Register Ka Cakung Timur 2023

NO REGISTER JAMINAN
f TGL NIK
BARU LAMA BPJS UMUM
1 03-01-2023 562/22 V
2 563/22 V
3 564/22 V
4 3175062611220008 001/23 V
5 002/23 V
6 3175062411220005 003/23 V
7 3175062112220007 004/23 V
8 3373040307210001 005/23 V
9 006/23 V
10 3175061608220002 406/22 V
11 3175062209200037 296/22 V
12 3571061010220001 441/22
13 3175065706220002 304/22 V
14 05-01-2023 3175062412220008 007/23 V
15 3402144207210001 350/21 V
16 256/21 V
17 3175062112220007 004/23 V
18 3175060311220001 516/22 V
19 464/22 v
20 3175066908220007 409/22 V
21 395/22 V
22 3175064107220004 396/22 V
23 3175064411220003 486/22 V
24 356/22 V
25 317506207220007 437/22 V
26 3175066908220009 402/22 V
27 3275084708220001 355/22A V
28 3275022810220001 465/22 v
29 317506507190030 86/22 V
30 3175066410220001 504/22 V
31 3175061603220006 221/22 V
32 3175062804220015 361/22 V
33 3175062508220003 343/22 V
317506240916002
34 104/22 V
7
35 403/22 V
36 3175062502220007 129/22 V
37 229/21 V
38 435/22 V
39 10-01-2023 3175060912220001 008/23 V
40 3175060412220002 009/23 V
41 3.1750641122E+15 010/23 V
42 317506011220006 011/23 V
43 3175142511220082 012/23 V
44 3175060812220003 013/23 V
45 014/23 V
46 3175064612220007 015/23 V
47 3175066909220006 016/23 V
48 3175064510220001 017/23 V
49 317506612220003 018/23 V
50 3175066509220002 429/22 v
51 3175066909220004 463/22 v
52 3175066309220007 522/22 V
53 543/22 V
54 3175063110220002 506/22 V
55 439/22 V
56 #FMT 474/22 v
57 3175064912220005 547/22 V
58 3175060712220010 536/22 V
59 531/22 V
60 374/22 V
61 3175062507220000 471/22 v
62 3175064512220013 532/22 V
63 3175060510220008 475/22 v
64 12-01-2023 019/23 V
65 317506470420006 020/23 V
66 3376016207950001 021/23 V
67 022/23 V
68 3175064401230001 023/23 V
69 3175064910220004 483/22 V
70 484/22 V
71 3328176102220001 252/22 V
72 214/22 V
73 3175063006220009 346/22 V
317506540222000
74 109/22 V
4
75 307A/22 V
76 214/22 V
77 3175061608111099 472/22 v
78 339/22 v
317506570621001
79 369/21 V
0
80 16-01-2023 024/23 V
3175060601230001
81 17-01-2023 3175060901230005 025/23 V
82 3212123010220001 026/23 V
83 3175061712220003 027/23 V
84 3175060501230012 028/23 V
85 030/23 v
86 031/23 v
87 032/23 v
88 033/23 v
89 034/23 v
90 476/22 v
91 518/22 v
92 527/22 v
93 405/22 v
94 493/22 V
95 353/22 V
96 541/22 V
97 550/22 V
98 3175024808220004 477/22 YA
99 331/22 V
100 002/23 V
101 315/22 YA
102 19-01-2023 3172040811220003 035/23 V
103 036/23 V
104 3175060211220004 037/23 V

105 038/23 V
106 457/22 YA
317506491221001
107
0
26/22 V
108 3175064910220004 438/22 YA
109 195/22 V
110 3171035010220004 542/22 YA
111 317506210920002 394/22 V
112 3175064309220004 478/22 YA
113 3175060609220006 421/22 YA V
114 3175060108220014 479/22 YA
115 366/21 V
116 3175066711200006 484/20 YA
117 410/22 YA
118 31750610010220018 482/22 YA
119 548/22 V
120 485/22 YA
317506166112200
121 549/22 V
06
317506060422000
122 162/22 V
6
317506540422000
123 185/22 V
2
124 216/22 V
317506440922000
125 401/22 V
8
126 3175065103220004 107/22 V
127 454/22 V
128 489/22A V
129 490/22 V
317506140721000
130 381/21 V
7
131 24-01-2023 039/23 V
132 040/23 V
133 041/23 V
134 3175062110220018 491/22 V
135 399/22 V
136 31750651062100i8 328/21 V
137 317506101220011 480/22 V
138 3175064410220003 420/22 V
139 3175065309220002 434/22 V
140 019/23 V
141 3175060409220010 354/22 V
142 3175062112220007 004/23 V
143 3175066609220006 489/22 V
144 317506440922002 440/22 V
145 3175025810220002 494/22 V
146 443/22 V
147 3175062210220005 459/22 v
148 3175060108220006 534/22 V
149 26-01-2023 042/23 V
150 043/23 V
151 044/23 V
152 31752043007220007 045/23 V

153 046/23 V
154 047/23 V
155 048/23 V
156 313/22
157 149/22 V
158 3175066908220003 408/22 V
317506520422000
159 177/22 V
2
160 500/22 v
161 436/22 V
162 3175066409220008 452/22 v
163 546/22 V
164 427/22 V
165 148/22 V
166 557/22 v
167 3175066412210009 448/22 V
168 3175062209220007 453/22 V
169 111/22 V
170 507/22 V
171 209/22 V
172 3175060204200009 348/21 V
173 535/22 V
174 270/22 v
526/22 V
175 30-01-2023 049/23 V
046/23 V
176 27-01-2023 050/23 V
177 31-01-2023 051/23 V
178 052/23 V
179 053/23 V
180 054/23 V
181 055/23 V
182 492/22 V
317506150822001
183 364/22 V
0
184 561/22 V
185 556/22 v
SARMUT 98.9 %
JK/UMUR
NAMA ANAK TTL NAMA ORANGTUA

L P
Arkana Dwi Hermansyah 21-11-2022 1 Bln Mei Kristines / Danu Hermansyah

Lavanya Ginandyta Ayudisha 29-11-22 1 Bln Nafiroh / Iswahyudi
Afanes 03-10-2022 3 Bln Emah Rohimah / Jefri Hidayat
Boy Matthew Latumeten 26-11-2022 1 Bln Devi Susanti / Yason Latumeten
Salsabila Nur Rahma 17-12-2022 14 Hr Mila Arum Listiani / Rahmadhani
Prince Novmender 24-11-2022 1 Bln Sri Devi Anna / Rio Arthasasta
Galih Estiawan 21-12-2022 13 hr Mufiatun / Mulyono
Muhammad Yazeed Alfatih 3-7-2021 18 Bln Linda Surya S / Aditya Wahyu N
Abizen Firdaus 22-11-2022 2 Bln Gilang Ayu / Feri
Reynard Christian Sianturi 16-08-2022 Ret Taria / Richard Hariyono
Naura Zharifah Alnaira 01-07-2022 6 Bln Meylinda Sugi / Ahmad Sauqi
Hamid Ali Ardi 10-10-2022 3 Bln Rahma Kusuma Ayu / Koeswadi
Zainabila Ahmad 17-06-2022 7 Bln Siti Marlina / Ahmad Rifai
Muhammad Fahry 24-12-2022 18 Hr Feti Fateha / Dadi Subandi
Ainun Maryam Almahyra 02-07-21 18 Bln Fitra Sanjaya & Meyta Choiriyah
RR AYESTIA RAYNA 2-7-2021 18 Bln RATNAWATI/SHALITIN
Galih Estiawan 21-12-2022 15 hr Mufiatun / Mulyono

Muhammad Syafiq Valevi 03-11-2022 2 Bln Malia / M. Rizky Saputra
Aini Zea Arafah 24-10-2022 2 Bln Junaeni / Samto
Refalina Almayhira 29-08-2022 4 Bln Restu / Febri Ramadhan
Distiya Aliqa Putri 18-09-2022 4 Bln Riska Oktavia / Rohali
Ruri Sepriani / Roma Hadi Tri
Raeya Rima Azzahra 01-07-2022 5 Bln
Susanto
Naura Asyifa Khaswari / Windu
Naura Asyifa Khaswari 04-11-2022 2 Bln
Pamungkas
Rafif Alfarizi 25-08-2022 3 Bln Vera / Mulyadi
Muhammad Abizar Albirru 26-07-2022 5 Bln Erawati / M. Yasin
Winda Selly Septiana / Michel
Michelin Areta Saduk 26-08-2022 3.5 Bl
Victor
Samala Augustina 07-08-2022 5 Bln Okvi / Gunawam Saputra
Ghilman Dzuhairi 28-10-2022 2 Bln Erma Fitri / M Samsul
FEBRY INDRA / ANGGER
RASYA ELENO RAYYANZA 19-2-22 10 Bln
PAMUNGKAS
Hapsa Fadiah Maulida 24-10-2022 2 Bln Zauzatus Soliha / Rizal
KHALID ANANDA 16-3-22 10 BlnSRI APRIDA / HADI
Akbar Reska N 28-4-22 8 Bln Siti Aminah/Ahmad
Muhammad Ghani Wiratama 25-08-2022 4 Bln Rahayu Puji Astuti / Rafli Adi
11
Haidar Raziq Firmansyah 2/2/2022 Ade Irma Wati / Tedi Firmansyah
Bln
Samuel Sitorus 28-09-2022 3 Bln Lastaria / Budi
10
Muhammad Kautsar Razky 25/02/2022 Siti Nuristysna / Diky Sardini
Bln
Natanael Sianipar 13-06-21 18 Bln Riris Sihotang / Jonatan Sianipar
Ahmad Sauqi Al Fahriji 19-08-2022 4 Bln Khaerunisa / Ilham Tri Cahyo
Zephyrus Azzahir Sampurno 09/12/2022 1 Bln Shinta Setya Putri / Zulfikar Ali Akb
Raffa Shawqi Subhi 04/12/2022 1 Bln Hany Wulandari / Abdul Salam
Ervina Bunga Destian 01/12/2022 1 Bln Eis Siti Jubaidah / Cecep Septian
M. Hideo Al-Hanan Putra 01/12/2022 1 Bln Huswatun Hasanah / Irwansyah
Samantha Bryna Butar-butar 21/11/2022 2 Bln Yulianti / Binsar
Muhammad Alwi 08/12/2022 1 Bln Atikah / Ahas Ruddin
Ahmad Syahqir Desifa 06/12/2022 1 Bln Suci . Tabroni
Elvania Shareen Adhani 06/12/2022 1 Bln Anim / Suryadi
Qiana Nafeeza K. An 29-09-2022 4 Bln Eka / Bayu Laksono
Oktia Aisyah Putri Maggeti 05-10-2022 3 Bln Nina Delina / Tarmidi
Muhammad Lutfar Faaz -06-12-2022 7 Bln Nadira Aliya / Bahrul Ulum
Qalesyaava Kinarian 25-9-22 2.5 Bl Qurrotu Aini / Agus Kurniawan
Yasmin Khodijah Akbar 29-9-2022 3 Bln Yasmin Khodijah Akbar
Nafisa Aura Putri 23-09-2022 3 Bln Femi / Idris
Putri Rahmawati / Ardiansyah Ath
Arlisya Elshanum Haafizhah 09-12-2022 1 Bln
Thoriqy
Hartanu Sundi Harjo 31-10-2022 2 Bln Nurhasanah / TEguh Puji
Gaffi Zayn Alfarezel 01-09-2022 3 Bln Nurmawati / Anggi Wibi
Humaira Farwah 02-09-2022 4 Bln Dewi Kurnia Fahmi / Fahmi
Emira Khanza 9-12-22 1 Bln Rina M / Adrian
Ahmad Syafiq 07-12-2022 1 Bln Nur Azijah /Rio Kamandanu
Syahmi 4-12-22 1 Bln Sumiyati / Wagiman
Shakira Rasika 11-08-22 5 Bln Astin Fitria / Hakul Imam
Shahia Ayuna Nitami 05-10-2022 3 Bln Hana Febri / Abdul Zalgafur
Magdalena Sajar / Refky
Khaliqa Putri Ekina 5-12-22 1 Bln
Darmawan
Muhammad Nazim Haqqani 05-10-2022 3 Bln Citra / Iksan
Muhammad Rifki 24-12-2022 17 Hr Kotrunnada / Niko
Lailatul Fahira 07-04-2022 9 Bln Siti Nurul Janah / Abdul Latif
Baheera Qurrota Ayun Nigroho 5-1-2023 7 Hr Ashila / Dyan
Ahmad Rafaza 31-8-2022 5 bln Rizka / Yatno
Aralyne Sachikirani Mustangin 4-1-2023 8 hr Risma / Abdul Mustangin
By. Ny. Shinta 1 14-10-2022 3 Bln Shinta / Wahyu
Ayra Anindya Sanjaya 21-02-2022 11 BlnArifah Solehah / M Asep Sanjaya
Dzakira Zahra 19-05-2022 8 Bln Farhah / Badarudin
Abdan Alfatih 30-06-2022 7 Bln Ida Royani /Riska Yudistira
Naura zafina hidayat 2/14/2022 11 BlnAmanda saputri dan fandi alhidayat
Abila Kanaya Ramadhani 3-4-22 9 Bln Arikayani / Muhammad Afriadi
Dzakira Zahra 19-05-2022 8 Bln Farhah / Badarudin
Aliya Shakeela Zanitha 27-09-2022 4 Bln Ikit Pandan / Lukman Nulhakim
Zahra Nur Habibah 19-07-2022 5 Bln Juleha / Nurli
Zenia Asyifa Mecca 6/17/2021 19 BlnRahma&Syahrul
Muhammad Adib Al Muqid 6-1-23 10 hr Murtani /Muniroh
Darren Zio Maulana 9-1-23 8 hr Yasinta / Irsyad Ahmad

Akhtar Izqian 30-10-2022 3 Bln Ratinah / Agung Permana
Devanka Adi Alfareza 17-12-2022 1 Bln Murniyanti / Bagus
Evano Ersya Ravindro 5-1-23 11 hr Inda Inasya / Erwin Susanto
Inayah Salsabila 24-11-2022 2 Bln Alpiyah / Adi Ardiansyah
Ahmad Lutfi Ardianzah 08-11-2022 2 Bln Sriyanti / Tumiran
Eva Gwynet Faomasi Zega 12-12-22 1 Bln Hanifah / Jhini Mart Temani Zega
Khadijah Haura 28-11-2022 2 Bln Mustantifah / Zeki Zulkarnain
Arshaka Zayyan Diandra 6-1-23 11 Hr Diah Ayu M / Hendrawati
Shaquille Elzhan Davindra 05-11-2022 2 Bln Susi Purwanti / Mileh Santoso
Maudy Ahzara 17-10-22 3 Bln Leli / Dody
Felicia Adriella Hasibuan 13-11-2022 2 Bln Sutriani / Judea Rikson Hasibuan
Haura Yumna Fatimah 19-7-22 Lestari / M Sugandi
Alhanan Abyan. H 16-09-2022 4 Bln Pepi Saputri / Herman
Jennaira Laiba Kurniawan 07-8-2022 5 Bln Dita Iswara / Kurniawan
Khalisa Nur Aulia 13-08-2022 5 Bln Linda Sari / m. Busro
Ahmad Abyan Pratama 13-12-2022 1 Bln Puji Kurniati / Ahmad Fadli R
Salma Nafisah 8-8-22 5 Bln Nurul Azimah / Abdul Rahman
Carlos Tamaro Tefa 22-06-2022 7 Bln Dhyan Santalina / Alfrif Tefa
Salsabila Nur Rahma 17-12-2022 1 Bln Mila Arum Listiani / Rahmadhani
Nabila Harani 15-07-2022 4 Bln Rani Triana / Cahardi
Arshaka Virendra Shafwan 08-11-2022 2 Bln Dewi / Rudi
Ellena Oinke 12-1-2023 7 Hr Christine / Yaaro Ha
Haidar Maulana 02-11-2022 2 Bln Nurjanah / Echo Ujisucipto

Rayna Humaira Hadi 4-10-2022 3 Bln Lia Oktaviani / Lesmana
Kikanaya Hana Prasetyo 13-10-2022 3 Bln Ari Oktaviani / Yogi Prasetyo
Tavisha Kichi Alfigie 12/9/2021 13 BlnAsih Legiva / Fianda
Melisa Chrisdayanti / Belly
Audy Blesiannna Claire Hutaba 09-10-2022 3 Bln
Nomora Hutabarat
Aaliyah Noora Maryam 3/11/2022 10 BlnAna Miftahul / Saddi
Claudia Liasta 10-10-2022 3 Bln Eli Susanti BR / Ulung Armada
Fikri Al Dzaky 21-09-2022 4 Bln Mardiana / Pupung Purwadi
Kirani Swastika Edelweis 3-9-22 4 Bln Nunuk / Gilang
Nafeez Zavier Mumtadz 06-09-2022 4 Bln Dian Novita Sari / Nana Yulistiana
Leonzio Orlando Silalahi 1-8-22 5 Bln Deviana / Kevin
16
Ananda Timbul Jordan 27/09/2021 Dame Latsiur / Roruld
Bln Fathul Khafidz & Rahayu Sri
Fredella Myesha Alkhafidz 27-11-20 26 Bln
Kurniawati
Alfatih Danindra 02-09-2022 4 Bln Kani / Gilang
Kenzie Raffiansyah Ahmad 10-10-2022 3 Bln Siti Nurlaila / Ahmad Zulfikli
Muhammad Rais Ghifary 12/11/2022 2 Bln Rahmi / Abd. Rofi
Reiga Ammar Ghani 15-07-2022 6 Bln Ratna Sari / Suwantoro
Rabbani Ahza Mavandra 11/16/2022 2 Bln Arum Rahmawati /Fendi Setiawan
Muhammad Zayn Alfarizi 4/6/2022 9 Bln Sartika Dewi Dan Eko Prasetio
Naura Apriliansyah 4/14/2022 9 Bln Devi Lestiawati / Rudianysah
Akbar Razaqa Nur Daffa 13-06-2022 7 Bln Gisa Fitriani / Slamet Wahyudi
Adzkiya Shakila Putri 04-09-2022 4 Bln Eka Susanti / arisman
ANANDa PUTRI 11-3-22 11 BlnTITIN /KURTUBIN
Felix Timothi 16-09-2022 4 Bln Erika Lestari / Lasman Sitanggang
Norma Dharmasari / Moh Ali
Rafael Davin Amandeo 14-11-2022 2 Bln
Sadam
Mikail Kaili 15-10-2022 3 Bln Puja Melati / As'ad TR
18
Javas Raynar 7/14/2021 Kharina / Joni
Bln
Shafiyyah Naureen K 21-11-22 2 Bln Martsya / Mohamad Ryzky K
Fauzan Alfarizqi 12/15/2022 1 Bln Siti Jamilah / Iim Sahidin
M. Fahri Subandi 24-12-22 1 bln Feti Fatiha / Dadi Subandi
Radevan Alfarizi 21-10-2022 3 Bln Reta / Agus Hermawan
Kayla Rahma Azis 11-7-2022 6 Bln Maryanti / Abdul
19
Arumi Nasya Salsabila 11-06-2021 Leni Marlina / Rajudin Ibar
Bln
Abil Shidqi Arshalan 10-10-2022 3 Bln Alifah / Galang
Almira Nur Rahmah 04-10-2022 3 Bln Linda/Jamal
Adriella Zevanya Siagian 13-09-2022 4 Bln Amelia Yesika / Albert
Muhammad Rifki 24-12-2022 1 Bln Kotrunnada / Niko
Zavier Gaffi Azhra Azizayn 04-09-22 4 Bln Ghesti Wahyu / Rahmat Sri Aji
Galih Estiawan 21-12-2022 1 Bln Mufiatun / Mulyono
Elora Yosefa Purba 26-09-2022 4 Bln Esta / Rinaldi
Reviana Ameira Saputri 04-09-2022 4 Bln Evi Septiani / Ridwan Saputra
Mafaza Afsheen El Daneen 18-10-2022 3 Bln Aulia M. E I / Eko Susanto
Rayana Khoiruna 14-09-2022 4 Bln ;iddini Hanifah / Ajut Sudrajat
Muhamad Kenzie Atharrazka 22-10-22 3 Bln Mudih Afifah / Sahrul Anwar
Albi Arbani 1-8-22 5 Bln Nur Fauziah / Bani Adam
Inggil Jayantaka restu Trahjani 24-04-2022 9 Bln Erni / Jalu R Wisuda
Rivano Noviana Ibrahim 30-06-2021 19 Bln Prapti Handayani / Wahto
M. Hafidz Ismail 5-1-2023 21 Hr Iif Ma'difah / Ooj Nurmusafah
Isma Dzaka Dzulhanan 30-07-2022 6 Bln Ina Reni / Alikhin

Sakha Athar Razka Saputra 17-01-2023 9 Hr Tuti Zulfawwati / Sandi Ari Sputra
Rasya Alhafidzan 12-10-2022 3 Bln Siti Nurlaila / Hafif
Alkalfi Zikri Mumiaz 19-11-2022 2 Bln Nuraini / Samsul
Khaira Jovita 04-07-2022 6 Bln Emma Ayu Lestari / Muhammad Qos

10
ANGKASA NIZAR 3/30/2022 SUERNI / AHMAD ZARKONI
bln
ELSA / SAUDI 29-8-22 5 Bln FEBRI / SAUDIN
Agus Diah Eka Lestari (ibu), Evan
Kaina Almahyra Bestari 4/12/2022 9 Bln
Sevditra (ayah)
Ahmad Kalanda Shaquil 15-11-2022 1 Bln Rilma Maulida Fitria / Jeffry
Satya Khoirul Basyar 15-09-2022 4 Bln Suryani / Slamet Permadi
Anindita Septi Salsabila 24-09-2022 4 Bln Istiqomah / Pandi
Hafiz Danish Muttaqin 07-11-2022 2 Bln Pusparini / Mashuri
4
NAZIEF ZAAHY 5-9-22 OPIANTI / HAMIDAN
BLN Jeni Sentani Lingga / dr. Yudhi
Keenara Arceline H 3/6/2022 10 Bln
Andreas
Rumaisha Zalindra 18-11-2022 2 Bln Nuarika / Nurul Fadilah
Syakila Nur Aisha 24-12-21 13 BlnNidaul Husna/Nur Ramadhan
4
FAIREL AFNAN ATHARAZ 22-9-22 BLN
WINDARI / DADANG
CHOIZIAH NUR 22-3-22 10 BlnNUR AINI/KHOSASH
PHUTRY ALICE ARSYILA 11--11-22 2 Bln LAILATUL / ABDUL
Innara Khalisa Wijaya 14-4-22 9 Bln Nadiawati /Randi
ahmad afzal alman koto 2-4-2020 33 rio & indah
bLN Indah Maharani / Rio Paku
Alisa Fatharani 12-11-2021 14 Bln
Sodeno
Novita Mmelati / Jhonni
Juan Ramos Sipahutar 11-06-2022 18 Bln
Parlindungan Sipahutar
Khansa Almaira Putri Nugroho 11-11-2022 2 Bln Fatimah / Tomi Nugroho
Friska Syaquila 1/29/2023 1 Hr Siti Nadia Putri / Tarmiji Tahir
Sakha Athar Razka Saputra 17-01-2023 13 hr Tuti Zulfawwati / Sandi Ari Sputra
M. Hafidz Al Hanan 1/26/2023 1 Hr Restu / Faisal
Desiya Andara Putri 23-12-2022 1 Bln Siti Juleha / M. Syahroni
Kaela Shakira 21-01-2023 10 Hr Marlinda / Irawan
Zayn Leo Pratama 28-12-2022 1 Bln Fitri Handayani / Leonardo
Attar Alfarizky 16-12-2022 1 Bln Marni / Ade Suherdi
Yasmin Falisha Almahira 13-12-2022 1 Bln Ajeng Sri / Solihin
Ahmad Defin Elfatih 19-10-2022 3 Bln Fabiejana / Ahmad FIrdaus
Raja zanthiago hottua sinambe 20-8-22 5 Bln Leris Mayani / Biston
Soerendro Anggoro Beryl 9/15/2022 4 Bln Desy Marwati / Sugandi
Putri Ayu Elisa Beth / Slamet
Gavin Siregar 22-11-2022 2 Bln
Siregar
HASIL PEMERIKSAAN TATALAKSANA
ALAMAT NO HP BB PB/TB LK
SH KN IMUNISASI
(Kg) (Cm) (Cm)
kp. Buaran 02/02 089637441598 5.1 56.0 37.0 36.6 BCG

Gempol 14/01 089668222197 4.1 51.0 36.5 36.5 BCG, POLIO1
DPT1, POLIO2,
Kayu Tinggi 04/04 5.5 51.0 39.0 36.5
PCV1
Pulo Gebang 01/05 085172009223 4.1 54.0 35.0 36.5 BCG
Kayu Tinggi 07/03 083826745027 2.8 49.5 32 36.5 3
Kayu Tinggi 12/09 08812583164 4.1 56.5 38.5 36.5 BCG
Kayu Tinggi 03/09 081210990274 2.8 47 36 36.5 3
Metland UM 082226661464 10 77 45 36.7 Booster DPT
Kayu Tinggi 13/06 0857436629267 5.4 55 39 36.7 BCG dan Polio1
DPT2, Polio3 dan
Cempaka 6/9 081314114295 7 63 44 36.7
PCV2
Gempol 06/01 085890370779 1.3 6 42 36.5 IPV
DPT1, POLIO2,
Kayu Tinggi 13/06 087830235551 4.4 57.3 38 36.5
PCV1
Jl. Kayu Tinggi 3/4 0895602666500 5.5 58 41 36.5 DPT3, POLIIO4, IPV
KP. Buaran 2/02 85710958382 3.4 51 33 36.5 3 51
Jl.Tanjakan Auri RT 011 87781436714
RW 001 no:11 10 79 44 36.5 BOOSTER DPT
KAYU TINGGI RT3/RW1 089621518998 BOOSTER DPT dan
9.8 76 45 36.5
BOOSTER MR
Kayu Tinggi 03/09 081210990274 2.8 47 36 36.5 3
DPT1, POLIO2,
Kayu Tinggi 12/06 89688741137 5.2 58 39 36.6
DPT1,PCV1
POLIO2,
Kayu Tinggi 10/09 085811227680 5 58.5 40 36
PCV1
Kayu Tinggi 04/09 089667319424 6.2 60.5 41 36.5 DPT3, POLIO4, IPV
DPT2, POLIO3,
Kp. Buaran 12/02 083899157496 6.1 61 40 36.5
PCV2
Rusunawa UM 05/08 8.3 67 41.5 36.5 IPV
DPT1, POLIO2,
Kayu Tinggi 8/6 08822382617 5.7 558.5 39 36.5
PCV1
Buaran 06/02 0857171278842 7.7 66 43 36.5 DPT3, POLIO4, IPV
Kayu Tinggi 03/11 081388760608 5.9 63 40 36.5 DPT3, POLIO4, IPV
Cempaka 05/09 082284945138 8.6 68.3 44 36.5 DPT3, POLIO4, IPV
Bulak Indah 10/05 5.5 64.5 41 36.5 MR, IPV2
DPT2, POLIO3,
Kayu Tinggi 09/02 083890836261 5.7 55 39 36.5
PCV1
BUARAN RT1/2 08988355983 7.3 67 46 36.5 MR, IPV2
DPT1, POLIO2,
Tambun Selatan 5/8 0895330322576 5.7 55.5 39.5 36.5
PCV1
KAYU TINGGI RT8/RW4087784020189 8.5 67.5 44 36.5 MR, IPV2
Kayu Tinggi Rt6/Rw11 087877195013 7.5 66 44 36.5 DPT3, POLIO4, IPV
Kayu Tinggi 8/4 081320457024 7.1 63.5 42.4 36.5 DPT3, POLIO4, IPV
Kp.Buaran Rt.012/002 085719551959 9.2 69 46 36.5 MR, IPV2
DPT1, POLIO2,
Kayu Tinggi 04/05 081211826981 6.4 62 42 36.5
PCV1
Balai Rakyat 08/04 087760254545 7.9 7 44 36.5 MR
Bulak Indah 4/5 082213201859 10 82.9 49 36.5 BOOSTER DPT
DPT2, POLIO3,
Bulak Indah 104/05 087741361573 8.1 56.6 43 36.5
PCV2
Kandang sapi 04/06 89688865484 4.7 55.6 39 36.5 BCG
Bulak Indah 03/12 087787588278 3.1 51.8 37.2 36.5 BCG
KP. Buaran 13/02 083812542988 4.4 53 37 36.5 BCG
Kayu Tinggi 08/05 081290591903 5 58 38 36.5 BCG
Gempol 14/01 082122588657 5.8 53 37 36.5 BCG, POLIO1
R. Makmur 01/10 081313135172 3.9 52 35 36.5 BCG
Kayu Tinggi 07/04 081219286349 5.8 53.5 35 36.6 BCG, POLIO1
Kayu Tinggi 02/11 081384685330 5.4 54 36 36.5 BCG, POLIO1
DPT2, POLIO3,
Gempol 14/01 081283232297 7 59 40 36.5
DPT2,PCV2
POLIO3,
Ujung Menteng 08/12 089530841496 5 60.5 39 36.5
PCV2
Kandang Sapi 02/06 081293197716 4.6 55 37 36.5 BCG, POLIO1
DPT2, POLIO3,
Gempol 13/01 085156121185 5.6 61 39 36.5
DPT2,PCV2
POLIO3,
Kp. Buaran 9/2 081282017567 7.6\ 61 41 36.5
PCV2
DPT2, POLIO3,
Kayu Tinggi 09/11 085788317928 5.5 59.3 40 36.6
PCV2
Kayu Tinggi 11/01 87719027768 4.1 55 37.5 36.5 BCG
DPT1, POLIO2,
Cempaka 08/09 85889292713 7 60 41 36.5
DPT2,PCV1
POLIO3,
Kayu Tinggi 05/03 081380339958 5.6 58 40 36.5
PCV2
Gempol 08/01 0895606709007 6.1 62 40.5 36.5 DPT3, POLIO4, IPV
Buaran 03/02 85717792243 4.6 54 38 36.5 BCG
KP. Gempol 13/01 #FMT 5.1 53 38 36.5 BCG
Rorotan 4/7 0878420565560 6.9 61.5 41 36.5 DPT3, POLIO4, IPV
DPT2, POLIO3,
Kayu Tinggi 3/9 082110965870 4.8 57 40.5 36.5
PCV1
Pagar Jati 15/01 #FMT 4.1 53 35.5 36.5 BCG, POLIO1
DPT1, POLIO2,
Kayu Tinggi 6/11 087850784168 5.1 59.5 39.5 36.5
PCV1
KandangSapi 4/6 3.8 54 34 36.5
Kayu Tinggi 08/04 83874589250 7.7 66 44 36.5 IPV2, MR
Bulak Indah 6/12 087730530780 3.7 51.7 35 36.5 2
DPT2, Polio3 dan
Kayu Tinggi 8/4 082155483657 6.5 61.5 41 36.5
PCV1
Kayu Tinggi 10/09 085799322311 3.1 48 36 36.6 3
DPT1, POLIO2,
Kayu Tinggi 3/6 088809346979 4.7 55 38 36.6
DPT1,PCV1
POLIO2,
Kayu Tinggi 3/6 088809346979 4.4 53 39 36.5
PCV1
Gempol 10/01 0895321822977 7.5 68.5 43 36.5 IPV2, MR
DPT3, POLIO4,
Gempol 11/01 081281913631 8.1 65 43 36.5
PCV2
Kayu Tinggi Rt2/Rw4 087864541933 8 69 43 36.5 DPT3, POLIO4, IPV
004/013,cakung timur 081266611313 6.7 83 42 36.5 DPT2, POLIO3
Kayu Tinggi 7/6 085710760325 6.3 66.3 43 36.7 MR, IPV2
DPT3, POLIO4,
Gempol 11/01 081281913631 8.1 65 43 36.7
PCV2
DPT2, Polio3 dan
Kayu Tinggi 5/12 083872610780 6.2 61 41 36.7
DPT3,PCV2
Polio4 dan
Bulak Indah 5/12 089629901463 6 62 41 36.7
Jl Dahlia 10 No 94 IPV
Rt011 Rw005 Cakung 085697584414 10 82 49 36.7 Booster DPT
Timur
Tambun Rengas Rt.02/07

081384337703 4.2 55 37 36.7 3
Buaran 01/02 081212542529 3.2 49 38 36.7 3

Gempol 04/01 087838089851 5.7 62 38 36.7 BCG dan Polio1
Gempol 1/1 088293361343 4.3 53 37 36.7 BCG
Kayu Tinggi 3/5 085715201742 3.7 52 35.5 36.7 3
Kayu Tinggi 7/4 089791120961 5 53 38 36.7 BCG dan Polio1
DPT1, POLIO2,
Gempol 14/01 081288060577 6.3 60.5 43 36.7
PCV1
Kayu Tinggi 9/2 088289889838 3.7 56.2 37 36.7 BCG
Kayu Tinggi 1/9 088299528567 3.7 50.5 37 36.6 BCG dan Polio1
Kp. Buaran 6/2 08788433048 3.7 50 37 36.6 3
DPT1, Polio2 dan
Bulak Indah 9/12 081314901449 5.3 56.5 38 36.7
DPT1,PCV1
Polio2 dan
Kayu Tinggi 7/9 081297360076 6 56 39 36.7
PCV1
DPT1, Polio2 dan
Kayu Tinggi 4/9 081310362478 5 57.5 39 36.7
PCV1
DPT3, POLIO4,
Pulogebang 13/04 083836784987 9.5 70 46 39.6
PCV2
Gempol 11/01 4.5 60.5 40 36.5 BCG
Kt 07/09 081293404015 7.2 66.2 42 36.5 DPT3, POLIO4, IPV
DPT1, Polio2 dan
Gempol 13/01 82125695492 5.1 57.3 38 36.6
PCV1
Bulak Indah 05/05 895619114506 4 54 35 36.5 BCG
Kayu Tinggi 11/09 088210035117 5.5 52 39 36.5 DPT3, POLIO4, IPV
Kp. Buaran 03/02 081281876221 8.3 71 40 36.6 DPT3, Polio4, IPV
Kayu Tinggi 07/03 083826745027 3.6 52 35.5 36.5 BCG
Jl. Kayu Tinggi 10/09 5.5 63 41.9 36.5 DPT3, POLIO4, IPV
DPT1, Polio2 dan
Kayu Tinggi 02/03 821219322260 4.4 59.5 41 36.5
PCV1
JGC 14/14 81218901917 3.8 51 37 36.5 2
DPT1, Polio2 dan
Kayu Tinggi 02/03 85156905916 5.9 58 41 36.5
PCV1
Tambun Rengas 06/07 87770488675 5.5 82 39 36.5 DPT1, Polio2, PCV2
DPT2, POLIO3,
Kayu Tinggi 3/12 085889835010 4.7 57.3 41 36.5
PCV2
Ujung Menteng 08/02 087880906829 9.1 73.4 46 36.5 DPT3, Polio4, IPV1
DPT2, POLIO3,
Perum Metland 081284455251 6.2 58 41 36.5
PCV2
Gempol 11/01 081327111609 8 73 46 36.5 MR, IPV2
DPT2, POLIO3,
Taman Modern 16/6 84281223265 5.6 58 40 336.5
PCV2
DPT2, POLIO3,
Kayu Tinggi 9/3 081806468954 5.5 59.2 41 36.4
PCV2
Kayu Tinggi 1/5 081932948912 6.6 60.5 41 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi 08/04 088291474033 7.5 66 42 36.5 DPT3, POLIO4, IPV1
Kayu Tingi 081224194686 8 87 44 36.5 IPV1
Kayu Tinggi 09/11 081317006631 14 80 47 36.5 MR
Kayu Tinggi gg Melon Rt
085715627920 10 82 46 36.5 BOOSTER DPT
01 Rw 09
Kayu Tinggi 9/11 083891318266 8 63 43 36.5 DPT3, POLIO4, IPV1
DPT2, POLIO3,
Tambun Rengas 9/7 089653404927 6.1 58.7 39 36.5
PCV2
Gagar Jati 15/01 82211484950 5 59 39 36.5 DPT1, Polio2, PCV1
Tanjakan Auri 10/01 8 70.5 40 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi
Jl Waru Raya06/04
Rt 002 85211554337 6.1 55 40 36.5 DPT1, Polio2, PCV1
Rw 009 Kelurahan 085705062731 8.8 67.3 42 36.5 MR, IPV2
Cakung
Kayu Timur
Tinggi 5/3 088224946513 6.7 69 44 36.5 MR, IPV2
Jl. Komarudin 05/03 089630293256 8.1 71 44 36.5 IPV
Garuda 13/06 08 5.1 60 38.3 36.5 DPT3, POLIO4, IPV1
TAMBUN SELATAN RT11/RW5 7.1 68.3 43 36.5 MR, IPV2
DPT2, POLIO3,
Kayu Tinggi 03/09 081390721322 6.9 63.7 42 36.5
PCV2
Gempol 04/01 089630673930 5.9 60 41 36.5 DPT1, Polio2, PCV1
Bulak Indah 08/05' 7.8 64 41 36.5 DPT1, Polio2, PCV1
Kayu Tinggi 02/09 085351209685 10 77.3 47 36.5 BOOSTER DPT
Swadaya 12/1 81379328075 5.3 5 39 36.4 BCG, POLIO1
Gempol 03/01 895321747201 4.1 54 38.5 36.5 4 BCG
KP. Buaran 02/02 87510958382 4.3 54 38 36.5 4 BCG
Tambun Rengas DPT2, POLIO3,
0896704140401 6.6 60 41.5 36.5
04/07 PCV2
Tambun Selatan 07/08 089888033868 7.4 63 40 36.5 DPT1, Polio2, PCV1
Kayu Tinggi 10/05 089604576693 10 78 45 36.5 DPT2, POLIO3
DPT2, POLIO3,
Kayu Tinggi 9/3 89652897328 6.9 65 41 36.5
PCV2
DPT2, POLIO3,
Gempol RT9/RW1 089531759948 6.1 64 41 36.5
PCV2
Pagar Jati 15/01 087869112535 7.4 65 41 36.5 DPT3, POLIO4, IPV1
KandangSapi 4/6 08 4.4 53.5 37 36.6 4 BCG, POLIO1
Kayu Tinggi 04/03 085778711769 8.1 68 40.5 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi 03/09 081210990274 3.4 49 34 36.5 4 BCG, POLIO1
DPT2, POLIO3,
Bulak indah 04/05 081291157455 5.8 59 40 36.5
PCV2
Kayu Tinggi 043/04 089694070952 6.1 63.5 41.5 36.5 DPT3, POLIO4, IPV1
DPT2, POLIO3,
Kayu Tinggi 05/04 081398854433 5.7 61 40 36.5
PCV2
DPT2, POLIO3,
Buaran 05/02 087770115303 4.5 56 37.5 36.5
PCV2
DPT2, POLIO3,
Pagar Jati 05/01 081286980847 6.3 60 40 36.5
PCV2
Kayu Tinggi 03/12 089647122170 7.5 64 43.5 36.5 DPT3, IPV
Taman Pulogebang 04/0381335534378 7.8 69.7 44 36.5 MR
BOOSTER DPT,
Gempol 12/01 85770581104 8.2 80 46 36.5
BOOSTER MR
Kayu Tinggi 01/09 89637524139 3.6 51.5 37 36.5 3
Gempol 2/11 81398264526 7.1 65.3 41 36.5 IPV1, PCV1

Rorotan 05/10 89611615744 3.2 49.3 33 36.5 3
Kayu Tinggi 04/03 89630807992 5.7 60.5 40.5 36.5 DPT1, Polio2, PCV1
Buaran 04/02 81286888651 5.1 54.5 38.5 36.6 DPT1, Polio2, PCV1
Kayu Tinggi 7/5 082260732498 7.8 65 44 36.5 PCV2
GEMPOL RT9/RW1 081905977768 8.7 72 43 36.5 IPV2, MR

DPT2, POLIO3,
KAYU TINGGI RT8/RW0815920597 5.7 58 40 36.5
PCV2
005/009, kel cakung
081242243274 8.1 69 41 36.5 IPV2, MR
timur
Kayu Tinggi 7/9 085884008798 5.5 57.5 39 36.5 DPT1, Polio2, PCV1
Gempol 09/01 081585014275 8 63 42 36.5 DPT3, POLIO4, IPV1
Tambun Selatan 03/080895321022553 4.7 59.5 40 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi 02/03 815133685855 6 59 39 36.5 DPT1, Polio2, PCV1
JL MERPATI RT9/RW508984419093 7 63.5 41 36.5 DPT3, POLIO4, IPV1
JGC Cluster Zebrina
08113851992 8.5 66 43 36.5 IPV2, MR
No.326
Kayu Tinggi 1/11 085159477739 5 55 39 36.5 DPT1, Polio2, PCV1
Gempol 8/1 0895802934646 9.4 72.3 46 36.5 MR
BUARAN RT10
089609914502 7.5 63 41 36.5 DPT3, POLIO4, IPV1
/RW2
BUARAN RT6/RW2 085694824850 7.8 69 43 36.5 IPV2, MR
BULAK INDAH RT2/R 089694644297 4.8 56 40 36.5 DPT1, Polio2, PCV1
Kayu Tinggi
081219271665 7.6 69 44 36.5 IPV2, MR
Rt2/Rw12
jl komarudin kp buaran BOOSTER DPT,
#FMT 15 95 47 36.5
no 138 rt 10/02 BOOSTER MR
KP. Buaran no 10/02 89687889873 9 95 44 36.5 DPT1, POLIO2
BOOSTER DPT,
Kayu Tinggi 9/3 082164026938 10 73 46 36.4
BOOSTER MR
Kayu Tinggi 09/11 89609942490 5.1 57.3 38 36.5 DPT1, Polio2, PCV1
Tambun Rengas 06/07 89604702510 3.3 47.5 35 36.5 1 HB0
Rorotan 05/10 89611615744 3.2 49.3 33 36.5 3
Kayu Tinggi 04/09 81367972434 3.3 50 34 36.5 1 HB0
Tambun Selatan 01/08 89637269304 4.2 54 36 36.5 BCG
Perdana 06/12 81319571239 3.3 47 35 36.5 3
Buaran 12/02 8989079751 4 52 35 36.4 4 BCG
Kayu tINGGI 2/4 4.9 54 36 36.5 BCG, POLIO1
Dahlia 11/5 81380600500 5 56 36 36.5 BCG, POLIO1
DPT2, POLIO3,
Gempol 10/01 5.7 57 39 36.5
PCV2
Kt 06/03 081311452348 7.2 69.6 43 36.5 DPT3, POLIO4, IPV
DPT2, POLIO3,
Kayu Tinggi 07/06 89635602721 10 69 45 36.5
PCV2
DPT1, POLIO2,
Kayu Tinggi 1/5 082370180179 4.1 54 38 36.5
PCV1
KETEPATAN
LAKSANA
WAKTU IMUNISASI
OBS PASCA JADWAL
IC TIDAK SUNTIK 15 KEMBALI TEMPAT
SDIDTK TEPAT MENIT IMUNISASI BBL (Kg)
TEPAT LAHIR
V V V 2-2-2023
V V V 2-2-2023
V V V 2-2-2023
V V V 02-02-2023
RSIA Resti
17-1-2023 2.6
Mulya
V V V 02-02-2023
24-1-2023 BPM 2700
DS : 10 V V V LENGKAP
V V V 02-02-2023
V V 02-02-2023
DS : 10 V V 06-04-2023
V V 02-02-2023
V V 16-3-2023
24-01-2023 RSIA Resti Muly 3300
DS : 10 V V Lengkap
DS = 10 V V Lengkap
24-1-2023 2700
V V 07-02-2023
V V 07-02-2023
V V 07-02-2023
V V 07-02-2023
V V
V V 07-02-2023
V V
V V
V V
V V
V V 07-02-2023
V V
V V 07-02-2023
V V
V V
V V
V V
V V
V V
DS = 10 V V Lengkap
V V 07-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
V V 09-02-2023
RS. Islam
V V 3.6
Sukapura
DS = 10 V V
07-02-2023 RS Kartika 3970
v v 14-02-2023
07-02-2023 RS. Firdaus 3255
V V 14-02-2023
V V 14-02-2023
V V 21-2-2023
V V 23-2-2023
V V 30-3-2023
V V 14-02-2023
DS=10 V V 18 Bln
V V 23-2-2023
V V 14-02-2023
V V 18 bln
V V lengkap
RSKD Duren
7-4-2023 4200
Sawit
14-2-2023 RS Resti Mulya 3040

V V V 16-2-2023
V V V 16-2-2023
V V 7-2-2023 RS Resti Mulya 3250
V V V 6-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V V 7-2-2023 RS Resti Mulya 3620
V V V 16-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V V
V V V 16-2-2023
V V V 16-2-2023
V V V 16-2-2023
V V v 16-2-2023
V V V 16-2-2023
V V V 14-4-2023
V
V 14-4-2023 RSIA Resti 3.8
V
V V V 21-2-2023
V V V 21-2-2023
V V 19-1-2024
V V 21-2-2023
V V
V V 21-2-2023
V V 21-2-2023
V V
V V
V V
V V 19-2-2024
V V LENGKAP
V V
V V 21-2-2023
V V
DS = 10 V V
V V 21-2-2023
DS = 10 V V
DS = 10 V V
V V
V V
V V
V V
V V 21-2-2023
V V 21-2-2023
DS = 10 V V LENGKAP
V V V 23-2-2023
V V V 23-2-2023
V V V 23-2-2023
V V 23-2-2023
DS = 10 V V 23-2-2023
V V 23-2-2023
V V 23-2-2023
V V 23-2-2023
V V
V V 23-2-2023
V V
V V 23-2-2023
V V 23-2-2023
V V
V V 23-2-2023
V V 23-2-2023
V V 23-2-2023
V V
DS = 10 V
V LENGKAP
, RS Firdaus 3.4
DS = 10 V 28-2-2023
pkc cakung 2.8
V 28-2-2023
V 28-2-2023
DS = 10 V 28-2-2023
V 28-2-2023
DS = 10 V
V 28-2-2023
V
V
V 28-2-2023
V
V
V 28-2-2023
V
V
V 28-2-2023
V
DS = 10 V
V LENGKAP
V 28-2-2023
DS = 10 V LENGKAP
V 09-02-2023 PMB Surki 3.5

pkc cakung 2.8
V 09-02-2023 PMB Surki 3.2
V 02-03-2023
RS Islam
V 21-02-2023 3.2
Sukapura
V 02-03-2023
V 02-03-2023
V 02-03-2023
V 02-03-2023
V
V 02-03-2023
V 02-03-2023
0
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
SEHAT TETANUS TALI PUSAT
DJB (x/mnt) RR (x/mnt) SHK BELUM
YA TIDAK YA TIDAK PUPUT
PUPUT
120 40 YA YA
120 38 YA YA
132 40 ya ya ya
138 41 ya ya ya
v
235 40 v v v
132 41 v v v
143 40 v v v
132 41 V V V
138 41 V V V
132 40 V V V
132 40 V V V
120 40 V V V
120 40 V V V
120 40 V V V
120 40 V V V
120 40 V V V
120 39 V V V
120 40 V V V
RUJUK PENILAIAN YANKES
PENCEG
AHAN
RESIKO KIE TATA SESUAI
DIAGNOSA BAYI POLI MTBS POLI GIZI
NILAI SOP
JATUH
V V V V
V V V V
V V V V
V V V V
NCB SMK Usia
V V V V
14 hr KN3
V V V V
NCB SMK Usia
V V V V
13 hr KN3
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
NCB SMK KN3
V V V V
usia 13 hr
V V V V
V V V V
15 hr dengan
ikterik kramer 1, V V V V
rujuk rs islam V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
NCB SMK KN3 V V V V
V V V V
NCB SMK KN2 V V V V
V V V V
NCB SMK KN3 V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
By. M usia 10
hr, NCB SMK V V V V
KN3
By. D usia 8 hr,
V V V V
NCB SMK KN3
V V V V
V V V V
By. D usia 11 hr,
V V V V
NCB SMK KN3
V V V V
V V V V
V V V V
V V V V
NCB SMK KN3
V V V V
dengan Ikterus
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
By. E usia 7 hr,
V V V V
NCB SMK KN3
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V V
V V V V
By. m usia 21
hr, NCB SMK V V V V
KN3
V V V V
By. E usia 9 hr,
NCB SMK KN3
V V V V
dengan oral
trush
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
By. m usia 1 hr,
V V V V
NCB
NCB SMK
SMK KN2
KN3
V V V V
dengan oral
By. m usia 1 hr,
V V V V
NCB SMK KN2
V V V V
By. k usia 10 hr,
V V V V
NCB SMK KN3
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V V
PENILAIAN YANKES
HB0 (0<7 HR) BCG
CUCI KET
APD
TANGAN
L P L P
V V 1
V V 1
V V
V V 1
V V
V V 1
V V
V V
V V 1
V V
V V
V V
V V
V V
V V
V V
IKterik usia
V V 15 Hari,
V V Rujuk RS
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V 1
V V 1
V V 1
V V 1
V V 1
V V 1
V V 1
V V 1
V V
V V
V V 1
V V
V V
V V
V V 1
V V
V V
V V
V V 1
V V 1
V V 1
V V
V V
V V 1
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V 1
V V 1
V V
V V 1
V V
V V 1
V V 1
V V
V V
V V
V V
V V
V V 1
V V
V V
V V 1
V V
V V
V V 1
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V 1
V V 1
V V 1
V V
V V
V V
V V
V V
V V
V V 1
V V
V V 1
V V
V V
V V
V V
V V
V V
V V Dermatitits
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V Gizi Kurus
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V 1
V V
V V 1
V V 1
V V
V V 1
V V 1 1
V V
V V
V V
V V
V V GIZI KURUS
1 1 21 15
DPT/HB (1) DPT/HB (2) DPT/HB (3) POLIO 1
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
18 16 10 19 17 17 7
Tanggal Pemberian Imunisasi
POLIO 1 POLIO2 POLIO3 POLIO4
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
8 19 15 10 19 16 16
an Imunisasi
IPV 1 IPV 2 PCV 1 PCV 2
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
21 15 6 10 17 15 10
1
1
1
1
1
0 0 6
PCV 2 PCV 3 CAMPAK RUBELLA BOOSTER DPT
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
20 0 0 8 10 5 3
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7 9 7 4 9 6 10
BOOSTER CAMPAK
RUBELLA
L P
1
1
3 0 0 0 0 0 0
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2 3 9 7 4 9 6
0 0 0
1
1 1
1
1 1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1 1
1
1 1
1
1
1
1 1
1
1
1
1
1 1
1
1
1
9 9 6 2 6 8 6
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4 10 0 0 3 5 1
1
1 0 0
NO
JAMINAN
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BARU LAMA BPJS UMUM
1 02/02/2023 56/23 YA Ziya Arsyila Alfarizki
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4 319/21 YA Alesha Alifa Habatillah
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6 001/23 YA Boy Matthew Latumeten
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11 553/22 YA Abdul Malik Abbas
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20 3175064905220002 062/23 V Rabiza Zia Sakhi
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26 3175095310210001 068/23 V Satria Cahyo
27 3305122105220005 069/23 V Ibrahim Alfarizi
28 3175066207220005 070/23 V Abigail Liora Kathleen Gultom
29 464/22 v Aini Zea Arafah
30 023/23 V Aralyne Sachikirani Mustangi
31 024/23 V Muhammad Adib Al Muqid
32 044/23 V M. Hafidz Ismail
33 3175064411220003 486/22 V Naura Asyifa Khaswari
34 559/22 V Nayra Humaira Havva
35 455/22 V King Darel Alamsyah
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38 173/22 V Zulaikha Ramadhani
317506030821000
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41 013/23 V Muhammad Alwi

42 3175064612220007 015/23 V Elvania Shareen Adhani
43 3175060912220001 008/23 V Zephyrus Azzahir Sampurno
44 014/23 V Ahmad Syahqir Desifa
45 3175064510220001 017/23 V Oktia Aisyah Putri Maggeti
46 3.1750607122E+15 536/22 V Ahmad Syafiq
47 317506612220003 018/23 V Muhammad Lutfar Faaz
48 3175064512220013 532/22 V Khaliqa Putri Ekina
49 3175062009220011 386/22 V Dean Helbert H.
50 3175066309220007 522/22 V Nafisa Aura Putri
51 160/22 V Meyda Salsabilah
52 3175063110220002 506/22 V Hartanu Sundi Harjo
53 57/23 V Zanika Annika Ahmad
54 3526182103220001 326/22 V Muhammad Arsyad
55 14/02/2023 71/23 V Aliya Malika
56 3175061401230002 72/23 V Enos Basil Gultom
57 3175065401230009 73/23 V Hafsa Nahda Azzahra
58 74/23 V Cakra Zuhairi
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60 76/23 V Rafka Dwi Putra
61 3175060901230005 025/23 V Darren Zio Maulana
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63 3175066909220004 463/22 v Yasmin Khodijah Akbar
64 036/23 V Ellena Oinke
65 483/22 V By. Ny. Shinta 1
66 484/22 V By. Ny. Shinta 2
67 022/23 V Ahmad Rafaza
68 16-02-2023 3175060912220003 77/23 V Fathan Rafisky Kosasih
Muhammad El Moza
69 3175062705210000 202/22 V
Antalaric
70 3175060511221011 476/22 v Shaquille Elzhan Davindra
71 518/22 v Maudy Ahzara
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73 3175061312220003 550/22 V Ahmad Abyan Pratama
74 033/23 v Khadijah Haura
75 322/22 V Adelisha Arumi
76 031/23 v Ahmad Lutfi Ardianzah
77 3175066909220006 016/23 V Qiana Nafeeza K. An
78 3175061203220004 133/22 V Afzal Athallah
79 027/23 V Devanka Adi Alfareza
80 030/23 v Inayah Salsabila
81 002/23 V Salsabila Nur Rahma
82 3212123010220001 026/23 V Akhtar Izqian
83 526/22 V Khansa Almaira Putri Nugroh
84 267/22 V Bagas Maliq Al Rayid
85 332071005220001 264/22 V Muhammad Faizar Al Hanan
317506550221000
86 418/22 V Farrah Alesha Nadhifa
4
87 21/02/2023 3175066101230003 79/23 v Thanaya Musahhilah
88 3175061101230003 80/23 V Alsyazam Atharrazka Adhrya
89 3211054405220002 81/23 V Reservia Meikeyla
90 3175062501230003 82/23 V Muhammad Abyan Pratama
91 3171035010220004 542/22 YA Claudia Liasta
92 3175065310220011 457/22 YA Kikanaya Hana Prasetyo
93 317506210920002 394/22 V Fikri Al Dzaky
94 060/23 V Abizar
95 3175064910220004 483/22 V By. Ny. Shinta 1
96 066/23 V Nayla Zulfa Nur Latifah
97 489/22A V V Rafael Davin Amandeo
98 353/22 Jennaira Laiba Kurniawan
99 3175060501230012 028/23 V Evano Ersya Ravindro
100 454/22 V Felix Timothi
101 3175064910220002 482/22 V Arunika Djubilee Tandumai
102 52/23 V Kaela Shakira Putri
103 520/22 V Aiko Hania Andhri
104 23/02/2023 83/23 V Nazia Syifaturrahmah
105 84/23 V Kenzie Arkananta
106 85/23 v Kenzo Atharazka
107 86/23 v Arayan Dian Alfarizky
108 87/23 v Abidzar Ali Wibowo
109 78/23 v Alfarizqi Alman Mustafa
110 3306110705220001 278/22 v Muhammad Syafiq Ramadha
111 349/21 v Muhammad Hatta
112 3175025810220002 494/22 v Mafaza Afsheen El Daneen
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114 211/22 v Qinara Al Irhaz
115 490/22 V Mikail Kaili
116 388/21 V Jihan Salma Riyaudah
117 451/22 V Raisa Sasabita
118 362/21 V Anugrah Meishila S
119 39/23 V Shafiyyah Naureen K
120 40/23 V Fauzan Alfarizqi
121 19/23 V Muhammad Rifki
122 28-02-2023 317506260123003 88/23 V Melvin Daffinra Firdaw
123 89/23 V Dewi Aleshs Nareswari
124 3312172801230001 90/23 V Muhammad Nur Arshaka
125 3175062201230006 91/23 V Zahid Alfarizky
126 92/23 V El London Faturahman

127 93/23 V Arroyyan Dylan Alfarizqi
128 3175064701230003 94/23 V Khalisa El Nara
129 95/23 V Muhammad Zayn Alfarizki
130 96/23 V Radinka Fathan Pratama
131 97/23 V Demalik Al Hajj
132 98/23 V Aiza Nur Rihana
133 408/22 V Elsa Camillia Maheswari
134 31750651062100i8 328/21 V Arumi Nasya Salsabila
135 317506811220003 557/22 v Rumaisha Zalindra
136 425/22 V Shaqa Arkan Wiratama
137 038/23 V Rayna Humaira Hadi
138 405/22 v Haura Yumna Fatimah
139 31750615112200014 500/22 v Ahmad Kalanda Shaquil
140 541/22 V Khalisa Nur Aulia

Muhamad Kenzie
141 3175062210220005 459/22 v
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144 31752043007220007 045/23 V Isma Dzaka Dzulhanan
317506166112200
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146 3.1750641122E+15 010/23 V Ervina Bunga Destian

147 3175062112220007 004/23 V Galih Estiawan
148 041/23 V M. Fahri Subandi
149 048/23 V Alkalfi Zikri Mumiaz
150 3175061608220002 406/22 V Reynard Christian Sianturi
151 495/22 V Vania Jose Sinaga
JK/UMUR
TTL NAMA ORANGTUA ALAMAT
L P
14-07-2022 6 Bln Diana Rosa / Galih Afarizi H. Manis 11/1
31-01-2023 2 hr Sintia Putri / Ahmad Maulana Kayu Tinggi 02/03
20-11-2022 3 bln Financy S / Gidium Kayu Tinggi 12/09
20-07-2021 18 Bln PITRIYANA SARI/BAHRUDIN GANG ASEM
25-07-2021 18 Bln Yovita Sari / Alexander Silalahi Jl. Waru 10/09
26-11-2022 2 Bln Devi Susanti / Yason Latumeten Pulo Gebang 01/05
21-11-2022 2 Bln Mei Kristines / Danu Hermansyah kp. Buaran 02/02
7-11-22 3 Bln Umi Saropah / M. Fatul Kayu Tinggi 06/03
29-3-22 11 Bln Febriyani / Johanes Evando P. Parulian Gempol 05/01
Ujung Menteng
27-4-22 9 Bln Variati / Mursono
10/02
11-11-2022 2 Bln Maulidatu Zakiyah Kayu Tinggi 01/03
Kp.gempol RT 003
7/29/2021 18 Bln Yeni Rahman dan OKI sutrisna
RW 001
10-10-2022 4 Bln Rahma Kusuma Ayu / Koeswadi Kayu Tinggi 13/06
24-11-2022 2 Bln Sri Devi Anna / Rio Arthasasta Kayu Tinggi 12/09
6/13/2021 18 Bln Kasdana / Siti Aisyah Gempol 13/01
04/08/2022 6 Bln Siti Nurcahya / Reza Sandra Sukma Kayu Tinggi
06-01-2023 1 Bln Nurul Ulfa / Chairul Mariadi Gempol 4/1
17-01-2023 1 Bln Tri Purnawati / riki Iskandar Kayu Tinggi 9/4
02-12-2021 2 Bln Frika / Roytomi JGC / 14

09-05-2022 9 Bln Tri Puspita / Irwan Saleh Bulak Indah 3/12
30-1-2023 1 Bln Murtafiah / Fajar Kandang Sapi 7/6
12-12-2022 2 Bln Amelia / Heriyanto Kayu Tinggi 9/3
05-11-2022 2 Bln Nurjanah / Fajri Bulak Indah 2/12
18-02-2023 5 hr Depina / Tarzani Kandang Sapi 13/06
16-01-2023 22 hr Febrianti / Afif Mawar 16/1
16-12-2022 2 Bln Beta / Ekker UM

01-01-2023 1 Bln Yuliati / Siysnto Asrm Raya 2/6
02-05-2022 8 Bln Laila Fitri Nur / Moh Yusuf Adi Sukma Kayu Tinggi 8/6
leen Gultom 6 Bln Grifith Jennifer / Albet Dora Cempaka 8/9
24-10-2022 3 Bln Junaeni / Samto Kayu Tinggi 10/09
4-1-2023 1 Bln Risma / Abdul Mustangin Kayu Tinggi 10/09
6-1-23 1 Bln Murtani /Muniroh Tambun Rengas Rt.02/07
5-1-2023 1 Bln Iif Ma'difah / Ooj Nurmusafah Kayu Tinggi 01/09
04-11-2022 3 Bln Kayu Tinggi 8/6
Pamungkas
18-12-2022 2 Bln Agustin Rohmah / Dwi Ristiyanto Bulak Indah 3/5
04-09-2022 4 Bln Warnem / Dedi Rawa Makmur 04/10
5-1-2023 1 Bln Ashila / Dyan Bulak Indah 6/12
KAYU TINGGI
30-7-20 31 Bln SITI FAIZAH/ANNAFI KUSUMA
RT3/RW4
KAYUBulak IndahNO 8
TINGGI
1-4-22 10 Bln Fatmalah/Oktavian
RTRt7/Rw5
006/004
TEGUH ARI PRANOTO RANI
8/3/2021 18 bln CAKUNGKuning
Jl.Rawa TIMUR
RODIANINGSIH Gg.Rukun
JAKARTA TIMUR
Destinia Prastisia dan Yunan Kunto Rt.007/016 No.47
DKI JAKARTA
8/4/2021 18 Bln Aji Kel.PuloGebang
Kec.Cakung Jakarta
08/12/2022 2 Bln Atikah / Ahas Ruddin R. Makmur 01/10
Timur 13950
06/12/2022 2 Bln Anim / Suryadi Kayu Tinggi 02/11
09/12/2022 2 Bln Shinta Setya Putri / Zulfikar Ali Akbar Kandang sapi 04/06
06/12/2022 2 Bln Suci . Tabroni Kayu Tinggi 07/04
05-10-2022 4 Bln Nina Delina / Tarmidi Ujung Menteng 08/12
07-12-2022 2 Bln Nur Azijah /Rio Kamandanu KP. Gempol 13/01
-06-12-2022 2 Bln Nadira Aliya / Bahrul Ulum Kandang Sapi 02/06
5-12-22 2 Bln Magdalena Sajar / Refky Darmawan Pagar Jati 15/01
21-09-22 4 Bln Melanita A / Bahari Gempol 16/01
23-09-2022 4 Bln Femi / Idris Kayu Tinggi 09/11
Kandang Sapi
10-5-22 9 Bln Fitri /Iswanto
Rt1/Rw6
31-10-2022 3 Bln Nurhasanah / TEguh Puji Cempaka 08/09
31-01-2023 9 Hr Sintia Putri / Ahmad Maulana Kayu Tinggi 02/03
21-03-2022 11 Bln Halimah / Safiudin Kayu Tinggi 3/4
11-10-2022 4 Bln Rusmya A / Dian Firdyansyah Kayu Tinggi 07/03
14-01-2023 1 Bln Dewi Sri ulina / Edward Chandra Kayu Tingi 4/9
14-01-2023 1 Bln Afieny Tazkyatur / Dedi Sutrisno Kayu Tinggi 2/9
15-10-2022 4 Bln Mustaqimah / ana Suhendra Gempol 9/1
13-01-2023 1 Bln Hidayati / Robiansyah Buaran 24/2
09-01-2023 1 Bln Siti Sukaesih / Syaeful Bahri Kayu Tinggi 8/11
9-1-23 1 Bln Yasinta / Irsyad Ahmad Buaran 01/02
Tambun Rengas
07-09-22 5 Bln Asmah / Agung Riyadi
04/07
29-9-2022 5 Bln Yasmin Khodijah Akbar Kp. Buaran 9/2
12-1-2023 1 Bln Christine / Yaaro Ha JGC 14/14
14-10-2022 4 Bln Shinta / Wahyu Kayu Tinggi 3/6
31-8-2022 6 Bln Rizka / Yatno Kayu Tinggi 8/4
09-12-2022 2 Bln Fitria Handayani / Ari p Gempol 7/1
14-5-22 9 Bln Maryana / Mirza Julian Kandang Sapi Rt6/Rw6
05-11-2022 3 Bln Susi Purwanti / Mileh Santoso Bulak Indah 9/12
17-10-22 4 Bln Leli / Dody Kayu Tinggi 7/9
13-11-2022 3 Bln Sutriani / Judea Rikson Hasibuan Kayu Tinggi 4/9
13-12-2022 2 Bln Puji Kurniati / Ahmad Fadli R Bulak Indah 05/05
28-11-2022 3 Bln Mustantifah / Zeki Zulkarnain Kayu Tinggi 1/9
28-4-22 10 Bln Tati Setianingrum/Yusuf Waru Rt10/9
08-11-2022 3 Bln Sriyanti / Tumiran Gempol 14/01
29-09-2022 5 Bln Eka / Bayu Laksono Gempol 14/01
3/12/2022 11 Bln Sri Silastri Ningsih / Fahmi Hidayat Kp. Buaran 07/02
17-12-2022 2 Bln Murniyanti / Bagus Gempol 1/1
24-11-2022 3 Bln Alpiyah / Adi Ardiansyah Kayu Tinggi 7/4
17-12-2022 2 Bln Mila Arum Listiani / Rahmadhani Kayu Tinggi 07/03
30-10-2022 4 Bln Ratinah / Agung Permana Gempol 04/01
11-11-2022 3 Bln Fatimah / Tomi Nugroho Kayu Tinggi 09/11
15-04-2022 10 Bln Endah Pujiyanti / Sarkawi Bulak Indah 8/12
10-05-2022 9 bln Titik Mardiyati / Arfin Asanto Gempol 07/01
15-02-2022 24 Bln Ade Irma Suryani Kp. Buran 02/02
21-01-2023 1 Bln Tanti Marenta / Eko Abdiyanto Kayu Tinggi
11-01-2023 1 Bln Ninda Putri / Definal Gempol 11/1
04-05-2022 9 Bln Cindy Hemalia / M. Yunus Gempol 8/1
25-01-2023 1 Bln Diana Anggraini / M. Yusuf Kayu Tinggi 6/4
10-10-2022 4 Bln Eli Susanti BR / Ulung Armada Taman Modern 16/6
13-10-2022 4 Bln Ari Oktaviani / Yogi Prasetyo Kayu Tinggi 3/12
21-09-2022 5 Bln Mardiana / Pupung Purwadi Kayu Tinggi 9/3
17-01-2023 1 Bln Tri Purnawati / riki Iskandar Kayu Tinggi 9/4
16-01-2023 1 Bln Febrianti / Afif Mawar 16/1
14-11-2022 3 Bln Norma Dharmasari / Moh Ali Sadam Gempol 04/01
07-8-2022 6 Bln Dita Iswara / Kurniawan Kt 07/09
5-1-23 1 Bln Inda Inasya / Erwin Susanto Kayu Tinggi 3/5
16-09-2022 5 Bln Erika Lestari / Lasman Sitanggang Kayu Tinggi 03/09
09-10-2022 4 Bln Wahyu Bella / Yokhan A Tandumai Gempol 11/10
21-01-2023 1 Bln Marlinda / Irawan Perdana 6/12
03-12-2022 2 Bln Siti Royani / Saryono Timbul Kp. Buaran 10/02
19-07-2022 7 Bln Ai Murniawati / Asep Rudiana Tambun Selatan 2/8
15-10-2022 4 Bln Rusiyam / Sekhu Wibowo Kayu Tinggi 6/3
15-10-2022 4 Bln Rusiyam / Sekhu Wibowo Kayu Tinggi 6/3
17-01-2023 6 hr Sonia / Saipulloh Kayu Tinggi 8/5
15-12-2022 2 Bln Amanda / Bintang Gempol 12/01
12-03-2021 23 Bln Yuli / Dodi Mustova Waru Buntu 11/9
07-05-2022 9 Bln Anisa / Fatkhul Janah Hidayah Kayu Tinggi 03/04
Tambun Rengas
8/18/2021 18 Bln Selvina urani / mukri adi
05/07
18-10-2022 4 Bln Aulia M. E I / Eko Susanto Kayu Tinggi 05/04
Tambun Selatan
11-7-2022 7 Bln Maryanti / Abdul
07/08Taruna
Jl Karang
17-5-22 9 Bln Apriani/Zensi
Rt2/Rw9
15-10-2022 4 Bln Puja Melati / Asad Bulak Indah 8/5
8/20/2021 18 Bln Puja Melati / Asad Bulak Indah 8/5
18-10-22 3 Bln Irmalia / Agung Buaran 11/02
16-05-2021 21 Bln Latifah / Heryanto Kayu Tinggi 2/9
21-11-22 3 Bln Martsya / Mohamad Ryzky K Swadaya 12/1
12/15/2022 2 Bln Siti Jamilah / Iim Sahidin Gempol 03/01
24-12-2022 2 Bln Kotrunnada / Niko KandangSapi 4/6
26-01-2023 1 Bln Oktafiana / Yudi Firdaus Kayu Tinggi 9/4
14-01-2023 1 Bln Purwi Susanti / Dwi Susanto Gempol 4/1
28-1-2023 1 Bln Suratmi / Wahyudi Swadaya 4/6
22-01-2023 1 Bln Ika Kartika / Ahmad GG. Harapan 6/6
23-01-2023 1 Bln Suci INdriani / Lukman Kayu Tinggi 7/4

