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. BURHAN 1 82 TDK S PETANI 1 1 1 3 2
2. Mulie/ jarna 2 49 SMP petani 1 1 1 3 2
3. solestri/ moh. Yusuf 3 23 SMA PETANI 1 1 2 3 1 2 2 3 2 2 2 2
4. idang 1 82 TDK S IRT 1 1 1 3 2
5. ISKAR 1 26 SMA PETANI 1 1 1 3 2

6 DAARPENI 4 57 SD PETANI 1 1 1 3 2

7 REMIE 4 58 DIII GURU 1 1 1 3 2

8 JUSRAN 5 49 SD PETANI 1 1 1 3 2
9 OKRIE 1 29 S1 GURU 1 1 1 3 2
10 GALAN 3 35 SD PETANI 1 1 1 3 2
11. MARYADI 5 41 SD PETANI 1 1 1 3 1 3 3 3 2 2 2 2
12. joko sudarto 4 33 SMA SWASTA 1 1 1 3 1 1 1 3 2 2 2 2
13. sugi 4 29 SD PETANI 1 1 1 3 1 3 3 3 2 2 2 2
14 suyanto 4 37 SD SWASTA 1 1 1 3 1 2 3 4 2 2 2 2

15 raup adam 4 39 TDK S SWASTA 1 1 2 1 1 2 2 3 2 2 2 2

16 uniyati/ novie 4 41 SD SWASTA 1 1 2 3 1 2 2 3 2 2 2 2
17 saripah/ barahim 3 78 SD petani 1 1 1 3 2
18 mulyono HD 4 50 SD PETANI 1 1 1 2 1 2 2 3 2 2 2 2
19 Pira/ andri 3 35 SD SWASTA 1 2 1 3 1 2 2 3 2 2 2 2
20 sumarni/ duliah 2 35 SD PETANI 1 1 1 3 2
21 udin/ rusmini 3 57 SD PETANI 1 1 1 3 2
22 RATIH PURWASIH/ IPIN 4 34 SD PETANI 1 1 1 3 1 2 2 3 2 2 2 2
23 ASRIN BINARONG 5 52 SD PETANI 1 1 1 3 2
24 RINI SUSANTO/ YUDA 3 20 SMA PETANI 1 1 2 3 1 2 2 3 2 2 2 2
25 SETYAWAN
CULIATI/RUSLI 2 33 SD PETANI 1 1 2 3 2
26 MAHARI 5 34 SD PETANI 1 1 2 5 1 3 1 2 2 2 2
27 GIYAN 3 46 SD PETANI 1 1 2 5 2
28 MASITAH 2 64 SD PETANI 1 1 2 3 2
29 SARPENDI 3 29 SMA SWASTA 1 1 2 3 1 2 2 1 2 2 2 2
30 DEI/ JOHAN ISMAIL 5 41 SMA SWASTA 1 1 2 3 2
31 hikmah/ kasim maulana 4 34 SMA SWASTA 1 2 2 5 1 2 2 3 2 2 2 2
32 rinto 4 27 SD PETANI 1 1 2 3 1 2 2 3 2 2 2 2
33 fitri/ hendri 4 31 SD SWASTA 1 1 2 3 1 3 3 2 2 2 2
34 Warnidah/ Pirman 3 29 SD PETANI 1 1 1 3 2
35 LINDA/ M. YARSIR 4 28 SD petani 1 1 1 3 1 3 3 2 2 2 2
36 SEPENTRI 3 29 SD petani 1 1 1 3 1 2 2 3 2 2 2 2
37 Rusiyani/ M.FITRA 4 32 SD PETANI 1 1 1 3 1 3 2 3 2 2 2 2
38 JUMIATI/ SARMINTO 6 47 SD PETANI 1 1 2 3 2
39 AAT 1 42 SD PETANI 1 1 1 3 2
40 HERMAN 3 24 SD PETANI 1 1 1 3 1 2 2 3 2 2 2 2
41 RAPITA/DUDHA 3 34 SD SWASTA 1 1 1 3 2
42 RONA DEPRAHA/AHMAD M 3 22 SD SWASTA 1 1 1 3 1 2 2 3 3 2 2 2
43 BURHAN 2 82 SD PETANI 1 1 1 3 2
