7/25/2019 5. Lap. JKN Bln Mei 14

1/131

No. Nama UPT Puskesmas Alamat Kecamatan Klasifkasi

1 UPT PUSKESMAS WINONG DESA WINONG KEMIRI Pusk. Rajal.

7/25/2019 5. Lap. JKN Bln Mei 14

2/131

7/25/2019 5. Lap. JKN Bln Mei 14

3/131

7/25/2019 5. Lap. JKN Bln Mei 14

4/131

7/25/2019 5. Lap. JKN Bln Mei 14

5/131

7/25/2019 5. Lap. JKN Bln Mei 14

6/131

7/25/2019 5. Lap. JKN Bln Mei 14

7/131

7/25/2019 5. Lap. JKN Bln Mei 14

8/131

7/25/2019 5. Lap. JKN Bln Mei 14

9/131

7/25/2019 5. Lap. JKN Bln Mei 14

10/131

7/25/2019 5. Lap. JKN Bln Mei 14

11/131

7/25/2019 5. Lap. JKN Bln Mei 14

12/131

7/25/2019 5. Lap. JKN Bln Mei 14

13/131

JUMLAH

Dr Umum dr.Gigi idan T.Gi!i

dr. Hendi Rastiaan dr!. Susi Ari"ani 1. #u$iati A$d.Ke%

&. Retn' Suken!si() A$d.ke%

*. Usatun K(asana() A$d. Ke%

7/25/2019 5. Lap. JKN Bln Mei 14

14/131

7/25/2019 5. Lap. JKN Bln Mei 14

15/131

7/25/2019 5. Lap. JKN Bln Mei 14

16/131

7/25/2019 5. Lap. JKN Bln Mei 14

17/131

7/25/2019 5. Lap. JKN Bln Mei 14

18/131

7/25/2019 5. Lap. JKN Bln Mei 14

19/131

7/25/2019 5. Lap. JKN Bln Mei 14

20/131

7/25/2019 5. Lap. JKN Bln Mei 14

21/131

7/25/2019 5. Lap. JKN Bln Mei 14

22/131

7/25/2019 5. Lap. JKN Bln Mei 14

23/131

7/25/2019 5. Lap. JKN Bln Mei 14

24/131

7/25/2019 5. Lap. JKN Bln Mei 14

25/131

SDM

A"oteker anitarianPromkes Pera#at

La$orat %isiotera"&iUmum Gigi

7/25/2019 5. Lap. JKN Bln Mei 14

26/131

7/25/2019 5. Lap. JKN Bln Mei 14

27/131

7/25/2019 5. Lap. JKN Bln Mei 14

28/131

7/25/2019 5. Lap. JKN Bln Mei 14

29/131

7/25/2019 5. Lap. JKN Bln Mei 14

30/131

7/25/2019 5. Lap. JKN Bln Mei 14

31/131

7/25/2019 5. Lap. JKN Bln Mei 14

32/131

7/25/2019 5. Lap. JKN Bln Mei 14

33/131

7/25/2019 5. Lap. JKN Bln Mei 14

34/131

7/25/2019 5. Lap. JKN Bln Mei 14

35/131

7/25/2019 5. Lap. JKN Bln Mei 14

36/131

7/25/2019 5. Lap. JKN Bln Mei 14

37/131

7/25/2019 5. Lap. JKN Bln Mei 14

38/131

7/25/2019 5. Lap. JKN Bln Mei 14

39/131

7/25/2019 5. Lap. JKN Bln Mei 14

40/131

7/25/2019 5. Lap. JKN Bln Mei 14

41/131

7/25/2019 5. Lap. JKN Bln Mei 14

42/131

7/25/2019 5. Lap. JKN Bln Mei 14

43/131

7/25/2019 5. Lap. JKN Bln Mei 14

44/131

7/25/2019 5. Lap. JKN Bln Mei 14

45/131

7/25/2019 5. Lap. JKN Bln Mei 14

46/131

7/25/2019 5. Lap. JKN Bln Mei 14

47/131

7/25/2019 5. Lap. JKN Bln Mei 14

48/131

7/25/2019 5. Lap. JKN Bln Mei 14

49/131

T!l

1+,+&-1 1 1 /0-&& DIAH ARISA 2UNIARSIH

& & 1-1&//1 3INDA DWI 2ANTI

* * ,/44/, MUHMAMAD 2UP2 SAPUTRA

,,&-&0& TANGGUN U#I 3UT RIAWAN

, , ,//41 #UNITA PUTRI RAHA2U

4 4 ,,/&/4,0 TURINGAH

0 0 ,4*&-0 MUANAH

/ / ,,1/-04 SITI RO5IAH

,,*/-,0 MUH3ASIN

1- 1- ,4,1-01 ANDIKA PUTRA P

*+,+&-1 1 11 /404-1, SITI MARKHAMAH

& 1& ,,/**44 ARI WI6OWO

* 1* ,,*14,& KHA2ATI

1 11--0&-0 A6DU3 ROKHIM

, 1, ,/&01/ ROHIMAH

4 14 ,4&-,/*4 DAIMAH

0 10 /&&44, RO#I2AH

/ 1/ /0*,, WAKIDI

1 /0&*4* SITI SAMPUNI

1- &- 11&-&4 SETI2AWAN ARRI2ADH

11 &1 /*01-*/ WASINGAH

1& && ,,1/*&1 UMI SWAI6AH

,7.. 14 &* ,,0,-, AMAD SUGI2ONO

*- & ,,-,-0/ SEMINAH

* &, ,4*,&11 M ANIS 5UADI

1 &4 ,,110*/ #AMI3AH

& &0 ,,0-/* TARWI2AH

* &/ ,,10/0 GUNARTI

& ,0&* NUR 5AI8IN

, *- ,,*-*4 TUMI2AH

4 *1 1-1&0/* AMAT RO#IKIN

0 *& ,,&40/, PONIMIN

/ ** ,,&4 SEPTI WA3I2AH HANDA2ANI

* ,4,4-4*/ WATINAH

1- *, ,*-1/ AMAD 8AIDIN

11 *4 ,4-4*1 SUPARI2AH

1& *0 ,,&4-&4 NGADIMI

1* */ ,,-0*-4 ADI3 DWI PERMANA

1 * 1-1&0,,* ASTRO

1, - ,41/4* TUKIRAN

10 1 ,4&-4-, NUR KHO3ISAH

1/ & ,,-11 ARI SUWARGI2ANTO

7/25/2019 5. Lap. JKN Bln Mei 14

50/131

1 * ,/444-* SUR2ATI

&- ,4*41,01 SUWARTI2AH

&1 , ,*&1, 6A2U HIDA2AT

&& 4 ,,,-4,0 S3AMET SUWARNO

&* 0 ,4/011 I3HAM MAU3ANA

& / 1&&0&,1 MUSA#IDIN

&, ,,,1**-/ DEDI 2UDA TAMA

&4 ,- ,&* AMAT KORI3

&0 ,1 ,4,-041 WASITAH

&/ ,& ,,//&10 I6NU TAMIMU3 MUNA

& ,* ,/1&*&& 5ANA

*1 , ,44*,/1 SUPRI2ATI

*& ,, ,/1/1/ TAAT NUR 9ITA

** ,4 ,,1-10 SA3MI

*, ,0 ,,*4&&11 S3AMET AR2ANTO

*4 ,/ ,,*,*& MUDRIAH

47.. 4 , ,**-*&/10 WENI APRI3OWATI

&- 4- ,-1&,* PURWATI

&1 41 1-11/1,&1 TAU5IK WAH2UDI

1 4& 1&414&, MARWI2AH

& 4* 1&*&--/& MERI OKTARINI

* 4 ,410001 RINHANTIO

4, ,/,/0-, 5E6RI A6DU33AH

, 44 ,,4*4,& MI5TAH

0 40 ,&04 NAPSIE KHASANAH PUTRI

/ 4/ ,&-, DARSINAH

4 ,,111* RUSIDAH

1- 0- ,,1&&-, RA5IDAH DWI 2U3IANA

11 01 ,,4-4 A35I MA:RI5AH

1& 0& ,4**1&1 SENAP

1* 0* ,,11-4/ ADE3IA ASTUTIK

1 0 ,4/0& SOI5ATU3 5I5I

1, 0, ,1*&, REWOT

14 04 ,4*4-14 TURMI2ATI

10 00 ,44*1& ROHA2AH

1/ 0/ ,/0-/// 2AENAH

1 0 ,,4*01, SRI ENDANG WARNATI

077.. 1, /- ,,&0** NUR#AMI3AH

1 /1 /0&*,0 EMI 2U3IANI

& /& ,404*1 SUMINTRI

* /* 04/,-* TU3US

/ ,,1&,&-4 SU3IMAH

, /, ,,&&&/-1 6UDI2AH

4 /4 ,,11-4/ ADE3IA ASTUTIK

0 /0 ,,&,,*& SAMSI2AH

/ // ,,1011,& ERNING SARI

/ /*4--,/ SUMEH

1- - ,41/*/* 6AINGAH

7/25/2019 5. Lap. JKN Bln Mei 14

51/131

11 1 ,/1&* MUN5ARIDA

1& & ,4*-/, 5AU8ATU3 U35AH

1* * /&0& D#AENA6

1 1*-1&&0& TUKI#O

14 , /*01-*/ WASINGAH

10 4 ,4&4&& 8ENI ISTIKOMAH

1/ 0 ,/1/0, M NASRU3 MU#AHID

/77.. / / ,,0/041 USWATUN KHASANAH

1 0,-4/ ROSIDAH

& 1-- ,,***,1 ASRI2ATUN

* 1-1 ,,**/-40 SUPRAPTO

1-& 04/,11, TUMIRIN

, 1-* ,4141*-/ ARI2ANTI

4 1- ,,,&&-0* 5ATIMAH A8AHRA

0 1-, ,,,&1,,, SO3IKHUN

1-4 ,4*&-4 8AINU3 A6RORO

1- 1-0 1*-,/1*/4 WATINEM

11 1-/ ,,&/--1 HENI SUR2ANI

1& 1- ,0-1& SA2IDINA UMAR

1* 11- /0***1 SRI SODERIKAH

1 111 ,/-&4*, KHOIRU3 ANWAR

1, 11& ,/-1/,/ 6ARO2AH

14 11* ,4*&-0 MUANAH

10 11 ,/444-* SUR2ATI

1/ 11, ,,*-,0& SUPARNO

1 114 /4/4/*0 SUKO6AWANI

&- 110 ,01,100 RISMA PUSPA ;A3ENTIN

&1 11/ /0*14& SUGINING RAHA2U

&& 11 ,400&1 ANA MA3IKHATU88AHROH

77 1 1&- ,*-1/ AMAD 8AIDIN

& 1&1 ,,1-004 SU2ONO

1&& ,41*01 MAHADI

, 1&* 1-1&-,/ SITI 9HAMIDAH

4 1& 1-1&-* SUDIRMAN

/ 1&, ,&-1& ENI PU#I ASTUTI

1&4 ,,*040 PAINI

1- 1&0 /0-&& DIAH ARISA 2UNIARSIH

1& 1&/ ,**-*&/10 WENI APRI3OWATI

1 1& ,,&0** NUR#AMI3AH

1, 1*- ,4110/-, SITI ROKHANI

* 1*1 ,&1,&, MANISIH

