Tim Iii

Profesi**
No. Registrasi Nama Penerima Jenis Kelamin

NO NIK (A/B/C/D/E/F/
vaksin II Vaksin (L / P)
G/H)
1 P-24UK0RT4 3374146207070001 SITI SAFIYA ZAHRA AULI P REMAJA
2 P-27DKJZOH 3374142104090001 MUHAMMAD AL-FARI Y L REMAJA
3 P-2AFYPSTM 8204302305770001 M. AMIN HI. ADAM L R
4 Z-000BDMG1 3174102410580003 E. YUNIER MABEL L R
5 Q-000X5EV5 9171021506900007 ELFIS NUH HAREWAN L R
6 P-2GVIDDLK 9171014809000001 SISILIA AGAPA P R
7 Q-0010DLKD 9171024806990001 MEGASILVIA TELUSSA P R
8 Q-0011M1JF 9111051411710001 ROY KATO L R
9 Q-0010CO85 8171020211890007 JHONI SELANNO L R
10 Q-0011QSGM 9171035901900003 FRANSISKA WAICANG P R
11 Z-000BARYJ 9171051712710002 KHRISMA IRIANSON SIT L R
12 P-3B2WUIF5 8171030809940002 LIADI L R
13 Q-0011QEXD 9171031209860006 THEODORUS JANSEN OL R
14 Q-0012NNAD 9102440304970001 KORNELIS LOGO L R
15 P-3NH2KTZE 9122030601010003 SEROGO MABEL L R
16 Q-0011M6XD 9171054509090002 RAHMADHANIATUN AMIP REMAJA
17 Q-0011MTF1 9103070808750001 RASINO L R
18 P-4LSBR5QQ 9171035509070005 ANDINI EUANGGELION P REMAJA
19 P-QSZSXV8T 9171034902080002 NADIA SYAM P R
20 P-54FVI7P7 9102015004980001 RONNA FEBYOLA PASKALP R
21 Z-000BARRH 9171035209580002 LEONORA APROMBIS P R
22 Q-00118MCV 9171011712920003 ALI SUFYAN DUWILA L R
23 Q-0010H5BH 9171056604610002 NINIK.T.PRIYATMI P R
24 Q-0011Y8L8 1401042709970004 DENNI ADREANSYAH L R
25 Q-000W7QBR 9171016706760010 SRI DELY KAHAELA P R
26 Q-0012EPXH 8105017005760002 AISA WAULAT P R
27 Q-00138SQ8 1401012005870003 DERI ALFAJRI L R
28 P-5QOLDUVM 9171054204900004 LISABETH SARLOTA MO P R
29 P-5S6KSMWJ 9171015407890009 BIRTY TANALA FIRDAUS P R
30 Q-0011S5BH 8109031101840001 USMAN SOUWAKIL L R
31 P-61PT2HVM 9171020303020003 BRYAN ZIDANE SUMBARIL R
32 J-0006JE48 9102011608950002 ALFIAN E. DURMATURIAL R
33 Q-0012EXLG 9171014504830001 MALSIA P R
34 S-EA052EAF 9202121501880005 SAIFUL L R
35 S-FAA0F483 1211052010860002 JUBEL HUTABARAT L J
36 Q-0012CAUH 8201086607860002 YULIANA NYATA P R
37 S-A0C15F2E 9171036608870003 RINA NOPITA MANULLA P R
38 Z-000B3N6Y 9171035404530004 ESTI RIOSMI SIAHAAN P R
39 P-7AKJYSG1 9105016611800001 NORCE THIDORA KARIMP J
40 Q-02DEEA39 6271014203880001 MARIA PATRICIA PEARL P R
41 Z-000BALQN 9171031109570001 HERMAN SALINDEHO L R
42 Q-0010WDMO 9271054510820005 BERGITHA S. YOKIT P R
43 Q-000PCBLD 9106016502010002 SANTI FEBRIANTI NUSSYP G
44 Q-0012DO4U 5371045108760006 MARIA GORETTY DAENGP R
45 P-8D26ZRGF 9171055904020001 NABILA ROSA P R
46 Q-0010O7HB 9171031301900002 ERFAN PASANGKIN L R
47 Q-0010O7HB 8107014109000002 SALOMINA MANGAR P R
48 Q-0012DO53 5313066402932501 MARIA FRANSISKA MONP R
49 Q-0012D8SG 9171034709670003 TINI MUNIK P R
50 Q-0011S3I2 9171036006890001 WIDI IRYANA KORAREY P R
51 Q-0011WX80 9171036910060002 THERESCYA GOAW KORAP R
52 P-9U0SMH1F 9171016408090003 PRINCESS JULIA ABYGA P REMAJA
53 P-AAESEUCL 8171022110920602 IMRAN LA ARA P R
54 Q-0011UA5C 9171032906910004 ROMANTO SEBA L R
55 J-0006JEL9 9106122006990003 ADDE RIVALDO STEVIA L R
56 P-06485MA1 9102012002940009 ERWIN RUSDIN L R
57 Q-000ZPX5W 9171031505030001 SULKIFLI L R
58 Q-0010GU45 9171024701890009 AYU DWI ARIYANI. SE P R
59 Q-0010O5Z0 7315110303930005 ANSAR L R
60 Q-0010O5RJ 9171022201060004 ABDUL RAZAK L REMAJA
61 Q-000Z3C87 7309014106950004 NUR ATIKA P R
62 P-8SBLOMPG 5315062208970004 SIMFORIANUS FERDINA L R
63 Q-0012CJX6 9171034303050004 ANDI ZALSYHA REZKY P R
64 Q-0012CFIP 9171036906820003 FITRIA SAMAU P R
65 Q-0012UK9M 7403190107710210 LA JANATU L R
66 Q-000XFUTI 9171010505990003 GIAN PRAMUDYA CAESAL R
67 Q-000NJSRW 9171023007010002 MUH.WAHFI DWIYANSYL P
Q-0010H6MM 9103115405920001 SONYA MAATITA P R
69 Q-0010WE1D 9171020504670005 ANANIAS YOU L R
70 Q-0014LT8E 9117060804910001 ANTON HONI L R
71 Q-0012CC18 9171031108800005 BILTUS BURHAN L R
72 Q-000XH0AW 9171032408770001 IWAN SYAHRUL SANI L R
73 Q-000XGI6L 9171035810080002 CLAUDIA SANTIKA PERTP R
74 P-D7HSK58C 9171025010810012 N U R A E N I P R
75 P-6ZHB1XBQ 3203105104090003DY AVRILLIA GUNAWAN P R
76 Q-000ZQT38 7406062001940001 ALIASI L R
77 Q-0010O6MV 9106082808710001 YAKOB WADIBAR L R
78 P-E3EHDXTF 5310142003950003 DOLANSIANUS EO L R
79 MANUAL 9171012070001 DAISYA KUTAI L REMAJA
80 Q-0011TJAO 9171020903090001 AD RAEVAN SAPUTRA L REMAJA
81 P-MMGF5QV4 9171021501090005 SULTAN L R
82 Q-0010H4W8 9171024106890003 RANI HARTINI P R
83 Q-0010H76N 9171034708900010 RAMLAH P R
84 P-F7VF5WEZ 9171020807870001 ZULFYAN MUSLIM HUK L R
85 Q-000VYVHI 9171035212650006 RUTH KONDORURA P R
86 Q-0012KBVD 9171035607840006 MONALISA MONIKA SIMBP R
87 Q-0012J116 9171035203060004 FONIRIA F. SROYER P R
88 Q-0011V71I 8109011505820003 ADAM ALI L R
89 Q-000WV4EH 9171030709820003 SUHARTO L R
90 Q-000Z6BZD 3171032009770006 PETRUS HENDRIK MOFUL R
91 Q-000Z8BVT 9171012911820001 FREDI AYOMI L R
92 Q-0010ZR43 3526020107760015 JASULI L R
93 P-GTANG112 7305046602980001 RIZKA WAHDANIA TAHIRP R
94 P-H8HPTEGG 9171016504960006 CITRA APRILLIA P R
95 P-H85SR9HM 3518134911940006 RINDA LOLITA MELANWAP R
96 Q-0011VLWK 9171055712930002 DEWI TUTUT IRIANTI P R
97 Q-0011VKX0 3509185102820003 YUNI INDRAWATI P R
98 Q-0011V1EP 3509180107780594 AHMAT CHAEDORY L R
99 Q-000P6YN4 9171036609850003 WA ODE SITI RUWAEDA P R
100 Q-0009SLJK 9171034301740001 WIDI WINARTY P R
101 Q-0009SMPM 9271024405000002 MURNI ARYANI FESANL P R
102 P-IDQMMBYL 9271045509000002 SELINA SINTA BELLA MI P R
103 Q-0011SGIL 9205035804000001 PRISKILA BURDAM P R
104 Q-0011Q2OE 9271044403000001 MARTHIANSI RUMBINO P R
105 Q-0012G3DK 9171030510980005 GHOZY AFIF ALFARUQI L R
106 Q-0010RB4G 9101014304940006 EVAMARIA S. REGAR P R
107 Q-00110QO6 9171025901070003 REZKY WAHYUNI SALLE P REMAJA
108 P-J9XBGTTA 9208010103660001 MARKUS AWOITAU L R
109 Q-0012H8XX 3503121006890001 NUR CHOIRI L R
110 P-JM5CBN12 9171012203000003 EDWIN YOHANES RENYAL R
111 P-JRHHE6Z9 9171051111910008 ANTONIUS NAIAKI L R
112 P-JZNKND5Y 9106114607010001 DEBORA VALIANDRA SWP R
113 P-K79L6263 9106115308030001 JESICA JOAN ANGELA S P R
114 P-KJXIBAUD 9171022306000003 HERMAN RIO MARKUS DL R
115 P-KEWZ0FE3 9171025109990004 ERDHIA ARLEN SOKOY P R
116 P-KUGGDW4K 9171041105970001 KALVIN PATTIPEME L R
117 P-KZXY906V 9171055108090002 KAMILA AMALIA PUTRI P R
118 Q-0011VDRX 8205171709920001 JUFRI L R
119 Q-0011V6RL 5310030506010007 YOHANES NAMAR L R
120 P-VOOR0P56 9171026506900008 HASNAWATI P R
121 P-VOP75JWR 9171024706780005 HALIMAH P R
122 Q-0012Q2SV 9171025303850012 HAMIDA P R
123 Q-0012I01H 9171024507750010 AIDA SOLIHA P R
124 P-MDM1W65Q 1802181005000009 HERI YANTO L R
125 Z-000B7W8J 9171056001850007INDAIFURI R.REUMY.SH P R
126 Q-0012LL0O 9171052610700001 RANTE L PATANDIANAN L R
127 Q-000X3RYN 9171050401830004 ANTHONI IZAAK RUMAI L R
128 Q-0011UXCY 9111062701860001 COSMAS SAMBY LETA L R
129 Q-000Z5MXU 9110016802970001 MENTARI LIDIA M PASA P R
130 Q-000Z5L94 9119034210960001 PAULA DIANA IMBAB P R
131 Q-0012CPIV 5314015004820001 HERI HURIYANA MESAH P R
132 P-NAGCJSWH 9171015711030003 JEMIMA NUBOBA P R
133 Q-0011NJ36 9171016705970001 VENI MELIK P R
134 P-OJ4CX9LH 9171015109820003 LUDIA SHINTA HAAY P R
135 P-OPJCG308 9171014902900004 IREN MARKELYN HAAY P R
136 Z-000A2R27 9171011706710002 MUHAMAD TAQDIR L R
137 Q-000T4YUO 9171014604790003 SURYATI P R
138 Q-000T4YVL 9171013010990005 M. YUSUF FIKRI L R
139 Q-0012FWEC 5314066904810001 EMPI MESAH P R
140 P-PBUPO97D 5314015209970001 SELVI DEBORA HENUKH P R
141 Q-0011VR37 9171026211990007 NUR AFIA P R
142 P-POG46YXB 9103017003070001 ADAWIA P R
143 P-LXULITYL 9171020105000003 DINAR YUSRIANANDAR L R
144 Q-0012CPJH 3205380107800037 DIKI WARDI SUTIADI L R
145 P-Q3XGK2SA 9106056603000001 ADONIA MARYEN P R
146 P-FZ0G62D4 9104010108990007 ESSRON NARI L R
147 Q-0012CFGV 9171012211030004 ADRIAN RICHARDO SOBIL R
148 Q-0012CFF9 9171010601060006 ALVIAN BERNIFU L R
149 P-QNTK0E53 9171015907840002 RAHEL WERINGKUKLY P R
150 Q-0012OR3B 3504102908760001 SRI MUDA L R
151 P-VR3GVURJ 9171012802780006 SISWANTO L R
152 Q-000U488N 9171024401060002 RIA REVINA PETRISIA R P R
153 P-R665NJBO 9103011204050001 IMANUEL BENY TODING L R
154 P-RB59DNM5 9171015912030004 ALEDA SAWAKI P R
155 S-3E529135 9171034107580006 WA DONDO P R
156 Q-0012JFDR 7310111510920001 MULTAZAM L R
157 Q-0011C47J 9171034510890003 LITA SIAMPING P R
158 Q-0010VM2M 9171031611800003 YOHANIS SUGIANTO L R
159 Q-000Z8EZ1 3519144312030001 DIVA VITRANIA IMRAN P REMAJA
160 Q-000YMM33 9171034201040001 GALUH DWI WAHYUNING P R
161 Q-0012CK0I 9171015008900002 RAHMAWATI P R
162 Q-0012NU9M 9171025206030001 NANDA VIYANTI P R
163 Q-0012NU4D 9171026705810001 NURHAYATI P R
164 P-S35196FP 9171021304810001 KODRAT EFFENDI L R
165 Q-000YSKMW 9171050107020009 JONATHAN. FRIZZY. MEBL R
166 Q-000ZX8TM 9171011108090005 GABRIEL RENNE ANTONIL REMAJA
167 Q-000ZWXSI 9171014906820009 YUNITTA MANDOSIR P R
168 Q-000ZXBBU 9171012202050002 GEORGE ALMARTHIN MAL REMAJA
169 P-ETUL24DR 9171010510070004 ERNEZTHO CHE ALBERTL REMAJA
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Kelompok Kepesertaan BPJS (tulis 'YA' pada
Tanggal Lahir Umur Umur (18-30 / Alamat No. Hp
31-45 / 46-59) BPJS PBI
22-07-2007 14 JL DEMTA KOYA 081340394369
21-04-2009 12 JL DEMTA KOYA 085290681678
23-05-1977 44 PADSAR YOUTEFA082259201726
24-10-1958 63 PESANGGRAHAN 082122499030
J
15-06-1990 31 PERUM ROLLO GR081298493030
08-09-2000 21 KOMPLEKS RSUD 082239209815
08-06-1999 22 ENTROP JAPSEL 082248112839
14-11-1971 50 JL PROTOKOL KO 082154553038
02-11-1989 32 JL PERTAMBANG 082398526061 YA
19-01-1990 31 JL PIPA ATAS UN 081247542129 YA
17-12-1971 50 JL KEMIRI BELA 081248911773
04-09-1988 33 KOYA BARAT 082346058151 YA
12-09-1986 35 JL RARFIAH NO.0 081356355110
03-04-1997 24 BUPER WAENA 085283183447
06-01-2001 20 BUPER WAENA 082133060578
05-09-2009 12 ORGANDA ABEPU05-09-2009
08-08-1975 46 MBESUM 82239788040 YA
15-09-2007 14 KAMPUNG ENGG081245077501 YA
09-02-2008 14 JL. BARU , ABEPU 82312564368
10-04-1998 19 JL YAHIM SENTAN081344561603 YA
12-09-1958 63 KAMPUNG TIBA T081343169674 YA
17-12-1992 28 PERUM BTI 085254429401 YA
26-04-1961 60 GARAHA YOUTEF082198569851
27-09-1997 23 JK GRILYAWAN G082260566435
27-06-1976 40 JL. DOK VIII 82122467665 YA
30-05-1975 46 DOK 7 JAYAPURA082199400131 YA
20-05-1987 34 JL GERILYAWAN 082389198498
02-04-1989 28 JL. KAMPUNG YO 82197515868
14-07-1989 28 JL KEEROM NO.0508238709412
11-01-1984 37 KOYA BARAT 081343039991 YA
03-03-2002 19 JL. RAMBUTAN, 82117956509
16-08-1995 26 JL. RAMBUTAN, 081282039362
05-04-1983 38 JL SULAWESI DOK081354086214
15-01-1988 33 JL. APO BENGKEL 81240867970
20-10-1986 35 JL KOPI 13 NO 081375112540
26-07-1986 35 FURIA KOTARAJA081247808320 YA
26-08-1987 34 JL. PERTAMBANG 82162809208
14-04-1953 68 JL CEBDERAWASI081325263682
26-11-1980 41 JL MAMBRUK SER085342827270
02-03-1988 33 JL. TANAH HITAM 82139129063 YA
05-10-1982 40 AYAPO 85254411138
25-02-2001 20 FURIA KOTARAJA081248581414
11-08-1976 45 WAENA ABEPURA082336251904
19-04-2002 19 WAENA 82316247046
13-01-1990 31 KOTARAJA GRAN 081342615090
01-09-2000 21 JL. SILVAGNYA 081271224398
24-02-1993 28 JL. WAENA 82226734202
07-09-1967 54 KOMPLEKS SD INP085243127105 YA
20-06-1989 32 ABEPURA 82328190778 YA
29-10-2006 14 ABEPURA 82328190778 YA
24-08-2009 12 ABEPURA 082328190778 YA
16-07-1992 29 JL. ASANO 81216846808
29-06-1991 30 JL GELATIK AWIY 085244511800
20-06-1999 22 JLN. POLIMAK II 81343100467
20-02-1994 27 TANAH HITAM A 082261072682
15-04-2003 18 TANAH HITAM A 81247296137
07-01-1989 32 HAMADI PASAR 082255840844
03-03-1993 28 HAMADI PASAR 81354029356
22-01-2006 15 HAMADI PASAR 082176439434 YA
01-06-1995 26 GELANGGANG 2 82330192576
22-08-1997 25 WAENA ABEPURA082198025583
03-03-2005 16 PASAR LAMA 81344306890
29-06-1982 39 KAMPUNG TIBA-T085197133818 YA
01-07-1971 50 KALI ACAI 82197701487
05-05-1999 22 JL ANGKASA INDA081240725362 YA
30-07-2001 20 JL. NANGKA SAN 82239264117 YA
14-05-1992 29 ARGAPURA JAYA 082397078496 YA
05-04-1967 54 ARGAPURA JAYA 85244696361
08-04-1991 30 JL BARU KOTARAJ082238578883
11-08-1980 41 KOTARAJA 8124887802 YA
24-08-1977 44 KOMP PADAR BA081280514611
18-10-2008 13 KOMP PADAR BA081280514611 YA
10-10-1981 43 JL. ENTROP 81248967272
11-04-2009 12 KOYA BARAT 081217565297
20-01-1994 27 KOTARAJA 82387117348
28-08-1971 50 JL KELAPA DUA E 081240692411
20-03-1995 26 JLN. ABEPURA 81344397829
12-07-2007 14 HAMADI JAPSEL 082398890818
09-03-2009 12 HAMADI RAWA I 082116955080
15-01-2009 12 HAMADI 82121725752
01-06-1989 32 HAMADI RAWAI I082198588286
07-08-1990 30 HAMADI RAWA 82399847523
08-07-1987 34 BUCEND II ENTR 081311396284
12-12-1965 56 FURIA BPD 82188435798
16-07-1984 37 KAMPUNG TIBA-T085823539761 YA
12-03-2006 15 KAMPUNG TIBA-T085823539761 YA
15-05-1982 27 SKOW 81283495654
07-09-1982 27 JLN WIRATAMA T081344671607
20-09-1977 44 JLN. RAMBUTAN 81247541977
29-11-1982 27 JL SULAWESI DOK081343125620
01-07-1976 45 KALI ACAI 82120432456
26-02-1998 23 ENTROP KELAPA 081280944154
25-04-1996 25 DEPAN FIF MIE 082248622615
09-11-1994 27 JL. PAGARAN 82257046365
17-12-1993 28 JL KALI ACAI ABE 082238026585 YA
11-02-1982 39 KALI ACAI 85216228286
01-07-1978 43 JALAN KALI ACAI 082397068796
26-09-1985 37 PASAR YOUTEFA 85244573431
03-01-1974 47 JL GARUDA BTN 081325420553
04-05-2000 21 BTN BAWAH 81336362051
15-09-2000 21 JL KESEHATAN N 081343057026
18-04-2000 21 BELAKANG KORA 82238861370 YA
04-03-2000 21 BELAKANG KORA085254287434
05-10-1998 23 JL WOROT PERU 081344821051
03-04-1994 27 FURIA 82311149494
19-01-2007 14 POLIMAK 3 081247771928
01-03-1966 54 JL. PADANG BUL 82299822018
10-06-1989 32 ANGKASA JAYAP 085344942499
22-03-2000 21 JL. TRIKORA 81385293600 YA
11-11-1991 22 PADANG BULAN 082199387440 YA
06-07-2001 21 JL. WAENA PERUM 81354080363 YA
15-08-2000 21 PERUMNAS II WA082198132867 YA
23-06-2000 21 FURIA INDA JALUR 082142281314
11-09-1999 22 JL. BARU YOUTEF 82142281314 YA
11-05-1997 24 FURIA INDAH JAL082347952517 YA
11-08-2009 12 PERUM PERMATA 8134056677
17-09-1992 23 DESA BAPENU 085331530151
08-04-1998 23 KOYA KOSO 82197590511
25-06-1990 31 JL BARU TOBATI 081247619000
07-06-1978 43 JL BARU TOBATI 082239545000
13-03-1985 36 HAMADI 82198902201 YA
05-07-1975 46 HAMADI TANJUN081281997298
10-05-2000 21 JL. ENTROP 82189610818 YA
20-01-1985 36 PERMNAS 3 WEA082399309664
26-11-1970 51 JL SENTANI NO. 082238669099
04-01-1983 38 PADANG BULAN 82271410271
27-01-1986 35 KAMPUNG AMYU081344899422
28-02-1996 25 JL WOROT KALI A082197849530
02-10-1996 25 DOK IV BAWAH 082210006998
10-04-1982 39 PASAR YOUTEFA 81344993252
17-11-2003 18 DEPLAT KANAN J 082147677228
27-05-1996 25 TANJUNG RIA 82110094506 YA
11-09-1982 39 BHAYNAGKARA I 082198523738
09-02-1990 31 JL. BHAYANGKAR 81247691089 YA
17-06-1971 50 JL SUNGAI TAMI 085343287033
06-04-1979 42 JL BATU RAYA IX 081344352988
30-10-1999 21 JL BATU RAYA IX 81344684261
29-04-1981 40 JL. BARU YOUTFE 81337846332
12-09-1997 23 BELAKANG PASAR081344993252
22-09-1998 23 HAMADI JAPSEL 0813144707155
30-03-2007 14 JL. SENTANI 82239404765
01-05-2000 21 HAMADI JAPSEL 081248467986
14-04-1980 41 BELAKANG PASAR081344993252
26-03-2001 20 KELAPA 2 ENTRO 81240243820
01-08-1999 22 JL JERYK NIPIS F 081248187151 YA
22-11-2003 18 JL TELUK NO.31 D081344689616
06-01-2006 15 JL. BELUT 82239178484
19-07-1984 37 JL KABUPATEN II 081354088755
29-08-1976 46 JL. ANGKASA 81344795739
28-02-1978 43 JL PERINTIS I K 081344279698
04-01-2006 15 JL. ARDIPURA III 82198481740
12-04-2005 16 BELAKANG KANT 082217748690
19-12-2003 17 KOMP. BPN DOK 82248218166
01-07-1958 63 JL KAMPUNG AM081344542061
15-10-1994 27 JL. ENTROP 85344564441
05-10-1989 32 JL BARU ABEPUR 081340061983
16-11-1980 41 JL. BARU BTN 82177776104
03-12-2003 17 JL V BARAT NO.188081247738166
02-01-2004 17 JL. YOUTEFA 85161367657
10-08-1990 31 LEMBAH SUNYI A082238173617
12-06-2003 18 JL. ENTROP 81344443099 YA
27-05-1981 40 JL RAYA ABEPURA081344443099 YA
13-04-1981 40 JL. RAYA ABEPUR 81240457777
01-07-2002 19 JL. PADANG BUL 82199111896
11-08-2009 12 KOMP RSUD DOK081247671183
09-06-1982 39 PADANG BULAN 82239429114
22-02-2005 15 KOMP RSUD DOK081234942334
05-10-2006 15 KOMP RSUD DOK082198818819
esertaan BPJS (tulis 'YA' pada kolom yang KOMORBID /
TUNDA TIDAK
sesuai) TANGGAL SAKIT
(TANGGAL DIBERIKAN ( √
BPJS Non PBI Non Anggota SCREENING II LAINNYA
KEMBALI) )
TIDAK ADA 21 OKT 2021 (SEBUTKAN)
TIDAK ADA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
TIDAKA DA 21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
21 OKT 2021
21 OKT 2021
YA 21 OKT 2021
YA 21 OKT 2021
TIDAKA DA 21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
21 OKT 2021
Merek TANGGAL DOSIS 1 TANGGAL DOSIS 2 KETERANGA
Vaksin*** PEMBERIAN NO. BATCH PEMBERIAN NO. BATCH N
VAKSIN
20 Sep 2021 24005321 21 OKTVAKSIN
2021 24005321 VAKSIN SELESAI
20 Sep 2021 24005321 21 OKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKISN I
23-09-2021 24200321 21 OKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
22 Sep 2021 24005321 21 OKY 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
23 Sep 2021 24005321 21-09-2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN SELESAI
23 Sep 2021 24005321 10-OKT-2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 21 OKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
23-09-2021 24005321 21 PKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VASKIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
22 Sep 2021 24005321 21 OKT 2021 24005321 VASKIN SELESAI
22-09-2021 24005321 21 OKT 2021 24005321 VASKIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
22-09-2021 24005321 21 OKT 2021 24005321 VAKSIN SELSAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
