Nama Puskesmas/Fasyankes/Pos Kabupaten/Kota Provinsi

Nama Puskesmas/Fasyankes/Pos : UPT PUSKESMAS SAMARANG
Kabupaten/Kota : GARUT
Provinsi : JABAR
Jenis
No No. Tiket NIK Nama Penerima Vaksin
Kelamin
H. Elan Suherlan
1 N-12A007AD Amd.Kep.,SKM.,M.Kes
L
3205041212640001
2 N-AA1B6EFF Rd. Acep Kurniadi, SKM.,M.Si L

3205051212790004
3 N-C0E0617F Komala Trianah, SST P

3205076005660003
4 Hj.Tikah Rosyati, SST P

N-EBE300C2 3205045102720001
5 N-03D1147D Hj. Yuyu Yuliani SST,MM P

3205085207710001
6 N-B2E0C4B8 Ika Julaeha,SST P

3205056409710003
7 N-4018BA1B Cecep Salahudin, SKM L

3205042701700003
8 N-65F71027 Siti Kurniasih, Amd.Keb P

3205046703690001
9 N-7CA0DCA2 Hj.Riska Risanti,AMK P

3205215805790002
10 N-C5854AF5 dr. Hj. Yeyen Siti Permana P

3205046503800001
11 N-31B94553 Rizki Gilarna,S,Farm.APT L

3205041409840003
12 N-59DD460A Nur Hasanah, Amd AK P

3205046810750003
13 N-4A516391 dr. Dian Aryanti P

3205046209850004
14 N-861CFC59 Ratih Nurani, SST P

3205076107760003
15 N-025D6D0C Elis Nia K, STR.Keb P

3205074909750001
16 N-D68F5A4A drg. Lovi Aprilia P

3275016704870008
17 Evi Susanti, Amd.Keb P

N-938A5F0E 3204334506720026
18 N-0C5F89F1 Anton Suseno, S.Kep.,Ners L

3206280401850001
19 N-A21B34CC Noviani Risdawati CK Amd.Keb P

3205174511880002
20 Suryati, AMKG P
N-FBC94572 3205084505810001
21 N-2FF915F4 Tina Martina,Amd.Keb P

3205074503850006
22 N-EE97871E Ida Farida, Amd.Keb L
3205045401870001
23 Susanti,Amd.Keb P
N-82DC57D0 3205054908860004
24 N-B318517D Parman Suparman L

