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Vaksin 30 Maret 2021
Vaksin 30 Maret 2021
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket
1 Q-4EBE6539
2 W-CFEA6C65
3 W-790F218C
4 W-A78350D9
5 S-9C8AFI4E
6 S-78SEA016
7 Z-ACCF34CO
8 Z-65F8A2D1
9 W-58262D24
10 W-C23A8132
11 W-FC3B7AA5
12 W-BEC75E02
13 Z-10B7CAEF
14 Z-10F3C1B5
15 Q-8CD955C50
16 P-BF8A9KJI
17 W-20B3B7FA
18 S-COCDB5E4
19 W-4E335BA3
20 S-786854C6
21 P-94C5D430
22 W-1845FDE3
23 Z-3CEABDDD7
24 W-OECO1DD7
25 W-8C5F9D86
26 Z-BAS1ADE7
27 Z-53CE65E7
28 Z-SDE8DE6B
29 Q-9D6C60E6
30 Q-8FDI67E8
31 Z-EDFD5B3F
32 Q-EA9EAF02
33 W-F2B5A65C
34 Q-03A50D1
35 W-CBF9F88F
36 W-44AA102D
37 W-91F74297
38 Z-DI39C5AE
39 W-38A49A6F
40 Q-DAF5B641
41 Q-6F32BI6E
42 Q-094A5E35
43 Q-6EAFFCEA
44 N-259F8DC7
45 Q-7EA3CCAC
46 S-9BIF7580
47 P-LM3YF10H
48 P-LLXXDTLJ
49 S-3383F9A9
50 S-9B3F3280
51 S-6C956D75
52 W-55F2A78F
53 N-D608F2IE
54 S-B4EB94F5
55 Z-04CE53C6
56 Q-0E2FCFB
57 Q-2EBED066
58 Q-086F9343
59 Q-DEE63076
60 q-bs2lsmgm
61 Z-BC5096A3
62 S-105E1F09
63 W-D434B5A3
64 S-80F733C5
65 W-985AI6F7
66 Q-092CC6DF
67 P-LVSBDUTZ
68 P-LWH0F5NG
69
70
Keterangan
* Pekerjaan dikelompokkan menjadi:
A = Petugas Medis dan Non Medis di Fasilitas Pelayanan Kesehatan
B = Petugas pelayanan publik yang berhadapan langsung dengan masyarakat
C = Administrator Pemerintahan
D = Lainnya
E = Tidak Bekerja
NIK
3213096509780008
3213166902800003
3213165606710009
3213161707690004
3213164103620005
3213160402600005
3213164212860001
3213164604730004
3213164506890008
3213161206700008
32131051910730001
3213052608760001
32131667105920003
3213161503660003
3213036612700002
3213035307990007
3213030105740014
3213094805800014
3213160407750004
3213162505610003
3213050109630001
3213161703900011
3213160505950021
321316611187002
3213161702839991
3213092205740001
3213166805820004
3213164709760005
3213160205920012
3213094110850011
3213161805760002
3213051508860004
3213161903640004
3213162805890004
3213160603720006
3213166510720003
3213042703660001
3213164709790003
3213115607690003
321311681093003
3175040803920007
3274051701990004
3213160703830007
3213221904720001
3213160512730007
3213160403640004
3213064209010002
3213161611960004
3213161512730001
3213166207670002
3213160502900003
3213064609970001
321309231900008
3213066305750001
3213165106970003
3213165808790007
3213162708830001
3213162707820003
3275055006840038
3213095602980002
3213161309740004
3213164408830003
3213091403680018
3213166806870004
3213091708680017
3213092802020010
3273101010820006
3213165405820010
Kelompok Umur:
18-30
31-45
46-59
≥ 60 tahun
Total
Pekerjaan:
A
B
C
D
E
Total
:
:
:
:
Jenis
Nama Penerima Vaksin Pekerjaan*
Kelamin
UU UKAESIH P GURU
ROHIYATI P GURU
ANGGIH ANDRIANI P GURU
ADIN L GURU
JUMANTA L GURU
DADANG L GURU
DAYAT L GURU
HASANUDIN L GURU
WANDI L WIRASWASTA
***Merek Vaksin
A = Sinovac