0 1*& ,&104& HA6I6

11 1** ,&//&4 OKTA5IA

1* 1* ,,,10*0 NUR A5I5AH

1-77.. 1 1*, /&10&1 NURU3 A8IMAH

& 1*4 /&10* DIMAS 5ARIS MU6AROK

* 1*0 1-1&*4-/ ISNI MAU3UDI2AH

1*/ ,,,/0&// 6ANAT KHU3UKU3 NGA3I

7/25/2019 5. Lap. JKN Bln Mei 14

52/131

, 1* ,/,010 NUR KHO3ISOH

4 1- 1-1&010, MUHAMMAD 5ATAH A3I

0 11 1-1&014 5INA AN8I33IROHMAN

/ 1& ,4*14-& SUPIRAH

1* ,10/0 RIA 2UNINGSIH

1- 1 ,,14/&1, 2ANU WARSITO

11 1, ,,01114 MUNAWIR

1& 14 ,*--1* 9EPIR SOTIRTO

1* 10 ,&&-* SRI AM6ARWATI

1 1/ ,4*4*1&* HASNIWATI

1, 1 /*-&&1& SRIWATI

14 1,- 04/41 SUMARSIH

10 1,1 11-&0-/1& SUGIRI

1/ 1,& ,/& M 5ARKHAM ROMADHON

1 1,* ,/&11 NUR SANGIDAH

&- 1, ,,14*, AMIR 5AI8IN

&1 1,, 1&40,/41 MUHAMAD A6DU3 MU:ID

&& 1,4 ,,&1 A2UP

1&77.. 1 1,0 ,/&&014 RI2AN #U3I2ANTO

& 1,/ ,,4/-,4 NGAIDAH

* 1, ,,-4404* ROKHIMAH

14- ,,-4404* ROKHIMAH

, 141 ,,,/** SUWITO WI#O2O

4 14& ,,,&10,0 PAR2ATI

0 14* ,/10*, SUPRA2ITNO

/ 14 ,,*-,0& SUPARNO

14, ,/,/0-, 5E6RI A6DU33AH

1- 144 ,,&4-&4 NGADIMI

11 140 ,,&&-&4 WAHONO

1& 14/ ,0*-14 TURI2AH

1* 14 ,/*/*4, PARTI#AH

1 10- ,010*/* NUR KHA3IMAH

1, 101 ,4*44*4 MUNTAMAH

14 10& ,,1/4-& NGADI3AN

10 10* &-&/*44&& 6INGKAS ;ISDA KURNIAWAN

1/ 10 ,010*/* NUR KHA3IMAH

1 10, &-1-*0, NI9HA SARI TUTHI: A3AWI2AH

&- 104 ,/&10 AHMAD 5AU8AN

&1 100 ,,&*0*& 5ERRI SETIAWAN

&& 10/ 1-11/1,&1 TAU5IK WAH2UDI

&* 10 ,,144/*& SITI 9HOTI#AH

& 1/- 11-*-*,/ DES2 KURNIASARI

&, 1/1 ,/&0*4 SITI MARKASIH

&4 1/& ,4&&*/ #AENAH

&0 1/* ,/*,4 #UMONO

&/ 1/ 1-1&/&&0 TISNGATUN

& 1/, ,41/*/* 6AINGAH

*- 1/4 ,,*004-1 SUKRASNO

7/25/2019 5. Lap. JKN Bln Mei 14

53/131

*1 1/0 ,&*&& SITI U6AIDAH

*& 1// ,,*04& MUHAMAD HANI5 S

** 1/ ,&0/*4 ANITA DEWI

* 1- /*--&-/ DWI 3IST2ARINI

*, 11 /*01-*/ WASINGAH

*4 1& ,,4,0,&* SRI MU#I2ATI

*0 1* /---4 MARSINAH

1*7. 1 1 /0,-, SITI MUS2ARO5ATUN

& 1, ,,*-1&1* TUKIRMAN

* 14 ,,*-&1& AHMAD 3UT5I

10 /&&-/* SUTRISNO

, 1/ ,&&-* SRI AM6ARWATI

4 1 ,,&&-0& SITI AENAH

0 &-- ,&,4&1 MUD3IKAH

/ &-1 1-1&*-4 MUNA5INGAH

&-& ,4/011 I3HAM MAU3ANA

1- &-* ,4/4*,, NGA3I2AH

11 &- ,,,44&1 WA3IMAH

1& &-, /-*/44 2UNI HARTUTI

1* &-4 ,,144 RIKI ADRIAN

1 &-0 ,4-411, SUDAR

1, &-/ ,,4*4,& MI5TAH

14 &- ,,&4&4* SUPARMI

177.. 1 &1- ,,4-,/1 WARSITO

& &11 ,4,1-01 ANDIKA PUTRA P

* &1& ,/444-* SUR2ATI

&1* ,4*1*4/ SITI RO9HIMAH

, &1 0,-4/ ROSIDAH

4 &1, ,04-01 S2A5I< RI5AN HAKAM

0 &14 ,,&/14/ TEGAR NO;IAN

/ &10 ,,0&0* ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

54/131

/ &*, ,,/-,** SITI KA3IMAH

&*4 ,,&414& #UMINI

1- &*0 ,,14/4 TANTI USWATI

11 &*/ ,410&0, KUSRINAH

1& &* ,&&-* SRI AM6ARWATI

1* &- 1-1&,440 ROWI2AH

1 &1 ,///1,0 AMI KUSKIA WANTARI

1, && ,0/,-/, SURTINAH

14 &* ,&-1& SUKINI

10 & ,,&01// SURO#I

1/ &, &-4-*0,&0 R. 3ARASWATI

1 &4 1-1&,-&4 SU3ASIH

&- &0 ,/1&*&& 5ANA

&1 &/ ,,&/--1 HENI SUR2ANI

&& & ,441*/1 ROPINGAH

&* &,- ,44114& ANAWI2AH

107.. / &,1 /*01-*/ WASINGAH

&,& ,410&0,1 SARI5 A3I UMAM

1 &,* ,4,&1,1 DHEA A3TI MUHANTI

& &, ,*-1/ AMAD 8AIDIN

* &,, ,,-0444 MASRI2AH

&,4 ,4*4*1&* HASNIWATI

, &,0 ,4&1&0 SIGIT NUR HIDA2AT

4 &,/ ,/14, MANISUN

0 &, ,,0*/// 6AHRO

17. & &4- 1-1&44&44 NGADIRANN

* &41 ,,110,1 SUPI2AH

&4& ,,14-1 PONIATI

1 &4* 1*-,44-&, IRMAN

1, &4 ,0/*/ PARI2EM

10 &4, ,,&,& WAH2U EKA KURNIAWAN

1/ &44 ,,1-1-,* PAIMUN

&- &40 ,0*,-&* ROWI2AH

&1 &4/ ,/14, MANISUN

&& &4 ,4*4*1&* HASNIWATI

&* &0- /*110-4 A35I2AH

&, &01 ,,144 DWI NURU3 AR5AH

&0 &0& ,,0,-, AMAD SUGI2ONO

& &0* ,,&1 A2UP

*1 &0 ,,/,/1 SITI MARWI2AH

*& &0, ,,/4*4, AMAT SO3IHIN

* &04 1*1-*/0 MU32ADI

*, &00 ,,0&0* ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

55/131

1 &/* ,,-11& SANEN

* &/ ,41/*/* 6AINGAH

&/, ,&00,0 IRHAMUDIN

1 &/4 ,/04& MUSTA

7/25/2019 5. Lap. JKN Bln Mei 14

56/131

1* **1 ,/*/ PAINGAH

1, **& ,,&*4/4 PAR#I2EM

14 *** ,,-4-/-1 NGADENAN

10 ** ,,--4&41 SU2ONO

1/ **, 1-1&44&44 NGADIRANN

1 **4 ,/40-,* I3HAM WU3AN RAMADHAN

&- **0 ,/44/, MUHMAMAD 2UP2 SAPUTRA

&1 **/ 04/41 SUMARSIH

&&7. ** ,&&-* SRI AM6ARWATI

1- *- ,4*1*4/ SITI RO9HIMAH

11 *1 ,,*&&01 SAMAWI2AH

1& *& ,,0&0* ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

57/131

11 *0 ,4**4 PAI#AH

1& */- /4,// MUH MUS3IH

1, */1 ,,&-*/ NGANTI2AH

14 */& ,,*0-1 MARSI2AH

10 */* ,41-&0& KOIMI

1 */ /4,4-4 MUSTOPO

&7.. 1 */, ,,10/0 GUNARTI

& */4 ,4,*-** MUH ARIP ANWAR

* */0 ,4,*&4 PAED2

*// ,,14,0 KISMI2ATI

, */ ,&**&, 3INDA 5ADI3AH

4 *- ,4,&,/* SUNTIONO

0 *1 ,01/* S2ARI5 HIDA2AT

/ *& /0&*,0 EMI 2U3IANI

** ,*-1/ AMAD 8AIDIN

1- * ,,1/*40* IKROM SAPTA PRATAMA

11 *, ,,1/&1/ HERNI 5ITRI2ANI

1& *4 1-1&,&*-, SUSI MAR2ANI

1* *0 ,,***,1 ASRI2ATUN

1 */ ,4*1/- TUWI2AH

1, * ,1,0/ MUNTASIROH

14 -- ,,01&* 8U3;IA KHASANAH

10 -1 ,,-4-/-1 NGADENAN

&47 38 -& 545234624 SUPARYANTI

39 -* 545284001 HENI SURYANI

40 - 545234591 ETI SIYAMI

41 -, 545334827 KARYATI

45 -4 174677703 FAIRUZ MAULANA A

48 -0 545167192 TUPARIYAH

49 -/ 545167798 YANI HENDRAYANTI

51 - 545234624 SUPARYANTI

52 1- 545234591 ETI SIYAMI

58 11 544901938 MOH ROIL

1 1& 545021223 ENDAH RIYAH

2 1* 545316671 TOYIBUL KAFI

3 1 545314329 SANIYAH

4 1, 544895998 SARMINI

5 14 544914832 SITI MUNIROH

6 10 544305497 NUR SANTININGSIH

7 1/ 545552188 PAINAH

8 1 1269394391 SULAMI

10 &- 1019244486 MUNIROH

11 &1 1311797046 PONIMAN

12 && 545410045 SRIYATUN

13 &* 545038648 SUTARMI

14 & 47549068 ROSIDAH

15 &, 545727598 SUPRATMI

16 &4 544676319 SUMINTRI

7/25/2019 5. Lap. JKN Bln Mei 14

58/131

&0 1267571979 RAKHA MAALI ROBI

18 &/ 545335007 KHOLIFAH

19 & 544988463 MA!ARDI

20 *- 545461356 SUKARMINAH

21 *1 545785896 MUSRIYATI

22 *& 544816912 TA!ANG UTOMO BADARUDIN

23 ** 545060801 NGADENAN24 * 545080735 NURMAH

25 *, 545643652 MIFTAH

26 *4 544823155 TITIK ARIYANTI

27 *0 544973174 !ASIYAH

28 */ 546530049 SRI PARYATI

29 * 84218769 MUH HADI

30 - 546183483 BAINGAH

31 1 544873577 SULISTIYATUN

