Vaksinasi Oktober 21

LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN ANAK-ANAK (6-11 TAHUN) KOTA PASURUAN
PER PUSKESMAS
TARGET CAPAIAN SELISIH KETERANGAN

NO PUSKESMAS %
ANAK-ANAK DOSIS 1 % DOSIS 2 % D1-D2
1 GADINGR 2,454 0.00% #DIV/0! 0 #DIV/0!
2 KARANGK 2,259 0.00% #DIV/0! 0 #DIV/0!
3 SEKARG 3,010 0.00% #DIV/0! 0 #DIV/0!
4 KEBONA 2,828 0.00% #DIV/0! 0 #DIV/0!
5 BUGULKI 3,133 0.00% #DIV/0! 0 #DIV/0!
6 TRAJENG 2,243 0.00% #DIV/0! 0 #DIV/0!
7 KEBONSA 1,916 0.00% #DIV/0! 0 #DIV/0!
8 KANDANG 2,566 0.00% #DIV/0! 0 #DIV/0!
TOTAL 20,409 0 0 0 0 0 0
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN LANSIA KOTA PASURUAN

PER PUSKESMAS
TARGET CAPAIAN SELISIH

NO PUSKESMAS
LANSIA DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGR 1,930 804 41.66% 628 78.11% 4 0.64% 624
2 KARANGK 1,707 0.00% #DIV/0! #DIV/0! 0
3 SEKARG 2,386 0.00% #DIV/0! #DIV/0! 0
4 KEBONA 2,506 0.00% #DIV/0! #DIV/0! 0
5 BUGULKI 2,607 0.00% #DIV/0! #DIV/0! 0
6 TRAJENG 1,710 0.00% #DIV/0! #DIV/0! 0
7 KEBONSA 1,392 0.00% #DIV/0! #DIV/0! 0
8 KANDANG 1,929 0.00% #DIV/0! #DIV/0! 0
TOTAL 16,167 804 0 628 0 4 0 624
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN MASYARAKAT UMUM (18 TAHUN KEATAS) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
MASY. UMUM DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGR 12,206 4933 40.41% 2936 59.52% 67 2.28% 2,869
2 KARANGK 10,757 0.00% #DIV/0! #DIV/0! 0
3 SEKARG 15,856 0.00% #DIV/0! #DIV/0! 0
4 KEBONA 15,382 0.00% #DIV/0! #DIV/0! 0
5 BUGULKI 15,768 0.00% #DIV/0! #DIV/0! 0
6 TRAJENG 10,621 0.00% #DIV/0! #DIV/0! 0
7 KEBONSA 8,702 0.00% #DIV/0! #DIV/0! 0
8 KANDANG 12,074 0.00% #DIV/0! #DIV/0! 0
TOTAL 101,366 4,933 0 2,936 0 67 0 2,869
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN REMAJA (12-17 TAHUN) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
REMAJA DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO 1153 #DIV/0! 1083 93.93% 0.00% 1,083
2 KARANGKETUG #DIV/0! #DIV/0! #DIV/0! 0
3 SEKARGADUNG #DIV/0! #DIV/0! #DIV/0! 0
4 KEBONAGUNG #DIV/0! #DIV/0! #DIV/0! 0
5 BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! 0
6 TRAJENG #DIV/0! #DIV/0! #DIV/0! 0
7 KEBONSARI #DIV/0! #DIV/0! #DIV/0! 0
8 KANDANGSAPI #DIV/0! #DIV/0! #DIV/0! 0
TOTAL 0 1,153 #DIV/0! 1,083 #DIV/0! 0 #DIV/0! 1,083
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN MASYARAKAT RENTAN (50-59 TAHUN) KOTA PASURUAN
PER PUSKESMAS

NO PUSKESMAS
MASY RENTAN
DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO 1060 #DIV/0! 770 72.64% 1 0.13% 769
5 BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! 791
7 KEBONSARI #DIV/0! #DIV/0! #DIV/0! 0
8 KANDANGSAPI #DIV/0! #DIV/0! #DIV/0! 0
TOTAL 0 1,060 #DIV/0! 770 #DIV/0! 1 #DIV/0! 769
LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN HAMIL KOTA PASURUAN

PER PUSKESMAS

NO PUSKESMAS
MASY RENTAN
DOSIS 1 % DOSIS 2 % DOSIS 3 % D2-D3
1 GADINGREJO #DIV/0! #DIV/0! #DIV/0! 0
5 BUGULKIDUL 59 #DIV/0! 34 57.63% 5 14.71% 791
7 KEBONSARI 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0
8 KANDANGSAPI 3 #DIV/0! 3 100.00% 1 33.33% 2
TOTAL 0 62 #DIV/0! 37 #DIV/0! 6 #DIV/0! 31
PUSKESMAS KEBONSARI UNTUK BUMIL MASUK KE MASYARAKAT UMUM

JANUARI 2021 PEBRUARI 2021 MARET 202
KETERANGAN ANAK ANAK ANAK
DOSIS 1 DOSIS 2 DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF DOSIS 1
RUAN

LANSIA LANSIA LANSIA
%
15600.00% 6 6 1 1 98
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
0
ATAS) KOTA PASURUAN

UMUM UMUM UMUM
%
4282.09% 32 93 125 52 52 629
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
0
TA PASURUAN

REMAJA REMAJA REMAJA
%
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
UN) KOTA PASURUAN

RENTAN RENTAN RENTAN
%
76900.00% 23 23 3 3 181
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
RUAN

IBU HAMIL IBU HAMIL IBU HAMIL
%
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
15820.00%
#DIV/0!
#DIV/0!
200.00%
#DIV/0!
MARET 2021 APRIL 2021 MEI 2021
ANAK ANAK ANAK
KOMULATIF DOSIS 2 KOMULATIF DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF DOSIS 1 KOMULATIF DOSIS 2

LANSIA LANSIA LANSIA
104 6 7 163 267 127 134 34 301 113

UMUM UMUM UMUM
722 440 492 60 782 252 744 170 952 84

RENTAN RENTAN RENTAN
204 139 142 36 240 73 215 38 278 26

2021 JUNI 2021 JULI 2021 AGUSTUS 2021
NAK ANAK ANAK ANAK
2021 JUNI 2021 JULI 2021 AGU

NSIA LANSIA LANSIA
247 324 625 32 279 56 681 250 529 10
2021 JUNI 2021 JULI 2021 AGU

MUM UMUM UMUM
828 227 1179 77 905 1270 2449 239 1144 999
MAJA REMAJA REMAJA REMAJA
257 257 139
2021 JUNI 2021 JULI 2021 AGU