44 JUNAI/ MIMO 4 37 SD PETANI 1 1 1 3 2
45 MISBA 4 54 SD PETANI 1 1 1 3 2
46 JUATI SARI/ RAHMAT 4 29 SMP PETANI 1 4 1 3 1 3 2 3 2 2 2 2
47 VERA WATI/ SYABAN 5 46 SMA PETANI 1 1 1 3 2
48 JHON HENDRI 4 49 SMA PETANI 1 1 1 3 2
49 PRISKA JULIA/PARLAN 5 15 SD PETANI 1 1 1 3 2
50 MASUWATI/LAMPUNG 3 58 SD PETANI 1 1 1 3 2
51 ELIS/KENEDI 4 54 SMA PETANI 1 1 1 3 1 3 3 1 2 2 2
52 SANTIYA DEWI/BOBY PRANATA 4 30 SMA SWASTA 1 1 1 3 1 4 3 2 2 2 2 2
53 ARI KUSMIRAN/ MINTO 5 47 SMA GURU 1 1 2 3 2
54 RINA/ ASPAN 5 57 SD PETANI 1 1 2 3 2
55 ISIE 1 73 SD PETANI 1 1 1 3 2
56 TUNI/SIMUN 2 48 SD PETANI 1 1 1 3 2
57 YATIE/MARDIANTO 4 42 SMA PETANI 1 1 1 3 2
58 MELIE/ MADDI 4 42 SD PETANI 1 1 1 3 2
60 ANWAR 3 62 SD PETANI 1 1 1 3 2
61 YANI 2 43 SD PETANI 1 1 2 3 2
62 SITTI RANTI/ RANDI 3 31 SD PETANI 1 1 1 3 1 2 2 3 2 2 2 2
63 JONI/ WIWIN INDRIYANI 3 31 SD PETANI 1 1 2 3 2
64 SAIMAN 2 30 SD PETANI 1 1 2 5 2
65 MINIM 2 57 SD PETANI 1 1 1 5 2
66 IYUM 3 79 SD PETANI 1 1 1 3 2
67 SARPENDI 5 40 SMP PETANI 1 1 2 3 2
68 NOYAM 4 41 SD PETANI 1 1 1 3 1 3 3 2 2 2 2
69 GAFAR 3 47 SMP PETANI 1 1 1 3 2
70 DANY 3 24 SMA PETANI 1 1 2 3 1 2 2 2 2 2 2
71 JUNAIDI 4 28 SD PETANI 1 1 2 3 1 1 3 2 2 2 2
72 SARJONO/ SRIWATI 5 39 SMA PETANI 1 1 2 3 1 3 3 2 2 2 2
73 RIRIN WAHYUNI/ JAELANI 6 34 SMA SWASTA 1 1 2 5 2 2
74 SUPRAN/ YUNI 3 39 SMA SWASTA 1 1 2 5 1 2 3 2 2 2 2
75 PERDI APIZAL 3 19 SD SWASTA 1 1 1 5 1 4 3 3 2 2 2 2
76 DINAR 1 72 TDK S IRT 1 1 1 2 2
77 SUHAITI 5 51 TDK S IRT 1 1 1 3 2
78 HERY 4 40 SMA SWASTA 1 2 2 3 1 4 2 3 2 2 2 2
79 H. SAMSURI 4 65 SD PETANI 1 2 1 5 2
80 SARJI 3 22 SD PETANI 1 1 2 3 1 2 3 2 2 2 2
81 IHSAN/ DEWI 4 43 SD PETANI 1 1 1 5 2
82 KARTINI/ KARMO 4 39 SD PETANI 3 1 1 5 2
83 MEGAWATI/ M. NASRULLAH 5 30 SD SWASTA 1 2 2 5 1 2 3 2 2 2 2
28 68 34 11 29
7 53 17 54 13 48 2
9 4 59 2
23 18
28
13
2
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
4 1 1 2 2 2 1 1 2 3 1 4 1 3 2 1 1 1 6 1 1
4 1 1 1 4 1 1 1 2 1 2 4 3 3 2 1 1 1 6 1 1
2 2 3 2 2 2 1 1 1 1 2 2 1 1 1 2 1 2 4 3 3 1 1 1 1 6 1 1
4 2 1 1 5 1 1 1 2 2 1 4 3 3 2 2 1 1 3 1 1
1 1 2 1 1 3 4 1 2 2 3 3 3 2 2 1 6 1 1

