Puskesmas Dawan II PDF

Daftar Peserta Askes Sosial
Kantor Cabang
KLUNGKUNG
Nama PPK
22050302-Puskesmas Dawan II
Bulan / Tahun
02
No
2013
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
1. 0000206060106
A.A ISTRI WULAN
30/07/2011
2. 0000143969466
I GST A SINTA AMARA YUDA
29/01/2002
PURI SATRIA KALERAN, DS.

PAKSEBALI
BR. PENINJOAN
3. 0000144196931
I NENGAH SASTRAWAN
31/12/1955
SAMPALAN KLOD
4. 0000037185682
NI NENGAH KORTI
31/12/1960
DSN. BUAYANG DS.
5. 0000143899569
A A AYU RATIH
30/12/1948
PAKSEBALI
6. 0000143754851
A A GD NGURAH
01/12/1944
BR PURI SATRIA KAWAN
7. 0000143700287
A A GEDE NGURAH
01/12/1944
BR SATRIA KAWAN
8. 0000143709063
A A GEDE SAYANG
31/12/1939
DESA SATRIA,DAWAN
9. 0000143709041
A A I NGURAH RESI
17/10/1941
N/A
10. 0000143704247
A A ISTRI INDRAWATI
20/05/1965
DS PAKSEBALI,KLUNGKUNG
11. 0000143709074
A A ISTRI OKA
31/12/1940
12. 0000143709603
A A ISTRI OKA YUNIWATI
31/12/1951
13. 0000143683222
A A PUTRI KANIA PRATIWI
04/10/2001
N/A
PURI SATRIA KANGINAN, DS.
PAKSEBALI
JL.SATRIA DS.PAKSEBALI
14. 0000143726264
A. A AYU RATIH
31/12/1955
15. 0000143649832
A. A. GDE IKA YASHALUGRA
03/10/1995
16. 0000143649821
A. A. GDE PARWATHA
27/03/1970
17. 0000143660812
A. A. GEDE ANOM LABA
31/12/1969
18. 0000144206199
A. A. GEDE NATA PRAWIRA
14/08/1996
19. 0000144206188
A. A. ISTRI NATA PRATIWI
25/04/1992
20. 0000144206177
A. A. ISTRI OKA PARWATI
31/12/1963
21. 0000143649843
A. A. ISTRI RATU MASAYU N
31/08/2002
22. 0000205023936
A.A GD ANOM MEGA WIBAWA
21/07/2009
23. 0000205023903
A.A GD SAYANG TRI MEGA P,S.KOM
02/08/1985
24. 0000144152638
A.A ISTRI A.PRABA NINGRUM
19/10/2005
25. 0000205023914
A.A ISTRI PUTERA WIDIASTITI
10/03/1987
26. 0000143683233
A.A RADEYA GANA PRADATA
14/03/2005
27. 0000143683198
A.A. GDE ANOM ADITYA. W
28/10/1984
28. 0000143778712
A.A. ISTRI ANOM ADNYANI
31/12/1959
29. 0000143644072
A.A. MADE SUSILA PUTRA
01/05/1968
30. 0000144219521
A.A.ANOM KRISNA SUARI
17/12/1994
DS GUNAKSA
PURI SATRIA KAWAN, DSN.
PENINJOAN
PENINJOAN
PAKSEBALI
PAKSEBALI
PAKSEBALI
PAKSEBALI
PENINJOAN
BR BUCU PAKSEBALI
DAWAN KLUNGKUNG
BR BUCU PAKSEBALI
DAWAN KLUNGKUNG
BR. BUCU DS. PAKSEBALI
BR BUCU PAKSEBALI
DAWAN KLUNGKUNG
JLN SATRIA NO 19
PURI SATRIA KAWAN DS.
PAKSEBALI
PURI SATRIA KANGINAN
BR. PURI SATRIA KANGINAN
DS.PAKSEBALI
PAKSEBALI
31. 0000143785956
A.A.DEYA PRABAWANITA.
01/08/1989
BR.PENINJOAN
32. 0000144219508
A.A.GDE OKA GULEM
31/12/1961
PAKSEBALI
33. 0000144152616
A.A.GDE OKA PHAWANA
31/12/1969
34. 0000977560582
A.A.GDE PRAYOGA TANAYA
16/09/1983
35. 0000143779678
A.A.GDE SAYANG SUTANTRA
15/02/1959
DSN BUCU
DUSUN PENINJOAN, DS
PAKSEBALI
SATRIA KANGINAN
36. 0000143709221
A.A.GDE YUDHA SANDYASTICA
27/06/1940
37. 0000144206166
A.A.GEDE NATA KUSUMA.
31/12/1964
DSN.BUCU PEKSEBALI
38. 0000143804711
A.A.I.ALIT PUTRI INDRA D.
09/01/1995
DSN PENINJOAN
39. 0000143804687
A.A.I.NGURAH ERAWATI, S,AG
31/12/1960
40. 0000205044748
A.A.ISTRI ALIT MULIAWATI
18/01/1990
41. 0000143796352
A.A.ISTRI ANOM ASTINI
31/12/1963
DSN PENINJOAN
PAKSEBALI
DSN PAKSEBALI DAWAN
2/1/13 4:56 PM
Page 1 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
42. 0000210347223
A.A.ISTRI ANOM BINTANG P.
11/05/2002
DSN PENINJOAN
43. 0000195370121
A.A.ISTRI ANOM MAHENDRAWATI,A.MA
05/07/1987
PAKSEBALI
44. 0000195350444
A.A.ISTRI KOMALA SARI,A.MA
05/06/1985
DUSUN TENGAH DESA AKAH
45. 0000144219519
A.A.ISTRI NGURAH MAYA P.
30/01/1991
PAKSEBALI
46. 0000143709478
A.A.ISTRI NGURAH WATI
31/12/1945
SATRIA DS.BUCU
47. 0000143762488
A.A.ISTRI NGURAH,A.MA.PD
31/12/1948
BR PAKSEBALI KANGIN
48. 0000143701773
A.A.ISTRI OKA CANDRAWATI
26/08/1972
49. 0000144219497
A.A.ISTRI OKA CITA,S.PD
31/12/1963
PAKSEBALI
50. 0000143704258
A.A.ISTRI OKA KRISNADEWI
31/12/1967
BR.BUCU PAKSEBALI
51. 0000143785967
A.A.ISTRI OKA SUJANI.
03/02/1995
BR.PENINJOAN
52. 0000143726321
A.A.ISTRI RAKA SUTJIATI
31/12/1947
53. 0000143709682
A.A.ISTRI SAYANG
31/12/1940
BANJAR SATRIA
54. 0000143681826
AA GDE SAYANG KARTIKA
14/07/1955
BR BUCU
55. 0000144152627
AA I A. DIAH WIDIANTARI P
19/05/2001
56. 0000143726332
AAI AGUNG WIRATIH
19/01/1947
PURI SATRIA
57. 0000141622007
ABDUL GANI
31/12/1955
DESA KUSAMBA
58. 0000172249762
ADE LAKSMI JASANANDA DEWI
08/10/1988
BR KANGINAN
59. 0000005392348
AGUS ERISTANA DEWANTA
16/04/1993
60. 0000143644094
ANAK AGUNG DEWA YANI
10/10/2000
61. 0000147907495
ANAK AGUNG DEWI SURYANINGRAT
20/03/2009
62. 0000143644105
ANAK AGUNG ESA KURNIA. D
10/12/2003
63. 0000143709467
ANAK AGUNG GDE ANOM
31/12/1940
BR PANCINGAN KUSAMBA
DS.PAKSEBALI
PAKSEBALI DAWAN
DS.PAKSEBALI
SATRIA DS.BUCU
64. 0000143683209
ANAK AGUNG GDE ANOM,S.SOS
31/12/1970
JLN SATRIA NO 19
65. 0000143804698
ANAK AGUNG GDE MAYUN WIJA
31/12/1960
DSN PENINJOAN
66. 0000143700355
ANAK AGUNG GDE SAJANG
31/12/1940
BANJAR AGUNG
67. 0000143726343
ANAK AGUNG GDE SAYANG
31/12/1947
68. 0000143778701
ANAK AGUNG GEDE NGURAH
31/12/1949
69. 0000143726365
ANAK AGUNG GEDE RAI
11/09/1939
BR. PENINJOAN DS.
70. 0000143700399
ANAK AGUNG GEDE SAYANG
31/12/1938
BR PENINJOAN
71. 0000143709704
ANAK AGUNG GEDE SAYANG
18/08/1949
DESA PAKSEBALI
72. 0000143683211
ANAK AGUNG IST.RAI MIRAH
23/10/1975
JL.SATRIA DS.PAKSEBALI
73. 0000143700401
ANAK AGUNG ISTRI RAI
31/12/1940
BR PENINJOAN
74. 0000143714169
ANAK AGUNG ISTRI RAKA
31/12/1951
BR. RAME DS. KUSAMBA
75. 0000147907484
ANAK AGUNG ISTRI RAKA SUATI
16/04/1977
PAKSEBALI DAWAN
76. 0000143727265
ANAK AGUNG MADE SIDHARA
05/03/1939
SATRIA KANGIN PAKSEBALI
77. 0000143700322
ANAK AGUNG RAI KALAM
24/01/1933
PURI SATRIA DS. PAKSEBALI
78. 0000147907473
ANAK AGUNG RAI MAHAYASA
27/03/1972
PAKSEBALI DAWAN
79. 0000143700377
ANAK AGUNG SAYANG
14/08/1947
SATRIA KALERAN
80. 0000143969916
AYU KRISNA SARASTI
03/12/1990
DS.KANGINAN PAKSEBALI
81. 0000143658988
AYU NYOMAN SUASTIKA
31/12/1967
DSN. KAWAN DS. PAKSEBALI
82. 0000143762556
BGS WIRA WIGRAHA
31/12/1982
KLUNGKUNG
83. 0001078736128
BY. NI KOMANG WIDIASIH
16/12/2012
JL RAYA SAMPALAN KLOD
84. 0000143762949
COK.ISTRI AGUNG PRADNYANI
12/08/1960
BR.TENGAH DESA GUNAKSA
85. 0000143710119
DAYU PUTU OKA
31/12/1933
DS PAKSEBALI,DAWAN KLK
86. 0000005392359
DEK TWO RAGIL JENIAWAN
20/06/1998
87. 0000143648853
DESAK MADE MAYA SAPUTRI
15/08/1980
BR SAMPALAN
88. 0000143704293
DESAK MADE NEPOWATI
12/12/1964
89. 0000143711728
DESAK PUTU MADRI
31/12/1945
90. 0000143644601
DESAK PUTU MARIATI
20/03/1956
DESA GUNAKSA
BR. PENINJOAN DS.
PAKSABALI
BR. PANCINGAN, DS.
91. 0000143710165
DESAK PUTU RAKA
31/12/1928
PURI SATRIA DAWAN
92. 0000143802922
DEWA AYU EKA AGUSTINI, SPD
14/08/1981
BR LEBAH
93. 0000208222503
DEWA AYU SANTHI DEVI
17/10/2010
BATU NUNGGUL NUSA
2/1/13 4:56 PM
Page 2 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
94. 0000209935012
DEWA MADE ANGGA KUSUMA PUTRA
06/10/1988
ULUNSWI
95. 0000143769969
DIMAS DWI JAYA PALGUNA
16/12/2003
BR. TENGAH DS. GUNAKSA
96. 0000143704427
DODEX DEGUNG KRISNANDA
23/01/1995
BR. BATUR
97. 0000143654949
DR I KETUT SUTARTHA
09/04/1957
98. 0000143738021
DR. NI LUH PILIANTARI MEIGAWATI
02/05/1977
99. 0000144329782
DR. NI MADE MAYUNI
29/06/1974
DSN LEKOK
JL. DEWI SITA NO. 2 DS.
SAMPALAN TENGAH
DSN PAKEL
100. 0000143789242
DRA DSK MD SUSILANINGSIH
10/12/1957
DESA GUNAKSA
101. 0000143807725
DRA. NI MADE MUSTARI
27/05/1962
BR. KANGINAN DS.
102. 0000143969455
DRH. NI NYM WILASNI, SKH
10/08/1975
BR. PENINJOAN
103. 0000143138103
DRS A A OKA WAICAKA
16/10/1955
PURI SATRIA KANGINAN KLK
104. 0000143728334
DRS A A RAKA
31/12/1938
PUIR SATRIA PAKSEBALI
105. 0000142702075
DRS I KETUT ARDANA, M.PD
04/09/1959
BR KANGINAN
106. 0000143661385
DRS I KETUT RIASA
31/12/1961
JL.BIMA GANG SAHADEWA
107. 0000143662994
DRS I KOMANG TISTA
31/12/1960
108. 0000195097195
DRS I NENGAH KARTU
31/12/1956
109. 0000143789837
DRS I NYOMAN SUNARTA
20/12/1963
DSN PASEKAN DAWAN

