Professional Documents
Culture Documents
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Sarah/Tio Riski K 8/I V
2 Kusmiyati/Wahidin K 6/I 16-10-2014
3 Sumarni/Moh.Khariri K 5/I 7-10-2014C
4 Desi Restina K 5/I 6-10-2014
5 Adi Wahyuni/Andri A K 1/I 27-10-2014
6 Monica K 8/I 11-11-2014 11-12-14
7 Haryani K9/I 28-10-2014
8 Indri Anggraeni K 7/I 4-12-14
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Dwi Sapta/M.Zakaria K 6/I 10-2-2015
2 Kristin/Ripto R K 8/I 13-1-2015
3 Anjar Melati/Raswin K 2/I 17-3-2015 23-4-15
4 Yuli Astuti K 5/I 10-2-2015 10-3-15
5 Nurjanah/Agus S K 8/I 30-5-2015
6 Suci Anggraeni K1/I 9-7-2015
6 Nyai Kasmi/Widi W K6/I 23-1-2015
7 Astini/Kharis J K 8/I 8-8-2015
8 Dian A/Arif K3/I 8-8-2015
9* Ayu Salak 74 7-7-2015
10 Vera Muda Lisa/Fauzan K 8/I 3-9-2015
11 Sulistioningsih/M.soheh K8/I 4-10-2015
12 Agustina/Eko Saputra K5/I 1-11-2015
13 Sumarni/Moh.Khariri K5/I 6-11-2015
14 Lucky H/M. Nurokhman K3/I 10-12-2015
15 Tita Rohayati/Ari H K7/I 30-11-2015
16 Yuni Irmasari/Tri Heri K9/I 5-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Yuni Irmasari/Tri Heri K9/I 11-1-2016
2 Lina Yuliati/Kasirun K 9/I 29-1-2016
3 Fatikhah/Ali.A K 6/I 13-2-2016
4 Imasghina/Fikri Y K6/I 1-3-2016
5 Rayi Rahayu/Tahril P K2/I 27-2-2016
6 Hidayah/Fajar K 7/I 16-3-2016 2-5-2016
7 Imanis Gina/Fikri Y K 6/I 1-3-2016C 30-3-2016
8 Prihatin/Fredi Permana K8/I 20-5-2016 29-8-2016
9 Nia Ramadhani/M.Irfan K7/I 28-8-2016
10 Fenti/Rujeki K7/I 4-9-2016
RB.St.Hj(3,1)sc
Bd.Mas(1,85)
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LAPORAN BULANAN IMUNISASI BAYI
POSYANDU MAWAR A
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Marni/Mulyawan K 1/II 9-12-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nazalina/A.Salman K 1/II V
2 Sri Mulyani/Teguh K 4/II 8-4-2015
3 Catur Yulia/Ruslan K 4/II 8-6-2015
4 Ita Masitah/Heri K3/II 5-2-2015
5 Hanifah/Abu Bakar K1/II 13-2-2015
6 Hidayah/Rizky K3/II V 9-1-2015
7 Wahyuni C/Adi F K4/II 6-4-2015
8 Vivi H/Agus S K2/II 10-6-2015
9 Nurdiana/Andi K K2/II 5-1-2015
10 Shelia/Teguh M K3/II 8-7-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Hidayah/M.Agus K 4/II 6-2-2016 2-4-2016
2 Dinayah/Wasikin K4/II 18-2-2016
3 Mahdalena/Junaedi K2/II 5-3-2016 2-4-2016
4 Wahyuningrum/Kusnul K1/II 1-3-2016
5 Yuniar Adi/Budi S K2/II 28-3-2016
6 Siti Maryam/ Soleh K 2/2 4-1-2016 2-4-2016
7 Resti M/Dwi Heriyanto K4/2 3-10-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU MAWAR B
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 v
2 Dwi Indira/Tofikudin K 8/II 27-11-2014
3 Nur Fitriani/A.Subhan K 6/II 13-12-2014
4 Ika Rosiana/Watno K 7/II 19-12-2014
5 Nur Masitah K 3/II 13-12-2014
6 Sonita/Amak Toni K 6/II 15-12-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nur Fitriani/Ah.Subhan K 6/II 14-1-15
2 Hidayah/Rizky K 3/II V
3 Dwi Indira/Tofikudin K 8/II V
4 Ika Rosiana/Watno K 7/II 16-1-15
5 Ernawati/Achqad Zaeni K 8/II V V
6 Retno W/Fahruroji K 6/II 5-1-2015
7 Rizki Yuliani/Heftan K 7/II 4-3-15
8 Tri Wijayanti/Wahyudi K 7/II 6-3-2015
