FORMAT PELACAKAN / PENDATAAN SEKALIGUS FORMAT PELAYANAN IM

SASARAN ≥ 12 BULAN SD 59 BULAN UNTUK KEJAR IM

POSYANDU : RT/RW :
DESA : PUSKESMAS :
KELURAHAN : JEGU KAB/KO :
PROVINSI :

JENIS
KELAMIN
ALAMAT
TANGGAL lengkap
NO NAMA SASARAN NAMA IBU TELP
LAHIR (RT/RW/DSN/
DESA)
L P

1 2 3 4 5 6 7
M HASBI RIDHA 9/1/2017 L SITI ROSIDA POS 1
1
JUANG UNTINA 9/9/2017 L SUTRISNO POS 1
2
SHABIRA 10/11/2017 P HARI SASONO POS 1
3
AUNI YUMNA 10/23/2017 L M. FUAD POS 1
4
5 AHMAD FAIQ HIBATULLAH 11/3/2017 L ASIKU POS 1
DHARMA SENA 12/4/2017 L SUDARMANTO POS 1
6
ADAM LAKSAMANA 12/6/2017 L FREDI DUWI KUSUMA POS 1
7
M. RIZQULAH 12/8/2017 L DIDIK PURWOKO POS 1
8
M.YUSUF 1/4/2018 L NASTAIN POS 1
9
GANDIS PUTRI KINANTHI 2/1/2018 P NURHIDAYATUL POS 1
10
ARSYLA SOVEA 2/25/2018 P TRISUKOHADI POS 1
11
UWAIS PRASETYA ASSEGAF 3/26/2018 L ANGGA PRASETYO POS 1
12
AZRIEL ROFIQ AL FARIZI 4/4/2018 L CHOIRUL ROFIQ POS 1
13
ARUNA VISHAKA 4/14/2018 L SOFYAN HADI POS 1
14
IBRAHIM HASAN AL MUSTOF4/30/2018 L INDAH POS 1
15
SHOFIA ADISTA M 6/16/2018 P SAIFUL ARIFIN POS 1
16
AHMAD AZKA R 6/24/2018 L RISKA POS 1
17
AZZAM KHALIF PUTRA 6/12/2018 L WIJI UTAMI POS 1
18
ALIFAH AISYA R 8/16/2018 P ANIK POS 1
19
M. FAISAL 8/28/2018 L INDRA POS 1
20
CHIO AHMADS 9/21/2018 L PIPIT POS 1
21
SAFANA ASITA 9/28/2018 P WINARTI POS 1
22
CITRA AIZA PRAMESWARI 10/13/2018 P HENDRI SANTOSO POS 1
23
ALIFAH DAFFA SYAMSIAR 10/22/2018 L M. TULUS H POS 1
24
 BERYL GHIBRAN 11/6/2018 L MEGA POS 1
25
AZAHRA KHAIRINA A 11/21/2018 P SUPRAYITNO POS 1
26
OLIVIA LARASATI 11/25/2018 P SIGIT POS 1
27
DANIA AMEERA P 12/2/2018 P AWALUL POS 1
28
RASYA M ATAYA 12/18/2018 L AHMAD AKBAR POS 1
29
LAFIFUDIN DZAKI 12/2/2018 L LAMIASIH POS 1
30
AISYAH NAJWA 1/3/2019 P RIKA POS 1
31
RINGGO FABOAN 1/6/2019 L MIRANDA POS 1
32
ANINDITA INEZ N S 1/12/2019 P ENDARWATI POS 1
33
CHALISTA BILLA 1/31/2019 P RINA POS 1
34
NAULAA ASYIFA 2/25/2019 P HANA POS 1
35
GAMALIEL 3/18/2019 L ENDANG POS 1
36
AZZASKA ELGIO 4/14/2019 L ARI FITRIANA POS 1
37
NAFISA HASNA ADIRA 6/14/2019 P RUBIATUN POS 1
38
SENJA PARAMITA 6/23/2019 P MEI YUANA POS 1
39
DEFANO H 9/7/2019 L HARIANTI POS 1
40
M. ALDAM ASYRAAF 9/12/2019 L KHUSNUL POS 1
41
M. ZAKARIYA 9/15/2019 L UMI M POS 1
42
RANIA A.K 10/11/2019 P LAURENSIA POS 1
43
BRIANA MAHESWARI 10/30/2019 P YURISTA POS 1
44
REYVANDO 11/12/2019 L NOVA POS 1
45
EL ZAVIRA 11/16/2019 P P TATI POS 1
46
KUNY MUSTAFIDATUL 11/18/2019 P P NURCHOLIFAH POS 1
47
KEVIN G 11/22/2019 L YULIA POS 1
48
FAIZA SYABNA 12/2/2019 P P RETNO POS 1
49
AHMAD FARHAN 12/24/2019 L ENI POS 1
50
RAFIZQI ZAYU A 10/3/2020 L ONI POS 1
51
MUSA AL MUSTOFA 1/8/2020 L ENDAH POS 1
