7/25/2019 3. Lap. JKN Bln Maret 14
1/99
No. Nama UPT Puskesmas Alamat Kecamatan Klasifkasi
1 UPT PUSKESMAS WINONG DESA WINONG KEMIRI Pusk. Rajal.
7/25/2019 3. Lap. JKN Bln Maret 14
2/99
7/25/2019 3. Lap. JKN Bln Maret 14
3/99
7/25/2019 3. Lap. JKN Bln Maret 14
4/99
7/25/2019 3. Lap. JKN Bln Maret 14
5/99
7/25/2019 3. Lap. JKN Bln Maret 14
6/99
7/25/2019 3. Lap. JKN Bln Maret 14
7/99
7/25/2019 3. Lap. JKN Bln Maret 14
8/99
7/25/2019 3. Lap. JKN Bln Maret 14
9/99
7/25/2019 3. Lap. JKN Bln Maret 14
10/99
7/25/2019 3. Lap. JKN Bln Maret 14
11/99
7/25/2019 3. Lap. JKN Bln Maret 14
12/99
7/25/2019 3. Lap. JKN Bln Maret 14
13/99
7/25/2019 3. Lap. JKN Bln Maret 14
14/99
7/25/2019 3. Lap. JKN Bln Maret 14
15/99
7/25/2019 3. Lap. JKN Bln Maret 14
16/99
7/25/2019 3. Lap. JKN Bln Maret 14
17/99
7/25/2019 3. Lap. JKN Bln Maret 14
18/99
7/25/2019 3. Lap. JKN Bln Maret 14
19/99
7/25/2019 3. Lap. JKN Bln Maret 14
20/99
7/25/2019 3. Lap. JKN Bln Maret 14
21/99
7/25/2019 3. Lap. JKN Bln Maret 14
22/99
7/25/2019 3. Lap. JKN Bln Maret 14
23/99
7/25/2019 3. Lap. JKN Bln Maret 14
24/99
7/25/2019 3. Lap. JKN Bln Maret 14
25/99
SDM
A"oteker anitarianPromkes Pera#at
La$orat %isiotera"&iUmum Gigi
7/25/2019 3. Lap. JKN Bln Maret 14
26/99
7/25/2019 3. Lap. JKN Bln Maret 14
27/99
7/25/2019 3. Lap. JKN Bln Maret 14
28/99
7/25/2019 3. Lap. JKN Bln Maret 14
29/99
7/25/2019 3. Lap. JKN Bln Maret 14
30/99
7/25/2019 3. Lap. JKN Bln Maret 14
31/99
7/25/2019 3. Lap. JKN Bln Maret 14
32/99
7/25/2019 3. Lap. JKN Bln Maret 14
33/99
7/25/2019 3. Lap. JKN Bln Maret 14
34/99
7/25/2019 3. Lap. JKN Bln Maret 14
35/99
7/25/2019 3. Lap. JKN Bln Maret 14
36/99
7/25/2019 3. Lap. JKN Bln Maret 14
37/99
7/25/2019 3. Lap. JKN Bln Maret 14
38/99
7/25/2019 3. Lap. JKN Bln Maret 14
39/99
7/25/2019 3. Lap. JKN Bln Maret 14
40/99
7/25/2019 3. Lap. JKN Bln Maret 14
41/99
7/25/2019 3. Lap. JKN Bln Maret 14
42/99
7/25/2019 3. Lap. JKN Bln Maret 14
43/99
7/25/2019 3. Lap. JKN Bln Maret 14
44/99
7/25/2019 3. Lap. JKN Bln Maret 14
45/99
7/25/2019 3. Lap. JKN Bln Maret 14
46/99
7/25/2019 3. Lap. JKN Bln Maret 14
47/99
7/25/2019 3. Lap. JKN Bln Maret 14
48/99
7/25/2019 3. Lap. JKN Bln Maret 14
49/99
REKAPITULASI
LAPORAN PELAYANA
RAWAT JALAN TINGKAT PERT
UPT PUSKESMAS WINO
TAHUN 2014
BULAN : MARET 20
Kepala Kepaa Y!" :
#$% Kepala &'a Kee"a!a Ka*+ P,-./-e/' Tepa!
Be-aa '' Ka' a,3a !a'"a Kla' Pea!'a B'a5a Pela5aa Ra.a! Jala Pee-!a JKN
No Nama Pasien Umur Kode No Card. Jamkesmas Alamat
Ket
diisi Tujuan
Kode
J A JKN TP JT
! & ' ) $
1 AGUNG RUDI+ANTO ,- Askes ,*--&1/ 1 U$u$ 0an"u Uri
& RI2KI SAPUTRO 3 #PS 4,,&&-5, 1 Gi!i Win'n! 3 #UMINI ,3 #PS 4,4&5/15& 1 U$u$ Giri$ul"'
, PONI+AH , #PS 4,5&4,*3/ 1 U$u$ Sut'ra!an
5 +U6I HARTATI & #PS 4,,,&-/-1 1 U$u$ Kedun!l'
5 SUPIRAH ,* #PS 4,5*15-,& 1 U$u$ Win'n!
7 MUNIROH ,, #PS 1-1/&,,,5 1 K0 6'nin!
SUKINI 3& #PS 4,,&,/-1& 1 U$u$ 6'nin!
9 PAI#AH 4 #PS 4,5**,,,5 1 U$u$ Win'n!
1- ISROWATI &, #PS 4,,/*343 1 Gi!i Win'n!
11 0AINGAH 5 #PS 4,51*,* 1 U$u$ Turus
1& PAI#AH 4 #PS 4,5**,,,5 1 Gi!i #atian!san
7/25/2019 3. Lap. JKN Bln Maret 14
50/99
13 7(usnul 7('ti$a( 5/ #PS 1&3&3114/ 1 U$u$ Mlaran
1, KISMI+ATI &- #PS 4,415,4,3 1 K0 Win'n!
15 NUR A8I8AH &3 #PS 4,4413*,3 1 U$u$ Win'n!
15 PARI+EM 41 #PS 4,,/3,* 1 U$u$ Tursin'
17 RO9HIMAH */ #PS 4,,,/435 1 U$u$ Tursin'
1 0ADRI+ATUN *- #PS 4,,4*&&5 1 U$u$ Girij'"'
19 7(usnul 7('ti$a( 5/ #PS 1&3&3114/ 1 U$u$ Turus
&- WA6RO8INGAH ,& #PS 4,44&1,3 1 K0 Turus
21 ANDIKA PUTRA P , #PS 4,54/1-31 1 K I A Sut'ra!an
&& SITI AMINAH 4& #PS 4,51&-3 1 U$u$ #atian!san
23 TRI ASIH &/ #PS 4,,515-3 1 K0 6'nin!
&, SURIP SUPRI+ANTO 41 #PS 4,,/&&4* 1 U$u$ 6'nin!
25 HA0I0 * #PS 4,,/&135& 1 K I A Win'n!
&5 ENI PU#I ASTUTI ,, #PS 4,,/&-,1& 1 U$u$ Win'n!
27 I68I RO#A0 1& #PS 4,5&-/,4 1 U$u$ Tursin'
& SITI MUDRIKAH &- #PS 4,5*5-*&& 1 K I A Win'n!