NTAN RENTAN RENTAN R
241 223 501 28 269 237 738 226 495 102

HAMIL IBU HAMIL IBU HAMIL IBU HAMIL
AGUSTUS 2021 SEPTEMBER 2021 OKTOBER 2022
ANAK ANAK ANAK
AGUSTUS 2021 SEPTEMBER 2021

LANSIA LANSIA
691 29 558 4 4 65 756 25 583 0

UMUM UMUM
3448 795 1939 67 67 721 4169 339 2278 0
396 151 151 575 971 176 327 182 1153 756

RENTAN RENTAN
840 99 594 1 1 121 961 47 641 0

BER 2022
NAK
KOMULATIF
OKTOBER 2022
LANSIA
KOMULATIF DOSIS 1 KOMULATIF DOSIS 2 KOMULATIF DOSIS 3 KOMULATIF
4 48 804 45 628 0 4
OKTOBER 2022
UMUM
67 764 4933 658 2936 0 67
BER 2022
MAJA
KOMULATIF
1083
OKTOBER 2022
RENTAN
1 99 1060 129 770 0 1
BER 2022
HAMIL
KOMULATIF
Nama Puskesmas/Fasyankes/Pos : PKM GADINGREJO
Kabupaten/Kota : PASURUAN
Provinsi : JAWA TIMUR
Tanggal Pelaksanaan : 30 OKTOBER 2021
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Merek Tanggal Tanggal
No No. Registrasi NIK Nama Penerima Vaksin Umur ok Alamat No. Hp
Vaksin Pemberian No. Batch Pemberian No. Batch
Umur
Vaksinasi Vaksinasi
1 S-9E18F7E4 3575010107490018 ATMOHADI 72 LANSIA JL SLAMET RIYADI 1/3 GENTONG 8978865722 CoronaVac 01/10/2021 202108154G
2 Z-000BY06K 3575011612620002 MOH. IKROM 62 LANSIA jl slamet riyadi 1/1 gentong 8135839502 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
3 Z-000BXS91 3575010909570003 TEGUH EKO PURWANTO 64 LANSIA JL. URIP SUMOHARJO RW 02 RT 003 83833086170 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
4 P-3SYE6FRJ 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 BIOFARMA 05/10/2021 202108154G
5 S-93F67103 3575014107590081 KASIYATI 62 LANSIA JL BANDA 4/6 GADINGREJO 813777705 BIOFARMA 05/10/2021 202108154G
6 S-C2A220D8 3575015708600001 SUHARNING TATIK 61 LANSIA JL HANGTUAH 8123359918 BIOFARMA 05/10/2021 202108154G
7 S-C450DEB7 3575010109410001 SODIQ 80 LANSIA BUKIR 03/06 8965298331 Biofarma 07/10/2021 202108172F
8 S-7D7970A6 3575010107480086 SOLEH 73 LANSIA BUKIR PASURUAN 8113777705 Biofarma 07/10/2021 202108172F
9 S-86084BF6 3575016202560001 SRI SUPRIHATIN 65 LANSIA JL URIP SUMOHARJO - Biofarma 07/10/2021 202108172F
10 S-947AE586 3575012512560001 ASY'ARI 66 LANSIA JL URIP SUMOHARJO 8965295633 Biofarma 07/10/2021 202108172F
11 S-AE99A4F3 3575010107420018 SUPII 83 LANSIA JL URIP SUMOHARJO 8965498331 Biofarma 07/10/2021 202108172F
12 P-I4OOSKJI 3575031301610001 TRISNO WIBOWO 60 LANSIA LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
13 S-D58B3BBB 3575014107550061 SOEMIANI 66 LANSIA JL BANDA RT03/RW02 GADINGREJO 8113777705 CoronaVac 08/10/2021 202108172F
14 S-B1DAF41F 3575014107550110 JUHAR NANIK 66 LANSIA JL IRIAN JAYA GG ANGGREK RT02/RW02 GADINGRE8113777705 CoronaVac 08/10/2021 202108172F
15 S-B5375736 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 CoronaVac 08/10/2021 202108172F
16 P-GEOHPIPL 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 CoronaVac 08/10/2021 202108172F
17 S-3C612F5B 3575011006570002 AJI HANDOKO 64 LANSIA JL SLAMET RIYADI 813777705 CoronaVac 08/10/2021 202108172F
18 S-3533E274 3575010709580001 MAHFUD 62 LANSIA JL SLAMET RIYADI 8225775527 CoronaVac 08/10/2021 202108172F
19 S-A78BE4A9 3575016104430001 LISA SUPARSIAH 78 LANSIA PERUM KARYA BAKTI B 16 8223319647 CoronaVac 08/10/2021 202108172F
20 S-38566937 3575010107520029 ABD ROKIB 69 LANSIA GENTONG RT 1 RW 3 8113777705 CoronaVac 09/10/2021 202108172F
21 S-C1A17411 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 CoronaVac 09/10/2021 202108172F
22 S-6E52BF55 3575014101570005 YANAH 64 LANSIA JL SLAMET RIADI GG 13 - CoronaVac 09/10/2021 202108172F
23 P-OK6IYXY2 3575014512610001 PAENI 60 LANSIA Jl. Hangtuah rt 04 rw 03 8318524654 Biofarma 09/10/2021 202108172F
24 S-17ADC156 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 CoronaVac 13/10/2021 202108172F
25 S-D28196DC 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 BIOFARMA 18/10/2021 C202106115
26 S-04D4B02A 3575011202480001 FATAH 73 LANSIA JL HANGTUAH 1/4 GADINGREJO 8113777705 BIOFARMA 18/10/2021 C202106115
27 S-23A09B9A 3575011110580002 SUNARIYO 65 LANSIA JL SLAMET RIYADI 003/003 GENTONG 8575537795 CoronaVac 21/10/2021 C202106115
28 S-629C221D 3575015102600001 SUHARTIK 61 LANSIA JL. GATOT SUBROTO 2/7 - BUKIR 89699582643 CoronaVac 21/10/2021 C202106115
29 S-E354FBFA 3575010101560009 ENTIN SURYADI 65 LANSIA JL SLAMET RIYADI 1/3 GENTONG 8113777705 BIOFARMA 22/10/2021 C202106115
30 S-0A982B6C 3575010107430034 MUSTOFA 78 LANSIA jl hangtuah 5/4 gadingrejo 8113777705 BIOFARMA 23/10/2021 C202106115
31 S-9243B708 3575014107510022 SAPUAH 70 LANSIA JL SLAMET RIADI NO - BIOFARMA 23/10/2021 C202106115
32 S-7539DD45 3575014505620001 ELIS YULIASTUTIK 63 LANSIA PERUM KARYA BAKTI / GENTONG 8214012660 BIOFARMA 25/10/2021 C202106115
33 S-71A528A4 3575014107530163 BAWON 68 LANSIA JL HANGTUAH 11 29 - BIOFARMA 26/10/2021 C202106115
34 S-E8FF0629 3575012807590001 BUKHORI 61 LANSIA JL KYAI SEPUH RT01/05 GENTONG 8220050105 BIOFARMA 26/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
35 P-TGP5V1AT 3522245109560001 TARMINI 65 LANSIA JL HAYAM WURUK 2/10 KEBONSARI 8239955042 CoronaVac 27/10/2021 C202106115
36 P-66SOD39Q 3575014107630172 SANEYAH 60 LANSIA JL HANGTUAH 2/3 GADINGREJO 8383471370 BIOFARMA 29/10/2021 202108178F
37 S-A48C3BD6 3575014809550001 SUTIYEM 66 LANSIA JL.GATOT SUBROTO 1 NO 49 85784482878 CoronaVac 30/10/2021 202108178F
38 S-C2AA1BAF 3575014107590009 KUSMIATI 62 LANSIA GENTONG 1/5 8886059548 CoronaVac 11/10/2021 202108172F
39 S-AB71D53D 3575010805560001 MUDJIONO 70 LANSIA JL SLAMET RIYADI 1/1 8113777705 BIOFARMA 11/10/2021 202108143H
40 S-5C552B9C 3575010101500011 ISMAD SUMONO 70 LANSIA JL SLAMET RIYADI 2/4 SEBANI 8113777705 BIOFARMA 11/10/2021 202108143H
41 S-8A28A9A9 3575014106540001 MURTI NINGSIH 68 LANSIA JL SLAMET RIYADI 4/2 SEBANI 8113777705 BIOFARMA 11/10/2021 202108143H
42 S-FEC15BF1 3575014806540001 SIFAK'ATI 66 LANSIA JL SLMAET RIYADI 1/2 SEBANI 8113577770 BIOFARMA 11/10/2021 202108143H
43 S-E647E3BA 3575021201550002 SUKARMAN 66 LANSIA Sebani 2/1 Pasuruan 8113777705 BIOFARMA 11/10/2021 202108143H
44 S-19241FEF 3575010106570001 MUNIP 65 LANSIA sebani 3/6 8113577770 BIOFARMA 11/10/2021 202108143H
45 S-A8EBA74F 3575010312580001 KOSIM 63 LANSIA GENTONG 2/3 8953970772 CoronaVac 12/10/2021 202108172F
46 S-CB984EC9 3575011006580001 SOLICHIN 63 LANSIA JL KYAI SEPUH RT 2 RW 5 GENTONG 8775454117 CoronaVac 12/10/2021 202108172F
47 S-4E3C4480 3575014107570025 FATA BASAMA 64 LANSIA jl urip sumoharjo 8953091010 Biofarma 04/10/2021 202108154G
48 S-0E02B0BD 3575012305580002 SENTOT SULASMONO 61 LANSIA jl banda 4/2 8155456441 Astrazeneca 16/10/2021 A1076
49 Q-0011NQV8 3575014107610101 MUNAWAROH 60 LANSIA BUKIR RT 3 RW 1 8113777705 CoronaVac 21/10/2021 C202106115
50 Z-000B94AT 3575016506620002 JUMIATI 61 LANSIA GENTONG RT 2 RW 5 8113777705 CoronaVac 21/10/2026 C202106120
51 Z-000B94ZY 3575011808540001 GIMAN 63 LANSIA GENTONG RT 2 RW 5 8113777705 CoronaVac 21/10/2025 C202106119
52 Z-0005E717 3575014107530095 SULAMI 66 LANSIA JL BANDA 11 - CoronaVac 08/10/2021 202108172F
53 Z-000BFXVS 3575015607580002 SRI MURNIATI 63 LANSIA jl banda 2/2 gadingrejo 8573290584 BIOFARMA 26/10/2021 C202106115
54 Z-000A454B 3575010101600026 JUMINO 63 LANSIA JL BANDA 3/3 8523675835 CoronaVac 01/10/2021 202108154G
55 Z-000B6GK9 3575010107520064 M. DJAMIL 69 LANSIA jl banda 4/2 gadingrejo 8155456441 BIOFARMA 22/10/2021 C202106115
56 Z-000A8DU7 3575011902570002 SUWARNO 64 LANSIA JL BANDA 5/2 GADINGREJO 8778563210 Biofarma 02/10/2021 202108154G
57 Z-000A8C7F 3575011010590001 MUCHAMMAD TAUCHID 62 LANSIA JL BANDA 6/2 GADINGREJO 8311102158 Biofarma 02/10/2021 202108154G
58 Z-000BN9J8 3575011906580001 SUTRISNO 63 LANSIA JL BUKIR 2 BUKIR 8123258781 BIOFARMA 26/10/2021 C202106115
59 Z-000B92FI 3575011207510001 SUBANI 64 LANSIA JL GATOT SUBROTO 82331660558 CoronaVac 22/10/2021 C202106115
60 Z-000B1DQB 3575015010590001 ENOK WINATINI 61 LANSIA JL GATOT SUBROTO 8573645175 BIOFARMA 18/10/2021 C202106115
61 Q-000AV33A 3575012503610003 ARIFIN 60 LANSIA JL GATOT SUBROTO RW 07 RT 001,GADINGREJO 8121634915 Astrazeneca 08/10/2021 PW40166
62 Z-000B9CTQ 3575014107340022 SAROKHA 87 LANSIA JL HALMAHERA / GADINGREJO 8113777705 BIOFARMA 29/10/2021 202108178F
63 Q-000U1CW4 3575025008610002 MUSRIFAH 60 LANSIA JL HALMAHERA 2/3 GADINGREJO 8113777705 Biofarma 10/04/2021 202108154G
64 Z-000BDPYE 3575014107470051 MUTAYAM 74 LANSIA JL HALMAHERA 3/3 GADINGREJO 8113777705 BIOFARMA 22/10/2021 C202106115
65 Z-0005WAAQ 3575014110620003 RODILAH 62 LANSIA JL HALMAHERA GG 9 - BIOFARMA 12/10/2021 202108172F
66 Z-0005VMA2 3575014101600054 SATUMI 61 LANSIA JL HALMAHERA GG 9 - BIOFARMA 12/10/2021 202108172F
67 Q-000TZQK9 3575014708610001 JULAIKHA 60 LANSIA JL HANG TUA 3/3 GADINGREJO 8193708650 Biofarma 10/04/2021 202108154G
68 Z-000AG2Y3 3575016909640003 SULASTRI 64 LANSIA JL HANGTUAH 4/4 GADINGREJO 8385198812 CoronaVac 06/10/2021 202108172F
69 Q-0015KX4X 3575011301610001 ABD MANAP 60 LANSIA JL HANGTUAH GG II RT 01 RW 03 GADINGREJO 8831141098 CoronaVac 27/10/2021 C202106115
70 Z-000BGXXV 3575010107570046 MAT KAREN 65 LANSIA JL HANGTUAH RT 3 RW 3 8113777705 BIOFARMA 23/10/2021 C202106115
71 Z-000AX9GG 3575020101460008 SUROSO 75 LANSIA JL HANGTUAH XA / 22 NGEMPLAKREJO 8224596114 BIOFARMA 22/10/2021 C202106115
72 Z-00089RQN 3575011002600001 ANTUR HASIM 61 LANSIA JL IRIAN JAYA 8383353353 Astrazeneca 22/10/2021 A1076
73 Z-000BKMRY 3575010107560050 SOLIHUDIN 65 LANSIA JL IRIAN JAYA 1/2 GADINGREJO 8213327966 BIOFARMA 25/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
74 Z-000B53HF 3575015111580002 YASMINAH 63 LANSIA jl irian jaya gadingrejo 8133448644 BIOFARMA 25/10/2021 C202106115
75 Z-000B95IE 3575014501490001 MURTIANI 74 LANSIA JL KYAI SEPUH GG 18 GENTONG 8213992885 CoronaVac 21/10/2022 C202106116
76 Z-0000JHPC 3575015708590003 SITI FATIMAH 62 LANSIA JL SLAMET RIADI NO 8383406030 CoronaVac 02/10/2021 202108154G
77 Z-000A4IWJ 3575013006580003 DJAYUS 63 LANSIA JL SLAMET RIYADI 1/2 SEBANI 8588357510 CoronaVac 06/10/2021 202108172F
78 Z-000BDNUX 3575010612510002 M. SOLICHUN 70 LANSIA JL SLAMET RIYADI 1/4 GENTONG 8520343023 BIOFARMA 22/10/2021 C202106115
79 Z-000AX9PK 3575010710500001 M. SAKIR 74 LANSIA JL SLAMET RIYADI 2/1 SEBANI 8389870033 CoronaVac 18/10/2021 C202106115
80 Z-000A899I 3575010505590003 AKHMAD SUGIANTO 62 LANSIA JL SLAMET RIYADI 2/4 GENTONG 8135347995 Biofarma 02/10/2021 202108154G
81 Z-000AD7LB 3575012809550001 BB. YUDO SUHANDOKO. 66 LANSIA JL SLAMET RIYADI 2/4 GENTONG 8113777705 BIOFARMA 23/10/2021 C202106115
82 Z-000B8XN8 3575016504540002 BUANG SARI 67 LANSIA JL SLAMET RIYADI GENTONG 8233857457 CoronaVac 21/10/2023 C202106117
83 Z-000B8XQL 3575010307540001 JUMAIN 67 LANSIA JL SLAMET RIYADI GG 14 8113777705 CoronaVac 21/10/2024 C202106118
84 Z-000B9CZ8 3575014204520001 SITI KHODIJAH 69 LANSIA JL SLAMET RIYADI GG 14 GENTONG 8113777705 BIOFARMA 22/10/2021 C212106115
85 Q-0009XOAP 3575010107610002 MULYADI 60 LANSIA JL SLAMET RIYADI SEBANI 8113777705 Biofarma 04/10/2021 202108154G
86 Z-000BK9NW 3575014107480071 SOETASMI 73 LANSIA JL SOEKARNO HATTA 1/1 GADINGREJO 8113777705 BIOFARMA 25/10/2021 C202106115
87 Z-0000T2TA 3575014101480014 LASMININGSIH 73 LANSIA JL SUKARNO HATTA 8124422352 Biofarma 10/04/2021 202108154G
88 Z-000AXBCY 3575010606510003 RB. ABD KADIR 70 LANSIA JL URIP SUMOHARJO 2/2 BUKIR 8123421238 BIOFARMA 18/10/2021 C202106115
89 W-0000B7G9 3575011711610001 SLAMET SUKRISNO 60 LANSIA JL. URIP SUMOHARJO RT.002 RW.002 KEL. BUKIR 8224567030 Astrazeneca 28/10/2021 A1076 -
90 Z-000BPZE7 3575014707570001 YULI EKTIARI 64 LANSIA KEL GENTONG KEC GADINGREJO 8953091090 CoronaVac 27/10/2021 C202106115
91 Z-0000HBQK 3575016108680002 TASLIMAH 66 LANSIA NGAGLIK PASURUAN 8385199008 CoronaVac 08/10/2021 202108172F
92 S-39531017 3514161206600046 SOLIKHAN 61 LANSIA KALIMAS UTARA 2/2 BENDUNGAN KRATON 8573301683 Astrazeneca 01/10/2021 ABY1312
93 S-9450E47A 3578140112560001 SISWANTO 65 LANSIA PAKAL RESIDENCE B20 RT05/RW03 SURABAYA 8581543165 Biofarma 02/10/2021 202108154G
94 S-95ECC56E 3578145708580003 SUGIARTI 63 LANSIA PERUM PAKAL RESIDENCE PAKAL SURABAYA 8533527382 Biofarma 02/10/2021 202108154G
95 S-38B5F224 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 05/10/2021 202108154G
96 S-F02C5DC4 3514204310470001 WIDANINGRUM 74 LANSIA KEDAWUNG WETAN 8133315976 CoronaVac 08/10/2021 202108172F
97 S-893BAA22 3573050411540003 HARUN WARSITO 67 LANSIA JL KEDAWUNG 8A MALANG 8123210033 Astrazeneca 16/10/2021 A1076
98 P-ZBP9BCAR 3507084304610002 SRI ASIH 60 LANSIA WAJAK MALANG 16/5 8123320205 Astrazeneca 16/10/2021 A1076
99 S-882AF1A3 3507052407500001 HADI WASONO 71 LANSIA JL SEMERU SELATAN 2/1 8585069743 CoronaVac 19/10/2021 C202106115
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Q-000LJ7Q3 3575010201040003 MUKHAMAD NUR MUKHYBBIN 17 REMAJA JL GATOT SUBROTO 1/7 GADINGREJO 8823182020 Astrazeneca 30/10/2021 A1063
2 P-34NVQSJM : 3575014906090002 INTAN NUR LAILI 12 REMAJA JL. KYAI SEPUH RT.001/006 KELURAHAN GE 8213529933 BIOFARMA 29/10/2021 202108178F
3 P-QSW4UVA5 : 3575030210090001 MOCH ARIF 12 REMAJA JL. HALMAHERA RT. 2 RW. 3 GADINGREJO 8133533218 BIOFARMA 28/10/2021 202108178F
4 P-4ENH96F8 : 3575011502090001 REZA FAJAR ADI PUTRA 12 REMAJA JL. HALMAHERA IX RT 03 RW 03 GADINGREJO 8510146303 BIOFARMA 28/10/2021 202108178F
5 P-4EELQT1V : 3575014704090001 ZAINA RIZQIAYATUN NAFIA 12 REMAJA JL. KALIMANTAN III PANGGUNGREJO 8537710494 BIOFARMA 28/10/2021 202108178F
6 P-4DCOKXIL : 3507124810090002 AYU OKTAVIA RAMADANI 12 REMAJA JL. PURWOREJO RTO. 36 RW.5 KARANGKATE 8383107435 BIOFARMA 28/10/2021 202108178F
7 P-H17KYDZT : 3575011504090001 AQMAL ANUGRAH ILHAM 12 REMAJA JL. BANDA GG TERATAI GADINGREJO 8533017237 BIOFARMA 28/10/2021 202108178F
8 P-PL8WJUDP : 3575016103090002 SITI ALIFAH 12 REMAJA JL. HANGTUAH GADINGREJO 8384681525 BIOFARMA 28/10/2021 202108178F
9 P-PISGG25G : 3575010203090004 MUHAMMAD MAULANA 12 REMAJA JL. SULAWESI UTARA TRAJENG PANGGUNGRE8951479168 BIOFARMA 28/10/2021 202108178F
10 P-4ED5UW4F : 3575012307080003 MOCHAMMAD MAULANA RIFQI 12 REMAJA JL. SULAWESI 17 NO. 42 RT 01 RW 05 TRAJENG8380763474 BIOFARMA 28/10/2021 202108178F
11 P-4DD1E47C : 3575021601090001 MUHAMMAD YANUAR 12 REMAJA JL. KH. WAHID HASYIM V/8 RT 02 RW 02 KEL. 8139465508 BIOFARMA 28/10/2021 202108178F
12 P-21VQJ1SW 3575011804090001 PAMUNGKAS WAHYU DIONO 12 REMAJA JL. GATOT SUBROTO 3/5 - BUKIR 89699427450 CoronaVac 27/10/2021 C202106115
13 P-68LAF8HC : 3575015909090001 YENITA FITRI SEPTIASA 12 REMAJA JL URIP SUMOHARJO 3/8 BUKIR 8311450636 BIOFARMA 22/10/2021 C202106115
14 P-DOWPY4LW 3575014210090001 ANGELA AURELLIA PUTRI 12 REMAJA JL KYAI SEPUH 3/18 8578524729 CoronaVac 21/10/2021 C202106115
15 P-TNAFXXIF 3575030810090001 HAIDAR ALI YUSUF 12 REMAJA JL ANJASMORO XII 8133492711 CoronaVac 19/10/2021 C202106115
16 P-TOIT21G4 3575022105090001 DAFFA JAVIER MIRZA 12 REMAJA JL SULTAN AGUNGII/06 8125907343 CoronaVac 19/10/2021 C202106115
17 P-5GRUGHU9 3575014205090003 MELISA SOFIA WARDANI 12 REMAJA JL. URIP SUMOHARJO 2/3 - BUKIR 8575536935 CoronaVac 18/10/2021 C202106115
18 P-OLRNRDJH 3575011702090002 ACHMAD SAIFUL ANWAR 12 REMAJA JL. HANGTUAH RT 4 RW 4, GADINGREJO 8574535730 Biofarma 09/10/2021 202108172F
19 P-BA9WLE3R 3575014909090001 RIZKA KAMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 CoronaVac 08/10/2021 202108172F
20 P-99I85G3J 3575014909090002 RIZKIA AMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 CoronaVac 08/10/2021 202108172F
21 P-GDLCUOED 3575016109090001 ISNAINI YOVITA SYAFITRI 12 REMAJA bukir 2/1 bukir 8953960721 Biofarma 07/10/2021 202108172F
22 P-3S1GRR5E 3575032701090002 ALDIANSYAH 12 REMAJA JL HANGTUAH 8776597766 CoronaVac 06/10/2021 202108172F
23 P-1BK3HPV4 3215260403090001 MUHAMMAD WAFDAN ZUFAR NAWW12 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8564846251 BIOFARMA 06/10/2021 202108172F
24 P-5TGBMXHH 3526012309090002 RUSYDAN RAFA HUSAIN 12 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8233820663 BIOFARMA 06/10/2021 202108172F
25 P-6NUIGV6Z 3514192003090001 AKHMAD JAVIER ATHAILLAH 12 REMAJA WINONGAN PASURUAN 8123150896 BIOFARMA 06/10/2021 202108172F
26 P-TCB2SB9Q 3514164308090002 AULIANISA RANA ZAHIRA 12 REMAJA JL URIP SUMOHARJO 1/8 BUKIR 8133433283 Biofarma 02/10/2021 202108154G
27 P-MFKMCYJ9 3575025703090002 ANNISA MAULIDIYAH 12 REMAJA PERUM LUMBUNG PADI REGENCY 8223223105 CoronaVac 02/10/2021 202108154G
28 Q-0017KHRM 3514164308090002 AULIANISA RANA ZAHIRA 12 REMAJA JL URIP SUMOHARJO 1/8 BUKIR 81334332837 CoronaVac 01/10/2021 202108154G 30/10/2021 202108178F
29 Q-0015KU66 3575015601090001 AZIZATUL NABILA 12 REMAJA JL HANGTUAH GG 2 8813495952 CoronaVac 27/10/2021 C202106115
30 Q-0015TXJH 3574045405050003 IKRAM RAFIF NUR WAHID 12 REMAJA GADINGREJO KOTA PASURUAN 8564834400 CoronaVac 27/10/2021 C202106115
31 Q-0010RSGN 3575011403090002 MUHAMMAD REINO MAULUDDIN 12 REMAJA JL HALMAHERA GG 11 8135300174 BIOFARMA 19/10/2021 C202106115
32 Q-0010GZMW : 3575010807090001 NAUFAL MIRZA MUHAMMAD 12 REMAJA JL SLAMET RIYAID 2/1 SEBANI 8585964960 BIOFARMA 18/10/2021 C202106115
33 Q-000XZYPD 3575031601090001 ADAM FARHAMSAH 12 REMAJA JL. JEND S PARMAN PANGGUNGREJO 8180414082 BIOFARMA 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 Q-000XZYOO 3575012402090001 AJI DARMAWAN 12 REMAJA JL. HALMAHERA GG. 9 GADINGREJO 8233317969 BIOFARMA 27/10/2021 C202106115
35 Q-000Y3APP 3575021104090002 AINUN NAJIB 12 REMAJA JL. HANGTUAH 9 NGEMPLAKREJO PANGGUNG8384681734 BIOFARMA 27/10/2021 C202106115
36 Q-000Y363Z 3575016401090003 AMALIA HASANAH 12 REMAJA JL. HALMAHERA RUSUN NAWA LANTAI 2 NO 2 8385463574 BIOFARMA 27/10/2021 C202106115
37 Q-000Y419P 3575024108090003 ICA MUNAWAROH 12 REMAJA JL. HANGTUAH 13D PANGGUNGREJO 8383210098 BIOFARMA 27/10/2021 C202106115
38 Q-000Y6X39 3575046402090001 KEYLA AZZAHRA 12 REMAJA JL. SULAWESI KELURAHAN TRAJENG 8383598586 BIOFARMA 27/10/2021 C202106115
39 Q-000Y7C1L 3575016903090001 BINTAN FARA ADIFA 12 REMAJA JL. HANGTUAH VII TAMBA'AN PANGGUNGREJO8199918607 BIOFARMA 27/10/2021 C202106115
40 Q-000Y9YSX 3575041803090001 HAIKAL SYIBRA MAULIDHANI 12 REMAJA Jl. Hangtuah, Gadingrejo 8133533218 BIOFARMA 27/10/2021 C202106115
41 Q-000Y9V2C 3575032801090001 MOHAMMAD HABIY BUSY SYAHID 12 REMAJA Jl. Sulawesi 10/24, Trajeng 8533507567 BIOFARMA 27/10/2021 C202106115
42 Q-000Y9ECH 3575010201090001 RIZAL FIRMANSYAH 12 REMAJA JL. HALMAHERA GG IX GADINGREJO 8133533218 BIOFARMA 27/10/2021 C202106115
43 Q-000Y9YMA 3514212105090001 ACHMAD NUR HIDAYAT 12 REMAJA JL. KALIMANTAN GG 3 NO 15 KELURAHAN TRA 8311452692 BIOFARMA 27/10/2021 C202106115
44 Q-000YAG98 3575014903090001 AFISKA MAULIDIYAH 12 REMAJA JL. BANDA GG 2 KELURAHAN GADINGREJO 8575539623 BIOFARMA 27/10/2021 C202106115
45 Q-000YAJRF 3575014901090002 BILQIS DEWI YANUAR 12 REMAJA Jl. Halmahera Gg. 9 , Gadingrejo 8191815795 BIOFARMA 27/10/2021 C202106115
46 Q-000YB11I 3575012508090001 DWI RIO RAMADHANI 12 REMAJA JL. HANGTUAH IX KELURAHAN NGEMPLAKREJ 8581502608 BIOFARMA 27/10/2021 C202106115
47 Q-000YAMDY 3575024801090002 SILFANA ULFA 12 REMAJA JL. HANGTUAH XIB NGEMPLAKREJO PANGGU 8953970027 BIOFARMA 27/10/2021 C202106115
48 Q-000YETW9 3575034909090003 CHOIRUN NISAK 12 REMAJA JL. JENDRAL S PARMAN KELURAHAN PANGG 8383140012 BIOFARMA 27/10/2021 C202106115
49 Q-000Y2HV7 3575016207090002 RAFIKA DWI ANGGRAINI 12 REMAJA JL. BANDA GG MAWAR KELURAHAN GADINGRE8383460374 BIOFARMA 27/10/2021 C202106115
50 Q-000Y32HU 3575011801090001 MUHAMAD RIKO 12 REMAJA JL. HALMAHERA G.II TAMBA'AN PANGGUNGRE 8383598196 BIOFARMA 27/10/2021 C202106115
51 Q-000Y41AR 3575014801090001 GRESIA AULIA SYAFARA 12 REMAJA JL. SOEKARNO HATTA 2/39 KELURAHAN KAR 8533053178 BIOFARMA 27/10/2021 C202106115
52 Q-000Y5HPV 3575011203090002 MUHAMMAD MAULANA 12 REMAJA JL. SULAWESI UTARA TRAJENG PANGGUNGRE8810365739 BIOFARMA 27/10/2021 C202106115
53 Q-000Y5ZZF 3575012202090002 MARVEL FEBRIAN MAULANA 12 REMAJA JL. HALMAHERA G 8 TAMBA'AN PANGGUNGRE 8785580975 BIOFARMA 27/10/2021 C202106115
54 Q-000Y8FG6 3575010906090001 MUBAIDILA AFANDI 12 REMAJA JL. BANDA GG MAWAR, GADINGREJO 8560777475 BIOFARMA 27/10/2021 C202106115
55 Q-000Y75LW 3575016802090002 YASMIN SAFIRA MAULIDA 12 REMAJA JL.BANDA GADINGREJO 8525923929 BIOFARMA 27/10/2021 C202106115
56 Q-000Y8KMO 3575014203090001 MUTIARA KASIH 12 REMAJA JL. HALMAHERA APARTEMEN PANTAI MAS BLOK 8775677199 BIOFARMA 27/10/2021 C202106115
57 Q-000Y79S1 3575014907090004 RIZKY INDRIANI 12 REMAJA JL. HALMAHERA GG 9 KELURAHAN GADINGRE 8384683020 BIOFARMA 27/10/2021 C202106115
58 Q-000YAZUZ 3575014103090002 FAIRUZ JAVIERA BARRAQ GHALIYA 12 REMAJA JL. IRIAN JAYA GADINGREJO 8570706525 BIOFARMA 27/10/2021 C202106115
59 Q-000YAKT4 3575026802090004 MAULIDDINA KHIKMATA'ANIS QURLI12 REMAJA JL. HASANUDIN GG 13 NO 10B KELURAHAN K 8810360183 BIOFARMA 27/10/2021 C202106115
60 Q-000Y5YTT 3575011706090002 MUHAMMAD MARIQ HIDAYAH 12 REMAJA JL. HALMAHERA GG IX KELURAHAN GADINGRE85706863047 CoronaVac 25/10/2021 C202106115
61 3507241002090002 AHMAD IKMAL 12 REMAJA PERUM TAMAN BAYANGKARA 85234133600 BIOFARMA 06/10/2021 202108172F
62 Q-000X20NH : 3575010101090001 MUHAMMAD ARDAN ARDIANSYA 12 REMAJA JL SLAMET RIYADI 3/1 SEBANI 8314289066 BIOFARMA 18/10/2021 C202106115
63 Q-000WYTLM 3575014205090004 YELENA MARYAMAH 12 REMAJA JL GATOT SUBROTO 8967690503 CoronaVac 18/10/2021 C202106115
64 Q-000WDESP 3575010403090001 SINTA FARKHIYAH 12 REMAJA JL HANGTUAH GADINGREJO 8135905648 Biofarma 09/10/2021 202108172F
65 Q-000WKDKV 3575026903080003 SHOFIA RAHMADINA 12 REMAJA JL HALMAHERA 8312027815 Biofarma 09/10/2021 202108172F
66 Q-000WBZWZ 3514164605090003 IQLIL ANIQIYAH 12 REMAJA KEBONSAWAH KRATON 8788799394 Biofarma 09/10/2021 202108172F
67 Q-000WE6SB 3575011508090001 TAFIQ HIDAYAT 12 REMAJA JL HANGTUAH GADINGREJO 8573278462 Biofarma 09/10/2021 202108172F
68 Q-000WETGN 3575010208090003 MUHAMMAD FAHRI 12 REMAJA JL HANGTUAH GADINGREJO 8125941295 Biofarma 09/10/2021 202108172F
69 Q-000UMM9Y 3575012202090001 ACHMAD FAUZAN ADZIM 12 REMAJA RT 003 RW 002 8123402322 BIOFARMA 21/10/2021 C202106115
70 Q-000UHH59 3575014903090003 ANGGI MAULIDIYAH 12 REMAJA JL SMAET RIYADI RT 01 RW 02, SEBANI 8133413664 BIOFARMA 21/10/2021 C202106115
71 Q-000UK37P 3575016703090001 CINTA DINDA CALISTA 12 REMAJA RT 001 RW 002 8570645859 BIOFARMA 21/10/2021 C202106115
72 Q-000UFNCK 3575015802090001 FEBRITA CAHYANI 12 REMAJA RT 02 RW 01 KECAMATAN GADINGREJO 8385199209 BIOFARMA 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
73 Q-000UO3CP 3575015407090004 IRMA BIMATIARA PUTRI 12 REMAJA PETAHUNAN GADINGREJO 8571031485 BIOFARMA 21/10/2021 C202106115
74 Q-000UK5X0 3320054502090002 LIVIA FEBRIANI 12 REMAJA RT 04 RW 02 SEBANI 8587586962 BIOFARMA 21/10/2021 C202106115
1 Q-000UN91O 3514161701090005 MOCHAMAD ANDRE SETIAWAN 12 REMAJA RT 02 RW 02 KALIREJO 8319504427 BIOFARMA 21/10/2021 C202106115
2 Q-000UTH0X 3575022503080001 MUCHAMAD SHOFIYAN MAULANA 12 REMAJA JL GATOT SUBROTO RT 01 RW 05 8950805931 BIOFARMA 21/10/2021 C202106115
3 Q-000UUCMY 3575032303090002 MUHAMMAD RAFLY AKBAR 12 REMAJA PERUM GRAHA INDAH BLOK U- NO 18 KRAPYA8121737361 BIOFARMA 21/10/2021 C202106115
4 Q-000UTLPJ 3575012505080003 MUKHAMAD NAFI' ZUHRI 12 REMAJA PETAHUNAN KEC. GADINGREJO 8823580556 BIOFARMA 21/10/2021 C202106115
5 Q-000UT19D 9171024403090002 RENSA CENDIKIA 12 REMAJA RT 004 RW 006 8122490502 BIOFARMA 21/10/2021 C202106115
6 Q-000UGB44 3575012801090001 SATRIA KHALISH MULIANSYAH 12 REMAJA RT 04 RW 02 KECAMATAN GADINGREJO 8585287121 BIOFARMA 21/10/2021 C202106115
7 Q-000UFFKV 3575016006090001 YASMIN RIFANISA SALSABILA 12 REMAJA JL R MUNGINSIDI GG PANCAWARNA RT 01 RW 8213146650
0 BIOFARMA 21/10/2021 C202106115
8 35183230107090002 MOCH YUSUF DANISWARA 12 REMAJA PROBOLINGGO 82147119869 BIOFARMA 06/10/2021 202108172F
9 M NANDA ARIF SULAIMAN 12 REMAJA GRESIK 8155231136 BIOFARMA 06/10/2021 202108172F
10 P-4EUODTPL : 3575020306080001 M. NABIL SAPUTRA 13 REMAJA Jl RA KARTINI 1/29 8595969069 BIOFARMA 28/10/2021 202108178F
11 P-4DFN7KTI : 3575030905080004 MOCHAMAD RIDWAN 13 REMAJA JL. LETJEN SUTOYO MANDARANREJO 8384865358 BIOFARMA 28/10/2021 202108178F
12 P-4CUPHUCX : 3575045705080001 MAGDALENA LAWRENCIA MAY KRI 13 REMAJA JL. HANGTUAH VII RT 02 RW 02 TAMBAKAN 8124953571 BIOFARMA 28/10/2021 202108178F
1 P-4H3VQ2D4 : 3575012009080002 MUHAMMAD SOBIRIN 13 REMAJA JL HANGTUAH GANG 2 RT 01 RW 03 KEL. GAD 8564851506 BIOFARMA 28/10/2021 202108178F
2 P-4GBTJRMZ : 3575011411080001 M. YAHYA FIRMANSYAH 13 REMAJA JL. HANGTUAH RT.2 TW.3 GADINGREJO 8533560332 BIOFARMA 28/10/2021 202108178F
3 P-4G2Z59RV : 3575010803080002 ALIFIYAN GHOZALI 13 REMAJA JL. SULAWESI GG VIII, TRAJENG, PANGGUNGR8821700531 BIOFARMA 28/10/2021 202108178F
4 P-4FZW7VH5 : 3575012809080001 MUHAMMAD ALFIANSYAH 13 REMAJA JL. HALMAHERA V, TAMBA'AN, PANGGUNGREJ8782783882 BIOFARMA 28/10/2021 202108178F
1 P-4FXIAWVZ : 3575040212080001 DIKA TAMMAM SYAH 13 REMAJA JL. HANGTUAH 13 D/05 RT.3 RW.5 NGEMPLAK 8133533218 BIOFARMA 28/10/2021 202108178F
2 P-DF0R5JHJ : 3575014312080002 ROUDHOTUL WARDAH 13 REMAJA JL. HALMAHERA KELURAHAN TRAJENG 8883867805 BIOFARMA 28/10/2021 202108178F
3 P-29AZA62F : 3575021304080004 MUCHAMAD WAHYU PRIMA APRILIA13 REMAJA JL. ERLANGGA NO. 10 RT. 2 RW.5 PURWOREJO8384919266 BIOFARMA 28/10/2021 202108178F
4 P-4B4UW23S : 3575016210080001 AMELIYATUS SOLICHA 13 REMAJA JL. HANGTUAH GG IX NGEMPLAKREJO, PANG 8880577242 BIOFARMA 28/10/2021 202108178F
5 P-4AS23B28 : 3575010609080003 M. ZIDAN MAULANA 13 REMAJA JL. HALMAHERA GG 9 GADINGREJO 8784886472 BIOFARMA 28/10/2021 202108178F
6 P-RPCT8K8X : 3575025805080002 WARDAH ZAHRA ATHIRAH 13 REMAJA Jl. Erlangga Selatan No. 11 , Purworejo 8956011306 BIOFARMA 28/10/2021 202108178F
7 P-4B2KOFYP : 3575015712080003 PUTRI FIRDA HIDAYAH 13 REMAJA JL. GAMBIRAN RT.5 RW.2 GAMBIRKUNING KEC8311773939 BIOFARMA 28/10/2021 202108178F
8 P-4CQOJE1I : 3514232011080002 MUHAMMAD IZZUL LABIBA 13 REMAJA PERUM WIROGUNAN RESIDENCE BLOK S-116 8533506887 BIOFARMA 28/10/2021 202108178F
9 P-4EV3ELLH : 3575011607080004 MUKHAMMAD SOFIAN FAJRI 13 REMAJA JL. HANGTUAH RT 02 RW 03 GADINGREJO 8573062720 BIOFARMA 28/10/2021 202108178F
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-30-2021 INDUK
1 Q-000LJ7Q3 3575010201040003 MUKHAMAD NUR MUKHYBBIN 17 REMAJA JL GATOT SUBROTO 1/7 GADINGREJO 8823182020 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
2 Q-000LI96L 3575017006020001 FATIN IMAMAH 19 UMUM JL GATOT SUBROTO 4/7 BUKIR 8585267083 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
3 Q-000LILHO 3575011311020002 MUHAMMAD RIZAL RACHMADANI 19 UMUM JL SLAMET RIADI 1/2 8589529772 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
4 Q-000LIDU8 3575010409000001 ACHMAD HARIS 21 UMUM JL GATOT SUBROTO 5/7 BUKIR 8964476064 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
5 Q-000LIQLF 3575015008000001 ENDAH IKHTIARINI 21 UMUM JL SLAMET RIYADI 1/1 8953950485 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
6 Q-000K44JX 3575016709000001 LISMA ALFIANA 21 UMUM JL GATOT SUBROTO SEBANI 8133688984 Astrazeneca 29/07/2021 ABY1911 30/10/2021 A1063
7 Q-000L62BA 3575015909990001 ARANDA CITRA FIRDAUS 22 UMUM HALMAHERA GADING 8223245361 Astrazeneca 05/08/2021 ABY1911 30/10/2021 A1063
8 Q-000LIKNV 3575015309980001 ARDILA INTAN BAHARI 23 UMUM JL BANDA GG KAMBOJA NO 82 3/2 GADINGREJ 8123528845 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
9 Q-000LJ5XE 3575011204970003 WAHYU RISKI ANDRIATNO 24 UMUM JL BANDA GG DAHLIA 3/2 8788215349 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
10 Q-000LIHWN 3575010607960002 FAHMI FAJAR BAHARI 25 UMUM JL BANDA GG KAMBOJA 3/2 GADINGREJO 8223442539 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
11 Q-000LIYIZ 3575015506940001 ELIS DWI KURNIAWATI 27 UMUM JL GATOT SUBROTO 3/7 BUKIR 8575537745 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
12 Q-000LIMCT 3575015611920001 PIPIT TRI UTAMI 29 UMUM JL SLAMET RIYADI 1/1 8564654577 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
13 Q-000LIN9A 3575015811910001 NOVELIA MULYANINGTYAS 30 UMUM JL SLAMET RIYADI 4/2 SEBANI 8570812238 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
14 Q-000AWYYM 3575011610900002 MOCHAMAD USMAN 31 UMUM JL GATOT SUBROTO, JAWA TIMUR, KOTA PAS 8224347319 Astrazeneca 03/07/2021 ABY1911 30/10/2021 A1063
15 Q-000LILM4 3575016901880001 SILVIANA SARI 33 UMUM JL SLAMET RIYADI 1/1 8223113966 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
16 Q-000LIK2Q 3515046711830005 TRINA KURNIAWATI AKBAR 38 UMUM JL BANDA NO 20 3/2 GADINGREJO 8213250250 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
17 Q-000LIRVF 3575014108830005 RINI 38 UMUM JL BANDA 3/2 GADINGREJO 8777100755 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
18 Q-000LIX71 3575012704820003 NUR ZAINI 39 UMUM JL GATOT SUBROTO 1/7 8123040361 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
19 Q-000LISB9 3575011404820003 WIDARTONO 39 UMUM JL GATOT SUBROTO 5/7 8510078725 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
20 Q-000LIADY 3575014406790001 EMI SUSIATI 42 UMUM JL GATOT SUBROTO 4/7 BUKIR 8133271157 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
21 Q-000LJ13M 3575026710770002 ISNAINI 44 UMUM JL SLAMET RIYADI 5/2 GADINGREJO 8123022019 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
22 Q-000LIXD6 3575016602740001 KHASANAH 47 UMUM JL GATOT SUBROTO GG 8 BUKIR 8135953030 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
23 Q-000LJ2CQ 3573022005730003 OETAMANING BUDI 48 UMUM JL SLAMET RIYADI 5/2 GADINGREJO 8578526592 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
24 Q-000LI9Z9 3575010303720001 MOCH MUDHOFAR 49 UMUM JL GATOT SUBROTO 4/7 BUKIR 8133174872 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
25 Q-000LIH5S 3575014104710002 MUSRIATIN 50 RENTAN JL BANDA GG KAMBOJA 82 3/2 GADINGREJO 8213993720 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
26 Q-000LLP25 3575013007720002 SUPARDI 51 RENTAN GADINGREJO 8178511230 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
27 Q-000LJ4IF 3575012505690002 SUYATNO 52 RENTAN JL BANDA GG DAHLIA 3/2 GADINGREJO 8574634462 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
28 Q-000K3RYI 3575014210680003 SUPIATI 53 RENTAN JL SLAMET RIYADI 8133688984 Astrazeneca 29/07/2021 ABY1911 30/10/2021 A1063
29 Q-000LIG2A 3575010912670003 BUDI HARIYONO 54 RENTAN JL BANDA GG KAMBOJA 82 3/2 8125246784 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
30 Q-000LI7XO 3575015008660002 LANNY 55 RENTAN PERUM KARYA BAKTI C3 1/7 GENTONG 8785989008 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
31 Q-000LLP40 3575011005640002 KARSONO 57 RENTAN GADINGREJO 8113777705 Astrazeneca 07/08/2021 ABY1911 30/10/2021 A1063
32 P-80KGZI2D 3575014105030004 MEI NUR DIANTRI 18 UMUM sebani 2/6 sebani 8579601683 Astrazeneca 30/10/2021 A1063
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 P-7I6SGUIV 3575015209010002 HIKARI SEPTIAN AISYAH RAHMAN 20 UMUM JL BANDA GADINGREJO 8223079750 Astrazeneca 30/10/2021 A1063
34 P-7KNAYBBO 3575012103010003 A'AN EFENDI 20 UMUM JL MULYOREJO 8595969084 Astrazeneca 30/10/2021 A1063
35 P-7L69KCTQ 3575022503970001 MUHAMAD SIDI 24 UMUM JL HANG TUAH GADINGREJO 8592992132 Astrazeneca 30/10/2021 A1063
36 P-EPB0RPFH 3575011905970002 MUKHAMAD LUTFI AMINULLAH 24 UMUM JL GATOT SUBROTO RW 04 RT 001 SEBANI 8313265459 Astrazeneca 30/10/2021 A1063
37 P-7TU8ACEM 3575024705960004 NIKMATUL ROKHMAH 25 UMUM JL JAMBANGAN 2 8312206042 Astrazeneca 30/10/2021 A1063
38 P-7I0J7PBH 3575010107930101 MUHAMMAD MUNIR 28 UMUM JL BANDA GADINGREJO 8385057036 Astrazeneca 30/10/2021 A1063
39 P-7IJEE6YP 3526175707930004 INA JAMI'ATUS. S 28 UMUM JL BANDA GADINGREJO 8193848180 Astrazeneca 30/10/2021 A1063
40 P-739LNGSG 3575014107920113 ROSIDAH 29 UMUM JL BANDA GG MAWAR RT05/RT02 GADINGREJ 8819434078 Astrazeneca 30/10/2021 A1063
41 P-7ZEHYPLF 3514220304910003 SULHAN 30 UMUM jl hang tuah gadingrejo 8133220527 Astrazeneca 30/10/2021 A1063
42 P-7GYS85AK 3575010107880047 DARMAJI . 33 UMUM JL BANDA GADINGREJO 8819434078 Astrazeneca 30/10/2021 A1063
43 P-818KQ4UD 3575015906880005 EKA RAKHMAWATI 33 UMUM sebani 2/6 sebani 8967562038 Astrazeneca 30/10/2021 A1063
44 P-7HTGP6XF 3575011407860002 EDY SANTOSO 35 UMUM JL URIP SUMOHARJO 8575500966 Astrazeneca 30/10/2021 A1063
45 P-7JPR3LWJ 3514204106860004 NUR HALIMA 35 UMUM KAMPUNG BARU GRATI 8564927388 Astrazeneca 30/10/2021 A1063
46 P-5B6ECBYA 3575012203850003 WINARTO 36 UMUM JL HALMAHERA 7 8122874479 Astrazeneca 30/10/2021 A1063
47 P-7HQJZRUH 3575015906820001 YUNIS SOLIKHA 39 UMUM JL HASANUDIN 8383300771 Astrazeneca 30/10/2021 A1063
48 P-7INT2666 3575015007810007 YANTI 40 UMUM JL BANDA GADINGREJO 8564653705 Astrazeneca 30/10/2021 A1063
49 P-7POAUMGS 3514142708810004 AGUS ARIANTO 40 UMUM jl cucut 2/1 bangil 8554623222 Astrazeneca 30/10/2021 A1063
50 P-6FSACDHL 3575011610800001 FAUZI 41 UMUM jl hang tuah gadingrejo 8113777705 Astrazeneca 30/10/2021 A1063
51 P-7HLW1PXQ 3575017101800003 WIWIN WULANDARI 41 UMUM JL HASANUDIN 17/90 8222904036 Astrazeneca 30/10/2021 A1063
52 P-7J3PIG38 3514237012740003 NUR KHIKMAH 47 UMUM REJOSO KIDUL 8580626545 Astrazeneca 30/10/2021 A1063
53 Q-0017HP91 3575010105050001 MUHAMMAD ALFARIZI MUSTHOFA 16 REMAJA JL HASANUDIN IX NO 53 RT01/RW07 KARANGA 8885638663 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
54 Q-00170FGW 3575010604040001 NOVITA 17 REMAJA JL GATOT SUBROTO 4/1 KRAPYAKREJO 8899695972 CoronaVac 01/10/2021 202108154G 30/10/2021 202108178F
55 Q-0016HKRB 3574035102020004 ANANDA MARETA ANGGRAENI 19 UMUM JL KALIJOGO 2/8 MAYANGAN PROBOLINGGO 8956222544 CoronaVac 30/09/2021 202108154G 30/10/2021 202108178F
56 Q-0014S9SL 3575010812990005 RIKI BAKHTIAR 22 UMUM JL. SLAMET RIYADI RT 002 RW 004 GENTONG 8233351159 CoronaVac 27/09/2021 24202821 S 30/10/2021 202108178F
57 Q-0015TAI6 3514161910990002 ANWAR HUDA 22 UMUM KALIREJO 03/03 8580899920 CoronaVac 29/09/2021 202108167I 30/10/2021 202108178F
58 Q-00151X31 3575014909990003 SITI SOFIYAH 22 UMUM JL HALMAHERA 3/5 GADINGREJO 8385214320 CoronaVac 28/09/2021 202108154G 30/10/2021 202108178F
59 Q-0017JEJC 3514196408970004 SYAFITRI IDAHYANINGSIH 24 UMUM dusun bandaran kidul 8383253078 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
60 Q-0015VLKB 3514142406960001 MISBACHUL MUNIR 25 UMUM JL TENGIRI 007/003 BANGIL 8810271410 CoronaVac 29/09/2021 2021081671 30/10/2021 202108178F
61 Q-0017E1Y2 3514166206950003 ZULAIFATUL MAULIDIA 26 UMUM SEDODOL SELATAN 2/4 PLINGGISAN 8133355288 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
62 Q-0015VTOD 3514170401950001 MOCHAMAD MUSTOFA 26 UMUM PARASREJO 04/02 8223292799 CoronaVac 29/09/2021 202108167I 30/10/2021 202108178F
63 Q-00150VDR 3575010107860141 MUKHAMAD IKSAN 35 UMUM JL BANDA RT 03 /RW 03 GADINGREJO 8133665511 CoronaVac 28/09/2021 202108154G 30/10/2021 202108178F
64 Q-0017KAQ7 3575011510840003 MOH. JUNAIDI 37 UMUM JL GATOT SUBROTO 8383454875 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
65 Q-0017FBT2 3514164406750004 HARTINI 46 UMUM GADINGREJO 8233120499 CoronaVac 02/10/2021 202108172F 30/10/2021 202108178F
66 Q-000ZQEOH 3514167112700003 MUNAWAROH 51 RENTAN Ngabar Kraton Pausruan 8123183209 CoronaVac 18/09/2021 202108118H 30/10/2021 202108178F
67 Q-00155A8L 3575010101650007 SUBANDI 56 RENTAN KELURAHAN GENTONG 8560710262 CoronaVac 28/09/2021 202108154G 30/10/2021 202108178F
68 Z-000BY06K 3575011612620002 MOH. IKROM 62 LANSIA jl slamet riyadi 1/1 gentong 8135839502 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
69 P-6P31FWIU 3575011509060001 M. BAKHRUDDIN IKHYA' 15 REMAJA GADING PASURUAN 8224549051 CoronaVac 30/10/2021 202108178F
70 P-7HAM2L1X 3575012012050004 M. ARDHAN ALAMSYAH 16 REMAJA JL SLAMET RIYADI SEBANI 8311943081 CoronaVac 30/10/2021 202108178F
71 P-7HEDZKAO 3575011508050004 AGUS SIGIT CAHYONO 16 REMAJA JL GATOT SUBROTO PETAHUNAN 8953258377 CoronaVac 30/10/2021 202108178F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
72 P-7UODDZ5F 3575010107040020 MOCH ARSYAD 17 REMAJA JL HALMAHERA GG9 8310525058 CoronaVac 30/10/2021 202108178F
73 P-7ULVCP2A 3575015508990002 RODIYATUL KHASANAH 22 UMUM jl hangtuah 4/3 gadingrejo 8124629125 CoronaVac 30/10/2021 202108178F
74 N-C0CFA5A8 3207146501960002 ELA NURKAMILAH 25 UMUM JL WAHIDIN UTARA PETAMANAN 8585051221 CoronaVac 30/10/2021 202108178F
10-30-2021 PUSTU BUKIR
1 Q-0017KHRM 3514164308090002 AULIANISA RANA ZAHIRA 12 REMAJA JL URIP SUMOHARJO 1/8 BUKIR 81334332837 CoronaVac 01/10/2021 202108154G 30/10/2021 202108178F
2 Q-0017HOX3 3514194609030001 ULFATUN NADHIROH 18 UMUM DSN WULU 2/3 MENDALAN 85803357880 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
3 Q-000X9A5U 3575014106030001 FIRDA LAILI MAGFIROH 18 UMUM Jl Gatot Subroto Rt 002 Rw 005 Sebani 85735957986 CoronaVac 13/09/2021 202108118H 30/10/2021 202108178F
4 Q-001700PO 3575011810000001 MOCH ANDI MASHURI 21 UMUM BUKIR 1/1 PASURUAN 83846710133 CoronaVac 01/10/2021 202108154G 30/10/2021 202108178F
5 Q-0014092J 3514164610000004 DEWI KARIMAH 21 UMUM JL GATOT SUBROTO 8980103081 CoronaVac 25/09/2021 202108154G 30/10/2021 202108178F
6 Q-0017I9DC 3575010711930001 MUHAMMAD IRFAN 28 UMUM JL. GATOT SUBROTO 5/7 GADINGREJO 81937007050 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
7 Q-0017IL43 3575010710920001 KUKUH DWI CAHYO 29 UMUM JL URIP SUMOHARJO BUKIR 89635169770 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
8 Q-00154SU9 3575015703850001 ANDINA RAHAYU 36 UMUM JL GATOT SUBROTO RT 4 RW 7 81357285439 CoronaVac 28/09/2021 202108154G 30/10/2021 202108178F
9 Q-0016FXGU 3575012412030005 AKHMAD ALDI RO'AMIN 47 UMUM BUKIR RT 5 RW 7 89519264131 CoronaVac 30/09/2021 202108154G 30/10/2021 202108178F
10 Z-000BXS91 3575010909570003 TEGUH EKO PURWANTO 64 LANSIA JL. URIP SUMOHARJO RW 02 RT 003 83833086170 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
11 S-A48C3BD6 3575014809550001 SUTIYEM 66 LANSIA JL.GATOT SUBROTO 1 NO 49 85784482878 CoronaVac 30/10/2021 202108178F
12 P-7SLUEYYF 3575012507860002 RULLY OETOMO 35 UMUM JL. GATOT SUBROTO 1/5 - BUKIR 85784482878 CoronaVac 30/10/2021 202108178F
10-30-2021 PUSTU SEBANI
1 Q-0015GN6Z 3575015704010002 CHOIRUN NISA' 20 UMUM JL SLAMET RIYADI 8135369226 CoronaVac 28/09/2021 202108154G 30/10/2021 202108178F
2 Q-0017EDLR 3514167112960002 SITI FATIMAH 25 UMUM SEBANI RT 2 RW 5 8573133447 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
3 Q-0017EH83 3575016606900003 NUR DHUCHA 31 UMUM SEBANI RT 3 RW 4 8532766295 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
4 Q-0017E5ZC 3575015204730004 SITI MACHMUDAH 48 UMUM JL. SLAMET RIYADI SEBANI 8787768862 CoronaVac 02/10/2021 202108154G 30/10/2021 202108178F
Pasuruan, 30-10-2021
Kepala UPT Puskesmas Gadingrejo Admin Vaksinasi
drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-29-2021 INDUK
1 P-63K7FYZ9 3575012110030001 MU'ADZ 18 UMUM PERUM KARYA BAKTI 4/7 GENTONG 8516290233 Astrazeneca 29/10/2021 A1063
2 P-65I113HL 3575014209010001 SAFIRA DIAN SAFITRI 20 UMUM JL HALMAHERA 3/5 GADINGREJO 8581204415 Astrazeneca 29/10/2021 A1063
3 P-6LCZ5QWO 3575012608010003 MUKHAMAD SUYUTI 20 UMUM JL HALMAHERA 2/3 GADINGREJO 8113777705 Astrazeneca 29/10/2021 A1063
4 P-63ZXGDXB 3575014512950003 MUTIMMATUL AMALAH 26 UMUM GADINGREJO 8565529064 Astrazeneca 29/10/2021 A1063
5 P-643SYZXL 3575010107930105 MARZUKI 28 UMUM JL BANDA 4/2 GADINGREJO 8773214517 Astrazeneca 29/10/2021 A1063
6 P-658G14FP 3575011006870005 SUGIONO 34 UMUM JL HANGTUAH GADINGREJO 8135912339 Astrazeneca 29/10/2021 A1063
7 P-63WS1E7W 3575014812850002 SITI MAULIYAH 36 UMUM GADINGREJO 8573319146 Astrazeneca 29/10/2021 A1063
8 P-63C3YV4F 3575010101830024 ABD. ROHMAN 38 UMUM JL HALMAHERA GADINGREJO 8223437923 Astrazeneca 29/10/2021 A1063
9 P-67AJOGF6 3575011111810004 KHOIRUL ANWAR 38 UMUM JL HANGTUAH 2/3 GADINGREJO 8383471370 Astrazeneca 29/10/2021 A1063
10 P-6BACRCXP 3575014102820003 NUR FATIMAH 39 UMUM JL HALMAHERA GADINGREJO 8113777705 Astrazeneca 29/10/2021 A1063
11 P-6ODF4VB0 3575010107810158 KRISTIAWAN 40 UMUM JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 29/10/2021 A1063
12 P-6353RWFG 3514236911800003 SITI KHOLIFAH 41 UMUM DESA SAMBIREJO 8233331142 Astrazeneca 29/10/2021 A1063
13 P-6NNXBPC2 3575021508790002 GIGIH PRASETYO 42 UMUM JL URIP SUMOHARJO POHJENTREK 8133179033 Astrazeneca 29/10/2021 A1063
14 P-6AJU6FNY 3575015507780005 JULAEHAH 43 UMUM JL BANDA 5/2 GADINGREJO 8124925404 Astrazeneca 29/10/2021 A1063
15 P-6AYLPI6Q 3575014107740027 RUBIYATI 44 UMUM JL BANDA 5/2 GADINGREJO 8124925404 Astrazeneca 29/10/2021 A1063
16 P-6CBE8UOB 3575014408770002 ZULAICHAH 45 UMUM JL HANGTUAH GADINGREJO 8578568041 Astrazeneca 29/10/2021 A1063
17 P-6DMTVAO9 3575015501030002 TYAS NUR HIDAYATI 45 UMUM JL HALMAHERA 4/5 GADINGREJO 8954005604 Astrazeneca 29/10/2021 A1063
18 P-64OOEQ7C 3575014107720085 SIANAH 49 UMUM JL BANDA 4/2 GADINGREJO 8385297998 Astrazeneca 29/10/2021 A1063
19 P-5Z005FGP 3507165001720007 ERNA WAHYU PURWATI 50 RENTAN PERUM TUMPANG PERMAI 13/4 TUMPANG 8133463408 Astrazeneca 29/10/2021 A1063
20 P-637R10SS 3575011206670001 AKHROJI 54 RENTAN JL KYAI SEPUH 8510163180 Astrazeneca 29/10/2021 A1063
21 P-6LXMG2DL 3575014101660037 ASIYAH 55 RENTAN JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 29/10/2021 A1063
22 Q-000LCEP6 3575014603030001 ZAHROTUL IKHDA ANGGREANI 18 UMUM BUKIR RT 2 RW 4 8122913013 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
23 Q-000LBVON 3575011104020004 FIQIE SUWANDARU 19 UMUM BUKIR RT 2 RW 4 8958052099 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
24 Q-000LCJ4J 3575014811020003 SHOIMATUS SHANIA 19 UMUM BUKIR RT 2 RW 4 8574835176 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
25 Q-000LCNFC 3575010901010002 M HAMZAH 20 UMUM GENTONG RT 1 RW 1 8383527744 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
26 Q-000LBDU8 3575010105000001 AKHMAD MASDUQI 21 UMUM PETAHUNAN RT 2 RW 1 8595471324 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
27 Q-000LBNY3 3575015306000001 YUNIA DWI MAULIDINA 21 UMUM GADINGREJO RT 2 RW 2 8525917770 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
28 Q-000LCT8R 3575011301980001 TANJUNG RAMADHAN 23 UMUM BUKIR RT 3 RW 4 8958004531 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
29 Q-000LC3KT 3575012810970002 UBAIDILLAH 24 UMUM GADINGREJO RT 2 RW 2 8771102251 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
30 Q-000LCR5X 3575012707960001 MUKHAMAD RIZAL MAULANA 25 UMUM BUKIR RT 3 RW 4 8969917165 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
31 Q-000LCVJU 3575015503950001 FITRI ANGGRAENI 26 UMUM SEBANI RT 2 RW 3 8384151497 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
32 Q-000LCVRV 3575012703940001 MOKHAMMAD ASYAZDILI PUTHROH 27 UMUM BUKIR RT 2 RW 4 8810361916 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 Q-000L3MYB 3514184410620003 SUUDIYAH HASANAH 28 UMUM JL URIP SUMOHARJO 8233449856 Astrazeneca 05/08/2021 ABY1911 29/10/2021 A1063
34 Q-000LBS4R 3575014712910001 NUR AINI 30 UMUM BUKIR RT 3 RW 4 8213166055 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
35 Q-000LBDIT 3575011109900001 MAHMUD ARIF 31 UMUM GADINGREJO RT 2 RW2 8581575514 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
36 Q-000LC5T5 3514196810900002 DEWI KUMALASARI 31 UMUM GADINGREJO RT 2 RW 2 8573290584 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
37 Q-000K4COD 3575015107890002 SITI NASLIKHAH 32 UMUM JL. GATOT SUBROTO, SEBANI 8223128509 Astrazeneca 29/07/2021 ABY1911 29/10/2021 A1063
38 Q-000LCFMM 3575015705800002 NURUL HIBA 36 UMUM BUKIR RT 2 RW 4 8214034040 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
39 Q-000LBZL2 3575015302850003 ENDANG SRI MARTINI 36 UMUM SEBANI RT 2 RW 3 8968095906 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
40 Q-000LCST6 3575011109850007 MUHAMMAD SUBAKIR 36 UMUM BUKIR RT 3 RW 4 8575561195 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
41 Q-000LBIU9 3575015904840004 RATNA FATMAWATI 37 UMUM GADINGREJO RT 2 RW 2 8214535358 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
42 Q-000LCZD2 3509216603840007 KISFANDIAH 37 UMUM GENTONG RT 7 RW 7 8124986400 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
43 Q-000LBJN1 3524174712820001 DINI PUSPASARI 39 UMUM GADINGREJO RT 2 RW 2 8573062860 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
44 Q-000LCNOY 3575014805810002 NUR HANDAYANI 40 UMUM GADINGREJO RT 2 RW 2 8383374312 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
45 Q-000LDGFE 3575026607810004 FITRIANINGSIH 40 UMUM JL. SUKARNO HATTA 49 PASURUAN 8123320842 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
46 Q-000LDJD5 3575030605800005 DENNY SUGIARTI BARNOWO 41 UMUM GENTONG RT 7 RW 7 8123000457 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
47 Q-000LBFC0 3575014406790003 SRI WAHYUNI 42 UMUM GENTONG RT 1 RW 1 8224403463 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
48 Q-000LCCCR 3575015111780003 AYATI 43 UMUM GADINGREJO RT 2 RW2 8523611192 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
49 Q-000LBFBM 3575012207780004 SUGENG YULIONO 43 UMUM GENTONG RT 1 RW 1 8222715265 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
50 Q-000LC53Z 3575012108770002 AGUS DANI B 44 UMUM GENTONG RT 1 RW 7 8133056489 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
51 Q-000LBV89 3575013101770001 M SHOKHEH 44 UMUM BUKIR RT 3 RW 4 8123178612 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
52 Q-000LDGD6 3575020108750001 YUDI SANTOSO 46 UMUM JL. SUKARNO HATTA 49 PASURUAN 8113500232 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
53 Q-000LFH18 3575012801730003 ISWAHYUDIANTO 48 UMUM JL BANDA GG KENONGO 40, 8123361501 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
54 Q-000L628X 3575016310720001 USWATUN KHASANAH 49 UMUM JL. SLAMET RIYADI RT. 03 RW 01 8133650577 Astrazeneca 05/08/2021 ABY1911 29/10/2021 A1063
55 Q-000LBFAH 3575016104680001 AIDAH 50 RENTAN GENTONG RT 1 RW 1 817339861 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
56 Q-000LBN6R 3575010507660005 EKO SISWANTO 55 RENTAN GADINGREJO RT 2 RW 2 8135982067 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
57 Q-000K1D5O 3575016403600001 JAMILATUL MAFAID 57 RENTAN SEBANI RT 1 RW 6 8953359349 Astrazeneca 29/07/2021 ABY1911 29/10/2021 A1063
58 Q-000LC1J1 3575010402640004 EKO SULIYANTO 57 RENTAN GADINGREJO RT 2 RW 2 8573076029 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
59 Q-000LBIBO 3575016306640001 LULUK ARIANI 57 RENTAN GADINGREJO RT 2 RW 2 8573076029 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
60 Q-000L4GZ0 3575011904640005 TEKSONO SAHABOEDIN 57 RENTAN GENTONG GADINGREJO 8113777705 Astrazeneca 05/08/2021 ABY1911 29/10/2021 A1063
61 Q-000LBCQX 3575016012630001 SULIANIK 58 RENTAN GADINGREJO RT 2 RW 2 8133221400 Astrazeneca 06/08/2021 ABY1911 29/10/2021 A1063
62 P-34NVQSJM : 3575014906090002 INTAN NUR LAILI 12 REMAJA JL. KYAI SEPUH RT.001/006 KELURAHAN GE 8213529933 BIOFARMA 29/10/2021 202108178F
63 P-631SSHZC : 3575014406060002 NURUL MASFIYAH 15 REMAJA JL HANGTUAH GG 4 8311883916 BIOFARMA 29/10/2021 202108178F
64 P-6BYU7NV1 : 3575014311060003 AYU DIAN LESTARI 15 REMAJA GADINGREJO 8385456955 BIOFARMA 29/10/2021 202108178F
65 P-63PLPAFM : 3575016512990001 INAS 22 UMUM PERUM KARYA BAKTI 4/7 GENTONG 8880365574 BIOFARMA 29/10/2021 202108178F
66 P-6OJ0UHB4 : 3575010107860091 SAMSUL 35 UMUM JL HANGTUAH GADINGREJO 8113777705 BIOFARMA 29/10/2021 202108178F
67 P-66SOD39Q : 3575014107630172 SANEYAH 60 LANSIA JL HANGTUAH 2/3 GADINGREJO 8383471370 BIOFARMA 29/10/2021 202108178F
68 Q-00171Z45 : 3507304404040006 APRILIA SUSANTI 17 UMUM GADINGREJO 8384551226 BIOFARMA 01/10/2021 202105154G 29/10/2021 202108178F
69 Q-0016C6N6 : 3575013011040004 ACHMAD ILHAM MUZAKKI 17 UMUM JL HANGTUAH 1/4 GADINGREJO 8113777705 BIOFARMA 30/09/2021 202108154G 29/10/2021 202108178F
70 Q-000S317A : 3575014309040001 MARSADAH HANIM ILMIA 17 UMUM jln. kyai sepuh NO 208 RT 01 RW 06 Gentong 8823081657 BIOFARMA 01/09/2021 24202621 29/10/2021 202108178F
71 Q-0014YKUR : 3575010806040001 MUCHAMMAD FIKRI HIDAYAT 17 UMUM jl halmahera 2/3 gadingrejo 8589568188 BIOFARMA 28/09/2021 202108154G 29/10/2021 202108178F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
72 Q-00172U1G : 3575014107950041 MUSRIFAH 26 UMUM JL HANGTUAH 4/4 GADINGREJO 8591896818 BIOFARMA 01/10/2021 202108154G 29/10/2021 202108178F
73 Q-00171W9X : 3575014107980057 YULIANA 26 UMUM JL HANGTUAH 8135912339 BIOFARMA 01/10/2021 202108154G 29/10/2021 202108178F
74 Q-00172XMY : 3514234108950002 DEFI AGUSTIYANINGSIH 26 UMUM JL HALMAHERA GG. 9 8560651549 BIOFARMA 01/10/2021 202108154G 29/10/2021 202108178F
75 Q-0015CCVC : 3575014611950002 AMRINA ROSADA 26 UMUM JL HANGTUAH 8314095031 BIOFARMA 28/09/2021 202108154G 29/10/2021 C202106115
76 Q-0015NSGL : 3575012803930002 SYAIFUL ANWAR 28 UMUM JL KYAI SEPUH GG23 RT01/RW06 GENTONG G 8522222628 BIOFARMA 29/09/2021 202108154G 29/10/2021 202108178F
77 Q-001730CH : 3575015205900002 NUR FADILAH 31 UMUM JL HALMAHERA 3/5 GADINGREJO 8523077649 BIOFARMA 01/10/2021 202108154G 29/10/2021 202108178F
78 Q-0012FE8M : 3575024505870006 HANUM BAHANAN 34 UMUM PERUMAHAN LUMBUNG PADI REGENCY RT 04/ 8191342908 BIOFARMA 23/09/2021 202108123H 29/10/2021 202108178F
79 Q-0012Q84H : 3575015506800003 KHOLISAH 41 UMUM JL HALMAHERA 8113777705 BIOFARMA 23/09/2021 202108123H 29/10/2021 202108178F
80 Q-000HGU2Y : 3575014707790002 KHUSNIA 42 UMUM JL HALMAHERA GG 9, GADINGREJO 8133048624 BIOFARMA 15/07/2021 24200421 29/10/2021 202108178F
81 Q-0016DIGY : 3575014107730049 CHAMIDAH 43 UMUM JL HANGTUAH 1/4 GADINGREJO 8113777705 BIOFARMA 30/09/2021 202108154G 29/10/2021 202108178F
82 Q-0015OBPY : 3575010701770003 AGUS SUGIYANTO 44 UMUM JL GATOT SUBROTO RT01/RW05 BUKIR GADIN 8575546199 BIOFARMA 29/09/2021 202108154G 29/10/2021 202108178F
83 Q-0015UB6M : 3575020107750097 ABD BASID 46 UMUM JL HANGTUAH 1/3 GADINGREJO 8219923451 BIOFARMA 29/09/2021 202108154G 29/10/2021 202108178F
84 Q-0016GA9F : 3575014107730134 CHAMAMI 48 UMUM JL HANGTUAH 2/4 GADINGREJO 8113777705 BIOFARMA 30/09/2021 202108154G 29/10/2021 202108178F
85 Q-0015VCZM : 3575012501730001 BENI NURHIDAYAT 48 UMUM JL KYAI SEPUH GG23 RT01/RW06 GENTONG G 8380344455 BIOFARMA 29/09/2021 202108154G 29/10/2021 C202106115
86 Q-00168B04 : 3575010107740037 ACHMAD 49 UMUM JL HALMAHERA 5/5 GADINGREJO 8233751244 BIOFARMA 30/09/2021 202108154G 29/10/2021 202108178F
87 Z-000B9CTQ : 3575014107340022 SAROKHA 87 LANSIA JL HALMAHERA / GADINGREJO 8113777705 BIOFARMA 22/09/2021 2021081546 29/10/2021 202108178F
1 Q-0016HIGE 3575013112690002 SUDAR 55 RENTAN SEBANI PASURUAN 8113777705 CoronaVac 30/09/2021 202108154G 29/10/2021 202108178F
2 Q-0016ZTVJ 3575014408710002 TINARSIH 47 UMUM SEBANI 1/6 81217456993 CoronaVac 01/10/2021 202108154G 29/10/2021 202108178F
3 Q-0016C5NT 3575011404950002 AKHMAD ABDUL HARIS 26 UMUM SEBANI PASURUAN 895365221238 CoronaVac 30/09/2021 202108154G 29/10/2021 202108178F
4 Q-00170F5N 3508196012870003 DIAN ROSMIATI 34 UMUM WORO KOYO TIMUR 1/1 BEJI 81336599981 CoronaVac 01/10/2021 202108154G 29/10/2021 202108178F
5 Q-001555I4 3575015508830001 SUTINING 38 UMUM BEGORO RT 2 RW 7 82228812833 CoronaVac 28/09/2021 202108154G 29/10/2021 202108178F
6 P-64XSCWWP 3575014705880001 LUSIAMA 33 UMUM KRAPAYAKREJO RT02 RW04 82245288445 CoronaVac 29/10/2021 202108178F
7 P-65LLESYZ 3514164101910013 ANDRIANI 30 UMUM JL.GATOT SUBROTO 1/6 - BUKIR 81553542954 CoronaVac 29/10/2021 202108178F
8 P-66IUCY7T 3575011107740002 FAUJI 47 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 89508086376 CoronaVac 29/10/2021 202108178F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-28-2021 INDUK
1 Q-000L4HKS 3575012604030002 AHMAD NUR ELMI MUBAROK 18 UMUM JL TEUKU UMAR 8956041361 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
2 Q-000L7ZUQ 3575011806030001 MUCH AKIB 18 UMUM JL GATOT SUBROTO kEL SEBANI 8525791013 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
3 Q-000L626B 3575015804020002 AZIZAH AMALIA 19 UMUM JL URIP SUMOHARJO 8573891217 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
4 Q-000L62JO 3575015701010002 DEWI RASAH 20 UMUM JL URIP SUMOHARJO 8594503674 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
5 Q-000L61WD 3575016101000001 NABILAH NIMATUL FITRIYAH 21 UMUM JL URIP SUMIHARJO 8213993884 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
6 Q-000L4JTW 3575015002000001 TIKA INDAH PURWANTI 21 UMUM JL URIP SUMOHARJO 8988918755 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
7 Q-000L3PPZ 3575010304000004 SOFIYAN AFANDI 21 UMUM JL HANGTUAH 8956316851 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
8 Q-000L4HR6 3575014610990001 ROBI''ATUL ADAWIYAH 22 UMUM JL GATOT SUBROTO 8589505517 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
9 Q-000L3Q3K 3575010405990001 SOFFI ASBI MAULANA 22 UMUM JL KYAI SEPUH 8151519747 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
10 Q-000L4HL7 3575015002980002 NIKMATUL FITRIA 23 UMUM JL . URIP UMOHARJO 8125237200 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
11 Q-000L3LQJ 3507241204980001 SANDY DICKY WAHYUDI 23 UMUM JL TUMAPEL BARAT Gg MAKAM 187 8214230988 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
12 Q-000L618L 3575024904000001 DIAN IKA NUR ISLAMIAH 24 UMUM JL URIP SUMOHARJO 8533109138 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
13 Q-000L4JRW 3575014408960001 NUR MAULIDDIYA 25 UMUM JL URIP SUMOHARHO 8573012750 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
14 Q-000L4JX4 3575014103960001 DEWI KHILMIAH 25 UMUM JL URIP SUMOHARJO 8953363989 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
15 Q-000L3PQ9 3507241601950004 SYARIF SYAMSUDIN 26 UMUM LESANPURO, BARAN SONOSARI KOTA MALAN 8133197890 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
16 Q-000L3Q6E 3515056110930001 RETNO ASEWEDI DWI MEGAWATI 27 UMUM JL URIP SUMOHARJO 8214170049 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
17 Q-000L4HIZ 3575012106920001 EKO JUNIANTO 29 UMUM JL TEUKU UMAR 8784607441 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
18 Q-000L3PP7 3507242506950002 TEGUH HERMAWAN 29 UMUM JL. TOHJOYO II / 93 RT. 7 RW.7 KABUPATEN M 8224522580 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
19 Q-000L61K6 3575015306840005 INDAH FITRIAWATI 37 UMUM JL URIP SUMOHARJO RT 3/8 8523026053 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
20 Q-000L4LDU 3575014507750010 SUPTIAH 37 UMUM SEBANI 3/1 8570761564 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
21 Q-000L4KOB 3575015107030001 SITI KHODIJAH DIYANTI 40 UMUM JL SLAMET RIYADI 8135905532 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
22 Q-000L4IUB 3575011108800001 SANTOSO 41 UMUM JL. SLAMET RIADI 8575523497 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
23 Q-000L3PKR 3575010206750002 MAKHROJAN 46 UMUM JL GATOT SUBROTO 8533440131 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
24 Q-000L4HH4 3575010609740001 SUPRIYANTO 47 UMUM JL SLAMET RIYADI 8121755016 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
25 Q-000L4IQN 3575015205740001 AMINAH 47 UMUM SEBANI PASURUAN 8956302695 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
26 Q-000L3PR1 3573044707980004 JASMINE DZUHRY MAULIDINA 47 UMUM JL. S. SUPRIADI V/48 KOTA MALANG 8180379946 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
27 Q-000L3N0W 3575010605730001 MAMAN HERMAWAN 52 RENTAN SEBANI 1/3 8575537734 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
28 Q-000L3MUL 3575010110680001 ARBAI 53 RENTAN SLAMET RIYADI 8573119333 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
29 Q-000K3TL4 3575020112850002 ACHIRUDIN 54 RENTAN JL. GATOT SUBROTO BUKIR 8313241638 Astrazeneca 29/07/2021 ABY1911 28/10/2021 A1076 -
30 Q-000L62FI 3575015505780001 SRIATI 54 RENTAN SEBANI PASURUAN 8575523497 Astrazeneca 05/08/2021 ABY1911 28/10/2021 A1076 -
31 W-0000B7G9 3575011711610001 SLAMET SUKRISNO 60 LANSIA JL. URIP SUMOHARJO RT.002 RW.002 KEL. BU 8224567030 Astrazeneca 03/07/2021 ABY1911 28/10/2021 A1076 -
32 P-22ZGNSSF 3575010204810001 MOKHAMAD MANSUR 18 UMUM JL SLAMET RIYADI 2/1 GENTONG 8523409390 Astrazeneca 28/10/2021 A1076
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 P-4KTBFNQP 3575014311970002 INA RACHMADINA 21 UMUM JL HANGTUAH RT03/04 GADINGREJO 8382310000 Astrazeneca 28/10/2021 A1076
34 P-3MOO68OY 3575015602740001 INTAN ROSIANI 23 UMUM JL HALMAHERA RT02/RW 03 GADINGREJO 8133221376 Astrazeneca 28/10/2021 A1076
35 P-5WQ6KUUF 3575012601920002 YANUAR WAHYUDI 26 UMUM JL BANDA GG TERATAI 8113777705 Astrazeneca 28/10/2021 A1076
36 P-200NMT8F 3575010107670059 WASIL 36 UMUM JL BANDA 4/2 GADINGREJO 8950807780 Astrazeneca 28/10/2021 A1076
37 P-ACI9FSTL 3575011904640004 PONIMAN 43 UMUM JL BANDA GADINGREJO 8133410971 Astrazeneca 28/10/2021 A1076
38 P-4BBVC7BJ 3575010107860143 MOCH AMIN 46 UMUM JL BANDA GG MAWAR RT05/RW02 GADINGREJ 8124925404 Astrazeneca 28/10/2021 A1076
39 P-4HKIVLXL 3575015208690002 MARIA ULFA 48 UMUM JL KYAI KYAI SEPUH GG 20 GENTONG 8123117304 Astrazeneca 28/10/2021 A1076
40 Q-000UUG4Z 3575016511070001 SHAILA FARIZQIYA 2007-11-25 REMAJA RT 003 RW 005 8123349451 CoronaVac 07/09/2021 202108118H 28/10/2021 202108178F
41 Q-001696J5 3575016510080002 AMANDA SAFITRI 2008-10-25 REMAJA JL SLAMET RIADI GG.09 GENTONG 8312534374 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
42 Q-000TACCR 3575014103040003 AMINATUN MUJAHROH 2004-03-01 REMAJA JL BANDA GG MAWAR 5/2 GADINGREJO 8573076341 CoronaVac 04/09/2021 2021071371 28/10/2021 202108178F
43 Q-0015K7T5 1471106604040061 DIAH AYU THYRTA ISTIQOMAH SAD 2004-04-26 REMAJA JL. KELILING MAHARANI RESIDENCE BLOK F N 8213993079 CoronaVac 29/09/2021 202108167I 28/10/2021 202108178F
44 Q-001CR855 3575015504050001 TIARA MAULUDIA PUTRI 2005-04-15 REMAJA JL SLAMET RIADI 002/003 GENTONG 8534873188 CoronaVac 30/09/2021 202108154 28/10/2021 202108178F
45 Q-0016JB9I 3575012604070002 DHASA SUNA HAYYUM MAUJUUD 2007-04-26 REMAJA JL SUKARNO HATTA 7/1 GADINGREJO 8810265772 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
46 Q-00169I91 3575015805700002 MARWATI 1970-05-18 RENTAN JL SLAMET RIADI 2/1 GENTONG 8233897828 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
47 Q-0016A3IU 3575012001700001 DIDIK JAINURI 1970-01-20 RENTAN JL SLAMET RIADI GG.5 8233897828 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
48 Q-0015WCTV 3575010608710003 SAFUAN 1971-07-01 RENTAN JL HALMAHERA GG9 RT03/RW05 GADINGREJO 8113777705 CoronaVac 29/09/2021 202108154G 28/10/2021 202108178F
49 Q-0016JWYK 3514235504690001 BADRIYAH 1969-04-15 RENTAN KEMANTRENREJO 6/2 REJOSO 8233186148 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
50 Q-0016JM6P 3575011003630001 ISMAIL 1966-07-01 RENTAN GATOT SUBROTO 3/4 8123546447 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
51 Q-0016C9YU 3575010409620001 MUSTOFA 1962-09-04 RENTAN JL HANGTUAH 1/4 GADINGREJO 8113777705 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
52 Q-00169D68 3575014111970004 SITI CHOTIJAH 1996-11-01 UMUM JL HALMAHERA PASURUAN 8570732140 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
53 Q-001692FD 3575015511010002 SURYATI 2001-11-17 UMUM JL HALMAHERA GADINGREJO 8579171562 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
54 Q-00168L0Z 3508035205020002 MIA KURNIASIH 2002-05-12 UMUM CANGKRING MALANG UTARA BEJI 8385111149 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
55 Q-00167XQB 3575024802790002 SUITA 1979-02-08 UMUM DUSUN SUNGI SELATAN 2/2 8113777705 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
56 Q-0015T768 3575010804030004 MOCHAMMAD ALIF MAULANA 2003-04-08 UMUM JL IRIAN JAYA RT01/RW02 GADINGREJO 8564522861 CoronaVac 29/09/2021 202108154G 28/10/2021 202108178F
57 Q-000Z2DJB 3575016102730001 BENNY SOEGIATI 1973-02-21 UMUM BUKIR GADINGREJO 813777705 CoronaVac 16/09/2021 202108118H 28/10/2021 202108178F
58 Q-00168B31 3514175402860001 ERWIN ARINTA 1986-02-14 UMUM PENULUPAN 3/3 8823573071 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
59 Q-00169HL3 3575015111890001 RICHLAH 1989-11-11 UMUM JL BANDA 4/2 GADINGREJO 8560650274 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
60 Q-0015LR19 3575014511840003 ZUHRO 1986-11-05 UMUM JL SLAMET RIYADI Gg 12 RT 1 RW 3 8570728736 CoronaVac 29/09/2021 202108167I 28/10/2021 202108178F
61 Q-00168LDK 3575014107850154 WATIKHAH 1987-02-07 UMUM JL BANDA 4/2 GADINGREJO 8113777705 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
62 Q-0015CNZA 3575016507980001 RISKYATUS ZAHKIYAH 1998-07-26 UMUM JL HALMAHERA 8585566990 CoronaVac 28/09/2021 202108154G 28/10/2021 202108178F
63 Q-00168B3B 3575014906950002 NURHALIMAH 1995-06-09 UMUM JL HANGTUAH GADINGREJO 8578429421 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
64 Q-00169H7O 3575016807780001 IRNA YULIATININGSIH 1978-07-28 UMUM ASRAMA 7/1 GADINGREJO 8135814984 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
65 Q-0016FON6 3514166409000001 YULIANTI 2000-09-24 UMUM PEJAWAN 2/4 KRATON 8574843548 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
66 Q-0015VIGR 3575011207030002 ZULQIFLI 2003-07-12 UMUM JL HALMAHERA RT03/RW05 GADINGREJO 8199772899 CoronaVac 29/09/2021 202108154G 28/10/2021 202108178F
67 Q-00168P9I 3575024501730004 LULUK MUNAWAROH 1973-01-05 UMUM JL ERLANGGA 5/4 8155699954 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
68 Q-00168HF5 3514201706910002 EDI MARIANTO 1991-06-17 UMUM GRATI TUNON 8312515696 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
69 Q-0016E5RU 3514214512760008 SUGIATI 1976-12-05 UMUM MRONGGIAN 1/2 DANDANG GENDIS 8775458451 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
70 Q-000SKUUI 3575014403820002 EKAPTI LINDAH SETIA 1982-03-04 UMUM JL BANDA RT03/RW03 GADINGREJO 8573383492 CoronaVac 02/09/2021 2021071371 28/10/2021 202108178F
71 Q-0016IW90 3575017012010006 DESHYNTA TRIWAHYUNINGSIH 2001-12-30 UMUM JL KYAI SEPUH GG 18 8823043896 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
72 Q-001695PX 3575015207750004 JAMIK 1975-07-12 UMUM JL HALMAHERA GADINGREJO 8113777705 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
73 Q-001CR7VN 3575014107770037 UMI KULSUM 1977-07-01 UMUM 3/3 8578408826 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
74 Q-0015KM0X 1471104203740001 SULIS INDRAWATI 1974-03-02 UMUM JL. KELILING MAHARANI RESIDENCE BLOK F N 8136552265 CoronaVac 29/09/2021 202108167I 28/10/2021 202108178F
75 Q-0016JM28 3575011907970004 FATCHUR ROCHMAN 1997-07-19 UMUM JL HANGTUAH 1/3 GADINGREJO 8813495932 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
76 Q-0016IGXM 3575012902000003 M. SUGIYANTO 2000-02-29 UMUM JL HANGTUAH 1/3 GADINGREJO 8810261027 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
77 Q-000U3PCB 3575015708020004 MUKTAFIYAH FI KANAFILLAH 2002-08-17 UMUM JL HANG TUA 1/4 GADINGREJO 8969907353 CoronaVac 06/09/2021 2021071371 28/10/2021 202108178F
78 Q-000U5M16 3575017006990003 ULFA SAFITRI 1999-06-30 UMUM JL BANDA 5/2 GADINGREJO 8578440394 CoronaVac 06/09/2021 2021071371 28/10/2021 202108178F
79 Q-0016PB6I 3575016501850005 SITI JUARIYAH 1985-06-02 UMUM JL HANGTUAH 8585450788 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
80 Q-0016O5YR 3575014107950084 SITI MUALIFAH 1996-07-17 UMUM JL HANGTUAH 8125992565 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
81 Q-00168POK 3575012402980002 MUKHAMAD FAJAR AROBY 1998-02-24 UMUM JL GATOT SUBROTO 3/1 PETAHUNAN 8383374094 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
82 Q-0016ATZA 3575016805870001 HANA SURYAWATI 1987-05-26 UMUM JL GATOT SUBROTO 2/3 PETAHUNAN 8161554384 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
83 Q-0016DFKA 3514224306830007 JUMAÀSI 1983-06-03 UMUM PASINAN 1/6 LEKOK 8135772841 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
84 Q-0016HH1O 3575016210760002 USWATUL KHASANA 1976-10-22 UMUM JL KYAI SEPUH 1/6 GENTONG 8823081657 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
85 Q-00169C1O 3575014107750029 ST. KOMARIYAH 1975-07-01 UMUM JL HANGTUAH 3/3 GADINGREJO 8113777705 CoronaVac 30/09/2021 202108154G 28/10/2021 202108178F
86 Q-0015PE0M 3575034803860003 WAHYUNI MARTA ANDINI 1986-03-08 UMUM JL BANDA RT04/RW02 GADINGREJO 8823577385 CoronaVac 29/09/2021 202108154G 28/10/2021 202108178F
87 Q-00156VJ5 3575012112000004 ANDRA MAGHFIRA RAMADHANI 2000-12-21 UMUM JL A YANI (PERUM GADING PERMAI) ,RT 5/1 , Kel 8555901501 CoronaVac 28/09/2021 B20210606 28/10/2021 202108178F
88 P-LJEQLB0K 3575015407090002 WARDAH ZAHIRAH 2009-07-14 REMAJA JL GATOT SUBROTO BUKIR 8233233331 CoronaVac 28/10/2021 202108178F
89 P-4FSZSCN3 3575034909040001 NURI ALWANI 2004-09-09 REMAJA JL HALMAHERA RT01/RW05 TAMBAAN 8822623789 CoronaVac 28/10/2021 202108178F
90 P-4TOB9KKS 3575011304080001 SAFIRA AL MAGHFIROH 2008-04-13 REMAJA JL HANGTUAH GADINGREJO 8319274744 CoronaVac 28/10/2021 202108178F
91 P-4FCG8QDL 3575036310060002 SAFITRI RATNA UTAMI 2006-10-23 REMAJA JL HALMAHERA RT01/RW05 TAMBAAN 8310525032 CoronaVac 28/10/2021 202108178F
92 P-4J029TKR 3575012004700001 M. FAUZI 1971-07-01 RENTAN JL HALMAHERA GADINGREJO 8193698041 CoronaVac 28/10/2021 202108178F
93 P-4AI13O7T 3524246002020003 PUTRI ASMAUL KHOIROH 2002-02-20 UMUM JL TENGKU UMAR RT03/RW01 SEBANI 8573087358 CoronaVac 28/10/2021 C202106115
94 P-4JVMLAYD 3575016810720001 ASMAUL CHUSNAH 1972-07-01 UMUM JL HALMAHERA RT01/05 GADINGREJO 8193698041 CoronaVac 28/10/2021 202108178F
1 Q-000TACAS 3575014404040001 KHARISMA AURA UMMI 17 REMAJA JL GATOT SUBROTO 2/5 BUKIR 81334120983 CoronaVac 04/09/2021 2021071371 28/10/2021 C202106115
2 Q-0016M026 3514192709010001 ROBIATUL KHUSNIA 20 UMUM JL URIP SUMOHARJO RT 3 RW 3 85736162443 CoronaVac 30/09/2021 202108154G 28/10/2021 C202106115
3 Q-0015ZYJV 3575015511870001 LUTFIAH 34 UMUM JL URIP SUMOHARJO RT 1 RW 3 81233513753 CoronaVac 29/09/2021 202108154G 28/10/2021 C202106115
4 Q-0016ADRK 3575010503820004 PORWANTO 39 UMUM JL URIP SUMOHARJO BUKIR 82233607772 CoronaVac 30/09/2021 202108154G 28/10/2021 C202106115
5 Q-0016MD50 3575014107810092 NUNUK SUSIANA 40 UMUM JL MULYOREJO RT 1 RW 6 87754551015 CoronaVac 30/09/2021 202108154G 28/10/2021 C202106115
6 Q-0014PVSE 3575011108740003 HARIYANTO 47 UMUM JL MULYOREJO 1/6 SEBANI 87754551015 CoronaVac 27/09/2021 202108154G 28/10/2021 C202106115
7 Q-0016ADGP 3575016610670001 SURIFAH 54 RENTAN URIP SUMOHARJO 56 81331321282 CoronaVac 30/09/2021 202108154G 28/10/2021 C202106115
8 P-24XVBYL2 3575016503990001 NUNGKI SUKMAWATI 22 UMUM JL. PANG. SUDIRMAN GG. III 1/5 - KEBONAGUN 89699427450 CoronaVac 28/10/2021 C202106115
9 P-4ES8USK2 3575011110900002 MUHAMMAD KHAMIM 31 UMUM JL. URIP SUMOHARJO 3/3 - BUKIR 81563633573 CoronaVac 28/10/2021 C202106115
10 P-4BRCQHDS 3514182807880001 M.ABDI SOLEH 33 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 85259378115 CoronaVac 28/10/2021 C202106115
11 P-4DKWGI02 3575011705870003 EKO WIRIYANTO 34 UMUM JL GATOT SUBROTO 5/7 - BUKIR 8814918656 CoronaVac 28/10/2021 C202106115
12 P-4ECMLYZR 3575026408870003 SITI HARIYANTI 34 UMUM JL. GATOT SUBROTO 5/7 - BUKIR 8814918656 CoronaVac 28/10/2021 C202106115
13 P-4KE10R2Y 3575015004840006 ALFIYAH 37 UMUM JL. IRIAN JAYA 1/2 - GADINGREJO 81336146654 CoronaVac 28/10/2021 C202106115
14 P-4CCKEV5V 3575011206770002 SUNARTO 44 UMUM JL. GATOT SUBROTO 4/7 - BUKIR 82232585496 CoronaVac 28/10/2021 C202106115
15 P-0UQMERWU 3575020205770002 BAMBANG AKHMADI 44 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 89654983318 CoronaVac 28/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
16 P-4PDQT5Y1 3575016606780001 SAROFAH 44 UMUM JL. URIP SUMOHARJO 2/8 - BUKIR 895630274043 CoronaVac 28/10/2021 C202106115
17 P-4QOU4SUT 3575014102750002 KHOSIAH 46 UMUM JL. GATOT SUBROTO 3/4 - BUKIR 85733282961 CoronaVac 28/10/2021 C202106115
18 P-0L2MPJTR 3575010205800001 MUHAMMAD SAIFUL 51 RENTAN JL. GATOT SUBROTO 2/7 - BUKIR 8557293962 CoronaVac 28/10/2021 C202106115
19 P-4LDCBY0L 3575017004690001 KHODIJAH 52 RENTAN JL. GATOT SUBROTO 3/4 -BUKIR 89699208180 CoronaVac 28/10/2021 C202106115
20 P-DRCR33XC 3575011505640002 SLAMET 57 RENTAN JL URIP SUMOHARJO 895630274043 CoronaVac 28/10/2021 C202106115
10-28-2021 SMP NEGERI 11
1 Q-000YVOQO : 3575013003070003 WILDANSYAH 14 REMAJA Jl. Sulawesi Gg. 11 No. 20, Trajeng 8958012403 BIOFARMA 16/09/2021 24202621 28/10/2021 202108178F
2 P-QSW4UVA5 : 3575030210090001 MOCH ARIF 12 REMAJA JL. HALMAHERA RT. 2 RW. 3 GADINGREJO 8133533218 BIOFARMA 28/10/2021 202108178F
3 P-4ENH96F8 : 3575011502090001 REZA FAJAR ADI PUTRA 12 REMAJA JL. HALMAHERA IX RT 03 RW 03 GADINGREJO 8510146303 BIOFARMA 28/10/2021 202108178F
4 P-4EELQT1V : 3575014704090001 ZAINA RIZQIAYATUN NAFIA 12 REMAJA JL. KALIMANTAN III PANGGUNGREJO 8537710494 BIOFARMA 28/10/2021 202108178F
5 P-4DCOKXIL : 3507124810090002 AYU OKTAVIA RAMADANI 12 REMAJA JL. PURWOREJO RTO. 36 RW.5 KARANGKATE 8383107435 BIOFARMA 28/10/2021 202108178F
6 P-H17KYDZT : 3575011504090001 AQMAL ANUGRAH ILHAM 12 REMAJA JL. BANDA GG TERATAI GADINGREJO 8533017237 BIOFARMA 28/10/2021 202108178F
7 P-PL8WJUDP : 3575016103090002 SITI ALIFAH 12 REMAJA JL. HANGTUAH GADINGREJO 8384681525 BIOFARMA 28/10/2021 202108178F
8 P-PISGG25G : 3575010203090004 MUHAMMAD MAULANA 12 REMAJA JL. SULAWESI UTARA TRAJENG PANGGUNGRE 8951479168 BIOFARMA 28/10/2021 202108178F
9 P-4ED5UW4F : 3575012307080003 MOCHAMMAD MAULANA RIFQI 12 REMAJA JL. SULAWESI 17 NO. 42 RT 01 RW 05 TRAJENG 8380763474 BIOFARMA 28/10/2021 202108178F
10 P-4DD1E47C : 3575021601090001 MUHAMMAD YANUAR 12 REMAJA JL. KH. WAHID HASYIM V/8 RT 02 RW 02 KEL. 8139465508 BIOFARMA 28/10/2021 202108178F
11 P-4EUODTPL : 3575020306080001 M. NABIL SAPUTRA 13 REMAJA Jl RA KARTINI 1/29 8595969069 BIOFARMA 28/10/2021 202108178F
12 P-4DFN7KTI : 3575030905080004 MOCHAMAD RIDWAN 13 REMAJA JL. LETJEN SUTOYO MANDARANREJO 8384865358 BIOFARMA 28/10/2021 202108178F
13 P-4CUPHUCX : 3575045705080001 MAGDALENA LAWRENCIA MAY KRI 13 REMAJA JL. HANGTUAH VII RT 02 RW 02 TAMBAKAN 8124953571 BIOFARMA 28/10/2021 202108178F
14 P-4H3VQ2D4 : 3575012009080002 MUHAMMAD SOBIRIN 13 REMAJA JL HANGTUAH GANG 2 RT 01 RW 03 KEL. GAD 8564851506 BIOFARMA 28/10/2021 202108178F
15 P-4GBTJRMZ : 3575011411080001 M. YAHYA FIRMANSYAH 13 REMAJA JL. HANGTUAH RT.2 TW.3 GADINGREJO 8533560332 BIOFARMA 28/10/2021 202108178F
16 P-4G2Z59RV : 3575010803080002 ALIFIYAN GHOZALI 13 REMAJA JL. SULAWESI GG VIII, TRAJENG, PANGGUNGR 8821700531 BIOFARMA 28/10/2021 202108178F
17 P-4FZW7VH5 : 3575012809080001 MUHAMMAD ALFIANSYAH 13 REMAJA JL. HALMAHERA V, TAMBA'AN, PANGGUNGREJ 8782783882 BIOFARMA 28/10/2021 202108178F