9 Novia Rizqiana K 7/II 15-4-2015
10 Marlina/Hari K 6/II 26-5-2015
11 Wiarti/Tarsono K9/II 21-4-2015
12 Dhani Fitria/Nanang S K 8/II 30-7-2015
13 Filia/Andri K 6/II 12-10-2015 1-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Siti Azizah/A.Muzaki K8/II 14-4-2016 23-5-2016
2 Fitrawati/Aji Bakar K9/II 7-4-2016 2-5-2016
3 Dwi Rizki H/Taufik K K3/II 8-5-2016 14-7-2016
4 Wati/Supriyadi K7/II 19-7-2016 16-8-2016
5 Suneti/ Ahimsa K 8/II 16-8-2016 20-9-2016
6 Sri Yuli E/Kapidin K7/II 28-9-2016 15-11-2016
7 Elvi Sukaesih/Waskito K 8/II 13-7-2016 15-8-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU KENANGA A
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Pipit K 2/III 31-5-2014
2 Andika/Yusuf K 2/III 5-9-2014 5-10-2014
3 Sri Indahwati K 2/III -9-2014 16-10-2014
4 Akhyatmi K 1/III 11-10-14
5 Intan Muharini/Waryono K 2/III 9-11-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Risqa Nursa/Maulana K 3/III 7-2-2015 11-4-15
2 Noni Oktarian/Kusnoto K 1/III 5-3-2015
3 Eli/Yohanes Edi K 3/III 5-4-2015
4 Nani Cahyani/Tofiq H K 2/III 5-5-2015C
5 Rokhayati/Sugiono K 3/III 8-6-2015
6 Rian Arindi K1/III 1-6-2015 2-7-2015
7 Ika Yuniarti Putri/SlametR K3/III 5-8-2015 5-9-2015
8 Sari Nofiana/Herfyan R K2/III 7-10-2015
9 Nuryati/ Muh. Nurul Iman K 3/III 4-11-2015
10 Dewi Eka Yani/Kuswantoro K3/III 5-11-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nuryati/ Muh. Nurul Iman K 3/III 14-12-2015
2 Dewi Eka Yani/Kuswantoro K3/III 7-1-2016
3 Farkhatunnisa/ Ibnu Syafiq K 3/III 14-12-2015 23-1-2016
4 Eti Solikha/M.Baiquni K 8/III 4-2-2016 3-3-2016
5 Nila Safitri/Zazuli K 1/III 4-2-2016 3-3-2016
6 Suginah/Takim K 1/III 16-1-2016
7 Kusrini/Adi Prakoso K2/III 20-4-2016 23-5-2016
8 Yesi Tri S/Moh.Iqbal K3/III 7-5-2016 6-8-2016
9 Nila febrilianti P/Handi H K8/III 27-7-2016 15-10-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU KENANGA B
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Yuyun Y//Koko Aji K 6/III 21-4-2014
2 Teti/Nur Abdullah K 4/III 20-9-2014
3 Darti/Wardi K 5/III 11-10-2014C
4 Yuyun L/Edi Samsudin K 5/III 18-10-2014 15-11-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Christian Fajarwati K 4/III 9-2-2015 1-6-2015
2 Maslikha/Sujatno K 6/III 18-2-2015 13-6-2015
3 Chuswatun/Iwan S K 5/III 6-6-2015
4 Ridianah/Hartono K 6/III 21-11-2015 18-12-2015
5 Dyah Mitriana S/Imam K5/III 14-12-2015
6 Kartika/Rismarno 5/III 21-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Ismiyati/sutrisno K 4/III 9-1-2016
2 Susanti/Adi Cahyo K 4/III 9-1-2016
3 Hana Febrina/Syahroni K 5/III 9-1-2016 6-2-2016
4 Estri Nur/Dede W K 4/III 26-8-2015 19-1-2016
5 Dyah M/Imam Waluyo K5/III 3-2-2016
6 Kartika/Rismarno K5/III 4-2-2016
7 Nuraeni/Rosidi K5/III 14-5-2016 18-2-2016
8 Nia Kurniasari/Maryo K5/III 2-5-2016
9 Dini Febriani/Suleman K4/III 2-5-2016 11-6-2016
10 Khusnul K/ Rasikun K5/III 13-8-2016
11 Sulis Setyaningsih/Joko P K5/III 13-7-2016 13-8-2016
12 Kapsah/Rasdi K5/III 18-10-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU ASTIKA A
