Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat

NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

M. Zaky Mubarak HSU

1
01/04/21
Ayyub HSU
2
6308050704210001 07/04/21
Syafiya Azkayla HSU
3
6308054801210001 08/04/21
M. Al-zaky HSU
20
13/04/21
Asanum HSU
20
15/04/21
Nadira HSU
4
19/04/21
Siti Khadijah HSU
5
6308052711170006 4/26/2021
Rahmadania Safitri HSU
6
6308056804210001 28/04/21
Adinda Norsafitri HSU
7
12/05/21
M. Ramadhan HSU
8
6308051904210001 19/05/21
Azkia Norsyifa HSU
9
27/05/21
M. Rifa'i HSU
10
6308053105210001 31/05/21
M. Ammar K HSU
11
6308050906210001 09/06/21
12 M. Daffa Ramadhan HSU
10/06/21
12 M. Nafis HSU
6308051206210002 12/06/21
Noor Yasmin Nadira HSU
13
12/06/21
M. Hafiz Badali HSU
14
6308052606210001 26/06/21
M. Ridho HSU
15
6308052307210002 23/07/21
M. Dzaffari Athayya H HSU
16
16
63080105210001 01/05/21
M. Nazriel Al - H HSU
17
6308051005210001 10/05/21
Hanif Maqil Hafizan HSU
18
6308050208210001 02/08/21
Alesha Azkia F HSU
20
6308052711180006 27/07/21
A. Hisnan Kawwaid HSU
20
07/08/21
M. Ammar Muzaki HSU
19
6308051308210002 13/08/21
Hanifa Nurin J HSU
20
6308055808210001 18/08/21
Alsyah Al-mira F HSU
20
6308056008210001 20/08/21
Arrasya Athayla R HSU
19
6308032808210002 28/08/21
M. Wildan Al- Fatih HSU
20
01/09/21
Alena Zumaira A HSU
20
25/09/21
M. Sirajul Huda HSU
20
29/09/21
Agnia Nor Fadila HSU
20
6306056909210001 9/29/2021
Aulia Rahmah HSU
19
6308057009210003 30/09/21
Gina Lia Syarifah HSU
20
6308054610210001 06/10/21
M. Faqih Rahman HSU
20
6308051810210002 10/18/2021
M. Zidan Maulana HSU
19
6308051910210002 19/10/21
M. Rifky Akbar HSU
20
6308050411210003 04/11/21
Al- Fariski HSU
19
10/11/21
Mutia Adelia HSU
19
6308056511210001 25/11/21
Allesha Syafiya HSU
20
6308056811210001 28/11/21
Al -Farezei Arfan HSU
19
6308050112110001 01/12/21
 M. Noor Bina S HSU
20
6308050212210002 12/2/2021
Syahla Nayara M HSU
19
6308055012210001 12/10/2021
Siti Zahrah HSU
20
6308055412210001 14/12/21
Saquile Desta K HSU
19
6308051612210001 16/12/22
M. Chairil Nazir HSU
20
6308050202220001 2/2/2022
Khanza Alesha Mecca HSU
19
6308054402220001 2/4/2022
Dewi Aisyah N HSU
20
13/02/22
Amira HSU
20
2/16/2022
M. Azka Maulana HSU
20
18/03/22
Mirna HSU
19
3/21/2022
Muhammad Azka HSU
20
6308050404220002 4/4/2022
Ahmad Hafi B HSU
19
6308050404220001 04/04/22
Eva Najla Al- M HSU
20
4/22/2022
M. Rayyan Ramadhan HSU
20
23/04/22
M. Rizky Ramadhan HSU
20
6308052404220002 24/04/22
M. Fadil Taufik HSU
19
30/04/22
Annisa Fitri HSU
19
6308044105220002 5/1/2022
Anisa Syafa Mardiyah HSU
20
6308045205220001 12/05/22
Amelia Norhafizah HSU
19
15/05/22
Raisa Aida Yanti HSU
20
20/05/22
Rania Rizky Yana HSU
19
05/06/22
Fania Nora Medira HSU
20
20
6308055106220001 11/06/22
M. Azmal Alfarizi HSU
19
6308051506220002 15/06/22
Ahmad Zuhdiannor HSU
20
6308051706220001 17/06/22
M. Alif Arkan F HSU
19
6308050407220003 04/07/22
Khairunnida Iriana HSU
20
23/0722
M. Aulia Al- M HSU
19
6308051108220001 11/08/22
Alesha Azahra HSU
20
19/08/22
M. Zaini Hasan Al- A HSU
20
8/25/2022
Arifa Nurul Husna HSU
20
30/08/22
Natasya Azzatina HSU
19
14/09/22
Gadis Maulida HSU
20
27/09/22
Safaluna Azzahra HSU
20
19/09/22
M. Arfan Ghifari HSU
19
10/1/2022
Faqih Al Farizqi HSU
20
10/9/2022
Arsy Nor Khalisah HSU
19
10/20/2022
B. Milsa Rusiati HSU
20
31/10/22
HSU
19

HSU
20
 REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Zaky Mubarak HSU Dariani
L 11
01/04/21 6308052203880004

Ayyub HSU

6308050704210001 07/04/21

Syafiya Azkayla HSU Nani Herliani

6308054801210001 08/04/21 6308052203880004

M. Al-zaky HSU

13/04/21

Asanum HSU Nani Herliani

15/04/21 6308052203880004

Nadira HSU

19/04/21

Siti Khadijah HSU Nani Herliani

6308052711170006 4/26/2021 6308052203880004

Rahmadania Safitri HSU Sania

P 11
6308056804210001 28/04/21

Adinda Norsafitri HSU Nani Herliani

12/05/21 6308052203880004

M. Ramadhan HSU

6308051904210001 19/05/21

Azkia Norsyifa HSU Nani Herliani

27/05/21 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Rifa'i HSU Nani Herliani
L 11
6308053105210001 31/05/21 6308052203880004

