FORMAT

TING

Nama Puskesmas/Fasyankes/Pos : PUSKESMAS MAIWA

Kabupaten/Kota : ENREKANG
Provinsi : SULAWESI SELATAN
Hari, Tanggal : Selasa / 07-09-2021

Umur
Jenis
No No. Tiket NIK Nama Penerima Vaksin Pekerjaan* Tanggal Lahir (18 sd ≥ 60
Kelamin
tahun)

1 P-PKG9M45Z 7316017007990003 SURIANI P PEL.PUBLIK 30-07-1999

2 P-PW1DPEEH 7316016301620001 SAKKA P UMUM 23-01-1962
3 S-E1C92BCC 7316014409540001 GIMBANG P LANSIA 4/9/1954
4 Q-000M3CJ 7316012301000002 ISWINA RENIARTI P UMUM 23-01-2000
5 P-PW1SKIGI 7316015003810001 SALMIAH P IRT 10/3/1981
6 P-PUPSOURD 7316014211050001 SRI WAHYUNI P PELAJAR 2/11/2005
7 P-PURHWISL 7316014709050005 NUR AFNI P MAHASISWA 7/9/2005
8 P-PT8Y9LUQ 7602040107910114 KARMI L UMUM 24-11-1992
9 P-PSQOL2M1 7316014107030016 AHMAD ZAKIUDDIN L MAHASISWA 07/01/2003
10 7314056203960001 IRMAYANTI BAMBANG P IRT 24-04-1996
11 7314050503910001 ASHAR BAMBANG L WIRASWASTA 5/3/1991
12 7314052302920001 SUHERMAN MANSYUR L WIRASWASTA 23-02-1992
13 7314050706940001 SUBHAN MANSYUR.P L WIRASWASTA 7/6/1994
14 7372044409940001 ISMA HARYATI P WIRASWASTA 4/9/1994
15 7314056512600001 HAMRIANY P WIRASWASTA 25-12-1950
16 7314050606520001 DRS.MANSYUR PANGGALA L WIRASWASTA 06/06/1952
17 7314045704000001 UMMU APRIANI P MAHASISWA 17-04-2000
18 7314044109970001 PUTRI DIANA P WIRASWASTA 09/01/1997

19 731601620776 0001 SANIATI P IRT 22/07/1976

20 731601470766 0001 ATIKA P IRT 07/07/1966

21 731601630301 0001 RENI P MAHASISWA 3/23/2001
22 731601601005 0002 NUR SAHWA RAMADANI P REMAJA 20/10/2005
23 P-Q6X1MMCW 731600156120 0001 NUR FITRA RAMADANI P IRT 16/12/2000
23 P-Q4CYGEO3 731601410771 0007 SAHARIA P IRT 01/07/1971
25 P-Q35B405N 731601080607 0001ANDIKA REZKY MAULANA ARIF L REMAJA 06/06/2007
26 P-Q3ONDBSL 731601670281 0001 JUSMIN P IRT 27/02/1981
27 P-Q1ZTOWYJ 731601050671 0001 ARIF RAHIM L WIRASWASTA 05/06/1971
28 P-Q3POPS3E 731601670305 0001 AUDIA WARAHMA P REMAJA 27/03/2005
29 P-Q2IQHKPL 731601570606 0003 SIFA SYAHIRA P REMAJA 17/06/2006
30 731601600785 0003 ANI P IRT 20/07/1985
31 P-Q2TIWGX7 731601641005 0001 FITRI RAMADANI P REMAJA 24/10/2005
32 P-Q1UMP5WS 731601620205 0001 ASRIANI MUSTAMIN P REMAJA 22/02/2005
33 P-Q1MCSKAF 731601470405 0001 RISKA ALICIA P REMAJA 07/04/2005
34 P-Q19BFLAS 73160620405 0001 ISMAYANTI P REMAJA 22/04/2005
35 P-Q1COVLDC 731601660504 0001 HASRIANTI P REMAJA 26/05/2004
36 P-QOMZGJQZ 731601581104 0002 PUTRI CAHAYA P REMAJA 11/18/2004
37 P-P2YKJUHR 731601250767 0001 UMAR L PETANI 7/25/1967
38 P-P2BYRUAC 731601660987 0003 SARIPA P IRT 26/09/1986
39 P-PYBYI6M9 731601411105 0002 HERLIN P REMAJA 01/11/2005
40 P-PZY6H9PU 731602301284 0003 YUSRAN L WIRASWASTA 30/12/1984
41 P-PYHFLCAD 7316012104910 0002 MARWIN L SWASTA 21/04/1991
42 P-PXQPVUEO 731601250803 0001 RUSLI L UMUM 8/25/2003
43 P-PXCKGKOI 731601110602 0001 RIZAL L UMUM 6/11/2002
44 P-PWVZHQMG 731601440793 0002 HASNI P IRT 7/4/1993
45 P-9TH592MD 7316114412050001 SRY RAHAYU JAFAR P D 12/4/2005 16
46 P-9GLTRUFK 7316014605080001 REVI ANUGRAH YANTI P D 5/6/2008 12
47 P-8AZZJP1X 7371125802050001 SABILA ZAHRA SUPARDI P D 2/18/2005 16
48 7314055001070003 ANDI ASYRANTUN K P D 1/10/2007 14
49 P-A3U3EGCJ 7316116508050001 NURHIKMA P D 8/25/2005 16
50 P-AKBR1G5B 7316014106050001 WAHYUNI P D 6/1/2005 16
51 S-36D8B27C 7316015010700001 HUSNAINI P E 10/10/1970 51

P-E654QUTU MUH. ALIF NOOR

52 7316012932080001 L D 3/29/2008 13
RAMADHAN
53 P-CKII2Q9Q 706406600606002 FARAH SYAHIDA KADIR P D 6/20/2006 15
54 P-6R86WWFF 7315046810050001 FATIA NURUL SUCI P D 10/28/2005 15
55 P-FKSI48HQ 7316011108080001 RENDY ADITYA L D 10/11/2008 13
56 P-EYUQAIPE 9109012103070010 FAREL ASMAN L D 14
57 P-EHERY19K 7316010209070002 MUH. ANUGRAH L D 9/2/2007 14
58 P-FZ8PHL3D 7315091012060002 MUH. TAKDIR L D 12/10/2006 14
59 P-HFRXWLUI 7316012311070002 ISKANDAR L D 11/23/2006 14
60 P-HH45TPXZ 7316010704070002 FATURRAHMAN SYAHAB T L D 4/7/2007 14
61 P-GWTMY3M4 7316012311060002 MUH TAUFIK L D 11/23/2006 14

62 P-G6ZE5FMK 7316010905070003 FADHEL RUKMAN L D 5/9/2007 14

63 P- 7316010506090000 MARVEL ALVIANO L D 6/5/2009 13

64 P-JR4NWUQN 7316010802070001 MUH. DZAKI AKRAM L D 2/8/2007 14

65 P-0DLPLJP8 7316010405090001 RANGGA AL ZUKRI L D 5/4/2009 12

66 P-K8R64AJP 731602606090001 AHMAD FAUZAN L D 6/26/2009 12

67 P-J7XNTWVR 7316012405080001 MUH. SYAHRUL L D 5/4/2008 12
68 P-1NUYI3HL 7316010607050001 ILYAS L D 7/6/2005 16
69 P-8GSPMESB 7316016903990001 SUCITRA ALDANI P E 3/29/1999 22
70 P-8TARYJTI 7316010108080004 ALIF L D 8/1/2008 14
71 P-8C2770D2 7316010904080001 AHMAD MAULANA L D 4/9/2008 13

72 P-651P56CY 6473025901070003 IVA RIZQIA SYAMSUL P D 1/19/2007 14

73 P-2B3EL1BM 7316010706090001 RAFI SAFARANG MUKTI L D 12

74 7316012008060001 MUH ADE RAFLI L D 8/20/2006 15

75 P-GPNF0C6Q 7316014209070001 NASYWA KHAIRIYAH S P D 9/2/2007 14
76 7316010121070002 IMRAN L D 14
77 P-CJX3TEBU 7316016709060001 ALDAYANTI P D 9/27/2006 14
78 P-EY57AARM 737122812070007 ABYAN FAYRUZ B L D 12/28/2007 14
79 P-EXOL8KTZ 7316014910080001 FITRI ARSYAD P D 10/9/2008 12

