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Borang Imunisasi
Borang Imunisasi
Pelayanan : Imunisasi
.............................2022
Mengetahui,
Ketua Ranting Banten Girang
Atasan Langsung Bidan
( )
( ) ( )
.............................2022
Mengetahui,
Ketua Ranting Banten Girang
Atasan Langsung Bidan
( )
( ) ( )
Pelayanan : Imunisasi
Periode kegiatan : 2019
1. 13/Mei/2019 By. Ny. F 3 bln By. Ny F usia 3 bln dgn imunisasi Suntik DPT-HB 2,
DPT-HB 2 & Polio 3 Polio 3
2. 13/Mei/2019 By. Ny. D 9 bln By. Ny D usia 9 bln dgn imunisasi Suntik Campak
Campak
3. 13/Mei/2019 By. Ny. Y 6 bln By. Ny Y usia 6 bln dgn imunisasi Suntik DPT-HB 3,
DPT-HB 3, IPV & Polio 4 IPV, Polio 4
4. 13/Mei/2019 By. Ny. K 3 bln By. Ny K usia 3 bln dgn imunisasi Suntik DPT-HB 2,
DPT-HB 2 & polio 3 Polio 3
5. 13/Mei/2019 By. Ny. H 6 bln By. Ny H usia 6 bln dgn imunisasi Suntik IPV
IPV
6. 13/Mei/2019 By. Ny. I 7 bln By. Ny I usia 7 bln dgn imunisasi Suntik DPT-HB 3,IPV
DPT-HB 3, IPV & Polio 4 & Polio 4
7. 13/Mei/2019 By. Ny. G 1 bln By. Ny G usia 1 bln dgn imunisasi Suntik BCG & Polio
BCG & Polio 1 1
8. 13/Mei/2019 By. Ny. T 5 bln By. Ny T usia 5 bln dgn imunisasi Suntik DPT-HB 2 &
DPT-HB 2 & Polio 3 Polio 3
9. 13/Mei/2019 By. Ny. E 2 bln By. Ny E usia 2 bln dgn imunisasi Suntik DPT-HB 1 &
DPT-HB 1 & Polio 2 Polio 2
10. 13/Mei/2019 By. Ny. L 3 bln By. Ny L usia 3 bln dgn imunisasi Suntik DPT-HB 2,
DPT-HB 2 & Polio 3 Polio 3
11. 13/Mei/2019 By. Ny. R 1 bln By. Ny R usia 1 bln dgn imunisasi Suntik BCG & Polio
BCG & Polio 1 1
12. 13/Mei/2019 By. Ny. B 7 bln By. Ny B usia 7 bln dgn imunisasi Suntik IPV
IPV
.............................2022
Mengetahui,
Ketua Ranting Banten Girang
Atasan Langsung Bidan
( )
( ) ( )
Pelayanan : Imunisasi
1 16/Mei/2019 By. Ny. A 6 bln By. Ny A usia 6 bln dgn imunisasi Suntik DPT-HB 3, IPV
DPT-HB 3,IPV & Polio 4 & Polio 4
2 16/Mei/2019 By. Ny. S 3 bln By. Ny S usia 3 bln dgn imunisasi Suntik DPT-HB 2, Polio
DPT-HB 2 & Polio 3 3
3 16/Mei/2019 By. Ny. R 2 bln By. Ny R usia 2 bln dgn imunisasi Suntik DPT-HB 1, polio
DPT-HB 1 & Polio 2 2
4 16/Mei/2019 By. Ny. W 4 bln By. Ny W usia 4 bln dgn imunisasi Suntik DPT-HB 2, Polio
DPT-HB 2 & Polio 3 3
5 16/Mei/2019 By. Ny. L 2 bln By. Ny L usia 2 bln dgn imunisasi Suntik DPT-HB 1, Polio
DPT-HB 1 & Polio 2 2
6 16/Mei/2019 By. Ny. T 7 bln By. Ny T usia 7 bln dgn imunisasi Suntik DPT-HB 3, IPV,
DPT-Hb 3, IPV & Polio 4 Polio 4
7 16/Mei/2019 By. Ny. F 5 bln By. Ny F usia 5 bln dgn imunisasi Suntik DPT-HB 3, IPV
DPT-HB 3 & Polio 4 & Polio 4
8 16/Mei/2019 By. Ny. Y 2 bln By. Ny Y usia 2 bln dgn imunisasi Suntik DPT-HB 1, Polio
DPT-HB 1 & Polio 2 2
9 16/Mei/2019 By. Ny. C 9 bln By. Ny C usia 9 bln dgn imunisasi Suntik Campak
Campak
10 16/Mei/2019 By. Ny. H 6 bln By. Ny H usia 6 bln dgn imunisasi Suntik DPT-HB 3, IPV
DPT-HB 3 & Polio 4 & Polio 4
11 16/Mei/2019 By. Ny. O 1 bln By. Ny O usia 1 bln dgn imunisasi Suntik BCG, Polio 1
BCG & Polio 1
12 16/Mei/2019 By. Ny. M 3 bln By. Ny M usia 3 bln dgn imunisasi Suntik DPT-HB 2, Polio
DPT-HB 2 & Polio 3 3
.............................2022
Mengetahui,
Ketua Ranting Banten Girang
Atasan Langsung Bidan
( )
( ) ( )