22-09-2022 5 Bln Lilis / Diansyah Kayu Tinggi 6/11
07-01-2023 1 Bln Suci Pratiwi / Maulana Kyu Tinggi 6/5
29-12-22 2 Bln Dede Nurjanah / Ahmad Samuji Tambun Rengas 10/7
3-12-22 2 Bln Rikhe / Zaenal Bulak Indah 8/5
14-1-23 1 Bln Siti Khoirunisa / Row iKayu Tinggi 5/11
19-1-2023 1 Bln Yuliany / Danu Gempol 09/01
29-08-2022 6 Bln Febri / Saudin Kayu Tinggi 08/02
11-06-2021 30 Bln Leni Marlina / Rajudin Ibar Kayu Tinggi 10/05
18-11-2022 3 Bln Nuarika / Nurul Fadilah Kayu Tinggi 1/11
25-08-2022 6 Bln Nuraini / Ahmad Gozali Bulak INDAH 01/12
4-10-2022 4 Bln Lia Oktaviani / Lesmana Tambun Rengas 06/07
19-7-22 7 Bln Lestari / M Sugandi Pulogebang 13/04
15-11-2022 3 Bln Rilma Maulida Fitria / Jeffry Kayu Tinggi 7/9
13-08-2022 6 Bln Linda Sari / m. Busro Gempol 13/01

22-10-22 4 Bln Mudih Afifah / Sahrul Anwar Pagar Jati 05/01
26-09-2022 5 Bln Esta / Rinaldi Bulak indah 04/05
20-06-2022 8 Bln Fitria Handayani / Armando Sinaga Bulak Indah 04/05
30-07-2022 7 Bln Ina Reni / Alikhin Gempol 2/11
11/16/2022 3 Bln Arum Rahmawati /Fendi Setiawan Kayu Tinggi 06/04
01/12/2022 2 Bln Eis Siti Jubaidah / Cecep Septian KP. Buaran 13/02
21-12-2022 2 Bln Mufiatun / Mulyono Kayu Tinggi 03/09
24-12-22 2 Bln Feti Fatiha / Dadi Subandi KP. Buaran 02/02
19-11-2022 3 Bln Nuraini / Samsul Buaran 04/02
16-08-2022 5 Bln Ret Taria / Richard Hariyono Cempaka 6/9
20-06-2022 5 Bln Fitria Handayani / Armando Sinaga Bulak Indah 04/05
NO HP PB/TB LK IC
BB (Kg) SH KN IMUNISASI SDIDTK
(Cm) (Cm)
DPT3, Polio4 dan

083806117545 7.1 64 41 36.5 DS=10 v
PCV2
089658163633 2100 43.5 34 36.5 1 HB.0 v
DPT1, Polio2 dan

081289446975 3.1 50 34 36.7 v
PCV1
Booster DPT,
082111226626 9 76 43 36.7 DS=10
Booster MR
Booster DPT,
081259028006 12 77 47 36.7 DS=10
Booster MR
DPT1, Polio2 dan
085172009223 5 56 38 36.7
PCV1
DPT1, Polio2 dan
089637441598 6 67 39 36.8
PCV1
DPT1, Polio2 dan
83861882884 5.2 58 40 36.5
PCV1
081382128835 9.3 68 46 36.7 MR, IPV2
085779665448 9.5 70.5 43 36.7 MR, IPV2 DS = 10
DPT1, Polio2 dan

0887820576420 5.9 57 40 36.7
PCV1
082128070770 9 76 47 36.7 Booster DPT DS = 10
DPT2, Polio3 dan

087830235551 5.5 58.5 40 36.7
PCV2
DPT1, Polio2 dan

08812583164 6.1 59 39.5 36.7
PCV1
Booster MR dan
081388802426 12 83 48 36.7 DS = 10
Booster DPT
DPT3, Polio4 dan
08577449059 6.9 63.5 40 36.5 DS = 10
PCV2
85813839642 3.6 56 37 36..5 4 BCG, POLIO1
88296293912 2.8 50 35 36.5 3
81296962994 10 73 36 36.5 IPV2

081332098375 7.3 64.5 42.5 36.6 MR, IPV2 DS = 10
85775706584 2.9 48 34 36.5
82210164770 5.2 54 36 36.6 BCG
DPT1, POLIO2,
83895368034 5.3 66 39.5 36.6
PCV1
081586115118 3.2 49 35 36.7 2
88292237881 4.2 53.5 36 36.5 3
85640839629 5.4 58 39 36.5 BCG, POLIO1

82311025364 4.5 53.5 36 36.5 4 BCG, POLIO1
DPT3, POLIO4,
81906609345 8.3 70 44 36.5
IPV1
DPT3, POLIO4,
87748004631 5.9 59.6 36 36.5 DS = 10
IPV1
DPT2, POLIO3,
085811227680 5.8 62 40 36.5
PCV2
085799322311 3.8 51 36 36.5 4 BCG, POLIO1
081384337703 4.7 54 36 36.5 4 BCG
89637524139 4 52 37 36.5 4 BCG, POLIO1
DPT2, POLIO3,
08822382617 5.7 59 39.5 36.5
PCV2
089643226776 5 55 36 36.5 BCG
DPT3, POLIO4,
089637275045 7 60 41.4 36.5
IPV1
087730530780 4.6 51 37 36.5 4 BCG, POLIO1
089628959019 10 80 44 36.5 BOOSTER MR
085691254203 7.4 69 43 36.5 IPV2, MR
BOOSTER DPT,
087883521676 10 80 46 336.5 DS : 10
BOOSTER MR
BOOSTER DPT,
085780673795 10 78 46 36.5 DS : 10
BOOSTER MR
DPT1, POLIO2,
081313135172 5.2 57 39 36.5
PCV1
DPT1, POLIO2,
081384685330 5.4 59 37 36.5
PCV1
DPT1, POLIO2,
89688865484 5.9 59.5 39 36.5
PCV1
DPT1, POLIO2,
081219286349 4.4 55 39.5 36.5
PCV1
DPT3, POLIO4,
089530841496 5.2 63 39.5 36.5
IPV1
#FMT 6 54 41 36.5 POLIO2
DPT1, POLIO2,
081293197716 5.7 58 40 36.5
DPT1,PCV1
POLIO2,
#FMT 5.2 56 38 36.5
PCV1
081385042227 8.1 65 43 36.5 PCV1
DPT3, POLIO4,
085788317928 5.7 61.5 40 36.5
IPV1
0895357077111 8.4 72.5 40 36.5 IPV2, MR DS = 10
DPT2, POLIO3,
85889292713 7.8 62.5 42 36.5
PCV2
089658163633 2.2 44 36.5 36.5 3
08770519955 7.8 71 45 36.5 IPV2, MR
5.3 59 40 36.7 BCG
81387613642 4 52 38 36.5 4 BCG
82294315359 4 53.5 37 36.5 4 BCG
89479171468 6 59 40 36.5 BCG, POLIO2
89566595703 3.8 51 37 36.5 4 BCG
89616881994 3.8 52 36 36.5 4 BCG
081212542529 4.8 58 38.5 36.5 4 BCG
DPT3, POLIO4,
0895386891645 6.6 62.5 42 36.5
DPT3,IPV1
POLIO4,
081282017567 8.8 64 42 36.5
IPV1
81218901917 4.5 53.5 39 36.5 4 BCG
DPT2, POLIO3,
088809346979 5.1 57 40 36.5
DPT2,PCV2
POLIO3,
088809346979 4.7 55 39.5 36.5
PCV2
DPT3, POLIO4,
082155483657 6.8 63 41.5 36.5 DS : 10
DPT1,IPV1
POLIO2,
81213455186 7 60 39 36.6
PCV1
087782781402 7.4 68 44 36.5 IPV2, MR DS : 10
DPT2, POLIO3,
081314901449 6.2 60.3 40 36.5
DPT2,PCV2
POLIO3,
081297360076 6.6 28.2 41 36.5
PCV2
DPT2, POLIO3,
081310362478 5.7 61 40 36.5
DPT1,PCV2
POLIO2,
895619114506 4.7 57 38 36.5
PCV1
DPT1, POLIO2,
088299528567 4.3 56 39 36.5
PCV1
089637709020 7.8 70 41 36.5 IPV2, MR
DPT2, POLIO3,
081288060577 7.2 61 43 36.5
PCV2
081283232297 7.9 63.5 41 36.5 DPT3, POLIO3,IPV
087779229641 7.5 66 43 36.5 IPV2, MR
DPT1, POLIO2,
088293361343 5.9 58 40 36.5
DPT1,PCV1
POLIO2,
089791120961 5.9 57 38 36.5
PCV1
DPT1, POLIO2,
083826745027 4.8 56 36 36.5
PCV1
DPT1, POLIO2,
087838089851 6.4 61 40 36.5
PCV1
DPT2, POLIO3,
89609942490 5.4 58 39 36.5
PCV2
085781265949 8 70 43 36.5 IPV2, MR
081901926688 7.3 69 41 36.5 IPV2, MR DS : 10
08569112061 12 88 43 36.5 DPT3 DS : 10
081287188630 4.2 50.5 36 36.6 4 BCG dan Polio1 v
81380466447 4.8 56 34 36.5 4 BCG
83819888340 8.1 67 45 36.5 BCG dan POLIO4 DS : 10
8997336743 4.6 55 40 36.5 4 BCG dan Polio1
84281223265 5.9 58 41.5 36.5 DPT3, POLIO3,IPV
085889835010 5.5 60 41.5 36.5 DPT3, POLIO3,IPV
081806468954 6 60.5 41 36.5 DPT3, POLIO3,IPV
88296293912 4.2 52 34 36.5 4 BCG dan Polio1
088809346979 6.7 61 42 36.5 DPT3, POLIO3,IPV
88292237881 5 56 38.5 36.5 4 BCG
DPT2, POLIO3,
089630673930 7.4 63.5 42 36.5
PCV2
081293404015 7.7 66.5 42 36.5 DS : 10
085715201742 5.3 55 36 36.5 BCG
081390721322 7.5 67 43 36.5 DPT3, POLIO3,IPV
087871716525 6.7 67.5 41 36.5 DPT3, POLIO3,IPV
081319571239 4.4 51 39 36.7 4 BCG dan Polio1
DPT1, POLIO2,
089806724347 3.6 53 40 36.5
PCV1
DPT3,
0082299307843 7 63 44 36.5 v
POLIO4,PCV1
DPT2, Polio3 dan
085774124468 6.6 64.5 41 36.7 v
PCV2
DPT2, Polio3 dan
085774124468 6.4 63.5 41 36.7 v
PCV2
081774179798 3 48 35 36.7 2
DPT1, Polio2,
081385666602 5.4 57 39 36.7 v
PCV2
Booster MR dan
14 89 49 36.7 v
Booster DPT
087882607831 7.6 68.5 44.5 36.7 MR, IPV2 DS = 10
Booster MR dan
11 78.5 48 36.7 DS = 10
Booster
DPT3, DPT
Polio4 dan
081398854433 6.5 63.5 40 36.7
IPV
DPT2, Polio4 dan
089888033868 8.2 65 43 36.5
PCV2
'089661153405 7.3 66 43 36.5 MR, IPV2 DS = 10
DPT2, Polio3 dan
0881024753575 8.6 67 42 36.7
PCV2
0881024753575 10 79 47 36.7 Booster DPT DS = 10
DPT2, Polio3 dan
0895357323148 6.2 59 40 36.7
PCV2
081219068217 12 81 49 36.6 Booster DPT DS = 10
DPT1, Polio2,
81379328075 6.2 60 42 36.6
PCV1
DPT1, Polio2,
895321747201 5.2 56 40 36.6
PCV2
DPT1, Polio2,
6.4 59 38 36.7
PCV1
81285203216 4.3 55 39 36.5 4 BCG, POLIO1
8970167035 4.4 54 36 36.5 BCG, POLIO1
85328560129 4.5 53 36 36.5 4 BCG, POLIO1
81317858731 4.1 57 36.5 36.5 4 BCG
085156572939 4.4 55 38.5 36.5 4 BCG

DPT3, POLIO4,
83807591412 7.3 63.5 43 36.5
IPV1
089644042743 4.9 54.4 37 36.6 BCG
81290467882 5.7 57.5 38 36.5 BCG, POLIO1
DPT1, POLIO2,
81311508800 5.8 59.5 40 36.5
PCV1
8908320491 3.1 46.3 36.5 36.5 BCG, POLIO1
88214742674 3.7 49.5 37 36.5 4 BCG
DPT3, POLIO4,
08159205397 5.8 60 41 36.5 DS = 10
IPV1
089604576693 10 78 45 36.5 DPT3, POLIO4
DPT2, POLIO3,
085159477739 5.6 59.3 39 36.5
PCV2
DPT2, POLIO3,
#FMT 7.5 62.5 45 36.5
PCV2
DS =10
87770488675 6.4 65 41 36.5 DPT2, POLIO3
083836784987 9.6 72.5 44 36.5 IPV

DPT2, POLIO3,
085884008798 6.1 60.3 39 36.5
PCV2
DPT3, POLIO4,
82125695492 6.7 64 48 36.5 DS = 10
IPV1
DPT3, POLIO4,
081286980847 7 65 41 36.5
IPV1
DPT3, POLIO4,
081291157455 6.3 59.5 40 36.5
IPV1
085218835674 6.5 70.5 45 36.5 DPT3, IPV
81398264526 7.3 66.5 43 36.5 PCV2
DPT3, POLIO4,
85211554337 7.2 59 41 36.5
IPV1
DPT1, POLIO2,
083812542988 5.6 58.6 40 36.5
PCV1
DPT1, POLIOI2,
081210990274 4 53.5 40 36.5
PCV1
DPT1, POLIOI2,
87510958382 5.9 59.3 39.2 36.5
PCV1
DPT2, POLIO3,
81286888651 5.8 58 39.5 36.5
PCV2
DPT3, POLIO4,
081314114295 7.7 68 43.5 36.5
IPV1
DPT3, POLIO4,
085218835674 6.5 70.5 45 36.6
IPV1
TOTAL
KETEPATAN
WAKTU
IMUNISASI OBS PASCA JADWAL
TIDAK SUNTIK 15 KEMBALI TEMPAT
TEPAT MENIT IMUNISASI BBL (Kg)
TEPAT LAHIR DJB (x/mnt)
v v 02/03/2023
v v 07/03/2023 RSHJ 2200 132
v v 02/03/2023
V V Lengkap
V V Lengkap
V V 2/3/2023
V V 2/3/2023
V V 2/3/2023
V V 18 Bln
V V 18 Bln
V V 2/3/2023
V V Lengkap
V V 2/3/2023
V V 2/3/2023
V V LENGKAP
V V 04-05-2023
V V 07-03-2023
RS suliyanti
v v 2500 133
Saroso
v v 18 bln
v v 18 bln
RS THB 2700 130
v v 07-03-2023
v v 07-03-2023
Pkm Kec.
21-03-2023 3270 132
Cakung
RSIA Resti Muly 3.1 135
v v 07-03-2023
v 07-03-2023
v v 9 bln
v v 9 bln
v v 07-03-2023
v 07-03-2023
v 07-03-2023
v 07-03-2023
v v 07-03-2023
v v 07-03-2023
v v 9 bln
v 07-03-2023
v v lengkap
v v 18 bln
v v lengkap
v v lengkap
v v 09-03-2023
v v 09-03-2023
v v 09-03-2023
v v 09-03-2023
v v 9 bln
v v 09-03-2023
v v 09-03-2023
v v 09-03-2023
v v 09-03-2023
v v 9 bln
v v 18 bln
v v 09-03-2023
RSHJ 2200 132
v v 9 bln
v v 14-03-2023
v 14-03-2023
v 14-03-2023
v v 14-03-2023
v 14-03-2023
v 14-03-2023
v 14-03-2023
v v 9 bln
v v 9 bln
v 14-03-2023
v v 14-03-2023
v v 14-03-2023
v v 9 bln
v v 16-03-2023
v v 18 bln
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 18 bln
v v 16-03-2023
v v 18 bln
v v 18 bln
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 16-03-2023
v v 18 bln
v v 18 bln
v V v 16-02-2024
v 21-03-2023
v 21-03-2023
V v 21-03-2023
v 21-03-2023
V v 9 BLN
V v 9 BLN
V v 9 BLN
v 21-03-2023
V v 9 BLN
v 21-03-2023
V v 21-03-2023
9 bln
V v 21-03-2023
V v 20-06-2023
v v 11-07-2023
v 21-03-2023
v v 21-03-2023
v v 9 Bln
v v 23/03/2023
v v 23/03/2023
21-03-2023 RSUD Koja 2900 148
v v 23/03/2023
v v Lengkap
v v 18 Bln
v v Lengkap
v v 9 Bln
v v 23/03/2023
v v 18 Bln
v v 23/03/2023
v v Lengkap
v v 23/03/2023
v v Lengkap
v v 23/03/2023
v v 23/03/2023
v v 23/03/2023
v 28/03/2023
v v 28/03/2023
v 28/03/2023
v 28/03/2023
v 28/03/2023
v v
v v 28/03/2023
v v 28/03/2023
v v 28/03/2023
v v 28/03/2023
v 28/03/2023
v v 9 BLN
v v 9 BLN
v v 28/03/2023
v v 28/03/2023
v v 28/03/2023
v v 9 BLN
v v 28/03/2023
v v 9 BLN
v v 9 BLN
v v 9 BLN
v v 9 BLN
v v 28/03/2023
v v 9 BLN
v v 28/03/2023
v v 28/03/2023
v v 28/03/2023
v v 28/03/2023
v v 9 BLN
v v 9 BLN
TOTAL
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
SEHAT TETANUS TALI PUSAT
RR (x/mnt) SHK BELUM
PUPUT
40 V V V
40 V V V
40 V V V
41 v v v
40 V V V
40 V V V
39 v v v
PENCEGAH RUJUK PENILAIAN YANKES
AN RESIKO CUCI
KIE POLI POLI TATA SESUA
DIAGNOSA BAYI TANG APD
JATUH MTBS GIZI NILAI I SOP
AN
v v v v v v
BY. Z NCB KMK KN1
Dengan Ikterus Kramer 1 v v v v v v v v
dan BBLR
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
BY. Z NCB SMK KN 3

BY. M NCB SMK KN 3
BY. N NCB SMK KN2

v v v v v v v
dengan ikterus kramer 1
BY. N NCB SMK KN3
v v v v v v
ikterus kramer 2
BY. Z NCB KMK KN3
Dengan BBLR
v v v v v v
By. A usia 2 bln dengan
v v v v v v
status gizi kurang
By. A usia 6 hr NCB SMK

v v v v v v
dengan Ikterus Kramer 4
KUNJUNG
KUNJUNGAN
CAKUPAN KN AN BAYI
BALITA
KET (Usia 12-59
1 2 3 4 ( USIA 0-11
Bln)
L P L P L P L P L Bln) P L
1
KOMPLIKASI NEO 1
1
komplikasi neo 1
komplikasi neo 1
1
Komplikasi Neo
1
Rujuk RS
Post Rawat NICU RS pondok Kopi

0 1 2 0 1 2 16 7 0 3 0
KUNJUNGAN
BALITA
HB0 (0<7 HR) BCG DPT/HB (1)
(Usia 12-59
Bln) L P L P L P
P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0 0 0 20 11 17 9
DPT/HB (2) DPT/HB (3) POLIO 1 POLIO2
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
9 10 10 16 10 5 17
POLIO2 POLIO3 POLIO4 IPV 1
P L P L P L P
1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1
1
1
1 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1 1
8 9 11 9 15 9 14
IPV 2 PCV 1 PCV 2 PCV 3
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7 4 19 14 8 7 0
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0 0 6 7 9
BOOSTER CAMPAK
PCV 3 CAMPAK RUBELLA BOOSTER DPT
RUBELLA
P L P L P L P
1 1
1 1
1 1
1
1
1
1 1
1 1
1
1
1
1 1
1
0 6 6 5 2 5 2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7 4 9 6 10 2 3
NO
JAMINAN
REGISTER
NO TGL NIK
BARU LAMA BPJS UMUM
1 02/03/2023 3175064112220004 99/23 V
2 100/23 v
3 01/23 v
4 246/22 v
5 181/22 v
6 263/21 v
7 58/23 v
8 230/22 v
9 79/21 v
10 441/21 v
11 07-03-2023 101/23 v
12 V
317506011220008 102/23
13 V
3175060402230006 103/23
14 V
3209336311220001 104/23
15 V
3175066401230006 105/23
16 V
3175065201230007 106/23
17 107/23 V
18 3175061402230003 108/23 V
19 3673011112220001 109/23 V
20 111/23 V
21 021/23 V
22 034/23 v
3175060601230008
23 067/23 V
24 068/23 V
25 053/23 V
26 504/22 V
27 V
507/22
28 559/22 V
29 023/23 V
30 3175062411220005 003/23 V
31 546/22 V
32 024/23 V
33 09-03-2023 110/23 V
34 112/23 V
35 3175066505220001 256/22 YA
36 044/23 V
37 3175065005720015 349/22 V
38 31750608220007 254/22 V
39 553/22 YA
40 3175142511220082 012/23 V
41 257/22 V
42 60/20 V
43 563/22 V
44 V
3175064069210001 336/21
45 V
3175064609210004 335/21
46 3175065205220002 218/22 V
47 561/22 V
48 31750630`0220001 510/22 V
49 3175060211220004 037/23 V
50 3175064711220007 533/22 YA
51 14-03-2023 3175060902230003 113/23 V
52 114/23 V
53 115/23 V
54 3175066011200010 116/23 V
55 117/23 V
56 118/23 V
57 3175064902230007 119/23 V
58 3175060901230005 025/23 V
59 317506101220011 480/22 V
60 059/23 V
61 3175064612220007 015/23 V
62 3175064512220013 532/22 V
63 3175061402230003 108/23 V
64 3175065401230009 73/23 V
65 564/22 V
66 3175060511221011 476/22 v
67 3175061401230002 72/23 V
68 71/23 V
69 429/22 v
70 3175064411220003 486/22 V
71 317506011220008 102/23 V
72 036/23 V
73 483/22 V
74 484/22 V
75 317506612220003 018/23 V
76 16-03-2023 120/23 V
77 121/23 V
78 122/23 V
79 123/23 V
80 124/23 V
81 125/23 V
82 126/23 V
83 127/23 V
84 443/22 V
85 3175063005220005 241/22 V
86 527/22 v
87 3175066411220002 030/23 v
88 435/22 V
89 3175060912220003 77/23 V
90 3175063110220002 506/22 V
91 3175065901220006 139/22 V
92 1208146803950002 287/22 YA
93 3175060912220001 008/23 V
94 3305122105220005 069/23 V
95 3175061312220003 550/22 V
96 31750650099990002 239/22 V
97 3175061603220006 221/22 V
98 033/23 v
99 292/22 V
100 032/23 v
101 3175060909210010 237/22 V
102 3175065111220021 526/22 V
103 002/23 V
104 230/21
105 20-03-2023 128/23 V
106 21-03-2023 3175062412220005 129/23 V
107 130/23 V
108 3175061401230010 131/23 V
109 132/23 V
110 3175061701230004 133/23 V
111 134/23 V
112 135/23 V
113 136/23 V
114 3171040611220001 137/23 V
115 3175066102230006 138/23 V
116 139/23 V
117 3171035502230003 140/23 V
118 3171031002230006 141/23 V
119 3201036312220001 142/23
120 143/23 V
121 144/23 v
122 110/23 v
123 3175064701230003 94/23 V
124 065/23 v
125 060/23 V
126 3175060510220008 475/22 v
127 531/22 V
128 3175062501230003 82/23 V
129 3175060712220010 536/22 V
130 3175062507220000 471/22 v
131 311/22 v
132 031/23 v
133 520/22 V
134 #FMT 474/22 v
135 027/23 V
136 57/23 v
137 3175066101230003 79/23 v
138 268/22 V
139 066/23 V
140 3175061101230003 80/23 V
141 24-03-2023 145/23 V
142 3175065703230008 146/23 V
143 147/23 V
144 28-03-2023 3175066612220001 148/23 V
145 149/23 V
146 3175060601230005 150/23 V
147 3175065301230001 151/23 V
148 3175066602230005 152/23 V
149 153/23 V
150 3175061103230009 154/23 V
151 3175066402230004 155/23 V
152 3175066802230001 156/23 V
153 3175061801230001 158/23 V

154 157/23 V
155 159/23 V
156 160/23 V
157 112/23 V
158 110/23
159 40/23 V
160 89/23 V
161 3212123010220001 026/23 V
162 048/23 V
163 90/23 V
164 500/22 v
165 31750616611220006 549/22 V
166 3175062201230006 91/23 V
167 3175062601230003 88/23 V
168 317506811220003 557/22 v
169 145/23 V
170 30-03-2023 161/23 V
171 3318030406220001 162/23 V
172 163/23 V
173 3175046701230006 164/23 V
174 1701056012220002 165/23 V
175 248/22 V
176 3175062300890014 250/22 V
177 3175060501230012 028/23 V
178 355/21 V
179 3211054405220002 81/23 V
180 317203210002 381/22 V
181 3175060311220001 516/22 V
182 3175061509210011 352/21 V
183 399/22 v
184 3175062008210060 283/22 V
185 490/22 V
186 3175063009210001 419/21 V
187 31750651062100i8 328/21 V
188 92/23 V
JK/UMUR
L P
Syafazea Kayla H 01-12-2022 3 Bln Irmay / Dodi Prasetyo
Muhamad Alfarezel Ghifari 26-02-2023 4 hr Farah / Asep Abdi
Boy Matthew Latumeten 26-11-2022 3 Bln Devi Susanti / Yason Latumeten
31-05-22 9 Bln Ranti / Firman

Mevlano Arshaka
23-05-2022 9 Bln Lais Indriyati / Agus Purwono
Hanan Abqory Alfarizqi
Muhammad Zakaria 7/13/2021 19 Bln Ismi dan totok
Muhtadi
Yosia Meshach Gultom 20-11-2022 4 Bln Financy S / Gidium
20-5-22 9 Bln Natalia / Agus

Chester John R Sihite
Alya Almahira 17-2-21 24 Bln Siska Nuraini / Fiqri Aliansyah
Hamid Ali Ardi 10-10-2022 5 Bln Rahma Kusuma Ayu / Koeswadi
Masheel Jovial Motiea 19-11-2022 4 Bln Nandra Vahada / Fauzi M
11/1/2023 4 Bln Khodijah / M. Jagwan

Arfan Naufal
04-02-2023 1 Bln Latifatul / Rahmaddani

Atha Rayhan Shakeil
23-11-2022 4 Bln Nurul Hidayah / Toni

Qanita Avicenna
Azzura Putri Malika 1/24/2023 2 Bln Erna S / Bayu P
12-1-2023 2 Bln Rina Mutiara / SIGIT Setya

Farhana Putri Setiya
Ebiella Chloe Sanjaya 23-12-2022 3 Bln Desi Novianti / Topan S
Gallio Tirta 14-2-2023 21 hr Timesta / Franklin

Endang Komalasari / Nelson
Arsyad Pradipta Vernando 11-12-2022 3 Bln
Vernando
Intan Riandra 24-2-2023 10 hR Rohila / Suhendra
Baheera Qurrota Ayun Nigro 5-1-2023 2 Bln Ashila / Dyan
Arshaka Zayyan Diandra 6-1-23 2 Bln Diah Ayu M / Hendrawati
Miroslav Antonius 16-12-2022 3 Bln Beta / Ekker

Satria Cahyo 01-01-2023 2 Bln Yuliati / Siysnto
Zayn Leo Pratama 28-12-2022 2 Bln Fitri Handayani / Leonardo
Hapsa Fadiah Maulida 24-10-2022 5 Bln Zauzatus Soliha / Rizal
11--11-22 4 Bln LAILATUL / ABDUL

PHUTRY ALICE ARSYILA
Nayra Humaira Havva 18-12-2022 2 Bln Agustin Rohmah / Dwi Ristiyanto
Aralyne Sachikirani Mustangi 4-1-2023 2 Bln Risma / Abdul Mustangin

Prince Novmender 24-11-2022 4 Bln Sri Devi Anna / Rio Arthasasta
Hafiz Danish Muttaqin 07-11-2022 4 Bln Pusparini / Mashuri
Muhammad Adib Al Muqid 6-1-23 2 Bln Murtani /Muniroh

Bahtiar Zaynuary 01-06-2023 9 Bln Nurhalimah / Mulud
Arsyila Ayahbani Azzahra 22-02-2023 15 Hr Tyas Eka Setiya / Yamur
Belvania Nur Azkiya 25/05/2022 10 Bln Isah Siti Aisyah / Juniar Sanditika
M. Hafidz Ismail 5-1-2023 2 Bln Iif Ma'difah / Ooj Nurmusafah

Meidina Eristia 10-5-22 10 Bln Rifqiyatul/Eri Setianto
Muhammad Rifai 8-6-22 9 Bln Evie Nur Dwi/Abdul Aziz
Abdul Malik Abbas 11-11-2022 4 bLN Abdul Malik Abbas
Samantha Bryna Butar-butar 21/11/2022 4 Bln Samantha Bryna Butar-butar
Assyfa Dafana 21/04/2022 10 bln Anisatul Kaarimah / Fredikta Dianu
Gabriella Felisia 15-11-19 40 Bln Dewi Yulindah / Robbani

Lavanya Ginandyta
29-11-22 3 Bln Nafiroh / Iswahyudi
Ayudisha
9/6/2021 18 Bln Ribina / Ahmad Fauzi
Ayasha Naura Fauziah
9/6/2021 18 Bln Siti Nur Mualifah / M Saifan

Syafa Adrena
Nafiza Zalfa Adzkiya 12-05-2022 10 Bln Nurhidayah / Imam Supriyadi
Soerendro Anggoro Beryl 9/15/2022 6 Bln Desy Marwati / Sugandi
Fatih Rizky Oktavian 30-10-2022 4 Bln Aprilia / Haryanto
Haidar Maulana 02-11-2022 4 Bln Nurjanah / Echo Ujisucipto
Micha Salwa 7-11-22 4 Bln Umi Saropah / M. Fatul
Mauza Razzan Khalis 2/9/2023 1 Bln Liana Anjar / Webi
Elzio Atharrazka 20-01-2023 2 Bln Dwi Nurwina / Agus
Devi Dayana 10-12-22 3 Bln Meylani / Rahmanda
Renata Stefhani Siregar 20-11-20 5 Bln Santa Lucia / Daud
Annaila Nazra Azizah 26-01-2023 2 Bln Ade Juliati / Fauzi P
Alesha Syahputri 11-12-22 4 Bln Sya'diah / Dian
Aeza Safazea Rizki 09-02-2023 1 Bln Suara P / rID Muh
Darren Zio Maulana 9-1-23 2 Bln Yasinta / Irsyad Ahmad
Abil Shidqi Arshalan 10-10-2022 5 Bln Alifah / Galang
Ahmad Najib Baihaqi 06-01-2023 2 Bln Nurul Ulfa / Chairul Mariadi
Darmawan
Gallio Tirta 14-2-2023 1 Bln Timesta / Franklin
Hafsa Nahda Azzahra 14-01-2023 2 Bln Afieny Tazkyatur / Dedi Sutrisno
Afanes 03-10-2022 5 Bln Emah Rohimah / Jefri Hidayat
Shaquille Elzhan Davindra 05-11-2022 4 Bln Susi Purwanti / Mileh Santoso
Enos Basil Gultom 14-01-2023 2 Bln Dewi Sri ulina / Edward Chandra
Aliya Malika 11-10-2022 5 Bln Rusmya A / Dian Firdyansyah
Qalesyaava Kinarian 25-9-22 6 Bln Qurrotu Aini / Agus Kurniawan
Naura Asyifa Khaswari 04-11-2022 4 Bln
Pamungkas
Arfan Naufal 11/1/2023 4 Bln Khodijah / M. Jagwan
Ellena Oinke 12-1-2023 2 Bln Christine / Yaaro Ha
Muhammad Lutfar Faaz -06-12-2022 3 Bln Nadira Aliya / Bahrul Ulum
Afifah Salmanur Saadah 30-9-22 6 Bln Atams Saoder / Fahmi Fauzi
Syafiq Alfarizi 08-07-2021 20 Bln Rika / Dwi Budiyono
Muhammad Aqsha Syabar 07-03-2023 9 Hr Iyang Wida / Lucky D
Adinda Azania Putri 06-03-2023 10 Hr Senia F / Aryo A
Azana Putri K 4-1-23 2 Bln Lutfiana Putri / Muzaki A
Rafasya Alfarizky 6-3-23 10 Hr Indah Lestari / Riki Rumansyah
Kenzie Callisto 28-7-21 20 Bln Rini / Martua Pakpaher
Maher Zayyan Z 9-10-2022 5 Bln Dede / M. Zulfikar
Rayana Khoiruna 14-09-2022 6 Bln ;iddini Hanifah / Ajut Sudrajat
Putra Hanan Pahlevi 30-05-22 9 Bln Ayu Fitriyani / Hendi Andriandyah
Felicia Adriella Hasibuan 13-11-2022 4 Bln Sutriani / Judea Rikson Hasibuan
Ahmad Sauqi Al Fahriji 19-08-2022 7 Bln Khaerunisa / Ilham Tri Cahyo
Fathan Rafisky Kosasih 09-12-2022 3 Bln Fitria Handayani / Ari p
Faradisa Almeera Bagya 1/19/2022 14 Bln Putri Nuryati / Adji Surya Bagya
Yoona Elora 26-05-2022 9 Bln Rosmina Haloho / Benny Eko
Zephyrus Azzahir Sampurno 09/12/2022 3 Bln Shinta Setya Putri / Zulfikar Ali Akbar
Ibrahim Alfarizi 02-05-2022 8 Bln Laila Fitri Nur / Moh Yusuf Adi Sukma
Ahmad Abyan Pratama 13-12-2022 3 Bln Puji Kurniati / Ahmad Fadli R
Syifa Azzahra 30-5-22 10 Bln Erlitatul/Ahmad Rifai
Khalid Ananda Fachri 16-3-22 12 Bln SRI APRIDA / HADI
SHANUM HOLINKA 13-7-22 5 Bln AMALIA/SISWANTO
Eva Gwynet Faomasi Zega 12-12-22 3 Bln Hanifah / Jhini Mart Temani Zega
Siti Rahayu Kuryani / Achmad
Rizu Gharim Arzani 09/09/2021 18 bln
Mantazaka
Khansa Almaira Putri Nugroh 11-11-2022 4 Bln Fatimah / Tomi Nugroho
Salsabila Nur Rahma 17-12-2022 3 Bln Mila Arum Listiani / Rahmadhani
Muhamad Al faqih 04-06-21 21 Bln Rosmala / Nawasi
Chaira Putri Ramadhani 11-03-2023 9 hr Widayati / Dodi Yanto
Muhammad Gaza Aswindra 24-12-2022 3 Bln Fitri Dwi A / Pradikta Fajar
Anjali Asyaria 09-01-2023 2 Bln Amanda / Wahyu Cahyadi
Elfathan Rizky Nurrahman 14-1-23 2 Bln Dwi Septianingrum / Ahmad Faturrohman
Thara Azalea 9-2-23 1 Bln Dwi Darmayanti / M. Adi Susanto
Raden Ahmad Diredja 17-01-2023 2 Bln Maya / Andriyana
Tilford Simon Hariniko 19-02-2023 1 Bln Vonny Simon / Jimmo Lasmono Harniko
Zemira Hanna Krunia 22-12-2022 3 Bln Tri Wahyuni / Leonardus S
Nabila Putri Zahra 21-02-2023 1 Bln Ledini Miyati / Syahlan
Muhammad Danesh Alfarizqi 6-11-2022 4 Bln Kartika / Fadilah
Inggira Inka Yuspranta 21-2-2023 1 BlnAqua Risma Dian Sari / Bagus Sanjaya
Farida Kusumaningtyas /
Ameer Alfarizqi Rangkuti 03-08-2020 7 Bln
Syamirvan Rangputih
Shaziva Nazaleya Mahveen K15-02-2023 1 Bln Rani Nuraini / Januar Kurniawan
Elzio Nazeep Sanjaya 10-02-2023 1 Bln Mutia Hamidah / Asep Sonjaya
Joana Berlian 22-12-2022 3 Bln Tri Wahyuni / Leonardus S
Alif Mohammad 08-02-2023 1 Bln Feni Friliyani / Malik Maulana
Makaila Syifanazia 28-12-2022 3 Bln Fidan Nur Azizah / Naufal
Veronika Elizabeth V 28-02-2023 21 hR Kartika sari / Suhendra Pasaribu
Khalisa 07-01-2023 2 Bln Suci Pratiwi / Maulana
Gilang Firaz Araska 18-02-2023 1 Bln Depina / Tarzani
Abizar 17-01-2023 2 Bln Tri Purnawati / riki Iskandar
Syahmi 4-12-22 3 Bln Sumiyati / Wagiman
Muhammad Abyan Pratama 25-01-2023 2 Bln Diana Anggraini / M. Yusuf
Ahmad Syafiq 07-12-2022 3 Bln Nur Azijah /Rio Kamandanu
Almeira Rania Anwar 01-08-2022 7 Bln Nurbaeda / Riski Anwar
Ahmad Lutfi Ardianzah 08-11-2022 4 Bln Sriyanti / Tumiran
Aiko Hania Andhri 03-12-2022 3 Bln Siti Royani / Saryono Timbul
Humaira Farwah 02-09-2022 6 Bln Dewi Kurnia Fahmi / Fahmi
Zanika Annika Ahmad 31-01-2023 2 Bln Sintia Putri / Ahmad Maulana
Thanaya Musahhilah 21-01-2023 2 Bln Tanti Marenta / Eko Abdiyanto
Desi Abriani / Muhammad Geza
Muhammad Zikrillah Al Hazi 16-06-2022 8 Bln
Tamzil
Nayla Zulfa Nur Latifah 16-01-2023 2 Bln Febrianti / Afif
Alsyazam Atharrazka Adhrya 11-01-2023 2 Bln Ninda Putri / Definal
Bella Cintya Gustina / Refindo
Padipta Rafif Al Kareem 11-03-2023 13 Hr
Danang Aldian
Alesha Mysha Andralan 17-03-2023 7 Hr Dinda Novrijal / Venes Andralan
Ramdan Gunawan 21-03-2023 3 Hr Yeni Yasmin / Giman Gunawan
Afifa Fathima Mumtazha 26-12-2022 21 hr Jumiati / Abd. Somad
Halwa Qonita A 23-08-2023 8 Bln Asmah / Agung Ryadi

Ghathaf Abrisam Mahesvara 06-01-2023 2 Bln Dwi Feriyani / Kabul
Syua Bestari Renjana Muqsih13-01-2023 2 Bln Ovi Aprianti / M. Rifai M
Asyifa Shaquena Ahmad 26-02-2023 1 Bln Aulia Rahma / Ahmad Sefi
Nadia Anindita 22-12-2022 3 Bln Wulandari / Abdul Azim
Hamid Al Walidan 11-03-2023 16 Hr Ayunda Sari / Faiz Septian
Adiva Shanum Arsyilla 24-12-2023 1 Bln Rivanka Adya / Panji Candra
Janneva Raqeesha 28-02-2023 1 Bln Kharina R / Jony Setiawan
Mohamad Ashyraf Rabbani 18-01-2023 2 Bln Rohani / Pahri Saini

Jasmine Inayah Annaedi 21-02-2023 1 Bln Mansilah / Dedi Junaedi
Farhana Putri Andien 22-02-2023 1 Bln Entin Martin / Andi Apandi
Abdullah Syami 26-03-2023 2 Hr Nur Fadilah / Wahyu Alfian
Arsyila Ayahbani Azzahra 22-02-2023 1 Bln Tyas Eka Setiya / Yamur
Veronika Elizabeth V 28-02-2023 1 Bln Kartika sari / Suhendra Pasaribu
Dewi Aleshs Nareswari 14-01-2023 2 Bln Purwi Susanti / Dwi Susanto
Alkalfi Zikri Mumiaz 19-11-2022 4 Bln Nuraini / Samsul
Muhammad Nur Arshaka 28-1-2023 2 Bln Suratm / Wahyudi
Ahmad Kalanda Shaquil 15-11-2022 4 Bln Rilma Maulida Fitria / Jeffry
Rabbani Ahza Mavandra 11/16/2022 4 Bln Arum Rahmawati /Fendi Setiawan
Zahid Alfarizky 22-01-2023 2 Bln Ika Kartika / Ahmad
Melvin Daffinra Firdaw 26-01-2023 2 Bln Oktafiana / Yudi Firdaus
Rumaisha Zalindra 18-11-2022 4 Bln Nuarika / Nurul Fadilah
Bella Cintya Gustina / Refindo
Padipta Rafif Al Kareem 11-03-2023 17 Hr
Danang Aldian
Fathian Saddam
Muhammad Yusuf Putra 28-05-2022 10 Bln Khuzemah / Riko
Ariyanto 04-06-2022 9 Bln Mursilah / Bambang Supriyanto
Muhammad Yusuf 25-03-2023 6 Hr Rizaiyatul Aini / Agus Andriyanto
Grace Leticiauli 27-01-2023 2 Bln Rika Marsaulina / Lambok Indra
Hafiza Echa Qumairoh 20-12-22 3 Bln Etika Budiarti / Chandra Andan
Rafa Mateo Manullang 10-6-22 9 Bln Mayatur/Merton
Muhammad Raffasya 07-06-22 9 Bln Nurmawati/M.Mukhlis
Evano Ersya Ravindro 5-1-23 2 Bln Inda Inasya / Erwin Susanto
Nayyira Karlina Putri 14/09/2021 18 Bln Difia Havana Putri / Ismail
Reservia Meikeyla 04-05-2022 10 Bln Cindy Hemalia / M. Yunus
Hasbi Putra Riyadi 6/22/2022 9 Bln Siti Maryam / Slamet Riyadi
Muhammad Ryuga
Muhammad Syafiq Valevi
Al 03-11-2022 4 Bln Malia / M. Rizky Saputra
Ayyubi 15/09/2021 18 Bln Fristianti Susanti / Ndaru Rahino
Kayla Rahma Azis 11-7-2022 8 Bln Maryanti / Abdul
Marátus Solichan / M Andri
Mafaza Ayu Azkadina 24-06-2022 9 Bln
Muzaeni
Mikail Kaili 15-10-2022 5 bLN Puja Melati / Asad
Nathan Immanuel Wijaya 9/30/2021 18 Bln Lea Gunawan Dan Andy Wijaya
Arumi Nasya Salsabila 11-06-2021 31 Bln Leni Marlina / Rajudin Ibar
El London Faturrahman 23-01-2023 2 Bln Suci INdriani / Lukman
SH KN IMUNISASI
(Kg) (Cm) (Cm)
Taman Pulogebang
081296876540 5.8 57 39 36.7 PCV1
RT.08/13
Kayu Tinggi 7/9 087878663378 3.1 48 38 36.7 2
DPT2, Polio3 dan

Pulo Gebang 01/05 085172009223 5.8 60 39 36.5
PCV2
081311415040
Kayu Tinggi 001/009 9.2 72.5 47 36.7 MR dan IPV2
2
KT 12/01 081808940755 7 66 42 36.7 MR dan IPV2
RUSUN CIPBESEL Booster MR & Booster

083896065833 10.5 79 49 36.7
BLOK B LT 2 NO. 203 DPT
DPT2, Polio3 dan
Kayu Tinggi 12/09 081289446975 5.8 59 41 36.7
PCV2
KAYU TINGGI
RT9/RW5
085217741058 9.3 70.5 47 36.6 MR dan IPV2
Booster MR & Booster

Kayu Tinggi 05/05 085719967353 11 82 46 36.7
DPT
DPT2, Polio3 dan
Kayu Tinggi 13/06 087830235551 6.5 62 39 36.7
PCV2
DPT1, Polio2 dan
Harapan Baru Bekasi 085262222619 5.9 59.5 40.5 40.5
PCV1
Kayu Tinggi 4/4 8985308182 6.2 62.5 41 36.5
Kayu Tinggi 2/4 81547275795 4.1 54 38 36.5 BCG
Bulak Indah 1/5 85651367225 5.9 58.5 39 36.5 DPT2, POLIO3, PCV2
Kayu Tinggi 7/5 81219072408 4.7 54 38.5 36.5 BCG, POLIO1
Kayu Tinggi 6/11 89530987096 5.7 57.5 39 36.5 DPT1, POLIO2, PCV1
Bulak Indah 9/12 81382006055 3.4 50.3 35 36.6 3
KP. Gempol4 /1 85212600989 4 54 36.5 36.5 BCG, POLIO1

Tambun Selatan 9/8 8990776563 3.4 50.5 34.5 36.5 3
Bulak Indah 6/12 087730530780 5.5 55.5 38 36 DPT1, POLIO2, PCV1
Kp. Buaran 6/2 08788433048 5.6 54.2 39 36.6 DPT1, POLIO2, PCV1
UM 85640839629 6.4 61.5 41 36.4 DPT1, POLIO2, PCV1

Asrm Raya 2/6 82311025364 5.5 55.5 39 36.5 DPT1, POLIO2, PCV1
Buaran 12/02 8989079751 5 56 38 36.5 DPT1, POLIO2, PCV1
Tambun Selatan 5/8 0895330322576 6.3 61 41.4 36.5 DPT2, POLIO3, PCV2
BULAK INDAH RT2/RW8089694644297 5.86 60 40.5 36.5 DPT2, POLIO3, PCV2
Bulak Indah 3/5 089643226776 5.7 57 39 36.5 DPT1, POLIO2, PCV1

Kayu Tinggi 10/09 085799322311 5 54.5 38 36.5 DPT1, POLIO2, PCV1
Kayu Tinggi 12/09 08812583164 7.2 61 41 36.5 DPT2, POLIO3, PCV2
Tambun Rengas Rt.02/07081384337703 6.9 59 38 36.5 DPT1, POLIO2, PCV1
87802836080 6.7 66 40 36.5 MR, IPV2
Gg. Gurame 5/6 85817573304 3.3 48 34.5 36.5 3
Gempol 07/01 083122227126 8.5 69.5 44 36.5 MR, IPV2
Gempol Rt4/Rw1 0895322329015 8.6 70 39 36.5 MR, IPV2
Kayu Tinggi Rt3/Rw3 081385923989 6.4 66 42 36.5 MR, IPV2
088782057642
11-11-2022 6.6 61 41 36.5 DPT2, POLIO3, PCV2
0
21/11/2022 082122588657 6.3 58 40 36.5 DPT2, POLIO3, PCV2
Kayu Tinggi 13/09 13 90 46 36.5 BOOSTER DPT, IPV
Gempol 14/01 089668222197 6.1 57 40 36.4 DPT2, POLIO3, PCV2
Tambun Selatan BOOSTER DPT,
10.5 75 46 36.5
02/08 BOOSTER MR
088211821182
Kayu Tinggi 07/04 9.5 70 45 36.5 BOOSTER DPT
6
Buaran 5/2 082114315491 13.2 75 45 36.5 IPV2, MR
Balai Rakyat 15/01 85692953739 6.8 60.3 40.5 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi 02/03 85156905916 6.8 60.5 41.5 36.5 DPT2, POLIO3, PCV2
Gempol 9/1 8979944025 3.6 53 36 36.5 BCG
Auri 11/1 0888801161052 4.9 56.5 38.5 36.5 BCG, POLIO1
Tanjakan Auri 10/1 89509340070 6.3 58 40.5 36.6 BCG, POLIO1
Gempol 6/1 81288926804 12 86 49 36.5 DPT1, POLIO2
Gempol 7/1 081310261227 4.9 55.5 38 36.5 BCG, POLIO1
Buaran 10/2 88224967649 5.5 59 39 36.5 BCG, POLIO1
Buaran 4/2 89654884247 4.4 52 36 36.5 BCG
Buaran 01/02 081212542529 5.6 59 40 36.5 DPT1, POLIO2, PCV1
Kayu Tinggi 9/3 89652897328 7.6 65 43 36.5 DPT3, POLIIO4, IPV1
Pagar Jati 15/01 #FMT 5.9 60.8 38 36.5 DPT2, POLIO3, PCV2
Bulak Indah 9/12 81382006055 3.7 50.3 37 36.5 BCG, POLIO1
Kayu Tinggi 04/04 6.3 65 41 36.5 DPT2, POLIO3, PCV2
Bulak Indah 9/12 081314901449 6.8 61.5 39.3 36.5 DPT3, POLIO4, IPV1
Kayu Tingi 4/9 81387613642 4.9 56 38 36.5 DPT1, POLIO2, PCV1
Kayu Tinggi 07/03 5.6 60 40.3 36.5 DPT1, POLIO2, PCV1
Gempol 13/01 085156121185 6.2 63.2 39.8 36.5 POLIO4, IPV1
JGC 14/14 81218901917 5.4 57 38.5 36.5 DPT1, POLIO2, PCV1
Kayu Tinggi 3/6 088809346979 5.1 57.7 39.5 36.5 DPT3, POLIO4, IPV1
Kandang Sapi 02/06 081293197716 6.4 60 41 36.5 DPT2, POLIO3, PCV2
Cakung Barat 85714428247 7.5 61.5 41.5 36.5
BOOSTER, DPT,
Gempol 10/1 895343264710 9.7 75.6 44 36.5
Taman Pulo Gebang BOOSTER MR
85697277376 3.4 50 34 36.5 3
5/13
Kayu Tinggi 9/6 8989836747 2.3 47 31 36.5 3
Tambun Rengas 9/7 8 3.4 51 35 36.5 3
Cempaka Elok 12/9 8 10.8 79.5 45 36.5 MR, BOOSTER DPT
Buaran 05/02 087770115303 5.1 58 38 36.5 DPT3, POLIO4, IPV1
Kandang Sapi 10/06 081282895102 8.6 69 45 36.5 IPV2, MR
Bulak Indah 104/05 087741361573 8.7 68 44 36.5 DPT3, POLIO4, IPV1
Gempol 7/1 81213455186 8.1 65.5 41 36.5 DPT2, POLIO3, PCV2
Cempaka 08/09 85889292713 8.6 64 43 36.5 DPT3, POLIO4, IPV1
Bulak Indah 09/05 085695162132 9.2 74.3 45 36.5 MR
Cempaka Elok 4/9 081397347989 8.8 79.5 42.5 36.5 IPV2, MR
Kandang sapi 04/06 89688865484 6.9 62.3 42.5 36.5 DPT2, POLIO3, PCV2
Kayu Tinggi 8/6 81906609345 8.6 70.5 45 36.5 IPV2, MR
Bulak Indah 05/05 895619114506 5.6 54.5 39 36.5 DPT2, POLIO3, PCV2
Gempol Rt11/1 081285873626 8.3 69 44 36.5 IPV2, MR
KAYU TINGGI RT8/RW4087784020189 8.4 72 43 36.5
BUARAN RT11/RW2 6.6 66 41 36.5 DPT3, POLIO4, IPV1
BOOSTER DPT,
Kayu Tinggi 05/09 0812118348843 7.8 11.1 48 36.6
BOOSTER MR
Kayu Tinggi 1/9 089630750197 BOOSTER DPT,
36.5
BOOSTER MR
Kandang Sapi 4/6 85697884651 3.3 49 34 36.5 2
Kayu Tinggi 4/11 81293632079 6.2 59 41 36.5 PCV1
Kayu Tinggi 8/11 8111115586 3.2 48.5 35 36.5 BCG
Kayu Tinggi 09/11 87777136131 5 54 36 36.5 DPT1, POLIO2, PCV1
JGC 81318465084 3 47 34 36.5 BCG
Gempol 8/1 87880837668 3.9 53 35 36.5 BCG
Kayu Tihnggi 08/12 82280399108 4 51.5 36 36.5 BCG, POLIO1
Rorotan 3/10 85820101142 8.3 66 44 36.5 BCG
Gempol 08/01 85776862015 4.3 53.5 36 36.5 BCG, POLIO1
Tambun Rengas 4/7 85883555902 4.7 53 36 36.4 BCG, POLIO1
Kayu Tinggi 10/9 85718519135 5.4 58 38 36.5 PCV1
Buaran 10/2 895348599240 4.8 57 38 46.5 BCG, POLIO1
Gempol 11/01 895384442390 5.4 57 40 36.4 BCG, POLIO1
Kayu Tinggii 3/5 87786968087 3.4 50 34 36.5 3
Kyu Tinggi 6/5 8964404 5.4 57 39 36.5 DPT1, POLIO2, PCV1
Kayu Tinggi 07/11 83843358479 7.1 63 42 36.5 DPT2, POLIO3,PCV2
KP. Gempol 13/01 #FMT 6.9 60 42 36.5 DPT2, POLIO3,PCV2
Kp. Kandang Sapi 3/6 082113523334 6.7 65 40 36.5 DPT3, IPV1
Gempol 14/01 081288060577 7.6 63.8 43 36.5 DPT3, POLIO4, IPV1
Kp. Buaran 10/02 089806724347 4.5 55 38 36.5 DPT2, POLIO3,PCV2
Gempol 08/01 0895606709007 7.1 64 42 36.5
Gempol 1/1 088293361343 7.1 60 40.5 36.5 DPT2, POLIO3,PCV2
Kayu Tinggi 081287188630 4.6 54 37.5 36.5 DPT1, POLIO2, PCV1
Tambun Rengas 3/7 081385251250 7 68.5 44 36.5 DPT3, POLIO4, IPV1
Mawar 16/1 88292237881 6 59 39 36.5 DPT1, POLIO2, PCV1
Gempol 12/1 85161471208 3.2 48 36 36.5 3
Kayu Tinggi 2/11 81284770934 3 47 34 36.5 2 HB.0
Kandang Sapi 4/6 2.5 44.5 34 36.5 2
Buaran 2/2 89512181301 3.6 49.4 34 36.5
Rambun Rengas 4/7 89698176074 14 98 36.5 DPT2, POLIO3, PCV2

Kandang Sapi 9/6 89643461498 5.6 59 39 36.5 DPT1, POLIO2, PCV1
Gempol 2/1 8121924383 3.9 52 36 36.5 BCG, POLIO1
Tambun Rengas 4/7 87800041131 6.2 59.2 41 36.5 BCG, POLIO1
Kayu Tinggi 5/3 881023275431 2.8 49 35 36.5 3
Kayu Tinggi 2/9 85351209685 4.3 53 35 36.5 BCG
Tambun Selatan 4/8 895326386865 5.5 48 39 36.5 DPT1, POLIO2, PCV1

Kandang Sapi 4/6 85678545454 4.1 52.5 35 36.5 BCG, POLIO1
Gempol 3/1 818234522 3.3 50.3 35 36.5 BCG
Tambun Rengas 5/7 82110715393 2.8 49 34 36.5 2 HBO
Gg. Gurame 5/6 85817573304 4.1 50 34 36.5 BCG, POLIO1
Kayu Tinggii 3/5 87786968087 3.5 51 34 36.5 BCG, POLIO1
Gempol 4/1 8970167035 5.3 60 37.5 36.6 DPT1, POLIO2, PCV1
Gempol 04/01 087838089851 6.8 63 40.5 36.5 DPT2, POLIO3, PCV2
Buaran 04/02 81286888651 6.2 60.6 40.5 36.5 DPT3, POLIO4, IPV1
Swadaya 4/6 85328560129 5.7 57.3 39.8 36.5 DPT1, POLIO2, PCV1
GG. Harapan 6/6 81317858731 5 59 39.8 36.5 DPT1, POLIO2, PCV1
Gempol 12/1 85161471208 3.4 48 36 36.5 3
Gempol 15/1 89508441674 8.7 70.5 45 36.5 IPV2, MR
Kayu Tinggi 7/4 87788240616 2.4 44.5 31 36.5 2
JL. Waru 3/9 81269289780 4.6 57 39 36.5 DPT1, POLIO2, PCV1
Ujung Menteng 85664726301 5.9 60 39 36.5 DPT1, POLIO2, PCV1
Gempol Rt16/1 081384608524 6.9 67.5 42.4 37.9
Kayu Tinggi
081514701481 7.5 67.2 43 36.5 IPV2, MR
Rt1/Rw11
Kayu Tinggi 3/5 085715201742 6.1 59.3 40 36.5
BOOSTER DPT,
Jl. Kayu Tinggi 4/11 085880194630 10 87 45 36.5
BOOSTER MR
Gempol 8/1 83819888340 7.7 69 46 36.5 DPT3, POLIO4, IPV1
Perdana 08/12 081294589213 8.5 69 43.5 36.5 IPV2, MR
BOOSTER DPT,
Jl. Teratai 5/5 089512181286 9.8 78 46 36.5
BOOSTER MR
Tambun Selatan 07/08 089888033868 8.4 69 42 36.5 DPT3, POLIO4, IPV1
Kayu Tinggi 6/12 087781357480 7.7 67 42.5 36.5 IPV2, MR
Bulak Indah
Cluster 8/5I6 0881024753575 8.2
Victoria 69 43 36.5 DPT3, POLIO4, IPV1
BOOSTER DPT,
No.9. Metland, Ujung 081315556975 9.4 85 46 36.5
BOOSTERDPT,
BOOSTER MR
KayuMenteng
Tinggi 10/05 089604576693 10 79 45 36.5
BOOSTER MR
KETEPATAN
LAKSANA WAKTU
SDIDTK TEPAT MENIT IMUNISASI BBL (Kg)
TEPAT LAHIR
v v v 04/04/2023
RS Sari Asih
07/03/2023 3.4
Tangerang
V V 04/04/2023
DS = 10 V V 18 Bln
DS = 10 V V 18 Bln
V V Lengkap
V V 04/04/2023
DS = 10 V V 18 Bln
DS = 10 v v Lengkap
v v 9 Bln
V v V 4/4/2023
V V
V V
V V
V V
V V
V v
V v
RSPI SS 2.8
V V
V V RSIA Resti Muly 3.3
V 06-04-2023
V
V
V v
V v
V V
V V
V V
V V
V V
V V
V v
DS : 10 V V v
V V V RSI Pondok Kopi 3.1
V V
V V 11-04-2023
V V
DS : 10 V V
V V 11-04-2023
V v 11-04-2023
V v
V V
V V 11-04-2023
DS : 10 V V
DS : 10 V V
V V
DS : 10 V V
V v
V v 11-04-2023
V V 11-04-2023
V V V 18-04-2023
V V V 18-04-2023
V V V 18-04-2023
V V V 18-04-2023
V V V 18-04-2023
V V v 18-04-2023
V V v 18-04-2023
V V 18-04-2023
V V
V V 18-04-2023
V V 18-04-2023
V V 18-04-2023
V V 18-04-2023
V v 18-04-2023
V v 18-04-2023
V V
V V 18-04-2023
V V 18-04-2023
DS : 10 V V
V V
V V 18-04-2023
V v 18-04-2023
V v
V V
V V 18-04-2023
DS : 10 V
V LENGKAP
V 11-04-2023 RSIA Resti Muly 3300
V RSIA Resti Muly 2300
RS THB 3350
DS : 10
DS : 10 v
DS : 10 v
DS : 10
DS = 10 18 Bln
DS : 10
RSI Bunda Aliya 3250
PKM Cakung 2.8