23 Sep-2021 24005321 21 OKT 2021 24005321 VAKSIN SELESAI
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
21 OKT 2021 24005321 VAKSIN I
1
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
1 TUNDA BAPIL
20
21
22
2 TUNDA/GRAVIDA
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
41
42
3 TUNDA
43
Jenis Profesi**
No. Registrasi
NO NIK Nama Penerima Vaksin Kelamin (L / (A/B/C/D/E/
vaksin II
P) F/G/H)
1 Q-000VY84X 9171051910870005 EKA HANDOKO SIMANJUNTAK L R
2 J-0003XSJ1 9171054210940001 QORI ATUL FATIKHAH P J
3 P-3PEFPKPX 5304021906010001 YULIUS MALI BEREK L R
4 P-Q3J6HF7M 9171055509900005 HILDA LUCIA YOMIMA MOMOT P R
5 S-03C1FA3F 9171056108940003 LETTYSIA GESKY P R
6 P-W5LAFFK4 9171015606850005 TITIK AFITA NURYANTI P R
7 S-0D719646 9171015506550002 KALSUM P R
8 P-KUPTCTHU 9171024707090006 FASJANA IMANUELA KOMERA P REMAJA
9 P-5Q29JKA8 9116025705980002 MARIA KATARINA KORON P R
10 MANUAL 9171034909090004 PUTRICIA ANASTASYA JANIS R P REMAJA
11 P-7B3ZRSFG 3321144511690001 MUTMAINAH P R
12 P-9BOKRH4U 9171030104070001 ANDI MUHAMMAD RAFLI PASH L R
13 P-BTD6MEYW 9171026703800004 NURHAYATI TIANOTAK P R
14 Z-000BB15N 9171031304560003 LA MALO L R
15 Q-0012H80F 9171035203650006 WA ASIH P R
16 Q-0018IW7H 9171030607070001 RIZKY MUKHRADIS L REMAJA
17 P-C7KDKPMM 9171021512930001 LOUDRY RONALD HAMADI L R
18 P-C80I0XTC 9171022706990003 JUNI ARDI DWI PRASETYO L R
19 Q-0010H5MB 9171034408090002 LENITA INA HANA LEUTUALY P REMAJA
20 Q-0010EGGX 9103151302830001 RUDIANTO L R
21 P-CCT8H4IW 9171033001870003 MOHADI L R
22 N-1BED2EBD 9171024902850003 WAHYUNI P J
23 P-CE2JYVOU 7401040307740002 TAHIR L R
24 P-S01VQU0T 9171015603750003 AKSAMINA IMELDA MENUFAND P J
25 S-9C1C751E 9171012707720004 NICANOR .F WARBANDIDO L R
26 P-CEY3NDQD 7110022302960001 RAFI YOHANES OROH L R
27 Q-0017XJYD 7102121906880001 MELKRI JOAN TENDA L R
28 P-CFIPRWS6 9171014506780003 JUNITA ISABELLA MENUFANDU P J
29 S-3FDB1534 9107010703640002 DAIBER WEYA L J
30 P-CFXQVNDH 9171010801800003 ELIEZER YAN MANYAKORI L J
31 P-CG74VEKT 9114043112651001 NAS WEYA L R
32 S-47FB15FE 9171034611650001 RAHMANI A. OHEE P J
33 P-Q67MW9SN 9107010308960002 LAM LAMBER WEYA L R
34 P-CH0PIUWM 9171013103820001 NELSON RIANDO PURBA L R
35 P-CHCVPFVE 9171014904820004 JERMINA FRIENCE PELAMONIA P R
36 P-CHJON7QB 9171014611940001 RIDHATULLAH INDRAJATI P R
37 Q-000W4LM2 9171034906980002 PRISCILLA JANET DEMETOUW P R
38 Q-000W4LM2 9171035301980001 JANET EVELYN DAMO P R
39 P-CKIMRL61 9101016803880004 DIAN ASTRIANI ACHMAD P R
40 MANUAL FANI MOU P R
41 S-F519678E 9101016205760001 ANTASARI PUTRI ISTUNINGRU P J
42 P-CKBL7UJ5 9103130606890003 NIKIUS BUGIANGGE L R
43 P-CKHNZ3PC 9171030909070006 JACOBUS PERVIDDYA SOLOSSA L REMAJA
44 P-CKT7I2WR 9171050112780005 YOPPY WENDA L R
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Kelompok Kepesertaan BPJS (tulis 'YA' pada kolom
31-45 / 46-59) BPJS PBI
19-10-1987 34 JL RAYA SENTAN 085311111187
02-10-1994 27 18-30 PERUMNAS IV BL081248890411
19-06-2001 20 18-30 JL BELUT WAENA081244789814
15-09-1990 31 31-45 JL BUPER PERUM081240833182
21-08-1994 27 18-30 JL. POS PENGUM 081211335123
16-06-1985 36 31-45 BHANYANGKARA 081318046295
15-06-1955 66 BHANYANGKARA 082248013887
07-07-2009 12 SKYLINE INDAH 081248483359 YA
17-05-1998 23 PERUMNAS 3 JL B081343486847 YA
09-09-2009 12 KAMPUNG TIBA-T081212371579
05-11-1969 52 BUCEND IV KOTA081344820578
01-04-2007 14 TANAH HITAM 081247493013
27-03-1980 41 ASRAMA HAJI KO082136361117
13-04-1956 65 TANAH HITAM 085244157450 YA
12-03-1965 56 TANAH HITAM 085244157450 YA
15-12-1993 28 BELAKANG KANTOR 082248288778
27-06-1999 23 POLIMAK IV ARD 082110094286
04-08-2009 12 KOTARAJA DALAM 085212165848
13-02-1983 38 JL BARU BTN SKY 081240214038
30-01-1987 34 JL YOBE ABEPURA082197524454
09-02-1985 37 PERUM RESIDENT08114801253
03-07-1974 47 ARSO 2 KEEROM 085334852832 YA
16-03-1975 46 JL. KRI MACAN T 081340360025
27-07-1972 49 JL. KRI MACAN T 082197773722
23-02-1996 25 KOTARAJA DALA 081244018667
19-06-1988 33 KOTARAJA DALA 082198323383
05-06-1978 43 JL MACAN TUTUL081244913461
07-03-1964 57 JL KOMBA KAMP 082248560011
08-01-1980 41 JL TELUK DOK 9 A081344887615
31-12-1963 58 MILINIK SENTANI082132648185
06-11-1965 56 JL RAYA SENTANI085337744948
03-08-1996 25 JL KOMBA KAMP 081314042226
31-03-1982 39 JL TANJUNG RIA 081240178575 YA
09-04-1982 39 JL TANJUNG RIA 081240981910 YA
06-11-1994 27 JL TANJUNG RIA 082199303503 YA
09-06-1998 23 JL ABEPANTAI 082248664010 YA
13-01-1998 23 JL KARYA TANAH 081391086306
28-03-1988 33 PEMDA II BLOK 08114842828 YA
21-11-2000 21 PEMDA II BLOK 081343053889
22-05-1976 45 JL GANG GEREJA 081248176350
22-07-1989 32 BTN SOSIAL SENT082288889841 YA
09-09-2007 14 JL PASIFIK INDA 081344446299
01-12-1978 43 PERUMNAS III W 085200009710
TUNDA TIDAK
KEMBALI) )
YA 04 Nov 2021 (SEBUTKAN)
YA 04 Nov 2021
TIDAK ADA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
YA 04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
04 Nov 2021
Merek TANGGAL DOSIS 1 TANGGAL DOSIS 2
KETERANGAN
Vaksin*** PEMBERIAN NO. BATCH PEMBERIAN NO. BATCH
VAKSIN
09 Oct 2021 24005321 VAKSIN
04 Nov 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VASKIN I
09 Feb 2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
10 Aug 2021 202106B1129 04 Nov 2021 24005321 VAKSIN SELESAI
24-09-2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
09 Oct 2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
10 May 2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
10 Mar 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
09 Oct 2021 24005321 04 Nov 2021 24005321 VAKISN SELESAI
09 Oct 2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
10 OKT 2021 24005321 04 Nov 2021 24005321 VAKISN SELESAI
03 OKT 2021 24005321 04 Nov 2021 24005321 VAKSIN SELESAI
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321 VAKSIN I
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
04 Nov 2021 24005321
TUNDA/ISPA
1
2
3
TUNDA/HIPERTENSI
4
6
7
8
9
10
11
12
13
14
15
Jenis Profesi**
No. Registrasi Nama Penerima
NO NIK Kelamin (A/B/C/D/E
vaksin II Vaksin
(L / P) /F/G/H)
1 P-LM0L59AJ 9103011012690001DENNY PANDEGIROT L R
2 Q-000JJJZ8 9171052004010003 BOY ARNOLD MOESIEL R
3 P-IFPJ5GHU 9103026203010002 JEALFIE ANGEL'LIA S P R
4 Q-000YIESP 9103016810970004 RAHIMA WALANGKE P R
5 S-0C82E01C 9103024712670001 Wahyu Purwaningsih,P R
Q-000JJTMI
6 Q-000X4IW7 9104016810990003 JUWITA
INGGRIDEGETEN
GITA BONAYP R
7 9171024907840006 P R
8 Q-000X0MP9
P-XUJ6S1H4 9101122507020002 KRISTIANUS
OTNIEL BABU M L
KAMBEY R
9 9171010410790002 L R
Q-000OUOWW
10 Z-000AGRX5 9101120212960001 ENGEL
TIDORUS MAHUSE L
MAYOR R
11 Q-000XOFFP 9103010508820002 UMIATI L R
12 Q-000Z0RJW 9103015709770001 HILDA OHEE P R
13 Q-000NBYNJ 9103016605920003 FIRMANSYAH P R
14 Q-000WV4ET 3202092605950002 TRIVENA VICTORIA H.LLALY R
15 9109015910020001 P R
16 Q-000XJ3SG 9109092906870001 AKBAR L R
17 P-WJOIDK4I 9110014908940002 SHERLY S B TONJAU P R
18 P-WLTH0B6R 9105014808030005 SOPHIE CHRISTINE D P R
19 P-73TZFL0J 9105014505000006 MELANI KARAMOY P R
20 P-WN639YDN 9171024610030001 DEBORA DOROTHY D P R
21 P-NL31R1GK
P-WNJ9C6M2 9105011501070001 NICKY JONATHAN
MARTHA M. SUEBUDA L R
22 9103014706700004 P R
23 Q-000WX9V8
P-WUQ3H8KK 9171016312750004 RUT MUNDULUNG P
KAHAR R
24 Q-000SGUYF 9103011506870008 BAMBANG STEDI L R
25 3671120904000010 L R
26 P-XKI35KR0 9103012909040001 JUAN SEBASTIAN ANJ L R
27 P-X0SJ6ORI 7371131805820019 RUSDY R L R
28 P-Y8O3UDRK 9171031211920003 YULLAN KEVIN PATTY P R
29 Z-000ARZ74 7308122303890002 A. RUSTAN L R
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
Kelompok Kepesertaan BPJS (tulis 'YA
31-45 / 46-59) BPJS PBI
10-12-1969 52 46-59 JLN IFAR GUNUNG SENT 085340005041
20-04-2001 20 18-30 PERUMNAS IV BLOK A 082198090593 YA
22-03-2001 20 18-30 DESA NENDALI, SENTANI081248466871 YA
29-10-1997 24 18-30 ABE PANTAI ABEPURA 082287533337
07-12-1967 53 46-59 KAMPUNG HARAPAN, SE082199629019 YA
28-10-1999 22 18-30 UNCEN BAWAH 081343385500
09-07-1984 37 31-45 PERUMAHAN GRAHA NEN 082238307825
25-07-2002 20 18-30 BASEG JAPUT 081247066795 YA
04-10-1979 42 31-45 PERUMAHAN GRAHA NEN 081240995151
02-12-1996 25 18-30 BASEG JAPUT 081344034104 YA
05-08-1982
17-09-1977 39 31-45 ASRAMA POLISI SENTANI082199667307 YA
26-05-1992 44 31-45 JLN IFAR GUNUNG SENT 081344291513 YA
26-05-1995 29 18-30 JL YOKA, HERAM 082398809611 YA
19-10-2002 26 18-30 KP. CIHALU, SUKABUMI 08561635940
18 18-30 TANAH HITAM 082245663393
29-06-1987 35 31-45 BTN MATOA SENTANI 081240916362
09-08-1994 27 PERUMNAS II JL SPG TA 081240425507
08-08-2003 18 18-30 JL SUNGAI HANYAAN EN081316008008
05-05-2001 20 JL SUNGAI HANYAAN EN081299285850
06-10-2003 18 JL SUNGAI HANYAAN EN085289616685
15-01-2007 14 12-17 JL SUNGAI HANYAAN EN081344020033
07-06-1970 51 46-59 JL KOMP CAMAT LAMA, 085283762933 YA
23-12-1975
15-06-1987 45 31-45 KOMP. RSUD DOK II 081343180912
34 31-45 JLN PASIR FLAVOUW, SE 081248918682
09-04-2000 21 18-30 PASAR LAMA SENTANI 081311814655
29-09-2004 17 12-17 ASRAMA RINDAM IFAR 082398210092 YA
18-05-1982 39 31-45 JL PERPONDOK ASRI 082394555483
12-11-1992 28 18-39 SENTANI JAYAPURA 081381853777
23-03-1989 32 31-45 JL KELAPA DUA ENTROP 082198307281
TUNDA TIDAK
KEMBALI) )
TIDAK ADA 14 OKT 2021 (SEBUTKAN)
14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
YA 14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
14 OKT 2021
Merek TANGGAL DOSIS 1 TANGGAL DOSIS 2
KETERANGAN
VAKSIN
14 Sep 2021 24005321 14 OKTVAKSIN
2021 24005321 VAKSIN SELESAI
12 -07-2021 22400621 14 OKT 2021 24005321 VAKSIN SELESAI
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
13 SEPT 2021 24005321 14 OKT 2021 24005321 VAKSIN SELESAI
14 OKT 2021 24005321 VAKSIN I
16 SEPT 2021 24005321
24201821A 14 OKT 2021 24005321 VAKSIN SELESAI
16 AGT 2021 14 OKT 2021 24005321 VAKSIN SELESAI
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321 VAKSIN I
14 OKT 2021 24005321
14 OKT 2021 24005321 TOTAL :
14 OKT 2021 24005321 BATAL :
14 OKT 2021 24005321 VAKSIN I :
14 OKT 2021 24005321 VAKSIN II :
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
14 OKT 2021 24005321
1
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29
1 (DM, GDS TINGGI)
12
16
No. Registrasi Jenis Kelamin (L /
NIK Nama Penerima Vaksin
vaksin II P)
1 P-A7PB59XC 9171014402080002 KHOIRUN
DWI SARI HIDAYA
NISA FAUZIAH HASAN P
2 Q-000XHIRM 9171044206080001 P
3 Q-000LZA6Z 9102632204010001 SONIMO YELIPELE L
4 Q-000XYWEL 9171045103090001 WAHYU NURUL KHOFIFAH
Q-000XYVZJ ADHYA UL'LAYLA P
5 9171046502060001 P
6 Q-000XYWF8 9171026106080002 MUTIARA CITRA P
7 P-QU0E3YNQ 3577026401070002 TIA
Q-000XYWEW ANISA SALSABILA
DUWI TRIWAHYUNI
NURCAYANTI P
8 9171044507070002 P
9 Q-000XYTJR 9171045203070001 ALIA PUSPITA P
10 P-GZC1TT4R 7310034910070002 HUSNUL FAHRIANI P
11 P-1W1EG1II 9103012205090001 MUHAMMAD RAKA NABIL ALI L
12 Q-000S20XV 9171044611080001 FARIDAH NOVITASARI P
13 Q-000XYS9T 7322015401070002 ASRIANI P
14 P-3CYZPYZ0 7308066706070003 KHOIRUN NIKMAH SELI RAMADANI
Q-000XYSUY P
15 9171055203090001 P
16 Q-000YDGWZ 9171032303090001 SULTAN SAID L
17 Q-000Y0JKA
Q-000YG82P 9171045305090001 SYARASIAH DWI ZAHARANI DAIKO P
18 9171044603090002 P
19 Q-000XZAI5 9171041906090001 JUMADIL AKBAR L
20 P-KEDAEGW6 7401196307090001 NABILA MAYZUNNAH RAHMAH P
21 P-4LCMH5Q5 9171045607070002 NURUS L. ANGGASTATIK P
22 MANUAL
Q-000SCX3P 9171038111070008 FARHAN
WAHYU SANDI IRYANTO
ALFAREZI L
23 7308121612080002 L
24 P-MVKYRN0G
Q-000YDPCC 9171036702070005 ZULFIKAR
TASYA BAIM ALFARIZI P
25 9171041104090001 L
26 Q-000VLK1G 9171037010070005 VIOLA BERLIANA PUTRI P
27 Q-000YG7KS 9171045510080001 FITRAH
Q-000Y3I3I FATIMAH AZ ZAHRA
AULIA P
28 7308124409090001 P
29 Q-000YFAED 9171045108080001 ZAHROTUL M. SEKAR MAWARNI P
30 Q-000YDGXZ 7308124901850002 LENNY P
31 P-QGMNMSYU 9102632701070001 SIDIK NURSALIM ASSO L
32 Q-000UKR9W 7308126911050002 NURFIFIANA P
33 P-2A4Y8ZBW 9171045404090002 HASNI P
34 P-RSN5MBMT
Q-000XYSVN 9171046704090003 JIHAN
SYARDINA
APRILIANI P
35 9171050804090002 P
36 P-6G096E61 9171010206070001 M. RIZKI AL MUQSIT
Q-000YFU06 TIGGO ADHIGUNA L
37 9171041707070001 L
38 Q-000UIIHY 9171041102070001 DWI WIRDIYANINGSIH
Q-000XZJNC DAVA TRI ARDIANSYAH L
39 9171047105090001 P
40 Q-000YG7LR 9103011502090003 ANAN SETIADI L
41 P-8NJSY1H8 9171041909090001 FITRAH RAMADAN L
42 P-LGELU33D 9171042108080001 MUAMMAR ALI FATH L
43 Q-000YDVCA 9171045206090001 NABILA
Q-000XZC48 PUJI LESTARI
SALSABILA P
44 9171045907090001 P
45 Q-000YDVCG 9171045206090002 PUJI RAHAYU P
46 P-I5S457WJ 6207011012820001 DARYOSO L
47 P-KJFH1ATN
Q-000YGY03 9171040204940001 AYUB
M. NUR ROMADHON L
48 Q-000YFAD8 9171040204080001 MUH. AZWAR YASRI L
49 9171042605080001 L
50 P-MI1K6RNR 9171040207800001 SUSANTO L
51 P-N5MJ861V
Q-000XZVME 9171052404070001 MUHAMAD
DARWIS ARDIANSYAH SUL
FAHRI SETIAWAN L
52 9171040205070001 L
53 P-S1ZBZX6L
Q-000YFAEB 7308023003070002 ARDIANSYAH
RENALDI ANSARI ASAP L
54 9171022908080002 L
55 MANUAL 9171032603080001 M. SAHRIL L
56 P-S1ZBZX6L 3515055605770005 DEWI MASITOH P
57 P-S8BU2XDA 9171051911060002 ALDO KURNIAWAN PRATAMA L
58 Q-000TYQDA 9171031708050004 RANDI BAYU SYAMJAYA L
59 P-4HLY8IOS 9171040912070001 MUHAMMAD PADIL RIAN L
60 Q-000YG7LF 9171040602090002 M. ARDIANSYAH L
61 Q-000XYRU4 9171022101090002 NAUFAL AFRIAN NUR HIDAYAT SAID L
62 Q-000YFK5C 9171041104080001 L
63 P-3KP5H02C 9171040306080001 MUHAMMAD NUR SADEWA L
64 P-T5L529J6 9171046710080001 ALENA ARISTIYANTI P
65 Q-000XYTJK 9171055810080003 ILLYAH FAHDA P
66 P-T64X46IC
Q-000YGOYQ 9171036107090006 IKBAL
SISILIA P
67 9171031702080003 L
68 P-QOA0N5FT 9171040304090001 VIKY ANRA SHEBASTIAN MADDO L
69 Q-000YG7LV 9171040304090001 MUH. IRMANSYAH MANSUR L
70 P-TBAOJCN6 9171042008840003 LA KOTE L
71 Q-000YE30C 3509212905080002 AHMAD IRJA MAULANA L
72 P-5LSE9C71
Q-000WXM43 9171040812060001 SATRIO NUGROHO QOIRULLAH
MUH. FEBRI ARIANTO SAPUTRA L
73 Q-000YG7KH 9171040911060001 ALGUSDHY MAULID RAMADHAN L
74 9171042308060001 L
75 Q-000YDVC6 9171042906070001 AHMAD SUPRIYADI L
76 P-TF8YN51I 9171020405070002 M.IBNU ALMU'MINING L
77 P-TEXTZ71X
Q-000XZV7E 9171011008060002 GALANG
WAHYUDIADICHANDRA MAHARDIKA L
78 9171020610080002 L
79 P-S5UXNQUV 9171041104090002 TIGAR
Q-000Y06I9 ADNAN MAULANAHERDIANSYAH
RAMADHIKA MOKODOMPIS L
80 9171042008080005 L
81 Q-000YDVCB 9171030210070004 MUHAMMAD
Q-000WWQJN FAIZ ZAKY MUBAROK
RIZAL EFENDI L
82 1807032808060001 L
83 P-6NFUXNCH 9171041710070001 MUHAMAD FAJAR ARDIANSAH L
84 Q-000YDVC9 7310091108070001 PANGERAN INDRA SAPUTRA L
Q-000YE30Z ADIL SUHARDI
85 7401191504080001 L
86 MANUAL
Q-000YDGWV 9171050206050001 MUHAMMAD
MUH YUSRON WILDAN
H L
87 9171042102070001 L
88 Q-000XGHX8 9171042407060001 WILDAN GILANG PRATAMA L
89 Q-000Y06SV 9171010810060005 ALVIAN
Q-000YH34Z ARJEN VAN TALLI
MUBARAK L
90 Q-000YGYAJ 9171031903080002 AMRULLAH DANISH ZAKI PRATAMA L
91 9171041005090003 L
92 P-TR5YO43J
Q-000YDVCW 3315121707050001 MUHAMMAD MAULANA
KHOIRIL LATIF RAMADHANEKA PUTRA L
93 9171041010070002 L
94 MANUAL ALJULYANDHY RIZKIANDHY L
95 Q-000YFU08 7301010509040002 SABRI ADI L
96 P-TTZ1CLZI 7401192009090001 LUKMAN L
97 P-TV4VLWBG 7471050907040002 ALI TAQWA L
98 MANUAL FATUL BADRAN L
99 MANUAL 9171031702080002 AKBAR L
100 Q-000YECZT 9171020902090001BAGUS
Q-000YG7LB SOFYANRACHMAD PUTRA PRATAMA L
101 9171030802080008 L
102 Q-000YED01 9171032707080002 MUHAMMAD RANDY L
103 Q-000YEMSC 9171030212060004 MUH. RAFI AMANDA L
104 Q-000YDGXM 9171041405180001 M.RISKY ADITYA L
105 P-U0VKWP1R
Q-000YFAEF ARINUN HANIFFADLI ABDILLAH
9171041707080001 MUHAMMAD L
106 9171040611080002 L
107 Q-000YECZR 9171040509080001 SEPTIAN RAHMADANI L
108 Q-000YECZN 9171041212080001
Q-000YDVCV REHAN DWIRIZKI
REFALINO ENGTIANTO
AKBAR L
109 9171041311070001 L
110 P-U4OV0QYT
Q-000Y436A 3509041707090003 ARDI
MOHAMAD
BAGUSSHOLEH
PRASETYO L
111 9171040108080001 L
112 Q-000YG7KJ 9171042310060001 AD'NAN IRBAR SETIAWAN L
113 Q-000YG7KQ 7316012809060001 AMRIL L
114 P-Q6XAX6IO 3509210310090006 FERDIAN B.S. L
115 Q-000YDVCO
Q-000YDGW2 3509215010900008 SUCI INDAH LESTARI
BINTANG EKA SAPUTRY P
116 9171056410030003 P
117 Q-000YFAD0 9171040907700001 NUR
Q-000N82VQ SUPONO
EKA HANDAYANI L
118 Q-000V8O0G 9171036903040001 HARMOKO P
119 9171040107850008 L
120 Q-000YFU0J 5301085104980001 SUDARGO
Q-000YFK5J CHRISTIN FRANSISKA DEONA P
121 Q-000X21BK 3317101406840003 AVRISZHA KURNIA. P. P L
122 Q-000YD6BK 9111056804990001 MOH. RAJAB YELIPELE P
123 Q-000MYMYC 9171010409040011 KERAGI LANI L
124 9102050801040001 L
125 P-UM1TDTSO 8104031904880003 NUROKIM L
126 P-UNALHYTK
W-E45F890F 9171044205820001 HAMIRUN
SUYAHMI P
127 9103010304960001 L
Z-000AM7KY PUSPA INDAH PAPINAN, AMK
128 Z-000ADCYL 7271036112890007 HIDAYAT HI.GANI P
129 9171040707730001 L
130 P-URVUVRUL 9171034508750005 HJ. NASRAWATI P
131 P-UTH1CQ0I 8104031507940004 ROFI NUR FRIYANTO L
132 P-UU4RO6MS 3510141704910002 EKO PRASETYO L
133 P-UUMH0263 3510081310750005 BUSAIRI L
134 Q-000WEQJI 9171050808090002 SULTAN HAIDAR SAKHIY ACHMAD L
135
68
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Profesi** Kelompok
(A/B/C/D/E/F/ Tanggal Lahir Umur Umur (18-30 / Alamat No. Hp
G/H) 31-45 / 46-59)
REMAJA 03-03-2008 13 JL MERAUKE KOY082248031787
REMAJA 02-06-2008 13 JL DURIAN II KOY 081231532215
R 22-04-2001 21 JAYAPURA KOTA 082195344802
REMAJA 11-03-2009
25-02-2006 12 12-17 JL RAMBUTAN I 82217181590
REMAJA 15 JL DURIAN III KO 082199871703
REMAJA 21-06-2008 13 12-17 KOYA KOSO 85351245763
REMAJA 24-01-2007 14 12-17 JL KROTOKOL 85381840202
REMAJA 05-07-2007 14 JL JAYAWIJAYA K 082337349393