29 SU6ASTRI ** #PS 4,,/-&, 1 U$u$ Tursin'
*- PAINAH ,/ #PS 4,444&1 1 K0 Girij'"'
31 +AH+A DWI PRASETI+ANTO * #PS 4,4-331,5 1 K I A Win'n! 6'r
*& 6ASMI ,1 #PS 4,5*,13/* 1 K0 Win'n!
33 SUTARMI ,4 #PS 4,4-5&5/ 1 K0 Turus
*, TUKIRAN 4* #PS 4,515//* 1
U$u$ Girij'"'35 ASMINAH , #PS 1-1/&5*411 1 U$u$ Win'n!
*5 NUR KHO6ISAH ,1 #PS 4,5&/-5-4 1 U$u$ Re%u!
37 +OGA A6AMS+AH 4 #PS 4,,&111 1 U$u$ Win'n!
* TU8UDHA & #PS 1-1/&,4,35 1 Gi!i Mlaran
39 AMAT SO6IHIN 1, #PS 4,4,5*54 1 U$u$ Sut'ra!an
,- SI6:IANA 8ADHI6A 4 #PS 4,41/5/*5 1 K I A Karan! Duur
41 MUHAMAD NUR 0A++IN / #PS 4,5*&331 1 U$u$ Win'n!
,& MUD6IKAH *& #PS 4,,&45/&1 1 K I A Win'n!
43 SARMINI *4 #PS 4,,/4// 1 K0 6'nin!
,, NUR HIDA+AH ** #PS 4,,&1/& 1 K0 6'nin!
45 SUDIRO 3* Askes 15&154&-4 1 U$u$ Win'n!
7/25/2019 3. Lap. JKN Bln Maret 14
51/99
,5 MOEHADI 3& Askes 33-**/5 1 U$u$ Win'n!
47 TE#O SUNARKO 3 #PS 4,,3,5/& 1 U$u$ Win'n!
, SUHARTI ,- #PS 4,51*&5// 1 U$u$ Sut'ra!an
49 SATINAH 45 #PS 4,,/,&34, 1 U$u$ Turus
4- UMMI KU6SUM 11 #PS 4,5-4/-1 1 Gi!i Win'n!
51 DARWI+AH ** #PS 4,5-4/53 1 K0 Turus
4& SITI NGAISAH */ #PS 1-1/&3,15 1 U$u$ Turus
53 NA8IS HAIKA6 5 #PS 1-1/&3,,/ 1 U$u$ Win'n! Kidul
4, NURI6 ANWAR 1* #PS 4,,3-3- 1 U$u$ Win'n! Kidul
55 HUSNAH A8I8AH 13 Askes /354*,/4* 1 U$u$ Sut'ra!an
45 HENDI RASTIAWAN * Askes ,,-,15/ 1 U$u$ 6'nin!
57 +ATIMAH 41 Askes ,54-43 1 U$u$ Pa!er'n
4 PARTI 45 #PS 4,,4/31- 1 U$u$ Pa!er'n
59 KHOIRI+AH *, #PS 4,4,5,*, 1 U$u$ Sut'ra!an
5- M SODA MAU6ANA 3 #PS 4,,/1&,1 1 U$u$ Win'n!
61 S6AMET ;OSHIRI ,- #PS 4,4*4&&54 1 U$u$ Win'n! Kidul
5& MUSTO;I+AH 4 #PS 1-1/&,4,&1 1 U$u$ Win'n!
63 IRMA WAH+U 8E0RIANINGSIH 5 #PS 4,5*,/,*& 1 U$u$ Win'n!
5, GUNARTI ,1 #PS 4,413/,3 1 U$u$ #atian!san
65 PARINGAH , #PS 4,4*,1& 1 U$u$ Turus
55 IMAN HASANUDIN &4 #PS 4,5*5,15 1 U$u$ Win'n!
67
ASRO8I+AH *3 #PS 4,4&5/4&& 1
U$u$ Sut'ra!an5 MUHAMMAD S+A8I N / #PS 4,,/3&13* 1 U$u$ #atian!san
69 SITI RU0AEAH *3 #PS 4,,/3-535 1 U$u$ #atian!san
3- SATI+AH */ #PS 4,,/&&-/ 1 U$u$ #atian!san
71 RO00IATUS SO6IKHAH 14 #PS 4,515*/5 1 U$u$ Turus
3& 0AH#ATU6 HIDA+ATI 5 #PS 4,513--41 1 K I A Turus
73 MARI+ATU6 KI0TI+AH #PS 4,,&5/4- 1 U$u$ 6'nin!
3, ADE6IA ASTUTIK #PS 4,411-,5 1 U$u$ #atian!san
75 SITI MUNAWAROH ,5 #PS 4,4&14& 1 U$u$ #atian!san
35 DIAH ARISA +UNIARSIH *3 Askes ,*--1*1 1 U$u$ Pa!er'n
77 AMAD MANSUR 44 #PS 4,454//5 1 U$u$ 6'nin!
3 SUGI+ATI ,/ #PS 4,51&3-/3 1 U$u$ Turus
7/25/2019 3. Lap. JKN Bln Maret 14
52/99
79 9AHA+A DWI WI#A+ANTI 4 #PS 1-1/&4&/*4 1 K I A Kedun!l'
- A68+ RAHMAWATI 4 #PS 4,,/5-&,3 1 K I A Kedun!l'
81 SETI+AWAN ARRI+ADH 4 Askes 1//1&/-&5 1 K I A 6'nin!
& #ARI+AH EKA +U6IANTI &3 #PS 1-1/&4&/1* 1 U$u$ #atian!san
83 MIS+ATI 54 #PS 4,,&/,/1& 1 U$u$ Sut'ra!an
, KHA8ID 4 #PS 4,,51///& 1 U$u$ Win'n!
85 IMAN HASANUDIN &4 #PS 4,5*5,15 1 U$u$ Win'n!
5 AU6I+A 2AHROTUNNISA / #PS 4,5&4&&&1 1 U$u$ Turus
87 A0DU6 ROHMAN & #PS 1-1/&,5* 1 U$u$ #atian!san
MUHAMMAD KAUTSAR 1/ #PS 4,4&&/54 1 U$u$ #atian!san
89 TUKI+AH ,1 #PS 4,,/11/*/ 1 U$u$ Turus
/- NUR 8AU2IAH #PS 4,,/1,4, 1 U$u$ Turus
91 SUDIRO 3* Askes 15&154&-4 1 U$u$ Win'n!
/& SURO#I ,3 #PS 4,4&31, 1 U$u$ Sut'ra!an
93 MUHAMAD A6I8 , #PS 4,4*5/5*4 1 U$u$ W'n'suk'
/, ROSIDAH 4 #PS ,34,/-5 1 U$u$ Win'n!
95 HARIS SETIAWAN 1& #PS 4,411&&1* 1 U$u$ W'n'suk'
/5 SO6I9HUN 1* #PS 4,44-*&4 1 U$u$ Sut'ra!an
97 SUSANTI *1 #PS 4,4*&31,, 1 U$u$ Sut'ra!an
/ SUMINTRI 41 #PS 4,,535*1/ 1 U$u$ Pus'
99 HARINI 41 Askes ,3*,*1* 1 U$u$ Sid'rej'
1-- SITI NUROHIMAH ,* #PS 4,415/3-1 1
K I A #atian!san101ISTINGANAH & #PS 4,,*&5, 1 U$u$ Sut'ra!an
1-& SRI NUR+ANTI */ Askes 1--35/& 1 U$u$ Win'n! 6'r
103SENAP 5* #PS 4,5**,1&1 1 U$u$ Win'n!