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nelly Fauziyah K 6/IV V
2 Marlina/Dinroso K 4/IV 10-7-2014
3 Desi Rosanti K 6/IV 12-9-2014
4 Sefti K 8/IV 26-8-2014
5 Darti/Madraslim K 8/IV 6-10-2014
6 Yunita Putri K 8/IV 6-10-2014 11-11-2014
7 Beti Madiyanti K 8/IV 6-10-2014
8 Indah D K 6/IV 10-9-2014
9 Dewi Katresnaningsih K 6/IV 6-10-2014 10-11-14
10 Syifa Afiyati/Nurhadi K 6/IV 28-11-14C
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Siti Nurjanah/Tiswanto K 6/IV 4-2-2015
2 Indah Eka K 8/IV 23-4-15
3 Ratna Yuliani/Sarwo Edi K 6/IV 15-6-2015 3-9-2015
4 Endang M/Sakti Utomo K 6/IV 9-6-2015
5 Uswatun C/Rosadi K 4/IV 6-6-15
6 Intan Sari/Nur Wahid K 6/IV 27-6-2015
7 Ina Krisnawati K6/IV 6-7-2015 10-8-2015
8 Chosilah K4/IV 22-7-2015
9 Surati K 8/IV 13-7-2015
10 Tri Mulyaningsih/Winarno K 7/IV 3-8-2015C
11 Yayah Siti Vani/Fatkhul R K 6/IV 19-8-2015 1-10-2015
12 Rini Anggraeni/A. Saefudin K6/IV 3-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nuraeni/Heri Setiono K6/IV 22-1-2016
2 Bani Qonaatu/Koko A K 4/IV 6-1-2016 6-2-2016
3 Mei dwi/Febby K 6/IV 8-2-2016
4 Patmi/Ardiansyah K7/IV 20-2-2016
5 Karnita/Tarjono K 6/IV 2-3-2016
6 Retno Winarti/Achmad F K4/IV 4-5-2016C
7 Indah Dwi/Sigit Arie K 6/IV 4-8-2016
8 Daroyani/ Suro K 8/IV 6-8-2016
9 Endang Indarni/Hadi K 6/IV 6-9-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU ASTIKA C
No Imunisasi TT
Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Mudrikah K 5/IV 10-7-2014
2 Sri Rejeki/Juyanto K 5/IV 13-10-14C
3 Weni/Darmanto K 5/IV 20-12-2014
4 Dwi Jayanti/Imam K 5/IV 7-12-14
No Imunisasi TT
Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Weni/Darmanto K 5/IV 20-1-15
2 Ramini/Sodikin K 5/IV 4-2-2015
3 Tuslia laela/M.Yusuf K 5/IV 4-2-2015
4 Nur Trisnawati/Ramani K 5/IV 26-10-2015
5 Undari/Sadi K 5/IV 10-1-2015
6 Vina Septhiana/Riza K 5/IV 9-3-2015
7 Wuningsih/A.Hakim K 5/IV 23-5-2015
8 Rosi Ariyah/Lutfi K 5/IV 11-5-2015
9 Silvana/Imam S K 5/IV 6-7-2015 6-8-2015
10 Suyati/Mustofa K10/IV 29-6-2015
11 Katimi/Mahmud K 10/IV 14-8-2015 4-11-2015
12 Desi Arisandi/Sunori K10/IV 16-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Desi Arisandi/Sunori K10/IV 19-2-2016
2 Rike Sista/Casmudianto K 10/IV 15-2-2016 22-3-2016
3 Kustiah/Tasori K 10/IV 5-4-2016
4 Sri Kanti/Kariman K 10/IV 5-4-2016
5 Upik Pitriyami/Agus N K 5/IV 3-5-2016 17-6-2016
6 Suhernih/Sapei K 10/IV 19-4-2016 20-5-2016
7 Murniasih/Mukharomsyah K10/IV 11-4-2016C 7-9-2016
8 Mujianti/Prayitno K10/IV 2-6-2016 20-7-2016
9 Rudini T/Teguh K10/IV 30-6-2016C
10 Suryani/Dedy K10/IV 1-9-2016 2-10-2016
11 Dian Utami/M nurofi K 5/IV 2-9-2016C
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU KARTINI A
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Pariyah/Usman K 3/V 13-8-2014C
2 Taryati/Ali Sodikin K3/V 22-9-2014
3 Indah I/Nurokhim K 9/V 24-10-2014
4 Indriyani/Suratin K 3/V 29-10-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nurhayati/Imam K 9/V V 9-2-2015
2 Suci Cayani/Danny M K 3/V 4-3-2015C
3 Kustiah/Rudiyanto K 9/V 28-3-2015C
4 Gita Nur H/Mifa K 9/V 27-4-2015
