REKAPITULASI

Pencatatan Pelayanan Vaksinasi COVID-19 di Puskesmas Ngulak Tgl 11 JANUARI 2022

Kabupaten Musi Banyuasin

Kepesertaan JKN DOSIS 1 DOSIS 2

TANGGAL Kelompok BPJS BPJS Non Non MERK TANGGAL TANGGAL TANGGAL
NO No Register NIK NAMA JK PEKERJAAN ALAMAT NO_HP NO BATCH NO BATCH KET
LAHIR Umur PBI PBI Anggota VAKSIN SKRINING VAKSIN VAKSIN
1 2 34 5 67 8 9 10 11 12 13 14 19 20 21 22 23
1 P-Y0GHXP5T 1220086001910001 YURLINA GULO P 1/20/1991 PENGGAGE 082181376572 CoronaVac 11/01/2022 11/01/2022 202110202I LANJUT
2 P-Y0K4KG25 5304021708810004 AGUSTINUS GONSALVES P 1/13/1981 TANJUNG RAYA 082181376572 CoronaVac 11/01/2022 11/01/2022 202110202I LANJUT
3 P-YA4CF358 1606050305040002 PANJI L 5/3/2004 TERUSAN 081253635470 COVID-19 Vaccine Pfizer 11/01/2022 11/01/2022 FM7785 LANJUT
4 Q-0008PJAE 1606050708880001 ZAZPIZER L 11/28/1988 NGUNANG 082374628003 CoronaVac 11/01/2022 6/26/2021 24200721 11/01/2022 202110202I SELESAI
5 Q-000KVBEN 1606056508000002 MEGA RIA P 12/12/2000 DOYONG 08881241240 CoronaVac 11/01/2022 8/3/2021 24004221 11/01/2022 202110202I SELESAI
6 Q-000PEMFA 1204216406730001 MASATIA ZEGA P 6/24/1973 WPG 082233599816 CoronaVac 11/01/2022 8/25/2021 24005421 11/01/2022 202110202I SELESAI
7 Q-000PERQM 1220081712890001 DESI MEELI GEA P 12/17/1990 AEKBARU 081267692234 CoronaVac 11/01/2022 8/25/2021 24005421 11/01/2022 202110202I SELESAI
8 Q-000PF1AY 1220080208970001 SOZA NOLO GEA P 8/2/1997 WPG 082233599816 CoronaVac 11/01/2022 8/25/2021 24005421 11/01/2022 202110202I SELESAI
9 Q-000PF1CA 1403130202750002 FOA ROTA HIA P 2/2/1975 WPG 082268462226 CoronaVac 11/01/2022 8/25/2021 24005421 11/01/2022 202110202I SELESAI
10 Q-001559SL 1610014911960002 INDRI WIDIA ASTUTI P 11/9/1996 KARANG ANYAR 082373449226 CoronaVac 11/01/2022 9/28/2021 202108154i 11/01/2022 202110202I SELESAI
11 Q-001G7L1K 1606056510930003 RISNANI P 10/25/1993 NGUNANG 0812139861907 CoronaVac 11/01/2022 10/20/2021 202108145H 11/01/2022 202110202I SELESAI
12 Q-001G7L1Q 1606055211850002 SANTI P 11/12/1985 NGUNANG 081213986107 CoronaVac 11/01/2022 10/20/2021 202108145H 11/01/2022 202110202I SELESAI
13 Q-001G8G40 1606056706090002 SALSA BELA P 6/27/2009 TANJUNG RAYA 083192660133 CoronaVac 11/01/2022 10/20/2021 202108145H 11/01/2022 202110202I SELESAI
14 Q-001IXIBU 1606057012030002 WINDA SARI P 12/30/2003 TANJUNG RAYA 0838025116735 CoronaVac 11/01/2022 10/26/2021 202108145H 11/01/2022 202110202I SELESAI
15 Q-001MQSIH 1606054407910001 MARLINDA P 7/4/1991 SANGA DESA 085279739232 CoronaVac 11/01/2022 11/3/2021 24203121 11/01/2022 202110202I SELESAI
16 Q-001Q4LLH 1606054407910001 YENTI P 7/4/1991 SANGA DESA 082178338085 CoronaVac 11/01/2022 11/3/2021 24203121 11/01/2022 202110202I SELESAI
17 Q-001U2J8H 1606055504760002 MARNI P 4/15/1976 NGULAK I 085709853796 CoronaVac 11/01/2022 11/22/2021 202109149O 11/01/2022 202110202I SELESAI
18 Q-001U2J8Z 1606052705680001 KOMARUDIN L 5/27/1968 NGULAK 085709853796 CoronaVac 11/01/2022 11/22/2021 202109149O 11/01/2022 202110202I SELESAI
19 Q-001UGJNH 1605035206880002 WARSINI P 6/12/1988 LUBUK TUA 082176532425 CoronaVac 11/01/2022 11/24/2021 24203321 11/01/2022 202110202I SELESAI