80 P-DSLRGIH0 7316016512070002 MELANI P D 12/25/2007 13

81 P-BNRV0DZ2 7316015802080002 NUR DIAN AZIZAH P D 2/18/2008 13

82 P-KMM59G87 6405026506060000 ROSALIA B P D 6/25/2006 15
83 P-KL3J4POX 7316016405100002 AINUL AISYAH P D 7/15/2008 12
84 P-KJFSDLTE 6471016905090001 FIKA ANATASYA P D 5/29/2009 12
85 P-KEF12OZL 7316016512080001 NUR SABILA P D 12/25/2008 13
86 P-KDFIES7Q 7314075409080003 DWI PUTRI RAMADHANI P D 9/14/2008 13
87 P-KDZ30KEE 7316014904090002 SALINAH P D 4/9/2009 13
88 P-KCHKNY3F 7316015811060002 NATASYA P D 11/18/2006 14

89 P-LOIGEIZI 7316015909080002 NURFADILA P D 9/19/2008 12

90 P-KZ14D7HW 7316016407070001 YULIA CAHYA P D 7/24/2007 14

91 P-KVH4TNKD 7316016808070001 NURUL AZQIAH P D 8/28/2007 14

92 P-KVNSY0V3 7316014411060001 ANDI ALYFAH MAHFUDZAH P D 11/4/2006 14
93 P-KUCUD7GT 7316016705060002 RESKI RAGITA CAHYANI P D 5/27/2006 15
94 P-KSZIU324 7316015612080001 HUMAIRAH TUSZAHRAH P D 12/16/2008 12
95 P-KRQYZQ43 7316014102070001 NUR HIKMA NURDIN P D 2/1/2007 14
96 P-KQ31E10M 7316012505010003 ADIAKBAR L E 5/25/2001 20
97 P-KP0B41J8 7316016910040003 NURFITRIANA P D 10/29/2004 16

98 P-KB34K248 7316016608080003 NAJHIFAH NAURAH P D 8/26/2008 13

99 P-KAXVFLON 7316015907080002 CAHYANA SALSABILA P D 7/19/2008 13

100 P-JWFJTADC 7316015812060001 DANIA ISYA RABBANI R P D 12/18/2006 14
101 P-IKYAZJNA 7316016403070001 NUR IZZATI P D 5/24/2007 14
102 P-BRNQSGJ7 7316011306080001 ZHALIYON P CARU PUTRA L D 7/13/2008 13
103 P-DLST208AX 7316016912070002 RAISYA NUR FADILAH P D 12/24/2007 13
104 P-LRHTLDEM 7316014503070001 SISY OLIVIA P D 3/5/2007 14
105 P-LP5AGQAS 7316015809080001 MAURA ALZAHRA P D 9/18/2008 13

106 7371102307060004 AMIRUDDIN L D 7/23/2006 15

107 P-LJWWFE9R 7316016602030001 MAYA AYU SRI ASTUTI P D 2/26/2007 14

108 P-LFVNDZ1M 7316014101080005 AURA ATIFAH P D 7/1/2008 13
109 P-LDNH7AEQ 7316015910080002 GHINA SALSABILA P D 11/19/2008 12
110 P-LFKNJOSK 731601490908002 ANGGITA PRATIWI P D 9/9/2008 12
111 7371112808060030 DARINA ZAYYAN YAQUTAH P D 3/23/2009 13
112 P-L8QIXTFB 7316016903080001 MAGFHIRA AWALIYAH P D 3/29/2008 13
113 P-LGAZITSR 7315055011070002 SARTIKA P D 10/10/2007 13
114 P-L5POVU2P 7316015108080002 INDRI P D 9/1/2008 13

115 P-L4SSBQLT 7316016604070003 NURUL AFIFAH P D 4/26/2007 14

116 P-L1L1WQYQ 7316015302080001 AIRIN ANGGREIN P D 2/13/2008 13

117 P-M0LSJZ1I 7204054112060003 DESI SYUKRIANI P D 12/1/2006 14
118 P-MJ7OJFAY 7324065109080002 NUR ASTRI RAMADANI P D 9/11/2008 13
119 P-MJKTYQKT 7316014609060004 NOVI AULIA P D 9/6/2006 15
120 Y-0134F4XF 3171055709081001 ANDI ABIAQIL L D 9/17/2008 12
121 7316014609060002 DEWI RAHMAYANTI P D 9/6/2006 14
122 P-M83HTNAY 7316012612960002 SUPIYADI ALI L E 12/26/1996 25
123 P-M3GY01C8 7315027006090001 ZAHRA ARTAFUNNISA P D 4/30/2009 12
124 P-LZMD320U 7316015604090001 SITI KHOMAIROH P D 4/16/2009 12

125 P-LWNSNBDS 9102016612080003 MUTHIA ANGGITA HUMAIRO P D 12/26/2008 12

126 7316011404810001 NUR AFIFAH P D 5/17/2009 13

127 P-LUBPX7E6 7316016603070003 NUR HARIANA P D 3/26/2007 14

128 P-LSQZ8DC8 7316015806070001 MARSYA ALFIAN SALSABILA P D 6/18/2007 14
129 P-M2CPYQ75 7316016308080002 ZAZKIA TRI AULIA P D 8/23/2008 12
130 P-N01DS2NX 7316016409070002 NURLELA P D 9/24/2007 13
131 P-MXXGV0WI 7316614308080002 NURUL AQILA FALQA P D 9/3/2008 12
132 P-NL21344X 7316011610070000 IBNUK FARUQ AMMA L D 10/16/2007 13
133 P-NK2QTLF6 7316011209060001 ERIK ERLANGGA L D 9/12/2006 14
134 P-NJSL2QBC 731601054090001 ANUGRAH ARSA L D 4/5/2009 12
135 P-NQTQEBDD 7372023008060003 M. FIDEL L D 6/6/2006 15
136 P-NPHUXWHF 7316010608080002 MUH. GAISAN AFGANI L D 8/6/2008 13
137 P-NN5H6CV1 7316011008070001 MUH. PARLAN L D 8/10/2007 14

138 P-N07ADCVC 7316011409070001 MUH. RAHMAT RAMADHAN L D 9/14/2007 13

139 P-NMCOEZRN 7316012906990003 SANDY L E 6/29/1999 22

140 P-NLECSB72 7316011502090001 HAIKMAL L D 2/15/2009 12

141 P-NJYYDU9R 7316012712080002 MUH. SYAHREZA L D 12/27/2008 12
142 P-NH328I4L 7316011012070002 MUHAMMAD AMIKA L D 12/10/2004 16
143 P-N708PTN7 7316010807060001 MUH SYAFIQ IQHAL HASPI L D 7/8/2006 15
144 P-N6VPRDCY 731601211006002 RISKI L D 10/21/2006 14
145 P-N4FSL9U0 7316012702050001 MUHAMMAD ALWI ALFIAN L D 2/27/2005 16

146 P-N3UBT1I5 731435104070001 SUCHI FAUZIAH HARYADI P D 4/11/2007 14

147 P-054IRP1K 7316012311080002 FAREL IBRAHIM L D 11/23/2008 12

148 P-PPETUN2B 7316120807010001 MUH WAHYULLAH L D 7/2/2002 19
149 P-ODGPK5S5 7316012206070001 RAHMAT L D 5/22/2007 14
150 P-OI15FOTX 7604060108070005 MUH SYAHRIL L D 15
151 P-O168ZNRI 7316012408060002 HABIBI L D 8/24/2006 15
152 P-OPFMBNG4 7316015905050002 NUR AISYAH P D 5/19/2005 16

153 P-ONWYCN81 7316012602050003 AHMED HADIDINSAAN L D 6/26/2005 16

154 P-OOVP6EZA 7316015311050001 NUR AISYAH SYAFITRI B P D 11/13/2005 15

155 P-OS1SCKLA 7316010701050001 FADHEL KHALIL ATALLAH HS L D 1/7/2005 16
156 P-ORC8I663 7316012311030001 MUH. RIZKY RAMADHAN L D 11/23/2003 17
157 P-ORNOLALGZ 7316011007050003 AHMAD ALWI L D 6/10/2005 16
158 P-OQVC53X8 73106206002 SETIA WULANDARI P D 2/22/2006 15
159 P-0T8RYHYH 7316011704050004 MUH. SYAMSUL AWAI L D 4/17/2003 16
160 P-OSLTQNVM 7316011205050001 AHMAD REYNDRA ADRIANS L D 5/12/2005 16
161 P-OSDG49SS 7316011704050003 MUH YADIL L D 3/17/2005 16
162 P-OSN1WRIP 7316019030400001 ARDY ARIANTO L D 3/19/2004 17
163 P-POLFN4Q 6401015503010003 UMRAH JABAL RAHMAH L D 3/15/2001 20

