No KK NIK/KITAS/KITAP Nama Lengkap 2 =PISAT

Suami Tgl Lahir Jenis Kelamin

Status Kawin
Alamat Tempat Tinggal
0=TD
Tempat Lahirdd/mm/yyyy1=L 2=P
3 = Istri
1=B, 2=K, 3=C
2 3 4 4 = Anak
5 6 7 8 9 10
3325112501110003 3325111609060003 MUHAMAD FATHIH AL FIKARI 5 BATANG 16/09/2006 1 1 BERAN
3325112501110003 3325116803120001 JIHAN MILA NADIA RAHMA 5 BATANG 28/03/2012 2 1 BERAN
3325110706080005 3325111012760006 AMAT TAUFIK 1 BATANG 10/12/1976 1 2 DUKUH BERAN
3325110706080005 3325114603760004 SUSANTI 3 BATANG 06/03/1976 2 2 DUKUH BERAN
3325112206100017 3325115604840009 KHUSNUL KHOTIMAH 4 BATANG 16/04/1984 2 2 DUKUH BERAN
3325112502071769 3325114501720001 SUPIYATI 3 MAGELAN 05/01/1972 2 2 GG JAMBE
3325112502071615 3325116112020001 NUR LATHIFAH AMILDA 4 BATANG 21/12/2002 2 1 GG ROTAN DK MBERAN
3325112502072028 3325112703100001 IRSYAD SURYA DEHANI 4 BATANG 27/03/2010 1 1 GG.KEMUNING
3325112611190001 3325111808870001 MUHAMAD NUR ROSIDIN 1 BATANG 18/08/1987 1 2 JL DR SUTOMO
3325111210110013 3375021201840001 MUHAMMAD ARWAN 1 BATANG 12/01/1984 1 2 JL DR SUTOMO DK BERAN
3325111210110013 3325115512110002 BAHJATUS SANIYYAH 4 BATANG 15/12/2011 2 1 JL DR SUTOMO DK BERAN
3325111609130016 3325111705980001 SLAMET URIP 4 BATANG 17/05/1998 1 1 JL DR SUTOMO GG RANDU
3325111509200010 3325116712650002 KASYATI 1 BATANG 27/12/1965 2 3 JL DR SUTOMO NO 33
3325111509200010 3325110312970001 MOCHAMMAD ROFIHAN ANWAR 4 BATANG 03/12/1997 1 1 JL DR SUTOMO NO 33
3325111509200010 3325110309040003 M.WAHYU SETIAWAN 4 BATANG 03/09/2004 1 1 JL DR SUTOMO NO 33
3325113011160018 3325110508950009 M. CHAERUR ROZIKIN 4 BATANG 19/02/1994 1 1 JL. DR. SOETOMO
3325110103170020 3325113004180006 MUKHAMAD ALTAF NI'AMI 4 BATANG 30/04/2018 1 1 JL. DR. SUTOMO
3325110103170020 3325117007190003 SYAKIRA ILMAN IRFANA 4 BATANG 30/07/2019 2 1 JL. DR. SUTOMO
3325112712100056 3325115009690003 SOPIYAH 1 BATANG 10/09/1969 2 3 JL. DR. SUTOMO
3325112712100056 3325116309020007 HANI SOFIATUS SHIFA 4 BATANG 23/09/2002 2 1 JL. DR. SUTOMO
3325112502072368 3325116111130001 NOVITA ANGGRAINI 4 BATANG 21/11/2013 2 1 JL. DR. SUTOMO GG. CEMARA
3325112502071610 3325115405930001 ERNI RUSDIANI 4 BATANG 14/05/1993 2 1 JL. DR.SUTOMO DUKUH MBERAN
3325112611190014 3325112108850001 MUHAMAD KHUSNI 1 BATANG 21/08/1985 1 2 JL.DR SUTOMO
3325112611190014 3325110711190002 AHMAD TAWWAB 'ISY JAWWADA 4 BATANG 07/11/2019 1 1 JL.DR SUTOMO
3325110608190016 3325111804920005 BURHANUDIN ALI 1 BATANG 18/04/1992 1 2 JL.DR SUTOMO GG.ROTAN BERAN
3325110608190016 3329036410960003 KIKI ERMAWATI 3 BREBES 24/10/1996 2 2 JL.DR SUTOMO GG.ROTAN BERAN
3325110608190016 3325113003190002 MUHAMMAD AL FATIH 4 BREBES 30/03/2019 1 1 JL.DR SUTOMO GG.ROTAN BERAN
3325112712100057 3325115505650001 ADE MAESAROH 1 BATANG 15/05/1965 2 3 JL.DR SUTOMO GG.ROTAN BERAN
