Nama Puskesmas/Fasyankes/Pos Kabupaten/Kota Provinsi Bulan Tahun

Nama Puskesmas/Fasyankes/Pos
Kabupaten/Kota
Provinsi
BULAN
TAHUN
No.
No NIK
Registrasi
1 0001 7202025209000003
2 0002 7202026507050001
3 0003 7202024706050001
4 0004 7202022112050001
5 0005 7202026012050003
6 0006 7202010710030004
7 0007 7306081201040001
8 0008 7202020402990001
9 0009 7202025005760001
10 0010 7202182303990001
11 0011 7202020207040004
12 0012 7202021508050001
13 0013 7202196904070001
14 0014 7202020105050001
15 0015 7601020907070002
16 0016 7202022806080002
17 0017 7202021210080001
18 0018 7271034309890011
19 0019 7202022505070001
20 0020 7202024110090002
21 0021 7202026502090002
22 0022 7202026606090001
23 0023 7202020505090002
24 0024 7202025906090001
25 0025 7202025710090001
26 0026 7202181811080002
27 0027 7202026803090002
28 0028 7202024702090001
29 0029 7202022808090002
30 0030 7202022910080001
31 0031 7202022311080002
32 0032 7202020105090001
33 0033 7202022511060002
34 0034 7202021211080002
35 0035 7202014902080003
36 0036 7202022310070003
37 0037 7202024709060001
38 0038 7202025604070004
39 0039 7202026604070002
40 0040 7202026912070001
41 0041 7202025704070001
42 0042 7202022804070003
43 0043 7202026309070001
44 0044 7202181309090001
45 0045 7202021109090001
46 0046 7202027003070001
47 0047 7202214112060001
48 0048 7202026207070001
49 0049 7202024705080001
50 0050 7202022502080003
51 0051 7202027005070001
52 0052 7271032508050003
53 0053 7202022511080001
54 0054 7202026203090001
55 0055 7202020110060006
56 0056 3318101704080002
57 0057 7202027105080001
58 0058 7202020509060002
59 0059 7202021708080002
60 0060 7202192404080001
61 0061 7202026808080002
62 0062 7202026307080001
63 0063 7202024801080001
64 0064 7202024407080003
65 0065 7202193110950002
66 0066 7202214209080001
67 0067 7202022209070001
68 0068 7202022511070001
69 0069 7202021507070002
70 0070 7202026812060002
71 0071 7202025301070001
72 0072 7202025305050002
73 0073 7202025505070002
74 0074 7202020809060001
75 0075 7202025412060001
76 0076 7202024306090005
77 0077 7202026907070003
78 0078 7202020911070001
79 0079 7202020304070001
80 0080 7202026105080002
81 0081 7202025004070003
82 0082 7202025803080001
83 0083 7202027011080002
84 0084 7202023103760002
85 0085 7202192808090001
86 0086 7202196606060003
87 0087 7203146905050001
88 0088 7202020701070001
89 0089 7202025904040002
90 0090 7202025401060001
91 0091 7202191903640001
92 0092 7202022407050002
93 0093 7202022204050001
94 0094 7209041010810002
95 0095 7202026801050001
96 0096 7202195701070001
97 0097 7322124203060001
98 0098 7202024511040001
99 0099 7202093010060001
100 0100 7202024609040001
101 0101 7203126810040003
102 0102 7202191505050001
103 0103 7202025209950002
104 0104 7202184802040002
105 0105 7202024106080001
106 0106 7202021010040004

107 0107 7202026306050001
108 0108 7202020305050002
109 0109 7206025604880002
110 0110 7202183107060002
111 0111 7202025107050002
112 0112 7208132408060001
113 0113 7202025510040001
114 0114 7202025609050003
115 0115 7202024206060002
116 0116 7202026912980003
117 0117 7202010710030003
118 0118 7202185011040001
119 0119 7202186907050003
120 0120 7202032901990005
121 0121 7202024101060001
122 0122 7202027004060001
123 0123 7202021002060002

124 0124 7202025105050002
125 0125 7202185907040001
126 0126 7202020701030004
127 0127 7202020910050003
128 0128 7202197107040001
129 0129 7202022609060001
130 0130 7310056104050001
131 0131 7202186706050001
132 0132 7202025805050003
133 0133 7202026010040004
134 0134 7202025903060001
135 0135 7202012810960001
136 0136 7202021908050002
137 0137 7202020801050002
138 0138 7202043009000003
139 0139 7202012701020003
140 0140 7202020205880001

