NAMA UNIT PELAYANAN KESEHATAN

ALAMAT
RUMAH SAKIT
BULAN
TAHUN

JENIS
NO NAMA TANGGAL LAHIR
KELAMIN

1 BY. NY. MARYANIH P 4/7/2019

2 KANA SAIRA P 18/06/2019
3 BY NY NETY PUSPITA S P 15/06/2019
4 RAMZAN KADYROV P 27/05/2019
5 KHALISA ALESHA P 8/6/2019
6 NAISHA HUMAIRA P 10/6/2019
7 BY NY SITI MAESAROH L 9/7/2019
8 BY NY AURORA BENITA L 9/7/2019
9 AZZAM KENZO LELONO L 15/04/2019
10 KAI MALIK DIRAYA L 3/5/2019
11 HAGIA AFIKA SHALIHA P 17/01/2019
12 CLARA ASTA PRAMUDIT P 10/5/2018
13 KENNETH WIKAN AJI P P 13/06/2019
14 FATIHIRO BARAHIMA L L 31/03/2019
15 LOVA NIRMALA H P 5/7/2019
16 SYAHREZA RASHIF R P 6/5/2019
17 M ARKAN L 8/11/2012
18 ELVREDO ADIRAJADA R L 10/9/2018
19 HANNAH MUHALIZAR K P 5/7/2017
20 KAEL ISNAN AR RAFIF L 3/3/2019
21 ALENYKA ATHARRAZKA P 10/7/2019
22 BY NY PUTRI NURUL A P 16/07/2019
23 RELIA EL-QAEDA WARMA P 17/07/2019
24 BY NY MEGA ARTHA T P 13/07/2019
25 FAIZAN AHMAD G L 27/03/2019
26 DINAN SATRIA GUSNI T L 16/01/2018
27 RAJENDRA DZIKRI A L 17/07/2019
28 AZIZAH SHERYLA HARAH P 29/06/2017
29 RUCHITAWANII P 31/12/2018
30 BY NY YANTI LUBIS P 17/07/2019
31 DWIANAKA ABYAZSA L 22/10/2018
32 ALISHA MIKHAYLA P 29/03/2019
33 ANYA NAIRA ANJANI P 21/05/2019
34 DARREL ESHAAL S L 28/10/2018
35 GEMMA GALGANI EMBUN P 10/3/2019
36 BY NY SITI JUBAIDAH L 20/07/2019
37 AYESHA LATHIFA MARWA P 30/09/2018
38 BY NY WIDYA RAHMANDI l 30/09/2018
39 ZAID AHMAD RIADI L 24/06/2019
40 QUEENDY LATHIFAH A P 8/6/2019
41 M. WAVI ADIFAZ L 23/07/2019
42 AXELLE RENNER HESPER L 27/06/2019
43 ALNAIRA ISNANIN P 27/07/2019
44 IBRAHIM ARROYAN L 3/4/2019
45 OLIVIA OKTAVIANI P 8/10/2018
46 ASHEEQA MEDINA P 26/03/2019
47 JASMINE AURORA G B P 21/01/2018
48 ABDALLAH THALHAH U L 30/09/2018
49 RASENDRIA ZHAFRAN EL L 16/09/2017
50 NADWA HUSNANIYAH F P 14/02/2019
51 BY NY DINA RAVINA L 1/8/2019
52 RANIA ILISHA A P 3/8/2019
53 MUHAMMAD SHAQIL R L 1/1/2018