3205040905640001
25 N-9010EA24 Ulfy Fadilah Nurul Fahmi, A.Md.Gz P

3205055305950002
26 W-DAC4B2BE Ayu Yulianingsih, A.Md.Kes P

3204346603970002
27 N-228DE3B8 Andri Purnama, A.Md.Kep L

3205080909880002
28 Neni Fitriani Hermin A.Md.Kep P

N-EC372C0F 3208105901950008
29 W-ED45B03B Rifki Firdaus Ramdani A.Md.Kep L

3273130703930002
30 N-3397368B Siska Sri Yuliani, A.Md.Kep P

3205046207860002
31 N-0C50FBC6 Ujang Suryana, A.Md.Kep L

3205081505940008
32 N-8E1FA508 M. Azizul J. Silitonga, A.Md.Kep L

3205042008960004
33 N-31E67011 Rini Agustina, AMKG P

3205054810790002
34 N-5377B707 Yani Maryanie, AMdG P

3205076402800001
35 N-965945EB Tina Lusiana Sari,A.Md.Kep P

3205175312830002
36 N-7DC00178 Pia Mayasari, AMK P

3205084307790001
37 N-A9FD3A49 Erwin Diana, AMK L

3205172301770001
38 N-5231E669 Kristin Roidah Marlin, AMK P

3205075411830002
39 N-26590924 Febi Febriansyah L

3205075702920003
40 N-9A9F5BA7 Sani Marlina, Amd,Keb P

3205055711890003
41 N-BF246F5D Peny Octaviani, Amd.Keb P

3205045810900002
42 N-7D4FF31A Wulan Kusmiati, Amd.Kep P

3205074810880004
43 N-7033AF7B Reni Nuraeni, Amd.Keb P

3205074802880005
44 N-A8C4CCF6 Meysa Yusliarti PP P

3205044506960005
45 N-7A1E3426 Elyana Ekayasa, Amd. Kep L

3205041410860001
46 N-4298FF52 Yayu Barokah Nugroho P

3205195110950004
47 N-4D89ADFF Citra Pertiwi Putri SKM P

3205195603960003
48 N-AA29144C Ima Siti Salimah, SE P

3205074210950003
49 N-2B671D41 Dean Andreansyah S.Kep.,Ners L

3205190601950009
50 N-80C7D1D3 Tetep Anto S.Kep.,Ners L

3205421009910008
51 N-EF4D791E Mohamad Yusuf Amd.Kep L

3206090911910001
52 N-C8509F5B Tedi Rustendi Amd.Kep L

3205151705920004
53 N-769FD5BA Riska Nuraisyah, Amd.AK P

3205206004970003
54 N-D35B363F Anisa Siti Nurjanah S. Farm P

3205054501950006
55 N-66CD578D Inggit Resta Krisnadya S.I.Kom P

3205175801970006
56 N-E4FA2C16 Salsa Syainurul Al Syaumi P
3205174501990007
57 N-DB0A92FA Nevi Ghaida N. Amd. Keb P

3205075011950012
58 N-42CC4682 Elis Riska Yonifah Amd. Keb P

3205054104980007
59 N-370F3C38 Ajeng Arvia, Amd.Keb P

3205046102920001
60 N-17AFD700 Razip Muhamad Alwi L

3205071808010002
61 N-525EA995 Rika Apriliani, Amd.Keb P

3205044507910010
62 N-208635B7 Adam Idharul Haq, Amd.Kep L

3205152705930002
63 N-48BDB0D4 Ajeng Siti Aisyah P

3205074109970002
64 N-4FE39CE1 3205020602900010 Riyan Febri Febriyan L
65 N-EE15C84B dr. Selvi Wardati Rahma P

3205056412920001
66 N-A4CD5483 Yosef Mulya L

3205050107930063
67 N-99C7DBAA Sugiharto Rahman L

3205072305970004
68 N-F7CDFFAB Vicky Surahman Pratama L

3205040712970005
69 N-F9911494 Yasa Alimin L

3205080205020001
70 Resviana P
N-FED53322 3205055310020001
71 N-BD0FB6B9 Agung Juniardi L

3205070806920004
72 dr. DEDI RAHMAT

N-E4199B91 3205070208840002 L
73 N-CF5EF27D dr. ELI YANTI

3205074901850002 P
74 RIZAL CAHYADI
N-113451C9 3205072306920001 L
75 SOPIANA PAUZI
N-A2CDEA01 3205071105960004 L
76 N-04127CDA RIZKI ANGGIA