BR.BANDUNG DESA
GUNKSA,DAWAN
KLUNGKUNG
110. 0000005166595
DRS I WAYAN SUDANA
31/12/1957
BR
111. 0000143789534
DRS I WAYAN SUKARA
31/12/1965
KLUNGKUNG
112. 0000143789589
DRS NYOMAN NARTHA
31/12/1957
DS.GUNAKSA KLUNGKUNG
113. 0000144216595
DRS. I KETUT SUJANA
10/12/1967
114. 0000144231805
DRS. I MADE KASJANA
12/03/1964
115. 0000143969905
DRS. I MADE KASJANA
12/03/1964
DS. KANGINAN PAKSEBALI
116. 0000143794912
DRS. I MADE RINDA
31/12/1948
JL.JEMPIRING SP.KLOD
117. 0000144215807
DRS. I NYOMAN SUWIRTA
31/12/1961
118. 0000143664513
DRS. I WAYAN BUDIARTHA
10/10/1968
119. 0000143737413
DRS. I WAYAN W. MERTANA
23/03/1969
120. 0000143785934
DRS.A.A. NGURAH KIRANA.
16/04/1960
BR BUCU DS.PAKSEBALI
BR. BOKONG KLOD DS.
SAMPALAN KLOD
BR. BATUR DS. SAMPALAN
KLOD
BR.PENINJOAN
121. 0000143918111
DRS.I MADE SUKA
02/02/1952
BR.KAYEHAN
122. 0000143789804
DRS.I NENGAH RADI ARTHA
31/12/1959
DUSUN TENGAH
123. 0000144005376
DRS.I NYOMAN OKA
22/02/1966
BR BANDUNG DESA
124. 0000143286827
DRS.I WAYAN BUDIARTHA,MSI
04/05/1955
DSN.LEKOK SAMPALAN
125. 0000143807714
DRS.I WAYAN MERTA
31/12/1964
BR. KANGINAN DS.
126. 0000143789848
DRS.I WAYAN MUSTIKA JAYA
31/12/1960
BR.KAWAN.PAKSEBALI
127. 0000143726782
DRS.I WAYAN SARKA
31/12/1944
BR BANDUNG GUNAKSA
128. 0000143710828
DRS.NYOMAN SUINDERA
15/01/1940
DESA SAMPALAN KLOD
129. 0000143669024
DRS.NYOMAN SUKERTA
14/04/1960
DS.TATAG SAMPALAN KLOD
130. 0000143743612
DSK NYM MURNI
03/11/1953
131. 0000143649819
DSK. KT. ALIT SUWITRI A. D.
25/03/1975
132. 0000143644612
DW AYU KARTIKA MAHARIANI
15/10/1996
JL CEMPAKA G II/8 A KLK

PENINJOAN
BR. PANCINGAN, DS.
133. 0000210405115
EKA JANUADIAA
22/03/2012
134. 0000145941243
EKA YULIANA AMBARWATI
05/07/1986
135. 0000142671341
FATHUR RAHMAN,SE
04/09/1979
KAMPUNG KUSAMBA
136. 0000142671352
FERA FITRIANA
24/04/1981
KAMPUNG KUSAMBA
137. 0000143798038
FINCA AKSAMINA
13/11/1956
BR.MANGGIS
138. 0000143654049
GDE AGUS SUJAYANA
19/01/1992
BR. TENGAH, DS. GUNAKSA
139. 0000143006444
GDE SRIDINA RAMANANDA S.
11/11/2000
140. 0000143738032
GEDE HERRY PRAYATNA
13/03/1977
141. 0000206788836
GEDE JAYA PRASETYA PUTRA
12/01/2001
JL. DEWI SITA NO. 2 DS.

SAMPALAN TENGAH
SAWO KABEH
142. 0000143767348
GEDE SUDIARSA
21/08/1958
JL. RAYA GUNAKSA
143. 0000143704282
GEDE YOGI PRADIVA YUDHA C
13/05/1997
BR.BUCU
144. 0000143712505
GST AYU NGR STIAWATI
31/12/1937
BR. KAWAN, DS. SULANG
2/1/13 4:56 PM
Page 3 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
145. 0000143678259
GST NGR NATHA PRADNYANA
28/03/2008
BR PASEKAN
146. 0000144013206
GST NYM OKA
31/12/1963
BR KANGINAN SULANG
147. 0000143712584
GST NYM RAI SADNYA
31/12/1940
N/A
148. 0000202207228
GUS DENAH
17/12/2005
149. 0000200051943
GUSTI ANOM DIRA PRADNYANA
14/06/1981
150. 0000162761872
GUSTI AYU PUTU WATI
31/12/1981
151. 0000200052112
GUSTI AYU RAI GANITRI
20/11/2008
152. 0000143678248
GUSTI KETUT ALIT ADNYANA
31/12/1980
153. 0000143700366
GUSTI PUTU KENDRI
31/12/1942
154. 0000143737435
HENDRA SETIAWAN
27/10/1995
155. 0000038011263
HERLIANSYAH
03/01/1986
SAMPALAN
BR. TENGAH, DS. DAWAN
KLOD
JL.RAYA GUNAKSA
KLOD
JL. SAWO KABEH, DS.
DAWAN KALER
BANJAR AGUNG
KLOD
-
156. 0000143682039
HERY SUHAIRI ,S.SOS
26/09/1975
DESA KAMPUNG KUSAMBA
157. 0000143766911
I B MADE SUGIARTA, A.MA
13/08/1981
DAWAN
158. 0000143786351
I DEWA AYU MADE PANCAKA
17/07/1960
BR. NYAMPING DS.
159. 0000143726376
I DEWA AYU MAYUN
31/12/1940
BR. PENINJOAN DS.
160. 0000143789859
I DEWA AYU NGURAH YUNIARI, S.PD
31/12/1967
161. 0000143743623
I DEWA GEDE SUSENA
31/12/1952
162. 0000143644599
I DEWA NYOMAN RAKA, SH.
31/12/1957
BR.KAWAN PAKSEBALI
JL. CEMPAKA GG. I / 8 A SP.
KLOD
BR PANCINGAN
163. 0000143789927
I DEWE GEDE ANOM
03/10/1966
BR.PENINJOAN
164. 0000160049935
I DW AYU YULI PARINADEWI
26/07/1985
DESA SULANG
165. 0000143969477
I G A ANGGI MANIKA YUDA
11/02/2005
BR. PENINJOAN
166. 0000143690984
I G.N.A ANDIKA PURNAMA. P
17/01/1995
BR. KAWAN DESA. SULANG
167. 0000143690995
I G.N.A.DHARMA RANDHIKA.P
10/07/1999
168. 0000143735949
I GD AGUNG WIGUNA NUGRAHA
05/01/1999
BR. PANCINGAN DS.
169. 0000143676652
I GDE ADITHYA PERMADI
31/10/1989
BR GROMBONG DS.SULANG
170. 0000143654962
I GDE WAHYU WIDNYANA
05/02/1997
DSN LEKOK
171. 0000001223199
I GEDE ARDIANA
07/07/2000
DSN BUAYANG
172. 0000144084791
I GEDE AGUS ASCANA
24/06/1980
DESA SATRIA KLUNGKUNG
173. 0000143006422
I GEDE AGUS SUANTARA
15/08/1975
PANDE
174. 0000195500158
I GEDE AGUS SURYAPUTRA
10/03/2009
175. 0000143303062
I GEDE ARIANTIKA PUTRA
05/06/2001
BR.PAPAH KEC DAWAN
176. 0000209283838
I GEDE BAGUS KUSUMA WIJAYA
16/06/2011
JL.RAYA KUSAMBA
177. 0000144215829
I GEDE EKA BAJRASWARA
19/05/2005
178. 0000143782053
I GEDE GANGGA PRAMANA
15/06/2000
BR. RAME, DS. KUSAMBA
179. 0000210319615
I GEDE GUNA ARYA WIJAYA
14/12/2011
BR.NYAMPING DESA
180. 0000198055089
I GEDE KARIANA
13/05/1982
GUNAKSA
181. 0000143646502
I GEDE MULIASTRA, SE.AK
01/04/1977
BR. PATUS DS. GUNAKSA
182. 0000143704269
I GEDE NGITE WIRAWAN
31/12/1967
183. 0000143793393
I GEDE PRIAMBADA
27/01/1990
184. 0000200524296
I GEDE SUKMA WIGUNA
15/09/2010
BR BUCU
BR. JABON DS. SAMPALAN
TENGAH
JL.MELATI GG.V NO.1
185. 0000143789861
I GEDE WAHYU KUSUMA
28/11/1994
BR. KAWAN PAKSEBALI
186. 0000141624055
I GEDE WAHYU WIRA YOGA
30/04/2009
DS BR.TAGTAG
187. 0000143795046
I GEDE WIRAGUNA,SPD
24/10/1979
BIMA NO 16 BR JABON
188. 0000143712461
I GST AYU RAKA
31/12/1931
N/A
189. 0000142834577
I GST KETUT ALIT ADNYANA
31/12/1960
BR. KAWAN, DS. PAKSEBALI
190. 0000143812045
I GST NGR AGUNG
31/12/1962
DESA SULANG DAWAN
191. 0000143855886
I GST NGR AGUNG ALIT
31/12/1963
BR KAWAN DS.SULANG
192. 0000143712459
I GST NGR OKA
31/12/1928
BR KAWAN,SULANG
193. 0000143652767
I GST NGURAH AGUNG,S.H
31/12/1962
DAWAN
194. 0000143696913
I GST NGURAH LATRA
31/12/1939
BR SATRIA
195. 0000143969444
I GST NGURAH YUDA, S.PD
30/09/1965
RAYA SATRIA
2/1/13 4:56 PM
Page 4 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
196. 0000143690962
I GST.NGURAH AGUNG SUBAWA
16/06/1969
BR.KAWAN DESA SULANG
197. 0000143712911
I GUSTI AYU ANOM
31/12/1953
DESA SULANG
198. 0000208041478
I GUSTI AYU NGR PUSPAWATI
02/02/1936
DS SULANG,DAWAN
199. 0000144019113
I GUSTI AYU RAKA
31/12/1957
200. 0000143690973
I GUSTI AYU SRI WARINI
29/05/1976
201. 0000144084789
I GUSTI AYU WIJANTARI
08/12/1982
DESA PAKSEBALI
202. 0000144019102
I GUSTI MADE OKA
31/12/1954
203. 0000143712819
I GUSTI NGURAH AGUNG
23/06/1943
BR.KAWAN DS.SULANG
204. 0000143727243
I GUSTI NGURAH SIDEMEN
31/12/1944
205. 0000143644083
I GUSTI PUTU RUSMIATI
09/10/1971
206. 0000164904254
I KADEK AGUS LEO WIJAYA
20/08/2009
BR. PENINJOAN DS.