REMAJA 12-03-2007 14 12-17 JL. SWAKARSA P 82198532825
REMAJA 09-10-2007 14 KOYA KOSO MATA 082192938932
REMAJA 22-05-2009 12 12-17 KOMPLEKS SMK 4 85292382305
REMAJA 06-11-2008 12 12-17 JL POROS 81385296104
REMAJA 14-01-2007 14 12-17 JL. SMP ROLO G 85252932931
REMAJA 27-06-2007 14 12-17 JL HALILINTAR K 81298995891
REMAJA 12-03-2009 12 SWAKARSA LUAR082399766428
REMAJA 26-03-2009 12 12-17 KOYA BARAT 81312062276
REMAJA 13-05-2009 12 12-17 SWAKARSA LUAR 82231920892
REMAJA 06-03-2009 12 JL NABIRE KOYA 081377674263
REMAJA 19-06-2009 12 12-17 JL DURIAN II KO 82398778442
REMAJA 23-07-2009 12 12-17 JL. PROTOKOL, K 81317178224
REMAJA 16-07-2007 14 12-17 JL ABEPURA I KO 85254356382
REMAJA 11-11-2007
16-12-2008 13 12-17 KOYA TIMUR 82397535495
REMAJA 12 JLN RAYA SKOUW082337694202
REMAJA 27-02-2007 14 12-17 KOYA KOSO JAYA 85254471783
REMAJA 11-04-2009 12 JL PROTOKOL KO 081343212158
REMAJA 30-10-2007 13 12-17 JL PROTOKOL KO 85254433795
REMAJA 15-10-2008 13 12-17 JL NABIRE KOYA 82338133855
REMAJA 04-03-2009 12 SKAMTO KOYA K 082189032241
REMAJA 11-08-2008 13 12-17 KOYA TIMUR 082195434145
UMUM 09-01-1985 36 31-45 SKAMTO KOYA K 81296992934
REMAJA 27-01-2007 14 BELAKANG MASJI082117811856
REMAJA 29-11-2005 15 12-17 SKAMTO KOYA K 085214925079
REMAJA 14-04-2009 12 12-17 JL MEGA MENDU 82199103326
REMAJA 27-04-2009 12 12-17 JL. PROTOKOL KO081297985547
REMAJA 08-04-2009 12 JLN JERUK KOYA 081391131675
REMAJA 02-06-2007
17-07-2007 14 12-17 JL JERUK KOYA T 82199156026
REMAJA 14 KOYA TIMUR 085377782087
REMAJA 11-02-2007
31-05-2009 14 12-17 JL. CEMPEDAK 3 082397107802
REMAJA 12 JL WAMENA KOYA082239272169
REMAJA 15-02-2009 12 12-17 JL. MATOA I, KO 082195434069
REMAJA 19-09-2009 12 12-17 JL ALPOKAT II 81346528763
REMAJA 21-08-2008 13 12-17 JL MATOA II 82148218240
REMAJA 12-06-2009
19-07-2009 12 12-17 JL. ABE II, KOYA 082199296608
REMAJA 12 KOYA BARAT 085254706039
REMAJA 12-06-2009 12 12-17 KOYA BARAT 82199296608
R 10-12-1982 38 31-45 KOYA BARAT 082210039685
R 02-04-1994 27 18-30 KOYA TIMUR 82171957122
REMAJA 02-04-2008
26-05-2008 13 JL DURIAN I 081240090451
REMAJA 13 JL ALPOKAT I KO 082247281763
R 02-07-1980 41 31-45 JL. SWAKARSA, K 082237537413
REMAJA 24-04-2007 14 12-17 ABEPURA I JAYA 81254275919
REMAJA 02-05-2007 14 JL ABEPURA II K 082198783239
REMAJA 30-03-2007
29-06-2008 14 12-17 JL POROS KOYA 85244505535
REMAJA 13 JL SALAK KOYA T 081244604722
REMAJA 26-03-2008 13 KOYA KOSO 081340985717
R 16-05-1977 44 31-45 JL. ABEPURA II, 082132411112
REMAJA 19-11-2006 14 12-17 PERUMAHAN ROLL 82189349056
REMAJA 17-08-2005 15 12-17 JL. RAYA SKOW, 082253908164
REMAJA 09-12-2007 14 12-17 JL SWAKARSA KO 85311748376
REMAJA 06-02-2009 12 12-17 JL SMP KOYA BAR 82399405836
REMAJA 21-01-2009 12 12-17 JL. HOLTEKAMP 081344238145
REMAJA 11-04-2008 13 JLN MERAUKE 085219892717
REMAJA 03-06-2008 13 12-17 JL SORONG 81247656317
REMAJA 27-10-2008 12 JLN JAYAWIJAYA 082248494445
REMAJA 18-10-2008 12 12-17 JL. DURIAN I, KO 082199351020
REMAJA 21-07-2009
17-02-2008 12 12-17 KOYA KOSO 82235124038
REMAJA 13 KOYA KOSO 082399768815
REMAJA 03-04-2009 12 12-17 JL PROTOKOL KO 82124049801
REMAJA 13-02-2009 12 12-17 JL. SENTANI, KO 082334840480
R 20-08-1984 TRANSAD, MUAR081240965861
REMAJA 29-05-2008 13 12-17 JAYA WIJAYA 82286064039
REMAJA 08-12-2006 15 12-17 JL PROTOKOL JAY 81343047050
REMAJA 09-11-2006
23-08-2006 14 JL MANOKWARI K085315086004
REMAJA 15 JL MATOA I 081346784048
REMAJA 29-06-2007 14 12-17 JL. SMP KOYA BA 081346701263
REMAJA 04-05-2007 14 12-17 JL DUREN III KOY 81344562784
REMAJA 10-08-2006 15 12-17 JL. MERAUKE, KO082324438833
REMAJA 06-10-2008 13 KOYA BARAT 082189032271
REMAJA 11-04-2009
20-08-2008 12 12-17 JL AB II KOYA BA 82297733290
REMAJA 13 JL BIAK KOYA BA 081247872849
R 02-10-2007
28-08-2006 14 PERUM GREEND 081344942668
REMAJA 15 KOYA BARAT 082312112813
REMAJA 17-10-2007 14 12-17 JL BIAK KOBAR 85311411192
REMAJA 11-08-2007 14 12-17 JL AB II KOYA BA 82237546041
15-04-2008
REMAJA 13 KOYA KOSO 082210081535
R 02-05-2006
21-02-2007 15 ABEPURA I JAYA 082198379937
REMAJA 14 JLN JAYAWIJAYA 081334954600
REMAJA 24-07-2006 15 12-17 JL SMP KOYA BAR 81216716689
R 08-10-2006
19-03-2008 15 JL PROTOKOL KO 082197790689
REMAJA 13 KUKUP KOYA KOS082399859509
REMAJA 10-05-2009 12 JLN SORONG KOY081241341155
REMAJA 17-07-2005 16 JL SWAKARSA KO081343053516
REMAJA 10-10-2007 14 JLN ABEPURA II 082215886091
REMAJA 29-07-2009 12 12-17 KOYA TIMUR 82299839081
REMAJA 05-09-2004 16 JL GAMBUT KOBA082214697936
R 11-07-2003 18 18-30 KOYA KOSO 085298250964
REMAJA 21-08-2004 17 KOYA KOSO MUA082217493053
REMAJA 14-02-2007 14 12-17 DUSUN SALANRA082231063080
REMAJA 17-02-2008 13 12-17 KM IX, KAMPUNG082399845542
REMAJA 09-02-2009 12 JL MANOKWARI K081344977393
REMAJA 08-02-2008 13 12-17 KOYA KOSO 081344237858
REMAJA 27-07-2008 13 12-17 JL. PROTOKOL, K 081344273250
REMAJA 02-12-2006 14 KOYA KOSO MUA082199904061
REMAJA 14-05-2008 13 JL WAMENA KOYA082311453596
REMAJA 17-07-2008 13 12-17 JL. WAMENA, KO082248003245
REMAJA 06-11-2008 13 12-17 JLN WAMENA, KO085243875114
REMAJA 05-09-2008 12 JL WAMENA 082235123352
REMAJA 12-12-2008
13-11-2007 12 JL WAMENA KOYA082399704043
REMAJA 13 12-17 JLN ABEPURA II 081317250886
REMAJA 17-07-2009
21-08-2008 12 12-17 JL. ABEPURA I, K 085311638206
REMAJA 13 12-17 JLN PANIAI, KOY 081344710458
REMAJA 23-10-2006 14 JL PROTOKOL ABE082312106755
REMAJA 28-09-2006 16 JL GAMBUT KOBA082264374574
REMAJA 03-10-2009 12 12-17 JLN JAYAWIJAYA,085213037479
REMAJA 10-10-1990
24-10-2003 31 31-45 JL. JAYAWIJAYA, 085211832278
REMAJA 17 12-17 JLN DEMBA KOYA082291288439
R 09-07-1970
29-03-2004 51 46-59 JL. MANOKWARI,085254077649
REMAJA 17 12-17 JLN SWAKARSA 081248381513
R 01-07-1985 36 31-45 JLN PANIAI, KOY 081240949431
R 11-04-1998
14-06-1984 23 18-30 JL. ABEPURA II, 082199058874
R 28-04-1999 37 31-45 JLN PANIAI, KOY 082397003288
R 22 18-30 KEEROM, JAYAPU081343088398
REMAJA 04-09-2004 17 12-17 KAMPUNG YAGA 085398716151
REMAJA 01-01-2005 16 12-17 KAMPUNG YAGA 081344100257
R 19-04-1988 33 31-45 JLN ABEPURA II 082398831891
R 02-05-1982 39 31-45 JLN WAMENA, KO085244010772
R 03-04-1996 25 18-30 KOMP PASAR LAM 082197530545
21-12-1989
R 31 31-45 FURIA JALUR 8, 081344305892
R 07-07-1973 48 46-59 KOYA BARAT, JA 081344010941
R 05-08-1975 46 46-59 JALAN ALPUKAT I082399197691
R 15-07-1994 27 18-30 JL. BRAWIJAYA K 85211961515
R 17-04-1991 30 18-30 JLN ABEPURA II 085232445948
R 13-10-1975 46 46-59 KOYA BARAT 82297413569
R 08-08-2009 12 12-17 GRAHA YOUTEFA 81330395430
Kepesertaan BPJS (tulis 'YA' pada kolom yang KOMORBID /
TUNDA
(TANGGAL
BPJS PBI BPJS Non PBI Non Anggota SCREENING II LAINNYA
KEMBALI)
TDK ADA 13 OKT 2021 (SEBUTKAN)
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13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
13 OKT 2021
TIDAK DOSIS 1 DOSIS 2
Merek TANGGAL TANGGAL
DIBERIKAN ( √
)
VAKSIN
13 OKT 2021 24005321 VAKSIN
14 SEPT 2021 24005321 13 OKT 2021 24005321
09-08-2021 24201212 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 2400532
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
01 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
09-09-2021 24005321 13 OKT 2021 24005321
09-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
09-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
09-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
09-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
07-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
06-09-2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEP 2O21 22005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
16 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
13 Sep 2021 24005321 13 OKT 2021 24005321
13 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
16 SEPT 2021 24005321 13 OKT 2021 14005321
13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
14 Sep 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OKT 2021 24005321
15 Sep 2021 24005321 13 OJT 2021 24005321
13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
15 AGT 2021 24004721 13 OKT 2021 24005321
08 SEPT 2021 24005321 13 OKT 2021 24005321
22 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
13 SEPT 2021 24005321 13 OKT 2021 24005321
15 SEPT 2021 24005321 13 OKT 2021 24005321
14 AGT 2021 24004421 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
26 Jan 2021 202009005 13 OKT 2021 24005321
11 SEPT 2021 24005321 13 OKT 2021 24005321
07 SEPT 2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
11-09-2021 24005321 13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321 TOTAL :
13 OKT 2021 24005321 BATAL :
13 OKT 2021 24005321 VAKSIN I :
13 OKT 2021 24005321 VAKSIN II :
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
13 OKT 2021 24005321
KETERANGAN
VAKSIN I 1
VAKSIN SELESAI 1
VAKSIN SELESAI 2
VAKSIN SELESAI 3
VAKSIN SELESAI 4
VAKSIN SELESAI 5
VAKSIN SELESAI 6
VAKSIN SELESAI 7
VAKSIN SELESAI 8
VAKSIN I 2
VAKSIN SELESAI 9
VAKSIN SELESAI 10
VAKSIN SELESAI 11
VAKSIN SELESAI 12
VAKSIN SELESAI 13
VAKSIN SELESAI 14
VAKSIN SELESAI 15
VAKSIN I 3
VAKSIN SELESAI 16
VAKSIN 1 4
VAKSIN SELESAI 17
VAKSIN SELESAI 18
VAKSIN SELESAI 19
VAKSIN I 5
VAKSIN SELESAI 20
VAKSIN SELESAI 21
VAKSIN SELESAI 22
VAKSIN SELESAI 23
VAKSIN SELESAI 24
VAKSIN SELESAI 25
VAKSIN I 6
VAKSIN SELESAI 26
VAKSIN SELESAI 27
VAKSIN I 7
VAKSIN SELESAI 28
VAKSIN SELESAI 29
VAKSIN SELESAI 30
VAKSIN SELESAI 31
VAKSIN SELESAI 32
VAKSIN SELESAI 33
VAKSIN I 8
VAKSIN I 9
VAKSIN SELESAI 34
VAKSIN SELESAI 35
VAKSIN SELESAI 36
VAKSIN I 10
VAKSIN I 11
VAKSIN SELESAI 37
VAKSIN SELESAI 38
VAKSIN I 12
VAKSIN I 13
VAKSIN SELESAI 39
VAKSIN I 14
VAKSIN SELESAI 40
VAKSIN SELESAI 41
VAKSIN I 15
VAKSIN I 16
VAKSIN SELESAI 42
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 17
VAKSIN SELESAI
VAKSIN I 18
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 19
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 20
VAKSIN I 21
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 22
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 23
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 24
VAKSIN I 25
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 26
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 27
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 28
VAKSIN I 29
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN SELESAI
VAKSIN I 30
VAKSIN I 31
VAKSIN I 32
VAKSIN I 33
VAKSIN SELESAI
134
0
33
101
Profesi**
Jenis
No. Registrasi (A/B/C/D
No NIK Nama Penerima Vaksin Kelamin Tanggal Lahir
vaksin II /E/F/G/H
(L / P)
1 Q-000SXXID 9171034503860001 ANNISA NURHASANAH P R) 1986-03-05
2 S-9EE33EAA 9171010309870010 ERIK PABESAK L G 03-09-1987
3 K-0000BYNP 3404121809710001 AGUS PRAMONO L R 18-09-1971
4 Q-0002IFJ1 9171016407620001 SUJIATI P R 24-07-1962
5 P-LKEJC4HN 9171020812060004 MUHAMMAD FAHED AJRAN L REMAJA 08-12-2006
6 P-OHSBB7CM 9171022402070001 MUHAMMAD ANSWAR PU L REMAJA 24-02-2007
7 Q-000BQQUJ 9105081707030004 YOSUA SAMUEL ARISOI L R 17-07-2003
8 P-OOODUY3G 9171026304880001 NURHALISA P R 23-04-1988
9 P-PNNXO7EO 9171053009790006 HADI PRAYOGO, ST L R 30-09-1979
10 Q-000WBO0V 9171020508090001 SHEVCHENKO LEONARDO L R 05-08-2009
11 Q-000WMKY4 3522152711920004 ANDRIANUS L R 27-11-1992
12 Q-000WMKXO 7371110101980010 IRWAN B L R 01-01-1998
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
Kelompok Kepesertaan BPJS (tulis 'YA' pada kolom y
Umur Umur (18-30 / Alamat No. Hp sesuai)
31-45 / 46-59) 085254210184 BPJS PBI BPJS Non PBI
35 31-45 BTN SKYLINE INDAH BLOK D
34 31-45 PERUM MEGAPURA RESIDENT 082248018091 YA
50 46-59 ENTROP TERMINAL LAMA 087739293444
59 ASPOL SPN BASEG 081378049874 YA
15 BELAKANG KLINIK HEWAN E 081231332390 YA
14 JL SUNGAI HANYAAN ENTRO 085244323354
18 SKOUW DISTRIK MUARA TAM082399264665
33 31-45 JL SUNGAI HANYAAN ENTRO 085244323354 YA
42 PERUM MENDALI SENTANI 081356919334 YA
12 PERUM KODIM ENTROP 085343129304 YA
29 SAMPINH POLSEK JAYAPURA081320070367 YA
24 SAMPINH POLSEK JAYAPURA082197230998
(tulis 'YA' pada kolom yang KOMORBID /
TUNDA TIDAK
sesuai) TANGGAL SAKIT Merek
Non Anggota SCREENING II LAINNYA Vaksin***
KEMBALI) )
09 OKT 2021 (SEBUTKAN)
09 OKT 2021
TDK ADA 09 OKT 2021
09 OKT 2021
09 OKT 2021
TDK ADA 09 OKT 2021
TDK ADA 09 OKT 2021
09 OKT 2021
09 OKT 2021
09 OKT 2021
09 OKT 2021
TDK ADA 09 OKT 2021
TANGGAL DOSIS 1 TANGGAL DOSIS 2 KETERANGA
PEMBERIAN NO. BATCH PEMBERIAN NO. BATCH N
VAKSIN
2021-09-03 24005321 09 OKTVAKSIN
2021 24005321 VAKSIN SELESAI 1
09 OKT 2021 24005321 VAKSIN I
28/07/2021 24201521 09 OKT 2021 24005321 VAKSIN SELESAI 2
2021-06-15 24001921 09 OKT 2021 24005321 VAKSIN SELESAI 3
09 OKT 2021 24005321 VAKSIN I
09 OKT 2021 24005321 VAKISN I
09 OKT 2021 24005321 VAKSIN I
09 OKT 2021 24005321 VAKISN I
2021-09-11 c 24005321 09 OKT 2021 24005321 VAKSIN SELESAI 6
Jenis (A/B/C/
No. Registrasi Nama Penerima Kelamin D/E/F/
No vaksin II NIK Vaksin (L / P) G/H) Tanggal Lahir
1 Q-000X0BZ3 9171024811030002
TIARA PRISKILA ESTER LUMIP R 08-11-2003
2 S-F431ECA6 9171033006750005
JOHN COURSE MAWIRING BANTI L R 30-06-1975
3 P-9MLM7FMV 6471052701980002
ALFADIS FEBRIAN SILAEN L R 27-01-1998
4 W-0000D1V7 1571012607870001MUHAMMAD AMIN L R 26-07-1987
5 Q-000WWZ54 9109011111030005
PETRUS FERNANDO RUMTHE L R 11-11-2003
6 Q-000WBHEM 3528050305850003 HARIYADI L R 11-05-1985
7 P-D3QVDIYF 9171054704850002 SITI ZULAIKHA P R 07-04-1985
8 P-DC9W24JP 9171055207060001INDI NURLISTIANI ALI P R 12-07-2006
9 P-E5WZEK0W 9171055207060002
INDAH NURLISTIANA ALI P R 12-07-2006
10 Q-000WSXAN 9171051602810007 LUIS YARANGGA L U 16-02-1981
11 P-FB6CUC65 7403274407880001 SALMIA P U 04-06-1988
12 P-FBOCU5UI 9171053009830001
LA TAHURU JALALUDIN L R 30-09-1983
13 Z-000AOXDI 9109012607560003 PAULUS REYAAN L U 26-07-1956
14 Q-000WBHFZ 9171054510690002 SITI AMINAH P R 05-10-1969
15 Q-000WWR5J 9171050201020003
JANUARIO MARITS SITOMPUL L R 02-01-2002
16 P-HNIZCSK7 9171054207920003 DWI WULANDARI P U 02-07-1992
17 Q-000WWRHV 9171056310980001
GLADYS NABILA MELLDA SENDOH P U 23-10-1998
18 Q-000WWQSW6471010607070004
MUHAMMAD ARIFIN NUR AMIN L R 06-07-2007
19 Q-000WT94O 9171036401770002BERTHA SUITELA P R 24-01-1977
20 Q-000WT955 9171036407030001
JULIANI MANAVELLA TASIDJAWA P R 24-07-2003
21 P-9Y8BJ6QO 9171016302820003 SUDARNINGSIH P R 23-02-1982
22 P-DSLKWV46 9123015212000002 PELINDA WENDA P R 03-01-2002
23 P-GEM2QVGZ 9123135305030001 NELA KOGOYA P R 14-05-2003
24 Q-000W5A23 9101011402950001
FIDELIS FAISAL MAHUZE L R 14-02-1995
25 P-IWOXESPZ 5306034907920001
THERESIA YUNINGSI L. DOPO
P R 09-07-1992
26 Q-000WWSWP9171057012980001
THRESIA HARDIANTI MAGRIT LALY
P R 30-12-1998
27 P-O56YHQHW 9102432601010002 JULIAN YIKWA L R 26-01-2001
28 Q-000WGAYR 9115086811900001
ERENSINA AKSAMINA SAIDUIP R 28-11-1990
29 N-00001D0O 1220046802940001ELSA SRI GANTINA P R 28-02-1994
30 Q-000RFC78 9171054612020001
CHRISTIN YAHYANTI REBALI LALY
P R 06-12-2002
31 Q-000WWR5W9171055708050002
VICTORIA YOLANDA MARGHRIET ELLEANOR
P IBO
R 17-08-2005
32 Q-000WX4Y9 9171054209020002
HERLINDA KAMARUDDIN P R 02-09-2002
33 P-RNTTZKBD 9171055812810002
MERRY CHRISTIANA AYOMIP R 18-12-1981
34 Q-000WWQEB 9171056505060003GAVRILA M N BUINEI P R 25-05-2006
35 Q-000WDS6H 9109015504020003
AVIANA CHRISTINE XAVIERA SILIWIER
P IBO R 15-04-2002
36 Q-000WWRI1 9171052708060001
MICHAEL IVANDER CH. RUMADAS
L R 27-08-2006
37 Q-000WIK7S 9105010109010002
JUAN CHARLLOS.A. KUMBUBUIL R 01-09-2001
38 P-RA51FTFD 9171050907020003
PAPUANO JULEV ALESSANDRO FURAY
L R 09-07-2002
39 P-RCH2EANH 9109017005030008MERINCE M. PIGAI P R 30-05-2003
40 P-RC2HH5AD 9109015805020001
DIANA RESTY KALA'LEMBANGP R 18-05-2002
41 Q-000WWW81 9171051909020003
JULENS SEPTINUS JIKWA L R 19-09-2002
42 Q-000CDSM7 9101015202020005 MADELINE PATRICK DHEA P R 12-02-2002
43 Z-000AOVQJ 9111024605900003REBALINA RAHEL BUINEI P R 06-05-1990
44 P-OZ0AFLAV 9171030712840004PERMENAS AWOM L R 07-12-1984
45 P-RTCFB2AH 9171036007980002 LIDIA SUSAN SARA WAY P R 20-07-1998
46 P-GRKQH450 3316041603040001 WIRO ADI NUGROHO L R 16-03-2004
47 P-RZCCMHYP 9171021110990007 TAUPIK HIDAYAT L R 11-10-1999
48 Q-000WWRHX 9171055207870002 FERLLYN VIANA HIND P R 12-07-1987
49 P-S3Y4WACV 9102014603020001 MARLITA DABY P R 06-03-2002
50 P-S73D2M2E 9104017007020005 YENNI T.A. WATAHA P R 30-07-2002
51 P-SBFBEHHB 8101214605040002 MEISYE HUKOM P R 06-05-2004
52 P-SE4LP1U9 9111014812020001
DEVITA WATI LAUFA WANIMBO P R 08-12-2002
53 P-SFDN0RVT 9171014109010004
STELLA NATHANIA LEWERISSA P R 01-09-2001
54 P-SHURQXS6 9106043107010001
FREDINAND YAVEN RIVALDO WAMBRAUW
L R 30-09-2001
55 P-SIXOUU4L 8171040308850001 EFRADUS YUSUF L R 03-08-1985
56 P-SK8LELTN 9103141504940002 ARDI MANGIWA L R 15-04-1994
57 Q-000N91K7 3308061109000003 ENDRA DWI SAPUTRA L R 11-09-2000
58 P-3IDCASUD 9171052505830004 FIRMAN L R 25-05-1983
59 Q-000A52R3 9171030510770013 Bakri L R 05-10-1977
60 P-VZBCL8W7 9103012807010001 MUH. MAFTUH IHSAN L R 28-07-2001
61 Z-000A7ZZM 9171034801560001SUNARNIK NINGSIH P LANSIA 08-01-1956
62 P-SRTSC2N8 9106010109950002 RIKHO GROTIUS AP L R 01-09-1995
63 P-SU6IXDBF 9271056001990002ANSTASIA .M. SESA P R 20-04-1999
64 Z-000AOBAB9171051812600001 DEMIANUS BRABAR L LANSIA 18-12-1960
65 P-SYBPWKJG 9106012704060002SUPRI AQUIALA AP L R 27-04-2006
66 P-SYZDHA9T 9111052512000001NATALIS GABRIEL HAN L R 25-12-2000
67 P-SYY03LPL 9171010604000003AGUS MANGGAPROUW L R 06-04-2000
68 P-SZV8S9XR 9106013101030002GERAD KAREL AP L R 31-01-2003
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
Umur (18- Kepesertaan BPJS (tulis 'YA' pada
30 / 31-45 / BPJS kolom yang sesuai)