M. Ammar K HSU
 6308050906210001 09/06/21

M. Daffa Ramadhan HSU Nani Herliani

L 11
10/06/21 6308052203880004

M. Nafis HSU Erliyana

L 10
6308051206210002 12/06/21

Noor Yasmin Nadira HSU Nani Herliani

12/06/21 6308052203880004

M. Hafiz Badali HSU

6308052606210001 26/06/21

M. Ridho HSU Nani Herliani

6308052307210002 23/07/21 6308052203880004

M. Dzaffari Athayya H HSU

63080105210001 01/05/21

M. Nazriel Al - H HSU Nani Herliani

6308051005210001 10/05/21 6308052203880004

Hanif Maqil Hafizan HSU

6308050208210001 02/08/21

Alesha Azkia F HSU Nani Herliani

6308052711180006 27/07/21 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
A. Hisnan Kawwaid HSU Nani Herliani

07/08/21 6308052203880004

M. Ammar Muzaki HSU

6308051308210002 13/08/21

Hanifa Nurin J HSU Nani Herliani

6308055808210001 18/08/21 6308052203880004

Alsyah Al-mira F HSU

6308056008210001 20/08/21

Arrasya Athayla R HSU Nani Herliani

6308032808210002 28/08/21 6308052203880004

M. Wildan Al- Fatih HSU

 01/09/21

Alena Zumaira A HSU Nani Herliani

25/09/21 6308052203880004

M. Sirajul Huda HSU

29/09/21

Agnia Nor Fadila HSU

6306056909210001 9/29/2021 6308052203880004

Aulia Rahmah HSU Hariati

P 11
6308057009210003 30/09/21

Gina Lia Syarifah HSU Nani Herliani

6308054610210001 06/10/21 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Faqih Rahman HSU Nani Herliani
L 12
6308051810210002 10/18/2021 6308052203880004

M. Zidan Maulana HSU

6308051910210002 19/10/21

M. Rifky Akbar HSU Nani Herliani

6308050411210003 04/11/21 6308052203880004

Al Farizi HSU Kamriah

L 11
10/11/21

Mutia Adelia HSU Murni

P 11
6308056511210001 25/11/21 6308052203880004

Allesha Syafiya HSU

P 10
6308056811210001 28/11/21

Al Farezal Arfan HSU Nani Herliani

L 11
01/12/21 6308052203880004

M. Noor Bina S HSU

6308050212210002 12/2/2021

Syahla Nayara M HSU Nani Herliani

P 10
6308055012210001 12/10/2021 6308052203880004

Siti Zahrah HSU

 6308055412210001 14/12/21

Saquile Desta K HSU Nani Herliani

6308051612210001 16/12/22 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Chairil Nazir HSU Nani Herliani
L 11
6308050202220001 2/2/2022 6308052203880004

Khanza Alesha Mecca HSU

P 13
6308054402220001 2/4/2022

Dewi Aisyah N HSU Nani Herliani

13/02/22 6308052203880004

Amira HSU

2/16/2022

M. Azka Maulana HSU Nani Herliani

18/03/22 6308052203880004

Mirna HSU
P 11
3/21/2022

Muhammad Azka HSU Nani Herliani

L 11
6308050404220002 4/4/2022 6308052203880004

Ahmad Hafi B HSU

6308050404220001 04/04/22

Eva Najla Al- M HSU Nani Herliani

4/22/2022 6308052203880004

M. Rayyan Ramadhan HSU

23/04/22

M. Rizky Ramadhan HSU Nani Herliani

6308052404220002 24/04/22 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
 M. Fadil Taufik HSU Nani Herliani

30/04/22 6308052203880004

Annisa Fitri HSU Lailatul A.

P 10
6308044105220002 5/1/2022

Anisa Syafa Mardiyah HSU Nani Herliani

6308045205220001 12/05/22 6308052203880004

Amelia Norhafizah HSU

15/05/22

Raisa Aida Yanti HSU Nani Herliani

20/05/22 6308052203880004

Rania Rizky Yana HSU

05/06/22

Fania Nora Medira HSU Nani Herliani

6308055106220001 11/06/22 6308052203880004

M. Azmal Alfarizi HSU

L 10
6308051506220002 15/06/22

Ahmad Zuhdiannor HSU Afrida

L 11
6308051706220001 17/06/22 6308052203880004

M. Alif Arkan F HSU

6308050407220003 04/07/22

Khairunnida Iriana HSU Nani Herliani

23/0722 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Aulia Al- M HSU Misdaniah
L 11
6308051108220001 11/08/22 6308052203880004

Alesha Azahra HSU

19/08/22

M. Zaini Hasan Al- A HSU Nani Herliani

8/25/2022 6308052203880004

Arifa Nurul Husna HSU

30/08/22
Natasya Azzatina HSU Nani Herliani

14/09/22 6308052203880004

Gadis Maulida HSU Kamriah

P 11
27/09/22

Safaluna Azzahra HSU Nani Herliani

19/09/22 6308052203880004

M. Arfan Ghifari HSU Hapijah

L 11
10/1/2022

Faqih Al Farizqi HSU Lailatul Fitri

L 10
10/9/2022 6308052203880004

Arsy Nor Khalisah HSU

10/20/2022

B. Milsa Rusiati HSU Nani Herliani

31/10/22 6308052203880004
MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* 15/06/21 15/06/21 13/10/21 13/10/21 14/12/21 14/12/21 *

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

28/04/21 15/06/21 15/06/21 13/10/21 13/10/21 14/12/21 14/12/21 13/04/22

24/02/23

0371G0729

24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* 15/06/21 15/06/21 * * * * 14/12/21

0371G0729
 * * * * * * * *

0371G0729

12/06/21 15/06/21 15/06/21 14/09/21 14/09/21 13/10/21 13/10/21 12/01/22

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729
 24/02/23

0371G0729

24/02/23

0371G0729

* * * * * * * *

24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* * * * * 03/01/23 * * 15/03/22