1-, WI#I ASTUTI 15 #PS 4,41-,*, 1 U$u$ Win'n! Kidul
105SRI SODERIKAH 45 Askes ,3**/*1 1 U$u$ Seren
1-5 8IKRI+ANA 2AKARIA &- Askes ,3&*33& 1 U$u$ Win'n!
107ANANG KHO6I6UR 4 #PS 1-1/&,*3 1 U$u$ 6'nin!
1- 8ATKHUROHMAN 1* #PS 4,,*-&5*/ 1 U$u$ Win'n!
109UMI INDA+ANI &1 #PS 4,5&&/11 1 U$u$ Win'n!
11- RODI+AH INDA A+U ,5 #PS 4,5&&/31/ 1 U$u$ Win'n!
111A0U DARDAK 3, Askes ,35&4, 1 U$u$ Sut'ra!an
7/25/2019 3. Lap. JKN Bln Maret 14
53/99
11& ISTI+ANA *5 #PS 4,4,4*-54 1 K I A Pus'
113SITI MARKHAMAH 4, #PS 4,5&&-,/4 1 U$u$ Win'n!
11, ANNA IRAWATI && #PS 4,,3&14&* 1 K0 Sut'ra!an
115SITI AMINAH 45 #PS 4,,-4&53 1 U$u$ Sut'ra!an
115 NUR+ATI ,4 #PS 1-1/&,*3 1 U$u$ #atian!san
117A+U NO:ITA SARI &- #PS 1-1/&,*/ 1 U$u$ #atian!san
11 HAR+ANTI *1 #PS 4,4-35- 1 U$u$ W'n'suk'
119SUGINING RAHA+U 4 Askes ,3*15/& 1 U$u$ Sid'rej'
1&- SAUDAH 42 #PS 546189344 1 K I A Karang Duwur121 FAIS ABDUL AZIS 3 #PS 1279724679 1 K I A Wonosuko
1&& A!AS"A #UIKA AFAI 5 #PS 545$92266 1 K I A Wonosuko
123 %KA U&DI"A!' 11 #PS 545$77$89 1 U(u( W)nong Lor
1&, *U!ASI&'H 59 #PS 544915798 1 U(u( W)nong
125 DA*A& 58 #PS 5462$7827 1 U(u( W)nong
1&5 SUDI"A!I 6$ #PS 5457991$4 1 U(u( Lon)ng
127 SI!I *AH*UDAH 42 #PS 5458$1758 1 U(u( Lon)ng
1& WASI+A!U 49 #PS 544641276 1 U(u( W)nong
129 &'H*ADI 8$ #PS 544824584 1 U(u( W)nong
1*- FAA 31 #PS 544812322 1 U(u( Su,oragan
131 AL &IZK" ZAH &'!UL HIDA"AH 2 #PS 545339981 1 K I A Lon)ng
1*& ALFI!' &A*ADHA 5 #PS 545339665 1 K I A Lon)ng
133 SAFA&UDI 36 #PS 544821491 1 U(u( Su,oragan
1*, #UI!A -U!&I &AHA"U 3 #PS 544886919 1 K I A Lon)ng
135 SA!I"AH 39 #PS 544922$98 1 U(u( #a,)wangsan
1*5 SA*U&I 49 #PS 544921288 1 U(u( #a,)wangsan
137 SUDI&' 73 Askes 1621652$5 1 U(u( W)nong
1* I*A*A!UL KH'I&I"AH 23 Askes 84245$51 1 U(u( W)nong
139 DIA DWI 'K!A.IAI 7 #PS 544689426 1 U(u( Su,oragan
1,- I&*A WAH"U F%B&IAI+SIH 6 #PS 546349432 1 +)g) W)nong
141 *AKI"AH 29 #PS 544998$69 1 KB #a,)wangsan
1,& *A&ZUKI 83 #PS 544819263 1 U(u( W)nong
143 SUWA&!I 69 #PS 544439441 1 U(u( K/0ungo
1,, BAI+AH 68 #PS 546183483 1 U(u( W)nong
7/25/2019 3. Lap. JKN Bln Maret 14
54/99
145 !ULUS #AU&ISWA!' 21 #PS 545157292 1 U(u( Brunor/o
1,5 I*A!UL +AII ZAI*AH 3 #PS 546658121 1 K I A !urus
147 HAWA S"AKILA 9 #PS 545$73232 1 U(u( W)nong Lor
1, ADA* S"A&UL HABIBI 7 #PS 545$73636 1 U(u( W)nong Lor
149 A&IF "'+A -A*U+KAS 6 #PS 545$73$96 1 U(u( W)nong Lor
14- HIDA"A! 18 #PS 1$19244$69 1 U(u( Lon)ng
151 *UHA**AD AUFAL 3 #PS 545715674 1 K I A *aran
14& %K' WIDI"A!I 31 Askes 198393243 1 U(u( K/0ungo
153 BA+US BI*'K' WIU++'#A!I 12 Askes 14879$248 1 +)g) #a,)wangsan14, USWA!U KHASAAH 45 Askes 84411281 1 U(u( W)nong
155 DA&WA!IK 34 #PS 545$14$56 1 KB -uang Agung
145 &'-I"A!U 49 #PS 544834$12 1 U(u( Lon)ng
157 KAS*IAH 5$ #PS 5454$7413 1 U(u( W)nong K)0u
14 SU-&I"A!I 26 #PS 546635981 1 K I A !urus
159 SU+II+ &AHA"U 58 Askes 84731692 1 U(u( S)0or/o
15- S'.IA WA&DAI 4 #PS 54462$431 1 K I A &/ug
161 S&I &'KHI*AH 39 #PS 544675836 1 U(u( Su,oragan
15& SU-IAH 6$ Askes 173573684 1 U(u( W)nong K)0u
163 !UKIAH 41 #PS 545234769 1 KB Su,oragan
15, AS*ULK'DA& 39 #PS 544619226 1 KB &/ug
165WA+I"%*
4$#PS 5456$8269
1 U(u(
+)r)(uo
155 SU*A&I 58 Askes 84733841 1 U(u( W)nong
167 S'LIDAH 4$ #PS 544651852 1 U(u( &/ug
15 !U!I WA&SIH 33 #PS 545771136 1 KB +)r)oo
169 SU+II+ &AHA"U 58 Askes 84731692 1 LAB S)0or/o
13- *A&WI"AH 5$ #kn 1261649259 1 U(u( -ag/ron
171 AULI"A ZAH&'!UISA 9 #PS 546252221 1 U(u( Su,oragan
13& S&I DA"A!I 39 #PS 545141564 1 U(u( W)nong K)0u
173 A*AD SA&IFUDI 27 #PS 1$19246229 1 U(u( W)nong
13, SA%-U&A 37 #PS 5446211$5 1 U(u( W)nong
175SRI SODERIKAH 45 Askes ,3**/*1 1 U$u$ Seren