BPJS
Umur 46-59) Alamat No. Hp PBI Non PBI Non Anggota
18 18-30
JL. KAYA SENTANI UNCEN BAWAH
082199802022 YA
AR GG MANGGIS
46 ASRAMA46-59HAJI KOTA RAJA RT/RW 081364564749
003/012 KEL. VIM DISTRIK
YA ABEPURA
23 18-30 WAENA ABEPURA 81347490862 TIDAK ADA
34 JL.
31-45
SLAMET RIADI SOLOK SIPIN085266976060
JAMBI YA
18 18-30 UNGKARAN ABEPURA82199672497 YA
36 JL31-45
SPG TARUNA BAKTI NO 16 82110037757
WAENA TIDAK ADA
36 JL31-45
SPG TARUNA BAKTI NO 16 82143454758
WAENA TIDAK ADA
15 12-17
PERUMNAS 4 PANDANG BULAN 81295864564 TIDAK ADA
15 12-17
PERUMNAS 4 PANDANG BULAN 81344558246 TIDAK ADA
40 31-45 PERUMAHAN ORGANDA 81344290533 YA
33 31-45
KOMP BUTON KAB YABONSAI 82199725275 TIDAK ADA
38 31-45
KOMP BUTON KAB YABONSAI 82199725275 TIDAK ADA
65 60>JLN KIMIRI PADANG BULAN81240215557 YA
52 46-59 PERUMNAS IV 81340969317 YA
19 JL ONDLIKEO
18-30 NO 47 PERUMNAS82116726624
1 WAENA YA
29 18-30 UNCEND 3 WENA 82199368242 YA
22 18-30 GANG JATI 6 82136448782 YA
14 12-17
JL KAMPUNG WOLKER NO 82248457994
2 YA
44 31-45 TANAH HITAM 82248456454 TIDAK ADA
39 31-45 PERUMNAS II WAENA81344258828 YA
20 18-30 PERUMNAS II WAENA82199994748 YA
18 JL
18-30
BUPER GANG DOLOROSA 85244415020
WAENA YA
26 18-30 BINALOKA 82198828062 YA
29 18-30 WAENA PERUM I 81247695492 YA
22 18-30 PADANG BULAN 82110035299 TIDAK ADA
20 18-30
PERMUNAS IV PADANG BULAN
81344678465 TIDAK ADA
30 18-30PADANG BULAN SOSIAL 082398922943 TIDAK ADA
JL KALI
27 ACAI,
18-30
PERUMAHAN ISTANA YOUTEFA
81391604554
BLOK E NO 13 TIDAK ADA
19 18-30JL SOSIAL PADANG BULAN
82199234266 YA
81344675928 YA
82398432940 YA
82248566481 YA
82199151361 TIDAK ADA
81257895751 TIDAK ADA
82199495005 YA
20 18-30 ARGAPURA MISSI 85216930117 TIDAK ADA
19 18-30
KOMP ORGANDA PADANG BULAN
82216229920 YA
18 18-30 PADANG BULAN 81222559330 YA
19 BUCEN
18-30 IV KOTA RAJA, JL RAJAWALI
81393774308 YA
19 18-30 PADANG BULAN 82238962959 YA
19 18-30 JL GAK BAMBU PEMALI81340963513 YA
31 31-45 PADANG BULAN 82248453730 YA
37 31-45 PEMDA 3 MELATI 82199111984 TIDAK ADA
23 18-30 JL NURI KAMKEY 82239404059 YA
17 12-17 BTN DOYOBARU 85727074502 YA
22 18-30 ABEPURA JAYAPURA 81282469705 YA
34 31-45 PERUMNAS 2 82199778955 YA
19 18-30
JL YAKONDA PADANG BULAN 82399720734 TIDAK ADA
19 18-30
JL YAKONDA PADANG BULAN 82154959167 TIDAK ADA
17 12-17 PERUMNAS I 82190947397 TIDAK ADA
19 18-30
BTN PUSKOPAD TANAH HITAM 81343483985 TIDAK ADA
20 18-30BHAYANGKARA JAYAPURA 81343134345 YA
20 18-30 ABEPURA JAYAPURA 81247624005 TIDAK ADA
35 31-45 ABEPURA JAYAPURA 82197511854 TIDAK ADA
27 18-30 WAENA JAYAPURA 81240103527 TIDAK ADA
43 31-45 BTN KAMKEY 81344688366 TIDAK ADA
20 18-30TANAH HITAM JAYAPURA 81240040088 TIDAK ADA
65 60> BTN SKYLAND 82311441275 YA
26 18-30 JL JERUK NIPIS FURIA 81340366059 TIDAK ADA
22 18-30 PERUMNAS III WAENA 81363250464 TIDAK ADA
61 60> GG CAMAR PERUM O 82177840382 YA
15 12-17 JLN JERUK NIPIS 82198049343 TIDAK ADA
20 18-30 JLN JERUK NIPIS 82248363778 YA
21 18-30 JLN JERUK NIPIS 85254459091 YA
18 18-30 JLN JERUK NIPIS 81240507191 TIDAK ADA
SAKIT TUNDA TIDAK
TANGGAL LAINNYA (TANGGAL DIBERIKAN ( √ Merek PEMBERIANDOSIS 1
SCREENING II (SEBUTKAN) KEMBALI) ) Vaksin*** VAKSIN
11 OKT 2021 CoronaVac 13 SEPT 2021
11 OKT 2021 CoronaVac 11 OKT 2021
11 OKT 2021 CoronaVac 03 JULI 2021
11 OKT 2021 CoronaVac 10-09-2021
11 OKT 2021 CoronaVac 11 Sep 2021
11 OKT 2021 CoronaVac 11-09-2021
11 OKT 2021 CoronaVac 11-09-2021
11 OKT 2021 CoronaVac 13-09-2021
11 OKT 2021 CoronaVac 08-07-2021
11 OKT 2021 CoronaVac 13-09-2021
11 OKT 2021 CoronaVac 13-09-2021
11 OKT 2021 CoronaVac 15-08-2021
11 OKT 2021 CoronaVac 01 JULI 2021
11 OKT 2021 CoronaVac 15-08-2021
11 OKT 2021 CoronaVac 04-09-2021
11 OKT 2021 CoronaVac 12-09-2021
DOSIS 1 DOSIS 2
PEMBERIAN KETERANGA
NO. BATCH VAKSIN NO. BATCH N
24005321 11 OKT 2021 24005321 VAKSIN SELESAI 1
24005321 VAKSIN I 1
24005321 VAKSIN I 2
VAKSIN I 3
24005321 VAKSIN I 4
24005321 VAKSIN I 1
24005321 VAKSIN I 5
24005321 VAKSIN I 6
24005321 VAKSIN I 7
24005321 VAKSIN I 8
24005321 VAKSIN I 9
24005321 VAKSIN I 10
24005321 VAKSIN I 11
24005321 VAKSIN I 2
24005321 VAKSIN I 12
24005321 VAKSIN I 13
24005321 VAKSIN I 14
24005321 VAKSIN I 15
24005321 VAKSIN I 16
24005321 VAKSIN I 17
24005321 VAKSIN I 18
24005321 VAKSIN I 19
24005321 VAKSIN I 20
24005321 VAKSIN I 21
24005321 VAKSIN I 22
24005321 VAKSIN I 23
24005321 VAKSIN I 24
24005321 VAKSIN I 25
24005321 VAKSIN I 26
24005321 VAKSIN I 27
24005321 VAKSIN I 28
24005321 11 OKT 2021 24005321VAKSIN SELESAI 34
24005321 VAKSIN I 29
24005321 VAKSIN I 30
24005321 VAKSIN I 31
24005321 VAKSIN I 32
TOTAL : 68
BATAL : 2
VAKSIN I : 32
VAKSIN II : 34
Profesi**
No. Registrasi Jenis Kelamin
No NIK Nama Penerima Vaksin (A/B/C/D/E/F/
vaksin II (L / P)
G/H)
1 P-2XO447W5 9105016011030003 JUSTINA DIDIMA CAREP R
2 P-31ZUKEZX 9171036309030004 RIA DROUS RUMAIKEW P R
3 P-36XAVT5J 9105017103040001 TATYANA VANESA GLAP R
4 P-3AKVLERS 9171034807010002 TAMARA MIRANDA RUP R
5 P-3F2CTZ14 3525091203820003 YANAN L R
6 P-1G6YEBIT 9171021907070001 IKLAS HERLAMBANG L R
7 P-1FHVY7Y2 9171020408080002 PUTRA PRATAMA L R
8 P-3OUYRB9G 9171024504030001 FARINA METTA DHAM P R
9 P-MEYX36F5 9171035612690001 Dwi warsiani P R
10P-HO1FQ0QG 9171021203000003 ABDUL HAMID L R
11 Q-000T3M81 9171026905780004 DENNI KEZIA DEWI P R
12 Q-000SXNTU 7311075012790001 RATNAWATI P R
13 P-9X2LD5NA 7311031004740002 ABU BAEDA L R
14 Z-0009R6PY 9171012808760006 HABEL NUBOBA L R
15 P-4KAMGYFI 9206012502820003 FRANGKY BORAY L R
16 P-VLWUG78K 7109016412700006NELFIA ZACHAWERUS P R
17 P-9RBKSK7T 7304071005070002 HERMANSYAH L R
18 P-4PFKJEWH 9171010708990004 EDO ARDUS BRIA L R
19 P-5AVNNUQU 7102152911990001 GREAND CHIVALRY NO L R
20 P-54WN8SR6 5304085703970001 EMELIA LURUK SERANP R
21 Q-000T3YIX 9171022506090003 GHIMNORIZA ANUGRAH L REMAJA
22 P-5CQDT3YN 7102111005700001 MENLY RANTUNG L R
23 P-8SCAKGIS 9171010110800004 ISWADI L R
24 P-I2AU4X38 6408160408800001 SYAHRIL L R
25 S-3BBA7B39 9171050201960001 MUHAMMAD NUR SAPL R
26 P-BGI4BD5E 9171011812010001ARYOSETO PRAMESTI L R
27 P-69E7VUIF 9111022407960001 KURNIAWAN DWI YULIL R
28 P-6LERAXVY 9171022605040002 WARTO WILLIAM BASTL R
29 P-76JUZ7BG 9171011004020002 DANO MUHAMMAD KAHF L R
30 S-258524B0 9171021507560003 DANCE ASMURUF L R
31 Y-0132M5WB 3174032101721001 DANIEL SUGITO L R
32 P-7O5WCKKV 9171055301020005 JENIFER L P RUMPAISUM P R
33 Q-000SXWWM 9171010704050002 HEKTOR LATUPUTTY L R
34 P-8BYJ7UZ3 9171010408800005 ALFIAN IWAN PATTYLIMA L R
35 P-97C3FNAZ 9171011408030003 IZACH SAMUEL KOROMATL R
36 Q-000T5K1T 9171050305950001 RICHARD VEPLUN L R
37 Z-000A6A6R 9171025203760001 DELFINA MANURUNG P R
38 P-BXZJK1CL 5303077010650001 MARIA MARSEDES EKO P R
39 P-AOB56I9V 9171036809900004 DESIANA APIEM P R
40 Q-000SKWMC 7102132201630001FREDY JAPPY LONGKENG L R
41 Q-000HOLYI 5303074107720027 AGATHA OKI P R
42 P-CD8RBC16 9171032312870003 NIKO JOHAN MARSELINO L R
43 P-CGXOVV1D 9171024508740003 MEIKE WIJAYA P R
44 P-CDUJ9VEH 9171011009080003 FRANSISKUS OCLASIUS DE L REMAJA
45 Q-000SGYA0 9171035207760008 DEWI ASTUTI P R
46 P-EG0EHXFV 7312052502870002 DARMAWAN L R
47 P-EQNHFRKI 9171051909640002 RAHMAT SETIA DWI PUTR L R
48 P-FT6JKN5M 5319020208920004 ANSEL PUPUNG L R
49 Q-000SHTBM 9171024501730002 JAHIDAH P R
50 P-1GAI3V8Z 7326021606970001 L JUNI ANTO KARANGAN L R
51 P-GFA0RKSS 9171024703820002 LISA ANGGRENI P R
52 S-02BBB069 9171024104750004 FARIDASARI IRIANI P R
53 Q-000SHHCE 9171022302070003 ANDIKA PUTRA REVALDI L R
54 S-D1277B69 9171022402740001 TAMRIN HI MUHAMMAD L R
55 Q-000S2OUM 9171044410080002 SELVIANA ANISA P R
56 P-HMAZ2XT4 9171021912810001 SLAMET SUWANTO L R
57 P-IBLEFDX0 9171012801840001 VICTOR L.E. MATULESSY L R
58 P-IPGEJKPO 9171044909930001 YULI ASTUTI L R
59 P-DABOH9RP 9171022512940003 LMES NATANIEL MERASI L R
60 P-JD51AMNR 9171021502850003 DIDIMUS RAUNSAY L R
61 P-KO2WWCZH 9171026605710004 VENERANDA ILLUMINATA P K R
62 P-K5P5TJ4C 9102045710020002 AGUSTINA DOGA P R
63 P-ONR1ZNUK 9171021303020003 DAYVI ELUZAI KIRIHIO P L R
64 Q-000T4ESS 9171030507010005 ALFAJRI ALAMSYAH L R
65 P-LHEBWANL 9202126912910001 DESSY EFFERISTA HOWAY P R
66 Q-000SGDBV 9171031109060002 MUHAMMAD TAKDIR L R
67 P-MLFTCKGB 9171016010990001 ROSALINA E WAYOI P R
68 P-MRY3506Q 9105014705910006 MELISA MANSAI P R
69 P-N9B4GSER 9116015703020001 MINGGAS MERRY LEIN PA P R
70 P-NF8CIV0P 9171026208980003 SRI INDAH WAHYUNI P R
71 Q-000SJUI8 9116012105950002 MUSLIHIN L R
72 S-509FF635 9102060912790001 LAMBERTUS ITLAI L R
73 P-0K2065JA 3318031212820003 RIDOYO L R
74 P-4MWZ3WGU 7404074107790041 WD. ZALUMI P R
75 P-4G0N6XU5 9208011304770003 LA EMI L R
76 MANUAL 7404761607000001 LA ROY L R
77 P-9FIPKYF2 9171012707950002 BENYAMIN THOMAS WAPL R
78 P-8A2802D3 9171020203030005 BAHRI L R
79 S-594A808C 9171021001600002 NASRUL L LANSIA
80 P-B7Z2JYP5 9171051303840007 ROBI SUGARA L R
81 Q-000TABTJ 9171011010080001 AHMAD FAIZ MUYASSAR L R
82 Q-000TAC4A 9171015707030003 AZIZAH ASTRI WULANDARIP R
83 S-248FF0C1 9171025108920002 SITI AISYAH AGUSTINI P R
84 P-E4D8ISIO 9171024310000003 PUTRI WINDURI MANEMI P R
85 P-05VJ39V8 9171030612860015 REMLI SOUHOKA L R
86 Q-000SREVL 7373024606855987 BARNECE KUKUS P R
87 Q-000SLO44 9171021611820011 NAF BENYAMIN PANDIE L R
88 P-H9ZZ2G16 9171030701700002 BASTIAN WORABAY L R
89 Q-000S8FZZ 9171015509860001 MARGRITH S SEMBAI P R
90 P-JWCAOXBR 9171024109090001 KRISTIN HAWILA YOUWE P R
91 Q-000S8FSH 9171026008870003 HENI KAROLINA YUSPITA P R
92 P-L16KK4RI 9171020507090003 JANPIET ARNOLEO BISAY L R
93 P-M3O6FCWO 9171052112980001 GANDY SETIA PUTRA L R
94 Q-000SPC7A 9171036203030001 SANIA NADIA ELLY P R
95 P-MGOMIQDN 9111025801980003 AKSAMINA CORNELIA BILAP R
96 P-19QSJQ1S 9171035908030002 HENNY DWI LESTARI P R
97 P-NTQFINRY 8272062307970001 ZULKIFLI MUSA L R
98 W-63D8B825 9171015812740006 VEBY TEHUAYO P R
99 P-OMQDANOE 9171034708070008 HANJELIN KAROLIN SUKANP R
100 P-2VA9YFXQ 9171030507990004AKHLAK LUKMAN WAROY L R
101 MANUAL 9171011801090001 JERYCHOSIDNEY FILEMONL R
102 P-Q4Z45KOI 8101235705980001 MELVIN SERUMENA P R
103 P-QGLFXTKZ 9171016904870001REDRIKA MINCE PAWERE P R
104 P-QHG8TTLY 9106010303880003 DIEGO MARADONA L R
105 Y-01329G6L 3171077005640001 MARTINCE AP P R
106 P-TPNZTFTW 9106082705000001 NIKO
RENNYBENI EVODS.SOS
YUNIAR AP L R
107 Q-000R8N01 9171016506810003 p R
108 S-47F5AABB 9171031306910008 ROBERTHO YOHANIS MONL R
109 P-W2PHQS7K 9171016208020003 MUSTIKA AGI WULANDARIP R
110 Q-000SLO3V 5301102707890003 JHONI HANAS L R
111 Z-000A46H0 9171036606760003NGGAS SARLOTA YAWAN P R
112 Q-000S9YPP 9171024212880005 GRIMINCE GREES MANO P R
113 P-XX2UCLGR 9171014207870002 SITI SOLEHA P R
114 P-Y1Y0QKOC 9171030911710001 BENYAMIN BUNGA L U
115 Q-000SXXGX 9106122906980001 ADIRYANUS F.M. TANGGIPL R
116 P-YBU57IMB 9171025204000003 AULIA NURUL SYAMSYA P R
117 P-YBYOVTT2 9171022411840010 NOAK SIMON ASARIBAB L R
118 P-YCDATOHJ 9171024212050001 BRIGHIA ALLOBUA P R
119 P-YC5V7YP3 9171056302900003
9103072506800002 NURUL ASRI HASJIM P U
120 S-2EA8A17A 9171015305870010 REIEN CHOLAPITER LEWERL R
121 P-YCMK3CSO IMELDA MAYOR P U
122 P-YCQAZQLG 1804020409650001 SODRI L R
123 P-YCSSQ2CA 9171016808060001 ALVA CLAUDYA DWAA P R
124 P-C7UAWJAO 9171052904720002 JONNY L R
125 S-D78065DC 9171021211740004 CLAUDE PIERRE ARMAND L R
126 P-7TFWPSWF 9271064711030001ONNE ROSALIN DJOPARI P R
127 S-C735D875 9171011911900001 SEMUEL EDOWAI L R
128 Q-000ITYAJY 9171035203060003 NURUL FADILAH P R
129 Q-000SY01B 9171032810850001 RIKI N NGELYARATAN L R
130 P-1PPYDDQY 9171026606670003 LENY YUN P R
131 Z-0009MASN 9171011804930001 MAIKEL ESAU TOROBI L R
132 P-PXSOIZVZ 9171014101000001 MELANESYA ESTER TOROBP R
133 W-0000CRTT 9171016802910004 YULIANA N. RAUNSAI P R
134 Q-000TUTOL 9171034906980003 DORINCE IMELDA KYEU-K P R
135 P-YE4VPFU1 9110015611990002 NOVELA KETLIN FAIDIBAN P R
136 P-YE1JEPGB 9171014505980005 ELSYA DAMAYCA P R
137 S-6F1EC769 9111023012000001 Stevanus N Montoalu L R
138 S-507CE83E 9171035002970005 RIRIN DUALEMBANG P U
139 S-190E16FB 9171026507810004 JULIANA ANTOMINA MANP R
140 P-LJK461DK 9171035704980002 RAHEL AZUBA LADY CLAU P R
141 Q-000P6DJU 9171036112800001 SAFITRI P R
142 Q-000SXBB3 9202131503900002 BADARUDDIN L R
143 P-DMPPP04U 9171057008890001 IRAWATI BAJAHU P U
144 P-YEPKURRZ 9113091711990001 ERICH CHRIS YAKUNSON KL R
145 P-YER0QNRK 9171034210910002 SUCI RAMADANI P U
146 P-YEZLE9NL 9171036206090004 DILLA KAKA TANATI P R
147 P-YEZOMNFM 9171035806070002 EKLEVINA JEANET SESERAYP R
148 P-JT1H6RN2 9171014302870003 SANUGRAH P R
149 Q-000SIFQS 9171035412950001 DIAN SARA P R
150 P-6RBOYKMH 9171034508940002 RISMA MULYANA P U
151 P-8WZTV2ST 9171036509930004 RATNA SARI P R
152 P-YFCKAEOV 9171057108940002 RATNA FARIDA KUSUMA P R
153 P-YFBVGRU0 9105015808880001 MUZEINIYAH P R
154 P-CQR7Q6ZD 9171015711930002 WAHYU SUPARWATI P U
155 P-ORYD3GW6 3501101402790003 SUNARTO L R
156 P-YFGLASQK 9171021705840001 IRWAN P U
157 P-YFMYCKTQ 9271024207010001 KATHLEEN GRACE NOYA P U
158 Z-000A7BMT 9171031509650001 MONANG ARUAN L R
159 P-YFQXTGZ4 9171056111000001 NADYA NURYANI SITORUSP R
160 P-ORRLKDZM 3501100501780002 MISTO L R
161 P-OSDPJEFN 3501091505840003 PURWANTO L U
162 P-YFVU5V9U 9105091303060001 JEHEZKEL DANFRIT SARAR L R
163 P-ORZ21B2W 3501090711620002 PONIRAN L R
164 Q-000RXJL9 7105105911930001 NOVITA SINUNDENG P R
165 P-OW5VIGR3 7105096508030001 ANGREINE A. TAMBOTO P R
166 Q-000SM428 9171025910020005 ENNY VIOLA WOMSIWOR P R
167 P-QFJ8IISE 5314011701970001 ARYAN PETRONEL LOLO L R
168 P-YGCFMSZ4 7404270301920001 IRMAN ASDAR L R
169 P-QYMJRCOP 9171011511030002 ETHOVEN SITANIAPESSY L R
170 P-QZTJ9QA7 9171022207020002 ERNESTO OHOIWUTUN L R
171 Q-000TTZ0G 8203166708840001 SURATMI HI TAIB L R
172 910301030101006 EMI J MIRU L R
173 P-R0G049MD 9171020408040001 ALDIYANSYAH RURUK L R
174 P-YH609H0G 9171015404930002 ICA FILDHA PRASTITI P R
175 P-0PPOU1WU 7326066205000001 DAMITA PABATE P R
176 P-YHEQU0ST 5304142808860001 ALOYSIUS TAS L R
177 P-YHJ8WPFX 9171021105050005 FABIO VIO KARIM L R
178 P-YHKNH822 9105092010970001 YANTO PURWANTO RAUNSL R
179 P-36I7U8N7 9171024210740001 NOVALIA ANTHONEIT MANP R
180 Q-000SR50U 9171021708720010 ANS APOTOLOS KAMERI L R
181 P-YHTPKB2E 7104062903840001 YONATHAN BUDIMAN L R
182 S-20C43B7C 9171012702630001 FREDRIK YOSEF YERANGGAL R
183 P-LRNTMQYJ 9171011108700005 ALIF KEMADI L R
184 S-5F75BF4F 9171012002830003 FEBRY SANJAYA L R
185 P-YIHPIAR2 9171014709670004 MARTHINA SELINA MANDOP R