164 P-OZEK11R6 7316015902040002 SITI GITA AULIA AMIR P D 2/19/2004 17

165 P-OZFF99V8 7316016902040001 NURUL ANNISA P D 2/29/2004 17

166 P-OV5VN7OR 7316012710840002 TAMSIR L D 10/27/1984 36

167 P-8QOTXFDN 7316084707030002 Fatrani Citra Aulia P Pelajar 7/7/2003 18

168 P-90PEDPBW 7315056405040001 Anugrah Dewi Utami P Pelajar 24/05/2004 17

169 P-9EE19UH9 7316016504800001 Indrawati P Guru 25/04/1980 41

170 P-8PBIJGKA 7315065210050002 Asrah Sapri P Pelajar 12/10/2005 16

171 P-AFCKJ15F 7316036006060001 Nur Asqiah Rizal P Pelajar 20/06/2006 15

172 P-7YW3VCD7 7316014610030002 Alya Nurhafizah P Pelajar 6/10/2003 18

173 P-8EBECCST 7316012204750001 Abdull Salam P Guru 22/04/1975 46

174 P-ALLZPTEMB 7604084505070001 Siti Asia Putri P Pelajar 5/5/2007 14

175 P-890N9PQO 7372035802940002 Dwi Cahya Ningsih P Guru 18/02/1994 27

176 P-7RDO36Qi 7316014910060001 Annisa Azzahra P P D 9/10/2006 14

177 P-CV5VJNRZ 7316050802090002 M.Izral L D 8/2/2009 13

178 7316050810070001 Putra Ahmad Aswat L D 8/10/2007 13

179 P-7TZ78BB5 7314096409060001 Melza Alzahra P D 24/09/2005 16

180 P-EHVYPOVQ 7316011402070003 Muhammad Rayhan L D 14/02/2007 14

181 P-FKK6O8LQ 7316010906070001 Muh. Sullham L D 9/6/2007 14

182 7316011212040001 Muh.Aril L D 31/03/2007 14

183 731601230906001 Muhammad Ali L D 23/09/2006 15

184 P-HD2NPODO 7316012607060003 Abdul Azis L D 26/07/2006 15

185 P-GXLG270 6473020806060003 Muh.Nasry Amsyah L D 8/6/2008 13

186 P-651B2J4X 7604046806050001 Arsi'A Aulia Baka P D 28/06/2005 16

187 P-JSF2T6WH 7316011212080001 Muh. Reza L D 12/12/2008 12

188 P-J15VURBB 7316011905080001 Ihram Hasda L D 14/05/2008 13

189 P-24MB33GX 7316011305080001 Luthfi Aminul Haq L D 13/11/2008 12

190 P-K7SRQKP3 7316013012080002 Rezky Darmawan L D 30/12/2008 12

191 P-J3S27KFi 7316012909060001 Muh. Fadly Afurqan L D 29/11/2006 14

192 P-IQI07RL1 7316010606070002 Muh. Fadil Zulkifli L D 6/6/2007 15

193 6405091211070001 Nur Dzullfikar Syafaat L D 12/11/2007 14

194 P-8NUWVH25 7602082409070001 Mohammad Adam Fikram L D 24/09/2007 14

195 P-71VFLIW4 73160110508090001 Ghalib Haykal L D 5/8/2009 13

196 P-77E21NW7 7316016710070003 Nur Syaqiqah P D 27/10/2007 13

197 P-3RYVSOHJ 7316011609070001 Muhammad Iqballl L D 16/09/2007 14

198 7316017107070001 Erica Erianti Jailani P D 31/07/2007 14

199 7316016911080002 Dhia Afratia Andina P D 29/11/2008 13

200 P-DGA57J32 7316015903070001 Naylah Nur Azizah P D 19/03/2007 14

201 P-BQGEBFDF 7316016105070001 Nur Hikmayanti P D 21/05/2007 14

202 P-KO59EFC 7316014410060001 Gina Zaskia Ramadhani P D 4/10/2006 15

203 P-KIDP43ND 7316015206080001 Andi Ainun Zahirah P D 12/6/2008 13

204 P-KG1HZCJX 7316015105080002 Nurulll Afiqah Amalia P D 11/5/2008 13

205 P-KFE4S8BA 7316016003080001 Ainun Mardiyah Naim P D 20/03/2008 13

206 P-KZ81B7JN 7316016710080001 Fara Diana P D 27/10/2008 13

207 P-KX6KUA7H 7316016210070001 Nur Syafira P D 22/10/2007 14

208 P-KW5ZLRDF 7316015112060001 Hasriani Basri P D 22/11/2006 14

209 P-KUV1USTK 7316015908070001 Zaskiah Afiqah Azzahrah P D 19/08/2007 14

210 P-KTO20LYG 7316015508070001 MiftahullllJannah P D 15/08/2007 14

211 P-KRODVB8G 7316016903070003 Mutmainnah P D 29/03/2007 14

212 P-KPBIAZCP 7316014204070003 Qadieza Jasmine P D 2/4/2007 14

213 P-KNXZZQT6 7316016709000003 Adelia Hanum Ramadani P D 27/09/2008 13

214 P-KC712ZY 7316045003050002 Tripina P D 15/04/2006 15

215 P-K7GFOOXM 7316016506080001 Nur Zikria P D 25/06/2008 13

216 P-KAJJKDFK 7316016505060001 Nur Jannah P D 25/05/2006 15

217 P-J3LUL4FE 7316015803070002 A.Nur Fatzila Darwis P D 18/03/2007 14

218 P-AJEGAR3R 7316014507080002 Linda Rahman Yulianti P D 5/7/2008 13

219 P-lRMFD4G9 7316016903070002 Marlina P D 29/03/2007 14

220 7316014307070001 Andi Andini P D 3/7/2007 14

221 P-LMTOBFVZ 7316016106080001 Rindyasari P D 21/06/2008 13

222 P-KKTDWHH 7316014205070001 Nurul Farah Nabila P D 2/5/2007 14

223 P-LiHTMKRZ 7316125108080001 Nurul Khairah P D 11/8/2008 13

224 P-LHQPP43C 7316017112070005 Adelia Burhan P D 31/12/2007 14

225 7316014108070000 Nurul Natasya P D 1/8/2007 14

226 P-LH3TTMFM 7316015510070002 Tiara Safitri P D 15/10/2007 13

227 P-LELj5UTF 7316015312070001 Pegi Ananta Putri P D 13/12/2007 13

228 P-LCWIMZ1K 7316014205090001 Andi Nur Avnianty Maemuna P D 2/5/2009 12

229 P-LAXXCSRL 7316016606080001 Maya Humairah P D 26/06/2008 13

230 P-L8HP3OV2 7314056702080001 Hasrianti Mansur P D 27/02/2008 13

231 P-L2FT6DPS 731605204080002 Sri Selviani P D 12/4/2008 13

232 P-L2PZP6ZX 7316015807090001 Fanisa Isma Sabira P D 18/07/2009 12

233 7316016502080001 MiftahulJannah P D 25/02/2008 13

234 P-MM99i3XP 7316016609080001 Nur Rahmadani P D 26/09/2008 13

235 P-MGARODMG 7316015108080001 Fauziah Azizah P D 11/8/2008 13

236 P-MDDEVHOX 7316014305060002 Rasna P D 3/5/2006 15

237 P-M57HM78U 7316016005050001 Sumiati P D 22/05/2005 16

238 P-LYJEJMD 7316016611080002 Nanda Amira Restu P D 26/08/2008 12

239 P-WTMDR8D 7316015201090002 Zaskia Sasabila P D 12/1/2009 12

240 P-U8DKL3H 7316014509090001 Nur Asmi Faqia Islam P D 3/9/2009 12

241 P-P9iBD3G 6071034405070002 Asyifa Meirwin P D 4/5/2007 14

242 P-N2GSX1YW 7316016712070001 Zahrah Rahman P D 17/12/2007 13

243 7316015509080001 Nur Rahmadani P D 15/09/2008 13

244 P-MZ9IVSET 7016016102080001 Rezkiyah Zakin A P D 21/02/2008 13

245 P-MWKOSHCA 7316014604070001 Widya Pratiwi P D 6/4/2007 13

246 P-NHRTUFSP 7316012304090001 Adrian L D 6/5/2009 12

247 P-NGUSXXG7 731601030480001 Kasim Fadli L D 3/4/2008 13

248 P-NH3XT3RB 7316010603070003 Ahmad Munadhil L D 6/3/2007 14

249 P-NH1FUYQV 7316011812040002 Hafis Rudi L D 18/12/2004 16

250 P-NEO526PG 7316012111060001 Fais Yasdar L D 21/11/2006 15