32 & 84311695 DARNO

33 * 1305177489 GUNANI FITRI ASTUTI

34 1019289554 PUR!ANTO

35 , 544746892 TE"O SUNARKO

36 4 545894008 BAITUL AMANAH

37 0 53153032 SU!ARNO

42 / 545233522 MISYANINGSIH

43 545245907 YULIYATI

44 ,- 545213283 DARSIH

46 ,1 1019263645 SITI KHOTI"AH

,& 545200615 MUBAROKAH

50 ,* 545234591 ETI SIYAMI

53 , 544843394 ROKHIMAH

54 ,, 545178947 GUNARTI

55 ,4 544681607 TRI ASIH

56 ,0 84360058 SUMEH

57 ,/ 545859786 MUNTAMAH

&/7. , 47684092 SARONI

21 4- 545430565 MUHAMAD RASYA AGUSTIAN

1 41 544652583 SUNTIONO

2 4& 84371038 !ASINGAH

4 4* 544606391 SUPARIYAH

5 4 546127097 SUGIYATI

6 4, 544773172 RUKUN PRAYITNO

7 44 545178947 GUNARTI

8 40 545169701 SITI NUROHIMAH

9 4/ 545750144 RUMINAH

10 4 545649467 LASMINAH

11 0- 545284563 UMIYATI

12 01 545287342 !ARTIYAH

13 0& 545278702 SALATUN

14 0* 544721523 ANNA IRA!ATI

15 0 84302234 RESTU AN"AR!ATI

7/25/2019 5. Lap. JKN Bln Mei 14

59/131

16 0, 545285744 RAFI ANGGATIASTO

17 04 545284001 HENI SURYANI

18 00 1313839686 HAFIZA AULIA PUTRI ARIFIN

19 0/ 1307942921 BARDI

20 0 545204272 TANGGUN U"I LUT RIA!AN

22 /- 84438573 SITI "ARIYAH

23 /1 544429866 RO"IYAH24 /& 1019250393 PARTINI

25 /* 1019261373 YULIANI

/ 545364022 SUGUN

27 /, 544478872 TUYEM

28 /4 545023967 "AENAH

29 /0 544414511 TUYONO

30 // 544429732 TUGINO

31 / 545065885 NGAIDAH

32 - 544429866 RO"IYAH

33 1 544421564 ARTIKA PERMATASARI

34 & 544412621 SARYONO

35 * 544824584 ROHMADI

*-7 544895998 SARMINI

4 , 545336842 KESUT SUBANDI

5 4 545207567 MISKIYAH

6 0 1019246556 "ARODAH

7 / 544812322 FANA

8 84551409 D!I AGUS S

9 ,-- 84733852 AKHMAD

10 ,-1 545352265 SLAMET #OSHIRI

11 ,-& 53153032 SU!ARNO

12 ,-* 545269522 ASROFIYAH

13 ,- 84245051 IMAMATUL KHOIRIYAH

14 ,-, 544930716 ZAKHA AL FIRDAUS

15 ,-4 544659737 AULIA HIKMAH

16 ,-0 544819263 MARZUKI

17 ,-/ 1033508169 NURUL $HOBIBAH

18 ,- 545832821 ENY PU"I SETYA!ATI

19 ,1- 545916352 NASRI%ATUN

20 ,11 84702249 DIAH ARISA YUNIARSIH

22 ,1& 84702249 DIAH ARISA YUNIARSIH

23 ,1* 544841234 MUNFARIDA

24 ,1 544998069 MAKIYAH

1 ,1, 1131600802 D!I SUDARYATI

2 ,14 545556969 SUKARMINI

21 ,10 1131600802 D!I SUDARYATI

*177. 1 ,1/ 545322486 ISTI!IYAH

2 ,1 546313869 RIFAATUL MAHMUDAH

3 ,&- 544718586 SYAHRUL AKROM

4 ,&1 84662998 SAFRUDIN

5 ,&& 1315278314 UMI LATIFAH

7/25/2019 5. Lap. JKN Bln Mei 14

60/131

6 ,&* 84311695 DARNO

7 ,& 47684092 SARONI

8 ,&, 544653786 MUH KHANAFI

9 ,&4 544652583 SUNTIONO

10 ,&0 84371038 !ASINGAH

11 ,&/ 545859786 MUNTAMAH

12 ,& 545092064 TRI AYATI13 ,*- 1019289576 PUR!ANTI

14 ,*1 545194462 KHOFIFAH LAILATUL MUNA

7/25/2019 5. Lap. JKN Bln Mei 14

61/131

UMUR PENERIMA YANKES

> 1 Thn 1-5 Thn 6-12 Thn 13-18 Thn 19-6

L P L P L P L P L

Ala$at 6 7 8 9 10 11 12 13 14

P *0 U$u$ Pa!er'n

P U$u$ #atian!san 1

3 1- U$u$ 3'nin! 1

3 & K I A Mlaran 1

P * U$u$ 3'nin! 1

P 4 U$u$ 3'nin!

P 4& U$u$ Win'n! Kidul

P *1 K6 #atian!san

3 &- U$u$ Win'n!. 1

3 * K I A Turus 1

P ,& U$u$ Win'n!

3 1/ U$u$ 3'nin! 1

P */ U$u$ Giri$ul"'

3 ,& U$u$ Win'n! 1

P * U$u$ 3uar Wila"a(

P 0 U$u$ Win'n!

P 4 U$u$ Win'n!

3 ,- U$u$ Seren 1

P ,, U$u$ Sut'ra!an

3 , K I A Sut'ra!an 1

P 4/ U$u$ Win'n!

P &- U$u$ Sut'ra!an

3 0 Gi!i Sut'ra!an 1

P 4- Gi!i 3uar Wila"a(

3 4 Gi!i Win'n! 1

P ,& U$u$ #atian!san

P *, U$u$ Girij'"'

P 1 U$u$ #atian!san

3 K I A Tursin' 1

P 0 U$u$ Turus

3 4* U$u$ Win'n! Kidul 1

3 , U$u$ Sut'ra!an 1

P U$u$ Sut'ra!an 1

P & U$u$ Tursin'

3 ,/ U$u$ #atian!san 1

P 1 U$u$ Karan! Duur

3 4 U$u$ Giri$ul"' 1

3 & K I A #atian!san 1

3 /* U$u$ Win'n! Kidul

3 ,* U$u$ Turus 1

P 1 K6 Win'n!

3 1 U$u$ Win'n! Kidul 1

7/25/2019 5. Lap. JKN Bln Mei 14

62/131

P *, U$u$ 3'nin!

P 44 U$u$ Win'n!

3 / U$u$ Win'n! 1

3 - U$u$ 3uar Wila"a( 1

3 , K I A Sut'ra!an 1

3 ,- U$u$ #atian!san

3 1 U$u$ Kedun!l' 1

3 0, U$u$ Win'n!

P ,1 K6 Turus

3 * K I A Girij'"' 1

P *1 U$u$ Sut'ra!an

P &4 K I A Turus

3 & K I A Turus 1

P 04 U$u$ W'n'suk'

3 1& U$u$ Win'n! 1

P & K6 Sut'ra!an

P 1, Gi!i 3'nin! 1

P * K I A 3'nin!

3 1/ Gi!i 3uar Wila"a( 1

P ,- U$u$ Win'n!

P *1 U$u$ 3uar Wila"a(

3 *0 U$u$ Turus 1

3 & K I A Win'n! 1

P *4 U$u$ Giri$ul"'

P & K I A 3'nin! 1

P *4 U$u$ 3'nin!

P *4 U$u$ #atian!san

P K I A Win'n! 1

P 1& U$u$ Win'n! 1

3 4* U$u$ Win'n! 1

P / U$u$ #atian!san 1

P 1& U$u$ Turus 1

P 00 U$u$ Pus='

P * U$u$ Win'n!

P */ K6 Turus

P 0& U$u$ 3'nin!

P U$u$ 3'nin!

P & Gi!i Win'n!

P , U$u$ Win'n!

P ,1 U$u$ Pus='

3 4, U$u$ W'n'suk' 1

P ,& U$u$ #atian!san

P / U$u$ #atian!san

P / U$u$ #atian!san 1

P 44 U$u$ Sut'ra!an

P 1, U$u$ 3uar Wila"a( 1

P 00 U$u$ Win'n!

P 4/ U$u$ Win'n!

7/25/2019 5. Lap. JKN Bln Mei 14

63/131

P *& K6 Win'n!

P &4 U$u$ Win'n!

P ,* U$u$ 3uar Wila"a(

3 0 U$u$ W'n'suk' 1

P 4/ U$u$ Win'n!

P * K I A Win'n! 1

3 K I A Win'n! 1

P 11 Gi!i Win'n! 1

P /, U$u$ Win'n!

P ,0 U$u$ Turus

3 ,/ U$u$ Turus

3 /* U$u$ 3'nin!

P &4 K6 Pa!er'n

P 4 U$u$ Win'n! 1

3 *0 U$u$ Win'n! 1

3 , U$u$ Win'n! 1

P 0 U$u$ Karan! Duur

P *0 U$u$ Giri$ul"'

3 * U$u$ Sut'ra!an 1

P ,4 U$u$ Seren

3 4 U$u$ Sut'ra!an 1

P *4 K I A Sut'ra!an

P 4& U$u$ 3uar Wila"a(

P *, U$u$ 3'nin!

3 - U$u$ 3uar Wila"a( 1

P ,0 U$u$ 3uar Wila"a(

P 0 U$u$ Sut'ra!an 1

P ,/ U$u$ Pur'rej'

P / U$u$ Sut'ra!an 1

3 ,/ U$u$ #atian!san 1

3 4- U$u$ W'n'suk' 1

3 4- U$u$ Turus 1

P ,* U$u$ 3'nin!

3 4& U$u$ 3'nin! 1

P U$u$ 3'nin!

P U$u$ 3uar Wila"a(

P *0 U$u$ Pa!er'n

P 1, U$u$ 3'nin!

P & Gi!i Turus

P * U$u$ Pa!er'n

P , K6 3'nin!

3 & K I A 3'nin! 1

P , K I A 3'nin! 1

P &0 K6 3uar Wila"a(

P - U$u$ 3uar Wila"a(

3 1& U$u$ Win'n! 1

P &, U$u$ 3'nin!

3 Gi!i Turus 1

7/25/2019 5. Lap. JKN Bln Mei 14

64/131

P ** U$u$ Win'n!

3 * K I A Sut'ra!an 1

P U$u$ Win'n! 1

P & K6 Win'n!

P 1/ U$u$ 3'nin!

3 &- U$u$ #atian!san 1

3 14 U$u$ Giri$ul"' 1

3 01 U$u$ Kedun!l'

P *0 U$u$ 3'nin!

P 4 U$u$ Win'n!

