FORMAT PENDATAAN PUS 2017

KABUPATEN : SIDOARJO
PUSKESMAS : GEDANGAN
DESA :
POSYANDU :
ALAMAT (Dusun/RT/RW) : KETAJEN. RT01 RW02

Ket.(Kronis.
NO NIK KK/No. KK NIK ISTRI NAMA* Tgl Lahir* NIK SUAMI Nama* Tgl Lahir* NIK Anak Nama* JK* Tgl Lahir Metode KB*
Gakin)
1 NOVIA
MUJIB 3515164608010004 AGUSTIN I B
3515162601091523 3515165210800005 SRI IRAWATI 22/10/1980 3515161003740001 IBRAHIM 10/03/1971 P 06/08/2001
AYU CITRA
3515161104060001 CENDANA
P 11/04/2005
SARAH HAJAR
3515165606140001 IBRAHIM P 16/06/2014
2 SAMSUL RIKA AULIA
3515162601092886 35151661274000 TRIYANI 16/12/1974 35151631175000 HUDA 23/11/1975 351516300305000 PUTRI P 30/03/2005
3 MEGA
SUNTIK
3515162601092379 3515165705740002 SIH PANGANTI 17/05/1974 3515162206710002 KARIYONO 22/06/1971 3515165705940004 ARISANDI P 17/05/1994
CINDY DEWI
3515166101990001 FITRIYA P 21/01/1999
4 NINA SUSI
3515162601091702 3515165007650004 WARTINI 10/071965 3515161807650001 KOMSARI 18/07/1965 3515166711860002 LOWATI P 27/11/1986
ARJUNA DZAKY
3515160301070009 WIBOWO L 03/01/2007
35151091112940002 YINO MARTINO L 11/12/1994
5 DESTANTRA
NENI DWI KUKUN M. REYUAN SUNTIK
3515165111910002 RISWATI 11/11/1991 3515162112840003 WIDIATMOKO 21/12/1984 3515161005130006 ALVINO P 10/05/2013
6 ERTIN MUHAMMAD -
-
3515162010140007 35151660402920001 NICHATULKUSNA 23/02/1992 351516249900003 SYAFII 24/09/1990 - - - -
7 KHUSNUL ABDUL MALUY PUTRI
SUNTIK
3515164108790003 FARIDAH S 01/08/1979 3515160510760001 ROHMAN 05/10/1976 35156440490003 ARDASAWI P 04/04/1998
DANRIL
3515162903020002 MAHKTIR R P 29/03/2002
8 MUHAMMAD
3515162601091525 3515165406740002 ERNA MUFIDAH 14/06/1974 3515162011710004 KHOLIDIN 20/11/1971 3515161707070001 ERDIN R L
9 3515161208090006 3515164101450115 KASIHATI 01/01/1945 3515160101420051 AHMAD 01/01/1942 - - - - -
10 GENDUT DEDY WAHYU
3515172601090194 351517480668000 AINUR R 08/06/1968 351517001600110 SUMARDI 01/01/1960 3515112903920001 PRASETYO L 29/03/1992
DENI WAHYU
351517046050001 SETYAWAN L 04/06/1995
11 NOVI UMBAR ANTON AISHWA
3515162601095978 3515165211850002 RINI 12/11/1985 350617080280001 PURWANTO 08/02/1980 3515165912050001 INDIANI A P 19/12/2005
ALVAN
3515161006130002 PRATAMA P L 10/06/2013
12 AGUS ACMAD
3515164403780006 YANI ISNAINI 04/03/1978 3515161808760002 SUPRIYANTO 18/08/1976 3515162209980002 AKHARIS P 22/09/1998
13 RAHMAD SYAFRI
PIL
3515165112770001 FARIDA HANUM 11/12/1977 3515160911710002 HIDAYAT 09/11/1971 3515161711000005 FIRMANSYAH L 17/11/2000
 RIZALDI
3515160607040008 ARDIANSYAH L 06/07/2004
14 LAILATUL M. ARIF
3515166104810006 BIDAYAH 21/04/1981 3515161206790001 INDI HARTO 12/06/1979 3515101203030004 FAILANI L 12/03/2003
FEBI PUTRI
SUNTIK
3515162402100003 MAULIDA P 24/02/2010
15 BAMBANG
LAILAUL SUGENG UCIA PUJI MOW
