NO Nama (Diisi Dengan Nama Peserta) No - Identitas (Diisi Dengan Nip/Nrp/Npp/Nik)

no_identitas {Diisi dengan
NO nama {diisi dengan nama peserta} NIP/NRP/NPP/NIK}
1 ABRAR A. Md. RMIK 199607112020121004
2 IKA HUDAYANTI A.Md. Kep 198802122020122009
3 Apt. TEGUH SAPUTRA S.Si 198607192020121006
4 Apt. FARIDA NURYANINGSIH S.Farm 199406062020122024
5 SETIAWAN A. Md. RMIK 199103232020121013
6 MAWADDAH ATIKAH A.Md.Gz 199508132020122013
7 TRIKA SARI A. Md. RMIK 199608142020122012
8 dr. WORO ASRIATI NURJANNAH S.Ked. 199101122020122010
9 SUSANTO A. Md. KL 199110152020121008
10 NADIA AMBARINI A.Md.KG 199308082020122014
11 AFIFUDDIN Amd. KL 199012282020121004
12 YANI KURNIAWATI A.Md.RMIK 199503292020122016
13 LINA ANGGRAINI A.Md.Kep 198907212020122009
14 AMINAH Amd.Kep 198607162020122002
15 IRMARIKA RAMADHANTY A.Md.Kep 199801032020122006

16 DIAN PUSPITA A.md. Kep 199710152020122008
17 TONI PRIATMOJO A.Md.Kep 198905142020121007
18 YUSMAN ARDI NUGRAHA AMd. Kep 199109262020121011
19 REZZA KURNIAWAN A.Md. Kep 198912232020121009
20 RISQI PUSPITASARI A. Md. Kep 198901142020122009
21 EKA RAMADHANIYAH A.Md.RMIK 199402122020122012
22 GANGSAR YUWENDI A.Md.RMIK 199206292020121014
23 IMAM ATMAJAYA A.Md.RMIK 199501272020121006
24 apt. BARY AZHARI S.Farm. 199302152020121010
25 Apt. INNE NOVIANTI S.Farm 199411252020122024
26 Apt. WINNY ANDARILLA S.Farm 199504142020122023
27 APRIANA WINDA SAFITRI A.Md 199604102020122014
28 drg. NIKI PUTRI IRIANTI 199210202020122011
29 drg AMALIA NUR AFIYATI 199201312020122007
30 drg. MAYTY RAHMA FITRIA 198905172020122012
31 drg. MISHBAHANI 199411142020122009

32 dr. WINDA SEPTIA KHAIRUNNISA 199009112020122013
33 dr. FITRA HADI 199502262020121006
34 dr. PRISA DWICAHMI 199309172020122012
35 dr. TONI MAS IRWANDA S.Ked 198912102020121004
36 dr. VIDIA AMRINA RASYADA 199511162020122008
37 dr. DINNA HANIFAH 199305262020122019
38 HAIRUNISA A.Md.Gz 199309252020122024
39 LIDYA KURNIAWATI A.Md.Gz 199107132020122011
40 CAHYANTI FAUZIAH Amd.Gz 199307062020122008
41 PRATIWI HANDAYANI A.Md.A.K. 199111092020122014
42 QOMARYANI A.Md.A.K. 199202162020122017
43 KHAIRIN AKBAR PUTRA A.Md.A.K 199403022020121006
44 DINI MAGHFIRAH A.Md.Farm 199705222020122011
45 NURHASIANI SARTIANINGRUM A.Md.Far 198511132020122002
46 SINTA NUR HASANAH A.Md.Farm 199803032020122008
47 DESSI ANGGRAENI A.Md. Farm 199512072020122009