4 1 1 2 1,2,4, 3 2 1 2 3 1 4 3 3 2 1 1 1 6 1 1
11
1 1 1 8.12 1 1 1 2 2 2 2 4 3 1 2 1 1 6 1 1
1 1 1 2 1 1 1 1 2 1 2 4 3 3 2 3 1 1 6 1 1
1 1 2 1.11 3 2 1 2 3 1 4 5 3 2 1 1 1 6 1 1
4 1 1 2 5 3 1 3 3 1 1 4 5 3 2 1 1 1 6 1 1
2 2 4 1 2 1 1 1 1 1 2 1,8,5 1 1 3 3 2 1 4 3 3 2 1 1 1 6 1 1
2 2 2 2 2 2 2 1 1 1 1 1.5 1 1 1 2 2 1 4 3 3 2 2 1 1 3 1 1
2 2 4 2 2 2 1 1 1 1 1 2 1 3 4 2 1 4 3 3 2 2 1 1 6 1 1
2 2 lk 1 2 1 1 1 1 1 1 1 3 1 1 2 3 2 2 1 3 2 2 1 2 6 1 1

2 2 2H 1 1 1 3 1 3 2 3 1 3 2 2 1 2 6 1 1
2 2 lk 2 2 1 1 4 1 1 1 1 3 1 1 2 3 1 3 2 2 1 2 6 1 1
1 1 1 1 2 2 1 2 1 1 2 3 2 1 1 1 1 4 1 1
2 2 2 2 2 1 1 1 1 1 1 6 2 1 1 2 2 1 2 3 2 1 2 1 1 5 1 1
2 2 lk 2 2 1 1 1 1 1 1 1 3 2 1 2 1 2 2 1 3 2 3 3 3 6 3 2
4 1 1 1 2 2 3 3 2 2 2 1 2 2 2 2 3 6 1 1
4 1 1 1 2 2 3 3 2 2 2 1 2 2 2 2 3 6 1 1
2 2 LK 2 2 1 1 1 1 1 1 2 3 3 2 2 2 4 1 2 2 3 3 3 6 1 1
4 1 1 1 2 1 3 2 2 1 2 4 3 2 2 1 1 6 1 1
2 2 LK 2 2 1 1 4 1 1 1 3 1 3 1 2 1 2 4 3 2 2 2 1 2 3 1
4 1 1 1 2 3 1 3 2 3 1 2 2 2 1 2 6 1 1
2 2 LK 2 2 1 1 4 1 1 1 3 1 3 2 3 3 2 2 1 2 6 1 1
4 1 1 1 3 1 1 1 2 2 1 4 3 3 2 1 1 6 1 1
4 1 1 1 1 3 1 3 2 2 1 4 3 3 2 2 1 1 6 1 1
2 2 LK 2 2 1 1 4 1 1 1 1 1 1 1 2 1 2 4 2 2 2 1 1 6 1 1
4 1 1 1 1 1 1 1 1 2 2 2 4 1 1 1 1 1 3 1 1
2 2 lk 2 2 2 1 4 1 1 1 1 1 1 2 2 1 3 3 3 1 1 1 1 6 1 1
2 2 lk 2 2 1 4 1 1 1 1 1 1 3 2 1 1 4 3 2 1 1 1 1 4 1 1
2 2 lk 2 2 1 1 4 1 1 1 3 1 1 2 3 1 3 2 2 1 2 6 1 1
1 1 1 1 2 2 3 3 2 2 2 1 2 2 2 2 3 6 1 1
2 2 lk 2 2 1 1 1 1 1 1 1 2 2 1 2 3 1 4 1 2 2 3 3 3 6 1 1
2 2 lk 2 2 1 1 1 1 1 1 2 2 1 2 2 2 4 1 2 2 3 3 3 6 1 1
2 2 lk 2 2 1 1 1 1 1 1 2 2 3 1 3 1 4 3 2 2 3 3 3 6 1 1
1 1 1 1 3 2 3 3 3 3 1 3 2 2 2 2 1 1 1
4 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 2 2 2 1
2 2 LK 2 2 1 1 1 1 1 1 2 2 1 2 1 1 2 3 2 1 2 1 1 5 1 1
1 1 1 1 1 2 2 1 2 1 1 2 3 2 1 2 1 1 6 1 1
2 2 LK 2 2 1 1 1 1 1 1 1 1 2 1 2 1 1 2 3 2 1 2 1 1 5 1 1
4 1 1 1 2 1 1 1 2 1 1 3 3 2 1 1 2 3 2 1 1
1 1 1 1 2 2 1 1 1 1 1 4 3 1 2 1 1 1 5 1 1