351562601091577 3515166701650001 MUNIROH 27/01/1965 3515160702590002 TRISNO 07/02/1959 3515164803920005 RAHAYU P 08/03/1992
NADA RISKI
3515163105990010 ARISTA L 31/05/1999
ADRILIA PUJI
3515168804020001 LESTARI P 18/04/2002
16 NUR
H. AGUS IMANIATUS PIL
3515162601091621 3515166908690001 ST. MUTMAINAH 29/08/1969 3515162804640001 BUDIONO 28/04/1964 351516540930002 SADIYAH P 14/02/1993
AHMAD
3515161903000001 BUHARNUDINA L 19/03/2000
17 AFRIYAH
IUD
3515162601094424 3515166710670004 SULIMAH 27/10/1967 3515160101650049 SUPARDI 01/01/1965 3515164304920001 FITRIANA P 03/04/1992
18 AHMAD RECHAN
BAHARUDIN AHMAD FIL SUNTIK
351516200612007 3515166318400006 MARIYAM ULFA 13/01/1984 3515160403820002 MUHAYDI 04/03/1982 3515162103120002 BARKA L 21/02/2012
19 BAMBANG REZIYA AHMAD
PIL
3515162601091573 3515167012770001 IDA WINARSIH 30/12/1977 31515160306760001 SISWANTO 03/06/1970 3515166102150001 FIL BARKA L 21/02/2015
3515163007970001 ABD HAKAM L 30/07/1997
MAULANA
3515163103040003 MAKDUM IBR L 31/03/2004
NAKLA SIFA
3515166905140002 ARHYAR S P 29/05/2014
20 ASHRI AISYAH
3515165605840001 SOFIYATI 16/05/1984 3515166506040001 ROHAYANI P 25/06/2004
MUHAMMAD
3515162911080001 ALI’ YUSUP L 29/11/2008
MUHAMMAD
HISYAM
3515161805130003 AKMAL L 18/05/2013
21
3515162601091575 3515165408680006 NIWARNI 14/08/1968 3515160506550002 SAERI 05/06/1955 3515161303810003 SUPRIYO L 13/03/1981
YITA VIMA
3515164402900004 LASARI P 04/02/1990
22 ATIK CANDRA ALDI DWI
SUNTIK
3515162601091537 3506054404870002 WATI 04/04/1987 3515161812850001 BUDIANTO 18/12/1985 3515161709100006 CHANDRA R L 17/09/2010
ALDO EKA
3515161709100005 CHANDRA R L 17/09/2010
23
3515162304120005 3515166909740005 WIJIATUN 29/09/1974 3515163006650011 SARUDJI 30/06/1965 3515162604950001 KACHUL IBAD L 26/04/1995
MUHAMMAD
3515162609030001 IMABUDIN L 26/09/2003
3515165103100003 LAILIL MAROMI P 11/03/2010
24 NANANG
3515162304120005 3504084612870001 ERLA 06/12/1987 3515161208830007 EFENDI 12/08/1983 - - L
3515164210600002 ALFIAH 02/10/1960 - - - - - P
YUDI
PIL
3515160812840004 INDRIAWAN L 08/12/1984
25 M. NIZAR
35151601093172 3515166812700009 MAHMUDAH 18/12/1971 351516120003 ROHMAN 12/04/1961 3515160503930005 ARDIANSYAH L 05/03/1993
 HANIM
3515165903950001 AMIRIYAH L 19/03/1995
26 RULI DWI
SUNTIK
3515162601091668 3515164101700015 NASFIAH 01/01/1970 3515161108620000 SUHERI 11/08/1962 35151650001930002 SUSILOWATI P 10/01/1993
27 DESI SURATMI
PIL
3515162601091670 3515164101720006 DASRI 01/01/1972 3515161110700004 ISWADI 11/10/1970 351516610640001 NINGSIH P 21/06/1994
RISKY DWI
3515162411000005 KURNIAWAN L 24/11/2000
MUHAMMAD
3515160909040006 ERWIN P 09/09/2004
28
3515162601092502 35151690170000 INDAR PURWATI 29/01/2070 3515164407450002 MISIJAH 04/07/1945 35151680976000 MINUK SATITI P 28/09/1976
