Gg.

Mushola Nurul Huda Rt 15/5

 PENCATATAN IMUNISASI RUTIN BAYI/BATITA DI UNIT PELAYANAN
NAMA UNIT PELAYANAN KESEHATAN : RSIA "KASIH IBU" TEGAL

BULAN : APRIL
TAHUN : 2017

TANGGAL DPT-HB- DPT-HB- DPT-HB- DPT-HB- Campak

NO NAMA BAYI/BATITA JK NAMA ORANG TUA ALAMAT LENGKAP HB0 BCG Polio 1 Polio 2 Polio 3 Polio 4 IPV CAMPAK MEASLES KET
LAHIR Hib (1) Hib (2) Hib (3) Hib lanjutan lanjutan

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

1 An.Naila Chelze Azzhia P 29/1/2017 Ny.Ribut Sriwati Maribaya rt2/1 Kramat 3/4/17 3/4/17

2 An.Lukman Hakim L 4/1/17 Ny.Puji Ds.Jatilawang rt 4/3 Kramat 4/4/17 4/4/17

3 By. Ny. Saadah L 2/4/17 Ny.Saadah Ds.Kalinyamat wetan rt 4/1 3/4/17

4 By.Ny. Farikha P 4/4/17 Ny.Farikha jl.Kali jeruk rt 3/4, Mejasem Timur 4/4/17

5 An. Arief Rahman Rafif L 26/12/2016 Ny.Istianah Jl.Rambutan 10 no.13 Rt5/7 Kraton 5/4/17 5/4/17

4/3/17 Ny.Sri Hesti Pesarean rt 4/2 Adiwerna 5/4/17 5/4/17

6 An. Nazila Erum Fahima P

7 An. Viriya Ilma P P 28/9/15 Ny.Melisa Jl. Salak No.25 rt 4/1 Tegal DPT 4(5/4/17)

8 By. Ny St. Maslikha P 3/3/17 Ny. St.Maslikha Ds.Kesadikan rt 1/1 Tarub 4/3/17

9 By.Ny Sairah P 3/3/17 Ny.Sairah Ds.Kramat rt 6/2 Kramat 4/3/17

10 By.Ny Wiji Hastuti P 4/3/17 Ny.Wiji Hastuti Ds.Kertaharja rt 4/3 Kramat 4/3/17

11 An.Lutfia Muhbita P 31/1/2016 Ny.Alfi Nur Ds. Langgen rt 1/1 Talang 8/3/17 8/3/17

12 An.M Ashif L Ny.Tasliha Jl.Syeh kanan Pekauman kulon 8/3/17 8/3/17

13 By.Ny Vina Jarotul L 10/3/17 Ny.Vina Jarotul Ds.Sidoharjo rt 10/5 Suradadi 11/3/17

14 By.Ny St Ayu Restiani P 11/3/17 Ny.St Ayu Restiani Ds.Bongkok rt 1/1 Kramat 11/3/17

11/3/17 Ny.Nur Syamsiah Ds.Siwungkuk rt 12/3 wanasari Brebes 12/3/17

15 By.Ny Nur Syamsiah L

16 By.Ny Nani Musiati L 12/3/17 Ny.Nani Musiati Jl.Blanak no 22 rt 5/2 tegal sari 13/3/17

17 By.Ny Darningsih L 12/3/17 Ny.Darningsih Ds.Bongkok rt3/1 Kramat 13/3/17

18 An.Azkia Shafia P 5/12/16 Ny.Lisa Heliani Jl.Mawar rt 7/3 Kramat 13/3/17 13/3/17

19 An.M.Raja Bumi L 3/12/16 Ny.Yati Kusmiati Mejasem rt 11/9 Kramat 15/3/17 15/3/17

20 An.Hasna fathun P 11/11/16 Ny.Nidaul Ds.Pakembaran rt 2/4 Slawi 16/3/17 16/3/17