48 NADIA NURWAHYUNI A.Md.Far 199212142020122010
49 KIKI AMELIA A.Md.KL 199010122020122008
50 RICO INDRI SETIADY A. Md. KL 199301152020121010
51 SURAYA SHAHAB A.Md.Keb 199301172020122016
52 HIDAYATUR RAHMI A.Md.Keb 199309272020122017
53 RENY AUGTRI SOVIANA A.Md.KG 199408102020122008
54 BILLY RIANDA PRAYOGA 199706142020121008
55 TAMINASIH A.Md.Farm 199511012020122013
56 FEBYOLA AULIA PUTRI A.Md.KL 199603182020122012
57 VITRIANINGSIH A.Md.Keb 198905082020122010
58 Apt. FIDYA SAVITRI S.Farm 198905062020122010
59 LULU MA'RIFATUN KHUSNA A.Md.Gz 199302202020122009
60 RUSDIANA A.Md.Gz 199209092020122027
61 DEVI SILVIA A.Md.AK 199101112020122008
62 NEKA MULYANTI A.Md.A.K 199406142020122023
63 ALFIAN ZULMI A.Md. AK 199105242020121009

64 MIRANTI A.Md.Keb 199110152020122012
65 NURUL AN NISA A.Md.Kes. 199711272020122006
66 Apt. RIRIS ARIESTIASANY S. Farm 199004062020122010
67 ASTRI MARETA A.Md.A.K. 199503202020122011
68 FAUZI A.Md.KL 199702252020121010
69 AURELIA SEPTANIA A.Md. KL 199709252020122009
70 ANDI RATAM Amd. Kl 199107152020121003
71 PRATIWI MUFIDAH A.Md.Kep 199610282020122018
72 URSULA EMILIA A.Md.Kep 199210142020122011
73 BRENDA SEPTIANA AMd, Kep 199509302020122009
74 MAXSIMUS FRENANDO A.Md.RMIK 199105292020121004
75 UTIN ELLA ERLITA A.Md.Farm 199706092020122008
76 drg. AMANDA PUTRI NORIA SUSENO 198905032020122006
77 dr. MITHA ISMAULIDIA 199310102020122018
78 NUR RIDHA RAHAYUNINGTIAS A.Md.Kep 199307102020122022
79 FUJI SANTOSO A.Md.RMIK 199511042020121009

80 NUR AINI RAMADANI A.Md 199602182020122014
81 drg. DENTISIA ARI SHABAHATI 199212182020122006
82 TRI YULINDA LESTARI A.Md.Kep 199307212020122015
83 drg. SANDRA TAMPUBOLON 199005272020122013
84 NAUFAL JONIARTA A.Md.KL 199603242020121005
85 FLORENSIA NEVALDA ANGELA A.Md. Kep 199603022020122016

jenis_kelamin (Pilih agama (Pilih tempat_lahir {Diisi nama kota tgl_lahir
Satu) Satu) lahir} ("dd-mm-yyyy")
Pria Islam KUBU RAYA 11-07-1996
Wanita Islam KUBU RAYA 12-02-1988
Wanita Islam KAYONG UTARA 14-08-1996
Wanita Islam MAGELANG 12-01-1991
Pria Islam KETAPANG 15-10-1991
Wanita Islam KETAPANG 08-08-1993
Pria Islam LANDAK 28-12-1990
Wanita Islam PONTIANAK 29-03-1995

Pria Islam PONTIANAK 14-05-1989

Pria Katholik PONTIANAK 10-12-1989

Pria Islam SINGKAWANG 14-06-1997
Wanita Islam SINGKAWANG 01-11-1995
Wanita Islam SINGKAWANG 18-03-1996
Wanita Islam PATI 08-05-1989
Wanita Islam BANYUMAS 06-05-1989
Wanita Islam BANYUMAS 20-02-1993
Wanita Islam SAMBAS 09-09-1992
Pria Islam SAMBAS 24-05-1991