B = Lainnya (Mohon disebutkan jenis vaksin yang diterima Puskesmas/Faskes)
Umur
Tanggal Lahir Kelompok Umur
(18 sd ≥ 60 tahun)
25/09/1978 44 31-45
29/02/1980 42 31-45
16/06/1971 51 46-59
17/07/1969 53 46-59
01/03/1962 60 ≥60
04/02/1960 62 ≥60
02/12/1986 35 31-45
06/04/1975 47 46-59
05/06/1989 33 31-45
12/06/1970 52 46-59
19/10/1973 49 46-59
26/08/1976 46 46-59
31/03/1992 30 18-30
29/03/1966 56 46-59
26/12/1970 51 46-59
13/07/1999 23 18-30
01/05/1974 48 46-59
08/05/1980 42 31-45
04/07/1975 47 46-59
25/05/1961 61 ≥60
01/09/1963 59 46-59
17/03/1990 32 31-45
15/05/1995 27 18-30
21/11/1987 35 31-45
17/02/1983 39 31-45
22/05/1974 48 46-59
28/05/1982 40 31-45
07/09/1976 46 46-59
02/05/1992 30 18-30
01/10/1985 37 31-45
18/05/1976 46 46-59
15/08/1986 36 31-45
19/03/1964 58 46-59
28/05/1989 33 31-45
06/03/1972 50 46-59
25/10/1972 50 46-59
27/03/1966 56 46-59
07/09/1979 43 31-45
16/07/1969 53 46-59
28/10/1993 29 18-30
08/03/1992 30 18-30
17/01/1999 23 18-30
07/03/1983 39 31-45
19/04/1972 50 46-59
05/12/1973 48 46-59
04/03/1964 58 46-59
02/09/2001 21 18-30
16/11/1996 26 18-30
15/12/1973 48 46-59
22/07/1967 55 46-59
05/02/1990 32 31-45
06/09/1997 25 18-30
23/12/1990 31 31-45
23/05/1975 47 46-59
11/06/1997 25 18-30
18/08/1979 43 31-45
27/08/1983 39 31-45
27/08/1982 40 31-45
10/06/1984 38 31-45
16/02/1998 24 18-30
13/09/1974 48 46-59
04/08/1983 39 31-45
14/03/1968 54 46-59
28/06/1987 35 31-45
17/06/1968 54 46-59
28/02/2002 20 18-30
10/10/1982 40 31-45
14/05/1982 40 31-45
122 ≥60
122 ≥60
0
0
0
0
0
FORMAT PENCATATAN PELAKSANAAN VAKSINASI CO
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINA
Alamat
BAKANLAME, RT 5/ RW 3, RANCAMULYA
BAKANLAME, RT 5/ RW 3, RANCAMULYA
PABUARAN, RT 5/ RW 2, PABUARAN
SUKARESMI, RT 9/ RW 4, CIBERES
MARGASARI, RT 33/ RW 15
PUNDONG, RT 3/ RW 2, RANCAMULYA
BUWER, RT 5/ RW 2, RANCAJAYA
MULYASARI, RT 9/ RW 3, RANCAJAYA
BUWER, RT 1/ RW 1, RANCAJAYA
PATOKBEUSI, RT 27/ RW 13
CIRULUK, RT 2/ RW 1, CIRULUK
WANGUN, RT 1/ RW 1, RANCABANGO
WANGUN, RT 1/ RW 1, RANCABANGO
PATOKBEUSI, RT 27/ RW 13
CIKAUM TIMUR
CIRANGGON, RT 19/ RW 9, RANCAMULYA
BLENDUNG
RANCABANGO
RANCABANGO
KALIWADAS, RT 5/ RW 2, PAGON
NAMBO, RT 2/ RW 1, RANCAASIH
BAKANLAME, RT 6/ RW 3, RANCAMULYA
SUKAMANDI NO 56 RT 8/ RW 30
JALUPANG, RT 2/ RW 1
SUKAMANDI, RT 9/ RW 7
MAYASUTA, RT 30/ RW 9
Pekerjaan
A
B
C
D
E
Total
AKSANAAN VAKSINASI COVID-19
FASYANKES/POS VAKSINASI
No. Hp
087828450888
083128375218
082115159392
087828007859
085210661197
085295924847
087828172307
081809207658
082126894363
087760563829
081387286520
081912470846
081585347996
0878284260006
081292719846
081389429045
;081320246647
081214693799
081912541113
087760846346
087760695898
081912603516
089620007868
085863273938
081802201533
087828123399
081931484282
082316859792
081322438225
087760641675
087828474754
083174541911
085289479856
087760775034
087726220282
089532034441
