0 2 8 7 0 0 0 4 HARLIANI 14-Feb-1987 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

220 14-Jun-2023 FIRMAN WAHYUDI 6 3 7 1 0 4 7 1 0 3 8 0 0 0 1 1 SAUDAH 21-Mar-1980 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

221 14-Jun-2023 ZAINAL HAKIM 6 3 0 6 0 5 6 7 0 7 9 7 0 0 0 8 AHMAWATI NUFUS 27-Jul-1997 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

222 14-Jun-2023 TAUFIK TURAHMAN 6 3 0 6 0 6 4 7 0 4 7 3 0 0 0 1 NURSAPIAH 07-Apr-1973 PANTAI ULIN 3 0 0 0 6 1 0 0 1 0 0 0

223 14-Jun-2023 SAMSUDIN 6 3 0 6 0 5 4 8 0 3 9 1 0 0 0 1 HERLINA MULYANTI 08-Mar-1991 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

224 14-Jun-2023 SAMSUNI 6 3 0 6 0 6 5 0 0 6 8 2 0 0 0 2 HILMANIAH RUAIDA 10-Jun-1982 JL. W. HULU 3 0 0 0 4 1 0 0 1 0 0 0

225 14-Jun-2023 ZASTAN 6 3 0 6 0 6 5 9 0 3 9 7 0 0 0 2 RAMADAYANTI 19-Mar-1993 JL. DHARMA 3 0 0 0 4 1 0 0 1 0 0 0

226 14-Jun-2023 MAHRUDIN 6 3 0 6 0 6 4 9 0 7 8 4 0 0 0 1 MARINI 09-Jul-1984 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

227 14-Jun-2023 RIFANI 6 3 0 6 0 6 6 5 0 5 8 3 0 0 0 1 JUBAIDAH 25-May-1983 JALAN BALAI MAS PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

228 14-Jun-2023 MURSIDI 6 3 0 6 0 6 4 4 0 7 5 8 0 0 0 3 ASMAH 07-Apr-1958 JL BAYUR MUARA 3 1 0 0 2 1 0 0 1 0 0 0

229 14-Jun-2023 RAHMADI 6 3 0 6 0 9 5 0 0 7 8 6 0 0 0 1 JANAIDAH 10-Jul-1986 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

230 14-Jun-2023 JASNI 6 3 0 6 0 6 5 4 0 8 9 2 0 0 0 2 TINA MAWARTI 14-Aug-1992 JL BAYUR MUARA PANTAI ULIN 3 1 0 0 1 1 0 0 1 0 0 0

231 14-Jun-2023 GASLAN 6 3 0 6 0 6 4 1 0 7 7 7 0 0 5 5 NORSIAH 01-Jul-1977 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

232 14-Jun-2023 REZA WAHYUNI 6 3 0 6 0 4 4 7 0 9 8 9 0 0 0 2 SENIATI MUTHMAINAH 07-Sep-1989 JL. W. HULU 1 0 0 0 2 1 0 0 1 0 0 0

233 14-Jun-2023 AHMAD RIFANI 6 3 0 6 0 6 6 8 0 2 8 6 0 0 0 1 ENDANG SRI WAHYUNI 28-Feb-1986 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

234 14-Jun-2023 AHMAD ZAINI 6 3 0 6 0 6 5 1 0 6 9 2 0 0 0 1 NOR WAHIDAH 11-Jun-1992 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

235 14-Jun-2023 TAMRIN 6 3 0 4 0 4 6 1 0 3 7 5 0 0 0 1 ARBAINAH 21-Mar-1975 JL. PADANG HAUR 1 0 0 0 4 1 0 0 1 0 0 0

236 14-Jun-2023 ZAINUL FIKRI 6 3 0 6 0 6 6 3 1 0 8 5 0 0 0 3 RAHMAWATI 23-Oct-1985 JL. BUKHARI WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

