Uteun Dama Suppin 2
Uteun Dama Suppin 2
Uteun Dama Suppin 2
Jenis
No. Nama Anak Tgl lahir Umur Kelamin
(L/P)
Aba bakrim 2/3/2011 L
1 11
2 Abidzar al ghifari 5/29/2014 8 L
3 Afra naila 2/18/2014 8 P
4 Ahlul Zikri 8/11/2014 8 L
5 Afifa fitya 2/4/2012 10 P
Amelia Natasya 7/15/2014 P
6 8
7 Anin lia putri 9/9/2013 9 P
8 Ahmad mufaddal 8/16/2015 6 L
9 Ahmad zaki al 11/1/2011 11 L
10 Ahmad tunusi 11/30/2010 12 L
Azkia saufa 10/25/2014 P
11 8
12 AISAH MAHERA 5/22/2012 10 P
13 M.Al farabi 3/9/2014 8 L
Al bilalul arsya 7/2/2013 L
14 9
15 Al munawir 4/8/2011 11 L
16 Alaisa zahra 9/27/2015 7 P
17 Al fiyatul ikramah 11/26/2011 11 P
M.farhana 1/14/2014 L
18 8
Andika saputra 12/1/2014 L
19 8
20 M. ikram 5/27/2014 8 L
21 Asni kaisya 1/19/2012 10 P
22 M.syawal 8/22/2014 8 L
Khairani 12/23/2012 P
23 10
24 Epi aulia 11/6/2011 11 P
25 Fajar maulana 4/3/2010 10 L
26 Fatimah zuhra 3/15/2013 9 P
27 Fatyan almttaqin 5/25/2013 9 L
Hadiyatul hikmah 1/8/2015 P
28 7
29 Hilma shaleha 3/23/2011 11 P
30 Hilma zakia 12/5/2010 12 P
31 Jasmine mauliza 3/1/2015 7 P
Khairul rizal 4/2/2012 L
32 10
33 Nafitul zahda 2/8/2014 8 P
34 Nurma mayani 12/1/2013 9 P
35 Laila rahima 2/3/2011 11 P
36 M. syarief H 8/21/2010 12 L
37 Putri nadila 9/19/2014 8 P
38 Maifire 3/28/2013 9 P
39 Marjanul hikmal 11/10/2009 12 L
40 Rais arzani 11/5/2014 8 L
Maulidia Nanda 2/20/2011 P
41 11
42 Miftahul jannah 6/2/2015 7 P
43 Zazkia nazira 1/15/2014 8 P
44 Misratin nisa 9/17/2013 9 P
45 M.zahin 4/23/2015 7 L
46 Saydatul nafisah 3/20/2014 8 P
47 M.rafiq 2/13/2011 11 L
Siti munawarah 8/23/2014 P
48 8
49 Muhammad 11/30/2015 7 L
M.Al asqi 11/9/2011 L
50 11
51 SAHIBUL IBDAL 11/9/2011 11 L
52 M.ASRAF 8/16/2013 9 L
53 M.AZIZ 8/20/2011 11 L
M.KHAIRUL AZMI 11/19/2014 L
54 8
55 AFDHALUL ZIKRI 5/11/2010 12 L
AFDHALUL ZIKRI 12/4/2011 L
56 11
57 M.FURQAN 4/22/2011 11 L
AIDIL MAULANA 4/1/2013 L
58 9
59 AKLI SABIRUN 9/12/2011 11 L
M.IKRAM 12/4/2012 L
60 10
61 M.IKBAL 9/9/2015 7 L
62 M.IKBAL 4/6/2012 10 L
KHAIRUNNISA 8/2/2009 P
63 12
64 M.JARJANI 7/23/2012 9 L
65 M.MAHDI 9/23/2015 7 L
M.MAULANA 2/1/2013 L
66 9
67 M.NAZAR 3/9/2015 7 L
68 KQAYYIM HAKIMI 4/2/2015 7 L
69 M.RIZKI 4/2/2015 7 L
70 M.RIZKI 5/29/2012 10 L
M.RIZKI 24011-2011 L
71 11
MAHMUDIN 28-03-20012 L
72 10
73 M.ZAKIR 10/30/2009 12 L
74 MULIANA 7/1/2010 12 P
75 MASYKUR 11/1/2012 10 L
ENCATATAN HASIL SUB PIN POLIO PUTARAN KE 2
TEUN DAMA Nama petugas : ENDRIANI
Puskesmas : Peureulak
ID Puskesmas :
Kabupaten : ACEH TIMUR
‘1103072309150001 Juliana -
‘1103160102130001 Maimunah ‘11180343504880001 Blang bate