DS : 10
RSIA Resti Muly 2.9

RS Islam Sukapu 2.9
RS Pekerja 2.4
RS suryanti saro 800gr

V 27-04-2023
V 27-04-2023
V 27-04-2023
V 27-04-2023
V 27-04-2023
RS Resti Mulya 2.6
V 27-04-2023
V 27-04-2023
V 27-04-2023
V 27-04-2023
V 27-04-2023
BPM Surki 2.8
V 27-04-2023
V 27-04-2023
27-04-2023
27-04-2023
27-04-2023
27-04-2023
27-04-2023
27-04-2023
27-04-2023
RSIA Resti Muly 2.9
DS : 10
RS Resti Mulya 2.2
DS : 10
DS : 10
DS : 10
DS : 10
DS : 10
DS : 10
DS : 10
TOTAL
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
SEHAT TETANUS
DJB (x/mnt) RR (x/mnt) SHK
YA TIDAK YA TIDAK
132 40 v v
120 40 YA YA
134 34 YA YA
133 40 YA YA
120 40 YA YA
118 38 YA YA
120 40 YA YA
123 39 YA YA
124 40 YA YA
120 40 YA YA
122 38 YA YA
122 38 YA YA
120 38 YA YA
124 40 YA YA
120 40 YA YA
120 40 YA YA
124 40 YA YA
PENCEGAH RUJUK
AN RESIKO
KIE POLI POLI
TALI PUSAT DIAGNOSA BAYI
BELUM JATUH MTBS GIZI
PUPUT
PUPUT
v v
NCB SMK KN3 Usia 4 hr

v v v
dengan ikterik kramer 1
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
By. G usia 21 hr, NCB v v
YA SMK KN3
v v
By. I usia 10 hr, NCB SMK
YA KN3 v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
By. A usia 15 hr, NCB SMK
YA KN3 v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
KN3 dengan ikterus kramer v v
YA 3
By. A usia 10 hr, NCB SMK v v v
YA KN3 ikterus kramer 2 v v v
By. R usia 10 hr, NCB SMK v v
YA KN3 v v
v v
By.R usia 6 bln dengan v v
status gizi Kurang v v v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
V v
V v
V v
V v
V v
V v
V v
By. M usia 4 hr, NCB SMK V v
YA KN2 V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
KN3 dengan ikterus kramer V v
YA 1
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
By. P usia 13 hr, NCB SMK V v
YA KN3
By. ADg Ikterus
usia 7 hr, Kramer1
NCB SMK V v V
YA KN2 Dg kramer3 V v V
By. R usia 2 hr, NCB SMK
YA KN2 dengan BBLR V v V
By. A usia 21 hr, NKB KMK

YA KN3 V v V
V v
V v
V v
V v
By. H usia 16 hr, NCB SMK V v
YA KN3 V v
V v
post nicu V v V
V v
V v
By. A usia 2 hr, NCB SMK V v
YA KN2 V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
By. P usia 17 hr, NCB SMK V v
YA KN3 Dg Kramer3 V v V
V v
By. M usia 6 hr, NCB SMK V v
YA KN2 V v
V v
V v
V v V
V v
V v V
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
PENILAIAN YANKES
CAKUPAN KN
CUCI KET
TATA SESUA
TANG APD 1 2 3
NILAI I SOP
AN L P L P L P
v v v v
v v v v komplikasi neo 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v Rujuk RS ikterus
v v v v berat
Rujuk RS iKTERUS 1
v v v v Krimer II 1
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
KOMPLIKASI NEO 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v KOMPLI NEO 1
v v v v KOMPLI NEO 1
v v v v BBLR POST
KOMPLI NEO 1
RAWAT INAP NICU
RUJUK RS
FIRDAUS
v v v v KONTROL 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v
By. G usia 1 Bln dg
Sepsis Neonatal
Ikterus, Asfiksia
v v v v (03/03/23)
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v NCB SMK KN3 Dg
v v v v Kramer3 1
v v v v
v v v v
v v v v 1
v v v v
v v v v By. R usia 9 bln dg
v v v v Febris
v v v v Telinga kanan
v v v v Keluar Cairan
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
0 0 4 2 7 4
KUNJUNG
KUNJUNGAN
N KN AN BAYI
BALITA
HB0 (0<7 HR) BCG
(Usia 12-59
4 ( USIA 0-11
Bln) L P L
L P L Bln) P L P
1
1
1
1
1
1
1
1
0 0 4 0 2 1 1 0 13
BCG DPT/HB (1) DPT/HB (2) DPT/HB (3)
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
20 19 17 15 15 16 13
Tanggal Pemberian Imunisa
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
12 13 21 16 14 16 15
ggal Pemberian Imunisasi
POLIO4 IPV 1 IPV 2 PCV 1
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1 1
1 1
1
1
1 1
1 1
1
1 1
1
1 1
1 1
1
1
1
1 1
1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1 1
1
1
1 1
1
1
1
13 12 18 9 7 24 17
0 0
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
16 13 1 0 13 10 7
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
6 7 9 7 4 9 6
BOOSTER CAMPAK
BOOSTER DPT
RUBELLA
P L P
1 1
1
1 1
1
1
1
1
1
1
1 1
6 5 3
1
1
1
1
10 2 3
NO
JAMINAN
REGISTER
F TGL NIK
BARU LAMA BPJS UMUM
1 3175061302131053 V
03-04-2023 166/23
2 v
03-04-2023 167/23
3 3207104212220002 v
04-04-2023 168/23
4 v
169/23
5 V
170/23
6 3175064203230002 v
171/23
7 v
172/23
8 v
173/23
9 v
174/23
10 3275022810220001 465/22 v
11 425/22 V
12 v
101/23
13 V
128/23
14 31720403112200035 V
556/22
15 3175062611220008 v
01/23
16 3175062011220005 58/23 v
17 V
004/23
18 v
87/23
19 V
98/23
20 3175061804220010 V
06-04-2023 175/23
21 067/23 V
22 3326095904210001 V
414/21
23 V
006/23
24 3673011112220001 V
109/23
25 V
123/23
26 3175066401230006 V
105/23
27 3175065201230007 V
106/23
28 3175060601230001 V
024/23
29 3175064501230001 021/23 V
30 068/23 V
31 3201036312220001 142/23
32 3175060601230008 034/23 v
33 V
507/22
34 V
023/23
35 3209336311220001 V
104/23
36 559/22 V
37 3175066506220007 V
305/22
38 3175061606220009 v
389/22
39 3175060402230006 V
103/23
40 3175064109210008 V
341/21
41 31750608003230009 V
11-04-2023 176/23
42 v
177/23
43 v
178/23
44 V
179/23
45 317506403230009 v
180/23
46 3175064803230004 V
181/23
47 v
182/23
48 v
183/23
49 533/22 v
50 V
044/23
51 v
122/23
52 v
148/23
53 v
37/23
54 v
154/23
55 v
12-04-2023 147/23
56 V
13-04-2023 185/23
57 V
186/23
58 V
187/23
59 3175065401230009 v
73/23
60 V
318/22
61 V
163/23
62 3175063006220009 V
346/22
63 V
375/22
64 3175062411220005 003/23 V
65 60/20 V
66 485/22 v
67 062/23 V
3175063001230004 062/23 B V
68 014/23 V
69 3175066312220007 107/23 V
70 3175060708210004 334/21 V
71 393/22 V
72 17-04-2023 188/23 v
73 18-04-2023 189/23 v
74 190/23 V
75 salah jadwal imunisasi 191/23 v
76 192/23 v
77 v
193/23
78 3175064212220013 194/23 v
79 3175061503230007 195/23 v
80 196/23 v
81 3175061402230003 108/23 V
82 128/23 V
83 146/23 V
84 3175066411220002 030/23 v
85 3175060912220001 008/23 V
86 118/23 V
87 392/22 v
88 3175064612220007 015/23 V
89 3175061312220003 550/22 V
90 123/23 V
91 3175065206220005 298/22 v
92 33/23 v
93 317506011220008 102/23 V
94 3201036212220002 135/23 V
95 27-04-2023 197/23 V
96 198/23 V
97 199/23 V
98 139/23 V
99 116/23 V
100 144/23 V
101 124/23 V
102 66/23 V
103 80/23 v
104 140/23 v
105 36/23 v
106 334/22 V
107 57/23 v
108 321/22 v
109 143/23 v
110 75/23 V
111 3175060804131017 115/21 V
JK/UMUR
L P
20-03-2023
Ahmad Rizwan 14 hr Dewi Setyaningsih / Junari
27-03-2023
Muhammad Alfino 7 hr Dede Megawati / Jana
02-12-2022
Jasmine Hanna Cheryl 4 Bln Fitri Tena / Egi
01-03-2023
Alesha Cahyanika Putri 1 Bln Titin Chaironi / Subardi
21-02-2023
Nafisya Putri Febriyanti 2 Bln Dian Fajar Rini / Jefri
02-03-2023
Arsyila Jazlyn 1 Bln Fadila Setyonni / Ranu Rahar
14-02-2023
Bianca Hanna Sahrainna 2 Bln Nurul Hidayat / Muhamad Alb
01-11-2022
Pramusita Ayunisari 5 Bln Ratna / Ahmad Bayhaqi
07-08-2020
Muhammad Azka Baehaki 32 Bln Ratna Sari / Ahmad Bayhaqi
28-10-2022
Ghilman Dzuhairi 6 Bln Erma Fitri / M Samsul
Shaqa Arkan Wiratama 25-08-2022 7 Bln Nuraini / Ahmad Gozali
Masheel Jovial M 19-11-2022 4 Bln Nandra Vahada / Fauzi M
Chaira Putri Ramadhani 11-03-2023 19 hr Widayati / Dodi Yanto
22-11-2022 Putri Ayu Elisa Beth /

Gavin Siregar 4 Bln Slamet Siregar
Devi Susanti / Yason
Boy Matthew Latumeten 26-11-2022 4 Bln
Latumeten
Yosia Meshach Gultom 20-11-2022 5 Bln Financy S / Gidium
Galih Estiawan 21-12-2022 4 Bln Mufiatun / Mulyono
Abidzar Ali Wibowo 15-12-2022 3 Bln Amanda / Bintang
Aliza Nur Rihana 19-1-2023 2.5 BlnYuliany / Danu
18-04-2022
Kenzy Fahrul Ramadhan 12 Bln Lely / Latif
Miroslav Antonius 16-12-2022 4 Bln Beta / Ekker
4/19/2021 Feri Kurdika Rokhim. Gilang

Ameera Naureen Kurdika 24 Bln Ayu Candra
Endang Komalasari / Nelson

Arsyad Pradipta Vernando 11-12-2022 4 Bln
Vernando
06-03-2023 28 Hr
Adinda Azania Putri Senia F / Aryo A
1/24/2023 3 Bln
Azzura Putri Malika Erna S / Bayu P
12-1-2023 3 Bln
Farhana Putri Setiya Rina Mutiara / SIGIT Setya
6-1-23 3 Bln
Muhammad Adib Al Muqid Murtani /Muniroh
Baheera Qurrota Ayun Nigroho 5-1-2023 3 Bln Ashila / Dyan

Joana Berlian Kasih 22-12-2022 4 Bln

Tri Wahyuni / Leonardus S
Arshaka Zayyan Diandra 6-1-23 3 Bln Diah Ayu M / Hendrawati
11--11-22 5 Bln
PHUTRY ALICE ARSYILA LAILATUL / ABDUL
4-1-2023 3 Bln
Aralyne Sachikirani Mustangin Risma / Abdul Mustangin
23-11-2022 5 Bln
Qanita Avicenna Nurul Hidayah / Toni
Agustin Rohmah / Dwi
Nayra Humaira Havva 18-12-2022 4 Bln
Ristiyanto
25-6-22
Kyra Dwi Syafira 9 Bln Nurul /Dwi Satria
16-06-2022
Rasendria Sidqi 10 Bln Juanah / Lutfi
04-02-2023 2 Bln
Atha Rayhan Shakeil Latifatul / Rahmaddani
9/1/2021
Ceisya Elma Humaira 19 Bln Listitin Rahmani / Markondi
08-03-2023
Abizar Dewantara 1 Bln Aprilia / Nurman
10-02-2023
Zea Diyana 2 Bln Yanti / Dirga Hayu
23-03-2023
Syadamar Emmeril 14 hr Andi Farida / Erik Sulistyono
01-03-2023
Muhammad Syakir 1 Bln Lis Marisa / M Nur Romadho
06-03-2023
Yumna Safwara 1 Bln Dora W.P / Azwar Efendi
08-03-2023
Annisa Humaira 1 Bln Nursalastina / Farid Wahyudi
06-03-2023
Muhammad Azzam Alfarizi 1 Bln Nani / Rudi
08-02-2023
Rebecca Nathania 2 Bln Santa Lucia / Daud Alfred
Micha Salwa 7-11-22 5 Bln Umi Saropah / M. Fatul
5-1-2023 3 Bln Iif Ma'difah / Ooj

M. Hafidz Ismail Nurmusafah
07-03-2023 1 Bln
Muhammad Aqsha Syabar Iyang Wida / Lucky D
26-12-2022
Afifa Fathima Mumtazha 1 Bln Jumiati / Abdul Somad
02-11-2022 5 Bln
Haidar Maulana Nurjanah / Echo Ujisucipto
Hamid Al Walidan 11-03-2023 1 Bln Ayunda Sari / Faiz Septian
21-03-2023
Ramdan Gunawan 14 hr Yeni Yasmin / Giman Gunawa
02-12-2022
Ranya Faleska Harap 4 Bln Rizma Maulina / Haula Prasu
13-09-2021
Evelyn David Betricia 19 Bln Halimah / Alberd David
01-11-2020
Asya Risqiyah Maulida 29 Bln Ida / Riska
14-01-2023
Hafsa Nahda Azzahra 3 Bln Afieny Tazkyatur / Dedi Sutri
8-7-22
Freya Mackenzie 9 Bln DWI ANGGRAINI/DANI
25-03-2023 19 Hr Rizaiyatul Aini / Agus

Muhammad Yusuf Andriyanto
30-06-2022
Abdan Alfatih 9 Bln Ida Royani /Riska Yudistira
07-07-22 Fitria Meylani /

Lyvia Zivanka Hafizha 9 Bln Muhammadvhafidz Kamal
Sri Devi Anna / Rio
Prince Novmender 24-11-2022 4 Bln
Arthasasta
Gabriella Felisia 15-11-19 40 Bln Dewi Yulindah / Robbani
Rabiza Zia Sakhi 09-05-2022 5.3 Tri Puspita / Irwan Saleh
Muhammad Fatihif 30-1-2023 3 Bln Murtafiah / Fajar
Ahmad Syahqir Desifa 06/12/2022 4 B ln Suci . Tabroni
20 Anita diana sari dan jefri
Arkana reyndra alfahrezy 8/7/2021 Rizka Anisa Putri / Rama
Bln setiawan
Reaito Albara Razka 07-07-2022 9 Bln Putra S
Bilqis Ramadhani N 11-04-2023 6 Hr Nuraini / Muh Rizki
Selvira Putri 15-03-2023 1 Bln Sepa Nur / Gunawan
Muhammad Azzafran 28-02-2023 2 Bln Iriyanti / Astalika
Shazia Assylega Q 17-09-2022 7 Bln Neneng K / Faisal Abdahu
Syafa Zaina Rahman 01-02-2023 2 Bln Beta H / Kholilurrahman
19-03-2023
Muhamad Badrut Tamam 1 Bln Buna'ah / Kurtubi
Shanum Aghnia Putri 02-12-2022 4 Bln Siti Nurhoeriah / Arif Afrianto
Ivander Axel Benedict 15-03-2023 1 Bln Hendia Yunita / Kristian
Elvano Panji Ramadhan 10-4-2023 10 hr Kusmiati / Sigit Purwanto
Chaira Putri Ramadhani 11-03-2023 1 Bln Widayati / Dodi Yanto
Alesha Mysha Andralan 17-03-2023 1 BlnDinda Novrijal / Venes Andralan
Zephyrus Azzahir Sampurno 09/12/2022 4 Bln Shinta Setya Putri / Zulfikar A
Asa Marendra 24-09-2022 7 Bln Triyanti / Yakim F
Puji Kurniati / Ahmad Fadli
Ahmad Abyan Pratama 13-12-2022 4 Bln
R
Adinda Azania Putri 06-03-2023 1 Bln Senia F / Aryo A
Tazqia Anindita Putri 12-06-2022 10 Bln Indah Rafika Sari / Zulham Pu
Arfan Naufal 11/1/2023 5 Bln Khodijah / M. Jagwan
Zemira Hanna Karunia 22-12-2022 4 Bln Tri Wahyuni / Leonardus S
Rayyan Haziq Alhaq 18-04-2023 9 hr Rahma / Ziaul Haq
Hadriana Fatimah Azzahra 12-12-2022 4 Bln Rica E / Ahmad Soleh
Muhammad Dalfa Prasetya 25-01-2023 3 Bln Nia Fitriana / Anggi
Syamirvan Rangputih
Renata Stefhane S 20-11-20 29 Bln Santa Lucia / Daud
Alsyazam Atharrazka Adhryan 11-01-2023 3 Bln Ninda Putri / Definal
Rani Nuraini / Januar
Shaziva Nazaleya Mahveen K 15-02-2023 2 Bln
Kurniawan
Muhammad Keyaan Farouq 19-07-2022 9 Bln Ika Septiani / Muhammad Rizk
Zanika Annika Ahmad 31-01-2023 3 Bln Norma
Sintia Putri / Ahmad
Sulastri Maulana
Harahap /B
Lamtio Gloretha Panjaitan 09-07-2022 9 Bln Arvino Panjaitan
Feni Friliyani / Malik
Alif Mohammad 08-02-2023 2 Bln
Maulana
Queensyah Shanum Azkadina 13-01-2023 2 Bln Hidayati / Robiansyah
30 Bln
Mohammad Revansyah Abqory 16-11-2020 Hidayati / Robiansyah
11 hr
20 18
SH KN IMUNISASI SDIDTK
(Kg) (Cm) (Cm)
2,2 kg 45 35 cm 36.6 3
Cakung Timur 9/6 089673503630
3.1 kg 50 34 36.7 2
Buaran 2/2 089636783294
DPT2, Polio3
2,2 kg 47 34 36.7
DAN PCV2
Kayu Tinggi 9/11 088210183619
3.4 55.5 37 36.7 BCG

Buaran 3/2 081317044825
BCG dan
4.1 54 38 36.7
PCV1
Kandang Sapi 2/6 0895345944832
BCG dan
4.1 52 36 36.6
Polio1
Kav. Barokah 8/12089508882577
BCG dan
4.8 56 37 36.6
Polio1
Tambun Rengas 1085715119120
BCG dan
6 62 41 36.7
Polio1
Kayu Tinggi 4/6 0895619127708
13 89 49 36.7 DPT1, Polio2

Kayu Tinggi 4/6 0895619127708 DS = 10
6.9 74 40 36.7
Kayu Tinggi 09/02083890836261 DS = 10
Bulak Indah DPT3, Polio4
#FMT 8.1 65 45 36.5
01/12 dan IPV
Harapan Baru DPT2, Polio3

085262222619 5.9 59.5 40.5 36.6
Bekasi dan PCV2
Kandang Sapi 4/6 85697884651 3.8 51 34 36.7 3
DPT2, Polio3
5.7 59 41 36.7
dan PCV1
Kayu Tinggi 1/5 082370180179
Pulo Gebang DPT3, Polio4
085172009223 6.5 64 40 36.6
01/05 dan IPV
DPT3, Polio4
Kayu Tinggi 12/09 081289446975 6.7 63 41.5 36.7
dan IPV
Kayu Tinggi DPT2, Polio3

081210990274 4.7 57 42 cm 36.7
03/09 dan PCV1
DPT2, Polio3
Gempol 12/01 081385666602 6.3 62 40 cm 36.7
dan PCV1
DPT1, Polio2
Gempol 09/01 88214742674 4.5 53.5 38 36.7
dan PCV1
8 69 45 36.5 MR, IPV2

Kayu Tinggi 1/4 85813485895 DS = 10
DPT2,
UM 85640839629 7.1 63.1 41 36.5 POLIO3,
PCV1
BOOSTER
DPT,
Balai Rakyat 11.5 82.5 36.4
BOSSTER
08/04 085775644012 MR DS = 10
DPT1,
Kayu Tinggi
0857436629267 8.8 64 43 36.5 POLIO2,
13/06 PCV1
DPT1,
KP. Gempol4 /1 85212600989 4.9 57.3 37 36.5 POLIO2,
PCV1
Kayu Tinggi 9/6 3.7 51.3 34 36.5 3

8989836747
DPT1,
Kayu Tinggi 7/5 5.7 57.5 39 36.5 POLIO2,
81219072408 PCV1
DPT1,
85697166284 PCV1
DPT2,
Tambun Rengas Rt.02/07 8 64.5 41 36.5 POLIO3,
081384337703 PCV2
DPT2,
Bulak Indah 6/12 087730530780 6.2 61 40 36.5 POLIO3,
PCV2
DPT2,
Asrm Raya 2/6 82311025364 6.5 59.5 42 36.5 POLIO3,
PCV2
DPT2,
Kayu Tinggi 10/9 5.7 59 39 36.4
POLIO4, IPV
85718519135
DPT2,
Kp. Buaran 6/2 08788433048 6.5 61 41 36.5 POLIO3,
PCV2
DPT3,
BULAK INDAH RT2/RW8 6.3 62 42 36.5
POLIO4, IPV
089694644297
DPT2,
Kayu Tinggi 10/09 6.2 59 38 36.5 POLIO3,
085799322311 PCV2
DPT3,
Bulak Indah 1/5 6.3 60.4 40 36.5
POLIO4, IPV
85651367225
DPT2,
Bulak Indah 3/5 089643226776 6 58.4 40 36.5 POLIO3,
PCV2
8.3 70.3 40 36.5 MR, IPV2

Perdana 08999338028 DS = 10
8.5 67.5 45 36.5 MR, IPV2

Kayu Tinggi 05/4 081804416840
DPT1,
81547275795 PCV1
BOOSTER
DPT,
Tambun Rengas 10 75 45 36.5
BOOSTER
01/07 085693230540 MR
4.1 51 39 38.5
Jl. Komarudin 13/ 085892954600
BCG dan
4 52 38 36.7
Polio1
Kayu Tinggi 1/3 081385865166
2700 51.5 34 36.7 3

Pagar Jati 15/01 0881024361515
BCG dan
4.6 54.5 38 36.7
Polio1
Kayu Tinggi 5/4 0895424458243
BCG dan
4.1 52 36 36.7
Polio1
Kay Tinggi 2/4 081285262606
4.1 53 39 36.7 BCG

Kav.Barokah 8/12 082213462192
BCG dan
4 53 37 36.7
Polio1
Kandang Sapi 7/6 0878889443553
5.6 56 39 36.7 BCG

Gempol 16/01 08164398446
DPT3,Polio4
Kayu Tinggi 06/03 083861882884 6.7 62 43 36.7
dan IPV
DPT2,Polio3
Kayu Tinggi 01/09 5.9 60 40 36.7
dan PCV2
089637524139
Taman Pulo
4.7 54.6 37 36.7 BCG
Gebang 5/13
85697277376
DPT1,
4 52 38 36.7 Polio2 ,
Buaran 2/2 089512181301 PCV1
DPT3,Polio4
Kayu Tinggi 02/03 7.1 65 41.5 36.6
dan IPV
085156905916
Kayu Tinggi 5/3 881023275431 3.3 50.5 37 37 BCG
2.8 49.5 35 36.7 3

Kandang Sapi 4/6
6.9 60.5 41.5 36.5 PCV1

JGC / 14 81519121919
BOOSTER
DPT,
8.5 74 46 36.5
BOOSTER
Cempaka 12/9 81388094081 MR
BOOSTER
DPT,
14 82 47.5 36.4
BOOSTER
Kayu Tinggi 2/4 87864541933 MR
DPT2,Polio3
5.8 57 39 36.7
dan PCV2
Kayu Tinggi 2/9 082294315359
8 69 41 36.5 IPV2, MR
BULAK INDAH RT 895366480080 DS = 10
Kayu Tinggi 7/4 3 50 31 36.5 3

87788240616
Kayu Tinggi 10.1 7.3 43 36.5 IPV2, MR

Rt2/Rw4 087864541933 DS = 10
Cempaka Elok 7.4 66 42 36.5 IPV2, MR

8/9 082211962303 DS = 10
Kayu Tinggi DPT3,
08812583164 7.8 67.5 41 36.7
12/09 POLIO4, IPV
Kayu Tinggi BOOSTER
12 93 46 36.7
13/09 MR
Tanjakan Auri 10/01 9 70.5 44 36.5 IPV2, MR DS = 10
DPT1,
Bulak Indah 3/12 081332098375 56 39 39 36.5 POLIO2,
DPT1,
Kandang Sapi 7/6 85775706584 5.3 56 39 36.5 PCV1
POLIO2,
DPT3,
PCV1
Kayu Tinggi 07/04 081219286349 6 63 41 36.5 DPT2,IPV
POLIO4,
Kayu Tinggi 6/11 89530987096 6.7 60.5 39 36.5 POLIO3,
rt006 rw04 DPT,
PCV2
082110170232 10 81 45.5 36.5
kel.cakung timur BOOSTER
Titian Indah No.6 087770120514 7.6 70 43 36.5 IPV2, MR DS = 10
Kayu Tinggi 10/06083873200111 2.8 46 33 36.7 2
Kayu Tinggi 7/4 082111757082 3.8 53 38 36.7 BCG
BCG dan
Kp. Baru 15/04 08526718729 6.1 54.5 39.5 36.7
Polio1
Gempol 9/1 085813092100
Kayu Tinggi 2/4 08998039844 5.2 55 40 36.6 Polio2
BCG dan
3.5 51 36 36.7
Kayu Tinggi 6/4 081513924065 Polio1
DPT3, Polio4
Kayu Tinggi 6/4 082141120518 6.7 63 41 36.7
dan IPV
BCG dan
Jl. Cempaka 9/9 0816402087 4.4 54 39 36.7
Polio1
Kayu Tinggi 3/3 085885289905 3.7 51 35 36.7 3 DPT1,
Kandang Sapi 4/6 85697884651 4.2 52 37 36.6 PCV1
BCG
Kayu Tinggi 2/11 81284770934 3.7 50.5 36 36.5 BCG
DPT3, Polio4
Kayu Tinggi 7/4 089791120961 6.4 63.5 40.5 36.5
dan IPV
DPT3, Polio4
Kandang sapi 04/06 89688865484 7.3 64 43.5 36.5
dan IPV
DPT1,Polio2
Buaran
Bulak Indah10/2 88224967649 6.1 60 39 36.7
dan PCV1
03/05 082311718820 7.8 64 44 36.5 IPV1, PCV2
DPT3, Polio4
Kayu Tinggi 02/11 081384685330 6.3 62 40 36.5
Bulak Indah dan IPV
DPT3, Polio4
895619114506 6.7 63 40.5 36.5
05/05 dan IPV
Kayu Tinggi 9/6 8989836747 4 54 35 36.5 BCG
Kayu Tinggi 002/1081385881835 7.2 68.5 44.5 36.7 DPT3,Polio4
DPT3, Polio4
Kayu Tinggi 1/9 088299528567 5.4 58.5 39 36.7
dan IPV
DPT2,Polio3
Kayu Tinggi 4/4 08985308182 7 63 43 36.6
dan PCV2
DPT2,Polio4
Kayu Tinggi 10/09085718519135 4.2 53 37 36.7
dan PCV2
Kp. Buaran 10/2 085886634721 3 48 35 36.7 3
DPT3,Polio4
Kandang Sapi 4/6 087812351253 7.3 61 44 36.7
dan IPV
DPT1, Polio2
Kayu Tinggi 2/11 089644841666 4.5 53 37 36.7
dan PCV1
DPT1,Polio2
Rorotan 3/10 085820101142 8.8 70 44.5 36.7
dan PCV2
DPT2,Polio3
Gempol 6/1 81288926804 12 86.5 49.5 36.7
dan IPV
DPT1, Polio2
Gempol 11/01 895384442390 6.1 60 41 36.7
dan PCV1
DPT2,Polio3
Kayu Tinggi 9/3 89633360900 7.2 60 41 36.7
dan PCV2
DPT2, Polio3
Mawar 16/1 88292237881 6.3 61 39 36.7
dan PCV2
DPT2, Polio3
Gempol 11/1 81380466447 6.6 63 41 36.7
dan PCV2
DPT1,Polio2
Gempol 08/01 85776862015 5.5 55 39 36.7
dan PCV1
DPT2, Polio3
JGC 14/14 81218901917 6.1 61 40.5 36.7
dan PCV2
Kayu Tinggi 7/4 082124103016 8.6 69 43.5 36.5 MR & IPV2 DS = 10
DPT1, Polio2
Kayu Tinggi 02/03 089658163633 4.6 54 39 36.5
dan PCV1
JJl. Cempaka 3 5/088223580576 9.6 71.5 45 36.7 MR & IPV2 DS = 10
DPT1, Polio2
Buaran 10/2 895348599240 5.9 60 43 36.5
dan PCV1
DPT2,Polio3
Buaran 24/2 89566595703 5.2 58 39 36.6
dan PCV2
Buaran 24/2 89566595703 11 77 49 36.7 DP = 7
KETEPATAN WAKTU
TEPAT MENIT IMUNISASI BBL (Kg)
TEPAT LAHIR
v 02-05-2023
RSUD Koja 2260
v 02-05-2023
RS Resti Mulya 3280
v v v 04-05-2023
V V V 04-05-2023
V V V 04-05-2023
V V V 04-05-2023
v v v 04-05-2023
v v v 04-05-2023
v v v 04-05-2023
04-05-2023
v v 9 Bln
v v 04-05-2023
18-04-2023
RS BUNDA ALIY 3250
v v 04-05-2023
v v 9 Bln
v v 9 Bln
v v 04-05-2023
v v 04-05-2023
v v 04-05-2023
v v v 18 Bln
v v 09-05-2023
v v LENGKAP
v v 09-05-2023
v v 09-05-2023
RSIA Resti
Mulya 2300
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 09-05-2023
v v 24-08-2023
v v 09-05-2023
v v 12 Bln
v v 12 Bln
v v 09-05-2023
v v LENGKAP
18 -04-2023
v v v 11-05-2023
02-05-2023
RS. Resti Mulya 2580
v v v 11-05-2023
V V V 11-05-2023
v v v 11-05-2023
v v v 11-05-2023
V V V 11-5-2023
v v 9 Bln
v v 11-05-2023
v v 11-05-2023
v v 11-05-2023
V V 9 Bln
v v 11-05-2023
02-05-2023
RS Pekerja 2480
v v 16-05-2023
v v lengkap
v v lengkap
v v 16-05-2023
v v 12 Bln
RS Resti Mulya 2.2
v v 12 Bln
v v 12 Bln
v v 9 bln
v v lengkap
v v 16-05-2023
v v 16-05-2023
v v 16-05-2023
v v 9 bln
v v 16-05-2023
v v Lengkap
v v 12 Bln
16-05-2023 PKM Kec Cakun 2800
V V V 18-05-2023
v v v 18-05-2023
v v v 18-05-2023
v v v 18-05-2023
v v v 9 Bln
v v v 18-05-2023
09-05-2023 RS Resti Mulya 3400
v v v 15-04-2023
v v v 15-04-2023
v v v 15-04-2023
v v v 9 bln
v v v 9 Bln
v v v 15-04-2023
v v v 15-04-2023
v v v 9 Bln
v v 9 bln
v v 15-04-2023
v v 9 Bln
v v 9 Bln
V V 15-04-2023
V V 15-04-2023
23-05-2023 RS Bunda Aliya 2800
V V V 12-09-2023
V V V 30-05-2023
v v v 30-05-2023
v v 30-05-2023
v v 30-05-2023
v v 30-05-2023
v v 30-05-2023
v v 30-05-2023
v v 30-05-2023
V V 30-05-2023
V V 12 Bln
v V 30-05-2023
v 12 Bln
V 30-05-2023
V 30-05-2023
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
SEHAT TETANUS
DJB (x/mnt) RR (x/mnt) SHK
YA TIDAK YA TIDAK
132 41 v v
132 40 v v v
V V
V V
132 41 V V
118 38 YA YA
132 41 v v
132 41 v v
124 40 YA YA
132 41 v v
132 41 v v
135 40 v v
PENCEGAH RUJUK PENILAIAN YA
AN RESIKO
KIE POLI TATA
TALI PUSAT DIAGNOSA BAYI POLI GIZI
BELUM JATUH MTBS NILAI
PUPUT
PUPUT
NKB KMK KMK
KN3 dengan ikterus v v v
v Kramer 3 v
NCB SMK KN2 v v v

v dengan belekan v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
V NCB SMK KN3 v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
By. A usia 28 hr, v v

YA NCB SMK KN3 v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
v v
v
By. A usia 1 bln v v

dengan Febris v
v v
v
v v
v NCB SMK KN3 v
v v
v
V V
V
v v
v
v v
v
V V
V
V V
V
V V
V
V V
V
V V
V
V V
V
V V
V
NCB SMK KN3 V V

v USIA 14 HR V
V V
V
V V
V
V V
V
V V
V
V V
By. M usia 19 hr, V
NCB SMK KN3
dengan tali pusat V V
YA berair V
V V
V
V V
V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
BY.B NCB SMK V V V
v KN2 Uia 6 hr v v v
v v v
v v v
v v v
v v v
v v
v
v v v
v v v
v NCB SMK KN3 v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v By, R NCBSMK KN3V V V
dengan Status Gizi V V V
Kurus Sekali V v v V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
Speech Delayed V V V v
PENILAIAN YANKES
CAKUPAN KN KUNJUNGAN BAYI
CUCI KET ( USIA 0-11 Bln)
SESUAI
TANG APD 1 2 3
SOP
AN L P L P L P L
v v v komplikasi neo
1
v v v komplikasi neo
1
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
1
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
1
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
1
v v v
V V V
v v v
v v v
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
1
V V V
V V V
V V V
V V V
V V V
komplikasi
V V V
neonatus
1
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
v v v 1
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v 1
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
v v v
V V V 1
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
V V V
Sukaura poli
v v v
Tumbuh
0 0 1 1 7 1 0
UNJUNGAN BAYI KUNJUNGAN BALITA
HB0 (0<7 HR) BCG
( USIA 0-11 Bln) (Usia 12-59 Bln)
L P L P
P L P
1
1
1
1
1
1
1
1
1
1
0 0 0 0 0 7 12
L P L P L P L
1
1
1
1
1 1
1
v
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
11 8 11 12 6 11 5
P L P L P L P
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4 10 9 11 10 6 13
an Imunisasi
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7 12 6 4 8 9 13
P L P L P L P
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
10 0 0 7 4 1 4
BOOSTER CAMPAK
RUBELLA
L P
1
1
1
1
0 4
NO REGISTER JAMINAN
NO TGL NIK
BARU LAMA BPJS UMUM
1 3175061803230005 200/23 v
02-05-2023
2 201/23 v
3 3175064309220005 202/23 v
4 203/23 v
5 204/23 v
6 3175063107220004 205/23 v
7 206/23 V
8 207/23 V
9 3175060410220007 208/23 V
10 3175062412220005 129/23 V
11 178/23 v
12 3175064112220004 99/23 v
13 520/22 V
14 3175062201230006 91/23 V
15 060/23 V
16 3175066102230006 138/23 V
17 027/23 V
18 40/23 V
19 52/23 V
20 134/23 V
21 131/23 V
3175061401230010
22 3175062501230003 82/23 V
23 31750608003230009 176/23 V
24 3175066101230003 79/23 v
25 3175062505220011 065/23 v
26 3175061302131053 166/23 V
27 491/22
3175062110220018 V
28 163/23
V
29 72/23 v
30 31750622102200014 209/23 V
04-05-2023
31 3175064302230009 210/23 V
32 317506641120007 211/23 V
33 3175066205180013 212/23 V
34 213/23 V
35 3175064302230009 214/23 V
36 3175066207220005 070/23 V
37 101/23 v
38 312/22
3175061007220011 V
39 534/22
3175060108220006 V
40 157/23 V
41 3207104212220002 168/23 v
42 270/22
v
43 3175060406200000 252/20 V
44 98/23 V
45 411/22 V
46 31750641032300014 169/23 v
47 032/23 v
48 3175064203230002 171/23 v
49 164/23 v
50 530/22 v
51 386/21 V
52 189/22 V
53 3175062112220007 04/23 v
54 3175061703230011 215/23 V
09-05-2023
55 216/23 V
56 217/23 V
57 218/23 V
58 219/23 V
59 3175060804230005 220/23 V
60 1222010602230001 221/23 V
61 3175062004230003 222/23 V
62 223/23 V
63 224/23 v
64 90/23 V
65 3175060902230003 113/23 V
66 3175060402230006 V
103/23
67 3175060601230005 150/23 V
68
3175064410220003 420/22 V
69 V
023/23
70 v
167/23
71 3175061801230001 158/23 V
72 89/23 V
73 3175064501230001 021/23 V
74 3201036312220001 142/23
75 3175065201230007 V
106/23
76 3175060601230001 V
024/23
77 V
66/23
78 451/22 V
79 11-05-2023 225/23 v
80 292/22 V
81 006/23 V
82 365/22 V
83 181/23 V
84 3172043007220007 045/23 V
85 437/22 V
86 122/23 v
87 3175060501230012 028/23 V
88 044/23 V
89 353/22 v
90 160/22 V
91 242/22 V
92 355/22A V
93 3175024808220004 477/22 YA
94 124/22 V
95 177/23 v
226 C /23
12-05-2023 V
96 3175064904230005 227/23
16-05-2023 V
97 228/23 V
98 229/23 V
99 230/23 v
100 231/23 V
101 3374074502230002 232/23 V
102 233/23 V
103 3305202311220001 234/23 V
104 235/23 v
105 236/23 V
106 3173020104230003 237/23 V
107 3175061104230003 238/23 V
108 239/23 V
109 3175060408151113 240/23 V
110 3175066602230005 152/23 V
111 317506403230009 v
180/23
112 201/23 v
113 3175064302230009 214/23 V
114 3171031002230006 141/23 V
115 3175066312220007 107/23 V

116 3175061701230004 133/23 V
117 196/23 v
118 062/23 B V
119 3175065401230009 73/23 v
120 3212123010220001 026/23 V
121 495/22 v
122 19/5/2023 226 B /23 v
123 23/5/2023 241/23 v
124 242/23 v
125 243/23 V
126 3175061804320010 244/23 v
127 245/23 V
128 246/23 V
129 247/23 v
130 3201036212220002 135/23 V
131 502/22 V
132 197/23 V
133 192/23 V
134 118/23 V
135 193/23 v
136 128/23 V
137 146/23 V
138 210/23 V
139 136/23 V
140 240/23 V
141 3175060601220001 182/23 v
142 219/23 V
143 190/23 V
144 189/23 v
145 185/23 V
146 195/23 v
147 230/23 v
24-05-2023
148 25-05-2023 248/23 V

149 249/23 V
150 250/23 V
151 251/23 V
152 252/23 V
153
317103108220002 300/22 V
154
3175061111210005 441/21 V
155 317506011220008 V
102/23
156
311/22 V
157
3175081810180035 278/21 V
158
265/22 V
159
405/22 V
160 3175065206220005 V
298/22
161
405/22 V
162 3175061803230009 226 A/23 v
163 26-05-2023 253/23 v
164 256/23 v
226 C/23 v
165 29-05-2023 254/23 v

166 30-05-2023 060/23 V
167 107/23 V
168 v
80/23
169 V
139/23
170 3175064802230004 183/23 V
171 222/23 V
172 v
143/23
173 199/23 v
174 317506681222000 V
144/23
175 v
140/23
176 255/23 v
177 257/23 v
178 258/23 v
179 259/23 v
180 260/23 v
181 261/23 V
31-05-2023
JK/UMUR
L P
Irham Wafiq Ramadhan 18-03-2023

2 Bln Sakilah / Ma'Mun
Almahira Shazia 13-04-2023

19 hr Sheenta / Nyamin
Hana Maryam 03-09-2022

7 Bln Rahma / Tri Lukman
Raisha Adeeva 24-03-2023

1 Bln Ratna Sekarwangi / Ricky Fe
Humairah 29-04-2023
3 hr Komariah / Ari Nur Muhamm
Cedrio Victor Guinandra 31-07-2022

9 Bln Atika Dewi / Bandar Guntur
Habib Al Habsy Jansen 25-04-2023

7 hr Nurhaeti / Ivan Christian
Denia Alfarizki 16-03-2023

2 Bln Kurniati / Ade S
Uwais Izar Fauzi 04-10-2022

7 Bln Yulia Safitri / Rahmadi Fauzi
Muhammad Gaza Aswindra 24-12-2022 5 Bln

Fitri Dwi A / Pradikta Fajar
Syadamar Emmeril 23-03-2023

1 Bln Andi Farida / Erik Sulistyono
Syafazea Kayla H 01-12-2022 4 Bln Irmay / Dodi Prasetyo
Aiko Hania Andhri 03-12-2022 5 Bln Siti Royani / Saryono Timbul

Inggira Inka Yuspranta 21-2-2023 3Aqua

Bln Risma Dian Sari / Bagus Sanjaya
Kaela Shakira Putri 21-01-2023 4 Bln Marlinda / Irawan
Vonny Simon / Jimmo

Tilford Simon Hariniko 19-02-2023 3 Bln
Lasmono Harniko
Elfathan Rizky 14-1-23 4 Bln Dwi Septianingrum / Ahmad

Faturrohman
Abizar Dewantara 08-03-2023

2 Bln Aprilia / Nurman
Thanaya Musahhilah 21-01-2023 4 Bln Tanti Marenta / Eko Abdiyant
Ahmad Rizwan 20-03-2023

2 Bln Dewi Setyaningsih / Junari
Radevan Alfarizi
21-10-2022 6 Bln Reta / Agus Hermawan
Muhammad Yusuf 25-3-23 1 Bln

Rizaiyatul Aini / Agus Andriyanto
Dewi Sri Ulina / Edward
Enos Basil Gultom 14-1-2023 4 Bln
Chandra
Muhammad Dwiaksa 22-10-2022 6 Bln Eva Damayanti / Muhammad
Nuaira Shanum 20-4-2023 14 hr

Siti Chasanah / M. Amin
Natania Annora Ompungsunggu 24-11-20 29 Bln Martini / Tunggul
Putri Anggraini 22-05-2018 60 Bln Martini / Tunggul
Muhammad Zein A 24-04-2023 10 Hr Difiya Rizky / Handry Tri
Zilvia Mardianah 3-2-2023 3 Bln

Riyanti / M. Suryanto
Abigail Liora Kathleen Gultom 22-07-2022 9 Bln Grifith Jennifer / Albet Dora
Masheel Jovial M 19-11-2022 6 Bln Nandra Vahada / Fauzi M
Ibrahim Ar Gifari
10-07-22 10 Bln Adjeng Suci /Rizki
Albi Arbani
1-8-22 9 Bln Nur Fauziah / Bani Adam
Jasmine Hanna Cheryl 02-12-2022

5 Bln Fitri Tena / Egi
Juan Ramos Sipahutar Novita Mmelati / Jhonni

11-06-2022 11 Bln Parlindungan Sipahutar
Faris Muhamad Saad 6/4/2020 Astri Sulastri / Wahyu Eka

35 Bln Putra
Aliza Nur Rihana 19-1-2023 3.5 BlnYuliany / Danu

Ifra Mikayla 04/08/2022 9 Bln Siti Nurcahya / Reza Sandra
Alesha Cahyanika Putri 01-03-2023

2 Bln Titin Chaironi / Subardi
Eva Gwynet Faomasi Zega 12-12-22 5 Bln

Hanifah / Jhini Mart Temani Zega
Arsyila Jazlyn 02-03-2023

2 Bln Fadila Setyonni / Ranu Rahar
Grace Leticiauli 27-01-2023

3 Bln Rika Masaulina / Lambok Ind
Jamil Muttaqin 26-07-2022

9 Bln Anna Widayani / Yudhi
Hengkara Mahardika Nugroho 21-10-2021

18 Bln Hety Nurhayani / Adik Ahmad
Tomiy Al Fiansyah Pratama 1-6-22 11 Bln Diah Dwi Rahayu / Mustofa
Galih Estiawan 21-12-2022 5 Bln

Mufiatun / Mulyono
Hibrizi Randi Q 17-03-2023 2 Bln

Suryati / Anwar
Abiyasa Aiman 17-2-2023

3 Bln Avaf Fatimah / Hendrawan Ha
Ibra Naumi Arzanka 04-05-2023 5 Hr

Mutia Intan R / nOVIAn Aprianto
Lois Mutia Sianturi 1-3-2023 2 Bln Herlin / Hotman Lumpak
Amelia Safea 17-4-2023 22 Hr Ana Susilawati / Parlan
Muhamad Syahdan 8-4-2023 1 Bln Riska Muriana / Rohmat

Owen Felix Sinaga 6-2-2023 3 Bln Weldianti R / Okto Togap
Elfathan Ramadhan 20-4-2023 2 Bln Dwi Siti Fajar / Aryanto
El Fathan Ramadhan 20-4-2023 19 Hr Dwi Siti Fajar / Aryanto
Rayyan Tunggal 1-4-2023 1 Bln Hindun / Sapri Tunggal
2/9/2023 3 Bln
Mauza Razzan Khalis Liana Anjar / Webi
04-02-2023 3 Bln
Almira Nur Rahmah 04-10-2022 7 Bln Linda/Jamal
4-1-2023 4 Bln
27-03-2023
Muhammad Alfino 2 Bln Dede Megawati / Jana
Dewi Aleshs Nareswari 14-01-2023 4 Bln Purwi Susanti / Dwi Susanto
Baheera Qurrota Ayun Nigroho 5-1-2023 4 Bln Ashila / Dyan
Joana Berlian Kasih 22-12-2022 5 Bln

12-1-2023 4 Bln
Farhana Putri Setiya Rina Mutiara / SIGIT Setya
6-1-23 4 Bln
Muhammad Adib Al Muqid Murtani /Muniroh
Raisa Sasabita 18-10-22 5 Bln Irmalia / Agung
Bhainaka Kahfi 12-9-2021 19 Bln Tri Utami / Abdul Utami
Amalia Kuswijaya/Siswanto
Shanum Halinka Talia 7/13/2022 10 Bln
Geraha

M. Kenzie Alfarizqi 10-08-22 9 Bln Karlita / Iwan
Annisa Humaira 08-03-2023 2 Bln Nursalastina / Farid Wahyudi
Isma Dzaka Dzulhanan 30-07-2022 9,5 bln Ina Reni / Alikhin
9,5
Muhammad Abizar Albirru 26-07-2022 Erawati / M. Yasin
Bln
Muhammad Aqsha Syabar 07-03-2023 2 Bln Iyang Wida / Lucky D
Iif Ma'difah / Ooj
M. Hafidz Ismail 5-1-2023 4 Bln Nurmusafah
Meyda Salsabilah 10-5-22 12 Bln Fitri /Iswanto
Aisyah Qiara Mueezzha 28-5-22 12 Bln Siti /Abdul Muiz
Samala Augustina 07-08-2022 9 Bln Nurul
Okvi / Azimah
Gunawam Saputra
/ Abdul
Salma Nafisah 8-8-22 19 9 Bln Rahman
AHMAD FAUZI 10/6/2021 Bln EDI//ULIS IS MARLINA
Zea Diyana 10-02-2023 3 Bln Yanti / Dirga Hayu
Asira Almayra Ayu Dewi Kunanti / Doni

08-05-2023 4 hr Kurniawan
Azkira Azalia
09-04-2023 1 Bln Umi / Hafidan
Bilqis Ramadhani Fajar 11/04/2023 1 Bln Nuraini / M. Rizki

Mauza Asshiyam Muttaqi 17-04-2023 1 Bln Siti Khotimah / Bambang
Muhammad Dilan Ramadhan 08-05-2023 8 hr

Nadia Selvia / Erwan
Azzahra Nadia 13-04-2023

1 Bln Imah Salimah / Rizki Ardians
Adalia Claresta Wright 5-2-2023

3 Bln Cornelia / James
Aluna Lakeisha 4/14/2023 1 Bln

Sastia / Aris
Faiq Hannan Al Karim 23-11-2022

6 Bln Rizki Astuti / Hanugrah A
Osean Savierra Achmad 16-04-2023

1 Bln Kartika / Ahmad Taufik
Qwenaya Aprilia 04-04-2023 1 BlnDenti Br Silalahi / Aldi Salendho
Dieter Haloman 01-04-2023 1 Bln Tesya Larasati / Naftali Partogi
Alvier Mikolas 11-04-2023 1 Bln Yovita Sari / Alexander
Cannavaro Alfarizqi 09-04-2023 1 Bln Yuyun Yunita / Iwan Prasetno
Yumna Agnia 23-03-2023 2 Bln Rani Radianingsih / Teguh
06-03-2023

1 Bln Sheenta / Nyamin
Zilvia Mardianah 3-2-2023 3 Bln
Riyanti / M. Suryanto
Mutia Hamidah / Asep
Elzio Nazeep Sanjaya 10-02-2023 3 Bln
Sonjaya
Elvano Panji Ramadhan 10-4-2023 1 Bln Kusmiati / Sigit Purwanto
Muhammad Fathif 30-1-2023 4 Bln Murtafiah / Fajar
Hafsa Nahda Azzahra 14-01-2023 3 Bln Afieny Tazkyatur / Dedi Sutri
Vania Jose Sinaga 20-06-2022 11 Bln Fitria H / Armando Sinaga
Muhammad Nizar 15-05-2023 4 hr Siti Rahmawati / Angga
Arsyad Aryan Athallah 13-04-2023 1 Bln Rika Santika / Dedi
Humairah Putri 17-05-2023 6 hr Siska A / Anggi A
Nayyara Safwa 04-04-2023 2 Bln Fitri Nuraini / Ahmad M
Adlan Ramadhan 18-04-2023 1 Bln Indah Sari
Nova LinaSilitonga
/ Yunet Saputro
/
Arion Ro Binsar Siahaan 12-04-2023 1 Bln Sugianto Siahaan
Muhammad Kenzie Ramadhan 22-03-2023 2 Bln Carsiti / Didi
Muhammad Raffasya Raja 19-04-2023 1 Bln Jubaedah /Ardiansyah
Zemira Hanna Karunia 22-12-2022 5 Bln Nur
Tri Wahyuni
Bidayanti/ Leonardus
/ Jefri S
Razika Syakila Hana 08-09-2022 8 Bln Harsana
Rayyan Haziq Alhaq 18-04-2023 1 BLN Rahma / Ziaul Haq
Syafa Zaina Rahman 01-02-2023 3 Bln Beta H / Kholilurrahman
Alesha Syahputri 11-12-22 5 bln Sya'diah / Dian
Muhamad Badrut Tamam 19-03-2023 1 Bln Buna'ah / Kurtubi
Nuaira Shanum 20-4-2023 1 Bln Siti Chasanah / M. Amin
Rebecca Nathania 08-02-2023 2 Bln Santa Lucia / Daud Alfred
Amelia Safea 17-4-2023 1 Bln Ana Susilawati / Parlan
Muhammad Azzafran 28-02-2023 3 Bln Iriyanti / Astalika
Selvira Putri 15-03-2023 2 Bln Sepa Nur / Gunawan
Ranya Faleska Harap 02-12-2022 5 Bln Rizma Maulina / Haula Prasu
Muh Dilan Ramadhan 08-05-2023 16 hr Nadia Selvia / Erwan
Rafael Bintang 20-11-2021 18 Bln Florencia / Yosep

Diori Manuel Hamonangan 12-3-2021 26 Bln Emmi Sihombing / Rony Fred
Fairel Putra A 20-9-2021 20 Bln Fitriani / Agtamaron
Afifah Zahra Hafidzah 9-12-2019 41 Bln Siti Umroh / Hadri Ikhsan
Devanya Michelle 4-5-2023 21 Hr

Kiki F / Lutfi Hasbulloh
10
Alfarezel Aldelbano 1-8-22 Bln Nopi/Amir
18 Tetty Siburian/ Tumpal
Ayub Halomoan Sianturi 11/11/2021 Bln Sianturi
11/1/2023 6 Bln
Arfan Naufal Khodijah / M. Jagwan
Almeira Rania Anwar 01-08-2022 9 Bln Nurbaeda / Riski Anwar
M Alkalifi Dzikri 02-02-21 22 Bln Jilly Perdani Putri
Nuha Adiba 1-7-22 10 Bln Mawah / Supriadi
Haura Yumna Fatimah 19-07-2022 12 Bln Lestari / m. Sugandi

12-06-2022
Tazqia Anindita Putri 11 Bln Indah Rafika Sari / Zulham Pu
Haura Yumna Fatimah 19-07-2022 12 Bln Lestari / m. Sugandi

Ahmad Asyraf 18-3-2023 2 BLN Sunariyah / Maksum
Chelsea Zhea Genaira 7 hr Virda Yunia / Faisal
Putra Arsya Novaldi 15-11-2021 18 bln Karjo / Siti Masruroh
Asira Almayra
Ayu Dewi Kunanti / Doni
08-05-2023 18 hr Kurniawan
Bilal Hafizh Athailah 23-5-2023 6 hr Eka Meirinah / Mujiono

Alsyazam Atharrazka Adhryan 11-01-2023 4 Bln Ninda Putri / Definal
Syamirvan Rangputih
08-02-2023
Madinah Zelmira 22-3-2023 2 Bln Shena / Arief

Alif Mohammad 08-02-2023 3 bln
Maulana
25-01-2023
Muhammad Dalfa Prasetya 4 Bln Nia Fitriana / Anggi

Kurniawan
Happy Elina Risdian 30-4-2023 1 Bln Sri Hikmayanti / Farlan Leo R
Ve Ahavta Elohecha 19-2-2023 3 Bln Margaretha / Arkies Apriyandi
Salwa Fauzia 28-3-2023 2 Bln Aisyah Indriyani / Al Fauzi
Shine Queenza Purba 28-4-2023 1 Bln Mentari / Sastra James
Muhammad Sulthon Alfatih 31-1-2023 4 Bln Nurul Mawadah / Ahmad Rob
Cristine Gabriela Hasibuan 24-05-2023

7 Hr Ely Sabet / Jupri HAsbun
(Kg) (Cm) (Cm)
BCG dan
3.8 52 36 36.7
Polio1
Tambun Selatan 608577987509
3.2 51.5 34 36.7 3

Buaran 10/02 085776092462
DPT3,Polio4
7.4 67 41 36.7
dan IPV
Buaran 11/02 081283309464
3.4 38.5 35 36.6 BCG

JL. Paguyuban 4//0895359808764
2.6 48.5 32 36.7 2

Kayu Tinggi 1/9 089604602694
8.9 70 43 36.7 POLIO1

TPG 02/13 082275836418 DS = 10
3.2 48 43 36.6 2
Kayu Tinggi 7/4 081278068364
4.5 55 37 36.6 BCG

Buaran 5/2 08143363310
DPT3,IPV
7 65 44 36.6
dan PCV2
Perdana 5/12 085696208017
DPT1,Polio3
Kayu Tinggi 10/5 63 42 36.7
dan PCV1
81386397745 6.4
52 39 36.7 BCG
Pagar Jati 15/01 0881024361515 4
Taman
Pulogebang 081296876540 6.9 62.3 40 36.7 PCV2
RT.08/13
DPT3,Polio 4
Kp. Buaran 10/02 089806724347 5.2 58.7 38.5 36.6
dan IPV
DPT2,
GG. Harapan 6/6 81317858731 5.2 63 40 36.5 POLIO3,
PCV2
DPT2,
Kayu Tinggi 9/4 88296293912 5.6 60 39 36.5 POLIO3,
PCV2
DPT1,Polio2
Kayu Tihnggi 08/12 82280399108 5 57.3 38 36.5
dan PCV1
DPT3,Polio 4
Gempol 1/1 088293361343 7.7 64 41 36.5
dan IPV
Gempol 03/01 895321747201 6.6 62 41 36.5 POLIO4
DPT2,
Perdana 6/12 081319571239 6.4 52 40 36.5 POLIO3,
PCV2
DPT1,
JGC 81318465084 5.2 56.5 39 36.5 POLIO2,
PCV1
DPT3,Polio 4
Kayu Tinggi 4/11 7.2 65.5 43 36.4
dan IPV
81293632079
DPT2,
PCV2
DPT1,
5 56 39 36.5 POLIO2,
Jl. Komarudin 13/ 085892954600 PCV1
DPT2,
Kayu Tinggi 081287188630 5.4 56.5 57.5 36.5 POLIO3,
PCV2
DPT1,
Kandang Sapi 13/06 081586115118 5.4 58.2 38 36.5 POLIO2,
PCV1
3.4 50.3 36 36.5 BCG, POLIO1

Cakung Timur 9/6 089673503630
DPT3,Polio 4
Tambun Rengas 7.5 65 43 36.5
dan IPV
04/07 0896704140401 DS = 10
Kayu Tinggi 7/4 3.9 51.3 35 36.6 BCG

087788240616
DPT2,Polio3
Jl. Cempaka Elok 4/9081387613642 5.4 61 40 36.6
dan PCV2
DPT2,Polio3
Jl. Perdana 4/12 89624051563 9.7 67 44 36.5
dan PCV2
DS : 10
Tambun Rengas 6/7 081281961628 3.7 51 36 36.5 3
BOOSTER
DPT,
Kayu Tinggi 1/9 89501289862 9.1 79 45 36.5
BOOSTER
MR
BOOSTER
DPT,
Kayu Tinggi 1/9 89501289862 16 104.5 50 36.5
BOOSTER
MR DS : 10
Tambun Rengas 3/7 895341435433 3.4 51 34 36.5 3
Kayu Tinggi 4/11 87760968431 4.4 56 39 36.5
Cempaka 8/9 87748004631 6.9 65 42 36.5 MR, IPV2

DS = 10
Harapan Baru DPT3,
085262222619 6.1 61.5 43 36.5
Bekasi POLIO4, IPV
DS : 10
9.1 72 47 36.5 MR, IPV2

Gempol Rt3/Rw1 081289828723
8.1 69 45 36.5 MR, IPV2

Kayu Tinggi 03/12089647122170 DS : 10
DPT1,
Kandang Sapi 4/6 85678545454 5.3 56 38 36.5 POLIO2,
PCV1
DPT3,
6 61 40 36.5
POLIO4, IPV
Kayu Tinggi 9/11 088210183619
7.9 69.5 44 36.5 MR, IPV2

Kayu Tinggi 9/3 082164026938
BOOSTER
DPT,
Kandang Sapi 12 92.5 47 36.5
BOOSTER
2/6 83893277071 MR
DPT2,
Gempol 09/01 88214742674 5.2 57 39 36.5 POLIO3,
PCV2
Kayu Tinggi 08577449059 8.2 66.5 42 36.5 MR, IPV2
DS : 10
DPT1,
4 56 39 36.5 POLIO2,
Buaran 3/2 081317044825 PCV1
DPT2,
088289889838 PCV2
DPT1,
5 55 37 36.6 POLIO2,
Kav. Barokah 8/12089508882577 PCV1
DPT2,Polio3,
5.5 62 41 36.7
PCV2
Jl. Waru 3/9 081269289780
7.9 63 44 36.5 MR, PCV1

Kayu Tinggi 3/3 088210370709 DS = 10
Booster DPT,
9.8 75 47 36.7 BOOSTER
Kayu Tinggi 4/9 083871411336 MR DS = 10
Kayu Tinggi 7/5 08962010819 8.9 70 43 36.7 MR & IPV2
DPT3,POLIO
Kayu Tinggi 3/9 5.1 58 43 36.7
4 dan IPV
081210990274
BCG,
Rorotan 5/10 5 57 38 36.5
POLIO2
89644485129
BCG,
6.2 61 41 36.5
POLIO2
JL. Waru III 2/9 81283623305
Buaran 2/2 2
83805848226
BCG,
Babelan 89607828461 4.9 57 39 36.5
POLIO1
Kayu Tinggi 3/9 81514563754 3.2 47 33 36.5 3
BCG,
Tambun Rengas 2/7 88975932007 4.3 52 35 36.5
POLIO1
DPT1,
Taman moder UM 813920440007 5.6 58 41 36.5 POLIO2,
PCV1
Gempol 3/1 81387441545 4.8 55 34 36.6 BCG
Gempol 3/1 81387441545 4.1 55 38 36.6 3
BCG,
Buaran 12/2 83839492509 3.5 49 35 36.6
POLIO1
DPT2,
Swadaya 4/6 85328560129 7.1 60 42 36.5 POLIO3,
PCV2
DPT1,
Gempol 9/1 5.2 88 38 36.5 POLIO2,
8979944025 PCV1
DPT2,
81547275795 PCV2
DPT1,
Kayu Tinggi 12/6 81398994442 6.8 62 40.5 36.4 POLIO2,
PCV1
Gempol 7.5 66 41 36.5 IPV1

RT9/RW1 089531759948
DPT3,
Kayu Tinggi 10/09 7.3 61 38 36.5
POLIO4,IPV1
085799322311
DPT3,
7.2 67 42 36.5
POLIO4,IPV1
Buaran 2/2 089636783294
DPT2,
Tambun Selatan 4/8 895326386865 6.4 62 41 36.5 POLIO3,
PCV2
DPT2,
Gempol 4/1 8970167035 6.4 64.4 39 36.5 POLIO3,
PCV2
DPT3,
Bulak Indah 6/12 087730530780 6.8 62 40 36.5
POLIO4,IPV1
DPT3,
Kayu Tinggi 10/9 6.1 60 41 36.5
POLIO4,IPV1
85718519135
DPT2,
85697166284 PCV2
DPT3,
Tambun Rengas Rt.02/07 6.4 68 42 36.5
POLIO4,IPV1
081384337703
DPT2,
Mawar 16/1 88292237881 6.5 61 40 36.5 POLIO3,
PCV2
Buaran 11/02 0895357323148 6.8 64 42 36.5 DPT3, IPV1
Booster MR
Gempol rw 01 081291439685 11.5 79.5 48 36.7 dan Booster
DPT
Buaran 11/02 6.9 67 42.5 36.6 MR dan IPV2
Kayu Tinggi DPT2,Polio3

0857436629267 9.5 65.5 43 36.6
13/06 dan PCV2
Kt 01/11 089639262217 6.4 63 43.5 36.6 MR dan IPV2 DS = 10
DPT1, Polio2
Kav.Barokah 8/12 082213462192 4.6 57 39 36.7
dan PCV1
Gempol 2/11 81398264526 7.6 68 42.5 36.7 MR dan IPV2 DS = 10
Kayu Tinggi
081388760608 6.5 67 42 36.7 MR dan IPV2 DS = 10
03/11
Taman Pulo DPT1,POLIO
85697277376 6.2 58 39 36.8
Gebang 5/13 2 dan PCV1
DPT1,POLIO
Kayu Tinggi 3/5 085715201742 6.5 62 41 36.7
2 dan PCV1
DPT3,Polio4
Kayu Tinggi 01/09 089637524139 6.5 62.5 41.5 36.7
dan IPV
Kt 07/09 081293404015 8.3 70 43 36.7 MR dan IPV2 DS = 10
Kandang Sapi
Bulak Indah 0895357077111 9.7 96.5 45.5 36.7 DM = 8
Rt1/Rw6
Rt5/Rw5
Bulak Indah 082281298524 8.2 72 44 36.7 MR dan IPV2 DS = 10
10/05 7.1 69 44 36.7 MR dan IPV2 DS = 10
Kayu Tinggi
KAYU TINGGI11/09088210035117 6.3 65 40.5 36.5 MR dan IPV2
Booster MR DS = 10
RT5/RW4 085694246265 10.3 79 46 36.8 dan Booster
DPT1,Polio2
DPT
Kayu Tinggi 1/3 081385865166 4.7 54 39.5 36.7
dan PCV1
2.5 47.5 35 36.6 2
Kayu Tinggi 4/11 08871225520
BCG,
5.4 57 39 36.5
POLIO1
Gempol 3/1 85891495562
BCG,
Kayu Tinggi 10/6 083873200111 4 51 36 36.5
POLIO1
BCG,
Kayu Tinggi 9/9 81316311477 3.7 53 38 36.5
POLIO1
Jl. Buntu 7/4 3.2 49 35 36.7 3

081399053103
BCG,
4.4 52 37 36.5
POLIO1
Kayu Tinggi 1/3 89512181701
DPT2,
5.2 54 39.5 36.6 POLIO3,
JGC /14 81319764622 PCV2
BCG,
Kayu Tinggi 1/4 2.9 50 39 36.5
POLIO1
895327369467
DPT3,
7.2 64 44 36.5 POLIO4,
gEMPOL 11/1 83120472348 IPV1
Tunda
3.6 49 36 36.7
Imunisasi
Buaran 7/2 085161925135
BCG,
Cempaka 13/9 81318462231 4.2 51 35.5 36.5
POLIO1
BCG,
UM 89654831230 5.7 56 40 36.5
POLIO1
BCG,
Kayu Tinggi 10/09 81259028006 4.4 52 39 36.5
POLIO1
BCG,
Bulak Indah 1/12 81213804263 4.4 52.5 38 36.5
POLIO1
Kayu Tinggi 6/4 87883521676 4.4 54 36 36.5 POLIO2
DPT1,
Gempol 2/1 8121924383 5.4 55 39 36.5 POLIO2,
PCV1
DPT1,
5.5 56 40 36.5 POLIO2,
Kay Tinggi 2/4 081285262606 PCV1
3.8 53 37 36.5 BCG