AGUS
35151620867000 IRWANTO L 12/08/1967
AGRA PRANA
35151600600000 ADI CANDRA L 10/06/2000
29 ANDIKA
3515162601091665 3515164504640001 KUNDAYATIK 05/04/1964 3515161405570003 SUPADI 14/05/1957 3515162010870003 HERMANSYAH L 20/10/1987
30 NOVI MUNITA DEVI ALIF
SUNTIK
3515165711860001 SARI 17/11/1985 3515162003820002 CHOIRUL 20/03/1982 3515164312050008 FADILLAH P 03/12/2005
31 PIL
3515162601091661 SUTIK 01/01/1961 3515162905590001 SAKUWAN 29/05/1959 IRWANTO L 08/09/1989
32 -
3515102601091528 3515164505590002 HJ. KAROMAH 05/03/1959 3515160210550001 H. SUTRISNO 02/10/1955 - - - -
33 ZAINUL ANIS DESVITA
3515162601093085 3515165310780001 HIDAYATIN 23/10/1978 35151674000 AINUN ROFIK 30/08/1974 3515165812050001 NURTAZALI P 28/12/2005
MUHAMAD
FATIR
3515162703130001 ALQOZALI L 27/03/2013
34 PIL
3515162601091574 3515164101570039 SALEKAH 01/01/1957 3515160101530011 BAKERI 01/07/1953 3515164204920008 PUJI RAHAYU P 02/04/1992
3515163005950002 HARIYANTO L 30/05/1995
351516204990002 BUDI UTOMO L 12/04/1999
35 -
3515160905120003 3515164609830003 MUDJAYATI 06/09/1983 3515160204870002 M. YAHYA 02/04/1987 - - - -
36 PIL
35151621091572 3515165205650005 SITI ROHMAH 12/05/1965 3515162212550002 HIDAYAT 22/12/1955 3515162312900002 RYAN H L 23/12/1990
3515162400010002 JIHAN RIFALDI L 24/06/2001
37 ACHMAD
3515162601091571 3515165104650001 ASYIFAH 11/04/1965 3515160501620002 SUTIKNO 05/01/1962 3515160602890002 SAIFUL ARIF L 06/02/1989
RETNO
MOW
351565701920003 WAHYUNI P 17/01/1992
38 RAASYA
AHMAD
RENI DIAH PRATAMA
3515162707100003 3515165511870003 FARIDA YANTI 15/11/1987 3515162008780001 PRIYADI 20/08/1978 3515162906100002 PUTRA L 29/06/2010
RACHEL PUTRI
DWI SUNTIK
3515164605120002 WULANDARI P 06/05/2012
3515162910610001 M. ARIFIN P 29/10/1961 SUNTIK
39 HANUS TETI PUTRA
SUNTIK
3515162601092665 35151074510710004 INDAYANTI 15/10/1971 3515162812720002 IRAWAN 28/12/1972 35151626030002 INDAWAN L 26/01/2009
40 BAMBANG
SULIS TIANING MUJI -
351516905150007 3515164704830002 DEWI ASIH 07/04/1984 35057031410670001 SUHARTONO 14/10/1967 - - - -
41 SULIS
WAHYUNING SULISTIYONO
1214150205712 3515164612610001 PAMUNGKAS 06/12/1961 3515160104560003 SUGIANTORO 01/04/1956 351562005880004 DIMAS S L 20/05/1988
 SULISTIA RISTA
3515166209050004 P P 22/09/2005
42 MOCHAMAD M. RENDRA
SUNTIK
3515162601093060 3515165903810001 ASIH HAYATI 19/03/1981 3515160805750002 ISBANDI 08/09/1979 3515162810050002 RAMADANI L 28/10/2005
M. RIFQI AL
3515161811140003 GHIFARI L 18/11/2014
43 ICHWAN
-
3515162909100003 3515164910820604 SRI LESTARI 09/10/1982 3515163006840004 ABDILLAH 30/06/1984 - - - -
44 MOCH AGUS
SUNTIK
1214150205682 3515164101740009 NOATIANI 01/01/1974 3515161905640003 MUSTAKIM 19/05/1964 3515160108920004 DRIYANTO L 01/08/1992