21 An.Shava Almira P 19/11/17 Ny.Fania Jl.Mejasem Pala raya 17/3/17 18/3/17

22 By.Ny.St Nur Lisnawati L 14/3/17 Ny.St Nur Lisnawati Ds.Gembong Kulon rt 13/4 Slawi 16/3/17

23 By.Ny. Cici Jumaroh L 14/3/17 Ny.Cici Jumaroh Ds.Banjarharjo rt 2/1 Brebes 15/3/17

24 By.Ny Musdalifah P 15/3/17 Ny.Musdalifah Jl.Kemuning no 48 rt 1/3 Tegal 15/3/17

24 By.Ny. Tri Iza P 15/3/17 Ny.Tri Iza Ds.Kesadikan rt 13/2 Kramat 16/3/17

25 By.Ny.Imaningtyas P 17/3/17 Ny.Imaningtyas Kerandon rt 4/2 Margadana 17/3/17

26 By.Ny.Nur khikmah P 16/3/17 Ny.Nur KhikmaH Jl.Nusa Indah rt 5/3 Tegal 20/3/17

27 By.Ny. Waefuroh p 17/3/17 Ny.Waefuroh Ds.Bangsri rt 3/1 Bulakamba 19/3/17

18/3/17 Ny.Silfia Sanggreani Randusanga Wetan rt 1/1 19/3/17

28 By.Ny Silfia Anggreani L

29 An.Kinanti Navisya P 30/10/16 Ny.Radarina Jl.Klapa Sawit rt 6/2 22/3/17 22/3/17

30 An.Ainun Khoerunisa P 8/2/17 Ny.Kalimah Ds.Kaligangsa rt 2/7 22/3/17 22/'3/17

31 An.Hafsah Alisya P Ny.Desi Jl.Nakula rt 3/6 Tegal 22/3/17 22/3/17

32 By.Ny Nurul Akmaliyah P 20/3/17 Ny.Nurul Akmaliyah Adiwerna rt 9/2 Tegal 20/3/17

33 By.Ny Erli Sirotun P 19/3/17 Ny.Erli Sirotun Ds.Kepandean rt 2/6 Dukuhturi 20/3/17

34 By.Ny.Warniti P 21/3/17 Ny.Warniti Ds.Bengle rt 10/2 Talang 21/3/17

35 By.Ny Murtiati P 21/3/17 Ny.Murtiati Ds.Margapadang rt 3/1 tarub 22/3/17

36 By.Ny.Karningsih P 22/3/17 Ny.Karningsih Jl.Brawijaya rt 2/2 Muarareja 23/3/17

37 By.Ny.Riska P 22/3/17 Ny.Riska Ds.Pacul rt 17/4 Talang 23/3/17

38 By.Ny Tanti Rahayu P 23/3/17 Ny.Tanti Rahayu jl.Hanoman 2 no 1 Slerok 23/3/17

39 By.Ny Nur hikmah L 25/3/17 Ny.Nur hikmah Ds.Kramat rt 5/2 Tegal 26/3/17

40 By.Ny Endang Astuti L 24/3/17 Ny.Endang Astuti Ds.Tanjungharja rt 1/5 Kramat 24/3/17

41 An.Fayzah Rahmah P 6/6/2016 Ny.Darti Ds.Suradadi rt 3/5 Tegal 24/3/17

42 By.Ny Sulastri L 27/3/17 Ny.Sulastri Ds.Banjarturi rt 2/3 Warureja 29/3/17

43 By.Ny Lia Ayu K L 29/3/17 Ny.Lia Ayu K Ds.Kaligangsa rt 3/3 Tegal 29/3/17

44 By.Ny Tailah P 19/12/16 Ny.Tailah Ds.Kramat rt 2/1 30/3/17 30/3/17

45 An.Akbar Aliya L 11/11/2016 Ny.Mafiyah Pagongan rt 2/4 Talang 30/3/17 30/3/17

Mengetahui
Plt.Direktur
RSIA "Kasih Ibu" Tegal

dr. Rohmatullah