Buaran 10/02 085776092462
BCG,
Kayu Tinggi 4/11 87760968431 4.5 55 39 36.5
POLIO1
DPT1,
Tambun Rengas
85883555902 6 60 39 36.5 POLIO2,
4/7 PCV1
DPT3,
DPT2,
Kayu Tinggi 09/11 87777136131 5.8 67 41 36.5 IPV1
POLIO3,
BCG,
PCV2
Kayu Tinggi 3/3 085885289905 4.9 55 38 36.5 DPT2,
POLIO2
Kandang Sapi 7/6 85775706584 6 60 40.5 36.5 POLIO3,
DPT3,
Kayu Tinggi 2/9 082294315359 6.2 52 42 36.5 PCV2
POLIO4,
DPT3,
Gempol 04/01 087838089851 7.4 68 43 36.5 IPV1
POLIO4,
Bulak Indah 4/5 085218835674 6.5 72 47 36.7 IPV1 DP = 4
Kayu Tinggi 5/5 081399842733 3 48 36 36.7 2
BCG dan
Kayu Tinggi 4/9 082120621743 3.6 54 37 36.7
Polio1
Kandang Sapi 11/ 08977675351 2.8 48 35 36.7 2 Hep.B.0
BCG dan
Bulak Indah 5/5 085777280297 4 52.5 37 36.7
Polio1
BCG dan
Buaran
Jl. 13/2
Walikota 083805848520 4.3 52 48 36.7
Polio1
Pondok Kopi 082288473905 5.2 57 36 36.7 BCG
BCG dan
Buaran Gowo 6/2 085921157404
Taman 5.3 57 40 36.7
Polio1
BCG dan
Pulogebang 8/13 081286355233 4.4 53 36.5 36.6
Polio1
Kayu Tinggi 10/09085718519135 4.5 55 37.5 36.7 DPT3,IPV
Gempol 07/07 085798825354 5.9 61 41 36.7 DPT3,PCV2
Kp. Buaran 10/2 085886634721 4 51 38 36.7 BCG
Kayu Tinggi 2/4 08998039844 5.9 58.5 40 36.7 Polio3
DPT2,Polio3
Buaran 10/2 88224967649 6.6 61 39 36.6
dan PCV2
DPT1,POLIO
Kayu Tinggi 6/4 081513924065 4.9 55.5 36 36.6
2, PCV1
DPT1,Polio2
Kandang Sapi 4/6 85697884651 5.1 57.5 39 36.5
dan PCV1
DPT1,Polio2
Kayu Tinggi 2/11 81284770934 4.5 55 39 36.6
dan
BCGPCV1
dan
Tambun Rengas 6/7 081281961628 4.6 54 37 36.7
Polio1
DPT1,Polio2
Gempol 8/1 87880837668 5.9 60 40 36.7
dan PCV2
Kayu Tinggi 6/4 87883521676 4.4 54 54 36.7 BCG
DPT1,Polio2
Gempol 16/01 08164398446 5 58.5 38.5 36.7
dan PCV1
Kayu Tinggi 3/9 81514563754 4 50 39 36.7 BCG
DPT1,Polio2
Kp. Baru 15/04 08526718729 7.3 60 40.5 36.5
dan PCV1
DPT1,Polio2
Kayu Tinggi 7/4 082111757082 4.6 57 38.5 36.7
dan PCV1
DPT2,Polio3
JGC / 14 81519121919 7.2 63 43 36.7
dan PCV2
DPT1,Polio2
Jl. Cempaka 9/9 0816402087 5.6 60.5 40.5 36.5
dan PCV1
Jl. Buntu 7/4 081399053103 3.5 50 39 36.6 3
BOOSTER
Kayu tINGGI 10/9 85772888825 10.2 78.5 45 36.5 DS : 10
MR
BOOSTER
DPT,
Kayu Tinggi 12/9 81389910596 10.4 78 47 36.5
BOOSTER
BOOSTER
MR
DPT,
Taman Pulo Gebang 8/13
81310070579 11 80 47 36.5
BOOSTER
MR
Tambun Selatan 5/8 8567207716 13 87 47 36.5 MR
Kayu Tinggi 2/11 81283026593 3 47 34 36.5 3
8.6 71 47 36.5 IPV2, MR

Rt4/Rw5 085772569717 BOOSTER
Kayu Tinggi Rt DPT,
9.8 78 46 36.5 DS : 10
8/4 082192918933 BOOSTER
MR
DPT3,
Kayu Tinggi 4/4 7.6 68 44 36.5 POLIO4, DS : 10
08985308182 IPV1
Kp. Kandang 7.4 66.5 42 36.5 IPV2, MR DS : 10
Sapi 3/6 082113523334 BOOSTER
DPT,
8.7 78 46 36.6
Kayu Tinggi 03/11 085946450245 BOOSTER
MR
Gempol 7.7 69 43 36.5 IPV2 + MR
Rt14/Rw1 0895352046834
7.6 67.3 43 36.5 IPV2 + MR DS : 10

Pulogebang 0838836784987
7.5 70.5 45 36.5 IPV2 + MR

Kayu Tinggi 002/1081385881835
7.6 67.3 43 36.5 IPV2 + MR DS : 10

Pulogebang 0838836784987
Tunda
Rorotan 6A 3.2 54.5 34.5 38.5
Imunisasi
Buaran 10/2 081288853331 3.2 50 36 36.7 2
RW 12 085351209685 8.4 78 47 36.7 DP = 6
3.2 48 36 36.7 3
Kayu Tinggi 4/11 08871225520
Kayu Tinggi 9/3 088214524142 3 50 41 36.6 2

DPT3,Polio4
Kayu Tinggi 9/4 88296293912 6 62 40 36.6
dan IPV
DPT3,Polio4
Kayu Tinggi 6/11 89530987096 7.1 62 41 36.7
dan IPV
DPT3,Polio4
Gempol 11/1 81380466447 7.1 65 41.5 36.7
dan IPV
Rorotan 3/10 085820101142 8.8 89 45 36.7 DPT2, Polio3

DS = 10
DPT1,Polio2
6.7 62 41 36.6
Gempol 16/01 08164398446 dan PCV1
BCG dan
Cakung Residene 81316053517 5.3 56 38 36.7
Polio1
DPT2,Polio3
Buaran 10/2 895348599240 6.5 62 41 36.7
dan PCV2
DPT2,Polio3
5.2 62 37.5 36.7
Kayu Tinggi 2/11 089644841666 dan PCV2
DPT2,Polio3
Gempol 11/01 895384442390 6.6 62 42 36.6
dan PCV2
DPT2,Polio3
Gempol 08/01 85776862015 6.2 59 40 36.5
dan PCV2
BCG dan
Kayu Tinggi 4/4 087885792831 3.8 51.5 37 36.7
Polio1
DPT2, Polio3,
Kay Tinggi 2/9 085775458749 6.5 60 40 36.7
PCV2
BCG dan
Kayu Tinggi 9/3 088976130572 4.2 55 39 36.7
Polio1
BCG dan
Cempaka 9/12 081313375333 4.3 53 39 36.7
Polio1
DPT2, Polio3
Buaran 2/2 08888486124 5.9 62 40 36.6
dan PCV1
3.7 48 35 36.5 3
Kayu Tinggi 9/9 81280920382
KETEPATAN
WAKTU OBS KU
IMUNISASI PASCA JADWAL
IC TIDAK SUNTIK KEMBALI TEMPAT
TEPAT 15 IMUNISASI BBL (Kg)
TEPAT LAHIR DJB (x/mnt)
MENIT
v v v 01-06-2023
16-05-2023
RS Resti Mulya 3000 132
v v v 06-07-2023
v v v 01-06-2023
30-05-2023
Bd. Surki 2700 132
V V V v 01-06-2023
30-05-2023
RS Islam Sukapu 3200 132
V V V V 01-06-2023
V V V V 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
V V V V 01-06-2023
v v v v 07-09-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 07-09-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 07-09-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 07-09-2023
v v v v 01-06-2023
v v v v 01-06-2023
v v v v 06-06-2023
23-05-2023
RS Islam 3390 132
v v v v LENGKAP
v v v v LENGKAP
RS Koja 3.2 120
v v v v 09-05-2023
v v 18 Bln
v v 9 Bln
v v 18 Bln
v v 18 Bln
v v 06-06-2023
v v 9 Bln
v v 18 Bln
v v LENGKAP
v v 06-06-2023
v v 18 Bln
v v 06-06-2023
v v 06-06-2023
v v 06-06-2023
v v 06-06-2023
V V 06-06-2023
V V LENGKAP
V V 18 Blln
V V 9 Bln
V V V 08-06-2023
V V V 08-06-2023
V
RS Resti Mulya 2.8 130
V V V 08-06-2023
V 23-05-2023
RS Firdaus 2600 132
V V V 08-06-2023
V V V 08-06-2023
V V V 08-06-2023
V 23-05-2023
BPM Ari 3800 132
V V V 08-06-2023
V V 08-06-2023
V V 08-06-2023
V V 08-06-2023
V V 08-06-2023
V V 9 Bln
V V 9 Bln
V V 9 Bln
V V 08-06-2023
V V 08-06-2023
V V 9 Bln
V V 9 Bln
V V 08-06-2023
V V 9 Bln
V V 08-06-2023
V V 9 Bln
V V V LENGKAP
v v 18 Bln
v v 13-06-2023
V V 18 Bln
v v 13-06-2023
V V 18 BLN
V V 18 BLN
v v 13-06-2023
v v 13-06-2023
v v 9 Bln
V V 18 Bln
18 Bln
V V 18 Bln
V V 18 Bln
V V 18 Bln
v v Lengkap
v v 13-06-2023
PKM Kec.Cakun 2590 132
v v v 15-06-2023
v v v 15-06-2023
v v v 15-06-2023
13-06-2023
RSKD DUREN
SAWIT 3300 132
v v v 15-06-2023
v v v 15-06-2023
v v v 15-06-2023
v v v 9 Bln
v v v 23-05-2023
v v v 15-06-2023
v v v 15-06-2023
v v v 15-06-2023
v v v 15-06-2023
v v v 15-06-2023
v v 15-06-2023
v v 15-06-2023
v v 15-06-2023
v v 15-06-2023
v v 15-06-2023
v v 9 Bln
v v 15-06-2023
v v 15-06-2023
v v 15-06-2023
v v 9 Bln
v v 9 Bln
25-05-2023
01-06-2023 PKM Ke. Cakung 3200 120
v v v 22-06-2023
v v v 19-06-2023 RS. Resti Mulya 2800 132
v v v 22-06-2023
V V V 22-06-2023
V V V 22-06-2023
V V V 22-06-2023
V V V 22-06-2023
V V 05-10-2023
V V 22-06-2023
V V 22-06-2023
V V 22-06-2023
v V 22-06-2023
v V 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
v v 22-06-2023
13-06-2023
132
V V V Lengkap
V V V Lengkap
V V V Lengkap
V V V 20/11/2023
V V 06-06-2023 RS Sukapura 3 120
V V 18 Bln
V V Lengkap
V V 9 Bln
V V 18 Bln
V V Lengkap
V V 1
V V 18 Bln
V V 18 Bln
V V 18 Bln
V V V 01-06-2023
20-06-2023 RS. Resti Mulya 2990 132
13-06-2023
v 27-06-2023 RS. Resti Mulya 3000 132

v v v 19-10-2023
v v v 28-09-2023
v v v 12-10-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
v v v 04-07-2023
RS 3.6 120
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
SEHAT TETANUS TALI PUSAT DIAGNOSA
PUPUT
By. A NCB SMK

KN3
41 v v v
By. H NCB SMK KN

40 v v v
By. H NCB CMK KN

40 v v v
By.M usia 1 bln
dengan status gizi
kurang
By. E usia 4 bln
dengan status gizi
kurang
By. N usia 14 hr
NCB SMK KN3
41 v v v
Kontrol kembali 11-

05-2023
40 V V V
By. I usia 5 hr NCB
SMK KN2 dg
40 v v v Ikterus Berat
By. A usia 22 hr
NCB SMK KN3
41 v v v
By. E usia 19 hr
NCB SMK KN3
40 v v v
By. M usia 9 Bln
dengan Status Gizi
Kurang dan tidak
naik BB 2 bulan
Berturut-turut
dengan hasil KPSP

Meragukan, Kontrol
dengan status gizi

kurang dan susp
By. A NCB SMK

KN2 usia 4 hr
41 v v v
By. M usia 11 hr
NCB SMK KN3
dengan Ikterus
Berat dan Tali
40 V V V Pusat belum puput
By. A Usia 1 bln

dgn status gizi
kurang
By.O usia 1 bln

dengan ikterus di
mata dan wajah
dengan masalah
pertumbuhan dan
By. M usia 4 hr
40 V V NCB SMK KN2
By. H usia 6 hr
40 v v NCB SMK KN2
NCB SMK KN3 usia 1

40 v v v
NCB SMK KN3 usia
40 v v v 21 hr
Febris
By. C usia 7 hr
41 v v v
NCB SMK KN2
By. P usia 18 bln
dengan status gizi
kurus dan
Penyimpangan
Perkembangan
By. A usia 18 hr
NCB SMK KN 3
By. B NCB SMK

41 v v v KN2 dengan DX
Bilateral
By. C NCB SMK
v v v KN3 dengan DX
40 Bilateral
PENCEGAH RUJUK PENILAIAN YANKES CEK
AN RESIKO MANTOUX
KIE POLI POLI TATA SESUAI CUCI KET
BAYI APD SKRINING
JATUH MTBS GIZI NILAI SOP TANGAN TB
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V V V V v
V V V V V V
V V V V V V
V V V V V V
v V V V V V
v V V V V V
v V V V V V
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
Badan
v v V v v v v gatal 1
Minggu
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
rujuk rs
v v v v v v
ingin
dilakukan
skrining
v v V v v v v mata dan
telinga
v v v v v v
v v v v v v v
v v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v V V V V
v v V V V V
v v v v v v
v v v v v v
v v v v v v
v v v v v v
Rujuk RS
Ikterus
v v V v v v v (dirawat di
rs)
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V v v V V V V 1
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v v
komplikasi
neonatus
v v v v v v
v v v v v v
v v v v v v v
v v v v v v
v v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v v v 1
v v v v v v
v v v v v v
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V V
V V V v V V V V
V V V v V V V V
v v v v v v v
rujuk RS
Resti
V V V V V V V Mulya
(Komplika
si Neo)
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
KUNJUNGAN KUNJUNGAN
CAKUPAN KN BAYI BALITA
HB0 (0<7 HR)
( USIA 0-11 (Usia 12-
1 2 3 Bln) 59 Bln) L P
L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
0 0 3 5 5 5 5 9 5 2 0 0
BCG DPT/HB (1) DPT/HB (2) DPT/HB (3)
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
20 17 13 15 16 13 14
Tanggal Pembe
DPT/HB (3) POLIO 1 POLIO2 POLIO3
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
12 15 12 14 16 17 14
POLIO4 IPV 1 IPV 2 PCV 1
L P L P L P L
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1
1
1
1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1 1
1 1
14 9 14 12 8 13 17
PCV 1 PCV 2 PCV 3 CAMPAK RUBELLA
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
13 12 14 0 1 9 13
BOOSTER CAMPAK
BOOSTER DPT
RUBELLA
L P L P
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
7 3 8 3
NO
JAMINAN
REGISTER
F TGL NIK
BARU LAMA BPJS UMUM
1 07-06-2023 262/23 V
2 263/23
3 264/23 V
4 265/23 V
5 3175061401230010 131/23 V
6 157/23 V
7 v
36/23
8 3175064203230002 171/23 v
9 3175062505220011 065/23 v
10 3175066102230006 138/23 V
11 3175062501230003 82/23 V
12 3175060410220007 208/23 V
13 3175066101230002 52/23 V
14 530/22 v
15 217/23 V
16 3175061803230005 200/23 v
17 3175062412220005 129/23 V
18 3175062201230006 91/23 V
19 3175060902230003 113/23 V
20 31720403112200035 V
556/22
21 180704401230002 V
124/23
22 317506171220004 266/23 V
08-06-2023
23 3175067007220009 267/23 V
24 268/22 V
25 V
269/23
26
3175066908220009 402/22 V
27 216/23 V
28 90/23 V
29
3175066908220003 408/22 V
30
3171044106220001 244/22 V
31 3175060402230006 V
103/23
32
3175062908210003 293/22 V
33 3175060601230005 150/23 V
34 3175095310210001 068/23 V
35 3175064309220005 202/23 v
36
3175060609220006 421/22 YA V
37
3175060112210018 464/21 V
38 409/22 V
3175066908220007
39
257/21 ya
40 374/22
V
41 3175064512220013 532/22 V
42
3175062908220006 496/22 V
43
317506108220004 336/22 V
44 270/23 V
09-06-2023
45 271/23 V
12-06-2023
46 272/23 V
47 218/23 V
13-06-2023
48 226 C/23 v
49 230/23 v
50 V
181/23
51 3175066802230001 156/23 V
52 3175062504230004 206/23 V
53 V
75/23
54 v
177/23
55 72/23 v
56 3175060601230005 150/23 V
57 261/23 v
58 273/23 v
59 232/23 v
15-06-2023
60 042/23 v
3172042404220006
61 3175066207220005 070/23 V
62 3171031002230006 141/23 V
63 227/22 V
64 317506403230009 v
180/23
65 196/23 v
66 455/22 V
67 V
228/23
68 201/23 v
69
24/22 V
70 3175061703230011 215/23 V
71 317506044092200010
354/22 V
72
90/22 V
73 3175061104230003 238/23 V
74 3175066101230003 79/23 v
75 239/23 V
76 062/23 B V
77
3175065309220002 434/22 V
78 3175066602230005 152/23 V
79 V
313/22
80 3175060804230005 220/23 V
81 410/22 V
82 134/23 V
83 3175064904230005 227/23 V
84 315/22 v
85 16-06-2023 274/23 V
86 275/23 V
19-06-2023
87 20-06-2023 3175062904230001 276/23 v
88 3175061505230009 277/23 v
89 3175065505230010 278/23 v
90 279/23 v
91 280/23 v
92 281/23 V
93 282/23 v
94 242/23 V
95 253/23
V
96 v
122/23
97 241/23 v
98 233/23 v
99 377/19 v
100 3328032007220001 283/23 v

22-06-2023
101 3175065008950001 284/23 v
102 285/23 v
103 286/23 v
104 287/23 v
105
478/22 YA
106 136/23 V
107 V
128/23
108 3175061801230001 158/23 V
109
54/22 V
110 192/23 V
111 243/23 V
112 247/23 v
113 3175061804230008 197/23 V
114 210/23 V
115 379/22 v
116 378/22 v
117 317506440922002 440/22 V
118 19/23 v
119 145/23 V
120 219/23 v
121 193/23 v
122 453/22 V
123 26/06/2023 288/23
124 289/23
125 245/23 v
126 27/6/2023 290/23 V
127 3175066703230008 291/23 V
128 3175066205230013 292/23 V
129 293/23 V
130 294/23 V
131 295/23 V
132 3175061205230005 296/23 V
133 280/23 v
134 118/23 V
135 543/22 V
136 272/23 V
137 3175061701230004 133/23 V
138 3175060601220001 182/23 v
139 3175061804320010 244/23 v
140 3175061302131053 166/23 V
141 3175061106220005 363/22 V
142 1222010602230001 221/23 V
143 235/23 v
144 146/23 V
145 3175066312220007 107/23 V
146 269/23 V
147 261/23 v
148 130/23 V
149 271/23 V
150 3175065703230008 146/23 V
151 254/23 v
152 3175066312220007 107/23 V
153
JK/UMUR
L P
Shafa Nadhira Laurelyn 09-03-2023

2 Bln Sheliya / Sugiharto
Lutfian 15-05-2023
21 Hr Deby Febrianti / Arif Setiawan
Maherza Nizam 23-03-2023

2 Bln Ndaru F / Marsha
Muh Nizar Fadillah 15-05-2023

22 Hr Siti Rahmawati / Angga
Elfathan Rizky 14-1-23 5 Bln Dwi Septianingrum / Ahmad

Faturrohman
Arsyila Jazlyn 02-03-2023

4 Bln Fadila Setyonni / Ranu Rahar

Uwais Izar Fauzi 04-10-2022

8 Bln Yulia Safitri / Rahmadi Fauzi
Kaela Shakira Putri 21-01-2023 5 Bln Marlinda / Irawan
Jamil Muttaqin 26-07-2022

11 Bln Anna Widayani / Yudhi
Ibra Naumi Arzanka 04-05-2023 1 Bln
Mutia Intan R / nOVIAn Aprianto
Irham Wafiq Ramadhan 18-03-2023

2 Bln Sakilah / Ma'Mun
Muhammad Gaza Aswindra 24-12-2022 5 Bln

2/9/2023 3 Bln
Mauza Razzan Khalis Liana Anjar / Webi
22-11-2022 Putri Ayu Elisa Beth /

Gavin Siregar 7 Bln Slamet Siregar
4-1-23 4 Bln
Azana Putri K Lutfiana Putri / Muzaki A
Hernan Alvarendra 17-12-2020 30 Bln Sumarsihi / Joko
Eunike Lyora R 30-07-20022

11 Bln Emmi Sihombing / Rony Fred
Raihana Septiani
11-09-2022 9 Bln Sri Wahyuni / Hipzillah
Maharani Zahwa / Achmad

Zafina Alesha 23-5-23 1 Bln Zacky
Winda Selly Septiana /

Michelin Areta Saduk 26-08-2022 9 Bln Michel Victor

ELSA / SAUDI 29-8-22 9 Bln FEBRI / SAUDIN

Aishwa Palestine Saddam 01-06-22 11 Bln Melisa / Wahyu Adam
04-02-2023 4 Bln
RAFA ALFAREZKY 29-8-21 24 Bln RISKA /ARYO
Hana Maryam 03-09-2022

Dian Novita Sari / Nana

Nafeez Zavier Mumtadz 06-09-2022 9 Bln Yulistiana
19
Muhammad Alvero Andriansyah 12/1/2021 Bln Ellarahmawati/Riankurniaa
Dwi Fitriana Widia Putri &

Dinandra Shanum Marta 14-6-2021 24 Bln Indra Marta Wicaksono
Shakira Rasika 11-08-22 9 Bln Astin Fitria / Hakul Imam

Darmawan
Muthtmar Baihaqi 29-8-2022 10 Bln Chanifatul Chamdiyah / Abdu
Dwi Saka Adnan Setyadi 15-08-2022 10 Bln Martini / Amin Jaka Setyadi
Ihsan Nur Rasyid 01-06-2023 8 Hr

Istiqomah / Eko Saputro
Syakila Humaira S 24-05-2023
20 Hr Puspita Sari / Nur Ali Abdillah
Adreena Rayya Prasetya 22-5-23 21 Hr

Choziah Safitri / Ade Puji
Asira Almayra Ayu Dewi Kunanti / Doni

08-05-2023 1 Bln Kurniawan
Muhammad Dilan Ramadhan 08-05-2023 1 Bln

Nadia Selvia / Erwan
08-03-2023
Annisa Humaira 3 Bln Nursalastina / Farid Wahyudi
Janneva Raqeesha 28-02-2023 3 Bln Kharina R / Jony Setiawan
Habib Al Habsy Jansen 25-04-2023

2 Bln Nurhaeti / Ivan Christian
Queensyah Shanum Azkadina 13-01-2023 5 Bln Hidayati / Robiansyah
10-02-2023
Zea Diyana 4 Bln Yanti / Dirga Hayu
Chandra
Cristine Gabriela Hasibuan 24-05-2023

20 Hr Ely Sabet / Jupri HAsbun
Pricelia Alzena 4-4-2023 2 Bln Nenti / Alfrido
Adalia Claresta Wright 5-2-2023 4 Bln Cornelia / James

Inggil Jayantaka Restu Trahjani 24-4-2022 14 Bln Erni / Jalu R Wsuda
Abigail Liora Kathleen Gultom 23-07-2022 10 Bln Grifith Jennifer / Albet Dora

Sonjaya
Desi Milandari / Prakon

Afsheena Nuyara Prakon 10-5-2022 13 Bln
Prasadana Soleh Putra
06-03-2023
King Darel Alamsyah 04-09-2022 9 Bln Warnem / Dedi
Bilqis Ramadhani Fajar 11/04/2023 2 Bln Nuraini / M. Rizki

2 Bln Sheenta / Nyamin
Khalisa Aiza Azzahra 15-12-21 18 Bln Mega /Selamet Nuryanto
Hibrizi Randi Q 17-03-2023 3 Bln

Suryati / Anwar
Ghesti Wahyu / Rahmat Sri

Zavier Gaffi Azhra Azizayn 04-09-22 9 Bln Aji
18
Muhammad Zahdan 12/10/2021 Bln Safitri
Thanaya Musahhilah 21-01-2023 5 Bln Tanti Marenta / Eko Abdiyant

Emma Ayu Lestari /

Khaira Jovita 04-07-2022 11 Bln Muhammad Qosti
Alfatih Danindra 02-09-2022 9 Bln Kani / Gilang
Vonny Simon / Jimmo
Tilford Simon Hariniko 19-02-2023 4 Bln
Lasmono Harniko
Azkira Azalia 09-04-2023 2 Bln Umi / Hafidan
Nabila Harani 15-07-2022 5 Bln Nadia
Rani Triana
Urofah/ Cahardi
Widiyani /
Muhammad Kavin Fawwazz 11-06-2023 5 Hr Achmad Rifki
Winni Lestari / Sopian Tegih
Muhammad Gatot Prabowo 14-6-23 5 Hr
Kurniawan
Dewi Arsyanti / Rendi
Muhammad Kenizio Saputra 29-4-2023 2 Bln Saputra
Ferina / Muhamad Firda
Muhamad Elfathan K 15-05-2023 1 Bln
Fauzan
Linda Yuliandari / Ahmad
Gwen Syakila Azzahra 15-5-23 1 Bln
Dian
Gumi Caramel Lunara 20-1-23 5 Bln Eva Pujiyanti
Yucky // Muchabar
Ganjar
Putri Keumalahayati 13-06-2023 7 Hr Reza
Elshanum Nasyira 13-3-23 3 Bln Rasyidah / Jefri Juliadi
Aira Alsahnum Azzahra 6/13/2023 10 Hr Tri Dayanti / Sukadi
Humairah Putri 17-05-2023 1 Bln Siska A / Anggi A
Chelsea Zhea Genaira 19-05-2023 1 Bln Virda Yunia / Faisal
07-03-2023 3 Bln
Muhammad Aqsha Syabar Iyang Wida / Lucky D
Arsyad Aryan Athallah 13-04-2023

2 Bln Rika Santika / Dedi
Aluna Lakeisha 4/14/2023 2 Bln

Sastia / Aris
Muhammad Rizieq 07-10-2019
42 Bln Nur Istiqomah / M Faiz
Zayyan Arkana Alfarizki 20-7-2022

11 Bln Nur Afita / Jamaludin
Muhammad Hadwan Ramadhan 4/15/2023 2 Bln

Kursita / Lukman
Muhammad Khaizuran Syabil 23-8-2022

10 Bln Elly / Sofa Kamaih
Rania Az Zahra 28-06-2022 Cik Nuni Asna Putri / Tri

12 Bln Hardiansyah
Rachman Hidayat / Nur
Muhammad Omar Affiansyah 02-03-2023 3 Bln
Apriansyah
Kirani Swastika Edelweis 3-9-22 9 Bln Nunuk / Gilang
18 Sri Mulyani & Rachmat

Keanu Firdaus 12/21/2021 Bln Ramadhan
01-02-2023
Syafa Zaina Rahman 4 Bln Beta H / Kholilurrahman
Nayyara Safwa 04-04-2023

3 Bln Fitri Nuraini / Ahmad M
Muhammad Raffasya Raja 19-04-2023

2 Bln Jubaedah /Ardiansyah
18-04-2023
Rayyan Haziq Alhaq 2 Bln Rahma / Ziaul Haq
M Haidir Salim 27-07-2022 11 Bln Susan / M Salim
M. Haidar Salim 27-7-22 11 Bln Susan / M. Salim
Evi Septiani / Ridwan
Reviana Ameira Saputri 04-09-2022 5 Bln Saputra
Padipta Rafif Al Kareem 11-03-2023 3 Bln Bella Cintya Gustina / Refin
Amelia Safea 17-4-2023 2 Bln Ana Susilawati / Parlan
Muhamad Badrut Tamam 19-03-2023 3 Bln Buna'ah / Kurtubi
FAIREL AFNAN ATHARAZKA 22-9-22 9 Bln WINDARI / DADANG
Alluna Nahda Qiana 15-06-2023 11 Hr Nuryani / Agus
Yunike Kanaya Putri 13-06-2023 10 Hr Nova
Namiroh
Sari/ Agus Triadi
Silitonga /
Arion Ro Binsar Siahaan 12-04-2023 2 Bln Sugianto Siahaan
Zea Khalisa 11-04-2023 2 Bln Nirpa Yunita / Sanusi
Khaira Nur Ramadhani 27-03-2023 3 Bln Isa Fatonah / Jamal
Shareen Gabriela S 22-05-2023 1 Bln Winarti / Rizki
Rafandra Ghaisan 23-05-2023 1 Bln Reno Jayanty / Bimo
Nur Maulida Hasanah 26-01-2022 17 Bln Nur Istiqomah / M. Faiz
Qizar Daviandra Al Hakim 30-05-2023 1 Bln Putut
Siti Anggun
Nur Halimah / Mustopa
/ Rahmat
Azmi Rahmat Rumi A 12-05-2023 1 Bln Fajar
Eva Pujiyanti / Muchabar
Putri Keumalahayati 13-06-2023 14 hr Reza
Putri Rahmawati /
Arlisya Elshanum Haafizhah 09-12-2022 6 Bln Ardiansyah Ath Thoriqy
Adreena Rayya Prasetya 22-5-23 1 Bln Choziah Safitri / Ade Puji
Rebecca Nathania 08-02-2023 3 Bln Santa Lucia / Daud Alfred
Adlan Ramadhan 18-04-2023 2 Bln Indah Lina / Yunet Saputro
Ahmad Rizwan 20-03-2023 3 Bln
12 Dewi Setyaningsih / Junari
El Fatih Zhian 11-06-22 bLN Alifta/Ahmad
Osean Savierra Achmad 16-04-2023 2 Bln Kartika / Ahmad Taufik
Alesha Mysha Andralan 17-03-2023 3 bLNDinda Novrijal / Venes Andralan
Ebiella Chloe Sanjaya 23-12-2022 6 Bln Maharani
Desi Novianti / Topan
Zahwa S
/ Achmad
Cristine Gabriela Hasibuan 24-05-2023 1 Bln Ely Sabet / Jupri HAsbun
Anjali Asyaria 09-01-2023 5 Bln Amanda / Wahyu Cahyadi
Syakila Humaira S 24-05-2023 1 Bln Puspita Sari / Nur Ali Abdillah
Bilal Hafizh Athailah 23-5-2023 1 Bln Eka Meirinah / Mujiono
(Kg) (Cm) (Cm)
6 60 40 36.5 BCG, POLIO1

Kayu Tinggi 8/4 8828983427
3.5 53 35 36.5 3
Kayu Tinggi 2/3 85890581935
6.4 59.5 40 36.5 BCG

Kayu Tinggi 9/3 8998195985
3.3 50.5 35 36.5 3

Gg. Gelatik 5/5 81399842733
DPT3,
Kayu Tinggi 4/11 7.6 66 44 36.5
POLIO4, IPV1
81293632079
DPT2,
PCV2
DPT3,
JGC 14/14 81218901917 63 43 36.5
POLIO4, IPV1
6.7
DPT2,
58.5 38 36.5 POLIO3,
Kav. Barokah 8/12089508882577 5.9 PCV2
DPT2,
Kandang Sapi 13/06 081586115118 6.5 62.5 38.5 36.5 POLIO3,
PCV2
DPT2,
Kayu Tihnggi 08/12 82280399108 5.5 60 60 36.5 POLIO3,
PCV2
DPT3,
Kayu Tinggi 6/4 8997336743 7.4 63 43 36.6
POLIO4, IPV1
7.4 67 44 36.5 DPT3, IPV1

Perdana 5/12 085696208017
DPT3,
Perdana 6/12 081319571239 6.8 61 42 36.5
POLIO4, IPV1
8.1 66 45 36.5 PCV2

Kayu Tinggi 3/3 088210370709
Buaran 2/2 4 52 38 36.5 BCG
83805848226
DPT1,
5.1 55 39 36.5 POLIO2,
Tambun Selatan 608577987509 PCV1
DPT2,
81386397745 PCV2
DPT3,
GG. Harapan 6/6 81317858731 5.4 65 41 36.5
POLIO4, IPV1
DPT2,
Gempol 9/1 5.6 61 39.5 36.5 POLIO3,
8979944025 PCV2
DPT3,
6.6 65 43 36.5
POLIO4, IPV1
Kayu Tinggi 1/5 082370180179
DPT3,
Kayu Tinggi 9/3 8 61 43 36.5
POLIO4, IPV1
89633360900
BOOSTER
Gempol 11/1 81287662537 11 87 48.5 36.5
MR
7.3 66 42.5 36.5 MR, IPV2

Kayu Tinggi 12/09
6.8 65 44 36.5 MR, IPV2

Kayu Tinggi 2/6 85909220004 DS = 10
3.2 48 35 36.5 3
Bulak iindah 8/5 838871867081
9.9 71.5 43 36.5 MR, IPV2

Cempaka 05/09 082284945138 DS : 10
DPT1,
7.1 63 41 36.5 POLIO2,
JL. Waru III 2/9 81283623305 PCV1
DPT3,
Swadaya 4/6 85328560129 7.8 63 42 36.5
POLIO4, IPV1
6.6 65 43 36.5 MR, IPV2

KAYU TINGGI RT0815920597 DS : 10
DPT2,
69 42 36.5
POLIO3,
Gempol 12/01 6.9
DPT3,
Kayu Tinggi 2/4 7 64 41 36.5
POLIO4, IPV1
81547275795
BOOSTER
DPT,
11 77 47 36.5
BOOSTER
KAYU TINGGI RT8/RW5 - MR DS : 10
DPT1,
PCV1
BOOSTER
DPT,
Asrm Raya 2/6 82311025364 9.2 75 48 36.5
BOOSTER
MR
7.7 69 44 36.5 MR, IPV2

Buaran 11/02 081283309464 DS : 10
Kayu Tinggi 8.7 73.5 42.5 36.5 MR, IPV2

08/04 088291474033 DS : 10
BOOSTER
DPT,
KAYUTINGGI 10.2 80.7 44.5 36.5
BOOSTER
NO:41 085894076031 MR
Kayu Tinggi 7.8 68 46 36.5 MR, IPV2

04/09 089667319424
BOOSTER
DPT,
Jl. KP Gempol Rt 9.6 79 47 36.5
BOOSTER
04/Rw 01 No.26 081294310309 DS : 10
MR
7.7 68.5 44.5 36.5 MR, IPV2

Rorotan 4/7 0878420565560 DS : 10
DPT3,
Pagar Jati 15/01 #FMT 6.4 63 40 36.5
POLIO4, IPV1
DS : 10
7 70 43 36.5 MR, IPV2

Kayu Tinggi 07/04 087888127666
Bulak Indah Rw 8.4 72 46 36.5 MR, IPV2

02 081213170208
2.8 49 36 36.5 3
Bulak Indah 6/5 82213757810
3.8 51 36 36.5
Kav. Barokah 8/12 89666619773
Buaran 13/02 2.9 46 36 36.6

85721496928
Babelan 89607828461 5.4 60 39 36.7
3.9 54 36 36.7 BCG , Polio1

Kayu Tinggi 4/11 08871225520
Jl. Buntu 7/4 4.7 55 37 36.7 BCG , Polio1

081399053103
DPT2,Polio3
5 58.5 37.5 36.7
dan PCV2
Kav.Barokah 8/12 082213462192
DPT2,Polio3
Kayu Tinggi 2/9 85351209685 5.3 60 38.5 36.7
dan PCV2
4.3 51.5 37 36.7 BCG , Polio1

Kayu Tinggi 7/4 081278068364
DPT3, Polio4
Buaran 24/2 89566595703 5.8 58.5 41 36.6
dan IPV
DPT2,Polio3
5.5 57 40 36.6
dan PCV2
Kayu Tinggi 1/3 081385865166
DPT3, Polio4
Jl. Cempaka Elok 4/9081387613642 6 64 41 36.6
dan IPV
DPT2,Polio3
Kayu Tinggi 12/6 81398994442 7.6 63 43 36.6
dan PCV2
4.2 49.5 37 36.7 3

Kayu Tinggi 9/9 81280920382
Rawa makmur 1/10 089623317845 4.9 55 3.5 36.6 BCG , Polio1
DPT3, Polio4
JGC 14/14 081319764622 5.9 56 41 36.6
dan IPV
Taman
081335534378 8.2 74 47 36.5 IPV
Pulogebang 4/13
Cempaka 8/9 87748004631 7.3 64 45 36.7 PCV1
Tambun Rengas DPT2, Polio3

85883555902 6.5 62 45 36.5
4/7 dan PCV2
Rawa Makmur 03/10 08987979760 9.5 70 49 36.7 MR + IPV2
DPT2, Polio3
6.6 60.5 43.5 36.7
dan PCV2
Kay Tinggi 2/4 081285262606
DPT1,Polio3
Kayu Tinggi 3/3 085885289905 6.1 59 43 36.7
dan PCV1
Rawa Makmur
089637275045 9.2 71.2 47 36.5 MR + IPV2
04/10
DS : 10
DPT1,Polio2
Kayu Tinggi 10/6 083873200111 4.9 54.8 42.5 36.7
dan Pcv1
DPT1, Polio2
4.8 58 37 36.7
dan PCV1
Buaran 10/02 085776092462
Booster MR
Ujung Menteng 9.2 76.2 47 36.5 dan Booster
Rt8/Rw2 085781414816 DPT DS : 10
DPT1, Polio2
Rorotan 5/10 6.2 59 44 36.5
dan PCV1
89644485129
Kp Kandang
Kayu Tinggi Sapi 10.1 78.5 47 36.5 MR + IPV2
04/03
Gang Gurame Rt 085778711769 DS : 10
05 Rw 06 No 31 Booster MR
Cakung Timur 10 76 46 36.5 dan Booster
Jakarta Timur 087813208629 DPT DS : 10
DPT1, Polio2
Kayu Tinggi 10/09 81259028006 5.1 55 38.7 36.5
dan PCV1
DPT3, Polio4
Kayu Tinggi 081287188630 5.8 59 38.7 36.5
dan IPV
DPT1, Polio2
Bulak Indah 1/12 81213804263 5.3 57 39 36.5
dan PCV1
TUNDA
Kandang Sapi 7/6 85775706584 6.6 63 41 36.5
IMUNISASI
9 69 47.5 36.5 MR + IPV2

Pagar Jati 15/01 087869112535 DS : 10
DPT2, Polio3
Gempol 2/1 8121924383 6.2 60.2 43.5 36.5
dan PCV2
8.8 70.3 49 36.5 MR + IPV2

Kayu Tinggi 7/5 082260732498
DPT1, Polio2
Tambun Rengas 2/7 88975932007 5.5 59 43 36.5
dan PCV1
Kayu Tinggi 9/11 083891318266 9.2 71 49 36.5 MR + IPV2 DS : 10
DPT2, Polio3
JGC 81318465084 6.2 59 40 36.5
dan PCV2
DPT1,Polio2
Gempol 3/1 85891495562 6.8 59 40.8 36.5
dan Pcv1
Jl. Kayu Tinggi 10/09 6.4 67 43 36.5 MR + IPV2
Kp. Kandang
085694054918 5.5 47 43 36.5 2
Sapi 11/06
Kayu Tinggi 19/03 08585881981 2.6 46 34 36.7 2
BCG dan
Gempol 4/1 0895412742770 5.3 59 39 36.7
Polio1
JGC 16/14 082169541902 5 54.5 37 36.7 BCG
Kayu Tinggi 6/4 081213499562 3.2 47.5 34 36.6 BCG
DPT3,Polio4
Rawa Kuning 085162612100 5.7 62 40.5 36.6
dan PCV
Kayu Tinggi 4/9 0895359805502 3.1 46 36 36.7 2
Bulak Indah
Tambun 1/5 082170973130
Rengas 5 60 37 36.7 BCG, Polio1
7/7 085934263747 1.9 42 32 36.7 3
Kandang Sapi 11/ 08977675351 3.9 52.5 35 36.6 BCG
BCG dan
Buaran 10/2 081288853331 4.1 52 37 36.6
Polio2
Taman Pulo DPT2,Polio3

7.4 64 40 36.6
Gebang 5/13 dan PCV2
85697277376
DPT1, Polio2
4.4 55 37 36.6
dan PCV1
Kayu Tinggi 4/9 082120621743
DPT1, Polio2
Kayu Tinggi 1/4 4.3 54 37 36.6
dan PCV1
895327369467
DPT3,POLIO4
14 98 46 36.6
DAN IPV
Bulak Indah 2/12 081617518231 DS : 10
9.4 72 46.7 36.7 DPT2,Polio3

Gempol 11/01 083806462606
DPT1,Polio2
Cempaka 7 9/9 5.8 58 39 36.7
dan PCV1
083897222380
8.3 69 43 36.7 MR & IPV2

Tambun Selatan 708999262409
8 68.5 42.5 36.5 PCV3, IPV2

Kayu Tinggi 4/9 081212757773 DS = 10
DPT2,Polio3
Gempol 12/01 08561051807 6.7 63 41 36.6
dan PCV2
7.8 67 44 36.6 MR & IPV2

Kayu Tinggi 1/5 081932948912 DS = 10
DPT2,Polio3
Gempol 8/1 87880837668 6.5 62 40 36.7
dan PCV2
DPT2,Polio3
Kandang Sapi 4/6 85697884651 5.7 60.5 40 36.7
dan PCV2
DPT3,POLIO4
Tambun Selatan 4/8 895326386865 6.6 63.5 42 36.7
DAN IPV
Booster MR
kp.kandang sapi 10 81 45 36.7 dan Booster
rt012/006 089626376902 DPT DS : 10
DPT3,POLIO4
6.2 59.5 40.5 36.7
DAN IPV
Kayu Tinggi 2/4 08998039844
DPT1,Polio2
57 37 36.7
dan PCV1
Bulak Indah 5/5 085777280297 4.6
DPT1,Polio2
Taman 55 38 36.7
dan PCV1
Pulogebang 8/13 081286355233 5.4
DPT1,Polio2
5.1 56 39 36.7
dan PCV1
Kp. Buaran 10/2 085886634721
DPT1,Polio2
Tambun Rengas 6/7 081281961628 5.5 58 40 36.7
dan PCV1
Tambun Selatan 085711716637 9.3 71 44 36.7 MR & IPV1
Tambun Selatan 085711716637 9.3 71.5 41 36.7 MR & IPV1
Kayu Tinggi
043/04 089694070952 7.7 69.5 41 36.7 MR & IPV2
DPT2, Polio3
KandangSapi 4/6 7.1 65.5 41.5 36.7 DS = 10
dan PCV2
DPT2, Polio3
Gempol 12/1 85161471208 6.7 62 42.5 36.6
dan PCV2
DPT1, Polio2
Kayu Tinggi 3/9 81514563754 5.3 53 38 36.7
dan PCV1
DPT2,Polio3
Kayu Tinggi 6/4
BUARAN 081513924065 5.6 59 40 36.6
dan PCV2
RT10 /RW2
Kandang Sapi 089609914502 8.6 67 42 36.6 MR & IPV2 DS = 10
11/6
Tambun Rengas 8 3.4 50 36.5 36.6 3
7/7
Jl. Walikota 89670339016 2.4 47 36 36.5 3
DPT1,Polio2
Pondok Kopi 082288473905 6.6 59.5 40 36.7
dan PCV1
DPT1,Polio2
Buaran 13/02 87803121377 5.9 57.5 38 36.5
dan PCV1
PG 5/4 85710428212 4.7 54.4 36 36.5 BCG
Bulak Indah 1/5 3.8 55 35 36.5 BCG, POLIO1
DPT1,
Bulak Indah 2/12 85780187611 9.8 79 44.5 36.5
POLIO2
Gempol 16/01 81932929072 3.8 53 39 36.5 BCG, POLIO1
Gempol 05/01 85691603810 4.3 47 36.5 36.5 BCG
Kayu Tinggi 4/9 0895359805502 3.2 51.2 34 36.7 3
DPT3,
Buaran 10/2 88224967649 6.8 64 42 36.5
POLIO4, IPV1 DS : 10
Kayu Tinggi
87719027768 7.2 65 41.3 36.5 DS : 10
11/01
Buaran 13/02 85721496928 3.5 51.4 35 36.5 BCG
DPT3,
Kayu Tinggi 09/11 87777136131 7.1 64 42 36.5 DPT2,IPV1
POLIO4,
Gempol 16/01 08164398446 5.8 62.5 59.3 36.5 POLIO3,
DPT1,
Buaran 13/2 083805848520 5.3 60.5 39 36.5 PCV1
POLIO2,
DPT1,
Cakung 5.3 59 36 36/5 PCV1
POLIO2,
Kayu Timur
Tinggi9/6 089673503630
DPT3,
PCV1
Rt2/Rw4 0895336693008 8.5 72.3 44.8 36.5 DPT2,IPV1 DS : 10
POLIO4,
Taman moder UM 813920440007 6.5 62 42 36.5 POLIO3,
Buaran 7/2 085161925135 56.6 5.3 38 36.5 PCV1
BCG, POLIO1
DPT2,
Kayu Tinggi 6/11 89530987096 7.4 64 42 36.5 PCV1 DS : 10
Bulak iindah 8/5 838871867081 3.9 52.5 35.3 36.5 BCG, POLIO1
Kayu Tinggi 9/9 81280920382 4.7 52 37.3 36.5 DPT1,
Kav. Barokah 8/12 89666619773 4.3 55 36 36.5 PCV1
BCG
DPT2,
Kayu Tinggi 2/11 81284770934 4.8 57.5 37.5 36.5 POLIO3,
Kayu Tinggi 9/3 088214524142 4.1 54 38.5 36.5 PCV1
BCG
Kayu Tinggi 6/11 89530987096 7.4 64 42 36.5 DS : 10
KETEPATAN
WAKTU OBS KUNJUNGAN N
IMUNISASI PASCA JADWAL HASIL PEM
IC TIDAK SUNTIK KEMBALI TEMPAT BBL
TEPAT 15 IMUNISASI LAHIR DJB RR
TEPAT (Kg) SHK
MENIT (x/mnt) (x/mnt)
V V 06-07-2023
V 1 Bln 3.2 120 39

Rs Firdaus
V V 06-07-2023
V 1 Bln 3.2 128 40

RB Cakung
V 9 Bln
V 06-07-2023
V 9 Bln
V 06-07-2023
V 06-07-2023
V 06-07-2023
V 9 Bln
V 9 Bln
V 9 Bln
V 9 Bln
V 06-07-2023
V 06-07-2023
V 06-07-2023
V 9 Bln
V 06-07-2023
V 9 Bln
V 9 Bln PKM Pulo 2.8 140 40

Gadung
V V LENGKAP
V V 12 Bln
V V 12 Bln
V V v 12 Bln
V v 11-07-2023
V v 9 Bln
V v 12 Bln
V v 11-07-2023
V v 9 Bln
V v LENGKAP
V v 11-07-2023
V v LENGKAP
V v 12 Bln
V v 12 Bln
V v LENGKAP
V v 12 Bln
V v LENGKAP
V v 12 Bln
V v 9 Bln
V v 12 Bln
V v 12 Bln
RS Islam 2.8 140 40

Sukapura
Rs Mitra
V v 27-06-2023 Kelapa 3.1 138 40
Gading
V v 27-06-2023 RS Resti 2.9 140 38

Mulya
v v 13-07-2023
v v v 13-07-2023
V V V 13-07-2023
V V 13-07-2023
V V 13-07-2023
V V 13-07-2023
V V 12-10-2023
V V 13-07-2023
V V 9 Bln
V V 13-07-2023
V V 27-06-2023 3600 132 41

RS Ananda
v v 13-07-2023
v v 9 Bln
v v ###
v v 18-07-2023
v v 18-07-2023
V V 12 Bln
v v 18-07-2023
v v 18-07-2023
v v 12 Bln
v v 18-07-2023
v v 18-07-2023
v v LENGKAP
v v 18-07-2023
v v 12 Bln
v v Lengkap
v v 18-07-2023
v v 26-10-2023
v v 18-07-2023
v v 12 Bln
V V 18-07-2023
v v 18-07-2023
V V 18-07-2023
V V 18 Bln
V V 18-07-2023
V V 18-07-2023
v v 12 Bln RSIA Resti
v v 11-07-2023 Mulya 2560 132 40
v 18-07-2023 RSIA Resti 2870 132 41

Mulya
v v v 25-07-2023
v v v 25-07-2023
v v v 25-07-2023
v v v 9 Bln Pondok
29-06-2023 Kopi 2900 132 40
v v v 25-07-2023 RSIA Resti
18-07-2023 Mulya 1750 132 41
V V V 25-07-2023
v v v 25-07-2023
v v v 25-07-2023
v v v 25-07-2023
v v v 25-07-2023
v v v 27-07-2023
V V V 25-07-2023
v v v 25-07-2023
V v v 12 Bln
V V V 18 Bln
v v v 25-07-2023
V V 18 Bln
v v 25-07-2023
v v 25-07-2023
v v 9 Bln
V v Lengkap
V v 9 Bln
v v 25-07-2023
v v 25-07-2023
v v 25-07-2023
v v 25-07-2023
v v 27-07-2023
V V 27-07-2023
V V 12 Bln
v v 27-07-2023
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
V V 18 Bln Rs. Islam
1 Bln Sukapura
Rs. Islam 3400 140 40
1 Bln Sukapura 2400 138 38
v v 27-07-2023
v v 27-07-2023
v v 27-07-2023
V V 27-07-2023
v v 27-07-2023
V 27-07-2023
V V 27-07-2023
V V 27-07-2023 Pondok
29-06-2023 Kopi 2900 138 40
V V 9 Bln
9 Bln
V V 27-07-2023
V V 9 Bln
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
V V 9 Bln
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
9 Bln
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
V V 27-07-2023
9 Bln
KUNJUNGAN NEONATAL PENCEGAH RUJUK
HASIL PEMERIKSAAN AN RESIKO
KIE POLI
SEHAT TETANUS TALI PUSAT DIAGNOSA BAYI
BELUM JATUH MTBS
PUPUT
v v
By. L usia 21 hr
v v v v v V
NCB SMK KN3
v v
By. M usia 22 hr
v v v v v v
NCB SMK KN3
v v
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v v
v v
V V
By. Z usia 16 hr
v v v v v
NCB SMK KN3
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
V V
v v
v v
By. I usia 7 hr NCB

v v v v v
SMK KN3
By. S usia 20 hr
v v v v v
NKB KMK KN3
By. A usia 21 hr
v v v v v
NKB KMK KN3
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN3

v v v v v
Usia 20 hr
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
By.M usia 4 bln

v v v
dengan dermatitis
v v
v v
v v
v v
v v
v v
By. N usia 11 bln v v
dengan status Gizi v v V
NCB SMK KN2
Kurang
v v v v v v
dengan Ikterus
By. M usia 5 hr
NCB SMK KN2
V V V v v V
dengan Ikterus
Berat
v v
v v
v v
v v
v v v By. P NCB SMK KN2 v v
v v
KN3 rujuk RS
v v v v v
dengan Prematur
v v
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v v
v v
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v v
v v
v v
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v v
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v v
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v v
v v
v v
v v
v v v By. A NCB SMK KN3
v v v By. Y NCB SMK KN3
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v v v By. P NCB SMK KN3 v v

v v
RUJUK PENILAIAN YANKES CEK CAKUPAN KN
CUCI MANTOUX
POLI TATA SESUA KET
TANGA APD SKRINING 1 2 3
GIZI NILAI I SOP TB
N L P L P L P
v v v v
Pneumoni
v v v v a
Neonatus 1
v v v v
Mata
v v v v
Belekan
1
v v v v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
Gizi
v v v v v kurang
usia 4 bln
v v v v
V V V v
v v v v
1
v v v v
V V V v
v v v v
v v v v 1
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
V V V v
v v v v
v v v v
v v v v
1
v v v v
1
v v v v
1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V v v v v RSIA Resti 1
v v v v Mulya
Rujuk 1
(Komplika
RSIA Resti
v v v v Mulya 1
(Komplika
v v v v si Neo)
v v v v
v v v v
v v v v
v v v v 1
v v v v
KOMPLIK
v v v v 1
ASI NEO
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
1
1
v v v v
v v v v 1
v v v v
1 0 0 2 1 4 8
KUNJUNGAN KUNJUNGAN
BAYI BALITA
HB0 (0<7 HR) BCG
( USIA 0-11 (Usia 12-
Bln) 59 Bln) L P L P
L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
8 8 4 2 0 0 11 12
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
15 10 13 16 11 9 6
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
6 14 11 14 16 10 9
an Imunisasi
L P L P L P L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
14 9 10 11 15 9 13
P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
15 0 1 12 10
BOOSTER CAMPAK
RUBELLA
L P
1
1
1
1
1
1
NO
JAMINAN
REGISTER
TGL NIK
BARU LAMA BPJS UMUM
1 04-07-2023 297/23 V
2 298/23 V
3 299/23 V
4 300/23 V
5 3175061704230005 301/23 V
6 302/23 V
7 3175060606230004 303/23 V
8 304/23 V
9 66/23 V
10 3175062008210060 283/22 V
11 3175065201230007 106/23 V
12 3175065206220005 298/22 V
13 116/23 V
14 346/22 V
15 3175065902231005 257/23 v
16 143/23 v
17 3275047004130001 255/23 v
18 06-07-2023 305/23 V
19 007/22 V
20 3175062505220011 065/23 v
21 429/22 v
22 343/22 V
23 392/22 v
24 248/22 V
25 3175064203230002 171/23 v
26 3175066309220007 522/22 V
27 3175060408151113 240/23 V
28 153/22 V
29 218/23 V
30 3175063107220004 205/23 v
31 3175066211210013 459/21 V
32 3175066102230006 138/23 V
33 11-07-2023 31740806230003 306/23 V
34 307/23 v
35 308/23 V
36 309/23 v
37 310/23 v
38 311/23 v
39 312/23 v
40 3175061401230002 72/23 v
41 217/23 V
42 530/22 v
43 259/23 v
44 3175061503230007 195/23 v
45 144/23 V
46 244/22 V
47 3175064405230009 252/23 V
48 157/23 V
49 261/23 v
50 274/23 v
51 12-07-2023 313/23 v
52 13-07-2023 3174084805213331 314/23 V
53 3175061111210009 315/23 V
54 316/23 V
55 317/23 v
56 318/23 V
57 3175062507220000 471/22 v
58 449/21 V
59 3175060410220007 208/23 V
60 3175062504230004 206/23 V
61 061/23 V
62 468/21 V
63 403/22 V
64 3175060601230005 150/23 V
65 BLM dtulis di status 3175066506220007 305/22 V
66 BLM dtulis di status 3175064510220001 017/23 V
67 177/23 v
68 375/22 V
69 313/22 YA
70 3175060510220008 475/22 v
71 3175064910220004 438/22 YA
72 226 C/23 v
73 18-07-2023 3271051406230001 319/23 v

74 320/23 v
75 321/23 v
76 322/23 v
77 323/23 v
78 324/23 v
79 325/23 v
80 3175062004220019 326/23 v
81 327/23 v
82 298/23 v
83 152/23 V
84 3175064904230005 227/23 V
85 66/23 v
86 196/23 v
87 3171031002230006 141/23 V
88 270/23 V
89 3175064603230009 180/23 V
90 3175061703230011 215/23 V
91 3175065304230008 201/23 V
92 239/23 V
93 3171035502230003 140/23 v
94 3175065306230003 280/23 v
95 181/23 v
96 20-07-2023 3271011710220001 328/23 V
97 3172035005230002 329/23 v
98 330/23 v
99 3175060804230005 220/23 V
100 245/23 v
101 3175065704230003 219/23 v
102 253/23
V
103 3175064404230005 243/23 V
104
31750610010220018 482/22 YA
105 V
561/22
106 210/23 V
3175066004230011
107 216/23 V
108 3175065401230009 v
73/23
109
3175061007220011 312/22 V
110
3175061097220008 334/22 v
111 3175066207220005 070/23 V
112 3175067101230004 v
57/23
113 287/23 v
3175064912890007
114 450/21 v
115 451/22 V
116 24 July 2023 3175061507230002 331/23 v
117 25 July 2023 3173044203220005 332/23 v
118 3173044203220004 333/23 v

119 334/23 v
120 335/23 v
121 336/23 v
122 3175061407230006 337/23 v

123 338/23 v
124 3175062506230006 339/23 v
125 340/23 v
126 233/23 v
127 145/23 V
128 297/23 V
129 128/23 V
130 3172036203230002 222/23 V
131 3206321304230001 241/23 v
132 167/23 v
133 3175061505230009 277/23 v
134 3175061104230003 238/23 V
135 242/23 V
136 3172011904230003 247/23 v
137 3175061701230004 133/23 V
138 1701056012220002 165/23 V
139 27-07-2023 3175061410220013 341/23 v
140 342/23 v
141 296/22 v
142 518/22 v
143 377/19 v
144 294/23 v
145 3175062305230006 254/23 v
146 182/23 v
147 318/21 V
148 134/23 V
149 269/23 V
150 325/23 v
151 530/22 v
152 293/23 V
153 3175066703230008 291/23 V
154 31750641032300014 169/23 v
155 3175062203180024 98/22 V
156 3175061205230005 296/23 V
157 485/22 v
158 122/23 v
159
3172017012210003 58/22 V
160 3175025810220002 494/22 v
161
3175067001220005 112/22 V
162 1222010602230001 221/23 V
163
19/23 v
164 343/23 v
28-07-2023
165 344/23 v
JK/UMUR
L P
Kairan Arshaka 22-06-2023 1 Bln Schella Dwi / Alvin
Irsyad Dwi Arjuna 18-06-2023 1 Bln Suistiowati /
Kaisar El Syabani 21-11-2022 8 Bln Desi Komala / Ahma Sutrisno
Aliy Moktavi Mamduhy 13-05-2023 1.5 Bln Neneng TS / Ihsan Maulana
Muhammad Rafka R 17-04-2023 3 Bln Mira Emilia / Rizky
Anasya Putri 23-05-2023 1.5 Bln Rachmawati / Joko
Muhammad Akhsan Alfarizi 06-06-2023 28 Hr Listianingsih / Nanang Hida
Muhammad Ikhsan Alfarizi 06-06-2023 28 Hr Listianingsih / Nanang Hida
Marátus Solichan / M Andri

Mafaza Ayu Azkadina 24-06-2022 12 Bln
Muzaeni
Farhana Putri Setiya 12-1-2023 6 Bln Rina Mutiara / SIGIT Setya
Tazqia Anindita Putri 12-06-2022 12 Bln Indah Rafika Sari / Zulham Pu
Renata Stefhane S 20-11-20 32 Bln Santa Lucia / Daud

Abdan Alfatih 30-06-2022 12 Bln Ida Royani /Riska Yudistira
Ve Ahavta Elohecha 19-2-2023 4 Bln Margaretha / Arkies Apriyandi

Alif Mohammad 08-02-2023 5 Bln
Maulana
Kevin Servius Levy 01-09-2022 10 Bln Meyan Ayu / Robert S
19
Revanda Rasyid 11/27/2021 Dini / Sopan
Bln
Qurrotu Aini / Agus

Qalesyaava Kinarian 25-9-22 9 Bln
Kurniawan
Muhammad Ghani Wiratama 25-08-2022 10 Bln Rahayu Puji Astuti / Rafli Adi
Asa Marendra 24-09-2022 9 Bln Triyanti / Yakim F
Rafa Mateo Manullang 10-6-22 12 Bln Mayatur/Merton
Arsyila Jazlyn 02-03-2023 4 Bln Fadila Setyonni / Ranu Rahar
Nafisa Aura Putri 23-09-2022 9 Bln Femi / Idris
18 Bella Fransisca / Agus

Devvangga Putra Hasibuan 1/9/2022
Bln Priono
Cedrio Victor Guinandra 31-07-2022 11 Bln Atika Dewi / Bandar Guntur
Myra Ivana Marbun 11/22/2021 20 Bln Marini / Julianto

Arsa Hyuga 08-06-2023 1 Bln Sarnizia / Angga Dri
Yanuar Affandi 14-01-2023 5 Bln Atikah / Nurhadi
Indry Nicky Lestari / Heri

Kaysa Azkadina Azzahra 8-6-23 1 Bln
Maulana
Yasmin Ciara Islami 06-06-2023 1 Bln Della / M Faradiaz
Naysila Devania 09-06-2023 1 Bln Juhria / Dwi Utomo
Abyan Rafisqy Irfani 29-05-2023 2 Bln Yayah Alfiah / Irfan
Jasmin Eltavia Shahnum 05-01-2023 6 Bln Ely Wulan / Oktariza

Chandra
Ibra Naumi Arzanka 04-05-2023 2 BlnMutia Intan R / nOVIAn Aprianto
Jamil Muttaqin 26-07-2022 12 Bln Anna Widayani / Yudhi
Shine Queenza Purba 28-4-2023 3,5 BlnMentari / Sastra James

Aishwa Palestine Saddam 01-06-22 13 Bln Melisa / Wahyu Adam
Devanya Michelle 4-5-2023 2 Bln Kiki F / Lutfi Hasbulloh
Cristine Gabriela Hasibuan 24-05-2023 1 Bln Ely Sabet / Jupri HAsbun
Nadia Urofah Widiyani /

Muhammad Kavin Fawwazz 11-06-2023 1 Bln
Achmad Rifki
Muhammad Hakim Al Habsy 01-07-2023 11 hr Ernawati / Sobri
Priyanka Zafira Alnaira 08-05-2021 2 Bln Rica / Ahmad Syeh
Fathian Razqa Fahrezi 11-11-2021 20 Bln Dewi Irmayanti / Solihin
Adzriel Muhfarih 28-06-2023 15 Hr Tri Murti / Muhammad Undan
Karen Gracella Chnsty 08-07-2023 10 hr Febe Dwi Endah / Marcus
Archika Gelya Wulandari 28-04-2023 3 Bln Dewi Wulandari / Onekesi Gu
19
Barra Ahmad Prasetyo 11-12-21 Hesty/Bayu
Bln
Uwais Izar Fauzi 04-10-2022 9 Bln Yulia Safitri / Rahmadi Fauzi
Habib Al Habsy Jansen 25-04-2023 3 Bln Nurhaeti / Ivan Christian
George Immanuel Dn 02-12-2021 19 Bln Frika / Roytomi
Valerie Hanesya 12/27/2021 18 Bln NATASYA / YOHANES
Samuel Sitorus 28-09-2022 10 Bln Lastaria / Budi
Kyra Dwi Syafira 25-6-22 12 Bln Nurul /Dwi Satria
Oktia Aisyah Putri Maggeti 05-10-2022 9 Bln Nina Delina / Tarmidi
Zea Diyana 10-02-2023 5 Bln Yanti / Dirga Hayu
Fitria Meylani /
Lyvia Zivanka Hafizha 07-07-22 12 Bln
Muhammadvhafidz Kamal
Emma Ayu Lestari /

Khaira Jovita 04-07-2022 12 Bln
Muhammad Qosti

Audy Blesiannna Claire Hutabarat 09-10-2022 9 Bln Nomora Hutabarat

Asira Almayra 08-05-2023 2 Bln
Kurniawan
Arsya Khalif Nadhirrizky 14-06-2023 1 Bln Maryam / Agus K

Difayanti Aishla Faakhira 08-06-2023 1 Bln Dian Fitrianti / Alfian Fadillah
Aksa Abiyathama 6/17/2023 1 Bln Lit Anggita Sari / Riswanto
Giovanna Careen Simanjuntak 12-03-2023 4 Bln Vina Siagian / Natanael
Muhammad Gibran Alfarisi 14-06-2023 1 Bln Suci Retno Sari / Ilham Darus
Emmeril Khalid Arrayan 09-06-0223 1 Bln Erni Ernawati / Bily Thaca
Hazia Ahmad 11-7-2023 7 hr Risna Ristiani / Ahmad Kurtub
Rifqiyatul Aropah / Eri

Rafael Paradita 28-5-23 1 Bln
Setianto
Aishwa Rasyedha Safe 08-05-2023 2 Bln Susilawati / M Yunus
Irsyad Dwi Arjuna 18-06-2023 1 Bln Suistiowati /
Azkira Azalia 09-04-2023 3 Bln Umi / Hafidan

Sonjaya
Ihsan Nur Rasyid 01-06-2023 1 Bln Istiqomah / Eko Saputro
Yumna Safwara 06-03-2023 4 Bln Dora W.P / Azwar Efendi
Hibrizi Randi Q 17-03-2023 4 Bln Suryati / Anwar

Almahira Shazia 13-04-2023 3 Bln Sheenta / Nyamin
Kurniawan
Putri Keumalahayati 13-06-2023 1 Bln
Reza
Annisa Humaira 08-03-2023 4 Bln Nursalastina / Farid Wahyudi
Xavier Edvaro H 10/17/2023 9 Bln Abby Suryana / Frans
Syahcyra Kamila Meidina 5/10/2023 2 Bln Siti Rahayu / Irkhamsyah
Arfan Mahardika 26-03-2023 4 Bln Fatma Liyara / Yulin
Arion Ro Binsar Siahaan 12-04-2023 Nova Sari Silitonga /