085222209869
087888562572
081324372077
082316835922
081382521778
082217006177
087804035922
08121485685
082215231233
085975139791
083102092556
081383356197
089501880967
083195575323
083816621176
082217802440
085224319591
082161035261
081214698537
081212157173
085314429667
082216487377
085156748632
0817621139
082115555577
082216842925
087726914500
;087828046161
081320759093
082214562400
083842511562
n
0
0
0
0
0
0
a' pada kolom yang sesuai)
Non Anggota
Dosis I
Tanggal Pemberian
No. Batch No. Serial
Vaksinasi
Dosis 2
Tanggal Pemberian
No. Batch No. Serial
Vaksinasi
Keterangan
(Ditunda/Tidak Diberikan/Lanjut)
FORMAT REKAPITULASI PELA
TINGKAT PUSKESMAS/FA
Nama Puskesmas/Fasyankes/Pos :
Kabupaten/Kota :
Provinsi :
Sasaran
Tahap 1 Tahap 2
Tanggal/ Bulan
Pelaksanaan Total Sasaran
SDM Kesehatan Lansia Pelayan Publik
3/16/2021 1 68 69
0
0
0
0
0
0
0
0
0
TOTAL 1 0 68 69
ULASI PELAKSANAAN VAKSINASI COVID-19
SKESMAS/FASYANKES/POS VAKSINASI
# % # % # % # %
# % # % # % # %
69 100.0 0 #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
69 100.0 0 0 0 #DIV/0! 0 0
Batal Vaksin Dosis 1
Total Batal Dosis I Tahap 1 Tahap 2
(Semua Tahapan)
SDM Kesehatan Lansia Pelayan Publik
# % # % # % # %
0 0.0 0 #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
0 #DIV/0! 0 0 0 #DIV/0! 0 0
Penerima Vaksin Dosis 2
Total Tunda Dosis
Total Dosis 2 Tahap 1 Tahap 2 2
(Semua Tahapan)
(Semua Tahapan)
SDM Kesehatan Lansia Pelayan Publik
# % # % # % # % #
0 0 0 #DIV/0! 0 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0
0 0 0 0 0 #DIV/0! 0 0 0
Tunda Vaksin Dosis 2 B
Total Tunda Dosis
Tahap 1 Tahap 2 Total Batal Dosis 2 Tahap 1
2
(Semua Tahapan)
(Semua Tahapan)
SDM Kesehatan Lansia Pelayan Publik SDM Kesehatan
% # % # % # % # % #
Vaksin Covid-19 BF
(Multi Dose Vial)
Jmlh
IP
Diimunisasi
69 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
69 #DIV/0!
FORMAT REKAPITULASI HARIAN PELAKSANAA
TINGKAT KABUPATEN/KO
Kabupaten/Kota :
Provinsi :
Hari, Tanggal :
Sasaran
Tahap 1 Tahap 2
Puskesmas/Fasyankes/
NO
Pos Vaksinasi
SDM Kesehatan Lansia
TOTAL 0 0
RIAN PELAKSANAAN VAKSINASI COVID-19
T KABUPATEN/KOTA
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 0 #DIV/0! 0 #DIV/0! 0
enerima Vaksin Dosis 1 Tunda Vaksin Dosis 1
Total Tunda Dosis
Tahap 2 I Tahap 1 Tahap 2
(Semua Tahapan)
Lansia Pelayan Publik SDM Kesehatan Lansia
% # % # % # % #
% # % # % # % # %
# % # % # % # % # %
# % # % # % # % # %
Vaksin Covid-19 BF
(Multi Dose Vial)
Provinsi
Hari, Tanggal
Sasaran
Tahap 1 Tahap 2
NO Kabupaten/Kota
SDM Kesehatan Lansia
TOTAL 0 0
APITULASI HARIAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT PROVINSI
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 #DIV/0! #DIV/0!
0 0 0 #DIV/0! 0 #DIV/0!
SI COVID-19
# % # % # % # %
# % # % # % # % # %
# % # % # % # % # %
# % # % # % # % # %
Vaksin Covid-19 BF
(Multi Dose Vial)