<table border='0' cellpadding='5' cellspacing='0'><tr><td colspan='10'

align='center'><h2>Rekapitulasi Nasional - ICV Rekap<h2></td></tr><tr><td

colspan='10' align='center'>Rumah Sakit : Semua </td></tr><tr><td colspan='10'
align='center'>Periode : 01-01-2021 - 31-12-2021 </td></tr><tr><td
colspan='10'></td></tr><tr><td></td><td style='color:white;background-
color:#244c82;'>Total Data</td><td>96</td><td
colspan='7'></td></tr><tr><td></td><td style='color:white;background-
color:#244c82;'>Jumlah Data</td><td>96</td><td colspan='7'></td></tr><tr><td
colspan='10'></td></tr><tr><td
style='color:white;background-color:#244c82;'>No</td><td
style='color:white;background-color:#244c82;'>Nama KKP</td><td
style='color:white;background-color:#244c82;'>No Dokumen ICV</td><td
style='color:white;background-color:#244c82;'>No Barcode</td><td
style='color:white;background-color:#244c82;'>Nama</td><td
style='color:white;background-color:#244c82;'>Tanggal Lahir</td><td
style='color:white;background-color:#244c82;'>Jenis Kelamin</td><td
style='color:white;background-color:#244c82;'>Kebangsaan</td><td
style='color:white;background-color:#244c82;'>No Identitas</td><td
style='color:white;background-color:#244c82;'>Tanggal Terbit</td><td
style='color:white;background-color:#244c82;'>Rumah
Sakit</td></tr><tr><td>1</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421716</td><td>K00-421716</td><td>TATANG
TARYANA</td><td>1982-03-10</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-04</td><td></td></tr><tr><td>2</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421717</td><td>K00-421717</td><td>MAT
SUKRI JUMLI</td><td>1972-04-08</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-18</td><td></td></tr><tr><td>3</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421719</td><td>K00-421719</td><td>ADRIANA
SYAHRIL
JUDE</td><td>1985-09-01</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-18</td><td></td></tr><tr><td>4</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421718</td><td>K00-421718</td><td>MULIA
JUDE BAHAR</td><td>1958-12-31</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-18</td><td></td></tr><tr><td>5</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421720</td><td>K00-421720</td><td>ASNAH
DURANI</td><td>1958-07-01</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-18</td><td></td></tr><tr><td>6</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421721</td><td>K00-421721</td><td>RODI</td><td>1983-06-16</
td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-01-19</td><td></td></
tr><tr><td>7</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421723</td><td>K00-421723</td><td>AGUS SALIM ATIM
SAMAN</td><td>1976-08-08</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>8</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421722</td><td>K00-421722</td><td>ISWAHYUDI ISKANDAR JONG KUI
SAN</td><td>1980-06-06</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>9</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421726</td><td>K00-421726</td><td>ERNI
FANDIANI</td><td>1982-05-18</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>10</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421725</td><td>K00-421725</td><td>BUDY
RAMADHANY
BASRI</td><td>1977-04-23</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>11</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421729</td><td>K00-421729</td><td>YUSNETI
BURHANUDIN
IBRAHIM</td><td>1974-07-21</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>12</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421724</td><td>K00-421724</td><td>TINAH
SANDI SARON</td><td>1965-12-12</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>13</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421728</td><td>K00-421728</td><td>NURHAYATI MUHAMAD
SAIDE</td><td>1980-11-23</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>14</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421727</td><td>K00-421727</td><td>SITI
SYARIEFAH
SUGIMAN</td><td>1981-12-31</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-19</td><td></td></tr><tr><td>15</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421730</td><td>K00-421730</td><td>ENGKOS
KOSASIH</td><td>1966-06-12</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-20</td><td></td></tr><tr><td>16</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421731</td><td>K00-421731</td><td>IMAT
MULYANI</td><td>1977-02-14</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-20</td><td></td></tr><tr><td>17</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421732</td><td>K00-421732</td><td>FACHRURRAZI MUHAMMAD
TURIDI</td><td>1972-11-02</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-20</td><td></td></tr><tr><td>18</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421733</td><td>K00-421733</td><td>ABU
ABDUL SAREH</td><td>1980-06-20</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-20</td><td></td></tr><tr><td>19</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421734</td><td>K00-421734</td><td>NOFENDRA
ACHMAD SUNARTO
SAFARI</td><td>1981-11-11</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>20</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421735</td><td>K00-421735</td><td>SITI
SUSANTI