ELIS NUR
351516660960002 HIDAYAT P 16/05/1996
45 AGUS SALIM ACHMAD ANDI
PIL
3515162601092581 3515166504750003 WINARSIH 25/04/1975 3515162708730001 GUNAIDI 27/08/1973 3515162210950001 FIRMANSYAH P 22/10/1995
MOCH RISKY
3515162411980001 DARMANI L 24/11/1998
NABILA TRI
3515164709070004 WIJAYA P 07/09/2007
46 YUNITA TEGUH BUDI SHAFIRAH
3515162601091567 3515166906770006 PRABAWATI 19/06/1977 3515162506730006 SUBAGYO 25/06/1973 3515164906030004 NABILA SAMAH P 09/06/2003
SHABINA H
3515165108040004 MUMTAZZAH P 11/08/2004
47 HENDRO
3515162601091531 3515165705640002 KARTINA 17/05/1964 3515160505620001 ABD. ROCHIM 05/06/1962 3515160706850001 PRAMONO L 07/06/1985
NOVI DWI
3515166907890002 ASTUTIK P 29/07/1989
PUTRI
3515164404940004 APRILLINA P 04/04/1994
48 ASEP
3515162601091543 3515166306840003 NANIK IRAWATI 23/06/1984 3515160604840002 AWALUDIN 06/04/1984 - - - -
49 ALIF DHIMAS
3515162802140005 3515166310770003 SITI AMINAH 23/10/1977 352411710110730002 SUKARDI 10/10/1973 3515160306990003 ARROHMAN L 03/06/1999
RANGGA
3515162804040005 PRASTYA BUDI L 28/04/2005
RAHMAT BAYU
3515161310060009 SEJATI L 13/10/2005
50 ADI PUTRA
3515162601091548 3515164101650025 KUDRIYAH 01/01/1965 - - - 3515162612850001 RAHMANUS L 26/12/1985
51 YAAYIK ILHAM
3515162601091560 3515164805810006 SETIA ANDAYANI 08/05/1981 3515160202740005 YASAIR 02/02/1974 3515160607010005 M L 06/07/2001
DWI WAHYU
3515162309030005 FIRMANSYA L 23/09/2003
52 YASIRUL AYU WULAN
3515162601091554 3515166607710004 KHATIMAH 26/07/1971 351516291069003 DARMINTO 29/10/1969 3515166610950001 DARI W L 26/10/1995
M KIKI
3515163010000003 BAHARUDIN L 30/10/2000
53 BUDI AFANDI
3515162601091530 35151628720001 LAKSONO 26/01/1972 3515160302940001 HIDAYAT L 03/02/1994
3515165908000004 VIKA ANDANI P 19/08/2000
54
3515162601091539 3515164609650002 LINA 06/09/1965 3515160501570001 SYAIFUDIN 06/09/1965 - - - -
55 KHOIRUL NUR IMAM
3515162601091558 - - - 3515162504690001 ANAM 25/04/1969 3515160911930004 SYAFII L 09/11/1993
NUR
MUHAMMAD
3515160711030004 ALI ZAKI L 07/11/2003
56 WAHYU NOVI
PIL
3515162601091557 3515166103700002 KHOLILAH 21/03/1970 35151160506740004 LAMIDIN 05/06/1974 3515160811990004 DIYANTO L 08/11/1999
EKA
3515166008060001 WULANDARI P 20/08/2006
57
3515162601091559 3515164101450053 MUTMAINAH 01/01/1945 3515160101530026 KARNI 01/01/1953 3515162409730002 YUSUF L 24/09/1973
58
35151626010920500 - - - 3515160101550006 SUPARLAN 01/01/1955 3515164304820001 BADRIYAH P 03/04/1982
CHOIRUN
3515166307840001 NIKMA P 23/07/1984
MIFTAKUL
3515160112870006 HUDA L 01/02/1987
59 MUHAMAD
FEBRINIA EKA EKO FAIRUZ BAGAS SUNTIK
351516260109155 3578205302830001 RINDIARTI 13/02/1983 351516221830003 NUGROHO 22/11/1983 351516161210005 P L 16/12/2010