0371G0729

24/02/23

0371G0729

* * * 08/11/22 08/11/22 03/01/23 03/01/23

25/11/21 12/14/2021 14/12/21 15/03/22 15/03/22 * * *

0371G0729

* 14/12/21 14/12/21 15/02/22 15/02/22 15/07/22 15/07/22 17/05/22

01/12/21 14/12/21 14/12/21 15/03/22 15/03/22 13/04/22 13/04/22 *

0371G0729

* * * * * 15/03/22 15/03/22 17/04/22

0371G0729
 24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
02/02/22 15/03/22 15/03/22

0371G0729

* * * 13/04/22 13/05/22 03/01/23 17/05/22 17/05/22 16/08/22

24/02/23

0371G0729

24/02/23

0371G0729

* * * 14/06/22 14/06/22 16/08/22 16/08/22 06/12/22

* 15/05/22 15/05/22 14/06/22 14/06/22 14/07/22 14/07/22 16/08/22

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
 24/02/23

0371G0729

* * * * * 13/09/22 13/09/22 11/10/22

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

* 16/08/22 16/08/22 13/09/22 13/09/22 03/01/23 03/01/23

* * * * * 11/10/22 11/10/22

0371G0729

24/02/23

0371G0729

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* 11/10/22 11/10/22

0371G0729

24/02/23

0371G0729
 24/02/23

0371G0729

* 11/10/22 11/10/22 03/01/23 03/01/23

24/02/23

0371G0729

* 08/11/22 08/11/22 03/01/23 03/01/23

* 08/11/22 08/11/22

0371G0729

24/02/23

0371G0729
 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
* * 17/05/22

13/0422 * 13/09/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
14/12/21 17/05/22
 * * 14/12/21

12/01/22 13/09/22 17/05/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
 * * 13/09/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
15/03/22 18/08/22 *

08/11/22 10/11/22

* * 13/09/22

17/05/22 13/09/22 11/10/22

* 03/01/23 11/10/22

17/04/22 17/05/22 13/09/22

 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :

16/08/22 13/09/22 08/11/22

06/12/22

16/08/22 13/09/22 03/01/23

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
 11/10/22 03/01/23

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
MUNISASI

Keterangan

MUNISASI

Keterangan
MUNISASI

Keterangan
MUNISASI

Keterangan
MUNISASI

Keterangan

MUNISASI

Keterangan
MUNISASI

Keterangan
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

M. Rafi HSU
1 L
05/04/21
Syafira Assyifar HSU
2
6308055904210002 19/04/21
Rayyan Maizar HSU
3
6308052104210001 21/04/21
Muhammad Azmi HSU
4
6308052304210002 23/04/21
M. Aqmar Ramadhan HSU
5
6308052304210003 23/04/21
Ahmad Aufa HSU
6
25/04/21
M. Ikhsan HSU
7
6308052604210001 26/04/21
Meissa Ramadhani HSU
8
6308056904210001 29/04/21
M. Alfa Rizki Ramadhan HSU
9
6308052204210002 29/04/21
M. Fikri Ramadhan HSU
10
6308050905210001 09/05/21
Azril Rafif Fahri HSU
11
6308052505210001 5/25/2021
Revalina Jihan Majaya HSU
12
6308055106210001 6/11/2021
Hilya Nadhifa HSU
13
6308055406210001 14/06/21
M. Raihan HSU
14
03/07/21
M. Nasir HSU
15
6308051307210001 14/07/21
Alula Raini Maulana HSU
16
6308036508210001 25/08/21
Aqila Raika Zahira HSU
9
26/09/21
Ruhyi Devina HSU
10
29/09/21
Ahmad Hanan Al Hafidz HSU
15
15
6309090610210001 06/10/21
M. Al Fatih HSU
16
16/10/21
By. Nor HSU
12
27/10/21
M. Kahfi HSU
11
28/10/21
Muhammad Kamil HSU
16
29/10/21
M. Kafeel Zain A HSU
13
6308050111210001 01/11/21
Ahmad Novyan HSU
12
6308050111210002 01/11/21
M. Al Gazali HSU
13
23/11/21
Lathifatun Nuha El Kamila HSU
14
6308054112210001 01/12/21
M. Rifani HSU
15
6308050812210004 08/12/21
A. Daffa Andika HSU
16
6308050912210002 09/12/21
Muhammad Zain HSU
8
6308051112210001 11/12/21
Jihan Almaera HSU
9
6308055212210001 12/12/21
A. Zayyan HSU
10
22/12/21
Annasya Andreena Saila HSU
11
01/01/22
Amanda Rizkywati HSU
12
6308055601220001 16/01/22
Nur Amara HSU
13
13/02/22
Kaureen Noura Ramiza HSU
14
6308054203220002 02/03/22
Raisya Humaira HSU
15
6308054903220001 09/03/22
Jennaira Agnia Nur Aufa HSU
16
24/03/22
Soraya Medina Aprilianza HSU
13
6308054304220002 4/3/2022
Zakia Malik HSU
14
04/04/22
 M. Akbar Ramadhan HSU
15
19/04/22
Sofia Fitriani HSU
16
03/05/22
Muhammad Muhyidin HSU
13
6308050705220001 07/05/22
Ardi Muhammad Hidayat HSU
14
24/05/22
Adiba Khanza Adira HSU
15
21/06/22
By. Eka HSU
16
14/07/22
M. Yahid Mubarak HSU
13
17/07/22
M. Alfarizi Muharam HSU
16
30/07/22
Raisya Khairisa HSU
14
6308054109220001 9/1/2022
Raisya Faradilla HSU
15
6308055309220001 13/09/22
Ahmad Rafa Ilmi HSU
16
17/09/22
Selvi HSU
13
21/09/22
Desi Adella HSU
14
06/10/22
By. Aulia F HSU
15
10/10/2022
M. Maulana Yusuf HSU
16
6308051510220001 15/10/22
M. Rais Husin HSU
13
6308051610220002 16/10/22
By. Fitria HSU
14
17/10/22
David Yahya Abidzar HSU
15
6308052210220001 22/10/22
By. Norhidayati HSU
16
04/11/22
By. Makiah HSU
16
17/12/22
HSU
16

HSU
16
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16
 REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Rafi HSU Nani Herliani