DS.PAKSEBALI
DESA PAKSEBALI
207. 0000143789826
I KADEK ANOM SUDIARTANA
03/05/1989
DUSUN TENGAH
208. 0000976928062
I KADEK ARY SUGIANTARA
27/01/2012
BR. BANDUNG DS. GUNAKSA
209. 0000204747333
I KADEK BAWA PEBRI KUSUMA
13/02/2004
BR KEBON
210. 0000143807747
I KADEK DWI RENDRAHADI
31/01/1995
BR. KANGINAN DS.
211. 0000143798736
I KADEK EDY DESTRAWAN
15/12/1992
BR. TIMBRAH DS.
212. 0000143659001
I KADEK OKSTRADA
01/10/1995
213. 0000001223201
I KADEK SETIA ADNYANA
27/09/2003
DSN BUAYANG
214. 0000143790028
I KADEK SUANTIKA, S.PD
11/06/1972
BR.JABON SAMPALAN
215. 0000143670148
I KADEK SUASTIKA
30/09/1983
BR. KAWAN DS. PAKSEBALI
216. 0000143782997
I KADEK SURYA MAHARDIKA
21/04/1999
BR. BANDUNG, DS.
217. 0000209234608
I KD RADITYA TIRTA PRAYOGA
11/09/2011
BR.KEBON GUNAKSA
218. 0000143782929
I KDK ADI SANJAYA
05/04/1996
BR SENGGUAN
219. 0000207521076
I KETUT ALIT JULIARTAWAN
23/07/2008
BR BUAYANG,DS GUNAKSA
220. 0000143696057
I KETUT DARNA
31/12/1976
DS. GUNAKSA
221. 0000001223177
I KETUT DIANA
31/12/1976
DSN BUAYANG
222. 0000143790052
I KETUT KARDIKA
31/12/1963
DESA DAWAN KLOD
223. 0000143697071
I KETUT KARYA B.
31/12/1925
PAKSEBALI
224. 0000010681828
I KETUT KUSUMANASA
04/02/1979
DSN. KAWAN, DS. BESAN
225. 0000143713618
I KETUT MUDIRA
10/08/1942
BR.NYAMPING DS.GUNAKSA
226. 0000143809143
I KETUT MUDRA, A. MA. PD
31/12/1960
BR. KAWAN
227. 0000200509446
I KETUT PARSANA
13/05/1982
DSN NYAMPING
228. 0000143643374
I KETUT PARWATA
27/08/1965
BR.TENGAH DAWAN KLOD
229. 0000143768261
I KETUT RASNA
31/12/1958
DSN TENGAH, GUNAKSA
230. 0000143704675
I KETUT RUMIANA
07/06/1967
BR. SANGGING DS.
231. 0000143727287
I KETUT SIDRA
31/12/1950
BR. MINCIDAN DS. SULANG
232. 0000143790142
I KETUT SUDIARTA
31/12/1965
BR. BUAYANG DS. GUNAKSA
233. 0000143782031
I KETUT SURATA
16/07/1982
234. 0000143695181
I KETUT SURITA
23/09/1952
JL.ARJUNA NO.4 SAMPALAN
235. 0000143748235
I KETUT SUWECA
31/12/1952
BR. KANGINAN, DS. SULANG
236. 0000143714193
I KETUT TAMBER
31/12/1947
DSN KEBON
237. 0000141624033
I KETUT WIRAWAN
31/03/1982
DS BR.TAGTAG
238. 0000174643255
I KETUT WITYA DHARMA YASA
19/06/2006
JL.RAYA GUNAKSA
239. 0000143773751
I KETUT YOGA ARYANATA, A.MA
01/11/1979
240. 0000143769914
I KOMANG ADHI ANTARA
06/01/1992
241. 0000199844638
I KOMANG ALIT WILANTARA
17/03/1979
BR.SANGGING DAWAN KLOD
242. 0000206084316
I KOMANG ASTIKA
06/06/1983
243. 0000143662768
I KOMANG EDY SUDIANTARA
03/02/1991
244. 0000202206543
I KOMANG GUNARAKSA
14/06/1977
I GUSTI NGURAH RAI

JL. SAWO KABEH, DS.
DAWAN KALER
SAMPALAN
245. 0000143793011
I KOMANG KARDA, S.PD
12/09/1948
BR.LEKOK
246. 0000207417936
I KOMANG SAGUNG HEDI PERMANA
29/12/1987
247. 0000143658516
I KOMANG SUANTARA
16/05/1998
DUSUN TIMBRAH
DSN. KANGINAN DS.
PAKSEBALI
2/1/13 4:56 PM
Page 5 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
248. 0000194358172
I KOMANG SUARDANA
28/06/2010
249. 0000169878644
I KOMANG SUPARIAWAN
24/09/1984
250. 0000977166977
I KOMANG WAHYU NUGRAHA
14/09/2006
DSN KAWAN DS.PAKSEBALI

JL.SRI RAMA SAMPALAN
TENGAH
DSN. BANDUNG, DS.
251. 0000195499089
I KOMANG WIDIAPURA,S.P
06/12/1981
252. 0000143751429
I KT DANA
31/12/1950
N/A
253. 0000143684504
I KT KANTUN
31/12/1952
BR NYAMPING, DS GUNAKSA
254. 0000143697385
I KT SUMARSA
31/12/1928
BR PENINJOAN SATRIA KLK
255. 0000143661429
I KT.DENI SATRIA RAHARJA
10/07/1993
256. 0000143700388
I MADE TERANGARSA
10/10/1950
257. 0000143762657
I MADE ADNYANA
24/04/1949
258. 0000207798006
I MADE AGUS ADNYANA,SH
24/08/1985
SATRIA KALERAN
BR. LEKOK, DS. SAMPALAN
KLOD
BR BOKONG KAJA
259. 0000193341328
I MADE ANGGA WIRA SATYA
05/02/2004
DUSUN BUCU PAKSEBALI
260. 0000167222305
I MADE ARSANA
31/12/1971
BANJAR BUCU PAKSEBALI
261. 0000148490234
I MADE ARYA WIBAWA
23/09/1993
SAMPALAN KLOD
262. 0000203713784
I MADE EKA SULANTARA
12/02/1982
SAMPALAN TENGAH
263. 0000144033107
I MADE HARI SUKRAWAN,S.PD
13/10/1978
BR KANGINAN
264. 0000143663152
I MADE KENAK
31/12/1951
DS.GUNAKSA
265. 0000143654984
I MADE MERTA
20/03/1964
BR PENINJOAN PAKSEBALI
266. 0000143697418
I MADE MUSTIKA
01/12/1946
DUSUN TIMRAH
267. 0000143692997
I MADE POETERA
31/12/1928
268. 0000207360145
I MADE SAKA WISNAWA
05/03/2011
269. 0000143646669
I MADE SEGER,SH
31/12/1962
270. 0000143951725
I MADE SINTYA ADHI PUTRA
07/10/1991
271. 0000976005393
I MADE SUMBERDANA
23/08/1984
BR LEKOK
BR. PENINJOAN, DS.
PAKSEBALI
JL RAYA GUNAKSA
BR LEKOK, DS. SAMPALAN
KLOD
DS GUNAKSA
272. 0000143654973
I MADE WAHYU NARENDRA
25/06/2005
DSN LEKOK
273. 0000167226715
I NENGAH ARI SUARTAMA
14/03/2002
DESA SULANG
274. 0000193706741
I NENGAH DHARMA WIJAYA,ST
23/01/1981
275. 0000143726894
I NENGAH JIWA
31/12/1943
276. 0000143769881
I NENGAH KANDEL
31/12/1954
GUNAKSA
BR. PAPAAN DS. SAMPALAN
TENGAH
DSN TENGAH,GUNAKSA
277. 0000143786373
I NENGAH MERTHA YASA
28/03/1993
BR. NYAMPING DS.
278. 0000143715824
I NENGAH MUKTI
31/12/1939
DSN PATUS GUNAKSA
279. 0000143697723
I NENGAH NUGERA
06/01/1942
BR ULUNSUI SAMPALAN
280. 0000143663995
I NENGAH OPRIA ARIASTAWAN
04/04/1998
DSN. BANDUNG, DS.
281. 0000193888901
I NENGAH PARSA
25/04/1981
BR.TENGAH GUNAKSA
282. 0000143658347
I NENGAH PICA
31/12/1954
DSN.BR.BUCU PAKSEBALI
283. 0000143782896
I NENGAH PUSPITA
31/12/1964
BR SENGGUAN
284. 0000203127434
I NENGAH RAMIA
31/12/1942
DS. GUNAKSA
285. 0000143700333
I NENGAH RAMIA
31/12/1942
286. 0000143746852
I NENGAH SUARTA
31/12/1961
DS.SANPALAN KLOD KLK
287. 0000143649955
I NENGAH SUARTA
06/04/1975
DS GUNAKSA
288. 0000206750979
I NENGAH SUASNA
28/10/1979
GUNAKSA DAWAN
289. 0000143303051
I NENGAH SUASTIKA
09/06/1975
BR.PAPAHAN KEC.DAWAN
290. 0000143738291
I NENGAH SUBAWA KARDIKA P
03/05/1998
BR NYMPING DESA
291. 0000143807556
I NENGAH SUDIANA
31/12/1960
BR. KEBON DS. GUNAKSA
292. 0000143768237
I NENGAH SUDIARTA
31/12/1951
DSN TIMBRAH
293. 0000143782964
I NENGAH SUKARSA, SE
06/11/1967
BR. BANDUNG, DS.
294. 0000143783008
I NENGAH SUKERA
31/12/1954
295. 0000143658483
I NENGAH SUKRA
02/05/1962
296. 0000206788792
I NENGAH SUMARJAYA
13/10/1972
DS PATUS GUNAKSA KLK