3205046309980004 P
77 N-2FE68B07 LIA ATIYAH SOLIHAH

3205075702000002 P
78 N-B0039465 SANTI NURAENI

3205075512990001 P
79 P-0IXMQJIK 3205045506910005 ADE ISAN P
Keterangan ***Merek Vaksin
* Pekerjaan dikelompokkan menjadi: A = Sinovac
A = Petugas Medis dan Non Medis di Fasilitas Pelayanan Kesehatan B = Lainnya (Mohon disebutkan jenis vaksin yang diterima Puskesmas/Fask
B = Petugas pelayanan publik yang berhadapan langsung dengan masyarakat
C = Administrator Pemerintahan
D = Lainnya
E = Tidak Bekerja
Kelompok Umur:
18-30 40
31-45 29
46-59 9
Total 78
Pekerjaan:
A 0
B 0
C 0
D 0
E 0
Total 0
FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI
Umur
Pekerjaan* Kelompok Umur Alamat No. Hp
(18-59 tahun)
56 46-59
KEPALA PUSKESMAS KP.CIJUGUL RT. 03 RW. 02 MEKARWANGI TAROGONG K 08122116539
41 31-45
KASUBAG TU PERUM PESONA INTAN BLOK E2 NO.12 RT. 01 RW. 011 085220044228
52 46-59
BIDAN Kp. Sawargi RT. 001 RW. 010 Desa. Sukakarya Kec. Sam 085222468454
48 46-59
BIDAN KP. NEGLASARI RT. 02 RW.02 DS. SUKAWANGI - TAROG 081323238994
49 46-59
BIDAN KP. RT. 003 RW. 002 DS. PADAMUKTI - PASIRWANGI 082315331952
49 46-59
BIDAN Kp. Pamoyanan RT. 05 RW. 01 Ds. Sukagalih Kec. Tarogo 081322562533
50 46-59
PERAWAT PERUM BUMI MALAYU ASRI BLOK H-1 RT. 03 RW. 010 082315725656
51 46-59
BIDAN PERUM BUMI MALAYU ASRI BLOK H-1 RT. 03 RW. 010 085220127290
41 31-45
PERAWAT KP. RAJAPOLAH RT. 003 RW. 003 DS. PADAMUKTI - SUK 081313688429
40 31-45
DOKTER UMUM KP.CIJUGUL RT. 03 RW. 02 MEKARWANGI TAROGONG K 081323388755
36 31-45
APOTEKER PERUM PESONA INTAN BLOK D NO.2 RT. 002 RW. 011 D 081394815060
45 31-45
PELAKSANA LAB PERUM PURI CIMANGANTEN ASRI BLOK A.18 085223405575
35 31-45
DOKTER UMUM KP. LEGOK RT. 001 RW. 006 Ds. Cintarakyat Kec. Samara 082119391821
44 31-45
BIDAN Babakan Cisanca Rt. 04 Rw. 05 Ds. Cintarakyat - Samara 081321469503
45 31-45
BIDAN KP. CIKAMIRIRT. 02 RW. 02 DS. SIRNASARI - SAMARANG 081220078446
33 31-45
DOKTER GIGI jl.irida barat 17 blok D8 no 11 rt 07 rw 14 bekasi 085771260000
48 46-59
BIDAN KP. LEBAKGEDE RT. 01 RW. 08 DS. MEKARWANGI - TA 085315743641
35 31-45
PERAWAT KP.NANGGORAK JATI RT.025/RW.006 DSJAYAMUKTI KEC 082119605071
32 31-45
BIDAN PERUM AZZAHRA NO. 15 RT. 01 RW. 12 DS. CIMANGAN 082129461129
39 31-45
PERAWAT GIGI KP. GADOG 081320144127
35 31-45
BIDAN KP. BONGKOR RT. 02 RW. 03 DS. SAMARANG - SAMARA 082318284885
33 31-45
BIDAN KP.PASIR RT. 05 RW. 04 DS. CINTAKARYA - SAMARANG 085223535972
34 31-45
BIDAN JL CIMANUK BLK NO 77RT. 02 RW. 01 DS. JAYARAGA - 081221634842
56 46-59
STAF TU KP. BARU PAROS 085220026653
26 18-30
NUTRISIONIS Jl. Terusan Pembangunan, Gg. Cikopo 212 RT. 004 RW. 01 081222841322
24 18-30
PERAWAT GIGI KP. NAMICALUNG RT 01 RW 06 DESA PANYADAP KEC 089689088526
32 31-45
PERAWAT KP. PASIR KIAMIS 082115682016
26 18-30
PERAWAT PERUM BUMI MALAYU REGENCY BLOK B1 NO 10 RT.01 081283886704
27 18-30
PERAWAT Jl. Garden Villas III no. 50, Pinus Regency, 085720368188
34 31-45
PERAWAT Perum Putri Dinar Lestari blok c1 no 14 ds tj kemuning 082120207400
26 18-30
PERAWAT Kp Cigadog RT/RW 003/002 Ds Padamukti Kec Pasirwang 081270271053
26 18-30
PERAWAT Perum Griya Bumi Praja Blok B.15 RT 004 RW 012 Ranca 081223832717
41 31-45
PERAWAT GIGI KP.CIREUNGIT 088220389412
40 31-45
NUTRISIONIS PERUM BARU PAROS INDAH 082321988763
37 31-45
PERAWAT KP. CIBODAS RT. 01 RW. 01 DS. BANJARSARI - BAYONG 085220489328