05/04/21 6308052203880004

Syafira Assyifar HSU

6308055904210002 19/04/21

Rayyan Maizar HSU

6308052104210001 21/04/21

M. Alfa Rizki Ramadhan HSU Nor Faizah

L 17
6308052204210002 22/04/21

Muhammad Azmi HSU

L 16
6308052304210002 23/04/21

M. Aqmar Ramadhan HSU

6308052304210003 23/04/21

Ahmad Aufa HSU

25/04/21

M. Ikhsan HSU Nani Herliani

6308052604210001 26/04/21 6308052203880004

Meissa Ramadhani HSU

6308056904210001 29/04/21

M. Fikri Ramadhan HSU Fitriani

L 12
6308050905210001 09/05/21

Azril Rafif Fahri HSU Zubaidah

L 14
6308052505210001 5/25/2021 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Revalina Jihan Majaya HSU Muliyati
P 15
6308055106210001 6/11/2021

Hilya Nadhifa HSU Lisda

P 13
 P 13
6308055406210001 14/06/21

M. Raihan HSU Nani Herliani

03/07/21 6308052203880004

M. Nasir HSU
L 13
6308051307210001 13/07/21

Alula Raini Maulana HSU Nani Herliani

6308036508210001 25/08/21 6308052203880004

Aqila Raika Zahira HSU Nani Herliani

26/09/21 6308052203880004

Ruhyi Devina HSU

29/09/21

Ahmad Hanan Al Hafidz HSU Erni

L
6309090610210001 06/10/21

M. Al Fatih HSU Norhafizah

L 17
16/10/21

By. Nor HSU

27/10/21

M. Kahfi HSU Nani Herliani

28/10/21 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Muhammad Kamil HSU Norma
L 17
29/10/21

M. Kafeel Zain A HSU

6308050111210001 01/11/21

Ahmad Novyan HSU

L 14
6308050111210002 01/11/21 6308052203880004

M. Al Gazali HSU

23/11/21

Lathifatun Nuha El Kamila HSU Nani Herliani

6308054112210001 01/12/21 6308052203880004

M. Rifani HSU Anita Rupaidi

L 17
 L 17
6308050812210004 08/12/21

A. Daffa Andika HSU Hana

L 12
6308050912210002 09/12/21 6308052203880004

Muhammad Zain HSU Mariati

L 13
6308051112210001 11/12/21

Jihan Almaera HSU Endang

P 13
6308055212210001 12/12/21 6308052203880004

A. Zayyan HSU

22/12/21

Annasya Andreena Saila HSU Ria Helda

P 14
01/01/22 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Amanda Rizkywati HSU Nani Herliani

6308055601220001 16/01/22 6308052203880004

Nur Amara HSU

13/02/22

Kaureen Noura Ramiza HSU Nani Herliani

6308054203220002 02/03/22 6308052203880004

Raisya Humaira HSU

6308054903220001 09/03/22

Jennaira Agnia Nur Aufa HSU Nani Herliani

24/03/22 6308052203880004

Soraya Medina Aprilianza HSU Imah

P 17
6308054304220002 4/3/2022

Zakia Malik HSU Nani Herliani

04/04/22 6308052203880004

M. Akbar Ramadhan HSU

19/04/22

Sofia Fitriani HSU Nani Herliani

03/05/22 6308052203880004

Muhammad Muhyidin HSU

 6308050705220001 07/05/22

Ardi Muhammad Hidayat HSU Irma

L 12
24/05/22 6308052203880004

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Adiba Khanza Adira HSU Rosita
P 17
21/06/22

By. Eka HSU Nani Herliani

14/07/22 6308052203880004

M. Yahid Mubarak HSU Nani Herliani

17/07/22 6308052203880004

M. Alfarizi Muharam HSU Lailatul Jannah

L
30/07/22 6308052203880004

Raisya Khairisa HSU Raida Hartati

P 12
6308054109220001 9/1/2022

Raisya Faradilla HSU Normila

P 12
6308055309220001 13/09/22

Ahmad Rafa Ilmi HSU Dina Novia

L 4
17/09/22

Selvi HSU Malina

P 12
21/09/22

Desi Adella HSU

06/10/22

By. Aulia F HSU Nani Herliani

10/10/2022 6308052203880004

M. Maulana Yusuf HSU

6308051510220001 15/10/22

REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
M. Rais Husin HSU Erniyanti
L 13
6308051610220002 16/10/22

By. Fitria HSU

17/10/22

David Yahya Abidzar HSU Nani Herliani

6308052210220001 22/10/22 6308052203880004

By. Norhidayati HSU

04/11/22

By. Makiah HSU Nani Herliani

17/12/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

* * * * * * * *

* * * * * * * *

0371G0729

24/02/23

* * * * * * * *

* * * * * * * *

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23 14/09/21 14/09/21 13/10/21

* * * * * 13/10/21 13/10/21 16/11/21

 24/02/23

* * * 13/10/21 13/10/21 14/12/21 14/12/21 15/02/22

24/02/23

* * * * * * * *

24/02/23

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* * * * * * * *

0371G0729

* * * 12/01/22 12/01/22 15/02/22 15/02/22 15/03/22

24/02/23

* 15/02/22 15/02/22 15/03/22 15/03/22 17/05/22 17/05/22 *

 * * * 15/02/22 15/02/22

11/12/21 17/01/22 17/01/22 17/02/22 17/02/22 24/03/22 24/03/22 17/05/22

* * * 15/02/22 15/02/22 15/03/22 15/03/22 13/04/22

* 15/02/22 15/02/22 15/03/22 15/03/22 * * *

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

24/02/23

03/09/22 17/05/22 17/05/22 14/06/22 14/06/22 14/07/22 14/07/22 16/08/22

24/02/23

24/02/23
 * * * 16/08/22 16/08/22 11/10/22 11/10/22

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* 16/08/22 16/08/22 11/10/22 11/10/22 03/01/23 03/01/23

