FORMAT PENDATAAN PUS

TAHUN 2017

Kota :
Puskesmas :
Desa :
Posyandu :
Alamat (dusun/RT/RW) :

No NIK KK / No KK NIK ISTRI Nama Tgl Lahir NIK SUAMI Nama Tgl lahir

1 357101011205067451 3571016705710004 Mujiat 27-05-1971 3571012502640004 Suwardi 25-02-1964

2 3571010506070407 3571014107780125 Feeny 01-07-1978 3571012111620001 Budiono 21-11-1962

3 3571010506070399 3571014512730009 Ruslina 05-12-1973 3571010407720002 Setyo Sudarmono 04-07-1972

4 3571010506070366 3571015506830006 Sri rahayu 15-06-1983 3571011206810008 Slamet Hariyono 12-06-1981
5 3571010506070342 3571015406740002 Kasri 14-06-1974 3571012008720005 Asep Sukarjo 20-08-1972

6 3571011305080008 3571015208850002 Linda Ratna Wat 12-08-1985 3571011612820002 Dedi triwahyudi 16-12-1982
7 3571011205066651 3571014204850005 Winda Lestari 02-04-1985 3571010712780001 Wiba Nasukin 07-12-1978

8 3571012310070012 3571014404810009 Fauzul Haniah 04-04-1981 3571011810760006 M. Saiful 08-10-1976

9 3571011205067463 3571016902760005 Imro'ah 29-02-1976 3571012701730003 Kastomo 27-01-1973

10 3571012811070007 3571016811770005 Kensie Waryaningsih 28-11-1977 3571011303730009 Jumanto 13-03-1973

11 3571012107090015 3571016209870001 Dwi Lukita Ningtas 22-09-1987 3571023006840001 Sugeng Hariyono 30-06-1984
12 3571011205067475 3571015205790003 Bibit Waluyat 12-05-1979 3571012312770003 Iswanto 23-12-1977
13 3571012502100006 3571014701880010 Lailatul Mahmudah 07-01-1988 3571012505840005 Jamali 25-05-1984
14 3571010203090020 3571016804810009 Erny Dwi Purnamasari 28-04-1981 3571012003800004 Ari Prasetyo 20-03-1980
15 3571010506070393 3571014101890011 Kristn Yulianes 01-01-1989 3571012503800006 Slamet Widodo 25-03-1980
16 3571010506070402 3571010471280006 Yuty Ghamar G. 07-12-1980 3571011704790009 Beni Sudarta 17-04-1979
17 3571010508080007 3571016006860006 Nur Cholidah 20-06-1986 3571012709780004 Didik Haryudi 27-09-1978
18 3571010506070410 3571015202820007 Rodiyah 12-02-1982 3571012212790005 I Gede Suniarta 22-12-1979
19 3571011205066627 3571014501820007 Ita Juniaris 05-01-1982
20 3571011111080001 3571014407760001 Kartningsih 04-07-1976 3571010611730006 Andik Eko Nur Cahyo 06-11-1973

21 3571011006090004 3571015010880005 Sit Arie Rahmawat 10-10-1988 3571013103820004 Nuriyantono 31-03-1982

22 3571011010080003 3571016402840007 Erna Ningtas 24-02-1984 3571011606840012 Ahmad 16-06-1984

23 3571011102080022 3571015003810013 Soryat 10-03-1981 3571011404730007 Sunyoto 14-04-1973

24 3571011205066643 3571014311650002 Paniat 03-11-1965 3571011506590003 Miranto 15-06-1959

25 3571011305061514 3571014206720006 Sumiat 02-06-1972 3571012405680005 Huni Asmara 24-05-1968

26 3571010209100008 3571017107780002 Ida Yuliant 31-07-1978 3571013101730003 Andi Waluyo 31-01-1973

27 3571011211080030 3571016312830005 Dessy Lutfiasari 23-12-1983 3571012112590004 M. Sajid 21-12-1958