60 IMAM DIDAN
MOW
3515162601091553 35151650468 ROZITU 05/04/1968 3515160904680003 WAHYUDI 09/04/1968 35151680994 RESTIAN L 18/09/1994
AHMAD
35151670106 AFANDHI L 27/01/2006
61 AFRIZA AFNI
3515165505780004 NUR SHOLIKHAH 15/05/1978 3515162803770005 SAMSUL AFAR 28/03/1977 3515166101020001 AZIZAH P 21/01/2002
M. RIFQI RIZAL
UID
35151623305030005 ALKARIZA L 23/05/2003
62 ENY M. LUKMAN
MOW
3515162601091541 3515165211700002 MUSYAROFAH 12/11/1970 - - - 3515160709970002 HAKIM L 07/09/1997
IRVENI YULIA
3515164603100004 VITA AURINI P 06/03/2010
63 DENDI
3515162601091544 3515164503760001 FATMAWATI 05/03/1976 35151625107000 WARTON 25/10/1970 3515162307980002 ALVAREZA R L 23/07/1998
VALERINA
35151667070600 PUTRI AZIZAH P 27/07/2006
64 KARIS
MUHAMMAD FANDANA SUNTIK
3515162601093548 3515164405700004 ST. SULAIMAH 04/05/1970 3515161911640002 ROIS 19/11/1964 3515162111020001 REVINATA L 21/11/2002
65
3515162601091537 3515164101610024 KAYATI 01/01/1961 3515160101530063 WARTIMO 01/01/1953 3515165004860004 ST. FARIDA P 10/04/1986
MOH RUDI
3515160411940001 HERMANSYA L 04/11/1994
DIYAH
3515164902960001 RAHMAWATI P 09/02/1996
66 ARIF
RAHMAN NUR SANTIKA DWI
3515162601092583 3515166404790005 ST JUMAIYAH 24/04/1979 3515160903780001 CAHYO 09/03/1978 3515160610990003 CNDRA KIRANA P 26/04/2008
ARMALIA DEWI
351516830408000 P. C. P 23/04/2008
67 RIZKA LAILA SATRIYO SOPHIE ALICIA
IUD
35151601091561 3515165201870004 PUSPITA 12/01/1980 3515161401800005 BAYU MURTI 14/01/2080 3515165407110002 NABILAH P 14/07/2011
68 WIWIT RIZKA NUR
3515162601091566 351516051079005 INDAYANI 25/10/1979 3515161408740004 MARGIONO 14/08/1974 3515165210040001 IMANIA P 12/10.2004
69 BINTI DWI TITO NADIA
SUNTIK
3515162001140008 3515108461090001 HANDAYANI 06/10/1990 3515161304900001 RAMABANA 13/04/1990 3515164911140001 MAULIDA H P 08/11/2014
70 SENEN WAHYU EKA
3515162601093225 3515166406670002 SUPENI 24/06/1967 3515160709670003 RIYANTO 07/09/1967 3515161109920002 SETYAWAN L 11/09/1992
BAGUS DWI
3515160105010002 RIYANTO L 01/05/2001
71 SUHENDRIK
3515162601091535 3515164502660002 SRI NINGSIH 05/02/1966 3515163112660001 HARTAMAN 31/12/1966 35151601028010002 RIDHO F L 01/02/1989
GILANG YUDHA
3515162610940003 WICAKSONO L 28/10/1994
 FIRDAUS AYU
3515162008010001 ANGREANI L 20/08/2001
72 IRNUR H. MOH.
3515162601091540 351516601740002 WAHYUNINGSIH 15/01/1974 3515162907710002 SAYFUDIN SH 20/07/1971 3515160211950001 M AFYUDIN S L 02/01/1996
FAIRA NUR
3515165811980001 RAHMA P 18/11/1998
IFFAH ULI
35151166805030001 NUHA P 28/05/2003
73 ASTUTIK
3515162601092580 3515164111510001 KUSIYAH 11/11/1951 - - - - - P
74 MUHAMMAD
3515162601091550 351508450480010 POPI NIRTA RIA 05/04/1985 3515160101710001 ABDUL KODIR 01/01/1971 3515160305120001 ABDUL FAREL P 02/05/2012