24/02/23

0371G0729

* 13/09/22 13/09/22 08/11/22 08/11/22

* * * 06/12/22 06/12/22 06/12/22 03/01/23 03/01/23

* 10/11/22 10/11/22 06/12/22 06/12/22 06/12/22

0371G0729

* 11/10/22 11/10/22

21/09/22 08/11/22 08/11/22

24/02/23

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
* * * 03/01/23 03/01/23
 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :

08/12/22

* 16/11/21 * 08/11/22

* 14/09/21

* 16/11/21 15/03/22

* 15/02/22 13/04/22 06/12/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
13/10/21 16/11/21 15/03/22 03/01/23

16/11/21 14/12/21 15/03/22

 15/02/22 11/10/22 13/04/22

* * 16/08/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
* * 16/08/22

15/03/22 11/10/22

* * 1/3/2023
 17/05/22

13/04/22 17/05/22 13/09/22

* 14/07/22

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
13/09/22

13/09/22

16/08/22 13/09/22 03/01/23

 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :

REGISTER PELAYANAN IMUNISASI

NISASI DASAR IMUNISASI LANJUTAN
INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
MUNISASI

Keterangan

MUNISASI

Keterangan
 D

MUNISASI

Keterangan
MUNISASI

Keterangan
MUNISASI

Keterangan

MUNISASI

Keterangan
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

Mutia Aisyah Firdaus HSU

1
6308054604210001 06/04/21
M. Fatih Al- Mubarak HSU
2
02/06/21
Muhammad Rayyan HSU
3
6308052706210002 6/27/2021
M. Razdan Rizqullah HSU
4
29/06/21
Ahmad Haris M. HSU
5
07/08/21
Siti Aisyah HSU
6
09/08/21
Naila Shafira Amin HSU
7
6308055608210001 15/08/21
Kaula Aisyah R. HSU
8
26/08/21
A. Nabil Habibi HSU
9
6308050509210003 05/09/21
Qonita Aleena Mazida HSU
10
07/09/22
Kartin Nida HSU
11
6308056909210001 29/09/21
Afia Nura Hefani HSU
12
6308054510210001 15/10/21
Nor Asifa Alisya HSU
13
15/10/21
Ahmad Ziyad Abdurrahman HSU
14
6308051710210001 17/10/21
M. Rizky Akbar HSU
15
6308050411210003 04/11/21
Ahmad Kawwas Azhari HSU
16
6308052311210001 23/11/21
M. Zyan Rizki HSU
16
6308052312210002 23/12/21
Raisya Kamila Az Zahra HSU
16
6308054602220002 06/02/22
M. Febrian Al- Kahfi HSU
16
16
6308050802220001 08/02/22
Gendis Aqila HSU
16
18/02/22
Fatimah Azwa HSU
16
26/02/22
Nur Aira Aidayah HSU
16
28/02/22
Malika Iriana Zivana HSU
16
6308055603220001 16/03/22
M. Rudi Akmal HSU
16
29/03/22
Maisya Aleena Mecca HSU
16
08/05/22
Syafira Khaira Rabbani HSU
16
6308055005220001 10/05/22
M. Adnan Karimi HSU
16
27/05/22
M. Fawwas Kamil HSU
16
6308050306220001 03/06/22
Ayra Fadhila Mathin HSU
16
10/26/2022
Muhammad Fauzan HSU
16
21/11/22

16
 REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Mutia Aisyah Firdaus HSU Nani Herliani

6308054604210001 06/04/21 6308052203880004

M. Fatih Al- Mubarak HSU

02/06/21

Muhammad Rayyan HSU Nani Herliani

6308052706210002 6/27/2021 6308052203880004

M. Razdan Rizqullah HSU

29/06/21

Ahmad Haris M. HSU Nani Herliani

07/08/21 6308052203880004

Siti Aisyah HSU

09/08/21

Naila Shafira Amin HSU Nani Herliani

6308055608210001 15/08/21 6308052203880004

Kayla Aisyah R. HSU

26/08/21

A. Nabil Habibi HSU Nani Herliani

6308050509210003 05/09/21 6308052203880004

Qonita Aleena Mazida HSU

07/09/22

Kartin Nida HSU Nani Herliani

6308056909210001 29/09/21 6308052203880004

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Afia Nura Hefani HSU Nani Herliani

6308054510210001 15/10/21 6308052203880004

Nor Asifa Alisya HSU

15/10/21

Ahmad Ziyad Abdurrahman HSU Nani Herliani

 6308051710210001 17/10/21 6308052203880004

M. Rizky Akbar HSU

6308050411210003 04/11/21

Ahmad Kawwas Azhari HSU Nani Herliani

6308052311210001 23/11/21 6308052203880004

M. Zyan Rizki HSU

6308052312210002 23/12/21

Raisya Kamila Az Zahra HSU Nani Herliani

6308054602220002 06/02/22 6308052203880004

M. Febrian Al- Kahfi HSU

6308050802220001 08/02/22

Gendis Aqila HSU Nani Herliani

18/02/22 6308052203880004

Fatimah Azwa HSU

26/02/22

Nur Aira Aidayah HSU Nani Herliani

28/02/22 6308052203880004

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Malika Iriana Zivana HSU Nani Herliani

6308055603220001 16/03/22 6308052203880004

M. Rudi Akmal HSU

29/03/22

Maisya Aleena Mecca HSU Nani Herliani

08/05/22 6308052203880004

Syafira Khaira Rabbani HSU

6308055005220001 10/05/22

M. Adnan Karimi HSU Nani Herliani

27/05/22 6308052203880004

M. Fawwas Kamil HSU

6308050306220001 03/06/22

Ayra Fadhila Mathin HSU Nani Herliani

10/26/2022 6308052203880004

Muhammad Fauzan HSU

 21/11/22

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23
 0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729
24/02/23