52
ALMEEZA HASNA 1/15/2020 P RIA RISKI POS 1
53
AZKYA KEYNARA 3/21/2020 P YAYUK POS 1
54
BAYU CAHYO KUSUMO 4/22/2020 L WINARTI POS 1
55
RAISKA AQNIA KAMIL 4/24/2020 P NALA SITI POS 1
56
CALVINO JULIO CHALID A 7/16/2020 L CHASNA POS 1
57
KEYSA SALSABILA PUTRI P 7/20/2020 P DINA POS 1
58
M. ATHARAZKA RAYYAN S 8/18/2020 L NUNIK POS 1
59
ARROYAN DILLAN A 9/17/2020 L RINA NURIKAH POS 1
60
 A. M IBRAHIM WAFA 10/17/2020 L DINA POS 1
61
SYAKILA SA 10/22/2020 P WIJI UTAMI POS 1
62
M. BILAL ASAFIQ 12/22/2020 L PUJI WANTI POS 1
63
M. AHYAR A 12/27/2020 L RETNO WIDI POS 1
64
HAIKAL RAHEEL F 2/22/2021 L HANA POS 1
65
SHIVA DWI ANINDITA 4/4/2021 P LAMIASEH POS 1
66
DHIRA ELYANA PUTRI 7/10/2021 P INGE NOVITA POS 1
67
AQILA OLIVIA 8/9/2021 P WINARSIH POS 1
68
MARZEL AMAR M A 8/23/2021 L SUYANTIK POS 1
69
MIZELA NUR QORI 8/23/2021 P SUYANTIK POS 1
70
IBRAHIM CANDRA MUKTI 8/27/2021 L BINTI POS 1
71
SYAQILA ALMAHIRA F 8/28/2021 P IKA DEWI POS 1
72
SANUM ALMAHERA QUENSA9/16/2021 P P SRI WAHYUNI POS 1
73
M. EVANO AL BARA 10/12/2021 L TETY AHIMATTUR POS 1
74
ALMAHYRA ADZKIA P 10/27/2021 P DEVITA BINTI POS 1
75
75
ZAHID HAMIZAH 2/8/2018 L POS 2
1 SUDARIANTO
AHMAD FAYZA 2/19/2018 L POS 2
2 ROHMAD S
AZRIL RAFFASYA 3/9/2018 L POS 2
3 HADI MUSTOFA
RENATA ANGGRAINI 3/23/2018 P POS 2
4 EKO HARIANTO
YENZA ANINIA 6/21/2018 L POS 2
5 NANANG SUBAKTI
BRIYAN PUTRA HADI 10/27/2018 L POS 2
6 SIKHA
KAYLA SERLY 11/20/2018 P POS 2
7 FITRI
NAFEEZA ADWA AL 11/20/2018 P POS 2
8 BINTI
AURORA JIHANIA G 1/15/2019 P POS 2
9 LILIS
AL-MUQSIH GAIZA 3/14/2019 P POS 2
10 INA
QUIN TRIBUANA A 5/1/2019 P POS 2
11 ERMA
RHEANDRA ARFAH 6/21/2019 L POS 2
12 YULI
AHMAD BARA K 8/3/2019 L POS 2
13 KRISTININGSIH
KYRA DEWI 10/25/2019 P POS 2
14 NURMALASARI
AZAHRA WIDYA 11/1/2019 P POS 2
15 NURMA
A. MELVIANO T 12/21/2019 L POS 2
16 ANIK
TRISTAN ZULFIANSYAH 12/21/2019 L POS 2
17 YULIANA
M. DAVIN ALFARIZI 1/11/2020 L POS 2
18 WIJI WAHYUNI
NAYLA AQILA HAFIZAH 1/31/2020 P POS 2
19 TRISNAWATI
KHORIDATUL BAHIYAH 3/23/2020 P POS 2
20 UMI ROSIDAH
 ABRINA HAFLANY 4/17/2020 P POS 2
21 SRI W
AVICENNA CHAYRA 4/17/2020 P POS 2
22 SINTA
M. ABAYOMI AYELLO 4/23/2020 L POS 2
23 ANA YULI ASTUTIK
NAURA SHAFA APRILIA 6/8/2020 P POS 2
24 AGUSTIN LEVI
AHMAD FAJAR TAUFIQ 7/9/2020 L POS 2
25 AYAH AHMAD
ALUISIA FIRDAUS 10/11/2020 P POS 2
26 NURLIA
CHAYRA ARUMI R 11/27/2020 P POS 2
27 HANIK LINA
DIO RAVENDRA A 12/24/2020 L POS 2
28 ENI SETYOWATI
YELLCE YANUARISA 1/28/2021 P POS 2
29 HENI MARMIATI
DAVIRA SEPTIA PUTRI 9/15/2021 P POS 2
30 DIANA NOFANTIKA
FERDINAN ELVANO 11/3/2021 L POS 2
31 DIAN PRIYANI
SUHAILA NUR SYIFA 11/27/2021 P POS 2
32 TRI PANCA W
32