KASMAN</td><td>1965-12-05</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>21</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421736</td><td>K00-421736</td><td>SUMARYATI JEMIYO
KERTAMUNAWI</td><td>1958-11-21</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>22</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421737</td><td>K00-421737</td><td>ISNANTO
SISWO SUNARMO</td><td>1957-11-19</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>23</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421738</td><td>K00-421738</td><td>MASENI
JIO ASMADI</td><td>1957-09-23</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>24</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421739</td><td>K00-421739</td><td>SUPARMAN
MARZUKI
MUTINGGAL</td><td>1964-08-15</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>25</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421740</td><td>K00-421740</td><td>WALGINAH
SARIO
TARIYO</td><td>1964-02-10</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>26</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421741</td><td>K00-421741</td><td>SUDARMINI JASMADI
SIMAN</td><td>1984-05-06</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>27</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421743</td><td>K00-421743</td><td>URAY
AZHARIE</td><td>1976-10-10</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>28</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421742</td><td>K00-421742</td><td>ACHMAD
LAHABI BEDU</td><td>1960-12-24</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-25</td><td></td></tr><tr><td>29</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421744</td><td>K00-421744</td><td>CAS
MUDRIAH CAS
MUKLIS</td><td>1972-12-29</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>30</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421745</td><td>K00-421745</td><td>TALEM
SAMINGAN
KROMO</td><td>1958-01-10</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>31</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421746</td><td>K00-421746</td><td>PURWANDI
SUBARI KERTA</td><td>1952-03-17</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>32</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421747</td><td>K00-421747</td><td>TURIAH
RATNO
SUWONO</td><td>1979-05-03</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>33</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421748</td><td>K00-421748</td><td>SALOMA
JOHAN RUSLI</td><td>1967-08-18</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>34</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421749</td><td>K00-421749</td><td>SITI
LESTARI
PATAWI</td><td>1968-06-16</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-27</td><td></td></tr><tr><td>35</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421750</td><td>K00-421750</td><td>AGUS
SISWANTORO</td><td>1969-12-23</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-01-29</td><td></td></tr><tr><td>36</td>
<td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421751</td><td>K00-421751</td><td>SRIWANI ISMAIL
BAKRI</td><td>1968-12-22</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>37</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421752</td><td>K00-421752</td><td>TASMIN
MUHAMMAD
NASIR</td><td>1959-06-04</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>38</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421753</td><td>K00-421753</td><td>NOVA
MILASARI
SUHAIRI</td><td>1983-11-30</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>39</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421754</td><td>K00-421754</td><td>TRI
SUGIHARTO</td><td>1976-06-29</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>40</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421755</td><td>K00-421755</td><td>NOVITA
YULI
SUSILOWATI</td><td>1979-11-25</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>41</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421756</td><td>K00-421756</td><td>WITA
TAKARI
HAMDANY</td><td>1965-08-31</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>42</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421757</td><td>K00-421757</td><td>BASUKI
RAHARJO
SOEKARYONO</td><td>1965-08-05</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-01</td><td></td></tr><tr><td>43</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421758</td><td>K00-421758</td><td>SYANIAH
GUBAD ABUN</td><td>1971-12-31</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-03</td><td></td></tr><tr><td>44</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421759</td><td>K00-421759</td><td>ABDANIA
ALWI
MAMUDDIN</td><td>1976-09-09</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-03</td><td></td></tr><tr><td>45</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421760</td><td>K00-421760</td><td>ALPIAN
RAJUNI SIDUL</td><td>1963-07-12</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-03</td><td></td></tr><tr><td>46</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421761</td><td>K00-421761</td><td>YUHANI
SUGIONO
KUYUNG</td><td>1964-03-12</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-03</td><td></td></tr><tr><td>47</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421762</td><td>K00-421762</td><td>KOMSATUN
BENO TAHAL</td><td>1973-06-10</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-03</td><td></td></tr><tr><td>48</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421763</td><td>K00-421763</td><td>ASNIARNI