20 Q-001UGJQ6 1605032211030002 ANDREA SAFITRI P 11/22/2003 LUBUK TUA 082279089352 CoronaVac 11/01/2022 11/24/2021 24203321 11/01/2022 202110202I SELESAI
21 Q-001V6LMM 1606056204870001 SUHAINAH P 4/22/1987 TERUSAN 085271688574 CoronaVac 11/01/2022 11/24/2021 24203321 11/01/2022 202110202I SELESAI
22 q-001W05AG 1606051704990003 LEKAT BOBI IRAWAN L 4/23/1999 NGULAK II 085374295169 CoronaVac 11/01/2022 11/22/2021 202109149O 11/01/2022 202110202I SELESAI
23 q-001W05GU 1405104309970003 NURUL HIKMAWATI P 3/9/1998 NGULAK II 085374295169 CoronaVac 11/01/2022 11/22/2021 202109149O 11/01/2022 202110202I SELESAI
24 q-001WDHX6 1605196403000001 PUPUT MERISTA P 3/24/2000 TERUSAN 085273212492 CoronaVac 11/01/2022 11/25/2021 202109149O 11/01/2022 202110202I SELESAI
25 q-001XPFLK 1606021603010001 ALDI SAMUDRA L 3/16/1998 TELUK KIJING 085323091683 CoronaVac 11/01/2022 12/2/2021 202109202E 11/01/2022 202110202I SELESAI
26 q-001XPN8V 1403130906040002 FADRIAN NUR FAISAL L 6/9/2004 MUARA BASUNG 082377346652 CoronaVac 11/01/2022 12/2/2021 202109202E 11/01/2022 202110202I SELESAI
27 q-001XVJ8V 1606056612910001 HOLMA SARI P 12/26/1991 TERUSAN 081367440507 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
28 q-001XVRFE 3320040211930001 AHMAD SURYANTO L 4/7/1993 PANCUR 081373492370 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
29 q-001XVRKU 1606054507690002 RUSMIYATI P 7/5/1969 TERUSAN 085357804339 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
30 q-001XW1Z2 3320055505960001 SITI ROISAH P 5/15/1996 PANCUR 082175519849 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
31 q-001XW86L 3320041203940004 SULISTIYONO L 3/12/1994 TERUSAN 085213018223 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
32 q-001Y9F1M 1606050204640002 CEK MAL L 4/2/1964 TANJUNG RAYA 081271297595 CoronaVac 11/01/2022 12/2/2021 202109202E 11/01/2022 202110202I SELESAI
33 q-001YM64V 1673082108830001 AGUS SALIM L 8/21/1983 NGULAK I 082375227831 CoronaVac 11/01/2022 12/3/2021 202109202E 11/01/2022 202110202I SELESAI
34 q-001ZA78R 1605034507850007 SARMILA P 7/5/1985 AIR BALUI 082260970937 CoronaVac 11/01/2022 12/5/2021 202109149O 11/01/2022 202110202I SELESAI
35 q-001ZCFYD 1606055203620001 MARINDU P 3/12/1962 NGUNANG 085368799700 CoronaVac 11/01/2022 12/8/2021 202109199K 11/01/2022 202110202I SELESAI
36 q-001ZCLLX 1802125206790008 PUJIATI P 6/12/1979 NGUNANG 082281285130 CoronaVac 11/01/2022 12/8/2021 202109199K 11/01/2022 202110202I SELESAI
37 q-001ZGC7S 1606054505670001 ZURYATI P 5/5/1967 NGUNANG 082195838745 CoronaVac 11/01/2022 11/26/2021 2021091490 11/01/2022 202110202I SELESAI
38 Q-0026V6JD 1606051301730003 AGUSCIK L 1/13/1973 NGUNANG 082281954200 COVID-19 Vaccine Pfizer 11/01/2022 12/9/2021 FL4213 11/01/2022 FM7785 SELESAI
39 Q-0026Z0FD 1606062708940002 BUSTAM EFENDI L 8/27/1994 NGULAK I 085279287494 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
40 Q-0026Z0FY 1605120112680001 PUJUD L 12/1/1968 NGULAK I 082292161438 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
41 Q-0026ZT14 1606055105740001 SITI MAHARANI P 5/11/1974 WPG 082280513424 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
42 Q-0026ZT4J 1606052608040001 ILHAM AGUSTIAN L 8/26/2004 WPG 082370527036 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