1 ALDINAR 9/11/2017 P APRILIA POS 3

2 M. RIZAL ALBARA ### L NENI POS 3

3 AZKA KUMAIRA ### P DYAH POS 3

4 RAFKA 1/20/2018 L ANDIK PUJIONO POS 3

5 FEBRI WAHYU S 2/7/2018 L FRANSISCA POS 3

6 REYHAN ALKANTARA 2/27/2018 L YOVI ACHMAD P POS 3

7 NADA 3/20/2018 P KRISWANTO POS 3

8 RANI APRILIA PUTRI 4/13/2018 P JARNO POS 3

9 ATTAYA 4/21/2018 P HENDRAWANTO POS 3

10 SILVIA PUTRI 4/24/2018 P WIJI RIANTO POS 3

11 M. FARIS ASKA 6/5/2018 P NOVA POS 3

12 VALENCIA CHANSA A 9/13/2018 P NIA H POS 3

13 RICHARD ### L NAPSIAH POS 3

14 NAYORA ARDY TAMA 1/15/2019 L LISA POS 3

15 M. YANUAR R 1/30/2019 L ANNISA POS 3

16 FABIO BYANTARA ALA 3/9/2019 L KIKI POS 3

17 ALAN ATHALA P 4/25/2019 L KRISWANTO POS 3

18 SYAKILA YULIA A 5/10/2019 P AYU POS 3

19 DEVANO KENZIE 5/21/2019 L SUMIATI POS 3

20 M. AZRIL RAFASYA 8/20/2019 L HETI POS 3

21 AKMAL DAVID 9/27/2019 L NINIS POS 3

22 RAFFI ALYA RIZKY 10/2/2019 L DEVI POS 3

23 SHAKILA HIMATUL ### P TANTI POS 3

24 ALESA AYU ZAHRA 11/6/2019 P ANISA POS 3

25 NEVAN PUTRA F 1/8/2020 L EKA POS 3

26 BARA KENZO R 1/23/2020 L RENI POS 3

27 AQMAR KHAIZAN ARYA 1/24/2020 L YESI POS 3

28 ALI SHAIHUL 2/21/2020 L PITA POS 3

29 DEVIA KHANZA KIRANA 2/29/2020 P SUYANTI POS 3

30 PUTRI KARINTA 2/29/2020 P NOVI POS 3

31 SYAQILA RAHMA 4/20/2020 P CUCIK POS 3

32 AQIFAH NAILA RAHMA D 5/4/2020 P SANTI POS 3

33 NABILA FAHIRA VALERINE 5/24/2020 P NURWATI/AHMAD POS 3

34 ALSYILA DHESWINA A 6/6/2020 P AYU DESTA POS 3

35 SHERINA AURELIA 6/20/2020 P IDAYU POS 3

36 ASSYIFA NUR HIDAYAH 7/13/2020 P TUTIK/RUDI POS 3

37 ANDRA GIOVANO 9/24/2020 L TRISNI POS 3

38 FADHELA ZIVANYA 10/3/2020 P APRILIA POS 3

39 KENZIA CORNELIA 10/3/2020 P SUMIATI POS 3

40 DANIYA MUSTIKA ### P ZULAIKAH POS 3

41 AL FAREZEL ARFAN ### L WIWIK POS 3

42 ELVANO DANIYAL RAFKA 2/18/2021 L ARYANTI POS 3

43 ELVANO DANIYAL RIFKI 2/18/2021 L ARYANTI POS 3