Wanita Islam MEMPAWAH 27-11-1997
Pria Islam MEMPAWAH 25-02-1997
Wanita Katholik MEMPAWAH 25-09-1997
Pria Islam MEMPAWAH 15-07-1991
Wanita Islam SANGGAU 28-10-1996
Wanita Katholik SANGGAU 14-10-1992
Wanita Katholik SANGGAU 30-09-1995
Pria Katholik SANGGAU 29-05-1991
Wanita Islam SANGGAU 09-06-1997
Wanita Islam BANDUNG 03-05-1989
Wanita Islam BANDUNG 10-10-1993
Wanita Islam SLEMAN 10-07-1993
Pria Islam YOGYAKARTA 04-11-1995

Wanita Islam YOGYAKARTA 18-02-1996
Wanita Islam SEMARANG 18-12-1992
Wanita Islam LAHAT 21-07-1993
Wanita Kristen PEMATANGSIANTAR 27-05-1990
Pria Islam BANJARBARU 24-03-1996
Wanita Katholik JAKARTA 02-03-1996

TINGGI BADAN BERAT BADAN PENYAKIT BAWAAN/YANG PERNAH
(cm) (kg) GOL DARAH
ATAU SEDANG DIDERITA
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- Asma
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no_hp / telp kantor {diisi
email {Diisi dengan alamat email } nomor telepon} gol (Pilih Satu)
abrarabd96@gmail.com 085213948380 II/C
ikahudayanti88@gmail.com 081254891617 II/C
teguhsaputra8877@gmail.com 081398993432 III/B
faridanur6695@gmail.com 089677932260 III/B
wawanaresha009.ws@gmail.com 08993927072 II/C
atikahmawaddah08@gmail.com 0895702230512 II/C
Trikasari451@gmail.com 081254636009 II/C
woro.asriati@gmail.com 089693383034 III/B
santo9148@gmail.com 0895705898133 II/C
nadiaambarini@gmail.com 089694988093 II/C
tolong456@gmail.com 0895701712552 II/C
kurniawatiyani0@gmail.com 082358160313 II/C
melodianggraini@gmail.com 082150937002 II/C
ayeshaliya16@gmail.com 085245484159 II/C
nurseramadhanty@gmail.com 085787420070 II/C

dianpuspita1513@gmail.com 089613011470 II/C
toni.priatmojo14@gmail.com 08995587011 II/C
yusmanardinugraha@gmail.com 08977893595 II/C
rezzakurniawan1@gmail.com 087814448937 II/C
iqi_vela@yahoo.com 08125026089 II/C
ramadhanieka12@gmail.com 089693441264 II/C
wenw72@yahoo.co.id 085245998603 II/C
imamsax27@gmail.com 082154058568 II/C
bary.azhari26@gmail.com 087818191255 III/B
apt.inne@gmail.com 089694107129 III/B
andarillawinny@gmail.com 089693809014 III/B
aprianawindasafitri@gmail.com 089693841611 II/C
niki.putri.irianti@gmail.com 081212423007 III/B
amalianurafiaty@yahoo.co.id 081238941701 III/B
mayty1723@gmail.com 085228935888 III/B
mishbah.hanny@gmail.com 081249352123 III/B

Khairaasmonie12@gmail.com 085752833352 III/B
fitrahadi26@gmail.com 085753222779 III/B
prisadwicahmi@gmail.com 085215165937 III/B
doctor.thony@gmail.com 083155949812 III/B
vidiarasyada@gmail.com 082252365016 III/B
dinnhanifah@gmail.com 085652039502 III/B
hairunisa.yusuf@yahoo.com 089693505142 II/C
Lya91_pelangi@yahoo.co.id 085252410303 II/C
cahyantiocha4@gmail.com 0895411912060 II/C
tiwtiw.tuid@gmail.com 085386559237 II/C
d2yani92@gmail.com 082251192236 II/C
khairinakbarputra@gmail.com 089693952725 II/C
maghfirahdini@gmail.com 089633057191 II/C
nur.hasyani@gmail.com 085753529778 II/C
Sintastory@gmail.com 082151915863 II/C
anggraenidessi@gmail.com 089510571483 II/C