135 MUSTO;I+AH 4 #PS 1-1/&,4,&1 1 U$u$ W)nong
177ENI PU#I ASTUTI ,, #PS 4,,/&-,1& 1 U$u$ Lon)ng
7/25/2019 3. Lap. JKN Bln Maret 14
55/99
13 MUH ARI8IN && #PS 4,4,/,,/ 1 U$u$ Su,oragan
179SU9I NUR#ANAH 5 #PS 4,,/&1315 1 U$u$ Lon)ng
1- SU6ASIH *, #PS 1-1/&4-&,5 1 U$u$ K/0ungo
181SUKARMAN 5- #PS 1-1/&,5&4* 1 U$u$ W)nong
1& AHMAD 0AKIR 34 #PS 4,,3--** 1 U$u$ Su,oragan
1839HA6IMATUS SA
7/25/2019 3. Lap. JKN Bln Maret 14
56/99
211HASAN 8AU2I */ #PS 4,5*&445/ 1 K I A Lon)ng
&1& NGAISAH *& #PS 4,4,/53* 1 6A0 #a,)wangsan
213USWATUN KHASANAH ,4 Askes ,,11&1 1 U$u$ W)nong
&1, MINI * #PS 4,4-/5-5 1 K I A -uang Agung
215SUPONO 53 #PS 4,4&4/ 1 U$u$ -uso
&15 SUMI+ATI , Askes &-441&&*& 1 U$u$ Lon)ng
217AHMAD 8AU2AN 13 #PS 4,,/&13, 1 U$u$ Lon)ng
&1 KHA8ID 4 #PS 4,,51///& 1 U$u$ W)nong
219SURATMI &/ #PS 11*,,&5/-* 1 K I A W)nong Lor&&- TAMRO , #PS 4,43,-4-* 1 U$u$ +)r)oo
221S6AMET ;OSHIRI ,- #PS 4,4*4&&54 1 U$u$ W)nong K)0u
&&& MUSTO;I+AH 4 #PS 1-1/&,4,&1 1 U$u$ W)nong
223WAHID RAMDANI 14 #PS 4,45/,/3, 1 U$u$ #a,)wangsan
&&, NUR KHA0I0AH 4* #PS 4,44--4*/ 1 U$u$ Su,oragan
225DASIMAH ,* #PS 4,4&4*&- 1 Gi!i Su,oragan
&&5 SUMARSIH 5, Askes ,,&// 1 U$u$ -ag/ron
227MISKI+AH 51 #PS 4,4&-3453 1 U$u$ Su,oragan
&& MAR+ANAH */ #PS 4,411* 1 Gi!i Lon)ng
229GUNARTI ,1 #PS 4,413/,3 1 U$u$ #a,)wangsan
&*- SOERONO ADIPUTRO ,1 #PS 1-1/&3,, 1 U$u$ W)nong
231NGAMI6ATUN 4, Askes ,31-1,3 1 U$u$ +)r)(uo
&*& ARI SUWARGI+ANTO &- #PS 4,4,/-1/1 1 U$u$ K/0ungo
233SUGINING RAHA+U 4 Askes ,3*15/& 1 U$u$ S)0or/o
&*, KURNIA ADI #A2U6I R 3 #PS 4,,3,31, 1 U$u$ Su,oragan
235NGAISAH *& #PS 4,4,/53* 1 U$u$ #a,)wangsan
&*5 DA88A ANANT+O 1- Askes ,*--&&1 1 U$u$ D/(angan
237USWATUN 0ARIROH & #PS 4,543,5/ 1 K I A !urus
&* 0ARODIN 4- #PS 1&&4*-&5& 1 U$u$ D)/(
239SA8RUDIN 4/ Askes ,55&// 1 U$u$ W)nong K)0u
&,- MUSTAKIM *4 #PS 4,,//,*3/ 1 U$u$ !urus
241TRIANA NUR 9AH+ANI 4 #PS 4,43,//5 1 K I A &/ug
&,& AMAD 2AIDIN 4 #PS 4,,/*-/1 1 U$u$ #a,)wangsan
243SATINAH 45 #PS 4,,/,&34, 1 U$u$ W)nong
7/25/2019 3. Lap. JKN Bln Maret 14
57/99
&,, K. 0UDI SUHARNI 45 Askes ,3,-&/3 1 U$u$ #a,)wangsan
245HERU SUPRAPTO 5& Askes ,3,-&5 1 U$u$ Su,oragan
&,5 MISTI+AH ,, #PS 1&&5,/-3* 1 U$u$ #a,)wangsan
247SUKARTIM - #PS 4,,4/5*// 1 U$u$ &/ug
&, SITI NGASAH 5& #PS 1-1/&,,&15 1 U$u$ W)nong
249MUTIMAH ,5 #PS 4,,14&,*1 1 U$u$ Kroo
&4- RO#I+AH 5/ Askes ,,&&554 1 U$u$ W)nong
251AMAD 0ASORI 41 #PS 4,4-*,533 1 U$u$ #a,)wangsan
&4& MISTINAH 41 #PS 4,4-*,/& 1 U$u$ #a,)wangsan253MARDAH ,& #PS 4,,54&5* 1 U$u$ W)nong
&4, NUR A8I8AH 1- #PS 4,41333// 1 U$u$ #a,)wangsan
255KOMSI+AH 45 #PS 4,,&443, 1 U$u$ Lon)ng
&45 DWI 6IST+ARINI ,- Askes ,*--&- 1 U$u$ D/(angan
257AGUNG RUDI+ANTO */ Askes ,*--&1/ 1 U$u$ D/(angan
&4 EKO WIDI+ATI *1 Askes 1/*/*&,* 1 U$u$ K/0ungo
259SUKARNI &3 #PS 1&1331&1 1 U$u$ Pa!er'n
&5- KHA8ID 4 #PS 4,,51///& 1 U$u$ W)nong
261PUTRI ENDANG SETIOWATI 11 #PS 4,4&&1534 1 U$u$ +)r)(uo
&5& SITI SARI+AH *3 #PS 4,4554-3& 1 K0 Lon)ng
263SUMARNO ,- #PS 4,455,31& 1 U$u$ Lon)ng
&5, SU6ASTRI ,- #PS 4,,/53*1 1 K0 Lon)ng
265TUTI ASIH ,* Askes ,3&*5&4 1 U$u$ Su,oragan
&55 S(ENA AMRINA ROSADA #PS 1&5*511/ 1 U$u$ Su,oragan
267SUKARNI &3 #PS 1&1331&1 1 U$u$ -ag/ron
&5 KHA8ID 4 #PS 4,,51///& 1 U$u$ W)nong
269PUTRI ENDANG SETIOWATI 11 #PS 4,4&&1534 1 U$u$ +)r)(uo
&3- SITI SARI+AH *3 #PS 4,4554-3& 1 K0 Lon)ng
271SUMARNO ,- #PS 4,455,31& 1 U$u$ Lon)ng
&3& SU6ASTRI ,- #PS 4,,/53*1 1 K0 Lon)ng
273S(ENA AMRINA ROSADA #PS 1&5*511/ 1 U$u$ Su,oragan
&3, RATINEM *- #PS 4,45&/,1/ 1 K0 +)r)(uo
275SITI PAINGAH *, #PS 4,,&*-4, 1 K0 #a,)wangsan
&35 SURTINAH ,/ #PS 4,,-&, 1 K0 Su,oragan
7/25/2019 3. Lap. JKN Bln Maret 14
58/99