0371G0729

24/02/23

0371G0729
 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
10/15/2022

5041921

9/17/2022

10/15/2022

NISASI DASAR IMUNISASI LANJUTAN

INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
 9/17/2022

NISASI DASAR IMUNISASI LANJUTAN

INPUT
NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
MUNISASI

Keterangan

Keterangan
Keterangan
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

M. Zidan Al Farizi HSU

1
6308052004210001 20/04/21
Syalwa Syakila HSU
2
6308055405210001 14/05/21
Adia Rizki HSU
3
6308050906210002 09/06/21
A. Gribran Maulana HSU
4
6308052611210001 26/11/21
Raisya Aqila HSU
5
6308055804220001 18/04/22
Syahwa Mamtazah HSU
6
6308056006220001 20/06/22
M. Semman HSU
7
6308050407220002 04/07/22
Saidatunnisa HSU
8
24/08/22
Ahmad Fauzan HSU
9
6308052309220001 22/09/22
Shafida Zuyyina Alisha HSU
10
05/11/22
By. HSU
11
25/11/22
Nur Annisa Putri HSU
12
30/11/22
HSU
13

HSU
14

HSU
15

HSU
16
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

M. Azhar HSU
1
6308056910220001 03/04/21
M. Rasyid Al- F HSU
2
6308050404210001 04/04/21
Nor Gina Afifa HSU
3
6308055504210001 15/04/21
Rima Adelia HSU
4
6308056404210002 24/04/21
SAMIRA AZAHRA HSU
5
6308054603210001 06/03/21
SALSABELA AZKIA HSU
6
6308045603210001 16/03/21
Al Farisi HSU
7
6308050305210001 03/05/21
M. Fazar HSU
8
6308052005210001 20/05/21
Nadia Ulfa HSU
9
6308054506210001 05/06/21
M. Wildan HSU
10
6308050506210001 05/06/21
M. Nabil HSU
11
6308052006210001 20/06/21
M. Radillah HSU
12
11/07/21
M. Naufal HSU
13
6308051507210002 15/07/21
M. Hafiz Abdullah HSU
14
6308052306210001 23/07/21
M. Rahmad Illahi HSU
15
01/08/21
Aira Anurada HSU
16
07/08/21
M. Rafi'i HSU
10
6308051008210001 10/08/21
Zainal Abidin HSU
11
13/08/21
Mahmudah HSU
12
12
6308076609210002 26/09/21
M. Alfa Risky HSU
13
6308052609210001 26/09/21
Siti Mulia Az Z HSU
14
6308054210210002 02/10/21
M. Helmi HSU
15
05/10/21
M. Abdul Rahim HSU
16
6308051210210003 12/10/21
Yumna HSU
10
18/10/21
Ridha Hayati HSU
11
19/10/21
Musthafa HSU
12
6308052810210001 28/10/21
M. Hasan Sabit HSU
13
6308050311210001 03/12/21
Ridha Nafisa HSU
14
14/11/21
Naura Salsabila HSU
15
26/11/21
M. Ares Nugraha HSU
16
6308050612210001 06/12/21
Khadijah HSU
16
26/12/21
Siti Aisyah H. HSU
16
6308056812210001 28/12/21
M. Yajid Miliani HSU
16
30/01/22
M. Raffa HSU
16
06/03/22
Khadijah HSU
16
6308055103220002 11/03/22
M. Nabil HSU
16
02/04/22
M. Adzam HSU
16
05/05/22
By. HSU
16
08/05/22
M. Meinanda Argaza A HSU
16
12/05/22
M. Azka Putra S. HSU
16
6308051305220001 13/05/22
 Ahmad Mirza HSU
16
23/05/22
Siti Karliyani HSU
16
6308057105220001 30/05/22
M. Nasir HSU
16
04/06/22
Khaida Mumtazah HSU
16
6308054507220001 05/07/22
Abdul Hamid HSU
16
07/07/22
Nur Haifa HSU
16
6308056607220001 26/07/22
Yumna R. HSU
16
6308054508220001 05/08/22
Zia Alina H. HSU
16
6308055108220001 8/11/2022
M. Habri HSU
16
21/08/22
Adiba Maryam A. HSU
16
6308055709220001 17/09/22
Nazira Aziza HSU
16
25/09/22
Dona Nayla HSU
16
24/10/22
Kamila Naura HSU
16
6308054711220001 07/11/22
By. Fatmawati HSU
16
10/12/22
By. HSU
16
11/12/22
Muhammad HSU
16
14/12/22
HSU
16

HSU
16

HSU
16

HSU
16

HSU
16

HSU
16
16

HSU
16

HSU
16
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

Shafa aysha HSU

1
6308055308210001 13/08/21
Alya Humaira HSU
2
6308055310210001 03/10/21
M. Damar Fa'az HSU
3
6308050912210001 09/12/21
Khalisha Nor Salsabila HSU
4
25/12/21
M. Nor Arfan HSU
5
6309042612210001 26/12/21
M. Rizqan Musthafa HSU
6
30/12/21
Aqila Nur Adira HSU
7
6308055601220002 16/01/22
HSU
8

HSU
9

HSU
10

HSU
11

HSU
12

HSU
13

HSU
14

HSU
15

HSU
16
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

SITI KHADIJAH HSU

1
6308056910220001 31/01/21
M. ZAINI HSU
2
6308050302210001 03/02/21
M. FAUZI HSU
3
03/02/21
M. FARQAN HSU
4
6308052102210001 21/02/21
SAMIRA AZAHRA HSU
5
6308054603210001 06/03/21
SALSABELA AZKIA HSU
6
6308045603210001 16/03/21
HSU
7

HSU
8

HSU
9

HSU
10

HSU
11

HSU
12

HSU
13

HSU
14

HSU
15

HSU
16
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

SITI KHADIJAH HSU

1
6308056910220001 31/01/21
M. ZAINI HSU
2
6308050302210001 03/02/21
M. FAUZI HSU
3
03/02/21
M. FARQAN HSU
4
6308052102210001 21/02/21
SAMIRA AZAHRA HSU
5
6308054603210001 06/03/21
SALSABELA AZKIA HSU
6
6308045603210001 16/03/21
HSU
7