18 P-4FXIAWVZ : 3575040212080001 DIKA TAMMAM SYAH 13 REMAJA JL. HANGTUAH 13 D/05 RT.3 RW.5 NGEMPLAK 8133533218 BIOFARMA 28/10/2021 202108178F
19 P-DF0R5JHJ : 3575014312080002 ROUDHOTUL WARDAH 13 REMAJA JL. HALMAHERA KELURAHAN TRAJENG 8883867805 BIOFARMA 28/10/2021 202108178F
20 P-29AZA62F : 3575021304080004 MUCHAMAD WAHYU PRIMA APRILIA 13 REMAJA JL. ERLANGGA NO. 10 RT. 2 RW.5 PURWOREJO 8384919266 BIOFARMA 28/10/2021 202108178F
21 P-4B4UW23S : 3575016210080001 AMELIYATUS SOLICHA 13 REMAJA JL. HANGTUAH GG IX NGEMPLAKREJO, PANG 8880577242 BIOFARMA 28/10/2021 202108178F
22 P-4AS23B28 : 3575010609080003 M. ZIDAN MAULANA 13 REMAJA JL. HALMAHERA GG 9 GADINGREJO 8784886472 BIOFARMA 28/10/2021 202108178F
23 P-RPCT8K8X : 3575025805080002 WARDAH ZAHRA ATHIRAH 13 REMAJA Jl. Erlangga Selatan No. 11 , Purworejo 8956011306 BIOFARMA 28/10/2021 202108178F
24 P-4B2KOFYP : 3575015712080003 PUTRI FIRDA HIDAYAH 13 REMAJA JL. GAMBIRAN RT.5 RW.2 GAMBIRKUNING KEC 8311773939 BIOFARMA 28/10/2021 202108178F
25 P-4CQOJE1I : 3514232011080002 MUHAMMAD IZZUL LABIBA 13 REMAJA PERUM WIROGUNAN RESIDENCE BLOK S-116 8533506887 BIOFARMA 28/10/2021 202108178F
26 P-4EV3ELLH : 3575011607080004 MUKHAMMAD SOFIAN FAJRI 13 REMAJA JL. HANGTUAH RT 02 RW 03 GADINGREJO 8573062720 BIOFARMA 28/10/2021 202108178F
27 P-4F465BUT : 3575010603080002 FAIDL ALI RIFQI 13 REMAJA JL. HANGTUAH IV RT 02 RW 04 KEL. GADINGR 8383001014 BIOFARMA 28/10/2021 202108178F
28 P-Q6DCWWIH : 3575011606080001 MOCHAMMAD ANDIKA 13 REMAJA JL. BANDA GG MAWAR GADINGREJO 8533578694 BIOFARMA 28/10/2021 202108178F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
29 P-4E3KCIBH : 3575011001080002 MOH. MANARUL HIDAYAT 13 REMAJA JL. HANGTUAH RT 01 RW 03 GADINGREJO 8385198814 BIOFARMA 28/10/2021 202108178F
30 P-3YLJON4W : 3575010605080003 M. FAHRI AKBAR 13 REMAJA JL. HALMAHERA GANG IX RT 01 RW 05 GADIN 8384919311 BIOFARMA 28/10/2021 202108178F
31 P-4EYCS3DV : 3575012911080001 ALI AKBAR 13 REMAJA JL. IRIAN JAYA KOMPLEK PASAR, KARANGAN 8232308977 BIOFARMA 28/10/2021 202108178F
32 P-4RMGWG8O : 3575011607080006 BIRUL ALIM 13 REMAJA JL BANDA GG TERATAI GADINGREJO 8213925886 BIOFARMA 28/10/2021 202108178F
33 P-4Q8I87HQ : 3575012704080002 MOCHAMAD ATIM WAHYUDI 13 REMAJA JL HALMAHERA G.8 TAMBAAN 8785580975 BIOFARMA 28/10/2021 202108178F
34 P-4FGCCS5U : 3514161107080003 M. ALDIYANSYAH 13 REMAJA KISIK RT.5 RW.5 KALIREJO 8133533218 BIOFARMA 28/10/2021 202108178F
35 P-4DTCUEMI : 3575022112070001 RAMA RAFANDI ARDIANSYAH 14 REMAJA JL. KOLONEL SUGIONO III D / 95 RT 04 RW 04 8383454869 BIOFARMA 28/10/2021 202108178F
36 P-RLA60K65 : 3575015804070002 ETIK SUSANTI 14 REMAJA JL. HALMAHERA GG VII KELURAHAN GADINGR 8312311702 BIOFARMA 28/10/2021 202108178F
37 P-S6D4ZZFE : 3514225710070002 NIKMATUL IZAH 14 REMAJA JL. HASANUDIN GG VII KARANGANYAR PANG 8589526746 BIOFARMA 28/10/2021 202108178F
38 P-4HPJSZXI : 3575042910070001 FAREL RAHMAT DANI 14 REMAJA JL. KOM YOS SUDARSO, PANGGUNGREJO 8523666353 BIOFARMA 28/10/2021 202108178F
39 P-4I155SWS : 3575011901070001 ROSSY ADI SAPUTRA 14 REMAJA JL. SULAWESI GG. II/08 RT. 3 RW. 2 TRAJENG 8573122046 BIOFARMA 28/10/2021 202108178F
40 P-4BQOB9WE : 3575044904070001 RAHMANIA 14 REMAJA JL. JENDRAL S PARMAN 8384988216 BIOFARMA 28/10/2021 202108178F
41 P-4D4KU37P : 3526176610070001 PUTRI 14 REMAJA JL. BANDA RT 04 RW 02 8573370140 BIOFARMA 28/10/2021 202108178F
42 P-4DTKSA0R : 3575015103070003 INTAN AYU PRASASTIWI 14 REMAJA JL. HANGTUAH 2 GADINGREJO 8770293166 BIOFARMA 28/10/2021 202108178F
43 P-4HQHPGYV : 3514162904070003 ALVIN EKA SAPUTRA 14 REMAJA KISIK RT 04 RW 04 KEL. KISIK 8315261530 BIOFARMA 28/10/2021 202108178F
44 P-4CHCDN7Q : 3575015905060004 ZUMROTUL LEYAGIS 15 REMAJA JL. BANDA GANG KAMBOJA RT 03 RW 02 8384813201 BIOFARMA 28/10/2021 202108178F
45 P-S7E6JXP0 : 3575011403060001 M. IQBAL ALFARIZI 15 REMAJA JL. SLAMET RIYADI GG.16 GENTONG GADINGR 8311768304 BIOFARMA 28/10/2021 202108178F
46 P-4DRVA94B : 3575011401060004 MUKHAMAD MUZZAQI 15 REMAJA JL. BANDA GG. TERATAI RT.4 RW.3 8589527115 BIOFARMA 28/10/2021 202108178F
47 P-4IHMYYBH : 3575012106060001 JUNAIDI 15 REMAJA JL HANGTUAH GANG 4 RT 02 RW 04 KEL. GAD 8125358650 BIOFARMA 28/10/2021 202108178F
48 P-4IK9THQO : 3575012106060005 ABDUL GHOFUR 15 REMAJA JL. HANTUAH GG. 2 RT. 1 RW.2 GADINGREJO 8880370660 BIOFARMA 28/10/2021 202108178F
49 P-4I4QCOQD : 3575011410060002 LUTHFI NURUDDIN 15 REMAJA JL. HALMAHERA GG 11, GADINGREJO 8770282822 BIOFARMA 28/10/2021 202108178F
50 P-4G5Y7O8K : 3575011710060003 MAULANA TENGKU SAABIQ 15 REMAJA JL. SULAWESI GG V / 26 RT 03 RW 08 KEL. TR 8965370107 BIOFARMA 28/10/2021 202108178F
51 P-SATOZJKY : 3575010312060002 MUCHAMMAD IRHAM SAID 15 REMAJA JL. HALEMAHERA RT.2 RW.5 GADINGREJO 8580669344 BIOFARMA 28/10/2021 202108178F
52 P-4FWFJBEH : 3575010908060001 ADAM KURNIAWAN 15 REMAJA JL. HALMAHERA GANG 9 RT 02 RW 02 KEL. GA 8578429751 BIOFARMA 28/10/2021 202108178F
53 P-4RORF0S1 : 3514161107060002 M. FIKRI HAIKAL 15 REMAJA JL. HANGTUAH RT 04 RW 03 KEL. GANDINGRE 8135781428 BIOFARMA 28/10/2021 C202106115
54 P-4R5S8JMY : 3514162206060001 QISTOLANI 15 REMAJA KEBONSAWAH RT 005 RW 007, KALIREJO, KRA 8315375081 BIOFARMA 28/10/2021 202108178F
55 P-S8YM4MMR : 3575020505060006 RAKHMAD ADAM 15 REMAJA JL. HANGTUAH XI-E KELURAHAN NGEMPLAKR 8383223818 BIOFARMA 28/10/2021 202108178F
56 P-4L1GSNLA : 3575016709060002 NURRIYA 15 REMAJA JL. HALMAHERA GG 7, GADINGREJO 8785072202 BIOFARMA 28/10/2021 202108178F
57 P-SAH3Z8O4 : 3575015012060003 SIRIN ZAHROTUL NAZWA 15 REMAJA JL. HALMAHERA GG IX KELURAHAN GADINGRE 8580713990 BIOFARMA 28/10/2021 202108178F
58 P-4KNERYBA : 3514160409060005 AKH.HAIKAL ADJI SAPUTRA 15 REMAJA KEBONSAWAH, KRATON 8133533218 BIOFARMA 28/10/2021 202108178F
59 P-4CT56YDY : 3575012802060002 ABDUL HOFUR 15 REMAJA JL. HANGTUAH IV GADINGREJO 8383438616 BIOFARMA 28/10/2021 202108178F
60 P-RNHSETUA : 3578155510060003 INTAN PERMATASARI 15 REMAJA JL. KOL SUGIONO III C/28 KELURAHAN MAYAN 8123397464 BIOFARMA 28/10/2021 202108178F
61 P-4EITZ7JF : 3575012606060001 MOCHAMMAD ALAN TAUFIK 15 REMAJA JL. HALMAHERA 66. GG. 11 RT. 5 RW.5 8380120636 BIOFARMA 28/10/2021 202108178F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
62 P-4GS66BUN : 3574025110060001 KIENANTI FITRIA RAHMADHANI 15 REMAJA JL. KYAI SEPUH GG 4 NO. 2, GADINGREJO 8578487108 BIOFARMA 28/10/2021 202108178F
63 P-4H7TKDVW : 3507241911060001 AKHMAD KHILMI ARRIZKI 15 REMAJA JL. HANGTUAH GG 03/29, TAMBA'AN, PANGGU 8311168860 BIOFARMA 28/10/2021 202108178F
64 P-4HXMKXRL : 3575032112060002 MUKHAMMAD AKBAR MUZZAKI 15 REMAJA JL SULAWESI UTARA 8122450690 BIOFARMA 28/10/2021 202108178F
65 P-4I524KFU : 3575010702020002 MUCH. IRFAN LUBIS 15 REMAJA JL. MALUKU RT 01 RW 04 KEL. TRAJENG 8389851933 BIOFARMA 28/10/2021 202108178F
66 P-4IHMYYBH : 3575012106060001 JUNAIDI 15 REMAJA JL HANGTUAH GANG 4 RT 02 RW 04 KEL. GAD 8125358650 BIOFARMA 28/10/2021 202108178F
67 P-19GIXW83 : 3575011412060001 IMAM BUHKORI 15 REMAJA JL HAKMAHERA NO 9B RT 04 RW 05 KEL. GAD 8383071683 BIOFARMA 28/10/2021 202108178F
68 P-4N8GGUS2 : 3575015012060002 AYU MADURATNA 15 REMAJA JL. HALMAHERA GG 9, GADINGREJO 8231475622 BIOFARMA 28/10/2021 202108178F
69 P-S8MJBRL5 : 3575020110060001 MOCHAMMAD ROMANSYAH 15 REMAJA JL. HANGTUAH NGEMPLAKREJO PANGGUNGR 8133533218 BIOFARMA 28/10/2021 202108178F
70 P-4LIF630V : 3575011507060002 WISNU WARDANA 15 REMAJA JL. HASANUDIN GG 13, KARANGANYAR, PAN 8191813902 BIOFARMA 28/10/2021 202108178F
71 P-4ILDCF4X : 3514161707060001 MOH.SULFI KHAMZAH 15 REMAJA GUMENG, KALIREJO, KRATON 8838012077 BIOFARMA 28/10/2021 202108178F
72 P-52LK5Q3I : 3514161506060003 MUHAMMAD FARIZAL 15 REMAJA kebun sawah 8575520798 BIOFARMA 28/10/2021 202108178F
73 P-4MUQ1FPH : 3575011603050005 SAIFUL ADIM 16 REMAJA JL. HALMAHERA GANG 9 RT 03 RW 05 KEL. GA 8384975582 BIOFARMA 28/10/2021 202108178F
74 P-4M7XTO7O : 3575012007050002 MUHAMMAD RIFKY 16 REMAJA JL. HALMAHERA GANG 11 / NO. 8 RT 04 RW 05 8820092340 BIOFARMA 28/10/2021 202108178F
75 P-4KTJLDTR : 3575010107040015 MOCHAMMAD SAHRUL 17 REMAJA JL HALMAHERA RT 05 RW 03 KEL. TAMBA'AN 8810275786 BIOFARMA 28/10/2021 202108178F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-27-2021 INDUK
1 P-48F8LAPA 3575015908700003 YURO 51 RENTAN JL IRIAN JAYA 2/2 GADINGREJO 8125959909 Astrazeneca 27/10/2021 A1078 G
2 P-QOCQCPUC 3575026010680006 MARISAH 53 RENTAN JL HAYAM WURUK 2/10 KEBONSARI 8233799997 Astrazeneca 27/10/2021 A1078 G
3 P-NX9H2NYT 3575024101610010 SITI RUKOIYAH 57 RENTAN JL HANGTUAH 10 RT03/RW02 NGEMPLAK REJ 8384693181 Astrazeneca 27/10/2021 A1078 G
4 P-0PK75IMO 3575010109930002 MUHAMMAD ARIFIN 28 UMUM JL BANDA GADINGREJO 8885113443 Astrazeneca 27/10/2021 A1078 G
5 P-0PU0YH4P 3575014905850002 DAHLIA 36 UMUM JL BANDA GG TERATAI GADINGREJO 8113777705 Astrazeneca 27/10/2021 A1078 G
6 P-0PXPJKLK 3575010107870108 FAUZI 34 UMUM GADINGREJO 8381105102 Astrazeneca 27/10/2021 A1078 G
7 P-0Q2JFDQA 3575016402980001 ROCHIYATI 23 UMUM JL HANGTUAH GADINGREJO 8585980148 Astrazeneca 27/10/2021 A1078 G
8 P-0RY1QHGL 3514170701940002 AKHMAD ROZI 27 UMUM WARUNGDOWO TIMUR 8383775367 Astrazeneca 27/10/2021 A1078 G
9 P-0S9IASC6 3514162010980001 MUHAMMAD WARI'AN 23 UMUM TAMBAKREJO 8564847358 Astrazeneca 27/10/2021 A1078 G
10 P-0TE8GLGA 3575014308840007 PAIJAH 37 UMUM JL HANGTUAH 2/3 GADINGREJO 8311084232 Astrazeneca 27/10/2021 A1078 G
11 P-0VXAZV0B 3575015508930003 SALEHA 28 UMUM JL HALMAHERA GADINGREJO 8570886669 Astrazeneca 27/10/2021 A1078 G
12 P-1ADKZ6M6 3575011109020003 MOCHAMAD IQBAL AFFANDI 19 UMUM JL HANGTUAH GADINGREJO 8953950325 Astrazeneca 27/10/2021 A1078 G
13 P-1DBPSSTE 3575010205820002 MUCHAMAD ZAINUL 38 UMUM JL HANGTUAH 2/4 GADINGREJO 8113777705 Astrazeneca 27/10/2021 A1078 G
14 P-TGP5V1AT 3522245109560001 TARMINI 65 LANSIA JL HAYAM WURUK 2/10 KEBONSARI 8239955042 CoronaVac 27/10/2021 C202106115
15 P-0UIM2XOE 3575016608050004 PUTRI SALSABILLA 16 REMAJA JL HANGTUAH 1/4 GADINGREJO 8135953043 CoronaVac 27/10/2021 C202106115
16 P-0TLQM1VQ 3575015708830002 SOFI HIDAYATI 38 UMUM JL HANGTUAH 1/4 GADINGREJO 8314778820 CoronaVac 27/10/2021 C202106115
17 P-1ER5XNRP 3575011606990003 SULTON 22 UMUM JL HANGTUAH 3/3 GADINGREJO 8885900311 CoronaVac 27/10/2021 C202106115
18 Q-0015KU66 3575015601090001 AZIZATUL NABILA 12 REMAJA JL HANGTUAH GG 2 8813495952 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
19 Q-0015TXJH 3574045405050003 IKRAM RAFIF NUR WAHID 12 REMAJA GADINGREJO KOTA PASURUAN 8564834400 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
20 Q-0015WARD 3575012804000003 MUHAMMAD HENDRA PRATAMA 21 UMUM JL URIP SUMOHARJO RT02/RW01 BUKIR GADI 8951490245 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
21 Q-0015MDPW 3575016607990001 INDAH WAHYUNINGSIH 22 UMUM GENTONG KOTA PASURUAN 8580373183 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
22 Q-0015VH0I 3575016210980001 RESI KRISNAOKTAVIA 23 UMUM JL SLAMET RIYADI RT01/RW03 SEBANI GADIN 8381810897 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
23 Q-0015M9FS 3575015001970009 DIAH RULIANA SAFITRI 24 UMUM KEL. GENTONG KEC. GADINGREJO 8234210930 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
24 Q-0015U8JR 3575014107960030 KHUSNUL KHOTIMAH 25 UMUM JL HANGTUAH 2 RT04/RW03 GADINGREJO 8578454067 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
25 Q-0015X2OC 3575014302950007 SITI AISYAH 26 UMUM JL HANGTUAH RT03/RW04 GADINGREJO 8953258603 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
26 Q-0015T7GU 3507324408930003 LUDIA UTAMIMA 27 UMUM JL SELOBEKITI RT23/RW04 PLANDI,WONOSARI 8121792921 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
27 Q-000VECXK 3514065210990001 KHUSNUL KHOTIMAH 27 UMUM jl hangtuah 2/4 gadingrejo 8384919197 CoronaVac 09/09/2021 2021071371 27/10/2021 C202106115
28 Q-0015VH8L 3514234506940004 AINUN KHURROTIN 27 UMUM DESA TOYANING RT01/RW05 REJOSO 8133308424 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
29 Q-0015O9GN 3575034105930002 RIZKA 28 UMUM JL KYAI SEPUH RT02/RW06 GENTONG GADING 8235005095 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
30 Q-0015P4KK 3575014403930001 KHUSNIA 28 UMUM JL BANDA RT03/RW03 GADINGREJO 8573356080 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
31 Q-00151US1 3575010410930001 SLAMET HARIYONO 28 UMUM JL HANGTUAH RT03/RW04 GADINGREJO 8950809292 CoronaVac 28/09/2021 202108154G 27/10/2021 C202106115
32 Q-0015T3L0 3575010710910001 YUDI SANTOSO 30 UMUM JL BANDA GG MAWARRT05/RW02 GADINGREJ 8951467749 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
33 Q-0015RYLU 3575010306910003 FATHUSSURUR 30 UMUM JL BANDA NO24 RT04/RW02 GADINGREJO 8786579722 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 Q-0015QJAU 3575012005890002 ABD. HAMID 32 UMUM JL. HALMAHERA RT 5 RW 4 TAMBA'AN 8383275241 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
35 K-0001NMUP 3575010807890003 IMAM SAFII 32 UMUM JL HALMAHERA GGXI RT05/RW05 GADINGREJO 8821814638 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
36 Q-000REJY2 3575010107860107 HUMAIDI 35 UMUM JL HANG TUA 2/4 GADINGREJO 8384919197 CoronaVac 30/08/2021 24202221 G 27/10/2021 C202106115
37 Q-0015U56Y 3575011005850002 SITI MAISAROH 36 UMUM JL BANDA RT04/RW02 GADINGREJO 8594732399 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
38 Q-00162MLW 3514110911850001 MUHAMAD SAKUR 36 UMUM PALEMBON 003/004 REJOSO 8581557053 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
39 Q-0014ZEE3 3575014912830001 SITI FATIMAH 38 UMUM jl banda 3/3 gadingrejo 8113777705 CoronaVac 28/09/2021 202108154G 27/10/2021 C202106115
40 Q-0015XV30 3575011212820008 MUKHAMMAD ROKHIM 39 UMUM JL BANDA RT03/RW03 GADINGREJO 8573356080 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
41 Q-0015KJF9 3575014107780109 RUCHANA 43 UMUM JL HANGTUAH GG 2 8813495932 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
42 Z-000BPVKM 3575012704770001 SUHANDOKO 44 UMUM DUSUN PON MANDIRANCAN KUNINGAN 8951921899 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
43 Q-00162UBR 3575024510730004 HANNA R. 44 UMUM JL PARAS REJO 012/005 8226419281 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
44 Q-0015LH9X 3575016105740001 NISWATI 47 UMUM JL KYAI SEPUH RT 1 RW 6 KEL GENTONG 8579095782 CoronaVac 29/09/2021 202108167i 27/10/2021 C202106115
45 Q-0015BOG4 3575014101730003 SITI AMINAH 48 UMUM JL. SLAMET RIYADI GENTONG 8560710262 CoronaVac 28/09/2021 202108154G 27/10/2021 C202106115
46 Q-0015M9ZX 3575014510720003 MISNAH 49 UMUM JL KYAI SEPUH GG 21 RT 01 RW 06 GENTONG 8580373183 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
47 Q-0015WH5E 3575015708720005 WAGISRI 50 RENTAN JL HANGTUAH RT04/RW03 GADINGREJO 8113777705 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
48 Q-0015KJJA 3575015009700005 MISNAWATI 51 RENTAN JL. HANGTUAH RT/RW 001/003 GADINGREJO 8125981120 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
49 Q-000VXQZ9 3575033101670003 AGUS NUGROHO BASUKI 54 RENTAN GADINGREJO RT 4 RW 1 8129775674 CoronaVac 10/09/2021 202108118H 27/10/2021 C202106115
50 Q-0015R750 3575017012660003 SUPIYATI 55 RENTAN JL BANDA GG TERATAI RT04/RW03 GADINGRE 8225700197 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
51 Q-0015W7DQ 3575010107600074 MOCH. MISTUR NADIN 59 RENTAN JL HALMAHERA RT 03/RW05 GADINGREJO 8113777705 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
52 Q-0015KX4X 3575011301610001 ABD MANAP 60 LANSIA JL HANGTUAH GG II RT 01 RW 03 GADINGREJO 8831141098 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
53 Z-000BPZE7 3575014707570001 YULI EKTIARI 64 LANSIA KEL GENTONG KEC GADINGREJO 8953091090 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
1 P-3A77OWKA 3575015512870002 RINTA SARI 34 UMUM SEBANI GADINGREJO 8123006431 CoronaVac 27/10/2021 C202106115
2 P-3C3BBOFU 3575011603630001 SUNANDAR 58 RENTAN SEBANI 2/6 8128894312 CoronaVac 27/10/2021 C202106115
3 P-3CQCGRER 3575015804630001 MARCHUMAH 58 RENTAN SEBANI 2/6 8128894312 CoronaVac 27/10/2021 C202106115
4 P-3DK3JX9V 3575011608660002 MOKHAMAD HASYIM 53 RENTAN SEBANI 5/2 8131010423 CoronaVac 27/10/2021 C202106115
5 Q-0015QQUA 3507012009980001 EKO DWI CAHYONO 23 UMUM PASAR PON RT 23 RW 06 BANJAREJO 8573849577 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
6 Q-0015VKFE 3507014307970003 YULIKA AYU IRAWATI 24 UMUM PASAR PONRT 23 RW 06 BANJAREJO 8585463566 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
7 Q-0014EU14 3514215311910004 NOFI ROCHMANIA 30 UMUM JL SLAMET RIYADI 8580333319 CoronaVac 27/09/2021 202108154G 27/10/2021 C202106115
8 Q-0015WQXT 3575011712890003 NUR WAHYU EKO PRAYITNO 32 UMUM JL SLAMET RIYADI 1/3 SEBANI 8123006424 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
9 Q-0015P1LC 3575014106840003 NURKASANAH 37 UMUM SEBANI GADINGREJO 8200000000 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
10 Q-0015U4QU 3575014607740003 SULISTIANI 47 UMUM jl slametriyadi 1/1 sebani gadingrejo 8578581624 CoronaVac 29/09/2021 202108167i 27/10/2021 C202106115
11 Q-0015RC3N 3575015805710003 SRI HARTATIK 50 RENTAN JL. MULYOREJO 8951575331 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
12 Q-0015V1AW 3575010311700001 SUMIDIONO 51 RENTAN JL SLAMET RIYADI RT 1 RW 1 KEL SEBANI 8578581624 CoronaVac 29/09/2021 202108167i 27/10/2021 C202106115
13 Q-0008IY9M 3575014101640007 ISMIYATUN 56 RENTAN SEBANI GADINGREJO 8133593212 CoronaVac 26/06/2021 24200821 27/10/2021 C202106115
14 Q-0015XJ0K 3575011701660002 MUSLICH 56 RENTAN SEBANI KOTA PASURUAN 02/05 8384975355 CoronaVac 29/09/2021 202108167I 27/10/2021 C202106115
15 Q-00162UOT 3578277006620145 SITI AISAH 59 RENTAN SIMOREJOSARI 1/6 SURABAYA 8135319867 CoronaVac 29/09/2021 2021081671 27/10/2021 C202106115
1 K-00013A9P 3575015208070002 SAFIRA ARTHA DEWI 14 REMAJA Jl. gatot subroto, Gadingrejo, KOTA PASURUAN, 895397001390 CoronaVac 25/09/2021 24202321 27/10/2021 C202106115
2 Q-000VHZKM 3575012712020005 M. ALI ZAINI 20 UMUM JL GATOT SUBROTO 1/4 BUKIR 89678858504 CoronaVac 09/09/2021 20212071371 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
3 Q-0015M09P 3575036010940001 SITI CHUSNIAH 27 UMUM JL URIP SUMOHARJO RT 3 RW 3 83185241610 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
4 Q-000JEK1R 3575013001930002 MUHAMMAD SOFYAN 28 UMUM JL URIP SUMOHARJO 85742218482 CoronaVac 25/07/2021 24003521 27/10/2021 C202106115
5 Q-001405WR 3575016412910001 DEVI SEPTIA RATNASARI 30 UMUM JL GATOT SUBROTO 87754444878 CoronaVac 06/09/2021 202108154G 27/10/2021 C202106115
6 Q-0015M0N2 3575012203910002 RAMA DANI 30 UMUM JL GATOT SUBROTO 5/7 82137744226 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
7 Q-0015RYRZ 3575014906830001 AYUN YUNIATI 38 UMUM JL GATOT SUBROTO 5/7 82257477846 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
8 Q-0015XU8E 3575012206800002 ABDUL ROKHIM 41 UMUM BUKIR RT 5 RW 7 81395268342 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
9 Q-000BIHWU 3575015206740001 YANAH 47 UMUM JL GATOT SUBROTO 82230504706 CoronaVac 05/07/2021 24003521 27/10/2021 C202106115
10 Q-0015UP86 3575016501720001 SITI ALIMAH 49 UMUM JL URIP SUMOHARJO RT 2 RW 8 83848545475 CoronaVac 29/09/2021 202108154G 27/10/2021 C202106115
11 P-21VQJ1SW 3575011804090001 PAMUNGKAS WAHYU DIONO 12 REMAJA JL. GATOT SUBROTO 3/5 - BUKIR 89699427450 CoronaVac 27/10/2021 C202106115
12 P-0PJ7TOM6 3575012008070002 MOCHAMMAD RISQI FACHRUDIN 14 REMAJA JL. GATOT SUBROTO 3/5 - BUKIR 85727464860 CoronaVac 27/10/2021 C202106115
13 P-25AZCVVB 3575016910000003 RISKA NOVITA SARI 21 UMUM JL. GATOT SUBROTO 2/4 - BUKIR 82131074524 CoronaVac 27/10/2021 C202106115
14 P-2LA5D5XK 3575015901980001 LIANA AMALIA 23 UMUM SARIREJO 4/2 - ARJOSARI 881036219354 CoronaVac 27/10/2021 C202106115
15 P-27LX1QOH 3575012907930003 SLAMET WAHYU RUTAMA 28 UMUM JL. GATOT SUBROTO 3/5 - BUKIR 895336398924 CoronaVac 27/10/2021 C202106115
16 P-0RIPEGU1 3514204104910001 ANITA PURNAMASARI 30 UMUM JL. URIP SUMOHARJO 3/2 - BUKIR 85648959313 CoronaVac 27/10/2021 C202106115
17 P-0PHDTHSD 3575014912880002 MUTIMATUS ZAHRO 33 UMUM BUKIR RT03 RW05 85727464860 CoronaVac 27/10/2021 C202106115
18 P-27E6E4DQ 3575014109760003 SUGIYANTI 45 UMUM JL. GATOT SUBROTO 2/4 - PETAHUNAN 82131074524 CoronaVac 27/10/2021 C202106115
19 P-1C9LKCWO 3575010607740001 MOCH. ROCHIM 47 UMUM JL. GATOT SUBROTO 3/5 - BUKIR 895397004014 CoronaVac 27/10/2021 C202106115
20 P-0WKVFH7Y 3575012512730001 SUWADI 48 UMUM BUKIR RT RT03 RW05 85727464860 CoronaVac 27/10/2021 C202106115
10-27-2021 SMP NEGERI 11
1 Q-000XZYPD 3575031601090001 ADAM FARHAMSAH 12 REMAJA JL. JEND S PARMAN PANGGUNGREJO 8180414082 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
2 Q-000XZYOO 3575012402090001 AJI DARMAWAN 12 REMAJA JL. HALMAHERA GG. 9 GADINGREJO 8233317969 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
3 Q-000Y3APP 3575021104090002 AINUN NAJIB 12 REMAJA JL. HANGTUAH 9 NGEMPLAKREJO PANGGUNG 8384681734 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
4 Q-000Y363Z 3575016401090003 AMALIA HASANAH 12 REMAJA JL. HALMAHERA RUSUN NAWA LANTAI 2 NO 2 8385463574 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
5 Q-000Y419P 3575024108090003 ICA MUNAWAROH 12 REMAJA JL. HANGTUAH 13D PANGGUNGREJO 8383210098 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
6 Q-000Y6X39 3575046402090001 KEYLA AZZAHRA 12 REMAJA JL. SULAWESI KELURAHAN TRAJENG 8383598586 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
7 Q-000Y7C1L 3575016903090001 BINTAN FARA ADIFA 12 REMAJA JL. HANGTUAH VII TAMBA'AN PANGGUNGREJO 8199918607 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
8 Q-000Y9YSX 3575041803090001 HAIKAL SYIBRA MAULIDHANI 12 REMAJA Jl. Hangtuah, Gadingrejo 8133533218 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
9 Q-000Y9V2C 3575032801090001 MOHAMMAD HABIY BUSY SYAHID 12 REMAJA Jl. Sulawesi 10/24, Trajeng 8533507567 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
10 Q-000Y9ECH 3575010201090001 RIZAL FIRMANSYAH 12 REMAJA JL. HALMAHERA GG IX GADINGREJO 8133533218 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
11 Q-000Y9YMA 3514212105090001 ACHMAD NUR HIDAYAT 12 REMAJA JL. KALIMANTAN GG 3 NO 15 KELURAHAN TRA 8311452692 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
12 Q-000YAG98 3575014903090001 AFISKA MAULIDIYAH 12 REMAJA JL. BANDA GG 2 KELURAHAN GADINGREJO 8575539623 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
13 Q-000YAJRF 3575014901090002 BILQIS DEWI YANUAR 12 REMAJA Jl. Halmahera Gg. 9 , Gadingrejo 8191815795 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
14 Q-000YB11I 3575012508090001 DWI RIO RAMADHANI 12 REMAJA JL. HANGTUAH IX KELURAHAN NGEMPLAKREJ 8581502608 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
15 Q-000YAMDY 3575024801090002 SILFANA ULFA 12 REMAJA JL. HANGTUAH XIB NGEMPLAKREJO PANGGU 8953970027 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
16 Q-000YETW9 3575034909090003 CHOIRUN NISAK 12 REMAJA JL. JENDRAL S PARMAN KELURAHAN PANGG 8383140012 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
17 Q-000Y2HV7 3575016207090002 RAFIKA DWI ANGGRAINI 12 REMAJA JL. BANDA GG MAWAR KELURAHAN GADINGRE 8383460374 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
18 Q-000Y32HU 3575011801090001 MUHAMAD RIKO 12 REMAJA JL. HALMAHERA G.II TAMBA'AN PANGGUNGRE 8383598196 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
19 Q-000Y41AR 3575014801090001 GRESIA AULIA SYAFARA 12 REMAJA JL. SOEKARNO HATTA 2/39 KELURAHAN KAR 8533053178 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
20 Q-000Y5HPV 3575011203090002 MUHAMMAD MAULANA 12 REMAJA JL. SULAWESI UTARA TRAJENG PANGGUNGRE 8810365739 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
21 Q-000Y5ZZF 3575012202090002 MARVEL FEBRIAN MAULANA 12 REMAJA JL. HALMAHERA G 8 TAMBA'AN PANGGUNGRE 8785580975 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
22 Q-000Y8FG6 3575010906090001 MUBAIDILA AFANDI 12 REMAJA JL. BANDA GG MAWAR, GADINGREJO 8560777475 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
23 Q-000Y75LW 3575016802090002 YASMIN SAFIRA MAULIDA 12 REMAJA JL.BANDA GADINGREJO 8525923929 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
24 Q-000Y8KMO 3575014203090001 MUTIARA KASIH 12 REMAJA JL. HALMAHERA APARTEMEN PANTAI MAS BLOK 8775677199 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
25 Q-000Y79S1 3575014907090004 RIZKY INDRIANI 12 REMAJA JL. HALMAHERA GG 9 KELURAHAN GADINGRE 8384683020 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
26 Q-000YAZUZ 3575014103090002 FAIRUZ JAVIERA BARRAQ GHALIYA 12 REMAJA JL. IRIAN JAYA GADINGREJO 8570706525 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
27 Q-000YAKT4 3575026802090004 MAULIDDINA KHIKMATA'ANIS QURLI 12 REMAJA JL. HASANUDIN GG 13 NO 10B KELURAHAN K 8810360183 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
28 Q-000Y295J 3575010110070002 ALIF AZI SANTOSO 13 REMAJA Jl. Halmahera Gg. 9 Gadingrejo 8570811725 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
29 Q-000Y75HH 3575010701080002 FARID 13 REMAJA JL. HALMAHERA RT.3 RW.5 GADINGREJO 8961418883 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
30 Q-000Y1CBZ 3575010803080003 EDI PURWANTO 13 REMAJA JL BANDA GG TERATAI KECAMATAN GADINGR 8383422554 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
31 Q-000Y05Z6 3575015311080001 ARFIRANI 13 REMAJA JL. BANDA GADINGREJO 8385336275 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
32 Q-000XZXZI 3575010210080001 YUDHA PRASYETYA PRATAMA 13 REMAJA JL, HALMAHERA GG IX/B 66 KELURAHAN GADI 8560725305 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
33 Q-000Y18RL 3575010110080001 MOCH SAIFUL AKBAR 13 REMAJA JL. SULAWESI KELURAHAN TRAJENG 8821752164 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
34 Q-000Y1D3J 3575015204080003 YUNITA PUSPITA SARI 13 REMAJA JL. HALMAHERA GG. XI RT.5 RW.5 GADINGREJ 8383425282 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
35 Q-000Y3NCP 3575016704080005 AZZAHROTUL CHUSNIYA 13 REMAJA JL. BANDA RT.3 RW.3 GADINGREJO 8958004633 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
36 Q-000Y4RFN 3575011004080001 MOCHAMAD YAHYA 13 REMAJA JL. HANGTUAH 2 GADINGREJO 8578408737 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
37 Q-000Y7902 3514166210080002 SITI AYU WANDIRA 13 REMAJA DUSUN KEBONSAWAH KALIREJO KRATON 8311539743 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
38 Q-000Y5H05 3514160708080003 MUKTASYIM BILLAH 13 REMAJA KEBON SAWAH KECAMATAN KRATON 8224585220 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
39 Q-000YA4JI 3575012211080002 AINUN MAYMUNAJIB HIJRIYANTO 13 REMAJA KETUG MLAGI KARANGKETUG GADINGREJO 8315194337 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
40 Q-000Y7XKF 3575016911080003 NOVITA NUR AINI 13 REMAJA JL. KALIMANTAN GG. 111/23 TRAJENG 8384919184 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
41 Q-000Y8JEJ 3575011609080001 MUHAMMAD IQBAL RAMADIYANTO 13 REMAJA JL. BANDA GG MAWAR GADINGREJO 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
42 Q-000Y7UZR 3575044811080001 YASMIN NOVITA FIRDAUSY 13 REMAJA JL. MALUKU TRAJENG PANGGUNGREJO 8384172269 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
43 Q-000Y7TH3 3575045110080001 RIZKY FITRIANI 13 REMAJA JL KOLONEL SUGIONO TRAJENG 8123421081 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
44 Q-000Y9U08 3575020108080002 AMIN ABDUL AZIZ 13 REMAJA Jl. Hangtuah XI , Ngemplakrejo 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
45 Q-000YAF0R 3575014312080001 FINDA ROHMATUL ADHA 13 REMAJA JL. HALMAHERA GG 12 A TRAJENG PANGGUN 8384832699 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
46 Q-000YDRM0 3575012712080004 FAKHRIL MAULANA 13 REMAJA JL. HANGTUAH GG 6 KELURAHAN GADINGREJ 8880825683 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
47 Q-000YDS0X 3575012703080001 MUKHAMMAD RAFLI MAULANA 13 REMAJA Jl. Hangtuah Gg. 4 , Gadingrejo 8133533218 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
48 Q-000YAFL4 3575015510080002 RAHMAWATI 13 REMAJA Jl. Hangtuah Gg.2 , Gadingrejo 8570850867 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
49 Q-000YDTKJ 3575010911080004 YANTO 13 REMAJA JL. SULAWESI TRAJENG PANGGUNGREJO 8953383991 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
50 Q-000YBWM4 3514052404080003 BAGUS BAYUWIJIANTO 13 REMAJA JL. HALMAHERA RUSUNAWA TAMBAAN 8338484907 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
51 Q-000YC0BJ 3575014606080001 NADYA SHOFWAH 13 REMAJA JL. KOLONEL SUGIONO 18 TRAJENG PANGGU 8573031974 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
52 Q-000YE6HY 3575036308080002 SINTA JUWITA SARI 13 REMAJA JL. JEND S PARMAN PANGGUNGREJO 8953960036 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
53 Q-000YE694 3575021308080001 FELANO AKBAR 13 REMAJA JL. LAKS. MARTADINATA RT.3RW.7 NGEMPLAK 8316869434 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
54 Q-000YE62K 3575014103080001 FARAH ADIBA UMMAROH 13 REMAJA Jl. Halmahera No. 25, Tambaan 8533063103 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
55 Q-000YE69U 3575035005080005 FANI FARADILA 13 REMAJA Jl. Jend.S. Parman , Panggungrejo 8133122477 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
56 Q-000YD0KQ 3514162702080001 MUHAMAD ADIB FAHMI FIRMANSYA 13 REMAJA Dsn. Gumeng, Desa Kalirejo , Kraton 8383105225 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
57 Q-000YFA1X 3575012002080002 MUHAMAD FERY ARDIANSYAH 13 REMAJA Jln. Hasanudin Gg. 1 , Karanganyar 8121967664 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
58 Q-000YF1NM 3575036201080001 SAFIRA ANDINI 13 REMAJA JL. JEND S PARMAN PANGGUNGREJO 8213943083 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
59 Q-000YEUNU 3575016802080001 ZAKIYATUL AINIYAH 13 REMAJA Jl. Hasanudin Gg. IV , Karanganyar 8775652527 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
60 Q-000YCU6M 3574014901080001 ANDHINI WIDYASARI 13 REMAJA JL. ERLANGGA WIRONINI GANG 8 8880534449 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
61 Q-000YF0VB 3575016304080003 DEVI PUTRI ARIFIN 13 REMAJA JL. HALMAHERA APARTEMEN PANTAI MAS BL 8570709838 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
62 Q-000YF05C 3575016901080001 JIHAN NUR LAELA 13 REMAJA JL. HALMAHERA XI RT. 5 RW.5 GADINGREJO 8311559574 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
63 Q-000Y2BWA 3575030609080003 A. RAMADANI 13 REMAJA JL. HANGTUAH KELURAHAN GADINGREJO 8233151102 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
64 Q-000Y05ZE 3575015408080002 ADINDA FIRNANDA AGUSTINA 13 REMAJA JL. JOLONDRIO KELURAHAN KRAPYAKREJO 8389821918 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
65 Q-000XZRET 3575014405080001 AYU INDAH LESTARI 13 REMAJA JL. HALMAHERA APARTEMEN MAS BLOK 01.02 8311075220 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
66 Q-000Y2EI4 3575015611080004 LUNA ELISIA 13 REMAJA JL. HALMAHERA 10/30 TREJENG 8311174847 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
67 Q-000Y33U2 3575016612080002 ALIN DWI FUJIANINGSIH 13 REMAJA JL. BANDA RT. 5 RW.2 GADINGREJO 8133412303 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
68 Q-000Y754X 3575015411080002 SITI AFRILIA 13 REMAJA JL. BANDA GG MAWAR KELURAHAN GADINGRE 8389215709 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
69 Q-000Y5GYM 3575010310080002 MUHAMMAT AUFAR SADAT 13 REMAJA JL. MALUKU GG. I NO. V TRAJENG PANGGUNG 8383434535 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
70 Q-000Y5B2H 3575011907080002 MOCHAMMAD AGIL ALI MUSTOFA 13 REMAJA JL. HALMAHERA GG. II NO. 16 GADINGREJO 8385976949 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
71 Q-000Y7YMR 3575015406080003 INDAH FAJAR SUSIANTI 13 REMAJA JL.HANGTUAH 2 GADINGREJO 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
72 Q-000YB5WC 3575011303080001 MUHAMMAD ALDO 13 REMAJA JL. IRIAN JAYA I/58 KARANGANYAR PANGGUN 8573298095 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
73 Q-000Y9AEP 3575020307080003 RIZAL SOLMARIUS 13 REMAJA JL. HANGTUAH XI TAMBAKSARI KELURAHAN 8953684006 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
74 Q-000YB0RY 3575022002080001 MOHAMAD KHOIRIL IBAD 13 REMAJA JL. HANGTUAH 17A NGEMPLAKREJO PANGGU 8133533218 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
75 Q-000YB0FO 3575011712030002 SAMSUL ARIFIN 13 REMAJA Jl. Hangtuah Gg. 2 , Gadingrejo 8121686662 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
76 Q-000YAIWM 3575014911080001 YANTI 13 REMAJA JL. SULAWESI TRAJENG PANGGUNGREJO 8951925326 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
77 Q-000YDS93 3575021304080002 ACHMAD NOUVAL 13 REMAJA JL. LAKS. MARTADINATA RT.2 RW.7 NGEMPLA 8954032387 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
78 Q-000YF028 3575010809080002 AKHMAD FAHRI ADITYA RAMADHAN 13 REMAJA Jl. Kalimantan No. 67, Trajeng 8233487394 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
79 Q-000YCX5C 3514162212080004 NUR RIZAL 13 REMAJA Dsn. Kisik, Desa. Kalirejo, Kraton 8889897174 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
80 Q-000YCI7J 3575011905080002 M. SOFYAN MUCHLIS 13 REMAJA JL. IRIAN JAYA GG ANGGREK GADINGREJO 8585906200 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
81 Q-000YGVMS 3575016808080003 RHEZAQY AMELLYA FIRSTY 13 REMAJA JL. HASANUDIN KARANGANYAR 8969947019 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
82 Q-000YBMSJ 3514165511070002 HYANG CINTA ASHARA 14 REMAJA KISIK KALIREJO KRATON 8585060354 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
83 Q-000YE61O 3575012807070002 ACHMAD ROJABI KAHFI 14 REMAJA JL. MALUKU RT. 2 RW.4 TRAJENG 8383400047 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
84 Q-000YDSER 3575011608070002 MARTA AGUSTIAN HERMANSYAH 14 REMAJA JL. BANDA GADINGREJO 8233140222 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
85 Q-000YC0NJ 3514162006070001 MUHAMMAD ARIF 14 REMAJA TAWANG SARI KELURAHAN KALIREJO 8384881515 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
86 Q-000YBL72 3575015003070001 JUHRIA 14 REMAJA Jl. Halmahera Gg. XI , Gadingrejo 8384668232 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
87 Q-000YCK0P 3575011712070002 DESTA FA AKBAR 14 REMAJA JL. HALMAHERA KELURAHAN GADINGREJO 8573301529 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
88 Q-000YCGJP 3522136912070002 NURIL AULIA 14 REMAJA JL. HALMAHERA NO 10/15 KELURAHAN TRAJE 8573030836 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
89 Q-000YE50G 3575047011070001 ZAHROTUS SYAQILA 14 REMAJA Jl. Hangtuah 9d no. 75 , Ngemplakrejo 8135787321 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
90 Q-000YEWL5 3575026712070001 NUR LIA SYELA HUDA 14 REMAJA Jl. Erlangga Selatan No. 32, Purworejo 8585576010 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
91 Q-000YE7DP 3575016710070001 WARDATUL FITRIAH 14 REMAJA Jl. kalimantan No. 53 , Trajeng 8778307233 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
92 Q-000YCYOA 3575015212070001 IDA MAULIDIYAH 14 REMAJA JL. HANGTUAH KELURAHAN GADINGREJO 8560658609 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
93 Q-000YF2FU 3575012212070003 FIQRI MAULANA IBRAHIM 14 REMAJA JL. SULAWESI PANGGUNGREJO 8123550777 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
94 Q-000YD08I 3313032203070001 FATHUR ROHMAN MAULANA 14 REMAJA JL. KOLONEL SUGIONO GG 03 PESAPEN 8215039229 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
95 Q-000YCYAN 3514161003070003 M. SOFIUL FUAD 14 REMAJA ASEMKANDANG BARAT KELURAHAN ASEM KA 8384919643 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
96 Q-000YEZUC 3575012111070003 M. JEFRI ANDIKA 14 REMAJA JL. SULAWESI GG. 1 TRAJENG 8789733662 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
97 Q-000YF881 3575035606070001 SHERLY AULIA DIAS PRATAMA 14 REMAJA JL. HASANUDIN XI KELURAHAN KARANGANYA 8575525332 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
98 Q-000Y5SN0 3575014208070001 SITI ROBIATUL ADAWIYAH 14 REMAJA JL BANDA 5/2 GADINGREJO 8898981431 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
99 Q-000VXNT4 3575014806070001 MUKH JURAIS 14 REMAJA JL HANG TUA 3/3 GADINGREJO 8222930090 BIOFARMA 10/09/2021 202108118H 27/10/2021 C202106115
100 Q-000YCURA 3514151907070002 FAJAR NUR RIFAI 14 REMAJA PEKOREN KECAMATAN REMBANG 8219787938 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
101 Q-000YFBCJ 3575016303070002 AMINA 14 REMAJA JL. HASANUDIN KARANGANYAR PANGGUNGRE 8560729074 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
102 Q-000YCU87 3575016101070005 HILDA FATIMA 14 REMAJA JL. SULAWESI GG. II/212 RW. 3 RW.2 8777291704 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
103 Q-000VXL9F 3575014108070001 NUR JANNAH 14 REMAJA JL BANDA 4/3 GADINGREJO 8384656090 BIOFARMA 10/09/2021 202108118H 27/10/2021 C202106115
104 Q-000YFHTO 3575012401070002 MUCHAMMAD MUSTHOFA ZAKI 14 REMAJA JL. HALMAHERA XIX/35 KELURAHAN KARANG 8573017294 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
105 Q-000YG7ZN 3575021301070005 MUHAMMAD ZULFIKAR ARISWANTO 14 REMAJA JL. PANGLIMA SUDIRMAN NO. 7 A PURWOREJO 8510068670 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
106 Q-000YG7IK 6302182703070001 RANGGA RAHMAN 14 REMAJA KERAYAAN UTARA KELURAHAN KERAYAAN UT 8223222905 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
107 Q-000YDDLD 3575015501070003 LAILLATUL JANNAH 14 REMAJA JL. HALMAHERA GADINGREJO 8574986656 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
108 Q-000YG6YD 3575015201070001 NAJWA SASIANA 14 REMAJA JL. HALMAHERA 19/26 KELURAHAN KARANG A 8384660622 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
109 Q-000YFUDP 3575030303070002 MUHAMAD. MUFARIQ RIZQI 14 REMAJA Jl. Jend. S. Parman, Panggungrejo 8594045216 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
110 Q-000Y451M 3575010810070003 FIRMANSYAH 14 REMAJA JL. BANDA GG MAWAR GADINGREJO 8573022032 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
111 Q-000Y7Z02 3575017010070001 DINI ANGGREANI 14 REMAJA JL. HALMAHERA GG 7 KELURAHAN TAMBA'AN 8380120668 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
112 Q-000YB28J 3575013107070001 MUHAMMAD FIRMANSYAH 14 REMAJA JL. HALMAHERA GG 9 KELURAHAN GADINGRE 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
113 Q-000YB45Q 3575016711070001 ANGGUN ASYIFAUL QOLBU 14 REMAJA Jl. Halmahera Gg. 9 , Gadingrejo 8810360146 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
114 Q-000YDTI9 3575011406070003 MOCH. IBNU RAFI 14 REMAJA JL. HALMAHERA IX KELURAHAN GADINGREJO 8233894587 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
115 Q-000YDRIM 3575013009070002 ISMAUL KOMARI 14 REMAJA Jl. Halmahera Gg. 9 , Gadingrejo 8383426021 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
116 Q-000EKYSM 3575046602070001 AMINAH 14 REMAJA JL KOL SUGIONO NO TRAJENG 1/5 8384922734 BIOFARMA 14/07/2021 24201421 Tr 27/10/2021 C202106115
117 Q-000YBGIS 3575016011070003 DIAN FITRIAH 14 REMAJA JL. HALMAHERA GG 09 GADINGREJO 8383794817 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
118 K-0001C3AB 3575016610070003 KHUSNIA 14 REMAJA JL. BANDA GG. MAWAR RT. 5 RW.2 GADINGRE 8383604282 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
119 Q-000YE7PQ 3575011208070002 ACH. ANDREAN WARDANA 14 REMAJA JL. HALMAHERA GG VII KELURAHAN TAMBA'AN 8223311928 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
120 Q-000YE706 3575022812070003 ANDHA NICHOLA SAPUTRA 14 REMAJA JL. ERLANGGA GG. III PURWOREJO 8560767284 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
121 Q-000YE7P7 3575016808070003 AMELIA NADYA PUTRI 14 REMAJA Jl. Hangtuah No. 4, Gadingrejo 8560778045 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
122 Q-000Y7AGJ 3575014804070003 DINA MARIATI MAULUDIA 14 REMAJA Jl. Banda, Gadingrejo 8383473811 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
123 Q-000YCF33 3575015209070003 FIA PURWANTI 14 REMAJA Jl. Banda Gg Mawar , Gadingrejo 8585520336 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
124 Q-000YCWDI 3575010612070001 MOCH. FATHUR ROCHMAN 14 REMAJA Jl. Sulawesi No. 25 , Trajeng 8784462748 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
125 Q-000YF0MX 3575012905070001 EKO SETIAWAN 14 REMAJA jl banda gg teratai gadingrejo 8311959413 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
126 Q-000YCHX4 3575015402070002 WAHYU FIRDAUS 14 REMAJA Jl. Halmahera Gg. 7, Tambaan 8383537824 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
127 Q-000YCG2X 3575015711070002 NAJWATUL JANNAH 14 REMAJA JL. HALMAHERA GG 9 GADINGREJO 8135896498 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
128 Q-000YCTQR 3575010802070003 MOCHAMAD ILHAM 14 REMAJA JL. KYAI SEPUH GADINGREJO 8155399179 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
129 Q-000YEXRA 3575022710070002 ACHMAD DWI CAHYA 14 REMAJA JL. LAKSAMANA MARTADINATA 53-55 KELUR 8951575915 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
130 Q-000YCEMP 3575010610070002 SUFIE ARYA VERMAS AZ SHIVA 14 REMAJA JL. HALMAHERA RT.4 RW.4 TAMBAAN PANGG 8777310496 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
131 Q-000YCTS5 3575010304070002 M. SAIFULLOH YUSUF 14 REMAJA JL. HALMAHERA KELURAHAN GADINGREJO 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
132 Q-000YEUTJ 3575014811070001 SUSI RAHAYU 14 REMAJA JL. HASANUDIN PANGGUNGREJO 8589521456 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
133 Q-000YFHJI 3575036704070003 DUROTUN NAFISAH 14 REMAJA Jl. Jendral. S. Parman, Panggungrejo 8572755013 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
134 Q-000YCU8U 3514161106070006 M. BAYU CAHYONO 14 REMAJA KEBONSAWAH KALIREJO KRATON 8191815798 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
135 Q-000YD0WE 3303010110070001 FAJAR ANGGORO 14 REMAJA Jl. Hasanudin Gg. XIII , Karanganyar 8951926401 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
136 Q-000YFRJB 3575012303070001 MULYO RENALDI 14 REMAJA RUSUNAWA LANTAI 3 NO. 19 RT.1 RW.5 TAMB 8313947459 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
137 Q-000YDCYQ 3514162208070003 MOCHAMAD FAIZAL 14 REMAJA JL. HANGTUAH GADINGREJO PASURUAN 8389838011 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
138 Q-000YG9U1 3575026501070003 NADIFAH ANANDA PUTRI 14 REMAJA JL. ERLANGGA GG 11 KELURAHAN PURWOREJ 8589568258 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
139 Q-000YDDXJ 3514165304070001 NAFA PUTRI MAULIDAH 14 REMAJA GUMENG KALIREJO KRATON 8382330223 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
140 Q-000Y8HPO 3575045108060001 JIHAN SYAFITA SARI 15 REMAJA JL. HALMAHERA APARTEMEN PANTAIMAS BLOK 8384975568 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
141 Q-000Y96I8 3575022412060001 ADITIYA FIRMANSYAH 15 REMAJA JL. HANGTUAH 17A NGEMPLAKREJO PANGGU 8383426581 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
142 Q-000YFBX5 3575014401060002 SITI CHOIRIYAH 15 REMAJA JL. HALMAHERA GG. IX RT.3 RW.5 GADINGREJ 8777100787 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
143 Q-000YFA6L 3575032112060001 ROYHAN AKBAR 15 REMAJA JL. IMAM BONJOLGG I BUGUL LOR PANGGUNG 8384859856 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
144 Q-000YFBEA 3575016303060002 DWI AMANATUS ZAROH 15 REMAJA JL. HALMAHERA GG XI/13 KELURAHAN GADIN 8214311710 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
145 Q-000YCVER 3575010606060003 ABDUL KIFLI 15 REMAJA JL. HANGTUAH RT.6 RW,4 GADINGREJO 8585568347 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
146 Q-000YFJLQ 3575026105060001 ROUDHOTUL JANNAH FIIL ALFI ZAK 15 REMAJA JL. LAKS RE MARTADINATA PANGGUNGREJO 8384722254 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
147 Q-000YCTWG 3514164411060002 FITRI ROKHMAWATI 15 REMAJA KISIK KALIREJO - KRATON RT.3 RW.4 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
148 Q-000YFK05 3575014508060004 ISMA NURIA 15 REMAJA JL. HALMAHERA GADINGREJO 8383451441 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
149 Q-000YFI16 3514166410060003 LAILATUL FITRIA 15 REMAJA KEBONSAWAH KRATON 8385336263 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
150 Q-000YFQI2 3575012201060001 MOCH. UBAIDILLAH 15 REMAJA JL. HANGTUAH GG 4 KELURAHAN GADINGREJ 8951925053 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
151 Q-000YCVQU 3575010312060001 MUCHAMMAD ILHAM SAID 15 REMAJA KELURAHAN TRAJENGJL. HALMAHERA 8161554382 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
152 Q-000YFSS2 3575034802060001 NURLIYA 15 REMAJA JL. JENDRAL S PARMAN KELURAHAN PANGG 8313259185 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
153 Q-000YGCLD 3514166412060001 INDAH DIAN SAPUTRI 15 REMAJA KEBONSAWAH KALIREJO KRATON 8574843854 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
154 Q-000YFR4G 3575026701060005 NURJANNAH ISLAMIYAH 15 REMAJA JL. HANGTUAH 13C/24 NGEMPLAKREJO PANG 8958010414 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
155 Q-000YFI8O 3575011206060003 MOCH VICKY NURDIANSYAH 15 REMAJA JL. HALMAHERA 19/21 RT. 2 RW.6 KARANGANY 8213953179 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
156 Q-000YD9EN 3514161010060003 RAFLI RAMADHAN 15 REMAJA DUSUN KISIK KALIREJO RT.1 RW.5 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
157 Q-000YGCJW 3575011905060001 MOCH NAZRIL ILHAM 15 REMAJA Jl. Hangtuah, Gadingrejo 8810226265 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
158 Q-000YD9EP 3575010801060001 MUKHAMAD RIO PRASUTIYO 15 REMAJA JL. HASANUDIN 201 KELURAHAN PANGGUNGR 8951599272 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
159 Q-000YFUF5 3575012205060002 IMAM SUBAWAI 15 REMAJA JL. KALIMANTAN V/20 TRAJENG PANGGUNGRE 8575541945 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
160 Q-000YDE1Q 3575015409060001 IZZA KAMELIA 15 REMAJA JL. HANGTUAH IV GADINGREJO 8312996776 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
161 Q-000YDD8X 3575016208060001 MUFIDAH DAMIRA 15 REMAJA JL. HANGTUAH GADINGREJO 8952843630 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
162 Q-000YG767 3575035209060001 NAILUL AMANIA 15 REMAJA JL. IMAM BONJOL TAPA'AN BUGUL KIDUL 8224593633 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
163 Q-000YFQBV 3575012204060003 ROCHMAD MAULIDI 15 REMAJA JL. HANGTUA GG. 2 RT.2RW.3 GADINGREJO 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
164 Q-000YFIQV 3575011009060005 SYAHRUL ULIL AZMI 15 REMAJA JL. HALMAHERA NO 9 KELURAHAN GADINGRE 8596234567 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
165 Q-000YCVNO 3575015712060003 FARISHA HIDAYATUZAHRA 15 REMAJA Jl. Banda Gg. Kamboja, Gadingrejo 8560164433 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
166 Q-000YFSOQ 3575012509050003 AGUNG VIRISZI 15 REMAJA JL. KALIMANTAN TRAJENG PANGGUNGREJO 8133533218 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
167 Q-000YF2RU 3575011911060003 MUHAMMAD KHARIS KONDIAS 15 REMAJA Jl. Halmahera IX , Gadingrejo 8384838351 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
168 Q-000YCWL3 3514163006060002 M. TAUFIK HIDAYAT 15 REMAJA Dsn. Kisik, Desa kalirejo , Kraton 8313891324 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
169 Q-000YEW41 3575020212060005 MOCHAMMAD HABIL MUSA 15 REMAJA JL. LAKS MARTADINATA 14 PANGGUNGREJO 8314945139 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
170 Q-000YFHMF 3575014310060001 KARTIKA SARI DEWI 15 REMAJA Jl. Halmahera Gg. X No.9 , Trajeng 8224528799 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
171 Q-000YFJAJ 3575016707060001 BERLINA KHUSNIL KHOTIMA 15 REMAJA Jl. Halmahera 10 / 30 , Trajeng 8785712839 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
172 Q-000YCWAU 3575015810060001 RISA RAMADHANI 15 REMAJA Rusunawa Tambaan 8383430062 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
173 Q-000YFQKG 3575012002060001 MOCH. NUR WACHID 15 REMAJA JL. HANGTUAH GADINGREJO 8816073094 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
174 Q-000YD8XW 3514160805060001 MAULANA ROSULI 15 REMAJA DUSUN KISIK KALIREJO KRATON 8383439758 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
175 Q-000YFI0G 3575021210060003 ICHWANSYAH RAMADANI 15 REMAJA JL. HANTUAH 13 C RT.2 RW.5 PANGGUNGREJO 8214338816 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
176 Q-000YFLBU 3575011010060002 MUCHAMMAD ANGGA RAMDHANI 15 REMAJA JL. HALMAHERA GG 9 KELURAHAN GADINGRE 8233051823 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
177 Q-000YFS9T 3575021010000628 M. SHOLIKIN 15 REMAJA Jln. Hangtuah XI , Panggungrejo 8133412843 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
178 Q-000YFBJY 3575012311060004 AHMAD ALFANSYAH 15 REMAJA Jl. Halmahera Gg. XI No. 11 , Gadingrejo 8523116765 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
179 Q-000YF8II 3575011810060001 MUKHAMAD REYHAN BAIHAQI 15 REMAJA Perum. Mutiara Keluarga, 8233538331 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
180 Q-000YG64P 3575022002060002 MUHAMMAD ARIFIN ILHAM 15 REMAJA JL. HANGTUAH GG. 9 RT.2 RW.9 NGEMPLAKRE 8383030914 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
181 Q-000YGECU 3575015112050001 MUCHAMMAD SAIFI ABDILLAH 15 REMAJA JL. HANGTUAH GG. 7 RT. 4 RW.2 TAMBAAN 8810274509 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
182 Q-000YG9U5 3575014511060001 MAHARANI ASRI 15 REMAJA JL. HALMAHERA KARANGANYAR PANGGUNGR 8135919841 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
183 Q-000HFA3V 3575021904060003 MUHAMMAD DAVVA' FAIRUZ HAKIM 15 REMAJA JL KOL SUGIONO III.4 B, MAYANGAN 2/5 8953661475 BIOFARMA 15/07/2021 24201421 27/10/2021 C202106115
184 Q-000YG63Z 3575014809060001 SAFIRA TRI AULIA 15 REMAJA JL. HANGTUAH KELURAHAN GADINGREJO 8233103294 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
185 Q-000YDCHG 3575015505060006 ZANNUBA ARIFAH CHAFSOH 15 REMAJA JL. HALMAHERA GG 9 GADINGREJO 8776294462 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
186 Q-000YFQC2 3575026301060001 REVA AULIA 15 REMAJA JL. HANGTUAH 13A KELURAHAN NGEMPLAKRE 8382355393 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
187 Q-000YDA7Q 3514160509060033 ACH. KIKI RAMADHANI 15 REMAJA Dsn. Kisik, Desa. Kalirejo, Kraton 8525923930 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
188 Q-000YFKK7 3575016802050001 IIT SUGIAWATI 16 REMAJA JL. HALMAHERA 19/50PANGGUNGREJO 8785308255 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
189 Q-000YFSDB 3575014101050004 PUTRI AMALIYA 16 REMAJA JL. HALMAHERA KELURAHAN GADINGREJO 8572690691 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
190 Q-000YG9RW 3575010805050002 MOHAMMAD MAULUDI 16 REMAJA JL. HANGTUAH GG.2 RT.3 GADINGREJO 8898978879 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
191 Q-000YGE3A 3575016707050002 ISNA SABRINA RAHMAWATI 16 REMAJA JL. SULAWESI 1 NO 11 KELURAHAN TRAJENG 8383210087 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
192 Q-000YFRMF 3514166210050010 SITI RAKHMAWATI ULINNUHA 16 REMAJA KEBONSAWAH KELURAHAN KALIREJO 8387420086 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
193 Q-000YFUL5 3575012312050002 MOCHAMMAD SISWANTO 16 REMAJA JETIS RT.4 RW. 3 DHOMPO KRATON 8214091553 BIOFARMA 15/09/2021 202108118H 27/10/2021 C202106115
194 Q-000YGLSU 3575011607960001 JOKO SUPRIYANTO 28 UMUM JL. HALMAHERA GG.11 RT.4 RW.5 GADINGREJ 8158157695 BIOFARMA 15/09/2021 20210811H G 27/10/2021 C202106115
195 Z-000AK8LU 3575036303820004 MARINA SYARIFIRDIANTI 39 UMUM JL DR WAHIDIN S HUSODO SELATAN 1/3 PET 8223030130 BIOFARMA 10/09/2021 202108118H 27/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 P-0B98SAP1 3526105810830001 MARNIJA 38 UMUM JL ERLANGGA RT06/RW04 PURWOREJO 8233489702 Astrazeneca 26/10/2021 A1076 Ga
2 P-0UZFJXWW 3575015010000005 KHABIBAH 21 UMUM JL HALMAHERA RT01/RW05 GADINGREJO 8113777705 Astrazeneca 26/10/2021 A1076 Ga
3 P-08TOTLBL 3575010707900001 SOLIKIN 31 UMUM JL HANGTUAH RT01/RW04 GADINGREJO 8319290016 Astrazeneca 26/10/2021 A1076 Ga
4 P-1HPKAGIC 3575010611010003 WAHYU FIRMANSYAH 20 UMUM JL HANGTUAH RT02/RW03 GADINGREJO 8574904863 Astrazeneca 26/10/2021 A1076 Ga
5 P-15HAHLC9 3309072903870003 AGUS BUDIYANA 34 UMUM JL KYAI SEPUH RT01/RW05 GENTONG 8132713919 Astrazeneca 26/10/2021 A1076 Ga
6 P-1JPXLJMW 3575012204010003 MOCH BISRI 20 UMUM JL HANGTUAH RT01/RW03 GADINGREJO 8573858222 Astrazeneca 26/10/2021 A1076 Ga
7 P-1TXJ7MQE 3575012411900001 MUKHAMAD FARUQ BUSTHOMI 31 UMUM JL GATOT SUBROTO RT03/RW01 PETAHUNAN 8589515721 Astrazeneca 26/10/2021 A1076 Ga
8 P-1V7LFVPT 3575014411950001 LAILATUN NISFIYAH 26 UMUM JL GATOT SUBROTO RT03/RW01 PETAHUNAN 8953221981 Astrazeneca 26/10/2021 A1076 Ga
9 P-1XPFACF8 3575014610670004 SITI MUCHLISO 54 RENTAN JL GATOT SUBROTO PETAHUNAN 8523615093 Astrazeneca 26/10/2021 A1076 Ga
10 P-1ZPRTH24 3575011506780004 SAEKHON 43 UMUM JL GATOT SUBROTO PETAHUNAN 8233546246 Astrazeneca 26/10/2021 A1076 Ga
11 P-254R3WL3 3575016707950001 YULINDA MANDASARI 26 UMUM JL HALMAHERA RT01/RW05 GADINGREJO 8381881118 Astrazeneca 26/10/2021 A1076 Ga
12 P-216Q36FC 3575010107860165 MOCH HADI 35 UMUM JL HANGTUAH NO 8 GADINGREJO 8319474744 Astrazeneca 26/10/2021 A1076 Ga
13 P-2JXUMHWA 3575016708860001 JUMARO 35 UMUM JL HANGTUAH RT01/RW04 8213900734 Astrazeneca 26/10/2021 A1076 Ga
14 Q-00154FOG : 3575016504780004 ROSIDA 43 UMUM KELURAHAN GENTONG 8510093907 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
15 Q-001557GV : 3575010308710001 SABAR SUTIKNO 50 RENTAN KELURAHAN GENTONG 8510093907 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
16 Q-0014Y88E : 3575014209790001 SUHARTIK 42 UMUM JL. SLAMET RIYADI GG 12 A GENTONG 8573095272 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
17 Q-0014XW5C : 3575010310710001 DASUKI 50 RENTAN JL. SLAMET RIYADI GG 12 A GENTONG 8578524783 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
18 Q-0014YQKR : 3575014707890002 KHASANAH 32 UMUM jl banda 3/3 gadingrejo 8113777705 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
19 Q-0014ZEUT : 3575015811760001 MAISYAROH 45 UMUM JL. SLAMET RIYADI NO 15 GENTONG 8383372762 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
20 Q-00151SZY : 3524130704880004 TAUFIQ HIDAYAT AKBAR 33 UMUM DSN NGAMBEG 1/1 LAMONGAN 8223347455 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
21 Q-001518KD : 3575035507830002 SULASTRI 38 UMUM P.KARYA BHAKTI C.8,1/7 GENTONG JAWA TIM 8523439160 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
22 Q-00151Q80 : 3575024405860005 ISTIKHAROH 35 UMUM JL. SLAMET RIYADI GENTONG 8234204732 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
23 Q-00150NDH : 3514165309860002 DEWI KARTIKA SARI 35 UMUM KERTOSARI KALIREJO 8384658444 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
24 Q-0014ZEK2 : 3575036310690001 CHUSNUL CHOTIMAH 52 RENTAN JL. KRISNA BLOK F NO. 1 GENTONG 8510078048 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
25 Q-001504GY : 3575030309620001 BAMBANG SUSILO 59 RENTAN JL. KRISNA BLOK F GENTONG 8223326058 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
26 Q-00150G6C : 3575015806740001 KASIATUN 47 UMUM JL HANGTUAH II RT04/RW03 GADINGREJO 8113777705 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
27 Q-0014XU6Z : 3575025503930002 SOLICHATI KHOLIFAH 28 UMUM GENTONG 1/3 8213252737 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
28 Q-0014XPQ4 : 3575014208000002 SITI HALIMAH 21 UMUM GENTONG 1/3 8956321895 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
29 Q-0014XTKU : 3514066702030001 ZAKIYYATUL AROFAH 18 UMUM KEJAYAN 4/2 8953813375 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
30 Q-0014Y6H7 : 3575015901700001 CHURIATUN 51 RENTAN jl banda 4/3 gadingrejo 8113777705 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
31 Z-000BN9J8 : 3575011906580001 SUTRISNO 63 LANSIA JL BUKIR 2 BUKIR 8123258781 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
32 Q-0014ZZVI : 3575014704720003 DEWI MUJAYANAH 49 UMUM JL SLAMET RIYADI 3/4 SEBANI 8113777705 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
33 Q-000RNO5P : 3575015502050001 RINA FEBRY ARSANA 16 REMAJA JL SLAMET RIYADI GENTONG GADINGREJO 8135903438 BIOFARMA 31/08/2021 24202321 26/10/2021 C202106115
34 Q-0014XTTZ : 3514206905990004 RIZKY JASUMA PUTRI 22 UMUM jl slamet riyadi 3/2 sebani 8578431685 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
35 Z-000BC3C6 : 3578074908320001 TAN JEK MEI 89 LANSIA BLAURAN 3/8 SURABAYA 8595918686 BIOFARMA 23/09/2021 202108123H 26/10/2021 C202106115
36 Q-00154E25 : 3514235807640002 KARSIYATI 57 RENTAN REJOSO 4/3 8233238575 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
37 Q-0015D1Z6 : 3506164206920001 SRI WIJAYANTI 29 UMUM KELURAHAN GENTONG 8233785865 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
38 Q-00150Z1D : 3575010909750004 ARIYAWAN HIDAYAT 46 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8383153559 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
39 Q-00150UDK : 3575011404980002 MOHAMMAD SOFI'I 23 UMUM JL URIP SUMOHARJO RT02/RW 01 BUKIR GAD 8968240582 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
40 Q-0014YQSG : 3575014107760042 RONISA 50 RENTAN jl halmahera 2/3 gadingrejo 8141312068 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
41 Q-0015CTPY : 3575015209790003 CHUBATUL BARIZAH 42 UMUM KELURAHAN GENTONG 8313623285 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
42 Q-00151X35 : 3575021611780001 SUGENG WAHYUDI 43 UMUM JL DARMOYUDO UTAMA NO31A RT 02/RW 01 8573093018 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
43 Q-00150EAH : 3575015202760002 NIKMATUL KHOIROH 45 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8525829674 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
44 Q-00152H47 : 3502074908860004 SRI ASTUTIK 35 UMUM JL SLAMET RIYADI 2/4 SEBANI 8127802254 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
45 Q-0014YJ9A : 3575014211870001 NOFITA DEWI 34 UMUM JL. SLAMET RIYADI RT 2 RW 4 GENTONG 8964376670 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
46 Z-000BFXVS : 3575015607580002 SRI MURNIATI 63 LANSIA jl banda 2/2 gadingrejo 8573290584 BIOFARMA 25/09/2021 202108154G 26/10/2021 C202106115
47 Q-00151SLQ : 3575014104730002 SRI RAHAYU 48 UMUM JL. SLAMET RIYADI GENTONG 8573315551 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
48 Q-001516ED : 3575015509810001 ZULAEKHA 40 UMUM GENTONG 2/1 8123233209 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
49 Q-0014ZYAW : 3575010705790006 DJUMADIONO 42 UMUM GENTONG 2/1 8123233209 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
50 Q-00150U7Z : 3575011803050004 MUCH. AZKA MUBTAGHI WAJHILLAH 16 REMAJA jl banda 4/2 gadingrejo 8579176597 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
51 Q-00151WI0 : 3575014304050002 ADITA NUSELDI ERLANA 16 REMAJA jl banda 4/2 gadingrejo 8135903402 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
52 Q-00152HSA : 3575016607690002 SARI LAKSMI 52 RENTAN JL KYAI SEPUH I NO 30 RT02/RW01 GADINGRE 8126848208 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
53 Q-0014YK9Z : 3575016905050002 AURA FATIMAH 16 REMAJA perum nuansa candi petahunan 8786158623 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
54 Q-0014YNTL : 3575017003070003 YUNIA NINGSIH 14 REMAJA jl hangtuah 1/3 gadingrejo 8311410989 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
55 Q-00151SUV : 3575011308830001 M. YUSUF 37 UMUM JL HANGTUAH 1/3 GADINGREJO 8318524330 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
56 Q-001553DD : 3575010502720002 ACHMAD AFAN 49 UMUM JL IRIAN JAYA GG ANGGREK GADINGREJO 8570756188 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
57 Q-00154DFD : 3575010909660001 SEGER SUPRAYITNO 55 RENTAN GENTONG 2/4 8523166651 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
58 Q-00154DKR : 3575015505660001 MUNADAH 55 RENTAN GENTONG 2/4 8121648404 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
59 Q-00151YXY : 3575010606930002 AHMAD ALFIAN MIFTAHUR RAHMAN 28 UMUM JL URIP SUMOHARJO GG 2 RT02/RW08 BUKIR 8137256060 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
60 Q-0015270O : 3575014402730002 KHAYATUL ILMI 48 UMUM JL BANDA 3/2 GADINGREJO 8510262526 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
61 Q-0014ZEA9 : 3575014107680030 SUMARMI 53 RENTAN GENTONG 1/3 8223293378 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
62 Q-0014YRMI : 3575010404710003 SUMISLAN 50 RENTAN JL. SLAMET RIYADI RT 1 RW 3 GENTONG 8758500239 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
63 Q-00154SUC : 3575014612780001 UMI FADHIYAH 43 UMUM JL. SLAMET RIYADI GG12A 8585002394 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
64 Q-00155E5B : 3575015102840002 NAILATUL JANNAH 37 UMUM KELURAHAN GENTONG 8133005539 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
65 Q-00155TMZ : 3575011007690003 NUR CHOLIS 52 RENTAN PERUM KARYA BHAKTI BLOK O 8193716289 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
66 Q-0015DXWO : 3507070506000003 ASMADI 21 UMUM KELURAHAN GENTONG 8121767802 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
67 Q-0014R12V : 3526041007880002 HAFILUDDIN 33 UMUM JL HASANUDIN 2/7 KARANG ANYAR 8113777705 BIOFARMA 27/09/2021 202108154G 26/10/2021 C202106115
68 Q-0015D13D : 3526045710850002 TITA HARYANTI 36 UMUM JL HASANUDDIN 813777705 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
69 Q-0015CVTZ : 3575016107880003 DEWI YULIANI 33 UMUM JL HALMAHERA 8123575198 BIOFARMA 28/09/2021 202108154G 26/10/2021 C202106115
70 P-0LKXSNKH : 3575016103060003 BIDAYATUL HIDAYAH 15 REMAJA JL SLAMET RIYADI NO 84 GENTONG 8125240561 BIOFARMA 26/10/2021 C202106115
71 P-0IRIG5EP : 3575013005070002 MUHAMMAD NUURUDDIN ABDUN 14 REMAJA JL SLAMET RIYADI NO 84 GENTONG 8784294705 BIOFARMA 26/10/2021 C202106115
72 P-1QDGL70U : 3575025704760001 MASLUKHA 45 UMUM JL LAKS MARTADINATA MAYANGAN 8123398077 BIOFARMA 26/10/2021 C202106115
73 S-E8FF0629 : 3575012807590001 BUKHORI 61 LANSIA JL KYAI SEPUH RT01/05 GENTONG 8220050105 BIOFARMA 26/10/2021 C202106115
74 P-1FKINPRK : 3515054910690001 NURSIYAH 52 RENTAN DSN BENDUNGAN RT 01 RW 01 JABON KAB SI 8193884333 BIOFARMA 26/10/2021 C202106115
75 P-2BZ0O9U4 : 3575015104990002 ANA LASTRI 22 UMUM JL HALMAHERA RT01/RW04 GADINGREJO 8113777705 BIOFARMA 26/10/2021 C202106115
76 P-1IMQEJ79 : 3528040107640023 SOLEHUDDIN 57 RENTAN jl raya nyalaran gg2 rt11 rw03 8533675424 BIOFARMA 26/10/2021 C202106115
77 P-1JOHVD0W : 3528047112680106 SAMIASIH 53 RENTAN jl raya nyalaran gg2 rt 11 rw 03 8533675424 BIOFARMA 26/10/2021 C202106115
78 S-71A528A4 : 3575014107530163 BAWON 68 LANSIA JL HANGTUAH 11 29 - BIOFARMA 26/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-25-2021 INDUK
1 Q-000AUBQ1 3575016607730002 SITI DJULAEKHAH 48 UMUM JL. SLAMET RIYADI SEBANI GADINGREJO 8123525588 Astrazeneca 03/07/2021 ABY1911 25/10/2021 A1076 Ga
2 Q-000AWYZC 3575011808640003 POERWOKO 57 RENTAN JL. SLAMET RIYADI 8123525588 Astrazeneca 03/07/2021 ABY1911 25/10/2021 A1076 Ga
3 P-AHU2MZYG 3575010302990002 FEBRI ANDHIKA PUTRA 22 UMUM JL HALMAHERA GADINGREJO 8384776819 Astrazeneca 25/10/2021 A1076 Ga
4 P-4Z6DXJKH 3575010702930002 A. SYAIKHUDIN 28 UMUM JL HALMAHERA 5/4 TAMBAAN 8113777705 Astrazeneca 25/10/2021 A1076 Ga
5 P-EZF2X0NP 3575015102880001 CHOLIDAH 33 UMUM JL HANGTUAH 1/5 NGEMPLAKREJO 8193007617 Astrazeneca 25/10/2021 A1076 Ga
6 P-5LFWO8H0 3575016506870004 LAILATUL MUBAROKAH 34 UMUM JL HANGTUAH 4/3 GADINGREJO 8578408867 Astrazeneca 25/10/2021 A1076 Ga
7 P-5GGZKI31 3575010103840006 SOLIHIN 37 UMUM JL HANGTUAH 4/3 GADINGREJO 8585226987 Astrazeneca 25/10/2021 A1076 Ga
8 P-CTENFJYQ 3575016502840003 ALFIYAH 37 UMUM GADINGREJO 8822817223 Astrazeneca 25/10/2021 A1076 Ga
9 P-B4PKYYPP 3575014107810061 SUADAH 42 UMUM JL HALMAHERA 5/5 GADINGREJO 8113777705 Astrazeneca 25/10/2021 A1076 Ga
10 P-C6EABF5T 3575014107790064 MUSRIFAH 42 UMUM JL HALMAHERA 5/5 GADINGREJO 8113777705 Astrazeneca 25/10/2021 A1076 Ga
11 P-6GX4KMUL 3575014812750002 SADIYAH 46 UMUM JL HANGTUAH 6/4 GADINGREJO 8193569791 Astrazeneca 25/10/2021 A1076 Ga
12 P-GGTCS6QG 3575015312720002 KHASANAH 49 UMUM SEBANI 3/5 8161597819 Astrazeneca 25/10/2021 A1076 Ga
13 P-H3XARRIK 3514164609690003 RUCHANI 52 RENTAN KEBONSAWAH 4/7 KRATON 8123986065 Astrazeneca 25/10/2021 A1076 Ga
14 Q-0014H4Z6 : 3575015505040003 MAULUDIAH 17 UMUM JL HALMAHERA GADINGREJO 8385198812 BIOFARMA 27/09/2021 202108154G 25/10/2021 C202106115
15 Q-000I1CL4 : 3575011009950003 GERRY AGUNG LUCKYANTO 26 UMUM JL KYAI SEPUH 39 8199772777 BIOFARMA 18/07/2021 24200821 25/10/2021 C202106115
16 Q-000I9LDI : 3575011002930002 JUMA'ALI 28 UMUM JL HANGTUAH NO 39 8952988507 BIOFARMA 19/07/2021 24200421 25/10/2021 C202106115
17 Q-0014QLWD : 3514234210930003 INA MIFTAKHUL SAIDAH 28 UMUM KEMANTREN REJO 6/2 REJOSO 8968376345 BIOFARMA 27/09/2021 C202106114 25/10/2021 C202106115
18 Q-0014V58N : 3515055208930003 RENI AGUSTIAN 28 UMUM TROMPOASRI 005/002 JABON 8574511057 BIOFARMA 27/09/2021 24006421 25/10/2021 C202106115
19 Q-000RQH5B : 3575010107800087 SUTRISNO 41 UMUM JL BANDA 5/2 GADINGREJO 8589573916 BIOFARMA 31/08/2021 24202321 25/10/2021 C202106115
20 Q-0014Q891 : 3514236007770002 ENDAH 44 UMUM KEMANTRENREJO RT06/RW02 KEL. KEMANTRE 8533592937 BIOFARMA 27/09/2021 C202106114 25/10/2021 C202106115
21 Z-000B53HF : 3575015111580002 YASMINAH 63 LANSIA jl irian jaya gadingrejo 8133448644 BIOFARMA 21/09/2021 202108118H 25/10/2021 C202106115
22 Z-000BKMRY : 3575010107560050 SOLIHUDIN 65 LANSIA JL IRIAN JAYA 1/2 GADINGREJO 8213327966 BIOFARMA 27/09/2021 202108154G 25/10/2021 C202106115
23 Z-000BK9NW : 3575014107480071 SOETASMI 73 LANSIA JL SOEKARNO HATTA 1/1 GADINGREJO 8113777705 BIOFARMA 27/09/2021 202108154G 25/10/2021 C202106115
24 S-7539DD45 : 3575014505620001 ELIS YULIASTUTIK 63 LANSIA PERUM KARYA BAKTI / GENTONG 8214012660 BIOFARMA 25/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
25 S-D031D310 : 3514165403550004 TAMAMI 66 LANSIA KEBONSAWAH 4/7 KRATON 8822205199 BIOFARMA 25/10/2021 C202106115
26 P-8SD67UFZ : 3575012801050002 JABAD GUSTI PENATAS 16 REMAJA JL SLAMET RIYADI 8113777705 BIOFARMA 25/10/2021 C202106115
27 P-IZYFVSYB : 3575012012700001 CHOLIB 51 RENTAN JL HANGTUAH 6/4 GADINGREJO 8311109898 BIOFARMA 25/10/2021 C202106115
28 P-KDHRLTFX : 3575015809000002 LAILA ALIEF MAULIDIA HERKAMTO 21 UMUM JL SLAMET RIYADI 3/4 SEBANI 8113777705 BIOFARMA 25/10/2021 C202106115
29 P-KHLF5TBV : 3575010406990003 MOCH. SOFYAN 22 UMUM JL HALMAHERA 1/5 GADINGREJO 8594343052 BIOFARMA 25/10/2021 C202106115
30 P-FYTLQ25R : 3575016810980001 SUKAINAH ALATAS 23 UMUM JL KARYA BAKTI 6/7 GENTONG 8214338827 BIOFARMA 25/10/2021 C202106115
31 P-KN7W3I32 : 3575010603940001 AKHMAD LUTFI 27 UMUM JL KYAI SEPUH 2/5 8956153902 BIOFARMA 25/10/2021 C202106115
32 P-O3RIEJ61 : 3575011304910002 SUGIANTO 30 UMUM JL BANDA 5/2 GADINGREJO 8113777705 BIOFARMA 25/10/2021 C202106115
33 P-O8P0SNVK : 3575015208900003 NUR AZIZAH 31 UMUM JL HALMAHERA GADINGREJO 8823862724 BIOFARMA 25/10/2021 C202106115
34 J-0006LABF : 3575031103860001 NGAHADI 36 UMUM JL HALMAHERA GADINGREJO 8575458872 BIOFARMA 25/10/2021 C202106115
35 P-IIU1X9M3 : 3575012602800002 CHOIRON 38 UMUM GADINGREJO 8113777705 BIOFARMA 25/10/2021 C202106115
36 P-8B5IHAUO : 3575011707820001 MUKHAMMAD SAIFUL MAULANA 39 UMUM BUKIR - GADINGREJO 8564927610 BIOFARMA 25/10/2021 C202106115
37 P-1DEB5WED : 3514160411750002 ZAINI 46 UMUM MUNENG BENDUNGAN 8384846035 BIOFARMA 25/10/2021 C202106115
38 P-K5CEE65Q : 3575015708740007 KHAMIDAH 47 UMUM JL SLAMET RIYADI 3/4 SEBANI 8123492962 BIOFARMA 25/10/2021 C202106115
10-25-2021 PUSTU GADING 2
1 Q-000Y5YTT 3575011706090002 MUHAMMAD MARIQ HIDAYAH 12 REMAJA JL. HALMAHERA GG IX KELURAHAN GADINGRE 85706863047 CoronaVac 15/09/2021 202108118H 25/10/2021 C202106115
2 Q-0014QW4D 3575012909770002 M. SOLEH 46 UMUM JL HALMAHERA 3/5 GADING 813777705 CoronaVac 27/09/2021 202108154G 25/10/2021 C202106115
3 Q-0014RQT4 3311055902720001 JUNARTI 49 UMUM NGAMBAL-AMBIL SUKOHARJO 813777705 CoronaVac 27/09/2021 202108154G 25/10/2021 C202106115
4 Q-0014SMJ0 3575014412700001 NAIMAH 50 RENTAN JL HALMAHERA 81231159887 CoronaVac 27/09/2021 202108154G 25/10/2021 C202106115
5 Z-000BK9KB 3575036306660002 ENDANG WARDININGSIH 55 RENTAN PERUM GRAHA CANDI 2/8 BAKALAN 8113777705 CoronaVac 27/09/2021 202108154G 25/10/2021 C202106115
6 P-092WB2JQ 3575014404060003 NAFAKHATIL MAULAINI 15 REMAJA JL. HALMAHERA GG. IXB 8113777705 CoronaVac 25/10/2021 C202106115
7 P-0GW2GLAX 3575044308060001 WULANDARI 15 REMAJA JL. HANGTUAH 3/2 - GADINGREJO 83153263319 CoronaVac 25/10/2021 C202106115
8 P-0JQHEMCX 3575016510050001 RINA RAMADANI 16 REMAJA JL. HANGTUAH IV 1/4 - GADINGREJO 895338400962 CoronaVac 25/10/2021 C202106115
9 P-0TWWBVCI 3575011701050004 MUKHAMMAD ALFIN 16 REMAJA JL. HALMAHERA GG. 11 4/5 - GADINGREJO 811333777705 CoronaVac 25/10/2021 C202106115
10 P-0L5KJUGW 3575011407030002 M. REZA EKA JULIANTO 18 UMUM JL. HALMAHERA 5/5 - GADINGREJO 858380120816 CoronaVac 25/10/2021 C202106115
11 P-0FLKQSUS 3575016212990001 NUR FADILAH 22 UMUM JL. HALMAHERA 4/5 - GADINGREJO 83830716765 CoronaVac 25/10/2021 C202106115
12 P-0BZJDFVF 3575022012970001 MUKHAMMAD SOLIKHIN 24 UMUM KARANG JUWET 1/5 - WIROGUNAN 85649497948 CoronaVac 25/10/2021 C202106115
13 P-0MJQYKGP 3575012202910001 JUNAEDI 30 UMUM JL. HALMAHERA GG. 09 5/5 -GADINGREJO 83119807305 CoronaVac 25/10/2021 C202106115
14 P-0LWLBZLL 3575014107900105 IIS FUJI ASTUTIK 31 UMUM JL. HALMAHERA 5/5 - GADINGREJO 85707806531 CoronaVac 25/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
15 P-07T5YMQV 3575015011710002 KHUSNUL KHOTIMAH 32 UMUM JL. HALMAHERA 4/5 - GADINGREJO 8113777705 CoronaVac 25/10/2021 C202106115
16 P-03XHVTQ3 3575011001800006 M. IDHAM HURI 41 UMUM JL. HALMAHERA 5/5 - GADINGREJO 858380120816 CoronaVac 25/10/2021 C202106115
17 P-ZBJ5S4MN 3575011103730002 YUSUF 48 UMUM JL. HANGTUAH 2/4 - GADINGREJO 82132276546 CoronaVac 25/10/2021 C202106115
18 P-01MS3PIQ 3575014910730002 MARIYAM 48 UMUM JL. HALMAHERA 5/5 - GADINGREJO 85754719390 CoronaVac 25/10/2021 C202106115
19 P-0FJ943QF 3575014107720063 SUAENI 49 UMUM JL. HANGTUAH GG.4 2/4 - GADINGREJO 83115578988 CoronaVac 25/10/2021 C202106115
20 P-0BQ2PAZS 3575015204680002 NAIMA 53 RENTAN JL HALMAHERA 3/5 - GADINGREJO 83153263319 CoronaVac 25/10/2021 C202106115
21 P-UZ8FFZWM 3575010808650004 ISKANDAR 56 RENTAN JL. HALMAHERA GG. XI 5/5 - GADINGREJO 85754719390 CoronaVac 25/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-23-2021 INDUK & PUSTU SEBANI

