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NO IDENTITAS RESPONDEN/NAMA ANGGOT UMUR PENDIDIK PEKERJAA AKSES PELAYANAN KIA, KB,GIZI, DAN IM

A KL RESPOND AN KK N KK DAN PEMBIAYAAN


EN
P1 P2 P3 P4 K1 K2 K3 K4 K5 K6.1 K6.2 K6.3
1. MARIA/ JOKO 4 28 SD SWASTA 1 3 2 3 1 3 3 3 1 2 2 2
2. EKO/ LASTRI 3 31 SMA SWASTA 1 3 2 3 1 2 2 2 1 2 2 2
3. JARENAH/ ASRAN 4 65 SD TANI 1 1 1 3 2
4. SRIDEVI/ HARNO 4 42 SD TANI 1 1 2 3 1 1 2 3 2 2 2 2
5. RUTYA SAPESIN/ SARJONO 4 22 SD PETANI 1 2 2 5 1 2 2 3 2 2 2 2

6 HERMAWATI/ YEYEN 6 22 SMP TANI 1 2 2 3 1 1 1 2 2 2 2 2


7 LIDIA MINSIH/ MULIYADI 7 43 SMP TANI 1 2 2 3 1 1 1 3 2 2 2 2
8 SITI NURBAITI 2 30 SD TANI 1 2 1 3 1 4 4 3 2 2 2 2
9 SITI HABIZAH/ TAUFIQ 3 28 S1 SWASTA 1 2 2 3 1 1 1 3 2 2 2 2
10 NUR SIKIN/ M. ZAINAL 6 40 SMP TANI 1 4 3 1 1 1 1 4 2 1 2 2
11. SANAH/ AGUS SISWANDI 3 23 SD PETANI 1 4 2 3 1 2 2 3 2 2 2 2
12. CICI PARAMIDA/ ABDUL SADI 3 30 SMP JUALAN 1 1 2 3 1 1 1 3 2 2 2 2
13. MARIANA/ ISAR 5 37 SMA TANI 1 1 1 3 1 2 2 3 2 2 2 2
14 SURIATUN/ NUR RAHCHMAN 3 20 SD SWASTA 1 3 2 5 1 3 3 3 2 2 2 2
15 ELISABET/ DEDI YANTO 4 33 SMP SWASTA 1 1 1 3 1 2 2 3 1 2 2 2
16 KRISTIANI / KORNELIUS 3 31 SLTA SWASTA 1 1 1 3 1 2 3 3 2 2 2 2
17 DINA/ ABDUL JABAR 3 59 SMA SWASTA 1 1 1 5 1 1 2 3 2 2 2 2
18 SRI WATI 4 39 SD IRT 1 3 2 5 1 2 2 3 2 2 2 2
19 ELISA 2 27 DIII SWASTA 1 3 2 5 2
20 ELSA/INGHING 5 27 SD PETANI 1 3 2 5 2
21 7 6 1
22 5 13
23 6 1 13
24 2
25 6
26
27
28
29
30
31
32
33
KIA, KB,GIZI, DAN IMUNISASI SURV RUMAH DAN LINGKUNGAN
EILAN

K6.4 K7 K8 K9 K10 K11 K12 K13 K15 K16 K17 S1 R1 R2 R3 R4 R5 R6 R7 R8 R9 R10 R11 R12 R13 R14 R15 R16
2 2 5 2 2 1 1 1 1 1 1 7 1 2 1 1 2 2 2 3 2 2 2 3 1 6 2 1
2 2 5 2 2 1 1 1 1 1 1 1 1 1 3 2 3 1 4 1 3 2 3 3 2 6 3 1
4 1 1 1 12 1 2 1 2 1 1 3 3 2 2 1 1 1 4 1 1
2 2 6 1 2 1 1 4 1 1 1 1 3 1 3 1 2 1 3 1 2 2 1 1 1 4 1 1
2 2 4 2 1 1 2 1 1 1 2 11 1 2 1 1 1 1 4 3 3 2 2 1 1 6 1 1

2 2 2 2 1 1 1 1 2 1 3 1 3 1 1 1 4 3 3 2 1 2 2 6 1 2
2 2 1 1 2 1 1 1 1 1 1 11 1 1 1 2 1 1 4 3 3 2 1 1 1 6 1 1
2 2 5 2 1 2 4 1 1 1 1 1 2 1 1 1 1 3 1 2 2 3 3 2 5 3 1
2 2 5 2 2 1 1 1 1 1 1 1 1 2 1 1 1 1 4 5 2 2 1 1 1 4 1 1
2 2 1 2 2 2 4 1 1 1 1 1 2 1 1 2 1 4 1 2 2 3 2 3 6 2 1
2 2 5 2 2 2 2 1 1 1 1 11 1 2 1 1 1 1 4 1 2 2 2 1 1 6 1 1
2 2 5 2 2 2 1 4 1 1 1 8 1 2 1 1 1 1 2 1 2 2 2 1 1 5 1 1
2 1 6 2 2 2 1 1 1 1 2 1 1 2 1 2 2 1 2 4 3 2 2 2 2 3 2 1
2 2 5 2 2 1 1 1 1 1 1 1 1 1 1 2 1 1 4 1 3 2 2 2 2 6 1 1
2 2 5 1 2 1 1 1 1 1 1 1 1 1 2 1 1 2 1 3 2 1 1 2 6 1 1
2 3 1 2 1 1 1 1 1 1 1 1 1 3 1 2 1 4 1 3 2 2 1 1 6 1 1
2 5 2 2 1 1 1 1 2 1 1 1 3 1 1 1 3 1 4 1 3 2 3 3 3 6 3 1
2 2 5 1 2 2 2 1 1 1 1 1 2 1 2 1 1 2 1 3 2 2 3 2 6 1 1
4 1 1 1 1 1 1 1 1 1 2 1 3 2 1 1 1 6 1 1
4 1 1 1 1 1 2 1 2 1 1 4 1 3 2 1 1 1 6 1 1

9 17
1 3
PERILAKU ANGGOTA KELUARGA

R17 R18 R20 PK1 PK2 PK3 PK4 PK5 PK6 PK7 PK8 PK9 PK10 PK11 PK12
5 1 3 1 2 1 1 1 1 1 1 1 1 1 1
5 1 3 2 1 1 1 1 1 1 1 1 2 1 1
5 1 1 2 2 1 1 1 1 1 1 1
1 1 1 1 2 1 2 1 1 1 2 1 1 1 1
5 3 1 1 2 1 1 1 1 1 1 1 1 1 1

4 3 3 1 2 1 2 2 1 1 2 1 1 1 1
4 2 1 1 1 1 2 1 1 1 1 1 1 1 2
5 3 3 2 1 2 1 1 1 1 2 1 1 2
5 3 1 2 1 1 1 1 1 1 1 1 1 2
5 3 1 1 2 1 1 1 1 1 1 2 1 1 1
5 3 1 2 1 1 1 1 1 1 1 2 1 1 1
4 3 1 1 2 1 2 1 1 1 1 2 1 1 2
5 3 1 2 1 1 1 1 1 1 1 1 1 2
5 1 3 2 1 1 1 1 1 1 1 1 1 1
5 1 3 1 2 1 1 1 1 1 1 1 1 1 1
1 1 3 2 1 2 1 1 1 1 1 1 1 1
5 3 3 2 1 1 1 1 1 1 2 2 1 2 1
5 3 2 2 1 1 1 1 1 1 1 1 1 1
5 3 2 2 1 1 1 1 1 1 1 1 1 1
5 3 2 2 2 1 1 1 1 1 1 1 1

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