277SITI #AMI6AH ,- #PS 4,,45453 1 K0 W)nong
&3 SUKARMI *5 #PS 4,41/*4, 1 K0 Su,oragan
279SADAR+ANTI &/ #PS 4,4341-55 1 K0 +)r)oo
&- WAGISAH * #PS 4,,&*&-3/ 1 K0 Lon)ng
281WASIDAH ,5 #PS 4,,**,-, 1 U$u$ Su,oragan
&& SUPI+ATI 55 #PS 4,5&14--4 1 U$u$ W)nong
283REWOT 33 #PS 4,,/1*&,4 1 U$u$ -uso
&, MUH KHANA8I / #PS 4,,54*35 1 U$u$ W)nong
285SUMINTRI 41 #PS 4,,535*1/ 1 U$u$ -uso&5 GUNARTI ,1 #PS 4,413/,3 1 U$u$ #a,)wangsan
2870AINGAH 5 #PS 4,51*,* 1 U$u$ W)nong
& SITI TRIANA 8A#ARWATI 3 #PS 4,45/5/- 1 U$u$ *aran
289SITI NGANANI+AH */ #PS 4,5&-//54 1 U$u$ W)nong
&/- RUMI+ATI *, #PS 4,41-31, 1 U$u$ #a,)wangsan
291RIRIN DWI ARI+ANTI 5 #PS 4,,33&,4 1 U$u$ #a,)wangsan
&/& SITI MUNAWAROH ,5 #PS 4,4&14& 1 U$u$ #a,)wangsan
293MUSTAKIM 4* #PS 4,4-&1,& 1 U$u$ #a,)wangsan
&/, #UMINURHADI #PS 4,,/1-*3 1 U$u$ Lon)ng
295SU6ASI+AH 4, Askes ,54//, 1 U$u$ #a,)wangsan
&/5 SI+ONO 44 Askes ,3*3*/4 1 U$u$ W)nong
297SUGI+ANTO * #PS 4,,51-554 1 U$u$ Karang Duwur
&/ SARINDI 3, #PS 4,451-1 1 U$u$ +)r)oo
299KESUT SU0ANDI ,3 #PS 4,4**5,& 1 U$u$ +)r)oo
*-- MISTI+AH ,, #PS 1&&5,/-3* 1 U$u$ &/ug
301SU+ATI ,- #PS 4,,53/3/5 1 K0 Su,oragan
*-& NUR+ATI ,4 #PS 1-1/&,*3 1 U$u$ #a,)wangsan
303ARI8 DWI 9AH+O 1 #PS 4,,,-*/1 1 U$u$ Lw
*-, MARATUR RO8IAH / #PS 4,5*14&35 1 U$u$ W)nong
305ASTRO , #PS 1-1/&3/44* 1 U$u$ Lw
*-5 ROUPI+AH 45 #PS 4,,5515 1 U$u$ Lon)ng
307SET+O UTOMO *- #PS 4,4*15,/ 1 Gi!i W)nong K)0u
*- SUHAR+ANTO ** #PS 4,4&1*&-, 1 Gi!i Su,oragan
309MUHAMAD SID;UN M 5 #PS 4,4&-,5- 1 U$u$ Su,oragan
7/25/2019 3. Lap. JKN Bln Maret 14
59/99
*1- MUH ARI8IN && #PS 4,4,/,,/ 1 U$u$ Su,oragan
311DASIMAH ,* #PS 4,4&4*&- 1 Gi!i Su,oragan
*1& 2AINUDIN 3, #PS 1-1/&*/,1 1 U$u$ -ag/ron
313RUKUN PRA+ITNO */ #PS 4,,33*13& 1 U$u$ -uso
*1, WAHID RAMDANI 14 #PS 4,45/,/3, 1 U$u$ *aran
315SANDI 3, Askes ,35,--& 1 U$u$ Su,oragan
*15 H# MUNDAR+ATI SANDI 5/ Askes ,35*--1 1 U$u$ Su,oragan
317PARTI */ #PS 4,4-&&1-1 1 U$u$ Wonosuko
*1 SETI+AWAN ARRI+ADH 4 Askes 1//1&/-&5 1 K I A Su,oragan319SITI RO9HIMAH * #PS 4,5*1*5/ 1 K I A W)nong
*&- I6HAM MAU6ANA 4 #PS 4,,5311/ 1 K I A Su,oragan
321SU6IMAN ,/ #PS 4,5&/1&1 1 U$u$ *aran
*&& KHO8I8AH 6AI6ATU6 MUNA #PS 4,41/,,5& 1 U$u$ Su,oragan
323KAROMATUNISA 1, #PS 4,,3-1*,1 1 U$u$ Su,oragan
*&, PONISAH 3- #PS 4,4,3/4& 1 U$u$ W)nong
325TRISNANI 4* #PS 4,5,*&/4& 1 U$u$ W)nong
*&5 SUPINATUN ,1 #PS 4,,/-/31 1 U$u$ W)nong
327A6=8ANI ADI KURNIAWAN 5 #PS 4,,3&45-5 1 K I A Su,oragan
*& A68IN KURNIAWAN * #PS 4,43,/-5 1 K I A &/ug
329#UINAH *, #PS 4,54,15* 1 U$u$ !urus
**- KUSMIRAWATI &5 #PS 1-1/&5,-41 1 K0 +)r)(uo
331NASRU6 11 #PS 4,4&&4* 1 U$u$ +)r)(uo
**& KA6IMAH 4- #PS 4,411,3&& 1 U$u$ Wonosuko
333S+ARI8 IMAM SANTOSO *5 Askes ,,-&/,, 1 U$u$ W)nong
**, MUHAMAD HANI8 S 4 #PS 4,4*,35&/ 1 K I A Lon)ng
335SRI+ANI ,3 #PS 1&5--&/3 1 U$u$ Lon)ng
**5 TUR+ANTO *1 #PS 4,44-3-3 1 U$u$ +)r)(uo
337SUKARMI *5 #PS 4,41/*4, 1 Gi!i Su,oragan
** WENI APRI6OWATI 15 #PS 4**-*&13 1 K I A Lon)ng
339SANGADAH 4/ Askes ,*,,,11 1 U$u$ W)nong Lor
*,- SITI 9HOTIMAH *1 #PS 4,,/5441 1 K I A !urus
341 2AHRITUSS+I8A , #PS 4,5&&11& 1 U$u$ W)nong
*,& IKMA6UDIN 1- #PS 4,,-&1,1 1 U$u$ Su,oragan
7/25/2019 3. Lap. JKN Bln Maret 14
60/99
343MISKI+AH 51 #PS 4,4&-3453 1 U$u$ Su,oragan
*,, ROHMADI - #PS 4,,&,4, 1 U$u$ !urus
345A0DU6 HA8I2D AS SAI8I &- #PS 4,45414*3 1 U$u$ *aran
*,5 SUR+ATI *4 #PS 4,,555-* 1 U$u$ Lon)ng
347AMAD 2AIDIN 4 #PS 4,,/*-/1 1 U$u$ #a,)wangsan
*, KHATAMI A6I 8A9HRI+AN 5 #PS 4,,511&, 1 U$u$ Karang Duwur
349A68IAH ,, Askes ,&,4-,/ 1 U$u$ W)nong
*4- SET+O UTOMO *- #PS 4,4*15,/ 1 Gi!i W)nong K)0u
3510ADRI+ATUN *- #PS 4,,4*&&5 1 U$u$ Karang Duwur*4& SUPARMI ,/ Askes ,3*4*4 1 U$u$ W)nong