54 AISHA PUTRI KINANTI P 15/05/2019
55 RAIHANA UMAIRA ELSYA P 12/7/2019
56 FATIRA HANINA A P 28/01/2019
57 BY NY SITI MAESAROH L 9/7/2019
58 KAI MALIK DIRAYA L 3/5/2019
59 MARVINO AXEL PUTRA L 30/11/2018
60 BY NY DIAN L 16/07/2019
61 BY NY INDAH L 16/07/2019
62 BY NY WIWIT L 16/07/2019
63 BY NY SITI R P 16/07/2019
64 BY NY ANISA P 16/07/2019
65 BY NY SOPHIA L 17/07/2019
66 BY NY YANTI L P 17/07/2019
67 BY NY SITI J L 20/07/2019
68 BY NY SITI N L 20/07/2019
69 BY NY TIYA L 20/07/2019
70 BY NY ETI M P 22/07/2019
 71 BY NY MICKY S L 22/07/2019
72 BY NY NOVITA SARI L 22/07/2019
73 BY NY NURLAELA L 22/07/2019
74 BY NY ASIH S L 22/07/2019
75 BY NY HAPPY L 22/07/2019
76 BY NY PRITA SARI L 22/07/2019
77 BY NY KUSMARTINI L 23/07/2019
78 BY NY RESTU L 23/07/2019
79 BY NY NENI P 23/07/2019
80 BY NY RENITA 1 P 24/07/2019
81 BY NY RENITA 2 P 24/07/2019
82 BY NY ANI P P 25/07/2019
83 BY NY NURAINI P 25/07/2019
84 BY NY WIDYA L 26/07/2019
85 BY NY LINA YATI P 26/07/2019
86 BY NY ASNAWIYAH L 27/07/2019
87 BY NY HUSNAH L 27/07/2019
88 BY NY YUYUN P 27/07/2019
89 BY NY ANDRIANI P 27/07/2019
90 BY NY SRI M P 28/07/2019
91 BY NY MAEMUNAH L 29/07/2019
92 BY NY MUTIARA SARI L 29/07/2019
93 BY NY NENENG P 29/07/2019
94 BY NY FADYA L 30/07/2019
95 BY NY AINU WARDAH P 30/07/2019
96 BY NY ZULFAH I L 31/07/2019
97 BY NY NINA L 01/08/2019
98 BY NY TRI HASTUTI L 01/08/2019
99 BY NY DINA RAVINA L 01/08/2019
100 BY NY MARYATI L 01/08/2019
101 BY NY FAMELIA P 05/08/2019
102 BY NY QIESTHIC P 06/08/2019
103 BY NY IMAS SAMIASI P 06/08/2019
104 BY NY LILIS L 08/08/2019
105 BY NY INDAH P 08/08/2019
106 BY NY EMBUN L 08/08/2019
107 BY NY EKA R L 09/08/2019
108 BY NY MANADDINA L 09/08/2019
109 BY NY SUSAN SUSANTI P 09/08/2019
110 BY NY EKA F P 10/08/2019
112 BY NY ALIN H = HBSAG + L 13/08/2019
113 BY NY LINDAWATI L 13/08/2019
114 BY NY INNAH L 14/08/2019