‘1103070903150001 Mariati Alue 2 paya gajah
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
FORMAT PENCATATAN HASIL SUB PIN POLIO PU
Nama Posyandu/Sekolah/Pos layanan : SDN UTEUN DAMA
Nama Desa/kelurahan : UTEUN DAMA
Tanggal :
Jenis
No. Nama Anak Tgl lahir Umur Kelamin NIK
(L/P)
MIRATUN NAFIS 6/1/2012 P ‘1103074106120001
1 10
MUSYKIATI 7/1/2013 P ‘1103072606130004
2 9
3 MUHAMMAD 4/21/2012 10 L ‘1103072204120002
4 M.FURQAN 8/28/2012 10 L ‘1103072808120001
M.HABIL 4/30/2012 L ‘1103073004120001
5 10
M.IKRAM 6/3/2012 L ‘1103070306120002
6 10
7 NAZILA DESIANA 9/23/2015 7 P ‘1103075112100001
NIZAM MAULANA 6/19/2013 L ‘1103072604140001
8 9
NUR KHALISYA 12/9/2012 P ‘1103075906130002
9 10
M.RIFKI 19-11-20`5 L ‘1103070912110002
10 7
11 NURLIZA 6/10/2011 11 P ‘11030709012110002
12 MUNAWWARAH 1/14/2011 11 L ‘1103075909150001
13 PUTRI NASYWA 3/23/2012 10 P ‘110307471006110001
RAHISAL MAHIRA 8/27/2010 P ‘110318511100001
14 10
RAHMADANI 7/15/2013 P ‘1103076003120003
15 9
16 RAHMATUL LATIFAH 11/19/2012 10 P ‘1103076708100001
MUTIARA 10/6/2015 P ‘1103075507130001
17 7
18 RAIYAN NUSRI 10/7/2013 9 L ‘1103074911120003
19 RAJUL RIFKI 6/21/2015 7 L ‘1103070610150001
20 RIFATUSSAUMA 9/13/2013 9 P ‘1103070710130005
21 RIZA MAHDIRA 12-08-2-12 10 L ‘1103076106150002
22 NADIRA RAHMADANI 7/12/2012 10 P ‘1174025208120001
23 NAILA TUSYIFA 7/17/2011 11 L ‘1103075207120003
24 SAIDUL AKMAL 12/14/2011 11 L ‘1103071707110002
25 SALWA KHALISA 6/25/2012 10 P ‘110307541210001
26 SASKIA RAMADANA 10/7/2012 10 P ‘1103076506120001
27 NANDA SAPUTRA 12/13/2012 10 L ‘1103070710120001
28 NADILA 8/29/2012 10 P ‘11030713121210004
29 RIZKI ANANDA 3/18/2013 9 L ‘1103072908120001
30 SRIMULIANI 5/25/2015 7 P ‘1103075803130001
RISKI ANANDA 8/29/2012 L ‘1103076505150001
31 9
SYAKIRA ANDARANI 12/17/2012 P ‘1103072908120001
32 9
33 SYAKIRA RAHMADANI 7/18/2013 9 P ‘1116045712120002
34 SAMSUDIN 4/19/2011 11 L ‘1103075807130001
35 SYARIFAH MAULIDA 28-02-2012 10 P ‘1103076802120002
SYARIMA ATIKA 10/5/2012 P ‘110307451012001
36 10
37 SARYULIS AZHAR 5/20/2010 12 L ‘1103072005100001
SYIFA MAHERA 6/11/2015 P ‘1103072005100001
38 7
T.MUHAMMAD 7/24/2012 L ‘1103075106150001
39 10
40 ZAHRATUL ULFIA 8/5/2015 7 P ‘1103072407120001
ZIKRUL MARWAZIH 9/18/2012 L ‘1103071804120002
41 10
ZULFA KAMILA 4/26/2015 P ‘1103076604150001
42 7
43 M.Azis 11/19/2014 8 L ‘1103071911140004
44 Salwa 12/14/2011 11 P ‘1103076412110001
45 Zahratul Ulfia 8/5/2015 7 P ‘1103076412110001
46 M.ikram 11/23/2015 7 L ‘1103072311150002