44 INGGIT AQELLA 2/24/2021 P ARINA POS 3

45 KENNAN IBRAM 3/18/2021 L BELINDA POS 3

46 ARSHYLA NURAINI 3/27/2021 P DIKA DWI R POS 3

47 ALKHALIFI 4/16/2021 L WIDYAWATI POS 3

48 ASKIYA PUTRI INARA 4/28/2021 P PENI WAHYUNI POS 3

49 ARFAN RAFIF ALKHALIFI 5/11/2021 L MUNTOHAROH POS 3

50 MAHATUA ARSHAKA 5/22/2021 L VINA POS 3

51 LUQMAN RANDU 5/23/2021 L JOIS APLILIA POS 3

52 MUHAMAD WILIAM 7/3/2021 L LILIS ZULAIKAH POS 3

53 NAFISHA SYAFA A 7/3/2021 P SUSI NURHAYATI POS 3

54 AZKA NAGATA EFENDI 8/4/2021 L RINI DWI POS 3

55 SEPTIAN DWI ANDIKA 9/1/2021 L LIA POS 3

56 GRISCA AGHELIA 9/18/2021 P ANA SETIANA POS 3

57 ARSHAKA OCTAVIAN ### L ISVINA POS 3

58 ALIF ARICA FAUZAN M ### L SANTI POS 3

59 ALFAREZI PUTRA ### L NURCOLIFAH POS 3

60 GIO KURNIAWAN ### L RINI POS 3

60

1 M. FAREL ### L LELITA POS 4

2 RAYHAN ### L TRIONO POS 4

3 FATHAN ### L BAYU NURYANTO POS 4

4 BALQIS OLIVIA 10/5/2018 P M. SAIFUL FUAT POS 4

5 PRISKIA CHACA R D ### P LILIS POS 4

6 ALIANDO 6/18/2019 L YENI POS 4

7 NABIL A.F.M 6/25/2019 L ERNI POS 4

8 SULFA ERLANGGA SANDI 8/7/2019 L SRIWAHYUNI POS 4

9 SYADANA FA 9/21/2019 L MUSLIMAT POS 4

10 NIDIA AZAKINA DARI 11/1/2019 P TRI RATNA WATI POS 4

11 ALMAHYRA ### P RUSWATI POS 4

12 INARA SYAQUILLEY 9/12/2020 P GIZELA OKA S POS 4

13 SAFARAS ABIYAN N ### L NANANG DIMAS POS 4

14 MAVADA AFDILAN 6/24/2021 P GUNAWAN POS 4

15 AIDA NUR HAFLANI 8/22/2021 P HARI SUSANTO POS 4

MAT PELAYANAN IMUNISASI KEJAR TAHUN 2022
N UNTUK KEJAR IMUNISASI

UPT PUSKESMAS SUTOJAYAN

KAB. BLITAR
JAWA TIMUR

IMUNISASI LANJ
IMUNISASI DASAR YANG BELUM DIDAPAT YANG BELUM
DIDAPAT
DPT-HB-HIB 2

DPT-HB-HIB 4
KET
DPT-HB-HIB3
DPT-HB-IB 1
OPV 1

OPV 2

OPV 3

OPV 4

MR 2
MR1
IPV

8 9 10 11 12 13 14 15 16 17 18 19
 FORMAT PENDATAAN BULAN IMUNISASI ANAK 2022
SASARAN USIA 9 BULAN SD 59 BULAN
POSYANDU : RT/RW
DESA : PUSKESMAS
KELURAHAN : JEGU KAB/KO
PROVINSI