237 14-Jun-2023 HAIRIL ANWAR 6 3 0 6 0 6 6 1 0 3 9 0 0 0 0 1 SRI RATMI IRVANTI 21-Mar-1990 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

238 14-Jun-2023 KHAIRUDIN PANANI 6 3 0 6 0 6 4 2 0 3 8 9 0 0 0 4 SITI MASITAH 03-Feb-1989 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0

239 14-Jun-2023 ARIPIN 6 3 0 6 0 6 7 0 0 1 8 1 0 0 0 2 SRI HARTATI 30-Jan-1981 JL BAYUR MUARA 3 1 0 0 1 1 0 0 1 0 0 0

MUHAMMAD AMIN
240 14-Jun-2023 6 3 0 6 0 6 5 0 0 6 9 8 0 0 0 1 LILI MARLINA 10-Jun-1998 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0
MAJIDI

241 14-Jun-2023 TAUFIK RAHMAN 6 3 0 6 0 5 4 2 0 1 7 9 0 0 0 2 HERLIANI 02-Jan-1979 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

FAHRIANOR
242 14-Jun-2023 6 3 0 6 0 6 6 8 0 7 9 6 0 0 0 3 ZAHRATUN NISA 28-Jul-1996 JL. WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0
RAHMAN

243 14-Jun-2023 IRIADI 6 3 0 6 0 6 5 8 0 1 7 5 0 0 0 1 NORJANAH 18-Jan-1975 JL THOBA 1 0 0 0 4 1 0 0 1 0 0 0

244 14-Jun-2023 ROMLI 6 3 0 6 0 6 4 6 0 6 9 0 0 0 0 1 EKA NORJANNAH 06-Jun-1990 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

245 14-Jun-2023 M ARIFIN 6 2 0 3 0 3 6 3 0 4 8 8 0 0 0 4 MARNAH 13-Sep-1988 WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

246 14-Jun-2023 THAMBERAN 6 3 0 6 0 6 0 5 0 6 7 3 0 0 0 4 MASALIAH 16-Jun-1973 JL. WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

247 14-Jun-2023 MANSI 6 3 0 6 0 6 5 1 1 2 8 6 0 0 0 1 JURAIDAH 11-Dec-1986 JL. MUNDAR 3 1 0 0 2 1 0 0 1 0 0 0

248 14-Jun-2023 RAFI'I HAMDI 6 3 0 6 0 6 6 3 1 0 8 5 0 0 0 2 DIANA RISMAYANTI 23-Oct-1985 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

249 14-Jun-2023 ABDUL KHAIR 6 3 0 6 0 6 5 0 1 0 8 2 0 0 0 4 IDA WATI 10-Oct-1982 JL. THOBA 1 0 0 0 6 1 0 0 1 0 0 0

250 14-Jun-2023 RONI ANSHARI 6 3 0 6 0 6 5 7 0 7 8 5 0 0 0 2 NORLAILA RAHMAWATI 17-Jul-1985 WASAH TENGAH 3 0 0 0 4 1 0 0 1 0 0 0

251 14-Jun-2023 LUKMANUL HAKIM 6 3 0 6 0 6 5 7 0 8 9 2 0 0 0 1 MAULIDA HAYATIE 17-Aug-1992 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

252 14-Jun-2023 SABERI 6 3 0 6 0 6 4 1 0 7 7 7 0 0 5 4 MARFUAH 01-Jul-1977 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

253 14-Jun-2023 FITRIADI 6 3 0 6 0 1 5 5 0 7 9 1 0 0 0 1 HILDA WATI 15-Jul-1991 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

254 14-Jun-2023 ARIFIN 6 3 0 6 0 6 4 4 0 1 8 1 0 0 0 1 MAULIDAYATI 04-Jan-1982 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

255 14-Jun-2023 AHMAD SHALIH 6 3 0 6 0 6 4 1 0 7 9 7 0 0 3 1 SILA RUSSUPIANI 01-Jul-1997 JL. PAMUJAAN 3 1 0 0 1 1 0 0 1 0 0 0

