FORMAT REKAPITULASI PELAKSANAAN VAKSINASI COVID-19

TINGKAT PUSKESMAS / FASYANKES / POS VAKSINASI

Nama Puskesmas/Fasyankes/Pos : Puskesmas Tanjung Redeb

Kabupaten/Kota : Berau
Provinsi : Kalimantan Timur
Tanggal Pelaksanaan : 29 MEI 2021
NOMOR NOTIKET NIK NAMALENGKAP TANGGALLAHIR
1 P-0K9KLVIN **********0001 ERNI ZUFITA SARI 28/06/1987
2 P-0TXKMDVK **********0001 RIFGI SETIA 22/09/1995
3 P-1443B54R **********0001 ARPINA YUSNITA 06/07/1992
4 P-1GS2KIOU **********0004 SUSI SUSANTI 14/01/1986
5 P-1J2PZ3LY **********0003 MERCHIA FITRIANA SAMARA 01/03/1994
6 P-1NOVN0NH **********0002 INDRA BILLY PATTILIMA 01/04/1979
7 P-1S0I2UJQ **********0002 LOLLY MARLINA 07/08/1976
8 P-1XJCTGCF **********0001 JAMES SIAHAAN 20/04/1968
9 P-278ZWGQN **********0002 SURYADI TRIHASTONO 21/07/1963
10 P-2UU0T9VZ **********0001 MUHAMMAD SHOLIKHIN 24/04/1986
11 P-36Z8WIVO **********0001 HENTJE, ST 11/04/1973
12 P-3FOECFUE **********0002 MALVA DAVIO KARSTEN SARAY 10/12/2000
13 P-3NB9ZR47 **********0003 ARIF HADIANTO 19/05/1980
14 P-4IADTQIA **********0005 CITRA FITRIA WARDANI 22/07/1982
15 P-4RMYPXTW **********0003 IR.YAN ADRIANSYAH 13/01/1974
16 P-4ZLOK0NN **********0032 RAHMA FITRIAN 11/04/1991
17 P-5KWXK00T **********0002 MARCELLINA EFREM NGAI 04/03/1989
18 P-66P7LYEV **********0002 BOTTOR HOTMAIDA PARDEDE 19/10/1974
19 P-8LHDJ0SZ **********0001 HENDRA ATMAJA, SH 27/03/1979
20 P-9A3O5JR3 **********0002 MUSTAMIR 19/10/1984
21 P-9FRA1FPI **********0001 SIANOVEMBER PASARIBU 09/11/1962
22 P-9FUKIOO3 **********0001 DARNAWATI SIBAGARIANG 26/06/1968
23 P-9LFFYN5V **********0005 NOMENSEN SIBAGARIANG 12/04/1964
24 P-9ZUFHB0X **********0004 HIMPU BR HUTABARAT 08/07/1968
25 P-AI2I5BJA **********0002 AJI VIENA FIRMANYTA 11/10/1998
26 P-B9QU4WT6 **********0003 ASKANDAR ALI 25/03/1971
27 P-BHIJ6VJZ **********0001 DWI BRILLIANTI 05/05/1994
28 P-BNWEL6P1 **********0003 YOHANIS 27/07/1968
29 P-C29K4QKG **********0002 RELI NAINGGOLAN 10/10/1962
30 P-E7WHP160 **********0001 SANTI HIDAYAH 11/06/1998
31 P-EHGHLK9M **********0001 ADYATMA EILLEN RASYID 19/01/2001
32 P-EQ40AJA5 **********0002 PASCALITA VIVERONICA NABAN 18/03/1999
33 P-FEVVP6I7 **********0002 RUDINI 20/12/1990
34 P-FJMIH1FJ **********0002 SITI HANIFATUS SHOLIKHA 08/11/1994
35 P-FQA20VC9 **********0003 BASTIAH 22/09/1983
36 P-G4AFIYWX **********0001 SOFIYAH MUTAMIMAH 10/03/1985
37 P-HZ8DG55K **********0002 RIDWANSYAH 19/06/1998
38 P-I6ROEEKN **********0006 AS'AD FAJARDIN 13/03/1981
39 P-IDUFGUSW **********0001 ADE SUHARTADI 10/05/1990
40 P-IOAZFOGT **********0002 LINARTI RUTH SIHOMBING 09/05/1975
41 P-J2HTGUGC **********0008 HELI RIANI 14/03/1974
42 P-JKLMH7HW **********0002 ARIF FADILLAH 04/03/1984
43 P-JQH8QDRW **********0003 FERNANDO 17/07/1993
44 P-JVGXNRJH **********0003 Nur Asikin 06/02/1974
45 P-K0O64KQJ **********0002 Eka Julita 10/10/1972
46 P-KW01GIPN **********0004 MASNARIA SOTIANA GORAT 15/10/1992
47 P-KWI0LCO4 **********0003 ROFIF ATHOYA NUR PRABU 20/01/2001
 48 P-KWM1EEMG **********0005 MARIA MAGDALENA NOVITA SARI 10/11/1981
49 P-KWXRGHVL **********0001 WIDYA VANESSA CINTAMY RAHMA04/09/1998
50 P-KX9PAXRI **********0003 JEMILA 06/06/1995
51 P-KXNW56AZ **********0001 PIUS KUKU MEO 31/08/1978
52 P-KY00DZUK **********0001 ROSNIA AGUSSARI, SH 22/05/1992
53 P-KY56HNMZ **********0001 VICTOR SILALAHI 21/07/1970
54 P-KYX3FK6E **********0003 SRI INDAH PRASETYAWATI 16/04/1989
55 P-KZ1Q3S83 **********0002 KARWANTO 23/05/1978
56 P-L1WE9VCJ **********0001 SUNARSIH 15/07/1981
57 P-L3VRNZAL **********0001 EVRIANSYAH 25/03/1983