41 31-45
PERAWAT KP.CIGADOG TR. 02 RW. 02 DS. PADAMUKTI - PASIRWA 081222485442
43 31-45
PERAWAT KP. CIBODAS PASANTREN RT. 05 RW. 03 DS. BANJARSA 081313744692
37 31-45
PERAWAT KP. SOMONG RT. 03 RW. 04 DS. CINTAKARYA - SAMAR 082318164466
28 18-30
STAF TU KP. BARU 087793407767
31 31-45
BIDAN KP. PANAWUAN 085224402323
30 18-30
BIDAN PERUM PESONA INTAN BLOK E.1 NO. 25 RT. 01 RW. 011 085221030433
32 31-45
BIDAN KP.CISANCA 085324535441
32 31-45
BIDAN KP. CISAAT RT. 01 RW. 09 DS. SUKAGALIH - SAMARANG 085320616167
25 18-30
PROMKES KP. TAROGONG TENGAH 089601633434
34 31-45
PERAWAT KP. BABAKAN PASANTREN RT. 03 RW. 12 DS. PANANJU 081222845050
26 18-30
STAF TU KP PADAREK 081312138119
25 18-30
KESLING JL. OTISTA GG. BUNTU NO. 209 RT. 02 RW. 01 DS. TA 088218981796
26 18-30
STAF TU KP SOMONG RT. 03 RW. 03 DS. CINTAKARYA - SAMARA 082240081103
26 18-30
PERAWAT KP.CILEDUG RT. 02 RW. 02 DS. NGAMPLANGSARI - CIL 08980815801
28 18-30
PERAWAT KP. BOJONGLARANG RT. 03 RW. 15 DS. SUKAMENTRI - 085793449073
29 18-30
PERAWAT KP. SIRNAGALIH RT. 014 RW. 01 DS. SUKAGALIH - TAR 083890383767
30 18-30
PERAWAT KP. GALUMPIT RE. 01 RW. 03 DS. CIPANCAR - LELES 085974889588
24 18-30
PELAKSANA LAB KP. PASIR JEUNGJING RT. 05 RW. 07 DS. SIMPANGSARI 0'89662237778
26 18-30
ASISTEN APOTEKER Kp. Sukagalih RT. 02 RW. 012 Ds. Sukagalih Kec. Tarogon 081997403092
24 18-30
STAF TU Kp. Cijelereun RT. 001 RW. 005 Desa Mekarsari Kec. Ba 089634162446
21 18-30
STAF TU Kp. Palnunjuk RT. 001 RW. 005 Ds. banjarsari Kec. Bayo 08977079798
25 18-30
BIDAN Kp. Sawargi RT. 001 RW. 010 Desa. Sukakarya Kec. Sam 081223653743
22 18-30
BIDAN Kp. Pamoyanan RT. 05 RW. 01 Ds. Sukagalih Kec. Tarogo 081717273952
28 18-30
BIDAN Kp. Cisanca RT. 001 RW. 001 Ds. Mekarwangi Kec. Tarog 085322023373
19 18-30
STAF TU Kp. Jati Toblong RT. 002 RW. 005 Ds. Cintarakyat Kec. 0895428828855
29 18-30
BIDAN KP. BABAKAN PASANTREN RT. 03 RW. 12 DS. PANANJU 085352777725
27 18-30
PERAWAT KP. BABAKAN SLAAWI 0859138602969
25 18-30
STAF TU Kp. Panyingkiran RT. 002 RW. 009 Ds. Samarang Kec. S 085320512880
30 18-30
Perawat JL.CIPANAS NO.61
28 18-30
DOKTER UMUM Kp. Karangmulya RT.RW 002/002 Ds. Sukajaya Kec. Taro 081223338086
26 18-30
SECURITY KP. MEKARSARI RT. 01 RW. 09 DS. SUKAKARYA - TAROG 0852127444002
24 18-30
SECURITY KP. JATITOBLONG RT. 02 RW. 05 DS. MEKARWANGI - 0895612823040
23 18-30
OFFICE BOY KP. LEGOK RT. 02 RW. 03 DS. MEKARWANGI - TAROGON 085352948900
18 18-30
OFFICE BOY KP. NYANGKOKOT RT. 01 RW. 04 DS. PADAMUKTI - PAS 081460932654
18 18-30
JURU MASAK KP. GANEA RT. 05 RW. 05 DS. KERSAMENAK - TAROGON 087891502299
28 18-30
JURU PARKIR KP. BABAKAN KIARA RT. 02 RW. 07 DS. CINTARASA - S 082122269534
36 31-45
DOKTER KP.NANJUNG SARI, RT/05. RW09. DS. SAMARANG. KEC. SAMARANG 081214965227
35 31-45
DOKTER KP.NANJUNG SARI, RT/05. RW09. DS. SAMARANG. KEC. SAMARANG 081323752217
28 18-30
PERAWAT KP.PAJAGAN, RT/05. RW/05. DS. SAMARANG. KEC. SAMARANG 081221791818
25 18-30
ANALIS KP.PAJAGAN, RT/05. RW/05. DS. SAMARANG. KEC. SAMARANG 081320227292
22 18-30
ASISTEN APOTEKER KP.CIRENGIT, RT/04. RW/01. DS. MEKARGALIH. KEC. TAROGONG KIDUL 081398066740
20 18-30
ASISTEN APOTEKER KP. NEGLASARI 085860497368
21 18-30
ADMIN KP. CIPARAY 089639299645
PERAWAT 29 18-30 KOMPLEK PESONA ANGGREK REGENCY. BLOK D I JL. TPA 087733943446
nis vaksin yang diterima Puskesmas/Faskes)
Kepesertaan BPJS Pekerjaan