251 P-NTi4BQC3 7316015810970004 Eva Djayanti P Umum 18/10/1997 23

252 P-EB8X8YTK 7316010603070002 Hadi Zaidatua Majid P D 6/3/2007 14

253 7316013108030000 Himan L D 27/11/2006 15

254 P-HNACXHTRQ 7316012007060001 Fatir Dwi Ardana L D 20/07/2006 15

255 P-NAFD2SMN 7316012510060001 Muh. Nur Iftahu Fiqh L D 25/10/2006 15

256 P-NGOZP4Q 731601161208005 AIif Ziyad Natsir L D 16/12/2009 13

257 P-MVQORBN 7316014710070001 Ika Fajriah Ramadani P D 7/10/2007 14

258 P-MTTGGYR8 7316016107070001 Nur Iryana P D 21/07/2007 14

259 P-MUGVY75N 7316015003080001 Nur FadhiIah M.Nur P D 10/3/2008 13

260 P-MQO2CAT2 7316015810070001 Ayu Fitria P D 18/10/2007 14

261 P-MQMK622M 7316015711060001 Andi Chantika Aura Syafa P D 17/11/2006 15

262 P-MQSIAKG1 7316016304050002 Nur Afni P D 24/04/2005 16

263 P-MN2DCVCB 7314055311060001 RevaIewi L D 13/11/2006 15

264 P-OFPiIZUY 7316014509060002 Ernika Sari P D 5/9/2006 15

265 P-OME1BG4B 7316010806040006 Muh. AI Fiansyah L D 8/6/2004 17

266 P-OGPi78EI 7316014403060001 KaiIa NabiIa Putri P D 4/3/2006 15

267 P-OKXO8CZj 7316010306070001 Andi Asraf L D 9/8/2006 15

268 P-OEEZHS6 7316016803050001 Anugerah L D 28/03/2005 16

269 P-OWJQ4K9B 7316013009040001 Muh.Faruq L D 30/09/2004 17

270 P-OVQDOOEP 7316010304000001 IsmaiI L D 3/4/2000 21

271 P-OVSPNCQ2 7316015112820001 Misna P D 11/12/1982 40

272 S-BEE95443 7316042311830003 SuIaiman, S.Pd L D 23/11/1983 38

273 P-OV3jYPGS 7316012708970001 Hendri Arsyad L Umum 27/08/1997 24

274 P-OUUJX7P7 7316014901050001 Iznawati P D 9/1/2005 16

275 P-P8A66QGU 7316014209060002 NabiIa Rezki Rahmadani P D 2/9/2006 15

276 P-OU5OXCYEM 7316016709920009 NursabiIIah P Wiraswasta 27/09/1992 19

277 P-OUFHIYOW 7316014502950001 Hasniati P IRT 5/2/1995 26

278 P-OTHCVZVJ 7316016202060001 Aiya Ayudia Iestari P D 22/02/2006 15

279 S-8159024B 7316017112490011 Hj.ratnawati P D 31/12/1949 72

280 P-P1iPT1I 7316011904040004 Muh. Rezky A Hidayat L D 19/04/2004 17

281 P-P1BCPYR 7316012007040002 Adyan Nugraha L D 20/07/2004 17

282 P-POYOOD6Q 7315026206040001 Siti Hardianty P D 22/06/2004 17

283 P-P1258YTU 7316012010040002 Muhammad HazmiruI L D 20/10/2004 16

284 Q-OOODHSDA 6471030411870003 Burhanuddin L D 4/11/1987 33

285 P-PD4iNR8J 7316015212030005 HiIdayanti P D 12/12/2003 18

286 P-OZXVI8i6 7316011506790001 Saharuddin L D 15/06/1979 42

287 P-OYRSHGCQ 7316017112730005 Jumria P D 31/12/1973 48

288 P-OYSiSWVB 7316014101060001 Masita P D 1/1/2006 15

289 P-OXWAFGDF 7316013112660020 Zainuddin L D 31/12/1966 55

290 P-OWi1M29V 7316010110960001 Aswin L D 1/10/1996 25

291 P-OXCY3BCK 7316011604040001 Nur Asikin L D 16/03/2004 17

292 P-OWP6F10P 7316014708040001 Irmayanti P D 7/8/2003 18

293 P-P3M3O2NS 7316014903050001 YuIiani P D 9/3/2005 16

294 P-P4BFGB3k 7316016604060001 Hasnawi Sudirman P D 26/04/2006 15

295 P-P4XKPQU3 7316012103060002 Rasdayanti P D 21/03/2006 15

296 P-P6VKDGM 7316011301080003 Mulyadi L D 13/01/2003 18

297 P-P3SKBONW 7316016503050003 Nirma P D 25/03/2005 16

298 P-P62PK4IZ 7316012107040002 Muh Fiqri L D 21/07/2004 17

299 P-P5ACH24W 7316015309950001 Nadira P IRT 13/09/1995 26
300 P-P4UFONPR 7316016101770001 Nasira P IRT 21/01/1977 44
301 7314056904840000 Riry Hamriani P IRT 29/04/1984 37
302 3578126804070003 Rheva Shaula Attania P D 28/04/2007 14
303 3578120909080000 Reza Rifqy Ramadhan P D 9/9/2008 13
304 3578126910850000 Rira Ariani P IRT 29/10/1985 36
305 P-PS8SFY5X 7316010406050002 Hafni Khamamah P D 4/6/2006 15
306 P-PRTKZ2W4 7316011008710001 Sappe P Petani 10/8/1971 50
307 P-PRIBPBOV 7316011206720003 Hasan L Petani 12/6/1972 49
308 P-PRG2FXZ6 7316014303760003 Dasa Sanri P IRT 3/3/1976 45
309 P-PQYW08W3 7316017107040002 Reski Amalia P D 31/07/2004 17
310 P-PQM7YADK 7316014504010002 Susi Fika Sari P D 5/4/2001 20
311 P-PQLKLe8F 7316010805830002 Arsyad L Petani 8/5/1983 38
312 P-PPY8AJLS 7316015212970001 Sriwahyuni Mukhtar P Umum 12/12/1997 24
313 P-PQ72O6Q5 7316010312950001 Ilham L Umum 3/12/1995 26
314 P-PPOVZLE8 7316011207710001 Supriadi Haddasa L Wiraswasta 12/7/1971 40
315 P-PP4SPO3i 7316011502040002 Muh.Wahyudi Anwar L D 15/02/2004 17
316 P-POM41ZED 7316010810010001 Asrul Suriadi L Mahasiswa 8/10/2001 20
317 P-P2HUN47W 7316016511030001 Nur Putri P D 25/11/2003 18
318 P-PJG3282HE 73160154002030002 Jumiati P D 14/02/2003 18
319 P-PIKNJENO 7316016403030001 Andi Saniang P D 24/03/2004 17
320 P-PiKN1ENO 7316016403030001 Andi Rahmatia P D 3/8/2004 17
321 P-PH3HYMT4 7316016401050003 Haslinda S P D 24/01/2005 16
322 P-PEKDKVXL 7316016509060001 Ramadhani P D 25/09/2006 15
323 P-PC86CRIY 7316011410040001 Muhammad Adam Haris L D 14/10/2004 17
324 P-PFSDOX2E 7316015011050002 Nur azisa P D 15/11/2005 16
325 P-PFG1AokC 7316014210050003 Inayah Zil Izzah P D 2/10/2004 17
326 P-PECNQ089 7316016901060001 Suriani P D 29/01/2006 15
327 7314054111870001 Hanipa P IRT 1/11/1989 32
328 P-PMNQTSXR 7316011811000001 Ilham Yasdar L Mahasiswa 18/11/2000 21
329 P-OCNDHQYO 7316013006060001 Muhammad Jamal L Pelajar 30/06/2006 15
330 P-PM22T9LH 7316012505070001 Ferdiansyah L Pelajar 16/03/2005 16
331 P-PLED4JAP 7316015209060001 Feby Risma Yanti P Pelajar 12/9/2006 15
332 P-PKWVTLH 7316014810000002 Nur Indah Sari P Umum 8/10/1999 22
333 P-PWXMSPNF 7316014211870002 Suherna P IRT 2/11/1987 24
334 P-PUD6TFFP 9109016505890010 Mahira P Wiraswasta 25/05/1988 33
335 P-PTYTQE8P 7316017107640001 Aminah P IRT 31/07/1964 57
336 P-PU23KGiZ 7316013112610019 Rusdar L Petani 31/12/1961 60
337 P-PT8U6OiO 7602040107830089 Wandi L Umum 1/7/1983 38
338 P-PSCHQi4B 7316013006040003 Muhammad Kelvin L Pelajar 30/06/2004 17
339 7314055708960001 Era Fasirah P Wiraswasta 17/08/1996 25
 FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI

Kepesertaan BPJS (tulis 'Ya' pada kolom

yang sesuai) Nama/
Kelompok
Alamat No. Hp BPJS Non Tanggal Screening Jenis/Merek
Umur BPJS PBI Non Anggota
PBI Vaksin***

MAROANGIN 087755971265 YA 9/7/2021 SINOVAC

MAROANGIN 085341422741 YA 9/7/2021 SINOVAC
MAROANGIN 085341422741 YA 9/7/2021 SINOVAC
P.HARAPAN 081341318730 YA 9/7/2021 SINOVAC
MAROANGIN 085341356908 YA 9/7/2021 SINOVAC
P.HARAPAN 085255881840 YA 9/7/2021 SINOVAC
P.HARAPAN 085827690738 YA 9/7/2021 SINOVAC
MAMUJU 082253674832 YA 9/7/2021 SINOVAC
BOTTO MALLANGGA 081342114163 YA 9/7/2021 SINOVAC
RAPPANG 085145345454 YA 9/7/2021 SINOVAC
RAPPANG 082396654505 YA 9/7/2021 SINOVAC
RAPPANG 085299229221 YA 9/7/2021 SINOVAC
RAPPANG 085298430854 YA 9/7/2021 SINOVAC
RAPPANG 081258482538 YA 9/7/2021 SINOVAC
RAPPANG 085298526139 YA 9/7/2021 SINOVAC
RAPPANG 082339323352 YA 9/7/2021 SINOVAC
BARANTI 082193008115 YA 9/7/2021 SINOVAC
SIMAE 085229950995 YA 9/7/2021 SINOVAC

MANGKAWANI 085 397 774 495 YA 9/7/2021 SINOVAC

MAROANGIN 085 967 052 981 YA 9/7/2021 SINOVAC

MANGKAWANI 082 197 308 541 YA 9/7/2021 SINOVAC
JL. PAHLAWAN 085 398 369 330 YA 9/7/2021 SINOVAC
MAROANGIN 082 196 384 341 YA 9/7/2021 SINOVAC
MANGKAWANI 085 242 441 285 YA 9/7/2021 SINOVAC
MAROANGIN 085 937 408 132 YA 9/7/2021 SINOVAC
MAROANGIN 085 210 534 083 YA 9/7/2021 SINOVAC
MAROANGIN 082 377 774 344 YA 9/7/2021 SINOVAC
PAKKODI 085 348 662 529 YA 9/7/2021 SINOVAC
JL. PAHLAWAN 085 725241 218 YA 9/7/2021 SINOVAC
MANGKAWANI 085 341 557 484 YA 9/7/2021 SINOVAC
JL. PAHLAWAN 085 247 222 193 YA 9/7/2021 SINOVAC
MAROANGIN 085 967 052 981 YA 9/7/2021 SINOVAC
TUNCUNG 083 865 494 731 YA 9/7/2021 SINOVAC
TEMPE-TEMPE 082 250 957 642 YA 9/7/2021 SINOVAC
 TEMPE-TEMPE 081 775 147 314 YA 9/7/2021 SINOVAC
LEBANI 082 210 692 466 YA 9/7/2021 SINOVAC
BOTTO MALLANGGA 083 136 919 003 YA 9/7/2021 SINOVAC
BOTTO MALLANGGA 083 136 919 003 YA 9/7/2021 SINOVAC
SALOKARAJA 088 245 463 702 YA 9/7/2021 SINOVAC
MAROANGIN 085 242 020 521 YA 9/7/2021 SINOVAC
BOTTO MALLANGGA 082 344 450 313 YA 9/7/2021 SINOVAC
BATUAPI 085 256 022 365 YA 9/7/2021 SINOVAC
BATUAPI 085 256 590 661 YA 9/7/2021 SINOVAC
MANGKAWANI 081 291 243 983 YA 9/7/2021 SINOVAC
12-17 ENREKANG 081244976439 YA 7-Sep-21 A
12-17 MALINO 083136412866 YA 7-Sep-21 A
12-17 ENREKANG 085341826060 YA 7-Sep-21 A
12-17 SIDRAP 082189641855 YA 7-Sep-21 A
12-17 ENREKANG 082290428869 YA 7-Sep-21 A
12-17 MALINO 081239522596 YA 7-Sep-21 A
46-59 PAKKODI 085242230104 YA 7-Sep-21 A

12-17 LANGSAGAGA 082344512414 YA 7-Sep-21 A

12-17 POLMAN 085255417733 YA 7-Sep-21 A

12-17
ENREKANG PPM RAHMATULASRI
081355606177 YA 7-Sep-21 A
12-17 SALOKARAJA 7-Sep-21 A
12-17 MALINO 082246406005 YA 7-Sep-21 A
12-17 JL. DR. RATULANGI 085824812043 YA 7-Sep-21 A
12-17 PAKKONTENG 081356189670 YA 7-Sep-21 A
12-17 SALOKARAJA 0882020592075 YA 7-Sep-21 A
12-17 MALINO 082259791246 YA 7-Sep-21 A
12-17 PAKKODI 083847759188 YA 7-Sep-21 A
JLN. SULTAN
12-17 081355532233 YA 7-Sep-21 A
HASANUDDIN
12-17 DUSUN TAMBILI 085218088091 YA 7-Sep-21 A
12-17 JALAN HASANIDDIN 085397866788 YA 7-Sep-21 A

12-17 JLN SALAK PAKKODI 083152022513 YA 7-Sep-21 A

12-17 JLN RATULANGI 082296558630 YA 7-Sep-21 A

12-17 PAKKODI 083847759188 YA 7-Sep-21 A
12-17 JLN JERUK MANIS 082349325585 YA 7-Sep-21 A
18-30 SALOKARAJA 082346584854 YA 7-Sep-21 A
12-17 JLN DR RATULANGI 081527020617 YA 7-Sep-21 A
12-17 MALINO 082251119400 YA 7-Sep-21 A
JLN SALU BULA/ANDI
12-17 082238914821 YA 7-Sep-21 A
CARI

12-17 JLN SALAK PAKKODI 085244578294 YA 7-Sep-21 A

12-17 SALO DUA 082241072647 YA 7-Sep-21 A

12-17 BANGKALA 087816633015 YA 7-Sep-21 A
12-17 SANTUNA 081355513953 YA 7-Sep-21 A
12-17 KAJUBULO 085696730206 YA 7-Sep-21 A
12-17 PAKKODI 085824830042 YA 7-Sep-21 A
12-17 JLN RATULANGI 085824668153 YA 7-Sep-21 A
JALAN SALAK
12-17 085256337847 YA 7-Sep-21 A
PAKKODI
12-17 JL RAKKE BUKU 082247061611 YA 7-Sep-21 A
12-17 JLN DR RATULANGI 081244650772 YA 7-Sep-21 A
12-17 SALOKARAJA 082187780952 YA 7-Sep-21 A
12-17 MALINO 087772829045 YA 7-Sep-21 A
12-17 TANETE 085333167340 YA 7-Sep-21 A
12-17 CAKKE MAROANGIN 085241094950 YA 7-Sep-21 A
12-17 MAROAGIN 087763251094 YA 7-Sep-21 A
12-17 TANETE 082142830823 YA 7-Sep-21 A