28 3571011205066659 3571014509690007 Sriyani 05-09-1969 3571012307660001 Hariyanto 23-7-1966

29 3571011205067452 3571016704650004 Sriatun 27-04-1965 3571012504610003 Suparman 25-04-1961

30 3571011305062559 3571014302800003 Upik Safitri 03-02-1980 3571012505750003 Sigit Djatmiko 25-05-1975

31 3571010506070401 3571015406810007 Sit Maisaroh 14-06-1981 357101190780006 Andik 19-07-11980

32 3571010601110009 3571015805830001 Suwarni 18-05-1983 3571012305760004 Critoadi 23-05-1976
33 3571011111100001 3571014808800002 Sulis Styowat 08-08-1980 3571011008660003 Seger 10-08-1966
34 3571010811100006 3571014409850001 Rini Renaningsih 04-091985 3571010903790003 Panca Pradono 09-03-1979
35 3571010301110001 3571016910830005 Bekah Rahmawat 29-10-1983 3571012512810005 Dwi Heri Minto 25-12-1981
36 3571010301110025 3571016802910003 Bint Kholifah 28-02-1991 3571012507730001 Suryono 25-07-1973
37 3571012502100006 3506234701880002 Lailatul Mahmudah 07-01-1988 3571012505840005 Jamali 25-05-1984
38 3571011101100008 3571014208830021 Sit Maimunah 02-08-1983 3571012711720002 H. M. Nafis Kurtubi 27-11-1972

39 3571010608080008 3571015102830003 Sumarlik 11-02-1983 3571012407840006 Agus Yunito 24-07-1984

40 3571010606070188 3571016910800004 Sri Ani 29-10-1980 3571013101730002 Nyoni 31-01-1973
41 3571012409070021 3571015006810001 Rini Astutk 10-06-1981 3571012202780008 Waras 22-02-1978

42 3571011409090006 3571025506820013 Rahmawat 15-06-1982 3571012408830010 Ayub Buhari 24-08-1983

43 3571012310070024 3571014603900004 Mariana 06-03-1990 3571011808860004 Agus Arifin 18-08-1986
44 3571012404080063 3571016201320001 Gesang Wiji Astutk 22-01-1982 3571010808840009 M. Yunus 08-08-1984
45 3571012404080061 3571016704730001 Sukarlis 27-04-1978 3571012208770004 Putut Sudarwoko 22-08-1977
46 3571011709080024 3571015506790007 Sunart 15-06-1979 3571010803720008 Moch. Ilyas 08-03-1972

47 3571011305063586 3571014301870005 Lilik Purwiyant 03-01-1987 3571010512760002 Ana Tolik 05-12-1976

48 3571011305063580 '3571014202840002 Cicik Yuweni 02-02-1984 3571010809680002 Asmirin 08-09-1968
49 3571011305090013 3571025807800003 Eni Puryant 18-07-1980 3571011110780002 Andang Andriyas Irham 11-10-1978
50 3571010606070187 3571015108830004 Imroatul Mukaromah 11-08-1983 3571012204750006 Wijianto 22-04-1975
51 3571010606070184 3571016203820005 Sulis Tiyani 22-03-1982 3571011006730004 Nanang Prastomo 10-06-1973
52 3571010408080002 357101606810008 Sudarmiat 26-06-1981 3571012505830007 Agus Setawan 25-05-1983
53 3571012608100006 3571017108740001 Muawanah 31-08-1974 3571012109680004 Muhamad Toha 21-09-1968

54 3571013011100015 3571014612860001 Astriani. SE 06-12-1986 3571012805840005 Hendra Kurniawan, S.sos 28-05-1984

55 3571011709100004 3571015709820001 Diah Ratnawat 17-09-1982 3571010507820008 Puguh Settiawan 05-07-1982
56 3571011611100016 3571015307780003 Rita 13-07-1978 3571010903790005 Jumadi 09-03-1979
57 3571012055066603 3571016506800001 Musdalifah 25-06-1980 3571011107680003 Daim 11-07-1968