186 P-YIM1UTNE 9171036007810003 SRI MARIATUN P R
187 P-RYYYTDX5 9171030408980003 HABELINO MARKUS C.M.P.L R
188 P-YIOIRUB0 9171031005720008 DEMIANUS MAXIMILAN A L R
189 P-YIRAGE2Q 9171024707870010 RITA ALEDA NELLY SAWAKIP R
190 P-DBNH8MXI 9171031607000004 DO MEKY KOISI SAWAKI L R
191 P-YIXKM17W 9171031602730003 YOHANIS ST. SAWAKI L R
192 MANUAL 9171026203090010 MARDIANA P R
193 P-YJ1MYGGG 9171036712850001 IRMAWATI P R
194
195
196
197
198
199
200
201
202
203
204
31-45 / 46-59) BPJS PBI
20-11-2003 17 JL BTN WALIK 085243127901 YA
23-09-2003 18 PERUM WALIKO 081248287830
31-03-2004 17 JL RAYA ABEP081327834095 YA
08-07-2001 20 18-30 PERUM WALIKO 081219820990 YA
12-03-1982 39 JL RAYA ENTR082199212962
19-07-2007 14 12-17 BELAKANG KEL 81346720102 YA
04-08-2008 13 12-17 KARANTINA H 085244036198 YA
05-04-2003 18 ENTROP 45 JA082340011332
16-12-1969 51 KOMPLEKS LAU 082199504391 YA
20-12-2000 21 BUCEN II ENT 081344779802
29-05-1978 43 31-45 ARDIPURA II 085244554549
10-12-1979 42 31-45 JL PERCETAK 85345548477 YA
10-04-1974 45 JL PERCETAKAN YA
28-08-1976 45 31-45 JL ENAROTALI081236316072 YA
25-02-1982 39 MELATI KOTAR081296270343
24-12-1970 50 46-59 FURIA 081248703593 YA
13-10-2002 19 ENTROP SMA 4085298507826
07-08-1999 22 18-30 JL PEMUDA K 82351526261
29-11-1999 21 18-30 TANAH HITAM 085397496085 YA
17-03-1997 24 JL BARU KALI 081343324527 YA
25-06-2009 12 BELAKANG HOT 081340194445
10-05-1970 51 46-59 JL ABEPANTAI 81248090023 YA
01-10-1980 41 31-45 APO BUKIT BA081346797060
04-08-1980 41 APO BENGKEL081240885223 YA
02-01-1996 24 ASR DENZIPUR081344887844 YA
18-12-2001 19 18-30 JL RAMBUTAN 081248588146
24-07-1996 25 18-30 JLN CYKLOP 81240405115 YA
26-05-2004 17 HAMADI PERT 081244386753
10-04-2002 19 18-30 JL TANJUNG RIA 082198996422
15-07-1954 67 POLIMAK JAPS081387548124
21-01-1972 49 46-59 KELURAHAN ABE 81229250595
13-01-2002 19 WAENA ABEPURA082198486357
07-04-2005 16 18-30 DOK V ATAS 081248640900 YA
04-08-1980 41 31-45 KAMPUNG APO KA 81344810098 YA
14-08-2003 18 18-30 JL OLAHRAGA GU081247032519
03-05-1995 26 18-30 LAP. TRIKORA IV 82397968139 YA
12-03-1976 45 ROLLO GREND BL0811488680
30-05-1998 23 SUMBER AIR II 082217479068 YA
28-09-1990 31 31-45 ABEPURA 082399247102
22-01-1963 58 46-59 JL ABEPANTAI 08124844201 YA
12-08-1974 47 SUMBER AIR II 082147578257 YA
23-12-1987 33 31-45 JLN DONDAI ABE 082117949032
05-08-1974 47 ARDIPURA I POL 081248756583
10-09-2008 13 12-17 JL POLIMAK II 81227508945 YA
12-07-1976 45 TANAH HITAM JL081344407048 YA
25-02-1987 34 31-45 HAMADI JAYAPU 085197216720
19-09-1964 58 JL KAMWOLKER P082194574739
02-08-1992 29 SMU 4 ENTROP 081343429315
05-01-1973 48 46-59 PERUM JAYA ASR 85244611508
16-06-1997 24 18-30 BELAKANG HOTE 081341992351
07-03-1982 39 31-45 HAMADI GUNUN082257210878
01-04-1975 46 KOTARAJA ABEP 085254133324
23-02-2007 14 12-17 JALAN ENTROP 8124093288 YA
24-02-1974 47 PEMDA I ENTROP081343438824
04-10-2008 12 12-17 JLN ALPOKAT 1 082144852157
19-12-1981 40 KOMP BINTANG 082199149331
28-01-1984 37 31-45 DOK VIII JAYAPU 081248499055
09-09-1996 25 18-30 JL ALPOKATI 82144852157
25-12-1994 26 18-30 JLN ARDIPURA II 081392997013 YA
15-02-1985 36 JL K.S TUBUN RE 085354765317
26-05-1971 50 41-59 JLN RAYA ABE JA 081344342687
17-10-2002 19 18-30 JL JAYA ASRI JAY 81247906017
13-03-2002 19 JL RAYA ABE TA 081247695383 YA
05-07-2007 14 12-17 JL RAYA ABEPANT 82238539695
29-12-1991 29 DOK V ATAS YAPI082197749964
11-09-2006 15 12-17 ABEPURA TANAH082171774151
20-10-1999 21 JL KAYU BATU TA081344113895 YA
07-05-1991 30 18-30 JL KAYU BATU TA 81311901374
17-03-2002 19 18-30 JLN KOTARAJA D 082320027978 YA
22-08-1998 23 SMU 4 ENTROP 082399572820 YA
21-05-1993 28 18-30 RAWA I JAYAPUR081340194300
09-12-1979 42 41-59 LAYTOPO DESA 81248846096 YA
01-07-1979 42 31-45 HAMADI RAWA 082122385409
13-04-1977 43 31-45 JL RESIMEN PERU 82123580849
18-07-2000 21 HAMADI RAWA I 082191573303
27-07-1995 26 KOMP PEMDA KAB. 081247871878
02-03-2003 18 18-30 HAMADI JAYAPU 082199219149 YA
10-01-1960 61 >60 HAMADI DEPAN G 82239863150 YA
13-03-1984 37 31-45 ENTROP JAYAPUR081344895999
10-10-2008 12 BHAYANGKARA 081266639813
17-07-2003 18 18-30 BHAYANGKARA 82238034969
11-08-1992 29 JL PANTAI KELA 081248825551
03-10-2000 21 18-30 ARDIPURA IV 81350243803 YA
06-12-1986 34 31-45 TANAH HITAM 082238014500
06-06-1985 36 31-45 HAMADI RAWA I 081240861164
16-11-1982 38 ENTROP CV THOM 082397224620
07-01-1970 51 41-59 DOK V JLN AGATS 85240120697 YA
15-09-1986 35 RUMAH ADAT EN082238486187
01-09-2009 12 12-17 JL SUMBER KAYU082113779035 YA
20-08-1987 34 31-45 KOLAM BUAYA E 81247878532
05-07-2009 12 POLIMAK II SAN 0812401714689
21-12-1998 22 18-30 WAENA ABEPURA081240501524
22-03-2003 18 JL KOMP BINAMA081248322620
18-01-1998 22 18-30 JLN POROS PIR I 82239330018 YA
19-08-2003 18 18-30 JL PONDOK PESA 082248292963
23-07-1996 25 JL KALI HANYAAN081247906770
18-12-1974 47 41-59 JL. SULAWESI DOK 81344059296 YA
07-08-2007 14 JL WOROT ABEPU082199246419 YA
05-07-1999 22 18-30 JL PANTAI ENGG 082198655602 YA
18-01-2009 12 12-17 APO KAI KOLAM 081247954554 YA
17-05-1998 23 18-30 ENTROP JAYAPUR081248603071 YA
29-04-1987 34 31-45 JL PRAJAMUKTI 082398750985
03-03-1988 33 31-45 JL PRAJAMUKTI 082395503666 YA
30-05-1964 57 41-59 JL PRAJAMUKTI 081210358072 YA
27-05-2000 21 18-30 ANGKASAPURA 081248612316 YA
25-06-1981 40 31-45 PEMDA II NO A-408114828810 YA
13-06-1991 30 18-30 PEMDA III MELAT081392841891
22-08-2002 19 18-30 JL KAYU BATU K 081373122472 YA
27-07-1989 32 31-45 PERUMAHAN BINT 085337657186
26-06-1976 45 31-45 PERUMAHAN BINT 082197829673 YA
12-12-1988 32 31-45 JL SUMBER AIR II 082399180520
02-07-1987 34 31-45 JALAN PEMUDA J082110087616
09-11-1971 49 41-59 JL Gelatik No 20 81247779030
29-06-1997 24 18-30 JLN SUPIORI DOK 81343281609
12-04-2000 21 18-30 JAYAPURA SELAT 82158406472
24-11-1984 37 31-45 JL SIRIH NO 40 82133751400
02-12-2005 16 12-17 KOMP. KARANTI 81247808609
23-02-1990 31 31-45 JAYAPURA SELAT 85244053291
25-06-1980 41 31-45 JLN BARU OTON 081281443346 YA
13-05-1987 34 31-45 JAYAPURA UTARA 81281443346
04-09-1965 56 41-59 JL SUMBER AIR I 085283185041
28-08-2006 15 12-17 KOMP. TNI AL H 81258302341
29-04-1972 49 41-59 JL VETERAN PAS 82154653083 YA
12-10-1974 46 41-59 ARDIPURA I NO 408114879780
07-11-2003 18 18-30 JLN MENTIMUN P 81248770545 YA
19-11-1990 30 18-30 BUKIT TINGGI 082198077469
2006-03-12 15 12-17 BELAKANG KANTO 81248665408
28-10-1985 35 31-45 JL MERPATI III Y 085244594066
26-06-1967 54 41-59 ARDIPURA I 081394649565
18-04-1993 28 18-30 APO BELAS JIWA 081248211648 YA
01-01-2000 21 18-30 APO JIWASRAYA 82199992103 YA
28-02-1991 30 18-30 KAMPUNG DOYO082399191182 YA
09-071998 23 18-30 CIGOMBONG KOT 81343419871
16-11-1999 21 18-30 JLN RAYA ABEPU 081343487083
05-05-1998 23 18-30 JAYAPURA UTARA 82248485404 YA
29-12-2000 20 18-30 PERUMNAS III 082198182126
10-02-1997 24 18-30 ABEPURA 82248101928 YA
05-07-1981 40 31-45 ARDIPURA II 085254238268
17-04-1998 23 18-30 KOTARAJA 81344624998 YA
21-12-1980 40 31-45 TANAH HITAM 081217451231 YA
05-03-1990 31 31-45 KOMP MENARA J 85394566491
30-08-1989 32 31-45 JAYAPURA SELAT 81248180957
17-11-1999 22 18-30 JL PADANG BULAN 82256223183 YA
2-10-1991 29 18-30 TANAH HITAM 81240605051 YA
22-06-2009 12 12-17 KOTA RAJA 081344553541 YA
18-06-2007 14 12-17 KOTA RAJA 82199158558 YA
03-02-1987 34 31-45 JL NENAS ABEPU 81248544400 YA
14-12-1995 25 18-30 JLN FLAMBOYAN 081343412233
05-08-1994 27 18-30 ABEPURA 81247273616
25-09-1993 28 18-30 JL BARU PASAR 81344221193
31-08-1994 27 18-30 GANG MATOA I 082399769046
18-08-1988 33 31-45 JL PERINTIS I KL 81299687788 YA
17-11-1993 27 18-30 BUCENDE 8124804971
14-02-1979 42 31-45 JL DOK VIII 82236298199
17-05-1984 37 31-45 JAYAPURA SELAT 85244778922 YA
02-07-2001 20 18-30 ABEPURA JAYAP 8124001405
15-09-1965 56 41-59 BUCEND IV KOTA081344187280 YA
21-11-2000 20 18-30 WAENA ABEPURA082171805892
05-01-1978 43 41-59 DOK VIII JAYAPU 82267234271
15-05-7984 36 31-45 85334058439
13-03-2006 15 12-17 POLIMAK II 082125013858
07-11-1962 59 41-59 DOK VIII 82236298199
19-11-1993 27 18-30 SKYLINE JAYAPUR081243578588
25-08-2003 18 18-30 PERUMAHAN VIL 85298948175 YA
19-10-2002 18 18-30 KOMPLEKS ONDO082397270328
17-01-1997 24 18-30 ABE TANAH HITA 81248754248
03-01-1992 29 18-30 JL PADANG BULA085283068745
15-11-2003 18 18-30 APO TUGU 81240688918 YA
22-07-2002 19 18-30 KODAM LAMA 85354787070
27-08-1984 37 31-45 JL GANG MERPATI082398778540 YA
03-01-2001 20 18-30 JL MANGGA DUA 81240402504
04-08-2004 17 12-17 ASRAMA KODAM081247629508
14-04-1993 28 18-30 JL LEMBAH SUNY 82199421793 YA
22-05-2000 21 18-30 KOTARAJA JLN W 81289053224 YA
28-08-1986 35 31-45 ARGAPURA 081240091149 YA
11-05-2005 16 12-17 POLIMAK I PEMA 8534064475
20-10-1997 23 18-30 SKYLINE JAYAPUR081248666102
02-10-1974 47 31-45 HAMADI KOTA JA 81245078914 YA
17-08-1972 49 46-59 JL SD NEGERI HA 082394412315 YA
29-03-1984 37 31-45 KAMPUNG HAMA 82320079087
27-02-1963 58 46-59 DOK IX ATAS 082399674461 YA
11-08-1970 51 46-59 JL SAMRATULANG 81297419258
20-02-1983 38 31-45 JL SERUI JAYAPU 082238192451
07-09-1967 54 46-59 JALAN KESEHATAN 81248601192
20-07-1981 40 31-45 CIGOMBONG KOT081240089275
04-08-1998 23 18-30 FURIA KOTARAJA 82133336274
10-05-1972 49 46-59 CIGOMBONG KOT085254650837
07-07-1987 34 31-45 JALAN KESEHATAN 081361633907
16-07-2000 21 18-45 FURIA KOTARAJA 82398491088
16-02-1973 48 31-45 FURIA KOTARAJA 81344122228
12-03-2009 12 12-17 JL ARGAPURA 085243246567
27-12-1985 35 31-45 JL BARU MELATI 081344272088
TUNDA TIDAK
KEMBALI) )
TDK ADA 01 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
TDKA DA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
TDK ADA 1 OKT 2021
TDK ADA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
TDK ADA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
TDK ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
ADA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
YA 1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
1 OKT 2021
VAKSIN
01 OKT 2021 24005321 VAKSIN VAKSIN I
01 OKT 2021 24005321 VAKSIN I
01 OKT 2021 24005321 VAKSIN I
01 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
O3/09/2021 24005321 1 OKT 2021 24005321 VAKSIN 2
3 SEPT 2021 24005321 1 OKT 2021 24005321 VAKSIN 2
1 OKT 2021 24005321 VAKSIN I
03/09/2021 24005321 1 OKT 2021 24005321 VAKSIN 2
27 AGT 2021 24005321 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
23 JULI 2021 24003921 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
03-09-2021 24005321 1 OKT 2021 24005321 VAKSIN 1
03-09-2021 24005321 01 OKT 2021 24005321 VAKISN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
02-09-2021 24005321 01 OKT 2021 24005321 VAKSIN 2
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
02/09/2021 24005321 01 OKT 2021 24005321 VAKSIN 2
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
03-09-2021 24005321 1 OKT 2021 24005321 VAKSIN 2
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN 1
02-09-2021 24005321 01 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
03/09/2021 24005321 01 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
9 JULI 2021 24002521 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
27AGT 2021 24005321 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
02-09- 2021 24005321 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
31082021 24005321 1 OKT 2021 24005321 VAKSIN SELESAI
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
01 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
1 OKT 2021 24005321 VAKSIN I
Jenis Profesi**
No. Registrasi
No NIK Nama Penerima Vaksin Kelamin (A/B/C/D/ Tanggal Lahir
vaksin II
(L / P) E/F/G/H)
1 P-1UNVNB0M 7324072006970003 RUDOLF SUSANTO SIPATU L R 20/06/1997
2 P-1YK546XT 9102011211840004 ONES HELEMBO L R 12/11/1984
3 P-23OWI9R8 9171026807690001 IJUHANA P R 28/07/1969
4 P-1WXSBD1K 9171031405970000 MAIKEL VAN ROLLING BARANSANO L R 06-09-1998
5 P-25EHAC1G 9171026905880003 ZYUKRIANI MANSYUR P R 29/05/1988
6 Q-000QCBOD 9106016002960002 GEMPALIN FREBIYANI KAISIRI P R 20-02-1996
7 Q-000QCBOA 9171010610980002 HENCI OKTOVIANUS SWABRA L R 06-10-1998
8 Q-000QL97Q 9171022009000009 BRANDO DEMIANUS YOWEI L R 20-09-2000
9 W-AB505031 9171023001980003 A L F I A N L R 30-01-1998
10 P-3B7DCE41 9171035701760002 RUSNI P R 17-01-1976
11 P-3DTKX8KH 9171031911040007 RISKI MARLAN ABDULLAH L R 19-11-2004
12 K-0000P98P 9171030805970003 Fadel Ibrahim Asmara L R 08-05-1997
13 P-3P1DPWV3 9171022811060004 MARCELLO SANTHOS KUNDRAT WAROMI L R 28-11-2006
14 Q-000Q6D2K 9171031903840007 ANANG SOENARKO L R 19-03-1974
15 Q-000QE0I0 9171035301050001 KHANZA ADINDA SALSABILA P R 13-01-2005
16 W-000078RQ 9171035809730005 RINI SETIAWATI HASAN P R 18-09-1973
17 Q-000OK15B 1211011606960002 ALEXANDER GUNTUR P.SITUMEANG L R 16-06-1996
18 W-0000B0YO 9171023012710002 MELKE MENTANG, SH L J 30-12-1971
19 P-519TYQ7K 3525154909700005 SUHAYATI P R 09-09-1970
20 P-5J20A3YN 9171024511010003 NUR FADILAH SALSABILAH P R 05-11-2001
21 Q-000QAL3F 9171013108080001 TRIONO SEPUTRA IRIANSYAH L R 31-08-2008
22 P-6SVHGLMQ 9171030111810005 RUSDAM L R 01-11-1981
23 P-A2AERRU1 9171030510990002 ALDRIAN LATUMETEN L R 05-10-1999
24 P-A2EQXNHP 9171032303020007 HENDRIK LATUMETEN L R 23-03-2002
25 S-CD2E4C5D 9171022612870003 MUHAMMAD YAMIEN HAMID L R 26-12-1987
26 P-GL4UFCLJ 3501082707710001 UMARYANI L R 27-10-1972
27 P-GUPAMBPI 9171015404910003 ALVA EMILIA MERLYN MANUFANDU P R 14-04-1991
28 Q-000Q0CEX 1807242104990001 DICKI APRIYANSYAH ALI L R 21-04-1999
29 P-M0ED4VIH 9171024107650045 HJ.RAHMATIA P R 01-07-1965
30 P-IFTHCSTZ 9171022608950002 SYAHRUL L R 26-08-1995
31 P-7MN3XBVH 9171022008990002 MAJ MA'AL BAHRAIN L R 20-08-1999
32 P-KLZ20U8M 9111055003930002 SUSI SUSANTI P R 10-03-1993
33 P-LT4A6CI6 3522081505000002 MARGONO L R 04-02-1997
34 W-F5339891 9171012406940001 ZAINI RACHMAN ABDILLAH L R 24-06-1994
35 P-MP7KKS1S 9171012104050006 MOZARDT ALFIUS MANUFANDU L R 21-04-2005
36 Q-000Q60BD 9171010909880003 JEMSI TUASUUN L R 09-09-1988
37 P-NPDPVMNS 9102011811840003 JEAN STEFANI PATTIPEME L R 18-11-1984
38 Q-000Q5S6F 9171022206030006 ARDIANSYAH L R 22-06-2003
39 P-PD32I6FB 9271064302030003 FEBI VIOLETA LARAWO L R 03-02-2003
40 P-SF4POQO7 9171021002860001 DANANG EKO PRASETYO L R 10-02-1986
41 P-3MNSJ2VN 9171025107010005 ORCHIDITA DANIELA TESALONIKA DE' LIMAP R 11-07-2001
42 S-E32ED103 9106123101800003 HENDRIK RONALD HAY L R 31-01-1980
43 P-FZHGVBKN 9171036505920002 NOLDA MELIKSA ROLAFKE ONDOAFO P R 25-05-1992