47 Syarima Atika 10/5/2012 10 P ‘1103074510120001
48 M.khairul 7/16/2016 6 L ‘1103071607160001
49 M.zafir 5/8/2016 6 L ‘1103070805180001
50 Jasmin Mauliza 3/1/2015 7 P ‘1103074103150001
51 Saskia Ramadana 6/25/2012 10 P ‘1103076506120001
52 M.Alif 5/28/2020 2 L ‘1103072805200004
53 M.Alfatih 5/23/2019 3 L ‘1103072305190003
54 M.Iqbal 4/6/2012 10 L ‘11030706041`20001
55 Misratin Nisa 9/7/2013 9 P ‘1103075709130003
56 Rizky Ramadhan 6/25/2016 6 L ‘1103072506160002
57 M.Ashraf 22-062021 1 L ‘1103072206210001
58 Akifa Naila 6/15/2019 3 P ‘1103071506190004
59 Muhammad 1/30/2015 7 L ‘1107133001150002
60 Marhaban 6/23/2016 6 L ‘1103132306160001
61 Siti Aisyah 3/31/2020 2 P ‘110713710320001
62 Nazila Safiara 11/23/2018 3 P ‘1103076311180001
63 M.Adam 10/1/2021 1 L ‘1103070110210001
64 Rahma ulana 5/15/2019 3 P ‘1103075505190002
65 Ramadhan 5/15/2019 3 P ‘1103075505190001
66 Muhammad asraf 8/24/2011 11 L ‘1108242408110001
67 Riza Mahdhira 9/13/2013 9 L ‘1103071309120004
68 Zahwa Althafunnisa 7/2/2018 4 P ‘1103074207180003
69 Faizha Putri 1/27/2018 4 P ‘1103076701180002
70 Myesha Amila 1/19/2021 1 P ‘1103075901210001
71 Rizki Ananda 8/29/2012 10 L ‘1103072908120001
72 Saydatul Nafisah 3/20/2014 8 P ‘1103076003140002
73 Miftahul Jannah 9/14/2019 3 P ‘1103075409190001
74 M Dafa shuhada 6/19/2014 8 L ‘1103131908140003
75 Humaira 8/5/2015 7 P ‘1103134508150001
76 M.Arsyil 7/13/2019 3 L ‘1103071307190004
77 Ulfi Riadhatul ulia 5/15/2010 12 P ‘1103075505100001
78 Muhammad qusyairi 9/13/2012 10 L ‘1103071309120003
79 Badatul zatasil 6/16/2018 4 P ‘1103075606180003
80 Muhammad 8/14/2019 3 L ‘103071408190004
81 Nailul Rizqia 3/18/2012 10 P ‘1103075803120001
82 M.syafiq 12/13/2015 7 L ‘1103071312150004
83 Siti Kamila 12/28/2019 3 P ‘1103076812190001
84 Alaisa Zahra 9/27/2015 7 P ‘1103076709150003
85 Muhammad Sahlan 11/17/2018 4 L ‘1103071711180006
86 Sabriel Raiyyan 8/6/2019 3 L ‘1103070608190002
87 Naila Tusyifa 7/12/2012 10 P ‘1103075207120003
88 Khalisa Fairuza 7/7/2020 2 P ‘1103074707200003
89 Muhammad hamrir 4/13/2020 2 L ‘1103071304200001
90 Afdalul Rizki 7/20/2012 10 L ‘1103072007120003
91 Muhammad Hafiz 5/27/2020 2 L ‘1103072705200001
92 Muhammad Fadil 12/15/2016 6 L ‘1103071512160001
93 M.Tajul 9/25/2011 11 L ‘1103072509110001
94 M.Rasya 4/2/2015 7 L ‘1103070204150001
95 Badrul Fajri 3/12/2017 5 L ‘1103071203170002
96 Syakira Adarani 12/17/2012 10 P ‘1116045712120002
97 M.Rizki 3/28/2012 10 L ‘1103072803120001
98 Zulfa KAMILA 4/26/2015 7 P ‘1103076604150001
99 M.Ridha 10/25/2017 5 L ‘1103072510170001