58 3571012404080062 3571015802710002 Sulastri 18-02-1971 3571012112670006 Pueyanto 21-12-1967

59 3571012009070016 3571016011650003 Suminah 20-11-1965 3571011804580001 Sutrisno 18-04-1958

60 3571010706070064 3571015209660002 Halimah 12-09-1966 3571010712520001 Suwarno 07-12-1952

61 3571010706070056 3571014512870001 Dewi Susant 05-12-1987 3571012906790003 Ginyang Setono 29-06-1979
62 3571010701100014 3571015002860001 Bint Zulaikah 10-02-1986 3571011507820007 Faisal Zulham Fanani 15-07-1982
63 3571010706070055 3571016008890005 Agest Sevianingtyas 20-08-1989 3571010802860004 Andi Purwantoro 08-02-1986
64 3571010706070058 3571014809830004 Sumiat 08-09-1983 3571012107790006 Gunawan 21-07-1979
65 3571011102100002 3571014104920009 Sulatri 01-04-1992 3571010105840005 Prawoto 01-05-1984
66 3571010706070069 3571014404700005 Alfa Sichah 04-04-1970 3571010509670002 Umar Ali 05-09-1967

67 3571010706070067 3571016607760003 Jumini 26-07-1976 3571011107790006 Khoirudin Rifai 11-07-1979

68 3571010706070060 3571014607620010 rukant 06-07-1962 3571010903690003 sumeri 09-03-1969

69 3571011205066620 3571015505530004 suhartni 15-05-1953 '3571011703840001 hudayat nur cahyo 17-03-1984

70 3571011205066624 35710114102570005 yatmi 01-02-1957 3571011503620003 waidin 15-03-1962
71 3571011205066597 3571014507620010 sugat '05-07-1962 35710111401520001 sudarno 14-01-1952

72 3571010506070515 3571010402010003 Sit isnaini 06-11-1980 35710126044780004 nanang budi pra setya 26-04-1978

73 3571010406080023 3571015706740006 Sri lulut 17-06-1974 3571011910690005 Supryanto 19-10-1969

74 3571010506070514 3571014306740009 sri susnt 03-06-1974 3571012202710003 Baidlowi 22-02-1971

75 3571011305063560 3571018907800001 Umi umaroh 29-07-1980 3571011001710002 Abdul Azis 10-01-1971

76 35711012710100002 3571015312850002 Dipita purbosari 13-12-1985 3571010108830001 Agus widodo 01-08-1983
77 3571010204090006 35710115612800008 Yuliatn 16-12-1980 3571012501730003 Mohamad anas 25-01-1973

78 3571011111080027 3571016009800004 Mamik asmaul hasanah 20-09-1980 357101070470001 Moh jamil 07-04-1970

79 35710110100880005 3571016501800009 munawaroh 25-01-1980 3571010808750005 Mansur zamawi 08-08-1975

80 3571010811080044 3571014706820007 Yuni lestari 07-06-1982 35710112201780001 Yan kurniawan 22-01-1978

81 3571010707080006 3518016511890009 Lastri 25-11-1989 35711010808780024 Dini antoro 08-08-1978
82 3571010608100007 3571015307790006 Nik etk palupi' 13-07-1979 3571012112800006 Hery cahyono 21-12-1980

83 3571010511080012 357101503810006 Nurul Rakhmawat 1976-06-14 3571011406760005 Muhamad Samsul Ma'arif 14/06/1976
84 3571010606070011 3571015001760004 Nur Lestari 1976-01-10 3571010504720004 Suyono 05/04/1972

85 3571010704090010 3571014205760002 Sri Wahyuni 1976-05-02 357101401760004 Rhomandhon 14/01/1976

86 3571011305062577 3571015012650006 Suryat 12/10/1965 357101702580001 Jaelani 07/02/1958

86 3571011305062492 3571016812800002 Mintayani 12/28/1980 3571010806740005 Jaelani 08/06/1974