43 Q-0026ZXXW 1606051506690003 MUSTADI L 6/15/1969 NGULAK I 085624120722 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
44 Q-0026ZY13 1606010902790003 RUSTAM EPENDI L 2/9/1979 WPG 085384140063 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
45 Q-002702KL 1606020609690001 IRWAN L 9/6/1969 SUKA DAMAI 082372212957 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
46 Q-002706C1 1606024609710001 ROHIDA WATI P 9/6/1971 SUKA DAMAI 081215131405 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202I SELESAI
47 Q-00274GSB 1606051203760002 YUSNI SURYONO L 3/12/1976 PENGGAGE 082297922550 CoronaVac 11/01/2022 12/10/2021 202109199 11/01/2022 2021102021 SELESAI
48 Q-0027IG29 1605161010910003 YATIMIN L 10/10/1991 SUMBER JAYA 085809871200 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
49 Q-0027LJOT 3302161510930001 SLAMET GINANJAR L 10/15/1993 AIR BALUI 085382679160 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
50 Q-0027LJRD 1607120107650018 YETNO L 7/13/1965 AIR BALUI 085282652104 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
51 Q-0027LJSM 1607120106000005 JUNAIDI L 6/1/2000 AIR BALUI 085282652104 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
52 Q-0027MDV8 1607120106000005 MULYANTO L 6/1/2000 AIR BALUI 085384022756 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
53 Q-0027MDZL 1605125510740003 YUNANI P 10/15/1974 NGULAK 082176012032 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
54 Q-0027MNG9 1605100508000001 ANGGIT AL SIDIK P 8/5/2000 NGULAK 082374802309 CoronaVac 11/01/2022 12/11/2021 202109199K 11/01/2022 202110202I SELESAI
55 Q-0027MNH5 1606054808000002 KLIWON L 8/8/2000 NGULAK II 082176012032 CoronaVac 11/01/2022 12/7/2021 12/7/2021 11/01/2022 202110202I SELESAI
56 Q-0027TE1U 1606054808000002 SRI RAHAYU P 8/8/2000 NGULAK II 081275968239 CoronaVac 11/01/2022 12/7/2021 12/7/2021 11/01/2022 202110202I SELESAI
57 Q-00288GO4 1606051707660001 NURJANA P 7/17/1966 NGUNANG 082195838745 CoronaVac 11/01/2022 11/26/2021 202109149O 11/01/2022 202110202I SELESAI
58 Q-0028FN3F 1606055007050001 AYU WULANDARI P 7/10/2005 DUSUN II 081368504766 CoronaVac 11/01/2022 12/14/2021 202109199K 11/01/2022 202110202I SELESAI
59 Z-000G06ZP 1606051305480001 MASTI P 5/13/1948 NGULAK I 081273019165 CoronaVac 11/01/2022 12/6/2021 202109202E 11/01/2022 202110202I SELESAI
60 Z-000G40MT 1606050204580001 ZULBASRI L 4/2/1958 NGUNANG 085368799700 CoronaVac 11/01/2022 12/8/2021 202109199K 11/01/2022 202110202I SELESAI
61 Z-000G69OZ 1606051209560003 SUHAIMI L 9/12/1956 NGULAK I 085368687131 CoronaVac 11/01/2022 12/9/2021 202109199K 11/01/2022 202110202i SELESAI
62 Z-000GCR2G 1606052002450001 BAHATIAR L 2/20/1945 KEMANG 082179072066 CoronaVac 11/01/2022 12/13/2021 202109199K 11/01/2022 202110202I SELESAI
62 Z-1D3961D6 1606050807400003 ZAINI L 8/7/1940 NGULAK I 081366062301 CoronaVac 11/01/2022 5/4/2021 24001921 11/01/2022 202110202I SELESAI
64 Z-CF3D8C6F 1606055911560002 RODIA P 11/19/1956 NGULAK I - CoronaVac 11/01/2022 5/4/2021 24001921 11/01/2022 202110202I SELESAI
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KELOMPOK UMUR KEPESERTAAN BPJS KEPALA PUSKESMAS PJ.VAKSINATOR