DSN. KANGINAN DS.
PAKSEBALI
SAWO KABEH
297. 0000143798218
I NENGAH SUMARNAYA, S.PD
18/02/1963
BR TENGAH
298. 0000143755198
I NENGAH SUNARTA
13/07/1968
DSN PATUS DESA GUNAKSA
2/1/13 4:56 PM
Page 6 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
299. 0000143645264
I NENGAH SUTA
31/12/1968
BR. KANGINAN DS.
300. 0000143738278
I NENGAH TARU
11/12/1970
BR NYAMPING DESA
301. 0000143787576
I NENGAH WARDANA
29/10/1966
DSN. TENGAH, DS.
302. 0000143740618
I NENGAH WARKA
31/12/1956
BR
303. 0000143664186
I NENGAH WIDIANA
26/11/1998
BR. KANGINAN DS. SULANG
304. 0000143803113
I NENGAH WIJANA, SE
06/11/1980
DSN. KELODAN
305. 0000143726613
I NGH SUATHA
17/08/1936
BR BATUR SAMPALAN
306. 0000143769418
I NGH SUDIARTHA
09/09/1952
BR KANGINAN
307. 0000143689318
I NGH SUJANA
27/01/1971
BR JABON
308. 0000143778802
I NGH SUKATANA
05/12/1966
WANASARI
309. 0000143704348
I NGH SUNARTHA
31/12/1954
DSN KEBON
310. 0000143740642
I NGH WAHYU ASTINA PUTRA
21/10/1995
BR
311. 0000143697892
I NJOMAN TENGKOG
22/06/1928
DSN.PATUS DESA GUNAKSA
312. 0000143691208
I NYOMAN ARDANA
25/01/1960
BR METULIS
313. 0000143707509
I NYOMAN ARDANA
27/02/1977
BR. NYAMPING DS.
314. 0000203606741
I NYOMAN BUDIARTA,S.PD
04/07/1979
RAYA GUNAKSA
315. 0000167224162
I NYOMAN KARDANA
22/03/1972
DESA SULANG
316. 0000143735927
I NYOMAN MUDIA
23/10/1967
BR PANCINGAN
317. 0000143663962
I NYOMAN MUSTA
22/09/1967
DSN. BANDUNG, DS.
318. 0000143798231
I NYOMAN PATRA
05/04/1957
DESA PAKSEBALI
319. 0000143798714
I NYOMAN PATRA, S.SOS
05/04/1957
BR. TIMBRAH DS.
320. 0000143664153
I NYOMAN SADIA
31/12/1962
321. 0000143807613
I NYOMAN SUDARMA,S.PD
18/12/1961
KLUNGKUNG
322. 0000164272487
I NYOMAN SUKARSA
16/06/1969
JL.BUAYANG
323. 0000143656165
I NYOMAN SUMARTHA, SKM
12/01/1960
DESA BESAN
324. 0000144181539
I NYOMAN SUNARTA
23/05/1964
SAMPALAN KLOD
325. 0000977163063
I NYOMAN WIDI JUNIADA P.S
12/06/2002
DESA BESAN
326. 0000148483563
I NYOMAN WINASTRA,SE
31/10/1985
JL.RAYA GUNAKSA
327. 0000143689353
I PT BAYU APRIADI
10/04/1998
BR JABON
328. 0000143704416
I PT BGS PRADNYA SUARA
20/02/1992
BR. BATUR
329. 0000148489659
I PUTU ADI PUTRA
26/07/1995
JL.RAYA SAMPALAN
330. 0000193340496
I PUTU ARIAWAN
14/04/1975
331. 0000976618146
I PUTU ARY DANA W.P.
22/06/2012
DS GUNAKSA
332. 0000166480176
I PUTU EDI UDIYANA,SE
10/05/1986
333. 0000143951714
I PUTU EKA PUTRA
29/05/1989
334. 0000193341227
I PUTU EKA YUDA
02/11/2001
PAKSEBALI
KLOD
335. 0000165171701
I PUTU ERLYANT KUSUMA.
23/09/2009
MES SD.NO.2 SAMPALAN
336. 0000209270125
I PUTU GANGGA ADI NATHA
09/02/2012
BIMA NO 16 BR JABON
337. 0000201951303
I PUTU GEDE ARY SUARTAMA
21/12/2010
BR/DUSUN BATUR
338. 0000210162227
I PUTU GEDE WAHYU SUDIADNYANA
02/03/2011
CEMPAKA
339. 0000196098445
I PUTU PRADNYA DHARMA PUTRA
24/03/2010
340. 0000143674053
I PUTU RANU FAJAR MAHARTA
02/10/1995
341. 0000144329793
I PUTU RISDIANTHARA
10/10/1972
SRI RAMA
JL. MATAHARI IV NO. 1 SP.
KLOD
DSN PAKEL
342. 0000143786305
I PUTU SUASTIKA, SH
31/12/1964
DESA PAKSEBALI
343. 0000143786327
I PUTU SUDANA YASA
17/04/2001
DESA PAKSEBALI
344. 0000144127776
I PUTU SUDIARSANA
03/10/2000
345. 0000198055361
I PUTU WAHYU DIPRAYANA
10/03/2007
GUNAKSA
346. 0000173707119
I PUTUARYADANA
28/11/1997
SAMPALAN KLOD
347. 0000143717771
I WAJAN TJANDERA
01/12/1945
DSN BUCU DS.PAKSEBALI
348. 0000208444702
I WAYAN ARSA
31/12/1982
PAKSEBALI
349. 0000143676628
I WAYAN BAGIADA
09/04/1960
350. 0000143726714
I WAYAN BANTIR
31/12/1950
2/1/13 4:56 PM
Page 7 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
351. 0000143409159
I WAYAN BUDIASA
31/12/1958
BR.GEROMBONG SAMPALAN
352. 0000143951692
I WAYAN BUDIASA, A.MA.PD
31/12/1961
BR LEKOK
353. 0000163094578
I WAYAN BUDISUSILA
17/11/1976
BR LEKOK
354. 0000143726736
I WAYAN DEGENG
31/12/1925
BR.TAGTAG
355. 0000143660125
I WAYAN EDI SUARDIKA, S.PD
06/09/1985
DESA SULANG
356. 0000202493856
I WAYAN EKA SUARJAYA
26/11/2010
DESA SULANG
357. 0000143727377
I WAYAN GD SUARDANA
08/05/1967
BR. LEKOK
358. 0000143695631
I WAYAN GEGER ARTHA
31/12/1957
359. 0000143763039
I WAYAN KARTA
20/01/1971
360. 0000143698432
I WAYAN KARYA
31/12/1932
JL.NUSA KAMBANGAN 20
BR. PAKEL - SAMPALAN
TENGAH
BR KAWAN PAKSEBALI KLK
361. 0000143786349
I WAYAN KATEL, BA
31/12/1960
BR. NYAMPING DS.
362. 0000143733879
I WAYAN KERTI
31/12/1932
BR.PATUS GUNAKSA
363. 0000143718355
I WAYAN LABA
31/12/1941
GUNAKSA,DAWAN
364. 0000143718467
I WAYAN LONDERA
10/12/1935
BR.KLODAN BESAN
365. 0000143760868
I WAYAN M BAGIASTRA
31/12/1951
BR PAKSEBALI
366. 0000144191632
I WAYAN MADRA
31/12/1960
BR.LEKOK DS.SAMPALAN
367. 0000143698511
I WAYAN MUDARA
31/12/1940
BR.JABON SAMPALAN
368. 0000143718737
I WAYAN MUDIANI
31/12/1948
369. 0000143793371
I WAYAN MUDIASA
31/12/1964
370. 0000195049743
I WAYAN NOPA SUSILABAWA,A.MA
19/11/1984
SAMPALAN TENGAH
SAMPALAN TENGAH
KLUNGKUNG
DESA GUNAKSA
371. 0000143718873
I WAYAN NORDI
31/12/1948
DESA GUNAKSA, DAWAN
372. 0000143752173
I WAYAN NUARA
31/12/1959
GUNAKSA
373. 0000143700311
I WAYAN PANTJA
17/04/1943
.GIRIWISATA NO.13 BESAN
374. 0000037185671
I WAYAN PATRA
31/12/1955
DSN BUAYANG DS.
375. 0000143683705
I WAYAN PILEM,SH
07/12/1968
JL. RAYA GUNAKSA
376. 0000205496561
I WAYAN PRADNYA KAWIYASA
14/09/2010
DSN. KELODAN
377. 0000143653656
I WAYAN PUDJA SATRIAWAN
06/11/1953
BR.BOKONG KAJA
378. 0000143782986
I WAYAN PUTRA MARTHAYASA
03/03/1994
BR. BANDUNG, DS.
379. 0000206486741
I WAYAN RASEM,A.MD
31/12/1975
JLN.RAYA DESA GUNAKSA
380. 0000143704394
I WAYAN RUSTADI
02/06/1964
BR. BATUR
381. 0000143645668
I WAYAN SOMA
23/02/1963
PAKSEBALI
382. 0000143658977
I WAYAN SUARDANA
01/03/1966
383. 0000207654759
I WAYAN SUBAGIADA
04/04/1982
DUSUN PAPAHAN
384. 0000201951134
I WAYAN SUDANA
15/09/1980
385. 0000143741766
I WAYAN SUDARMA,S.PD.H
25/01/1961
386. 0000143727478
I WAYAN SUDARTA SH
29/12/1947
BR/DUSUN BATUR
MES SD 2 SAMPALAN KLOD
DAWAN KLUNGKUNG
BR. PENINJOAN
387. 0000195313588
I WAYAN SUDIARSA,A.MA
16/07/1986
388. 0000143736412
I WAYAN SUDIARTA
11/10/1965
389. 0000143755389
I WAYAN SUDIASA
31/12/1959
BR.NYAMPING DESA
DSN. PAKSEBALI DS.
PAKSEBALI
DSN BABUNG
390. 0000143790693
I WAYAN SUJANA, SE
21/05/1976
BR. BUAYANG, DS.
391. 0000167224937
I WAYAN SUKARMAYASA
26/10/1997
DESA SULANG
392. 0000143664175
I WAYAN SUKARSA
01/02/1992
393. 0000143720155
I WAYAN SUMIRTA
31/12/1942
394. 0000143671116
I WAYAN SUPARTA
31/12/1962
395. 0000148489637
I WAYAN SURAPASI
13/08/1967
BR BOKONG,SAMPALAN
JL. KRESNA GG II/B, DS.
SAMPALAN TENGAH
JL.RAYA SAMPALAN
396. 0000143698746
I WAYAN SUTARAMA
26/07/1927
BR.TIMBRAH PAKSEBALI
397. 0000143755907
I WAYAN SUTRESNA
31/12/1957
BR GEROMBANG
398. 0000143778835
I WAYAN SWARTIKA
31/12/1964
DSN BOKONG KAJA
399. 0000144051816
I WAYAN TJITA
31/12/1952
DS GUNAKSA KLK
400. 0000143720403
I WAYAN WARDA
24/08/1949
BR NYAMPING GUNAKSA
401. 0000144127754
I WAYAN WARSA, A.MA.PD
31/12/1964
2/1/13 4:56 PM
Page 8 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
402. 0000976932145
I WAYAN WEDY SUARBHAWA
31/03/2012
BR.TENGAH GUNAKSA
403. 0000157016946
I WAYAN WIDANA
12/09/1974
JL.RAYA GUNAKSA
404. 0000148490212
I WAYAN WIJANA
01/04/1964
SAMPALAN KLOD
405. 0000143769936
I WAYAN YUDIARTANA
29/04/1972
406. 0000143645826
I WYN DARMADA
31/12/1955
JL SAWO KABEH
407. 0000143763164
I.B.GDE KURNIA DYATMIKA
12/11/1999
SIDEMEN
408. 0000143794811
IDA AYU PUTUI SURYANI SPD
31/12/1946
BR.BOKONG KAJA
409. 0000143669035
IDA AYU RATNAWATI
16/04/1970
410. 0000143763131
IDA AYU SUARTINI, S.PD
19/04/1959
SIDEMEN
411. 0000143704405
IDA AYU SURYANTI
13/05/1969
BR. BATUR
412. 0000143763142
IDA BAGUS PUTU SUKARTIKA
05/06/1955
SIDEMEN
413. 0000143674031
IR.I MADE URDAYA
12/04/1963
DESA KLUMPU
414. 0000143650427
IRMA PRIHARTINI K
13/02/1990
KMPNG ISLAM KUSAMBA
415. 0000141622018
JASMINAH
31/12/1959
DESA. KAMPUNG KUSAMBA
416. 0000143727276
JERO MADE RATNAWATI
31/12/1944
417. 0000143712821
JERO WIARSA
31/12/1943
418. 0000143671149
KADEK ADI JUWITARA
22/07/1995
419. 0000143726297
KADEK AGUS JAYA TRISNA.
26/04/1991
BR.KAWAN DS.SULANG
SAMPALAN TENGAH
DS GUNAKSA
420. 0000206316066
KADEK DIAH ARIANTI
08/12/2009
DUSUN BOKONG
421. 0000005393327
KADEK DIAHSANTI AGUSTINI
04/08/1997
422. 0000167573621
KADEK DIAN SANTI AGUSTINI
04/08/1997
423. 0000143656198
KADEK DWI AGUS P. S.
21/08/1994
424. 0000143654275
KADEK KURNIAWATI,AMD.AK
07/09/1984
425. 0000144216538
KADEK MIRA ADNYASWARI
25/10/2000
BR.TENGAH
DAWAN KLUNGKUNG
DSN. KLODAN, DESA BESAN
BR.PAKEL DESA SAMPALAN
TENGAH
BR.BANDUNG DS.GUNAKSA
426. 0000197624924
KADEK NANIK KENCANA,A.MD.KEB.
17/07/1988
BR.PATUS
427. 0000143696079
KADEK SOMA KURNIAYANTI
01/10/2001
DS. GUNAKSA
428. 0000210162137
KADEK SUDIANA
05/06/1981
429. 0000143790085
KADEK SUKMA TIKA SAPUTRA
08/08/1990
430. 0000143778824
KADEK SURYA JULIANA P.
07/07/2001
431. 0000143669057
KADEK WIJAYA KUSUMA
26/03/2003
CEMPAKA
JL. SAWO KABEH, GG.
CEMPAKA, DS. DAWAN KLOD
JLN. RAYA GUNAKSA ,
DS.SAMPALAN.
DS.TATAG DS.SAMPALAN
432. 0000202207353
KADEK WIRA ADI MERTA
05/06/2009
SAMPALAN
433. 0000143807589
KADEK YUDIS ADITIANA
22/09/1991
434. 0000143695653
KD AYU DEPIYANTHI
10/05/1992
N/A
435. 0000143006455
KD.VINDHYA PALGUNA S.
06/03/2005
PANDE
436. 0000199773178
KETUT KARTIKA PUTERI
26/10/2007
DSN BOKONG KAJA
437. 0000197374419
KETUT RATNA YUANITA ASTARI
29/01/2009
438. 0000143726916
KETUT SANIA
13/07/1945
439. 0000143767359
KETUT SUPINI
31/12/1964
JL. RAYA GUNAKSA

