inputan data intan (05)

8/16/2019 Inputan Data Intan (05)

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ctrl ID KD daerah wajib daerah wajib daerah wajib

1 Profl KD >> Nama KD Tanggal Lahir

2 Kegiatan Harian >> jenis aktivitas

0 Petunjuk ada di commen Pem acaan Data mulai aris ini !aji diisi "ormat tanggal0


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1 i3a %0!! 01 i3al 1' %-0!-! 1! !01*-10-0* 01&

1 ldo% 010%01 ldo 1'% -01-0% 1! !01*-10-0* 01&

1 ega%'0&.001 ega 1'%'-0&-.0 1! !01*-10-0* 01&

1 mar 00.0101 mar 1' 0-0.-01 1! !01*-10-0* 01&

1 Dest 10'0'01 Desta 1' 1-0'-0' 1! !01*-10-0* 01&

1 l !111.01 l n 1' !-11-1. 1! !01*-10-0* 01&

1 ony'00'1%01 ony 1''0-0'-1% 1! !01*-10-0* 01&

1 "lan &0%0 01 "lang 1' &-0%-0 1! !01*-10-0* 01&

1 dan%'0 0&01 dang 1'%'-0 -0& 1! !01*-10-0* 01&

1 may% 110.01 may 1'% -11-0. 1! !01*-10-0* 01&

1 Dan 00&!001 Dan 1' 0-0&-!0 1! !01*-10-0* 01&

1 poy'!010&01 poy 1''!-01-0& 1! !01*-10-0& 01&

1 den'11!0%01 den 1''1-1!-0% 1! !01*-10-0& 01&

1 ris'0101*01 ris 1''0-10-1* 1! !01*-10-0& 01&

1 Dodi'00*1001 Dodi 1''0-0*-10 1! !01*-10-0& 01&

1 Indr %0%0&01 Indra 1' %-0%-0& 1

! !01*-10-0& 01&

1 4 ka %0%0&01 4 kas 1' %-0%-0& 1! !01*-10-0& 01&

1 Isme &0 0'01 Ismet 1' &-0 -0' 1! !01*-10-0& 01&

1 io0 *100*01 io 1' *-10-0* 1! !01*-10-0& 01&


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1 4 km'001!001 4 kmat 1''0-01-!0 1! !01*-10-0& 01&

1 Dwi0 10!0 01 Dwi 1' 1-0!-0 1! !01*-10-0& 01&

1 l ky '0!!!01 l ky 1' '-0!-!! 1! !01*-10-0& 01&

1 sony &110%01 sony 1' &-11-0% 1! !01*-10-0& 01&

1 /end .0&1001 /endi 1' .-0&-10 1! !01*-10-0& 01&

1 Ikin& 0!1.01 Ikin 1'& -0!-1. 1! !01*-10-0& 01&

1 5erd'!0.0 01 5erdy 1''!-0.-0 1! !01*-10-0& 01&

1 /amd%011!!01 /amdan 1'%0-11-!! 1! !01*-10-0& 01&

1 2yah'!0 !&01 2yahr l 1''!-0 -!& 1! !01*-10-0& 01&

1 6en*&0%1!01 6eng 1'*&-0%-1! 1! !01*-10-0& 01&

1 sm%!0 1&01 sma 1'%!-0 -1& 1! !01*-10-0& 01&

1 tep &0&!001 tep 1' &-0&-!0 1! !01*-10-0& 01&

1 +ogi%.0 1001 +ogi 1'%.-0 -10 1! !01*-10-0& 01&

1 li %111101 li 1' %-11-11 1! !01*-10-0& 01&

1 # lk&&0%0101 # lki 1'&&-0%-01 1! !01*-10-0& 01&

1 ano *0!0101 ano 1' *-0!-01 1

! !01*-10-0& 01&

1 Indr% 0.0'01 Indra 1'% -0.-0' 1! !01*-10-0& 01&

1 Ihsa' 0%1*01 Ihsan 1'' -0%-1* 1! !01*-10-0% 01&

1 oma'!0.0101 oma 1''!-0.-01 1! !01*-10-0% 01&


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1 ngg'!0*1&01 ngga 1''!-0*-1& 1! !01*-10-0% 01&