3325111401100111 3325115112790004 IMTIANAH 3 BATANG 11/12/1979 2 2 JL.DR. SUTOMO GANG RANDU
3325112502071759 3325113112800005 CISWANTO 1 BATANG 31/12/1980 1 2 JL.DR.SUTOMO
3325112502071759 3325115001820004 NURMALA 3 PEKALONG10/01/1982 2 2 JL.DR.SUTOMO
3325111009070008 3325112311900006 ABDUL HOFAR MU'MIN 4 BATANG 23/11/1990 1 1 JL.DR.SUTOMO DUKUH MBERAN
3325111009070008 3325116308130001 DURROTUN NAFISAH MUNZALIN 5 BATANG 23/08/2013 2 1 JL.DR.SUTOMO DUKUH MBERAN
3325111308200009 3325115212410001 KHUNAENAH 1 BATANG 12/12/1941 2 3 JL.DR.SUTOMO GG PALEM DUKUH BERAN
3325112502072279 3325114107470038 WASTIAH 1 BATANG 01/07/1947 2 3 JL.P.KEMEREDEKAAN GANG MAHONI
3325112502072279 3325112909920010 ACHMAD SUBARI 4 BATANG 29/09/1992 1 1 JL.P.KEMEREDEKAAN GANG MAHONI
3325113103080013 3325110107720124 FURYANTO 1 BATANG 09/02/1969 1 2 JL.PERINTIS KEMERDEKAAN GG. KEMUNING
3325112502072173 3325114812660002 RUKUN 1 BATANG 08/12/1966 2 3 JL.PERINTIS KEMERDEKAAN GG.SALAM
3325112502072173 3325111308930003 AGUS SUPARJO 4 BATANG 13/08/1993 1 1 JL.PERINTIS KEMERDEKAAN GG.SALAM
3325111802190005 3325115011650006 SAMAWATI 1 BATANG 10/11/1965 2 3 JL.PERINTIS KEMERDEKAAN WATESALIT
3325111802190005 3325112910080001 RIO FIRMAN 4 BATANG 29/10/2008 1 1 JL.PERINTIS KEMERDEKAAN WATESALIT
3325112712090051 3325110801780001 MUTAKIN 1 BATANG 08/01/1978 1 2 KEL.WATESALIT GG JAMBE
3325113110140001 3325112304900001 ACHMAD RIFA'I 1 BATANG 23/04/1990 1 2 KEL.WATESALIT GG.ROTAN
3325113110140001 3325115805920002 ENI KUSWORO 3 BATANG 18/05/1992 2 2 KEL.WATESALIT GG.ROTAN
3325113110140001 3325112102140004 EL DAFFA KAFIEL HUSAIN 4 BATANG 21/02/2014 1 1 KEL.WATESALIT GG.ROTAN
3325113110140001 3325111012160002 ALI SHAQIEL HUSAIN 4 BATANG 10/12/2016 1 1 KEL.WATESALIT GG.ROTAN
3325113110140001 3325110512190002 MUHAMAD AQSHANADA HUSAIN 4 BATANG 05/12/2019 1 1 KEL.WATESALIT GG.ROTAN
3325111605170031 3325110503890006 MUKHAMAD ZAKI 1 BATANG 05/03/1989 1 2 MBERAN
3325111605170031 3325111112180001 FAHREZA AHMAD ZAHID 4 BATANG 11/12/2018 1 1 MBERAN
3325110305160003 3325115112760001 PAR'ISAH 3 BATANG 18/03/1976 2 2 WATESALIT
3325112502071633 3325112204870002 MUCH KHAFIDH 4 BATANG 22/04/1987 1 1 WATESALIT
3325112502071709 3325115908810004 TARLINAH 3 BATANG 31/12/1981 2 2 WATESALIT
3325112502071709 3325110309210004 BILAL HAFIDZ 4 BATANG 03/09/2021 1 1 WATESALIT
3325113003110009 3325111205810002 MURDIYANI 1 BATANG 12/05/1981 1 2 WATESALIT
3325113007130001 3325111007850003 ABDUL SALAM 1 BATANG 10/07/1985 1 2 WATESALIT
3325113007130001 3325112709130002 MUHAMMAD HABIBI ALFAJRI 4 BATANG 27/09/2013 1 1 WATESALIT
3325113007130001 3325117110200001 AFIZA GHANIA 4 BATANG 31/10/2020 2 1 WATESALIT
 USULAN BARU PBI KIS APBD DATA DTKS NON JKN
KELURAHAN WATESALIT TAHUN 2023