256 14-Jun-2023 NORJANI 6 3 0 5 0 1 4 7 1 1 8 4 0 0 0 1 TITIN 07-Nov-1984 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

257 14-Jun-2023 BAHRANI 6 3 0 6 0 6 5 3 0 5 9 0 0 0 0 1 SITI MUSTANIRAH 13-May-1990 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

258 14-Jun-2023 SAIFULLAH 6 3 0 6 0 6 4 7 0 1 8 3 0 0 0 1 FATMAWATI 07-Jan-1983 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 1

JL BAYUR MUARA
259 14-Jun-2023 FITRIADI HADI 6 3 0 6 0 6 5 0 0 7 8 1 0 0 0 3 HARIATUL KUBERA 07-Oct-1981 3 1 0 0 1 1 0 0 1 0 0 0
PANTAI ULIN

260 14-Jun-2023 ANDRI 6 3 0 6 0 6 5 5 0 4 8 5 0 0 0 3 LUTHFIAH ZURAIDA 15-Apr-1985 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

261 14-Jun-2023 yamani 6 3 0 6 0 6 6 2 0 3 8 1 0 0 0 1 MASNIAH 22-Mar-1981 JL.SEBERANG 1 1 1 0 8 1 0 0 1 0 0 0

262 14-Jun-2023 SYAHRANI 6 3 1 0 0 9 5 0 1 2 7 3 0 0 0 1 JAMILAH 12-Oct-1973 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

263 14-Jun-2023 AMI WAHYUDI 6 3 0 6 0 9 5 2 0 8 9 4 0 0 0 2 NORLIA AZIZAH 06-Dec-1994 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

264 14-Jun-2023 MUHYAR 6 3 7 1 0 3 4 7 0 7 8 5 0 0 1 9 SITI FATIMAH 07-Jul-1985 JL. TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 1

265 14-Jun-2023 M. RIZWAN NOR 6 3 0 6 0 6 4 2 0 2 9 9 0 0 0 3 ANISA FITRI 02-Feb-1999 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
266 14-Jun-2023 HANIL 6 3 0 6 0 6 6 6 0 8 7 2 0 0 0 1 NORSINAH 16-Aug-1972 3 1 0 0 1 1 0 0 1 0 0 0
PANTAI ULIN

267 14-Jun-2023 ABDULLAH 6 3 0 6 0 6 6 4 0 5 9 3 0 0 0 1 SITI RAHMAH 24-May-1993 JL SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

268 14-Jun-2023 AKHMAD ALFIAN 6 3 0 6 0 6 4 6 0 6 9 1 0 0 0 2 MIRA JUNIARTI 06-Jun-1991 JL. WH 1 0 0 0 2 1 0 0 1 0 0 0

269 14-Jun-2023 SYAIFULLAH 6 3 0 6 0 6 5 2 0 7 6 9 0 0 0 2 FARIDAH 12-Jul-1969 JL PANTAI ULIN 3 0 0 0 6 1 0 0 1 0 0 0

MABDUL RAHMAN
270 14-Jun-2023 6 3 0 6 0 6 4 1 0 9 9 2 0 0 0 2 ALFIATI NAIMAH 08-Oct-1992 JL. WASAH HULU 1 0 1 0 4 1 0 0 1 0 0 0
RAHIMI

271 14-Jun-2023 M.TAURIK 6 3 0 6 0 6 6 6 1 2 9 1 0 0 0 1 RISNAWATI 26-Dec-1991 WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

272 14-Jun-2023 GAZALI 6 3 0 6 0 6 4 9 0 6 7 3 0 0 0 1 MASERIAH 09-Jun-1973 JL PANGGUPAU 3 1 0 0 2 1 0 0 1 0 0 0

273 14-Jun-2023 M. IQBAL 6 3 0 6 0 5 5 8 0 2 9 6 0 0 0 2 LAILA FITRIANI 15-Feb-1996 JL. WH 3 1 0 0 2 1 0 0 1 0 0 0

274 14-Jun-2023 ZIKRI ADI 6 3 0 6 0 6 4 1 0 7 8 1 0 0 3 8 MAIMUNAH 20-Nov-1973 JL PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