nadianurwahyuni111@gmail.com 08990237511 II/C
amelia.qyqy12@gmail.com 089603795225 II/C
rico.indri13@gmail.com 085345235817 II/C
sorayashahab17@gmail.com 089529837405 II/C
hidayaturrahmie@yahoo.com 089693838922 II/C
renyutomo05@gmail.com 089693203447 II/C
billy.prayoga789@gmail.com 089659179281 II/C
apotik.sbs12@gmail.com 089670736112 II/C
febyolaaulia1807@gmail.com 089515432904 II/C
vee.three080589@gmail.com 085712166956 II/C
fidyasavitri@gmail.com 081251063964 III/B
lulumarifatun24@gmail.com 085822067850 II/C
anarsdn49@gmail.com 085252044562 II/C
devisilvia.sanjaya@gmail.com 085247284488 II/C
nekamulyanti25@gmail.com 081386398688 II/C
alfian.zulmi24@gmail.com 085215154616 II/C

mirantisalim@gmail.com 085933449990 II/C
annisadi1nurul@gmail.com 082159130668 II/C
riris.ariestiasany@gmail.com 0811567830 III/B
astrimareta203@gmail.com 081256010208 II/C
Uncleojik.12@gmail.com 62895701972613 II/C
aureliaseptania2509@gmail.com 0895389992090 II/C
andijohnson39@gmail.com 082386544278 II/C
pratiwimufidah293@gmail.com 089655299329 II/C
Emiliau70@gmail.com 085246260980 II/C
brendaseptiana@gmail.com 085393515126 II/C
maxsimusfrenando@gmail.com 082133325143 II/C
ellaerlita74@gmail.com 083142049396 II/C
amanda.putri.suseno@gmail.com 081225502800 III/B
mithaismaulidia@yahoo.com 089695346206 III/B
mynameidaa@gmail.com 085729764593 II/C
nool.fuji@gmail.com 082248419037 II/C

nurainiramadani0@gmail.com 085642748436 II/C
dentisiaari@yahoo.com 085743700218 III/B
Indahlestari531@gmail.com 085267315785 II/C
sandratampubolon90@gmail.com 085296420275 III/B
naufalrfd@gmail.com 089691167641 II/C
fnangelaa@gmail.com 0895393473785 II/C

pangkat (Pilih Satu) jabatan {Diisi jabatan terakhir}
Pengatur PELAKSANA/TERAMPIL - PEREKAM MEDIS
Pengatur PELAKSANA/TERAMPIL - PERAWAT
Penata Muda Tingkat I AHLI PERTAMA - APOTEKER
Pengatur PELAKSANA/TERAMPIL - NUTRISIONIS
Penata Muda Tingkat I AHLI PERTAMA - DOKTER
Pengatur PELAKSANA/TERAMPIL - SANITARIAN
Pengatur PELAKSANA/TERAMPIL - PERAWAT GIGI

Penata Muda Tingkat I AHLI PERTAMA - DOKTER GIGI

Pengatur PELAKSANA/TERAMPIL - PRANATA LABORATORIUM KESEHATAN
Pengatur PELAKSANA/TERAMPIL - ASISTEN APOTEKER

Pengatur PELAKSANA/TERAMPIL - BIDAN
Pengatur PELAKSANA/TERAMPIL - PERAWAT GIGI



NO Nama (Diisi Dengan Nama Peserta) No - Identitas (Diisi Dengan Nip/Nrp/Npp/Nik)