P / U$u$ Gintun!an

P 4, U$u$ Pa!er'n

3 U$u$ Sut'ra!an 1

3 4 U$u$ Win'n! 1

P 1 U$u$ Win'n! 1

3 *0 U$u$ 3 1

3 */ U$u$ Pa!er'n 1

3 0* U$u$ Sut'ra!an

3 4 U$u$ Win'n! 1

P & K6 Girij'"'

P */ U$u$ #atian!san

P */ K I A #atian!san

3 /- U$u$ Seren

P *, K I A Win'n!

3 ,* U$u$ 3'nin! 1

3 - U$u$ Win'n! Kidul 1

3 & K I A Win'n! 1

3 4 U$u$ Giri$ul"' 1

3 ,- U$u$ 3 1

P ,& U$u$ Sut'ra!an

P 0* U$u$ Kedun!l'

P * K6 Sut'ra!an

P ,, K6 Win'n!

3 ,* U$u$ #atian!san 1

3 & K I A Pa!er'n 1

P * U$u$ Sut'ra!an

P 1 U$u$ 3

3 10 U$u$ 3'nin! 1

3 , U$u$ Win'n! Kidul 1

3 1/ U$u$ Tursin' 1

P &, U$u$ Mlaran

P &* U$u$ Tursin'

P *4 K6 3'nin!

P , U$u$ Sut'ra!an

3 *, U$u$ 3'nin! 1

P , U$u$ Win'n! 3'r

P 4/ U$u$ Win'n!

3 * U$u$ Dile$ 1

7/25/2019 5. Lap. JKN Bln Mei 14

65/131

P - K I A 3'nin!

3 , K I A 3'nin! 1

P &* K6 3'nin!

P * Gi!i 3

P 4/ U$u$ Win'n!

P *0 K6 3'nin!

P ,& U$u$ 3

P 4- U$u$ Win'n!

3 , U$u$ Turus 1

3 1& U$u$ 3'nin! 1

3 ,/ U$u$ 3'nin! 1

P *0 U$u$ 3'nin!

P & K6 Giri$ul"'

P *& K I A Win'n!

P */ K6 3'nin!

3 , K I A Sut'ra!an 1

P * U$u$ Sut'ra!an

P , K6 Girij'"'

P * U$u$ Pu>an! A!un!

3 * K I A #atian!san 1

3 / U$u$ Turus 1

P *4 U$u$ 3'nin!

P & K6 3

3 ,- U$u$ W'n'suk' 1

3 * K I A Turus 1

P *, K6 3'nin!

P *0 K6 Win'n!

P / U$u$ Win'n!

3 4 U$u$ Sut'ra!an 1

3 1, U$u$ Sut'ra!an 1

P 4- U$u$ 3'nin!

P */ K I A #atian!san

3 4& U$u$ Win'n! 1

P 1- U$u$ Win'n! 1

P - U$u$ Win'n!

P 4 U$u$ Win'n!

P / U$u$ Sut'ra!an 1

3 0* U$u$ Sut'ra!an

3 , U$u$ #atian!san 1

P 1 K6 Sut'ra!an

P * K I A Wi'n! 1

P * U$u$ 3

3 4* U$u$ Pa!er'n 1

3 1 U$u$ Girij'"' 1

P 1/ U$u$ Pa!er'n

3 4 K I A Win'n! 1

3 &, U$u$ Win'n! 1

P *, K6 Pa!er'n

7/25/2019 5. Lap. JKN Bln Mei 14

66/131

P - K I A Girij'"'

P 0 U$u$ Giri$ul"'

P - K6 Win'n!

P ,& U$u$ 3'nin!

P *0 U$u$ 3'nin!

P 0 U$u$ Win'n!

P * U$u$ 3'nin!

P ,/ U$u$ 3'nin!

P 0& U$u$ 3'nin!

3 0 U$u$ Sut'ra!an 1

P 4- U$u$ 3'nin!

P * U$u$ Kedun!l'

P *1 U$u$ Sut'ra!an

P *0 U$u$ Giri$ul"'

P U$u$ Turus 1

P 1 U$u$ Turus

P 4/ U$u$ Win'n!

3 1, U$u$ Win'n! 1

P / U$u$ Turus 1

3 ,/ U$u$ #atian!san 1

P Gi!i #atian!san

P 4 U$u$ Win'n!

3 , U$u$ Win'n! 1

3 0& U$u$ Win'n!

3 ,1 U$u$ Girij'"' 1

P * U$u$ Sut'ra!an

P , U$u$ Sut'ra!an

P , U$u$ #atian!san

3 4 U$u$ Win'n! 1

P ,1 U$u$ 3

3 1- U$u$ Giri$ul"' 1

3 04 U$u$ #atian!san

P U$u$ Sut'ra!an

3 0& U$u$ Win'n!

P 4 U$u$ Win'n!

P 4/ U$u$ Win'n!

P / U$u$ #atian!san 1

3 0 U$u$ Girij'"' 1

3 0* U$u$ #atian!san

P *4 U$u$ 3

3 1 U$u$ #atian!san 1

3 01 U$u$ 3'nin!

P 4- U$u$ 3'nin!

3 ,1 U$u$ #atian!san 1

3 ,, U$u$ Win'n! Kidul 1

P U$u$ Turus 1

P / U$u$ Turus 1

3 , U$u$ #atian!san 1

7/25/2019 5. Lap. JKN Bln Mei 14

67/131

3 ,4 U$u$ #atian!san 1

P 4/ U$u$ Turus

3 &- U$u$ 3'nin! 1

P 4 U$u$ Sut'ra!an 1

3 0 U$u$ Win'n!

P *& Gi!i Win'n!

P *, U$u$ Sut'ra!an

P 1 U$u$ Win'n!

P * K6 Win'n!

P , Gi!i Girij'"' 1

3 1* Gi!i Girij'"' 1

3 ,* U$u$ Karan! Duur 1

P &/ Gi!i Girij'"'

P *& Gi!i Win'n!

P *, K6 Giri$ul"'

P && K6 Win'n!

P &4 K6 3'nin!

P , K6 #atian!san

P *, K6 #atian!san

3 * K I A 3 1

P 1 K I A Win'n! 1

P / K I A Gintun!an

P *1 K I A Kedun!l'

3 0 Gi!i Win'n! 1

P - K I A Girij'"'

P 4 K6 3'nin!

P *4 U$u$ Giri$ul"'

P ,- U$u$ Win'n!

P - U$u$ Win'n!

3 4, U$u$ Win'n! 1

3 4 U$u$ 3'nin! 1

3 ,, U$u$ 3'nin! 1

P 4* U$u$ Pa!er'n

P ,, U$u$ Sut'ra!an

P ,& U$u$ Win'n!

P 4 U$u$ Win'n!

3 4 Gi!i 3 1

P Gi!i Win'n! 1

P *& Gi!i Win'n!

P ** K I A Win'n!

P 1* U$u$ #atian!san 1

P 1- U$u$ #atian!san 1

P , K I A Sut'ra!an 1

P *, U$u$ Sut'ra!an

P *0 U$u$ Giri$ul"'

3 0 U$u$ 3'nin! 1

P 4 K I A Sut'ra!an 1

P 11 U$u$ Win'n! 1

7/25/2019 5. Lap. JKN Bln Mei 14

68/131

P */ K6 Win'n!

P *, K6 #atian!san

3 4 U$u$ #atian!san 1

3 ,, U$u$ #atian!san 1

P * U$u$ Pus='

3 4 K I A 3'nin! 1

3 1- U$u$ 3'nin! 1

P 4, U$u$ Pa!er'n

P *0 U$u$ 3'nin!

P *0 U$u$ Win'n!

P , U$u$ 3

P 4- U$u$ 3'nin!

3 01 U$u$ Sut'ra!an

3 4& U$u$ Win'n! 1

P 4/ U$u$ Win'n!

3 ,0 U$u$ 3'nin! 1

P *4 U$u$ 3'nin!

3 0 U$u$ Sut'ra!an 1

3 ,& U$u$ Sut'ra!an 1

3 ** U$u$ Giri$ul"' 1

3 4 U$u$ 3'nin! 1

3 - U$u$ 3 1

3 , K I A Sut'ra!an 1

3 ,/ U$u$ Giri$ul"' 1

P , U$u$ 3

P / U$u$ W'n'suk' 1

P &4 U$u$ Pa!er'n

3 & U$u$ Karan! Duur 1

3 ,1 U$u$ #atian!san 1

P U$u$ #atian!san 1

P * U$u$ 3'nin!

P * U$u$ Pu>an! A!un!

P * U$u$ 3

3 ,- U$u$ Pur'rej' 1

P 4 K I A Win'n! 1

P & K6 Pus='

P ** K I A Win'n!

3 , K I A 3'nin! 1

P - K6 Win'n!

P &1 U$u$ Win'n!

P *4 K I A 3'nin!

3 4, U$u$ Win'n! 3'r 1

3 4* U$u$ Pa!er'n 1

P , U$u$ Win'n! 3'r

P * U$u$ Win'n!

P 0 U$u$ Sut'ra!an

P 1, U$u$ Turus

P 1* U$u$ Win'n! 1

7/25/2019 5. Lap. JKN Bln Mei 14

69/131

P ,/ U$u$ Win'n!

3 , U$u$ #atian!san 1

P / U$u$ Pus='

P 0* U$u$ Win'n! Kidul

P ,, U$u$ Turus

3 01 U$u$ Win'n!

P 1 U$u$ #atian!san

3 , U$u$ Turus 1

3 U$u$ 3'nin! 1

P &- K6 #atian!san

P 4 U$u$ 3'nin! 1

3 ,- U$u$ Win'n! 1

3 K I A Sut'ra!an 1

P , U$u$ Win'n!

3 ,/ U$u$ #atian!san 1

3 , K I A Win'n! 1

P &4 K6 Kedun!l'

P &0 U$u$ Kedun!l'

P ,0 U$u$ Turus

P , U$u$ Win'n!

P , U$u$ Win'n!

P 11 U$u$ Girij'"' 1

3 4 U$u$ #atian!sanP 5 U&'& S'()*+,+- 1

P 37 U&'& G.*.&'/)

P 18 U&'& G.*.&'/)

P 55 U&'& G.*.&'/)

L 6 U&'& G.*.&'/) 1P 39 U&'& G.*.&'/)

P 16 U&'& G.*.&'/) 1P 5 G.,. G.*.&'/) 1P 18 G.,. G.*.&'/) 1L 48 U&'& G.*.&'/) 1P 55 U&'& G.*.&'/)

L 66 U&'& G.*.&'/)

P 22 K I A G.*.&'/)

P 35 KB G.*.&'/)

P 33 G.,. G.*.&'/)

P 32 G.,. G.*.&'/)

P 48 KB G.*.&'/)

P 61 U&'& !.-)-,

P 44 KB L)-.-,

L 50 U&'& !.-)-, 1P 50 U&'& !.-)-, L)*

P 41 U&'& !)-)')

P 84 U&'& !.-)-,

P 42 KB G.*.))

P 51 U&'& P')

7/25/2019 5. Lap. JKN Bln Mei 14

70/131

L 1 K I A "+(.+-,+- 1P 57 U&'& T'*.-)

L 59 U&'& T'*.-) 1P 71 U&'& M/+*+-

P 48 U&'& G.*.))