HSU
8

HSU
9

HSU
10

HSU
11

HSU
12

HSU
13

HSU
14

HSU
15

HSU
16
 REGISTER PELAYANAN IMUNISASI

Nama Anak / Tempat Lahir Nama Ibu Jenis Kelamin

NO Alamat (RT)
NIK Anak Tanggal Lahir NIK Ibu
L P
Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

Ayda Mehar Elshanum HSU Nani Herliani

6308056910220001 29/10/22 6308052203880004

MUNISASI

IMUNISASI DASAR IMUNISASI DASAR

HB-0 BCG Polio 1 Penta 1 Polio 2 PCV 1 Penta 2 Polio 3 PCV 2 Penta 3
No Batch : No Batch :
24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729

24/02/23

0371G0729
 REGISTER PELAYANAN IMUNISASI
NISASI DASAR IMUNISASI LANJUTAN
INPUT NO HP
Polio 4 IPV MR PCV 3 Penta 4 MR 2 IPV 2 ASIK
No Batch : No Batch :
MUNISASI

Keterangan
 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

Hilya Azkia HSU

1
6308054504214648 05/04/21
Husna Hulaimi HSU
2
6308055104211771 11/04/21
A. Daffa Bafif HSU
3
6308051304210001 13/04/21
M. Azka Pratama HSU
4
05/05/21
Adinda Napisa R. HSU
5
6308054507211267 05/07/21
Husna Habibah HSU
6
630804308210001 03/08/21
Nahla Naura HSU
7
21/09/21
M. Arsyad HSU
8
6308052810210002 28/10/21
Arisha S. HSU
9
6308057001220002 30/01/22
Khadeeja Fayruz A. HSU
11
6308054703220002 3/7/2022
Rizkia Aulia HSU
10
6308054503220001 08/03/22
Norsyifa Rigina P. HSU
11
25/08/22
Alka Dahayu Zea A. HSU
12
01/10/2022
M. Zaini HSU
13
6311070111220001 01/11/22
HSU
14

HSU
15

HSU
16
Nama Anak : Hilya Azkia Nama Ibu : Nama Anak : Husna Hulaimi Nama Ibu :
NIK Anak : '6308054504214648 NIK Ibu : NIK Anak : '6308055104211771 NIK Ibu :
TTL : '05/04/21 No. HP : TTL : '11/04/21 No. HP :
JK : Perempuan Alamat : JK : Perempuan Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2

Nama Anak : M. Azka Pratama Nama Ibu : Nama Anak : Adinda Napisa R. Nama Ibu :
NIK Anak : NIK Ibu : NIK Anak : '6308054507211267 NIK Ibu :
TTL : '05/05/21 No. HP : TTL : '05/07/21 No. HP :
JK : Laki - laki Alamat : JK : Perempuan Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2

Nama Anak : Nahla Naura Nama Ibu : Nama Anak : M. Arsyad Nama Ibu :
NIK Anak : '21/09/21 NIK Ibu : NIK Anak : '6308052810210002 NIK Ibu :
TTL : No. HP : TTL : '28/10/21 No. HP :
JK : Perempuan Alamat : JK : Laki - laki Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2

Nama Anak : Khadeeja Fayruz A. Nama Ibu : Nama Anak : Rizkia Aulia Nama Ibu :
NIK Anak : '6308054703220002 NIK Ibu : NIK Anak : '6308054503220001 NIK Ibu :
TTL : 07/03/2022 No. HP : TTL : '08/03/22 No. HP :
JK : Perempuan Alamat : JK : Perempuan Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4
 MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2

Nama Anak : Alka Dahayu Zea A. Nama Ibu : Nama Anak : M. Zaini Nama Ibu :
NIK Anak : NIK Ibu : NIK Anak : '6311070111220001 NIK Ibu :
TTL : '01/10/2022 No. HP : TTL : '01/11/22 No. HP :
JK : Perempuan Alamat : JK : Laki - laki Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2

Nama Anak : Nama Ibu : Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu : NIK Anak : NIK Ibu :
TTL : No. HP : TTL : No. HP :
JK : Alamat : JK : Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2
 Nama Anak : A. Daffa Bafif Nama Ibu :
NIK Anak : '6308051304210001 NIK Ibu :
TTL : '13/04/21 No. HP :
JK : Laki - laki Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Husna Habibah Nama Ibu :

NIK Anak : '630804308210001 NIK Ibu :
TTL : '03/08/21 No. HP :
JK : Perempuan Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Arisha S. Nama Ibu :

NIK Anak : '6308057001220002 NIK Ibu :
TTL : '30/01/22 No. HP :
JK : Perempuan Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Norsyifa Rigina P. Nama Ibu :

NIK Anak : NIK Ibu :
TTL : '25/08/22 No. HP :
JK : Perempuan Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu :
TTL : No. HP :
JK : Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu :
TTL : No. HP :
JK : Alamat :
PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

 Nama Anak / Tempat Lahir Nama Ibu Jenis Alamat
NO
NIK Anak Tanggal Lahir NIK Ibu Kelamin (RT)

Zafran Ibrahim HSU

1
6308042805210001 28/05/21
M. Arsya Fathan HSU
2
6308050302210001 28/05/21
M. Hafis Badali HSU
4
6308052606210001 26/06/21
M. Aidil Aswad HSU
3
30/06/21
Zafira Azzahra HSU
5
04/08/21
Mulia Aulia Azzahra HSU
6
05/10/21
Afifah Hanini Putri HSU
7
6308056010210001 20/10/21
Muhammad Jaini HSU
8
6308050811210001 08/11/21
Resqia Haira Paida HSU
9
09/12/21
M. Azhar HSU
10
03/06/22
M. Syauki HSU
11
6308052607220002 26/07/22
Raina Almira Bilqis HSU
12
14/09/22
M. Akbar Melviano HSU
13
63080051710220001 17/10/22
Raina Maulida HSU
14
6308045310220001 13/10/22
Aisha Nazia Al Mahira HSU
15
29/11/23
By. Bella HSU
16
12/23/2022
Nama Anak Zafran Ibrahim Nama Ibu : Nama Anak M. Arsya Fathan
NIK Anak 6308042805210001 NIK Ibu : NIK Anak 6308050302210001
TTL 28/05/21 No. HP : TTL 28/05/21
JK Laki - laki Alamat : JK Laki - laki
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