44 P-J5KVVL3S 9103020310720001 VICTOR KIAT L R 03-10-1972
45 P-JI7B5ILQ 9103024805020001 ELLEM FIORELLA KIAT P R 08-05-2002
46 P-LVFXKCUQ 9171034711700001 SITI AISYAH P R 07-11-1970
47 Z-0009RCZE 9171021104900007 DIMAS ARYESTA L R 11-04-1990
48 P-UZ5FPCOF 9103016804850001 SHERLY P R 28-04-1985
49 P-WCYVGFYO 9171015411060001 NOVA INRI SAWEN P R 14-11-2006
50 P-WE0QZEUQ 9171024810840001 GRES TOROBI P R 08-10-1984
51 Q-000EG1JJ 7326171507870001 RANTE L R 15-07-1987
52 P-WEDHPLN2 9105015803840002 WA NINI L R 18-03-1984
53 P-WEMFVKG4 9171052510690001 TONY HATTU L R 25-10-1969
54 Q-000QFYMI 9171054505980001 EVELINE RAIWAKI P R 05-05-1998
55 P-WF5AEDK5 9171027001030003 ANGEL COSTANTIN IREUW P R 30-01-2003
56 P-WF5Y1GP4 9171020207910007 ARFIAN PASAMBA L R 02-07-1991
57 Q-000OPIY2 9171051303030006 TIOGRIS PARANDANGAN MANGALLO L R 13-03-2003
58 P-6SV9G118 9171020507790005 HERMANUS MENGGE L R 05-07-1979
59 P-WHVW6IKB 9171026501900003 RAHMAWATI P R 25-01-1990
60 S-D5D20315 9171031202830007 JEAN H. RUMAROPEN L J 12-02-1983
61 Q-000PC68E 9106121802000001 JOHAN KEYNE ANDHIKA DIMARA L R 18-02-2000
62 Q-000QB3O6 9171034501040001 IMANIA AYU AINURJANAH P R 05-01-2004
63 P-WJ4VVG9D 9171032010030004 SYAHRIL L R 20-10-2003
64 P-WJAYEI6R 9171053012820006 RICHARD LUIS RUMBEWAS L J 30-12-1982
65 P-WJPT4IRT 9171032711000003 MUHAMMAD SAHRUL L R 27-11-2000
66 P-WJPODETP 9171030109000001 MAHFUD L R 01-09-2000
67 P-WKH9IXBZ 5206055406931002 USWATUN HASANAH P R 14-06-1993
68 P-WKUO2OBG 9171020305790009 KAMIL AFRIZAL DAWIR L R 03-05-1979
69 P-WKWG2KXW 9171021409060005 DEVON RYAN BASIR IREUW L REMAJA 14-09-2006
70 P-WLDFE0I7 9171021005020008 FIKRAM L R 10-05-2002
71 P-WLDMGHR3 9171020711050006 AHMADI L R 07-11-2005
72 P-WLQ3H5TF 9171022804800007 MURTOPO MUHAMAD L R 28-04-1980
73 P-WLYPVSMP 9171021912080005 FATUR.A.MURTOPO L R 19-12-2008
74 P-WMCTLOAA 9171021401790001 ALFRED A PAIKI L R 14-01-1979
75 P-WMGIKEXU 9171020706890003 KALEB. O.WAIMBO L R 07-06-1989
76 Q-000QBESQ 9171020802800004 AMBROSIUS SANYI L R AMBROSIUS SANY
77 Q-000ETT7C 9171021612820004 Jan Christian Arebo L R 16-02-1982
78 P-WN4VRTHM 9171015901790002 YENI ESTER TOREY P R 19-01-1979
79 P-WNA0IWEJ 9171056804000001 NADIA PUTRI APRILIA P R 28-04-2000
80 P-WNCCQ8PH 8106056805910001 FITRIANI SOSAL P R 28-05-1991
81 Q-000R7ZW5 9171026604090001 SHOPIA R. A. PIHAHEI P R 26-04-2009
82 Q-000KY0JY 3318092702830001 MAR SAHID L R 27-02-1983
83 P-WNKTX4WZ 7304013112990236 DION L R 31-12-1999
84 P-WNP4XOOM 9171014804000003 AMELIA DORTHEA PUTRI AWOM P R 08-04-2000
85 P-WNUF66MT 9171015404030001 MARACANA PASKA LENA BISAY P R 14-04-2003
86 P-WNX7DOUR 9103062606970001 JHON YUSAK YANSIP L R 26-06-1997
87 Q-000QAJJJ 3272024201630021 NENGSIH P R 02-01-1963
88 P-WO3QNIUO 9171014206760004 SURYATI P R 06-06-1976
89 P-WOAV4G1Y 9171021412740002 HENRY TANDY L R 14-12-1974
90 Z-0009XZ3G 9171024810790003 DIANE BEAUTY ISIR P R 08-10-1979
91 Q-000Q61KZ 9171020807030002 HERMES RAHALUS L R 08-07-2003
92 P-WP0TNN4H 9171021201040005 MUHAMMAD RIZAL L R 12-01-2004
93 P-WP2JEO2C 9171020101780004 H. AKBAR L R 01-01-1978
94 P-WP5HXQTM 9171034108870002 MURNI P R 01-08-1987
95 Q-000QKXM2 9171011810980003 KAREL S. SITANIAPESSY L R 18-10-1998
96 Q-000DOQ8H 9171050311700001 WELLEM E. SADA L R 03-11-1970
97 Q-000BCX1J 9171022202890004 IDRIS L R 22-02-1989
98 P-WPDQLP4I 9171014309880006 RITA TIKU LEMBANG P R 03-09-1988
99 P-WPTCHUER 8171050205970002 MELKIAS WILDOMS KESAULYA L R 02-05-1997
100 Q-0002936T 9171052109640001 VICTOR MAMAHI L R 21-09-1964
101 P-WQ24JO2O 9171021207850002 JHON RUMBIAK L R 12-07-1985
102 Q-000BLUFG 3321061004910004 EDY PURYANTO L R 10-04-1991
103 P-WQBERTLQ 7403192604970001 LA ODE MUHAMAD ASDUL L R 26-04-1997
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
Kelompok Kepesertaan BPJS (tulis 'YA' pada kolom yang
31-45 / 46-59) BPJS PBI BPJS Non PBI
23 JL RS BHAYANGKARA 081344957344
36 JL BUKIT TASANGKAPURA 085197141305 YA
48 FURIA PUSKKOPAD KOTARAJA 81248100420 YA
35.666666667 FURIA JALUR II KOTARAJA 81344280428 YA
32 JLN. FURIA PUSKOPAD 81248100420 YA
25 JL TELUK BO.25 DOK IX ATAS 082239750919 YA
23 JL TELUK BO.25 DOK IX ATAS 082197518167 YA
21 BATU PUTIH JAPSEL 082398783223
23 BATU PUTIH JAPSEL 81240959041 YA
65 JL GARUDA KOMP. KPR ABEPURA 08114891777 YA
16 PASAR YOUEFA 81240089643
24 BTN AWITYO LESTARI NO.69 081228413037
14 ARGAPURA BAWAH 81247238703
47 PERUM PURI KENCANA KOTARAJA 081344725121 YA
16 PERUM PURI KENCANA KOTARAJA 082199153578 YA
48 PERUM PURI KENCANA KOTARAJA 081344725121
25 PASAR YOUTEFA ABEPURA 085361971726 YA
49 YAPIS DOK V 08124899003 YA
50 FURIA PUSKOPAD KOTARAJA 081230994387
19 JL. HAMADI RAWA 1 082293458508 YA
13 APO PANTAI BAKAU 082152880286
40 TANAH HITAM 82198632442
21 GELANGGANG REMAJA EXPO 081247930041
19 GELANGGANG REMAJA EXPO 81317996088
34 JL HAMADI TANJUNG 082211114440
49 JL BARU PASAR YOUTEFA 0822217557079
30 JL. KOMP RSUD JAYAPURA 082197922893 YA
21 JL BARU PASAR YOUTEFA 082278323325
56 HAMADI PASAR 085244248636 YA
26 HAMADI TANJUNG 081233335427 YA
21 HAMADI PERTIGAAN 082137451971
28 JL. POLIMAK 082398839446 YA
24 HAMADI PELAYARAN 081212458968 YA
24 JL. POLIMAK 082248201120 YA
16 DEPLAT TANJUNG RIA 081247017691
33 APO CAMAT 082199874178
38 SANTAROSA DOLOG 081344250159
17 HAMADI RAWA I 082199122185 YA
18 JLN. HAMADI RAWA 082239332261 YA
35 KARANTINA HEWAN ENTROP 081344080333 YA
20 JL TASANGKAPURA NO.85 082239221744 YA
41 KOTARAJA KEL. WAHNO JL ALAM INDAH 081248426669
28 JLN.DOK II 082374814483 YA
48 KAMPUNG HARAPAN SENTANI 082132015134 YA
19 KAMPUNG HARAPAN SENTANI 082198049043
51 TASANGKAPURA 082347952337 YA
31 JL ARDIPURA 082248456565 YA
36 JL. ENTROP 082197814168 YA
14 JL. RS DOK II 081342986912 YA
36 ARGAPURA PANTAI 081262402843 YA
34 POLIMAK II BATU KARANG 082250226602
37 JL. ARGAPURA 082399769027
52 JL. PADANG BULAN 081287890869 YA
23 JL DOFONSORO NO.23 081390242502 YA
18 JLN. ARGAPURA 081262402843
30 JL MEGAPURA ENTROP 081232368238
18 JL. WAENA 082217722959 YA
41 JL AMPHIBI HAMADI PELAYARAN 081212425471
31 JL. HAMADI RAWA 081240104476 YA
39 BTN ORGANDA 082152876287 YA
21 DOK V BAWAH 082248569622 YA
17 KALI ACAI 082154650225
17 KOYA BARAT 082398923748 YA
38 JL. PERUMNAS III 081247358773 YA
21 TANAH HITAM 081344699157
21 JL. YOUTEFA 082199208152
28 KOMP MENARA JAYA POLIMAK 081344456232 YA
42 JL. ARDIPURA 081283974767 YA
15 POLIMAK 4 082248620637
19 HAMADI PASAR 082197594972
15 JL. HAMADI RESIMEN 082248457178 YA
41 JL. ENTROP 081247726688
13 JL. ENTROP 081247726688
42 JL. ARDIPURA II 82199254384
32 JL. ARDIPURA II 081248988168
40 POLIMAK II 081254650105
39 TANAH HITAM 081247739055
42 JL. TASANGKA 081247798148 YA
21 WAENA 082285019093
31 JL. HAMADI RAWA 081248583246
12 JL RAMBUTAN ARDIPURA 081240879799 YA
39 JL. KOTARAJA 082339306051
21 ENTROP 45 JAPSEL 081344506021
20 JL SULAWESI NO.64 082116948755 YA
18 JL SULWESI NO. 7 081343413475 YA
24 JLN. HAMADI 082197830934
58 JL. WOROTH 085722567397
45 KOM RSUD DOK II 082398864156 YA
46 JL RAYA ABEPURA ENTROP 081248003917 YA
41 JL. ARDIPURA II 082297443374 YA
18 KOMPLEKS KARANTINA HEWAN 81247691769 YA
18 HAMADI PASAR 081338053096
42 JLN. HAMADI 081346791653
34 TANAH HITAM ABEPURA 082399833982 YA
23 APO GUNUNG 081283243877
51 JL SAYUR LILIN NO.15 HAMADI 081344393752 YA
32 HAMADI RESIMEN 082198143183 YA
33 JL. HAMADI 081240632211 YA
24 KLOOFKAMP JAPUT 081377312584 YA
56 JL YOKA ARSO 081329324446 YA
36 ARGAPURA JL PANTAI KELAPA 082398951937
30 JL. APO GUNUNG 082248130474
24 APO GUNUNG 081248004399
tulis 'YA' pada kolom yang KOMORBID /
TUNDA TIDAK DOSIS 1
esuai) TANGGAL SAKIT Merek TANGGAL
Non Anggota SCREENING II LAINNYA Vaksin*** PEMBERIAN NO. BATCH
KEMBALI) )
TDK ADA 25-Sep-21 (SEBUTKAN) VAKSIN
25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 28-08-2021 24005321
25-Sep-21 28-08-2021 24005321
TDK ADA 25-Sep-21 28-08-2021 24005321
25-Sep-21 26-03-2021 24000821
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 24-08-2021 24202221
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 27-08-2021 24200621
25-Sep-21 24-08-2021 24202221
TDK ADA 25-Sep-21 21-06-2021 24002521
25-Sep-21 24-08-2021 24202221
25-Sep-21 7-Feb-21 24003621
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 28-08-2021 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 27-08-2021 24002321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 24-03-2021 24001121
TDK ADA 25B SEP 2021 25-Sep-21 24005321
TDK ADA 25-Sep-21 27-08-2021 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 27-08-2021 24005123
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 27-08-2021 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 14-07-2021 24200621
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 28-08-2021 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 23-08-2021 24002221
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-08-2021
TDK ADA 25-Sep-21 28-08-2021 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 27-08-2021 24005321
TDK ADA 25-Sep-21 15-07-2021 24200621
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 28-08-2021 24005321
TDK ADA 25-Sep-21 8-Apr-21 24004121
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 28-08-2021 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 28-08-2021 24005321
25-Sep-21 27-08-2021 24200621
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 28-08-2021 24005321
25-Sep-21 7-Dec-21 24003621
25-Sep-21 7-Dec-21 24003621
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 6-Dec-21 24002221
TDK ADA 25-Sep-21 25-Sep-21 24005321
TDK ADA 25-Sep-21 7-Jun-21 24003621
TDK ADA 25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21 25-Sep-21 24005321
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
25-Sep-21
TANGGAL DOSIS 2
KETERANGAN
PEMBERIAN NO. BATCH
VAKSIN VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
25 Sep 2021 24005321 VAKSIN SELESAI 1
25-Sep-21 24005321 VAKSIN SELESAI 4
VAKSIN I 1 POST COVID JULI
VAKSIN I
VAKSIN I
25 Sep 2021 24005321 VAKSIN SELESAI
25 Sep 2021 24005321 VAKSIN SELESAI 2 RIW. ASMA, NYERI MENELAN,
25-Sep-21 24005321 VAKSIN SELESAI 3 TUNDA/COVID
25-Sep-21 24005321 VAKSIN SELESAI 4 YUNDA/COVID
VAKSIN I
VAKSIN I 5 RIW. ASMA
25S SEP 2021 24005321 VAKISN SELESAI 7
VAKSIN I 6 TUNDA / FLU
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
25 Sep 2021 24005321 VAKISN SELESAI 8
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKISN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I 7 FLU
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I 8 FLU
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
25-Sep-21 24005321 VAKSIN SELESAI 9 TUNDA/OTG
VAKSIN I
VAKSIN I
VAKSIN I
25 Sep 20201 24005321 VAKISN SELESAI 15
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
25 Sep 2021 24005321 VAKSIN I
VAKSIN I
No. Registrasi
No NIK Nama Penerima Vaksin
vaksin II
1 Q-000KT8U9 3312121701810001 RACHMAD TOTO BASUKI
2 K-0000EODP 3372041011760021 NUR HIDAYADJATI
3 K-000097H2 3372040903820006 KURNIA ARIANTO
4 Z-0008CDLV 3173060505800035 ELIAS UAS
5 Q-000JY42G 3201172512930005 ALAN SUHANDA MAHFUDIN
6 Q-000K6MB2 3328180803810002 AGUS SALIM
7 Q-000MOCWY 3204250312970006 DESMA YUDISTIRA
8 Q-000L8VZE 3308172709960001 ANDRIANTO PURNAWAN
9 K-0000F0BG 3308201703980001 NUSWANTORO AJI PRATAMA
10 K-0000HZNB 3505041001940003 DWI WAHYU CAHYONO
11 Q-000MORD0 3311090408780003 DWI DARYANTO
12 Q-000MVJ8P 3372051007960006 RIZKY FAUZI AL HAKIM
13 P-TUPSJGBU 9103120906020001 RIVAN YOM
14 P-XG77RJYU 9103020210990001 PHOLEU FREDRIK OKOKA
15 S-0DB30C03 9102011608500001 MUCHTAR LOTANG
16 Q-000LM78Y 3674041806780003 AHMAD YUSUF
17 P-57YVIRVB 3174012002900006 MULYADI
18 Q-A2415927 1803072007860008 RIKI
19 Q-000L6E1Q 3304121512980002 DEFIAN
20 Z-00089ZWY 3403070108940004 ROHWANDA SUSILA
21 Q-000RMNLR 9102010908760001 RUSMAN
22 S-489020DC 9103012106800003 SALMON TELENGGEN
23 P-XWIWF9OV 9103017007090006 SISCHA APTHARLINE GRACE T
24 P-XWKVXQ0K 9103017009850003 DEBBY WONDA
25 Q-000Q60AV 9171032510990002 MAIDOM BONI
YOHANIS RONILABOK
SASARARI
26 Q-000RZHB5 9171033011730002
27 G-0133U44W 3202161406880007 SUPRIANTO
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
Profesi** Kelompok
Jenis Kelamin
(A/B/C/D/E/F/ Tanggal Lahir Umur Umur (18-30 /
(L / P)
G/H) 31-45 / 46-59)
L R 17-01-1981 40 31-45
L R 10-11-1976 45 31-45
L R 09-03-1982 39 31-45
L R 05-05-1980 41 31-45
L R 25-12-1993 27 18-30
L R 08-03-1981 40 31-45
L R 03-12-1997 23 18-30
L R 27-09-1996 25 18-30
L R 17-03-1998 23 18-30
L R 10-01-1994 27 18-30
L R 04-08-1978 43 31-45
L R 10-07-1996 25 18-30
L R 06-06-2002 19 18-30
L R 02-10-1999 22 18-30
L A 16-08-1950 71 >60
L R 18-06-1978 43 31-45
L R 20-02-1990 31 31-45
L R 20-07-1986 35 31-45
L R 15-12-1998 22 18-30
L R 01-08-1994 27 18-30
L R 09-08-1976 45 31-45
L R 21-06-1980 41 31-45
P R 30-06-2009 12 12-17
P R 18-09-1988 33 31-45
L R 30-10-1997 24 18-30
L R 30-11-1973 47 46-59
L R 14-06-1988 33 31-45
Kepesertaan BPJS (tulis 'YA' pada kolom yang
Alamat No. Hp sesuai)
BPJS PBI BPJS Non PBI Non Anggota
JLN MAMBRUK PASAR LA081336743954 TIDAK ADA
JLN MAMBRUK PASAR LA081227391053 YA
ASRAMA RINDAM XVII C 081240353351 YA
KAMPUNG AYAPO 082358467971 TIDAK ADA
PASAR HAMADI JAYAPUR08114446503 TIDAK ADA
JLN SOSIAL BPD GUNUNG 082199322229 YA
JLN. SENTANI BLK. TOKO082199381387 TIDAK ADA
KAMKEY ABEPURA 082220892460 TIDAK ADA
PASAR LAMA SENTANI 085775704717 TIDAK ADA
KOMORBID /
TUNDA TIDAK DOSIS 1
TANGGAL SAKIT Merek TANGGAL
SCREENING II LAINNYA Vaksin*** PEMBERIAN
KEMBALI) )
28/09/2021 (SEBUTKAN) VAKSIN
3 Aug 2021
28/09/2021 5 Aug 2021
28/09/2021 22 Jul 2021
28/09/2021 22 Jul 2021
28/09/2021 28 Jul 2021
28/09/2021 5 Aug 2021
28/09/2021 28 Jul 2021
28/09/2021 5 Aug 2021
28/09/2021 28 Jul 2021
28/09/2021 28 Jul 2021
28/09/2021 28 Jul 2021
28/09/2021 13 Aug 2021
28/09/2021 28 Sep 2021
28/09/2021 28 Sep 2021
28/09/2021 28 Sep 2021
28/09/2021 7 Aug 2021
28/09/2021 7 Aug 2021
28/09/2021 5 Apr 2021
28/09/2021 7 Aug 2021
28/09/2021 5 Apr 2021
28/09/2021 7 Aug 2021
28/09/2021 28 Sep 2021
28/09/2021 28 Sep 2021
28/09/2021 28 Sep 2021
28/09/2021 27 Aug 2021
28/09/2021 31 Aug 2021
28/09/2021 23 Jun 2021
DOSIS 1 TANGGAL DOSIS 2 KETERANGA
NO. BATCH PEMBERIAN NO. BATCH N
24004021 VAKSIN
28/09/2021 24005321 VAKSIN 2
24201721 28/09/2021 24005321 VAKSIN 2
24201321 28/09/2021 24005321 VAKSIN 2
24201321 28/09/2021 24005321 VAKSIN 2