353A0DURROHMAN WA9HID 3 #PS 4,41/&-1/ 1 U$u$ W)nong K)0u
*4, 6IS NURHA+ATI *1 #PS 4,,*4&14 1 K0 Lon)ng
355MANISAH 4 #PS 4,41/&/3 1 U$u$ Su,oragan
*45 SANI+AH *3 #PS 4,4*1/54& 1 K I A W)nong K)0u
357SITI MASU6AH U68AH &- #PS 4,4*,5/ 1 K0 Wonosuko
*4 SU6ANINGSIH *1 #PS 4,411&/55 1 K I A Wonosuko
359KURNIASIH *1 #PS 4,43&4--1 1 K0 -ag/ron
*5- DWI HER+ANTI ** #PS 4,4&4535 1 K I A D)/(
3618E0RI A0DU66AH & #PS 4,,43-4 1 K I A W)nong
*5& 6ESTARI ,& #PS 4,,5&-14/ 1 K0 W)nong
363WI#I+ATI *, #PS 4,441/-/& 1 K0 K/0ungo
*5, WAH+UNINGSIH 4 #PS 4,,5&*/4 1 K I A W)nong
365SI6:IANA 8ADHI6A 4 #PS 4,41/5/*5 1 K I A Su,oragan
*55 KHAMIDAH ,- #PS 4,,*-&,14 1 K0 Lon)ng
367SITI KAU6AH * #PS 4,4**4,1 1 K0 Lon)ng
*5 TU6US 54 Askes ,354-/* 1 U$u$ Wonosuko
369USNADI PONIRAN 5- #PS 4,4&1514 1 U$u$ -ag/ron
*3- NGADIRUN 33 #PS 4,,35/&/ 1 U$u$ K/0ungo
371HARIS SETIAWAN 1& #PS 4,411&&1* 1 U$u$ Wonosuko
*3& INGGIT SIWIS RE#EKI 1, #PS 4,441/&*3 1 U$u$ K/0ungo
373SOIM 8AHRURO2I 15 #PS 4,4-,&,4 1 Gi!i #a,)wangsan
*3, IRHAMUDIN &- #PS 4,,&33/43 1 U$u$ Lon)ng
375RO#I+AH 5/ Askes ,,&&554 1 U$u$ W)nong
7/25/2019 3. Lap. JKN Bln Maret 14
61/99
*35 USWATUN KHASANAH ,4 Askes ,,11&1 1 U$u$ W)nong
377PATIMAN 5& #PS 4,,&-3-* 1 U$u$ Lon)ng
*3 SRI+ATUN 4- #PS 4,4,1--,4 1 U$u$ W)nong Lor
379PAR#AN 4/ #PS 4,4**,/*/ 1 U$u$ Lon)ng
*- 0AINGAH 5 #PS 4,51*,* 1 U$u$ W)nong
381 #UMINURHADI #PS 4,,/1-*3 1 U$u$ Lon)ng
*& AMAT TOI8UR */ #PS 1&41-&/45 1 U$u$ W)nong
383SUPINAH *1 #PS 4,,5,& 1 U$u$ W)nong K)0u
*, #UINAH *, #PS 4,54,15* 1
U$u$ !urus
385NASRUDIN 43 Askes ,31,-4 1 U$u$ W)nong
*5 IRMA WAH+U 8E0RIANINGSIH 5 #PS 4,5*,/,*& 1 U$u$ W)nong
387TUKIRIN 53 #PS 4,4**34* 1 U$u$ Lon)ng
* +U68A 8ITRI SAKINAH 3 #PS 4,4&-*&-* 1 U$u$ +)r)(uo
389KRIS MARSANI , #PS 4,,&4,5& 1 U$u$ Lon)ng
*/- SUPRI+ATI 4, #PS 1-1/&3335 1 U$u$ W)nong K)0u
391MUSTO;I+AH 4 #PS 1-1/&,4,&1 1 U$u$ W)nong
*/& MUHAMMAD KAUTSAR 1/ #PS 4,4&&/54 1 U$u$ #a,)wangsan
393SUGINING RAHA+U 4 Askes ,3*15/& 1 U$u$ Su,oragan
*/, WARSITO 4- #PS 4,45-4,1 1 U$u$ Wonosuko
395MARSI+AH 1 #PS 4,413/1, 1 U$u$ Su,oragan
*/5 AKHMAD 4, Askes ,3**4& 1 U$u$ Kroo
397SUGENG RAHAR#O 44 #PS 1-1/&33334 1 U$u$ W)nong K)0u
*/ KOTIMAH , #PS 4,4-/4*, 1 U$u$ Wonosuko
399MUGI ARISWANTI *- #PS 4,51*3/,* 1 K0 Karan! Duur
,-- 2U0AIDAH ,1 #PS 1-1/&,,5&& 1 K0 6'nin!
401WASI+AH 4 #PS 4,,/3*13, 1 U$u$ Turus
,-& DAMAR 4 #PS 4,5&-3&3 1 U$u$ Win'n!
4038AHRU ADI PAMUNGKAS #PS 4,4551- 1 U$u$ 6'nin!
,-, 2AROMI ,4 Askes ,55//*/ 1 U$u$ Krande!an
4050ONI+AH 4- #PS 4,,/*&,4/ 1 U$u$ Win'n!
,-5 A0DURROHMAN , #PS 4,,3-,5& 1 U$u$ Sut'ra!an
407WASI6ATUN 43 Askes ,3**5/, 1 U$u$ 6'nin!
,- M KHARIS MUHAIMIN 1* #PS 4,5*1,,44 1 Gi!i Win'n!
7/25/2019 3. Lap. JKN Bln Maret 14
62/99
409AS6AMI+ATI ,* #PS 4,,3-41- 1 K I A Sut'ra!an
,1- A+UP 3, #PS 4,4,,&,/1 1 U$u$ Sut'ra!an
411RO9HANI 5 #PS 1-1/&,4,1/ 1 U$u$ Win'n!
,1& SISKA NO:ITASARI 5 #PS 4,45-4& 1 U$u$ Giri$ul"'
413MU#I6AH *, #PS 4,45-4,-& 1 U$u$ Giri$ul"'
,1, ANGGA 0UDI PRATAMA 3 #PS 4,44133/3 1 U$u$ Mlaran
415WAKIDI 4- Askes ,3*,44/ 1 U$u$ Seren
,15 A0DUS SAKIR 14 #PS 4,4-&14* 1 Gi!i Girij'"'
417AS6AMI+ATI ,* #PS 4,,3-41- 1 K0 Sut'ra!an
,1 SOPI+AH 4- #PS 4,45333* 1 K0 Girij'"'
419MAR+ATI *4 #PS 4,4*&13 1 K0 Giri$ul"'
,&- MISKI+AH ,* #PS 4,4414*/ 1 K0 Win'n!
421WAIS A6=;ORNIA &* #PS 4,,3&4,51 1 K I A Win'n!
,&& SRI ROKHIMAH */ #PS 4,,534*5 1 K0 Sut'ra!an
423#ARODAH , #PS 1-1/&,5445 1 U$u$ Win'n!
,&, AMAT SO6IHIN */ #PS 4,4143,, 1 U$u$ #atian!san
425TITI U68AH &, #PS 4,43-435* 1 U$u$ Girij'"'
,&5 NI
7/25/2019 3. Lap. JKN Bln Maret 14
63/99
,,& SRI+ATI 41 #PS 4,,/*314 1 U$u$ Turus
443SITI RO9HIMAH *4 #PS 4,,313// 1 K0 6'nin!