12-17 0 BPJS PBI 0 NGULAK
18-30 0 BPJS NON PBI 0
31-45 0 NON ANGGOTA #REF!
46-59 0 TOTAL #REF!
>60 0 PEMBERIAN DOSIS dr. BAYU MURDALIN UMRIN, S.Kep
TOTAL 0 DOSIS 1 3 Penata TK.I / III.d Penata Muda TK I / III.b
PEKERJAAN DOSIS 2 61 NIP.19830308 201412 2 001 NIP.'197912072011011005
A 0 TUNDA 0
B 0 TOTAL 64
C 0
D 0
E 0
0
 REKAPITULASI
asi COVID-19 di Puskesmas Ngulak Tgl 29 JAN 2021
bupaten Musi Banyuasin

Kepesertaan JKN

TANGGA
Kelompok
NO No Register NIK NAMA JK PEKERJAAN L ALAMAT NO_HP
Umur
LAHIR

1 2 3 4 5 6 7 8 9
1 N-6D3B4 16060565ALIA P A 25-O1-1969 46-59 Nganti 082176080655
2 N-3A704516060661SAVITRI P A 21-02-1993 18-30 Babat To 08228105
3 N-60837A16060556RUSIA H P A 16-02-1965 46-59 ngunang 081373700903
4 N-0BE70E16060518HARMOK L A 18-09-1983 31-45 Jud II 081367336848
5 N-8D1D9A16060547SULASTR P A ### 46-59 Jud II 08527777236
6 N-24C35 16060517ZUBAIRI L A 17-08-1964 46-59 Macang sa082177836789
8
9
10
11
12
13
14

KEPESERTAAN BPJS
KELOMPOK UMUR BPJS PBI
18-30 BPJS NON PBI
 31-45 NON ANGGOTA
46-59 TOTAL
TOTAL PEMBERIAN DOSIS
PEKERJAAN DOSIS 1
A DOSIS 2
B TOTAL
C
D
E
 Kepesertaan JKN DOSIS 1 DOSIS 2
TANGGA
BPJS L TANGGA TANGGA
BPJS MERK
Non Non Anggota L NO BATCH L NO BATCH KET
PBI VAKSIN
PBI SKRININ VAKSIN VAKSIN
G
10 11 12 13 14 19 20 21 22 23
082176080655 √ 29-01-202
29-01-2021 2E+08 LANJUT
√ 29-01-2021 TIDAK DI VAKSIN
081373700903 √ 29-01-2021 TIDAK DI VAKSIN
081367336848 √ 29-01-202
29-01-2021 2E+08 LANJUT
08527777236 √ 29-01-2021 TIDAK DI VAKSIN
082177836789 √ 29-01-2021 DITUNDA
TIDAK DI VAKSIN
TIDAK DI VAKSIN

TIDAK DI VAKSIN
DITUNDA