5 Rahmawati/Saldi K 9/V 28-4-2015
6 Yuni Firdayanti K 3/V 11-4-2015
7 Endang S/Kodri Fajar K 3/V 19-6-2015
8 Anisah/Angga Yoga P K3/V -4-2015
9 Faridah/Subekhi K3/V 1-7-2015
10 Tarsijah/Mismo K3/V 29-7-2015C
11 Siti muniroh/M. Rojikun K10/V 27-7-2015C
12 Yuli Kurniasih/Yanuar K9/V 4-8-2015
13 Khumayroh/Mustofa A K3/V 18-12-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Sri Pujiati/Adi S K 3/V 12-1-2016 19-2-2016
2 Wulan Suci/M. Fatoni K3/V 3-2-2016 30-3-2016
3 Julianti/Puji Subekhi K3/V 11-2-2016
4 Rizky Khairun/Edy K K3/V 10-3-2016 14-4-2016
5 Nurchodijah/Ade P K3/V 18-1-2016 17-3-2016
6 Ayu/ Moh.Riski K 10/V 23-2-2016 21-3-2016
7 Puji Astuti/ Taufik K 3/V 28-9-2016
8 Nurjanah/ Rizky Eka K 3/V 13-10-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU KARTINI B
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Fifit/A.Khafid K 2/V 14-7-2014 10-8-2014
2 Dian Rahmayani/Ahmad K 8/V 3-7-2014C
3 Andriyani/Joko W K 2/V 14-8-2014
4 Lutvi Agustina/M.Riyadi K 2/V 10-8-2014
5 Fadlina Azmi K 7/V 10-7-2014
6 Suripah/M.Subhan K 7/V 4-9-2014
7 Merlin/Imam K 8/V 11-9-2014
8 Desti/Amipriyono K 1/V 9-10-2014C
9 Suheni/Mustofa K 7/V 23-12-14
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Suciati/M.Fathurochim K 7/V 28-12-2014 5-2-2015
2 Rofiko Nurdiana/M.Arif K 2/V 27-12-2014
3 Ristiawati/Maftufudin K 2/V 18-1-2015
4 Taruni/Mariono K 1/V 4-2-2015
5 Hesty K/Joni K 2/V 9-2-2015
6 Desi Lusiana/Eri K 2/V 2-3-2015
7 Tri Lestari/Rohman K 7/V 5-3-2015 2-4-2015
8 Desi Natalia/M.Nur Zaman K 8/V 14-4-2015 14-5-2015
9 Leni Sopiyati/Andi Purwanto K 7/V 6-5-2015 15-6-2015
10 Indah Rohyati/Indra K 2/V 23-5-2015 11-6-2015
11 Yulia Nur Atika/Imam P K 2/V 11-6-2015
12 Suciatiningsih/Danu S K 2/V 9-6-15C
13 Suciani/Kasidin K 2/V 22-6-2015C
14 Ratih Ratnasari/Madya K 5/V 5-5-2015
15 Eka Wulan/Alan K4/V 4-7-2015 13-8-2015
16 Shelia/Teguh Mulyono K 7/V 8-7-2015
17 Neni Mandera/Heru P K 8/V 13-8-2015
18 Erni Suszanah/Agus B K 2/V 18-8-2015
19 Wulandari/Ahmad K 7/V 8-7-2015 19-7-2015
20 Twin Wulan/Fathul Azis K 1/V 8-6-2015 31-7-2015
21 Taliyah/Joko Giyono K 8/V 17-9-2015
22 Sugiarti/Sahrudin K7/V 3-6-2015 5-8-2015
23 Ani Maulida/Eko Janantina K7/V 11-12-2015
24 Pujianah/Riswanto K8/V 11-12-2015
25 Yulistia/Firmansyah K7/V 30-11-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Ani Maulida/Eko Janantina K7/V 11-1-2016
2 Yulistia/Firmansyah K7/V 8-1-2016
3 Tatik Noviati/Muksin K 8/V 18-1-2016
4 Ayu Widya/Budi L K 2/V 6-1-2016
5 Suciani/Kasidin K2/V 11-2-2016
6 Sriningsih/Imam Budi K2/V 11-2-2016
7 Sri Haryati/Denang P K 5/V 14-3-2016C
8 Afriska Agustina/Sukma dwi K7/5 4-4-2016 4-5-2016
9 Chaulia Nur/Slamet K6/V 25-2-2016
10 Ayu Widya/Budi L K 2/V 6-1-2016
11 Tika Wiranti/Wily Kristianto K2/V 4-4-2016
12 Astrid Pradipta/Diki A K8/V 4-4-2016 2-5-2016
13 Febriyani L/Dede S K 1/V 6-2-2016 5-3-2016
14 Septi/Hendra K4/5 12-7-2016C
15 Agnes Tanjung/ Cahyanto K7/V 28-5-2016 29-6-2016
16 Ratih Ratnasari/Madya K5/V 18-6-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU SEKAR INDAH A