4 1 1 1 2 2 1 1 2 2 1 4 1 3 2 3 3 3 6 1 1
2 2 LK 1 2 1 1 1 1 1 1 4 3 2 1 2 1 1 2 4 2 2 2 1 1 5 1 1
1 1 1 1 11 1 1 1 2 1 2 2 3 3 2 1 1 1 6 1 1
1 1 1 2 3 1 3 3 3 1 4 3 3 2 3 1 1 6 1 1
1 1 1 2 1 1 1 2 1 2 4 3 3 1 3 1 1 6 1 1
4 1 1 2 12 2 1 1 2 2 1 4 3 3 2 1 1 1 6 1 1
2 2 LK 2 2 1 1 1 1 1 1 12 2 1 1 2 3 4 3 2 2 1 1 6 1 1
2 2 LK 2 2 2 1 1 1 1 1 5 1 1 1 2 1 2 4 4 3 2 1 1 1 6 1 1
1 1 1 1 1 1 1 1 2 1 2 4 3 2 1 1 1 1 6 1 1
1 1 1 2 1 2 2 1 2 1 2 4 3 3 1 1 1 1 6 1 1
4 1 1 1 12 2 1 3 4 2 1 4 3 3 2 2 1 1 6 1 1
4 1 1 2 1 1 1 1 2 1 2 3 3 3 2 1 1 1 6 1 2
4 1 1 1 12 1 1 1 1 1 2 3 3 3 2 1 1 1 6 1 1
1 1 1 1 11 1 2 1 2 1 2 2 4 3 2 2 1 3 6 1 1
4 1 1 1 11 1 1 1 2 1 2 4 4 3 2 1 1 1 6 1 1
4 1 1 1 12 1 2 1 2 2 2 2 4 3 1 1 1 1 6 1 2
2 2 LK 2 2 1 1 1 1 1 1 1 2 1 1 2 3 2 4 1 3 2 2 1 1 6 1 1
1 1 1 1 1 1 1 1 2 2 2 2 3 3 2 2 1 1 6 1 1
4 1 1 1 1 1 1 2 2 2 2 1 3 2 2 1 1 6 1 1
 4 1 1 1 1 1 1 1 2 2 2 2 1 3 2 2 1 1 6 1 1
4 1 1 1 1 1 2 1 2 1 2 2 1 3 2 2 1 1 6 1 1
4 1 1 1 1 1 1 1 2 1 2 4 3 3 2 2 1 1 6 1 1
2 2 2.3 2 1 2 1 1 1 1 2 1 1 1 1 2 1 2 4 3 3 2 2 1 1 6 1 1
4 1 1 2 DBD 1 1 1 2 2 2 3 3 3 2 2 1 1 6 1 1
2 2 LK 2 2 2 2 1 1 1 1 1 2 1 2 1 2 4 3 3 2 2 1 1 6 1 1
2 2 LK 2 2 1 1 1 1 1 1 5 1 1 1 2 1 2 4 3 3 2 2 1 1 6 1 1
2 2 LK2 2 2 2 1 1 1 1 1 1 1 1 2 1 2 2 3 3 2 1 1 1 6 1 1
1 1 1 1 4 1 1 1 1 2 2 3 3 3 2 1 1 1 6 1 1
2 2 LK 2 2 1 1 1 1 1 1 2 1 1 2 3 1 4 1 3 2 3 2 1 6 3 1
2 2 LK 2 2 1 1 1 1 1 1 2 2 1 1 2 3 2 4 1 3 2 2 1 1 6 1 1
4 1 1 1 4 1 1 1 1 2 2 2 2 3 2 2 1 1 6 1 1
2 1 1 1 12 2 1 1 2 3 2 4 1 3 2 2 1 1 6 1 1
2 2C 2 2 1 1 1 1 1 1 1 1 1 1 1 2 2 2 4 3 2 1 1 1 6 1 1
4 1 1 1 4 1 1 1 1 2 2 2 2 3 2 1 1 1 6 1 1
2 2C 2 2 1 1 1 1 1 1 4 3 1 1 2 2 2 2 3 3 2 2 1 1 6 1 1
1 1 1 1 4 1 1 1 2 3 1 4 3 3 2 3 1 1 6 1 2
1 1 1 1 4 2 1 1 2 2 2 2 1 3 2 2 1 1 6 1 1
2 2C 2 2 1 1 1 1 1 1 4 3 1 1 1 1 2 2 2 3 2 2 1 1 6 1 1
30 43 67 9 39 61 63 13 30 31 37 24 61 64 44 68 63 68
35 21 26 20 59 34 44 31 3 18 16 27 8 8 5
1 4 17 7 19 6 39 11 6 11 3
12 3
 PERILAKU ANGGOTA KELUARGA