BPJS PBI 0 A 0
BPJS Non PBI 72 B 0
Non Anggota 0 C 0
Total 72 D 0
Pemberian Dosis E 0
Dosis 1 78 Total 0
Dosis 2 78
Total
AKSINASI COVID-19
OS VAKSINASI
Kepesertaan BPJS (tulis 'Ya' pada kolom

Dosis I
yang sesuai)
Nama/Jenis/Merek
Tanggal Screening
Vaksin***
Tanggal Pemberian
BPJS PBI BPJS Non PBI Non Anggota No. Batch
Vaksinasi
Ya 01-Feb-2021 Sinovac 01-Feb-2021 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047

Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047

Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
- 03-Feb-2021 Sinovac 03-Feb-2021 202011047
- 01-Feb-2021 Sinovac 01-Feb-2021 202011047
- 01-Feb-2021 Sinovac 01-Feb-2021 202011047
- 03-Feb-2021 Sinovac 03-Feb-2021 202011047
- 03-Feb-2021 Sinovac 03-Feb-2021 202011047
Tidak 01-Feb-2021 Sinovac 01-Feb-2021 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047
Ya 01-Feb-2021 Sinovac - 202011047

osis I Dosis 2
Keterangan
Tanggal (Ditunda/Tidak Diberikan/Lanjut)
No. Serial Tanggal Pemberian No. Batch No. Serial
Screening Vaksinasi
15-Feb-2021 15-Feb-2021 202011047 DIBERIKAN
15-Feb-2021 - 202011047 TIDAK DIBERIKAN
15-Feb-2021 15-Feb-2021 202011047 DIBERIKAN ``````
- - - DIBERIKAN
- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TIDAK DIBERIKAN
- - 202011047 TUNDA

- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 DIBERIKAN
17-Feb-21 2/17/2021 202011047 DIBERIKAN

- - 202011047 TUNDA
- - 202011047 TUNDA
- - 202011047 TUNDA
- DIBERIKAN
- - 202011047 TUNDA
- - 202011047 DIBERIKAN
- - 202011047 TUNDA

Nama Puskesmas/Fasyankes/Pos Kabupaten/Kota Provinsi

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Nama Puskesmas/Fasyankes/Pos : UPT PUSKESMAS SAMARANG