58 P-L45SEL4Z **********0003 KHOIRUL FATIHIN 24/09/2000
59 Q-4494A8D0 **********0001 SUSI SIANTURI 19/01/1992
60 S-074BE021 **********0001 Junaedi 06/08/1993
61 S-08AB6DF3 **********0001 Bambang Miswanto 01/12/1989
62 S-0B6CE64B **********0001 ARLAN FEBRIAN RAMADHAN 05/02/1995
63 S-145BCCD7 **********0001 Ratna Nurviana 22/04/1997
64 S-1E28369E **********0002 Adji Putri Indah Ningrum 07/12/1998
65 S-207F90AB **********0006 ROSLIANA 10/07/1992
66 S-296D4C14 **********0001 Jailani 10/07/1988
67 S-2BB02D75 **********0002 Achmad Ibrahim 23/02/1987
68 S-2C8AB5E1 **********0001 Hendra Oktapianto 25/10/1995
69 S-31663374 **********0001 MARSONO 26/06/1980
70 S-39C75C06 **********0001 ROSMA 03/07/1977
71 S-3E99C0BE **********0001 Eko Herdianto 30/08/1990
72 S-41B600DE **********0001 HOTMAN SIAGIAN SSIT SE MM 18/11/1977
73 S-44373E8F **********0007 Feronika Audria Larkin 04/10/2002
74 S-49B7C7C0 **********0002 Desy Ratna Sari 08/12/1994
75 S-4B6D6E46 **********0001 Muhammad Din 24/06/1997
76 S-4EB9F5A7 **********0001 RUSLAN RUSMIN 11/01/1959
77 S-4EE0E0F7 **********0001 Febri Ersa Putri 02/02/1994
78 S-55DA87FE **********0004 Diyanti Takke 18/05/1992
79 S-5914CE3F **********0001 Mutiara Hanif 14/03/2000
80 S-59BFC6D6 **********0001 FATAH KHOIRUL ANAM 10/05/1979
81 S-5E8B6C98 **********0001 HERA ASNILA 13/03/1984
82 S-6178CF31 **********0003 Ramdani 23/02/1994
83 S-646B83B5 **********0002 AMINUDDIN 22/05/1984
84 S-660BE52F **********0003 ARIF TIA NINGSIH 19/06/1995
85 S-67D539D4 **********0001 BAWONO 15/10/1983
86 S-68B1A329 **********0001 Desi Malinda Sitepu 20/12/1984
87 S-715B3ED3 **********0003 ZULKIPLI 08/10/1980
88 S-728B8142 **********0001 Marhawaeni 02/10/1987
89 S-737A059D **********0001 ISLAMIAH 19/12/1962
90 S-73F30C66 **********0004 NURUL HIKMAH 23/09/1976
91 S-77809D98 **********0001 Ahmad Budianto 04/08/2001
92 S-7A862EEB **********0002 MONA FITRIA ANGGRAINI 04/02/1997
93 S-84131A52 **********0002 Nilam Tricita Cindarsari 29/03/1989
94 S-87042C80 **********0001 ERVIANAH 04/05/1993
95 S-8C72D675 **********0001 Arik Haryanto 25/05/1995
96 S-94D28736 **********0002 Sandi Pratama 29/07/1995
97 S-961943A0 **********0002 FRANKY FILIPUS MANAFE 25/01/1983
98 S-9A397873 **********0003 FLORA SITORUS 20/07/1990
99 S-9E17621D **********0001 KURADEN HUTAPEA 16/04/1963
100 S-9E945946 **********0001 BELA TIA APRIYANI 20/04/1995
101 S-A25640F7 **********0001 MONA LESTARI 20/11/1981
 102 S-AD142C19 **********0004 Nurman Aqsa 30/11/1991
103 S-AD1E782B **********0001 Muchamad Fuad Hasim 03/08/1986
104 S-B1624396 **********4001 Tamara 25/03/1998
105 S-B4EB7B87 **********0001 Faharuddin 09/11/1991
106 S-B692ED51 **********0002 Muhammad Adi Zulfikar 29/08/1997
107 S-B9340FDD **********0005 SUKRIADI 25/11/1978
108 S-C3FBC146 **********0024 DENNY ROSSARIO 27/08/1975
109 S-C566C793 **********0002 DATU MAHDIANSYAH 01/05/1988
110 S-CA217553 **********0001 DENDI UTAMA WISNO WARDANA 27/07/1978
111 S-D7A2C50E **********0003 Asrul 01/01/1991
112 S-DA050A71 **********0001 SUHARMAN 12/04/1961
113 S-DC26BF4B **********0001 Edi Kurniawan 24/04/1984
114 S-E3D14CFB **********0001 Muhammad Arif 04/10/1999
115 S-E6A54A09 **********0007 Budiono 15/05/1975
116 S-EF87D782 **********0001 ANSHAR 15/11/1987
117 S-F49C7D8C **********0005 DWI WULANDARI 13/04/1988
118 S-F84EF026 **********0002 Rinaldi 10/09/1998
119 Y-00005C9M **********0003 YENNI ERLINA 19/08/1969
120 Y-012YLP7M **********0004 IKA NURHADINI 20/05/1986
121 Z-3C6A8DD8 **********0003 CHARLIE OESIN 15/10/1993
REKAPITULASI PELAKSANAAN VAKSINASI :