12-17 JLN SALAK PAKKODI 087805941319 YA 7-Sep-21 A

JL ANDI
12-17 085231483173 YA 7-Sep-21 A
PAKKONTENG
12-17 JL JERUK MANIS 082334011811 YA 7-Sep-21 A
12-17 JLN ENAU 085255637324 YA 7-Sep-21 A
12-17 SALOKARAJA 087435172739 YA 7-Sep-21 A
12-17 SABBANG 087786610641 YA 7-Sep-21 A
12-17 MALINO 082244520673 YA 7-Sep-21 A
18-30 TAPONG 081527508634 YA 7-Sep-21 A
12-17 TAPONG 087848116448 YA 7-Sep-21 A
JL SULTAN
12-17 08221139669 YA 7-Sep-21 A
HASANUDDIN
12-17 MALINO 082111768884 YA 7-Sep-21 A
12-17 MAIWA 082251324385 YA 7-Sep-21 A
12-17 SALOKARAJA 087845029772 YA 7-Sep-21 A
12-17 JL DR RATULANGI 085215035526 YA 7-Sep-21 A
12-17 JLN TAKKE BUKU 083137906624 YA 7-Sep-21 A
12-17 JLN TEKKE BUKU 085242748129 YA 7-Sep-21 A
12-17 ONGKO JLN ENAU 085825039599 YA 7-Sep-21 A
REFORMASI / PT.
12-17 0878119733881 YA 7-Sep-21 A
SALU
12-17 SALOKARAJA 082261936457 YA 7-Sep-21 A
12-17 JL SALURAMA 085341808734 YA 7-Sep-21 A
12-17 JL DR RATULANGI 083122081000 YA 7-Sep-21 A
12-17 SANTUNAN 087784193255 YA 7-Sep-21 A
12-17 MAROAGIN 082228442410 YA 7-Sep-21 A
12-17 JLN DR RATULANGI 085343597969 YA 7-Sep-21 A
12-17 BOLLI 82192314319 YA 7-Sep-21 A
12-17 BATU API 083136775890 YA 7-Sep-21 A

12-17 JLN SALAK PAKKODI 082348642531 YA 7-Sep-21 A

12-17 JL DR RATULANGI 08221078721 YA 7-Sep-21 A

12-17 JAMBATAN DUA 082244511418 YA 7-Sep-21 A
12-17 SANTUNAN 085340038057 YA 7-Sep-21 A
12-17 JLN PAHLAWAN 082292709618 YA 7-Sep-21 A
12-17 JL TAKKE BUKU 081230172016 YA 7-Sep-21 A
12-17 DR RATULANGI 082196385423 YA 7-Sep-21 A
18-30 MAROAGIN 081917759832 YA 7-Sep-21 A
12-17 SALOKARAJA 081315415066 YA 7-Sep-21 A
12-17 ONGKO 08514263680 YA 7-Sep-21 A
JL JENDRAL
12-17 081344734171 YA 7-Sep-21 A
SUDIRMAN

12-17 JLN SALAK PAKKODI 082214232137 YA 7-Sep-21 A

12-17 SALOKARAJA 081907715748 YA 7-Sep-21 A

12-17 JLN LANGSAGAGA 087772821141 YA 7-Sep-21 A
12-17 JLN DR RATULANGI 085255547144 YA 7-Sep-21 A
12-17 MALINO 082319591190 YA 7-Sep-21 A
12-17 JLN ENAU 081543070939 YA 7-Sep-21 A
12-17 TAPONG 08760227823 YA 7-Sep-21 A
12-17 SALOKARAJA 087819901153 YA 7-Sep-21 A
12-17 SALOKARAJA 082158377216 YA 7-Sep-21 A
12-17 JL.PRAMUKA 085336737916 YA 7-Sep-21 A
12-17 MAROAGIN 085650506300 YA 7-Sep-21 A
12-17 MAROAGIN 085256119079 YA 7-Sep-21 A

12-17 TANETE 082190199394 YA 7-Sep-21 A

DUSUN BUNGA
18-30 085242445281 YA 7-Sep-21 A
TANJUNG
12-17 SALOKARAJA 082534034627 YA 7-Sep-21 A
12-17 SALOKARAJA 085249007516 YA 7-Sep-21 A
12-17 MALINO 083123579109 YA 7-Sep-21 A
12-17 CAKKE 082267019576 YA 7-Sep-21 A
12-17 SALOKARAJA 081934508341 YA 7-Sep-21 A
12-17 A. PANGERAN 085824095570 YA 7-Sep-21 A

12-17 ONGKO MAROANGIN 085927480114 YA 7-Sep-21 A

12-17 MALINO 082299378627 YA 7-Sep-21 A

18-30 PAMOLONGAN 082329195397 YA 7-Sep-21 A
12-17 ADIPAKONTENG 087755970960 YA 7-Sep-21 A
12-17 TAKKE BUKU 085298892889 YA 7-Sep-21 A
12-17 SALOKARAJA 085298340302 YA 7-Sep-21 A
12-17 BOLLI 081242459405 YA 7-Sep-21 A
BOTTO CENDANA
12-17 082398074295 YA 7-Sep-21 A
CAKKE
12-17 JLN JERUK MANIS 085299951429 YA 7-Sep-21 A
12-17 ANDI PAKKOTENG 082188034155 YA 7-Sep-21 A
12-17 PALADANG 085298340401 YA 7-Sep-21 A
12-17 KALUPPANG 081354940471 YA 7-Sep-21 A
12-17 POROS BOLLI 081393267581 YA 7-Sep-21 A
12-17 MAIWA 082193288574 YA 7-Sep-21 A
12-17 MAIWA 085719705409 YA 7-Sep-21 A
12-17 TANETE 082237498121 YA 7-Sep-21 A
12-17 JLN MONGINSIDI 085275057538 YA 7-Sep-21 A
18-30 BANGKALA 082153271099 YA 7-Sep-21 A
JLN SULTAN
12-17 082347568498 YA 7-Sep-21 A
HASANUDDIN
12-17 URU 085394251230 YA 7-Sep-21 A
JL SULTAN
31-45 081341576557 YA 7-Sep-21 A
HASANUDDIN