L 7 U&'& S'()*+,+- 1

L 69 U&'& "+(.+-,+-

P 23 K I A !)-)')

P 36 U&'& G.*.&'/)

P 31 U&'& K'-,/)

P 58 U&'& T'*'

P 39 U&'& T'*.-)

L 51 U&'& G.*.&'/) 1P 68 U&'& !.-)-,

P 46 U&'& L)-.-,

L 72 U&'& !.-)-,

P 35 U&'& P+,*)-

L 53 U&'& M/+*+- 1L 7 U&'& S'()*+,+- 1L 3 K I A P') 1L 65 U&'& !.-)-, K.'/ 1P 38 KB G.*.&'/)

P 41 KB G.*.&'/)

P 51 KB G.*.&'/)

P 44 KB G.*.&'/)

P 47 KB G.*.&'/)

P 18 K I A G.*.&'/)

P 34 U&'& G.*.&'/)

P 41 U&'& G.*.&'/)

P 29 KB G.*.&

P 77 U&'& !.-)-,

P 42 KB !.-)-,

L 71 G.,. S'()*+,+-

P 7 G.,. !.-)-, 1L 50 U&'& !.-)-, 1P 68 U&'& !.-)-,

P 41 U&'& P+,*)-

P 49 U&'& T'*'

L 39 U&'& P') 1P 41 U&'& "+(.+-,+-

P 43 KB "+(.+-,+-

P 51 U&'& D./&

P 31 KB D./&

P 51 U&'& D./&

P 37 U&'& D./&

L 73 U&'& D./&

P 22 KB S'()*+,+-

P 20 U&'& !.-)-,

7/25/2019 5. Lap. JKN Bln Mei 14

71/131

L 7 U&'& G.*.&'/) 1P 37 U&'& G.*.&'/)

P 0 K I A S'()*+,+- 1L 63 U&'& P+,*)- 1L 2 K I A K'-,/) 1P 58 U&'& !.-)-, K.'/

P 23 U&'& K'-,/)

P 49 U&'& K'-,/)

P 25 U&'& K'-,/)

L 34 U&'& K'-,/) 1P 59 U&'& K'-,/)

P 28 U&'& K'-,/)

L 41 U&'& K'-,/) 1L 29 U&'& K'-,/) 1P 27 U&'& K'-,/)

P 23 K I A K'-,/)

P 8 U&'& K'-,/) 1L 33 U&'& K'-,/) 1L 80 U&'& K'-,/)

P 35 K I A K'-,/)

L 47 U&'& G.*.)) 1P 61 U&'& !.-)-,

P 48 U&'& !.-)-,

P 31 U&'& S'()*+,+-

L 61 U&'& L)-.-, 1L 54 U&'& K*)) 1L 40 U&'& !.-)-, K.'/ 1L 65 U&'& !.-)-, L)* 1P 37 U&'& S'()*+,+-

P 23 U&'& !.-)-,

L 3 K I A "+(.+-,+- 1

P 2 K I A P+,*)- 1

L 83 U&'& P+,*)-

P 34 K I A P+,*)-

P 27 K I A P+,*)-

P 42 K I A P+,*)-

P 37 U&'& P+,*)-

P 37 G.,. P+,*)-

P 32 U&'& P+,*)-

P 29 KB P+,*)-

P 28 K I A L

P 32 U&'& K'-,/)

P 28 K I A INAP L

P 36 KB G.*.))

P 15 U&'& !.-)-, 1L 6 U&'& "+(.+-,+- 1

L 58 U&'& !.-)-, K.'/ 1P 21 K I A !.-)-,

7/25/2019 5. Lap. JKN Bln Mei 14

72/131

L 72 U&'& !.-)-,

L 71 U&'& S'()*+,+-

L 9 U&'& !.--, 1L 50 U&'& !.-)&, 1P 68 U&'& !.-)-,

P 42 U&'& "+(.+-,+-

P 26 U&'& "+(.+-,+-

P 30 U&'& G.*.&'/)

P 8 U&'& S'()*+,+- 1"'&/+: - 1 *1 1 &* & 0 1- 0

7/25/2019 5. Lap. JKN Bln Mei 14

73/131

Thn 65 + Thn

P L P

15 16 17

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

74/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

75/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

76/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

77/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

78/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

79/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

80/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

81/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

82/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

83/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

84/131

1

1

1

1

1

1

&40 &0 &, ,*1

7/25/2019 5. Lap. JKN Bln Mei 14

85/131

REKAPITULASI

LAPORAN PELAYANAN

RAWAT JALAN TINGKAT PERTAMA

UPT PUSKESMAS WINONG

TAHUN 2014

BULAN : MEI 2015

Kepaa Kepa!a Y"# :

$%& Kepaa 'a* Ke*e#a"a Ka+, P-./.e

! Te3pa"

Be.*a3a Ka3 a-a "a#a Ka3 Pea"a Ba6a Pea6aa Ra/a" Jaa Pe*e."a JKN

No Naa Pa!"#n U$% No &a%'( )a*#!a! Aaa,

K#,

'""!" T$$an

> 1

Ko'#

) A )KN TP )T L

1 2 3 4 5 5 6

1 DIAH ARISA 2UNIARSIH *0 /0-&& 1 U$u$ Pa!er'n

2 3INDA DWI 2ANTI 1-1&//1 1 U$u$ #atian!san

7 MUHMAMAD 2UP2 SAPUTRA 1- ,/44/, 1 U$u$ 3'nin!

4 TANGGUN U#I 3UT RIAWAN & ,,&-&0& 1 K I A Mlaran

5 #UNITA PUTRI RAHA2U * ,//41 1 U$u$ 3'nin! 8 TURINGAH 4 ,,/&/4,0 1 U$u$ 3'nin!

9 MUANAH 4& ,4*&-0 1 U$u$ Win'n! Kidul

SITI RO5IAH *1 ,,1/-04 1 K6 #atian!san

; MUH3ASIN &- ,,*/-,0 1 U$u$ Win'n!.

10 ANDIKA PUTRA P * ,4,1-01 1 K I A Turus

11 SITI MARKHAMAH ,& /404-1, 1 U$u$ Win'n!

12 ARI WI6OWO 1/ ,,/**44 1 U$u$ 3'nin!

17 KHA2ATI */ ,,*14,& 1 U$u$ Giri$ul"'

14 A6DU3 ROKHIM ,& 11--0&-0 1 U$u$ Win'n!

15 ROHIMAH * ,/&01/ 1 U$u$ 3uar Wila"a(

7/25/2019 5. Lap. JKN Bln Mei 14

86/131

18 DAIMAH 0 ,4&-,/*4 1 U$u$ Win'n!

19 RO#I2AH 4 /&&44, 1 U$u$ Win'n!

1 WAKIDI ,- /0*,, 1 U$u$ Seren

1; SITI SAMPUNI ,, /0&*4* 1 U$u$ Sut'ra!an

20 SETI2AWAN ARRI2ADH , 11&-&4 1 K I A Sut'ra!an

21 WASINGAH 4/ /*01-*/ 1 U$u$ Win'n!

22 UMI SWAI6AH &- ,,1/*&1 1 U$u$ Sut'ra!an

27 AMAD SUGI2ONO 0 ,,0,-, 1 Gi!i Sut'ra!an

24 SEMINAH 4- ,,-,-0/ 1 Gi!i 3uar Wila"a(

25 M ANIS 5UADI 4 ,4*,&11 1 Gi!i Win'n!

28 #AMI3AH ,& ,,110*/ 1 U$u$ #atian!san

29 TARWI2AH *, ,,0-/* 1 U$u$ Girij'"'

2 GUNARTI 1 ,,10/0 1 U$u$ #atian!san

2; NUR 5AI8IN ,0&* 1 K I A Tursin'

70 TUMI2AH 0 ,,*-*4 1 U$u$ Turus

71 AMAT RO#IKIN 4* 1-1&0/* 1 U$u$ Win'n! Kidul

72 PONIMIN , ,,&40/, 1 U$u$ Sut'ra!an

77 SEPTI WA3I2AH HANDA2ANI ,,&4 1 U$u$ Sut'ra!an

74 WATINAH & ,4,4-4*/ 1 U$u$ Tursin'

75 AMAD 8AIDIN ,/ ,*-1/ 1 U$u$ #atian!san

78 SUPARI2AH 1 ,4-4*1 1 U$u$ Karan! Duur

79 NGADIMI 4 ,,&4-&4 1 U$u$ Giri$ul"'

7 ADI3 DWI PERMANA & ,,-0*-4 1 K I A #atian!san

7; ASTRO /* 1-1&0,,* 1 U$u$ Win'n! Kidul

40 TUKIRAN ,* ,41/4* 1 U$u$ Turus41 NUR KHO3ISAH 1 ,4&-4-, 1 K6 Win'n!

42 ARI SUWARGI2ANTO 1 ,,-11 1 U$u$ Win'n! Kidul

47 SUR2ATI *, ,/444-* 1 U$u$ 3'nin!

44 SUWARTI2AH 44 ,4*41,01 1 U$u$ Win'n!

45 6A2U HIDA2AT / ,*&1, 1 U$u$ Win'n!

48 S3AMET SUWARNO - ,,,-4,0 1 U$u$ 3uar Wila"a(

49 I3HAM MAU3ANA , ,4/011 1 K I A Sut'ra!an

4 MUSA#IDIN ,- 1&&0&,1 1 U$u$ #atian!san

4; DEDI 2UDA TAMA 1 ,,,1**-/ 1 U$u$ Kedun!l'

50 AMAT KORI3 0, ,&* 1 U$u$ Win'n!

7/25/2019 5. Lap. JKN Bln Mei 14

87/131

51 WASITAH ,1 ,4,-041 1 K6 Turus

52 I6NU TAMIMU3 MUNA * ,,//&10 1 K I A Girij'"'

57 5ANA *1 ,/1&*&& 1 U$u$ Sut'ra!an

54 SUPRI2ATI &4 ,44*,/1 1 K I A Turus

55 TAAT NUR 9ITA & ,/1/1/ 1 K I A Turus

58 SA3MI 04 ,,1-10 1 U$u$ W'n'suk'

59 S3AMET AR2ANTO 1& ,,*4&&11 1 U$u$ Win'n!

5 MUDRIAH & ,,*,*& 1 K6 Sut'ra!an

5; WENI APRI3OWATI 1, ,**-*&/10 1 Gi!i 3'nin!

80 PURWATI * ,-1&,* 1 K I A 3'nin!

81 TAU5IK WAH2UDI 1/ 1-11/1,&1 1 Gi!i 3uar Wila"a(

82 MARWI2AH ,- 1&414&, 1 U$u$ Win'n!

87 MERI OKTARINI *1 1&*&--/& 1 U$u$ 3uar Wila"a(

84 RINHANTIO *0 ,410001 1 U$u$ Turus

85 5E6RI A6DU33AH & ,/,/0-, 1 K I A Win'n!