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

5 3 1 1 1 2 1 1 1 2

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

5 3 2 1 1 2 1 1 1 1
5 3 2 2 1 1 1 1 1 1 2 1 1 1 1
5 3 1 1 1 2 2 1 2 1
5 3 3 1 1 2 2 1 2 1
5 3 1 2 1 1 1 1 1 1 2 1 1 1 1
5 3 1 2 1 1 1 1 1 1
5 3 1 1 1 1 1 1 1 1
5 3 1 2 1 1 1 1 1 1 1 1 1 1 1
5 3 3 1 1 1 2 1 1 1
5 3 3 1 1 2 1 1 1 1 2 1 1 1
5 3 3 1 1 2 2 1 1 1
5 3 3 2 1 1 2 2 1 1 2 2 1 1 1
5 1 1 1 1 1 1 1 1 1
5 3 3 1 1 1 2 1 1 1
5 3 3 1 2 1 1 1 1 1 1 2 1 1 1
5 3 1 1 1 1 1 1 1 1
5 3 3 2 1 1 1 1 1 1 1 1 1 1 1
5 3 2 2 1 1 2 1 1 1 1 1 1 1 2
5 3 2 2 1 1 2 1 1 1 2 2 1 1 1
5 3 1 2 2 1 1 1 1 1 1 1
5 3 3 2 1 1 1 1 1 1 1 1 1 1 2
5 3 3 2 1 1 1 1 1 1 1 1 1 1 2
5 3 1 2 1 1 1 1 1 1 1 1 1 1 1
5 3 3 2 2 1 1 1 1 1 2 1 1 1 1
5 1 3 2 2 1 1 1 2 1 1 1
5 3 1 2 1 1 1 1 1 1 1 2 1 2 1
5 3 1 1 1 1 1 1 1 1
5 3 1 2 1 1 1 1 1 1 1 2 1 1 1
5 3 1 1 1 1 2 1 2 1
5 3 1 1 1 1 1 1 1 1
5 3 3 1 1 1 1 1 1 2
2 2 1 2 1 1 1 1 1 1 2 1 1 1 1
2 3 2 1 1 1 1 1 1 1
5 1 1 1 1 2 1 1 1 2
5 1 1 1 1 1 1 1 1 1
5 1 1 1 1 2 1 1 1 1
5 3 2 2 1 1 1 1 1 1 2 1 1 1 1
4 1 1 1 2 2 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
5 1 1 2 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
4 1 1 1 1 1 1 1 1 1
2 1 1 1 1 1 1 1 1 1
5 3 2 1 1 1 1 1 1 1
4 1 1 1 1 1 1 1 1 1
5 3 3 1 1 1 1 1 1 2
5 1 1 2 1 1 2 1 1 1 2 1 1 1 1
5 3 3 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
5 1 2 1 1 1 1 1 1 1
5 3 1 1 1 1 1 1 1 1
5 3 3 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
5 3 1 2 1 1 1 1 1 1 1 1 1 1 1
5 3 1 2 1 1 1 1 1 1 1 1 1 1 1
5 1 1 2 1 2 2 1 1 1 1 1 1 1 1
5 3 3 1 1 1 2 1 1 1
5 3 3 2 1 1 1 1 1 1 2 1 1 1 1
5 1 1 1 2 2 1 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 2
5 1 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1
5 3 3 2 1 1 1 1 1 1 1 1 1 1 2
5 3 2 1 1 1 1 1 1 1
5 1 2 1 1 1 1 1 1 1
5 1 1 2 1 1 1 1 1 1 2 1 1 1 1
29 11 27 23 61 70
3 52 51 9
3 20
4