JENIS ALAMAT
TANGGAL
KELAMIN lengkap
NO NAMA SASARAN LAHIR/(umur dlm NAMA IBU
(RT/RW/DSN/
bln)
DESA)
L P
1 2 3 4 5 6
M HASBI RIDHA 9/1/2017 L SITI ROSIDA POS 1
1
JUANG UNTINA 9/9/2017 L SUTRISNO POS 1
2
SHABIRA 10/11/2017 P HARI SASONO POS 1
3
AUNI YUMNA 10/23/2017 L M. FUAD POS 1
4
5 AHMAD FAIQ HIBATULLAH 11/3/2017 L ASIKU POS 1
DHARMA SENA 12/4/2017 L SUDARMANTO POS 1
6
ADAM LAKSAMANA 12/6/2017 L FREDI DUWI KUSUMA POS 1
7
M. RIZQULAH 12/8/2017 L DIDIK PURWOKO POS 1
8
M.YUSUF 1/4/2018 L NASTAIN POS 1
9
GANDIS PUTRI KINANTHI 2/1/2018 P NURHIDAYATUL POS 1
10
ARSYLA SOVEA 2/25/2018 P TRISUKOHADI POS 1
11
UWAIS PRASETYA ASSEGAF 3/26/2018 L ANGGA PRASETYO POS 1
12
AZRIEL ROFIQ AL FARIZI 4/4/2018 L CHOIRUL ROFIQ POS 1
13
ARUNA VISHAKA 4/14/2018 L SOFYAN HADI POS 1
14
IBRAHIM HASAN AL MUSTOFA 4/30/2018 L INDAH POS 1
15
SHOFIA ADISTA M 6/16/2018 P SAIFUL ARIFIN POS 1
16
AHMAD AZKA R 6/24/2018 L RISKA POS 1
17
AZZAM KHALIF PUTRA 6/12/2018 L WIJI UTAMI POS 1
18
ALIFAH AISYA R 8/16/2018 P ANIK POS 1
19
M. FAISAL 8/28/2018 L INDRA POS 1
20
CHIO AHMADS 9/21/2018 L PIPIT POS 1
21
SAFANA ASITA 9/28/2018 P WINARTI POS 1
22
CITRA AIZA PRAMESWARI 10/13/2018 P HENDRI SANTOSO POS 1
23
ALIFAH DAFFA SYAMSIAR 10/22/2018 L M. TULUS H POS 1
24
BERYL GHIBRAN 11/6/2018 L MEGA POS 1
25
AZAHRA KHAIRINA A 11/21/2018 P SUPRAYITNO POS 1
26
OLIVIA LARASATI 11/25/2018 P SIGIT POS 1
27
 DANIA AMEERA P 12/2/2018 P AWALUL POS 1
28
RASYA M ATAYA 12/18/2018 L AHMAD AKBAR POS 1
29
LAFIFUDIN DZAKI 12/2/2018 L LAMIASIH POS 1
30
AISYAH NAJWA 1/3/2019 P RIKA POS 1
31
RINGGO FABOAN 1/6/2019 L MIRANDA POS 1
32
ANINDITA INEZ N S 1/12/2019 P ENDARWATI POS 1
33
CHALISTA BILLA 1/31/2019 P RINA POS 1
34
NAULAA ASYIFA 2/25/2019 P HANA POS 1
35
GAMALIEL 3/18/2019 L ENDANG POS 1
36
AZZASKA ELGIO 4/14/2019 L ARI FITRIANA POS 1
37
NAFISA HASNA ADIRA 6/14/2019 P RUBIATUN POS 1
38
SENJA PARAMITA 6/23/2019 P MEI YUANA POS 1
39
DEFANO H 9/7/2019 L HARIANTI POS 1
40
M. ALDAM ASYRAAF 9/12/2019 L KHUSNUL POS 1
41
M. ZAKARIYA 9/15/2019 L UMI M POS 1
42
RANIA A.K 10/11/2019 P LAURENSIA POS 1
43
BRIANA MAHESWARI 10/30/2019 P YURISTA POS 1
44
REYVANDO 11/12/2019 L NOVA POS 1
45
EL ZAVIRA 11/16/2019 P P TATI POS 1
46
KUNY MUSTAFIDATUL 11/18/2019 P P NURCHOLIFAH POS 1
47
KEVIN G 11/22/2019 L YULIA POS 1
48
FAIZA SYABNA 12/2/2019 P P RETNO POS 1
49
AHMAD FARHAN 12/24/2019 L ENI POS 1
50
RAFIZQI ZAYU A 10/3/2020 L ONI POS 1
51
MUSA AL MUSTOFA 1/8/2020 L ENDAH POS 1
52
ALMEEZA HASNA 1/15/2020 P RIA RISKI POS 1
53
AZKYA KEYNARA 3/21/2020 P YAYUK POS 1