88 MI5TAH *4 ,,4*4,& 1 U$u$ Giri$ul"'

89 NAPSIE KHASANAH PUTRI & ,&04 1 K I A 3'nin!

8 DARSINAH *4 ,&-, 1 U$u$ 3'nin!

8; RUSIDAH *4 ,,111* 1 U$u$ #atian!san

90 RA5IDAH DWI 2U3IANA ,,1&&-, 1 K I A Win'n!

91 A35I MA:RI5AH 1& ,,4-4 1 U$u$ Win'n!

92 SENAP 4* ,4**1&1 1 U$u$ Win'n!

97 ADE3IA ASTUTIK / ,,11-4/ 1 U$u$ #atian!san

94 SOI5ATU3 5I5I 1& ,4/0& 1 U$u$ Turus

95 REWOT 00 ,1*&, 1 U$u$ Pus='98 TURMI2ATI * ,4*4-14 1 U$u$ Win'n!

99 ROHA2AH */ ,44*1& 1 K6 Turus

9 2AENAH 0& ,/0-/// 1 U$u$ 3'nin!

9; SRI ENDANG WARNATI ,,4*01, 1 U$u$ 3'nin!

0 NUR#AMI3AH & ,,&0** 1 Gi!i Win'n!

1 EMI 2U3IANI , /0&*,0 1 U$u$ Win'n!

2 SUMINTRI ,1 ,404*1 1 U$u$ Pus='

7 TU3US 4, 04/,-* 1 U$u$ W'n'suk'

4 SU3IMAH ,& ,,1&,&-4 1 U$u$ #atian!san

5 6UDI2AH / ,,&&&/-1 1 U$u$ #atian!san

7/25/2019 5. Lap. JKN Bln Mei 14

88/131

8 ADE3IA ASTUTIK / ,,11-4/ 1 U$u$ #atian!san

9 SAMSI2AH 44 ,,&,,*& 1 U$u$ Sut'ra!an

ERNING SARI 1, ,,1011,& 1 U$u$ 3uar Wila"a(

; SUMEH 00 /*4--,/ 1 U$u$ Win'n!

;0 6AINGAH 4/ ,41/*/* 1 U$u$ Win'n!

;1 MUN5ARIDA *& ,/1&* 1 K6 Win'n!

;2 5AU8ATU3 U35AH &4 ,4*-/, 1 U$u$ Win'n!

;7 D#AENA6 ,* /&0& 1 U$u$ 3uar Wila"a(

;4 TUKI#O 0 1*-1&&0& 1 U$u$ W'n'suk'

;5 WASINGAH 4/ /*01-*/ 1 U$u$ Win'n!

;8

8ENI ISTIKOMAH * ,4&4&& 1 K I A Win'n!

;9 M NASRU3 MU#AHID ,/1/0, 1 K I A Win'n!

; USWATUN KHASANAH 11 ,,0/041 1 Gi!i Win'n!

;; ROSIDAH /, 0,-4/ 1 U$u$ Win'n!

100 ASRI2ATUN ,0 ,,***,1 1 U$u$ Turus

101 SUPRAPTO ,/ ,,**/-40 1 U$u$ Turus

102 TUMIRIN /* 04/,11, 1 U$u$ 3'nin!

107 ARI2ANTI &4 ,4141*-/ 1 K6 Pa!er'n

104 5ATIMAH A8AHRA 4 ,,,&&-0* 1 U$u$ Win'n!

105 SO3IKHUN *0 ,,,&1,,, 1 U$u$ Win'n!

108 8AINU3 A6RORO , ,4*&-4 1 U$u$ Win'n!

109 WATINEM 0 1*-,/1*/4 1 U$u$ Karan! Duur

10 HENI SUR2ANI *0 ,,&/--1 1 U$u$ Giri$ul"'

10; SA2IDINA UMAR * ,0-1& 1 U$u$ Sut'ra!an

110 SRI SODERIKAH ,4 /0***1 1 U$u$ Seren111 KHOIRU3 ANWAR 4 ,/-&4*, 1 U$u$ Sut'ra!an

112 6ARO2AH *4 ,/-1/,/ 1 K I A Sut'ra!an

117 MUANAH 4& ,4*&-0 1 U$u$ 3uar Wila"a(

114 SUR2ATI *, ,/444-* 1 U$u$ 3'nin!

115 SUPARNO - ,,*-,0& 1 U$u$ 3uar Wila"a(

118 SUKO6AWANI ,0 /4/4/*0 1 U$u$ 3uar Wila"a(

119 RISMA PUSPA ;A3ENTIN 0 ,01,100 1 U$u$ Sut'ra!an

11 SUGINING RAHA2U ,/ /0*14& 1 U$u$ Pur'rej'

11; ANA MA3IKHATU88AHROH / ,400&1 1 U$u$ Sut'ra!an

120 AMAD 8AIDIN ,/ ,*-1/ 1 U$u$ #atian!san

7/25/2019 5. Lap. JKN Bln Mei 14

89/131

121 SU2ONO 4- ,,1-004 1 U$u$ W'n'suk'

122 MAHADI 4- ,41*01 1 U$u$ Turus

127 SITI 9HAMIDAH ,* 1-1&-,/ 1 U$u$ 3'nin!

124 SUDIRMAN 4& 1-1&-* 1 U$u$ 3'nin!

125 ENI PU#I ASTUTI ,&-1& 1 U$u$ 3'nin!

128 PAINI ,,*040 1 U$u$ 3uar Wila"a(

129 DIAH ARISA 2UNIARSIH *0 /0-&& 1 U$u$ Pa!er'n

12 WENI APRI3OWATI 1, ,**-*&/10 1 U$u$ 3'nin!

12; NUR#AMI3AH & ,,&0** 1 Gi!i Turus

170 SITI ROKHANI * ,4110/-, 1 U$u$ Pa!er'n

171 MANISIH , ,&1,&, 1 K6 3'nin!172 HA6I6 & ,&104& 1 K I A 3'nin!

177 OKTA5IA , ,&//&4 1 K I A 3'nin!

174 NUR A5I5AH &0 ,,,10*0 1 K6 3uar Wila"a(

175 NURU3 A8IMAH - /&10&1 1 U$u$ 3uar Wila"a(

178 DIMAS 5ARIS MU6AROK 1& /&10* 1 U$u$ Win'n!

179 ISNI MAU3UDI2AH &, 1-1&*4-/ 1 U$u$ 3'nin!

17 6ANAT KHU3UKU3 NGA3I ,,,/0&// 1 Gi!i Turus

17; NUR KHO3ISOH ** ,/,010 1 U$u$ Win'n!

140 MUHAMMAD 5ATAH A3I * 1-1&010, 1 K I A Sut'ra!an

141 5INA AN8I33IROHMAN 1-1&014 1 U$u$ Win'n!

142 SUPIRAH & ,4*14-& 1 K6 Win'n!

147 RIA 2UNINGSIH 1/ ,10/0 1 U$u$ 3'nin!

144 2ANU WARSITO &- ,,14/&1, 1 U$u$ #atian!san

145 MUNAWIR 14 ,,01114 1 U$u$ Giri$ul"' 148 9EPIR SOTIRTO 01 ,*--1* 1 U$u$ Kedun!l'

149 SRI AM6ARWATI *0 ,&&-* 1 U$u$ 3'nin!

14 HASNIWATI 4 ,4*4*1&* 1 U$u$ Win'n!

14; SRIWATI / /*-&&1& 1 U$u$ Gintun!an

150 SUMARSIH 4, 04/41 1 U$u$ Pa!er'n

151 SUGIRI 11-&0-/1& 1 U$u$ Sut'ra!an

152 M 5ARKHAM ROMADHON 4 ,/& 1 U$u$ Win'n!

157 NUR SANGIDAH 1 ,/&11 1 U$u$ Win'n!

154 AMIR 5AI8IN *0 ,,14*, 1 U$u$ 3

155 MUHAMAD A6DU3 MU:ID */ 1&40,/41 1 U$u$ Pa!er'n

7/25/2019 5. Lap. JKN Bln Mei 14

90/131

158 A2UP 0* ,,&1 1 U$u$ Sut'ra!an

159 RI2AN #U3I2ANTO 4 ,/&&014 1 U$u$ Win'n!

15 NGAIDAH & ,,4/-,4 1 K6 Girij'"'

15; ROKHIMAH */ ,,-4404* 1 U$u$ #atian!san

180 ROKHIMAH */ ,,-4404* 1 K I A #atian!san

181 SUWITO WI#O2O /- ,,,/** 1 U$u$ Seren

182 PAR2ATI *, ,,,&10,0 1 K I A Win'n!

187 SUPRA2ITNO ,* ,/10*, 1 U$u$ 3'nin!

184 SUPARNO - ,,*-,0& 1 U$u$ Win'n! Kidul

185 5E6RI A6DU33AH & ,/,/0-, 1 K I A Win'n!

188

NGADIMI 4 ,,&4-&4 1 U$u$ Giri$ul"'189 WAHONO ,- ,,&&-&4 1 U$u$ 3

18 TURI2AH ,& ,0*-14 1 U$u$ Sut'ra!an

18; PARTI#AH 0* ,/*/*4, 1 U$u$ Kedun!l'

190 NUR KHA3IMAH * ,010*/* 1 K6 Sut'ra!an

191 MUNTAMAH ,, ,4*44*4 1 K6 Win'n!

192 NGADI3AN ,* ,,1/4-& 1 U$u$ #atian!san

197 6INGKAS ;ISDA KURNIAWAN & &-&/*44&& 1 K I A Pa!er'n

194 NUR KHA3IMAH * ,010*/* 1 U$u$ Sut'ra!an

195 NI9HA SARI TUTHI: A3AWI2AH 1 &-1-*0, 1 U$u$ 3

198 AHMAD 5AU8AN 10 ,/&10 1 U$u$ 3'nin!

199 5ERRI SETIAWAN , ,,&*0*& 1 U$u$ Win'n! Kidul

19 TAU5IK WAH2UDI 1/ 1-11/1,&1 1 U$u$ Tursin'

19; SITI 9HOTI#AH &, ,,144/*& 1 U$u$ Mlaran

10 DES2 KURNIASARI &* 11-*-*,/ 1 U$u$ Tursin'11 SITI MARKASIH *4 ,/&0*4 1 K6 3'nin!

12 #AENAH , ,4&&*/ 1 U$u$ Sut'ra!an

17 #UMONO *, ,/*,4 1 U$u$ 3'nin!

14 TISNGATUN , 1-1&/&&0 1 U$u$ Win'n! 3'r

15 6AINGAH 4/ ,41/*/* 1 U$u$ Win'n!

18 SUKRASNO * ,,*004-1 1 U$u$ Dile$

19 SITI U6AIDAH - ,&*&& 1 K I A 3'nin!

1 MUHAMAD HANI5 S , ,,*04& 1 K I A 3'nin!

1; ANITA DEWI &* ,&0/*4 1 K6 3'nin!

1;0 DWI 3IST2ARINI * /*--&-/ 1 Gi!i 3

7/25/2019 5. Lap. JKN Bln Mei 14

91/131

1;1 WASINGAH 4/ /*01-*/ 1 U$u$ Win'n!

1;2 SRI MU#I2ATI *0 ,,4,0,&* 1 K6 3'nin!