1 Q-000K41VA 3575010201710001 EKA RAHARJA 50 RENTAN JL SLAMET RIYADI GG 12 B GENTONG 8214013843 Astrazeneca 29/07/2021 ABY1911 23/10/2021 A1076
2 Q-000K4ALL 3575026402970001 ELFA NUR IFTITAH 24 UMUM JL TEUKU UMAR SEBANI 8222833265 Astrazeneca 29/07/2021 ABY1911 23/10/2021 A1076
3 Q-000QEDYM 3514146112000001 ZAROTUL NUR AINI 21 UMUM BANGIL-PASURUAN 8161588143 Astrazeneca 28/08/2021 PV46700 23/10/2021 A1076
4 P-8ODBYIG7 3514162206730073 SLAMET MARIADI 48 UMUM JL KYAI SEPUH GADINGREJO 8113777705 Astrazeneca 23/10/2021 A1076
5 P-7JKMDH2X 3575010711780006 MUSA 43 UMUM JL HANGTUAH GADINGREJO 8223260711 Astrazeneca 23/10/2021 A1076
6 P-8XK9QDKG 3575012904730001 ARIFIN 48 UMUM JL KYAI SEPUH RT04/01 GADINGREJO 8113777705 Astrazeneca 23/10/2021 A1076
7 P-9J0UETN5 3575011210940002 PUJI SETIAWAN 27 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8573012460 Astrazeneca 23/10/2021 A1076
8 P-AF0BRWTV 3575010901940001 FATCHUR ROCHMAN 27 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8953960721 Astrazeneca 23/10/2021 A1076
9 P-CH204OCU 3575014107920054 MASLUKHA 29 UMUM JL HANGTUAH RT 03/RW 4 GADINGREJO 8383210088 Astrazeneca 23/10/2021 A1076
10 P-6IY7YFIT 3575012803030004 SATRIA BAYU WICAKSONO 18 UMUM JL HASANUDIN 5/7 KARANGANYAR 8310525581 Astrazeneca 23/10/2021 A1076
11 P-JPO8QKTG 3575016609830002 SANTI PURWANTI 38 UMUM JL KYAI SEPUH RT 03/RW01 GADINGREJO 8113777705 Astrazeneca 23/10/2021 A1076
12 P-JM2R6FWA 3575014107650086 TOMI 56 RENTAN jl ngaglik 6/2 gadingrejo 8113777705 Astrazeneca 23/10/2021 A1076
13 P-5WP2M2NF 3575012006850002 SAIKHU 36 UMUM jl hangtuah gadingrejo 8820094017 Astrazeneca 23/10/2021 A1076
14 Q-00138AZL : 3575044512060001 DEVINTA PUTRI MAHARANI 15 REMAJA JL DR WAHIDIN 3/4 PETAMANAN 8523161795 BIOFARMA 24/09/2021 202108154G 23/10/2021 C202106115
15 Q-000RB6KI : 3575015210050002 NUR AINI 16 REMAJA JL BANDA GADINGREJO 8573053282 BIOFARMA 30/08/2021 24202221 23/10/2021 C202106115
16 Q-000EBN3G : 3575013006040005 MUHAMAD ARIF MAULANA 17 UMUM JL SOEKARNO HATTA 09 GADINGREJO 8122874424 BIOFARMA 14/07/2021 24200421 23/10/2021 C202106115
17 Q-000UEUFV : 3575010102030001 HAMZAH ROHMATULLOH 18 UMUM JL SLAMET RIYADI 2/4 GENTONG 8880493070 BIOFARMA 07/09/2021 2021071371 23/10/2021 C202106115
18 Q-000UWOLK : 3575011905020005 ABD GHOFAR 19 UMUM JL HANGTUAH 2/3 GADINGREJO 8810271121 BIOFARMA 08/09/2021 2021071371 23/10/2021 C202106115
19 Q-000MSLIM : 3575011710990003 MUCHAMMAD CHUSNI MUBAROK 22 UMUM JL HANGTUAH - PASURUAN 8969921236 BIOFARMA 13/08/2021 24201921 23/10/2021 C202106115
20 Q-000TBEDP : 3575014107980027 ROKHMAH 23 UMUM JL BANDA GG MAWAR 5/2 GADINGREJO 8573351525 BIOFARMA 04/09/2021 2021071371 23/10/2021 C202106115
21 Q-0013X3U8 : 3575014501970001 ALIFAH KHILMIYAH 24 UMUM JL HANGTUAH GG 2 1/3 8113777705 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
22 Q-0013M21E : 3514125204970002 KRISNAWATI NINGTYAS 24 UMUM GADINGREJO 7/1 8135798206 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
23 Q-000RAS63 : 3514164807920006 RISATUL FAIZAH 29 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8313221403 BIOFARMA 30/08/2021 24202221 23/10/2021 C202106115
24 Q-00133XJR : 3526091307850001 MOHAMMAD FAJAR SODIK 36 UMUM JAMBANGAN III RT 5 RW 2 8123186744 BIOFARMA 24/09/2021 202108123H 23/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
25 Q-0008IY0B : 3571026212840003 UMI FADILAH 37 UMUM JL.PUNTA DEWA B 17 PERUM KARYA BHAKTI K8155565622 BIOFARMA 26/06/2021 24200821 23/10/2021 C202106115
26 Q-000UFHQI : 3575011104800002 AGUS HARIYANTO 41 UMUM JL SLAMET RIYADI 2/4 GENTONG GADINGREJO8233807614 BIOFARMA 07/09/2021 2021071371 23/10/2021 C202106115
27 Q-000UWILK : 3575015111800004 KHOLIFAH 44 UMUM JL HANGTUAH 2/3 GADINGREJO 8810271121 BIOFARMA 08/09/2021 2021071371 23/10/2021 C202106115
28 Q-0013PHFU : 3575015011690002 MINARNI 52 RENTAN SEBANI GADINGREJO 8133623852 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
29 Q-0013PHT2 : 3575010903640001 WARSITO 57 RENTAN SEBANI GADINGREJO 8133623852 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
30 Q-0013WCRV : 3575015410630001 ARIFAH 58 RENTAN JL HANGTUAH GG2 8113777705 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
31 Z-000BGXXV : 3575010107570046 MAT KAREN 65 LANSIA JL HANGTUAH RT 3 RW 3 8113777705 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
32 Z-000AD7LB : 3575012809550001 BB. YUDO SUHANDOKO. 66 LANSIA JL SLAMET RIYADI 2/4 GENTONG 8113777705 BIOFARMA 07/09/2021 2021071371 23/10/2021 C202106115
33 Q-000861E3 : 3575010905800006 ANAM 41 UMUM JL SLAMET RIYADI 8564592763 BIOFARMA 26/06/2021 24200821 23/10/2021 C202106115
34 Q-001332VU : 3575012305040002 BAGUS SAPUTRO 17 UMUM JL SLAMET RIYADI 2/6 SEBANI 8966643590 BIOFARMA 24/09/2021 202108123H 23/10/2021 C202106115
35 Q-0013PHIJ : 3508184402930003 MULIDEH 28 UMUM BENDUNGAN SELATAN 8213173083 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
36 Q-0013PHMD : 3575012802940002 AKHMAD RISMANTO 27 UMUM JL SLAMET RIYADI 8213173083 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
37 Q-0013O8FA : 3575011402780005 RUDYANTO 43 UMUM SEBANI 2/3 8135774868 BIOFARMA 25/09/2021 202108154G 23/10/2021 C202106115
38 P-AWVSSX0H : 3575011703070003 MOCH. RIZQI ALFIANSYAH 14 REMAJA JL HANGTUAH 2/3 GADINGREJO 8523613284 BIOFARMA 23/10/2021 C202106115
39 P-HLEZ9ZMG : 3575011911030003 MUHAMAD. TAUFIQUROHMAN 18 UMUM jl irian jaya gadingrejo 8953257031 BIOFARMA 23/10/2021 C202106115
40 S-0A982B6C : 3575010107430034 MUSTOFA 78 LANSIA jl hangtuah 5/4 gadingrejo 8113777705 BIOFARMA 23/10/2021 C202106115
41 P-IOXJVHGG : 3575011201720001 A. JAINUL ROCHIM 49 UMUM SEBANI RT 4 RW 2 8312556475 BIOFARMA 23/10/2021 C202106115
42 S-9243B708 : 3575014107510022 SAPUAH 70 LANSIA JL SLAMET RIADI NO - BIOFARMA 23/10/2021 C202106115
1 Q-00141WQF 3575011702050003 FEMAS SEBASTIAN 16 REMAJA JL GATOT SUBROTO GG 8 81359029037 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
2 Q-0014131O 3575016801980001 ITA FITRIYA 23 UMUM JL GATOT SUBROTO 4/7 8980103757 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
3 Q-00140UT6 3575015404950001 NILA APRILIA 26 UMUM JL GATOT SUBROTO 4/7 85748622689 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
4 Q-00140K1D 3575014210920001 NUR FARIDA 29 UMUM BUKIR RT 3 RW 7 82140522700 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
5 Q-00140X7K 3575011902910002 ZAINUL LUTFI 30 UMUM JL GATOT SUBROTO 3/7 82140522700 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
6 Q-00140LVS 3514181103910002 JUMADI 30 UMUM JL GATOT SUBROTO GG 8 85730704628 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
7 Q-0013BLY5 3575010606900001 ANGWYN WIDIYAFERI JANITRA 31 UMUM JL GATOT SUBROTO 8983888626 CoronaVac 24/09/2021 202108154G 23/10/2021 C202106115
8 Q-00141Y7Y 3518070303880001 IMAM AHMAD ROHMIN 33 UMUM BUKIR PASURUAN 8238642910 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
9 Q-00140EJB 3575020206870004 BAGUS ARIANTO 34 UMUM JL GATOT SUBROTO 5/7 85608267372 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
10 Q-00140O5T 3575015605850004 NEIKA MEITA DEWI 36 UMUM JL GATOT SUBROTO 85843706417 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
11 Q-001417XI 3575012401810001 MUKHAMMAD ARIFIN 40 UMUM JL GATOT SUBROTO RT 2/7 88217702977 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
12 Q-0013CFLB 3575015204780002 SUTIANI 43 UMUM JL URIP SUMOHARJO 82333850480 CoronaVac 24/09/2021 202108154G 23/10/2021 C202106115
13 Q-00141AD9 3575014608770001 SUHERMIN 44 UMUM BUKIR RT4/ RW7 813777705 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
14 K-0001LDGT 3575011203770001 SULCHAN 44 UMUM JL GATOT SUBROTO 2/7 81216874374 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
15 Q-001414AU 3575014403730001 KHUMAIYAH 48 UMUM JL GATOT SUBROTO 85791239700 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
16 Q-0014129S 3575010608680001 SAIFUL 53 RENTAN JL GATOT SUBROTO 82131879989 CoronaVac 25/09/2021 202108154G 23/10/2021 C202106115
17 Q-0011O6NQ 3575010412660001 SUIN 55 RENTAN BUKIR RT 2 RW 7 82143493866 CoronaVac 22/09/2021 202108154G 23/10/2021 C202106115
18 P-ZSHMAIQY 3575014209070004 NABILA HANIF FIRDAUS 14 REMAJA JL. GATOT SUBROTO 3/7 - BUKIR 8113041033 CoronaVac 23/10/2021 C202106115
19 P-ZRMQXWRO 3575020501870001 YEYEN JANUARI SETYOBUDI 34 UMUM JL. GATOT SUBROTO 2/6 - BUKIR 85757570775 CoronaVac 23/10/2021 C202106115
20 P-ZSLOBM7Y 3575017004780001 MUNTAMA 43 UMUM JL. GATOT SUBROTO 3/7 - BUKIR 83117056414 CoronaVac 23/10/2021 C202106115
21 P-ZSBCEMHB 3575015504760001 SUPATMI 45 UMUM JL. GATOT SUBROTO 2/7 - BUKIR 81259470733 CoronaVac 23/10/2021 C202106115
22 P-ZRYD2Q4N 3575015202710002 DAIPAH 53 RENTAN JL. GATOT SUBROTO 5/7 - BUKIR 89654983318 CoronaVac 23/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-22-2021 INDUK
1 Q-000K3OE0 3575015904030004 UMI PUSPITA DEVI 18 UMUM JL GATOT SUBROTO 8580250625 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
2 Q-000K1A23 3575011407020002 MUHAMMAD ZIDAN AL ATHOR 19 UMUM JL. MENARA NO. 15 A GENTONG 8968787383 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
3 Q-000K494C 3575011505010001 FARIZI WAHYU CAHYONO 20 UMUM SEBANI RT 3 RW 6 8383334024 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
4 Q-000K41VH 3575011403010002 MUCHAMAD IQBAL SATRIA 20 UMUM JL. MENARA No. 10 GENTONG 8573140862 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
5 Q-000K3M5T 3575012709980002 MOH NUR WACHID 23 UMUM JL GATOT SUBROTO, 8383311747 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
6 Q-000K3YC3 3575010811840003 AMIR SUNARYO 37 UMUM BUKIR rt 02 rw 02 8969959314 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
7 Q-000K4BP5 3575010506840006 ASMARI 37 UMUM JL MULYOREJO, SEBANI 8133319478 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
8 Q-000K3N1J 3575012801830001 NUR WAHYUDI 38 UMUM BUKIR gadingrejo 8128830994 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
9 Q-000K7PO0 3575010204780002 TARSONO 43 UMUM JL IRIAN JAYA 8383000174 Astrazeneca 30/07/2021 ABX2795 22/10/2021 A1076
10 Q-000K3UUM 3575016801770006 SULISTIYOWATI 44 UMUM JL GATOT SUBROTO bukir 8595431124 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
11 Q-000K43CO 3575016811750001 YATEMA AINUL CHULUB 46 UMUM SEBANI gadingrejo 8986608376 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
12 Q-000K43CE 3575011304740001 IMAM MUCHOLIS 47 UMUM SEBANI gadingrejo 8986608376 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
13 Q-000K4DBR 3575010510620001 KARTUBI 59 RENTAN JL URIP SUMOHARJO 8523487122 Astrazeneca 29/07/2021 ABY1911 22/10/2021 A1076
14 Z-00089RQN 3575011002600001 ANTUR HASIM 61 LANSIA JL IRIAN JAYA 8383353353 Astrazeneca 30/07/2021 ABX2795 22/10/2021 A1076
15 P-FQMWP3GL 3575016006010004 DEWI AYU SETYANINGSIH 20 UMUM JL BANDA 6/2 GADINGREJO 8181514827 Astrazeneca 22/10/2021 A1076
16 P-HU88FOYK 3514204306980005 LISTIYA WULANDARI 23 UMUM JL HANGTUAH 1/3 GADINGREJO 8385748809 Astrazeneca 22/10/2021 A1076
17 P-I1KC3DZS 3575011006980002 YOGA ARDIANSYAH 23 UMUM JL HANGTUAH 1/3 GADINGREJO 8385748809 Astrazeneca 22/10/2021 A1076
18 P-5JLITNFF 3575015402980003 SITI ROMLAH 23 UMUM jl banda 6/2 gadingrejo 8385649482 Astrazeneca 22/10/2021 A1076
19 P-FWHFA9FX 3575011801970001 ABDUL AZIS 24 UMUM JL BANDA 6/2 GADINGREJO 8151515827 Astrazeneca 22/10/2021 A1076
20 P-6LMNNNTL 3514155007970003 SAK' DEYA 24 UMUM JL BANDA 6/2 GADINGREJO 8313265715 Astrazeneca 22/10/2021 A1076
21 P-7S9FSPPY 3514075704970003 MAHSUSOH 24 UMUM jl halmahera 3/5 gadingrejo 8578526001 Astrazeneca 22/10/2021 A1076
22 P-F4V7ZWVL 3575015010960003 ISMAWATI 25 UMUM jl hang tua 1/3 gadingrejo 8190303651 Astrazeneca 22/10/2021 A1076
23 P-FJ6IHVHN 3514162710940005 M.CHOIRUL ANAM 27 UMUM JL HANGTUA 1/3 GADINGREJO 8193036513 Astrazeneca 22/10/2021 A1076
24 P-61OJE7LR 3575012806930001 BAHRUL ULUM 28 UMUM JL BANDA 6/2 GADINGREJO 8585691607 Astrazeneca 22/10/2021 A1076
25 P-G4ILZS3N 3575014102930004 SITI ZULAIKHA 29 UMUM JL BANDA 6/2 GADINGREJO 8564557531 Astrazeneca 22/10/2021 A1076
26 P-GTHG6YZS 3575031002860002 BENARD 35 UMUM JL GATOT SUBROTO 1/7 BUKIR 8312245032 Astrazeneca 22/10/2021 A1076
27 P-7B8Y3O9K 3575012002850003 MOCH MUBIN 36 UMUM jl banda 6/2 gadingrejo 8820092342 Astrazeneca 22/10/2021 A1076
28 P-GCVKJEIF 3575010702840003 SANALI 37 UMUM JL HANGTUA 1/4 GADINGREJO 8132002897 Astrazeneca 22/10/2021 A1076
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
29 P-9IF4FZI7 3575010107830177 NUR YATIM 38 UMUM JL HALMAHERA 8578526001 Astrazeneca 22/10/2021 A1076
30 P-A774A733 3514160603800027 M.MUJIB 41 UMUM jl halmahera 5/5 gadingrejo 8113777705 Astrazeneca 22/10/2021 A1076
31 P-5PYNPHKP 3575012502780002 SODIK 44 UMUM jl banda 6/2 gadingrejo 8311957298 Astrazeneca 22/10/2021 A1076
32 P-6XINQ167 3575014209740003 SUMINI 47 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8113777705 Astrazeneca 22/10/2021 A1076
33 P-6RPB7HUF 3575012011700001 AWI 50 RENTAN JL HALMAHERA 3/5 GADINGREJO 8233149555 Astrazeneca 22/10/2021 A1076
34 P-EB1V58BM 3575011909690003 MAKSUM AKMAD 52 RENTAN JL BANDA 6/2 GADINGREJO 8223326317 Astrazeneca 22/10/2021 A1076
35 P-5WY8NRT3 3575010107650061 MUFID 56 RENTAN JL BANDA 6/2 GADINGREJO 8113777705 Astrazeneca 22/10/2021 A1076
36 P-7426WY4C 3575010209630003 MOCH KAFI 58 RENTAN JL Banda 6/2 gadingrejo 8820092342 Astrazeneca 22/10/2021 A1076
37 Q-000YI4C9 : 3575016010070001 LAILATUL SAFITRI 14 REMAJA JL IRIAN JAYA 2/2 GADINGREJO 8311746417 BIOFARMA 16/09/2021 202108118H 22/10/2021 C202106115
38 Q-0011MP9Z : 3575011301040001 MOCHAMMAD SOFYAN LUTFI 17 UMUM JL HALMAHERA GADINGREJO 8223222726 BIOFARMA 22/09/2021 202108118H 22/10/2021 C202106115
39 Q-00133314 : 3575015805040003 SITI NUR ZAKIYAH INDASARI 17 UMUM JL HANG TUA 3/4 GADINGREJO 8589521201 BIOFARMA 24/09/2021 202108123H 22/10/2021 C202106115
40 P-7JN80L75 : 3575016303040001 ANGGI ISNAENI 17 UMUM JL GATOT SUBROTO 004/007 BUKIR 8135913185 BIOFARMA 24/09/2021 202108123H 22/10/2021 C202106115
41 Q-0011OJ77 : 3575016311920004 FIFIYANTI SUTEKNO 29 UMUM PERUM KARYA BAKTI5/7 GENTONG 8222904724 BIOFARMA 22/09/2021 202108118H 22/10/2021 C202106115
42 Q-000Z3MPD : 3575015808730004 CHAIDAROH 48 UMUM JL HALMAHERA 2/5 GADINGREJO 8510371337 BIOFARMA 17/09/2021 202108118H 22/10/2021 C202106115
43 Q-000VZWN9 : 3575017108670001 CHUMAIYAH 54 RENTAN JL IRIAN JAYA 4/2 GADINGREJO 8123556365 BIOFARMA 10/09/2021 202108118H 22/10/2021 C202106115
44 Q-000W1KTL : 3575010505670003 ABD.WAKHID 55 RENTAN JL BANDA 6/2 GADINGREJO 8113777705 BIOFARMA 10/09/2021 202108118H 22/10/2021 C202106115
45 Z-000B6GK9 : 3575010107520064 M. DJAMIL 69 LANSIA jl banda 4/2 gadingrejo 8155456441 BIOFARMA 21/09/2021 202108118H 22/10/2021 C202106115
46 Z-000BDNUX : 3575010612510002 M. SOLICHUN 70 LANSIA JL SLAMET RIYADI 1/4 GENTONG 8520343023 BIOFARMA 24/09/2021 202108123H 22/10/2021 C202106115
47 Z-000BDPYE : 3575014107470051 MUTAYAM 74 LANSIA JL HALMAHERA 3/3 GADINGREJO 8113777705 BIOFARMA 24/09/2021 202108123H 22/10/2021 C202106115
48 Z-000AX9GG : 3575020101460008 SUROSO 75 LANSIA JL HANGTUAH XA / 22 NGEMPLAKREJO 8224596114 BIOFARMA 16/09/2021 202108118H 22/10/2021 C202106115
49 Z-000B9CZ8 : 3575014204520001 SITI KHODIJAH 69 LANSIA JL SLAMET RIYADI GG 14 GENTONG 8113777705 BIOFARMA 22/09/2021 202108154G 22/10/2021 C212106115
50 P-68LAF8HC : 3575015909090001 YENITA FITRI SEPTIASA 12 REMAJA JL URIP SUMOHARJO 3/8 BUKIR 8311450636 BIOFARMA 22/10/2021 C202106115
51 P-GM3XZMOB : 3514156007960004 SOFIYAH 25 UMUM JL BANDA 6/2 GADINGREJO 8312270488 BIOFARMA 22/10/2021 C202106115
52 P-CIRVKADK : 3575016507890001 NUR KHUSNIA 32 UMUM JL BANDA 6/2 GADINGREJO 8778990787 BIOFARMA 22/10/2021 C202106115
53 S-E354FBFA : 3575010101560009 ENTIN SURYADI 65 LANSIA JL SLAMET RIYADI 1/3 GENTONG 8113777705 BIOFARMA 22/10/2021 C202106115
54 P-6V480LLU : 3575011904990001 MOKHAMMAD NIJAR 22 UMUM JL KYAI SEPUH 001/005 GENTONG 8969963919 BIOFARMA 22/10/2021 C212106115
55 P-KWK52OK0 : 3575012805910001 FATKHAN ZAINURI 30 UMUM JL KYAI SEPUH 001/005 8560704747 BIOFARMA 22/10/2021 C202106115
56 P-L98PT8V3 : 3575014508890001 IDA RAKHMAWATI 32 UMUM JL KYAI SEPUH 001/005 GENTONG 8560704747 BIOFARMA 22/10/2021 C212106115
57 P-DR4Z8F9N : 3575016111850004 SUCI INDRAWATI 36 UMUM JL SLAMET RIYADI 003/003 GENTONG 8575537795 BIOFARMA 22/10/2021 C212106115
1 Q-000E3RUS 3575016110680001 CHURRIYAH 53 RENTAN SEBANI RT.002 RW.006 KEL. SEBANI 8383377373 CoronaVac 13/07/2021 24200421 G 22/10/2021 C202106115
2 P-SDEUJ3AL 3575014607830003 ISTY QOMARIYAH 38 UMUM JL SLAMET RIYADI 8581522290 CoronaVac 22/10/2021 C202106115
3 P-T2LPQ1Y3 3575015205800001 SRI WAHYUNI 41 UMUM JL SLAMET RIYADI 8123574468 CoronaVac 22/10/2021 C202106115
4 P-U65EHWB2 3575016705890001 MARDIYYAH 32 UMUM SEBANI GADINGREJO 8214057427 CoronaVac 22/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi

1 Q-0013BMWH 3575016809930001 MAMIK SEPTIANI 28 UMUM JL GATOT SUBROTO 81219575327 CoronaVac 24/09/2021 202108154G 22/10/2021 C202106115
2 Q-0013BYM4 3575016412880003 TRI GANIS YUSPITA SARI 32 UMUM JL GATOT SUBROTO 8252472538 CoronaVac 24/09/2021 202108154G 22/10/2021 C202106115
3 Q-0013C10S 3575016304830001 ISLAMIATI 38 UMUM JL GATOT SUBROTO 82331660558 CoronaVac 24/09/2021 202108154G 22/10/2021 C202106115
4 Q-000NSNUQ 3575015307790001 LILIK MUFIDAH 42 UMUM JL. GATOT SUBROTO RT. 03 / RW. 06 BUKIR 82532250741 CoronaVac 18/08/2021 24004621 22/10/2021 C202106115
5 Q-000HZS7M 3575010110670003 MISLAN 54 RENTAN JL GATOT SUBROTO 3/6 BUKIR 81333210118 CoronaVac 17/07/2021 24200421 22/10/2021 C202106115
6 Z-000B92FI 3575011207510001 SUBANI 64 LANSIA JL GATOT SUBROTO 82331660558 CoronaVac 22/09/2021 202108154G 22/10/2021 C202106115
7 P-YM8109HH 3575015209800003 SUCIATI 51 RENTAN BUKIR RT02/RW06 81336836223 CoronaVac 22/10/2021 C202106115
8 P-24OOWMXU 3575011207890004 LILIK ZUBAIDAH 32 UMUM BUKIR RT03/RW02 83850107199 CoronaVac 22/10/2021 C202106115
9 P-YKU39KPP 3575011004960001 YOGI EKA PRANATA 27 UMUM JL. GATOT SUBROTO 3/6 - BUKIR 87705114616 CoronaVac 22/10/2021 C202106115
10 P-22WDBTMT 3575014706930001 AYU LESTARI 28 UMUM JL. GATOT SUBROTO - BUKIR 82359156543 CoronaVac 22/10/2021 C202106115
11 J-0006IYDA 3575015206990007 EVIA YUANITA 22 UMUM BUKIR RT02/RW06 882009044731 CoronaVac 22/10/2021 C202106115
12 P-25T5QNY4 3575016810910005 MUFIDAH 30 UMUM JL. URIP SUMOHARJO 1/8 - BUKIR 89682298706 CoronaVac 22/10/2021 C202106115
Pasuruan,22-10-2021