FORMAT PENDATAAN PUS 2017

KABUPATEN : SIDOARJO
PUSKESMAS : GEDANGAN
DESA : KETAJEN
POSYANDU :
ALAMAT (Dusun/RT/RW) : RT 04/RW 02

Ket.
Metode
No. NIK KK/No. KK NIK ISTRI Nama* Tgl Lahir* NIK SUAMI Nama* Tgl Lahir* NIK Anak Nama* JK* Tgl Lahir* (Kronis,
KB*
Gakin)
ERVIN
1 351516260109169 3515164302580000 PAIZI 03/02/1958 - - - 3515164712920001 WAHYUNINGTIYAS P 07/12/1992
LILIK ESA BAYU
3515086410800003 UMROTIN 24/10/1980 3515082606800000 YUNIAR 26/06/1980 3515161907030000 SAMUDRA P 19/07/2003 SUNTIK
BINTANG ALIZA
3515161601080004 TAFTAZAINI P 16/01/2000 SUNTIK
UMI SYAIFUDIN
2 3515162601093117 3515166511790004 SUMARNI 25/11/1979 3515161407770004 ZUHRI 14/04/1977 3515161509060002 M. SABILAL ALIF P 15/09/2006
NIDAL WAFA
351516210330004 AZZUMRI P 21/06/2013

3 3515162601091678 3515165410710004 SUMARMI 14/10/1971 3515161706650003 SUKOCO 14/10/1971 3515165801940001 NORMA GUPIKA P 18/01/1994 PIL
ETIKA NOVIA
3515164311030004 RAMADINI P 03/11/2003

3515160101230008 SUKIRAN S 01/01/2023

4 35151626091685 3515166605680001 KAMSATUN 26/05/1968 3515161304540003 MUNIF 13/04/1964 3515162305900002 ANDRIK P 23/05/1990 PIL

3515162007940002 KHOLIS L 20/07/1994

3515164506990002 MIFTAKHUL JANA P 05/06/1999

 M. YANI /
5 3515162601091683 3515164506630003 SUMIAH 05/06/1963 3515160509550001 WARAS 09/05/1958 3515102706830002 ADI PURNOMO P 27/06/1983 PIL

3515165712950001 SYIFA FAUZIA P 17/12/1995

ANIS CHOIRUL
6 351516260191684 3515164407710002 ST. AISYAH 04/07/1971 3515161706620003 SUI 17/05/1962 3515166401940001 NISAK P 24/01/1994 PIL
KHOILAH
3515163112010001 RAHMAN P 31/12/2001
NUR IVA BELLA
7 351516260191684 3515164505720005 KHOLIFAH 05/05/1972 3515161004690008 SUBEKAR 10/04/1969 3515165808940001 AGUSTINA P 18/08/1994 PIL
YOGI PRASETYO
3515161309020006 DWI PUTRA L 13/09/2002
SUGENG
35151641003730009 KARTINI 01/03/1973 3515160104690006 HARIYANTO 01/04/1969 3515164107920003 ST. ZHURIAH P 01/07/1992 SUNTIK

3515165805070003 AZZA MEIDIANA P P 18/05/2007

NUR AHMAD
8 3515162601091686 3515164502720002 MARKAMAH 05/02/1972 3515160201660002 CHOJIN 02/01/1960 3515160507940003 PURNOMO AJI P 05/07/1994 PIL
MOCHAMAD
3515162906960005 QOFARUDIN L 29/06/1996