18-30 Enrekang 081242279376 Ya 7-Sep-21 A

12-17 Pinrang 082346811817 Ya 7-Sep-21 A

31-45 Salokaraja 085242061836 Ya 7-Sep-21 A

12-17 Pinrang 085399874509 Ya 7-Sep-21 A

12-17 Enrekang 082311107414 Ya 7-Sep-21 A

18-30 Salokaraja Enrekang 081919837033 Ya 7-Sep-21 A

46-59 Salokaraja Enrekang 081354720189 Ya 7-Sep-21 A

12-17 Mandar 082190518295 Ya 7-Sep-21 A

18-30 Pesantren Rama 082310332203 Ya 7-Sep-21 A

12-17 Maroangin 085215809610 Ya 7-Sep-21 A

12-17 Maroangin 082188311934 Ya 7-Sep-21 A

12-17 Maroangin 085399062903 Ya 7-Sep-21 A

12-17 Maroangin 082332552734 Ya 7-Sep-21 A

12-17 Santunan 082337067149 Ya 7-Sep-21 A

12-17 Sultan Hasanuddin 082230819370 Ya 7-Sep-21 A

12-17 Maroangin 081244542408 Ya 7-Sep-21 A

12-17 Maroangin 082213220899 Ya 7-Sep-21 A

12-17 Karrang 081290612122 Ya 7-Sep-21 A

12-17 Pesantren Rama 085696735600 Ya 7-Sep-21 A

12-17 Enrekang 085255559921 Ya 7-Sep-21 A

12-17 Kaju Bulo 081907495912 Ya 7-Sep-21 A

12-17 Pakkodi 085242230104 Ya 7-Sep-21 A

12-17 Jalan Salak 085341422741 Ya 7-Sep-21 A

12-17 Batuapi 085225521596 Ya 7-Sep-21 A

12-17 Pakkonteng 085341425019 Ya 7-Sep-21 A

12-17 Uru 081216649153 Ya 7-Sep-21 A

12-17 Jalan Bau Massepe 082353285009 Ya 7-Sep-21 A

12-17 Salokaraja 088705494708 Ya 7-Sep-21 A

12-17 Batuapi 082271016917 Ya 7-Sep-21 A

12-17 Maroangin 082154743744 Ya 7-Sep-21 A

12-17 Limbuang 081543464354 Ya 7-Sep-21 A

12-17 Jalan Pendidikan 082252349833 Ya 7-Sep-21 A

12-17 Maroangin 082344409551 Ya 7-Sep-21 A

12-17 Maroangin 085395706499 Ya 7-Sep-21 A

12-17 Botto Mallangga 085298165443 Ya 7-Sep-21 A

12-17 Maroangin 087807978514 Ya 7-Sep-21 A

12-17 Maroangin 082363067224 Ya 7-Sep-21 A

12-17 Maroangin 081244542300 Ya 7-Sep-21 A

12-17 Maroangin 082394681631 Ya 7-Sep-21 A

12-17 Maroangin 085348189243 Ya 7-Sep-21 A

12-17 Maroangin 081230045764 Ya 7-Sep-21 A

12-17 Maroangin 085395801022 Ya 7-Sep-21 A

12-17 Maroangin 085825187248 Ya 7-Sep-21 A

12-17 Maroangin 85238909195 Ya 7-Sep-21 A

12-17 Maroangin 083132011742 Ya 7-Sep-21 A

12-17 Batuapi 082259798676 Ya 7-Sep-21 A

12-17 Salokaraja 081931522425 Ya 7-Sep-21 A

12-17 Jembatan III 085342315208 Ya 7-Sep-21 A

12-17 Maroangin 085299849506 Ya 7-Sep-21 A

12-17 Kaju Bulo 085217233088 Ya 7-Sep-21 A

12-17 Malino 082398838880 Ya 7-Sep-21 A

12-17 Takke Buku 087886863210 Ya 7-Sep-21 A

12-17 Takke Buku 085348483543 Ya 7-Sep-21 A

12-17 Jalan Enau 081527669908 ya 7-Sep-21 A

12-17 Batuapi 081241997180 Ya 7-Sep-21 A

12-17 Tuncung 083135768108 Ya 7-Sep-21 A

12-17 Maroangin 085320126076 Ya 7-Sep-21 A

12-17 Maroangin 087775580975 Ya 7-Sep-21 A

12-17 Maroangin 087841978307 Ya 7-Sep-21 A

12-17 Tanete 081256376560 Ya 7-Sep-21 A

12-17 Santunan 082348642817 Ya 7-Sep-21 A

12-17 Maroangin 082296410204 Ya 7-Sep-21 A

12-17 Batuapi 082228062530 Ya 7-Sep-21 A

12-17 Santunan 087730932125 Ya 7-Sep-21 A

12-17 Uru 087819858992 Ya 7-Sep-21 A

12-17 Maroangin 082296392982 Ya 7-Sep-21 A

12-17 Maroangin 085298318433 Ya 7-Sep-21 A

12-17 Maroangin 082296525783 Ya 7-Sep-21 A

12-17 Maroangin 082348449206 Ya 7-Sep-21 A

12-17 Maroangin 087781628803 Ya 7-Sep-21 A

12-17 Limbuang 083849791643 Ya 7-Sep-21 A

12-17 Malino 085255368918 Ya 7-Sep-21 A

12-17 Maroangin 082238503952 Ya 7-Sep-21 A

12-17 Pakkodi 087786610667 Ya 7-Sep-21 A

12-17 Ongko 082259590891 Ya 7-Sep-21 A

12-17 Kajubulo 081356702080 Ya 7-Sep-21 A

12-17 Salokaraja 082317274371 Ya 7-Sep-21 A

12-17 Malino 083131206937 Ya 7-Sep-21 A

12-17 Takke Buku 085298325064 Ya 7-Sep-21 A

12-17 Maroangin 083132057826 Ya 7-Sep-21 A

12-17 Maroangin 082344439104 Ya 7-Sep-21 A

12-17 Maroangin 081949328964 Ya 7-Sep-21 A

12-17 Maroangin 0887436456880 Ya 7-Sep-21 A

12-17 Maroangin 088705442239 Ya 7-Sep-21 A

18-30 Maroangin 082394646146 Ya 7-Sep-21 A

12-17 Maroangin 085796346846 Ya 7-Sep-21 A

12-17 Maroangin 087797591578 Ya 7-Sep-21 A

12-17 Maroangin 0887436245748 Ya 7-Sep-21 A

12-17 Maroangin 081259300474 Ya 7-Sep-21 A

12-17 Maroangin 081343596771 Ya 7-Sep-21 A

12-17 Maroangin 085940972600 Ya 7-Sep-21 A

12-17 Maroangin 082394420784 Ya 7-Sep-21 A

12-17 Maroangin 087840108532 Ya 7-Sep-21 A

12-17 Maroangin 085796068435 Ya 7-Sep-21 A

12-17 Maroangin 082195169667 Ya 7-Sep-21 A

12-17 Maroangin 085240955382 Ya 7-Sep-21 A

12-17 Maroangin 082334010334 Ya 7-Sep-21 A

12-17 Maroangin 081393484840 Ya 7-Sep-21 A

12-17 Maroangin 085824668135 Ya 7-Sep-21 A

12-17 Maroangin 085279226990 Ya 7-Sep-21 A

12-17 Maroangin 081257775165 Ya 7-Sep-21 A

12-17 Maroangin 081393467215 Ya 7-Sep-21 A

12-17 Maroangin 083841845905 Ya 7-Sep-21 A

18-30 Maroangin 085823107384 Ya 7-Sep-21 A

31-45 Maroangin 087819830871 Ya 7-Sep-21 A

31-45 Maroangin 082268151531 Ya 7-Sep-21 A

18-30 Maroangin 081241421062 Ya 7-Sep-21 A

12-17 MaIino 082230821696 Ya 7-Sep-21 A

12-17 Maroangin 085346515320 Ya 7-Sep-21 A

18-30 Bangkala 082394681702 Ya 7-Sep-21 A

18-30 Bangkala 082111860848 Ya 7-Sep-21 A

12-17 MaIino 082347789844 Ya 7-Sep-21 A

60-100 Maroangin 081242557976 Ya 7-Sep-21 A

12-17 Maroangin 081998859455 Ya 7-Sep-21 A

12-17 Maroangin 085342874034 Ya 7-Sep-21 A

12-17 Maroangin 085240882398 Ya 7-Sep-21 A

12-17 Maroangin 085725871746 Ya 7-Sep-21 A

31-45 Maroangin 85350381033 Ya 7-Sep-21 A

18-30 Maroangin 08134050544 Ya 7-Sep-21 A

31-45 Maroangin 082317729953 Ya 7-Sep-21 A

46-59 Maroangin 082344409846 Ya 7-Sep-21 A

12-17 Maroangin 085321015064 Ya 7-Sep-21 A

46-59 Maroangin 082344409046 Ya 7-Sep-21 A

18-30 Maroangin 081354388927 Ya 7-Sep-21 A

12-17 Maroangin 082195872040 Ya 7-Sep-21 A

18-30 Maroangin 081244252623 Ya 7-Sep-21 A

12-17 Maroangin 087833063422 Ya 7-Sep-21 A

12-17 Maroangin 081352061521 Ya 7-Sep-21 A

12-17 Maroangin 081527508577 Ya 7-Sep-21 A

18-30 Maroangin 082328143689 Ya 7-Sep-21 A

12-17 Maroangin 085399057412 Ya 7-Sep-21 A

12-17 Maroangin 085343815887 Ya 7-Sep-21 Coronavac

18-30 Maroangin 087780317668 Ya 7-Sep-21 Coronavac
31-45 Maroangin 087780317668 Ya 7-Sep-21 Coronavac
31-45 Maroangin 085240677383 Ya 7-Sep-21 Coronavac
12-17 Sidrap 081231528363 Ya 7-Sep-21 Coronavac
12-17 Sidrap 081231528363 Ya 7-Sep-21 Coronavac
31-45 Sidrap 081231528363 Ya 7-Sep-21 Coronavac
12-17 Maroangin 085240319704 Ya 7-Sep-21 Coronavac
46-59 Tuncung 087760054509 Ya 7-Sep-21 Coronavac
46-59 Tapong 081217744933 Ya 7-Sep-21 Coronavac
31-45 Tuncung 087760054509 Ya 7-Sep-21 Coronavac
12-17 Maroangin 087847068019 Ya 7-Sep-21 Coronavac
18-30 Maroangin 085341808668 Ya 7-Sep-21 Coronavac
31-45 Maroangin 081977098149 Ya 7-Sep-21 Coronavac
18-30 Maroangin 085298437192 Ya 7-Sep-21 Coronavac
18-30 Maroangin 085340715634 Ya 7-Sep-21 Coronavac
31-45 Maroangin 085253575146 Ya 7-Sep-21 Coronavac
12-17 Salokaraja 083395016042 Ya 7-Sep-21 Coronavac
18-30 Salokaraja 082320812807 Ya 7-Sep-21 Coronavac
18-30 Maroangin 085796544738 Ya 7-Sep-21 Coronavac
18-30 Kaluppang 083898910321 Ya 7-Sep-21 Coronavac
12-17 Tuncung 082349291082 Ya 7-Sep-21 Coronavac
12-17 Paraja 085245709481 Ya 7-Sep-21 Coronavac
12-17 Tuncung 085394474065 Ya 7-Sep-21 Coronavac
12-17 Bt.Lipang 082189700607 Ya 7-Sep-21 Coronavac
12-17 Maroangin 082215540680 Ya 7-Sep-21 Coronavac
12-17 Tuncung 081802133524 Ya 7-Sep-21 Coronavac
12-17 Maroangin 082349291051 Ya 7-Sep-21 Coronavac
12-17 Maroangin 081906200632 Ya 7-Sep-21 Coronavac
31-45 Rappang 085340999067 Ya 7-Sep-21 Coronavac
18-30 Salokaraja 085933340970 Ya 7-Sep-21 Coronavac
12-17 Maroangin 082293270114 Ya 7-Sep-21 Coronavac
12-17 Labuku 087805940613 Ya 7-Sep-21 Coronavac
12-17 Maroangin 087819830811 Ya 7-Sep-21 Coronavac
18-30 Maroangin 083136318406 Ya 7-Sep-21 Coronavac
18-30 Maroangin 085242800356 Ya 7-Sep-21 Coronavac
31-45 Malino 082296310065 Ya 7-Sep-21 Coronavac
46-59 Tuncung 085256008460 Ya 7-Sep-21 Coronavac
60-100 Tuncung 085256008460 Ya 7-Sep-21 Coronavac
31-45 Maroangin 088705607443 Ya 7-Sep-21 Coronavac
12-17 Maroangin 087819846584 Ya 7-Sep-21 Coronavac
18-30 Rappang 083142294644 Ya 7-Sep-21 Coronavac
 Keterangan
Dosis I Dosis 2 (Ditunda/
Tanggal Pemberian Tanggal Pemberian Tidak
No. Batch No. Serial No. Batch No. Serial Diberikan/La
Vaksinasi Vaksinasi
njut)
9/7/2021 24202621
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 FORMAT PENCATATA
TINGKAT PUSKES