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-21-2021 INDUK
1 K-0000CB5A 3575014107630080 CHUSNUL CHOTIMAH 58 RENTAN Jl. Banda No. 76, , KOTA PASURUAN, Jawa Timur8953285507 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
2 Q-000K1B7F 3575014511660001 SUTAMI 53 RENTAN SEBANI RT 01/01 8193465312 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
3 Q-000K0ZZ5 3575014701660001 SUPIAMI 53 RENTAN JL SLAMET RIYADI, GENTONG 8126220956 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
4 Q-000K44L6 3575010404690002 M. CHOZEN 52 RENTAN JL GATOT SUBROTO bukir 8385788634 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
5 Q-000K4EG1 3575011803690001 MOH KHAMIM 52 RENTAN JL GATOT SUBROTO bukir 8785056817 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
6 Q-000K4COH 3575010507700007 M. YAKUP 51 RENTAN JL SLAMET RIYADI 8521754392 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
7 Q-000K3N1E 3575014212710002 SUMININGSIH 50 RENTAN JL GATOT SUBROTO 8223415547 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
8 Q-000K4COB 3575016006710001 SRI RAHAYU 50 RENTAN JL SLAMET RIYADI 8113777705 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
9 Q-000K02RD 3575016704720001 MUTMAINAH 49 UMUM JL SLAMET RIYADI GG 14 RT03 RW03 KEL GE 8950730238 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
10 Q-000K3VMV 3575016806730004 SUNARSIH 48 UMUM JL. GATOS SUBROTO BUKIR 8574951903 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
11 Q-000K4ALY 3575014107740091 SATIAH 47 UMUM JL. IRIAN JAYA NO. 02 8113777770 Astrazeneca 29/07/2021 VAKSIN 1 21/10/2021 A1076 -
12 Q-000K2G84 3575010410740001 KASWAR 47 UMUM JL. TEUKU UMAR 8560703103 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
13 Q-000K4CP1 3575011208740003 MUHAMMAD KHOJIN 47 UMUM BUKIR , rt 02 rw o1 8573156733 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
14 Q-000K45BE 3575016411750002 SUWITA NINGSIH 46 UMUM JL SLAMET RIYADI SEBANI 8523478848 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
15 Q-000K44K9 3575010408750002 AGUS TAUFIQUR RAKHMAN 46 UMUM JL SLAMET RIYADI RW01 RT 002 sebani 8133270945 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
16 Q-000K3T5D 3575014502760003 IFA NUROIDAH 45 UMUM JL GATOT SUBROTO 8785056817 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
17 Q-000K4COA 3575015207760001 UMI KULSUM 45 UMUM JL SLAMET RIYADI 8958090490 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
18 Q-000K06AD 3575016112790001 NUR IDA 42 UMUM JL. RADEN PATAH, GENTONG 8523430501 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
19 Q-000K43CR 3514166904790003 ANISAH 42 UMUM JL. URIP SUMOHARJO bukir 8953950472 Astrazeneca 29/07/2021 ABY191 21/10/2021 A1076 -
20 Q-000K44IV 3575014802790001 UMUL LATIFAH 42 UMUM JL GATOT SUBROTO RW 05 RT 003 BUKIR 8523301060 Astrazeneca 29/07/2021 VAKSIN 1 21/10/2021 A1076 -
21 Q-000K4BOL 3575014805800003 ASIK FATIMAH 41 UMUM BUKIR RT 03 RW 03 PASURUAN 8232948148 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
22 Q-000K3YB3 3575011003800002 ABDULLAH HUNEN 41 UMUM JL URIP SUMOHARJO 8121748182 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
23 Q-000K41OU 3575021402810007 SUCAHYO FEBRIYANTO 40 UMUM JL. SLAMET RIYADI sebani 8121720145 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
24 Q-000K3HXZ 3575014405820004 AFIYAH 39 UMUM JL. IRIAN JAYA NO 22 8573145912 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
25 Q-000K489K 3575010212820001 HERI HERAWANTO 39 UMUM JL SLAMET RIYADI gentong 8780677748 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
26 Q-000K446B 3514162308830003 ACHMAD KHUSAIRI 38 UMUM JL IRIAN JAYA GG ANGGREK PASURUAN. 8224483006 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
27 Q-000K43C6 3575016105830002 ATIK KURNIA 38 UMUM SEBANI PASURUAN 8816901018 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
28 Q-000K38LD 3575020404840001 EDY NURYANTO 37 UMUM JL. SLAMET RIYADI GG. XI 8581667067 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
29 Q-000K3ODI 3575014708850001 RINI KUSTIYAH 36 UMUM JL SLAMET RIYADI 8780677748 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
30 Q-000K4COC 3575014709850002 RAHAYU NINGSIH 36 UMUM JL SLAMET RIYADI SEBANI 8233563255 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
31 Q-000K41OX 3514160905850002 SULTON 36 UMUM SEBANI PASURUAN 8816901018 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
32 Q-000JZO3G 3575011205880003 BAYU LASMONO 33 UMUM JL IRIAN JAYA GG ANGGREK RW 02 RT 001 8969975228 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 Q-000K488I 3514161707900041 MOHAMMAD NASRUDIN 31 UMUM JL. BANDA 4/2 8570614390 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
34 Q-000K41M4 3575016005910001 KHOIROTUL ISTIFAYAH 30 UMUM JL. SLAMET RIYADI GG. XI 8581667067 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
35 Q-000K488Y 3575015911910001 EVA RAHAYU 30 UMUM JL slamet riyadi 8223457176 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
36 Q-000K44L0 3575015505920005 FIRDAH AYU SOLIKHA 29 UMUM JL URIP SUMOHARJO bukir 8573203084 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
37 Q-000K45AU 3575016210920002 SITI NAFISA 29 UMUM JL IRIAN JAYA GG ANGGREK PASURUAN. 8224483006 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
38 Q-000K4E2R 3575015401930001 DINA AMALIA 28 UMUM JL DR WAHIDIN S HUSODO UTARA GG 7, 8510054508 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
39 Q-000K2AI1 3575010401940002 NUR YONO 27 UMUM JL RADEN PATAH, GENTONG 8574666340 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
40 Q-000K494F 3575010103940003 MOKHAMAD SARIFUDIN 27 UMUM JL MULYOREJO RW 06 RT 002 SEBANI 8585070067 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
41 Q-000K3UKY 3575011203960003 IMAM EFENDI 25 UMUM JL GATOT SUBROTO 8953216387 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
42 Q-000K4DC4 3575011505960001 INGGRIANI NOVITASARI 25 UMUM JL SLAMET RIYADI NO 27 sebani 8585483185 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
43 Q-000K4CO9 3575015112960002 DESTIANA DWI INDAH LESTARI 25 UMUM JL KYAI SEPUH GENTONG 8564991847 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
44 Q-000K3T5A 3575015410980002 NANDA OKTAVIANA 23 UMUM JL. BANDA GANG KENONGO NO.72 8133270606 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
45 Q-000K43C4 3575010811990003 SANTOSO 22 UMUM JL SLAMET RIYADI sebani 8581667067 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
46 Q-000K4BON 3575010808000003 MUKHAMAD ALMAS FERDIANSYAH 21 UMUM BUKIR RT 2 RW 1 8776342015 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
47 Q-000K1ELT 3575010902000001 FIKI FEBRIANTO 21 UMUM JL SLAMET RIYADI sebani 8193465312 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
48 Q-000K45B5 3575011312000001 MOCH. RIZAL MUHAIMIN 21 UMUM JL KYAI SEPUH GENTONG 8954005433 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
49 Q-000AW9P0 3575014309010001 ROFIQOH TRIAS LAILATUL JAHRO 20 UMUM JL SLAMET RIYADI GG 12 8573306872 Astrazeneca 03/07/2021 ABY1911 21/10/2021 A1076 -
50 Q-000K3VN8 3575011404010001 YOGA DWI FIRMANSYAH 20 UMUM JL. GATOT SUBROTO BUKIR 8573011549 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
51 Q-000K1FLS 3575016806020001 ZAKIYAH KHODIJAH 19 UMUM JL SLAMET RIYADI RW 01 RT 002 8578493705 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
52 Q-000K3ODM 3575011909020001 AHMAD RAFI 19 UMUM JL GATOT SUBROTO 8968095708 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
53 Q-000K0258 3575014309020003 IZZATUL MULA 19 UMUM JL IRIAN JAYA, JAWA TIMUR, KOTA PASURUAN,8823554734 Astrazeneca 29/07/2021 ABY1911 21/10/2021 A1076 -
54 P-D24BBKAI 3575012304630002 SUPRIYANTO 58 RENTAN JL HANGTUAH 4/3 8585456522 Astrazeneca 21/10/2021 A1076
55 P-G0MMBMBO 3575011204740007 ABD. QODIR JAELANI 47 UMUM 8510420967 Astrazeneca 21/10/2021 A1076
56 P-6G3BYNGY 3575010107820105 MUHAMMAD YUSUF 39 UMUM jl banda 6/2 8389209064 Astrazeneca 21/10/2021 A1076
57 P-5UI0UZLI 3575015811830001 SUMAIYAH 38 UMUM JL HANGTUAH GG 4 8190303648 Astrazeneca 21/10/2021 A1076
58 P-F61U0X6H 3575010101830021 YANUAR PRIBADI 38 UMUM JL SLAMET RIYADI 4/2 SEBANI 8223311786 Astrazeneca 21/10/2021 A1076
59 P-CSI5LZRX 3575010107830192 ARIFIN 38 UMUM JL HANGTUAH 4/3 8585456522 Astrazeneca 21/10/2021 A1076
60 P-5ZSCRNZR 3575014705850009 SUSILOWATI 36 UMUM JL HANGTUAH 8113777705 Astrazeneca 21/10/2021 A1076
61 P-6XO7WKID 3514221904850004 NANANG TUKI 36 UMUM ROWOGEMPOL LEKOK 8510777797 Astrazeneca 21/10/2021 A1076
62 P-FMYIA5PD 3575010107870120 ACHMAD SUMAL 34 UMUM 8123364338 Astrazeneca 21/10/2021 A1076
63 P-7J6KMN91 3514225509880004 AMINATUZ ZUHRO 33 UMUM PROKIMAL 29 LEKOK 8510224102 Astrazeneca 21/10/2021 A1076
64 P-EK77XW6L 3575011308880002 MOKHAMAD HIJRIYAH 33 UMUM JL KYAI SEPUH GENTONG 8575508248 Astrazeneca 21/10/2021 A1076
65 P-ET33GHG6 3575010107890098 MOCHAMAD SOFYAN 32 UMUM JL HANGTUAH 8123428896 Astrazeneca 21/10/2021 A1076
66 P-CBTW4WU4 3575015210930003 RETNO WULANSARI 28 UMUM jl hangtuah 4/3 8585456522 Astrazeneca 21/10/2021 A1076
67 P-FHNMK7CK 3575036005960002 ROBI'A 25 UMUM 8968235092 Astrazeneca 21/10/2021 A1076
68 P-DWUFVSID 3575016512990003 NAFISAH 22 UMUM JL HALMAHERA 8533494146 Astrazeneca 21/10/2021 A1076
69 P-7J9OLEV8 3575024107000065 NOR SOLEHATI 21 UMUM JL BANDA 8788799386 Astrazeneca 21/10/2021 A1076
70 P-E9BY3LV6 3575012507010002 FATKHUL ULUM 20 UMUM JL HALMAHERA 8133866492 Astrazeneca 21/10/2021 A1076
71 P-641IDKI9 3514165704010004 FENI ALIATUR RIFKA 20 UMUM JL A DAHLAN V / 16 8385345952 Astrazeneca 21/10/2021 A1076
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
72 P-7AQD1NUD 3575010107010062 JUNAEDI 20 UMUM JL BANDA 8214110116 Astrazeneca 21/10/2021 A1076