141 0141 7202185802050002
142 0142 7202064603060001
143 0143 7202022104810005
144 0144 7202185008060002
145 0145 7202025506050001
146 0146 7202021310050005
147 0147 7202020807060003
148 0148 7202020702030001
149 0149 7202220707980001
150 0150 7202180807060001
151 0151 7202022802060002
152 0152 7202020111040002
153 0153 7202020806060001
154 0154 7202011902930001
155 0155 7202012406990009
156 0156 7202011110980002
157 0157 7202025006040001

158 0158 7202024308050002
159 0159 7202022003990002
160 0160 7202224903050002
161 0161 7202025705780001
162 0162 7308141707890002
163 0163 7308145608860002
164 0164 7202024808990003
165 0165 7202225107010001
166 0166 7202020404050002
167 0167 7202021507920015
168 0168 7202020305060002
169 0169 7202022003080003
170 0170 7208090510070002
171 0171 7202022712070001
172 0172 7204070611980003
173 0173 7209071108000001
174 0174 7202013003980003

175 0175 7202214101020001
176 0176 7202024509970001
177 0177 7202020206680001
178 0178 7202026212030001
179 0179 7202186409080001
180 0180 7202025711080001
181 0181 7202026306080001
182 0182 7202016709050002
183 0183 7206026209070001
184 0184 7202015505060003
185 0185 7202022810050001
186 0186 7202021111040001
187 0139 7202022412050001
188 0140 7202022009060002
189 0141 7202020312030002
190 0142 7202021608040001
191 0143 7202026406080001

192 0144 7209055207050003
193 0145 7202020812050003
194 0146 7202045211060002
195 0147 7202026709050001
196 0148 7202026010060002
197 0149 7202014808070001
198 0150 7202030605080001
199 0151 7202190805050001
200 0152 7202196703080001
201 0153 7202026802090001
202 0154 7202026605040001
203 0155 7202026411030002
204 0156 7202190307050001
205 0157 7208060111040003
206 0158 7202025708060002
207 0159 7324016510050001
208 0160 7202021101060001

209 0161 7324035703030002
210 0162 7202025303050002
211 0163 7202022105050001
212 0164 7202021005080001
213 0165 7206016405030001
214 0166 7202022410070001
215 0167 7202020602060003
216 0168 7202015710650006
217 0169 7202014810760001
218 0170 7202021002800003
219 0171 7202026405860003
220 0172 7202020608720003
221 0173 7202022708780001
222 0174 7202020202680001
223 0175 7202191604010001
224 0176 7202015005750009
225 0177 7202026909860001

226 0178 7202016703710001
227 0179 7202014605710007
228 0180 7371106809900003
229 0181 7202010505670001
230 0182 7202024304080001
Keterangan
* Pekerjaan dikelompokkan menjadi:
A = Petugas Medis dan Non Medis di Fasilitas Pelayanan Kesehatan
B = Petugas pelayanan publik yang berhadapan langsung dengan masyarakat
C = Lansia
D = Masyarakat Umum
E = Remaja
Kelompok Umur:
12-17 (REMAJA)
18-30
31-45
46-59
LANSIA (>=60)
Total
Pekerjaan:
A
B
C
D
E
Total
: PUSKESMAS MAPANE
: POSO
: SULAWESI TENGAH
: SEPTEMBER
: 2021
Nama Penerima Vaksin Jenis Kelamin Pekerjaan*
RISKA YANTI P D
NURUL KHAIRU NISA P E
JHYAWIDIANA P E
MOH. RANGGA PANGESTU L E

FASMAWATI P E
MOH. MURSALIM L E
MUH. ADHITYA M L E
ALI GUNAWAN L D
IGUN SUTRIONO L D
ANDRIANTO L D
PUTRA ADITYA PRATAMA L E
ACHMAD FATHY DJAFAR L E
WINDA APRILIA P E
MOHAMMAD REZA L E
FAREL PRATAMA SALU L E
RIVALDY JUNIOR TANTANASA L E
GLEN WUMU W. KALIGIS L E
STEFANY RIFKA AKASSE P B
MUZZRIVAL KULUP L E
ELSA MARATO P E
MAJEFTI GABRIELLA RUMPAJANJI p E