YAHYA PEKIH</td><td>1976-12-29</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-04</td><td></td></tr><tr><td>49</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421764</td><td>K00-421764</td><td>JULIANSYAH
RABUDIN</td><td>1979-07-07</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-08</td><td></td></tr><tr><td>50</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421765</td><td>K00-421765</td><td>OKTA
FITRI YANTI</td><td>2000-10-12</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-11</td><td></td></tr><tr><td>51</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421766</td><td>K00-421766</td><td>Wariati
Mawarjo Ahmad
Musa</td><td>1967-07-15</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-15</td><td></td></tr><tr><td>52</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421767</td><td>K00-421767</td><td>SODIKIN MOKHAMAD
SALMAN</td><td>1979-09-01</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-18</td><td></td></tr><tr><td>53</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421769</td><td>K00-421769</td><td>SARIYEM
SUBADI
KARTO</td><td>1960-11-02</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-26</td><td></td></tr><tr><td>54</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421768</td><td>K00-421768</td><td>SULASTRI
TOIMAN
KARMOREDJA</td><td>1960-06-10</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-26</td><td></td></tr><tr><td>55</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421770</td><td>K00-421770</td><td>SRI
UTAMI BENI</td><td>1966-07-09</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-02-26</td><td></td></tr><tr><td>56</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421771</td><td></td><td>ARFI SYAHBANDI</td><td>1987-
04-25</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-03-10</
td><td></td></tr><tr><td>57</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421772</td><td>K00-421772</td><td>Deden Karta
Sasmita</td><td>1980-12-09</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-15</td><td></td></tr><tr><td>58</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421773</td><td>K00-421773</td><td>Sri
Wahyu</td><td>1983-03-17</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-15</td><td></td></tr><tr><td>59</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421775</td><td>K00-421775</td><td>HASAN
MUNADI</td><td>1983-05-16</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-22</td><td></td></tr><tr><td>60</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421774</td><td>K00-421774</td><td>BAGUS
JAKFAR</td><td>1972-08-20</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-22</td><td></td></tr><tr><td>61</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421776</td><td>K00-421776</td><td>AGUS
SALIM MUNADI</td><td>1988-03-13</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-22</td><td></td></tr><tr><td>62</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421777</td><td>K00-421777</td><td>DHANI KURNIA
BUDHISETIA</td><td>1997-11-04</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-03-24</td><td></td></tr><tr><td>63</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421778</td><td>K00-421778</td><td>ZERIKO
NOVENDRO PALA</td><td>1980-11-24</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-05-04</td><td></td></tr><tr><td>64</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421779</td><td>K00-421779</td><td>SUPRIYANDI</td><td>1997-05-
25</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-06-03</td><td></
td></tr><tr><td>65</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421780</td><td>K00-421780</td><td>LATIF FAUZI</td><td>1981-
09-21</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-06-03</
td><td></td></tr><tr><td>66</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421782</td><td>K00-421782</td><td>SULAIMAN ABU
RALI</td><td>1974-05-18</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-06-03</td><td></td></tr><tr><td>67</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421781</td><td>K00-421781</td><td>PITER
SULLE</td><td>1979-12-11</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-06-03</td><td></td></tr><tr><td>68</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421783</td><td>K00-421783</td><td>HERMANTO
MUCHNI</td><td>1979-06-02</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-06-07</td><td></td></tr><tr><td>69</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>L00-0015033</td><td>LOO-0015033</td><td>SLAMET
RIYADI</td><td>1978-01-20</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-06-25</td><td></td></tr><tr><td>70</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421784</td><td>K00-421784</td><td>RITA
PRISTIWATI
TUWO</td><td>1975-05-17</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-07-21</td><td></td></tr><tr><td>71</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421785</td><td>K00-421785</td><td>NUR
IHSANUDDIN</td><td>1996-06-12</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-08-05</td><td></td></tr><tr><td>72</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421786</td><td>K00-421786</td><td>CRISTIAR