100 Hilma Shaleha 3/20/2011 10 P ‘1103076003110001
101 Hafizul Furqan 5/22/2016 6 L ‘1103072205160001
102 Nuwaira Inaiya 11/5/2020 2 P ‘1103074311200002
103 Zulfikar 5/24/2015 7 L ‘1103072405150001
104 Alfa Mahriza 4/6/2017 5 L ‘1103070604170002
105 Aisha Alifa 6/21/2019 3 P ‘1103076108190005
106 Syakira Ramadan 7/13/2013 9 P ‘1103075807130001
107 Nadratul Nurzahra 1/29/2014 8 P ‘1103076901140001
108 Syuhura Manzila 12/28/2017 5 P ‘1103076812170001
109 Rahisa Mahira 3/20/2012 10 P ‘1103076003120003
110 m.RiSki 6/28/2013 9 L ‘1103072806130001
111 Nurfadilah 6/27/2014 8 P ‘1103070308140003
112 Nur Syakira 1/17/2022 1 P ‘11030775701220001
M.Alfarizi 5/10/2014 L ‘1103071005140002
113 8
114 M.Lutfi 3/27/2017 5 L ‘1103072503170003
M.Irvan 2/23/2016 L ‘1219022302160003
115 6
116 Mahira Ramadani 8/12/2012 10 P ‘11074025208120001
117 Athafarz Mauza 1/21/2017 5 L ‘1104022101170001
118 Naura Abdila 9/12/2018 4 P ‘1103075209180001
119 Rajul Rifki 10/7/2013 9 L ‘1103070710130005
120 Rahmat Baliya 12/25/2016 6 L ‘1103072512160002
121 Nazila Ulfa 6/7/2019 3 P ‘1103074706190003
122 M.Hafiz 1/11/2011 11 L ‘1103071102100001
123 Laila Rahimah 1/3/2011 11 P ‘1103074302110002
124 M.Khatani 4/24/2016 6 L ‘1103072404160002
125 Ulfa Mahira 2/27/2021 1 P ‘1103076702210001
126 Fatin arzani 11/20/2021 1 P ‘1103076011210001
127 Syammil fayyath 6/13/2016 6 L ‘1103071306160001
UB PIN POLIO PUTARAN KE 2
Nama petugas : ENDRIANI
Puskesmas : Peureulak
ID Puskesmas :
Kabupaten : ACEH TIMUR
Tanggal Diimunisasi
Nama orang tua NIK Orang Tua Alamat No.Hp Polio (nOPV2)
Dosis 1 Dosis 2
Zainab ‘1103074438000047 UTEUNDAMA
2
Asmiati ALUE
2PAYAGAJAH 2
AISYAH ‘1103072711750001 - 2
KHAIRIAH ‘1103074707840006 PUNTI 2
MAWADDAH ‘1103074603880005 ALUE 2 PAYA
GAJAH 2
NURHALIMAH ‘110307684800003 -
2
NURHAYAI ‘1103077012929000 UTEUNDAMA 2
PUTRI ADRIANI LAUE W PAYA
GAJAH 2
MAIMUNAH ‘110307034612920003 UTEUNDAMA
2
YUSRAWATI ‘1103076412810001 ALUE 2 PAYA
GAJAH 2
NURHAYATI TUALANG 2
JUARIAH ‘1103070902650003 UTEUNDANA 2
SALAMAH ‘1103181206840002 - 2
YUNI NAJMIN SD ‘1103076510760001 -
2
HABSAH ALI ‘1103075206730002 ALUE 2 PAYA
GAJAH 2
ROHANA ‘1103074510900007 UTEUNDAMA 2
WARNIATI ‘1103074107820454 ALUE 2 PAYA
GAJAH 2
JAMALIAH UTEUNDAMA 2
MAHBUDAH ‘1103075207830003 - 2
WAHYUNI - 2
WARNIATI ‘1103075409870001 - 2
- ‘1174024907850003 - 2
MURSIDA ‘1103074504920005 - 2
FTIRIANINGSIH ‘1103075504920002 - 2
ROSDIANA ‘1103074108730001 - 2
MUKHLISAH ‘118054107790193 - 2
TIHAWA ‘11740152055860002 - 2
MAYA ROSITA ‘1103072206770002 - 2