73 Q-0012R489 3575012810680003 MUBIN 53 RENTAN JL HALMAHERA 66 8770293227 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
74 Q-0012S7OM 3575014707700003 RIBUT JUMAIYA 51 RENTAN JL HALMAHERA 4/5 8113777705 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
75 Q-0012UHM7 3575015005700001 ST CHOTIMAH 51 RENTAN JL HALMAHERA GG 9 8560807530 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
76 Q-0014Y0U7 3529191507750009 SULIYONO 46 UMUM JL RADEN PATAH 1/5 GENTONG 8523430501 CoronaVac 28/09/2021 202108154G 21/10/2021 C202106115
77 Q-0012U1HP 3514166107810001 KAMILAH 40 UMUM HANGTUAH RT4 RW3 8564906491 CoronaVac 23/09/2021 202108150I 21/10/2021 C202106115
78 Q-000TZ1TO 3575014106920003 NURAINI FATMAWATI 29 UMUM JL BANDA 2/2 8384883430 CoronaVac 06/09/2021 2021071371 21/10/2021 C202106115
79 Z-000BC3ON 3575015105940002 DWI RAKHMAWATI 27 UMUM DESA TIDU POHJENTREK 8564642294 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
80 Q-0012FI8W 3575016111940002 NOFIAH MARDIYANI 27 UMUM PERUM GRAHA INDAH 8578560498 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
81 Q-0012PQNQ 3575013005970002 MOCHAMMAD TAUFIQIL ILAHI 24 UMUM JL HALMAHERA 9 8560807530 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
82 Q-000E3KSV 3575011402980001 MUHAMMAD YAHYA 23 UMUM JL SLAMET RIYADI GG 4 RW 01 RT 002 GENTO 8969884851 CoronaVac 13/07/2021 24200421 21/10/2021 C202106115
83 Q-0011M8BO 3514243008030001 IVAN RYANDHIKA PUTRA 18 UMUM DSN TOSARI DS TOSARI 8574827257 CoronaVac 22/09/2021 24202221 21/10/2021 C202106115
84 Q-0011MMQZ 3575014310040001 ILFI 17 REMAJA 2/4 8312996862 CoronaVac 22/09/2021 202108118H 21/10/2021 C202106115
85 Q-0011MH9J 3575011306040001 MIFTAH YUNIARTA 17 REMAJA JL KYAI SEPUH 4/1 8525740637 CoronaVac 22/09/2021 202108118H 21/10/2021 C202106115
86 Q-0012FDA5 3575016703040004 NAHILDA HANUM 17 REMAJA JL SLAMET RIYADI 2/3 GENTONG 8523303317 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
87 Q-0012CISG 3575011602060003 MUHAMMAD FIRDAUS SYAIFULLAH 15 REMAJA JL HALMAHERA 3/3 8312027252 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
88 Q-0012FXXZ 3575015205080001 NURUL HIDAYAH 13 REMAJA JL SLAMET RIYADI 2/3 GENTONG 8554623253 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
89 Q-000K3WTN 3575011006080002 MUKHAMMAD RAFA RADITYA 13 REMAJA JL SLAMET RIYADI 8780677748 CoronaVac 29/07/2021 24004321 21/10/2021 C202106115
90 Q-0012FVCO 3575012505080005 AHMAD WILDANUL FIRDAUSI 13 REMAJA JL SLAMET RIYADI 2/3 GENTONG 8113777705 CoronaVac 23/09/2021 202108123H 21/10/2021 C202106115
91 P-68WP2CJW 3575011906050001 MOCH. RAYHAN DWI HADIANSYAH 16 REMAJA JL BANDA 8967023261 CoronaVac 21/10/2021 C202106115
92 P-DOWPY4LW 3575014210090001 ANGELA AURELLIA PUTRI 12 REMAJA JL KYAI SEPUH 3/18 8578524729 CoronaVac 21/10/2021 C202106115
1 Q-000YOHBR 3575015208660001 RUKHIYATI 55 RENTAN JL URIP SUMOHARJO 1/2 BUKIR 8113777705 CoronaVac 16/09/2021 202108118H 21/10/2021 C202106115
2 Q-0011NQV8 3575014107610101 MUNAWAROH 60 LANSIA BUKIR RT 3 RW 1 8113777705 CoronaVac 22/09/2021 2021081546 21/10/2021 C202106115
3 S-629C221D 3575015102600001 SUHARTIK 61 LANSIA JL. GATOT SUBROTO 2/7 - BUKIR 89699582643 CoronaVac 21/10/2021 C202106115
4 P-QQNO0VOW 3575012106050001 MUHAMMAD ROBBY RAHMADANI 16 REMAJA JL. URIP SUMOHARJO 2/2 - BUKIR 81217367163 CoronaVac 21/10/2021 C202106115
5 P-CIIAQQDS 3575034107960026 NIKMATUL HASANAH 25 UMUM JL. Komodor Yos Sudarso 1/4 - Mandaranrejo 85806461423 CoronaVac 21/10/2021 C202106115
6 P-PIR4Z0AN 3509034808730001 SITI SHOLEHA 48 UMUM BUKIR RT03/RW05 85236611387 CoronaVac 21/10/2021 C202106115
7 P-QDQRDCSV 3575012204980001 MUCLASON 23 UMUM JL. GATOT SUBROTO 1/7 - BUKIR 83117056414 CoronaVac 21/10/2021 C202106115
1 Q-000HZUE6 3575015403740002 LILIK FARIDA 1974-03-14 UMUM JL SLAMET RIADI 5/2 SEBANI 8213287001 CoronaVac 17/07/2021 24200421 21/10/2021 C202106115
2 Q-000VXBK7 3575015805850002 MARIYA ULFA 1985-05-15 UMUM JL SLAMET RIYADI 1/1 SEBANI 8968769743 CoronaVac 10/09/2021 202108118H 21/10/2021 C202106115
3 Q-000Z60FF 3575016610780001 SILVIYAH 1978-10-26 UMUM Ade Irma Suryani No.1 Sebani 8233702391 CoronaVac 17/09/2021 202108118H 21/10/2021 C202106115
4 P-JVG8AJQL 3575014506740002 WIWIT SOLICHA 1974-06-05 UMUM JL SLAMET RIYADI 2/3 8133434647 CoronaVac 21/10/2021 C202106115
5 P-NRH0TEFD 3575015403990001 ELIS AYU MAYANG SARI 1999-03-14 UMUM SEBANI RT 2 RW 5 8575499345 CoronaVac 21/10/2021 C202106115
6 P-O42ZN3GD 3575014505920004 MILA KARMILA 1992-05-05 UMUM JL SLAMET RIYADI 8230200550 CoronaVac 21/10/2021 C202106115
7 P-P2SF5MTJ 3523084104860005 MURTI 1987-08-18 UMUM SEBANI PASURUAN 8113577770 CoronaVac 21/10/2021 C202106115
8 P-PIPAO6NS 3575016606940002 INDAH YATI 1994-06-26 UMUM JL SLAMET RIYADI 8123429132 CoronaVac 21/10/2021 C202106115
9 P-Q7R1MVZC 3575011606980004 AKHMAD FALIKHUN NASSRULLAH 1998-06-16 UMUM JL SLAMET RIYADI 8124676974 CoronaVac 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10 P-QH2ESJWF 3575016104750001 DARIFAH 1975-04-21 UMUM JL SLAMET RIYADI 8951599116 CoronaVac 21/10/2021 C202106115
10-21-2021 PUSTU GENTONG
1 Z-000B95IE 3575014501490001 MURTIANI 74 LANSIA JL KYAI SEPUH GG 18 GENTONG 8213992885 CoronaVac 22/09/2021 202108154G
2 Z-000B8XN8 3575016504540002 BUANG SARI 67 LANSIA JL SLAMET RIYADI GENTONG 8233857457 CoronaVac 22/09/2021 202108154G
3 Z-000B8XQL 3575010307540001 JUMAIN 67 LANSIA JL SLAMET RIYADI GG 14 8113777705 CoronaVac 22/09/2021 2021081546
4 S-23A09B9A 3575011110580002 SUNARIYO 65 LANSIA JL SLAMET RIYADI 003/003 GENTONG 8575537795 CoronaVac 21/10/2021 C202106115
5 Z-000B94ZY 3575011808540001 GIMAN 63 LANSIA GENTONG RT 2 RW 5 8113777705 CoronaVac 22/09/2021 2021081546
6 Z-000B94AT 3575016506620002 JUMIATI 61 LANSIA GENTONG RT 2 RW 5 8113777705 CoronaVac 22/09/2021 2021081546
7 P-9CD6MGNY 3575010712720001 M. SUGIONO 49 UMUM JL KYAO SEPUH 001/005 GENTONG 8125991915 CoronaVac 21/10/2021 C202106115
8 P-DMXBHXDI 3575014806760003 ANISAH AMI 45 UMUM JL SLAMET RIYADI 002/004 GENTONG 8193621577 CoronaVac 21/10/2021 C202106115
9 P-0OV1MHJC 3575026104880002 NURYANTI 33 UMUM JL SLAMET RIADI 003/003 GENTONG 8585299542 CoronaVac 21/10/2021 C202106115
10-21-2021 SMP NEGERI 7
1 Q-000UUK05 6310022110070002 ABDUL HAFID 14 REMAJA RT 003 RW 001 8533178406 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
2 Q-000UQE4O 3575012109070001 ABDUL HOFUR RAMADANI 14 REMAJA RUJAK GADUNG RT 1 RW 1 8135935265 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
3 Q-000UFQFU 3575012811080002 ABDUR ROHMAN SAPUTRA 13 REMAJA JL KYAI SEPUH GG 18, GENTONG 8133286356 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
4 Q-000UF1IU 3575010511080003 ACH. ANDIKA PRATAMA 13 REMAJA Rt 03 Rw 02 kecamatan gadingrejo 8233538325 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
5 Q-000UGLGD 3575032006080001 ACHMAD DAHLAN MAULANA 13 REMAJA RT 001 RW 009 8123835720 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
6 Q-000UNT9O 3575010407080001 ACHMAD FAHRI ZAKARIYA 13 REMAJA JL GATOT SUBROTO PETAHUNAN 8383494003 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
7 Q-000UFOTJ 3575012204080003 ACHMAD FARIZ SYAHPUTRA 13 REMAJA JL SLAMET RIYADI GG 8 , GENTONG 8586043146 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
8 Q-000UMM9Y 3575012202090001 ACHMAD FAUZAN ADZIM 12 REMAJA RT 003 RW 002 8123402322 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
9 Q-000UEZG6 3575010911080003 ACHMAD NOUVAL SETYAWAN 13 REMAJA JL SLAMET RIYADI GG 8 GENTONG 8573066165 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
10 Q-000UQ9ET 3575010401070004 ACHMAT ZAMRONI 14 REMAJA RUJAKGADUNG KARANGKETUG 8578527620 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
11 Q-000UFM4W 3575016703080001 ADINDA PUTRI AZ ZAHRA 13 REMAJA JL SLAMET RIYADI RT 01/03, GAADINGREJO 8581543172 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
12 Q-000UI48W 3575016203080001 ADINDA PUTRI MAULIDIYA 13 REMAJA RT 04 RW 01 KECAMATAN GADINGREJO 8133860484 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
13 Q-000UUMFV 3575012212070001 ADITYA WARDHANI 14 REMAJA RT 03 RW 01 RANDUSARI 8222361378 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
14 Q-000UUL79 3575016211070001 AFIFATUN ZUHRIAH 14 REMAJA RT 04 RW 02 GADINGREJO 8585093755 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
15 Q-000UNTGA 3575010707080002 AHMAD FARDAN MAHFIYAN 13 REMAJA RT 03 RW 02 PETAHUNAN 8952349088 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
16 Q-000ULQNN 3575011707080004 AHMAD FATIR 13 REMAJA JL IRIAN JAYA RT 02 RW 02 8950809290 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
17 Q-000UUEXR 3575012611070001 AHMAD MUKHIBBIN ARDIYANSYAH 14 REMAJA JL GATOT SUBROTO GADINGREJO 8124907161 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
18 Q-000UWAHJ 3575012006070001 AHMAD ZAINUR RAFI'I 14 REMAJA PETAHUNAN RT 3 RW 4 8785694808 BIOFARMA 08/09/2021 202108118H 21/10/2021 C202106115
19 Q-000UQTNV 3575015004080002 AINUN NISA ASILMIYAH 13 REMAJA JL SALMET RIYADI RT 1 RW 2 8578401283 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
20 Q-000UETSV 3575024307080001 AISYAH PUTRI CAHYANI 13 REMAJA RT 7 RW01, POHJENTEREK, PURWOREJO, KO 8132717187 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
21 Q-000UU7BX 3575012302070001 AKHMAD AFIT SAIFULLAH 14 REMAJA RT 04 RW 04 PETAHUNAN 8953221979 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
22 Q-000UG8MA 3514162807080001 AKHMAD ALWI ZEN 13 REMAJA RT 001 RW 001 8224403835 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
23 Q-000UQO9R 3575013008070001 AKHMAD ARIFIN 14 REMAJA JL GATOT SUBROTO KEL. PETAHUNAN 8951926623 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
24 Q-000URZCQ 3575011606070004 AKHMAD ARSYAD YUDI ANSYAH 14 REMAJA RT 05 RW 07 BUKIR 8885131416 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
25 Q-000UGAIE 3575012506080005 AKHMAD MIKAL NASIM 13 REMAJA JL SLAMET RIYADI RT 03 RW 01, SEBANI, GAD 8225736246 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
26 Q-000UGV2P 3575010205080002 AKHMAD RAFI NURDIANSYAH 13 REMAJA RT 02 RW 02 RANDUSARI 8123448106 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
27 Q-000UU61W 3575012704080001 AKHMAD WILDAN 13 REMAJA JL GATOT SUBROTO GG 3 GADINGREJO 8838484610 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
28 Q-000UU7Y6 3575013103080002 ALDO ROMI SUJANA 13 REMAJA JL SLAMET RIADI GG 11 GADINGREJO 8573370231 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
29 Q-000URII4 3575015705080001 ALIFIA SALSABILATUL JANNAH 13 REMAJA RT 02 RW 06 SEBANI 8135735015 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
30 Q-000UI33E 3575016307080001 AMANDA NUR RISALATUL ILMIYAH 13 REMAJA JL GATOT SUBROTO RT 04 RW 01, KRAPYAKR 8560658574 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
31 Q-000UG7FU 3575016511080001 AMELIA INDAH SAPUTRI 13 REMAJA RT 01 RW 01 KECAMATAN GADINGREJO 8573263678 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
32 Q-000URCT6 3575011306080002 ANGGA DAVIAN PUTRAKHU 13 REMAJA RT 02 RW 01 GENTONG 8222896009 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
33 Q-000UHH59 3575014903090003 ANGGI MAULIDIYAH 12 REMAJA JL SMAET RIYADI RT 01 RW 02, SEBANI 8133413664 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
34 Q-000UU8CW 3575015706080001 ANGGITA MAYANG SARI 13 REMAJA RT 004 RW 006 8383210099 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
35 Q-000UN5RS 3573046308080003 ANNISA ERYANA ZAHRATUL NADINE 13 REMAJA PERUM SINARI B 338, POHJENTREK 8212200184 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
36 Q-000UV0YZ 3575014201080002 ANUGRAH CINTA ERIKA 13 REMAJA JL. GATOT SUBROTO KEL. PETAHUNAN 8570616399 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
37 Q-000UFQCK 3575014804080003 APRILIA WULAN SARI 13 REMAJA RT 004 RW 006 8953383940 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
38 Q-000UF4EH 3575017112070002 AQILA RATIH RINAJWA 14 REMAJA RT 01 RW 07 RANDUSARI,GADINGREJO 8199782571 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
39 Q-000UEN1M 3575012405080001 ARIL PRATAMA FIRMANSYAH 13 REMAJA RT 002 RW 005 8810268132 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
40 Q-000UR78N 3575014209070003 AURELLIA WINDYTASARI 14 REMAJA RT 006 RW OO1 8952349114 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
41 Q-000UGPEL 3575014705080002 AURILLIAH GITA TRI MARDIAN 13 REMAJA JL SLAMET RIYADI RT 02 RW 02 SEBANI 8953258608 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
42 Q-000UI2QM 3575015908080001 AYU SUSILOWATI 13 REMAJA RT 002 RW 003 8785265392 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
43 Q-000UJ0DE 3575010709070001 BRAMMONO SUPRIADI 14 REMAJA JL IRIAN JAYA GG ANGGREK 8950810126 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
44 Q-000UQAGG 3575010506070006 BRIAN RESTU RIZKY 14 REMAJA RT 01 RW 03 SEBANI 8223222943 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
45 Q-000UFQNR 3575016706080001 CAHAYA SAYYIDATUN NASIROH 13 REMAJA RT 04 RW 01 KECAMATAN GADINGREJO 8222935397 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
46 Q-000UF10W 3575011911080002 CHANDRA ANUWAS 13 REMAJA Rt 01 Rw 06 Kecamatan gadingrejo 8121511840 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
47 Q-000URGEM 3575014912070001 CHELSEA TASYA AULIA 14 REMAJA PERUM GRAHA INDAH BLOK J-23 KEL. KRAPY 8125919363 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
48 Q-000UU4Y8 3575015905070002 CHELYTA MEYVA PUTRI 14 REMAJA JL SLAMET RIYADI RT 3 RW 01 8121687630 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
49 Q-000UUM6O 3575014205070001 CHEYSHA MELANY PUTRI 14 REMAJA JL SLAMET RIYADI RT 3 RW 2 8573191268 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
50 Q-000UK37P 3575016703090001 CINTA DINDA CALISTA 12 REMAJA RT 001 RW 002 8570645859 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
51 Q-000UL09B 3575014210080002 CLARISTA DWI SAFITRI 13 REMAJA RT 04 RW 08 RANDUSARI 8574904923 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
52 Q-000UHCTL 3575010505080001 DANY FIRMANSYA 13 REMAJA JL HANGTUAH KEL. GADINGREJO 8214257124 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
53 Q-000URFRM 3575012604080002 DENDY WAHYU SAPUTRA 13 REMAJA RT 4 RW 1 , KARANGASEM, KARANGKETUG 8311198692 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
54 Q-000UQUZX 3575015508070001 DEWI ELSA NUR JANNAH 14 REMAJA JL SLAMET RIYADI KEL. SEBANI 8312027189 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
55 Q-000UEK0Y 3575015611070001 DEWI SOFIANA 14 REMAJA 8311953611 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
56 Q-000UFN46 3575014103080004 DEWI WAHYUNI LESTARI 13 REMAJA RT 001 RW 005 8138904963 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
57 Q-000UO38Q 3575012804080001 DIDIK IMAN WICAKSONO 13 REMAJA JL GATOT SUBROTO RT 01 RW 06 8581541632 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
58 Q-000UKNSK 3575015406080002 DIFA PUTRI FIRDAUS 13 REMAJA JL GATOT SUBROTO RT 04 RW 01 KRAPYAKRE8383429435 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
59 Q-000UOL4X 3575010203080005 DIMAS TRI ATMAJA 13 REMAJA RT 02 RW 08 PETAHUNAN 8384988207 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
60 Q-000UNGN9 3575017004080003 DINA HILDA HANDINI 13 REMAJA JL KYAI SEPUH RT 02 RW 05 GADINGREJO 8580553237 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
61 Q-000UQFX9 3575014912090001 DIVA LARASATI 13 REMAJA JL GATOT SUBROTO KARANGKETUG 8383425749 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
62 Q-000UUU82 3575015903070001 ELOK FARIDA 14 REMAJA RUJAK GADUNG KEL. KARANGKETUG 8822624647 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
63 Q-000UQ6XX 3575014503070001 FAIRUS NUR MAULIDIAH 14 REMAJA JL JEND A YANI RT 4 RW 1 8523560520 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
64 Q-000UF8N4 3575011209080002 FATAN RAMDHAN 13 REMAJA RT 003 RW 001 8589521096 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
65 Q-000UQQ57 3575015402060003 FATIMATUS ZAHRO 15 REMAJA KARANGASEM RT 2 RW 1, KARANG KETUG 8573191084 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
66 K-0000VVI2 3575010812080001 FAWWAS ZACKI NAUFAL FAVIAN 13 REMAJA Jl. Sriwijaya No.23, Gadingrejo, KOTA PASURUAN8239960122 BIOFARMA 30/08/2021 24004721 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
67 Q-000UUSRG 3575014106070002 FEBRI TRI JUNITA 14 REMAJA SEBANI KEL. SEBANI 8585026027 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
68 Q-000UFNCK 3575015802090001 FEBRITA CAHYANI 12 REMAJA RT 02 RW 01 KECAMATAN GADINGREJO 8385199209 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
69 Q-000UR5ZR 3575015302080001 FELITA FEBI IMANIAR 13 REMAJA RT 02 RW 04 PETAHUNAN 8199474750 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
70 Q-000ULOHF 3575016905080001 FIKA ANJANI 13 REMAJA RT 03 RW 02 PETAHUNAN 8967699586 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
71 Q-000ULP7Q 3575016909080002 FIRA DWI RAMADHANI 13 REMAJA JL GATOT SUBROTO RT 01 RW 02 8580610021 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
72 Q-000UFLYB 3575011205080001 FIRMAN ARDIANSYAH PRATAMA 13 REMAJA RT 02 RW 05 KECAMATAN GADINGREJO 8895192662 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
73 Q-000UH0HL 3510167105070001 GALUH PUJAYANTI 14 REMAJA JL GATOT SUBOTO RT 2 RW 5, KARANGKETUG8578524773 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
74 Q-000UHN2H 3575016707080001 GIANINA PUTRI IRAWANI 13 REMAJA RT 008 RW 007 8533830246 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
75 Q-000UFQU3 3575010505080002 GIOVANNI LUCAS PERMANA 13 REMAJA JL SLAMET RIYADI GADINGREJO 8574531729 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
76 Q-000UT55O 3575016001080002 HARNUM FIRA CAHYATI 13 REMAJA RT 03 RW 06 SEBANI 8384813293 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
77 Q-000UGLF0 3575025812080003 HASNA KHAIRUNISA 13 REMAJA JL ERLANGGA GG 16 PURWOREJO 8384863473 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
78 Q-000UFXQS 3575012006080002 HERU ADIT KURNIAWAN 13 REMAJA PETAHUNAN KEL. PETAHUNAN 8224469535 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
79 Q-000UVJVK 3575015806060002 INDAH DWI CAHYANI 15 REMAJA JL SLAMET RIYADI RT 1 RW 4 8384813323 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
80 Q-000UL6PF 3575014706080001 INDARI PRATAMA PUTRI 13 REMAJA JL GATOT SUBROTO NO 26 RT 03 RW 07 RAND8585640494 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
81 Q-000UO3CP 3575015407090004 IRMA BIMATIARA PUTRI 12 REMAJA PETAHUNAN GADINGREJO 8571031485 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
82 Q-000UQQYY 3575020307080001 IRVAN ALI NABIL 13 REMAJA JL MARGO TARUNO KEL. KEBONAGUNG 8960300333 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
83 Q-000UN952 3575014308080003 ISNI AMALIA 13 REMAJA JL IRIAN JAYA GG ANGGREK RT 02 RW 02 8573348374 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
84 Q-000UU6VU 3575012408070004 IVAN AGUSTIAN 14 REMAJA RT 002 RW 002 8384846100 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
85 Q-000UNWR6 3575012712080003 JUNDAN ARYA PRATAMA 13 REMAJA JL SLAMET RIYADI GG 16 GENTONG 8314611665 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
86 Q-000UETQU 3575014308080001 KARINA AL MAGHFIRAH 13 REMAJA Rt. 01 Rw 05 Kecamatan Gadingrejo 8125991937 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
87 Q-000UV00G 3575024301080001 KARINA DWI CAHYANI 13 REMAJA JL MARGOTARUNO NO 33 RT 1 RW 1 8123099710 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
88 Q-000UGI5R 3527030304080002 KENAR FAIRUZ HABIBI 13 REMAJA RT 005 RW 004 PETAHUNAN 8214338939 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
89 Q-000UH0L1 3575014212080001 KEYSHA SAUZANNE ASSHIFANNY 13 REMAJA SEBANI KEL. SEBANI 8214349737 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
90 Q-000UQPXJ 3575011301080001 KHAFIDZ ABDILLAH 13 REMAJA RT 03 RW 01 RANDUMANGU 8585278126 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
91 Q-000UUZTP 3575012211070001 KHAIYUN MAULANA 14 REMAJA JL GATOT SUBOTO RT 3 RW 3 8969947058 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
92 Q-000UNY20 3514190409080004 KHAMDAN MUBAROK 13 REMAJA RT 001 RW 006 8385199395 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
93 Q-000UJIQK 3575015606080002 LAILATUL MASRIFAH 13 REMAJA JL KYAI SEPUH GG 20 8384513114 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
94 Q-000URAMD 3575016708070003 LAILATUS SALAMAH 14 REMAJA JL GATOT SUBROTO RT 1 RW 3 8951926393 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
95 Q-000UFXGM 3575015304080001 LISTIANA SAHIRA 13 REMAJA JL IRIAN JAYA GG ANGGREK 164, RT 02 RW 02 8585812774 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
96 Q-000UK5X0 3320054502090002 LIVIA FEBRIANI 12 REMAJA RT 04 RW 02 SEBANI 8587586962 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
97 Q-000UMV49 3575012003080001 M. DANIL FIRDAUS 13 REMAJA JL SRIWIJAYA RT 06 RW 03 8573686015 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
98 Q-000UEN4M 3575010503080001 M. FABIO MARTHA ADINATA 13 REMAJA Rt..04 Rw 03 Kecamatan Gadingrejo 8132811393 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
99 Q-000UETRM 3575011103080001 M. ILYASUL MUSLIM 13 REMAJA JL SLAMET RIYADI GADINGREJO 8125293534 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
100 Q-000UGKF4 3575012107080004 M. RADJA ANDIKA 13 REMAJA JL GATOT SUBROTO KEL.PETAHUNAN 8574865876 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
101 Q-000UFM8V 3575013101080002 M. RAFI MAULANA YUSUF 13 REMAJA RT 001 RW 007 8123428969 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
102 Q-000UQPGX 3575013012060001 MADINATUL MUNAWAROH 15 REMAJA RT 02 RW 02 KARANGKETUG 8560778070 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
103 Q-000UMLHG 3514161601080004 MARVEL FABIANSYAH 13 REMAJA RT 0 RW 03 TAMBAKREJO 8573081674 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
104 Q-000UR9K8 3575016903070001 MAULID DITA NIRWANA PUTRI 14 REMAJA MULYOREJO RT 1 RW 6 SEBANI 8582198718 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
105 Q-000UG7G4 3575014208080001 MAYRA EVELYN NAHWA FIRDAUSI 13 REMAJA RT 003 RW 001 8123311852 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
106 Q-000UT7TK 3575016403080004 MEGA ANGGUN KARTIKA MAULIDYA 13 REMAJA JL. GATOT SUBROTO KARANGKETUG 8579176452 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
107 Q-000UUK5Y 3575016401070001 MIFTAHUL JANNAH 14 REMAJA JL SLAMET RIYADI GG 14 8566871145 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
108 Q-000UREAE 3575016609060001 MIFTAKHUL SOFIANA 15 REMAJA JL SRIWIJAYA KARANGKETUG RT 5 RW 3 8578408515 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
109 Q-000UIRHB 3575016308080004 MILA UL AGHISNIA 13 REMAJA JL JOLONRIO RT 03 RW 03 KRAPYAKREJO 8311203532 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
110 Q-000UOBAM 3505041405080002 MIRZA MUKHTAR BIAUL ALAM 13 REMAJA PERUM CITRA CANDI BLOK F-21 KARANGKETU8129050289 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
111 Q-000UOS3N 3572031004080002 MOCH. ILHAM RIZAL AL'ADIN 13 REMAJA RT 01 RW 02 BUKIR 8384872444 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
112 Q-000UQSIQ 3575011408070001 MOCH. ZAINAL ABIDIN 14 REMAJA RT 002 RW 001 8823075693 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
113 Q-000UENKD 3575010911080002 MOCHAMAD AFFAN 13 REMAJA RT 004 RW 001 8383429423 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
114 Q-000UN91O 3514161701090005 MOCHAMAD ANDRE SETIAWAN 12 REMAJA RT 02 RW 02 KALIREJO 8319504427 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
115 Q-000UF5FD 3575021305080002 MOCHAMAT DAFFA ALHAMDZA 13 REMAJA Rt 02 Rw 01 kecamatan Gadingrejo 8968095944 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
116 Q-000UFZ5V 3575010406080005 MOCHAMMAD GHOZALI 13 REMAJA RT 001 RW 001 8950832862 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
117 Q-000UUV7Z 3575010311070001 MOCHAMMAD RIFQIUL WAFA 14 REMAJA KLANGRINGAN RT 2 RW 2 8570727120 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
118 Q-000UHDDT 3575011507080001 MOHAMAD ILHAM YULIANTO 13 REMAJA RT 004 RW 002 8775737445 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
119 Q-000URDQ2 3521160303070001 MOHAMAD ZAINAL ARIFIN 14 REMAJA RT 04 RW 01 PETAHUNAN 8578435301 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
120 Q-000UKAN9 3514160607080003 MOHAMMAD ARIFY BUSTOMI 13 REMAJA KRAJAN KEL. TAMBAK REJO 8213577327 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
121 Q-000URBFH 3575011507070001 MOHAMMAD DIMAS BAGAS PRATAM 14 REMAJA RT 003 RW 001 8951652093 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
122 Q-000UUZLQ 3575011005070001 MOKHAMAD FIKHRI ZAKARIA 14 REMAJA RT 003 RW 004 8213187853 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
123 Q-000UIWFM 3575010607080001 MOKHAMMAD ARIS SETIAWAN 13 REMAJA RT 04 RW 03 PETAHUNAN 8383270160 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
124 Q-000UPEVG 3575012203080001 MOKHAMMAD FAKHRI BAKHTIAR 13 REMAJA JL GATOT SUBROTO 8578454361 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
125 Q-000UUS6F 3575012505070007 MUCHAMAD FARDHAN 14 REMAJA JL SLAMET RIYADI RT 3 RW 4 8885730814 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
126 Q-000UTH0X 3575022503080001 MUCHAMAD SHOFIYAN MAULANA 12 REMAJA JL GATOT SUBROTO RT 01 RW 05 8950805931 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
127 Q-000URZZO 3575010608070003 MUCHAMMAD BYANTARA ARYA PU 14 REMAJA RT 03 RW 04 PETAHUNAN 8958005005 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
128 Q-000UTVFY 3575012403080001 MUH. ARFIL ANNAS MAULIDIN 13 REMAJA JL GATOT SUBROTO RT 04 RW 01 8589521149 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
129 Q-000UNDKC 3575011803080001 MUHAMAD BURHANUDIN BAYU HID 13 REMAJA RT 02 RW 04 GENTONG 8133843150 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
130 Q-000UETPS 3575010202080003 MUHAMAD RASYID ABDILLAH 13 REMAJA JL KYAI SEPUH GG LIKU LIKU RT 2 RW 5, GE 8389838915 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
131 Q-000UUMKU 3575030809070002 MUHAMAD RIZKY SEPDIAN 14 REMAJA RT 004 RW 004 8125993147 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
132 Q-000UG3K7 3575011203080001 MUHAMMAD ANGGA SATRIA 13 REMAJA RT 03 RW 08 KECAMATAN GADINGREJO 8899659551 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
133 Q-000UMV8W 3575012808080004 MUHAMMAD FADOL YAHDAN NASR 13 REMAJA JL GATOT SUBROTO 8951926142 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
134 Q-000UUROM 3575012706070002 MUHAMMAD FAHRI HERKAMTO 14 REMAJA RT 03 RW 04 SEBANI 8123492962 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
135 Q-000UFYKF 3578150804080001 MUHAMMAD FAKHRY 13 REMAJA RT 03 RW 07 KECAMATAN GADINGREJO 816646596 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
136 Q-000UKQLZ 3575011807070002 MUHAMMAD FAREL YULIANSYAH 13 REMAJA RT 04 RW 04, PETAHUNAN, GADINGREJO 8579138570 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
137 Q-000UL288 3575012012080001 MUHAMMAD FAUZI RIZAL ASYKARI 13 REMAJA RT 003 RW 002 8585035480 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
138 Q-000UNDXM 3575010803080004 MUHAMMAD FIRMANSYAH 13 REMAJA JL SLAMET RIYADI GG 5 RT 02 RW 01 8953247595 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
139 Q-000UR44I 3575012106070002 MUHAMMAD GIGIH IMAN DANI 14 REMAJA RT 003 RW 001 8573084286 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
140 Q-000ULQNC 3575010804080004 MUHAMMAD IDHAM KHOLID MUBAR 13 REMAJA RT 002 RW 004 8575520815 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
141 Q-000UUCMY 3575032303090002 MUHAMMAD RAFLY AKBAR 12 REMAJA PERUM GRAHA INDAH BLOK U- NO 18 KRAPYA8121737361 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
142 Q-000UF1HN 3575010209080001 MUHAMMAD SAHRUL RAMADHANI 13 REMAJA RT 001 RW 004 8233148521 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
143 Q-000UX9SG 3575012711070002 MUHAMMAD TAUFIQ FAIRUS 14 REMAJA JL IRIAN JAYA GG ANGGREK KEL. GADINGREJ 8529086967 BIOFARMA 08/09/2021 202108118H 21/10/2021 C202106115
144 Q-000UUW6A 3575012401080002 MUHAMMAD YUSUF MAULANA 13 REMAJA JL SLAMET RIADI KEL. GENTONG 8190401021 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
145 Q-000UMMXK 3575011303080004 MUKHAMAD AJI PAMUNGKAS 13 REMAJA JL GATOT SUBROTO RT 03 RW 08 8953950477 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
146 Q-000UNCZ5 3575010906080003 MUKHAMAD FAIEZ 13 REMAJA JL GATOT SUBROTO KEL. BUKIR 8125991918 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
147 Q-000UOCNY 3575011408080002 MUKHAMAD FATKHUR RIZKI 13 REMAJA RT 001 RW 005 8579119090 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
148 Q-000UNEY5 3575011102080003 MUKHAMAD FATUROKHMAN AZIZ 13 REMAJA JL SLAMET RIYADI GG 9 RT 2 RW 2 GENTONG 8384919710 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
149 Q-000UTH7G 3575013107070004 MUKHAMAD IDRIS 14 REMAJA RT 01 RW 02 GENTONG 8564563836 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
150 Q-000UOR4K 3575012802080002 MUKHAMAD IKSAN FEBRIANSYAH 13 REMAJA JL SLAMET RIYADI RT 02 RW 02 8523036645 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
151 Q-000UWW56 3575011410060004 MUKHAMAD KHOIRUL ANAM 15 REMAJA JL SLAMET RIYADI GG 15 KEL. GENTONG 8573095242 BIOFARMA 08/09/2021 202108118H 21/10/2021 C202106115
152 Q-000UTLPJ 3575012505080003 MUKHAMAD NAFI' ZUHRI 12 REMAJA PETAHUNAN KEC. GADINGREJO 8823580556 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
153 Q-000UI96R 3575012405000007 MUKHAMAD ZAINUL ARIFIN 13 REMAJA KARANGASEM GADINGREJO 8581339547 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
154 Q-000UMQUW 3575011207080002 MUKHAMMAD GALANG AGUSTIAR 13 REMAJA JL SRIWIJAYA KEC. GADINGREJO 8385755596 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
155 Q-000UMMX0 3575011406080001 MUKHAMMAD HASIM AS'ARI 13 REMAJA RT 01 RW 01 KARANGKETUG 8214200688 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
156 Q-000UQ36U 3575012909070002 MUKHAMMAD ILHAM 14 REMAJA RT 02 RW 06 KARANGKETUG 8950809298 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
157 Q-000UGR7D 3575011608080002 MUKHAMMAD INDRA NASRULLOH 13 REMAJA RT 003 RW 004 8122508620 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
158 Q-000UKLK7 3575012803080002 MUKHAMMAD MAULANA AMIRUDIN 13 REMAJA JL GATOT SUBROTO PETAHUNAN 8956302567 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
159 Q-000K3WTN 3575011006080002 MUKHAMMAD RAFA RADITYA 13 REMAJA JL SLAMET RIYADI 8780677748 BIOFARMA 29/07/2021 24004321 G 21/10/2021 C202106115
160 Q-000UUQTQ 3575013107070002 MUKHAMMAD SULAIMAN 14 REMAJA RT 003 RW 001 8960300382 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
161 Q-000UUVAC 3575010110070001 MUKHAMMAD ZORDAN RAHMATULL 14 REMAJA RT 03 RW 01 KARANGKETUG 8564896624 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
162 Q-000UTUIS 3575016405080002 MUTIARAHMA RIZKYA PUTRI 13 REMAJA RT 03 RW 04, SEBANI 8573358483 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
163 Q-000UNB3F 3575015509080001 NABILA AZZAHRA RAMADHANI 13 REMAJA RT 003 RW 001 8233225548 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
164 Q-000UTVCD 3575016507080001 NADHIFAH ZALFA SOFIHAN 13 REMAJA RT 002 RW 001 8575531521 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
165 Q-000UL36D 3575014509080002 NAILA RAHMANIA 13 REMAJA JL GATOT SUBROTO KRAPYAKREJO 8124943188 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
166 Q-000UMV2O 3575015105080002 NAILA SARI 13 REMAJA RT 05 RW 02 PETAHUNAN 8952349177 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
167 Q-000UF0W1 3575025208080001 NANDA AMALYA AL-GANI 13 REMAJA PERUM NUANSA CANDI 2 8384610043 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
168 Q-000UQFD6 3575015208070001 NANDITA ZAZKY MAULEEAN 14 REMAJA RT 002 RW 001 8222909200 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
169 Q-000UOLFK 3575015405080001 NANIK KHUSNIAWATI 13 REMAJA RT 004 RW 002 8564896159 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
170 Q-000UMTJ6 3575015208080001 NASZWA CHOIRUNISA 13 REMAJA JL GATOT SUBROTO RT 02 RW 06 , KARANGK 8573191080 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
171 Q-000UTUAQ 3575014205080002 NAURA SAFITRI 13 REMAJA RT 03 RW 04 PETAHUNAN 8383071626 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
172 Q-000UT48Y 3575015812080002 NETA SUNGKONO 13 REMAJA JL GATOT SUBROTO KEL. PETAHUNAN 8133797135 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
173 Q-000UG230 3575015504080002 NISWATUL LAILI 13 REMAJA JL SLAMET RIYADI RT 01/RW 01, GENTONG 8953221983 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
174 Q-000UENKQ 3514164505080003 NUR AYU KHARISMA PUTRI 13 REMAJA DUSUN KEDONDONG SEMARE 8880371284 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
175 Q-0012FXXZ 3575015205080001 NURUL HIDAYAH 13 REMAJA JL SLAMET RIYADI 2/3 GENTONG 8554623253 BIOFARMA 23/09/2021 202108123H 21/10/2021 C202106115
176 Q-000UO0B1 3575010609080002 PUTRA RIZKY RAMADHAN 13 REMAJA RT 002 RW 005 8211978230 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
177 Q-000EDOCT 3575025410080005 QUEENSYLLA AJWA 13 REMAJA JL.MARGOTARUNO 8384165682 BIOFARMA 14/07/2021 24201421 21/10/2021 C202106115
178 Q-000UUD4U 3578142502080002 RAHADHIAN WAHYU MURTI PRATA 13 REMAJA RT 006 RW 07 8170370797 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
179 Q-000UGXPU 3575016803080002 RAISSA AINI SALSABILLA 13 REMAJA RT 01 RW 01 KRAPYAKREJO 8967876346 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
180 Q-000UT19D 9171024403090002 RENSA CENDIKIA 12 REMAJA RT 004 RW 006 8122490502 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
181 Q-000US04K 3575015009070002 RESYA DYAH PRAMESTI 14 REMAJA NUANSA CANDI PERMAI BLOK A NO 40 8899669921 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
182 Q-000UF1G7 3515084211080002 RHIORY AZARIA MAGALIH 13 REMAJA RT 1 RW 5, BANJARBENDO, SIDOARJO 8775603100 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
183 Q-000UOH1E 3575011007080002 RICKY ERLANGGA 13 REMAJA RT 05 RW 04 KARANGKETUG 8533467139 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
184 Q-000UFH4K 3575012605080002 RISCHO SETYAWAN 13 REMAJA JL GATOT SUBROTO RT 07 RW 01, KARANGKE 8133309256 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
185 Q-000UQTJ9 3575014905070002 RISKI AMELIA 14 REMAJA RT 001 RW 005 8596632633 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
186 Q-000URID4 3575012007070001 RIVALDY HELDAT ALFAHREZI 14 REMAJA JL GATOT SUBROTO KEL. PETAHUNAN 8233105045 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
187 Q-000UUPMO 3575031807070001 RIZKY ANDRIAN CAHYONO PUTRO 14 REMAJA RT 01 RW 06 SEBANI 8570728728 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
188 Q-000UENKW 3575011605080002 RIZKY REZA ARDIANSYAH 13 REMAJA JL ASTER 2 RT 01 RW 05 KEL PETAHUNAN KE 8233225966 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
189 Q-000UETTF 3575012706080005 RIZQI AGUNG TRI HARDIAN 13 REMAJA Rt 02 Rw 06 Kecamatan gadingrejo 8510262086 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
190 Q-000UPAX4 3575017004070001 SAIF ADITYA RAHMAN 14 REMAJA JL JOLONDRIYO RT 1 RW 5 8968099211 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
191 Q-000UGB44 3575012801090001 SATRIA KHALISH MULIANSYAH 12 REMAJA RT 04 RW 02 KECAMATAN GADINGREJO 8585287121 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
192 Q-000UJHNX 3575011705080001 SETYO PUJI PRATAMA 13 REMAJA RT 02 RW 06 KRAPYAKREJO 8575515080 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
193 Q-000UIZQM 3575010708080001 SHAFIRO SOBRI HARYANTO 13 REMAJA JL GATOT SUBROTO RT 04 RW 03 GADINGREJ 8883031910 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
194 Q-000ULWA3 3575014708080002 SHEINA KHARISA PUTRI 13 REMAJA JL SLAMET RIYADI GG 16, GENTONG 8315940261 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
195 Q-000URHE8 3575014408070001 SITI ILMIYATUL AGUSTINI 14 REMAJA RT 07 RW 05 PETAHUNAN 8135876605 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
196 Q-000UHAWI 3575014104080004 SITI MASHUDAH 13 REMAJA RT 02 RW 03 GENTONG 8389870885 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
197 Q-000UKN50 3575014605080001 SITI NUR AISA 13 REMAJA JL GATOT SUBROTO KRAPYAKREJO 8123421154 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
198 Q-000UQALJ 3575010308070001 SOBRI MUSAFIQ 14 REMAJA RT 03 RW 06 SEBANI 8571991212 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
199 Q-000UP17Z 3575015306070001 SRI WAHYUNI WULANDARI 14 REMAJA JL MULYOREJO RT 3 RW 6 8951472047 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
200 Q-000UQO7H 3575010304070004 SUGIARTO 14 REMAJA JL GATOT SUBROTO RT 3 RW 4 8575662435 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
201 Q-000UTG82 3575012706080006 SYARIFUDIN HIDAYATUWAN 13 REMAJA RT 02 RW 02 GADINGREJO 8586066048 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
202 Q-000UV15F 3575011101080001 TAUFIQUR ROKHMAN 13 REMAJA RT 03 RW 04 PETAHUNAN 8983392014 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
203 Q-000UUKQE 3575012605070003 TEGUH ANDRIANSAH 14 REMAJA RT 01 RW 05 GENTONG 8806426830 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
204 Q-000UT5JZ 3575015807080002 TRI EVAYULIANTI 13 REMAJA RT 01 RW 05 RANDUSARI 8950807858 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
205 Q-000UJUK7 3575014903080002 TRI MULAN SARI 13 REMAJA RT 05 RT 03 KARANGKETUG 8311940798 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
206 Q-000UJ85O 3575015705080002 TRI WULANDARI 13 REMAJA RT 003 RW 001 8581532420 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
207 Q-000UO0OS 3575016704080003 VINDI ATIKASARI 13 REMAJA JL GATOT SUBROTO RT 2 RW 1 8573204008 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
208 Q-000UUCXJ 3575016103070001 VIRNI MAULIDINIARTI 14 REMAJA RT 004 RW 001 8139021735 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
209 Q-000UQ6NV 3575014505070004 VIRNI NUR AULIA 14 REMAJA JL JENDERAL AHMAD YANI KEL. KARANGKETU8574833817 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
210 Q-000URCTB 3575016908070001 VIVI NUR FAIZAH 14 REMAJA RT 04 RW 03 KARANGKETUG 8857840709 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
211 Q-000UIYZP 3575010608080001 WAHYU AGUS SAPUTRA 13 REMAJA RT 04 RW 01, JL JEND A YANI, KARANGKETUG 8784451755 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
212 Q-000UU5KT 3575013105080001 WAHYU INDRA LESMANA 13 REMAJA RT 03 RW 03 8385630812 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
213 Q-000UUILE 3575013107070003 WAHYU JULIANTO 14 REMAJA RT 4 RW 4 PETAHUNAN 8574093458 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
214 Q-000ULQML 3575012805080003 WILDAN DWI SANTOSO 13 REMAJA RT 03 RW 05 SEBANI 8785516790 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
215 Q-000UFFKV 3575016006090001 YASMIN RIFANISA SALSABILA 12 REMAJA JL R MUNGINSIDI GG PANCAWARNA RT 01 RW 8213146650
0 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
216 Q-000UN8O1 3575012901080001 YOGA DIMAS SAPUTRA 13 REMAJA RT 001 RW 005 8578524782 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
217 Q-000UEJYX 3575015606080003 YUNIAR TRI AYU WULANDARI 13 REMAJA Rt.01/Rt 01 Kecamatan Gadingrejo 8311546488 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
218 Q-000UEHD7 3575015912070002 ZAHIRA SABIRA 14 REMAJA RT. 04 RW. 02 8953648606 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
219 Q-000UQEH3 3575010903070001 ZULKARNAEN TRI ADJI MAHAWIJAY 14 REMAJA RT 04 RW 05 PETAHUNAN 8214082606 BIOFARMA 07/09/2021 202108118H 21/10/2021 C202106115
220 P-5CTB2AAV 3603220710080001 DAVA ABDULLAH RASIM MAIN 13 REMAJA GENTONG-GADING REJO 8133459125 BIOFARMA 21/10/2021 C202106115
221 P-L37AMH7S 3575015305080001 DEWI AISYAH 13 REMAJA RT 01 RW 06 KRAPYAK REJO 8573138411 BIOFARMA 21/10/2021 C202106115
222 P-ZVLM36G1 3575014404080001 DEWI SILMIYYAH 13 REMAJA JL GATOT SUBROTO RT 03 RW 01 8191661115 BIOFARMA 21/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
223 P-694G1QHS 3514141012080005 DIMAS ALIF ARSYAD 13 REMAJA PERUM GRAHA INDAH JL VENUS IV BLOK N-22 8123421098 BIOFARMA 21/10/2021 C202106115
224 P-IAG858FG 3575010909070001 ERIK ANDREAWAN 14 REMAJA JL GATOT SUBROTO RT2 RW 2 PETAHUNAN 8956323406 BIOFARMA 21/10/2021 C202106115
225 S-751403AB 3523105309940001 FINISYA NUR SAPUTRI 13 REMAJA JL LAKS RE MARTADINATA RT 1 RW 1 MAYAN 8533002592 BIOFARMA 21/10/2021 C202106115
226 P-AWSWYMXJ 3574036809080001 JUWINTA RUSMADINAH 13 REMAJA RT 001 RW 002 8576455137 BIOFARMA 21/10/2021 C202106115
227 P-6PI4CL5A 3575012501080002 MOCH. WILDAN FIRDOUS 13 REMAJA JL JENDERAL AHMAD YANI RT 04 RW 01 KAR 8961419240 BIOFARMA 21/10/2021 C202106115
228 P-5BAQVKXS 3575011810080002 MUHAMMAD ALIF MUFLIKH 13 REMAJA JL GATOT SUBROTO BUKIR GADINGREJO 8822199197 BIOFARMA 21/10/2021 C202106115
229 P-JVPM2WW5 3575020801080001 MUHAMMAD ANDRA MAULANA 13 REMAJA PURWOREJO RT 09 RW 08 8574904886 BIOFARMA 21/10/2021 C202106115
230 P-LRI4WPKK 3575011108080003 MUKHAMAD RIFKY ROMADONI 13 REMAJA RT 06 RW 03 KARANGKETUG 8383135190 BIOFARMA 21/10/2021 C202106115
231 P-57AESP23 3575012301080001 MUKHAMAD RISWAN BAWAFI 13 REMAJA SEBANI - GADING REJO 8225728317 BIOFARMA 21/10/2021 C202106115
232 P-LT3RI8AD 3575011108080002 MUKHAMAD RIZKY RAMADANI 13 REMAJA KETUG MLAGI RT 6 RW 3, KARANGKETUG 8383071293 BIOFARMA 21/10/2021 C202106115
233 P-CKL8TIT6 3575026710080002 NADIA TUSSILFIA 13 REMAJA PURWOREJO RT 004 RW 008 8788148474 BIOFARMA 21/10/2021 C202106115
234 P-KUGKI7NL 3575014201080003 RANI MASFUFA 13 REMAJA JL GATOT SUBROTO PETAHUNAN 8573301469 BIOFARMA 21/10/2021 C202106115
235 P-GPJFHPZ3 3575014703080006 ZIAMATUL ALIYAH 13 REMAJA JL GATOT SUBROTO PETAHUNAN GADINGREJ 8953970768 BIOFARMA 21/10/2021 C202106115
Pasuruan,21-10-20212

