FORMULIR PELAPORAN PEMBERIAN OBAT CACING

POSYANDU SD WARIA
NAMA POSYANDU : SD WARIA
JUMLAH SISWA : 77
BULAN/TAHUN : FEBRUARI 2024

Bulan Lahir/Usia Pemberian Obat Alasan tidak

No Nama Anak Keterangan
diberi/menolak
L P Ya Tidak Tolak
1. Abdulrahman
√
Djutay
2. Aisya Mangar √
3. Alamsyah Mangar √
4. Bahrun Salay √
5. Eka Mangar
6. Felki Lee √
7. Karwan Djerfuy √
8. Marda Surey √
9. Nadira Mangar √
10. Rajap Djerfuy √
11. Ririn Mangar √
12. Rati Mangar √
13. Susy Djerfuy √
14. Anggun Djerfuy
15. Fitria Djerfuy √
16. Irfan Mangar √
17. Hotima Sorloy √
18. Siti M. Djutay √
19. Tasya Noya √
20. Watini Djerfuy √
21. Jesya Komal √
22. Ira Mangar √
23. Ayu A. Djerfuy √
24. Aulia I. Surey √
25. Marjan Djerfuy √
26. Marsa Djerfuy
27. Miya Djerfuy √
28. Moh. Hakiki Djerfuy √
29. Muharam A.
√
Mangar
30. Nasril Djerfuy √
31. Rasty Surey √
32. Ramadany Djerfuy √
33. Santira Djerfuy √
34. Sazkia Salay √
35. Triwi Mangar √
36. Arafi Djerfuy √
37. Budy Wal-wal √
38. Iskandar Salay √
39. Nur Mangar √
40. Musnay Surey √
41. Raisa Djerfuy √
42. Ramadan Djerfuy √
43. Salan Mangar √
44. Wapia Mangar √
45. Fardi Djerfuy √
46. Jakir Djerfuy √
47. Salfatiya Surey √
48. Arfin Djerfuy √
49. Abdula Surey √
50. Nana Dila Djerfuy √
51. Salsabila Hitimala √
52. Awal Wal-wal √
53. Bihan P. Surey √
54. Burhan Wal-wal √
55. Melinda Surey √
56. Novita Djerfuy √
57. Risyan U. Mangar √
58. Asisa Mangar √
59. Junaedi Mangar √
60. Fahril Mangar √
61. Rusman Djerfuy √
62. Amelia Djerfuy √
63. Binto Djerfuy √
64. Haikel Salay √
65. Ajena Surey √
66. Abas Wal-wal √
67. Alya Mangar √
68. Ani Wal-wal √
69. Alfin Djerfuy √
70. Firman Salay √
71. Gia Mangar √
72. Hamitu Djerfuy √
73. Inaya Mangar √
74. Lili Wal-wal √
75. Saiful Mangar √
76. Salim Djerfuy √
77. Rani Djerfuy √

Kobamar, Februari 2024

Kepala Sekolah/ Kader Pengelola Program

……………………………………….. Davpetbhom Apalem, S. Farm

Mengetahui,
Kepala Puskesmas Kobamar

Jackson Y. Rahangmetan, S. Kep, Ns

NIP. 19860501 201001 1 019