54
BAYU CAHYO KUSUMO 4/22/2020 L WINARTI POS 1
55
RAISKA AQNIA KAMIL 4/24/2020 P NALA SITI POS 1
56
CALVINO JULIO CHALID A 7/16/2020 L CHASNA POS 1
57
KEYSA SALSABILA PUTRI P 7/20/2020 P DINA POS 1
58
M. ATHARAZKA RAYYAN S 8/18/2020 L NUNIK POS 1
59
ARROYAN DILLAN A 9/17/2020 L RINA NURIKAH POS 1
60
A. M IBRAHIM WAFA 10/17/2020 L DINA POS 1
61
SYAKILA SA 10/22/2020 P WIJI UTAMI POS 1
62
M. BILAL ASAFIQ 12/22/2020 L PUJI WANTI POS 1
63
 M. AHYAR A 12/27/2020 L RETNO WIDI POS 1
64
HAIKAL RAHEEL F 2/22/2021 L HANA POS 1
65
SHIVA DWI ANINDITA 4/4/2021 P LAMIASEH POS 1
66
DHIRA ELYANA PUTRI 7/10/2021 P INGE NOVITA POS 1
67
AQILA OLIVIA 8/9/2021 P WINARSIH POS 1
68
MARZEL AMAR M A 8/23/2021 L SUYANTIK POS 1
69
MIZELA NUR QORI 8/23/2021 P SUYANTIK POS 1
70
IBRAHIM CANDRA MUKTI 8/27/2021 L BINTI POS 1
71
SYAQILA ALMAHIRA F 8/28/2021 P IKA DEWI POS 1
72
SANUM ALMAHERA QUENSA 9/16/2021 P P SRI WAHYUNI POS 1
73
M. EVANO AL BARA 10/12/2021 L TETY AHIMATTUR POS 1
74
ALMAHYRA ADZKIA P 10/27/2021 P DEVITA BINTI POS 1
75
75
ZAHID HAMIZAH 2/8/2018 L POS 2
1 SUDARIANTO
AHMAD FAYZA 2/19/2018 L POS 2
2 ROHMAD S
AZRIL RAFFASYA 3/9/2018 L POS 2
3 HADI MUSTOFA
RENATA ANGGRAINI 3/23/2018 P POS 2
4 EKO HARIANTO
YENZA ANINIA 6/21/2018 L POS 2
5 NANANG SUBAKTI
BRIYAN PUTRA HADI 10/27/2018 L POS 2
6 SIKHA
KAYLA SERLY 11/20/2018 P POS 2
7 FITRI
NAFEEZA ADWA AL 11/20/2018 P POS 2
8 BINTI
AURORA JIHANIA G 1/15/2019 P POS 2
9 LILIS
AL-MUQSIH GAIZA 3/14/2019 P POS 2
10 INA
QUIN TRIBUANA A 5/1/2019 P POS 2
11 ERMA
RHEANDRA ARFAH 6/21/2019 L POS 2
12 YULI
AHMAD BARA K 8/3/2019 L POS 2
13 KRISTININGSIH
KYRA DEWI 10/25/2019 P POS 2
14 NURMALASARI
AZAHRA WIDYA 11/1/2019 P POS 2
15 NURMA
A. MELVIANO T 12/21/2019 L POS 2
16 ANIK
TRISTAN ZULFIANSYAH 12/21/2019 L POS 2
17 YULIANA
M. DAVIN ALFARIZI 1/11/2020 L POS 2
18 WIJI WAHYUNI
NAYLA AQILA HAFIZAH 1/31/2020 P POS 2
19 TRISNAWATI
KHORIDATUL BAHIYAH 3/23/2020 P POS 2
20 UMI ROSIDAH
ABRINA HAFLANY 4/17/2020 P POS 2
21 SRI W
AVICENNA CHAYRA 4/17/2020 P POS 2
22 SINTA
M. ABAYOMI AYELLO 4/23/2020 L POS 2
23 ANA YULI ASTUTIK
 NAURA SHAFA APRILIA 6/8/2020 P POS 2
24 AGUSTIN LEVI
AHMAD FAJAR TAUFIQ 7/9/2020 L POS 2
25 AYAH AHMAD
ALUISIA FIRDAUS 10/11/2020 P POS 2
26 NURLIA
CHAYRA ARUMI R 11/27/2020 P POS 2
27 HANIK LINA
DIO RAVENDRA A 12/24/2020 L POS 2
28 ENI SETYOWATI
YELLCE YANUARISA 1/28/2021 P POS 2
29 HENI MARMIATI
DAVIRA SEPTIA PUTRI 9/15/2021 P POS 2
30 DIANA NOFANTIKA
FERDINAN ELVANO 11/3/2021 L POS 2
31 DIAN PRIYANI
SUHAILA NUR SYIFA 11/27/2021 P POS 2
32 TRI PANCA W
32