,,, #UMINURHADI #PS 4,,/1-*3 1 U$u$ 6'nin!
445MUAWANAH ,, #PS 4,4-&11 1 K0 Win'n!
,,5 M NASRU6 MU#AHID , #PS 4,,13,4 1 K I A Win'n!
4470ARODIN 4- #PS 1&&4*-&5& 1 U$u$ Dile$
,, SITI AMINAH &5 #PS 4,434&44 1 U$u$ Girij'"'
449SAMSU6 MA
7/25/2019 3. Lap. JKN Bln Maret 14
64/99
475DWI 6IST+ARINI ,- Askes ,*--&- 1 U$u$ De$an!an
,35 SUDIRO 3* Askes 15&154&-4 1 U$u$ 6'nin!
477WAGI+EM 5 Askes &-1--&,-/ 1 U$u$ Win'n!
,3 MU6+ANI ,5 #PS 4,41533- 1 K0 #atian!san
479TUPARI+AH */ #PS 4,,51/*,/ 1 U$u$ Pus'
,- RISKI +U6IANINGSIH #PS 4,4&,43-4 1 U$u$ Giri$ul"'
481PAINEM 4& #PS 4,4&,441, 1 U$u$ Giri$ul"'
,& HENI SUR+ANI *3 #PS 4,4&,--1 1 K0 Giri$ul"'
4838AIRU2 MAU6ANA A 3 Askes 13,5333-* 1 U$u$ Giri$ul"'
,, 8ADHI6 INSANI 11 Askes 13,45411 1 U$u$ Giri$ul"'
485MUNTO NGA6IMAN 14 #PS 4,4&,5,1, 1 U$u$ Giri$ul"'
,5 +U6I+ATI ,1 #PS 4,4&,4/-3 1 U$u$ Giri$ul"'
487HENI SUR+ANI *3 #PS 4,4&,--1 1 U$u$ Giri$ul"'
, 0AINGAH 5 #PS 4,51*,* 1 U$u$ Win'n!
489AR8A RAIHANA A 5 Askes /35415135 1 U$u$ Sut'ra!an
,/- 2AHROTU6 8ITRI+AH 1* #PS 4,,,&4, 1 U$u$ Win'n!
491S6AMET SUWARNO ,- #PS 4,44-,543 1 U$u$ Mlaran
,/& SU0OWO * Askes ,,-/5*3 1 U$u$ Krande!an
493A0DU6 8ARI2A6 5 #PS 4,4&,5,5/ 1 Gi!i Giri$ul"'
,/, ROWI+AH ,3 #PS 1-1/&,4553 1 U$u$ Win'n!
4958AIRU2 MAU6ANA A 3 Askes 13,5333-* 1 Gi!i Giri$ul"'
,/5 RAHMAWATU6 MUNA 5 #PS 4,5*,533 1
U$u$ Giri$ul"' 497SITI #ARI+AH 4 Askes ,,*43* 1 U$u$ Win'n! Kidul
,/ S+AMSU 0AHRI 3 #PS 4,,3,15*3 1 U$u$ Giri$ul"'
499WAGIMAN 3* #PS 4,,/-3311 1 U$u$ Win'n!
4-- SARMINI *4 #PS 4,,/4// 1 Gi!i 6'nin!
501HA6IMAH *1 #PS 1-1/&4&355 1 K I A Kedun!l'
4-& PUTRA ARDI+ANSAH , #PS 4,,5-35 1 K I A 6'nin!
503KRIS MARSANI , #PS 4,,&4,5& 1 K0 6'nin!
4-, SU6ANINGSIH *1 #PS 4,411&/55 1 K0 Win'n!
505DWI HER+ANTI ** #PS 4,4&4535 1 K0 Dile$
4-5 DWISINTA KHOIRONI 4 #PS 4,4,5,5*1 1 K I A Sut'ra!an
507WI#I+ATI *, #PS 4,441/-/& 1 K I A Sut'ra!an
7/25/2019 3. Lap. JKN Bln Maret 14
65/99
4- +ASIR &4 #PS 4,,,,*41 1 U$u$ Kedun!l'
509KOMAMI , #PS 4,,,,1& 1 U$u$ Kedun!l'
41- SAR+ONO ** #PS 4,,,1&5&1 1 K I A Kedun!l'
511TU+ONO ,1 #PS 4,,,1,411 1 U$u$ Kedun!l'
41& TU+EM 4/ #PS 4,,,33& 1 U$u$ Kedun!l'
513RUM6AH *& #PS 4,,,4445& 1 U$u$ Kedun!l'
41, ARTIKA PERMATASARI #PS 4,,,&145, 1 U$u$ Kedun!l'
515SHO8I NAI6A HANIE8AH / Askes 1&,41//& 1 U$u$ Win'n!
415 MUHAMMAD HAKAM ARROU8 1 Askes ,,-11 1 U$u$ Win'n!
517RETNO SUKENGSIH ,1 Askes ,,-1-3 1 U$u$ Win'n!
41 0ARODIN 4- #PS 1&&4*-&5& 1 U$u$ Dile$
519HENI SUR+ANI *3 #PS 4,4&,--1 1 U$u$ Giri$ul"'
4&- RU0I+ATI ,- #PS 4,,/4/-33 1 U$u$ #atian!san
521RODI+AH 1/ #PS 4,,51,* 1 U$u$ Girij'"'
4&& KA+6A 8E0+ NE6I2AR * #PS 4,441*/41 1 K I A Pa!er'n
523SUWARNI 31 #PS 4,,14*-* 1 U$u$ Kedun!l'
4&, SISNIANTI *3 #PS 4,,5/5315 1 K I A Sut'ra!an
525SARMINI *4 #PS 4,,/4// 1 Gi!i 6'nin!
4&5 RONDHI+AH ,- #PS 4,4335/,& 1 U$u$ Girij'"'
527RO#I+AH 5/ Askes ,,&&554 1 U$u$ Win'n!
4& AU6IA HIDA+ATI #PS 4,4&/41* 1 U$u$ 6'nin!
529
SUDARNO 3- Askes ,413,3/ 1
U$u$ Win'n!4*- TU6US 54 Askes ,354-/* 1 U$u$ W'n'suk'
531RO0IATU6 NGADAWI+AH ,& #PS 4,4*--,5/ 1 U$u$ Win'n! 6'r
4*& MU9H NURWAHIDIN HIDA 14 #PS 4,4*--3/5 1 U$u$ Win'n! 6'r
533A+U NO:ITA SARI &- #PS 1-1/&,*/ 1 Gi!i #atian!san
4*, PONI+AH 33 #PS 4,45*5&* 1 U$u$ Pa!er'n
535AMIR RE#O 3 #PS 4,45***1 1 U$u$ Pa!er'n
4*5 SAR+ONO 5- Askes ,3**/-3 1 Gi!i Seren
5378ARDAN 8A2A 8AU2AN / Askes ,,-&/55 1 U$u$ Win'n!
4* SUGINING RAHA+U 4 Askes ,3*15/& 1 U$u$ Sid'rej'
539U6:I 9HASANAH 15 #PS 4,4-&15&3 1 U$u$ #atian!san
4,- ENDAH RI+AH 44 #PS 4,4-&1&&* 1 U$u$ #atian!san
7/25/2019 3. Lap. JKN Bln Maret 14
66/99
541TE#O SUNARKO 3 #PS 4,,3,5/& 1 U$u$ Sut'ra!an
4,& SITI MUHANAH ,3 #PS 4,,3,4554 1 U$u$ Re%u!