BR.BOKONG DS.SAMPALAN
KLOD
BR LEKOK
440. 0000143727614
KETUT TISNI
20/08/1950
BR BOKONG KAJA
441. 0000143655028
KM ALIT PUTRI D PRATIWI
11/06/1995
442. 0000005166639
KM AYU SRI UTAMI
03/05/1992
N/A
443. 0000143699872
KMG GD JULIANTARA
26/07/1989
BR PENINJAUAN,PAKSE BALI
444. 0000143767383
KMG AGUS YUDA PRATAMA
15/03/2001
BR LEKOK
445. 0000143789613
KOMANG ANGGA MAHENDRA
29/06/1992
BR. BANDUNG DS .GUNAKSA
446. 0000143778868
KOMANG DEDI JULIAWAN
11/07/1995
DSN BOKONG KAJA
447. 0000206315829
KOMANG DEWI SUSILAWATI
02/09/1981
DUSUN BOKONG
448. 0000143695203
KOMANG GEDE PUTRA SANDI
01/06/1999
BR JABON
449. 0000143660215
KOMANG ISKARINI
01/01/1983
450. 0000206315392
KOMANG OKA ADI YASA,ST
22/02/1977
DUSUN BOKONG
451. 0000201940266
KOMANG SUKMA SARASWATI
23/07/1997
JL RAYA GUNAKSA
452. 0000144216505
KOMANG WIRABAWA,S.PD.
31/12/1969
BR.BANDUNG,GUNAKSA
2/1/13 4:56 PM
Page 9 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
453. 0000143769958
KORI YUNIARI
02/06/2002
454. 0000195400304
L NYM DEWI SRI UTAMININGSIH,AMD.KEB
05/02/1987
455. 0000167572967
LUH AYU DIAN MARTININGSIH
02/03/1991
456. 0000143704271
LUH GEDE FRISKA PRIYANTI
23/06/1993
BR.PENINJOAN PAKSEBALI
DAWAN KLUNGKUNG
BR BUCU
457. 0000143790041
LUH GEDE PRAMESTI I.
31/05/2001
458. 0000143654995
LUH GEDE SUATINI
31/12/1965
459. 0000143769407
LUH GEDE SUTARMI,S.PD
08/04/1958
BR.JABON SAMPALAN
BR PENINJAUAN DS,
PAKSEBALI
BR KANGINAN
460. 0000143678237
LUH KASMIASIH
04/05/1982
BR. PASEKAN
461. 0000143689757
LUH KMG DIAH KUSUMA DEWI
05/10/2005
462. 0000143951703
LUH KOMANG SERIASIH
22/10/1969
463. 0000143790039
LUH KOMANG YULIANTARI
06/07/1982
JLN RAYA KUSAMBA

KLOD
BR.JABON SAMPALAN
464. 0000143809762
LUH MADE ARTATI
31/12/1954
DS.PAKSEBALI
465. 0000200559892
LUH MADE ARTINI,A.MD.KEB
18/05/1985
BR. BUCU
466. 0000143782975
LUH MADE SUDIASTI
31/12/1968
BR. BANDUNG, DS.
467. 0000143713653
LUH NYOMAN SURATI
27/07/1940
DESA GUNAKSA
468. 0000206048406
LUH NYOMAN YAYUK RATNA DEWI
15/03/1987
I GUSTI NGURAH RAI
469. 0000143691221
LUH PT LAKSMI UTARI
26/04/1989
BANJAR METULIS
470. 0000143807624
LUH PT SUARTINI
29/03/1962
BR KAWAN
471. 0000144084802
LUH PUTU AYU PRITI SUSANTI
28/07/2007
DESA SATRIA KLUNGKUNG
472. 0000143790794
LUH PUTU MILA PRISTAYATI
23/05/1995
473. 0000143653678
LUH PUTU WARDANI
19/01/1990
474. 0000976959494
M.F SYAHPUTRA
06/08/1998
BR. PANDE, DS. DAWAN

DSN. BOKONG, DS.
SAMPALAN KLOD
DS.KMP.KUSAMBA, DAWAN
475. 0000173999259
M.KASRUDIN WASIR K
14/05/1985
KUSAMBA
476. 0000202889171
MADE ADITYA DARMA A.
16/12/2007
BR. BOKONG KAJA
477. 0000207590343
MADE BAGUS WIRADNYANA
01/07/2002
JL. RAYA GUNAKSA
478. 0000143789872
MADE BAYU DEWANTARA
25/04/1996
BR.KAWAN PAKSEBALI
479. 0000144005409
MADE BAYU SURYA PRAWITHA
07/12/1998
480. 0000143763063
MADE KRESNA BAYU
02/06/2001
481. 0000143674064
MADE RAHARJA SURYA MAHADI
26/10/1998
482. 0000977655148
MADE SATRIYA ADITYA D.
07/07/2012
BR BANDUNG DESA
TENGAH
JL. MATAHARI IV NO. 1 SP.
KLOD
483. 0000143727399
MADE SUBRATHA
31/12/1938
DSN BANDUNG GUNAKSA
484. 0000143699859
MADE SUKIATI
26/11/1964
BR PENINJAUAN,PAKSE BALI
485. 0000143691232
MADE YOGA PERMANA
04/01/1993
BR METULIS
486. 0000143704506
MARTINCE FAOT
03/03/1978
KLUNGKUNG
487. 0000143790849
MD ADISTHANAYA INDRA JAYA
02/01/1996
MESS SDN 2 PAKSEBALI
488. 0000143854536
MEIRZA NAEL QURNIAWAN
20/05/1993
DS.KMP.KUSAMBA,DAWAN
489. 0000198730833
MUHAMMAD AFAZANY RAHMAN
01/09/2010
KAMPUNG KUSAMBA
490. 0000142671363
NAZWA RAHMAN
27/08/2007
KAMPUNG KUSAMBA
491. 0000143681354
NENGAH RUDATHA
31/12/1950
492. 0000143787598
NENGAH SRI WAHYU DEWI
30/10/1998
493. 0000143722438
NENGAH SUDARSA
31/08/1943
DS.PESINGGAHAN
DSN TENGAH,GUNAKSA
DAWAN
DSN KANGIN,DS.BESAN
494. 0000143174316
NENGAH SUPARTIKA
08/08/1967
495. 0000143687474
NGH. ARIADI
31/12/1956
496. 0000143735951
NGR AGUNG INDRA NUGRAHA
23/12/2000
DESA SAMPALAN KLOD

BR.BANDUNG DESA
GUNKSA,DAWAN
BR. PANCINGAN DS.
497. 0000166480345
NI PUTU NANDA UDIYANA
08/05/2008
PAKSEBALI
498. 0000143660259
NI KADEK ARIANI,A.MA
10/05/1986
499. 0000143649685
NI KADEK ARYAWATI
31/12/1973
500. 0000143782064
NI KADEK DEVI PRASASTI
09/11/2001
PAKSEBALI
DSN. METULIS, DS. DAWAN
KALER
501. 0000143803855
NI KADEK DHESI
31/12/1961
BR BUUG DAWAN KLOD
502. 0000143645297
NI KADEK DWI SETIAWATI
11/09/1995
BR. KANGINAN DS.
2/1/13 4:56 PM
Page 10 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
503. 0000193341172
NI KADEK INDAH SUSILAWATI
28/02/1978
504. 0000143763041
NI KADEK PUTRI SUTRESNI
16/10/1971
505. 0000143645692
NI KADEK RINA SUMAWATI
28/03/1994