87 3571011305062565 3571014102790008 Suliat 2/1/1979 3571011504760009 Agutaji 15/04/1976

88 3571011305062562 3571014708800008 Endrawat 8/7/1980 3571011612780001 Syahriyar Wahyudin 16/12/1978

89 3571011305062552 3571016306740001 Dariat 23-06-19974 3571011607680001 Supeno 16/07/1968

90 3571011805090011 3571015809840005 Diani 9/18/1984 3571012704740003 Nurawan 27/04/1974

91 3571011305062593 3571015710770004 Nunung Lutfah 10/17/1977 3571011109790004 Saniman 11/09/1979
92 3571011305062590 3571016005680004 Erna Ningsih 5/20/1968 3571010703660001 Andik Mahendra 07/03/1966
93 3571011305062589 3571014304670009 Sumilah 4/3/1967 3571012705660001 Seger Santoso 27/05/1996

94 3571011305062586 3571015508800004 Rika Anita Sari 8/15/1980 3571010603790003 Anang Andrianto 06/03/1979

95 3571011305061544 3571016008670006 Mambaurosiqoh 8/20/1967 3571011004580004 DRS. Muhyidin, MM 10/04/1958

96 3571010509080007 3571014502840010 Sit sumarni 2/5/1984 3571012207830005 Imam khoiri 22/07/1983

97 3571012802080009 3571014404790010 Dyah Angraini 4/4/1979 3571010912770007 Mohammad Puji Santoso 09/12/1977

98 3571012404080082 3571016804740004 Lusmiat 4/28/1974 3571013004770005 Sunarto 30/04/1977

 99 3571011305062583 3571014809740006 Bidayat 9/8/1974 3571010104640002 Kuntariadi 01/04/1964

100 3571011305062581 3571014910690004 Sulastri 11/27/1965 3571012711650001 Kaderi 27/11/1965

101 3571011305062574 3571015705720003 Dewi Anawat 5/17/1972 3571011808700001 M. Agus Abadi 18/08/1970

103 3571011305062571 3571015211650004 Sriat 11/12/1965 3571010512630003 Moh. Sukarnadi 05/12/1963

104 3571011003100012 3571025006820010 Renita Ropsodia 6/10/1982 3571022203820002 Arif Setawan 22/03/1982

105 3571011305061552 3571016802820009 Kusmaita 2/28/1982 3571011212740001 Hari Suyoko 12/12/1974

106 3571011205090005 3571016205860005 Nunuk Anggraeny 5/22/1986 3571010712810006 Bastan Efendi 07/12/1981

107 3571010810080022 3571015706800005 Suwarsiningsih 9/15/1979 3571011509700006 Suhendri 15/09/1979

108 3571010906090018 3571016208830001 Anita Restywat 8/22/1983 3571012408820003 Agus Syaiful 24/03/1982

109 3571010803100007 3571016010820008 H. Elly Amelia 10/20/1982 3571010506750003 Yuwono 05/06/1975

110 3571010606070114 3571015201770002 Dwi Dewi Kusumawat 10/12/1977 3571010409780009 Bambang Harianto 04/09/1978
111 3571010912100004 3571014901840005 Dini Mayang Arumsari 1/9/1984 3571010509790009 Totok Wahyudianto 05/09/1979
112 3571011505080011 3571014211870010 Sit Nur Khasanah 11/2/1987 3571010107780149 Fuat. D 01/07/1978

113 3571011305063524 3571016007700004 Sudarsih 7/20/1970 3571012409680002 Sali 24/09/1968

114 3571011205067461 3571016811770004 Kensie Wuryaningsih 11/28/1977 3571011303730008 Jumianto 13/03/1973

115 3571011305062642 3571014212730003 Supiyah 12/2/1973 3571010306710006 Budi Utomo 03/06/1971

116 3571011305062539 3571016109730005 Istqomah 9/21/1973 3571011707690002 Srawiyono 17/07/1969