1 ALDINAR 9/11/2017 P APRILIA POS 3

2 M. RIZAL ALBARA 10/17/2017 L NENI POS 3

3 AZKA KUMAIRA 10/26/2017 P DYAH POS 3

4 RAFKA 1/20/2018 L ANDIK PUJIONO POS 3

5 FEBRI WAHYU S 2/7/2018 L FRANSISCA POS 3

6 REYHAN ALKANTARA 2/27/2018 L YOVI ACHMAD P POS 3

7 NADA 3/20/2018 P KRISWANTO POS 3

8 RANI APRILIA PUTRI 4/13/2018 P JARNO POS 3

9 ATTAYA 4/21/2018 P HENDRAWANTO POS 3

10 SILVIA PUTRI 4/24/2018 P WIJI RIANTO POS 3

11 M. FARIS ASKA 6/5/2018 P NOVA POS 3

12 VALENCIA CHANSA A 9/13/2018 P NIA H POS 3

13 RICHARD 10/31/2018 L NAPSIAH POS 3

14 NAYORA ARDY TAMA 1/15/2019 L LISA POS 3

15 M. YANUAR R 1/30/2019 L ANNISA POS 3

16 FABIO BYANTARA ALA 3/9/2019 L KIKI POS 3

17 ALAN ATHALA P 4/25/2019 L KRISWANTO POS 3

18 SYAKILA YULIA A 5/10/2019 P AYU POS 3

19 DEVANO KENZIE 5/21/2019 L SUMIATI POS 3

20 M. AZRIL RAFASYA 8/20/2019 L HETI POS 3

21 AKMAL DAVID 9/27/2019 L NINIS POS 3

22 RAFFI ALYA RIZKY 10/2/2019 L DEVI POS 3

23 SHAKILA HIMATUL 10/13/2019 P TANTI POS 3

24 ALESA AYU ZAHRA 11/6/2019 P ANISA POS 3

25 NEVAN PUTRA F 1/8/2020 L EKA POS 3

26 BARA KENZO R 1/23/2020 L RENI POS 3

27 AQMAR KHAIZAN ARYA 1/24/2020 L YESI POS 3

28 ALI SHAIHUL 2/21/2020 L PITA POS 3

29 DEVIA KHANZA KIRANA 2/29/2020 P SUYANTI POS 3

30 PUTRI KARINTA 2/29/2020 P NOVI POS 3

31 SYAQILA RAHMA 4/20/2020 P CUCIK POS 3

32 AQIFAH NAILA RAHMA D 5/4/2020 P SANTI POS 3

33 NABILA FAHIRA VALERINE 5/24/2020 P NURWATI/AHMAD POS 3

34 ALSYILA DHESWINA A 6/6/2020 P AYU DESTA POS 3

35 SHERINA AURELIA 6/20/2020 P IDAYU POS 3

36 ASSYIFA NUR HIDAYAH 7/13/2020 P TUTIK/RUDI POS 3

37 ANDRA GIOVANO 9/24/2020 L TRISNI POS 3

38 FADHELA ZIVANYA 10/3/2020 P APRILIA POS 3

39 KENZIA CORNELIA 10/3/2020 P SUMIATI POS 3

40 DANIYA MUSTIKA 12/25/2020 P ZULAIKAH POS 3