TENGAH
PAKSEBALI
506. 0000978026005
NI KADEK SALVIA CAHAYA P.
15/04/2012
JL.MELATI GG.V NO.1
507. 0000174518526
NI KADEK SWIYASNING
31/12/1996
JL.RAYA GUNAKSA
508. 0000195218548
NI KADEK WIJAYANTI,S.KOM
16/04/1984
509. 0000143746885
NI KD. OKA PADMIYANTI
08/02/1992
510. 0000144210464
NI KDK A MELIA ENDRAWATI
13/05/1990
SAMPALAN TENGAH
KLOD
BR ULUNSUI
511. 0000144051849
NI KDK AYU LESTARI D.
11/11/1994
BR TENGAH, DESA
512. 0000143649988
NI KDK DWI JUNIARTINI
26/06/2006
DS GUNAKSA
513. 0000206750529
NI KETUT BUDIASTITI,S.PD
24/02/1982
514. 0000143286838
NI KETUT INDRAWATHI
31/12/1957
515. 0000143700298
NI KETUT JEPUN
31/12/1938
GUNAKSA DAWAN
DSN. LEKOK DS. SAMPALAN
KLOD
BR.KAWAN PAKSEBALI
516. 0000143794923
NI KETUT KANTINI
31/12/1953
BR. BATUR, DS. KUSAMBA
517. 0000143726747
NI KETUT KIREG
31/12/1928
BR TAGTAG
518. 0000148483574
NI KETUT KRISTARI
30/03/1984
JL.RAYA GUNAKSA
519. 0000202207004
NI KETUT LARANINGSIH
30/04/1987
SAMPALAN
520. 0000052851071
NI KETUT LATHI
17/01/1942
BR PATUS GUNAKSA
521. 0000143790153
NI KETUT MARIATI
13/06/1965
522. 0000143737402
NI KETUT MULIYA WATY
25/07/1967
523. 0000143807951
NI KETUT MURSI,S.PD
12/06/1965
BR. BUAYANG DS. GUNAKSA

KLOD
DESA GUNAKSA
524. 0000208832477
NI KETUT MUSIANI,A.MA
11/07/1986
525. 0000143649448
NI KETUT NARIANI
12/08/1982
526. 0000144216516
NI KETUT NETRI
01/04/1970
527. 0000143697734
NI KETUT NITHI
01/12/1944
528. 0000126214233
NI KETUT RESINI SUANDARI
26/01/1972
BR.NYAMPING DESA
TENGAH
N/A
BR. ULUNSUI,DS. SAMPALAN
KLOD
DESA KLUMPU
529. 0000204919479
NI KETUT RESNING
31/12/1948
BR.PAKEL
530. 0000143689342
NI KETUT SRIASIH
31/12/1973
BR JABON
531. 0000143695192
NI KETUT SUDIARI
31/12/1962
JL.ARJUNA NO.4 SAMPALAN
532. 0000198052705
NI KETUT SUDIASIH,S.PD
30/10/1984
533. 0000143653667
NI KETUT SUKARMINI
21/04/1970
534. 0000193888719
NI KETUT SUMARNI
11/09/1979
GUNAKSA
DSN. BOKONG, DS.
SAMPALAN KLOD
BR.TENGAH GUNAKSA
535. 0000143798703
NI KETUT SUMIASIH, S.PD
17/03/1965
DESA PAKSEBALI
536. 0000143798229
NI KETUT SUPARWATI
31/12/1969
BR TENGAH
537. 0000143723428
NI KETUT SURATNING
31/12/1943
DESA SAMPALAN KLOD
538. 0000203265865
NI KETUT SURIARTINI
17/11/1984
539. 0000167572708
NI KETUT SUTARIATI
18/06/1968
540. 0000005393305
NI KETUT SUTARIATI.
18/06/1968
DAWAN
DAWAN KLUNGKUNG
BR.TENGAH
541. 0000143754849
NI KETUT SUWITRI
31/12/1949
BR PENINJOAN
542. 0000976927612
NI KETUT SWASTI
31/12/1988
543. 0000143723463
NI KETUT TJIPELEK
31/12/1928
BR.BANGDUNG GUNAKSA
544. 0000143786316
NI KETUT WISTARI
31/12/1976
DESA PAKSEBALI
545. 0000200509277
NI KETUT YUSTRIYANI
10/08/1986
DSN NYAMPING
546. 0000005384485
NI KM ASTINI
31/12/1964
N/A
547. 0000204708093
NI KOMANG ARIANTIKA PUTRI
13/09/2005
BR.PAPAHAN
548. 0000143303049
NI KOMANG ARIATI,SSI
03/12/1970
BR.PAPAHAN
549. 0000143969894
NI KOMANG ARSANI
14/12/1969
550. 0000144191654
NI KOMANG AYU ARYAWATI
26/05/1998
551. 0000141624044
NI KOMANG AYU MARTINI
17/03/1986
DS BR.TAGTAG
552. 0000143661418
NI KOMANG DIAN LESTARI
26/11/1990
2/1/13 4:56 PM
Page 11 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
553. 0000163095388
NI KOMANG JATU DWIJAYANTI
24/01/1981
BR LEKOK
554. 0000202311865
NI KOMANG MARHENA DEWI
06/03/1997
DESA PAKSEBALI
555. 0000173707029
NI KOMANG MIRNAWATI
23/05/1990
SAMPALAN KLOD
556. 0000143755209
NI KOMANG NURINI
12/01/1969
557. 0000143746896
NI KOMANG SRI DARMANI
24/07/1996
558. 0000202493529
NI KOMANG SRI PUSPITA DEWI
05/05/1990

KLOD
DESA SULANG
559. 0000148907079
NI KOMANG SRI YULIASTINI
31/01/1983
GUNAKSA
560. 0000206148407
NI KOMANG SUCI ARTINI,SE
23/09/1988
BR.PATUS DESA GUNAKSA
561. 0000143006433
NI KOMANG SURYAWATI
11/06/1979
PANDE
562. 0000195500046
NI KOMANG WIDIASIH
18/05/1984
563. 0000143737863
NI KOMANG WIDIASTUTI, SE.AK
03/12/1981
BR. PATUS
564. 0000204743981
NI KOMANG YULIANI
20/03/1977
BR KEBON DESA GUNAKSA
565. 0000143643385
NI KOMP.PT.MAHENDRAWATI
02/12/1968
BR.TENGAH DAWAN KLOD
566. 0000143790906
NI KT ARYANINGSIH
11/11/1991
RAYA GUNAKSA BR JABON
567. 0000143727401
NI KT JANTOS
31/12/1944
DSN BANDUNG GUNAKSA
568. 0000143138114
NI KT KARTININGSIH
21/04/1956
N/A
569. 0000143724903
NI KT PRAPTI
31/12/1947
N/A
570. 0000204884537
NI LUH AYU SUARDIASIH
17/12/1982
BIMA NO 16 BR JABON
571. 0000143643194
NI LUH DESIANI
30/12/1989
BR TENGAH DAWAN KLOD
572. 0000143663163
NI LUH KETUT SUDIRI
31/12/1951
DS.GUNAKSA
573. 0000143704563
NI LUH KUSUMA DEWI
01/08/1979
BR BUAYANG
574. 0000143691219
NI LUH MADE SARIATI
26/10/1965
BANJAR METULIS
575. 0000205200101
NI LUH PT JULIANI DEWI, S.PD
31/07/1986
576. 0000144191643
NI MADE ARI KUSUMADEWI
25/06/1994
577. 0000143762646
NI MADE ARIASIH
12/12/1951
BR LEKOK,SAMPALAN KLOD
578. 0000148909601
NI MADE ARNIATI, S.AG
06/02/1969
JLN CIUNGWANARA NO 2
579. 0000144005387
NI MADE BUDIASIH
11/06/1966
BR BANDUNG DESA
580. 0000142702086
NI MADE CITRAWATI
01/06/1960
BR KANGINAN
581. 0000143174327
NI MADE DARMIYANTI
08/02/1971
SAMPALAN KLOD
582. 0000976209592
NI MADE DIAN SULISTIOWATI
13/08/1984
BUAYANG
583. 0000143786338
NI MADE DWI SUSANTINI
17/05/2004
DESA PAKSEBALI
584. 0000143676639
NI MADE MASMINI
12/04/1962
585. 0000143760892
NI MADE RENI, A.MA.PD
25/07/1955
BR NYAMPING DS.GUNAKSA
586. 0000143678305
NI MADE SRITAMI RINDANI, SE
31/03/1981
587. 0000143726769
NI MADE SUDHIASIH
28/04/1947
588. 0000143653689
NI MADE SUGIARTI
04/04/1992
589. 0000143676663
NI MADE SUKMA YUSTINA
19/08/1992
JL.RAYA KUSAMBA
BR. BOKONG KAJA DS.
SAMPALAN KLOD
DSN. BOKONG, DS.
SAMPALAN KLOD
590. 0000143645275
NI MADE SUMIATI
20/05/1969
591. 0000143736423
NI MADE TAMAN
31/12/1967
592. 0000205081413
NI MADE WIRATI
07/10/1990
BR. KANGINAN DS.