3515165012110002 RANIA MARWAH P 10/11/2011

9 35151611020002 3515164101590114 TEMU 01/01/1959 3515160303550005 DJAKARI 03/03/1955 - - P - PIL

HERI
3515164705760003 NAFICHATIN 07/05/1976 3515162707770002 KUSWANTO 27/07/1977 3515163112010002 M. ROZAN FIKRI P 31/12/2001 PIL
M. ALBI CHIFARI
3515161810080003 HERFINO L 18/10/2008

10 3515162601092569 35151641015700023 MASNA'AH 01/01/1957 3515160101550076 TOHA 01/01/1955 3515164905870006 RIZRIZQIAH P 09/05/1987
IKA DIAN
11 3515162601092622 3515164301770010 ZUMAROH 03/01/1977 351516020570007 SUPENAN 02/05/1972 3515166305000003 PARAMITA P 23/05/2000
LATIFAH
3515164912030002 DWIYANTI P 09/12/2003
M. RIFKI TRI
351516160108000 ANDIKA P 16/01/2008

3515164101550081 SUPINAH 01/01/1955 - - - - - P

12 3515162601093114 3515160607710005 MUSRIYATI 26/07/1971 3515162604710004 SUMARNO 26/04/1971 3515162606990008 M. LUTFI ZAELANI P 26/06/1999

3515162001110001 ZIEDHAN SATRIA P L

IMAM M. IQBAL
13 3515162601092646 3515164507620003 MUDJIATI R 05/07/1964 3515160204640002 BASUKI 02/04/1964 3515163107970002 FIRMANSYAH P 31/07/1997
14 351516260109689 3515164906690002 SUNARTI N 09/06/1969 3515160507640006 SUGIONO 05/07/1964 3515166205930003 LINTANG MEIATI S P 22/05/1993

15 3515162601091690 3515165009690003 SUPRIYATI 10/09/1969 3515160102640001 BINANDJAR 01/02/1954 3515164802960001 ANITA FEBRIYANTI P 08/09/1996 IUD

3515161009970002 BERRI S P 10/09/1997

16 3515162601091696 3515164801660004 SUGIATI 08/01/1966 3515160101600041 SUWATI 01/01/1960 P - IUD

DEVI IKA
17 3515162601091677 3515165503720003 RAHMIATI 15/03/1972 3515161407710003 SUGIAYAR 14/07/1971 3515164108990001 ANGGRAENI P 01/08/1999 PIL
HERMIN
3515166006650004 NINGSIH 20/06/1965 - - - 3515164601920001 EVI KARTIKA SARI P 06/01/1992
DADANG LOLA AYU
18 3515162601092765 3515164701730001 PUJI ASTUTIK 07/01/1973 3515161610670002 ANDRIANTO 16/10/1967 3515166405930002 INDRIASTUTIK P 24/05/1993 MOW

3515164709970002 LELLYS ASTUTIK P 07/09/1997

LOVIA MAZWA
3515165108040001 UKHWATUL P 11/08/2002
M. ZAFRAN
3515163009130001 ALTHAARIQ L 30/09/2013

19 3515162601092632 3515164905600005 MARUPAH 09/05/1960 3515161007580004 MULYONO 10/07/1958 35151670088440006 DWI ANISYAH P 30/08/1984

3515161409870001 MOCH ALIF L 14/09/1987

ANANDA VERREL
3515160305050001 PRATAMA L 03/05/2005
ASMAUL ABDUL ABDULLOH LEXMA
3515164710870001 KUSNAH 07/10/1987 3515162309840001 MALIK 23/09/1984 3515162903110001 AL F L 29/03/2011
NI'MATUS
3515164101590024 MUNTAYAH 01/01/1952 - - - 3515166003800005 SYAFIAH P 20/03/1980
NAINUL ERFAN AFIFAH NURUL
3524058408850002 INAYAH 24/08/1985 3515160805870003 KURNIAWAN 08/05/1987 3524055007100002 AINI P 10/07/2010 SUNTIK

3515164507630004 SRIATI P 05/07/1962