1 JUMLAH YANG TER REGRISTASI : 121 ORANG

2 JUMLAH YANG DIVAKSIN : 119 ORANG
3 JUMLAH YANG TIDAK DIBERIKAN DIVAKSIN : 0 ORANG
JUMLAH YANG TUNDA DIVAKSIN : 2 ORANG
MULTI DOSE SINGEL DOSE
4 JUMLAH VAKSIN YANG DITERIMA 351 VIAL 258 VIAL
5 JUMLAH VAKSIN YANG SUDAH DIGUNAKAN 295 VIAL 258 VIAL
6 JUMLAH VAKSIN YANG DIGUNAKAN HARI INI 12 VIAL 0 VIAL
7 SISA VAKSIN YANG ADA 44 VIAL 0 VIAL
8 MERK VAKSIN DIGUNAKAN COVID-19 VAKSIN BIOFARMA SINOVAC
9 NO. BATCH 24002821 202011042
10 RINCIAN YANG DIVAKSIN SBB :

S/D YANG LALU HARI INI

KATEGORI VAKSIN 1 VAKSIN 2 VAKSIN 1
SDMK 163 144 0
PELAYAN PUBLIK 1145 662 109
LANSIA 337 308 2
GURU/TENAGA PENDIDIK 283 154 6
MASYARAKAT UMUM 0 0 0
JUMLAH 1928 1268 117

HARI INI TOTAL

KET: JEMAAH HAJI VAKSIN 1 0 0
JEMAAH HAJI VAKSIN 2 0 0

Tanjung Redeb , 29 Mei 2021

Koordinator Vaksinasi

dr.Trikortea Espandiarie Cahyasit

NIP. -
CATATAN : DATA SASARAN DIATAS DI DOWNLOAD DARI PCARE
ID-19
I

STATUS
Pemberian Vaksin Selesai
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KETERANGAN

HARI INI
VAKSIN 2
0
2
0
0
0
2

deb , 29 Mei 2021

r Vaksinasi

a Espandiarie Cahyasit