DSN. PAKSEBALI DS.
PAKSEBALI
BR RAME
593. 0000977639444
NI MADE WULAN WIRA A.
07/03/2012
DS BR.TAGTAG
594. 0000159399707
NI MD DARMI
31/12/1958
BR./DSN. PENINJOAN
595. 0000168548681
NI MD DARMI
31/12/1966
596. 0000143793404
NI MD KRISNA PRADNYA DEWI
09/06/1994
597. 0000203555801
NI MD RAI DIAH PURNAMA D,AMD,KEP
29/06/1988
598. 0000143790682
NI NENGAH ANGGRENI, S. PD
04/10/1977
N/A
BR. JABON DS. SAMPALAN
TENGAH
BR PENINJOAN DS
PAKSEBALI KLUNKUNG
BR. BUAYANG, DS.
599. 0000143778846
NI NENGAH BUDIASIH
08/12/1965
BR. BOKONG KAJA
600. 0000205606484
NI NENGAH GEREGEK
31/12/1945
DS. GUNAKSA
601. 0000143664164
NI NENGAH KARDI
02/06/1968
602. 0000143738267
NI NENGAH KARSININGSIH
10/10/1972
BR NYAMPING DESA
603. 0000001223188
NI NENGAH KERTIASIH
30/12/1981
DSN BUAYANG
2/1/13 4:56 PM
Page 12 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
604. 0000143727039
NI NENGAH MURNI
31/12/1953
BR. PAKSEBALI KANGINAN
605. 0000143727568
NI NENGAH NERTI
31/12/1945
606. 0000143748257
NI NENGAH RISNADI
02/11/1990
607. 0000143697082
NI NENGAH RUPIG
31/12/1930
N/A
608. 0000143645679
NI NENGAH SITI
31/12/1965
PAKSEBALI
609. 0000143768259
NI NENGAH SRI ARINI
31/12/1962
DSN TENGAH, GUNAKSA
610. 0000143786913
NI NENGAH SRI WIDIANI,S.PD
21/10/1984
DS GUNAKSA
611. 0000148489648
NI NENGAH SRININGSIH
12/02/1972
JL.RAYA SAMPALAN
612. 0000196430578
NI NENGAH SUARSANI
18/05/1987
BR KANGINAN DS SULANG
613. 0000143803664
NI NENGAH SUARSANI
08/01/1963
DS.GUNAKSA KLUNGKUNG
614. 0000144181541
NI NENGAH SUARYATI
08/08/1965
SAMPALAN KLOD
615. 0000143793022
NI NENGAH SUASTHI
31/12/1953
616. 0000143658505
NI NENGAH SUASTINI
06/03/1991
617. 0000005392337
NI NENGAH SUDARMI
31/12/1968
BR.LEKOK
DSN. KANGINAN DS.
PAKSEBALI
618. 0000144127765
NI NENGAH SUDIASIH
23/03/1978
619. 0000143726725
NI NENGAH SUKERTI
31/12/1951
N/A
620. 0000143707498
NI NENGAH SULASIH
07/10/1978
BR. NYAMPING DS.
621. 0000206845852
NI NENGAH SUMIARTINI, S.PD
24/04/1988
BR.BANDUNG
622. 0000143667999
NI NENGAH SURENI
20/05/1967
DSN. BANDUNG, DS.
623. 0000143668023
NI NENGAH SUTAMI
10/10/1965
DUSUN TENGAH
624. 0000143752184
NI NENGAH WARTI
31/12/1959
625. 0000143723856
NI NENGAH WERTI
30/12/1939
DSN KANGINAN BESAN KLK
626. 0000143751418
NI NGH KARDI
22/02/1950
BR NYAMPING GUNAKSA
627. 0000143740629
NI NGH SRI NATI
31/12/1967
N/A
628. 0000143783019
NI NGH SUWATI
31/12/1956
DS.PATUS GUNAKSA KLK
629. 0000143700309
NI NYM BERATI
31/12/1923
630. 0000143720414
NI NYM DARMI
31/12/1951
631. 0000143760879
NI NYM SUDIARI
31/12/1957
DS TIMBRAH
DS.BR.NYAMPING DESA
GUNAKSA
BR. PAKSEBALI
632. 0000143803721
NI NYM TIRTAWATI
15/07/1964
BR JABON SAMPALAN,KLK
633. 0000143695642
NI NYM. DENTRI
31/12/1960
N/A
634. 0000143726793
NI NYM.SARNI
31/12/1949
BR BANDUNG GUNAKSA
635. 0000143790737
NI NYOMAN ARINI,S.PD
04/01/1969
KLUNGKUNG
636. 0000143807567
NI NYOMAN KARTINI
31/12/1963
637. 0000143698757
NI NYOMAN MINDING
31/12/1930
N/A
638. 0000143658358
NI NYOMAN MUDIASIH
31/12/1960
PAKSEBALI
639. 0000143681365
NI NYOMAN RAPINI
31/12/1961
N/A
640. 0000143722449
NI NYOMAN RENGKIG
31/12/1949
DSN KANGIN DS.BESAN
641. 0000143748246
NI NYOMAN SARI
31/12/1958
642. 0000143727219
NI NYOMAN SARIATI
30/12/1952
643. 0000143752296
NI NYOMAN SARNI A,MA.PD
31/12/1949

BR. KAYEHAN, DS. DAWAN
KALER
BR BANDUNG GUNAKSA
644. 0000143694202
NI NYOMAN SRINATI
12/01/1965
645. 0000143787565
NI NYOMAN SUARTINI, S. PD
14/06/1968
646. 0000143746863
NI NYOMAN SULASTRI
31/12/1968
647. 0000143726905
NI NYOMAN SUNDRI
31/12/1948
648. 0000143654016
NI NYOMAN SUTIADNYANI
31/12/1966
DSN. TENGAH, DS.

KLOD
BR. PAPAAN DS. SAMPALAN
TENGAH
BR. TENGAH, DS. GUNAKSA
649. 0000143656176
NI NYOMAN TAMAN ASIH
11/08/1965
DSN. KLODAN, DESA BESAN
650. 0000143793382
NI NYOMAN TIRTAWATI
15/06/1964
N/A
651. 0000143663016
NI PT DEVI FITRYA DEWI
07/12/1989
DSN PASEKAN DAWAN
652. 0000143649977
NI PT EKA SUPRIANTINI
13/04/2003
DS GUNAKSA
653. 0000205656309
NI PT NADINE PRABANDARI SUSILA
04/07/2010
BR LEKOK
654. 0000206268963
NI PT SUARSANI ANANDA DEWI
29/07/2011
DAWAN KLOD
2/1/13 4:56 PM
Page 13 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
655. 0000143789938
NI PT YUNI HARI, S.PD
04/06/1968
DSN PENINJOAN
656. 0000143645681
NI PT.PERA ARIANDANI
01/01/1990
PAKSEBALI
657. 0000146380511
NI PT.SUDEWI B, M.PD.H
16/12/1981
DAWAN KLOD
658. 0000148483585
NI PUTU AYU KRISTIA LESTARI
17/06/2009
JL.RAYA GUNAKSA
659. 0000203650121
NI PUTU AYUMI HEMAWARI
09/06/2010
RAYA GUNAKSA
660. 0000143658999
NI PUTU AYUSTINI
29/05/1989
661. 0000976927814
NI PUTU DIAH NUSA A.D
28/03/2009
662. 0000143645286
NI PUTU EKA MARTINI
22/03/1991
BR. KANGINAN DS.
663. 0000206315998
NI PUTU EKA PARISYA
20/02/2004
664. 0000976934349
NI PUTU FINA WAHYUNI
02/11/2011
665. 0000206751082
NI PUTU FRIDA OKTAVIANI
10/10/2008
DUSUN BOKONG
TENGAH
GUNAKSA DAWAN
666. 0000143782918
NI PUTU IRA SUCIPTAWATI
04/03/1994
BR SENGGUAN
667. 0000143738651
NI PUTU IRMAYANI
21/05/1980
BR. JABON
668. 0000143807736
NI PUTU MEGANTARI
05/05/1992
BR. KANGINAN DS.
669. 0000206788511
NI PUTU NILA WARSIKI
11/08/1979
SAWO KABEH
670. 0000143783021
NI PUTU NOPIAWATI
01/11/1993
671. 0000143686157
NI PUTU NOVI ARYANTARI
16/11/1984
672. 0000143174338
NI PUTU NUNUNG WIJAYANTI
15/10/2005
DS PATUS GUNAKSA KLK

KLOD
SAMPALAN KLOD
673. 0000194509348
NI PUTU SRI ARINA PERMATA DEWI
12/04/2010
BR. BUAYANG, DS.
674. 0000207654682
NI PUTU SUARI PIRUSTI,A.MD.KEP
18/02/1983
DUSUN PAPAHAN
675. 0000143724374
NI PUTU SWANDEWI
31/12/1935
DESA GUNAKSA,DAWAN
676. 0000143733881
NI PUTU SWANDEWI
08/11/1935
BR.PATUS GUNAKSA
677. 0000204744341
NI PUTU TRISNA OKTA CAHYANI
11/10/2001
BR KEBON DESA GUNAKSA
678. 0000207654772
NI PUTU WINA PRADNYA SUARI
26/07/2008
DUSUN PAPAHAN
679. 0000143697903
NI WAJAN SEDET
31/12/1932
680. 0000143671127
NI WAYAN NURATNINGSIH
31/12/1964
681. 0000143755211
NI WAYAN ANDANI
17/11/1997
682. 0000144196942
NI WAYAN ARNASIH
31/12/1958
683. 0000143790748
NI WAYAN ASTITI
15/08/1965
684. 0000143790063
NI WAYAN ASTITI
15/08/1965
685. 0000144051827
NI WAYAN ASTITI S.E
31/12/1967
DSN.PATUS DESA GUNAKSA

SAMPALAN TENGAH
BR. BOKONG, DS.
SAMPALAN KLOD
DS DAWAN KLOD KLK
JL. SAWO KABEH, GG.
CEMPAKA, DS. DAWAN KLOD
BR TENGAH, DESA
686. 0000143409161
NI WAYAN ASTUTI
16/02/1970
N/A
687. 0000143704631
NI WAYAN DARMAYANTI
18/03/1984
JL.MELATI GG.V NO.1
688. 0000143696924
NI WAYAN DARSINI
15/08/1963
DESA SATRIA PAKSEBALI
689. 0000206487516
NI WAYAN DEWI JUNIARTINI
06/06/1988
JLN.RAYA DESA GUNAKSA
690. 0000143724385
NI WAYAN GARNASIH
31/12/1954
BR BOKONG KAJA SAMPALN
691. 0000143715835
NI WAYAN GERIA
31/12/1942
DSN. PATUS, DS. GUNAKSA
692. 0000143704653
NI WAYAN JUNIARI
27/06/1972
BR
693. 0000143058622
NI WAYAN KARTINI
22/12/1982
BR DINAS TIYINGTALI KLEOD
694. 0000143727096
NI WAYAN KENDERI
31/12/1942
JLN BIMA NO 24
695. 0000167224612
NI WAYAN LAMI
31/12/1972
DESA SULANG
696. 0000143727298
NI WAYAN LATRI
31/12/1954
697. 0000143658494
NI WAYAN LATRI
05/06/1950
698. 0000143763748
NI WAYAN LUH SUTRIATI
08/04/1970
BR. MINCIDAN DS. SULANG

DSN. KANGINAN DS.
PAKSEBALI
LEKOK DS.SAMPALAN
699. 0000143786362
NI WAYAN MARSININGSIH
30/03/1992
BR. NYAMPING DS.
700. 0000143782042
NI WAYAN MAWI
31/12/1964
701. 0000143720166
NI WAYAN MITHA
31/12/1945
BR.BOKONG,SAMPALAN
702. 0000143769947
NI WAYAN MUSNIARI, SS
15/04/1970
703. 0000195495772
NI WAYAN MUSNIARI,SS
15/04/1970
GUNAKSA
704. 0000143718366
NI WAYAN RAKNING
31/12/1942
N/A
705. 0000143735938
NI WAYAN RIANI
06/07/1974
BR. PANCINGAN DS.
2/1/13 4:56 PM
Page 14 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
Alamat
706. 0000143769892
NI WAYAN SARIASIH
31/12/1966
707. 0000976646518
NI WAYAN SEDET
02/07/1930
708. 0000143704359
NI WAYAN SEKEN
31/12/1955
DSN KEBON
709. 0000143699624
NI WAYAN SERENGKEG
31/12/1927
BR.JABON SAMPALAN
710. 0000143649966
NI WAYAN SUARTINI
04/03/1979
DS GUNAKSA
711. 0000144191621
NI WAYAN SUDARMI
31/12/1965
712. 0000143790761
NI WAYAN SUDARMI,S.PD
31/12/1963
DS SAMPALAN TENGAH KLK
713. 0000143698522
NI WAYAN SUDIASIH
31/12/1948
N/A
714. 0000143668708
NI WAYAN SUDIASNING
31/12/1961
BR.TENGAH DESA GUNAKSA
715. 0000143738289
NI WAYAN SUKMA TARANING R
31/05/1995
BR NYAMPING DESA
716. 0000143718748
NI WAYAN SULESTRI
31/12/1948
SAMPALAN KLOD
717. 0000143803091
NI WAYAN SUMENDRI
31/12/1961
DSN. TIMBRAH, DS.
718. 0000143727489
NI WAYAN SUMIASIH
31/12/1956
BR. PENINJOAN
719. 0000143790884
NI WAYAN SUMIATHI
31/12/1957
720. 0000143726927
NI WAYAN SUPINI
01/12/1947
721. 0000144215818
NI WAYAN SURIATI
10/08/1976
RAYA GUNAKSA BR. JABON