TOTAL
TOTAL
 LAPORAN HASIL IMUNISASI RUTIN D

: RAWAT JALAN
: JLN. JOMBANG RAYA NO. 56
: IMC BINTARO
: AGUSTUS
: 2019

NAMA ORANG TUA ALAMAT RT / RW

SAEFUL AZIS KP. SERUA PONCOL RT 02/10 NO. 24

MOH AMIN JL PIPIT KOMP ANITA RT004/002
FADZRIN BAHAR KP.CIPUTAT RT02/05 NO 3
MARYANI KP PONDOK AREN RT 02/012 NO. 34
NANA SUTISNA VILLA BINTARO REGENCY RT/RW 009/012
DENI PERMANA KAVLING KINAYUNANG RT004 RW009
ACHMAD ALIFIANTO JL. BELONG NO. 63
AURORA JL. PRATISTA TIMUR 1 RT. 006/010
ARIE JOKO JL. AKASIA II BLOK B3 NO.7 RT05/07
MAMAN JLTIDORE RT03/17 NO.10 B JOMBANG CIPUTAT
EKA ARISMAN JL.H SOM RT06 RW01
PRADIKA DWI JL BINTARO PARK VIEW A 10005
MARIA GORETI PARADISE SERPONG CITY
M ADHAN L JL KAYU PUTIH TENGAH 111A NO.10
M HILMAN HAZAZI T JL.KEMUNING INDAH 1 BLOK A12 NO.10 PD PU
PRISTYA KP PARIGI NO.40
PUTRI PERMATA JL. SUKA BAKTI III/77 RT. 03/06
ASEP PURNAMA JL. KALI JIUN NO. 112 RT. 002/002
DWI SAYEKTI JL CALLISYTA III BLOK D3/12
DENNY DWI PURI BINTARO HIJAU BLOK B3A NO 8
TANJUNG PUTRA JLN. SUMATERA NO 19 RT 002/002
NY. PUTRI PONDOK MAHARTA BLIK CG. NO.17
SUWARMAN JL. H GADUNG 4 RT.005/003
YUDI IRAWAN KP. PONDOK PETUNG
SIGIT TIAWAN JL. JOMBANG RAWA LELE RT. 003/007
CITRA SARI JL NIAS NO83 RT03/02
RIZKY JOMBANG RAYA RT. 002/003
DARMAWAN JL. PISOK 14 NO 4 BINTARO
R VENGATESH JL MALEO 18 BLOK J E4/9
DEBBY PERTIWI KAMPUNG BULAK PONDOK KACANG TIMUR
DEWI SANTI MALEO 1 JA 2 NO. 26 RT. 001/010
HERRY MURDIYANTO JL.WIRU INDAH RT005/001
ARMANDA MUTIARA JL. BINTARO JAYA NO. 32
FERI SAPUTRA JL. CISAUK PERUM. SABAR
WIDYASARI TAMAN MANGU INDAH A1/9
ALFI AL BASYAR JL. KP RAWA RT 06/12 NO. 20
DONNY DANANJAYA JL JAPOS PONDOK JATI NO.139
WIDYA RAHMANDI JL KEBON KOPI PD BETUNG
RIKI AFRIADI PONDOK MAHARTA BLOK C4/4
TRI MARGIYANTO BINTARO TENGAH BLOK B2. NO.22, JAKSEL
EVASARI JL PERIGI LAMA KP LIO
LYSANDER MERDEKA GRAHA RAYA UTAMA JL.H MADI RT004/001
ALNAIRA ISNANIN JL. BANGKA RAYA RT. 003/011 GG. AMAL. IV
IBRAHIM ARROYAN JL. SD INPRES RT005/006
OLIVIA OKTAVIANI JL JOMBANG RAYANO 53
DENY FIRMANSYAH JL.MELATI RT007/003 BINTARO
BIRANTA PANJI P S PERUMAHAN PONDOK SURYA BLOK O NO 7
ABDALLAH THALHAH U GRAHA BINTARO JAYA GR 38 NO 14
KRISNA S PURI BINTARO INDAH BLOK D5/9
M. ARIEFANDI PERUM KEMBANGLARANGAN JL.BROTOALI RT02/
DINA RAVINA KP. PD. AREN RT.003/002
ADE TITIK JL. OTISTA NO.41 CIPUTAT
H MUHAMMAD RIDWAN UTAMA GARDEN BINTARO
KARTIKO MUHAMMAD JAPOS GRAHA LESTARI BLOK D3/6
RESMAWAR PUTRI KP RAWA LELE RT 02/06 NO. 118
MORINE UTAMI JL ASEM II NO 13 RT001/06, CIPETE
ACHMAD ALIFIANTO JL. BELONG NO. 63
MAMAN JLTIDORE RT03/17 NO.10 B JOMBANG CIPUTAT