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Ayu/Toto K 3/VI V
2 Fina K 4/VI 8-10-2014
3 Kusmiyati/Wahidin K1/VI 3-12-2014
4 Restu Zalita K 1/VI 3-11-2014 3-12-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Nely/Dodi K 1/VI -12-2014
2 Warsiti/Soekarno K 5/VI V
3 Nyai Kasmi/Widi K 4/VI V
4 Udu Mahfudah/Bagus K 5/VI V
5 Sudiana/Rahman K 4/VI V 17-6-2015 12-8-2015
6 Fina K 4/VI 8-1-2015 9-3-2015
7 Fitri Meilana Surya K 3/VI 30-5-2015 14-8-2015
8 Nur Chasanah/Mokotip K3/VI 19-8-2015 19-9-2015
9 Lely Maulidah/Kartino K1/VI 9-9-2015 10-11-2015
10 Eti W/Suprapto K4/VI 3-11-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Farkhanah/Saleh K4/VI 13-1-2016
2 Shopaeni/Kasan K4/VI 13-1-2016
3 Apriyana/Sugiarto K 1/VI 8-12-2015 10-2-2016
4 Astika Nurjanah/Suroso K 1/VI 2-11-2015 30-1-2016
5 Indriyati/Seh husen A K 5/VI 30-5-2016 28-6-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU SEKAR INDAH B
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Laelatul/Eko Muttaqin K 6/VI 26-7-2014 29-8-2014
2 Dawimah/Sumarno K 6/VI 26-8-2014
3 Nastiti/Sigit K 9/VI 26-8-2014
4 Andriyani/Hartadi K 8/VI 1-11-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Ika Noviyanti/Nur Yadi K 7/VI VC
2 Cecilia/Daud K 8/VI V
3 Chamidah/Subandi K 7/VI 27-4-2015
4 Yeni Indah A/M.Soleh K 8/VI 3-9-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Sri Murti/Moh.Taefur K 8/VI 18-1-2016
2 Eti Kurniasih/Urip S K8/VI 18-1-2016
3 Nur Inayah/Eko P K6/VI 18-1-2016 18-3-2016
4 Laelatul B/Eko Muttaqin K 6/VI 23-12-2015
5 Winni C/Sukamdani K 8/VI 22-12-2015
6 Nurhayati/Topo K8/VI 15-7-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU MAYANG SARI
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
2 Eka Nurhidayah/M.Yunus K 3/VII -8-2014 18-9-2014
3 Siti Rahayu/Iwan K 1/VII 11-7-2014
4 Cariyah/Suryanto K 1/VII 9-7-2014
5 Komalasari/Ade Prasetyo K 4/VII 28-6-2014
6 Widiyati/Hasan Bisri K 1/VII 21-7-2014
7 Shinta Fitriyana/Wasiludin K 8/VII 26-6-2014
8 Kristanti/Michael Heru K 7/VII -6-2014 -7-2014
9 Yanti/Marcus K 3/VII 25-8-2014C
10 A.Yuli W/Partono K 3/VII 20-6-2014
11 Irdiana Dini/Wahyu T K 7/VII 11-7-2014
12 Erlina P K 1/VII 1-8-2014
13 Siti Sri W/Nuri Fauzi K 8/VII 2-9-2014
14 Rodhiyah/Alex Wibowo K 1/VII 5-5-2014 5-6-2014
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Wiwi Widiarti/Imron R K 3/VII 3-12-2014
2 Dhina Try/Shandi K 5/VII VC
3 Desi/Topik K 3/VII 22-2-2015 23-3-2015
4 Nazalia K/Abdul Salam K 1/VII 17-1-2015
5 Yanti/Marcus K 3/VII 23-2-2015
6 Tri Feriana/Yonandra B K 4/VII ?-11-2014 ?-12-14
7 Intan P.S/Nur Aulia Fikri K 1/VII 14-3-2015
8 Yuli Puspitasari/Herman K 2/VII 2-3-2015
9 Winarsih/Arja Hadi K 1/VII 2-4-2015
10 Yunike Rizka/Abdul Aziz K 4/VII 20-4-15C
11 Suryani/Andi Mulyono K 1/VII 19-5-2015 28-7-2015
12 Nur Baeti/Wahyu K 8/VII 14-5-2015
13 Nur Nafisah/Fariyantoro K 1/VII 18-5-2015 17-6-2015
14 Dewi Septiyaningsih K 1/VII 16-5-2015 23-6-2015
15 Desi Oktavia/Tabana K 2/VII 15-8-2015 15-9-2015
16 Desyarti/Windu K 8/VII 31-7-2015 11-10-2015