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no_identitas {Diisi dengan

NO nama {diisi dengan nama peserta} NIP/NRP/NPP/NIK}

1 ABRAR A. Md. RMIK 199607112020121004

2 IKA HUDAYANTI A.Md. Kep 198802122020122009

3 Apt. TEGUH SAPUTRA S.Si 198607192020121006

4 Apt. FARIDA NURYANINGSIH S.Farm 199406062020122024

5 SETIAWAN A. Md. RMIK 199103232020121013

6 MAWADDAH ATIKAH A.Md.Gz 199508132020122013

7 TRIKA SARI A. Md. RMIK 199608142020122012

8 dr. WORO ASRIATI NURJANNAH S.Ked. 199101122020122010

9 SUSANTO A. Md. KL 199110152020121008

10 NADIA AMBARINI A.Md.KG 199308082020122014

11 AFIFUDDIN Amd. KL 199012282020121004

12 YANI KURNIAWATI A.Md.RMIK 199503292020122016

13 LINA ANGGRAINI A.Md.Kep 198907212020122009

14 AMINAH Amd.Kep 198607162020122002

15 IRMARIKA RAMADHANTY A.Md.Kep 199801032020122006

17 TONI PRIATMOJO A.Md.Kep 198905142020121007

18 YUSMAN ARDI NUGRAHA AMd. Kep 199109262020121011

19 REZZA KURNIAWAN A.Md. Kep 198912232020121009

20 RISQI PUSPITASARI A. Md. Kep 198901142020122009

21 EKA RAMADHANIYAH A.Md.RMIK 199402122020122012

22 GANGSAR YUWENDI A.Md.RMIK 199206292020121014

23 IMAM ATMAJAYA A.Md.RMIK 199501272020121006

24 apt. BARY AZHARI S.Farm. 199302152020121010

25 Apt. INNE NOVIANTI S.Farm 199411252020122024

26 Apt. WINNY ANDARILLA S.Farm 199504142020122023

27 APRIANA WINDA SAFITRI A.Md 199604102020122014

28 drg. NIKI PUTRI IRIANTI 199210202020122011

29 drg AMALIA NUR AFIYATI 199201312020122007

30 drg. MAYTY RAHMA FITRIA 198905172020122012

31 drg. MISHBAHANI 199411142020122009

33 dr. FITRA HADI 199502262020121006

34 dr. PRISA DWICAHMI 199309172020122012

35 dr. TONI MAS IRWANDA S.Ked 198912102020121004

36 dr. VIDIA AMRINA RASYADA 199511162020122008

37 dr. DINNA HANIFAH 199305262020122019

38 HAIRUNISA A.Md.Gz 199309252020122024

39 LIDYA KURNIAWATI A.Md.Gz 199107132020122011

40 CAHYANTI FAUZIAH Amd.Gz 199307062020122008

41 PRATIWI HANDAYANI A.Md.A.K. 199111092020122014

42 QOMARYANI A.Md.A.K. 199202162020122017

43 KHAIRIN AKBAR PUTRA A.Md.A.K 199403022020121006

44 DINI MAGHFIRAH A.Md.Farm 199705222020122011

45 NURHASIANI SARTIANINGRUM A.Md.Far 198511132020122002

46 SINTA NUR HASANAH A.Md.Farm 199803032020122008

47 DESSI ANGGRAENI A.Md. Farm 199512072020122009

49 KIKI AMELIA A.Md.KL 199010122020122008

50 RICO INDRI SETIADY A. Md. KL 199301152020121010

51 SURAYA SHAHAB A.Md.Keb 199301172020122016

52 HIDAYATUR RAHMI A.Md.Keb 199309272020122017

53 RENY AUGTRI SOVIANA A.Md.KG 199408102020122008

54 BILLY RIANDA PRAYOGA 199706142020121008

55 TAMINASIH A.Md.Farm 199511012020122013

56 FEBYOLA AULIA PUTRI A.Md.KL 199603182020122012

57 VITRIANINGSIH A.Md.Keb 198905082020122010

58 Apt. FIDYA SAVITRI S.Farm 198905062020122010

59 LULU MA'RIFATUN KHUSNA A.Md.Gz 199302202020122009

60 RUSDIANA A.Md.Gz 199209092020122027

61 DEVI SILVIA A.Md.AK 199101112020122008

62 NEKA MULYANTI A.Md.A.K 199406142020122023

63 ALFIAN ZULMI A.Md. AK 199105242020121009