117 3571011607100001 3571015306850006 Rulik Siami 6/13/1985 3571010303840009 Moh. Ali Sulton 03/03/1984
118 3571012906090022 3571016107850005 Rutn Soluh Dwi Ningwarni 7/21/1985 3571012803780003 Andik Maryiono 28/03/1978
119 3571012111080007 3571014906850007 Fitri Handayani 6/9/1985 3571012601810001 Nurhansa 26/01/1981

120 3571012101080025 3571016907800004 Yekt Subekt, Amd 7/29/1980 3571011412790003 Eko Desianto 14/12/1979

121 3571012806080003 3571016907780002 Peni Sukesi 7/29/1978 3571011109800003 Hari Purnomo 11/09/1980

122 3571012404090001 3571014505710018 Maria Sri Rahayu 5/5/1971 3571011010620009 Puput Mujianto 10/10/1962
123 3571012404080068 3571015204760010 Sukarmi 4/12/1976 3571011309720001 M. Muksin 13/09/1972

124 3571011905080026 3571014506700010 Sugiem 6/5/1970 3571011301610002 Djumali 1/13/1961

125 3571011306080002 3571016703770005 Supriat 3/27/1977 3571012904770004 Arif Hiyanto 4/29/1977

126 3571010503080011 3571011808790007 Erie Rachmawaty 8/28/1979 3571011307780006 Saiful Malikin 7/13/1978
127 3571011305062546 3571014507750007 Erna Widiawat 7/5/1975 3571010904700001 Muhamad Kudori 4/9/1970

128 3571011305062532 3571015709710004 Sujinah 9/17/1971 3571011202700001 Misdi 2/12/1970

129 3571011305062528 3571014202720011 Suhartatk 2/2/1972 3571010505650010 Moch. Mahfud 5/5/1965

130 3571011305062516 3571015302660001 Sumarsini 13-02-1966 3571012904580001 Sutaji 29-04-1958

131 3571010511080011 3571015310850002 Nina Sariyawat 13-10-1985 3571012711750004 Sentosa 27-11-1975

132 3571010606070133 3571016502730002 Srigat 25-02-1973 3571011006690004 Kusaini 10-06-1969
133 3571010606070116 3571014702700001 Zujatun 07-02-1970 3571011712690003 Sakur 17-12-1969

134 3571010606070111 3571016503850001 Lusiana 25-03-1985 3571010704840010 Khoirul Fuad 07-04-1984

135 3571010109090007 3571014601870007 Nunung Dwi Prastwi 06-01-1987 3571010909870010 Heru Setono 09-09-1987
136 3571010602090008 3571014107790083 Suryani 01-07-1979 3571010607720007 Tomo 06-07-1972

137 3571010606070127 3571015008910013 Sunarmi 10-09-1981 3571011106780005 Ahmad Kholil 11-06-1978

138 3571010606070120 3571016709760005 Nani Puspita sari 27-09-1976 3571010603760003 Kus Heriyono 03-03-1976
139 3571010606070115 3571015909850007 Ina Mariana 19-09-1985 3571012304840007 Ayub Cahyono 23-04-1984

140 3571012404090016 3571017001850007 Sri Astutk 30-01-1985 3571012005840013 Tri Wahono 20-05-1984
141 357101200110003 3506226505880002 Eka firiani 25-05-1988 3571010607800012 Slamet Hariyono 06-07-1980
141 3571011305061541 3571015405730002 Lilik isnawat 14-05-1973 3571011406710003 Hari cahyono 14-06=1971

142 3571010203090015 3571016010900003 Yulia astut 20-10-1990 3571012905850007 Iiman riyanto 29-05-1985
143 3571010109080005 3571015601890002 Jayant 16-01-1989 3571010803800006 Jaenuri 08-03-1980
145 3571010304080015 3571016703800002 Ocetapia ayu hastari 27-03-1980 3571011206800008 Didi subagio 12-06-1980

146 3571010606070158 3571014208650002 khoirun nasikaah 02-08-1965 3571012207570002 Imam basyari 22-07-1957