41 AL FAREZEL ARFAN 12/25/2020 L WIWIK POS 3

42 ELVANO DANIYAL RAFKA 2/18/2021 L ARYANTI POS 3

43 ELVANO DANIYAL RIFKI 2/18/2021 L ARYANTI POS 3

44 INGGIT AQELLA 2/24/2021 P ARINA POS 3

45 KENNAN IBRAM 3/18/2021 L BELINDA POS 3

46 ARSHYLA NURAINI 3/27/2021 P DIKA DWI R POS 3

47 ALKHALIFI 4/16/2021 L WIDYAWATI POS 3

48 ASKIYA PUTRI INARA 4/28/2021 P PENI WAHYUNI POS 3

49 ARFAN RAFIF ALKHALIFI 5/11/2021 L MUNTOHAROH POS 3

50 MAHATUA ARSHAKA 5/22/2021 L VINA POS 3

51 LUQMAN RANDU 5/23/2021 L JOIS APLILIA POS 3

52 MUHAMAD WILIAM 7/3/2021 L LILIS ZULAIKAH POS 3

53 NAFISHA SYAFA A 7/3/2021 P SUSI NURHAYATI POS 3

54 AZKA NAGATA EFENDI 8/4/2021 L RINI DWI POS 3

55 SEPTIAN DWI ANDIKA 9/1/2021 L LIA POS 3

56 GRISCA AGHELIA 9/18/2021 P ANA SETIANA POS 3

57 ARSHAKA OCTAVIAN 10/16/2021 L ISVINA POS 3

58 ALIF ARICA FAUZAN M 10/18/2021 L SANTI POS 3

59 ALFAREZI PUTRA 10/26/2021 L NURCOLIFAH POS 3

60 GIO KURNIAWAN 11/27/2021 L RINI POS 3

60

1 M. FAREL 11/13/2017 L LELITA POS 4

2 RAYHAN 11/13/2017 L TRIONO POS 4

3 FATHAN 11/14/2017 L BAYU NURYANTO POS 4

4 BALQIS OLIVIA 10/5/2018 P M. SAIFUL FUAT POS 4

5 PRISKIA CHACA R D 12/15/2018 P LILIS POS 4

6 ALIANDO 6/18/2019 L YENI POS 4

7 NABIL A.F.M 6/25/2019 L ERNI POS 4

8 SULFA ERLANGGA SANDI 8/7/2019 L SRIWAHYUNI POS 4

9 SYADANA FA 9/21/2019 L MUSLIMAT POS 4

10 NIDIA AZAKINA DARI 11/1/2019 P TRI RATNA WATI POS 4

11 ALMAHYRA 11/15/2019 P RUSWATI POS 4

12 INARA SYAQUILLEY 9/12/2020 P GIZELA OKA S POS 4

13 SAFARAS ABIYAN N 10/20/2020 L NANANG DIMAS POS 4

14 MAVADA AFDILAN 6/24/2021 P GUNAWAN POS 4

15 AIDA NUR HAFLANI 8/22/2021 P HARI SUSANTO POS 4

UNISASI ANAK 2022
D 59 BULAN
:
: UPT PUSKESMAS SUTOJAYAN
: KAB. BLITAR
: JAWA TIMUR

TELP Tanggal Imunisasi MR BIAN KET

7 8 9