3 Bln Sugianto Siahaan
Amelya Safea 17-4-2023 3 Bln Ana Susilawati / Parlan
Chelsea Zhea Genaira 19-05-2023 2 Bln Virda Yunia / Faisal
Nayyara Safwa 04-04-2023

Kenzie Raffiansyah Ahmad 10-10-2022 9 Bln Siti Nurlaila / Ahmad Zulfikli

10
9/15/2022 Desy Marwati / Sugandi
Soerendro Anggoro Beryl Bln
Nuaira Shanum 20-4-2023 3 Bln

Siti Chasanah / M. Amin

14-01-2023
Hafsa Nahda Azzahra 6 Bln Afieny Tazkyatur / Dedi Sutri
Ibrahim Ar Gifari 10-07-22 12 Bln Adjeng Suci /Rizki
Ika Septianti / M Rizky

Muhammad Keyaan Farouq 19-07-2022 12 Bln Arajji
Abigail Liora Kathleen Gultom 23-07-2022 12 bln Grifith Jennifer / Albet Dora
Zanika Annika Ahmad 31-01-2023 5.5 BlnSintia Putri / Ahmad Maulana

Muhammad Omar Affiansyah 02-03-2023 4 Bln
Apriansyah
Hesty Prasetya Widi / Bayu

Barri Ahmad Prasetyo 11-12-2021 19 Bln
Prasetyo
Raisa Sasabita 18-10-22 9 Bln Irmalia / Agung
Shofiatun Nuraini / M Husnul

Ja'far Alhammad 15-07-2023 9 hr
Khuluq
Pricilla Yen Hermanto 02-03-2022 16 Bln Meta Setyani / Edi Hermanto
Pricillia Yen Hermanto 02-03-2022 16 Bln Meta Setyani / Edi Hermanto

M. Fauzan 12-06-2023 1 Bln Serli Marlina / Alm. Parosi
Naura Fiona Zea 22-5-23 2 Bln Ferja Wati / Feriyadi
By Ny AMBAR 22-7-23 3 Hr Ambar PA / Ulun Mubarak
Kafi Radeya Putra 14-07-2023 11 hr Fazar Sekar Utami / Adi Sapu

Muhammad Gatot Prabowo 14-06-2023 1 Bln Windi Lestari / Sofyan Teguh
Arharrazka Rayyan A 25-6-2023 1 Bln Safira Nabila / Ricky Reynald
Inge Al Zahra / Nur Adi
Kireina Azzahra Firmansyah 18-03-2023 4 Bln
Firmansyah
Aluna Lakeisha 4/14/2023 3 Bln Sastia / Aris
Padipta Rafif Al Kareem 11-03-2023 4 Bln Bella Cintya Gustina / Refin
Kairan Arshaka 22-06-2023 1 Bln Schella Dwi / Alvin
Elfathan Ramadhan 22-3-2023 4 Bln Shena / Arief
Arsyad Aryan Athallah 13-04-2023 3 Bln Rika Santika / Dedi
Muhammad Alfino 27-03-2023 4 Bln Dede Megawati / Jana

Ferina / Muhamad Firda
Muhamad Elfathan K 15-05-2023 2 Bln
Fauzan
Humairah Putri 17-05-2023 2 Bln Siska A / Anggi A
Muhammad Raffasya Raja 19-04-2023 3 Bln Jubaedah /Ardiansyah
Etika Budiarti / Chandra
Hafiza Echa Qumairoh 20-12-22 7 Bln
Andan
Bara Panjaitan 14-10-2022 9 Bln Katrine / Eristal Panjaitan
Gladis Rafela 7-7-23 20 hr Rosi Natalia / Ganesha A
Meylinda Sugi L / Ahmad
Naura Zharifah Alnaira 01-07-2022 12 Bln Sauqi
Maudy Ahzara 17-10-2022 9 Bln Leli / Dody
Muhammad Rizieq 07-10-2019 45 Bln Nur Istiqomah / M Faiz
Nur Maulida Hasanah 26-01-2022 18 Bln Nur Istiqomah / M. Faiz
Rebecca Nathania 08-02-2023 24 4 Bln Santa Lucia / Daud Alfred
Arga Gevariel 21-07-21 Bln Desi Ratna Sari /Jhon Rico F
Vonny Simon / Jimmo
Tilford Simon Hariniko 19-02-2023 5 Bln Maharani Zahwa / Achmad
Lasmono Harniko
Hazia Ahmad 11-7-2023 16 Hr Risna Ristiani / Ahmad Kurtub
Jamil Muttaqin 26-07-2022 12 Bln Anna Widayani / Yudhi
Rafandra Ghaisan 23-05-2023 2 Bln Reno Jayanty / Bimo
Khaira Nur Ramadhani 27-03-2023 4 Bln Isa Fatonah / Jamal
Alesha Cahyanika Putri 01-03-2023 4 Bln Titin Chaironi / Subardi
Ayasha Febrinazia Sari 2/3/2022 17 Bln Siti
JULAIHA DAN SAPRUDIN
Nur Halimah / Rahmat
Azmi Rahmat Rumi A 12-05-2023 2 Bln Fajar
Muhammad Aqsha Syabar 07-03-2023 4 Bln Iyang Wida / Lucky D
Anindya Zahra Ratu Liu 12/30/2021 18 Bln Jubaedah Dan Ardiansyah

Mafaza Afsheen El Daneen 18-10-2022 9 Bln Aulia M. E I / Eko Susanto
Lily Holiday Dan

Aleeza Putri Azahra 1/30/2022 18 Bln Muhammad Azizi
24-07-2023
M Zein Asyshauqi 4 hr Nurlaela / Iqbal
Khanza Defina Almira 23-7-23 5 hr Restika / Andrian
24 11
ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
Ujung Menteng 5/ 821111526425 3.3 49 37 36.5 3
Bulak Indah 3/5 81315474774 3.7 52 36 36.5 3
DPT2,
Ujung Menteng 8881915966 7 63 41 36.5 POLIO3,
PCV2
Kayu Tinggi 8999191484 4.8 57 37 36.5 BCG, POLIO1
DPT1,
Gempol 2/1 88111182558 5.1 58.3 38 36.5 POLIO2,
PCV1
Gempol 3/1 88214596624 4.8 54.5 38.5 36.5 BCG
Gempol 13/01 085777664441 3.8 51.5 35 36.6 3 BCG
Gempol 13/01 085777664441 3.3 50 35 36.6 3 BCG
DPT3,
Mawar 16/1 88292237881 6.7 64.5 41 6.5
POLIO4, IPV1
Kayu Tinggi 6/12 087781357480 7.9 69.5 43 36.5 PCV3
DPT3,
Kayu Tinggi 01/09 85697166284 6.7 69 42 36.5
POLIO4, IPV1
Kayu Tinggi 002/1 081385881835 7.4 75 45 36.5 PCV3
Gempol 6/1 81288926804 12 87 43 36.5 DPT3,Polio4 DS = 10

Kayu Tinggi
087864541933 10.7 76 45.5 36.7 PCV3 DS = 10
Rt2/Rw4
DPT3,POLIO4
Kay Tinggi 2/9 085775458749 6.9 61.7 40 36.7
DAN IPV
DPT3,POLIO4
Buaran 10/2 895348599240 7.1 65.5 42 36.7
DAN IPV
DPT1,
PCV1
Tambun Rengas 16/1 82299052589 9.1 72 47 36.5 MR, IPV2
BOOSTER
Kayu Tinggi DPT,
088808009344 9.3 75 48 36.5
02/03 BOOSTER
MR
DPT3,
Kandang Sapi 13/06 081586115118 6.8 62 40 36.5
POLIO4, IPV1
Gempol 13/01 085156121185 6.7 66 43 36.5 MR, IPV2
Kayu Tinggi 8/4 081320457024 8.7 69 43 36.5 MR, IPV2
Bulak Indah
082311718820 8.3 71 44 36.5 MR, IPV2
03/05
Gempol Rt16/1 081384608524 7.3 63 43 36.5 MR, IPV2 DS : 10
DPT3,
Kav. Barokah 8/12 089508882577 6.1 61.5 40 36.5
POLIO4, IPV1
DPT1,
PCV1
Rawa makmur Tunda

08121051116 8.9 87 43 36.5
Rt.03/10 imunisasi
DPT3,
Babelan 89607828461 5.8 61.5 36 36.5
POLIO4, IPV1
TPG 02/13 082275836418 9.1 77 43 36.5 MR
BOOSTER
Tambun Selatan DPT,
0895322330689 9 80 44 36.5 DP
05/08 BOOSTER
MR
DPT3,
Kayu Tihnggi 08/12 82280399108 5.9 60 40 36.5
POLIO4, IPV1
THB 03/22 BCG dan

081360891988 4 54 36 36.5
Polio1
BCG dan
Gempol 05/01 089509326187 6.9 63.5 40 36.5
Polio1
Gempol 07/01 0896307348319 3.8 49 50 36.5 BCG
BCG dan
Gempol 04/01 085770561006 4.1 54 35 36.5
Polio1
BCG dan
Kayu Tinggi 06/11 089509210019 3.8 51 37 36.5
Polio1
BCG dan
Tambun Selatan 1 087878384491 4.2 51 36 51
Polio1
DPT3,
Gempol 03/01 082310455805 7 63 40 36.5
POLIO4, IPV1
Jl. Cempaka Elok 4/9081387613642 6.3 65 41 36.5 DS : 10
DPT1,Polio2
Buaran 2/2 83805848226 5.3 58 38 36.5
dan PCV1
Kayu Tinggi 3/3 088210370709 8.2 69.2 45 36.5
DPT1,Polio2
Cempaka 9/12 081313375333 5.3 58.5 40 36.5
dan Pcv1
DPT2, Polio3
Jl. Cempaka 9/9 0816402087 7.1 64.5 41 36.5
dan PCV2
DPT3,Polio4
Gempol 11/01 895384442390 7.2 63.2 41 36.5
dan IPV1
Gempol 12/01 DPT3,Polio4

6.9 69.5 45 36.5
dan IPV1
DPT1,Polio2
Kayu Tinggi 2/11 81283026593 4.4 54.37 37 36.5
dan Pcv1
DPT3,Polio4
Kandang Sapi 4/6 85678545454 6.3 61 40 36.5
dan IPV1
Kayu Tinggi 9/9 81280920382 5 52 38 36.5 BCG
Kp. Kandang
Sapi 11/06
085694054918 3.6 51 36 36.5 BCG
Buaran 2/2 082213161287 3.2 48 35 36.7 3
BOOSTER
DPT,
Kayu Tinggi 06/09 87812351253 11 84 45 36.5
BOOSTER
MR
BOOSTER
DPT,
Kayu Tinggi 01/09 87788750297 12 80 45 36.5
BOOSTER
MR
Kayu Tinggi 3/9 81383018815 3.4 50.5 34 36.5
Bintara Kranji 085195110408 2.7 49 34 36.6 3
DPT1,
Kp. Buaran 14/02 82212741505 5.5 56 37 36.6 POLIO2,
PCV1
Kayu Tinggi 3/9 082110965870 6.2 64 41 36.5 MR, IPV2 DS : 10
BOOSTER
DPT,
Gempol Rt2/Rw1 089523257183 9.5 80 45 36.5
BOOSTER
MR
Perdana 5/12 085696208017 7.8 60.5 45 36.5 MR, IPV2 DS : 10
DPT1,
PCV1
BOOSTER
DPT,
JGC / 14 81296962994 12 79 45 36.5
BOOSTER
MR
BOOSTER
DPT,
JGC 081574327782 8.3 72 44 36.5 ds : 10
BOOSTER
MR
Kayu Tinggi
081211826981 8.2 68.5 43 36.5 MR, IPV2
04/05
DPT3,
Kayu Tinggi 12/6 81398994442 7.9 65.5 42 36.5
POLIO4, IPV1
Perdana 08999338028 9. 74.4 43 36.5 PCV3
Ujung Menteng 08/12089530841496 7 67 42 36.5 MR, IPV2
DPT3,
Kayu Tinggi 1/3 081385865166 6.1 61 40 36.5
POLIO4, IPV1
Cempaka Elok
082211962303 8.2 69.5 43 36.5 PCV3
8/9
Kayu Tinggi 07/05 082260732498 9.1 72.5 45 36.5 PCV3
Kayu Tinggi 6/11 087850784168 7 68.5 43 36.5 MR, IPV2
Perum Metland 081284455251 8.6 64.5 41 36.5 MR, IPV2
DPT1,
PCV1
BCG dan
Kayu Tinggi 10/5 81779273260 4.5 58 38 36.5
Polio1
Tambun Selatan BCG dan
089526083558 3.9 55 36 36.7
08/08 Polio1
Kp. Ujung BCG dan

089501564899 3.8 52 37 36.7
Krawang Polio1
BCG dan
Kayu Tinggi 9/3 081396778629 6 63 40 36.7
Polio1
Kayu Tinggi 12/06 0881025897219 4.1 50 36 36.7 BCG
Gg. Baru 01/12 4.6 54 36 36.7 BCG
Jl. Cempaka 06/09 082155483489 2.3 45 34 36.6 2
Gempol 04/01 0895322329015 4.2 52 39 36.7 BCG
BCG dan
Tambun Selatan 05/08
0895359846720 5.6 57 38 36.7
Polio1
Bulak Indah 3/5 81315474774 4.3 54.4 38 36.8 BCG
DPT3,Polio4
Gempol 2/1 8121924383 6.8 62.5 40.5 36.6
dan IPV
DPT2,Polio3
Gempol 3/1 85891495562 7.9 62 41.5 36.7
dan PCV2
Mawar 16/1 88292237881 6.9 65 42 36.7 DS = 10
Kayu Tinggi 3/3 085885289905 6.9 62.5 43 36.6 DPT2, Polio4
Tambun Rengas DPT3, Polio4
85883555902 7.1 63.5 42 36.6
4/7 dan IPV
BCG dan
Bulak Indah 6/5 82213757810 4.8 58 40.5 36.6
Polio1
DPT3,Polio4
Kay Tinggi 2/4 081285262606 7.7 61 43.5 36.6
dan IPV
DPT2,Polio3
Rorotan 5/10 89644485129 6.9 61.5 41 36.6
dan PCV2
DPT2,Polio3
Buaran 10/02 085776092462 5.9 60 39.5 36.7
dan PCV2
DPT2,Polio3
Bulak Indah 1/12 81213804263 6 59 40 36.6
dan PCV2
DPT3,Polio4
Gempol 08/01 85776862015 6.6 68 40.5 36.6
dan IPV
BCG dan
Kayu Tinggi 4/9 0895359805502 3.8 54.5 36 36.7
Polio1
DPT3,Polio4
Kav.Barokah 8/12 082213462192 5.3 61 39 36.7
dan IPV
Tambun Rengas
85891206230 9.2 76 42.5 36.5 IPV2 + MR DS = 10
12/01
Jl. Waru Raya DPT1, Polio2
085717380583 4.5 57.5 36.5 36.7
1/9 dan PCV1
DPT2, Polio3,
Kayu Tinggi 02/11 081219638118 6.8 63 42 36.7
PCV2
DPT2, Polio3
Tambun Rengas 2/7 88975932007 6.3 59 42 36.7
dan PCV2
DPT2, Polio3
Jl. Walikota 7.1 62 42 36.7
dan PCV2
Pondok Kopi 082288473905
DPT2,Polio3
Kayu Tinggi 3/9 81514563754 6.1 56 40 36.7
dan PCV2
DPT1,Polio3
Buaran 10/2 081288853331 4.9 56.2 38 36.7
dan PCV2
DPT2, Polio3
5.2 58.5 36
dan PCV2
Bulak Indah 5/5 085777280297
7.9 72 42 36.5 IPV2 + MR DS : 10

Tambun Rengas 9089653404927
Kayu Tinggi 07/06 89635602721 10.2 74 46 36.5 IPV2 + MR
Tambun Rengas 6/7 081281961628 DPT2, Polio3

5.9 60 40 36.6 dan PCV2
DPT2, Polio4
7.8 66 43 36.6
dan PCV2
JL. Waru III 2/9 81283623305
7.3 63 43 36.5 DS : 10
Kayu Tinggi 2/9 082294315359
75.7 47 36.5 PCV3 DS : 10

Gempol Rt3/Rw1 081289828723 10.1
8.9 69 41 36.5 PCV3 DS : 10

Kayu Tinggi 07/04 082124103016
Cempaka 8/9 87748004631 7.4 67.7 42 36.5 PCV2 DS : 10
DPT3, Polio4
Kayu Tinggi 02/03 089658163633 6.3 61 40 36.6
dan IPV
DPT3, Polio4
Gempol 12/01 08561051807 7.5 63 41 36.6
dan IPV
Booster MR
Gempol 02/01 089523257183 10 75 45.5 36.6 dan Booster
DPT
Buaran 11/02 0895357323148 7.1 66 44 36.6 MR dan IPV2 DS = 10
Kandang Sapi
0852169687749 3.9 56 36 36.7 3
07/06
Panti Asuhan DPT1, Polio2,

0821808836168 8.8 73 43 36.6
Guna Nande IPV
Panti Asuhan
0821808836168 6.8 46.4 42 36.6
Guna
TambunNande
Selatan
895337466394 4.3 55 37 36.5 BCG, POLIO1
8/8
Kayu Tinggi 7/5 852694919334 4.8 54.5 37.5 36.5 BCG, POLIO1
Bulak Indah 2/12 89528012626 2.8 48 37 36.5
Kav Pagar Jati 15/01 081318723681 3.1 51.5 34 36.7 3

Kayu Tinggi 9/3 085881581981 4.3 51.5 36.5 36.5 BCG
BCG dan
Gempol 2/2 08158077642 4.3 54 36 36.5
Polio1
DPT3,
Kayu Tinggi 5/3 088293146008 5.9 62 42 36.7 DPT2,
POLIO4, IPV1
DPT3,
PCV1
Gempol 12/1 85161471208 7.6 65.5 42 36.5
POLIO4, IPV1
Ujung Menteng 5/ 821111526425 4.1 51.5 36.5 36.5 BCG, POLIO1
DPT3,
Kandang Sapi 4/6 85697884651 6 60.5 40 36.5
POLIO4, IPV1
Cakung Residene 81316053517 7.1 61 40 36.5 DPT2,
PCV2
BCG dan
Buaran 2/2 089636783294 6.5 63 36.7 41
Polio2
DPT1,
JGC 16/14 082169541902 6.6 60 40 36.5 POLIO2,
DPT2,Polio3
PCV1
Kayu Tinggi 10/09 81259028006 5.7 58.5 39 36.7 DPT1,
dan PCV2
Kandang Sapi 11/ 08977675351
Taman 4.8 58 38.5 36.5 POLIO2,
DPT2,
Pulogebang 8/13 081286355233 6.1 64.5 38 36.6 PCV1
POLIO3,
DPT3,
PCV2
Kayu Tinggi 09/11 87777136131 7.2 64 42 36.5 DPT2,IPV1 DS =10
POLIO4,
Ujung Menteng 85664726301 7.1 67.3 43 36.5 POLIO3,
Gg. Bingung 7/6 087834291735 8.1 66 46 36.5 PCV2
MR, IPV2 DS = 10
Kandang Sapi 12/06 087861861922 3.4 50 33 36.6 3
Gempol 6/1 085890370779 6.9 69 44 36.6 MR, IPV2 DS = 10
Kayu Tinggi 7/9 081297360076 7.2 69 42 36.7 MR, IPV2 DS = 10
MR dan
Bulak Indah 2/12 081617518231 15 100 47 36.6
Booster DPT
DPT2,Polio2
Bulak Indah 2/12 85780187611 10 80 45 36.7 DS = 10
dan IPV
DPT1, Polio2
Kayu Tinggi 9/3 088214524142 5.5 59 39 36.6
dan PCV1
DPT3,Polio4
Gempol 16/01 08164398446 6.3 63 40 36.6
dan IPV
Taman Pulogebang 13 86.5 45 36.6 Booster MR DS = 10
DPT3,Polio4
JGC 81318465084 7.1 63.5 41 36.5
dan IPV
DPT1,Polio2
Bulak iindah 8/5 838871867081 5 56 37 36.6
dan pcv2
Jl. Cempaka 06/09 082155483489 2.5 45 36 36.6 3
Kayu Tinggi 3/3 088210370709 8.5 69.3 45 36.6 PCV3
DPT1,
DPT2, Polio3
PCV1
Buaran 13/02 87803121377 6.5 60 39 36.5 60
dan pcv2
DPT3,Polio4
Buaran 3/2
BULAK INDAH 081317044825 5.5 60 38 36.5
dan IPV
RT10/5 881025915580 8.6 76 46 36.5
DPT1,Polio2
Gempol 05/01 85691603810 5.3 59.5 39 36.5
dan pcv2
Tanjakan Auri 10/01 9 76.5 44 36.5 MR, IPV2 DS = 10
Taman Pulo DPT3,Polio4
85697277376 7.6 67 40 36.5
Gebang 5/13 BOOSTER
dan IPV
Pulo Gebang DPT,
9 77.6 43 36.5 DS = 10
08/13 081286355233 BOOSTER
MR
Jl. Balai Rakyat
Kayu Tinggi 05/04 081398854433
Kp.Gempol 6.8 67 40 36.5 MR, IPV2 DS = 10
Rt007/Rw001 BOOSTER
Cakung Timur DPT,
8.5 65 46 36.5 DS = 10
Jakarta Timur 085770225905 BOOSTER
MR
DPT3,Polio4
Taman moder UM 813920440007 7 63 43 36.5
dan IPV
DPT3,Polio4
KandangSapi 4/6 7.3 67 43 36.5
dan IPV
49 43 36.7 2
Gempopl 04/01 089517467424 3.4
Kayu Tinggi 6/3 089678393347 3.3 48 38 36.7 2

KETEPATAN
WAKTU OBS KU
IC SUNTIK KEMBALI
TIDAK 15 IMUNISASI TEMPAT
TEPAT BBL (Kg)
TEPAT MENIT LAHIR DJB (x/mnt)
V V V 03-08-2023
V V V 03-08-2023
V V V 03-08-2023
V V V 03-08-2023
RS.Islam
V v v 03-08-2023 2800 132
Pondok Kopi
RS.Islam
V v v 03-08-2023 2600 132
Pondok Kopi
V V 9 Bln
V V 18 Bln
v v 9 Bln
v v 18 Bln
v v 38 Bln
v v 18 Bln
v v 6 Bln
v v 9 bln
v v 03-08-2023
v v 18 Bln
v v Lengkap
v v 6 Bln
v v 12 Bln
v v 12 Bln
v v 12 Bln
v v 18 Blb
v v 6 Bln
v v 12 Bln
v v 08-08-2023
v v 9 Bln
v v 18 Blb
v v 9 Bln
v v v 10-08-2023
V V V 10-08-2023
v v v 10-08-2023
v v v 10-08-2023
v v v 10-08-2023
v v v 10-08-2023
v v v 9 Bln
V V V 9 Bln
v v 10-08-2023
10-08-2023
V V 10-08-2023
v v 10-08-2023
v v 9 Bln
v v 9 Bln
v v 10-08-2023
v v 9 Bln
v v 10-08-2023
v v 10-08-2023
RS Resti Mulya 2.9 kg 132
V V Lengkap
V V V Lengkap
V V V RS Hermina 2.8 136
08-08-2023 RS Ananda Beka 2.6 132
V V V 15-08-2023
V V 12 Bln
V V Lengkap
V V 12 Bln
V V 15-08-2023
V V Lengkap
V V Lengkap
V V 12 Bln
V V 9 Bln
V V 18 Bln
V V 12 Bln
V V 6 Bln
V V 18 Bln
V V 18 Bln
V V 12 Bln
V V 12 Bln
V V 15-08-2023
v v v 22-08-2023
V V V 22-08-2023
v v v 22-08-2023
V V V 22-08-2023
V V V 22-08-2023
V V V 22-08-2023
v v v 22-08-2023
v v v 22-08-2023
v v v 22-08-2023
v v 9 Bln
v v 22-08-2023
9 Bln
v v 22-08-2023
v v 9 Bln
v v v 22-08-2023
v v 22-08-2023
v v 22-08-2023
v v 22-08-2023
v v 22-08-2023
v v 9 Bln
v v 22-08-2023
v v 9 Bln
v v 12 Bln
v v v 24-08-2023
v v v 24-08-2023
v v v 24-08-2023
v v v 24-08-2023
v v v 24-08-2023
v v v 24-08-2023
v 24-08-2023
V V 12 Bln
V V 12 Bln
24-08-2023
v v
24-08-2023
v v
9 Bln
V V 18 Bln
V V 18 Bln
V V 22-08-2023
v v 9 Bln
V V 9 Bln
v v 24 Bln
V V 12 Bln
RS Islam
3400 132
Sukapura
v v v 24-08-2023
V v v v 24-08-2023
V v v v 24-08-2023
08-08-2023 RS Resti Mulya 3000 120
15-08-2023 RS Resti Mulya 3120 132

v v v 24-08-2023
v v 24-08-2023
v v v 24-08-2023
v v v 24-08-2023
v v v 9 Bln
v v v 24-08-2023
v v v 9 Bln
v v 24-08-2023
v v 24-08-2023
v v 24-08-2023
v v 24-08-2023
v v 24-08-2023
v v 24-08-2023
v v v 9 Bln
v v 24-08-2023
v v 29-08-2023
v v 08-08-2023 RS Hermina Priu 3400 132
v V 12 Bln
V V 12 Bln
v v 29-08-2023
V V 29-08-2023
v v 29-08-2023
v v 9 Bln
v v Lengkap
V V 9 Bln
v v 29-08-2023
15-08-2023 RS Resti Mulya 2.3 132
V V 18 Bln
V V 29-08-2023
v v 29-08-2023
V V 9 Bln
v v 29-08-2023
v V 12 Bln
V V 9 Bln
v V Lengkap
v V 12 Bln
v V Lengkap
V V 9 Bln
V V 9 Bln
3400 132
RS
PKM Kec. Cakun 3200 132

KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
PUPUT
38 v v v By. K NCB SMK KN3
40 v v v By. I NCB SMK KN3
41 v v v NCB SMK KN 3
41 v v v NCB SMK KN 3
40 v v v NCB SMK KN3
NCB SMK KN3

41 v v v dengan ikterus
kramer 1
NCB SMK KN2
41 v v v dengan BBLR dan
Ikterus Kramer 1
NCB SMK KN3
41 v v v
Usia 9 hr
dengan sedang
pengobatan TB dan
NCB SMK KN2

40 v v v
Usia 3 hr
NCB SMK KN3
41 v v v Usia 11 hr dengan
Ikterus Kramer 4
By. E usia 3 bln

dengan dermatitis
NCB SMK KN 3
41 v v v
Usia 20 hr
NCB SMK KN 2
41 V V V
Usia 4 hr
NCB SMK KN2
40 v v v
Usia 5 hr
AN RESIKO
KIE CUCI KET
BAYI POLI POLI TATA SESUAI
JATUH TANGA APD
MTBS GIZI NILAI SOP
N
v v v v v v
V V V V V v
v v v v v v
v v v v v v
V V V V V V
V V V V V V
V V V V V V
V V V V V V
v v v v v v
V V V V V v
v v v v v v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v V v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v v v
V V V V V v
Rujuk
v v V v v v v Tumbuh
Kembang
v v v v v v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v v v
V V V V V v
v v v v v v
v v v v v v
v v v v v v
hanya
V V V V V v
menimbang
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
v v v v v v komplikasi neo
v v v v v v
V V V V V V V Gizi Kurang
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
v v v v v v
v v v v v v
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V komplikasi neo
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V V V
v V V V V V
V V V V V V
V V V V V V
v V V V V V
V V V V V V
V V V V V V
v V V V V V
V V V V V V
V V V V V V
v V V V V V
V V V V V V
V V V V V V
v V V V V V
V V V V V V
v v v v v v
v v v v v v
v v v v v v v v Tunda Imunisasi
Neo (dirawat
v v v v v v
di RS TGL
v v v v v v
v v v v v v v v Tunda Imunisasi
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v komplikasi neo
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V V V V V
KUNJUNGAN KUNJUNGAN
CEK CAKUPAN KN BAYI BALITA
MANTOUX ( USIA 0-11 (Usia 12- HB0 (0<7
SKRINING BCG
Bln) 59 Bln) HR)
TB 1 2 3
L P L
L P L P L P L P L P
1 1
1 1
1
1
1
1
1
mplikasi neo 1
1
1
mplikasi neo 1
1
1
nda Imunisasi
1
1 1
1
nda Imunisasi
1
1
1
mplikasi neo 1
0 0 0 2 2 7 2 1 1 1 1 0 0 19
0 0 4 4 15 5 2 2 2 2 0 0 38
BCG DPT/HB (1) DPT/HB (2) DPT/HB (3) POLIO 1 POLIO2 POLIO3 POLIO4
P L P L P L P L P L P L P L
1 1
1 1
1
1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
10 7 10 14 7 11 20 8 7 10 10 12 7 13
20 14 20 28 14 22 40 16 14 20 20 24 14 26
ggal Pemberian Imunisasi
CAMPAK BOOSTER
POLIO4 IPV 1 IPV 2 PCV 1 PCV 2 PCV 3
RUBELLA DPT
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1
1 1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1
1
1 1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1 1
1
1
1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1 1
1 1
1 1
20 11 22 14 7 8 8 12 8 5 4 16 9 6
40 22 44 28 14 16 16 24 16 10 8 32 18 12
BOOSTER
BOOSTER
CAMPAK
DPT
RUBELLA
P L P
1 2
1
1
1 1
1
1
1 1
1 1
4 5 5
8 10 10
NO
JAMINAN
REGISTER
NO TGL NIK
BARU LAMA BPJS UMUM
1 01-08-2023 3172022505230003 345/23 V
2 346/23 V
3 3175062505230005 347/23 V
4 348/23 V
5 349/23 V
6 350/23 V
7 3175061605230002 351/23 V
8 3175062601230003 88/23 V
9 313/23 v
10 3172043007220007 045/23 V
11 03-08-2023 3175065607220002 352/23 v
12 491/22 v
13 94/21 v
14 78/22 v
15 3175060606230004 303/23 V
16 304/23 v
17 490/22 V
18 3175066205230013 292/23 V
19 317506011220008 V
102/23
20 534/22
3175060108220006 V
21 3175063005230003 295/23 v
22
3175066101220001 122/22 V
23 08-08-2023 3175060707230004 353/23 v
24 3175061806230005 354/23 v
25 355/23 v
26 3175064607230006 356/23 v
27 357/23 v
28 358/23 v
29 359/23 v
30 360/23 v
31 289/23 v
32 3174091305230006 300/23 v
33 90/23 V
34 062/23 B V
35 3175066305230006 302/23 v
36 3175061804230010 244/23 v
37 3175061704230005 301/23 v
38 331/23 v
39 10-08-2023 3175061104230012 361/23 V
40 3208304904230001 362/23 v
41 3175060311220002 363/23 V
42 33110148099220001 364/23 V
43 365/23 V
44 3175024808220004
477/22 YA
45 3175061010220001 441/22 YA
46 261/23 YA
47 3175064802230004 183/23 V
48 3175063110220002 506/22 V
49 3175066102230006 138/23 V
50
3175024808220004 477/22 YA
51 308/23 V
52 516/22 V
3175060311220001
53 259/23 v
54 3175064405230009 252/23 V
55 343/23 v
56
3175061106220005 363/22 V
57 3175064906230014 310/23 v
58 14-08-2023 366/23 V
59 15-08-2023 367/23 V
60 3175060507230002 368/23 v
61 369/23 V
62 370/23 V
63 3175061806230009 372/23 V
64 373/23 V
65 3175054206230005 374/23 V
66 3175062410170018 374A /23 V
67 375/23 v
68 3175065607230002 376/23 V
69 377/23 V
70 274/23 V
71 317500668042300012 318/23 V
72 325/23 v
73 31740806230003 306/23 V
74 3175061503230007 195/23 v
75 231/23 V
76 V
228/23
77
110/23
78 3175060405230007 217/23 V
79 3175061407230006 337/23 v
80 3175061507230002 331/23 v
81 3175062504230004 206/23 V
82 18-08-2023 374A/23 v
83 3175060908230002 371/23 v
84 22-08-2023 377 A/23 V
85 378/23 v
86 379/23 v
87 3175061707230004 380/23 V
88 381/23 V
89 382/23 V
90 383/23 V
91 3175065905230008 384/23 V
92 385/23 v
93 386/23 V
94 31750666606230008 387/23 v
95 388/23
96 389/23 V
97 390/23
98 391/23 V
99 394/23 v
100 216/23
101 042/23 v
102 3175066207220005 070/23 V
103 201/23 V
104 3175060804230005 220/23 V
105 3206321304230001 241/23 v
106 298/23 V
107 3175061804230008 197/23 V
108 210/23 V
109 245/23 v
110 3175062004220019 326/23 v
111 3271051406230001 319/23 v
112 3172011904230003 247/23 v
113 v
309/23
114 3172035005230002 v
329/23
115 v
323/23
116 v
321/23
117 V
139/23
118 3175064404230005 243/23 V
119 270/23 V
120 316/23 V
121 3175065306230003 280/23 v
122 136/23 V
123 196/23 v
124 216/23 V
125 23-08-2023
392/23 V
126 24-08-2023 3175064806230011 393/23 V
127 317506208220004 395/23 V
128 3175062510220001 396/23 V
129 3175061104230007 397/23 V

130 3305172203230001 398/23 V
131 3175064402220004 399/23 V
132 3175067007220009 267/23 V
133 3175062212200019 338/23 v
134 1701056012220002 165/23 V

135 3175061502210016 44/22 V
136
333/22 v
137
3175065311210004 439/21 V
138 O 91/22 V
139 31750615112200014 500/22 v
140 233/23 v
141 49/21 YA
142 31750622102200014 209/23 V
143 3175062011220005 58/23 v
144 492/22 V
145 3175062505220011 065/23 v
146 253/23 V
147 317506811220003 557/22 v
148 242/23 V
149 3175060511221011 476/22 v
150 526/22 V
151 3175061104230003 238/23 V
152 3175062506230006 339/23 v
153 3175064904230005 227/23 V
154 28/8/2023 3175065808900099 400/23 v
155 29-08-2023 3175062407230006 401/23 V
156 402/23 V
157 3175060706230005 403/23 V
158 3175066305230008 404/23 V
159 405/23 V
160 3175060205230013 406/23 V
161 407/23 V
162 3175065704230003 219/23 v
163 3175061703230011 215/23 V
164 3173044203220005 332/23 v
165 293/23 V
166 3175066703230008 291/23 V
167 336/23 v
168 3175062904230001 276/23 v
169 3175061410220013 341/23 v
170 330/23 v
171 269/23 V
172 157/23 V
173 110/23
174 294/23 v
175 3172036203230002 222/23 V
176 344/23 v
177 30-08-2023
408/23 V
178 31-08-2023 3175062312210011 409/23 V
179
3206025801230001 410/23 V
180 3175066503230012 411/23 V
181
3210054141122001 412/23 V
182 413/23 V
183
317506681122001 519/22 V
184 425/22 V
185 346/23 V
186 353/22 V
187 3175066609220006 489/22 V
188 3175062611220008 v
01/23
189
31750625052220007 129/22 V
190
3175060401220007 46/22 V
191
192
JK/UMUR
L P
Muhammad Ellmer Pratama ### 2 Bln Seli Alawiyah / Alfian Pratam
Guinandra Rijalullah ### 1 Bln Leli Magfiroh / Yudi Prasetyo
Muhamad Haikal ### 2 Bln Desi Sulastri / Apri Sandy
Putri Rodiyah ### 3 Bln Mutiyahti / Ilham
Rafisqi Albahri ### 2 Bln Tatu Mahpudoh / Saipul Bahri
Arrasya Kalief N ### 1 Bln Nurchaeni / Rois Sulaman
Fahmi Hidayati / Muhamad

Khalid Abdulloh ### 2 Bln
Juninto
Melvin Daffinra Firdaw ### 6 Bln Oktafiana / Yudi Firdaus
Muhammad Hakim Al Habsy ### 1 bLN Ernawati / Sobri
Isma Dzaka Dzulhanan ### 12 Bln Ina Reni / Alikhin
Nadhifa Almaira A ### 13 bln Triyana / Sukendar
Radevan Alfarizi
21-10-20229 Bln Reta / Agus Hermawan
Stacey Gabriella Simamora ### 19 Bln Margaretha Yulien

Elshanum Falisha Herlambang 1/26/2022 18 Bln Suraida / Herlambang
Muhammad Akhsan Alfarizi ### 2 Bln Listianingsih / Nanang Hida
Muhammad Ikhsan Alfarizi ### 2 Bln Listianingsih / Nanang Hida
15-10-202210 Bln Puja Melati / Asad
Shareen Gabriela S ### 3 Bln Winarti / Rizki
11/1/2023 9 Bln
Arfan Naufal Khodijah / M. Jagwan
Albi Arbani
1-8-22 12 Bln Nur Fauziah / Bani Adam
Qizar Daviandra Al Hakim ### 3 Bln Putut Anggun / Mustopa
Yasmine Sajidah Faradiba 2/21/2022 18 Bln Fitri Rosalina / M Cipto
Rafeyza Elvin Saman ### 1 Bln Septy Wulandari / Anang Ma'ruf
Bikry Hamizan Robbani 6/18/2023 1 Bln Rosyanti / Rohmani
Ehsan Alfarizi ### 1 Bln Indah / Wahyu
Khalisa Arumi Maheswari 6-7-23 1 Bln Siti / Fazlul
Farhana Zakiyah ### 2 Bln Fikriyah / Ismail
Ameer Pahlevi Alfarizqi ### 5 Bln Sifa Aulia / Wahyudi

Riyadoh Alfiyah / Aldi
Muhammad Elzayn Permana 13-6-23 1 Bln
Setiadi Permana
Muhammad Sahal Wafi ### Tiar Anggraini / Muhammad

1 Bln Fahmi
Yunike Kanaya Putri ###

1 Bln Namiroh / Agus Triadi
Aliy Moktavi Mamduhy ### 3 Bln Neneng TS / Ihsan Maulana
Anasya Putri ### 2,5 Bln Rachmawati / Joko
Adlan Ramadhan ###

3 Bln Indah Lina / Yunet Saputro
Muhammad Raska Ramadhan ### 3 Bln Mira Emilia / Rizky

Ja'par Alhammad ### 3 mgg
Khuluq
Raihan Albian Ramadhan 11-04-2023 4 Bln Ratna / Miswandi
Lidya Sitha Yola Sanouha /

Ratu Aulia Rahman ### 4 Bln
Tatang Agus Setiawan
Kenzo Zafran 3-11-22 9 Bln Sri Puji Lestari / Budi
Gadissa Rafanny Raharja ### 11 Bln

Sekar Pratiwi / Lindhu Tama Roza
Hasan Basri Alfatih ### 7 Hr Daminih / Sartono

Nurul Azimah / Abdul
Salma Nafisah 8-8-22 12 Bln Rahman
Rahma Kusuma Ayu /
Hamid Ali Ardi 10-10-202210 Bln
Koeswadi
Cristine Gabriela Hasibuan ### 2 Bln Ely Sabet / Jupri HAsbun
###

Nurul Azimah / Abdul

Salma Nafisah 8-8-22 10 Bln Rahman
Indry Nicky Lestari / Heri
Kaysa Azkadina Azzahra 8-6-23 2 Bln
Maulana
Malia / M. Rizky Saputra

Muhammad Syafiq Valevi 03-11-2022 9 Bln
###
M Zein Asyshauqi 1 Bln Nurlaela / Iqbal
13
El Fatih Zhian 11-06-22 Bln Alifta/Ahmad
Naysila Devania ### 2 Bln Juhria / Dwi Utomo
Aurora Adeta ### 5 Hr Wiwik Andriyani / Dadang M

Bening Amora ### 12 Bln Siti Anisa / Fajar Hadifin
Haidar Arzio Sakhi ### 1 Bln Erni / Ahm. Fadilah
Gafi Attaqi ### 3 Bln Salifah / Angga
Nurul Sharaswati / Muchlis

Mayzura Sandhya ### 3 Bln
Nurseno
Riska Dwi Astuti / Sokmo

Luffy Alfarendra 18-6-23 2 Bln
Prihantoro
Adzriel Parsha 6-6-23 2 Bln Siti Aisyah / Riza Pahlopi
Amelia Dwiyani / Ardhi

Arsylia Hanifah Khalia 2-6-23 2 Bln
Risky
### 18 Hr
Syafiq Maulana Syakir Nurul / Deni
### 4 Bln
Muhammad Arrayan Nur Saanah / Suratno
### 1 Bln
Shanum Pratista Friska / Purnomo
### 3 Bln
Ahmad Alwi Fahrezi Nunung / Darko
### 2 Bln Nadia Urofah Widiyani /

Muhammad Kavin Fawwazz Achmad Rifki
Archika Gelya Wulandari ### 3 Bln Dewi Wulandari / Onekesi Gu
Hazia Ahmad 11-7-2023 1 Bln Risna Ristiani / Ahmad Kurtub

Ivander Axel Benedict ### 5 Bln Hendia Yunita / Kristian
Azzahra Nadia ###

4 Bln Imah Salimah / Rizki Ardians
Bilqis Ramadhani Fajar ### 4 Bln Nuraini / M. Rizki
5.5 Kartika sari / Suhendra

Veronika Elizabeth V ###
Bln Pasaribu
Ibra Naumi Arzanka ### 3 BlnMutia Intan R / nOVIAn Aprianto
Kafi Radeya Putra 14-07-2023 1 Bln Fazar Sekar Utami / Adi Sapu

Ja'par Alhammad ### 1 Bln
Khuluq
Habib Al Habsy Jansen ### 4 Bln Nurhaeti / Ivan Christian
Syafiq Maulana Syakir ### 21 hr Nurul / Deni
Muzaffar Alharsa ### 9 hr Mar'atun S / Hasanudin
Ameesha Eka Kalf ### 2 bln DEBBY /ALFLON
Raid Syatir Alhasan ### 14 hr Mega / Suryadi
M.AUFA RIZKI ADHA ### 2 BLN INEKE / FATUR
1 SUNIAH /
AHMAD ZAIN ALGHIFARI 7/17/2023
BLN AHM.SYARIFUDIN
ARSYAD MUMTAZ HARDIKA ### 5 HR MULYANI / IBNU

JOVAN LUIZ TOBING ### 1 BLN ROSIANA /MESRADI
AMANDA MICHELLE MANULLAN ### 1 BLN NOVIA / RICHART
AYESHA DEENA ACHIERA 19-5-2023 3 BLN NADYA / TRI ISWANTO
Hamzah Bryatta Ehazian 19-6-23 2 Bln Puteri Sarah / Sidiq Munajat
MUHAMMAD NUR PRAYOGA ### 3 BLN NUR PRAMITA / KHAIRUL
Ameesha Eka Kalf ### 2 Bln DEBBY/ALFLON
Keysha Aqila ### 2 Bln Sri Komala Sari / Nuryadi

Jouvan Silaen ### 2 Bln Kristina Makdalena / Chandra
Red Muharrom Syafik ### 1 Bln Rosyidah / Sarjono
Belleza Nauli ### 12 Hr Anita Martauli P / Jan Pieter
Siti Nurindah Sari /
Dzakia Zia Muhaya ###
Muhammad Rohim

Abigail Liora Kathleen Gultom ### 13 Bln Grifith Jennifer / Albet Dora
Almahira Shazia ### 4 Bln Sheenta / Nyamin
Muhamad Syahdan 8-4-2023 4 bLN Riska Muriana / Rohmat
Arsyad Aryan Athallah ###
4 Bln Rika Santika / Dedi
Irsyad Dwi Arjuna ### 2 Bln Suistiowati /
Rayyan Haziq Alhaq ### 4 Bln Rahma / Ziaul Haq
Nuaira Shanum 20-4-2023 4 Bln Siti
Nova Chasanah / M. Amin
Sari Silitonga /
Arion Ro Binsar Siahaan ### 4 Bln Sugianto Siahaan
Setianto
Arsya Khalif Nadhirrizky ### 2 Bln Maryam / Agus K
Muhammad Raffasya Raja ###
4 Bln Jubaedah /Ardiansyah
Yasmin Ciara Islami ### 2 Bln Della / M Faradiaz

Muhammad Gibran Alfarisi ### 2 Bln Suci Retno Sari / Ilham Darus
Ameer Alfarizqi Rangkuti ### 12 Bln
Syamirvan Rangputih
Nayyara Safwa ###

Ihsan Nur Rasyid ### 2 Bln Istiqomah / Eko Saputro
Adzriel Muhfarih ### 2 Bln Tri Murti / Muhammad Undan

Putri Keumalahayati ### 2 Bln
Reza
Nabila Putri Zahra ### 6 Bln Ledini Miyati / Syahlan

Mei Kiki Anjelina / Raynal

Aziel Hasibuan 14-8-23 9 Hr Hasibuan
Faisha Khalira ### 2 Bln Puji Astuti / Ris Muhammad
M. Taqy Al Hiqme ### 12 Bln Tri Al Maidah / Ahmad Sutio
Puspa Tri Andini / Anang

Arkana Shakeel Wicaksono ### 10 Bln
Wicaksono
Neneng Hermayanti /
Abidzar Alfariky Ramadhan ### 4 Bln
Wahyudin
Mira Muthminah / Eko
Reyno Kenan Syahputra 22-3-23 5 Bln
Setiawan
Khaira Nur Fazila ###

6 Bln Lia Tuti / Rian
Eunike Lyora R ###

12 Bln Emmi Sihombing / Rony Fred
Muhammad Gatot Prabowo ### 2 Bln Windi Lestari / Sofyan Teguh

Etika Budiarti / Chandra
Hafiza Echa Qumairoh 20-12-22 30 7 Bln Andan
Afzal Reyhan Jonathan ### Bln Bella/ Sofiyanto
Michael Immanuel Situngkir ### 13 Bln Rahel / Saut Raja Situngkir
Raina Misha
ELMIKHA Aralyn GWEN
KIMBERLY ### 21 Bln Riana
Yenny/ Wahyu
astri ivoArfan
purba/BAIK
SIBARANI 2/2/2022 4 Bln KOSTER
Ahmad Kalanda Shaquil ### 9 Bln Rilma Maulida Fitria / Jeffry
Aluna Lakeisha 4/14/2023 4 Bln Sastia / Aris
Adifa Afsyi Meysa 20-01-21 31 Bln Fitri Handayani / Hanapi
Muhammad Dwiaksa ### 10 Bln Eva Damayanti / Muhammad
Yosia Meshach Gultom ### 9 Bln Financy S / Gidium
Ahmad Defin Elfatih 19-10-202210 Bln Fabiejana / Ahmad FIrdaus
Gilang Firaz Araska ### 6 Bln Depina / Tarzani
Chelsea Zhea Genaira ### 3 Bln Virda Yunia / Faisal
Rumaisha Zalindra ### 9 Bln Nuarika / Nurul Fadilah
Humairah Putri ### 3 Bln Siska A / Anggi A
Shaquille Elzhan Davindra ### 9 Bln Susi Purwanti / Mileh Santoso
Alvier Mikolas ### 4 Bln Yovita Sari / Alexander
Atharrazka Rayyan Albiruni 25-6-2023 2 Bln Safira Nabila / Ricky Reynald
Azkira Azalia ### 4 Bln Umi / Hafidan
Danendra Malik Dirgantara 20-8-23 8 hr Endang Pertiwi / Yacob
Muhammad Azka Alfarizal ### 1 Bln Nur Hawriyah / M. Aji Darma
Zunaira Zania Fatuh 20-7-23 1 Bln Nurul Magrifah / DZ Ulfatuh
Ghani Kaysan Ismail ### 2 Bln Wiranti / Nasihun Amin
Kirani Shania ### 3 Bln Komala Sari / Bibid Abidin
Nafisah Humaira Hidayat ### 1 Bln Pipin Setianingsih / Sarip Hid
Axel Mangihut Benedict 2-5-2023 3 Bln Lisbet Asima / Justri
Muh. Nizar 20-6-2023 2 Bln NuRHAYATI / mUH sALIM
Amelya Safea 17-4-2023 4 Bln Ana Susilawati / Parlan
Hibrizi Randi Q ### 5 Bln Suryati / Anwar
Pricilla Yen Hermanto ### 5 Bln Meta Setyani / Edi Hermanto
Rafandra Ghaisan ### 3 Bln Reno Jayanty / Bimo
Khaira Nur Ramadhani ### 5 Bln Isa Fatonah / Jamal
By Ny AMBAR 22-7-23 1 Bln Ambar PAArsyanti
Dewi / Ulun Mubarak
/ Rendi
Muhammad Kenizio Saputra 29-4-2023 4 Bln Saputra
Bara Panjaitan ### 10 Bln Katrine / Eristal Panjaitan
Arfan Mahardika ### 5 Bln Fatma Liyara
Maharani / Yulin
Zahwa / Achmad
Jasmine Inayah Annaedi ### 7 Bln Mansilah / Dedi Junaedi
Kartika sari / Suhendra
Veronika Elizabeth V ### 6 Bln
Pasaribu
Nur Maulida Hasanah ### 19 Bln Nur Istiqomah / M. Faiz
Madinah Zelmira 22-3-2023 5 Bln Shena / Arief
Khanza Defina Almira 23-7-23 1 Bln Restika / Andrian
Tiara Eldora Azzahra 8/27/2023 3 Hr Evawani Pasaribu / Borkat

Febryan Pastri 23-2-2021 30 Bln Afia Sari / Paswari
Inaya Qamilatun Nuhu 1/18/2023 7 Bln Miarti / Ade Kusmawan
Misha Aliya Kamilah 25-3-2023 5 Bln Mila / Andika
Theo Kaysan Sugara 14-11-2022 9 Bln Tita Mulyasari / Yudi Sugara
###
Felicia Gwen Br Sitorus 19 Bln Yuni / Martua Naek
Emira Afifah 28-11-2022 9 Bln Yani / Faiz

12
Shaqa Arkan Wiratama 25-08-2022 Nuraini / Ahmad Gozali
Bln
Elora Yosefa Purba 26-09-2022 11 Bln Esta / Rinaldi

Boy Matthew Latumeten 26-11-2022 9 Bln
Latumeten
18 Siti Nuristysna / Diky
Muhammad Kautsar Razky ### Bln Sardini
19 Reny Sulisyowati /
Riko Praditya Zakaria Shankara 1/4/2022 Bln Muhamad Eko Yulianto
ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
HI Tanah Apit 81772383418 5 56 36 36.5 BCG
DPT1,
Rusun Ujung Ment 8905040600 5.2 57 38.5 36.5 POLIO2,
PCV1
DPT1,
Buaran 13/02 8 4.7 58 37 36.5 POLIO2,
PCV1
Cempaka I dalam 13/9 85956690338 4.4 52 39 36.5 BCG
Gempol 11/01 83879969623 5.4 53 58 36.5 BCG, POLIO1
Jl. Merpati 9/5 895411990722 5.6 57 40 36.5 BCG
Kayu Tinggi 9/4 81285203216 7.1 66 45.5 36.6 DS = 10
Buaran 2/2 082213161287 4.1 51 39 36.7 BCG
Gempol 2/11 81398264526 7.8 79 49 36.5 PCV3 DS = 10
Bulak Indah 11/5 081314210985 7.5 73 43.5 36.6 PCV3
Tambun Rengas 9.8 68.5 45 36.7 MR + IPV2 DS = 10

04/07 0896704140401
Custer South Booster MR
Thames J10 10 80.3 47 36.6 dan Booster
No.30 , Rt14 /14 087889013939 DPT
KP.GEMPOL
RT.08/01,KEL.C 10 70 43 36.7 DS = 10
AKUNG TIMUR 085883293085
DPT1, Polio2
Gempol 13/01 085777664441 5 56.2 43 36.6
dan PCV1
DPT1, Polio2
Gempol 13/01 085777664441 4.6 54.3 38 36.6
dan PCV1
Bulak Indah 8/5 0881024753575 9.8 73 48 36.7 MR + IPV2
DPT1, Polio2
6.4 57.8 42 36.5
dan PCV1
PG 5/4 85710428212
Kayu Tinggi 4/4 8.4 67.8 45 36.5 MR + IPV2 DS = 10

08985308182
8.6 73 49 36.5 PCV3 DS = 10

Kayu Tinggi 03/12089647122170
DPT1, Polio2
5.5 58.2 40 36.7
dan PCV1
Gempol 16/01 81932929072
BOOSTER
10 76 46 36.5 DPT, DS = 10
Jp. Buaran 05/02 085899035703 BOSSTER MR
BCG dan
Kayu Tinggi 9/11 085774418880 3.1 49 35 36.5
Polio1
Kp. Baru 14/07 087822897201 3.7 52 37 36.7 BCG
Kayu Tinggi 7/4 089523659664 2.9 48 37 36.8 BCG
Gempol 2/11 085773170505 4.1 51 36 36.6 BCG
Bulak Indah 6/5 082114604899 3.7 54.5 37 36.7 BCG
DPT3, Polio4
Gempol 8/1 085932653566 5.9 62 41 36.7
dan IPV
BCG dan
Kayu Tinggi 7/4 085819319599 5.6 57 39 36.7
Polio1
BCG dan
4.7 57 37.5 36.7
Polio1
Gempol 7/1 085696550174
BCG dan
Tambun Rengas 3.5 51.5 37.5 36.7
Polio1
7/7 89670339016
DPT1, Polio2
Kayu Tinggi 8999191484 5.6 59 38 36.7
dan PCV1
DPT3, Polio4
Swadaya 4/6 85328560129 8.5 65 43.5 36.7
dan IPV
DS = 10
DPT3, Polio4
Kandang Sapi 7/6 85775706584 7.1 67 42.5 36.7 DS = 10
dan IPV
DPT1, Polio2
Gempol 3/1 88214596624 5.9 58 40.5 36.7
dan PCV1
DPT2,Polio3
6 62 45 36.7
dan PCV2
Buaran 13/2 083805848520
DPT2,Polio3
Gempol 2/1 88111182558 5.9 59 42 36.7
dan PCV2
Kandang Sapi
0852169687749 4.8 57 37 36.7 3
07/06
DPT1,
Kayu Tinggi 6.1 60 39 36.6 POLIO2,
PCV1
DPT1,
Tambun RengS
82120013995 6 64 42 36.6 POLIO2,
016/001
PCV1
DPT3,
Kayu Tinggi 03/03 87888866400 8.9 70 47 36.6 DS = 10
POLIO4, IPV1
Gempol2/1 81584522053 2.9 48 36 36.5 2

6.5 67 41 36.4 PCV3
Kayu Tinggi 11/09088210035117
Kayu Tinggi
087830235551 8.3 71.5 42 36.5 IPV2, MR
13/06
DPT1,
PCV1
DPT2,
7.9 65 42 36.5 POLIO3, DS : 10
Gempol 16/01 08164398446 PCV2
Cempaka 08/09 85889292713 9.8 69.5 45 36.5 IPV2, MR DS : 10
Kayu Tihnggi 08/12 82280399108 6.1 64 40 36.5 DS : 10
7.3 67 44 36.5 IPV2, MR

Kayu Tinggi 11/09088210035117
DPT1,
Gempol 07/01 0896307348319 4.3 52 38 36.5 POLIO2,
PCV1
Kayu Tinggi
89688741137 9.5 73 45 36.5 IPV2, MR DS : 10
12/06
DPT2,
Cempaka 9/12 081313375333 5.7 60 40.5 36.5 POLIO3,
PCV2
DPT2,
PCV2
4.1 52 37.5 36.5 2

Gempopl 04/01 089517467424
Kayu Tinggi 8.9 75 46 36.5 IPV2, MR DS : 10

Rt2/Rw4 0895336693008
DPT1,
PCV1
Kayu Tinggi 6/3 2.9 48 36 36.6 2

Kayu Tinggi 2/3 82324629187 7.8 73 44 36.5 PCV3 DS = 10
Bulak Indah 10/5 85925008708 4.6 54 37.5 36.5 BCG, POLIO1
DPT1,
Kayu Tinggi 04/05 81295684071 6.2 59 41 36.5
POLIO2, PCV
Kayu Tinggi 05/09 82123543234 6.5 62 40 36.5 Rota1
Kayu Tinggi
85886191961 2.1 54.5 33 36.5 BCG, POLIO1
05/12
Tambun Selatan
895331415492 6.1 60 40 36.5 BCG, POLIO1
01/08
Buaran 10/02 89678876442 4.7 57.5 36 36.5 Rotavirus 1
Kayu Tinggi
3.1 50 36 36.6 3
09/04
87741319457
DPT1,
Kandang Sapi
7.5 75 36 36.5 POLIO2,
4/6
81223140346 PCV1
Kandang Sapi
4.4 54 39 36.5 BCG
5/6
89667996799
DPT1,
Kayu Tinggi
4.7 54 40 36.6 POLIO2,
02/11
85717920072 PCV1, ROTA1
DPT1,
Kp. Kandang
5.9 47 40 36.5 POLIO2,
Sapi 11/06
085694054918 PCV1, ROTA1
DPT2,
Kp. Buaran 14/02 82212741505 6.3 68 38 36.5 POLIO3,
PCV2
Jl. Cempaka 06/09 082155483489 3.3 48.5 37 36.5 BCG, POLIO1
DPT1,
THB 03/22 081360891988 5.8 558.5 40 36.5 POLIO2,
PCV1, ROTA1
DPT3,
Jl. Cempaka 9/9 0816402087 7.7 65 43.5 36.5
POLIO4, IPV1
DPT2,
5.8 59 42 36.5 POLIO3,
Kayu Tinggi 1/3 89512181701 PCV2
DPT3,
Kayu Tinggi 10/6 083873200111 5.9 59 42 36.5
POLIO4, IPV1
DPT3,
Kayu Tinggii 3/5 87786968087 6.5 52 44 36.5
POLIO4, IPV1
DPT2,
Buaran 2/2 83805848226 6.4 59 40 36.5 POLIO3,
PCV2
Kav Pagar Jati 15/01 081318723681 4.1 55 40 36.5 BCG
Kandang Sapi
0852169687749 5 55 38 36.5 BCG, POLIO1
07/06
DPT2,
Kayu Tinggi 7/4 081278068364 5 56 39 36.5 POLIO3,
PCV2
Kayu Tinggi
87741319457 3.1 50 35 36.6 3
09/04
Bulak Indah 8/5 089682400723 3.1 48 35 36.6 3
KANDANG SAPI
089670122543 4 54 35 36 BCG,POLIO 1
RT 6/RW6
Buaran 10/02 - 3.7 50 37 36.7 3
SWADAYA IV
0895391739054 5 57 39 36.8 BCG, POLIO 1
RT12/1
KAYU TINGGI
085771006464 5.8 88 39 36 BCG, POLIO 1
RT7/RW4
CEMPAKA ELOK RT4/9

085723827018 3.1 50 34 36
BULAK INDAH RT4/5081283551315 4.4 54 36 36 BCG,POLIO 1
KAYU TINGGI RT3/9085715262449 4.2 50 39 36 BCG,POLIO 1
KAYU TINGGI RT4/RW4

081281176299 6.2 60 40 36 DPT1,POLIO2
PCV1,Rotaviru
Buaran 10/02 081212123249 5.2 57 39 36.7
s1
GEMPOL RT11/1 085871405756 4.9 57 39 36 DPT1,POLIO2
DBCG,POLIO
KANDANG SAPI 089670122543 4 54 35 36
1
DBCG,POLIO
Buaran 12/02 085727134676 4.3 54 37 36.5 DPT1,
1
Kandang Sapi 1/6 8113998427031 4.2 54 37 36.6 PCV1,
BCGROTA1
Cempaka II 5/09 81292469067 3.2 47 36 36.5 1
Kayu Tinggi
087876550108 4.3 53 38 36.7 BCG
10/09
8.6 66.5 43 36.6 DPT3,IPV DS = 10

JL. Waru III 2/9 081283623305
Taman
081335534378 75 45 36.4 IPV2
Pulogebang 4/13
Cempaka 8/9 87748004631 7.7 67.5 44 36.7 PCV3
DPT3,
Buaran 10/02 085776092462 6.2 62 39.5 36.7
POLIO4,
DPT3,IPV1
Tambun Rengas 2/7 88975932007 6.7 64.5 41 36.5
POLIO4, IPV1
DPT3,
6.3 62 37.5 36.5
Kayu Tinggi 4/9 082120621743 POLIO4,
DPT1,IPV1
DPT3,
PCV1, RR 1
Kp. Buaran 10/2 085886634721 62 6.2 41 36.5
POLIO4,
DPT3,IPV1
Tambun Rengas 6/7 081281961628
Jl. Walikota 6.3 65 41 36.5
POLIO4,
DPT3,IPV1
Pondok Kopi 082288473905 7.5 62 43 36.5
POLIO4,
DPT1,IPV1
Gempol 04/01 0895322329015 5.5 57 40 36.5 POLIO2,
DPT1,
PCV1, RR 1
Taman PCV1, RR 1
DPT3,
6.6 65 41 36.5
Pulogebang 8/13 081286355233 POLIO4, IPV1
DPT1,
Gempol 04/01 085770561006 4.8 56 37 36.5 POLIO2,
PCV1, RR 1
DPT2,
Jl. Waru Raya
085717380583 5.2 61 40 36.5 POLIO3,
1/9
PCV2
DPT1,
PCV1, RR 1
DPT1,
Kp. Ujung
089501564899 5.1 58 39 36.5 POLIO2,
Krawang PCV1, RR 1
DPT3,
Rorotan 3/10 085820101142 9.3 71.5 46 36.5
POLIO4, IPV1
DS = 10
DPT3,
5.6 60 39 36.5
POLIO4, IPV1
Bulak Indah 5/5 085777280297
DPT1,
PCV1, RR 1
Kayu Tinggi 3/9 81383018815 6.1 55 39 36.5 BCG
DPT1,
PCV1, RR 1
DPT3,
Gempol 8/1 87880837668 DS = 10
POLIO4, IPV1
6.6 63 42 36.5
DPT3,
Kayu Tinggi 3/3 085885289905 7.6 64 42 36.5
POLIO4, IPV1
DPT3,
8.6 66.5 43 36.5
POLIO4, IPV1
JL. Waru III 2/9 81283623305
Kayu Tinggi 2.9 49 34 36.5 3

13/09 8817790844
DPT1,
Buaran Gowok 4/2 85163563183 4.6 55 36 36.5 POLIO2,
PCV1, Rota1
Bulak indah 08/05 85852284469 9 69 42 36.5 MR, PCV3 DS = 10
Buaran 09/02 8999953887 8.7 67 45 36.5 MR, IPV2
DPT3,
Kandang Sapi 07/ 81513688244 7 64.5 42 36.5
POLIO3, IPV1
DPT3,
Kayu Tinggi 2/11 85643053458 6.2 62.5 40 36.5
POLIO3, IPV1
BOOSTER
DPT,
17 79 49.6 36.5 DS = 10
BOOSTER
Jl. Garuda 10/06 81281853191
MR
8 68 43 36.5 PCV3 DS = 10
Kayu Tinggi 12/09
DPT1,
PCV1, Rota1
DPT3,
Ujung Menteng 85664726301 7.3 65 41 36.5
POLIO3,
DPT,IPV1
Ujung Menteng 081285908070 12.5 89.5 48 36.5
BOOSTER
Kayu Tinggi 8.1 69.5 46 36.5 PCV3
12/09 082111358679
BOOSTER
DPT,
9.7 79 46 36.5 DS = 10
Gempol BOOSTER
cakung04/01
jakarta 089605500662
MR
DPT,
timur 085210107962 12 81 46 36.5
BOOSTER
Kayu Tinggi 7/9 085884008798 7.5 65 41 36.5 MR, IPV2 DS = 10
DPT3,
Kayu Tinggi 1/4 895327369467 5.9 59 39 36.5
POLIO3,
DPT3,IPV1
KP. Buaran 12/02 85776163656 9.8 83.8 46 36.5
POLIO3,
DPT3,IPV1
Jl. Perdana 4/12 89624051563 9.6 70 46 36.5
POLIO3, IPV1
Kayu Tinggi 12/09 081289446975 8.5 70.5 45 36.5 MR, IPV2 DS = 10
Gempol 10/01 7.5 64.5 43 36.5 MR, IPV2
Kandang Sapi 13/06 081586115118 7.6 64 41 36.5 DPT2, DS : 10
Buaran 10/2 081288853331 6 60 40 36.5 POLIO3,
Kayu Tinggi 1/11 085159477739 7.3 66 41 36.5 PCV1, Rota1 DS = 10
MR, IPV2
DPT2,
Kandang Sapi 11/ 08977675351 5.4 58 39.5 36.5 POLIO3,
PCV1, Rota1
Bulak Indah 9/12 081314901449 8.8 70.5 44 36.6 MR, IPV2 DS = 10
Kayu Tinggi 09/11 89609942490 7 65 39 36.5 MR, IPV2 DS = 10
DPT3,
POLIO3,
Gempol 2/2 08158077642 5.6 57 39 36.5 POLIO2,
DPT3,
PCV1, Rota1
Gempol 3/1 85891495562 8.6 67 43 36.5
POLIO3, IPV1
Gempol 9/1 083807200880 2.4 49.5 35 36.7 3
Kayu Tinggi 6/9 85693563923 4.7 56 39 39 BCG, POLIO1
Swadaya 12/01 8114491118 4.5 53.5 36 36.5 BCG, POLIO1
KP. Buaran 10/02 81908147585 DPT1,
Kav, Barokah Sapi 82257019991 4.8 54.5 40 36.5 POLIO2,
Gempol 9/1 82214624253 4 52 38 36.6 PCV1,POLIO1
BCG, Rota1
DPT1,
Buaran 12/2 81298618336 6 61.5 42 36.5 POLIO2,
PCV1
Gempol 8/1 81293940920 5.1 57 41 36.5 BCG, POLIO1
DPT3,
Kayu Tinggi 3/9 81514563754 6.6 61.5 41.5 36.5
POLIO3,
DPT3,IPV1
Rorotan 5/10 89644485129 7.4 63 42 36.5
Panti Asuhan POLIO3,
DPT2,IPV1
0821808836168 9.2 73.5 44.5 36.5 DPT2,
Guna Nande POLIO3
DPT3,
PCV2
Buaran 13/02 87803121377 6.7 60.8 40.5 36.5
POLIO3, IPV1
DPT1,
Gempol 4/1 0895412742770 6.6 65.5 42 36.5
POLIO2,PCV1
Gg. Bingung 7/6 087834291735 8.4 68.5 46 36.5 PCV1
DPT3,
POLIO3,
Bulak iindah 8/5 838871867081 5.5 59 40 36.5 POLIO3,
Kandang Sapi 4/6 85678545454 6.7 62 42 36.5 PCV2, Rota1
Kayu Tinggii 3/5 87786968087 6.8 60 42 36.5 ds - 10
DPT2,
Bulak Indah 2/12 85780187611 10.5 81.5 45 36.5
POLIO3
Cakung Residene 81316053517 7.6 64 43 36.5
2.4 47 36.7 36.5 1