1;7 MARSINAH ,& /---4 1 U$u$ 3

1;4 SITI MUS2ARO5ATUN 4- /0,-, 1 U$u$ Win'n!

1;5 TUKIRMAN , ,,*-1&1* 1 U$u$ Turus

1;8 AHMAD 3UT5I 1& ,,*-&1& 1 U$u$ 3'nin!

1;9 SUTRISNO ,/ /&&-/* 1 U$u$ 3'nin!

1; SRI AM6ARWATI *0 ,&&-* 1 U$u$ 3'nin!

1;; SITI AENAH & ,,&&-0& 1 K6 Giri$ul"'

200 MUD3IKAH *& ,&,4&1 1 K I A Win'n!

201 MUNA5INGAH */ 1-1&*-4 1 K6 3'nin!202 I3HAM MAU3ANA , ,4/011 1 K I A Sut'ra!an

207 NGA3I2AH * ,4/4*,, 1 U$u$ Sut'ra!an

204 WA3IMAH , ,,,44&1 1 K6 Girij'"'

205 2UNI HARTUTI * /-*/44 1 U$u$ Pu>an! A!un!

208 RIKI ADRIAN * ,,144 1 K I A #atian!san

209 SUDAR / ,4-411, 1 U$u$ Turus

20 MI5TAH *4 ,,4*4,& 1 U$u$ 3'nin!

20; SUPARMI & ,,&4&4* 1 K6 3

210 WARSITO ,- ,,4-,/1 1 U$u$ W'n'suk'

211 ANDIKA PUTRA P * ,4,1-01 1 K I A Turus

212 SUR2ATI *, ,/444-* 1 K6 3'nin!

217 SITI RO9HIMAH *0 ,4*1*4/ 1 K6 Win'n!

214 ROSIDAH / 0,-4/ 1 U$u$ Win'n!

215 S2A5I< RI5AN HAKAM 4 ,04-01 1 U$u$ Sut'ra!an 218 TEGAR NO;IAN 1, ,,&/14/ 1 U$u$ Sut'ra!an

219 ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

92/131

228 ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

93/131

281 SUPI2AH , ,,110,1 1 U$u$ Sut'ra!an

282 PONIATI , ,,14-1 1 U$u$ #atian!san

287 IRMAN 4 1*-,44-&, 1 U$u$ Win'n!

284 PARI2EM ,1 ,0/*/ 1 U$u$ 3

285 WAH2U EKA KURNIAWAN 1- ,,&,& 1 U$u$ Giri$ul"'

288 PAIMUN 04 ,,1-1-,* 1 U$u$ #atian!san

289 ROWI2AH ,0*,-&* 1 U$u$ Sut'ra!an

28 MANISUN 0& ,/14, 1 U$u$ Win'n!

28; HASNIWATI 4 ,4*4*1&* 1 U$u$ Win'n!

290 A35I2AH 4/ /*110-4 1 U$u$ Win'n!

291 DWI NURU3 AR5AH / ,,144 1 U$u$ #atian!san292 AMAD SUGI2ONO 0 ,,0,-, 1 U$u$ Girij'"'

297 A2UP 0* ,,&1 1 U$u$ #atian!san

294 SITI MARWI2AH *4 ,,/,/1 1 U$u$ 3

295 AMAT SO3IHIN 1 ,,/4*4, 1 U$u$ #atian!san

298 MU32ADI 01 1*1-*/0 1 U$u$ 3'nin!

299 ISTI

7/25/2019 5. Lap. JKN Bln Mei 14

94/131

2;8 ROSIDAH *& ,/00/*1 1 Gi!i Win'n!

2;9 SU3ASTRI *, ,,4*-&& 1 K6 Giri$ul"'

2; NURU3 KARIMATU3 5ATIMAH && ,,1-*- 1 K6 Win'n!

2;; 2U3IANTI 5ARIDA &4 1-1&*044 1 K6 3'nin!

700 SITI UTARI , ,,&/0&4 1 K6 #atian!san

701 RUNTI *, ,,1, 1 K6 #atian!san

702 MUHAMMAD NAU5A3 * ,,01,40 1 K I A 3

707 SHA5A PUTRI NUGRAHENI 1 1&*-44 1 K I A Win'n!

704 SRIWATI / /*-&&1& 1 K I A Gintun!an

705 EKO WIDI2ATI *1 1/**&* 1 K I A Kedun!l'

708

S2AMSU 6AHRI 0 ,014*0 1 Gi!i Win'n! 709 SITI KA3IMAH - ,,/-,** 1 K I A Girij'"'

70 TURINGAH 4 ,,/&/4,0 1 K6 3'nin!

70; MI5TAH *4 ,,4*4,& 1 U$u$ Giri$ul"'

710 NUR2ATI ,- ,4*10-*& 1 U$u$ Win'n!

711 SUPINATUN - ,-/01 1 U$u$ Win'n!

712 TUMIRAN 4, 1-1&4*/0 1 U$u$ Win'n!

717 WAHID 4 /&,-14/ 1 U$u$ 3'nin!

714 R WAH2U WIDA2AT ,, /000&, 1 U$u$ 3'nin!

715 RU6INI RATNO MU32ADI 4* 1-&-/0*141 1 U$u$ Pa!er'n

718 SITI SAMPUNI ,, /0&*4* 1 U$u$ Sut'ra!an

719 KUSRINAH ,& ,410&0, 1 U$u$ Win'n!

71 HASNIWATI 4 ,4*4*1&* 1 U$u$ Win'n!

71; DENIS SAPUTRA 4 ,,&&11,0 1 Gi!i 3

720 SARIAHAGUSTINA ,//&1, 1 Gi!i Win'n! 721 ROSIDAH *& ,/00/*1 1 Gi!i Win'n!

722 ISROWI2AH ** ,4&*&,00 1 K I A Win'n!

727 NURU3 AINI 1* ,,-&0,,4 1 U$u$ #atian!san

724 TIAS EKA PRAMESTI 1- ,4&,/ 1 U$u$ #atian!san

725 SI3;IANA 5ADHI3A , ,,14*4 1 K I A Sut'ra!an

728 WAR2ANTI *, ,,14/,0 1 U$u$ Sut'ra!an

729 HENI SUR2ANI *0 ,,&/--1 1 U$u$ Giri$ul"'

72 RA5I ANGGATIASTO 0 ,,&/,0 1 U$u$ 3'nin!

72; RIRIN DWI ARI2ANTI 4 ,00&/, 1 K I A Sut'ra!an

770

7/25/2019 5. Lap. JKN Bln Mei 14

95/131

771 PAINGAH */ ,/*/ 1 K6 Win'n!

772 PAR#I2EM *, ,,&*4/4 1 K6 #atian!san

777 NGADENAN 4 ,,-4-/-1 1 U$u$ #atian!san

774 SU2ONO ,, ,,--4&41 1 U$u$ #atian!san

775 NGADIRANN * 1-1&44&44 1 U$u$ Pus='

778 I3HAM WU3AN RAMADHAN 4 ,/40-,* 1 K I A 3'nin!

779 MUHMAMAD 2UP2 SAPUTRA 1- ,/44/, 1 U$u$ 3'nin!

77 SUMARSIH 4, 04/41 1 U$u$ Pa!er'n

77; SRI AM6ARWATI *0 ,&&-* 1 U$u$ 3'nin!

740 SITI RO9HIMAH *0 ,4*1*4/ 1 U$u$ Win'n!

741 SAMAWI2AH , ,,*&&01 1 U$u$ 3742 ISTIan! A!un!

787 DWI 3IST2ARINI * /*--&-/ 1 U$u$ 3

784 6AM6ANG TRI ANDONO ,- /-,--* 1 U$u$ Pur'rej'

785 RIRIN DWI ARI2ANTI 4 ,00&/, 1 K I A Win'n!

7/25/2019 5. Lap. JKN Bln Mei 14

96/131

788 KARTINI & ,,//*,4/ 1 K6 Pus='

789 ISROWI2AH ** ,4&*&,00 1 K I A Win'n!

78 RI8A MAU3ANA , ,,***11 1 K I A 3'nin!

78; 3ASMI - ,4*10* 1 K6 Win'n!

790 UMI INDA2ANI &1 ,4&&/11 1 U$u$ Win'n!

791 NUR MUNAWAROH *4 1&/0&*&& 1 K I A 3'nin!

792 SUWARNO 4, ,*1,*-*& 1 U$u$ Win'n! 3'r

797 6ARDI 4* 1*-0&&1 1 U$u$ Pa!er'n

794 TEMAH D#ATI ASTUTI , ,*1,*-* 1 U$u$ Win'n! 3'r

795 PURWATMI * 1-1&4110 1 U$u$ Win'n!

798

INDAH WUR2ANTI WIDIANINGSIH 0 1&0,/,14 1 U$u$ Sut'ra!an799 RO66IATUS SO3IKHAH 1, ,414/*4 1 U$u$ Turus

79 RIA SA5ITRI 1* ,4&**&0, 1 U$u$ Win'n!

79; PAI#AH ,/ ,4**4 1 U$u$ Win'n!

70 MUH MUS3IH , /4,// 1 U$u$ #atian!san

71 NGANTI2AH / ,,&-*/ 1 U$u$ Pus='

72 MARSI2AH 0* ,,*0-1 1 U$u$ Win'n! Kidul

77 KOIMI ,, ,41-&0& 1 U$u$ Turus

74 MUSTOPO 01 /4,4-4 1 U$u$ Win'n!

75 GUNARTI 1 ,,10/0 1 U$u$ #atian!san

78 MUH ARIP ANWAR , ,4,*-** 1 U$u$ Turus

79 PAED2 ,4,*&4 1 U$u$ 3'nin!

7 KISMI2ATI &- ,,14,0 1 K6 #atian!san

7; 3INDA 5ADI3AH 4 ,&**&, 1 U$u$ 3'nin!

7;0 SUNTIONO ,- ,4,&,/* 1 U$u$ Win'n!7;1 S2ARI5 HIDA2AT ,01/* 1 K I A Sut'ra!an

7;2 EMI 2U3IANI , /0&*,0 1 U$u$ Win'n!

7;7 AMAD 8AIDIN ,/ ,*-1/ 1 U$u$ #atian!san

7;4 IKROM SAPTA PRATAMA , ,,1/*40* 1 K I A Win'n!

7;5 HERNI 5ITRI2ANI &4 ,,1/&1/ 1 K6 Kedun!l'

7;8 SUSI MAR2ANI &0 1-1&,&*-, 1 U$u$ Kedun!l'

7;9 ASRI2ATUN ,0 ,,***,1 1 U$u$ Turus

7; TUWI2AH , ,4*1/- 1 U$u$ Win'n!

7;; MUNTASIROH , ,1,0/ 1 U$u$ Win'n!