147 3571010706070034 3571014604790002 Bint Adawiyah 06-04-1979 3571010802650004 Hisyam Mustofa 08-02-1965
148 3571010703090026 3571015908760006 Sulasmi 19-08-1976 3571010505700006 Dedy Sofyan 05-05-1970

149 3571011612100009 3571014905910007 Dah Meyana Dwi Saputri 09-05-1991 3571012106880006 Aris Kuswoyo 21-06-1988
150 3571011612100002 3571015505820001 Suyant 15-05-1982 3571011005830015 Wahyu Purnomo 10-05-1983
151 3571012404080007 3571014107750104 Lis Komala Sari 01-07-1975 3571010811660003 Agus 08-11-1966
152 3571010107080009 3571015809760002 Sinar Komala Sari, ST 18-09-1976 3571011210520004 Yahya 12-10-1952
153 3571010606070062 3571014505070006 Yuliani 27-06-1977 3571010312740003 Wahyu Muji Wahono 03-12-1974
154 3571011205065741 3571016303720001 Solekah 23-03-1972 3571011411680003 Jalil 14-11-1968

155 3571011205065733 3571014304670005 Dra. Intyas Wilujeng 03-04-1967 3571010502650004 Mustamar 06-02-1965
156 3571011205065730 3571016804750002 Wiwik Astutk 28-04-1975 3571010411730001 Imam Mahmudi 04-11-1973

157 3571011205065729 3571015708650001 Subiat 17-03-1985 3571011005640001 Kasianto 10-05-1964

158 3571011205066590 3571015601700004 Samsuria 16-01-1970 3571012812670004 Sunardi 28-12-1967

159 3571011205066587 3571015010650015 Swarni 10-10-1965 3571011212630003 Jujuk Gautama 12-12-1963
160 3517011205066586 3571014206720004 Yunik Rositawat 02-06-1972 3571010106650004 Dul Rahman 01-06-1965
 NIK Anak Nama JK Tgl Lahir Metode KB Ket (kronis, Gakin)