17 Veni Fitri /Doni B K 4/VII 1-8-2015 15-9-2015
18 Tiberly/Riski K 4/VII 15-6-2015
19 Romania F/Firma Edi K 3/VII 14-8-2015C
20 Sulastri/Wahyu K 7/VII 25-6-2015
21 Heni Kristiana/Mahardika K 2/VII 4-8-2015
22 Yeti/Waridi K 1/VII 4-8-2015
23 Rusniyati/Teguh Esar K 1/VII 1-10-2015
24 Nur Ulfah M/Nanang R K7/VII 11-11-15C
25 Kasiyani/Royani K 8/VII 23-11-2015
26 Nuni Faturohman/Slamet K3/VII 28-11-2015
27 Sri Hidayati/Slamet K 3/VII 8-12-15C
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Yuni Listiana/Carto K 8/VII ?-12-2015
2 Indah/Khasanudin K8/VII 1-2-2016 21-4-2016
3 Dina Daniati/Rucitra Mulya K 2/VII 1-2-2016
4 Kerlina/Rinoso K 2/VII 24-1-2016
5 Yunike Riska/Abdul Aziz K4/VII ?-4-2015 ?-12-2015
6 Rina Maria/Wasroni K 1/VII 23-3-2016C 4-6-2016
7 Fitri Nursecha/Yuli Adni K 2/VII 8-3-2016C
8 Feni Purwanti/Abdul Gofar K 1/VII 22-3-2016
9 Wiwik/Wastar K 2/VII 21-5-2016 15-7-2016
10 Suswanti/Kasmudi K4/VII 3-6-2016
11 Winda A/M Nababuri K1/VII 15-7-2016 20-9-2016
12 Fifi Tri L/ Rikom Alan K8/VII 14-8-2016 3-10-2016
13 Delima Lili/ Moh. Safaat K3/VII 25-8-2016
14 Eka Kuntari/Samsudin K1/VII 6-8-2016
15 Deniati/Diarto K8/VII 19-8-2016
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU SERUNI
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Elya Findawati/Bernadus K 1/VIII 11-11-2014 12-12-14
2 Marsella C/Toni K 2/VIII 13-5-2015C
3 Aqthiana Y/Andriyas M K 2/VIII 22-6-2015C
4 Cristiana/Mugi R K 3/VIII 8-12-15C
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Cristiana/Mugi R K 3/VIII 11-5-2016
2 Marsella C/Toni K2/VIII 11-5-2016
3 Mega Renawati/Jamaludin K3/VIII 7-5-2016 19-6-2016
4 Diyah Dwi M/ Ruli K1/VIII 4-3-2016
5 Friska Yulita/Aditya K1/VIII 24-6-2016
6 Rena Rizki/M Reza P K 3/VIII 8-8-2016C
LAPORAN BULANAN IMUNISASI BAYI
POSYANDU DEWI SARTIKA
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Rimadhona/M.Faqih K 4/IX(Sejahtera I) 10-6-2015
2 Dewi W/M. Salafudin K 1/IX 22-5-2015
3 Sri Wahyuningsih/Agustinus K4/IX 30-6-2015 20-7-2015
4 St. Chodidjah/Samsudin K2/IX 30-6-2015 23-11-2015
5 Kartini/Mei Pambudi K2/IX(Kartini B) 30-6-2015 22-7-2015
6 Ika Puspitasari/M.Soleh K4/IX(Kuncup Mekar) 25-6-2015 24-7-2015
7 Suryanti/Riyanto K3/IX(Kartini B) 22-7-2015
8 Malikhatun/Sulistio K 3/IX(Astika C) 21-10-2015 23-11-2015
9 Ike Nofiani/Abd.Rojak K3/IX(Kartini A) 29-10-2015 31-12-2015
10 Nelasari/Irwan K2/IX 3-12-2015
11 Eka Rizki Amalia/Sutaji K 2/IX 25-10-2015 23-11-2015
Imunisasi TT
No Nama Ibu Alamat (RT/RW)
1 2 3 4 5
1 Ayu Widya/Budi L K 4/IX(Kartini B) 6-1-2016
2 Castirah/Minggu Priana K 2/IX 25-1-2016
3 Nelasari/Irwan K2/IX(Mawar Merah) 1-2-2016
4 Mariah Ulfa/M. Subekhi K 4/IX 4-2-2016
5 Marlina/Rustanto K 4/IX 9-3-2016
6 Rohemi/Agus K /IX 21-9-2016
7 Sofuroh/ M.Jupriadi K 4/IX 21-9-2016
8 Anisa Bella/Eka Yulianto K 2/IX 18-10-2016
9 Rustini/ Eri Indrawan K /IX 18-11-2016
NAMA BAYI/BALITA POSYANDU DEWI SARTIKA
Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Hisyam Riyadi P Sofuroh/M. Juriyadi L 3-7-2011 4/IX Brebes
1 Nurazza I.P Suratmi/Ridho B P 24-3-2011 2/IX Pekauman