275 14-Jun-2023 RAJUDIN 6 3 0 6 0 5 4 3 1 2 9 1 0 0 0 1 JUMIARTI 02-Dec-1991 PANTAI ULIN 3 0 0 0 6 1 0 0 1 0 0 0

276 14-Jun-2023 BAHARUDIN 6 3 0 6 0 6 4 1 0 7 7 2 0 0 8 6 KAMSIAH 01-Jul-1972 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

277 14-Jun-2023 ZULKIPLI 6 3 0 6 0 6 5 2 0 4 7 3 0 0 0 3 FATMAWATI 05-Dec-1973 JL BAYUR MUARA 1 1 1 0 8 1 0 0 1 0 0 0

278 14-Jun-2023 JUANDI 6 3 0 6 0 5 4 1 0 7 7 7 0 2 5 3 SITI RAFIAH 20-Aug-1977 PANTAI ULIN 3 1 0 0 2 1 0 0 1 0 0 0

279 14-Jun-2023 RAHMAN KHAIRUDIN 6 3 0 6 0 6 7 0 0 8 7 4 0 0 0 2 NURUL MA'RIFAH 30-Aug-1974 JL. W. HULU 1 0 1 0 4 1 0 0 1 0 0 0

280 14-Jun-2023 A. JAYADI 6 2 0 4 0 4 4 5 0 4 9 2 0 0 0 1 SISCA FITRI 04-Apr-1992 JL. WH 3 0 0 0 4 1 0 0 1 0 0 0

281 14-Jun-2023 RUSLI 6 3 0 6 0 6 4 1 0 7 7 7 0 1 0 7 KAMSIAH 01-Jul-1977 JL TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

282 14-Jun-2023 FAHRI 6 3 0 6 0 6 4 9 1 0 8 6 0 0 0 2 AISYAH 09-Oct-1986 JL. SINGAJAYA 3 1 0 0 2 1 0 0 1 0 0 0

283 14-Jun-2023 AHMAD GAFURI 6 3 0 6 0 6 6 2 0 6 9 0 0 0 0 1 RAHMAH HIDAYAH 22-Jun-1990 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

284 14-Jun-2023 M. AMRULLAH 6 3 0 6 0 5 5 2 0 5 9 7 0 0 0 1 SRI MAIDA 12-May-1997 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

285 14-Jun-2023 SAIPULLAH 6 3 0 6 0 6 4 1 0 7 7 7 0 0 5 8 SABARIYAH 01-Jul-1977 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

286 14-Jun-2023 SYAMSIADI 6 3 0 6 0 6 4 7 0 1 8 5 0 0 0 2 MARIANI 07-Jan-1985 JL. W. HULU 1 0 0 0 2 1 0 0 1 0 0 0

287 14-Jun-2023 KHAIRUL ANWAR 6 3 0 6 0 6 4 4 1 0 8 3 0 0 0 1 RAHMIYATI 20-Jul-1978 JL. WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

288 14-Jun-2023 HERMIADI 6 3 0 6 0 6 7 0 1 2 8 0 0 0 0 1 ERMINA ZAINAH 30-Dec-1980 JL.PABRIK 3 0 0 0 4 1 0 0 1 0 0 0

289 14-Jun-2023 SYARIFUDIN 6 3 0 6 0 6 4 1 0 7 7 9 0 0 3 5 LINI NURULITA 01-Jul-1979 JL. W. HULU 3 1 0 0 2 1 0 0 1 0 0 0

290 14-Jun-2023 MUHAMMAD YUSUF 6 3 0 6 0 6 6 8 0 8 8 9 0 0 0 1 SAIBATUL ASLAMIAH 28-Aug-1989 PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