RENISHA TRIANDIN KATUME P E
TRY WAHYU PAPUTUNGAN L E
JUNIALIN SIMBADJU P E
OLVI AGRIYANI TOWONU P E
CRISTO GIMBO L E
AMELIA PUTRI W. DG NUSU P E
MUZDALIVA P E
ALFRETS FREDERIC MALAKIKI L E
SAAD IKHTIAR L E
ARYA JAGAD SATRIA L E
REZKY MANDIARA L E
NOVERRIYANTO MAGAU L E
MAIKEL ANUGRAH KODEA L D
CELSY C. TOBELY P E
KHUZNUL FAUZHY SARALAA L E
MERLIN TERI P E
DOLINDA VANESYA TOWENGKE P E

FRISCA GIZELLA PITI P E
NYOMAN TRI ELLYSIA PURAGOMBO P E
CHELSEA AVRYLIA WANU P E
BAMBANG APRIZAL L E
JESICA SAYUTI LANTIGIA P E
RADITIA POTOHU L E
GERALD DEVISKAL DJEPA L E
VICKA PAULINDA TOKUTENDE P E
NANCY FLORENSITA CLAUDIA TOBILI P E
DELVIANA YULIANI TOLAKI P E
NUR FATIMAH ZAHRA P E
AGUNG FEBRIAN L E
TITI KARINAH P E
AHMAD ZULFIKAR YUNUS L E
KRISTIAN ARMAN BORAHI L E
NURLINDA P E
OFEL SION MAGAU L E

ACHMAD SYAHRIR ZAKARIYA AFRIZAL L E
DILTA HANANDA P E
RIFAT BOLI L E
DIRGAMANSYAH L E
KEVIN DEFRAN TUMONGGI L E
DEVI AYUNITA SABIHI P E
SRI FERA JULIANI SUPARTO P E
VEBY CLAUDIA RATOSIGI P E
SITI JUMARIAH A. TALIBE P E
AFKAR IMANUEL ROHAN L B
SUCI RAMADHANI S. P. DJOYOSUROTO P E
FADLY MASURU L E
FAUZAN L E
AKSEL TOLOSI L E
FANY EKLESIA SUPARTO P E
DINA PUTRI TOLAGE P E
RATNA SARI P E
NURLIYANA ALIMA ELMAS P E
SELTIANUS KALAPADANG L E
MIRA LISTRA KATUME P E
DEA ELMA PANTJO'U P E
NURHALIMA UMAR T. P E
SYAHRUL YUSUF L E
DEVI PURNAMA SARI P E
NURHALISA P E
IRLANI APRILIA KATUME P E
ALDA AULIA P E
ARINA PUTRI CAHYANI P E
ANDRES FERIAN PURAGOMBO L D
ELON GIDEON DJANIBA L E
NIA HASTUTI P E
NINA SAPITRI P E
MOH. FAHRI L E
ISMI P E
ZAHRATUL JANAH P E
ROHAN L D
AHMAD GILAN FIRGIANSA L E
ARIEF MULIYADI NASRUDIN L E
HANNAS ISKANDAR. T L D
SUMIARTI P E
ENI SINTIAWATI P E
SRI ASTI ANANTA P E
INDAH RAMADANI P E
ANDI DIVA LATIFA PAWILOI P E
DEWI KARTIKA SARI P E
MUTIA SUCI RAMADANI P E
REZA SASTRA L E
RIFKI P D
VERAWATI P E
SOFIA FITRI SIFA ANI P E
AFDHAL JUKHAIRY L E
RAHMANIAH P E
FATURRAHMAN LIUMPOLE L E
CHRISTIN WELANA TUMAKAKA P D
RIYAN HIDAYAT L E
NURANISA FITRI P E
DWI ANDIKA L E
T. SAMSIA P E
HASMAH P E
NURUL SAVIRA P E
CINDI DEVITASARI P B
MOH. MURSALAM L E
RIRIN ARIYANTI P E
NUR AMALYA P E
MOH. RIDWAN L D
NURVADILLA P E
FATIMA AZAHRA P E
DELON SIMBAJU L E
NABILA MARSANINGSI P E
RESTI LUTFIAH P E
ALI FIQRIFIAR L D
SYAHRUL RAMADHAN L E
SAFIRA P E
RAGIL RAMADAN L E
RIDHAYANI PUTRI P E
NURUL INDAH SARI P E
TYARA ASSA LAFIAH P E
PUTRI RAMADANI P E
HIKMAH P E
MUH. GISWARI ALI PUTRA L D
RIFIAL ZIA ULHAQ L E
IHWAN L E
JAMES STEVAN ITO L D
ADITIYA EKO SAPUTRA L. L D
ALBAR L D
SYAFIA KEPAK P E
IMEL MARCELIA GUMPATA P E
ISKANDAR MS L D
NUR AFIFA P E
NIRMA SUKAWATI P E
ILHAM L E
GUGUN GUNAWAN HI. NUHUNG L E
ARDIANSYA L D
NUHDI ARDIYANTO L D
SAHRIL L E
ARILMAN L E
FITRA RAMADHAN AMIRUDIN L E
BASO MARDANI L E
FAHRUL SALMAN L D
RENDI FEIRARY SALMAN L D
ADIL FATWA A GANI L B
SRI WINARNI LABINTJI P E