2 Anugrah Nurwani Karsiwen/Jefri L 24-5-2011 3/IX Kartini B
3 Salwa Rahadatul Erma Putriasa/Ade Setiawan P 24-1-2011 4/IX Kejambon
4 Nayra D.P Rima/Diono P 4-12--2011 1/IX Kartini B
5 Aza Fatir Surya Susherwanti/Mursalim L 10-4-2011 1/IX Smpg
6 Shauma Nur Tanti/Sudibyo P 23-8-2011 4/IX Sekar Indah A
7 Alfiyah Yuli/Teguh P 23-8-2011 2/IX
8 Deandra B.P Herni/Agung L 8-1-2011 3/IX
9 M. Raihan Eka/Ardi L 8-9-2011 4/IX
10 Amara Anggraini Lili/Maryono P 9-12-2011 2/IX Mintaragen
11 M. Ardan Samilah/Tarjono L 16-6-2011 2/IX
12 Nata Kusuma Nana/Zaenal L 22-9-2011 4/IX
13 Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Subechi Mubarok Risnati Arni/A. Kholil L 13-11-2012 2/IX Mekarsari
1 Kirana Syafa A Aji Seti Indahyani/Eko S P 20-4-2012 4/IX Sejahtera I
2 Hasna Azalia A Ervina P 10-10-2012 2/IX Pekauman
3 Rafah Ayash A Nina V/Arief S L 24-4-2012 3/IX Kenanga A
4 Oniel Pramudya Ninda/Ade L 11-1-2012 3/IX Astika C
5 Dinda Sindi Dwi P Yuli/Amin P 22-3-2012 1/IX
6 Talita Azalia Ayu R/Wandito P 7-2-2012 4/IX
7 Shesya Ririn/Sapto P 17-10-2012 3/IX Kartini B
8 Indana Zulfa Davi/M. Hadil P 19-6-2012 1/IX
9 Arka Pranata W Dwi Nurbaeti/Triwijaya L 30-11-2012 2/IX Astika C
10 Ayu Mutiarahma Dwi Lestari P 27-2-2012 1/IX
11 Bagas Adi Saputra Nurlaela L 10-3-2012 4/IX
12 Syiffa Ayuda Putri D Yuni/Puji P 11-1-2012 3/IX Panggung
13 Daffa Nurmaulana Ratna/Subkhan L 14-10-2012 1/IX Mayangsari
14 Namira Novi P 4-4-2012 3/VI Kuncup Mekar
15 Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Azzahrotul Sya'baniyah Nur Ihya Sofiyah/Feri M P 13-6-2013 4/IX Mayangsari
1 Ibnu Zydane Pra Rodotul J/Dwi N L 24-8-2013 1/IX Randu Gunting
2 Abyan Zahran R Titin Safitri/Rusman L 2-8-2013 4/IX
3 Ahmad Nizam Sabani St.Elianawati/Yuyu W L 24-6-2013 1/IX Kamboja
4 Sakinah Millati H Yuliana/Teguh H P 14-6-2013 1/IX Kartini A
5 Moh Bagas Sadewo Ambarwati/M. Wiji L 22-9-2013 4/IX MKK
6 Naela Risriani Deni Sinta/Arisman P 25-12-2013 4/IX Kemandungan
7 Nur Amira Fitria Isnaeni/Nurwanto P 24-8-2013 4/IX Sejahtera I
8 Julia Putri Ramadani Erna P 12-7-2013 3/IX Margadana
9 Sri Kandita Tanti/Sudibyo P 20-9-2013 4/IX Sekar Indah A
10 Syahla Yuma Faiha Eva M/Guruh Eko P 18-3-2013 2/IX Sekar Indah A
11 Ratu Ajeng Khotijah/Zaenal P 14-2-2013 3/IX Pengabean
12 Aswhina Arsylia A Patmi/Ardiansyah P 18-5-2013 4/IX Astika B
13 Kiki Khairul Susi/Sopan L 6-10-2013 4/IX Kenanga B
14
Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Azuhra Zidni Aulia Erlin/Rosikin P 31-12-2014 2/IX Pekauman
1 M. Restu Asyira Nova P 9-9-2014 1/IX Kuncup Mekar
2 M. Nurul Fajar Rosanti/Syarifudin L 29-9-2014 1/IX Kamboja
3 Moh. Shoobirin Risnati Arni/A. Kholil L 10-4-2014 2/IX Mekarsari
4 Aulia Izatunisa Komariyah/Fani P 9-5-2014 3/IX Keturen
5 Resky Ramadhan Tri Nuryanti/Fandi L 18-7-2014 4/IX Kartini B
6 M. Fahri Alfatir Ersa/Apip L 19-2-2014 2/IX Debong
7 Najwa K Yuni/Indarno P 20-8-2014 2/IX Panggung
8 Naira Ayla Askana Nina V/Arief S P 12-2-2014 3/IX Kenanga A
9 Moh. Rasyid Erma Putria/Ade Setiawan L 10-7-2014 4/IX Kejambon