240003921 28/09/2021 24005321 VAKSIN 2
24201721 28/09/2021 24005321 VAKSIN 2
240003921 28/09/2021 24005321 VAKSIN 2
24201721 28/09/2021 24005321 VAKSIN 2
240003921 28/09/2021 24005321 VAKSIN 2
240003921 28/09/2021 24005321 VAKSIN 2
240003921 28/09/2021 24005321 VAKSIN 2
24003521 28/09/2021 24005321 VAKSIN 2
24005321 VAKSIN 1
24005321 VAKSIN 1
24005321 VAKSIN 1
24201821 28/09/2021 24005321 VAKSIN 2
24201821 28/09/2021 24005321 VAKSIN 2
24002221 28/09/2021 24005321 VAKSIN 2
24201821 28/09/2021 24005321 VAKSIN 2
24002221 28/09/2021 24005321 VAKSIN 2
24201821 28/09/2021 24005321 VAKSIN 2
24005321 VAKSIN 1
24005321 VAKSIN 1
24005321 VAKSIN 1
24005321 28/09/2021 24005321 VAKSIN 2
24202321 28/09/2021 24005321 VAKSIN 2
24002021 28/09/2021 24005321 VAKSIN 2
Nama Profesi**
No. Registrasi Penerima Jenis Kelamin (A/B/C/D/E/F/
No vaksin II NIK Vaksin (L / P) G/H)
1 P-1UGWU1NP
Q-000RB93L 7308131801050FAJRIL L R
2 9092808090005ANIS JEMALUT L R
3 P-TQH6IN4Q 7308134107820SUKMA P UMUM
4 P-VESS7AFN 7308136707040NINGSIH P R
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
Kelompok
Umur (18-30 /
Tanggal Lahir Umur 31-45 / 46-59) Alamat No. Hp
18-01-2005 16 12-17 KAMPUNG KOYA KOSO 081388165119
Kepesertaan BPJS (tulis 'YA' pada kolom yang SAKIT TUNDA
sesuai) TANGGAL LAINNYA (TANGGAL
BPJS PBI BPJS Non PBI Non Anggota SCREENING II (SEBUTKAN) KEMBALI)
TIDAK ADA 27/09/2021
YA 27/09/2021
TIDAK
DIBERIKAN ( √ Merek PEMBERIANDOSIS 1 DOSIS 2
PEMBERIAN
) Vaksin*** VAKSIN NO. BATCH VAKSIN NO. BATCH
CoronaVac 27 SEPT 2021 24005321
CoronaVac 30 AGUST 2021 24202221 27 SEPT 2021 24005321
KETERANGA
N
VAKSIN 1
VAKSIN 2
VAKSIN 1
VAKSIN 1
Nama Profesi**
No NIK Penerima (A/B/C/D/E/F/ Tanggal Lahir
vaksin II (L / P)
Vaksin G/H)
1 J-0005EJRD 91710369129600DIANNE SUABEY P R 29-12-1996
2 Q-000U56K19109014610980005HERICE NERE WALLY P R 06-10-1998
3 Q-000VX24G 6175104710002 IRMAWATI ELY P R 11-04-1971
4 Q-000UWQTF 1042611060003 MUKTI PRASETI L R 26-11-2006
5 Q-000SXD3Q 1043108060001 JHOSE REAWAR L R 31-08-2006
6 P-KZGL1KN5 91150102018800PAISEM BILL CLI L R 02-01-1988
7 S-64D680A5 91710242017800A ANACE YEWUN P R 02-01-1978
8 P-JWF3S7WU 1021701780001 KORNELIUS LARRL R 17-01-1978
9 P-NCJ2VWM5 91710347107800NURSIA DG. SIANP R 07-10-1978
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
24 18-30 JL KOKAS KOTA B081240411069 YA
23 JL 18-30
TRANS PAPUA KAMPUNG, 085232249352
ABEPURA YA
50 46-59 HAMADI RAWA II082142958345
14 JL. TIMIKA KOYA 82198595324
15 JL. TIMIKA KOYA 82334059933
33 31-45 ARGAPURA 81344291762
43 31-45 ARDIPURA III JA 81344100914 YA
43 31-45 ARDIPURA III JA 81343448409 YA
43 31-45 JLN WAYNAN AB 085243336656 YA
TUNDA TIDAK
KEMBALI) )
08 OKT 2021 (SEBUTKAN) CoronaVac
08 OKT 2021 CoronaVac
TIDAK ADA 08 OKT 2021 CoronaVac
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
08 OKT 2021
VAKSIN
08 OKT 2021 24005321 VAKSIN VAKSIN I
08 OKT 2021 24005321 VAKSIN I
08 OKT 2021 24005321 VAKSIN I
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
08 OKT 2021 24005321
Nama Profesi**
1 P-H24YE50A 9171021902030FABRYAN AHM L R
2 P-HDSVJH2B 1032703010003PUJA PAMBUDI L R
3 P-HMWFKO2F 9171022811990RONALDO COS L R
4 Q-000VDGDD 3275056208790ROSMEGAWATI M P R
5 Q-000VDGD9 71032101790002 JACOB LUCAS S L R
6 P-IVO8PMCR 5314021203880001
DUKMAD ZAKARIAS LEDOH L R
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
Umur (18-30 /
Tanggal Lahir Umur 31-45 / 46-59) Alamat No. Hp BPJS PBI
19-02-2003 18 BELAKANG
18-30
KAMP ANGKATAN LAUT081344959560
RT 005 RW 010
27-03-2001 20 18-30 FURIA KOTARAJA 081247074343
28-11-1999 22 JL18-30
PEMANCAR TVRI KEL. ARDIPURA
081247877474
I
22-08-1979 42 31-45 081248476517
PERUM PEMDA II CIGOMBONG
21-01-1979 42 31-45 081344463998
PERUM PEMDA II CIGOMBONG
12-03-1988 33 31-45 KOYA TIMUR 082297985072
esertaan BPJS (tulis 'YA' pada kolom yang SAKIT TUNDA TIDAK
sesuai) TANGGAL LAINNYA (TANGGAL DIBERIKAN ( √
BPJS Non PBI Non Anggota SCREENING II (SEBUTKAN) KEMBALI) )
YA 07 OKT 2021
YA 07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
07 OKT 2021
Merek PEMBERIANDOSIS 1 DOSIS 2
PEMBERIAN KETERANGA
Vaksin*** VAKSIN NO. BATCH VAKSIN NO. BATCH N
07 OKT 2021 24005321 VAKSIN I
07 OKT 2021 24005321 VAKSIN I
07 OKT 2021 24005321 VAKSIN I
07 OKT 2021 24005321 VAKSIN I
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
07 OKT 2021 07 OKT 2021
Nama Profesi**
No NIK Penerima (A/B/C/D/E/F/
vaksin II (L / P)
Vaksin G/H)
1 P-E1DAS4P2 74010152098700SURIANI P R
2 P-E5H2DRIM 91710350040600CLAUDEA ANTON P R
3 P-EJM94XWJ 91710128129000ROBY SEILATU L R
4 P-EQVWH0VM 91710109119000BRAMANTHIO S L R
5 Q-000RX2SB 91710122090500RAFLI ARFANSA L R
6 Q-0007XOOB 71012504810004 JUNAIDIN L R
7 P-1F8SOOVP 91710121039200GILBERTH M ARS L R
8 Q-000RQ05V 71016203710001 IMELDA SUN P R
9 Q-000PTS3J 91710218010600MUH. SULTAN AR L R
10 S-6B142787 91710315128300MAHFUD L R
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
31-45 / 46-59) BPJS PBI
12-09-1987 34 31-45 JL. PASAR YOUTEFA082239607033 YA
10-04-2006 15 12-17 JL. BIAK NO 5 ABEPURA 081212373343
28-12-1990 31 31-45 JL SETIAPURA II PALDAM 081342086850
09-11-1990 30 18-30JL SAMRATULANGI DOK V085244636960
ATAS
22-09-2005 16 12-17 KLOOFKAMP 082199076878
25-04-1981 40 31-45 APO BUKIT BARISAN081344557626 YA
21-03-1993 28 18-30JL. TRIKORA NO 76 DOK V082199351714
ATAS
22-03-1971 50 46-59
BHAYANGKARA JAYAPURA UTARA08124884608 YA
18-01-2006 15 12-17
JL KALIBOBO NO M40 PADANG 082196054810
BULAN YA
15-12-1983 38 31-45 KOYA BARAT 082235685833 YA
TUNDA TIDAK
KEMBALI) )
YA 06 OKT 2021
YA 06 OKT 2021
06 OKT 2021
YA 06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06 OKT 2021
06VAKSIN
OKT 2021 24005321 VAKSIN VAKSIN I
06 OKT 2021 24005321 VAKSIN I
06 OKT 2021 24005321 VAKSIN I
06 OKT 2021 24005321 VAKSIN I
31 Aug 2021 24005321 06 OKT 2021 24005321 VAKSIN SELESAI
25 JUNI 2021 24002521 06 OKT 2021 24005321 VAKSIN SELESAI
06 OKT 2021 24005321 VAKSIN I
06 OKT 2021 24005321 VAKSIN I
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
06 OKT 2021 24005321
Nama Profesi**
vaksin II (L / P)
Vaksin G/H)
1 K-0000QWKD 3578061810910001ARIF WIBOWO L R 18-10-1991
2 Q-000OP76J 3578271607840002 TONI ROMELI L R 16-07-1984
3 Q-000S3UZR 3509081506740010SOFYAN SAURY L R 15-06-1974
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
29 18-30 SAWAHAN SURABAYA 082231192944
37 SIMO
31-45
MAGERSARI 19 SIDOMULYO
081333910154
SURABAYA
47 46-59 KASIYAN TIMUR PUGER085784226731
TUNDA TIDAK
KEMBALI) )
TIDAK ADA 04 OKT 2021 (SEBUTKAN) CoronaVac
25VAKSIN
AGT 2021 24202221 04VAKSIN
OKT 2021 24005321 VAKSIN SELESAI
Nama Profesi**
NO NIK Penerima (A/B/C/D/E/F/ Tanggal Lahir
vaksin II (L / P)
Vaksin G/H)
1 Q-000UJ8H8 9171011010740009EDY MANGEMBA L R 10-10-1974
2 Q-000UHJ5I 9171016202960001
LINA FLORA SISKA SEMBAI P R 22-02-1996
3 P-05XBNY4V 9171032104970002
PENAMOTITOBI EMANUEL KUAYOL R 21-04-1997
4 Q-000TZR9X 9171012004090002
MUH. RAFA ARRAHMAN L R 20-04-2009
5 Q-000TZ2FD 9171010904810005RANUL WAHYUDI L R 09-04-1981
6 Q-000TYOMY 9171011508770003 AGUSRAM L R 15-08-1977
7 Q-000UEA7A 9171011702070001
MUH. NASKHATUL MAHRUM S. L R 17-02-2007
8 Q-000UPVPP 9171025109050007
QANITAH SYAFIQAH SYAMSUNARP R 11-09-2005
9 P-3EGXHW61 9105012906980004
THEIS ISMAEL FONATABA L R 29-06-1998
10 MANUAL 9171036601010002 GLORIYA HANASBEY P R 26-01-2001
11 Z-000ABAP1 9171020508650005RAHMAD AHMAD L R 05-08-1965
12 Q-000UEA7C 9171017012070006
NAZWA VAEZ JAEVANI S. P R 10-12-2007
13 Q-000TYJAR 91710205026700MARWANSYAH L R 05-02-1967
14 Q-000UEMR6 91710224037000 SYARIF KAMAL L R 24-03-1970
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
47 46-59 JL SETIAPURA PALDAM08124899957 YA
25 18-30 JL PASAR INPRES DOK 082238994042
IX YA
24 18-30BTN PUSKOPAD ATAS KAMKEY
0811354086891
12 12-17 JL OLAHRAGA 081215490773
40 31-45
JL. PERINTIS KLOOFKAMP, GURABESI
082199901184 YA
44 31-45 JL OLAHRAGA 081215490773
14 12-17ASPOL BASE G, TANJUNG08114886346
RIA YA
15 12-17 KOYA BARAT 081284201204
23 18-30 PERUM ORGANDA 081344369034 YA
20 18-30
JL PANTAI ENGGROS TANAH082398864926
HITAM
56 46-59 BATU PUTIH JAYAPURA 081344454255 YA
13 12-17ASPOL BASE G, TANJUNG08114886346
RIA YA
54 46-59
JL NANGKA ASRAMA KODAM 082122962821
LAMA YA
51 46-59 ASRAMA KODAM LAMA81344726390 YA
TUNDA TIDAK
KEMBALI) )
5 OKT 2021 (SEBUTKAN) CORONAVAC
5 OKT 2021 CORONAVAC
TIDAK ADA 5 OKT 2021 CORONAVAC
VAKSIN
07-09-2021 24005321 5VAKSIN
OKT 2021 24005321 VAKSIN SELESAI
5 OKT 2021 24005321 VAKSIN 1
5 OKT 2021 24005321 VAKSIN I
5 OKT 2021 24005321 VAKSIN I
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021 5 OKT 2021
5 OKT 2021
5 OKT 2021
5 OKT 2021
Nama Profesi**
1 Q-000RQG44 06010108890004MANUEL KAPITAN L R
2 P-C28LIUIY 2074308910001TRIA SONDAKH P R
3 MANUAL 9171036803880DIAN ASTRIAN P R
4 MANUAL 7105176111000FANI MOU P R
5 P-GF12S4MJ 5171606850001 KI FIANU LEPAR L R
6 MANUAL FRANDO OVAN L R
7 MANUAL AMOS ALFRITS L R
8 P-GXDAVOMT 71021219068800MELKRI JOAN TE L R
9 P-HE2C5CAE 71050350018200NITA TIWA P R
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
Umur (18-30 /
Tanggal Lahir Umur 31-45 / 46-59) Alamat No. Hp BPJS PBI
01-08-1989 32 31-45 PERUM GRIYA081344680023
03-08-1991 30 18-30 CIGOMBONG PE081248137222 YA
28-03-1988 33 31-45 CIGOMBONG PE08114842828 YA
21-11-2000 20 18-30 CIGOMBONG PE081343053889
16-06-1985 36 31-45 CIGOMBONG PE082292659135
23-10-2006 14 12-17 CIGOMBONG PE082246245274
25-04-1994 27 18-30 CIGOMBONG PE08124887262
19-06-1988 33 31-45 CIGOMBONG PE082198323383
10-01-1982 39 31-45 CIGOMBONG PEMD
082198375820
esertaan BPJS (tulis 'YA' pada kolom yang SAKIT TUNDA TIDAK
sesuai) TANGGAL LAINNYA (TANGGAL DIBERIKAN ( √
BPJS Non PBI Non Anggota SCREENING II (SEBUTKAN) KEMBALI) )
3 OKT 2021
3 OKT 2021
YA 3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
3 OKT 2021
Merek PEMBERIANDOSIS 1 DOSIS 2
PEMBERIAN KETERANGA
Vaksin*** VAKSIN NO. BATCH VAKSIN NO. BATCH N
CORONAVAC 31 Aug 2021 24005321 3 OKT 2021 24005321 VAKSIN SELESAI
CORONAVAC 3 OKT 2021 24005321 VAKSIN I
CORONAVAC 3 OKT 2021 24005321 3 OKT 2021
SIN SELESAI
No No. Registrasi vaksin II NIK Nama Penerima Vaksin
1 P-54X6R91R 9204062307000001 MEHEMIA SESA

2 P-562N3YVO 9105025011000002 AKSAMINA HANA SESA
3 Z-0007WN07 9271063006890003 RIBUT SUBAGIYO
4 P-9NUWHAFD 9103015512940001 GRACE HELEN MONIM
5 Q-000SAYUU 9103036312910003 HENDRIKA NATALIA ABISAY
6 P-B70BL7QI 9110094212850001 HENDERIKA YOBI
7 P-IZPVU33H 9171015208040001 SALSA BELITA FAYATI SAROGE
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
Profesi** Kelompok
Jenis Kelamin
(A/B/C/D/E/F/ Tanggal Lahir Umur Umur (18-30 /
(L / P)
G/H) 31-45 / 46-59)
P R 23-07-2002 19 18-30
P R 10-11-2000 21 18-30
L J 30-06-1989 32 31-45
P R 15-12-1994 26 18-30
P R 23-12-1991 29 31-45
P R 02-12-1985 35 31-45
P R 12-08-2004 17 18-30
Kepesertaan BPJS (tulis 'YA' pada kolom y
Alamat No. Hp
BPJS PBI
PADANG BULAN SOSIAL YA
JLN.PADANG BULAN SOSIAL 082133289341
JLN. YOKAWAENA 081248906958 YA
BTN JOKO INDAH FURIA YAHIM, SENTANI 85217419408 YA
JL. POROS ARSO X, YATURAHARA 81240089890
HOLTEKAMP 081247479634 YA
JL.ANGKASAPURA 81240504864 YA
TUNDA TIDAK
KEMBALI) )
(SEBUTKAN)
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
29/09/2021
Merek TANGGAL DOSIS 1 TANGGALDOSIS 2 KETERANGA
CORONAVAC VAKSIN
29-09-2021 24005321 VAKSIN VAKSIN 1
CORONAVAC 29/09/2021 24005321 VAKSIN 1
CORONAVAC 24/07/2021 24201421 29/09/2021 24005321 VAKSIN 2
CORONAVAC 01/09/ 2021 24202221 29-09-2021 24005321 VAKSIN 2
CORONAVAC 29-09-2021 24005321 VAKSIN 1
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
CORONAVAC
Nama Profesi**
vaksin II (L / P)
Vaksin G/H)
1 P-HL3DI5X7 91710257057100FENDI WONA P R 17-05-1971
2 P-HPY2TVDD 91710260110300LOISA HERMELINP R 20-11-2003
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
50 Pemda 3 Melati 82238433440 Ya
17 Pemda 3 Melati 85212164562 ya
TUNDA TIDAK
KEMBALI) )
26 Sep 2021 (SEBUTKAN)
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
26 Sep 2021
TANGGAL DOSIS 1 TANGGALDOSIS 2 KETERANGA
VAKSIN
26 Sep 2021 24005321 VAKSIN Vaksin I
26 Sep 2021 24005321 Vaksin I
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
26 Sep 2021 24005321
FORMAT PEN
Jenis Profesi**
Nama Penerima Pekerjaan*( Tanggal
No No. Registrasi NIK Kelamin (L (A/B/C/D/E/F/G/
Vaksin A/B/C/D/E) 10 Lahir
/ P) H)
1 9171…........ LINDA P A E OKTOBER
10
2 9171…........ LINDA P A E 1988
OKTOBER
10
3 9171…........ LINDA P A E 1988
OKTOBER
10
4 9171…........ LINDA P A E 1988
OKTOBER
10
5 9171…........ LINDA P A E 1988
OKTOBER
10
6 9171…........ LINDA P A E 1988
OKTOBER
10
7 9171…........ LINDA P A E 1988
OKTOBER
8 1988
9
10
KETERANGAN
*KRITERIA
A = LANSIA G = POLRI
B = PELAYANAN PUBLIK H = TNI
C = ATLIT J
I ==PARIWISATA
PEGAWAI PEMERINTAH (ASN
D = BUMD DAN NON ASN
E = BUMN K = PEJABAT NEGARA
F = KEAMANAN L = PENDIDIK
GELOMBA
NG
PERTAMA
TELAH DI KELOMPOK UMUR KEPESRTAAN BPJS
BERIKAN, 18-30 0 BPJS Non
PBI 0
VAKSIN 31-45 0 Non
PBI 0
GELOMBA 46-59 0 Anggota 0
NG KEDUA 60-90 0 Total 0
AKAN DI Total 0
BERIKAN PEMBERIAN DOSIS
SETALAH Dosis 1 327
14 HARI Dosis 2 0
KEDEPAN. Total 0
FORMAT PENCATATAN PELAKSANAAN IMUNISASI COVID-19
TINGKAT FASYANKES
Kelompok Kepesertaan BPJS (tulis KOMORBID /

'YA' pada kolom yang TANGGAL
Umur (18-30 BPJS SAKIT
Umur Alamat No. Hp BPJS sesuai) Non SCREENIN
/ 31-45 / 46- Non 01 G LAINNYA
59) PBI Anggota (SEBUTKAN)
32 31-45 GURABESI 0813***** PBI
YA FEBRUARI
01 HAMIL
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI
01 BATUK PILEK
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI
01 PENYINTAS
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI
01 HIPERTENSI
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI
01 TENSI TINGGI
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI
01 -
32 31-45 GURABESI 0813***** YA 2021
FEBRUARI -
2021
A =
**MEREK VA
N
M == TRANSPORTASI
TOKOH AGAMA B =
BIOFARMA
PUBLIK C=
SINOVAC
P
O == WARTAWAN DAN
WAKIL RAKYAT LAINNYA
PEKERJA MEDIA
Q = PEDAGANG PASAR
R = MASYARAKAT UMUM
KRITERIA
B = PELAYANAN
A LANSIA 0
PUBLIK 0
C = ATLIT 0
D = BUMD 0
E = BUMN 0
F = KEAMANAN 0
G = POLRI 0
J
H == PEGAWAI
TNI 0
PEMERINTAH
I = PARIWISATA (ASN 0
K
DAN= PEJABAT
NON ASN 0
NEGARA 0
L = PENDIDIK 0
N
M == TRANSPORTASI
TOKOH AGAMA 0
PUBLIK 0
P
O == WARTAWAN
WAKIL RAKYATDAN 0
Q = PEDAGANG
PEKERJA MEDIA 0
R =
PASARMASYARAKAT 0
UMUM 0
Total 0
TUNDA TIDAK
Merek DOSIS 1
TANGGAL DOSIS 2
TANGGAL KETERAN
(TANGGAL DIBERIKAN NO. NO.