291 14-Jun-2023 MAHMUDI NOOR 6 3 0 6 0 6 5 1 0 5 7 4 0 0 0 2 NORIZATIL HASANAH 05-Nov-1974 JL.SEBERANG 3 0 0 0 4 1 0 0 1 0 0 0

292 14-Jun-2023 FAUZI RAHMAN 6 3 0 6 0 1 7 0 0 6 9 7 0 0 0 1 NORHALIDAH 30-Jun-1997 JL. WASAH HULU 1 0 1 0 2 1 0 0 1 0 0 0

293 14-Jun-2023 BATDERI 6 3 0 6 0 6 4 6 0 3 7 5 0 0 0 2 ROSITA 06-Mar-1975 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

 M RIZQAN
294 14-Jun-2023 6 3 0 6 0 6 4 5 1 0 9 4 0 0 0 1 NORLAILA MARDHIATI 10-May-1994 JL BAYUR MUARA 3 0 0 0 4 1 0 0 1 0 0 0
KHARISMA

295 14-Jun-2023 SAIPUL RAHMAN 6 3 0 6 1 1 5 0 0 3 7 9 0 0 0 1 ARBAINAH 10-Mar-1979 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

296 14-Jun-2023 MAULANA 6 3 0 6 0 6 6 3 0 5 9 3 0 0 0 3 SITI RAFIAH RAHMI 23-May-1993 JL. W. HULU 1 0 1 0 2 1 0 0 1 0 0 0

297 14-Jun-2023 FAHRURRAZI 6 3 0 6 0 6 5 8 1 2 7 3 0 0 0 2 RAKIAH JAUHAR 18-Dec-1973 JL. W. HULU 3 0 0 0 4 1 0 0 1 0 0 0

298 14-Jun-2023 AHMAD YANI 6 3 0 6 0 6 4 3 0 2 9 0 0 0 0 5 BUDIYARTI 03-Feb-1990 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

299 14-Jun-2023 rusman 6 3 0 6 0 6 5 0 0 8 7 9 0 0 0 1 jamilah 05-Oct-1979 pantai ulin 1 1 1 0 8 1 0 0 1 0 0 0

300 14-Jun-2023 FAKHRURRAZI 6 3 0 6 0 6 4 8 0 7 8 3 0 0 0 2 HIDAYATI 08-Jul-1983 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

301 14-Jun-2023 RAHMAD HIDAYAT 6 3 0 6 0 6 5 5 0 8 8 6 0 0 0 1 MAISARAH 15-Aug-1986 Pantai Ulin RT 1 3 0 0 0 4 1 0 0 1 0 0 0

302 14-Jun-2023 6 3 0 6 0 6 4 1 0 7 6 4 0 0 6 2 HAPSAH 10-Jun-1964 JL. WASAH HULU 1 0 1 0 6 1 0 0 1 0 0 0

303 14-Jun-2023 ABAS BASERI 6 3 0 4 0 2 5 0 0 6 8 2 0 0 0 4 SAMSIAR ZULIANA 10-Jun-1982 JL. PAMUJAAN 3 1 0 0 1 1 0 0 1 0 0 0

304 14-Jun-2023 ZAINUDIN 6 3 0 6 0 6 5 9 1 1 7 8 0 0 0 1 MASTIKA MURNI 19-Nov-1978 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

305 14-Jun-2023 MUHYIDIN 6 3 0 6 0 6 4 3 0 5 7 8 0 0 0 1 IDA HARTATI 03-May-1978 JL. TUNGKARAN 3 0 0 0 4 1 0 0 1 0 0 0

306 14-Jun-2023 JARMUNI 6 3 0 6 0 6 6 0 1 1 7 6 0 0 0 2 MARTASIAH 20-Nov-1976 JL.MANGAMOL 3 1 0 0 1 1 0 0 1 0 0 0

307 14-Jun-2023 SYAMSURI 6 3 0 6 0 6 4 7 0 6 7 7 0 0 0 2 ERNI NORJAINAH 07-Jun-1977 JL. WASAH HULU 3 0 0 0 4 1 0 0 1 0 0 0