Jenis Status
PISAT Tgl Lahir
Kelamin Kawin

1 = Peserta 0=TD
No No KK NIK/KITAS/KITAP Nama Lengkap 2 = Suami
1=L
3 = Istri Tempat Lahir dd/mm/yyyy 1=B
2= P
4 = Anak 2=K
5 = Tambahan 3=C

1 2 3 4 5 6 7 8 9
1 3325112502072173 3325114812660002 RUKUN 1 BATANG 08/12/1966 2 3
2 3325110305160003 3325115112760001 PAR'ISAH 3 BATANG 18/03/1976 2 2
3 3325111802190005 3325115011650006 SAMAWATI 1 BATANG 10/11/1965 2 3
4 3325111802190005 3325112910080001 RIO FIRMAN 4 BATANG 29/10/2008 1 1
5 3325112502072279 3325114107470038 WASTIAH 1 BATANG 01/07/1947 2 3
6 3325112502072279 3325112909920010 ACHMAD SUBARI 4 BATANG 29/09/1992 1 1
7 3325111308200009 3325115212410001 KHUNAENAH 1 BATANG 12/12/1941 2 3
8 3325111509200010 3325116712650002 KASYATI 1 BATANG 27/12/1965 2 3
9 3325110608190016 3325111804920005 BURHANUDIN ALI 1 BATANG 18/04/1992 1 2
10 3325110608190016 3329036410960003 KIKI ERMAWATI 3 BREBES 24/10/1996 2 2
11 3325110608190016 3325113003190002 MUHAMMAD AL FATIH 4 BREBES 30/03/2019 1 1
12 3325112712100057 3325115505650001 ADE MAESAROH 1 BATANG 15/05/1965 2 3
13 3325111401100111 3325115112790004 IMTIANAH 3 BATANG 11/12/1979 2 2
14 3325112502071769 3325114501720001 SUPIYATI 3 MAGELANG 05/01/1972 2 2
15 3325110706080005 3325111012760006 AMAT TAUFIK 1 BATANG 10/12/1976 1 2
DATA DTKS NON JKN
T TAHUN 2023

Nama Nama Nomor

Nama
Alamat Tempat Tinggal RT RW Nama Desa Faskes Faskes Telepon
Kecamatan
Tk.I Dokter Gigi Peserta

10 11 12 13 14 15 16 17
JL.PERINTIS KEMERDEKAAN GG.SALAM 02 ;LM; BATANG WATESALIT
WATESALIT 03 02 BATANG WATESALIT
JL.PERINTIS KEMERDEKAAN WATESALIT 03 04 BATANG WATESALIT
JL.PERINTIS KEMERDEKAAN WATESALIT 03 04 BATANG WATESALIT
JL.P.KEMEREDEKAAN GANG MAHONI 03 05 BATANG WATESALIT
JL.P.KEMEREDEKAAN GANG MAHONI 03 05 BATANG WATESALIT
JL.DR.SUTOMO GG PALEM DUKUH BERAN 01 01 BATANG WATESALIT
JL DR SUTOMO NO 33 04 01 BATANG WATESALIT
JL.DR SUTOMO GG.ROTAN BERAN 02 01 BATANG WATESALIT
JL.DR SUTOMO GG.ROTAN BERAN 02 01 BATANG WATESALIT
JL.DR SUTOMO GG.ROTAN BERAN 02 01 BATANG WATESALIT
JL.DR SUTOMO GG.ROTAN BERAN 02 01 BATANG WATESALIT
JL.DR. SUTOMO GANG RANDU 03 02 BATANG WATESALIT
GG JAMBE 01 02 BATANG WATESALIT
DUKUH BERAN 04 01 BATANG WATESALIT

Batang, 18 Juni 2023

LURAH WATESALIT

HAFIDZ NANDA ANSARIZQIKA, S.STP

NIP. 19930625 201501 1 001