BR.BOKONG DS.SAMPALAN
KLOD
722. 0000143654951
NI WAYAN SURYATI, SPD
05/11/1966
DSN LEKOK
723. 0000143670159
NI WAYAN SUTARINI
19/06/1980
BR. KAWAN DS. PAKSEBALI
724. 0000143739292
NI WAYAN WIDIASIH.
28/08/1960
GUNAKSA DAWAN.
725. 0000143696046
NI WAYAN WITRI
27/10/1972
DS. GUNAKSA
726. 0000148490223
NI WAYAN YUSTINI
24/08/1964
SAMPALAN KLOD
727. 0000005166606
NI WY NGETIS
14/09/1964
N/A
728. 0000144210442
NI WY SERI ASIH
31/12/1965
BR ULUNSUI
729. 0000143718884
NI WY SUDIASNING
31/12/1961
GUNAKSA
730. 0000143646671
NI WY SUNDARI
22/06/1965
N/A
731. 0000143645837
NI WYN SADRI
31/12/1956
SAWO KABEH
732. 0000144051838
NI WYN SUCIATI UTAMI
23/03/1989
BR TENGAH, DESA
733. 0000143782907
NI WYN SUDIATI
02/05/1965
BR SENGGUAN
734. 0000143678687
NI WYN SUKAWATI
31/12/1974
BR LEKOK
735. 0000143654005
NJ. D A N A
31/12/1957
BR TENGAH DS.GUNAKSA
736. 0000142998377
NS. NI WYN SURYANI,S.KEP
17/07/1982
BR PATUS,DS GUNAKSA
737. 0000143854514
NUR IBADIYAH
11/11/1975
DS.KMP.KUSAMBA,DAWAN
738. 0000143699815
NY.NI WAYAN RESI
31/12/1930
BR.PENINJOAN
739. 0000207855459
NY.TATI BUDIASTUTI
28/07/1972
BR.PATUS GUNAKSA
740. 0000143790772
NYOMAN MELY ISMARYATI
24/05/1972
741. 0000143697429
NYOMAN NURANI
01/12/1947
DSN TIMBRAH
742. 0000143699848
NYOMAN SUKARSA
08/10/1945
743. 0000143807635
OSILA
05/04/1989
744. 0000195097364
P.WIRYAWAN PARITRANAYA
05/09/1989
745. 0000143790805
PANDE MADE DWIPAYANA
25/04/2000
BR KAWAN
BR.BANDUNG DESA
GUNKSA,DAWAN
746. 0000143663027
PANDE MADE SWASTAMA
25/12/1991
DSN PASEKAN DAWAN
747. 0000143704697
PANDE RUDY KUSUMA JAYA
01/12/1997
BR. SANGGING DS.
748. 0000137440528
PRENTTY NGAU
24/09/1960
TATAARAN I LINGKUNGAN IX
749. 0000143790816
PT MERTA JAYA KUSUMA P,S.PD
06/12/1964
750. 0000143696068
PUTU AGUS KURNIAWAN
24/08/1998
DS. GUNAKSA
751. 0000976310526
PUTU AGUS SUKMA K.
17/07/1988
DUSUN BINGIN
752. 0000143727388
PUTU ALDO PURNAMA DINATHA
04/12/1998
BR. LEKOK
753. 0000977891861
PUTU AMRITA SANTIANI P.
12/03/2012
DSN NYAMPING
754. 0000143409172
PUTU ANGGARA WATI
26/03/1996
N/A
755. 0000205082392
PUTU BHADRIKA WIRAYANA
09/06/2010
BR RAME
756. 0000143727254
PUTU DASIH
31/12/1945
BR. PENINJOAN DS.
757. 0000143707004
PUTU DIAH ASMARIANI
20/01/1977
BR. BOKONG KAJA
2/1/13 4:56 PM
Page 15 of 16
No
No Kartu
Nama
JK
Tgl Lahir
PISA
758. 0000207590196
759. 0000144329804
760. 0000143669046
761. 0000143704686
PUTU DIAN AYUNINGTYAS
16/06/1996
JL. RAYA GUNAKSA
PUTU GEDE JULIAN YUAN P.
07/07/1998
DSN PAKEL
PUTU HENDRA KUSUMA
03/09/1998
PUTU KARTIKA CHANDRA. L
21/09/1994
BR. SANGGING DS.
762. 0000202888967
PUTU MARISSA PRAMESTI A.
22/02/2006
763. 0000143737424
PUTU META LISTYAWATI
18/05/1993
764. 0000204846085
PUTU NARENDRA NATHAN W.
24/06/2011
765. 0000143778813
PUTU NUSADI PUTRA
02/04/1993
766. 0000144005398
PUTU OKA SUDEWA
12/09/1991
BR. BOKONG KAJA

KLOD
GUNAKSA
JLN. RAYA GUNAKSA ,
DS.SAMPALAN.
BR BANDUNG DESA
767. 0000143790838
PUTU PREMANA INDRA JAYA
20/10/1991
768. 0000143693008
PUTU PUTERI
31/12/1946
769. 0000143643205
PUTU RENA ANGGRENI
02/05/2006

BR LEKOK DS. SAMPALAN
KLOD
BR TENGAH DAWAN KLOD
770. 0000143704664
PUTU WIDIASTRI EKA PURNAWATI
19/09/1969
BR SANGGING DS.KAMASAN
771. 0000144216527
PUTU WILANDARI
12/01/1999
BR.BANDUNG DS.GUNAKSA
772. 0000143969927
RADHA KANTHA DEWI DASI
26/12/1995
773. 0000143697802
RR. SRI WAHYUNI, BA.
27/07/1946
BR.NYAMPING DS.GUNAKSA
774. 0000145941254
RUSLAN
27/10/1981
775. 0000143727186
SUKARDI
01/06/1950
776. 0000143727197
SUKARMI
07/09/1963
777. 0000196510544
SANG AYU REKHA D,S.SN
07/01/1986
778. 0000143681861
SITI MARDIYAH, S.PD.I
12/10/1980
779. 0000143803844
SN.MICARYASA S.PD
25/06/1959
DUSUN PENINJOAN
KAMP. KUSAMBA DS.
KAMPUNG KUSAMBA
BR BUUG DAWAN KLOD
780. 0000168548589
SRI SUYANTI
26/07/1950
N/A
781. 0000143650405
SUDJIATI
25/10/1958
KMPG ISLAM KUSAMBA
782. 0000143678463
SUSILAH
21/04/1960
BR.PENINJOAN
783. 0000143682041
V Z GHADZAFI ALFATIH
24/03/2007
DESA KAMPUNG KUSAMBA
784. 0000144210431
WAYAN ARSADANA
01/05/1960
BR ULUNSUI
785. 0000207657044
WAYAN IWAN ARDANA,S.PD
12/12/1986
JLN.RAYA GUNAKSA
786. 0000976209581
WAYAN NATA SEPTIADI
12/09/1984
BUAYANG
787. 0000143739887
WAYAN PURNIAWATI
04/01/1980
RAYA GUNAKSA
788. 0000143787587
WAYAN SATYA WERDAYA
27/07/1991
DSN. TENGAH, DS.
789. 0000143790783
WAYAN SUARBAWA
17/04/1969
790. 0000143763052
WAYAN TRISNA ANDIYANI
30/12/1996
791. 0000143790873
WAYAN WIDJA, S.PD
06/09/1957

TENGAH
RAYA GUNAKSA BR JABON
792. 0000143854503
ZAENAL ABIDIN, SH
31/12/1958
DS.KMP.KUSAMBA, DAWAN
2/1/13 4:56 PM
Alamat
JL.PELABUHAN KUSAMBA
DS.KMP KUSAMBA
DS.KMP KUSAMBA
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Daftar Peserta Askes Sosial

A.A ISTRI WULAN

I GST A SINTA AMARA YUDA

PURI SATRIA KALERAN, DS.

DSN. BUAYANG DS.

BR PURI SATRIA KAWAN

A A ISTRI OKA YUNIWATI

A A PUTRI KANIA PRATIWI

A. A. GDE IKA YASHALUGRA

A. A. GEDE ANOM LABA

A. A. GEDE NATA PRAWIRA

A. A. ISTRI NATA PRATIWI

A. A. ISTRI OKA PARWATI

A. A. ISTRI RATU MASAYU N

A.A GD ANOM MEGA WIBAWA

A.A GD SAYANG TRI MEGA P,S.KOM

A.A ISTRI A.PRABA NINGRUM

A.A ISTRI PUTERA WIDIASTITI

A.A RADEYA GANA PRADATA

A.A. GDE ANOM ADITYA. W

A.A. ISTRI ANOM ADNYANI

A.A. MADE SUSILA PUTRA

A.A.ANOM KRISNA SUARI

A.A.GDE OKA GULEM

A.A.GDE OKA PHAWANA

A.A.GDE PRAYOGA TANAYA

A.A.GDE SAYANG SUTANTRA

A.A.GDE YUDHA SANDYASTICA

PURI SATRIA KANGINAN

A.A.GEDE NATA KUSUMA.

A.A.I.ALIT PUTRI INDRA D.

A.A.I.NGURAH ERAWATI, S,AG

A.A.ISTRI ALIT MULIAWATI

A.A.ISTRI ANOM ASTINI

A.A.ISTRI ANOM BINTANG P.

A.A.ISTRI ANOM MAHENDRAWATI,A.MA

A.A.ISTRI KOMALA SARI,A.MA

DUSUN TENGAH DESA AKAH

A.A.ISTRI NGURAH MAYA P.

A.A.ISTRI NGURAH WATI

A.A.ISTRI OKA CANDRAWATI

PURI SATRIA KANGINAN

A.A.ISTRI OKA CITA,S.PD

A.A.ISTRI OKA KRISNADEWI

A.A.ISTRI OKA SUJANI.

A.A.ISTRI RAKA SUTJIATI

PURI SATRIA KANGINAN

AA GDE SAYANG KARTIKA

BR. BUCU DS. PAKSEBALI

AAI AGUNG WIRATIH

ADE LAKSMI JASANANDA DEWI

AGUS ERISTANA DEWANTA

ANAK AGUNG DEWA YANI

ANAK AGUNG DEWI SURYANINGRAT

ANAK AGUNG ESA KURNIA. D

ANAK AGUNG GDE ANOM

ANAK AGUNG GDE ANOM,S.SOS

ANAK AGUNG GDE MAYUN WIJA

ANAK AGUNG GDE SAJANG

ANAK AGUNG GDE SAYANG

PURI SATRIA KANGINAN

ANAK AGUNG GEDE NGURAH