Buaran 10/02 81265022621 BOOSTER
DPT,
Kayu Tinggi 3/6 81291804890 12 77 37 36.5
BOOSTER
MR
DPT3,
7.7 68 43.5 36.6
JL. Cempaka 4/9 81932777236 POLIO4, IPV1
DPT3,
Kandang Sapi 11/06 85156585914 5.6 61.5 39.5 36.5
POLIO4, IPV1
Cempaka Anyar 13/09 89646517500 9.6 72 47 36.5 MR, IPV2 DS = 10

BOOSTER
DPT,
79 45 36.5
Kayu Tinggi 5/9 10 BOOSTER
MR
7.8 67.5 43 36.5 MR, IPV2 DS = 10
Kayu Tinggi 07/05087889750347
Bulak Indah
#FMT 8.9 72 47 36.5 PCV3 DS = 10
01/12
DPT1,
Bulak Indah 11/05 895365362806 5.6 57.6 39 36.5 POLIO2,
PCV1, ROTA1
Kt 07/09 081293404015 10 80 44 36.5 PCV3 DS = 10
Bulak indah 04/05081291157455 7.6 67.8 43.5 36.5 MR, IPV2
Pulo Gebang
085172009223 8.1 72.5 45 36.5 MR, IPV2 DS = 10
01/05
BOOSTER
Balai Rakyat DPT,
9.8 83 49 36.5
08/04 087760254545 BOOSTER DS = 10
BOOSTER
MR
DPT,
12.5 90 50 36.5
Kayu Tinggi 081252525112 BOOSTER
MR
KETEPATAN
WAKTU OBS KU
IC SUNTIK KEMBALI
TEPAT BBL (Kg)
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V V 31-08-2023
V V 18 Bln
V V V 18 Bln
V V 12 Bln
V V LENGKAP
TUNDA
IMUNISASI
v v 05-09-2023
v v 05-09-2023
V V V 12 Bln
v v 05-09-2023
V V 12 Bln
V V 18 Bln
V V 05-09-2023
V V 21 Bln
v v v 07-09-2023
v v v 07-09-2023
v v v 07-09-2023
v v v 07-09-2023
v v v 07-09-2023
v v v 9 Bln
v v v 07-09-2023
v v v 07-09-2023
v v 07-09-2023
V V 07-09-2023
V V 9 Bln
V V 9 Bln
v V 07-09-2023
v V 07-09-2023
v V 07-09-2023
15-08-2023 RS Sukapura 3400 132
V V V 12-09-2023
V V V 12-09-2023
V V V 6 Bln
V V V 12 Bln
3150 49
RS
V V 18 Bln
V V 12 Bln
V V 12-09-2023
V V 12-09-2023
V V 12 Bln
V V 12 Bln
V V 12-09-2023
V V 12 Bln
V V 12-09-2023
V V 12-09-2023
3400 132
RS
V V
V V 12-09-2023
21-08-2023 RS 2900 234

V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V 3200 133
RS Resti Mulya
V V V 14-09-2023
V V V 14-09-2023
V V V 14-09-2023
V V 14-09-2023
v V 14-09-2023
v V V 14-09-2023
V V 14-09-2023
V V 6 Bln
V V 14-09-2023
V V 6 Bln
V V 6 Bln
V V 14-09-2023
v V V 14-09-2023
V V 14-09-2023
V V 14-09-2023
V RSIA Resti Muly 3.2 132
V RS Pekerja 3.2 130
V V V
V RS Resti 3.7 130
V V V
V V V
V V PUSKESMAS 2950 130

V V V
V V V 22-09-2023
V V V 22-09-2023
v v v 21-08-2023
V V V 22-09-2023
V V V 22-09-2023
V V V 22-09-2023
v v v 21-08-2023
v v v 21-08-2023
V V RSIA Resti Muly 2.8 136
v v v 21-08-2023
v V 9 Bln
v v
v V
v v 6 Bln
v V 6 Bln
v v 6 Bln
v V 21-09-2023
v v 6 Bln
v V 6 Bln
v v 6 Bln
v V 21-09-2023
v v 21-09-2023
v V 6 Bln
v v 21-09-2023
v V 21-09-2023
v v 21-09-2023
v V 21-09-2023
v v 6 Bln
v V 6 Bln
v v 21-09-2023
v V 21-09-2023
v v 21-09-2023
v V 6 Bln
v v 6 Bln
v V 6 Bln
v v 28-08-2023 RS 3.1 120
V v V 26-09-2023
V V v 18 Bln
V V V 12 Bln
V V v 26-09-2023
V V V 26-09-2023
V V v LENGKAP
V V V 18 Bln
V v 26-09-2023
V V 26-09-2023
V v LENGKAP
V V 18 Bln
V v LENGKAP
V V LENGKAP
V v 12 Bln
V V 26-09-2023
V v 26-09-2023
V V 26-09-2023
V v 12 Bln
V V 12 Bln
V v 9 Bln
V V 26-09-2023
V v 12 Bln
V V 26-09-2023
V v 12 Bln
V V 12 Bln
V v 26-09-2023
V V 26-09-2023
V v 26-09-2023
26-09-2023 RS Firdaus 2560 132
V v 28-09-2023
V v 28-09-2023
V V 26-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
V v 28-09-2023
RS 2.6 120
LENGKAP
9 Bln
6 Bln
V V 12 Bln
LENGKAP
V V 12 Bln
V V 18 Bln
V V 03-10-2023
V V 18 Bln
V V 12 Bln
V V 12 Bln
LENGKAP
LENGKAP
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
PUPUT
NCB SMK KN3
41 ya ya ya
USIA 3 mgg
NCB SMK KN 3
40 V V V
Usia 7 hr
NCB SMK KN 3
41 V V V
Usia 4 hr
NCB SMK KN2

40 ya ya ya
USIA 5 Hr
NCB SMK KN 3
41 V V V Usia 18 hr dengan
Ikterus Kramer 4
By.S usia 21 hr
kramer 3
By. M usia 9 hr
40 v v v
NCB SMK KN3
V V V
By. R usia 14 hr
40 v v v
NCB SMK KN3
V V V
BY.M USIA 5 HR
44 V V V
NCB SMK KN 2
By.B usia 21hr NCB
40 v v v
SMK KN3
By.S usia 9 hr NCB
40 V V V SMK KN3 ikterus
kramer 3
NCB SMK KN3
41 YA YA YA
Kramer 3
By.T usia 3 hr NCB
40 V V V
SMK KN 1
AN RESIKO
KIE CUCI KET
JATUH TANGA APD
MTBS GIZI NILAI SOP
N
Tunda
V imunisasi,
badan gatal"
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
Rujuk RSIA
v v v v v v v Resti Mulya
( Bilirubin 12)
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
Observasi
ikterus
v v v v v v Kontrol cek
lab tgl
22/8/2023
v v v v v v
V V V V V V
V V V V V V
V V V V V V
V V V V V V
V V V V
v v v v v
Observasi
ikterus
v v v v v v
Kontrol tgl
22/8/2023
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
Resti Mulya
v v v v v v
Ikterus
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v Dermatitis
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V V V V V
KUNJUNGAN KUNJUNGAN
SKRINING BCG
Bln) 59 Bln) HR)
TB 1 2 3
L P L
L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
0 2 3 1 7 0 1 0 0 1 0 1 26
Tanggal Pe
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1
1
1
1 1
1 1 1
1
1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
11 26 11 5 9 20 15 15 7 27 12 5 11 20
POLIO4 IPV 1 IPV 2 PCV 1 PCV 2 PCV 3 Rotavirus 1 Rotavirus 2

1
1
1
1
1
1
1
1
1 1
1 1
1 1
1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1
1 1
1
1 1
1 1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1 1
1 1
1
1
1
1 1
1
1
1
1
1
1 1
1 1
1 1
1
1 1
1
1
1 1
1
1
1
1 1
1 1
1 1
1 1
1
13 20 15 11 6 29 9 4 8 5 6 15 6 0
BOOSTER
CAMPAK BOOSTER
Rotavirus 2 Rotavirus 3 CAMPAK
RUBELLA DPT
RUBELLA
P L P L P L P L P
1 1
1
1 1
1
1
1
1
1
1 1
1 1
1 1
1 1
1
1
1
1
1
1 1
1 1
1
1 1
1 1
0 0 0 13 6 4 6 4 6
NO
JAMINAN
REGISTER
NO TGL NIK
BARU LAMA BPJS UMUM
1 01-09-2023 415/23 V
2 3172046408230003 416/23 V
3 04-09-2023 417/23 V
4 05-09-2023 418/23 V
5 419/23 V
6 3175065608230008 420/23 V
7 421/23 V
8 3175063006230007 422/23 V
9 423/23 V
10 424/23 V
11 3175067007230006 425/23 V
12 3175060307230004 426/23 V
13 427/23 V
14 428/23 V
15 343/23 v
16 365/23 V
17 3175062505230005 V
347/23
18 3172022505230003 V
345/23
19 410/22 YA
20 3175060408151113 240/23 V
21 3275047004130001 255/23 v
22 07-09-2023 430/23 v
23 431/23 v
24 432/23 v
25 408/23 v
26 408/22 v
27 100/23 v
28 317506062230003 304/23 v
29 3175060606230004 303/23 V
30 3175064112220004 99/23 V
31 V
3316020803220001 192/22
32 3175061806230005 354/23 V
33
3175066809220005 501/22 V
34
317506108220004 336/22 V
35 3175060507190030 86/22 v
36 3328032007220001 283/23 v
37
3175063101220001 80/22 V
39 3175061704230005 301/23 v
40 31750616611220006 549/22 V
41 3175066305230006 302/23 v
42 101/23 v
43
289/23 v
44 12-09-2023 428/23 A V
45 3175062906230001 429/23 V
46 3175064308230002 433/23 V
47 434/23
48 436/23 V
49 437/23 V
50 3175064708230005 438/23 V
51 439/23 V
53 441/23 V
54 3216055107230005 442/23 V
55 3175060908230002 371/23 v
56 3175062410170018 374A /23 V
57 3208304904230001 v
362/23
58 3175061104230012 V
361/23
59 V
349/23
60 3175064906230014 310/23 v
61 V
391/23
62 V
350/23
63 261/23 YA
64 3175060405230007 217/23 V
65 3175064607230006 356/23 v
66 3175063005230003 295/23 v
67 3175064405230009 252/23 V
13-09-2023 440/23 V
69 14-09-2023 443/23 V
70 V
444/23
71 V
445/23
72 V
317506101220011 480/22
73
3175062508220003 343/22 V
74 325/23 v
75
3202404909220003 424/22 V
76 259/23 v
77 357/23 v
78 3175062504230004 206/23 V
79
3175065309220002 434/22 V
80 3175065607230002 376/23 V
81
3175062107160000 164/22 V
82
3175062107160000 164/22 V
83 3275022810220001 465/22 v
84 3175062411220005 003/23 V
85 495/22 v
86 3175061312220003 550/22 V
87 31740806230003 306/23 V
88 3207104212220002 168/23 v
89
3175064803220004 127/22 V
90 3175061605230002 351/23 V
91 033/23 v
92
3175060211210008 426/21 V
93 274/23 V
94 status blm 3175060109220001 305/23 V
95 status blm 368/23 v
96 status blm 3175061407230006 337/23 v
97 status blm
408/23 V
98 ### 446/23 V
99 447/23 V
107 ### 435/23 V
100 3175060406230002 448/23 V
101 V
449/23
103
451/23 V
104
3175065607230005 452/23 V
105
3175065209230003 453/23 V
106 454/23 V
107 455/23 V
108
317506090823009 456/23 V
109 457/23
110 458/23 V
111 377/23 V
112 455/22 V
113 423/23 V
114 3175065103220004 107/22 V
115 317506044092200010 354/22 V
116 3175065608230008 420/23 V
117 3175066908220009 402/22 V
118 3175064805230001 226 C/23 v
119 3175061507230002 331/23 v
120 3175060708230012 392/23 V
21/9/2023 450/23 V
458/23 V
121 459/23 V
122 460/23 V
123 3175064207230005 461/23 V
462/23
124 3175062112220007 04/23 v
125 3175061806230004 298/23 V
126 3175060211220004 037/23 V
127 3175064612220007 015/23 V
128 317500668042300012 318/23 V
129 3175061707230004 380/23 V
321/23 v
131 3175060611151882 382/23 V
118/23 V
133 447/23 V
3175062004220019 326/23 v
3175062209220007 453/22 V
77/22 V
3175066205230013 292/23 V
323/23 v
027/23 V
379/23 V
3175066005230001 370/23 V
0 375/21 V
3175065306230003 280/23 v
3175060311220002 363/23 V
104/22 V
22-09-2023 463/23 V
25-09-2023 V
464/23
26-09-2023 V
3175062607230005 465/23
466/23 V
3175062305230008 467/23 V
3175065008230006 468/23 V
V
469/23
470/23 V
3212095105230001 471/23
V
253/23
V
460/23 V
V
449/23
V
269/23
383/23
316/23 V
381/23 V
293/23 V
386/23 V
3175061205230005 296/23 V
3175062506230006 339/23 v
3175061410220013 341/23 v
408/23 v
3175054206230005 374/23 V
385/23 v
389/23 V
242/23 V
3175066908220007 409/22 V
191
JK/UMUR
L P
Almahyra Shanum F 23-08-20239 Hr Ernawati / aris Fadilah
Anasera Lavannya Kaluna 24-08-202311 Hr Suriyana / Achmad Sirajul
Hesekiel Manurung 30-08-20235 Hr Dina Yosephine / Ridwan
Risqiana Abista ### 1 Bln Ega Aalistina / Hendra M
Rafan Julian Arrasyid ### 2 Bln Nurhada Sari / Alfiyan Satria
Syakilla Nuraisyah 16-08-2023 21 Hr Nurokhmah / Ikhsan Wira
Denadia Fermatari / Dimas

Enzo Zamorano Keynadi 8-1-23 1 Bln
Triandiko
Siti Nurul Jumroh / Ahmad

Ahmad Abisheva Malik 30-07-2023 1 Bln
Denhar
29-08-2023 7 Hr
Gefira Jazila Sumarti / Buang Sudiono
### 3 Bln Tri Novia Susanti / Lukman

Bellvanya Sandra Hakim Hakim
30-07-2023 1 Bln Siti Nur Apriani / Rolando

Zahra Salsabila Naewo Naewo
### 5 Bln
Muhammad Bilal Athallah Fitriana Astuti / Idham
22-07-2023 1 Bln Indah Permatasari /

Binuka Noah Antares Ardyantoro Hani
###
Divendra Ikhsan Alfiansyah 11 Hr Yulinar / Edi
###
M Zein Asyshauqi 1 Bln Nurlaela / Iqbal
Hasan Basri Alfatih ### 1 Bln Daminih / Sartono
Muhammad Ellmer Pratama ### 3 Bln Seli Alawiyah / Alfian Pratam
Alfatih Danindra ### 12 Bln Kani / Gilang
Yumna Agnia ### 6 Bln Rani Radianingsih / Teguh
Uhaila Tsamra ### 4 Bln Ani Nurfadilah / Syahrul Amin
Alfian Rizqi Azzaki 05-11-202210 Bln Rika Ristiana / Eko Wardoyo
Geo Saputra Pratama ### 4 Bln Ranti S / Wawan Saputra
Tiara Eldora Azzahra 8/27/2023 11 hr Evawani Pasaribu / Borkat
Elsa Camillia Maheswari ### 12 Bln Febri / Saudin
Muhamad Alfarezel Ghifari ### 6 Bln Farah / Asep Abdi

Syafazea Kayla H ### 9 Bln Irmay / Dodi Prasetyo
Rafan Ghifari Prayogo ### 9 Bln Wiji Astuti / Sutisna
18
Bikry Hamizan Robbani 6/18/2023 Rosyanti / Rohmani
Bln
Fira Khaerunisa 28-09-2022 11 Bln Yulita Sari / Sumarno
Dwi Saka Adnan Setyadi ### 12 Bln Martini / Amin Jaka Setyadi
Rasya Eleno Rayyanza 19-2-2022 19 Bln Febry Indra / Angger Pamun
Zayyan Arkana Alfarizki 20-7-2022

13 Bln Nur Afita / Jamaludin
19
Irsyad Yahya Hambali 1/31/2022 Bln Sahara / Lili Hembali
Muhammad Raska Ramadhan ### 5 Bln Mira Emilia / Rizky
Arum Rahmawati /Fendi
Rabbani Ahza Mavandra ### 10 Bln
Setiawan
Anasya Putri ### 3 Bln Rachmawati / Joko
Masheel Jovial Motiea ### 9 Bln Nandra Vahada / Fauzi M
Yunike Kanaya Putri ### 3 Bln Namiroh / Agus Triadi
Helen Situmorang 8-8-2023

1 Bln Ida Friska Angel / Tumbyr Re
Muh. Ashraf Lubis 29-6-2023

3 Bln Mutiara Lestari / Monang Lub
Agista Naura 3-8-2023

1 Bln Hasanah / Aripin
Ifani 6-9-2023 6 Hr Lstioro Tamba / Khotman T
Elga Azzahra A ###
1 Bln Kurlina / Hadi Haryadi
Najiba Khanza Hafifah 4-5-2023 4 Bln Salbah / Arinta
Maezura Alesha A ###
1 Bln Agesti Reonita / Riyan Sah
Raid Syatir Al Hasan ### 1 Bln Mega Silfiah
Andriani / Suryadi
Hutabarat / Elifati
Givany Buanathania 2-9-2023 10 Hr Zedrato
Goessera Putri / A.
Clemira Elfesya Asa ### 2 Bln muhaimin
Muzaffar Alharsa ### 1 Bln Mar'atun S / Hasanudin
Syafiq Maulana Syakir ### 18 Hr Nurul / Deni
Ratu Aulia Rahman ### 5 B ln
Belleza Nauli ### 1 Bln Anita Martauli P / Jan Pieter
Arrasya Kalief N ### 3 Bln Nurchaeni / Rois Sulaman
Cristine Gabriela Hasibuan ### 4 Bln Ely Sabet / Jupri HAsbun
Ibra Naumi Arzanka ### 4 BlnMutia Intan R / nOVIAn Aprianto
Tyarma Sahmawati / Mitro

Reno Axchel Siregar 6-9-2023 10 Hr
E. Siregar
Muhammad Attaqi K 17-9-2022 12 Bln Lisah / M. Yusri
9-6-2023 3 Bln Aprilia / Idis Apandi

Kalil Al Ghifari
23-8-2023 21 Hr Ernawati / Hasis Fadilah
Almahyra Shanum
### 5 Bln Alifah / Galang

Abil Shidqi Arshalan
Muhammad Ghani Wiratama ### 12 Bln Rahayu Puji Astuti / Rafli Adi
Khaira Almahyra ### 12 Bln Sri Nuraini / Karisman
Farhana Zakiyah ### 3 Bln Fikriyah / Ismail
Habib Al Habsy Jansen ### 5 Bln Nurhaeti / Ivan Christian
### 2 Bln
Shanum Pratista Friska / Purnomo
Ghafi Albiansyah Saputra ### 18 Bln Wardiyanti / Dedi Hartono
Ghafi Albiansyah Saputra ### 3 Bln Wardiyanti / Dedi Hartono
###
Ghilman Dzuhairi 11 Bln Erma Fitri / M Samsul
Sri Devi Anna / Rio
Prince Novmender 24-11-202210 Bln
Arthasasta
Vania Jose Sinaga ### 15 Bln Fitria H / Armando Sinaga

Ahmad Abyan Pratama ### 9 Bln R
Jasmine Hanna Cheryl ###

9 Bln Fitri Tena / Egi
Maria Sera 8-3-22 19 Bln CICA / RIZKI

Fahmi Hidayati / Muhamad
Khalid Abdulloh ### 4 Bln
Juninto
Khadijah Haura ### 9 Bln Mustantifah / Zeki Zulkarnain
22 Mutia Maharani / Abdul

Ahmad Liam Alkhalifi 11/2/2021 Bln Latief

Kevin Servius Levy ### 12 Bln Meyan Ayu / Robert S
Tiara Eldora Azzahra 8/27/2023 17 Hr Evawani Pasaribu / Borkat
Kiara Putri Setiawan ### Rahma Novita Sari / M.

6 Hr Rizki Setiawan
Afifa Fathima Septiani ###

6 Hr Fatimiyah / Kasyani
Kalila Dion 8/16/2023

Dian / Yahya Ansori
Arshan Zahwan Hakim ### 3 Bln Rosa Rosmala / Nurhasan
Dedeh Mahmudah / Pedo

PRadipta Aditya I 16-7-23 2 Bln
Agustiah Aretha Varadisha ### 1 Bln Yatimah / Toha
Yumna Shanum Irawan 7/16/2023 2 Bln Desi / Agus Irawan
Nuaira Hibatillah Lesmana 9/12/2023 7 Hr Riska M / Allen Lesmana
Azqiara Syajani Rizqi ### 1 Bln Hanifah / Harpan
Kautsar Razqi Alfian 8/11/2023 1 Bln Lutfi Nurhabibah / Ari

Alfian
Reifansyah Alfarezel Iskandar ### 1 Bln Yuliani / Deddy Iskandar
Muh Rasyid Al Aziz ### Murdiyati / Langgeng

1 Bln
### 1 Bln
Aksara Daryata Siti Nur / Teffly v
### 4 Bln
Ahmad Alwi Fahrezi Nunung / Darko
12
King Darel Alamsyah 04-09-2022 Warnem / Dedi
Bln
Gefira Jazila 29-08-2023 21 Hr Sumarti / Buang Sudiono
ANANDa PUTRI 11-3-22 5 BLN Ghesti
TITIN /KURTUBIN
Wahyu / Rahmat Sri
Zavier Gaffi Azhra Azizayn 04-09-22 12 Bln Aji
Syakilla Nuraisyah 16-08-2023 1 Bln Nurokhmah / Ikhsan Wira
Winda Selly Septiana /
Michelin Areta Saduk 26-08-2022 13 Bln Ayu Dewi Kunanti / Doni
Michel Victor
Asira Almayra ### 4 bLN Kurniawan
Ja'par Alhammad ### 2 Bln Mei Kiki Anjelina / Raynal
Khuluq
Aziel Hasibuan 14-8-23 1 Bln Hasibuan
Khadijah Aminah ### 10 Hr Khadijah Aminah / Kaedi
Susi Supriyanti / WAHYU
Raisa Umairoh Hidayatullah ### 9 Bln
hIDAYAH
TYuli Wulandari / M. Abdul
Salmon Alfariji ### 3 Bln
Rahman
Natania Cerryl Umairoh 14-6-23 3 Bln Endang / Tutus
Aulia Fauziana / Ahm.
Julia Risqiana Ahmad ### 2 Bln Tohirin
Raya Raisyah M / Rusyadi
Muhammad Marsyel Albyza 17-9-2023 4 hr Alfian
Galih Estiawan ### 9 Bln Mufiatun / Mulyono
Haidar Maulana 02-11-202210 Bln Nurjanah / Echo Ujisucipto
Elvania Shareen Adhani ### 9 Bln Anim / Suryadi
Archika Gelya Wulandari ### Dewi Wulandari / Onekesi Gu
SUNIAH /
AHMAD ZAIN ALGHIFARI 7/17/2023 2 Bln
AHM.SYARIFUDIN
JOVAN LUIZ TOBING ### 2 Bln ROSIANA /MESRADI
Afifa Fathima Septiani ### 12 Hr Fatimiyah / Kasyani
Setianto
FAIREL AFNAN ATHARAZKA 22-9-22 12 Bln WINDARI / DADANG
TRI SEPTIYANA dan
Qirania Ameera Sabia 1/24/2022 21 Bln TAUFIK UROKHMAN
Shareen Gabriela S ### 4 Bln Winarti / Rizki
Devanka Adi Alfareza ### 9 Bln Murniyanti / Bagus
Muhammad Aufa Rizki Adha ### 3 Bln Ineke Ayu Safitri / Fatur
3.5 Nurul Sharaswati / Muchlis
Mayzura Sandhya ### 24 Bln Nurseno
Damar Langit ### Bln Dwina/ Haris
Reza
Kenzo Zafran 3-11-22 10 Bln Sri Puji Lestari / Budi
19 Ade Irma Wati / Tedi
Haidar Raziq Firmansyah 2/2/2022
Bln Firmansyah
Refen Xtyan Shaqeena / M
Radeya Xtyan Shaqeena 11-9-2023 11 hr
Riyan Pratama
Anggun Dyah Ayu / M

Alesha Alifa Hibatillah 9/15/2022 12 Bln Andrean
Rafathan Naufal Irwan 26-07-2023 2 Dian Haryanti / Heri Irawan
Syahnaz Putri Ayunindya 14-06-2023 3 Bln Yuliani Ningsih / Abd. Saraf
23-05-2023
Gavian Narendra Al Cantara 4 Bln Miftah / Akbsr
Azqiara Nur Hafizah ### 1 Bln Cuzaimah / Syamsul Bahri
Muhammad Abizar Kurniawan 25-08-2023 1 Bln Jumaidah / Taufik
Nameena Oeulyshati ### 1 Bln Siti Masitoh / Hendrawan
Keysa Putri ### 4 Bln Kurniasih / Abdul Ropiq
Chelsea Zhea Genaira ### 4 Bln Virda Yunia / Faisal


Zidan Al Fawaz 16-7-23 2 Bln
Maharani Zahwa / Achmad
AMANDA MICHELLE MANULLAN ### 2 Bln NOVIA / RICHART
ARSYAD MUMTAZ HARDIKA ### 1 Bln MULYANI / IBNU
Rafandra Ghaisan ### 4 Bln Reno Jayanty / Bimo

MUHAMMAD NUR PRAYOGA ### 4 Bln NUR
Siti NurPRAMITA
Halimah // Rahmat
KHAIRUL
Azmi Rahmat Rumi A ### 4 Bln Fajar
Tiara Eldora Azzahra 8/27/2023 1 Bln Evawani Pasaribu / Borkat
Risky
Jouvan Silaen ### 3 Bln Kristina Makdalena / Chandra
Humairah Putri ### 4 Bln Siska A / Anggi A
ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
Gempol 11/1 82125995699 2.9 49 36 36.5 3
Kayu Tinggi 2/3 87833377877 2.6 48 36 336.5 3
PG 4/5 85710471749 3.2 50 36 36.5 2
kayu Tinggi 2/11 81333327030 4.7 58 39 36.5 BCG, POLIO1
Buaran 3/2 85885651197 4.8 58.2 39 36.5 BCG, POLIO1
Gempol 7/1 81210168177 3.2 50.5 36 36.6 3
Kayu Tinggi 85719219795 4.9 55 37 36.5 BCG
Kayu Tinggi 3/3 2.9 48 36.5 36.6 2

858438812858
DPT3,
Kayu Tinggi 4/11 85218029583 6.7 58.5 42 36.4
POLIO4, IPV1
Kayu Tinggi 1/4 4.2 5.5 36 36.5 BCG

81210041340
DPT2,
Jl. waru 11/09 5.5 56 38 36.6 POLIO3,
85888233810 PCV1, ROTA1
Kayu Pagar Jati 4.1 56.8 37 36.5 BCG

15/01 85959808588
3.2 50 34 36.5 3
Gempol 15/01 85814585907
5.3 47 37 36.5 BCG

Gempopl 04/01 089517467424
Gempol2/1 81584522053 3.8 51.5 34.5 36.5 BCG
DPT2,
Rusun Ujung Ment 8905040600 6 59.5 39.5 36.5 POLIO3,
PCV1, ROTA1
DPT1,
HI Tanah Apit 81772383418 5.6 60 40 36.5 POLIO2,
PCV1, ROTA1
Kayu Tinggi 9/11 083891318266 9.5 71 47 36.5 PCV3
DPT2,
PCV2
DPT3,
Kayu Tinggi 4/4 087885792831 5.6 61 41 36.5
POLIO4, IPV1
DPT2,POLIO3
Ujung Menteng 085719955139 6.1 61.5 41 36.5
dan PCV2
Kayu Tinggi 9/9 085770581370 6.8 68 44.5 36.6 MR & IPV2
DPT2,Polio3,P
Kayu Tinggi 2/3 081389300260 6.3 60 41 36.6 CV1 dan
Rotavirus1
2.4 47 36.7 36.5 3

Buaran 10/02 81265022621
Kayu Tinggi 7/9 087878663378 7.6 67 46 36.6 PCV2
DPT2, Polio3,
Gempol 13/01 085777664441 5.6 58 38 36.6 PCV2 dan
Rotavirus1
DPT2, Polio3,
Gempol 13/01 085777664441 5.9 58 43 36.5 PCV2 dan
Rotavirus1
Taman
Pulogebang 081296876540 8.3 70 36 36.6 MR, IPV2
RT.08/13
BOOSTER
DPT,
8.9 67.7 45 36.5
BOOSTER
Kayu Tinggi 2/11 082132272062 MR
DPT1,Polio2,P
Kp. Baru 14/07 087822897201 4.7 55 38 36.7 CV1,
Rotavirus 1
Kayu Tinggi 8.4 73 41.5 36.5 MR, IPV2

03/06 081361932206
Bulak Indah Rw 9.2 76 47 36.5 PCV3

02 081213170208
BOOSTER
DPT,
Kp. Buaran 01/02 08988355983 9.2 76 48 36.7 DS = 10
BOOSTER
MR
DPT3,
9.5 74 47 36.5
POLIO4, IPV1
Gempol 11/01 083806462606
BOOSTER
Cluster Zebrina III DPT,
9.3 76 47 36.5
Rt.04/14 08121051116 BOOSTER
MR
DPT3,
Gempol 2/1 88111182558 6.2 69 42 36.5
Kayu Tinggi POLIO4, IPV1
85211554337 8.7 68 45.5 36.6 MR, IPV2
DPT2,
06/04
Gempol 3/1 88214596624 6.5 61 41 36.5 POLIO3,
Harapan Baru PCV1,
085262222619 7.4 70 44 36.5 MR, ROTA1
IPV2 DS = 10
Bekasi DPT1,Polio2,P
Tambun Rengas 4.2 56.5 38.5 36.6 CV1,
7/7 89670339016 Rotavirus 1
4 52 36 36.5 BCG
Cempaka 81316178069
BCG, POLIO1,
5.5 58.5 39 36.5
Tambun Selatan 3/ 81293235877 ROTA1
4.2 51 39 36.5 BCG, POLIO1

Gempol 3/1 81280120007
Kayu Tinggi 3/9 81346217743 2.4 47 36 36.5 2
4.5 53 35 36.5 BCG

Kayu Tinggi 4/4 8783690217 DPT2,
PCV2
3.6 49 37 36.5 BCG
Kayu Tinggi 4/4 8981143626
Buaran 10/02 8 4.6 53 36 36.5 BCG
Kayu Tinggi 7/5 85266640799 3.6 51 34 36.5 3 DPT1,
Rorotan 5/8 85722909010 5.3 56 37 36.5 POLIO2,
PCV1, ROTA1
Bulak Indah 8/5 089682400723 4.4 53 36 36.5 BCG, POLIO1
Kayu Tinggi
87741319457 4.2 53 39 36.5 3 BCG
09/04
Tambun RengS DPT3,
82120013995 6.2 63 41 36.5
016/001 POLIO4, IPV1
DPT2,
Kayu Tinggi 6.5 61 40 36.5 POLIO3,
PCV2
DPT1,
Cempaka I dalam 13/9 85956690338 5.6 58.5 40 36.5 POLIO2,
PCV1
DPT2,
PCV2, ROTA1
Cempaka II 5/09 81292469067 3.8 50 36 36.5 BCG
DPT1,
Gempol 11/01 83879969623 6.4 52 39 36.5 POLIO2,
PCV1, ROTA1
DPT2,
PCV2, ROTA1
DPT3,
Buaran 2/2 83805848226 6.9 60.6 40.5 36.5
POLIO4, IPV1
DPT1,
Gempol 2/11 085773170505 5.1 56 38 36.5 POLIO2,
PCV1, ROTA1
DPT2,
6.7 61.2 41 36.5 POLIO3,
Gempol 16/01 81932929072 PCV2, ROTA1
DPT3,
Kayu Tinggi 2/11 81283026593
POLIO4, IPV1
5.9 60 39 36.5
Gempol 16/01 2.9 47 36 36.6 3
Kayu Tinggi 1/3 87875696446 8.8 69 45 36.5 MR DS : 10
DPT1,
Tambun Rengas 1/8 85715153225 4.7 57.5 37 36.5 POLIO2,
PCV1, ROTA1
Gempol 11/01 82125995699 3.3 49 34 36.4 3
8.8 72 45 36.5 PCV3 DS : 10

Kayu Tinggi 8/4 081320457024
DPT1,
Jl. Cempaka 06/09 082155483489 3.9 53 36 36.5 POLIO2,
PCV1, ROTA1
Kayu Tinggi 7.2 68.5 42 36.5 PCV3 DS : 10

02/05 085893684378
DPT3,
Cempaka 9/12 081313375333 6.2 62 41 36.5
POLIO4, IPV1
DPT1,
PCV1, ROTA1
DPT3,
Kayu Tinggi 7/4 081278068364 5.2 57 39 36.5
POLIO4, IPV1
9.6 74 47 36.5 PCV3 DS : 10

Pagar Jati 15/01 087869112535
DPT1,
Kandang Sapi 5/6 5.3 58 39 36.5 POLIO2,
89667996799 PCV1, ROTA1
BOOSTER
DPT,
10 75 49 366.5 DS : 10
BOOSTER
Gempol 14/01 089502759330
MR
DPT1,
4.7 55 38 36.5 POLIO2,
Gempol 14/01 089502759330 PCV1, ROTA1
7.6 69 44 36.5 MR, IPV2

Kayu Tinggi 09/02 083890836261
Kayu Tinggi
08812583164 9.4 71.5 48 36.5 IPV2
12/09
Bulak Indah 4/5 085218835674 7.5 74 47 36.5 MR, IPV2
Bulak Indah
895619114506 8.1 71.5 41 36.5 MR, IPV2 DS : 10
05/05
DPT2,
THB 03/22 081360891988 6.2 59.5 40 36.5 POLIO3,
PCV2, ROTA2
7.3 68.5 43 36.5 MR, IPV2 DS : 10

Kayu Tinggi 9/11 088210183619
BOOSTER
DPT,
10.5 81 49 36.5
BOOSTER
KT RT3/RW12 081294074211
MR
DPT1,
Jl. Merpati 9/5 895411990722 6.7 59 42 36.5 POLIO2,
PCV1, ROTA1

BOOSTER
DPT,
Kandang Sapi 12 85 47 36.5
BOOSTER
12/06 085860071799
MR
DPT2,
Kp. Kandang
5.7 59 39 36.5 POLIO3,
Sapi 11/06
085694054918 PCV2, ROTA2
Tambun Rengas 16/1 82299052589 9.9 97.5 47.5 36.6 PCV 3
DPT1,
PCV1, ROTA1
DPT1,
Kav Pagar Jati 15/01 081318723681 5.3 58 39 36.5 POLIO2,
PCV1, ROTA1
2.8 48 34 36.5 3
Buaran 10/02 81265022621
1.8 42 34 36.5 2
Kayu Tinggi 7/15 87814763742
2.6 48 34 36.5 2
Gempol 13/01 81214036019
Cempaka 7/9 3.2 50 35 36.5 BCG, POLIO1

82260668140
DPT2,
Gempol 13/1 81908681214 5.1 55 40 36.5 POLIO4,
PCV1, ROTA1
Tambun Rengas
85883206862 4.8 50 36 36.5
10/7
4.5 52 36 36.5 BCG, POLIO1
Kayu Tinggi 1/12 81284483982
DPT1,POLIO2
4.5 54 37 36.5 , PCV1,
Cempaka 6 8/9 81290114963 ROTA1
2.7 49 48 36.5 2
Pagar Jati 15/11 85693373318
Kandang Sapi 3/6 3.6 48 37 36.5 BCG, POLIO1
Gempol 9/1 3.8 50 36 36.5 BCG, POLIO1

89684164401
5 55 39 36.5 BCG, POLIO1

Kayu Tinggi 3/11 85817030365
Tambun Rengas 4/7 895376339318 4.2 52 36 36.5 BCG, POLIO1
Taman Modern 4.6 54 37 36.5 BCG, POLIO1

85776922290
DPT2,
Kayu Tinggi
5.4 57 38.5 36.5 POLIO3,
02/11 85717920072 PCV2, ROTA2
Rawa Makmur
089637275045 10 72 46 36.5 PCV3 DS : 10
04/10
Kayu Tinggi 3/3 858438812858 3.5 51 36 36.5 3
DPT,
TAMBUN SELATAN
Kayu 89657901296
Tinggi RT11/RW5 9 82 43 36.5
BOOSTER
04/03 085778711769 10.1 78.5 47 36.5 PCV3 DS : 10
Gempol 7/1 81210168177 5.8 52 38 36.5 BCG
Cempaka 05/09 082284945138 10.7 74 48 36.5 PCV3
DPT2,
DPT1,POLIO2
Kandang Sapi
Kayu 0852169687749 6.2 57 39 36.5 , PCV2
PCV1,
07/06 Tinggi
13/09 8817790844 4.2 52.5 38 36.5 ROTA1
BCG, POLIO1
JL. Balai Rakyat
87875240372 2.6 50 33 36.5 3 DPT2,
1/4
Gempol 4/1 895322232915 6 61.6 41 36.5 POLIO3,
DPT1,
Tambun Rengas PCV2, ROTA2
82297472484 4.7 60.5 40 36.5 POLIO2,
3/7
Rorotan 2/4 89620481868 4.8 59 40 36.5 PCV1, ROTA1
POLIO1
DPT1,
Tambun Rengas 6/7 85691289191 2.7 47 36.5 36.5 2 PCV1
Kayu Tinggi 3/9 081210990274 6 65 44 36.6 MR, IPV2
DPT2,
Kayu Tinggi 02/03 85156905916 7.8 71 44 36.5 PCV2,
MR, ROTA2
IPV2
Kayu Tinggi 02/11 081384685330 7.4 66.8 42.5 36.5 MR, IPV2
Kp. Buaran 14/02 82212741505 7.2 68 40 36.5 DPT1,
KAYU TINGGI
085771006464 7.2 60.5 42 36.5 POLIO2,
DPT2,
RT7/RW4
Kp. Ujung PCV1, ROTA1
089501564899 5.8 59 38.5 36.5 POLIO3,
DPT1,
Krawang PCV2, ROTA1
BULAK INDAH RT4/5081283551315 5.2 57.4 39.5 36.5 POLIO2,
Buaran 10/2 88224967649 7.8 66 49 36.5 PCV1
Gempol 13/01 81214036019 2.8 47 33 36.5 3 DPT2,
Gempol 04/01 0895322329015 6 61.5 41 36.5 POLIO3,
BUARAN PCV2, ROTA2
089609914502 8.6 72 44 36.6 PCV3
RT10
011/RW2
/ RW 09, DPT,
085714371943 10 72 45.5 36.5 DPT2,
Kelurahan BOOSTER
PG 5/4 85710428212 7.6 64.5 40 36.5 POLIO3,
DPT2,
Kayu Tinggi 12/06 0881025897219 6.3 58 38 36.5 PCV2, ROTA1
POLIO3,
Gempol 1/1 088293361343 7.6 66.3 43 36.5 PCV2,
MR, ROTA2
IPV2
DPT1, Polio2,
Swadaya IV 12/1 0895391739054 5.9 63 39 36.7 PCV1,
DPT2,
Kayu Tinggi 05/09 82123543234 7.2 64 40.4 36.5 Rotavirus1
POLIO3,
DPT,
PCV2, ROTA1
JGC 081223736288 10.5 79 48 36.5 DPT2, Polio3,
BOOSTER
Kayu Tinggi 4/9 0895359805502 4.7 59 37 36.7 PCV2 dan
Kayu Tinggi 03/03 87888866400 8.9 71.5 47 36.5 Rotavirus2
MR, IPV2
Booster DPT,
Kp.Buaran
085719551959 9.8 77 47 36.6 BOOSTER
Rt.012/002
MR
Buaran 9/2 081290026513 3.6 51 35 36.5 3
Tambun Selatan
RT.08/08 0895402464124
81283987586 3 49 33.5 36.5

Bulak Indah 2/12
Kayu Tinggi 4/3 85770256056 7 65.5 40.5 36.5 BCG, POLIO2
59 37 36.5
Kayu Tinggi 2/3 81291378340 4.5
4.7 54.5 39 36.5 BCG

Kayu Tinggi 87881907699
Kayu Tinggi
85691055232 4.5 54.5 36 36.5 BCG, POLIO1
07/05
Balai Rakyat 2/1 87877781086 4.4 51 38 36.5 BCG, POLIO1
Cacing 01/03 895364398625 3.8 56 36 36.6
DPT3, IPV1,
Buaran 10/2 081288853331 6.3 62 40.5 36.5
ROTA1
Rorotan 2/4 89620481868 4.9 59 40 36.5 BCG
Tambun Rengas
85883206862 4.8 56 39.4 36.5 BCG, POLIO1
10/7
DPT3, IPV1,
5.9 60 40.5 36.5
Bulak iindah 8/5 838871867081 ROTA1
DPT1,
KAYU TINGGI RT3/9 085715262449 5 54.5 39 36.5 POLIO2,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
CEMPAKA ELOK RT4/9
085723827018 4.4 56 39 36.5 BCG, POLIO1
DPT3,
Bulak Indah 1/5 8988132756 6.5 67 41 36.5 DPT2,IPV1
POLIO4,
GEMPOL RT11/1 085871405756 5.8 61 40 36.5 POLIO3,
DPT2,
Gempol 05/01 85691603810 6.3 63 40.5 36.5 PCV2, ROTA2
POLIO3,
DPT2,
Gempol 2/2 08158077642 6.5 62 40.5 36.5 PCV2
POLIO3,
Gg. Bingung 7/6 087834291735 8.6 71.5 46 36.5 PCV2, ROTA2
PCV2
Buaran 10/02 81265022621 3.2 50 36 36.5 BCG
Buaran 10/02 89678876442 5.3 62 40 36.5 ROTA2
Buaran 10/02 081212123249 6.3 65 40 36.5 PCV2, ROTA2
DPT2,
DPT3,
PCV2, ROTA2
Kandang Sapi 11/608977675351 5.9 62 39.5 36.5
Kayu Tinggi POLIO4, IPV1
089667319424 8.4 71.5 46 36.5 PCV3
04/09
KETEPATAN
WAKTU OBS KU
IC SUNTIK KEMBALI
TEPAT BBL (Kg)
26-09-2023 RS Resti Mulya 2.7 120
26-09-2023 PKC Cakung 2.6 115
11-09-2023 PKC Cakung 3.2 115
V V V 05/10/2023
V V V 05/10/2023
19-09-2023 Rs Resti Mulya 2.8 120
V V V 05/10/2023
V V V 05/10/2023
09-11-2023 2.5 120

RS thb
V V 6 Bln
V V 05-10-2023
V V 05-10-2023
V V V 10-05-2023
RS Budi Asih 3.3 120
V V 05-10-2023
V V 05-10-2023
V V 05-10-2023
V V 05-10-2023
V V 18 Bln
V V 05-10-2023
V V 6 Bln
v v 10-10-2023
V V 18 Bln
v v 10-10-2023
RS Resti Mulya 2650 132
V V 18 Bln
v v 28-12-2023
v v 10-10-2023
v v 10-10-2023
v v 12 Bln
v v Lengkap
v v 10-10-2023
v v 12 Bln
v v 18 Bln
V V Lengkap
v v 9 Bln
V V Lengkap
v v 6 Bln
v v 12 Bln
v V 10-10-2023
V V 18 Bln
v v 10-10-2023
V V V 12-10-2023
V V V 12-10-2023
V V V 12-10-2023
10-10-2023 RS Resti Mulya 2680 130
V V V 12-10-2023
V V V 12-10-2023
V V V 12-10-2023
V V V 12-10-2023
03-10-2023 RS Resti Mulya 3400 132
V V V 12-10-2023
V V 12-10-2023
V V 12-10-2023
V V 6 Bln
V V 12-10-2023
V V 12-10-2023
V V 12-10-2023
V V 12-10-2023
V V 12-10-2023
V V 12-10-2023
V V 6 Bln
V V 12-10-2023
V V 12-10-2023
V V 6 Bln
RS Resti 3 110
V V 18 BLN
V V 17-10-2023
24-09-2023 RS Resti 2.7 120
V V 12Bln
V V 18 BLN
V V 17-10-2023
V V 18 BLN
V V 6 Bln
V V 17-10-2023
V V 6 Bln
V V 18 BLN
V V 17-10-2023
V V LENGKAP
V V 17-10-2023
V V 12 Bln
V V 17-10-2023
V V 21 Bln
V V 12 Bln
V V 17-10-2023
V V 12 Bln
V V LENGKAP
V V 17-10-2023
V V 12 Bln
V V LENGKAP
V V 17-10-2023
V V 18 Bln
V V 17-10-2023
V V 17-10-2023
RS 2.6 120
RS 2 115
RS 2.4 118
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V 03-10-2023 Resti Mulya 3.2 110
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V 19-10-2023
V V 18 Bln
V V RS thb 2.5 120
V V Lengkap
V V 18 Bln
V V 19-10-2023
V V 18 Bln
V V 19-10-2023
V V V 19-10-2023
V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
V V V 19-10-2023
RS Firdaus 2.8 133
V V 12 Bln
V V 19-10-2023
V V 12 Bln
V V 12 Bln
V V V 19-10-2023
V V 19-10-2023
V V V 19-10-2023
RS 2.4 118
V V 19-10-2023
V V 19-10-2023
V V Lengkap
V V 19-10-2023
V V 19-10-2023
V V 12 Bln
v v 19-10-2023
V V 19-10-2023
V V Lengkap
v v 19-10-2023
V V 12 Bln
v v Lengkap
17-10-2023 RSIA Bunda Aliy 3050 135
V V V 26-10-2023
V V V 26-10-2023
V V V 26-10-2023
V V V 26-10-2023
V V V 26-10-2023
V V 6 Bln
V V 26-10-2023
V V 26-10-2023
V V 6 Bln
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 18 Bln
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 26-10-2023
V V 18 Bln
KUNJUNGAN NEONATAL
HASIL PEMERIKSAAN
PUPUT
NCB SMK KN3
38 v v v
Usia 9 hr
NCB SMK KN3

40 v v v
Usia 11 hr
NCB SMK KN2

40 v v v
Usia 5 hr
NCB SMK KN3

40 V V V
Usia 21 hr
NCB SMK KN2

40 V V V
Usia 7 hr
NCB SMK KN3
40 v v v
Usia 11 hr
NCB SMK KN 3
41 v v v
usia 11 hr
NCB SMK KN 2
40 v v v
usia 6 hr
NCB SMK KN 3
41 v v v
usia 10 hr
NCB SMK KN 2
38 V V V
usia 7 hr
NCB SMK KN 3
40 V V V
usia 21 hr
By.T usia 17 hr
40 V V V
NCB SMK KN 12
By.K usia 6 hr NKB

38 V V V
SMK KN 2
By.A usia 6 hr NCB

40 V V V
SMK KN 3
NCB SMK KN2
40 V V V
Usia 7 hr
NCB SMK KN3

40 V V V
Usia 21 hr
NCB SMK KN3

40 V V V
Usia 10 hr
NCB SMK KN2

38 V V V
Usia 4 hr
By.a usia 12 hr
40 V V V
NCB KMK KN 3
NCB SMK KN3

41 v v v
Usia 11 hr
AN RESIKO
KIE CUCI KET
JATUH TANGA APD
MTBS GIZI NILAI SOP
N
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
v v v v v v
V V Gizi Kurus
V BB Turun turun lebih dari 10%
V Hernia Umbilicalis
V Dermatitis
v v v v v v
v v v v v v
V V Gizi kurang
V V Gizi kurang
V V Susp. B20
V V V V V V
KUNJUNGAN KUNJUNGAN
SKRINING BCG
Bln) 59 Bln) HR)
TB 1 2 3
L P L
L P L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
Turun turun lebih dari 10% 1
rnia Umbilicalis
1
1
1
1
1
0 0 3 2 0 8 0 0 0 1 0 1 17
Tanggal Pe
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
16 18 8 16 12 5 7 11 8 18 9 15 12 7
POLIO4 IPV 1 IPV 2 PCV 1 PCV 2 PCV 3 Rotavirus 1 Rotavirus 2

1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1 1
1
1 1
1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1
1
1
1
1
1 1
1 1
1
1 1
1
1 1
1
1
1 1
1 1
1
5 5 8 11 4 19 9 17 11 7 5 22 9 11
BOOSTER
CAMPAK BOOSTER
Rotavirus 2 Rotavirus 3 CAMPAK
RUBELLA DPT
RUBELLA
P L P L P L P L P
1
1
1 1
1 1
1 1
1
1
1
1 1
1
1
1 1
1 1
1 1
1
1
1 1
1
1 1
1
1
1 1
1
1
7 0 0 11 6 6 4 6 3
NO
JAMINAN
REGISTER
NO TGL NIK
BARU LAMA BPJS UMUM
1 02-10-2023 472/23 V
2 473/23 V
3175060111120001
3 10-03-2023 474/23 V
3328012707230001
4 475/23 V
3175062609230003
5 476/23 V
6 477/23 V
7 478/23 V
8 3175062107230004 479/23 V V
9 3175066106231006 480/23 V
10 481/23 V
3175060208230002
11 3175064710200004 482/23 V
12 3172043105230013 483/23 V
13 3175064909230002 484/23 V
14 485/23 V
15 486/23 V
1306010401230001
16 3305172203230001 V
398/23
17 V
3306011509120773 423/23
18 v
3175065907230003 394/23
19 407/23 V
20 441/23 V
21 3175060205230013 406/23 V
22 344/23 v
23 390/23
3175060708110001
24 3175065808900099 400/23 v
25 V
3175066308230007 445/23
26 05-10-2023 476 A /23 v

3175066201220020
27 3175062305230003 487/23 v
28 388/23 v
29 3175062505230005 V
347/23
30 365/23 V
3175061907121021
31 V
3175060202220003 282/22
32 270/23 v
3175066005230001
33 19/23 v
34 291/23 V
3175066703230008
35 202/23 v
36 403/23 v
3175060706230005
37 552/22 v
3175064403220007
38 142/23
3201036212220001
39 V
3201036212220002 135/23
40
418/23
41 209/23 V
3175062210220014
42 V
546/22
43 333/23 v
3173044203220004
44 221/22 V
3175061603220006
45 10-10-2023 3175060509230007 488/23 V
46 317506108230018 489/23 V
47 490/23 V
48 491/23 V
49 492/23 V
50 3175060309230004 493/23 V
51 3175062908230006 494/23 V
52 495/23 V
53 V
3175066308230013 496/23
54 432/23 v
55 3175066305230006 302/23 v
56 3174091305230006 300/23 v
57 434/23
58 3172043105230013 483/23 V
59 343/23 v
60 304/23 v
3175060606230003
61 3175060606230004 303/23 V
62 440/23 V
63 3175061806230005 354/23 v
64 3175065306230004 289/23 v
65 12-10-2023 3175062307230006 497/23 v
66 498/23 v
67 3175060904220001 499/23
v
68 3175064706230001 500/23
v
69 3175060908230002 v
371/23
70 3175062412220005 129/23 V
71 3175062606230007 v
346/23
72 3175064308230002 v
433/23
73 362/23 v
74 3175062305230008 467/23 V
75 361/23 V
76
3175061911210003 261/22 V
77 359/23 v
3175061306230002
78 295/23 v
3175063005230003
79 V
3175064401230001 023/23
80 v
3175062207230002 427/23
81 464/22 v
82 3175066312220007 107/23 V
83 3175060601230005 150/23 V
84 437/23 V
85 356/23 v
3175000060723000
86 3175060307230004 426/23 V
87
3175060901220008 153/22 V
88 428/23 A V
89 3175062212200019 338/23 v
90 3175064906230014 310/23 v
91 16-10-2023
501/23 V
92 17-10-2023
502/23 V
93 3175065109230002 V
503/23
94
3175061109230001 504/23 V
95 505/23 V
3175060409230003
96 506/23 V
97 3175065706230001 507/23 V
98 508/23 V
99
3305155903230001 509/23 V
100 510/23 V
9404011408230002
101 511/23
102
512/23
103 3175061809230005 513/23 V
104 3175061408230018 514/23 V
105 V
175065307220010 292/22
106
3175065209230003 453/23 V
107 3175061407230006 337/23 v
108 463/23 V
3175065109230001
109 V
444/23
110 274/23 V
111 443/23 V
3175061709220003
112 3175060707230004 353/23 v
113 335/23 v
114 3175062904230001 276/23 v
115 V
391/23
116 3175064904230005 227/23 V
117 31740806230003 306/23 V
118 19/10/2023
3175064206230006 516/23 V
119 3172041010230006 517/23 v
120
3175066703220002 518/23 V
121 317506020291430 519/23

V
122 3175065009210017 520/23 V
123 blm ditulis 3175061806230004 298/23 V
124 317506090823009 456/23 V

125 436/23 V
126 3175064207230005 461/23 V
127 495/23 V
128 435/23 V
129 3175062305230006 254/23 v
130 321/23 v
131 3175060708230012 392/23 V
132 3175060611151882 382/23 V
133 3175060406230002 448/23 V
134 317506470420006 020/23 V
135 3175065306230003 280/23 v
136 450/23 V
137 3175065608230008 420/23 V
138 3175065401230009 73/23 v
139 3175064805230001 226 C/23 v
140 1807044401230002 124/23 V
141 3175066004230011 210/23 V
142 3175061707230004 380/23 V
143 3175066309220007 522/22 V
144 24-10-2023 3175062108230004 521/23 v
145 522/23 v
146 3175062008230004 523/23 v
147 3175065409230001 524/23 v
148 3175060909230003 525/23 v
149 526/23 v
150 3175066509230002 527/23 v
151 3175062811190088 528/23 v
152 529/23 v
153 530/23 V
154 3327032905230002 531/23 V
155 532/23
156 533/23 V
157 534/23 V
158 3175065709230002 535/23 V
159 3173040705230003 536/23 V
160 323/23 v
161 3175065607230005 452/23 V
162 446/23 V
163 3175066305230008 404/23 V
164 473/23 V
165 3175062607230005 465/23 V
166 219/23 v
167 472/23 V
168 349/23 V
169 130/23 V
170 o 374/23 V
171 26-10-2023 537/23 V
172 V
538/23
173 317506181220006 539/23 V
174 199/23 v
175 status blm 3175065905230008 384/23 V
176 408/23 v
3175066708230005
177 106/23 V
178 3175060804230005 220/23 V
179 385/23 V
180 018/23 V
3175060612220003
181 3175062506230006 339/23 v

182 3175061607230004 V
449/23
183 467/23 V
184 492/22 V
3175061910220003
185 460/23 V
186 3175065008230006
468/23 V
187 3175066208230003 451/23

V
188 3175061701230007 060/23 V
189 3175065807230009 383/23 V

190 3175065107230008 325/23 v
191 3175064910220004 438/22 YA
192 36/23 v
193 3175065406230008 466/23 v
194 3171022806230001 316/23 V
195 3172040610230007 498/23 V
196 341/23 v
197 317506414220005 173/22 V
198 3175061806230009 372/23 V
199 3175065310220011 131/23 V
200 3175061401230010 457/22 YA
201 27-10-2023 540/23 V
202 31-10-2023 3175065910230005 541/23 V
203 3175061809230003 542/23 V
204 543/23 V
205 544/23 V
206 545/23 V
3175062308230013
207 317506609230006 555/23 v
208 3175062810220015 546/23 V
209 264/23 V
210 387/23 v
3175066606230008
211 475/23 V
3175062609230003
213 255/23 v
3275047004230001
JK/UMUR
L P
Tasya Putri Alifya ### 10 Hr Savera Dwi / Alif Zalaludin
Kanaya Latisha Achmad ### 9 Hr Neneng Wardayanti / Achmad
Bimbim Arkhan Afidin ### 3 Bln Eliputri Anggraini / Afifudin
Haidar Aziz ### 7 Hr Yati / Absorihin
Faaz Hamzah ### 5 Bln Dea Lestari / Bintang Indra
Nurul Zannah / Muhamad

Muh Alwi Thohari ### 2 Bln
ulum
Enji Amalia Putri / Yudi

Muh Ahzan Davanka 26-8-23 2 Bln
Kristian
Muh Zemma Fadillah 21-7-23 3 Bln Bunga / A Fadilah
Kirana Fathin A 21-6-23 4 Bln Retno Pertiwi / Anjar Budi
Syaripah Alawiyah / Hasan

Muhammad Hamdan Syauqi 2-8-23 2 Bln
Murdani
Zahra Oktaviani 7-10-20 36 Bln Sri Wahyuni /
Elvin Maulana Gunawan 31-5-23 5 Bln Desti Istiani / Egi Gunawan
Xavia Chaiza Anzani ### 1 Bln

Yunita Sukitoamidjo / Zainal Abidin
Kimmi Esvianda 5-9-23 1 Bln Evi Yuliana / Angga p
Virendra Ehsan 4-1-23 9 Bln Mela Mirza / Rio Saputra
Mira Muthminah / Eko

Reyno Kenan Syahputra 22-3-23 7 Bln
Setiawan
29-08-2023 2 Bln
Gefira Jazila Sumarti / Buang Sudiono
Dzakia Zia Muhaya ### 3 Bln
Muhammad Rohim
Muh. Nizar 20-6-2023 4 Bln NuRHAYATI / mUH sALIM
Givany Buanathania 2-9-2023 1 Bln Andriani Hutabarat / Elifati

Zedrato
Khanza Defina Almira 23-7-23 3 Bln Restika / Andrian
Red Muharrom Syafik ### 3 Bln Rosyidah / Sarjono
Danendra Malik Dirgantara 20-8-23 2 Bln Endang Pertiwi / Yacob
23-8-2023 2 Bln Ernawati / Hasis Fadilah

Almahyra Shanum
Thania Regina Putri ### 22 Bln Sulisnawati / Hamzah
Eshan Iqrin Al Rayyan ### 4 Bln Berty / Iqbal
Keysha Aqila ### 4 Bln Sri Komala Sari / Nuryadi

Raffasaya Gian Luca 02/02/022 22 Bln Sugisrti / Andirawan

Nurseno
Khaira Nur Ramadhani ### 6 Bln Isa Fatonah / Jamal
Hana Maryam ###

Ghani Kaysan Ismail ### 4 Bln Wiranti / Nasihun Amin
Nayla Tavisha Bahri ### 19 Bln Ayu Lestari / Jamal Bahri
Joana Berlian Kasih ### 9 Bln

###
Zemira Hanna Karunia 9 Bln Tri Wahyuni / Leonardus S
Muhammad Dwiaksa ### 11 Bln Eva Damayanti / Muhammad
### 11 Bln Pusparini / Mashuri

Hafiz Danish Muttaqin
Pricillia Yen Hermanto ### 19 Bln Meta Setyani / Edi Hermanto

16-3-22 19 Bln SRI APRIDA / HADI
Khalid Ananda Fachri
Delana Ersya Nadhirnzky ### 1 Bln Mela Ftri / M. Reza
Althaf Mustahar ### 2 Bln Risinina Aulia / Fajar Cahyono
Aiyra Azzahra ### 1 Bln Emi Kemilawati / Hambali
Yumna Humaira Rizky 8/16/2023 2 Bln Ade Indriyani / Tomi Rizki
Devi Lestiawati /
Kinara Septianingsih 9/4/2023 1 Bln
Rudiansyah
Rizky Maulana Mahyudin 9/3/2023 1 Bln Suci Amelia / Mahyudin
Muhammad Rizhan A ### 2 Bln Suprihatin / Dara
Elfathan Asraf 17-7-2023 3 bln Gempita / Sekar Hadi
Mikayla Prameswari Humaira ### 2 Bln Lutfianita Popple / Dimar
Geo Saputra Pratama ### 5 Bln Ranti S / Wawan Saputra
Ifani 6-9-2023 1 Bln Lstioro Tamba / Khotman T

M Zein Asyshauqi ### 3 Bln Nurlaela / Iqbal

Reno Axchel Siregar 6-9-2023 1 Bln
E. Siregar
Muhammad Alvaro Leao ### 2 Bln Anggiyana / Ricco Shiwi
Arfanur Radif ### 6 hr Nurlatifah / A Sofyan
Ieneke Mega Saraswati /
Giandra Gadtra ### 18 Bln
Anes
Alea Nur Hafizah 07-06-2023 4 Bln Yafi Yanik / Dwi Iskandar
Muhammad Gaza Aswindra ### 10 Bln


Agista Naura 3-8-2023
2 Bln Hasanah / Aripin

Ratu Aulia Rahman ### 6 Bln
23-05-2023
Gavian Narendra Al Cantara 5 Bln Miftah / Akbsr
Almahyra Farhana 9-4-22 18 Bln Aulia Suhada/Taufik

Riyadoh Alfiyah / Aldi
Muhammad Elzayn Permana 13-6-23 4 Bln
Setiadi Permana
4-1-2023 9 Bln
22-07-2023 2 Bln Indah Permatasari /

Binuka Noah Antares Ardyantoro Hani
Aini Zea Arafah ### 11 Bln Junaeni / Samto
9,5
Ebiella Chloe Sanjaya ### Desi Novianti / Topan S
bln
Ghathaf Abrisam Mahesvara ### 9 Bln Dwi Feriyani / Kabul
Najiba Khanza Hafifah 4-5-2023 5 Bln Salbah / Arinta
### 3 Bln
Muhammad Bilal Athallah Fitriana Astuti / Idham
DEVVANGGA PUTRA HASSIAN 9-1-22 21 Bln BELLA /AGUS
Helen Situmorang 8-8-2023

2 Bln Ida Friska Angel / Tumbyr Re
Oktavia Revania ### 10 Hr Dini Handayani / Sopani
Shaquinna Ameena ### 9 Hr Desy Yuliarni / Rendi Septian
###
Khadijah Aminah 1 Bln Wiwin / Kaedi
Arkana Albyanadra Putra 11-9-23 1 Bln Supriyatin / Moch Idris
Kaivan Pradipta Wijaya 04-092023 1 Bln Yulinar / M. Ibnu
Tania Salsabila Agustin ### 2 Bln Ayu Sulastri / Dede Arifin
Nur Nadheera 17-06-2023 4 Bln Nuraiyda Nadia / M. Ridwan
Resti Ayu Khaitina ###

1 Bln Ryan Crissandy / Marzuki
Ririn Oktaviana / Muh

Hana Syakila 19-3-23 7 Bln Alfian
Hardi Sibarani ### 2 Bln Helda Lina / Hapriadi
M. Hanan K ### 2 Bln Laily Zakaria / Rahmad Hidayat

### 1 Bln Chairunnisa / Engkos
Rabiul Hibadzul Al wafi Kosasih
Nur Ashraf Zakariah ### 2 Bln Siti Khodijah / Nur Fajri
13-7-22 14 Bln AMALIA/SISWANTO