3571010811920003 mochamad rohmad L 08-11-1992 Pil

3571014802690003 dwi wuryani P 08-02-1994
3571014107970063 Riska Wahyu Ningsih P 01-07-1997 Suntk
3571010107980078 Asrul Budiarto L 01-07-1998
3571016303070001 Mareta Salsabila P 23-03-2007 Suntk
3571010312060004 Kiki Fadilah Wijaya L 03-12-2006 Suntk
3571010802950001 Dede Sagio L 08-02-1995 Mow
3571010209000007 Agung Priatna L 02-09-2000
3571015708040002 Ayu Agustn P 17-08-2004
3571011304080001 Hilmi Athiyata Naseha P 13-04-2008 Suntk
3571010910030003 Regar Valentno L 19-10-2003 Implan
3571017103060001 Elita Putri Azaria P 31-03-2006
3571016802900003 Bint Kholifah P 28-02-1990 Suntk
3571011105000004 Erik Eko Prasetyo L 11-05-2000 Mow
3571010412070002 Andrian Angga Pramudia L 04-12-2007
Suntk
Suntk
3571012708030003 Wildan Aditama L 27-08-2003 Suntk
3571014309090002 Setriani Fitri Carletasari P 03-09-2009 Suntk
Suntk
3571012508060002 Agira Nazneen Widodo L 25-08-2006 kondom
3571014812040003 Tesya Ardhata Dewi P 08-12-2004 Suntk
3571016508080001 Aura Sunny Ardhata Dewi P 25-08-2008
3571012609080003 AhmaDaaffi Imanulloh L 26-09-2008 Suntk
3571010411060006 I Putu Eka Dana L 04-11-2006 Suntk
3571010707880007 Inal Zonet L 07-07-1988 Suntk
3571012111950003 Andian Nor Pratama P. L 21-11-1995 Suntk
3571016912020003 Devina Dwi Nur K. P 29-12-2002
3571016303060002 Putri Aulia Nur Aini P 23-03-2006 Suntk
3571011209070002 Moch. Nanda Saputro L 12-09-2007 Pil
3571011102090003 Moch. Irnando Saputro L 11-02-2009
3571016201090004 Karis Setorin P 22-01-2009 Mow
3571011108870004 Eko Pramono L 11-08-1987 Mow
3571012206900006 Andri Miranto L 22-06-1990
3571012207900003 Ari Mirwanto L 22-07-1990
3571017006020001 Risa Ayu Mirna P 30-06-2002
3571015601940003 Yollafie Asmara P 16-01-1994 Suntk
3571010308970003 Jovanca Dwi Anjasmara L 03-08-1997
3571012912000005 Gabriel Dandi Suryo Wicaksono L 29-12-2000 Suntk
3571016205040004 Agatha Mellisa Dinda Rosari P 22-05-2004
3571010207830006 Agung Wibowo L 02-07-1983 Pil
3571011109900004 Yuni Ariyanto L 11-09-1990 Mow
3571014309920004 Sefi Hariyanto P 03-091992
3571014404970003 Diana Prella P 04-04-1997
3571011110500003 Tedy Setawan L 11-05-2000
3571015909830002 Sri Utami P 19-05-1983 Pil
3571016312900002 Sri handayani P 23-12-1990
3571015611970002 Sri Novita Sari P 16-11-1997
3571018110300004 Muhammad Maulana Fahlevi L 28-11-2003 Pil
3571012205070002 Ahmad Luthfi Fatullah L 22-05-2007
3571012404050003 Mayar Adi bekt L 24-04-2005 Suntk
Pil
3571010708060005 Mohamad anang Setawan L 07-08-2006 Suntk
3571010701090002 Rizal Aditama Putra Radono L 07-01-2009 Suntk
Pil
3571014811970002 Adist Hadisaputri P 08-11-1997 Suntk
3506234309090001 Septriani Fitri Carletasari P 03-09-2009 suntk
3571012505040002 Mahdi Mohammad Nafis L 25-05-2004 Kondom
3571016107060002 Atya Jazila P 21-07-2006
3571012505080003 Fathudin L 25-05-2008
3571016407080001 Marsha Yulita P 24-07-2008 Suntk
3571014210060003 Magdalena Unii Put P 02-10-2006 Suntk
3571010406010008 Nico Joan Saputra L 04-06-2001 Suntk
3571011512090002 Rasya Wijaya L 15-12-2009
Pil
3571010509080003 Mohammad Nggozali L 05-09-2008 Suntk
Pil
3571011011020005 Hifdzan Maulana Al-Zalzabilla L 10-11-2002 Suntk
3571011608960006 Brian Obi Pratama L 16-08-1996 Suntk
3571010710040002 Moch. Sujud Dwi Cahyo L 01-10-2004
Suntk
3571010504070001 muhammad Hamam Ali Akhsani L 05-04-2007 Suntk
3571015903090001 Jihan Rifat Zain P 19-08-2009 Pil
3571015111060001 Bint Samrotul Fitriah P 11-11-2006 Pil
3571010503050002 Bintang Anugrah Prastomo L 05-03-2005 Suntk
3571012007080001 Andyka Agasta Pratama L 20-07-2008 Suntk
3571011705000006 Intan Permata Sari L 17-05-2000 Mow
3571010709070004 Rendy Naufal Rahmatulloh L 07-09-2007
3571010901100004 Moh. Putra Praja Saktawan L 09-01-2010
Pil
Pil
3571015510100001 Jiantri Eka Cahyani P 15-10-2010 Suntk
3571010310990002 Sholah Huddin Rifqi Umama L 03-10-1999 Pil
3571015107060001 Nabila Kirani Surya P 11-07-2006
3571010907950004 Puji Prasetyo L 09-07-1995 Suntk
3571012408890004 Rudik Gunung Astomi L 24-08-1989 Suntk
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