Vaksin*** PEMBERIAN PEMBERIAN GAN
KEMBALI) (√) BATCH BATCH
05 - √ - VAKSIN
- - VAKSIN
- -
FEBRUARI - - - - - -
2021 - √ - - - - -
05 - √ - - - - -
FEBRUARI - - - - - -
2021 - 01 FEBRUARI 20000
- A - -
2021
01 FEBRUARI …. 14 FEBRUARI 20000 VAKSIN
20000
- - A
2021 …. 2021 …. SELESAI
Nama Profesi**
No NIK Penerima (A/B/C/D/E/F/
vaksin II (L / P)
Vaksin G/H)
1 Z-00092CMV 5022212940005 HARDIAN SYAPU L R
2 Q-000LHHV93312092212820002 DWI SUWARNO L R
3 P-B6UIOWVV 9171020504900006 ANTONIUS KEFI L R
4 Q-000SNXJF9109091905830001
YANSEN OTHNIEL KOIREWOA L R
5 P-TP6BP2ZI 91710113010500THOMAS OKTOVIA L R
6 P-VMG616AS 9103017108040003
ANGGELLYCA CRISTIN IRJA ADADIKAM P R
7 P-WSBCDVLG 32021650059700SITI PATIMAH P H
8 Q-000SGID1 03014312030003A PUTRI PANGKE P R
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
31-45 / 46-59) BPJS PBI
22-12-1994 27 18-30 JL. BELIMBING K 085893181673
05-04-1990 31 31-45JLN PERUMNAS III WAENA082110089283
13-01-2005 16 12-17 JALAN SELAT KA 081262190653 YA
31-08-2004 17 12-17
BPN JOKO INDAH SENTANI 082199375253 YA
10-05-1997 24 18-30 JL PASIR SENTANI 82213473288 YA
03-12-2003 17 12-17 PERUM BINTANG085256174417 YA
TUNDA TIDAK
KEMBALI) )
30/09/2021 (SEBUTKAN)
YA 30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
30/09/2021
CORONAVAC 12VAKSIN
Aug 2021 24201021 VAKSIN
30/09/2021 24005321 VAKSIN 2
CORONAVAC 6 Aug 2021 24004921 30/09/2021 24005321 VAKSIN 2
CORONAVAC 2 SEPT 2021 24004521 30/09/2021 24005321 VAKSIN 2
CORONAVAC 2 SEPT 2021 24201921 30/09/2021 24005321 VAKSIN 2
CORONAVAC 30 SEPT 2021 24005321 VAKSIN 1
CORONAVAC 2 Sep 2021 24005321 30/09/2021 24005321 VAKSIN 2
Jenis
No. Registrasi Kelam
No NIK Nama Penerima Vaksin
vaksin II in (L /
1 P-1EIJ41G0 5310131909960003 LEONARDUS JAMBAR P)
L
2 P-1IEWYL75 5310051411920007 HILARIUS ANTONIUS MANDANG L
3 Q-000U3EXM 3518120509900003 DAVIT HINDARDIK L
4 Q-000U3J1K 3518122804000001 NANANG AJI SANTOSO L
5 P-1QL8MULI 5206136306950001 SARIANI P
6 P-1S8L07ZT 9171025009890008 SUMIATI P
7 P-1UEQF926 7310096404900003 YULIANTI P
8 P-1VIJX6IG 9171024701680002 SITI SYARAH P
9 P-1XIMWPSY 9171031307830007 M. REMON SAHARA L
10 Q-000UWIEK 9111030709910005 DOLFINUS KRISTIAN WAMBALIAU L
11 Q-000XGXQU 9171012006830007 FIRDAUS L
12 P-23PR29DL 9204011403990002 KORNELES KONDORORIK L
13 Q-000XFFB9 7309082401840001 ACIL SATRIA WANDI L
14 P-2A7IKFYO 3509120107650177 MUJIATIN L
15 Q-000WXMD3 9171020409080005 KHAIDIR RAMADHAN L
16 Q-000WR7V0 9171025805730003 ROSYIDAH P
17 Q-000XH0ZP 3504180605890002 CARITO BAKTI L
18 Q-000XFN10 7315071212690004 DULLA L
19 Q-000XGXQL 7315071010900008 MUHAMMAD DEDI T L
20 Q-000XGI79 8103016506760002 FLORENTINA LERMATAN P
21 Q-000XH09F 7171026605880001 IRIANY NENGKEY P
22 Q-000TA7RI 3515104904710003 NUR ROHMANINGSIH P
23 P-3I37Z09T 9171010703080003 MARCHIO SEVEN LEO L
24 Q-000XUBHX 9171034709080001 SAKIRA RAMADANI P
25 Q-000XFD8G 8101146408930003 CHERLY MATITA P
26 Q-000WR7U5 9171021112760001 FRENGKY SENGE L
27 P-4JCOEDN4 9171015612880010. DIAN DEWI PUSPITA SARI ALWAN P
28 P-4PQY2PHW 9171025807860001 ERNI ESTHER YULIANTI TODING P
29 Q-000WWS2M 9171052812050002 RISTOVEL ARIEL YALENGE MAGAYANG L
30 P-5I34QOWK 9171024505760001 MERRY PASUBAH P
31 Q-000WU0MO 9106036312920001 DESSY NATALIA RONSUMBRE P
32 Q-000WBR99 8106022212940001 KELVIN NURUWE L
33 P-87RIMHQF 9171030612870002 ARIP WINANTO L
34 Q-000XQCX5 9271032108020007 HERMON AHOLIAB RONSUMBRE L
35 Q-000WOTG5 9171024410780001 NUR KHASANAH P
36 S-975FBEC9 9171011507870008 SULAIMAN L
37 Q-000TB8GF 9171024504070002 DIVA PRABANINGRUM L
38 Q-000XFD94 9171051405900002 AMIRULLA L
39 Q-000WZPU0 9103136508970001 TANIA KUSUMA ANDINI P
40 MANUAL 9171025906080002 PUTRI YOHANA CAECARIA P
41 Q-000PUFE1 9171024705950001 NURFITRIANA SYAM P
42 MANUAL 9171026809820005 SILVIA WAIMURI P
43 Q-000WTPOV 9171022508690004 HENDRIK DA COSTA L
44 Q-000W6IMN 9109011408010007 ELESIUS RAHAYAAN L
45 P-BXGWGSFP 3313081710000002 YOLA ADE PRASETYA L
46 Q-000XFN0L 9171020508880008 ARTHUR ELIESER PAPARA L
47 Q-000WCTFC 9171024803040006 KLENESIA DINA IRMA INDRIANI SOLO P
48 Q-000WCTF3 9171025205820006 MARIA MARTINCE P
49 Q-000TCKDW 3271045601830019 HENI YULIANTI P
50 Q-000K8Q7L 9171032312830003 ROY L.Y.LAIYAN S.HUT L
51 Q-000X04HX 9171026401090002 ZAKIYAH NISWA NUR JANAH P
52 Q-000X3O9D 9112011809950001 RAY CHRISTOPHER WINDESI L
53 Q-000VL9WY 9171034509970002 ROOSDIANA VERREN IRIANAWATI P
54 Q-0001VIYO 9171050401980001 RIZAL PRANATA MANURUNG L
55 Q-000WL9R0 9171010906690001 MUHAMAD SAKWAN L
56 Q-000XKMDX 7172026309730002 ADELINE TANOD P
57 Q-000LBSHV 7174041910000001 OKTAVIANTI R. SUMARTOWALUYO
GLORIA VANEZA RUMBIAK P
58 Q-000WZAY8 9171024309090001 P
59 Q-000RBFFB 9171036612930005 CIWAN BIN NUSE L
60 Q-000VZ8V7 9110056807040001 FARIDATUL JANNAH P
61 Q-000UAEVG 9110056911990001 AINUN ROFIQOH P
62 Q-000XHN2W 9171024912990005 ERCHY .A .K. TALAN P
63 K-000192VE 9111055208980001 USWATUN KHASANAH P
64 Q-000RER5D 9171024103850011 JUMINA P
65 P-FX9ANCJJ 9103191403020001 ARNOLDI WANGGUWAY L
66 Z-000AG1NV 9171020208740009 PURWADI L
67 Z-000ARJRH 9171011110710001 MUHAMMAD RASID RUMBARU L
68 P-GRVDOEEK 9171056601900001 SARAH CLAUDIA HELENA TARA P
69 P-H313NSKU 9171034204010001 ALFINA IBRAHIM P
70 P-HBMVLA0G 9171054509010001 MEIKE ANDRIANI DWI IRIANTI P
71 Q-000WEEJR 5318051606000002 MARSELINUS DODE BILI L
72 P-I4DZFSHP 9171026305080003 CINDY PUTRI MELANI P
73 P-IDY9F2UX 9111052909990001 MOH AMIRUL MUKLIS L
74 Q-000WDHQY 9171016104740003 ROSMIATI P
75 Q-000WT940 9171014901710001 ARCE MAHAKENA P
76 Q-000WTB7W 9171010108750004 AGUSTINUS LAA L
77 Q-000WU5SR
Z-000AMCNS 8101142303930001 YOSEPH MALA L
78 9171013103560001 TUKINO L
79 P-K47W4RS0
Z-000A2IMM 3525104706760005 LA ODE JUHRIMSUSMIATI
APRIANTO SYAFAAT P
80 9171021904960002 L
81 P-KJT8FX8F 9202122402890002 ORTIZAN MANBEFOR KREY L
82 P-KICRETSN 9171036705990004 SELVA ARNAS CHANDRA P
83 P-KRGPG34C 9171026810060005 MILDA JAYA P
84 P-KT0MG8OO 7371144310970004 RYAN REZKI PRATAMA L
Z-000A3WJQ MAYA FIRDAYANI
85 9171025203860005 P
86 Q-00084XXD 7309054703000001 NAHIRA P
87 P-LBYXQYFV 9171026203920013 NURLAILA P
88 P-LHK40EH8 9171021801870004 IRENG FAUZI FUAD L
89 P-LJQ01TCI 9171026108880001 LENORA PARAMITHA IRIWADAN P
90 P-LPMJYACX
Q-000WYNES 9171022505090003 FAHREZY
MUH RAFLI ALAMSYAH L
91 Q-000WIKJP 9171022404090002 L
92 9171022303740001 SOLIKIN L
93 Q-000WE2LU 9171025711060002 NOVIA CITRAWATI PUTRI P
94 P-LZOYGTRA 9171020709680002 M. NUR DG SITUJU L
95 Q-000O8NSI 9171025705000003 SRI WAHYUNINGSIH P
96 P-M5X2E6JC 9171014202790007 WA MAENA P
97 P-M4SPG60H 9115054906060002 SYOLINE EMA REFASI P
98 P-M88Y1Y7F 9171021703030003 STENLY HENDRIK KANDENAFA L
99 Q-000XIHJQ 9171024802980002 CHRISTELIN HERONIA MAURY P
100 P-MBF54YTV 8171030710920002 CHRIST GLORY SOUISA L
101 W-0000C3H5 9171056705560001 FLORA YVONNE DE QUELYOE P
102 Q-000SGAXV
Q-000X5ELC 9171021910960001 GILBERT NIC ISAY
AGUSTINA RAUBABA
CAOLINA MANIAGASI L
103 9110015005870004 P
104 Q-000X58E3 9171052106800002 PERRY MARTHEN WALLY L
105 P-MJTVDDQN 9171020505940002 SARISA AIBURA CH WANDOSA L
106 Q-000T5LE6 9111051906940001 YOHAN YUSAK NASADIT L
107 Q-000WX55E
P-WPGNJZWQ 9171022503080002 HAMMAD RAIHAN PASYA ALFIANSYAH
SRI ASTUTI L
108 9171024208850002 P
109 Q-000MJ3CI 1204212910030001 BEBALAZI HAREFA L
110 Q-000WP44D
Q-000X2Q6M 7317181011050003 YONAS LUTHER WAKARMAMU ALDI L
111 9171031110860007 L
112 Q-000WT34S
Q-000UMWLD 9171014103680005 MARTHA PAULA
SURIYA SEMBAI
PARANANDO ZEGA P
113 1204211804020002 L
114 P-N1SLPXPT 9171015012750004 WA BIA P
115 P-N6WBATSJ 9171010410910004 ANDHIKA SUDARMAWAN L
116 Q-000XFD5Z 9171054409690002 SRI WIDIASTUTI P
117 Q-000XFD5X
Q-000WM0X2 9171056403990002 RIZKY ARDHARANA SITORESMI L
118 9171017112730005 ANGGI ANGGRAINI P
119 Q-001BLF5K
Z-000ARZ4R 9103015508650002 SAKMAH
NOVITA ARLINDA P
120 9171016311730004 P
121 Q-000XFD5Y
Z-000AR0V6 9171056910020002 GHINAA FADHILLA SYA'BANY
SITI BADRIAH P
122 Q-000XMTF8 9171054608700002 SETIYAWAN P
123 9171011203680006 L
124 Q-000WOQ6W 9171050501980002 WAHYU SHAQTI RAMADHANY L
125 Q-001BJHZM 9171055312830003 SUHARTI P
126
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Profesi** Kelompok
(A/B/C/D/E Tanggal Lahir Umur Umur (18-30 / Alamat
/F/G/H) 31-45 / 46-59)
R 14-09-1996 25 18-30 ARGAPURA JAYAPURA
R 14-11-1992 29 18-30 ARGAPURA JAYAPURA
R 05-09-1990 31 31-45 TANAH HITAM ABEPURA
R 28-04-2000 21 18-30 TANAH HITAM ABEPURA
R 09-12-1995 26 18-30 JL EMPANG BUCEN 2 ENTROP
R 10-09-1989 32 31-45 ENTROP JAYAPURA
R 24-04-1990 31 31-45 KOPM. YAYASAN 45 BUCEND II ENTROP
R 13-07-1983 38 31-45 SKYLINE RESIDENCE KOTARAJA
R 07-09-1991 30 18-30 WAENA JAYAPURA
R 20-06-1983 38 31-45 JAYAPURA
R 14-03-1999 22 18-30 FURIA KOTARAJA JLN JERUK NIPIS
R 24-01-1984 35 31-45 JAYAPURA
R 01-07-1965 56 46-59 KOMPLEKS MUSI PERMAI GANG KEMIRI
R 18-05-1973 48 46-59 KOMP. KARANTINA HEWAN ENTROP
R 20-11-1980 41 31-45 APO KALI
R 10-10-1990 31 31-45 SAMBANG PARU
R 25-06-1976 45 31-45 PLAMBOYAN
R 26-05-1988 33 31-45 PERUMNAS I WAENA
R 09-04-1971 50 46-59 JL DIPONEGORO ASPOL KLOOFKAMP
R 07-03-2008 13 12-17 JL IRIAN NO 33
R 07-09-2008 13 12-17 JAYAPURA
R 24-08-1993 28 18-30 JAYAPURA
R 11-12-1976 45 31-45 BUCEN II ARDIPURA
R 18-07-1986 35 31-45 JL RAYA ABEPURA ENTROP
R 27-12-2005 16 12-17 JAYAPURA
R 05-05-1976 45 31-45 JL SUMBER KAYU I, ENTROP
R 23-12-1992 28 18-30 JL BINTAN NO 22 DOK V ATAS
R 22-12-1994 27 18-30 ENTROP BELAKANG POMPA BENSIN
R 06-12-1987 34 31-45 KALI ACAI ABEPURA
R 31-08-2002 19 18-30 ASRAMA HAJI
R 04-10-1978 43 31-45 BUCEN II ARDIPURA
R 15-07-1987 34 31-45 PASAR BARU
R 05-04-2007 14 12-17 JAYAPURA
R 14-05-1990 31 31-45 JL BUPER WAENA
R 25-08-1997 24 18-30 HAMADI JAYAPURA
REMAJA 19-06-2008 13 12-17 ENTROP JAYAPURA SELATAN
R 07-05-1995 26 18-30 JAYA ASRI
R 28-09-1982 39 31-45 JAYAPURA
R 14-06-2001 20 18-30 KAMKEY
R 17-10-2000 21 18-30 JL PEMBANGUNAN NO 12
R 05-08-1988 33 31-45 JAYAPURA
R 08-03-2004 17 12-17 JAYAPURA
R 12-05-1982 39 31-45 ENTROP JAYAPURA SELATAN
R 16-01-1983 38 31-45 ENTROP JAYAPURA SELATAN
R 23-12-1983 37 31-45 JL SENTANI NO 9 ABEPURA
REMAJA 24-01-2009 12 12-17 BUCEN II ARDIPURA
R 18-09-1995 26 18-30 SENTANI
R 05-09-1997 24 18-30 KOTARAJA
R 04-01-1998 23 18-30 JAYAPURA
R 09-06-1969 52 46-59 BUCEND II ADHIPURA
R 23-09-1973 48 46-60 JAYAPURA
R 19-10-2000 21 18-30 JAYAPURA
R 03-09-2009 13 12-17 JAYAPURA
R 28 18-30 KOYA KOSO
REMAJA 28-07-2004 17 12-17 ABEPURA JAYAPURA
R 29-11-1999 22 18-30 ABEPURA JAYAPURA
R 09-12-1999 21 18-30 JL DUKUH TASANGKAPURA
R 12-08-1998 23 18-30 JLR.II/B NO 473 ARSO IV
R 01-03-1985 36 31-45 JL BERINGIN V ENTROP
R 14-03-2002 19 18-30 ABEPURA JAYAPURA
R 11-10-1971 50 46-59 DOK V
R 26-01-1990 31 31-45 PERUMNAS IV BLOK C NO 99
R 02-04-2001 20 18-30 JL PASAR LAMA ABEPURA
R 08-05-2001 20 18-30 FURIA INDAH KOTARAJA
R 16-06-2000 21 18-30 BUCEND II ADHIPURA
REMAJA 23-05-2008 19 18-30 HAMADI JAYAPURA
R 29-09-1999 KOTARAJA, JAYAPURA
R 21-04-1974 JAYAPURA
R 09-01-1971 APO GUNUNG
R 01-08-1975 APO GUNUNG
R 23-03-1993 28 31-45 ENTROP
R 31-03-1956 JL SUMATERA GANG MANDIRI DOK V BAWAH
R 07-06-1976
19-04-1996 SAMPING HOTEL SAHID ENTROP
R HAMADI, JAYAPURA SELATAN
R 24-02-1989 JL JAYA ASRI BLOK AD 12
R 27-05-1999 22 18-30 JL. NURI YOUTEFA
R HAMADI RAWA II, JAYAPURA SELATAN
R 03-10-1997 JL. PEMUDA KLOOFKAMP
R 12-03-1986 TANAH HITAM ABEPURA
R 01-03-2000 21 18-30 HAMADI ENTROP
R 22-03-1992 ENTROP JAYAPURA
R 18-01-1987 34 31-45 JL. PEMANCAR TVRI NO. 35 POLIMAK I
R POLIMAK I
R 25-05-2009
24-04-2009 12 12-17 POLIMAK LABA LABA
R 23-03-1974 POLIMAK LABA LABA
R PASAR ENTROP
R 17-11-2006 16 12-17 PASAR ENTROP
R 07-09-1968 HAMADI RAWA I
R 17-05-2000 21 18-30 PASAR ENTROP
R 02-02-1979 LINGKARAN ABE
R 17-03-2003 18 18-30 HAMADI GUNUNG
R 08-02-1998 23 18-30 HAMADI LAPANGAN
R 07-10-1992 WAENA JAYAPURA
LANSIA 27-05-1956 65 60> JL BONSAI III BUPER WAENA
R 19-10-1996 25 18-30 JL. PERUM DOSEN UNCEN BUPER
R 10-05-1987 PERUMNAS IV
R 21-06-1980 41 31-45 PERUMNAS IV
R 05-05-1994 POLIMAK I
R 19-06-1994 27 18-30 PERUMNAS I
REMAJA 25-03-2008 13 12-17 BELAKANG SMA IV ENTROP
R 02-08-1985 BELAKANG SMA IV ENTROP
R 29-10-2003 19 18-30 JL. BERINGIN BELAKANG SMA 4
R 10-11-2005 16 12-17 HAMADI
R 11-10-1986 PERUMAHAN DOSEN UNCEN
R 01-03-1968
18-04-2002 53 46-54 JL. SEMERU DOK V ATAS
R KELAPA II ENTROP
R 10-12-1975 47 46-54 APO BUKIT BARISAN
R 04-10-1991 30 18-30 JL NIMBORAN NO 76, IMBI
R 04-09-1969 52 46-54 PADANG BULAN
R 24-03-1999
31-12-1973 22 18-30 EXPO WAENA
R 47 46-59 JAYAPURA
R 15-08-1965
23-11-1973 56 46-59 KOMP PASAR BARU SENTANI
R 47 46-59 KOMP AJENDAM
R 29-10-2002 19 18-30 EXPO WAENA
R 06-08-1970 51 46-59 EXPO WAENA
R 12-03-1968 53 46-59 KOMP AJENDAM
R 05-01-1998 23 18-30 EXPO WAENA
R 13-12-1983 37 31-45 PERUMNAS
Kepesertaan BPJS (tulis 'YA' pada kolom yang KOMORBID /
No. Hp
BPJS PBI BPJS Non PBI Non Anggota SCREENING II LAINNYA
81239569622 YA 12/10/2021 (SEBUTKAN)
81239569622 TIDAK ADA 12/10/2021
85733498693 TIDAK ADA 12/10/2021
83122324882 TIDAK ADA 12/10/2021
82398906280 YA 12/10/2021
82197967421 YA 12/10/2021
81262999959 YA 12/10/2021
81344011616 YA 12/10/2021
85244244552 YA 12/10/2021
82239646171 YA 12/10/2021
81344352229 TIDAK ADA 12/10/2021
81248702815 YA 12/10/2021
81343648902 TIDAK ADA 12/10/2021
82238966320 YA 12/10/2021
82261040580 YA 12/10/2021
81343078253 YA 12/10/2021
81247672773 TIDAK ADA 12/10/2021
81248575286 YA 12/10/2021
81238447145 TIDAK ADA 12/10/2021
81344783193 TIDAK ADA 12/10/2021
82399767591 YA 12/10/2021
85244272900 YA 12/10/2021
82197888889 YA 12/10/2021
81344770084 YA 12/10/2021
85243273002 YA 12/10/2021
81247728027 TIDAK ADA 12/10/2021
82199252153 TIDAK ADA 12/10/2021
81354655457 YA 12/10/2021
82397007398 YA 12/10/2021
82238265377 YA 12/10/2021
82397615794 YA 12/10/2021
85314166296 YA 12/10/2021
82332771922 TIDAK ADA 12/10/2021
85352656930 TIDAK ADA 12/10/2021
81335444431 TIDAK ADA 12/10/2021
85244785082 TIDAK ADA 12/10/2021
82175228346 YA 12/10/2021
85244428448 YA 12/10/2021
82198302748 TIDAK ADA 12/10/2021
81240501931 YA 12/10/2021
85254723488 TIDAK ADA 12/10/2021
81247618795 YA 12/10/2021
82238935095 YA 12/10/2021
82197659811 TIDAK ADA 12/10/2021
82128983028 TIDAK ADA 12/10/2021
81344339787 TIDAK ADA 12/10/2021
81343043824 YA 12/10/2021
82248451945 YA 12/10/2021
85281165141 TIDAK ADA 12/10/2021
81211596869 YA 12/10/2021
81325799170 YA 12/10/2021
85254170301 YA 12/10/2021
81288808969 YA 12/10/2021
82239474690 YA 12/10/2021
81344635401 TIDAK ADA 12/10/2021
81344704792 TIDAK ADA 12/10/2021
81344642474 TIDAK ADA 12/10/2021
81248584915 YA 12/10/2021
85354252474 TIDAK ADA 12/10/2021
81329265189 TIDAK ADA 12/10/2021
82199980029 YA 12/10/2021
82225559990 YA 12/10/2021
85344983813 TIDAK ADA 12/10/2021
81344618485 YA 12/10/2021
82239863338 YA 12/10/2021
81247739392 TIDAK ADA 12/10/2021
81344820371 YA 12/10/2021
8114833356 YA 12/10/2021
82132451771 YA 12/10/2021
85246236568 TIDAK ADA 12/10/2021
81299508691 YA 12/10/2021
82198172138 YA 12/10/2021
085244103364 YA 12/10/2021
085244445545 YA 12/10/2021
085243455367 TIDAK ADA 12/10/2021
085254298299 TIDAK ADA 12/10/2021
81247387967 TIDAK ADA 12/10/2021
085254218282 YA 12/10/2021
82163724028 YA 12/10/2021
085254354386 YA 12/10/2021
081240275873 TIDAK ADA 12/10/2021
82214288585 TIDAK ADA 12/10/2021
082199323427 YA 12/10/2021
81240046589 12/10/2021
085254459001 YA 12/10/2021
85256647069 YA 12/10/2021
082348357727 YA 12/10/2021
81322185581 YA 12/10/2021
081247047688 YA 12/10/2021
81344268587 YA 12/10/2021
081247500287 TIDAK ADA 12/10/2021
085344007108 TIDAK ADA 12/10/2021
81240248477 TIDAK ADA 12/10/2021
085244361479 YA 12/10/2021
82197544877 TIDAK ADA 12/10/2021
082199156635 TIDAK ADA 12/10/2021
81247025713 TIDAK ADA 12/10/2021
81247876607 YA 12/10/2021
82112258907 YA 12/10/2021
082298212171 TIDAK ADA 12/10/2021
81240842842 YA 12/10/2021
853449931213 TIDAK ADA 12/10/2021
081258331610 TIDAK ADA 12/10/2021
82198716260 TIDAK ADA 12/10/2021
085393229100 YA 12/10/2021
85247021801 TIDAK ADA 12/10/2021
81344980200 YA 12/10/2021
081344420250 YA 12/10/2021
81370060021 YA 12/10/2021
82271687093 YA 12/10/2021
082197516619 TIDAK ADA 12/10/2021
81344179128 YA 12/10/2021
082369953273 TIDAK ADA 12/10/2021
82397501505 YA 12/10/2021
082239420979 TIDAK ADA 12/10/2021
81248925969 YA 12/10/2021
82296325872 YA 12/10/2021
081325747174 TIDAK ADA 12/10/2021
081315548879 TIDAK ADA 12/10/2021
081344104812 TIDAK ADA 12/10/2021
82183281782 YA 12/10/2021
081248603541 TIDAK ADA 12/10/2021
085244415292 TIDAK ADA 12/10/2021
82199023236 12/10/2021
81344891983 TIDAK ADA 12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
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12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
12/10/2021
TUNDA TIDAK DOSIS 1 DOSIS 2
Merek TANGGAL TANGGAL
Vaksin*** PEMBERIAN NO. BATCH PEMBERIAN
KEMBALI) )
VAKSIN
12/10/2021 24005321 VAKSIN
12/10/2021 24005321
6/9/2021 202108150I 12/10/2021
6/9/2021 202108150I 12/10/2021
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4/9/2021 24005321 12/10/2021
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28/08/2021 24005321 12/10/2021
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12/10/2021 24005321 12/10/2021
13/09/2021 24005321 12/10/2021
11/9/2021 24005321 12/10/2021
11/9/2021 24005321 12/10/2021
12/10/2021 24005321
20-08-2021 24005321 12/10/2021
12/10/2021 24005321
12/10/2021 24005321
12/10/2021 24005321 12/10/2021
12/10/2021 24005321
12/10/2021 24005321
14-09-2021 24005321 12/10/2021
2/9/2021 24005321 12/10/2021
13/09/2021 24005321 12/10/2021
14-09-2021 24005321 12/10/2021
12/10/2021 24005321
2/9/2021 24005321 12/10/2021
14-09-2021 24005321 12/10/2021
12/10/2021 24005321
02-09-2021 24005321 12/10/2021
14-09-2021 24005321 12/10/2021
13/09/2021 24005321 12/10/2021
2/9/2021 24005321
202107134I 12/10/2021
7/9/2021 12/10/2021
12/10/2021 24005321 12/10/2021
12/10/2021 24005321
9/9/0202 24005321 12/10/2021
9/9/2021 24005321 12/10/2021
11/9/2021 24005321 12/10/2021
30/08/2021 24005321 12/10/2021
14/09/2021 24005321 12/10/2021
9/9/2021 24005321 12/10/2021
9/9/2021 24005321 12/10/2021
14/09/2021 24005321 12/10/2021
9/9/2021 24005321 12/10/2021
11/9/2021 24005321 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
12/10/2021 12/10/2021
DOSIS 2
KETERANGAN
NO. BATCH
VAKSIN I
VAKSIN I
24005321 VAKSIN SELESAI
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN I
VAKSIN SELESAI
VAKSIN I
VAKSIN I
VAKSIN I
24005321
24005321
TOTAL : 125
BATAL : 1 (HT)
VAKSIN I : 41
VAKSIN II : 83

Tim Iii

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1 P-54X6R91R 9204062307000001 MEHEMIA SESA

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