SAMOSIR</td><td>1997-01-05</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-09-02</td><td></td></tr><tr><td>73</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421787</td><td>K00-421787</td><td>SULASTRI</
td><td>1969-08-23</td><td>Female</td><td>Indonesia</td><td>PASSPORT</td><td>2021-
10-15</td><td></td></tr><tr><td>74</td><td>Pontianak / Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421788</td><td>K00-421788</td><td>Valentino Ronaldo
Edwardo</td><td>1998-02-10</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-10-18</td><td></td></tr><tr><td>75</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421789</td><td>K00-421789</td><td>REDHI APRIYONO
ALIT</td><td>1992-04-02</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-10-21</td><td></td></tr><tr><td>76</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421790</td><td></td><td>REDHI APRIYONO
ALIT</td><td>1992-04-02</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-10-22</td><td></td></tr><tr><td>77</td><td>Pontianak
/ Kantor Kesehatan Pelabuhan Kelas II Pontianak</td><td>K00-421791</td><td>K00-
421791</td><td>I Komang Adi
Pratama</td><td>1992-01-18</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-10-29</td><td></td></tr><tr><td>78</td><td>Kantor Kesehatan Pelabuhan
Kelas II Pontianak</td><td>K00-421792</td><td>K00-421792</td><td>EKO
SUHARTO</td><td>1977-02-10</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-11-10</td><td></td></tr><tr><td>79</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421793</td><td>K00-421793</td><td>DESINTA
RAHMAWATI</td><td>1996-01-01</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-11-16</td><td></td></tr><tr><td>80</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421794</td><td>K00-421794</td><td>CUNG FAT
LIONG</td><td>1967-02-11</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-11-22</td><td></td></tr><tr><td>81</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421795</td><td>K00-421795</td><td>ISKANDAR
HENDRO
PRASATYO</td><td>1992-04-19</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-11-24</td><td></td></tr><tr><td>82</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421796</td><td>K00-421796</td><td>SUPIANTO</td><td>1963-07-
03</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-11-30</td><td></
td></tr><tr><td>83</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421797</td><td>K00-421797</td><td>GINA FAHRINA</td><td>1989-
09-09</td><td>Female</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-01</
td><td></td></tr><tr><td>84</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421798</td><td>K00-421798</td><td>DENI PURWANTO</td><td>1989-
04-15</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-01</
td><td></td></tr><tr><td>85</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421799</td><td>K00-421799</td><td>MUSTAQIM</td><td>1979-06-
08</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-07</td><td></
td></tr><tr><td>86</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421800</td><td>K00-421800</td><td>TALAHA SUDIN</td><td>1955-
02-12</td><td>Female</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-07</
td><td></td></tr><tr><td>87</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421801</td><td>K00-421801</td><td>SUWANDI</td><td>1972-07-
15</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-16</td><td></
td></tr><tr><td>88</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421802</td><td>K00-421802</td><td>MUHAMMAD
AFFAIR</td><td>1993-01-07</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-17</td><td></td></tr><tr><td>89</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421803</td><td>K00-421803</td><td>SUYANTO</td><td>1969-12-
09</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-20</td><td></
td></tr><tr><td>90</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421804</td><td>K00-421804</td><td>ARFIANI RANI
ABDULLAH</td><td>1967-02-09</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-21</td><td></td></tr><tr><td>91</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II
Pontianak</td><td>K00-421805</td><td>K00-421805</td><td>NURBANUN</td><td>1963-01-
11</td><td>Female</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-23</td><td></
td></tr><tr><td>92</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421806</td><td>K00-421806</td><td>DANI SAPUTRA</td><td>1999-
08-26</td><td>Male</td><td>Indonesia</td><td>PASSPORT</td><td>2021-12-23</
td><td></td></tr><tr><td>93</td><td>Pontianak / Kantor Kesehatan Pelabuhan Kelas II
Pontianak</td><td>K00-421807</td><td>K00-421807</td><td>SIDIK PERMANA
KUWATA</td><td>1968-09-09</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-28</td><td></td></tr><tr><td>94</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421808</td><td>K00-421808</td><td>RIDWAN
SUHARNA
SADELI</td><td>1984-03-14</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-28</td><td></td></tr><tr><td>95</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421809</td><td>K00-421809</td><td>PELMI
KARYATI</td><td>1971-07-03</td><td>Female</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-28</td><td></td></tr><tr><td>96</td><td>Pontianak / Kantor Kesehatan
Pelabuhan Kelas II Pontianak</td><td>K00-421810</td><td>K00-421810</td><td>SYAMSUL
BAHRIE ABDUL
WAHID</td><td>1955-02-15</td><td>Male</td><td>Indonesia</td><td>PASSPORT</
td><td>2021-12-28</td><td></td></tr></table>