ROSDIANA ‘1103071708860006 - 2
NUR ASMI ‘1103071406890022 - 2
DESI MULIANA ‘1103074106890022 ALUE 2 PAYA
GAJAH 2
ISMATURRAHMI PUNTI
2
NUR ASMI ‘1103075708860005 UTEUNDAMA 2
MAULIDAR ‘11030748088950001 - 2
ZAHARA ‘1103075003780004 - 2
WIRDA PADANG SIKABU
2
SALBIAH ‘1103071109800003 UTEUNDAMA 2
ASMAUL HUSNA ‘1103076606720003 -
2
HALIMAH HASBI ‘1103071407890002 ALUE 2 PAYA
GAJAH 2
NUR AINI - 2
FARIDA ‘1103074106840003 SEUNEUBOK
TEUPIN 2
YUSRA UTEUNDAMA
MUHAMMAD 2
MAULINA WATI ‘11030771121790023 Sejahtera 2
Ramlah ‘1103074108730001 - 2
Mulisah ‘1103074106750003 Sejahtera 2
Ainul Mardiah ‘1103070304820005 - 2
Titin Nurhayati ‘1103076606720003 - 2
Asmaul Husna ‘1103075808760001 - 2
Mislahati ‘1103074108820002 - 2
Yusnidar - 2
- - 2
- - 2
- ‘1174025601920001 - 2
Ratin Prasiska ‘1103075108850001 - 2
Ayu ningsih ‘1103074304850004 - 2
Masyitah - 2
- - 2
- ‘1103075208790002 - 2
Nurlailawati ‘1107135007930003 - 2
Asmaul Husna - 2
- - 2
- ‘1103075810890001 - 2
Maulidar - - 2
Maulidar - - 2
- ‘1103074303950002 - 2
Rahma Izzati ‘1108245508800001 - 2
Nilawati ‘1103075409870001 - 2
Mursida ‘1103075409870001 - 2
- ‘1103074107770382 - 2
Nur Sakdah ‘1103075901210001 - 2
Fahda Maulida ‘1103075708860005 - 2
Nur Asmi ‘1103076008900001 - 2
Yusnidar - - 2
- ‘1103139604930001 - 2
Lina Sarisma - - 2
- - - 2
- ‘1103074107850445 - 2
Santi - - 2
- - - 2
- - - 2
- ‘1103075205870004 - 2
Nuraida - - 2
- ‘1103075205890002 - 2
Fitriani ‘1103174910970001 - 2
Akmalia - - 2
- ‘1103075606010006 - 2
Putri Alfian ‘1103075207120003 - 2
Fitrianingsih - - 2
- ‘1103075710940005 - 2
Darmiati ‘1103074107750323 - 2
Nurhayati ‘3308185008950010 - 2
Suprihati ‘1103075106920001 - 2
Zahara ‘1103074404810002 - 2
Fatimah - - 2
- ‘1103075208770001 - 2
Nurdiawati ‘1103074107680217 - 2
Ruaida ‘110307500950011 - 2
Maulina Wati - - 2
- - - 2
- ‘1103076014910002 - 2
AISYAH - - 2
- - - 2
- ‘1103076509950001 - 2
Erni Mauliza ‘1103075007880009 - 2
Anita - 2
- ‘1103075003780004 - 2
Zahara ‘1272075607850001 - 2
Esti wulandari ‘11074024601980001 - 2
Ayu Puspita ‘1103076510760001 - 2
Habsah Ali ‘11030707109770001 2
Nur Adnen ‘1103074106830006 - 2
Nurmida ‘1103075212890003 - 2
Halimatussakdia - -
h 2
Maulidar - - 2
- ‘110121190251048600 -
01 2
Nurhajjah ‘1114024907850003 - 2
Samsidar - - 2
- ‘1103074903960001 - 2
Nurfadilah ‘1103075207890003 - 2
Wahyuni - - 2
- - - 2
- - 2
Nurlela ‘110307456760002 - 2
Yusnadia ‘1103074101810005 Sejahtera 2
- - Tampak 2
Nurrahmi ‘1103076210970001 - 2
Nurfitria ‘1103075812030003 - 2
- -
Posyandu ID Posyandu