10 M. Haikal F Kusnul/Azam L 26-1-2014 2/IX Kartini A
11 Ratu Putri Khotijah/Zaenal P 17-11-2014 3/IX Pengabean
12 Ratu Ayu Khotijah/Zaenal P 17-11-2014 3/IX Pengabean
13 Airin Isnaeni Dewi P 20-6-2014 3/IX Slerok
14 Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Dihyah Al Kalby Arifah/Abu Khoiri L 18-1-2015 3/IX Mawar B
1 Dzakira Aulia Wiharyati/Zakaria P 6-3-2015 1/IX Panggung
2 Nandit Kusuma Pradita Maria/Zaenal A L 18-2-2015 4/IX Mintaragen
3 Najwa Aulia Murniati/Yanuar P 19-3-2015 2/IX Randugunting
4 Ziya Ulhaq Lulu/Burhanudin L 10-4-2015 4/IX Smpg
5 Marisa Nuramadhani Nur Isnaeni/Nurwanto P 10-7-2015 4/IX Sejahtera I
6 Achmad Hawwin Rozack Dewi Wulan Sari/Salafudin L 10-8-2015 1/IX Panggung
7 Anindya Putri Andari Lili Ismiyati/Maryono P 22-8-2015 2/IX Panggung
8 Rimadona/M.Faqih P 27-7-2015 4/IX Sejahtera I
9 Moh. Qori Ika Puspita Sari/M.Soleh L 8-6-2015 4/IX Kuncup Mekar
10 Thoani/Cholil L 11-9-2015 1/IX Panggung
11 Aditya Rifki Hamizan Kartini/Mei Pambudi L 10-11-2015 2/IX Kartini B
12 Anindita Keisha Z Sri Wahyuningsih/Agustinus P 7-12-2015 4/IX Panggung
13 Siti Nur Amaliyah Siti Chodijah/Samsudin P 24-12-2015 2/IX Panggung
14 Khansa Saniyyah Suryanti/Riyanto P 5-10-2015 3/IX Kartini B
15 Tanggal Alamat
Nama Bayi Nama Ortu L/P
Lahir (Rt / Rw) (Rt/Rw)
No
Nunung N/M.Wahyudi P 13-1-2016 2/IX
1 Rafka Hafid Maulana Ike Nofiani/Abd.Kodir L 19-1-2016 3/IX Kartini A
2 Hafidz Salman Arifin Eka Rizki A/Sutaji L 30-1-2016 2/IX
3
LAPORAN HARIAN PEMAKAIAN VAKSIN & LOGISTIK DI PUSKESMAS TEGAL BARAT
BULAN :
PEMAKAIAN VAKSIN/LOGISTIK TOTAL
NO VAKSIN/LOGISTIK
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 PEMAKAIAN
A VAKSIN
1 BCG
2 POLIO
3 PENTAVALEN
4 HB UNIJEC
5 CAMPAK
6 TT
B ADS/SPUIT
1 0,5 ml
a. Bayi
b.Bumil & WUS
c.BIAS
2 0,05 ml
3 5 ml
a.Bayi
b.BIAS
C SAFETY BOX
0,25L
5L
LAPORAN STOK HARIAN VAKSIN DI PUSKESMAS TEGAL BARAT
BULAN :
STOK VAKSIN
NO VAKSIN 1 2 3 4 5 6 7 8 9 10
Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak
A VAKSIN
1 BCG
2 POLIO
3 PENTAVALEN
4 HB UNIJEC
5 CAMPAK
6 TT
STOK VAKSIN
NO VAKSIN 11 12 13 14 15 16 17 18 19 20
Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak
A VAKSIN
1 BCG
2 POLIO
3 PENTAVALEN
4 HB UNIJEC
5 CAMPAK
6 TT
STOK VAKSIN
NO VAKSIN 21 22 23 24 25 26 27 28 29 30 31
Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak Aw K Ak
A VAKSIN
1 BCG
2 POLIO
3 PENTAVALEN
4 HB UNIJEC
5 CAMPAK
6 TT
LAPORAN STOK LOGISTIK DI PUSKESMAS TEGAL BARAT
BULAN :
STOK STOK
NO LOGISTIK PENERIMAAN PEMAKAIAN
AWAL BULAN AKHIR BULAN
B ADS/SPUIT
1 0,5 ml
a.Bayi
b.Bumil & Wus
c.BIAS
2 0,05 ml
3 5 ml
a.Bayi
b.BIAS
C SAFETY BOX
0,25L
5L
LAPORAN PEMAKAIAN OBAT
PEMAKAIAN OBAT
NO NAMA OBAT 1 2 3 4 5 6 7 8 9 10 NO
Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak
LAPORAN PEMAKAIAN OBAT
PEMAKAIAN OBAT
NO NAMA OBAT 11 12 13 14 15 16 17 18 19 20
Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak
LAPORAN PEMAKAIAN OBAT
PEMAKAIAN OBAT
NAMA OBAT 21 22 23 24 25 26 27 28 29 30 31
Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak Aw P K Ak