400 8U3;IA KHASANAH 11 ,,01&* 1 U$u$ Girij'"'

7/25/2019 5. Lap. JKN Bln Mei 14

97/131

401 NGADENAN 4 ,,-4-/-1 1 U$u$ #ati

402 SUPARYANTI 5 545234624 1 U&'& S'()*+

407 HENI SURYANI 37 545284001 1 U&'& G.*.&'

404 ETI SIYAMI 18 545234591 1 U&'& G.*.&'

405 KARYATI 55 545334827 1 U&'& G.*.&'

408 FAIRUZ MAULANA A 6 174677703 1 U&'& G.*.&'

409 TUPARIYAH 39 545167192 1 U&'& G.*.&'

40 YANI HENDRAYANTI 16 545167798 1 U&'& G.*.&'

40; SUPARYANTI 5 545234624 1 G.,. G.*.&'410 ETI SIYAMI 18 545234591 1 G.,. G.*.&'

411 MOH ROIL 48 544901938 1 U&'& G.*.&'

412 ENDAH RIYAH 55 545021223 1 U&'& G.*.&'

417 TOYIBUL KAFI 66 545316671 1 U&'& G.*.&'

414 SANIYAH 22 545314329 1 K I A G.*.&'

415 SARMINI 35 544895998 1 KB G.*.&'

418 SITI MUNIROH 33 544914832 1 G.,. G.*.&'

419 NUR SANTININGSIH 32 544305497 1 G.,. G.*.&'

41 PAINAH 48 545552188 1 KB G.*.&'

41; SULAMI 61 1269394391 1 U&'& !.-)-

420 MUNIROH 44 1019244486 1 KB L)-.-,

421 PONIMAN 50 1311797046 1 U&'& !.-)-

422 SRIYATUN 50 545410045 1 U&'& !.-)-

427 SUTARMI 41 545038648 1 U&'& !)-)

424 ROSIDAH 84 47549068 1 U&'& !.-)-

425 SUPRATMI 42 545727598 1 KB G.*.)

428 SUMINTRI 51 544676319 1 U&'& P')

429 RAKHA MAALI ROBI 1 1267571979 1 K I A "+(.+

42 KHOLIFAH 57 545335007 1 U&'& T'*.-

42; MA!ARDI 59 544988463 1 U&'& T'*.-

470 SUKARMINAH 71 545461356 1 U&'& M/+*+-

471 MUSRIYATI 48 545785896 1 U&'& G.*.)

472 TA!ANG UTOMO BADARUDIN 7 544816912 1 U&'& S'()*+

477 NGADENAN 69 545060801 1 U&'& "+(.+

474 NURMAH 23 545080735 1 K I A !)-)

475 MIFTAH 36 545643652 1 U&'& G.*.&'

7/25/2019 5. Lap. JKN Bln Mei 14

98/131

478 TITIK ARIYANTI 31 544823155 1 U&'& K'

479 !ASIYAH 58 544973174 1 U&'& T'*'

47 SRI PARYATI 39 546530049 1 U&'& T'*.

47; MUH HADI 51 84218769 1 U&'& G.*.&

440 BAINGAH 68 546183483 1 U&'& !.-)

441 SULISTIYATUN 46 544873577 1 U&'& L)-.-

442 DARNO 72 84311695 1 U&'& !.-)

447 GUNANI FITRI ASTUTI 35 1305177489 1 U&'& P+,

444 PUR!ANTO 53 1019289554 1 U&'& M/+*+445 TE"O SUNARKO 7 544746892 1 U&'& S'()*

448 BAITUL AMANAH 3 545894008 1 K I A P'

449 SU!ARNO 65 53153032 1 U&'& !.-)

44 MISYANINGSIH 38 545233522 1 KB G.*.&

44; YULIYATI 41 545245907 1 KB G.*.&

450 DARSIH 51 545213283 1 KB G.*.&

451 SITI KHOTI"AH 44 1019263645 1 KB G.*.&

452 MUBAROKAH 47 545200615 1 KB G.*.&

457 ETI SIYAMI 18 545234591 1 K I A G.*.&

454 ROKHIMAH 34 544843394 1 U&'& G.*.&

455 GUNARTI 41 545178947 1 U&'& G.*.&

458 TRI ASIH 29 544681607 1 KB G.*.&

459 SUMEH 77 84360058 1 U&'& !.-)

45 MUNTAMAH 42 545859786 1 KB !.-)

45; SARONI 71 47684092 1 G.,. S'()*

480 MUHAMAD RASYA AGUSTIAN 7 545430565 1 G.,. !.-)

481 SUNTIONO 50 544652583 1 U&'& !.-)

482 !ASINGAH 68 84371038 1 U&'& !.-)

487 SUPARIYAH 41 544606391 1 U&'& P+,

484 SUGIYATI 49 546127097 1 U&'& T'*'

485 RUKUN PRAYITNO 39 544773172 1 U&'& P'

488 GUNARTI 41 545178947 1 U&'& "+(.

489 SITI NUROHIMAH 43 545169701 1 KB "+(.

48 RUMINAH 51 545750144 1 U&'& D./&

48; LASMINAH 31 545649467 1 KB D./&

490 UMIYATI 51 545284563 1 U&'& D./&

7/25/2019 5. Lap. JKN Bln Mei 14

99/131

491 !ARTIYAH 37 545287342 1 U&'& D./&

492 SALATUN 73 545278702 1 U&'& D./&

497 ANNA IRA!ATI 22 544721523 1 KB S'()*

494 RESTU AN"AR!ATI 20 84302234 1 U&'& !.-)

495 RAFI ANGGATIASTO 7 545285744 1 U&'& G.*.&

498 HENI SURYANI 37 545284001 1 U&'& G.*.&

499 HAFIZA AULIA PUTRI ARIFIN 0 1313839686 1 K I A S'()*

49 BARDI 63 1307942921 1 U&'& P+,

49; TANGGUN U"I LUT RIA!AN 2 545204272 1 K I A K'40 SITI "ARIYAH 58 84438573 1 U&'& !.-)

41 RO"IYAH 23 544429866 1 U&'& K'

42 PARTINI 49 1019250393 1 U&'& K'

47 YULIANI 25 1019261373 1 U&'& K'

44 SUGUN 34 545364022 1 U&'& K'

45 TUYEM 59 544478872 1 U&'& K'

48 "AENAH 28 545023967 1 U&'& K'

49 TUYONO 41 544414511 1 U&'& K'

4 TUGINO 29 544429732 1 U&'& K'

4; NGAIDAH 27 545065885 1 U&'& K'

4;0 RO"IYAH 23 544429866 1 K I A K'

4;1 ARTIKA PERMATASARI 8 544421564 1 U&'& K'

4;2 SARYONO 33 544412621 1 U&'& K'

4;7 ROHMADI 80 544824584 1 U&'& K'

4;4 SARMINI 35 544895998 1 K I A K'

4;5 KESUT SUBANDI 47 545336842 1 U&'& G.*.)

4;8 MISKIYAH 61 545207567 1 U&'& !.-)

4;9 "ARODAH 48 1019246556 1 U&'& !.-)

4; FANA 31 544812322 1 U&'& S'()*

4;; D!I AGUS S 61 84551409 1 U&'& L)-.-

500 AKHMAD 54 84733852 1 U&'& K*))

501 SLAMET #OSHIRI 40 545352265 1 U&'& !.-)

502 SU!ARNO 65 53153032 1 U&'& !.-)

507 ASROFIYAH 37 545269522 1 U&'& S'()*

504 IMAMATUL KHOIRIYAH 23 84245051 1 U&'& !.-)

505 ZAKHA AL FIRDAUS 3 544930716 1 K I A "+(.

7/25/2019 5. Lap. JKN Bln Mei 14

100/131

508 AULIA HIKMAH 2 544659737 1 K I A P+,*)-

509 MARZUKI 83 544819263 1 U&'& P+,*)-

50 NURUL $HOBIBAH 34 1033508169 1 K I A P+,*)-

50; ENY PU"I SETYA!ATI 27 545832821 1 K I A P+,*)-

510 NASRI%ATUN 42 545916352 1 K I A P+,*)-

511 DIAH ARISA YUNIARSIH 37 84702249 1 U&'& P+,*)-

512 DIAH ARISA YUNIARSIH 37 84702249 1 G.,. P+,*)-

517 MUNFARIDA 32 544841234 1 U&'& P+,*)-

514 MAKIYAH 29 544998069 1 KB P+,*)-

515 D!I SUDARYATI 28 1131600802 1 K I A L

518 SUKARMINI 32 545556969 1 U&'& K'-,/)

519 D!I SUDARYATI 28 1131600802 1 K I A INAP L

51 ISTI!IYAH 36 545322486 1 KB G.*.))

51; RIFAATUL MAHMUDAH 15 546313869 1 U&'& !.-)-,

520 SYAHRUL AKROM 6 544718586 1 U&'& "+(.+-,

521 SAFRUDIN 58 84662998 1 U&'& !.-)-, K

522 UMI LATIFAH 21 1315278314 1 K I A !.-)-,

527 DARNO 72 84311695 1 U&'& !.-)-,

524 SARONI 71 47684092 1 U&'& S'()*+,+

525 MUH KHANAFI 9 544653786 1 U&'& !.--,

528 SUNTIONO 50 544652583 1 U&'& !.-)&,529 !ASINGAH 68 84371038 1 U&'& !.-)-,

52 MUNTAMAH 42 545859786 1 U&'& "+(.+-,

52; TRI AYATI 26 545092064 1 U&'& "+(.+-,

570 PUR!ANTI 30 1019289576 1 U&'& G.*.&'/)

571 KHOFIFAH LAILATUL MUNA 8 545194462 1 U&'& S'()*+,+

Jumla& '() *+ ,' ) ) (-,

7/25/2019 5. Lap. JKN Bln Mei 14

101/131

7/25/2019 5. Lap. JKN Bln Mei 14

102/131

7/25/2019 5. Lap. JKN Bln Mei 14

103/131

7/25/2019 5. Lap. JKN Bln Mei 14

104/131

Kunj. Askes

Kunj) #KN

Kunj. #t

Kunj. TNI+P'l

TU)UAN PELAYANAN AN ESARAN TARI SESUAI PERA

KES

PU "" KIA I' La(Thn 19-64 Thn 65 + Thn

P L P L P 18 19 20 21 22

13 14 15 16 17

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

105/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

106/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

107/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

108/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

109/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

110/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

111/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

112/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

113/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

114/131

1

1

1 1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

115/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

116/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

117/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

118/131

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

7/25/2019 5. Lap. JKN Bln Mei 14

119/131

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

1

1

,) /+ *+ + ( (-,

%.o%#o/ 3 )$n" 2014

T P$!*#!a! "non K#"%"

7/25/2019 5. Lap. JKN Bln Mei 14

120/131

'%( S$!" A%"an"

. 19631010 199202 2 001

7/25/2019 5. Lap. JKN Bln Mei 14

121/131

7/25/2019 5. Lap. JKN Bln Mei 14

122/131

7/25/2019 5. Lap. JKN Bln Mei 14

123/131

Tidak terda?tar

6ulan A=ril &-1

NO TANGGAL N) P;+* N)< KARTU NAMA PESERTA SE= USIA TU"UAN

P$%.o%#o/ 3 )$K#aa UPT P$!*#!a!

'%( S$!" A%"

NIP. 19631010 19920

7/25/2019 5. Lap. JKN Bln Mei 14

124/131

7/25/2019 5. Lap. JKN Bln Mei 14

125/131

7/25/2019 5. Lap. JKN Bln Mei 14

126/131

ALAMAT KET