308 14-Jun-2023 NASRUDINLATIF 6 3 0 6 0 6 5 2 0 2 7 9 0 0 0 1 SALAQIAH 02-Feb-1979 JL. ABAU 1 1 1 0 8 1 0 0 1 0 0 0

309 14-Jun-2023 SYAIFULLAH 6 3 0 6 0 6 4 4 0 5 7 7 0 0 0 3 HANA MARTINI 04-May-1977 JL. WASAH HULU 3 0 0 0 2 1 0 0 1 0 0 0

310 14-Jun-2023 AHMID 6 3 0 6 0 6 4 4 0 5 7 3 0 0 0 2 ASIH DEWI ARTI 04-May-1973 JL.SEBERANG 3 1 0 0 8 1 0 0 1 0 0 0

311 14-Jun-2023 SYAMSUDDIN 6 3 0 6 0 6 5 9 1 2 6 6 0 0 0 2 FITRIYANI 19-Dec-1966 JL. WASAH HULU 1 0 1 0 6 1 0 0 1 0 0 0

312 14-Jun-2023 M. RIDHA ADAULI 6 3 7 1 0 3 6 0 0 7 9 9 0 0 1 1 AULIA 20-Jul-1999 JL.TUNGKARAN 3 1 0 0 1 1 0 0 1 0 0 0

313 14-Jun-2023 KAMARUDDIN 6 3 0 6 0 6 8 7 1 0 8 7 0 0 0 2 RAHMIATI 17-Oct-1987 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

314 14-Jun-2023 SAMANI 6 3 1 0 0 2 4 5 0 0 9 5 0 0 0 3 SRI RAHMAWATI 04-Apr-1994 JL. KAPUH TENGAH 1 0 0 0 2 1 0 0 1 0 0 0

315 14-Jun-2023 KHAIRANI 6 3 0 6 0 6 4 1 0 7 7 2 0 0 8 7 SARIFAH 01-Jul-1972 JL PANTAI ULIN 3 1 0 0 1 1 0 0 1 0 0 0

316 14-Jun-2023 YUSRIANSYAH 6 3 0 6 0 6 5 5 0 6 7 6 0 0 0 2 MAISI 14-Jun-1975 SUNGAI HANYAR 3 0 0 0 4 1 0 0 1 0 0 0

317 14-Jun-2023 JAWARI HILMI 6 3 0 6 0 6 5 7 1 0 8 5 0 0 0 1 LILIS MAISARAH 17-Oct-1985 JL. WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

318 14-Jun-2023 NURURRAKHMAN 6 3 0 6 0 6 6 0 0 9 9 2 0 0 0 1 ELIANI FARIDA 10-Sep-1992 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

319 14-Jun-2023 TUKACIL 6 3 0 6 0 6 4 1 0 4 7 1 0 0 3 4 AHDANIAH 01-Jul-1971 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

M. FAZLI ADZANI
320 14-Jun-2023 6 3 0 6 0 6 5 8 1 0 9 4 0 0 0 1 HAFSAH 18-Oct-1994 JL. WASAH HULU 1 0 0 0 6 1 0 0 1 0 0 0
WAQFI

321 14-Jun-2023 HIFZI 6 3 0 6 0 6 4 9 0 6 7 4 0 0 0 1 SITI RAJIAH 09-Jun-1974 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

JL BAYUR MUARA
322 14-Jun-2023 RUDI FARIDI 6 3 0 6 0 6 5 9 0 7 8 2 0 0 0 1 FARIDA ELIYANA 19-Jul-1982 3 0 0 0 4 1 0 0 1 0 0 0
PANTAI ULIN

323 14-Jun-2023 SYARIFUDIN 6 3 0 6 0 5 5 0 0 3 7 5 0 0 0 3 NURMA 10-Mar-1975 JL PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