YUDHI S PUTRA JL. PIPIT III B4 NO. 15 RT. 004/005
NY DIAN/TN ARIF M SETU RAYA RT 01/06 PARIGI BARU
NY INDAH/TN SUBUR PD KACANG TIMUR RT 03/07
NY WIWIT/TN ABDUL GOPUR JL H RASIAM
NY SITI R/TN RENDI JL KEMIRI 8 RT 02/04
NY ANISA/TN AKHMAD M JL H UMAR NO 56 PD AREN
NY SOPHIA/TN RIZKI PD AREN RT 02/03
NY YANTI/TN MAHYUDIN KP BULAk RT 01/02 PD KACANG
NY SITI J/TN ALIF A JL KP RAWA BARAT RT 09/16
NY SITI N/TN MUJIONO JL GUNUNG RT04/09
NY TIA/TN MULYADI KP GEDONG
NY ETI M/TN BUDIANTO JL WIJAYA KUSAMA 1 BLOK H NO 18
NY MICKY S/TN ISMAIL H BEDONGAN 2 NO 57
NY NOVITA S/TN RAMDANI JL PD SERUT RT 3/3
NY NURLAELA/TN NURDIANSYAH JL KEBON KOPI NO 2 RT 05/04 PD BETUNG
NY ASIH S/TN ADITIYA KOMP PURI BINTARO HIJAU BLOK D2 NO 29
NY HAPPY/TN JAJA JL H YUSUF RT 01/ 09 PENINGGILAN
NY PRITA SARI/TN INDRA K JL SWADAYA NO 51 PD PUCUNG
NY KUSMARTINI/TN M RIDHO JL KASWARI 1 RT 04/05 CIPADU
NY RESTU/TN FAZRULLOH KP LIO GG H ACE RT 04/03 KP PARIGI
NY NENI/TN REZA KP MASJID RT 05/03
NY RENITA/TN DANY JL GRAHA RAYA PARIGI BARU
NY RENITA/TN DANY JL GRAHA RAYA PARIGI BARU
NY ANI P/TN ZAENUDIN JL MANDOR KHAMID RT 01/06
NY NURAINI/TN HERU HERMAN KP PABUARAN BARAT RT 03/03
NY WIDYA/TN ALDI F JL PD BETUNG
NY LINA Y/TN RIKO W JL SUKADAMAI GUNUNG SERUA INDAH
NY ASNAWIYAH/TN FAHRUL H KP GUNUNG CIPONDOH JL H BASIR
NY HUSNAH/TN AHMAD JL CEGER RAYA RT 01 NO 18
NY YUYUN/TN RAMIN JL H SARMAH PD AREN
NY ANDRIANI/TN SIGIT JL BANGKA RAYA GG AMAL 4 RT03/11
NY SRI M/TN IRFAN PURI BINTARO HIJAU BLOK B6 126
NY MAEMUNAH/TN ABDUL A KP PARIGI RT 02/04
NY MUTIARA S/TN RIZAL S JL MESJID BANIROHIM
NY NENENG/TN SAHRUL SIDIK KP BULAK RT 02/02
NY FADYA/ GG MERPATI KP MANGGIS RT 03/04
NY AINU/TN ABDUL ZAKARIA JL NIPAN MUJA NO 74
NY ZULFAH I/TN WAHYU JL H SARMILI JURANG MANGGU
NY NINA/TN FADILLAH PD SAFARI INDAH JL CENDAWASIH
NY TRI H/TN HERI FIRMANSYAH JL GARUF PERIGI
NY DINA R/TN HENDRA KP PD AREN RT 003/002
NY MARYATI/TN SAEFUL PD AREN RT 004/003
NY FAMELIA/TN AHMAD K JL ALBAYINAH 4 NO 56C JOMBANG
NY QIESTHIC/TN INDRA PD MAHARTA BLOK H5 NO 27 RT 010/009
NY IMAS S/TN ROBI PARIGI LAMA RT 001/001
NY LILIS/TN ANDRE A JL JURANG MANGGU RT 002/01
NY INDAH/TN MISNAN KP PERIGI LAMA RT 002/05
NY EMBUN/TN SUMA BINTARA KAMP PU PASAR JUMAT NO 402
NY EKA R/TN ACHMAD S JL PANDA 7 NO 221 RT 005/005
NY MANADDINA/TN PHAUZAN N JL ALTE RAYA NO 60B REMPOA
NY SUSAN S/TN ZULHAM PD KACANG TIMUR
NY EKA F/TN HARYONO GG SARI RT 03/06 PD AREN
NY ALIN/TN M SOFYAN GG MUSHOLAH PD KACANG TIMUR
NY LINDAWATI/TN HAERUDIN KP DUKUH GG SUKMA RT 04/01
NY INNAH/TN NIMROD S KP BULAK RT 01/03 PD KACANG