AGUSTINA P E
MUHAMAD FAJAR L D
NURUL SABRINA SAPIU P E
SUTRIANI P D
ERWIN L D
SUHARMINI P D
ADELIA P D
JEANE CLAUDIA LARIWU P D
RULI L E
MUH. ARSYAT L D
FALDI DANGKA L E
YUPITRAN AMRAFEL POGENTO L E
CLIF LIBER KUMOLONTANG L E
SAYES CHRISTIAN BASE L E
RISKAN KAIMUN L B
PARMAN MARJAN L B
SAM FADLAN TAHADJU L B

PRATIWI RAMADHANI P B
MAGFIRA P D
ARAS L D
FARADILLA NUR ITSNAINI P E
PUTRI LEMPO P E
ORIZA SATIVA RUMIHIN P E
TIRZA MAGAU P E
ANDI NAZALYA HUDZAIFAH P E
CLAUDIA SHALLOMITHA P E
SUCI HUSAIN P E
JUMADIL L E
MOH. IQBAL L E
FERI KURNIAWAN L E
JAMIL L E
RANDY SAPUTRA L E
RAHMAN L E
TENRI RISKA YANI P E

SRI YUWINDI P E
MUH. SYABIL L E
LASMATIUR ARITONANG P E
SAHRA YUSUF P E
REFITA IMROHATUN ASHARI P E
MUTIARA FAIRUS ASHYA P E
GAMALIEL MEYVICHO PEONI L E
CRISABELA LINDO P E
ADALYA MARGARETH LAPEARI P E
NADIA TRI ANANDA P E
ADE TIRTA DEWI P E
ROSMA P E
WANDI L E
AL MUQADDIM D. LACUKE L. L E
RISKAYANTI JOHORI P E
PUTRI ANJELINA P E
BAYU WIDIANTO L E
RENA P D
NUR MULIA P E
MOH. FIKAL ADITTIA L E
MAICHEL AGRIS POBAHI L E
MIRNA P D
MALKIA H.D ROSON L E
ALAN DANGKA L E
SUHARTI LUBAH P B
DARMAWATI P B
SYAMSUDDIN L B
SUPRIYATI P B
ABAS L B
SUDIRMAN L D
NASIR MADJID L B
DEVIS MANGULA L B
MAIMUNAH JUMPAI P B
NORMA YUNITA DJ. DINDA P B