324 14-Jun-2023 FERRY BASHANOVA 6 3 0 6 0 6 4 1 0 4 8 9 0 0 0 1 WIKE PUJI NURVITASAR 01-Apr-1989 JL. WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

325 14-Jun-2023 SIHRIN FARHAN 6 3 0 6 0 6 6 5 0 1 9 2 0 0 0 5 NOOR ASFIYA 25-Jan-1992 AMPARAYA 3 0 0 0 4 1 0 0 1 0 0 0

326 14-Jun-2023 MUKHLIS 6 3 0 6 0 9 4 4 0 5 7 9 0 0 0 2 KARTALINA 05-Apr-1979 JL.MANGAMOL 1 1 1 0 8 1 0 0 1 0 0 0

327 14-Jun-2023 AMRULLAH 6 3 0 6 0 6 4 4 0 6 8 6 0 0 0 3 MAHLIDA 04-Jun-1986 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

328 14-Jun-2023 SIRAJUDDIN 6 3 0 6 0 6 4 3 0 2 8 1 0 0 0 1 RINIMARTINI 03-Feb-1981 JL. ABAU 1 1 1 0 2 1 0 0 1 0 0 0

329 14-Jun-2023 RUDIANOR 6 0 3 0 0 6 5 5 1 2 7 9 9 0 0 0 HUDRIAH 15-Dec-1979 WASAH HULU 1 0 1 0 2 1 0 0 1 0 0 0

330 14-Jun-2023 HAIRANI 6 3 0 6 0 6 5 8 0 5 7 8 0 0 0 1 NURDIAH 18-May-1978 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

331 14-Jun-2023 AKHMAD FEISAL 6 3 0 6 0 6 7 1 0 1 9 7 0 0 0 1 NOOR RAHMADINA 31-Jan-1997 WASAH HULU 3 1 0 0 2 1 0 0 1 0 0 0

332 14-Jun-2023 MUHAMMAD NOOR 6 3 0 6 0 6 4 8 1 2 7 6 0 0 0 1 MASLIANI 08-Dec-1976 JL. WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

333 14-Jun-2023 SAMSURI 6 3 0 6 0 6 4 1 0 2 7 8 0 0 0 2 JANIAH 01-Feb-1978 JL. PADANG HAUR 1 0 0 0 4 1 0 0 1 0 0 0

334 14-Jun-2023 AHMADI 6 3 0 6 0 6 4 1 0 7 7 3 0 0 0 4 HJ. MAHYUNI ARIANI 01-Jul-1973 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

335 14-Jun-2023 ARIFIN 6 3 0 6 0 6 4 1 0 4 8 5 0 0 0 1 SANIAH 01-Apr-1985 JALAN TANJAK PANTAI ULIN 3 0 0 0 4 1 0 0 1 0 0 0

336 15-Jun-2023 MUHAMMAD NOOR 6 3 0 6 0 6 4 8 1 2 7 6 0 0 0 1 MASLIANI 08-Dec-1976 JL. WASAH HULU 1 0 0 0 4 1 0 0 1 0 0 0

337 15-Jun-2023 FAHRURAJI 6 3 0 6 0 6 4 8 0 8 8 7 0 0 0 1 RASIDAH IKRIMAH 08-Aug-1987 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

338 15-Jun-2023 HAFIZIN 6 3 0 6 0 6 6 2 0 1 8 1 0 0 0 1 MUSTIKA 22-Jan-1981 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

339 15-Jun-2023 AHMAD RIDANI 6 3 0 6 0 6 4 7 0 8 9 9 0 0 0 1 RAIHANAH 07-Aug-1999 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

340 15-Jun-2023 A KHAIRUN SHALEH 6 3 0 6 0 1 6 5 0 1 0 0 0 0 0 2 AL INSANIAH MIFTAHUL 25-Jan-2000 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

