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  • Form 18 - SDN 192

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    Budi Heryanto
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    yu

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    08. Form 18_SDN 192

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    yu

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    12 views5 pages

    Form 18 - SDN 192

    Uploaded by

    Budi Heryanto
    yu

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 5
    Formulir 18 Formulir Pemeriksaan Frambusia di Sekolah Kevuptenta Nama Sekolah, Kelas ‘Tanggal/Bulan/Tahun [SON 192 Sungai Buluh [-1]renunen Kegan J es 7] [C2piemanians ts [3 urian una Denes [172 [ [oman Kens Kontmesiprbane|_o | [5 bum asus Suspek (era igi a) [a fiumianKasus ROT) fastens] Catatan : Register dibuatsetiap kali melaksanakan kegiatan Pemeriksaen Frambusia oi Sekolah ‘Anak dengan diagnosis frambusia suspek, probable, konfirmasi, RDT (-) wajib dicatat Rengkuman wai disi dengan lengkap den benar Register ini disimpan Puskesmas dan digunakan sebagai behan taporan, *) Bentuk Lesi : papula (p), papiloma(p)), ulkus(u), makula(m), hiperkeratosis(k), les! tulang(t) *) Lokas! les: tangan(), kak(k), muka(m), badan(®) *) Sehat, suspek, onfimasi, probabel, suspek, ROT (+)/), RPR (*)4>) ‘Sungai Buluh, Ago? 2023 Penanggung Jawab Program oN Hema Malini, ANd.AK episeategptotions ‘wip, 19900S042015032008 ESEWES Daftar Peserta Didik ‘SD NEGERI 9al MUARO BUNGO. Kecamatan Kec. Ri ‘imbo Tengah, Kabupaten Kab, Bungo, Provinsi Prov. Jambi 4K | Tanggal Lahir: NIK Rombel Saat ini Alifah Thanzania £ | 2017-08-01 | is08i34i08170001 Kelas 7 |ALISHA KHAIRA PUTRI Pp 2016-10-13 3208325310160002 Kelas 1 JALTHAFANDRA ZUMI L 2017-07-08 1508130807170001 Kelas 1 |AMELIA AGUSTINA P 2017-08-07 1508134708170002 Kelas 1 JARSYILA SAHILA PUTRI P 2017-10-07 1508134710170001 Kelas 1 IDANU SEPTIAWAN 4 | 2016-09-18 | 1508101809160001 Kelas 1 L 2016-11-08 1508170811160003 Kelas 1 IM.ZAKRIYANDA PRATAMA, L 2016-08-21 1S08132108160001 Kelas 1 | 2016-12-25” |"1508032512160001 Kelas 1 [MUHAMAD FABIAN |" 2016-05-14 [~1872041405160002 Kelas 1 [NAURA AZKIYA P 2017-02-07 1508104702170001 Kelas 1 INAYSILA MEISA PUTRI P| 2017-05-24 |“1508136405170001 Kelas 1 [NURLYA EMELYSA PUTRIS P| 2017-07-27 |1508036707170001 Kelas 2 RAHMA OLIVIA HILPINA P| 2017-01-23 |"1508116301170001 Kelas 1 15 _|RAIHAN YURI ALFATIH. 1 | 2016-09-15 |-1508131509160002 Kelas 1 16 [SALMA SHOFIVAH, P| 2017-04-13 |1508135308170001 Kelas 1 17_|SINTIA RAHMADANT P| 2016-09-19 |1508135909160001 Kelas 1 18” |SYAHBILA NADA NADIFA P| 2017-01-02 | 1508134201170001 Kelas 1 19” [TASYA ARSYFA RAHEL P| 2016-10-01 | 1508034110160001 Kelas 1 20 [TRISTAN ALJARAS RAMADAN. {2017-06-06 _|"1508110606170001 Kelas 1 2 kaw PUTRI ANDOTA P| 2017-05-18 _|-1508175805170001 Kelas 1 22” |ABDA GUNAWAN SIREGAR P|" 2016-07-03 | 1508134307160 Kelas2 23 [ALVIN LESMANA SAKTI L {2015-11-14 |1508031411150001 Kelas 2 "24 |ANDINNI NURRAMADHANT P|” 2016-06-13 | 1508055306160001 Kelas 2 25_|APRILIA KHOLISA AZZAHRA P| 2016-04-18 _|"1508125804160002 Kelas 2 26 _|BANYU ALKAUTSAR. "2016-04-27 |1508132704160002 Kelas 2 27_|DIAH AYU AISYAH P| 2016-01-05 | 1508134501160001 Kelas 2 28_|DIFARMAN WARUWU L [2016-11-01 | 1204270111160007 Kelas 2 29_{DIRLY ARSENIO RAJENDRA SINURAYA SF&_1 | 2015-21-06 | 1508130611150001 tae 30_|Elang Wahyu Pranata L 2015-06-21 | 1508132106150002 — 1S - oe vee | estesr| es 32_|FELICIA AMIRA PUTRI P| 2016-05-31 | 1508037105160001 tz 33_|GILMOHAMMAD BATHUTA |” 2016-04-04 | 1508130404160001 ie ® ane

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