MUHRIANI P B
KASMARIA P B
SADRIWANTI ARIFIN P B
ANDI PONTOH L B
CELLINE AVRIL KAREPOUWAN P E
***Merek Vaksin
A = Sinovac
tas Pelayanan Kesehatan B = Lainnya (Mohon disebutkan jenis vaksin
apan langsung dengan masyarakat
Kelompok Umur:
176 Kepesertaan BPJS
27 Anggota
16 Non Anggota
9 Total
1 Pemberian Dosis
229 Dosis 1
Pekerjaan: Dosis 2
0 Total
21
0
33
176
230
FORMAT PENCATATAN PELAKSANAAN VAKSI
TINGKAT PUSKESMAS/FASYANKES/POS V
Umur
Kelompok Umur
(18-59 tahun)
21 18-30
16 12-17
16 12-17
15 12-17
16 12-17
17 12-17
17 12-17
22 18-30
22 18-30
23 18-30
17 12-17
16 12-17
14 12-17
16 12-17
14 12-17
13 12-17
13 12-17
32 31-45
14 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
12 12-17
14 12-17
12 12-17
13 12-17
13 12-17
15 12-17
14 12-17
14 12-17
14 12-17
14 12-17
14 12-17
14 12-17
12 12-17
12 12-17
14 12-17
14 12-17
14 12-17
13 12-17
13 12-17
14 12-17
16 12-17
12 12-17
12 12-17
15 12-17
13 12-17
13 12-17
15 12-17
13 12-17
13 12-17
13 12-17
13 12-17
13 12-17
13 12-17
25 18-30
13 12-17
14 12-17
13 12-17
14 12-17
14 12-17
14 12-17
16 12-17
14 12-17
15 12-17
14 12-17
12 12-17
14 12-17
13 12-17
14 12-17
13 12-17
14 12-17
15 12-17
12 12-17
45 31-45
12 12-17
15 12-17
16 12-17
13 12-17
17 12-17
15 12-17
57 46-59
16 0
16 12-17
40 31-45
16 12-17
14 12-17
15 12-17
16 12-17
14 12-17
17 12-17
16 12-17
16 12-17
17 LANSIA
17 12-17
13 12-17
17 12-17
16 12-17
16 12-17
33 31-45
15 12-17
16 12-17
15 12-17
17 12-17
16 12-17
15 12-17
22 18-30
17 12-17
16 12-17
16 12-17
22 18-30
15 12-17
15 12-17
15 12-17
16 12-17
17 12-17
18 18-30
16 12-17
17 12-17
15 12-17
16 12-17
16 12-17
16 12-17
17 12-17
15 12-17
24 18-30
16 12-17
16 12-17
21 18-30
19 18-30
33 31-45
16 12-17
15 12-17
40 31-45
15 12-17
16 12-17
16 12-17
15 12-17
18 18-30
23 18-30
15 12-17
15 12-17
16 12-17
15 12-17
28 18-30
22 18-30
23 18-30
17 12-17
16 12-17
22 18-30
16 12-17
43 31-45
32 31-45
35 31-45
22 18-30
20 18-30
12 12-17
33 31-45
15 12-17
13 12-17
14 12-17
13 12-17
22 18-30
21 18-30
23 18-30
21 18-30
24 18-30
53 46-59
17 12-17
13 12-17
12 12-17
13 12-17
16 12-17
14 12-17
15 12-17
15 12-17
16 12-17
16 12-17
15 12-17
17 12-17
17 12-17
13 12-17
16 12-17
15 12-17
14 12-17
15 12-17
15 12-17
14 12-17
13 12-17
16 12-17
13 12-17
12 12-17
16 12-17
17 12-17
16 12-17
16 12-17
15 12-17
15 12-17
15 12-17
18 18-30
16 12-17
16 12-17
13 12-17
18 18-30
13 12-17
15 12-17
56 46-59
45 31-45
41 31-45
35 31-45
49 46-59
43 31-45
53 46-59
20 18-30
46 46-59
35 31-45
50 46-59
50 46-59
31 31-45
54 46-59
13 12-17
n disebutkan jenis vaksin yang diterima Puskesmas/Faskes)
172
58
230
181
49
230
T PENCATATAN PELAKSANAAN VAKSINASI COVID-19
GKAT PUSKESMAS/FASYANKES/POS VAKSINASI
Alamat No. HP
KEL. MAPANE 082293109347
KEL. KASIGUNCU 082290312507
KEL. TABALU 082259730650
KEL. MAPANE 081356409938

KEL. MAPANE 082271129190
DESA TAUNCA 082259650281
KEL. TABALU 082393017283
JL. P. JAWA II 085242809281
DESA TUMORA 082259071096
KEL. MAPANE 082259103849
DESA PANTANGOLEMBA 085242325312
DESA BEGA 085249951770
DESA MALITU 081244580704
DESA BETANIA 082296497025
JL. P. IRIAN JAYA 085246333033
KEL. MAPANE 085249947855

DESA BEGA 082271305846
KEL. MAPANE 085249947855
KEL. TABALU 082192972919
KEL. TABALU 082188388862
DESA TOINI 082190925022

DESA SAATU 082259281213
DESA TOINI 082396480442
DESA TOINI 082259357251
DESA TOINI 082296234828
KEL. TABALU 082194242693
KEL. KAYAMANYA 085399949617
DESA TOINI 082192972046
DESA BEGA 082259733714