341 15-Jun-2023 M HERIYADI 6 3 0 6 0 6 7 1 0 1 7 8 0 0 0 2 ANDRIYANI 31-Jan-1978 WASAH TENGAH 1 0 0 0 4 1 0 0 1 0 0 0

342 15-Jun-2023 MIFTAHUR REZKI 6 3 0 6 0 5 6 9 1 1 0 0 0 0 0 4 SITI RAHMAH 29-Nov-2000 JL. BUKHARI 3 0 0 0 4 1 0 0 1 0 0 0

343 15-Jun-2023 GAZALI RAHMAN 6 3 0 6 0 6 6 7 0 3 7 4 0 0 0 1 RAIHANUL JANNAH 27-Mar-1974 JL. PADANG HAUR 1 0 0 0 4 1 0 0 1 0 0 0

344 15-Jun-2023 MUKHYAR ARIFIN 6 3 0 6 0 6 6 5 2 0 7 8 5 0 0 0 FITERIANA 12-Jul-1985 WASAH HULU 1 0 0 0 2 1 0 0 1 0 0 0

345 15-Jun-2023 M. AMIN 6 3 1 0 1 0 5 5 0 8 9 5 0 0 0 2 MAULIDI SANTI 15-Aug-1995 JL. THOBA 1 0 0 0 4 1 0 0 1 0 0 0

346 15-Jun-2023 ABDURRAHIM 6 3 0 6 0 8 7 1 1 2 7 8 0 0 0 3 TSANAWIYAH 31-Dec-1978 JL. BUKHARI 1 0 0 0 4 1 0 0 1 0 0 0

347 15-Jun-2023 AKHMAD ALFIAN 6 3 0 6 0 6 4 6 0 6 9 1 0 0 0 2 MIRA JUNIARTI 06-Jun-1991 JL. WH 1 0 1 0 2 1 0 0 1 0 0 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 11

1 2 3 4 5 V
6 3 0 6 0 1 8 Bulan : 2023
NAMA FASKES/ PUSKESMAS WASAH 7 8 9 10 11 12
:
JARINGAN/JEJARING Kode Provinsi Kode No. Register Faskes No. Jaringan/
Kabupaten/ Jejaring Faskes
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 1 0 1 1 0 0 0 0 0 0
2 PIL 0 0 0 0 0 0 0 0 1 0 0
3 PIL 0 0 0 0 0 0 0 0 1 0 0
4 PIL 0 0 0 0 0 0 0 0 1 0 0
5 PIL 0 1 0 1 0 0 0 0 0 0 0
6 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0
7 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0
8 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0
9 PIL 0 1 0 1 0 0 0 0 0 0 0
10 PIL 0 0 0 0 0 0 0 0 1 0 0
11 PIL 0 0 0 0 0 0 0 0 1 0 0
12 PIL 0 0 0 0 0 0 0 0 1 0 0
13 PIL 0 1 0 1 0 0 0 0 0 0 0
14 KONDOM 0 1 0 1 1 0 0 0 0 0 0
15 PIL 0 0 0 0 0 0 0 0 1 0 0
16 SUNTIKAN 0 0 0 0 0 0 1 0 1 0 0
17 PIL 0 0 0 0 0 0 0 0 1 0 0
18 PIL 0 0 0 0 0 0 0 0 1 0 0
19 PIL 0 1 0 1 0 0 0 0 0 0 0
20 PIL 0 1 0 1 0 0 0 0 0 0 0
21 SUNTIKAN 0 1 0 1 1 0 0 0 0 0 0
22 PIL 0 0 0 0 0 0 0 0 1 0 0

JUMLAH 15 145 0 145 31 0 63 0 202 0 0 0

Hulu Sungai Selatan , 19-June-2023

Pimpinan Faskes KB/Jaringan/Jejaring*

NOORJAINAH HAYATI, SKM

( .................................................................................................)
196904011994032008

NIP/NRP
* Coret yang tidak perlu