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  • Format Screening Pelaksanaan Imunisasi Bias-1

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    Kangmas Samiaji Purbawinasis
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    1. The document is a screening form for immunization implementation at Lumbir Community Health Center for Class 1. It lists 9 students' names, addresses, dates of birth, and whether they have symptoms of fever, cough, or contact with infected areas. 2. The screening is dated August 12, 2020 for SD N 3 Cidora elementary school. It records each student's symptoms and notes they had no fever above 38 degrees. 3. The form is signed by the head of Lumbir Community Health Center, Dr. Mahar Barlian, acknowledging the screening.

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    FORMAT SCREENING PELAKSANAAN IMUNISASI BIAS-1

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    1. The document is a screening form for immunization implementation at Lumbir Community Health Center for Class 1. It lists 9 students' names, addresses, dates of birth, and whether they have symptoms of fever, cough, or contact with infected areas. 2. The screening is dated August 12, 2020 for SD N 3 Cidora elementary school. It records each student's symptoms and notes they had no fever above 38 degrees. 3. The form is signed by the head of Lumbir Community Health Center, Dr. Mahar Barlian, acknowledging the screening.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    9 views1 page

    Format Screening Pelaksanaan Imunisasi Bias-1

    Uploaded by

    Kangmas Samiaji Purbawinasis
    1. The document is a screening form for immunization implementation at Lumbir Community Health Center for Class 1. It lists 9 students' names, addresses, dates of birth, and whether they have symptoms of fever, cough, or contact with infected areas. 2. The screening is dated August 12, 2020 for SD N 3 Cidora elementary school. It records each student's symptoms and notes they had no fever above 38 degrees. 3. The form is signed by the head of Lumbir Community Health Center, Dr. Mahar Barlian, acknowledging the screening.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 1

    FORM SCREENING PELAKSANAAN IMUNISASI BIAS

    PUSKESMAS LUMBIR
    KELAS 1
    Tanggal 12 -8-2020 Sekolah : SD N 3 CIDORA
    Gejala
    Kontak Wilayah
    No Nama Alamat Tanggal Lahir Terjangkit Demam > Batuk Keterangan
    Pilek
    38

    1 ARKHALITA SHEINNA AATHIFAH Cidora RT 04/RW 03 12-06-2014


    2 ANISA NURFAUZIAH Cidora RT 04/RW 03 31-08-2014
    3 BAHTIAR CHAIRY RAHMAN Cidora RT 04/RW 03 22-02-2014
    4 GATHAN TADIUS SUNI WIJAYA Cidora RT 04/RW 03 01-01-2010
    5 GALANT AQUILLA ALARIK Cidora RT 04/RW 03 19-12-2012
    6 GIBRAN AKHAMAD RAMADHANU Cidora RT 04/RW 03 05 -07-2014

    7 IBNU EZA MUDZAKI Cidora RT 04/RW 03 05-01-2015


    8 MOHAMAD NUR AZIZ Cidora RT 04/RW 03 10-04-2014
    9 PANJI PRAESTYO Cidora RT 04/RW 03 01-06-2014

    Mengetahui,
    Kepala Puskesmas Lumbir

    dr. Mahar Barlian


    (NIP. 19760606 201001 1 001)

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