543ANDRI WI#A+ANTO &1 #PS 4,,&3-5/ 1 Gi!i 6'nin!
4,, SARWI+AH * #PS 4,,/-5** 1 U$u$ 6'nin!
545 #UMINURHADI #PS 4,,/1-*3 1 U$u$ 6'nin!
4,5 SAR+ONO ** #PS 4,,,1&5&1 1 U$u$ Seren
547PAI#AH 4 #PS 4,5**,,,5 1 U$u$ Pus'
4, SITI 9HAMIDAH 4* #PS 1-1/&,,-4 1 U$u$ 6'nin!
549MUH KHANA8I / #PS 4,,54*35 1 U$u$ Win'n!
44- MUSTANGIN 5 #PS 4,5*5&541 1 U$u$ Win'n!
551RE0I+EM 5* #PS 4,,14,4/ 1 U$u$ Sut'ra!an
44& E:E6IN 9INTA MIRA0I6A , #PS 4,44&/1 1 K I A Pus'
553KARTINI ,& #PS 4,4*45 1 K0 Pus'
44, RATNO ,, #PS 4,4&541*, 1 U$u$ Dile$
555SITRISNO ,3 #PS 4,4&51&*1 1 U$u$ Dile$
445 SITI NUR#ANAH 1& #PS 4,4**&,3 1 U$u$ Girij'"'
557MUHAMMAD HARIS 8AISA6 , #PS 4,4,,,5 1 U$u$ Girij'"'
44 8ATIMAH 1 #PS 4,45,5511 1 U$u$ Girij'"'
559PARTI 45 #PS 4,,4/31- 1 U$u$ Pa!er'n
45- EN+ PU#I SET+AWATI &3 #PS 4,4*&&1 1 K I A Pa!er'n
561EN+ PU#I SET+AWATI &3 #PS 4,4*&&1 1 U$u$ Pa!er'n
45& 0ONISIH *- #PS 4,5&,*1,& 1
K I A Pa!er'n563NASRI:ATUN ,& #PS 4,4/15*4& 1 K I A Pa!er'n
45, SAUDAH ,& #PS 4,51/*,, 1 K I A Pa!er'n
565SAUDAH ,& #PS 4,51/*,, 1 U$u$ Pa!er'n
455 SUHARTI ,- #PS 4,51*&5// 1 K0 Mlaran
567TANGGUN U#I 6UT RIAWAN & #PS 4,4&-,&3& 1 Gi!i Pus'
45 PAISAH ,3 #PS 4,415&*1/ 1 U$u$ Pus'
569MAR2UKI * #PS 4,,1/&5* 1 U$u$ Win'n!
43- I6HAM WU6AN RAMADHAN 5 #PS 4,,53-4* 1 K I A 6'nin!
571SRI ASTIATUN ,& #PS 4,51/34/ 1 K0 Win'n!
43& RI2KI SAPUTRO 3 #PS 4,,&&-5, 1 U$u$ Win'n!
573MUKMINAH *3 #PS 4,,5&&3&4 1 U$u$ Win'n!
7/25/2019 3. Lap. JKN Bln Maret 14
67/99
43, U68AH MUSAROH &, #PS 4,4*4&45 1 K0 Giri$ul"'
575PRI+ANTI &3 #PS 4,,1-,35 1 U$u$ 6'nin!
435 PRI+ANTI &3 #PS 4,,1-,35 1 K I A 6'nin!
577SAR+ONO 5- Askes ,3**/-3 1 Gi!i Seren
43 MUH ARIP ANWAR 4 #PS 4,54,*-** 1 U$u$ Turus
# u $ l a ( ,5 & 1- - - 1
578
7/25/2019 3. Lap. JKN Bln Maret 14
68/99
7/25/2019 3. Lap. JKN Bln Maret 14
69/99
7/25/2019 3. Lap. JKN Bln Maret 14
70/99
Kunj. Askes
Kunj) #KN
Kunj. #t
Kunj. TNI>P'l
TUJUAN PELAYANAN 2AN 3ESARAN TARI4 SESUAI PER2A
KES
3PU 5i1i KIA I1d La6. T"n !+#%) T"n %$ 7 T"n
P L P L P !( !+ &, &! &&
!' !) !$ !% !*
'
1
1
1
1
1
1
1
1
1
1
7/25/2019 3. Lap. JKN Bln Maret 14
71/99
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 3. Lap. JKN Bln Maret 14
72/99
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
11
1
1
1
1
1
7/25/2019 3. Lap. JKN Bln Maret 14
73/99
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 3. Lap. JKN Bln Maret 14
74/99
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 3. Lap. JKN Bln Maret 14
75/99
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 3. Lap. JKN Bln Maret 14
76/99
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 3. Lap. JKN Bln Maret 14
77/99
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 3. Lap. JKN Bln Maret 14
78/99
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 3. Lap. JKN Bln Maret 14
79/99
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 3. Lap. JKN Bln Maret 14
80/99
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 3. Lap. JKN Bln Maret 14
81/99
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
11
1
1
1
1
1
7/25/2019 3. Lap. JKN Bln Maret 14
82/99
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 3. Lap. JKN Bln Maret 14
83/99
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 3. Lap. JKN Bln Maret 14
84/99
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 3. Lap. JKN Bln Maret 14
85/99
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 3. Lap. JKN Bln Maret 14
86/99
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 3. Lap. JKN Bln Maret 14
87/99
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
11
1
1
1
1
1
7/25/2019 3. Lap. JKN Bln Maret 14
88/99
1
1
1
1
1& /4 & &/ 1/
578
-orejo & A/ril &,!)
T Puskesmas 0inon1 Kemiri
dr1. Susi Ari8ani
. 19631010 199202 2 001
7/25/2019 3. Lap. JKN Bln Maret 14
89/99
7/25/2019 3. Lap. JKN Bln Maret 14
90/99
7/25/2019 3. Lap. JKN Bln Maret 14
91/99
Tidak terda?tar
0ulan Maret &-1,
' !A++AL o -ar/ o KA&!U A*A -%S%&!A S% USIA !U#UA
1 *>*>&-1, 4,451/-/ 8ar(an 6 5.4 0PU
& *>1->&-1, 4,4/3-535 Siti Ru%aia( P *4 K0* *>11>&-1, 4,45**3&5 Turi$an 6 44 0PU
, *>&5>&-1, 4,,4&5,*5 Wasis' 6 5- 0PU
Pur-orejo & A/rKe/ala UPT Puskesmas
dr1. Susi Ari8
NIP. 19631010 19920
7/25/2019 3. Lap. JKN Bln Maret 14
92/99
7/25/2019 3. Lap. JKN Bln Maret 14
93/99
7/25/2019 3. Lap. JKN Bln Maret 14
94/99
ALA*A! K%!
Girij'"'
#atian!san6'nin!
Tursin'
s
il &,!) inon1 Kemiri
ni
2 2 001
7/25/2019 3. Lap. JKN Bln Maret 14
95/99
7/25/2019 3. Lap. JKN Bln Maret 14
96/99
7/25/2019 3. Lap. JKN Bln Maret 14
97/99
7/25/2019 3. Lap. JKN Bln Maret 14
98/99
7/25/2019 3. Lap. JKN Bln Maret 14
99/99