SHANUM HOLINKA
Nuaira Hibatillah Lesmana 9/12/2023 1 Bln Riska M / Allen Lesmana
Refen Xtyan Shaqeena / M

Radeya Xtyan Shaqeena 11-9-2023
Riyan Pratama
1 Bln
9-6-2023 4 Bln Aprilia / Idis Apandi

Kalil Al Ghifari

Muhammad Attaqi K 17-9-2022 13 Bln Lisah / M. Yusri
Rafeyza Elvin Saman ### 3 Bln Septy Wulandari / Anang Ma'ruf
29-4-2023 6 Bln Dewi Arsyanti / Rendi

Muhammad Kenizio Saputra Saputra
Azkira Azalia ### 6 Bln Umi / Hafidan
Raline Areeta Vianka ### 3 Bln Novita / Kartam

Muh Hamzah ###
10 Hr Shapia Ridwan
Alesha Saffana Zidni ### 7 Bln Rini Sulastri / Dani Nurhadi
Nadindra Hanin Ardiansyah ### 2 Bln Nurul Fajriah / Rio Ardiansya
Aleeza Yildiz Akbar ### 1 Bln Lupi Azopilko / Taufik Akbar

Elga Azzahra A ### 2 Bln Kurlina / Hadi Haryadi
Elfathan Asraf 17-7-2023 3 bln Gempita / Sekar Hadi
Kalila Dion 8/16/2023 2 Bln Dian / Yahya Ansori
Aksa Abiyathama 6/17/2023 4 Bln Lit Anggita
Mei Sari // Raynal
Kiki Anjelina Riswanto
Aziel Hasibuan 14-8-23 2 Bln Hasibuan
JOVAN LUIZ TOBING ### 3 bln ROSIANA /MESRADI
Arshan Zahwan Hakim ### 4 Bln Rosa Rosmala / Nurhasan
Lailatul Fahira 07-04-2022 18 Bln Siti Nurul Janah / Abdul Latif
Reza
Khadijah Aminah ### 1 Bln Khadijah Aminah / Kaedi
Hafsa Nahda Azzahra ### 9 Bln Afieny Tazkyatur
Ayu Dewi Kunanti/ /Dedi
DoniSutri
Asira Almayra ### 5 Bln Kurniawan
SUNIAH /
AHM.SYARIFUDIN
Nafisa Aura Putri ### 12 Bln Femi / Idris
Muh Rifan Alfarizqi 8/21/2023 2 Bln Syabaniah / Tukiran
Hamzah Alfaro 8/3/2023 2 Bln Wati / Mursidi
Kaelan Arrasya M 8/20/2023 2 Bln Risma / Ramzi
Alesha Putri Haryanto 9/14/2023 1 Bln Maya / Tri Hariyanto
Kasaga Aaraf Arsenio 9/9/2023 1 Bln Ita Yunita / Haryono
Ariq Razka 9/19/2023 1 Bln Surwanti / Alfajri
Ermika Nainggolan / David
Sanga Pulina Sara Isabela 9/25/2023 1 Bln
H
Aslan Al Hasbi 9/20/2023 1 Bln Nurdiani / Roni Hasbi
Aniah Widji L / Muh
Syafia Zalfa Septaviola 9/22/2023 1 Bln
Saepullah
Narsyama Rania ### 1 Bln Lilah Hilya / Anton
Eza Hermansyah 5/29/2023 5 Bln Esti Setiarini / Hermanto
Arshaka Arazi 8/18/2023 2 Bln Reski / Habib
Raizel Putri Savira 9/16/2023 1 Bln Nurhasanah / Ali Sodikin
Azzahratunnisa ### 8 Hr Nurhayani / Mulia
Arshafa Nadhira Putri ### 1 Bln Novi Yang
Siti Nur / Durty/ Rizqi
Halimah Dhika
Zyonathan 7-5-23 5 Bln Gurtama
Yumna Shanum Irawan 7/16/2023 3 Bln Desi
Rahma/ Agus Irawan
Novita Sari / M.
Kiara Putri Setiawan ### 1 Bln Rizki Setiawan
Kanaya Latisha Achmad ### 9 Hr Neneng Wardayanti / Achmad
Rafathan Naufal Irwan 26-07-2023 3 Bln Dian Haryanti / Heri Irawan
Amelya Saffira ### 6 Bln Ana Susilawati / Parlan
Tasya Putri Alifya ### 1 Bln Savera Dwi / Alif Zalaludin
Anjali Asyaria ### 9 Bln Amanda / Wahyu Cahyadi
Risky
Adifa Zahira 25-1-23 9 Bln Fuji Fajriyani / Andika
Barra Chairansyah ### 14 hr Novita Sari / Bayu Indra
Muhammad Rayyan D ### Dwi Fujiastuti / Ruli Ripaldi
###
Muhammad Dalfa Prasetya 9 Bln Nia Fitriana / Anggi
AYESHA DEENA ACHIERA 19-5-2023 5 Bln NADYA / TRI ISWANTO

Farhana Putri Setiya 12-1-2023 9 Bln Rina Mutiara / SIGIT Setya
Muhammad Lutfan Faaz ### 10 Bln Nadira Aliya / Bahrul Ulum

Muh. Abizar Kurniawan 25-08-2023 2 Bln Jumaidah / Taufik
Ahmad Defin Elfatih 19-10-202212 Bln Fabiejana / Ahmad FIrdaus
Agustiah Aretha Varadisha ### 2 Bln Yatimah / Toha
Habizar Rifki Saputra ### 5 Bln Tri Purnawati / riki Iskandar

Audy Blesiannna Claire Hutabarat09-10-2022 12 Bln
Nomora Hutabarat
Arfanur Radif ### 14 hr Nurlatifah / A Sofyan
Zulaikha Ramadhani ### 18 Bln 18 Bln Fatmalah / Oktaravian
Riska Dwi Astuti / Sokmo
Luffy Alfarendra 18-6-23 4 Bln Dwi Septianingrum
Prihantoro / Ahmad
Elfathan Rizky 14-1-23 9 Bln Faturrohman
Kikanaya Hana Prasetyo ### 12 Bln Ari Oktaviani / Yogi Prasetyo
Muhammad Raffasya ### 1 hr Nadiva Putri / Dayan
Aila Nadhifa Almahyra ### 1 Bln Muthaimainnah / Abid Robani
Arshaka Elvander Rezqiano ### 1 Bln Windi / Faisal
Miscelle Abigain ### 3 Bln Christian Puji / Christoper
Nada Nur Kalila ### 1 Bln Fitriyani / Rahman Nurcahim
Muh Iqdam Assyadzili ### 2 Bln Nida / Dede Sulaiman

Talia Maulida Rizkiyah ### 1 Bln Mirna Wati Dewi / Muh Amar
Daniel Halomoan Manik ###

1 Thn Depi Sitompul / Sanggup Man
Maherza Nizam ###

7 Bln Ndaru F / Marsha
Ameesha Eka Kalf ### 4 bLN DEBBY/ALFLON
Haidar Aziz ### 1 Bln Yati / Absorihin
0
ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
Kp. Kandang Sapi 81291298263 2.8 48 33 36.5 3
Kayu Tinggi 4/4 88212953547 2.9 47 33 36.5 3
DPT1,
PCV1, ROTA1
Kt 2/11 85959370270 3.7 50.5 34.5 36.5 3
Gempol 6/1 087863649030 4.7 59.5 39 36.7
Rorotan 2/4 83877651187 5.6 57.3 38 36.5 BCG, POLIO1
Gempol 9/1 85615201625 4.4 53.5 34 36.5 BCG, POLIO1
Tambun Rengas
89603036551 5.1 54.3 38.5 36.5 PCV, ROTA1
2/8
DPT2,
Bulak Indah 1/5 81298479768 5.8 60.5 42 36.5 POLIO3,
PCV1, ROTA1
DPT1,Polio2,
Tambun Selatan
081297100255 6.2 60 39 36.8 PCV1,
4/8
Rotavirus1
BCG, POLIO2,
Tambun Rengas 85838541799 11 86 48 36.5
IPV1
Cempaka VI 8/9 085782157781
Bulak Indah 4/5 87789900795 4 52 39 36.5 BCG, POLIO1

KT 10/09 895397183914 4.1 53 37 36.5 BCG, POLIO1
KT 2/11 87831416205 10.3 75.3 44 36.5 BCG, POLIO1
Kayu Tinggi 2/11 85643053458 6.6 65 40 36.6 POLIO4, IPV1
Kayu Tinggi 3/3 4.1 53 37 36.5 BCG, POLIO1

858438812858
DPT1,
Kayu Tinggi
087876550108 5.8 57.5 39 36.5 POLIO2,
10/09
PCV1, ROTA1
Gempol 8/1 81293940920 5.3 61 43 36.5
Kayu Tinggi 7/5 85266640799 4 53.5 35 36.5 BCG
DPT2,
Buaran 12/2 81298618336 6.5 64 43 36.5 POLIO3,
PCV2
DPT1,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
Gempol 9/1 083807200880 3.5 51 37.5 36.5 BCG, POLIO1
Gempol 11/01 82125995699 3.8 51 36 36.5 BCG
Booster DPT,
Kandang Sapi 4/6 089510619966 10 78 47 36.6
Booster MR
DPT3,Polio4,I
Kayu Tinggi 4/4 082298266072 7.9 64 42 36.7 PV dan
Rotavirus2
Polio dan
Buaran 12/02 085727134676 5.6 61.5 38.5 36.7
Rotavirus1
DPT3,Polio4,I
Rusun Ujung Ment 8905040600 6.6 62 42 36.7 PV dan
Rotavirus2
DPT1,Polio2,
Gempol2/1 81584522053 4.9 58 38 36.7 PCV dan
Rotavirus 1
Booster DPT,
Kayu Tinggi 11 83 45 36.7
Booster MR
02/12 081295384254
DPT2,Polio3,P
Kayu Tinggi 05/09 82123543234 7.6 65 41 36.7 CV2,
Rotavirus2
KandangSapi 4/6 8 68.5 43 36.7 MR dan IPV2
Buaran 13/02 87803121377 6.8 63 43 36.7 DS = 10
8.6 72 43.5 36.7 PCV3 DS = 10

Buaran 11/02 081283309464
DPT2,Polio3,
KP. Buaran 10/02 81908147585 6.4 61 40 36.6 PCV2 dan
Rotavirus 2
Booster MR
Buran 11/2 08990085878 8.1 75 45.5 36.6 dan Booster
DPT
Kayu Tinggi 10/9 7.8 68 45.5 36.6 MR dan IPV2

85718519135
5.8 63 41 36.7 MR dan IPV2

Kayu Tinggi 10/09085718519135
DPT1, Polio2,
kayu Tinggi 2/11 81333327030 5.9 61.5 40.5 36.7 PCV1,
Rotavirus1
Jl. Perdana 4/12 89624051563 9.7 72 50 36.7 MR dan IPV2
Kayu Tinggi
815133685855 8.6 72 45.5 36.6 MR dan IPV2
02/03
Panti Asuhan DPT3,Polio4,

0821808836168 8.9 75 42 36.7
Guna Nande IPV
Booster MR
KAYU TINGGI
087784020189 9 76 43 36.7 dan Booster
RT8/RW4
DPT
Gempol 15/01 81336236824 3.9 53 35 36.5 BCG
DPT1,
Buaran 9/2 89633431414 7 60 42 36.5 PoOLIO2,
Tambun Selatan 5/8 89618605642 4 49 39 36.5 PCV1, ROTA1
BCG, POLIO1
Gempol 4/1 8989578142 6.4 60 41 36.5 BCG, POLIO1
Kayu tinggi 5/3 882249465134 4 51 36 36.5 BCG, POLIO1
Tambun Selatsan
8137878 3.8 52 36 36.5 BCG, POLIO1
3/8
Kayu Tinggi 07/11 81299366481 5 55 40 36.5 BCG
Sentra Timur 81299640594 5.6 60 41 36.5
DPT1,
4.5 55 37 36.5 PoOLIO2,
Gempol 12/1 83898385819 PCV1, ROTA1
DPT3,
Rota2
DPT3,
Gempol 3/1 88214596624 7.1 64 44 36.5 POLIO4, IPV1,
ROTA1
DPT2,
Kayu Tinggi 8999191484 6.9 63 39 36.5 POLIO3,
PCV2
Kayu Tinggi 3/9 81346217743 3.8 50 39 36.5 BCG
Cempaka VI 8/9 085782157781 7.3 62 42 36.5 BCG, POLIO1

DPT1,
Gempopl 04/01 089517467424 6.4 60 41 36.5 PoOLIO2,
DPT3,
PCV1, ROTA1
Gempol 13/01 085777664441 6.4 62 42 36.4 POLIO4, IPV1,
DPT3,
ROTA2
Gempol 13/01 085777664441 6.4 62.5 43 36.5 POLIO4, IPV1,
Gempol 16/01 4 51 36 36.5 ROTA2
BCG
DPT2,
Kp. BaruRengas
Tambun 14/07 087822897201 5.6 60 41 36.5 POLIO3,
DPT2,Polio3,P
7/7 89670339016 4.9 60 40 36.5 PCV2,
CV2 Rota1
dan
Rotavirus2
Gg. Angggur 5/4 08973334446 5.1 55 40.5 36.5 Rotavirus2
Kandang Sapi
087746473735 3.2 50 34 36.7 2
4/6
Kandang Sapi Booster DPT,
087877980006 11 77.5 47 36.6 DS = 10
6/6 Booster MR
Kayu tinggi 5/3 089533901604 5.1 60 38.5 36.7 Rotavirus 2
DPT1,Polio2,
Bulak Indah 8/5 089682400723 5.3 54.5 40 36.6 PCV1,
Rotavirus1
Kayu Tinggi 10/5 8.7 72 47.5 36.6 MR dan IPV2

81386397745
DPT2,Polio3,
Bulak Indah 11/05 895365362806 7.5 61 40 36.6 PCV2,
Rotavairus2
DPT1,Polio2,P
5.2 53 39 36.6 CV1,
Gempol 3/1 81280120007 Rotavirus1
Tambun RengS
82120013995 6.4 64 40 36.6 DS =10
016/001
DPT2,
5 60 40 36.6 POLIO3,
Kayu Tinggi 2/3 81291378340 PCV2, ROTA1
Kayu Tinggi DPT3,

6.9 62.5 41 36.6 DS = 10
Polio4,IPV
11 75 47 36.6 Booster MR DS = 10
Kt Rt5/Rw4 089628017086
DPT1,Polio2,
Kayu Tinggi 7/4 085819319599 PCV1,
6.9 66 41 36.7 Rotavirus1
DPT3,Polio4,I
7.5 64 44 36.7
PV, Rotavirus2
Gempol 16/01 81932929072
Kayu Tinggi 10/09 9.2 69.5 42 36.7 MR dan IPV2

085799322311
DPT1,Polio2,
Kayu Pagar Jati 5 58.5 40 36.6 PCV1,
15/01 85959808588 Rotavirus1
Kayu Tinggi 10/09085811227680 9.3 75.2 45.5 36.7 MR dan IPV2
Kayu Tinggi 6/11 89530987096 8.5 68.5 46 36.7 MR dan IPV2
Kayu Tinggi 12/6 81398994442 9.1 67 45 36.6 MR dan IPV2 DS = 10
DPT3,Polio4,I
Kayu Tinggi 4/4 895327575334 6.5 61 41 36.6
PV
DPT2,
Gempol 2/11 085773170505 5.8 58 40 36.7 POLIO3,
PCV2, ROTA2
DPT2,Polio3,P
Jl. waru 11/09 6.7 58 42 36.6 CV2,
85888233810 Rotavirus2
JL.RAWA
MR dan
MAKMUR 8.9 87 43 36.6 DS = 10
Booster DPT
RT3/RW10 081210551116
DPT1,Polio2,
4.8 53 39 36.5 PCV1,
Cempaka 81316178069 Rotavirus1
DPT2,
Kayu Tinggi 9/3 085881581981 5 62.2 41.5 36.5 POLIO3,
PCV2, ROTA2
DPT3,Polio4,I
Kayu Tinggi 06/11 089509210019 6.1 59 40 36.5
PV, Rota2
3.2 48 42 36.5
Bulak Indah 8/5 881024633200
3.3 49 36 36.5 3
Gempol 4/1 81282568636
3.4 53 36 36.5 BCG

Kayu ,Tinggi 1/4 831271343336
4.1 52 34 36.5 BCG

Kayu Tinggi 1/4 89630750084
Kayu Tinggi 2/11 83819403343 4.2 55 35 36.5 BCG
Kayu Tinggi 8/3 85723431949 5.2 57 37 36.5 BCG
DPT2,
Tambun Rengas
1/7 08997168017 5.7 63 38 36.5 POLIO3,
PCV2, ROTA2
3.6 50 34 36.5 BCG

Kayu Tinggi 6/11 8979512942
DPT2,
7 69 43 36.5 POLIO3,
Kandang Sapi 3/6 85701834840 PCV2
DPT1,
JL. Balai Rakyat 11/01 8134339144 5.7 59 39 36.5 POLIO2,
PCV1, ROTA1
Balai Rakyat 2/4 85882522786 4.8 59 37 36.5 BCG

Gempol 11/01 3 49 34 36.5
89678041000
BUARAN RT11/RW2 6.9 67 45 36.5
3.2 50.5 34 36.5 BCG

Pagar Jati 15/11 85693373318
DPT2,
Kav Pagar Jati 15/01 081318723681 5.9 64.5 40 36.5 POLIO3,
PCV2, ROTA2
Buaran 9/2 081290026513 4.4 54 35 36.5 BCG
DPT2,
Tambun Rengas 1/8 85715153225 5.4 62 39 36.5 POLIO3,
PCV2, ROTA2
DPT3,
Kp. Kandang
6.4 62 40 36.5 POLIO4, IPV1,
Sapi 11/06 085694054918 ROTA3
Kayu Tinggi 1/3 87875696446 8.8 70 45 36.5 ROTA3
DPT2,
PCV2, ROTA2
DPT1,
PCV1, ROTA1
DPT2,
Gempol 4/1 7 65 42.4 36.5 POLIO3,
0895412742770 PCV2
DPT1,
Cempaka II 5/09 81292469067 4.8 55 37 36.5 POLIO2,
PCV1, ROTA1
Gempol 3/1 85891495562 9.1 72 43 36.5 DS : 10
DPT3,
THB 03/22 081360891988 6.9 64.5 40 36.5 POLIO4, IPV1,
ROTA3
DPT3,
6.9 63 42 36.5 POLIO4, IPV1,
Kayu Tinggi 4/3 8137480030 ROTA1
Rorotan 11/4 895615787363 3.9 51.5 34 36.5 3
BOOSTER
Kayu Tinggi 5/4 89509901067 9.1 78 48 36.5 MR
BCG dan
Kayu Tinggi 1/4 0895324970759 5.1 54 39 36.6 Polio2,
Rotavirus1
BOOSTER
Balai Rakyat 11/0 8128994506 12 83 48 36.5
MR
DPT3,
Bulak Indah 3/5 81315474774 6.4 64 40 36.5 POLIO4, IPV1,
ROTA3
DPT1,
POLIO2,
PCV1, ROTA1
Kayu Tinggi 4/4 8783690217 5.8 58 36 36.5 DPT2,
PCV1, ROTA1
Sentra Timur 81299640594 5.6 60 37 36.5 PCV2,
PCV1, ROTA2
ROTA1
DPT1,
Cempaka 7/9 82260668140 4.3 51 37 36.5 POLIO2,
DPT2,
PCV1, ROTA1
DPT3,
Kp. Ujung PCV2IPV1,
KayuKrawang
Tinggi 089501564899 6.2 63 41.5 36.5 POLIO4,
DPT1,
13/09 8817790844 5.4 55.5 38 36.5 ROTA3
POLIO2,
DPT2,
BULAK INDAH RT4/5081283551315 5.5 60 40 36.5 PCV1, ROTA1
POLIO3,
DPT3,
Gempol 13/1 81908681214 5.7 56.5 42 36.5 PCV2, ROTA2
POLIO4, IPV1,
BOOSTER
ROTA3
Kayu Tinggi 08/04 83874589250 10 75 46 36.5 DPT3,
MR
DPT1, IPV1,
JL. Balai Rakyat ROTA3
87875240372 6.2 58.5 37.5 36.5 POLIO2,
DPT1,
1/4
Gempol 7/1 81210168177 4.7 56 37 36.5 PCV1, ROTA1
POLIO2,
Kayu Tinggi 2/9 082294315359 8.3 63 43 36.6 PCV1,
MR, ROTA1
IPV2 DS : 10
DPT3,
Kayu Tinggi 4/11 08871225520 5.5 60.5 39 36.5
POLIO4, IPV1
Tambun Rengas 6/7 081281961628 7 66.8 43 36.5 DS : 10
DPT2,
KAYU TINGGI
085771006464 8.2 65 41 36.5 POLIO3,
RT7/RW4 PCV2, IPV2
Kayu Tinggi 09/11 085788317928 6.8 67.5 42 36.5 PCV3
BCG dan
Tambun Rengas
083852440877 5.3 56 39 36.6 Polio2,
BCG dan
Tambun10/07
Selatan Rotavirus1
089510173192 4 51 37 36.7 Polio1,
DPT1,Polio2,
8/8 Rotavirus1
Jl. Cempaka 6/9 081311457442 5.2 56 39 36.7 PCV1 dan
Gempol 9/1 087787367588 3.9 53 34 36.7 Rotavirus1
BCG
BCG dan
Kayu Tinggi 7/11 083875249500 5.1 55 39 36.7
Polio1
Gempol 4/1 083877043458 4 52 36 36.7 BCG
Cempaka Elok BCG dan
081296237636 4.3 50 36 36.6
No.71Sapi
Kandang Polio1
BCG dan
089654434809 3.2 50 34 36.5
11/6 Polio1
Kayu Tinggi 9/3 081388326341 3.6 52 38 36.5 BCG
Kayu Tinggi 08/11 87889038730 3.6 50 37 36.6 BCG
DPT3,
Kayu Tinggi 1/3 83145893428 7.1 64 42 36.5 POLIO4, IPV1,
Kayu Tinggi 3/6 5 57 38 36.5 ROTA2
BCG, POLIO1,
Tambun Selatan
89520298636 4.7 54 38 36.5 BCG, POLIO1,
9/8
Buaran 13/02 87771646445 3.4 47.5 35 36.5 3
Kayu Tinggi 3/4 89531487230 3.3 51 34 36.5 BCG, POLIO1,
Cluster JGC 8118051289 8.2 66 45 36.5 PCV1
DPT3,
DPT2,IPV1,
Cempaka 6 8/9 81290114963 5.5 52.5 39 36.5 ROTA3
POLIO3,
Kayu Tinggi 7/15 87814763742 3.3 48 34 36.5 PCV2, ROTA2
BCG
DPT2,Polio3,
Kav, Barokah
82257019991 5.6 58 40 36.6 PCV2,
Sapi 8/12
Kayu Tinggi 4/4 88212953547 3.3 50 35 36.5 Rotavirus
BCG 2
, Polio1
BCG dan
Bulak Indah 2/12 81283987586 4 52 37 36.7 Polio1,
Kayu Tinggi 3/9 081514563754 7 61 42 36.7 Rotavirus1 DS = 10
Kp. Kandang BCG dan
81291298263 3.8 52 37 36.7 DPT2,Polio3,P
Sapi 6/6 I dalam
Cempaka Polio1
85956690338 6.1 61 41 36.6 CV2 dan
13/9 Rotavirus1
Kayu Tinggi 6/11 83878857308 9.3 71.5 43 36.6 DPT3,IPV
DPT1,Polio2,P
Buaran 10/02 89678876442 5.6 59 39 36.5 CV1 dan
Kayu Tinggi 9/3 08976571575 8.1 67 41 36.5 Rotavirus1
MR dan IPV2 DS = 10
Kandang Sapi
085710964112 2.9 48 34 36.5 3
04/06
Tambun Selatan 9/8 087826116981 7.4 70.5 43 36.5 MR dan IPV2
DPT3,Polio4,
6.5 65 40 36.6 DS=10
Kayu Tinggi 2/11 089644841666 IPV
KAYU TINGGI RT4/RW4

081281176299 7.3 65 42 36.4 Rotavirus 2
DPT1,Polio2,
4 53 37 36.5 PCV1,
Buaran 10/02 81265022621 Rotavirus1
Kayu Tinggi 01/09 85697166284 70.5 44 36.7 MR dan IPV2

9.1
Tambun Rengas 2/7 88975932007 7.1 65 65 36.7 PCV2 DS = 10
DPT2,Polio3,
Buaran 10/02 081212123249 7 64.5 44 36.7
Rotavirus3
Kandang Sapi 02/06 081293197716 8.2 71.6 41 36.5 MR dan IPV2

DPT3,Polio4,
Gempol 2/2 08158077642 6.9 62 41 36.5 IPV,
Rotavirus3
DPT1,Polio3,P
Tambun Rengas
85883206862 6.2 62 38 36.7 CV1,
10/7 Rotavirus1
DPT1,Polio2,P
Kayu Tinggi
85691055232 5.6 57 39 36.7 CV1,Rotavirus
07/05 1
Gempol 10/01 081283404874 7.5 67 44 36.7 PCV3
DPT1,polio2,
Rorotan 2/4 89620481868 5.1 60.5 39 36.7
PCV1
DPT1,Polio2,P
5.9 59 40 36.7 CV1 dan
Kayu Tinggi 87881907699 Rotavirus1
DPT1,Polio2,P
5.7 57 38 36.7 CV1,
Kayu Tinggi 1/12 81284483982 Rotavirus1
Kayu Tinggi 9/4 88296293912 7.8 66 40 36.5 MR dan IPV2
DPT2,Polio3,
KAYU TINGGI RT3/9085715262449 5.4 56.5 40 36.7 Rotavirus2,
DPT2,Polio3,
Jl. Cempaka 06/09 082155483489 4.7 54.5 38 36.7 PCV2
PCV2,
Perum Metland 081284455251 10 74 47 36.7 Rotavirus2
PCV3
JGC 14/14 81218901917 8 68.5 44 36.5 MR dan IPV2
DPT1,Polio3,P
Kayu Tinggi 4/3 85770256056 7.5 67 41 36.7 CV1 dan
DPT2,Polio3,P
Kayu Tinggi 3/9 81383018815 5.9 62 40 36.7 Rotavirus1
CV2,
Kandang Sapi Rotavirus2
087746473735 3.9 52 34 36.7 3
4/6
Gg. Bingung 7/6 087834291735 8.7 69 45 36.7 PCV3 DS = 10
Booster DPT,
Bulak Indah 7/5 085631254203 8.2 78 45 36.7 DPT3,Polio3,P DS = 10
Kayu Tinggi Booster MR
85886191961 4.2 54.5 37 36.7 CV2,
05/12 Rotavirus2
Kayu Tinggi 4/11 81293632079 8.5 68.5 47 36.7 MR, IPV2 DS = 10
Kayu Tinggi 2/3 089675826231 1995 44 29 36.7 1
Kayu Tinggi 8/5 895423488109 3.6 50 34 36.5 3
waru 11/09 81223454064 5.1 54 38 36.5 BCG
Inspeksi 2/3 87887883736 5.3 56 40 36.5 PCV2
Kayu Tinggi 7/4 85780738753 4.8 54 38 36.5 BCG

DPT1,
Bulak indah 1/5 895376969555 5.8 58 41 36.5 POLIO2,
PCV1, ROTA1
Tambun rengas 8/ 89637487358 4.2 53 38 36.5 BCG
8.9 71 48 36.5 PCV3 DS : 10

Kandang Sapi 4/6 81389751050
DPT3,
8 68.5 41 36.5
Kayu Tinggi 9/3 8998195985 POLIO4, IPV1,
DPT2,
KANDANG SAPI 089670122543 5.3 60 40 36.5 POLIO3,
PCV2, ROTA2
Kt 2/11 85959370270 5.1 53 38 36.4 BCG
Kayu Tinggi 4/4 087885792831 6.4 62.5 43 36.4 Rota3 DS : 10

KETEPATAN
WAKTU OBS KUNJUNGAN
IC SUNTIK KEMBALI HASIL PE
TIDAK 15 IMUNISASI TEMPAT BBL
TEPAT DJB RR
TEPAT MENIT LAHIR (Kg)
(x/mnt) (x/mnt)
24-10-2023 RS Duren Sawit 2.5 120 40
24-10-2023 PKC Cakung 2.8 47 36
V V V 02-11-2023
02-11-2023 RSIA Resti Muly 3.9 120 40
V V V 02-11-2023
V V V 02-11-2023
V V V 02-11-2023
V V V 02-11-2023
v v v 07-11-2023
V V V 02-11-2023
v v v 9-11-2023
V V V 02-11-2023
V V V 02-11-2023
V V 9 Bln
V V 02-11-2023
V V 02-11-2023
V V V 02-11-2023
V V 02-11-2023
V V 02-11-2023
V V 02-11-2023
V V V 02-11-2023
V V V 02-11-2023
v v Lengkap
v v v 9 Bln
v v 19-10-2023
v v 07-11-2023
v v 07-11-2023
v v Lengkap
v v 07-11-2023
v v 12 Bln
9 Bln
V V 18 Bln
v v 07-11-2023
V V Lengkap
V V 18 Bln
V V 18 Bln
v v 07-11-2023
V V 18 Bln
V V 18 Bln
v v 9 Bln
v v Lengkap
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v 9-11-2023
v v v 14-11-2023
RS Firdaus 3205 132 41
V V v Lengkap
v v v 14-11-2023
v v 14-11-2023
V V 12 Bln
v v 14-11-2023
v v 14-11-2023
V V 14-11-2023
V V 9 Bln
V V Lengkap
v v 14-11-2023
v v 14-11-2023
v v 12 Bln
V V 14-11-2023
v v 12 Bln
v v 12 Bln
V V 12 Bln
V V 9 Bln
V V 14-11-2023
v v 14-11-2023
V V
V V 14-11-2023
V V 14-11-2023
V V 9 Bln
Bpm 2.7 112 40
RS 3 110 38
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 6 bLN
V V V 9 Bln
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 16-11-2023
V V V 6 bLN
V V V 21-11-2023
RS Resti 3.5 120 38
V V V LENGKAP
v v v 23-11-2023
V V V LENGKAP
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V LENGKAP
V V V 21-11-2023
V V V 21-11-2023
V V V 21-11-2023
V V V 12 Bln
V V V 21-11-2023
V V V 12 Bln
V V V 9 Bln
V V V 21-11-2023
V V V 18 Bln
V V V 23-11-2023
V V V 23-11-2023
V V V 23-11-2023
v v v 23-11-2023
v v v 23-11-2023
v v v 23-11-2023
v v v 23-11-2023
v v v 23-11-2023
v v v 23-11-2023
30-11-2023
V V V 23-11-2023
V V V 23-11-2023
V V V 23-11-2023
RS Resti 2.9 120 40
V V V 23-11-2023
V V V 23-11-2023
V V V 6 Bln
V V V 23-11-2023
V V V 23-11-2023
V V V 23-11-2023
V V V 23-11-2023
V V V 23-11-2023
12 Bln
v v v 23-11-2023
v v v 23-11-2023
v v v 12 Bln
v v v 23-11-2023
V V V 12 Bln
14-11-2023
V V V 12 Bln
v v v 30-11-2023
v v v 28-11-2023
v v v 28-11-2023
V V V 12 Bln
V V V 9 Bln
v v v 28-11-2023
V V V 12 Bln
V V V 9 Bln
v v v 28-11-2023
v v v 28-11-2023
v v v 18 Bln
v v v 28-11-2023
v v v 28-11-2023
v v v 28-11-2023
v v v 18 Bln
v v v 28-11-2023
v v v 28-11-2023
v v v 18 Bln
v v v 18 Bln
v v v 28-11-2023
v v v 28-11-2023
7-11-2023
v v v 18 Bln
v v v LENGKAP
v v v
9 Bln
Rumah 2200 132 40
30-11-2023
30-11-2023
30-11-2023
30-11-2023
30-11-2023
Lengkap
6 Bln
30-11-2023
30-11-2023
30-11-2023
KUNJUNGAN NEONATAL PENCEGAH
AN RESIKO
HASIL PEMERIKSAAN KIE
BAYI
SEHAT TETANUS TALI PUSAT DIAGNOSA JATUH
SHK BELUM
PUPUT
NCB SMK KN3
V V V V v
Usia 10 hr
NCB SMK KN3

V V V V v
Usia 9 hr
V v
NCB SMK KN3

V V V V v
Usia 7 hr
By. F usia 5 bln
dengan DS, BJB
V v
dan Status Gizi
Kurang
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
By.K usia 4 bln

dengan Dermatitis v v
dan BP
v v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
V v
By. A NCB SMK
v v v v v
KN2
v
v
v
v
v
NCB SMK KN 3
V V V v
usia 10 hr
NCB SMK KN 3
V V V v
usia 7 hr
v
v
v
NCB SMK KN 3
V V V v
usia 10 hr
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
NCB SMK KN 3
V V V v
usia 8 hr
v
v
v
v
v
v
v
v
v
v
v
v
v
v
V
V
V
V
V
V
V
V
V
V
V
V
V
V
NKB KMK KN1
ya v v v Usia 1 hr dengan v V
lahir prematur
V V
V V
V V
V V
V V
V V
V V
V V
V V
MANTOUX
CUCI KET
POLI POLI TATA SESUAI SKRINING
TANGA APD TB 1 2
MTBS GIZI NILAI SOP
N L P L P
v v v v
v v v v
v v v v
v v v v
v v v v v v Rujuk RS
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v salah kontrol tgl
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V v v v v GIZI Kurang
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v v
v v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V Dermatitis
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V v v v v Kurus
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
v v V V V V Komplikasi Neo 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V i
V V V V
V V V V 1 0 1 0
KUNJUNGAN KUNJUNGAN
AKUPAN KN BAYI BALITA
( USIA 0-11 (Usia 12- HB0 (0<7
BCG DPT/HB (1) DPT/HB (2)
Bln) 59 Bln) HR)
3
L P L P L P L P
L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4 5 4 1 2 1 0 0 23 25 20 15 15 12
DPT/HB (3) POLIO 1 POLIO2 POLIO3 POLIO4 IPV 1 IPV 2

L P L P L P L P L P L P L P
1 1
1
1
1 1
1 1 1
1
1 1 1
1 1 1
1
1
1
1
1
1 1
1 1 1
1 1 1
1 1 1
1
1
1 1 1
1 1 1
1 1 1
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1 1 1
1 1 1
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1
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1 1 1
18 7 13 10 20 18 17 13 17 8 20 7 7 9
an Imunisasi
CAMPAK
PCV 1 PCV 2 PCV 3 Rotavirus 1 Rotavirus 2 Rotavirus 3
RUBELLA
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
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1 1
1 1
1 1
1 1
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1 1
1 1
1 1
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1 1
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1 1
1 1
1 1
1
1 1
1 1
1
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1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1
1
1 1
1
1 1
22 13 21 13 3 4 25 15 21 15 7 2 11 9
BOOSTER
BOOSTER
CAMPAK
DPT
RUBELLA
L P L P
1 1
1 1
1 1
1 1
1 1
1
1
1
1 1
3 3 3 6
NO REGISTER JAMINAN
NO TGL NIK
BARU LAMA BPJS UMUM
1 01-11-2023 547/23 V
2 548/23 V
3 549/23 V
4 02/11/2023 3301134511220001 550/23 V
5 3175062810230008 551/23 V
6 3175066308230007 445/23 V
7 3175063001230004 062/23 B V
8 3175067101230004 57/23 v
9 3312172801230001 90/23 V
10 3175062107230004 479/23 V
11 31750610010220018 482/22 YA
12 3206025801230001 410/23 V
13 3175060903220003 157/22 V
14 332801540220004 209/22 V
15 418/23 V
16 3175060205230013 406/23 V
17 3175065907230003 394/23 v
18 1306010401230001 486/23 V
19 3175066101230002 52/23
20 3172042404220006 042/23 v
21 441/23 V
22 3175065204220002 177/22 V
23 07-11-2023 3175066909230006 552/23 V
24 553/23 v
25 554/23 v
26 556/23 v
27 3175060308230000 557/23 V
28 3175064210230001 558/23 V
29 558 A /23 V
30 3175060210230009 559/23 V
31 560/23 V
32 3175061007230012 561/23 V
33 547/23 v
34 3175061806230005 354/23 v
35 3175061708230003 381/23 V
36 3175060507230002 368/23 v
37 3175061907121021 365/23 V
38 3175065304230008 201/23 V
39 3306011509120773 423/23 V
40 3172046408230003 416/23 V
41 3175025810220002 494/22 V
42 3175062305230003 487/23 v
43 549/23 V
44 09-11-2023 562/23 V
45 3175062003210007 563/23 V
46 3175066308230013 496/23 V
47 440/23 V
48 434/23 v
49 3175060309230004 493/23 V
50 3175063006230007 422/23 V
51 3175065005720015 349/22 V
52 3175065306230004 289/23 v
53 3172043105230013 483/23 V
54 3173044203220004 333/23 v
55 3175064512220013 532/22 V
56 492/23 V
57 3175060208230002 481/23 V
58 3175067001220005 112/22 V
59 3175060509230007 488/23 V
60 3175064909230002 484/23 V
61 192/23 V
62 490/23 V
13-11-2023 564/23 V
63 14-11-2023 565/23 V
64 3175062208190099 566/23 V
65 567/23 V
66 3175065109230005 568/23 v
67 569/23 V
68 570/23 v
69 571/23 V
70 572/23 V
71 3175060410230009 573/23 V
72 3601071007150013 574/23 V
73 436/23 V
74 502/23 V
75 3175060606230003 304/23 v
76 3175060606230004 303/23 V
77 317506108230018 489/23 V
78 3175000060723000 356/23 v
79 428/23 A V
80 3172041010230006 517/23 v
81 3172035005230002 329/23 v
82 3175066106231006 480/23 V
83 3175060908230002 371/23 v
84 3175062606230007 346/23 v
85 548/23 V
86 3172040610230007 498/23 V
87 15-11-2023 575/23 V
88 576/23 V
89 576 A / 23 v
90 577/23 v
91 16/11-2023 3602105710870002 578/23 V
92 3175064109230005 579/23 V
93 3175065211230002 580/23 V
94 3172041305220003 581 A/23 V
95 3175066208220007 581/23 V
96 3175061011220058 582/23 V
97 336/23 v
98 3174080806230003 306/23 V
99 508/23 V
100 327/23 v
101 3175061407230006 337/23 v
102 3216055107230005 442/23 V
103 3175066305230006 302/23 v
104 3175062307230006 497/23 v
105 3175062705210000 202/22 V
106 3175062207230002 427/23 v
107 3175063005230003 295/23 v
108 3175064308230002 433/23 v
109 3175060409230003 505/23 V
110 540/23 V
111 3175066812222000 144/23 V
112 3175061109230001 504/23 V
113 444/23 V
114 3175065111220021 526/22 V
226
115 3175061803230009 v
A/23
116 9404011408230002 510/23 V
117 3175060511221011 476/22 v
118 3175065109230002 503/23 V
119 17-11-2023 551/23 V

120 21-11-2023 3175061306230034 564/23 V
121 583/23 V
122 584/23 V
123 585/23 V
124 586/23 V
125 587/23 V
126 589/23 V
127 590/23 V
128 3175065706230001 507/23 V
129 549/23 V
130 511/23
131 435/23 V
132 548/23 V
133 538/23 V
134 478/23 V
135 3175060611151882 382/23 V
136 3175062904230001 276/23 v
137 391/23 V
138 3175062305230006 254/23 v

139 3175061707230004 380/23 V
140 3175060708230012 392/23 V
141 3175065808900099 400/23 v
142 450/23 V
143 3175062212200019 338/23 v
144 23/11/2023 3175065909230002 591/23 V
145 3175061912220005 592/23 V
146 1808131911200001 593/23 V
147 594/23 V
148 595/23 V
149 159/23 V
150 536/23 v
151 546/22 V
152 577/23 v
153 446/23 V
154 3175060111120001 473/23 V
155 335/23 v
156 3175061401230002 72/23 v
157 3175065608230008 420/23 V

158 3175061809230005 513/23 V
159 3175062811190088 528/23 V
160 317506090823009 456/23 V
161 3175062108230004 521/23 V
162 177/23 V
163 3175065709230002 535/23 V
164 3175066305230008 404/23 V
165 3327032905230002 531/23 V
166 3175062008230004 523/23 V
167 3175064805230001 226 C/23 V
168 3175062305220013 181/22 V
169 522/23 V
170 3175065409230001 524/23 V
1 28-11-2023 3175065910230002 588/23 V
2 3175066509230005 596/23 V
3 317506410230002 597/23 V
4 3175060312210000 598/23 V
5 599/23 V
6 321606280230001 600/23 V
7 3175063006160000 601/23 V
8 3171022806230001 316/23 V
9 3175066509230002 527/23 V
10 349/23 V
11 3175065807230009 383/23 V
12 460/23 V
13 3175065107230008 325/23 V
14 3175066708230005 408/23 V
15 3175061408230018 514/23 V
16 3175062011220005 58/23 V
17 3175065607230005 452/23 V
18 3175061809230005 513/23 V
19 3175065406230008 466/23 V
20 3175061607230004 449/23 V
21 3175065008230006 468/23 V
22 3175062810230008 551/23 V
23 3175060311220001 516/22 V
24 3175065910230005 541/23 V
25 3175064708230005 438/23 V
196 30-11-2023 602/23 V
197 603/23 V
198 604/23 V
199 605/23 V
200 3175064207230005 461/23 V
201 475/23 V
3175062609230003
202 3175061809230003 542/23 V
203 3171035502230003 140/23 v
204 3175060402230006 V
103/23
205 224/23 v
206 3171031002230006 141/23 V
207 3175064905220002 062/23 V
208
3175062908230006 494/23 V
209 3175062410170018 V
374A /23
210 544/23 V
211 530/23 V
212 264/22 v
213 3175066005230001 370/23 V
214 3175065608230010 491/23 v

215 101/23 v
216 3306110705220001 278/22 v
217 580/23 V
218 3175062203220006 152/22 V
219 3175062611220008 01/23 v
JK/UMUR
L P
Fathia Rana Lusiana ### 4 Hr Wahyubi / Fatara Adi
Muhammad Fathan Arizta ### 11 Hr Deddek / Yoga Arista Ramad
By. Ny Siti ### 10 Hr Siti / Fachrul Reza
Felisya Maheswari ### 12 Bln Nia Alimi / Bima Asih
Yesi Maryati / Amril

Muhammad Zaid Azril ### 5 Hr
Muminim
Almahyra Shanum 23-8-2023 3 Bln Ernawati / Hasis Fadilah
Zanika Annika Ahmad ### 9 Bln Sintia Putri / Ahmad Maulana
Muhammad Nur Arshaka 28-1-2023 12 Bln Suratmi / Wahyudi
Kenzie Raffiansyah Ahmad ### 12 Bln Siti Nurlaila / Ahmad Zulfikli
Inaya Qamilatun Nuhu 1/18/2023 9 Bln Miarti / Ade Kusmawan
19 Evon Else Kristianti Dan

Muhammad Zaid Alfarizki 3/9/2022
Bln Andri Afrizal Hakim
Innara Khalisa Wijaya 4/14/2022 18 Bln Nadiawati / Randi Wijaya

Dzakia Zia Muhaya ### 4 Bln
Muhammad Rohim
Kaela Shakira Putri ### 5 Bln Marlinda / Irawan
Andriani Hutabarat / Elifati

Givany Buanathania 2-9-2023 2 BLn
Zedrato
Agus Diah Eka Lestari (ibu),

Kaina Almahyra Bestari 4/12/2022 21 Bln
Evan Sevditra (ayah)
Ceisya Azifah Putri ### 1.5 BlnResi Mulyawati / Muh Faisal
Sakura Aizha Almahyra ### 5 Bln Tanti Dwi F / Imam Mawardi
Diyari Jafar Kurniawan ### 1 Bln Dewi Larasanti / Yosi
Atthar Izhul ### 1,5 bln Erianita / Nasuulloh
Alana syabilla rahma ### 2 Bln St. hidayati / Ahmad Ramdan
Arletta Sarah Z ### 1 Bln Lusi Emma / Santo

Inayah Muhita Maulida ### 1.5 BlnNur Alpiyani / Hidayatullah
Abizar Dafanka ### 1 Bln Rusmawati / Sukidi
Abizar Pratama ### 1, 5 Bln Laelah / Ari Setiawan
Rafandra Akbar ### 4 Bln Rini / Jeli Sanjaya
Fathia Rana Lusiana ### 11 hr Wahyuni / Fatara Adi
ARSYAD MUMTAZ HARDIKA ### 3 Bln MULYANI / IBNU
Almahira Shazia ### 7 Bln Sheenta / Nyamin
Gefira Jazila 29-08-2023 3 Bln Sumarti / Buang Sudiono
Anasera Lavannya Kaluna 24-08-20233 Bln Suriyana / Achmad Sirajul
Mafaza Afsheen El Daneen ### 12 Bln Aulia M. E I / Eko Susanto
Eshan Iqrin Al Rayyan ### 6 Bln Berty / Iqbal
By. Ny Siti ### 14 Hr Siti / Fachrul Reza
Shafa Zea Almahira ### 5 Bln Marwati / Sugeng Riyanto

Ibrahim Khatri ### 8 Bln Sri Nur KHayati / Prastyo
Mikayla Prameswari Humaira ### 3 Bln Lutfianita Popple / Dimar

E. Siregar
Ivani Romarito Pandiangan 6-9-2023 2 Bln Lstioro Tamba / Khotman T
Rizky Maulana Mahyudin 9/3/2023 2 Bln Suci Amelia / Mahyudin

Denhar
Meidina Eristia 10-5-22 18 Bln Rifqiyatul/Eri Setianto

Pricillia Yen Hermanto ### 19 Bln Meta Setyani / Edi Hermanto
Darmawan
Devi Lestiawati /
Rudiansyah
Murdani
Lily Holiday Dan
Aleeza Putri Azahra 1/30/2022 21 Bln
Muhammad Azizi
Delana Ersya Nadhirnzky ### 2 bln Mela Ftri / M. Reza
Xavia Chaiza Anzani ### 2 bln

Yunita Sukitoamidjo / Zainal Abidin
Syafa Zaina Rahman ### 9 Bln Beta H / Kholilurrahman
Aiyra Azzahra ### 2 bln Emi Kemilawati / Hambali
Aleena Masya Kyara 4-11-2023 9 Hr Hamanda Syahrani / Agung M

Zahira Putri Jasmin 4-11-2023 10 Hr Fitriyatul Ummah / Fardillah
Haqqi Ilham Arshaka 8-8-2023 3 Bln Syifa / M. Zihad
Harvy Maulidya 9-10-2023 1 Bln Khoiriyah / Pramudya Arif
Devanie Richel Alkhaleena 11-9-2023 3 Bln Rizka / M. Eko
Muh. Arsya Fathan 14-7-2023 5 Bln Fitri / Humaidi
Muh Ridho Alrasyid 9-10-2023 1 Bln Restianah / Abd. Rahim
Almahyra Azzahra 5-10-2023 1 Bln Yanti / Ujung
Jayful Noel Timothy 9-10-2023 1 Bln Sylvia / Fransistus
Sakha Arkan Wiratama ### 1 Bln Sella Khusulyah / Sodiq
Yardan Auliga M ### 2 Bln Yuli / Amin
Shaquinna Ameena ### 1 Bln Desy Yuliarni / Rendi Septian
Althaf Mustahar ### 3 Bln Risinina Aulia / Fajar Cahyono
Helen Situmorang 8-8-2023 3 Bln Ida Friska Angel / Tumbyr Re
Muh Hamzah ### 1 Bln Shapia Ridwan
Kirana Fathin A 21-6-23 5 Bln Retno Pertiwi / Anjar Budi

Muhammad Fathan Arizta ### 21 Hr Dedek / Yoga Arista Ramadh
Arfanur Radif ### 1 Bln Nurlatifah / A Sofyan
Fadhel Hanan Nurhidayat ### 12 hr Fitri Indriati / Feri Nurhidayat
Hanif Akhdan Ziyad 27-04-2023 7 Bln Siti Rokhyah / Nur Rohman
Muhammad Fatih Rahman 4-11-23 11 hr Muniroh / Saroni
Ade Frbriyanti / Fajar

Hanum Ardiana Defa 8-11-23
Ardiansyah
Ilfi Zakiah ### 4 Bln Hani / Dedi
Salsabila Agnia Putri 1-9-2023 2 Bln Rasih / Imam
Syahrotus Shyta ### 4 Hr Sohibah Isyah / Afi
Rasha Al Ghifari 13-5-23 6 Bln Fauziah / Andi Setiawan
Reyna Anjani A 22-8-23 3 Bln Anita / Juna Anasta
Aliska Cesya Qristina 7-11-23 9 Hr Irma Deswita / Khaerunnas
By Ny AMBAR 22-7-23 4 Bln Ambar PA / Ulun Mubarak
Resti Ayu Khaitina ### 2 Bln Ryan Crissandy / Marzuki
Aishwa Rasyedha Safe ### 6 Bln Susilawati / M Yunus

Goessera Putri / A.
Clemira Elfesya Asa ### 4 Bln
muhaimin
Muhammad Alvaro Leao ### 4 Bln Anggiyana / Ricco Shiwi
Muhammad El Moza Antalaric 14-5-22 18 Bln Maryana / Mirza Julian
Indah Permatasari /
Binuka Noah Antares 22-07-2023 4 Bln
Ardyantoro Hani
Agista Naura 3-8-2023 3 Bln Hasanah / Aripin
Kaivan Pradipta Wijaya ### 2 Bln Yulinar / M. Ibnu
Muhammad Raffasya ### 20 Hr Nadiva Putri / Dayan
Makaila Syifanazia ### 10 Bln Fidan Nur Azizah / Naufal
Arkana Albyanadra Putra 11-9-23 2 Bln Supriyatin / Moch Idris
Kalil Al Ghifari 9-6-2023 5 Bln Aprilia / Idis Apandi
Ahmad Asyraf 18-3-2023 2 BLN Sunariyah / Maksum
Shaquille Elzhan Davindra ### 12 BlnSusi Purwanti / Mileh Santoso
Khadijah Aminah ### 2 Bln Wiwin / Kaedi

Muhammad Zaid Azril ### 20 hr
Muminim
Queensha El Shanum ### 10 HrNova Pettyana / Fahmi Rosyid
Azura Nurainin 7-10-23 1 Bln Elia / Sandi
Naresha Qiana E 9/1/2023 2 Bln Munfaqoh Suranti / Yogi
Hamid Alghifari 17-11-2023 5 Hr Kurniawati / Syahrul ANH
Muhammad Umar ### 1 Bln Desi Triana / M. rAMADHAN
Arshaka Rayyan Atharazka 29-08-2023 3 Bln Siti Zahra / Royandi Laspan
Azkiya Nayla 20-10-2023 1 Bln Vivit Fatmawati / Madawi
Tiara Ayuning Tias / Rahmat

Rathtya Zea Humatra 08-11-2023 14 Hr
Kusmanto
Nur Nadheera 17-06-2023 5 Bln Nuraiyda Nadia / M. Ridwan
By. Ny Siti ### 1 Bln Siti / Fachrul Reza
Muhammad Fathan Arizta ### 1 Bln Deddek / Yoga Arista Ramad
Barra Chairansyah ### 1 Bln Novita Sari / Bayu Indra
Enji Amalia Putri / Yudi

Muh Ahzan Davanka 26-8-23 3 Bln
Kristian
JOVAN LUIZ TOBING ### 4 Bln ROSIANA /MESRADI
Dewi Arsyanti / Rendi

Muhammad Kenizio Saputra 29-4-2023 7 Bln
Saputra

SUNIAH /
AHM.SYARIFUDIN
Aziel Hasibuan 14-8-23 4 Bln
Hasibuan
Danendra Malik Dirgantara 20-8-23 3 Bln Endang Pertiwi / Yacob
Fazella Ghania Zahra ### 2 Bln Indri Kartika / Panji Gineng
Haziq Razan Kavindra ### 11 Bln Paramita Eka / Syaiful Alam
Muh. Aqil Delwyn ### 3 Th Serly Afrel / Catur Ardri
Syakilla Maura Khanaya 16-11-2023 8 Hr Sari Suryawati / Sofian Sauri
Jihan Zahira 4-11-2023 1 Bln Musarofah / Mujianto
Farhana Putri Andien ### 9 Bln Entin Martin / Andi Apandi
Siti Nur Halimah / Dhika

Zyonathan 7-5-23 6 Bln
Gurtama
Hafiz Danish Muttaqin ### 12 Bln Pusparini / Mashuri

Hanum Ardiana Defa 8-11-23
Ardiansyah
Rahma Novita Sari / M.
Kiara Putri Setiawan ### 2 Bln
Rizki Setiawan
Kanaya Latisha Achmad ### 1 Bln Neneng Wardayanti / Achmad

Chandra

Chairunnisa / Engkos
Rabiul Hibadzul Al wafi ### 2 Bln
Kosasih
Aslan Al Hasbi 9/20/2023 2 Bln Nurdiani / Roni Hasbi
V ### 9 Bln Yanti / Dirga Hayu
Arshafa Nadhira Putri ### 2 Bln Novi Yang / Durty Rizqi
Eza Hermansyah 5/29/2023 5 Bln Esti Setiarini / Hermanto

Asira Almayra ### 6 Bln
Kurniawan
18 Lais Indriyati / Agus
Hanan Abqory Alfarizqi 23-05-2022
Bln Purwono
Hamzah Alfaro 8/3/2023 3 Bln Wati / Mursidi
Alifa Zea Ananda ### 1 Bln Sri Wahyuni / Andri Joko
Deniandra Maulidiya I 9/25/2023 2 Bln Saruni Agustin / Yerri Eka
Devy Sintia / Muhammad

Anka Ashiqa Balvy ### 1 Bln
Iqbal
Gemma Putri Sihotang ### 2 Bln Maria Panggabean / Febahril
Muhammad ### 5 Hr Ade Haryani / Surya
Kaluna Aditya Sefa ### 3 Bln Septi / M. Fajar

Muhammad Reifan Daffa A ### 1 Bln Enok Fitriani / Mahfudin

H
AMANDA MICHELLE MANULLAN ### 4 bLN NOVIA / RICHART
Nur Ashraf Zakariah ### 3 Bln Siti Khodijah / Nur Fajri
Yosia Meshach Gultom ### 12 Bln Financy S / Gidium
Yumna Shanum Irawan 7/16/2023 4 Bln Desi / Agus Irawan
Kosasih
Syahnaz Putri Ayunindya 14-06-2023 5 bLN Yuliani Ningsih / Abd. Saraf
Zidan Al Fawaz 16-7-23 4 Bln Dedeh Mahmudah / Pedo

Muhammad Zaid Azril ### 1 Bln
Muminim
Muhammad Syafiq Valevi 03-11-202212 Bln Malia / M. Rizky Saputra
Aila Nadhifa Almahyra ### 1 Bln Muthaimainnah / Abid Robani
Maezura Alesha A ### 3 Bln Agesti Reonita / Riyan Sah

Aylin Tisha Eiliyah ### 14 Hr Putru Megatan / Rizki Fajar
Jian Zafirah Ayoula 20-2-2023 9 Bln Anisah / Abd. Rohman
Aiman ### 6 Hr Nurul Arifah / Ryan Septian
Shabila Saputra ### 21 Hr Dewi Sri / Paino

Haidar Aziz ### 2 Bln Yati / Absorihin
Arshaka Elvander Rezqiano ### 2 Bln Windi / Faisal

Shaziva Nazaleya Mahveen K ### 8 Bln
Kurniawan
### 8 Bln
Rayyan Tunggal 1-4-2023 7 Bln Hindun / Sapri Tunggal

Elzio Nazeep Sanjaya ### 9 Bln
Sonjaya
Rabiza Zia Sakhi ### 9 Bln Tri Puspita / Irwan Saleh
Muhammad Rizhan A ### 3 Bln Suprihatin / Dara
### 3 Bln
Syafiq Maulana Syakir Nurul / Deni
Nada Nur Kalila ### 2 Bln Fitriyani / Rahman Nurcahim
Narsyama Rania ### 2 Bln Lilah Hilya / Anton
Muhammad Faizar Al Hanan ### 18 Bln Titik Mardiyati / Arfin Asanto

Nurseno
Yumna Humaira Rizky 8/16/2023 2 Bln Ade Indriyani / Tomi Rizki
Masheel Jovial Motiea ### 12 Bln Nandra Vahada / Fauzi M
Muhammad Syafiq Ramadhan ### 18 Bln Anisa / Fatkhul Janah Hidaya
Syahrotus Shyta ### 21 19 Hr Sohibah Isyah / Afi
Muhammad Je Zayyid 3/22/2022 Bln Endah Sari W / Fajar Kevin B
Boy Matthew Latumeten 26-11-202212 Bln
Latumeten
ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
Bulak Indah 6/5 85218762188 2.9 45 34 36.5 2
Perdana VI 82246117898 3.5 50 35 36.5 3
Kandang Sapi 5/6 89603090123 2.7 46 35 36.5 3
Kayu Tinggi 9/9 82211315532 6.9 70.5 44 36.5 IPV2 DS : 10
Tambun Rengas 5/7 83813599679 3 48 34 36.5 2
DPT1,
Gempol 11/01 82125995699 4.5 54 37 36.5 POLIO2,
PCV1, ROTA1
Kandang Sapi 7/6 85775706584 8 69 44 36.5 MR, IPV2 DS : 10
Swadaya 4/6 85328560129 9 68.5 44 36.5 MR, IPV2 DS : 10
DPT2,
Tambun Rengas
89603036551 6 59 40 36.5 POLIO3,
2/8
PCV2, ROTA2
Tambun Rengas 9089653404927 7.9 73 45 36.5 PCV3 DS : 10
JL. Cempaka 4/9 81932777236 8.1 69 45 36.5 MR, IPV2 DS : 10
BOOSTER
Tambun Rengas
DPT,
Rt 01/07 Cakung 082124388264 11 82.5 47 36.5
BOOSTER
Timur
MR
BOOSTER
Kayu Tinggi DPT,
081219271665 9.1 80 47 36.5 DS : 10
02/12 BOOSTER
MR
DPT2,
kayu Tinggi 2/11 81333327030 6.5 65 41.5 36.5 POLIO3,
PCV2, ROTA2
DPT3,
Buaran 12/2 81298618336 6.9 65 37 36.5
POLIO4, IPV1
DS : 10
DPT2,
Kayu Tinggi
087876550108 6.7 61 40 36.5 POLIO3,
10/09
PCV2, ROTA2
MR, IPV2,
KT 2/11 87831416205 10.7 72 46 36.5 DS : 10
POLIO2
Perdana 6/12 081319571239 8 67 45 36.5 MR, IPV2 DS : 10
BOOSTER
Taman DPT,
081335534378 9 45 36.6
Pulogebang 4/13 BOOSTER
MR
DPT1,
PCV1, ROTA1
BOOSTER
005/009, kel DPT,
081242243274 10 77 46 36.5 DS : 10
cakung timur BOOSTER
MR
Bulak indah 9/5 85714430798 4.3 53 39 36.5 BCG
DPT2,Polio2,P
Tanjakan Auri 1/11 081215777379 5.8 62.5 41 36.7 CV2,Rotavirus
2
Jl. Bayam 09/03 083890589267 3.7 52 36 36.7 BCG
Tambun Selatan 4 085935173885 4.8 55 40 36.7 BCG, Polio1
Kayu tinggi 9/9 8775894903 5.2 56.5 38 36.5 BCG, POLIO1
Kayu Tinggi 10/05 85921955648 4.2 54 37 36.5 BCG

Tambun Rengas 7 8996488920 4.1 54 38 36.5 BCG
Kayu Tinggi 4/3 8979365006 4 53 37 36.6 BCG
Buaran 8/2 82186010819 4.1 52 38 36.5 BCG
DPT2,
Kandang Sapi 7/6 866799651 5.7 64.5 41 36.5 POLIO3,
PCV2, ROTA2
Bulak Indah 6/5 85218762188 2865 47 34 36.7 3
DPT3,
Kp. Baru 14/07 087822897201 5.9 61.5 40 36.4 POLIO4, IPV1,
ROTA3
DPT1,Polio2,
CEMPAKA ELOK
085723827018 5.2 57 40 36.7 PCV1,Rotaviru
RT4/9
s1
DPT2,
PCV2, ROTA2
DPT2,
Gempol2/1 81584522053 5.7 59.5 39 36.5 POLIO3,
PCV2, ROTA2
Buaran 10/02 085776092462 6.8 67 40 36.5 DS : 10
DPT1,Polio2,
Kayu Tinggi 3/3 858438812858 5.2 58 41 36.5 PCV1,Rotaviru
s1
DPT1,Polio2,
Kayu Tinggi 2/3 87833377877 4.9 54 37 36.5 PCV1,Rotaviru
s1
Kayu Tinggi 05/04081398854433 7.5 71 44 36.5 PCV3 DS : 10
Kayu Tinggi 4/4 082298266072 8.4 65 45 36.6 ROTAVIRUS 3 DS : 10
Kandang Sapi 5/6 89603090123 2.9 48.5 36 36.6 3
DP3, POLIO4,
Kandang Sapi 5/6 893517121014 5 57 37 36.5
IPV1. Rota3
BOOSTER
Cempaka 6/9 823228108388 11.5 85 49.5 36.5
MR
DPT2,
Gempol 12/1 83898385819 5.1 59 39 36.5 POLIO3,
PCV2, ROTA2
DPT1,
Gempol 16/01 4.8 55.7 37 36.5 POLIO2,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
DPT1,
Tambun Selatsan
8137878 5.2 57 38.5 36.5 POLIO2,
3/8
PCV1, ROTA1
DPT2,
Kayu Tinggi 85719219795 7 64.5 40 36.5 POLIO3,
PCV2, ROTA2
booster dpt,
Gempol Rt4/Rw1 0895322329015 9 80 45 36.5
booster mr
DS : 10
Tambun Rengas DP3, POLIO4,
89670339016 5.5 62.5 41.5 36.5 DPT1,
7/7 IPV1. Rota3
Cempaka VI 8/9 085782157781 7.3 67 43 36.5 POLIO2, DS : 10
Panti Asuhan PCV1, ROTA1
0821808836168 10 85 45.5 36.5 MR, IPV2
Guna Nande
Pagar Jati 15/01 #FMT 8.6 69 43.5 36.5 MR, IPV2
DPT1,
Kayu tinggi 5/3 882249465134 4.4 57 38 36.5 POLIO2,
PCV1, ROTA1
DPT2,
Tambun Selatan
081297100255 7.7 64 40.5 36.5 POLIO3,
Jl. Balai4/8
Rakyat PCV2, ROTA2
Kp.Gempol
booster dpt,
Rt007/Rw001 085770225905 9.4 77 43 36.5 DS : 10
booster mr
Cakung Timur
Jakarta Timur DPT1,
Gempol 15/01 81336236824 4.8 59 38 36.5 POLIO2,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
DPT1,
Tambun Selatan 5/8 89618605642 4.8 53.5 POLIO2,
PCV1, ROTA1
Buaran 10/02 89665701200 2.2 45 36 36.6 3
Kayu Tinggi 3/4 88212546449 3.7 49 36 36.5 3
DPT1,
Rukem UM 81281876314 6 53 40 36.5 POLIO2,
PCV1, ROTA1
KYU tINGGI 2/3 895339712637 3.2 48 35 36.5 BCG, POLIO1
DPT1,
PCV1, ROTA1
DPT3,
Fitri / Humaidi 89653229145 5.5 58 40 36.5 POLIO4, IPV1,
ROTA1
Kayu Tinggi
81289198146 3.9 53 38 36.6 BCG, POLIO1
10/09
Harapan indah 8999196529 3.8 52 36 36.5 BCG, POLIO1
Tambun Selatan 9/8 81929494004 5.2 57 36 36.5 BCG
Kayu Tinggi 8/12 8971007150013 5.4 56 38 38.5 BCG
Kayu Tinggi 4/4 8783690217 6.7 60 40 36.5 DPT1
Gempol 4/1 81282568636 4.4 52 38.5 36.5 BCG
Gempol 13/01 085777664441 6.8 64 42.5 36.5 ROTA3
Gempol 13/01 085777664441 6.8 64 42.5 36.5 ROTA3

DPT2,
Buaran 9/2 89633431414 8 65 43 36.5 POLIO3,PCV1
, ROTA2
DPT3,
Gempol 2/11 085773170505 6 60 40 36.5 POLIO4, IPV1,
ROTA1
DPT2,
Cempaka 81316178069 5.4 56 41 36.5 POLIO3,PCV1
, ROTA2
Rorotan 11/4 895615787363 5.2 54 38 36.5 BCG
Jl. Waru Raya DPT3,