Nama Puskesmas/Fasyankes/Pos : PUSKESMAS MAIWA

Kabupaten/Kota : ENREKANG
Provinsi : SULAWESI SELATAN
Hari, Tanggal : Selasa / 07-09-2021
Umur
Jenis Tanggal
No No. Tiket NIK Nama Penerima Vaksin Pekerjaan* (18 sd ≥ 60
Kelamin Lahir
tahun)
2 7316011608770004 MURSALIM, S.PD L GURU 16-08-1977
11 7316013112710016 SAHARUDDIN L PETANI 31-12-1971
APARAT
19 7316012108860001 RUSTAN L 21-08-1986
DESA
20 7316010107510004 ABD. MAJID L PETANI 07/01/1951
22 7316015311850001 RASNI L IRT 13-11-1985
23 7316010603790002 APRIADI L PETANI 03/06/1979
24 7316013112770017 ISRAIL L PETANI 31-12-1977
30 3172043108841001 USMAN YASIR LAWE L PELAUT 31-08-1983
31 7316013005930001 HASRIN L PETANI 30-05-1993
32 7316011608920002 HASAN ANSHARI.F L PETANI 16-08-1992
35 7316013112520018 TANREANG L PETANI 31-12-1952
41 7316012410890001 RUSMAN L PETANI 24-10-1989
43 7316011505710002 MUHAMMAD ABDUH L PETANI 15-05-1971
45 73160116-09930001 ABD.MUTTALIF L PETANI 16-09-1993
48 7316014107740064 RAMLAH L IRT 1/7/1974
50 7316016705770001 JUSLIANA L IRT 27-05-1977
58 7316010107590019 SANUSI L PETANI 1/7/1959
61 7316011307020001 ABIL ABDILLAH MUCHLIS L PELAJAR 13-07-2002
66 7316053112570025 LAMAPPA L UMUM 31-12-1957
67 7316012108790001 RAHMAT ALAMSYAH L APARAT DESA21-08-1979
69 7316010707710003 UMAR L PETANI 7/7/1971
70 7316012606710001 TAJUDDIN, S.AG L PETANI 26-06-1971
72 7316022901790001 AKBAR L PEL.PUBLIK 19-01-1979
73 7316014008790001 LATIF LAWEDA L PETANI 14-08-1979
79 7316011606670001 MUSLIMIN L PETANI 16-06-1967
81 7316013112520017 ALIMUDDIN L LANSIA 31-12-1952
89 7316011908980002 RAHMAN L UMUM 19-08-1998
91 7316012609010001 ASRAF AFANDI L MAHASISWA 26-09-2001
92 7316010503010002 MUHAMMAD FADIL L MAHASISWA 5/3/2001
93 7316012109980002 RAHMAN NASUTION L UMUM 11/10/1999
94 7316010307780002 NURDIN L GURU 3/7/1978
97 7316012209030001 ABDUL RAJAB NAIM L PELAJAR 22-09-2003
98 7316010102000004 AKBAR SYABIRIN L MAHASISWA 1/2/2000
102 7316010407720001 MAALI L PETANI 4/7/1972
103 7316010112720002 ABD.HAKIM L PETANI 1/12/1972
104 7316012001800001 JAMALUDDIN L APARAT DESA20-01-1980
105 7316010107740085 NURDIN L PETANI 19-09-1974
112 7316013112720020 ALIMUDDIN L PETANI 31-12-1972
115 7316021810900001 HIDAYAT L WIRASWASTA18-10-1990
116 7316012408990003 RAHMAT HIDAYAT L MAHASISWA 24-08-1999
117 7316010409820001 JAMALUDDIN L PETANI 4/9/1982
118 7316011106770001 SAHARUDDIN L PETANI 11/6/1977
119 7316012406920001 SYAMSUL RAHMI L PETANI 24-06-1992
120 7316011403910002 SALMAN L UMUM 14-03-1991
121 7316011010050003 MUHAMMAD JEFRI AL IKHSAN L PELAJAR 10/1/2005
122 7316011809750003 SUNANDAR L PETANI 18-09-1975
124 7316010804810001 JUMAIL L PETANI 8/4/1981
126 7316010409000002 HASRIL L MAHASISWA 4/9/2000
127 7316013112020016 ADE RISMAWAN L PETANI 31-12-2002
128 7316011812970002 MUH. ARMIN L PETANI 18-12-1997
129 7316010409000001 HASRUL L PETANI 4/9/2000
130 7316011607980001 JUPRIADI L PETANI 16-07-1998
131 7316010709880002 ANWAR L PETANI 7/9/1988
132 7316012005860002 SAHARUDDIN L PETANI 20-05-1986
133 7316011408800004 MUH. AKBAR L PETANI 14-08-1980
134 731601701950002 RINAL FADLI L UMUM 17-01-1995
136 7316011911990001 MUH. ALIM L MAHASISWA 19-11-1999
137 7316011010700005 MANGENRE L APARAT DESA10/10/1970
139 7316010107850020 JUMADIL L PETANI 1/7/1985
140 7316010702950001 MUH.RIVAL L PETANI 7/3/1995
143 7316011402760001 MANSUR L PETANI 14-02-1976
144 7316011610730001 ASRUL L PETANI 16-10-1973
147 7316010612050004 MASLAN L PELAJAR 6/12/2005
148 7307032008860003 ASBAR L PETANI 20-08-1986
 FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI

Nama/
Kelompok Kepesertaan BPJS (tulis 'Ya' pada Tanggal
Alamat No. Hp Jenis/Merek Dosis I
Umur kolom yang sesuai) Screening
Vaksin***
PALAKKA 085359841607 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082348882450 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 085757572212 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 085756263496 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082394467681 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 081333212788 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085210239960 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082348882450 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085801237468 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085156731171 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085756969068 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085258565446 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085757572212 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082245449467 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 081244354214 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082195275921 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 082394467681 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085298327294 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085756101474 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085656036616 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085796589042 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 081526194715 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085258565446 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085827879500 YA 9-Jul-21 SINOVAC 9-Jul-21
PASANG 085258565446 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 08295275921 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 082188368366 YA 9-Jul-21 SINOVAC 9-Jul-21

PASANG 085757415357 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085331938051 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 089505704094 Ya 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 081354853667 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 08556420967 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085696987584 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085298116765 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085298116765 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 081253258598 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085242858770 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 081343736554 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085242292474 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085796301132 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085242280564 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 081345489817 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082296654363 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085298184427 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082239244342 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 081268050470 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082296654363 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082296654363 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082293336323 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082293336323 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082154363175 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085788835916 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082394018675 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082157823334 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082349370570 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082259200992 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085823132563 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 085255594742 YA 9-Jul-21 SINOVAC 9-Jul-21

PALAKKA 082154363175 YA 9-Jul-21 SINOVAC 9-Jul-21

 (Ditunda/
Dosis I Dosis 2 Tidak
Diberikan/La
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