KEL. TABALU 082246912510
KEL. TABALU 082346912520
DESA TOINI 085220767724
DESA TOINI 082320622445
DESA BETALEMBA 081242230916
DESA BEGA 082262525447
DESA BEGA 081241611380

DESA BEGA 085823724249
DESA BEGA 082293840047
DESA LAPE 082293326539
KEL. TABALU 082348950121
DESA SAATU 082346910195
DESA BEGA 082252567270
DESA BEGA 082217039536
DESA BEGA 081355678089

KEL. TABALU 082259103719
DESA BETALEMBA 085242940167
DESA TOKORONDO 082195138654
DESA BEGA 082260487970
KEL. TABALU 082312799773
KEL. MAPANE 082296681800
DESA SAATU 082291525737
DESA KILO 082217358309
KEL. TABALU 082293427726

DESA BEGA 082251493174
DESA TOINI 082217467616
KEL. MAPANE 081342555987
DESA KILO 081523756693
DESA BEGA 082217029005
DESA TOINI 082259993216
KEL. TABALU 083152611063
DESA BEGA 082259103805
KEL. TABALU 082291236691
DESA KILO 085396781952
DESA KILO 085256177367
DESA TOYADO 082292825285
DESA UWERALULU 082213594491
DESA TOINI 085283774867

KEL. MAPANE 082239662577
DESA KILO 082293355324
KEL. TABALU 082262375267
KEL. MAPANE 082298371793
DESA KILO 085397951801
DESA KILO 082259181628
DESA TIWAA 082271438891
DESA LAPE 082189631147
KEL. MAPANE 082258883219
JL. P. TARAKAN 082223975546
KEL. MAPANE 085346089988
DESA MASAMBA 082298961751
KEL. PETIRODONGI 082290450249
JL. P. BUTON 082296173029

DESA KILO 082259056673
DESA KILO 082349838039
DESA PINEDAPA 082344677544
DESA TOWU 082236792789
DESA TOINI 082293315002
KEL. SAYO 082391395390
DESA KILO 082344677221
DESA TOWU 082210430551
DESA BEGA 082293840791
DESA TOWU 089636487825
JL. P. BUTON 085241313267
JL. P. BUTON 082293653918
JL. P. IRIAN JAYA 085342750698
DESA TOINI 083152256716

DESA BEGA 082295914215
KEL. MAPANE 082393015050
KEL. RANONONCU 082293839024
DESA TOINI 082290134612
KEL. MAPANE 081355592682
KEL. MAPANE 082296544151
KEL. MAPANE 082271324696
KEL. MAPANE 082393149398

KEL. SAYO 085342020272
DESA BEGA 082290826810
DESA BEGA 082259733714
DESA LANTO JAYA 085756228231
KEL. MOENGKO 082189266764
KEL. MAPANE 082290574109
DESA LAPE 082261658288
DESA MASANI 081297744058
KEL. TABALU 083152259444

KEL. GEBANGREJO 081241565064
DESA PANTANGOLEMBA 082271021202
DESA BEGA 082136388022
DESA BEGA 082290640437
DESA PATIWUNGA 082393023972
DESA TOINI 082259060659
DESA TIWAA 082290612956

DESA BEGA 082293370129
JL. P. BUTON 081341351878
KEL. MAPANE 081341150240
KEL. TABALU 082259968290
DESA TANGKURA 082213765207
JL. P. SABANG 082235195475

JL. P. BATAM 081342501559
KEL. MAPANE 081252044499
KEL. MAPANE 085255921512
Keterangan Vaksinasi
Lanjut 230
Ditunda 0
Tidak Diberikan 0
Total 230
Jenis Kelamin
Laki - Laki 108
Perempuan 122
Total 230
VID-19
SI
Kepesertaan BPJS
(tulis 'Ya' pada Dosis I
kolom yang sesuai)
Merek
Tanggal Screening
Vaksin***
Non Tanggal Pemberian
Anggota
Anggota Vaksinasi
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Ya A 21-10-2021
Dosis I Dosis 2
Tanggal Pemberian
No. Batch No. Batch
Vaksinasi
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
21-10-2021 C202106121
Dosis 3
Keterangan
(Lanjut / Ditunda /
Tanggal Pemberian Tidak Diberikan)
No. Batch
Vaksinasi
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
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Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
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Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut
Lanjut

Nama Puskesmas/Fasyankes/Pos Kabupaten/Kota Provinsi Bulan Tahun

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