Nama Anak M. Aidil Aswad Nama Ibu : Herdawati Nama Anak Zafira Azzahra
NIK Anak NIK Ibu : NIK Anak
TTL 30/06/21 No. HP : 0831 4200 7667 TTL 04/08/21
JK Laki - laki Alamat : Paliwara RT. 06 JK Perempuan
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1
02/07/2021 8/23/2021 3/7/2022

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

5/19/2022 2/2/2023 5/30/2022

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

4/8/2022

Nama Anak Afifah Hanini Putri Nama Ibu : Nama Anak Muhammad Jaini
NIK Anak 6308056010210001 NIK Ibu : NIK Anak 6308050811210001
TTL 20/10/21 No. HP : TTL 08/11/21
JK Perempuan Alamat : JK Laki - laki
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

Nama Anak : Nama Ibu : Nama Anak :

NIK Anak : NIK Ibu : NIK Anak :
TTL : No. HP : TTL :
JK : Perempuan Alamat : JK : Perempuan
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1
 DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

Nama Anak : Nama Ibu : Nama Anak :

NIK Anak : NIK Ibu : NIK Anak :
TTL : No. HP : TTL :
JK : Perempuan Alamat : JK : Laki - laki
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

Nama Anak : Nama Ibu : Nama Anak :

NIK Anak : NIK Ibu : NIK Anak :
TTL : No. HP : TTL :
JK : Alamat : JK :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4

Nama Ibu : Nama Anak M. Hafis Badali Nama Ibu :
NIK Ibu : NIK Anak 6308052606210001 NIK Ibu :
No. HP : TTL 26/06/21 No. HP :
Alamat : JK Laki - laki Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Ibu : Nama Anak Mulia Aulia Azzahra Nama Ibu :

NIK Ibu : NIK Anak NIK Ibu :
No. HP : TTL 05/10/21 No. HP :
Alamat : JK Perempuan Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Ibu : Nama Anak Resqia Haira Paida Nama Ibu :

NIK Ibu : NIK Anak NIK Ibu :
No. HP : TTL 09/12/21 No. HP :
Alamat : JK Perempuan Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Ibu : Nama Anak : Nama Ibu :

NIK Ibu : NIK Anak : NIK Ibu :
No. HP : TTL : No. HP :
Alamat : JK : Perempuan Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1
 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Ibu : Nama Anak : Nama Ibu :

NIK Ibu : NIK Anak : NIK Ibu :
No. HP : TTL : No. HP :
Alamat : JK : Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Ibu : Nama Anak : Nama Ibu :

NIK Ibu : NIK Anak : NIK Ibu :
No. HP : TTL : No. HP :
Alamat : JK : Alamat :
DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu : Nama Anak : Nama Ibu :
NIK Anak : NIK Ibu : NIK Anak : NIK Ibu :
TTL : No. HP : TTL : No. HP :
JK : Perempuan Alamat : JK : Perempuan Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu : Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu : NIK Anak : NIK Ibu :
TTL : No. HP : TTL : No. HP :
JK : Perempuan Alamat : JK : Laki - laki Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu : Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu : NIK Anak : NIK Ibu :
TTL : No. HP : TTL : No. HP :
JK : Alamat : JK : Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1 Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan
Nama Anak : Nama Ibu :
NIK Anak : NIK Ibu :
TTL : No. HP :
JK : Perempuan Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu :
TTL : No. HP :
JK : Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

Nama Anak : Nama Ibu :

NIK Anak : NIK Ibu :
TTL : No. HP :
JK : Alamat :
Hb0 BCG Polio1 DPTHib1 Polio2 PCV1

DPTHib2 Polio3 PCV2 DPTHib3 Polio4 IPV

MR1 PCV3 DPTHib4 MR2 IPV2 Keterangan

 REGISTER HARIAN IMUNISASI

Desa :
Tanggal :

Nama Anak Tanggal Lahir Nama Ibu No. HP/WA Imunisasi

No
NIK Anak Jenis Kelamin NIK Ibu Alamat No. Bacth
Nama Pos : Nama Pos :
Tanggal : Tanggal :
VAKSIN JUMLAH VAKSIN JUMLAH
VAKSIN NO. BATCH VAKSIN NO. BATCH
DIBAWA PEMAKAIAN/ DOSIS DIBAWA PEMAKAIAN/ DOSIS
BCG BCG
DPTHib DPTHib
POLIO ORAL POLIO ORAL
IPV IPV
PCV PCV
CAMPAK CAMPAK
TT TT

Nama Pos : Nama Pos :

Tanggal : Tanggal :

VAKSIN JUMLAH VAKSIN JUMLAH

VAKSIN DIBAWA PEMAKAIAN/ DOSIS NO. BATCH VAKSIN DIBAWA PEMAKAIAN/ DOSIS NO. BATCH

BCG BCG
DPTHib DPTHib
POLIO ORAL POLIO ORAL
IPV IPV
PCV PCV
CAMPAK CAMPAK
TT TT

Nama Pos : Nama Pos :

Tanggal : Tanggal :

VAKSIN VAKSIN JUMLAH NO. BATCH VAKSIN VAKSIN JUMLAH NO. BATCH
DIBAWA PEMAKAIAN/ DOSIS DIBAWA PEMAKAIAN/ DOSIS

BCG BCG
DPTHib DPTHib
POLIO ORAL POLIO ORAL
IPV IPV
PCV PCV
CAMPAK CAMPAK
TT TT

Nama Pos : Nama Pos :

Tanggal : Tanggal :
 VAKSIN JUMLAH VAKSIN JUMLAH
VAKSIN DIBAWA PEMAKAIAN/ DOSIS NO. BATCH VAKSIN DIBAWA PEMAKAIAN/ DOSIS NO. BATCH

BCG BCG
DPTHib DPTHib
POLIO ORAL POLIO ORAL
IPV IPV
PCV PCV
CAMPAK CAMPAK
TT TT