1 7awa'0011%01 7awan 1''0-01-1% 1! !01*-10-0% 01&

1 Ke8i'.0*1 01 Ke8in 1''.-0*-1 1! !01*-10-0% 01&

1 a 0%1%01 a 1' -0%-1% 1! !01*-10-0% 01&

1 9 rh %0!1'01 9 rhan 1' %-0!-1' 1! !01*-10-0% 01&

1 ri0 &011001 ri 1' &-01-10 1! !01*-10-0% 01&

1 2and'10 0.01 2andi 1''1-0 -0. 1! !01*-10-0% 01&

1 Karm'!0*0 01 Karmin 1''!-0*-0 1! !01*-10-0% 01&

1 /ari%'0 !.01 /ari 1'%'-0 -!. 1! !01*-10-0% 01&

1 7ild 10.0 01 7ildan 1' 1-0.-0 1! !01*-10-0% 01&

1 dna'10 1*01 dnan 1''1-0 -1* 1! !01*-10-0% 01&

1 # ly *0!0.01 # lyana 1' *-0!-0. 1! !01*-10-0% 01&

1 2ams 0%! 01 2amsir 1' -0%-! 1! !01*-10-0% 01&

1 /ida&&0%0101 /idayat 1'&&-0%-01 1! !01*-10-0% 01&

1 ahm 10.0&01 ahmat 1' 1-0.-0& 1! !01*-10-0% 01&

1 "r8i 1010 01 "r8in 1' 1-01-0 1

! !01*-10-0% 01&

1 :ae0 *0 0 01 :ae 1' *-0 -0 1! !01*-10-0% 01&

1 ri;%.0&0101 ri; 1'%.-0&-01 1! !01*-10-0% 01&

1 nwa'10 1*01 nwar 1''1-0 -1* 1! !01*-10-0% 01&


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1 /amd 00.1&01 /amdan 1' 0-0.-1& 1! !01*-10-0% 01&

1 /asa'!0 !%01 /asan 1''!-0 -!% 1! !01*-10-0% 01&

1 Dian .0*1001 Dian 1' .-0*-10 1! !01*-10-0% 01&

1 + ki%10.1&01 + ki 1'%1-0.-1& 1! !01*-10-0% 01&

1 7ard& 0%0101 7ardana 1'& -0%-01 1! !01*-10-0% 01&


6/64

daerah wajib daerah in"o >>

Ti*e KD se+ alamat *rovinsi ka ,kota

status kontak jenis kontak jenis kegiatan *aket

dalah # tahun $ tanggal ulan %&&&&$mm$dd'


7/64

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 5 rabaya .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

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1!00 1 9ojong 4opang .! .!0! .

9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1


8/64

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

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1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

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1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 9ojong 4opang .! .!0! .

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1!00 1 9ojong 4opang .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1


9/64

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

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1!00 1 .! .!0! .9ar 1 11 1 1

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1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1


10/64

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1

1!00 1 .! .!0! .9ar 1 11 1 1


11/64

*ekerjaan *ekerjaan/as *enghasilan nikah

I0 . T L3 PT)0

akses layanan

0 0 1 1 11 !01 -0%-!* 1 1 1

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jumlahtanggungan

jumlah anakkandung

PasanganTeta*

menda*atkan*ela&anan 4

0enda*atla&anan di

tanggal aksesla&anan


12/64

1 ! 1

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13/64

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14/64

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1 ! 1

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P3-0 3)T P0T T T-

Pasangantidak teta*

elalu 0enggunakanKondom

*akai kondomH( terakhir

5at &gdigunakan

5at &gdisuntikan

thn suntik*ertama


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terakhirmen&untik

"rekmen&untik

"rek men&untiksatuan

*nh agi jarum

slalu jarumsteril

selalu jarumsendiri

*nh agiasah


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status/hiv5at &g

disuntikterakhir

tem*atnongkrong

lokasikerja

tm*men&untik

ditahanna*sa

ditahanlain

ditahan a*ase utkan


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dukungan klg terli at kds 61 62 67 68mglmi kekerasandlm tahanankekerasan

a*a 4o*en

status 4o*en status

ke #


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69


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41/64

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