TOTAL
TOTAL
AN HASIL IMUNISASI RUTIN DI RUMAH SAKIT / UNIT PELAYANAN SWASTA

KELURAHAN ANTIGEN (DI ISI

HB 0 BCG POLIO 1 PENTA 1

SERUA 15/07/2019
PONDOK AREN 15/07/2019
CIPUTAT 16/07/2019
PONDOK AREN 16/07/2019
PONDOK KACANG 16/07/2019
PONDOK AREN 16/07/2019
PONDOK AREN 16/07/2019
PONDOK AREN 16/07/2019
PONDOK AREN 16/07/2019
JOMBANG 16/07/2019
PONDOK AREN
PONDOK AREN
SERPONG 19/07/2019
PONDOK AREN 20/07/2019
PONDOK AREN 20/07/2019
PARIGI 20/07/2019
SERUA INDAH
PARIGI
PONDOK AREN
PONDOK AREN
PONDOK AREN 21/07/2019
PONDOK AREN 21/07/2019
PONDOK AREN 21/07/2019
PONDOK BETUNG 24/07/2019
JOMBANG
 JOMBANG
JOMBANG 2/7/2019
PONDOK AREN
PONDOK AREN
PONDOK KACANG 27/07/2019
PONDOK PUCUNG
PONDOK AREN
PONDOK AREN 27/07/2019
CISAUK
PONDOK AREN
PONDOK AREN 27/07/2019
PONDOK JATI
TANGGERANG 3/8/2019
PONDOK AREN 3/8/2019
PONDOK AREN 3/8/2019
PONDOK AREN 3/8/2019
PONDOK AREN 3/8/2019
PONDOK AREN 3/8/2019
JOMBANG 3/8/2019
JOMBANG
PONDOK AREN
PONDOK AREN
PONDOK AREN
PONDOK AREN
PONDOK AREN
PONDOK AREN 8/8/2019
PONDOK AREN 8/8/2019
BINTARO
PONDOK AREN 10/8/2019
JOMBANG 12/8/2019
PONDOK AREN
PONDOK AREN 13/08/2019
PONDOK AREN
PONDOK AREN
PD AREN 16/07/2019
PD KACANG 16/07/2019
16/07/2019
16/07/2019
PD AREN 16/07/2019
PD AREN 17/07/2019
PD KACANG 18/07/2019
20/07/2019
JOMBANG 21/07/2019
JOMBANG 21/07/2019
PD KACANG 23/07/2019
 22/07/2019
PD KACANG T 23/07/2019
PD AREN 23/07/2019
PD AREN 23/07/2019
CILEDUG 24/07/2019
PD PUCUNG 24/07/2019
CIPADU 24/07/2019
PD PUCUNG 24/07/2019
24/07/2019
PD KACANGN 24/07/2019
PD KACANG 24/07/2019
25/07/2019
PABUARAN 26/07/2019
PONDOK BETUNG 27/07/2019
SERUA 27/07/2019
CIPONDOH 27/07/2019
JOMBANG 27/07/2019
PONDOK AREN 28/07/2019
28/07/2019
PONDOK AREN 29/07/2019
PD PUCUNG 30/07/2019
PD KARYA 30/07/2019
PD KACANG 30/07/2019
PD KACANG 30/07/2019
31/07/2019
JURANG MANGGU 01/08/2019
JURANG MANGGU 01/08/2019
PD AREN 01/08/2019
PD AREN 01/08/2019
PD AREN 02/08/2019
JOMBANG 05/08/2019
PONDOK KACANG 06/08/2019
PD AREN 06/08/2019
JURANG MANGGU 09/08/2019
PARIGI 09/08/2019
CIPUTAT 09/08/2019
CIPUTAT 09/08/2019
CIPUTAT 09/08/2019
PD KACANG 10/08/2019
PD AREN 09/08/2019
PD KACANG 13/08/2019
CIPUTAT 14/08/2019
PD KACANG 14/08/2019

54 64 17 7
54 64 17 7
YANAN SWASTA

ANTIGEN (DI ISI TANGGAL IMUNISASI)

POLIO 2 PENTA 2 POLIO 3 PENTA 3 POLIO 4 MR

15/07/2019

16/07/2019
17/07/2019 17/07/2019

20/07/2019

20/07/2019
20/07/2019
20/07/2019
20/07/2019
20/07/2019 20/07/2019

24/07/2019 24/07/2019
 27/07/2019
27/07/2019 27/07/2019

27/07/2019
27/07/2019 27/07/2019
27/07/2019
27/07/2019
27/07/2019 27/07/2019

27/07/2019

3/8/2019
3/8/2019
3/8/2019 3/8/2019

3/8/2019
3/8/2019
3/8/2019 3/8/2019

12/8/2019 12/8/2019

13/08/2019 13/08/2019
13/08/2019
6 6 7 4 3 11
6 6 7 4 3 11
 BADUTA

PENTA CAMPAK
IDL
BADUTA BADUTA

19/07/2019
2/7/2019

3/8/2019

10/8/2019
4
4