2 N-AA1B6EFF Rd. Acep Kurniadi, SKM.,M.Si L

3 N-C0E0617F Komala Trianah, SST P

4 Hj.Tikah Rosyati, SST P

5 N-03D1147D Hj. Yuyu Yuliani SST,MM P

6 N-B2E0C4B8 Ika Julaeha,SST P

7 N-4018BA1B Cecep Salahudin, SKM L

8 N-65F71027 Siti Kurniasih, Amd.Keb P

9 N-7CA0DCA2 Hj.Riska Risanti,AMK P

10 N-C5854AF5 dr. Hj. Yeyen Siti Permana P

11 N-31B94553 Rizki Gilarna,S,Farm.APT L

12 N-59DD460A Nur Hasanah, Amd AK P

13 N-4A516391 dr. Dian Aryanti P

14 N-861CFC59 Ratih Nurani, SST P

15 N-025D6D0C Elis Nia K, STR.Keb P

16 N-D68F5A4A drg. Lovi Aprilia P

17 Evi Susanti, Amd.Keb P

18 N-0C5F89F1 Anton Suseno, S.Kep.,Ners L

19 N-A21B34CC Noviani Risdawati CK Amd.Keb P

21 N-2FF915F4 Tina Martina,Amd.Keb P

24 N-B318517D Parman Suparman L

25 N-9010EA24 Ulfy Fadilah Nurul Fahmi, A.Md.Gz P

26 W-DAC4B2BE Ayu Yulianingsih, A.Md.Kes P

27 N-228DE3B8 Andri Purnama, A.Md.Kep L

28 Neni Fitriani Hermin A.Md.Kep P

29 W-ED45B03B Rifki Firdaus Ramdani A.Md.Kep L

30 N-3397368B Siska Sri Yuliani, A.Md.Kep P

31 N-0C50FBC6 Ujang Suryana, A.Md.Kep L

32 N-8E1FA508 M. Azizul J. Silitonga, A.Md.Kep L

33 N-31E67011 Rini Agustina, AMKG P

34 N-5377B707 Yani Maryanie, AMdG P

35 N-965945EB Tina Lusiana Sari,A.Md.Kep P

36 N-7DC00178 Pia Mayasari, AMK P

37 N-A9FD3A49 Erwin Diana, AMK L

38 N-5231E669 Kristin Roidah Marlin, AMK P

39 N-26590924 Febi Febriansyah L

40 N-9A9F5BA7 Sani Marlina, Amd,Keb P

41 N-BF246F5D Peny Octaviani, Amd.Keb P

42 N-7D4FF31A Wulan Kusmiati, Amd.Kep P

43 N-7033AF7B Reni Nuraeni, Amd.Keb P

44 N-A8C4CCF6 Meysa Yusliarti PP P

45 N-7A1E3426 Elyana Ekayasa, Amd. Kep L

46 N-4298FF52 Yayu Barokah Nugroho P

47 N-4D89ADFF Citra Pertiwi Putri SKM P

48 N-AA29144C Ima Siti Salimah, SE P

49 N-2B671D41 Dean Andreansyah S.Kep.,Ners L

50 N-80C7D1D3 Tetep Anto S.Kep.,Ners L

51 N-EF4D791E Mohamad Yusuf Amd.Kep L

52 N-C8509F5B Tedi Rustendi Amd.Kep L

53 N-769FD5BA Riska Nuraisyah, Amd.AK P

54 N-D35B363F Anisa Siti Nurjanah S. Farm P

55 N-66CD578D Inggit Resta Krisnadya S.I.Kom P

57 N-DB0A92FA Nevi Ghaida N. Amd. Keb P

58 N-42CC4682 Elis Riska Yonifah Amd. Keb P

59 N-370F3C38 Ajeng Arvia, Amd.Keb P

60 N-17AFD700 Razip Muhamad Alwi L

61 N-525EA995 Rika Apriliani, Amd.Keb P

62 N-208635B7 Adam Idharul Haq, Amd.Kep L

63 N-48BDB0D4 Ajeng Siti Aisyah P

64 N-4FE39CE1 3205020602900010 Riyan Febri Febriyan L

65 N-EE15C84B dr. Selvi Wardati Rahma P

66 N-A4CD5483 Yosef Mulya L