085717380583 6.2 64 42 36.5 DS : 10
1/9 POLIO4, IPV1
DPT3,
ROTA2
DPT2,
Bulak Indah 8/5 089682400723 6.2 60 40 36.5 POLIO3,PCV1
, ROTA2
DPT3,
Bulak Indah 11/05 895365362806 5.8 64.5 43 36.5 POLIO4, IPV1,
ROTA3
Perdana VI 82246117898 4.4 52.5 36 36.5 3
Kandang Sapi
087746473735 4.8 56 38 36.5 BCG, POLIO1
4/6
Gempol 07/01 089652235453 3.1 48 34.5 36.5 3
Rorotan 1/10 08577994721 7.8 63 42 36.5 DSP: 6
Kayu Tinggi 4/3 089668729981 3.2 46.5 34.5 36.5 3
Tambun Selatan
089520099631 3.2 47 35 36.5 3
5/8
DPT2,
PCV1, ROTA1
DPT1,
Gempol 4/1 81292821062 5 57.5 36 36.5 POLIO2,
PCV1, ROTA1
Kayu Tinggi 9/3 85920594660 3.3 47.5 34 36.5 2
Tambun Selatan BOOSTER

89693150010 10 7 45.5 36.5 DS : 10
4/8 MR
Kayu Tinggi 6/9 87878884422 8.4 74.5 45.5 36.5 MR, IPV1
Kayu Tinggi 8/9 81374868333 2.7 48 32 36.5 3
Polio2, pcv1,
Bulak Indah 2/12 89528012626 6.4 62.5 40 36.5
Rota1
THB 03/22 Polio2, pcv1,

081360891988 5.9 61 39 36.5
Rota1
POLIO2,
Kayu Tinggi 6/11 8979512942 4.6 55 35 36.5
PCV1, ROTA1
Tambun Selatan
0895359846720 6.4 64.5 39 36.5 DS : 10
05/08
Kav Pagar Jati POLIO4, IPV1,
081318723681 5.9 64.5 43 36.5
15/01 ROTA3
POLIO4, IPV1,
Rorotan 5/8 85722909010 6.6 64 42 36.5
ROTA3
Gempol 3/1 88214596624 7.5 66.4 44 36.5 ROTA3 DS : 10
POLIO3,
Gg. Angggur 5/4 08973334446 5.4 58 41 36.5
PCV2, ROTA3
BOOSTER
Kandang Sapi Rt6/Rw6087782781402 8.6 76 45 36.5
MR
DS : 10
Kayu Pagar Jati POLIO3,

85959808588 6.2 61 41 36.5
15/01 PCV2, ROTA3
Gempol 16/01 81932929072 8.1 66 45 36.5 ROTA 3 DS : 10

DPT2,
POLIO3,
Gempol 3/1 81280120007 5.8 57 43 36.5
PCV1, ROTA
1
DPT1,
PCV1, ROTA1
Kayu Tinggi 2/3 089675826231 24 45.5 36 36.5 3
Gempol 11/01 895384442390 7.8 70.5 42 36.5 MR, IPV2

DPT1,
PCV1, ROTA1
DPT3,
Tambun Rengas 1/8 85715153225 5.5 64 41 36.4 POLIO4, IPV1,
ROTA3
Kayu Tinggi 09/11 89609942490 7.1 70 42 36.5 PCV3 DS : 10
POLIO2,
Rorotan 6A 5.3 63 34.5 36.5
ROTA1
DPT2,
JL. Balai Rakyat 11/01 8134339144 6.4 62 39.5 36.5 POLIO3,
PCV2, ROTA2
Bulak Indah 9/12 081314901449 8.8 71 44 36.5 PCV3 DS : 10
DPT1,
Kayu ,Tinggi 1/4 831271343336 4.2 56.5 35 36.5 POLIO2,
PCV1, ROTA1
Tambun Rengas 5/7 83813599679 3.7 54 35 36.5 3
Buaran 6/12 81932485592 3 50 34 36.5 3
Kayu Tinggi 3/4 81314872449 4.3 54.5 37.5 36.5 BCG, POLIO1
POLIO2,
Kayu Tinggi 8/3 87889022721 5.5 58 38 36.5
PCV1, ROTA1
Bulak Indah 3/12 895348407072 2.5 47 35 36.5 2
Buaran 6/2 89530434062 4.5 54 34 36.5 BCG, POLIO1
Tambun Rengas BCG, POLIO1,

6/7 085894496228 4.8 59 36 36.5
ROTA1
Karang Taruna 3/9 081223199928 2.9 47.2 37 36.5 3
Tambun Rengas POLIO4, IPV1,

1/7 08997168017 6.2 63.7 42 36.5
ROTA3
Kandang Sapi 5/6 89603090123 3.6 50 35 36.5 BCG
POLIO2,
Balai Rakyat 2/4 85882522786 5.3 60.5 38.5 36.5
PCV1, ROTA1
POLIO3,
Cempaka 7/9 82260668140 5.3 57.4 37 36.5
PCV2, ROTA2
Perdana VI 82246117898 5 54 37 36.6 BCG, POLIO1
Kandang Sapi
085710964112 4.1 54 35 36.5 BCG
04/06
POLIO2,
Gempol 9/1 85615201625 5.7 61 37 36.5
PCV1, ROTA1
POLIO4,IPV1,
BULAK INDAH RT4/5081283551315 5.9 63 38.5 36.5
ROTA3
Gempol 4/1 0895412742770 7.3 58 41.5 36.5 POLIO4,IPV1
POLIO3,
Cempaka II 5/09 81292469067 5.4 58 39 36.5
PCV2, ROTA2
Kayu Tinggi 9/3 088214524142 7.5 67.5 43 36.5 POLIO4,IPV1 DS : 10

KAYU TINGGI POLIO4,IPV1,
085771006464 9.3 67 42 36.5
RT7/RW4 ROTA3
Kayu Tinggi POLIO3,
8817790844 6.3 60.5 40 36.5
13/09 PCV2, ROTA2
POLIO2,
Gempol 9/1 083807200880 4.5 58 40 36.5
PCV1, ROTA1
JL. Balai Rakyat POLIO3,
87875240372 7.7 60 39 36.5
1/4 PCV2, ROTA2
Kayu Tinggi 9/3 085881581981
POLIO2,
Kayu Tinggi 3/9 85362621995 5.3 56.5 39 36.5
PCV1, ROTA1
BOOSTER
Kayu Tinggi 3/5 85780346942 12 87 48 36.5
MR
Tanjakan Auri 11/ 81382238038 3.3 49.5 35 36.5 3
Buaran 8/12 081807242817 4.5 53 37 36.7 BCG
Gempol 3/1 818234522 8 70.5 44.5 36.5 MR, IPV1 DS : 10
Cluster JGC 8118051289 8.3 67 47 36.5 DS : 10
Kayu Tinggi
815133685855 8.9 73 47 36.5 PCV3 DS : 10
02/03
Tambun Selatan
089520099631 3.7 51 35 36.5 3
5/8
POLIO2,
Kayu Tinggi 7/15 87814763742 4.4 52 36 36.5 PCV1,
ROTAVIRUS1
POLIO2,
Kayu Tinggi 4/4 88212953547 4.3 54 38 36.5 PCV1,
ROTAVIRUS1
POLIO3,
Kayu Tinggi 7/5 852694919334 6.7 62.5 40 36.5
PCV2, ROTA2
DS : 10
Jl. Cempaka Elok 4/9081387613642 8.1 72 43 36.5 MR, IPV2
POLIO3,PCV2
Gempol 7/1 81210168177 4.9 60.5 40 36.5
, ROTA2
POLIO2,
Gempol 11/01 89678041000 4 53 35 36.5
PCV1, ROTA1
POLIO2,
Kandang Sapi
089654434809 4.4 54.5 39 36.5 PCV1,
11/6 ROTAVIRUS1
Kayu Tinggi 3/11 85817030365 POLIO3,
6.4 62 40 36.5
PCV2, ROTA2
POLIO2,
Tambun Rengas
083852440877 5.8 58.5 39 36.5 PCV1,
10/07 ROTAVIRUS2
Kayu Tinggi 1/3 081385865166 7.6 65.2 43 36.5 MR, IPV2 DS : 10
POLIO2,
Kayu Tinggi 3/4 89531487230 4.3 54.7 37 36.5 PCV1,
ROTAVIRUS1
Kav, Barokah POLIO4, IPV1,
82257019991 6 60 41 36.5 DS : 10
Sapi 8/12 ROTA3
Kayu Tinggi 1/3 83145893428 7.2 65.5 43 36.5 PCV1, ROTA2
POLIO3, PCV2,
Jl. Cempaka 6/9 081311457442 5.9 60 39 36.5 ROTA2
Kayu Tinggi 4/11 08871225520 5.9 60.5 40 36.5 DS : 10
BOOSTER
Kt 12/01 081808940755 8 70 43 36.5
MR
DS : 10
Tambun Selatan Polio2, PCV1,

089510173192 4.9 57 38 36.6
8/8 Rotavirus 2
POLIO2,
Gempol 9/1 087787367588 5.1 56 38 36.5 PCV1,
ROTAVIRUS1
Kayu Tinggi 3/3 8964292686 4.6 52.5 37 36.5 BCG
Kayu Tinggi POLIO2,

83891601625 5.1 57 38.5 36.5
13/09 PCV1, ROTA1
85782231290 4.5 53 36 36.5 BCG, POLIO1
POLIO1,
Kayu Tinggi /9 81287805866 4.6 53 38 36.5
PCV1, ROTA1
Tambun Rengas 4/7 89623049509 3 50 36 36.5 3 HB0
POLIO3,
Bekasi 858888801716 5.2 57 39 36.5
PCV2, ROTA2
POLIO4, IPV1,
Kayu Tinggi 3/9 81383018815 6.2 63.5 41 36.5
ROTA3
Cempaka Elok POLIO2,
081296237636 5.5 54 38 36.5
No.71 PCV1, ROTA1
Cempaka I dalam POLIO4, IPV1,
85956690338 6.6 61 42 36.5 DS : 10
13/9 ROTA2
POLIO4, IPV1,
KAYU TINGGI RT3/9085715262449 6 60 40 36.5
ROTA3
POLIO3,PCV2
Rorotan 2/4 89620481868 5.4 61 42 36.5
, ROTA2
POLIO4, IPV1,
Jl. Cempaka 06/09 082155483489 5.4 57 39 36.5
ROTA3
POLIO3,PCV2
Buaran 10/02 81265022621 5 56 39 36.5
, ROTA2
POLIO2,
Kayu Tinggi 5/3 85172260324 5.8 63 40 36.5
PCV1, ROTA1
Kayu Tinggi 12/09 081289446975 9.1 72.5 47 36.5 PCV3 DS : 10
POLIO4, IPV1,
Cempaka 6 8/9 81290114963 6.1 59 40 36.5
ROTA3
Gempol 11/01 89678041000 4.2 55 35 36.5 BCG
POLIO4,
Kayu Tinggi 4/3 85770256056 7.9 69 41 36.5
PCV2, ROTA2
Tambun Rengas POLIO4, IPV1,
85883206862 7.5 64.5 40 36.5
10/7 ROTA2, PCV1
POLIO3,
Kayu Tinggi 87881907699 6.6 62 40 36.5
PCV2, ROTA2
Tambun Rengas 5/7 83813599679 4 54 37 36.6 BCG, POLIO1
Kayu Tinggi
89688741137 9.4 71 45 36.5 PCV3 DS : 10
12/06
Kayu Tinggi 8/5 895423488109 9.2 57.5 38 36.5 BCG
POLIO3,
Kayu Tinggi 4/4 8981143626 5 59 39 36.5
PCV2, ROTA2
Pagar Jati 15/01 87888355111 3.4 50 33 36.5 3
Gempol 11/01 81219817028 6.1 64 43 36.5 MR, IPV2 DS : 9 Bln
Tambun Rengas 9 895326179443 3.1 47.3 33 36.5 2
Gempol 13/01 4.4 53 34 36.5 3
POLIIO4,
Kayu Tinggi 8/3 88212663927 5.3 64 38 36.6
IPV1, ROTA3
POLIO2,
Kt 2/11 85959370270 6.2 59 40 36.5
PCV1, ROTA1
POLIO2,
waru 11/09 81223454064 5.9 58 39 36.5
PCV1, ROTA1
Gempol 08/01 85776862015 8.3 70 43 36.6 MR, IPV2
Kayu Tinggi 2/4 8.8 72.5 46 36.5 MR, IPV2

81547275795
POLIO2,
Buaran 12/2 83839492509 6.8 65 38 36.5
PCV1, ROTA1
Tambun Rengas
85883555902 8.2 70 44 36.5 MR, IPV2
4/7
BOOSTER
Bulak Indah 3/12 081332098375 8 74 45 36.5 DS = 10
MR
POLIO2,
6.5 60.5 41 36.5
Kayu Tinggi POLIO3,PCV2
6.4 63 41 36.5
09/04 87741319457 ,ROTA2
Polio2, PCV1,
Kayu Tinggi 7/4 85780738753 5.9 57.5 38 36.7
ROTA1
POLIO2,
Kayu Tinggi 08/11 87889038730 4.1 55 37 36.5
PCV1, ROTA1
Gempol 7/1 081901926688 8.6 77.5 47 36.7 Booster MR DS =10
Kayu Tinggi 05/09 82123543234 8.1 70 42 36.5 PCV3

Polio2, PCV1,
Gempol 4/1 8989578142 6.4 59 41 36.7
Harapan Baru ROTA1
085262222619 8.2 71.5 446 36.5 PCV3
Bekasi BOOSTER
Kayu Tinggi 03/04 087882607831 8.6 77.5 47 36.5
MR
Kayu
Jl. Tinggi
Waru VI 9/3 85920594660 4 50.5 34 36.5 3
BOOSTER
Rt.10/09 089653524550 10 81 46 36.5
Pulo Gebang MR
085172009223 8.7 72.5 44 36.5 PCV3
01/05
KETEPATAN
WAKTU OBS KUNJUNGAN
TEPAT DJB RR
(x/mnt) (x/mnt)
v RS 2.6 120 40
v RS 2.6 118 38
v RS Resti 2.5 120 38
v V V 07-11-2023
RS THB 3.3 120 40
V V 05-12-2023
V V 12 Bln
V V 12 Bln
V V 12 Bln
V V 05-12-2023
V V 18 Bln
V V 12 Bln
V V Lengkap
V V Lengkap
V V 05-12-2023
V V 9 Bln
V V 05-12-2023
V V 05-12-2023
V V 12 Bln
V V Lengkap
V V 05-12-2023
V V Lengkap
v v v 07-12-2023
v v 07-11-2023
v v v 07-12-2023
V V V 07-12-2023
V v v 07-12-2023
V v v 07-12-2023
V v v 07-12-2023
V v v 07-12-2023
V v v 07-12-2023
v v 07-12-2023
PKM Cakung 2650 132 41
V V 6 Bln
v v 07-12-2023
v v 07-12-2023
v v 07-12-2023
v v 9 Bln
v v 07-12-2023
v v 07-12-2023
v v 18 Bln
v v 9 Bln
V V V 6 bln
V V V Lengkap
V V 12-12-2023
V V 12-12-2023
V V 12-12-2023
V V 12-12-2023
V V 12-12-2023
V V Lengkap
V V 9 Bln
V V 12-12-2023
V V 12 Bln
V V 12 Bln
V V 12-12-2023
V V 12-12-2023
V V Lengkap
V V 12-12-2023
V V 12-12-2023
V V 12 Bln
V V 12-12-2023
RS 2.1 120 40
5-12-2023 RS 3.8 118 40
v v v 14-12-2023
V V 14-12-2023
v v v 14-12-2023
v v v 9 Bln
v v v 14-12-2023
v v v 14-12-2023
v v v 14-12-2023
v v v 14-12-2023
v v v 14-12-2023
v v v 14-12-2023
v v v 14-12-2023
v v v 6 Bln
DPT3,
v v v POLIO4, v v
IPV1, ROTA1
v v v 14-12-2023
v v v 6 Bln
v v v 14-12-2023
v v v 14-12-2023
v v v 9 Bln
v v v 6 Bln
v v v 14-12-2023
v v v 6 Bln
RS 3.1 118 38
v v v 14-12-2023
RS Resti Mulya 3 132 40
RS Resti Mulya 3.2 130 40
V V 19-12-2023
V V 19-12-2023
PKM Cakunng 3.3 130 30
V V 19-12-2023
V V
RS Resti Mulya 3 133 40
V V 19-12-2023
V V 19-12-2023
V V V 16-11-2023
V 9 bln
V V 16-11-2023
V V 16-11-2023
V V 9 Bln
V V 16-11-2023
V V 16-11-2023
V V 16-11-2023
V V 9 Bln
V V 16-11-2023
V V 16-11-2023
Rumah 2200 132 40
V V 12 Bln
V V 16-11-2023
V V 6 Bln
V V 18 Bln
V V 16-11-2023
V V 16-11-2023
V V 18 Bln
V V 16-11-2023
RS THB 3.3 132 40

Resti Mulya 2.9 138 40
V V V 21-12-2023
V V V 21-12-2023
Rs. Bunda Aliyah 2.5 140 38
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
12-12-2023 Klinik Halo Bayi 2.8 140 40
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 12 Bln
V V V LENGKAP
RS. Resti 3.4 140 40
V V 11-01-2024
V V V 12 Bln
V V V 18 Bln
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 12 Bln
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 12 bLN
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V V 21-12-2023
V V 21-12-2023
V V 21-12-2023
V V V 21-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 18 Bln
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 28-12-2023
V V 18 Bln
V V 28-12-2023
V V 28-12-2023
Harapan
2.8 140 40
Jayakrta
V V 12 Bln
PKC Rorotan 2.8 140 38
V V 2-1-2024
V V 2-1-2024
V V 2-1-2024
V V 12 Bln
V V 12 Bln
V V 2-1-2024
V V 12 Bln
V V LENGKAP
V V 2-1-2024
V V 2-1-2024
v V 2-1-2024
V V 2-1-2024
V V LENGKAP
V V 18 BALN
Polio2,
v v PCV1,
V V Rotavirus1
18 BALN
V V LENGKAP
PKM Cakunng 3.3 130 30
V V LENGKAP
V V 12 Bln
AN RESIKO
BAYI
SHK BELUM
PUPUT
NCB SMK KN 2
V V V usia 4 hr ikterus V V
kramer 1
NCB SMK KN 3
V V V V V
usia 11 hr
NCB SMK KN 3
V V V V V
usia 10 hr
V V
NCB SMK KN 2
V V V V V
usia 5 hr
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
v v
v v
v V
v v
v v
v v
v v
v v
v v
NCB SMK KN 3
v v v Usia 11 hr ikterus v v
kramer 3
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN3 usia
V V V
9 hr SMK KN 3
NCB
V V V v v
usia 10 hr
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v 9 Bln v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN 3
V V V v v
usia 21 hr
v v
NCB SMK KN3
Usia 12 hari
v v v dengan v v
Konjungtivitis
Bakterial
v v
NCB SMK KN3

v v v v v
dengan Ikterus 4
NCB SMK KN3 usia
v v v v v
7 hr
v v
v v
NCB SMK KN2 usia

V V V V v v
4 hr
v v
v v
NCB SMK KN3 usia

V V V V v v
9 hr dg Krimer 3
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NKB KMK KN3

ya v v v Usia 20 hr dengan v v
lahir prematur
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN 3
V V V V V
usia 20 hr
NCB SMK KN 3
v V V V v v
usia 10 hr
v v
v v
NCB SMK KN 2
v V V V v v
usia 5 hr
v v
v v
v v
NCB SMK KN 3
V V V V v v
usia 14 hr
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN3 usia

V V V V v v
8 hr
v v
v v
v v
v v
NCB SMK KN3 usia

v v v v v
14 hr
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN3 usia
V V V V v v
14 hr
v v
NCB SMK KN2 usia

V V V V v v
6 hr
NCB SMK KN3 usia
V V V V v v
21 hr
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
v v
NCB SMK KN3 usia
V V V V v v
19 hr
v v
v v
MANTOUX
CUCI KET
TANGA APD TB 1 2
MTBS GIZI NILAI SOP
N L P L P
V V V V komplikasi neo 1
V V V V
V V V V
V V V V
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
v v v v
v v v v
V V V V
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
Rujuk RS
v v v v v
Resti Mulya
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v Kurus
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v v Rujuk RS
v v v v v Rujuk RS
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
Rujuk Rs
V v v v v Resti dg
Krimer 3
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
V V V V
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v v v GIZI KURANG
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v 1
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
v v v v
0 0 3 2
KUNJUNGAN KUNJUNGAN
( USIA 0-11 (Usia 12- HB0 (0<7
Bln) 59 Bln) HR)
3
L P L P L P L P
L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
7 11 0 0 0 2 1 0 20 11 9 10 9 7

1
1
1 1 1
1 1
1
1
1 1 1
1 1 1
1
1 1 1
1
1
1
1
1
1 1 1
1 1 1
1 1 1
1 1 1
1
1 1 1
1
1 1 1
1 1
1 1
1 1 1
1
1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1
6 5 11 4 22 24 16 15 15 13 14 14 6 11
an Imunisasi
CAMPAK
RUBELLA
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
2 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
21 20 17 21 6 4 20 21 18 21 13 11 10 10
BOOSTER
BOOSTER
CAMPAK
DPT
RUBELLA
L P L P
1 1
1 1
1 1
1 1
1
1 1
1 1
1
1
1
1
1
2 4 7 5
NO REGISTER JAMINAN
NO TGL NIK
BARU LAMA BPJS UMUM
1 01-12-2023 606/23 V
2 607/23 V
3 12-04-2023 608/23 V
4 05-12-2023 3175062810230001 609/23 V
5 610/23 V
6 317506020291430 519/23
V
7 547/23 V
8 441/23 V
9 576 A / 23 v
10 564/23 V
11 501/23
V
12 565/23 V
13 3175062607230005 465/23 V
14 3175062308230013 545/23 V
15 3175064112220004 99/23 V
16 3175061804230010 244/23 v
17 3175062004230003 222/23 V
18 7-12-2023 3578255604220003 611/23 V
19 612/23 v
20 1222010602230001 221/23 V
21 239/22
3175065009990002 V
22 133/22
3175061203220004 V
23 3175062107230004 479/23 V
24 3175060308230000 557/23 V
25 3306011509120773 423/23 V
26 3175065909230002 591/23 V
27 182/23 v
28 552/23 V
29 3175066602230005 152/23 V
30 3175064810210016 382/21 V
31 486/23 V
32 3175065902231005 257/23 v
33 317506609230006 555/23 v
34 08-12-2023 613/23 v
35 614/23 v
36 3513141708230001 615/23 V
37 3211266108230001 616/23 V
38 617/23 V
39 3175062708230002 618/23 v
40 619/23 V
41 620/23 V
42 3175065111230006 621/23 V
43 474/23 V
3328012707230001
44 575/23 V
45 3175066208230003 451/23
V
46 422/23 V
47 434/23 V
3175064609230003
48 435/23 V
49 605/23 V
3175061111230005
50 440/23 V
51 387/23 v
52 564/23 V
3175061306230034
53 526/23 v
54 3175060208230002 481/23 V
55 608/23 V
56 3175061907121021 365/23 V
57 577/23 v
58 3175065211230002 580/23 V
59 3175065907230003 394/23 v
60 3175061011220058 582/23 V
61 590/23 V
62 3174091305230006 300/23 v
63 3175064909230002 484/23 V
64 492/23 V
65 3328012707230001 474/23 V
66 13-12-2023 622/23 V
67 14-`12-2023 623/23 v
68 599/23 v
69 3175062305230008 467/23 V
70 428/23 A V
71 244/22
3171044106220001 V
72 572/23 V
73 3601071007150013 574/23 V
74 538/23 V
75 317506108230018 489/23 V
76 436/23 V
77 139/22 v
3175065901220006
78 433/23 v
3175064308230002
79 110/23 v
80 502/23 v
81 517/23 v
3172041010230006
82 568/23 v
3175065109230005
83 156/23 v
84 3175066308230013 496/23 V
85 332071005220001 264/22 V
86 571/23 V
87 458/23 V
88 3175060410230009 573/23 V
89 570/23 v
90 3175064603230009 180/23 V
91 19-12-2023 625/23 V
92 3175061311230003 626/23 V
93 627/23 v
94 3175061411230002 628/23 V
95 629/23 V
96 630/23 V
97 3216055107230005 442/23 V
98 3175060507230002 368/23 v
99 3602105710870002 578/23 V
100 054/23 V
101 506/23 V
102 602/23 V
103 3175061109230001 504/23 V
104 3175062904230001 276/23 v
105 3175065109230002 503/23 V
106 3175064109230005 579/23 V
107 594/23 V
108 453/23
3175065209230003 V
109 564/23 V
110 336/23 v
111 3175060409230003 505/23 V
112 317506181220006 539/23 V
113 20-12-2023 622/23 V
114 21-12-2023 631/23
115 632/23 v
3207191010230002
116 633/23 v
117 634/23 v
3175060210210012
118 635/23 v
119 591/23 v
3175065909230002
120 402/23 V
7371141810190663
121 161/23 V
122 391/23 V
123 241/22
3175063005220005 V
124 548/23 V
125 148/22
V
126 3175066308230007 445/23 V
127 511/23
128 523/23
3175062008230004
129 583/23 V
130 193/23 v
131 3175065409230001 524/23 V
132 3175062108230004 521/23 V
133 181/22 v
134 404/23 V
3175066305230008
135 450/23 V
136 287/22 YA
1208146803950002
137 456/23
317506090823009 V
138 28/12/2023 3175065008230006 468/23 V
139 636/23 V
140 317506510230009 637/23 V
141 638/23 V
142 639/23 V
143 3175061607230004 449/23 V
144 3175060708230012 392/23 V
145 3175066509230002 527/23 V
146 3175066509230005 596/23 V

147 3175061009100007 140/22 V
148 460/23 V
149 3175061312220003 550/22 V
150 3175060501230012 028/23 V
151 349/23 V
152 3175065008230006 468/23 V
153 3175065709230002 535/23 V
154 317506410230002 597/23 V
155 3175060312210000 598/23 V
156 3175062810230008 551/23 V
157 3175065107230008 325/23 V
158 3175061402230003 108/23 V
159 3175066507230003 543/23 V
160 3175064912890007 287/23 v
161 9404011408230002 510/23 V
162 3175061809230005 513/23 V
163 3175065807230009 383/23 V
164 3175065406230008 466/23 V
165 146/23 V
166 418/23 V
JK/UMUR
L P
Indah Pertiwi / Muhamad

Zakiya Fajriani Rahma ### 28 Hr
Maulana Abdul Malik
Novia Sukma Ayu / Andrian

Azriel Simanjuntak ### 9 Hr
Simanjuntak
William Zane Simbolon ### 26 Hr Vini Simatupang / Jefri
M. Fathan Hafizuan ### 1 Bln Nur Muzdalipah / Abdullah
Asma Nabillah / Indra

Helen Nabillah ### 12 BLN
Nandika
Nurul Fajriah / Rio

Nadindra Hanin Ardiansyah ### 3 Bln
Ardiansyah
Fathia Rana Lusiana ### 1 Bln Wahyubi / Fatara Adi
Andriani Hutabarat / Elifati

Givany Buanathania 2-9-2023 2 BLn
Zedrato
Muhammad Fatih Rahman 4-11-23 1 bLN Muniroh / Saroni

Hamanda Syahrani / Agung
Aleena Masya Kyara 4-11-2023 1 Bln
Maulana
2 Bln Dini Handayani / Sopani
Oktavia Revania ###
Zahira Putri Jasmin 4-11-2023 1 Bln Fitriyatul Ummah / Fardillah

Rafathan Naufal Irwan 26-07-2023 5 Bln Dian Haryanti / Heri Irawan
Muh Iqdam Assyadzili ### 3 Bln Nida / Dede Sulaiman
Syafazea Kayla H ### 12 bln Irmay / Dodi Prasetyo
Adlan Ramadhan ### 8 Bln Indah Lina / Yunet Saputro
Elfathan Ramadhan 20-4-2023 7 Bln Dwi Siti Fajar / Aryanto
Risha Novia Haryadi /

Nazla Parveen Aurora 16-4-2022 19 Bln
Fawwaz Hilmi
Adelia Putri ### 2 hr Kurniawati / Ali Syarif
Erlitatul/Ahmad Rifai
Syifa Azzahra 30-5-22 18 Bln
Sri Silastri Ningsih / Fahmi
21
Hidayat
Afzal Athallah 3/12/2022 Bln
St. hidayati / Ahmad

Alana syabilla rahma ### 3 Bln
Ramdani
Gefira Jazila 29-08-2023 4 Bln Sumarti / Buang Sudiono
Rebecca Nathania ### 9 Bln Santa Lucia / Daud Alfred

Ceisya Azifah Putri ### 2 Bln Resi Mulyawati / Muh Faisal
Asyifa Shaquena Ahmad ### 10 Bln Aulia Rahma / Ahmad Sefi
Ratu Zoeya Shannum ### 25 Bln Nurul / Riko
Margaretha / Arkies
Ve Ahavta Elohecha 19-2-2023 9 Bln
Apriyandi
Talia Maulida Rizkiyah ### 3 Bln Mirna Wati Dewi / Muh Amar
Aqila Fitria Sahara ### 1 Bln Tiara Kiminitsu / Sahrul
Muh Keenan ### 4 Hr Cindy Hermalia / M. Yunus
Naulia Kartika Sari / Setya

Setya Athariz Siswanto 8/17/2023 4 Bln
Adit
Yarif Nawas MUTTAQIN ### 3Bln Novianti / Rahmat
Muh Rifqi Barra ### 2 Bln Ely Erlina / Muh Iqbal
Fathir Ahmad Azzamy ### 4 Bln Delia / Ahm Fauzi
Nadin Saputri ### 11 bln Iis Dahlia / Irwansyah
Aat Syoffaturrahman / Dani

Nadhira Nahla Ardhani ### 2 Bln
Rosdiana
Alesta Putri Yumna ### 1 Bln Ida Komaria / Azhari

Fadhel Hanan Nurhidayat ### 1 bln Fitri Indriati / Feri Nurhidayat
Yatimah / Toha
Agustiah Aretha Varadisha ### 4 Bln
Denhar
Lastioro Tamba / Khotman

T
Ivani Romarito Pandiangan 6-9-2023 3 bln
Shabila Saputra ### 1 Bln Dewi Sri / Paino

E. Siregar
Ameesha Eka Kalf ### 6 bln DEBBY/ALFLON
Nova Pettyana / Fahmi

Queensha El Shanum ### 1 Bln
Rosyid
Ariq Razka 9/19/2023 3 Bln Surwanti / Alfajri

Murdani
William Zane Simbolon ### 1 Bln Vini Simatupang / Jefri
Hanum Ardiana Defa 8-11-23 1 Bln
Ardiansyah
Syahrotus Shyta ### 1 Bln Sohibah Isyah / Afi

Dzakia Zia Muhaya ### 5 bLN
Muhammad Rohim
Aliska Cesya Qristina 7-11-23 1 Bln Irma Deswita / Khaerunnas
Tiara Ayuning Tias / Rahmat

Rathtya Zea Humatra 08-11-2023 1 Bln
Kusmanto
Yunita Sukitoamidjo / Zainal

Xavia Chaiza Anzani ### 3 Bln
Abidin
Devi Lestiawati /
Rudiansyah
Rodhiyah / Hendra
Attharaskha Alfatir Mahendra 8-12-2023 5 Hr
Hardiyanto
Kenneth Gavryle Tan 22-1-2023 9 Bln Rani Agustini / Brin Sudarso
Alka Fayda Syahira ### 2 Bln Reza Sintya / Januari
23-05-2023 Miftah / Akbsr

Gavian Narendra Al Cantara 7 Bln
Ida Friska Angel / Tumbyr
Helen Situmorang 8-8-2023 4 Bln
Rejeki Situmorang
Melisa / Wahyu Adam

Aishwa Palestine Saddam 01-06-22 18 Bln
Jayful Noel Timothy 9-10-2023 2 Bln Sylvia / Fransistus
Yardan Auliga M ### 3 bLN Yuli / Amin
Barra Chairansyah ### 2 Bln Novita Sari / Bayu Indra
Risinina Aulia / Fajar

Althaf Mustahar ### 4 Bln
Cahyono
23 Putri Nuryati / Adji Surya

1/19/2022
Faradisa Almeera Bagya Bln Bagya
Agista Naura 3-8-2023 4 Bln Hasanah / Aripin
Bahtiar Zaynuary ### 18 Bln Nurhalimah / Mulud
Desy Yuliarni / Rendi

Shaquinna Ameena 8-10-2023 2 Bln
Septian
Muhammad Hamzah ### 2 bln Shapia / Ridwan
Devanie Richel Alkhaleena 11-9-2023 3 Bln Rizka / M. Eko
28-2-2023 9 Bln Kharina / Jony Setiawan

Jenneva Raqeesha
Mikayla Prameswari Humaira ### 4 bLN Lutfianita Popple / Dimar
Muhammad Faizar Al Hanan ### 19 Bln Titik Mardiyati / Arfin Asanto
Almahyra Azzahra 5-10-2023 2 Bln Yanti / Ujung
Susi Supriyanti / WAHYU

Raisa Umairoh Hidayatullah ### 12 Bln
hIDAYAH
Sakha Arkan Wiratama ### 2 Bln Sella Khusulyah / Sodiq
Muh Ridho Alrasyid 9-10-2023 2 Bln Restianah / Abd. Rahim
Yumna Safwara ### 9 Bln Dora W.P / Azwar Efendi
Amelia Indira 15-3-23 9 Bln Dewi Solaviona / Asee
Muh Fauzan ### 1 Bln Royanah / Zaenal
Deff Izz Xander 2-12-2023 17 Hr Ikas Alawiyah / Dian Darima
Anah Istianah / Taufik

Muh Elzio Atharazka ### 1 Bln
Ibrahim
Syifa Sukmawati / Saiful
Syifa Aira Sukmawati ### 2 Bln
Bahri
Suci Mulia Ningsih / Budi
Nazira Syafa ### 7 Hr
hendta
Goessera Putri / A.
Clemira Elfesya Asa ### 5 Bln
muhaimin
Ilfi Zakiah ### 5 Bln Hani / Dedi

Attar Alfarizky ### 12 Bln Marni / Ade Suherdi
Tania Salsabila Agustin ### 4 Bln Ayu Sulastri / Dede Arifin
Aylin Tisha Eiliyah ### 1 Bln Putru Megatan / Rizki Fajar
Arkana Albyanadra Putra 11-9-23 3 bLN Supriyatin / Moch Idris
29-4-2023 8 Bln Dewi Arsyanti / Rendi

Muhammad Kenizio Saputra Saputra
Khadijah Aminah ### 3 Bln Wiwin / Kaedi
Salsabila Agnia Putri 1-9-2023 3 Bln Rasih / Imam
Syakilla Maura Khanaya 16-11-2023 1 Bln Sari Suryawati / Sofian Sauri
3 Bln
Nuaira Hibatillah Lesmana 9/12/2023 Riska M / Allen Lesmana
Hamanda Syahrani / Agung
Aleena Masya Kyara 4-11-2023 1 Bln
Maulana
By Ny AMBAR 22-7-23 5 Bln Ambar PA / Ulun Mubarak
Kaivan Pradipta Wijaya ### 3 bln Yulinar / M. Ibnu
Muhammad Rayyan D ### 1 Bln Dwi Fujiastuti / Ruli Ripaldi
Rodhiyah / Hendra
Attharaskha Alfatir Mahendra 8-12-2023 12 hr
Hardiyanto
Alvan Dwi Zeeshan ### 2 Bln Arischa Dwi / M Mufroil
Amira Kharina 12-12-23 7 hr Nurhayani / Agus Widiyarto
Arfathan Khalifano Arsyad 5-10-2021 24 Bln Siti Mariatul / Irwansyah

Yunita Eka Putri / Aditya
Reyhan Raditya Zein ### 17 hr
Febrian
Zunaira Zania Fatuh 20-7-23 5 Bln Nurul Magrifah / DZ Ulfatuh
### 7 Bln Khuzemah / Riko

Fathian Saddam
18 Ayu Fitriyani / Hendi

Putra Hanan Pahlevi 30-05-22 Bln Andriandyah
Muhammad Fathan Arizta ### 2 Bln Deddek / Yoga Arista Ramad
KEENARA 6-3-22 21 Bln JENI/DR,YUDHI
Almahyra Shanum 23-8-2023 4 Bln Ernawati / Hasis Fadilah
Azura Nurainin 7-10-23 2 Bln Elia / Sandi
###
Muhamad Badrut Tamam 9 Bln Buna'ah / Kurtubi
19 Lais Indriyati / Agus

23-05-2022
Hanan Abqory Alfarizqi Bln Purwono
Rosmina Haloho / Benny

### 19 Bln
Yoona Elora Eko
Lis Quratul Aini / Muh

Arsyaka Zayyan Abqary ### 2 Bln
Munzir
Arumi Anastasia ### 2 Bln Nur laila / Edri Putra
Wulandari Anggraeni ### 22 Hr Mira Dewi P / Yudi Pramana
Silvia Rahmawati / Nur

Muh Haidar Ataraska ### 2 Bln
Ahmad

Aziel Hasibuan 14-8-23 4 Bln
Hasibuan
H
Deniandra Maulidiya I 9/25/2023 3 Bln Saruni Agustin / Yerri Eka

Suci Puspita Sari dan
Azril Sya'ban Ali Syakir 3/17/2022 19 Bln
Muhamad Yusuf
Natania Cerryl Umairoh 14-6-23 6 bLN Endang / Tutus
Ahmad Abyan Pratama ### 9 Bln
R
Arshafa Nadhira Putri ### 3 Bln Novi Yang / Durty Rizqi
Devy Sintia / Muhammad
Anka Ashiqa Balvy ### 2 Bln
Iqbal
Gemma Putri Sihotang ### 3 Bln Maria Panggabean / Febahril
Muhammad Zaid Azril ### 3 Bln
Muminim
Miscelle Abigain ### 5 Bln Christian Puji / Christoper
Muhammad Omar Affiansyah ### 9 Bln
Apriansyah
Kosasih
Alesha Mysha Andralan ### 9 BlnDinda Novrijal / Venes Andralan
BUKU REGISTER
UNIT POLI KESEHATAN ANAK
PUSKESMAS KELURAHAN CAKUNG TIMUR
TAHU

ALAMAT NO HP
BB PB/TB LK
(Kg) (Cm) (Cm)
Kayu Tinggi 2/6 83873217656 3.1 47 36 36.5 3
Kayu Tinggi 8/3 85770413621 3 50 36 36.5 3
Swadaya 4/2 89637284826 3.1 50 36 36.5 3
Tambun Selatan 8/8 85779526575 4.7 56.5 38 36.5 BCG, POLIO1
POLIO4, IPV1,
Kayu tinggi 47/4 881037549699 8.2 68.5 43 36.5 DS = 10
PCV2
POLIO3,
Kayu Tinggi 1/4 0895324970759 6.2 60 39 36.5
PCV1, ROTA2
Bulak Indah 6/5 85218762188 3.7 52 36 36.5 BCG, POLIO1
POLIO3,PCV2
Kayu Tinggi 7/5 85266640799 5.6 61 39 36.5
, ROTA2
Kayu Tinggi 4/3 089668729981 3.8 49.5 35 36.5 BCG
Buaran 10/02 89665701200 3.1 49.5 35 38.1
4 54 37 36.6 BCG, POLIO1

Bulak Indah 8/5 881024633200
Kayu Tinggi 3/4 88212546449 4 52.5 37 36.5 BCG, POLIO1

POLIO2,
81283987586 5.3 57.3 38 36.5
PCV1, ROTA2
Bulak Indah 2/12
POLIO3,PCV2
Bulak indah 1/5 895376969555 6 59 42 36.5
, ROTA2
Taman
Pulogebang 081296876540 8.6 70.5 46 36.5 DS : 10
RT.08/13
7.5 66 47 36.6 POLIO4, IPV1

Buaran 13/2 083805848520
Gempol 3/1 81387441545 7 69 44.5 36.5 POLIO4, IPV1
Tambun Rengas
085790787393 10.5 82 47.5 36.7 Booster MR
5/7 No. 34
Kayu Tinggi 8/5 0895333081813 3.2 48 43 36.7 1
Taman moder UM 813920440007 8.1 69 45.5 36.6 MR, IPV2 DS = 10
BOOSTER
DPT,
9.6 83 45.5 36.5 DS = 10
BOOSTER
Gempol Rt11/1 081285873626 MR
BOOSTER
DPT,
8.3 73.5 43 36.5 DS = 10
BOOSTER
Kp. Buaran 07/02 087779229641 MR
DPT3,
Tambun Rengas
89603036551 7 61.4 41 36.5 POLIO4, IPV1,
2/8
ROTA3
DPT1,
Kayu tinggi 9/9 8775894903 6.2 63 40.5 36.5 POLIO2,
PCV1, ROTA2
DPT2,
PCV2, ROTA2
Kayu Tinggi 3/9 85362621995 5.5 59 40 36.5
Gempol 16/01 08164398446 7.3 68 43 36.5 MR + IPV2 DS = 10

DPT1, Polio2,
Bulak indah 9/5 85714430798 5.1 58 40 36.5 PCV1,
Rotavirus1
Gempol 2/1 8121924383 8 67.7 44 36.5 MR + IPV2
BOOSTER
DPT,
Kp. Buaran 14/02 081906016962 10.5 84 47.7 36.5
BOOSTER
MR
DPT1, Polio4,
KT 2/11 87831416205 10.9 73 46 36.5
IPV
Kay Tinggi 2/9 085775458749 8.2 68.5 44 36.5 MR + IPV2
DPT1, Polio2,
Tambun rengas 8/ 89637487358 5.3 57 39 36.5 PCV1,
Rotavirus1
Kayu Tinggi 2/4 085890597583 3.3 43 39 36.5
Gempol 9/1 89509375371 2.9 47 37 36.5 2
DPT3,
Tambun Rengas
083848463397 6.5 63.5 41 36.5 POLIO4, IPV1,
9/7 ROTA3
BCG, POLIO1,
Gempol 13/01 81212918507 7.5 62 43 36.5
PCV1
DPT2,
PCV2, ROTA2
BCG, Polio2,
Buaran 9/2 081382626573 6.3 68.5 42 36.7
PCV1
Kandang Sapi
82214658401 4.1 47 36 36.5 BCG, POLIO1
4/6
Tambun Rengas 5 87788521644 4.3 52.8 36 36.5 BCG, POLIO1

DPT3,
PCV2,ROTA2
Gempol 07/01 089652235453 3.6 51.6 33.5 36.7 BCG
DPT2,Polio3,P
6.4 61.5 38 36.7 CV2,Rotavirus
Kayu Tinggi 1/12 081284483982 2
DPT3,Polio4,I
Kayu Tinggi 85719219795 7.4 62 41.5 36.7
PV, Rotavirus2
DPT2,Polio3,P
5.1 58.5 39 36.6 CV2,Rotavirus
Kayu Tinggi 3/9 81346217743 2
DPT2,Polio4,I
Cempaka 7/9 82260668140 5.7 60 38.5 36.6
PV, Rotavirus2
Gempol 13/01 4.7 56.2 56.2 36.7 BCG
DPT2,Polio3,P
Gempol 16/01 5.4 59.5 39.5 36.6 CV2,
Rotavirus2
DPT3.Polio4,I
KANDANG SAPI 089670122543 5.9 64 39 36.5
PV, Rotavirus3
Buaran 6/12 81932485592 4 52.7 37.5 36.5 BCG
Gempol 4/1 083877043458 5.1 60 39.5 36.7 DPT1

Tambun Selatan DPT3,Polio4,I
081297100255 9 68 42 36.5
4/8 PV, Rotavirus2
Swadaya 4/2 89637284826 3.3 50 36 36.5 BCG, POLIO1
DPT3.Polio4,I
Gempol2/1 81584522053 6.1 63.2 41 36.5
Tambun Selatan PV, Rotavirus3
089520099631 4.5 58 38 36.5 BCG
5/8
Kayu Tinggi DPT3.Polio4,I

087876550108 7.5 65 43 36.5
10/09 PV, Rotavirus3
Kayu Tinggi 8/9 81374868333 3.8 52 35 36.5 BCG
Karang Taruna 3/9 081223199928 3.4 48.5 36 36.5 BCG

DPT3.Polio4,I
Kayu Tinggi 8999191484 7.7 63 45 36.5
PV1
DPT2,
PCV2, ROTA2
DPT2,
Kayu tinggi 5/3 882249465134 5 58.3 39 36.6 POLIO3,
PCV2, ROTA2
DPT3,
PCV2, ROTA2
Kayu Tinggi 2/6 89623368223 3.2 49 34 36.5 2
JGC 13/04 081280088878 8.1 71 43.5 36.5 MR + IPV 2 DS = 10

DPT1,
Kayu tinggi 2/12 81212418142 4.1 54.4 35 36.5 POLIO2,
PCV1, ROTA1
DPT3,
6.1 62 41 36.5 POLIO4,
DPT3,
Cempaka 81316178069 5.8 58 41 36.5 POLIO4,
PCV2, ROTA3
8.2 75.2 42 36.5 MR, IPV2 DS = 10
Gempol 12/01
DPT1,
Harapan indah 8999196529 5.4 56.5 37 36.5 POLIO2,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
DPT1,
Kandang Sapi
085710964112 5 55.2 38 36.6 POLIO2,
04/06
PCV1, ROTA1
DPT3,
Buaran 9/2 89633431414 8.8 67 43 36.5 POLIO3,
ROTA3
DPT2,
PCV2, ROTA2
Booster MR
Bulak Indah
085695162132 11.7 81 46 36.5 dan Booste
09/05
DPT
DPT3, Polio4,
Gempol 3/1 081280120007 6.3 59.4 43 36.5 IPV,
Rotavirus3
Booster MR
Kayu Tinggi 87802836080 7.9 73 44 36.5 dan Booste DS = 10
DPT
Gempol 4/1 081282568636 5.2 56 38.5 36.5 DPT1
DPT1,
Rorotan 11/04 0895615787363 6 59 39 36.5 POLIO2,
PCV1, ROTA1
DPT2,Polio3,
Kayu Tinggi 8/6 81513382090 7.2 60.3 40 36.5 PCV2,
Rotavirus2
Kayu Tinggi 2/9 085351209685 6.7 67.5 42 36.5 MR + IPV DS = 10

DPT3, Polio4,
Gempol 12/1 83898385819 5.1 62 39 36.5 IPV,
Rotavirus3
BOOSTER
Gempol 07/01 081901926688 8.88 74 47 36.5
DPT
DPT1,
Kayu Tinggi
81289198146 4.8 56 39 36.5 POLIO2,
10/09 PCV1, ROTA1
Gempol 4/1 895322232915 7.2 70 41 36.5 DS = 10
DPT1,
Tambun Selatan 9/8 81929494004 6.3 57.3 40 36.5 POLIO2,
PCV1, ROTA1
DPT1,
PCV1, ROTA1
Kay Tinggi 2/4 081285262606 9.6 68.5 44 36.5 MR, IPV2 DS = 10
Um 12/03 85715252222 7.1 64 38 36.5 BCG, POLIO1 DS = 10
Kayu tinggi 11/06 4.2 54 36 36.5 BCG
Buaran 3/2 87741694355 4.1 51 36 36.5 3
Kayu Tinggi 6/4 85956573094 4.2 51 37 36.5 BCG

DPT2,
Rusun ujung
85743463141 5 60 40 36.5 POLIO3,
menteng
PCV2, ROTA2
Gempol 13/01 08965253``97 2.9 49 34 36.5 2
Rorotan 5/8 85722909010 6.8 65 42 36.5 DPT3

DPT3,
ROTA3
DPT3,
PCV2, ROTA2
Kayu tINGGI 2/4 8.3 68 49 36.5 PCV3 DS = 10
DPT2,
PCV2, ROTA2
Pagar Jati 15/01 87888355111 4.1 53 35 36.5 BCG, POLIO1
DPT2,
PCV2, ROTA2
Gempol 4/1 7.3 66 44.5 36.5 DPT3
0895412742770
Kayu ,Tinggi 1/4 831271343336 5.1 60 35 36.5

DPT2,
Gempol 4/1 81292821062 5.9 61 40 36.5 POLIO3,
PCV2, ROTA2
Tanjakan Auri 11/ 81382238038 4.3 55 38 36.5 BCG
DPT1,
4.5 57 39 36.5 POLIO3,
Pagar Jati 15/11 85693373318 PCV2, ROTA
Buaran 10/02 89665701200 3.5 51 39 36.5 BCG
DPT1,
PCV2, ROTA
DPT2,
PCV2, ROTA2
Tambun Selatan 9/8 087826116981 6.9 72 44 36.5
Kayu Tinggi 2/6 89623368223 3.4 42 35 36.7 3
BCG, Polio 2,
Tanjakan Auri
081292909286 6.2 59 41 36.7 PCV 2,
10/01 Rotavirus 1
Gg. Bingung 7/6 08210307299 3.1 49 40 36.5 2
Booster DPT,
Jl. Garuda 2 13/6 081318557419 11.8 83 49 36.7 DS = 10
Booster MR
Tambun Rengas 5/7 08992520427 2.1 46.5 35 36.7 3
DPT1,POLIO3
Kayu Tinggi 3/9 85362621995 6 61 40 36.7 , PCV2,
ROTAVIRUS2
POLIO4, IPV1,
Swadaya 12/01 8114491118 6.3 61 36 36.5
ROTA3
BOOSTER
DPT,
Gempol 15/1 89508441674 9.8 78 46 36.4
BOOSTER
MR
DPT2,
Cempaka II 5/09 81292469067 5.9 59 42 36.5 POLIO3,IPV1,
ROTA3
BOOSTER
Kandang Sapi DPT,
13 78 42 36.5 DS = 10
10/06 081282895102 BOOSTER
MR
DPT`,
Perdana VI 82246117898 6.4 68 39 36.5 POLIO2,
PCV1, ROTA1
BOOSTER
DPT,
10.9 78 46.5 36.5 DS = 10
JGC CLUSTER ZEBRINA BOOSTER
MR
DPT2,
Gempol 11/01 82125995699 5.8 60.5 38 36.5 POLIO3,PCV2
,ROTA2
Balai Rakyat 2/4 85882522786
DPT2,POLIO4
Jl. Cempaka 6/9 081311457442 6.2 64 41 36.5 ,IPV,ROTAVIR
US3
DPT1,
PCV1, ROTA1
8.2 70 44 36.5 MR, IPV2 DS = 10
Kayu Tinggi 6/4 081513924065
DPT1,
Gempol 9/1 087787367588 5.9 60 39 36.5 POLIO3,
PCV2, ROTA2
DPT1,
Tambun Rengas
083852440877 6.3 59.5 40 36.5 POLIO3,
10/07 PCV2, ROTA3
BOOSTER
DPT,
KT 12/01 081808940755 7.9 72 44 36.5
BOOSTER
MR
Kav, Barokah
82257019991 6.5 61 41 36.5 DPT3
Sapi 8/12
JL. Balai Rakyat POLIO3,
87875240372 7.7 60 39 36.5
1/4 PCV2, ROTA2
BOOSTER
DPT,
Cempaka Elok 4/9 081397347989 10.5 82 46 36.5
BOOSTER
MR
DPT2,
6.8 63 41 36.5 POLIO3, IPV1,
Kayu Tinggi 3/11 85817030365 ROTA3
DPT2,
Kayu Tinggi 87881907699 6.8 64.5 41 36.5 POLIO4, IPV,
ROTAVIRUS3
DPT1,
Tambun Rengas 5 81316056640 7 62 39 36.5 POLIO2,
PCV1, ROTA1
DPT1,
Kandang Sapi 7/6 89611596585 4 55 38 36.5 POLIO2,
PCV1, ROTA1
Tambun Selatin 4/ 89668096103 3.3 50 34 36.5 3
DPT1,
Tambun Rengas 0 89534990300 5.4 58 39 36.5 POLIO2,
PCV1, ROTA1
Tambun Rengas
85883206862 8 66.5 41 36.5 DPT2, ROTA2
10/7
DPT2,
Kayu Tinggi
8817790844 6.9 64 42 36.5 POLIO4, IPV1,
13/09
ROTA3
DPT1,
Cempaka Elok
081296237636 6.5 57 37 36.5 POLIO3,
No.71 PCV2, ROTA2
DPT2,
Kayu Tinggi
83891601625 5.9 59 39.5 36.5 POLIO3,
13/09 PCV2, ROTA2
Rt 004/Rw 009, DPT,
089530740082 10.2 75 45 36.5 DPT2,
Kelurahan BOOSTER
Rorotan 2/4 89620481868 5.7 63 43 36.5 POLIO4, IPV1, DS = 10
Bulak Indah ROTA3
895619114506 8.7 75 44 36.5 PCV3 DS = 10
05/05
Kayu Tinggi 3/5 085715201742 8 68 41 36.5 MR, POLIO4
Cempaka I dalam DPT3,
085956690338 6.9 65 43 36.5 DPT3,
13/9 Rotavirus3
Kayu Tinggi 87881907699 6.8 64.5 41 36.5 POLIO4,
DPT1,IPV1,
Kayu Tinggi 3/4 89531487230 5.2 57 38 36.5 ROTA3
POLIO3,
DPT1,
85782231290 5.3 58 38 36.5 PCV2, ROTA2
POLIO2,
DPT1,Polio3,
Kayu Tinggi /9 81287805866 5.6 56 39 36.5 PCV1, ROTA1
PCV2,
DPT1,
Tambun Rengas 5/7 83813599679 4.9 58 38 36.5 Rotavirus2
POLIO2,
DPT3,
PCV1, ROTA1
Jl. Cempaka 06/09 082155483489 5.7 60 40 36.5
Rotavirus3
Bulak Indah 9/12 81382006055 8.8 73 46 36.5 MR, IPV2
DPT2,Polio3,
Inspeksi 2/3 87887883736 5.8 59.5 38 36.5 PCV2,
Gempol 12/01 08561051807 10.2 70.5 46 36.5 Rotavirus
MR, IPV2 DS = 10
DPT3, Polio4,
JL. Balai Rakyat 11/01 8134339144 7.4 65 43 36.5 DPT1,
IPV1, ROTA3
Gempol 11/01 89678041000 5.3 57 40 36.5 POLIO3,
KAYU TINGGI RT3/9085715262449 6.1 62 41 36.5 PCV2, ROTA2
DPT3
DPT2,IPV,
Kayu Tinggi 4/3 85770256056 8.2 69 42 36.5 DS = 10
Rotavirus3
Kayu Tinggi 2/11 81284770934 7.4 67 43 36.5 MR , IPV2 DS = 10
DPT3, Polio4,
kayu Tinggi 2/11 81333327030 7.2 68 42 36.5
IPV1, ROTA3
EGISTER
SEHATAN ANAK
AHAN CAKUNG TIMUR
TAHUN 2023
KETEPATAN
WAKTU OBS KUNJUNGAN
TEPAT DJB RR
(x/mnt) (x/mnt)
12-12-2023 RS Resti Mulya 2.7 138 38
12-12-2023 RS Resti Mulya 2.9 140 40
RS Islam
12-12-2023 2.6 138 38
pondok kopi
V V 04-01-2024
V V 12-12-2023
V V 12-12-2023
V V 04-01-2024
V V 12-12-2023
V V 12-12-2023
V V 04-01-2024
V V 04-01-2024
V V 04-01-2024
V V 12-12-2023
V V 18 Bln
V V 12-12-2023
V V 12-12-2023
V V Lengkap
V V 12 Bln
V V Lengkap
V V Lengkap
V V 04-01-2024
V V 04-01-2024
V V 04-01-2024
V V 12 Bln
V V 04-01-2024
V V 12 Bln
V V Lengkap
V V 04-01-2024
V V 12 Bln
V V 04-01-2024
RS Pekerja 2100 132 40
RS HJ 2700 140 38
v v v 9 Bln
v v v 11-1-2024
v v v 11-1-2024
v v v 11-1-2024
v v v 11-01-2024
v v v 11-1-2024
v v v 11-1-2024
v v v 11-1-2024
v v 11-01-2024
v v 9 Bln
v v 11-01-2024
v v 11-1-2024
v v v 11-1-2024
v v v 11-1-2024
v v v 9 Bln
v v v 11-1-2024
v v 11-01-2024
v v 9 Bln
v v 11-01-2024
v v 9 Bln
v v v 11-1-2024
v v v 11-1-2024
v v 9 Bln
v v v 11-1-2024
v v v 11-1-2024
v v 9 Bln
v v v 11-1-2024
v v v 11-1-2024
v v v 11-1-2024
RS 3.2 138 38
v v v 18 Bln
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
12 Bln
v v v
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
Lengkap
v v v
9 Bln
v v v
Lengkap
v v v
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
18 Bln
v v v
9 Bln
v v v
LENGKAP
v v v
16-01-2023
v v v
16-01-2023
v v v
16-01-2023
v v v
12 Bln
v v v
18-1-2024
v v v
18-1-2024
v v v
RS Resti 3.6 120 40
18-1-2024
v v v
18-1-2024
v v v
RS Resti 2.9 118 40
9 Bln
v v v
9 Bln
v v v
18-1-2024
v v v
18 Bln
v v v
18-1-2024
v v v
18-1-2024
v v v
18-1-2024
v v v
9 Bln
v v v
18-1-2024
v v v
18-1-2024
v v v
18-1-2024
v v v
18-1-2024
v v v
18-1-2024
v v v
18-1-2024
v v v
23-01-2024
v v v
4-1-2024 RS Resti Mulya 3.1 132 40

v v v
lengkap
v v v
RS Firdaus 1.9 135 40
v v v
LENGKAP
23-1-2024
LENGKAP
LENGKAP
23-1-2024
V V 23-1-2024
V V 23-1-2024
V V 12 Bln
V V 23-1-2024
V V 23-1-2024
V V LENGKAP
V V 9 Bln
V V 23-1-2024
V V LENGKAP
V V 23-1-2024
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
RS Firdaus 3.1 132 40
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V LENGKAP
V V 30-1-2024
V V 18 Bln
V V 30-1-2024
V V 9 bln
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V 30-1-2024
V V 9 bln
V V 12 Bln
V V 30-1-2024
V V 12 Bln
V V 9 bln
V V 30-1-2024
V V 9 bln
V V 30-1-2024
V V 12 Bln
V V 9 bln
AN RESIKO
BAYI
SHK BELUM
PUPUT
NCB SMK KN3 usia
V V V V V V
28 hr
NCB SMK KN3 usia

V V V V V V
9 hr
NCB SMK KN3 usia

V V V V V V
26 hr
V V
V V
V V
dermatitis V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NCB SMK KN 1
dengan Ikterus V V
Kramer 1
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NKB KMK dengan

v v v Kranial Duct v v
Obstruktif
NCB SMK KN2 usia
v v v 4 hr dengan ikterus V V
kramer 1
V V
V V
V V
V V
V V
V V
V V
V V
v v
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NCB SMK KN2 usia
v v v 5 hr dengan ikterus V V
kramer 1
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NCB SMK KN3 usia

V V V V V V
17 hr
V V
V V
NCB SMK KN2 usia
V V V V 7 hr dengan ikterus V V
kramer 1
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NCB SMK KN 2
v v v dengan Ikterus V V
kramer 1
V V
NKB KMK KN 3
v v v V V
usia 17 hr
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
V V
NCB SMK KN 3
v v v
dengan usia 22 hr
MANTOUX
CUCI KET
TANGA APD TB 1 2
MTBS GIZI NILAI SOP
N L P L P
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
v V V V V
V V V V
V V V V
V Febris
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V Dermatitis
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
v v v v v
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
v v v v
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
by. M Usia 4
V bln dg gizi
kurang
V V V V
V V V V
by. R Usia
12 Bln
V dermatitis
tunda
imunisasi
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V V bayi influenza ditunda
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V BGM
V V V V
V V V V
V V V V
V V V V 1
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
V V V V
0 0 2 3
KUNJUNGAN KUNJUNGAN
( USIA 0-11 (Usia 12- HB0 (0<7
Bln) 59 Bln) HR)
3
L P L P L P L P
L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
5 2 0 0 0 0 0 0 9 14 16 15 9 19

1 1
1
1
1 1
1 1
1 1 1
1
1
1 1
1 1 1
1
1 1
1 1 1
1 1
1 1 1
1 1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1 1
1 1
1 1 1
1
1 1 1
1 1 1
1
1
1
1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1
1
1 1 1
1
1
1
1
1
1
1
1
1 1 1
1
1
1
1
1 1 1
14 11 5 7 12 10 12 20 18 12 16 14 6 5
an Imunisasi
CAMPAK
RUBELLA
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1 1
1 1
1 1
1 1
1
1
1 1
1
1
1 1
1 1
1
1
13 11 14 21 2 0 11 7 15 22 13 13 8 5
BOOSTER
BOOSTER
CAMPAK
DPT
RUBELLA
L P L P
1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
8 4 6 5
jan 21 15 18 22
feb 20 11 26 0 1 2
maret 13 20 26 0 0 4
aprl 7 12 13 0 0 1
Mei 20 17 27 0 0 3
Jun 11 12 26 0 0 2
92 87 136 22 1 12
179 111
0 1 2 16 7
2 7 4 0 0
1 7 1
5 5 5
1 4 8
9 24 20 16 7

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NO REGISTER JAMINAN

104 3175060211220004 037/23 V

152 31752043007220007 045/23 V

NAMA ANAK TTL NAMA ORANGTUA

Arkana Dwi Hermansyah 21-11-2022 1 Bln Mei Kristines / Danu Hermansyah

Galih Estiawan 21-12-2022 15 hr Mufiatun / Mulyono

Zenia Asyifa Mecca 6/17/2021 19 BlnRahma&Syahrul

Muhammad Adib Al Muqid 6-1-23 10 hr Murtani /Muniroh

Darren Zio Maulana 9-1-23 8 hr Yasinta / Irsyad Ahmad

Ellena Oinke 12-1-2023 7 Hr Christine / Yaaro Ha

Haidar Maulana 02-11-2022 2 Bln Nurjanah / Echo Ujisucipto

Isma Dzaka Dzulhanan 30-07-2022 6 Bln Ina Reni / Alikhin

Rasya Alhafidzan 12-10-2022 3 Bln Siti Nurlaila / Hafif

Alkalfi Zikri Mumiaz 19-11-2022 2 Bln Nuraini / Samsul

Khaira Jovita 04-07-2022 6 Bln Emma Ayu Lestari / Muhammad Qos

kp. Buaran 02/02 089637441598 5.1 56.0 37.0 36.6 BCG

Tambun Rengas Rt.02/07

Buaran 01/02 081212542529 3.2 49 38 36.7 3

Gempol 2/11 81398264526 7.1 65.3 41 36.5 IPV1, PCV1

Kayu Tinggi 7/5 082260732498 7.8 65 44 36.5 PCV2

GEMPOL RT9/RW1 081905977768 8.7 72 43 36.5 IPV2, MR

14-2-2023 RS Resti Mulya 3040

V 14-4-2023 RSIA Resti 3.8

V 09-02-2023 PMB Surki 3.5

1 02/02/2023 56/23 YA Ziya Arsyila Alfarizki

2 57/23 YA Zakira Annika Ahmad

3 3175062011220005 58/23 YA Yosia Meshach Gultom

4 319/21 YA Alesha Alifa Habatillah

5 422/21 YA Alvaro Matthew Silalahi

6 001/23 YA Boy Matthew Latumeten

7 562/22 YA Arkana Dwi Hermansyah

8 3175064711220007 533/22 YA Micha Salwa

9 150/22 YA Ester Jovanka Rotua Nauli

10 412/22 YA Hanum Rumaysa Jiova

11 553/22 YA Abdul Malik Abbas

13 3175061010220001 441/22 YA Hamid Ali Ardi

14 003/23 YA Prince Novmender

15 367/21 YA Gibran Firmansyah

16 411/22 YA Ifra Mikayla

17 07-02-2023 059/23 V Ahmad Najib Baihaqi

18 060/23 V Abizar Rifki Saputri

19 061/23 V George Immanuel Dn

23 065/23 v Gilang Firaz Araska

24 066/23 V Nayla Zulfa Nur Latifah

25 067/23 V Miroslav Antonius

41 013/23 V Muhammad Alwi

122 28-02-2023 317506260123003 88/23 V Melvin Daffinra Firdaw

123 89/23 V Dewi Aleshs Nareswari

124 3312172801230001 90/23 V Muhammad Nur Arshaka

125 3175062201230006 91/23 V Zahid Alfarizky

126 92/23 V El London Faturahman

128 3175064701230003 94/23 V Khalisa El Nara

129 95/23 V Muhammad Zayn Alfarizki

130 96/23 V Radinka Fathan Pratama

131 97/23 V Demalik Al Hajj

132 98/23 V Aiza Nur Rihana

133 408/22 V Elsa Camillia Maheswari

134 31750651062100i8 328/21 V Arumi Nasya Salsabila