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-19-2021 INDUK
1 P-74GVA3Y0 3514190108010001 M. RIZKI ABDUL MALIK 20 UMUM BENDO WINONGUN LOR 8232816946 ASTRAZENECA 19/10/2021 A1078
2 P-C5DL9NDK 3575010107010045 M. HASANUDIN 20 UMUM JL HALMAHERA GADINGREJO 8572783090 ASTRAZENECA 19/10/2021 A1078
3 P-5DOHJ2KV 3574036307000003 SHERLY NOVA INDAHSARI 21 UMUM JL SUNAN KALIJOGO 2/1 PROBOLINGGO 8573153431 ASTRAZENECA 19/10/2021 A1078
4 P-0GQJBDMN 3575010107990013 MUHAMMAD RIZAL 22 UMUM JL BANDA GADINGREJO 8382355325 ASTRAZENECA 19/10/2021 A1078
5 P-ZOGXXAVQ 3575030512950002 DIMAS MARDI SETIAWAN 26 UMUM JL KH HASYIM ASYARI, JAWA TIMUR, KOTA P 8225718597 ASTRAZENECA 19/10/2021 A1078
6 P-7R68ZLQR 3575020708940001 VENDHI DWI PUTRANTO 27 UMUM JL PANGLIMA SUDIRMAN 17 PURWOREJO 8229931117 ASTRAZENECA 19/10/2021 A1078
7 P-8FSK7ENO 3575011408940003 MOCH ROFIQ 27 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8564903488 ASTRAZENECA 19/10/2021 A1078
8 P-2FC3JE0O 3575015103860002 KHOIROTUN NISAK 35 UMUM JL HALMAHERA GADINGREJO 8952361113 ASTRAZENECA 19/10/2021 A1078
9 P-31VFNYN7 3575010804830002 M. CHOTIB 38 UMUM GADINGREJO 8212394423 ASTRAZENECA 19/10/2021 A1078
10 P-6PXYY6Q4 3575012006820005 TAUFIK HIDAYAT 39 UMUM JL IRIAN JAYA I/38 GADINGREJO 8560411031 ASTRAZENECA 19/10/2021 A1078
11 P-4T5NUHBN 3575016607770004 UMI KULSUM 44 UMUM jl kyai sepuh 32 GENTONG 8224731637 ASTRAZENECA 19/10/2021 A1078
12 P-5LP0K98H 3514220408730002 AGUS ISTIYANTO 48 UMUM PROKIMAL 29 LEKOK 8139450018 ASTRAZENECA 19/10/2021 A1078
13 P-ZED4VQEP 3575011008690005 AHMAD MAHFUDI 52 RENTAN JL IRIAN JAYA GADINGREJO 8123033385 ASTRAZENECA 19/10/2021 A1078
14 Q-0010RSGN 3575011403090002 MUHAMMAD REINO MAULUDDIN 12 REMAJA JL HALMAHERA GG 11 8135300174 BIOFARMA 21/09/2021 202108118H 19/10/2021 C202106115
15 Q-000I0AZ3 3575010103780004 WAHYU HIDAYAT 43 UMUM JL MULYOREJO , SEBANI 8233894733 BIOFARMA 17/07/2021 24200421 19/10/2021 C202106115
16 P-DMFULATB 3575011905080001 AKHMAD MAULANA 13 REMAJA JL HALMAHERA GADINGREJO 8560778047 BIOFARMA 19/10/2021 C202106115
17 P-B5J4TZAP 3575011901060003 FERDINAN NUR AULIA 15 REMAJA JL IRIAN JAYA GADINGREJO 8132639649 BIOFARMA 19/10/2021 C202106115
18 P-6B85BYOW 3575013003050005 MOCH MAKMUN YUSROH 16 REMAJA JL HANGTUAH 4/4 GADINGREJO 8113777705 BIOFARMA 19/10/2021 C202106115
19 P-53TBX2BI 3575015111040003 FITRIA AMALIA 17 UMUM JL HALMAHERA XI GADINGREJO 8579178913 BIOFARMA 19/10/2021 C202106115
20 P-2IU5KRCL 3575014609030001 SALWA AISYAH SILVARATIH 18 UMUM JL ALAMANDA GADINGREJO 8133118059 BIOFARMA 19/10/2021 C202106115
10-19-2021 TAMAN KOTA
1 P-TNAFXXIF 3575030810090001 HAIDAR ALI YUSUF 12 REMAJA JL ANJASMORO XII 8133492711 CoronaVac 19/10/2021 C202106115 19/10/2021 C202106115
2 Q-000Z8CBW 3575036303070001 MAULIDIA KHORIRIS 14 REMAJA SEKARGADUNG 8193504451 CoronaVac 17/09/2021 202108154G S 19/10/2021 C202106115
3 Q-000Z7D2B 3575034211060002 HIRSY ANDRIANI SAKUR 15 REMAJA JL CANDI JAWI 8575573609 CoronaVac 17/09/2021 202108154G S 19/10/2021 C202106115
4 Q-000PXX4Y 3514134103030001 HANA FIRYAL 18 UMUM JL KAKAP DANDANG,BEJI 8961274099 CoronaVac 26/08/2021 2021071321 19/10/2021 C202106115
5 Q-000U9ODD 3514145312030002 SITI NUR CHOTIMAH 18 UMUM SATAK 003/002 BANGIL 8570874971 CoronaVac 06/09/2021 24202321 19/10/2021 C202106115
6 Q-000PXMOW 3514165803020002 SITI AISA 19 UMUM PUKUL - KRATON 8570661069 CoronaVac 26/08/2021 2021071321 19/10/2021 C202106115
7 Q-000QJLPD 3514125706010005 ZAHROH INTAN PERMATASARI 20 UMUM DSN. KRIYAN DS. SUMBERSUKO 8770327820 CoronaVac 28/08/2021 24003521 19/10/2021 C202106115
8 Q-000XX9V3 3514166007000003 IFTITAH ARINAL HAQ 21 UMUM KRATON PASURUAN JAWA TIMUR 8564575369 CoronaVac 14/09/2021 2021071321 19/10/2021 C202106115
9 Q-000N82KW 3514225807990006 IMELDA YULIA IKA PUTRI 22 UMUM ROWOGEMPOL 8523250020 CoronaVac 15/08/2021 24201621 - 19/10/2021 C202106115
10 Q-000N847S 3514191209980002 SLAMET RIYADI 23 UMUM DESA MINGGIR 8575526436 CoronaVac 15/08/2021 24004621 - 19/10/2021 C202106115
11 A-00004U0I 3575016804960001 ULFA SRI WAHYUNI 25 UMUM JL BANDA 8968589623 CoronaVac 12/09/2021 2021081581 19/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
12 Q-000NJSR1 3514072204930001 SIROJUDIN 28 UMUM DUSUN ARENG-ARENG SELATAN 8122149319 CoronaVac 17/08/2021 24202221 - 19/10/2021 C202106115
13 K-00017MMC 3578202404900003 HARIANTO 31 UMUM RAYA MASTRIP NO. 180 8233446048 CoronaVac 10/09/2021 24202821 19/10/2021 C202106115
14 Q-00103KXC 3514231405880002 SOKHIBUL ANWAR 33 UMUM JODOKAN RT 1 RW 5 CANGKRING MALANG BEJ8132242028 CoronaVac 18/09/2021 202108144G 19/10/2021 C202106115
15 Q-000TCYZ0 3514071304880005 HUSEN 33 UMUM JATI GUNTING WONOREJO 8573061863 CoronaVac 04/09/2021 2021071371 19/10/2021 C202106115
16 Q-000HFB2Q 3516092304870001 HARI RIA ANTONI 34 UMUM PERUM MARGO UTOMO NO.21 KOTA PASURUA8122244790 CoronaVac 16/07/2021 24003021 19/10/2021 C202106115
17 Q-000BJDUP 3504172703860001 Heru Retno Prawiro 35 UMUM Dsn Bantengan Rt/Rw 001/001 Desa Bantengan Ke8573069014 CoronaVac 05/07/2021 24200821 19/10/2021 C202106115
18 K-00011HRY 3514071906830001 HADI SUSENO 38 UMUM kidul dalem wonorjo 8133451480 CoronaVac 04/09/2021 2021071321 G 19/10/2021 C202106115
19 Q-001002YC 3301104103810003 RETNO SETYOWATI 40 UMUM LIRBOYO 005/002 LOR KEC KAB PASURUAN 8784603892 CoronaVac 18/09/2021 24202521 - 19/10/2021 C202106115
20 Q-000QJLVA 3514124304810001 SRI WAHYUNI 40 UMUM DSN. KLURAK, KELURAHAN SUMBER SUKO - 8573606377 CoronaVac 28/08/2021 24003521 19/10/2021 C202106115
21 Q-000Y3H75 3275084809800038 SRI LESTARI FATMAWATI, S. SOS 41 UMUM BENDUNGAN KEC. KRATON 8193782288 CoronaVac 15/09/2021 2021081051 19/10/2021 C202106115
22 Q-00118DB1 3514065010790002 RUPIATI DEWI 42 UMUM DUSUN KRAJAN RT. 003 RW.002 DESA SLADI 8135744793 CoronaVac 20/09/2021 202108155I 19/10/2021 C202106115
23 Q-000N7NZS 3514082109770001 SUDARSONO 44 UMUM PURWOSARI PASURUAN 8564650902 CoronaVac 15/08/2021 24202221 - 19/10/2021 C202106115
24 Q-000YY6SY 3514113010760002 SISWANTO 45 UMUM LINGK.JABON 3/7 JOGOSARI PANDAAN 8579116515 CoronaVac 16/09/2021 24006021 - 19/10/2021 C202106115
25 Q-0009IB14 3514140201720004 SLAMET RIYADI 49 UMUM KOLURSARI, 8135716089 CoronaVac 29/06/2021 24200821 19/10/2021 C202106115
26 Q-000QJF71 3514124210700004 ISTI'ADA IMAROH 51 RENTAN DSN. KRIYAN, KEL. SUMBERSUKO - PASURUAN8190671598 CoronaVac 28/08/2021 24003521 19/10/2021 C202106115
27 Q-0011FIUL 3514161808650057 KAMRUL 56 RENTAN PERUM KRATON HARMONI A6-7 001/011 BEND 8383341847 CoronaVac 21/09/2021 202108123H 19/10/2021 C202106115
28 Z-000AT4SW 3578072107600002 SRUWANDONO 61 LANSIA BENDUNGAN KRATON PASURUAN 8123535172 CoronaVac 14/09/2021 2021071321 19/10/2021 C202106115
29 P-TOIT21G4 3575022105090001 DAFFA JAVIER MIRZA 12 REMAJA JL SULTAN AGUNGII/06 8125907343 CoronaVac 19/10/2021 C202106115
30 P-TOQE7EHP 3575021407080002 GHALY LANANG YANOAR 13 REMAJA JL JAMBANGAN II/ 56 PURWOREJO 8585238775 CoronaVac 19/10/2021 c202106115
31 P-S6WSX6C8 3514087010060001 HUSNUL LAILATUL B 15 REMAJA PERUM GREEN LANDMARTOPURO 8121268905 CoronaVac 19/10/2021 C202106115
32 P-SA9HIOSM 3514074107050001 SISKA RAHMAWATI 16 REMAJA SAMBISIRAH TIMUR 8880599389 CoronaVac 19/10/2021 C202106115
33 P-S88FHCU7 3514154607010003 SITI ROMLAH 19 UMUM DUSUN ROKUNCI ORO-ORO OMBOWETAN 8586994787 CoronaVac 19/10/2021 C202106115
34 P-SYHBRPBB 3575021901020002 SOLIKHAN 19 UMUM JL SUKUN 3/2 8956302518 CoronaVac 19/10/2021 C202106115
35 P-SYOCSYQ4 3575021901020001 SOLIKHIN 19 UMUM JL SUKUN PURUTREJO 8135935104 CoronaVac 19/10/2021 C202106115
36 P-THCU2B4B 3514181104020002 M. MASRUKHAN 19 UMUM DSN JAMBANGAN 8111096460 CoronaVac 19/10/2021 C202106115
37 P-TPQGK7XS 3514204908020001 SILVIA ALI MEGA 19 UMUM DSN TUGU 2/8 KEDAWUNG KULON 8580669268 CoronaVac 19/10/2021 C202106115
38 P-TJKWFR76 3514054502010002 ERNA WATI 20 UMUM SAPULANTE PASREPAN 8883007205 CoronaVac 19/10/2021 C202106115
39 P-SECL6JBW 3514180711020002 SOLIKHUL ULUM 20 UMUM DSN BRAMBANG GONDANG WETAN 8121620071 CoronaVac 19/10/2021 C202106115
40 P-S8HKFAAF 3514150309990002 HASYIM AS'ARY 22 UMUM DUSUN ROKUNCI 2/13 8533371075 CoronaVac 19/10/2021 C202106115
41 P-U2D10PPW 3575015206990006 SITI NUR AZIZAH 22 UMUM KRAPYAK 3/1 8953505580 CoronaVac 19/10/2021 C202106115
42 P-SKI8R2M0 3514221802970003 M. ALFINUR ROHMAN 24 UMUM BRANANG 8956275637 CoronaVac 19/10/2021 C202106115
43 P-TAKLFB3K 3514126111970001 SITI MUFIDAH 24 UMUM PUTAT 1/3 GEMPOL 8570771775 CoronaVac 19/10/2021 C202106115
44 P-U5XZFSQK 3506074112960001 IIS SETIYANI 25 UMUM Nguling Pasuruan 8574500151 CoronaVac 19/10/2021 C20216115 -
45 J-0006IPPJ 3514154512960001 WAHYU TRI CAHYANTI 25 UMUM PEKOREN REMBANG 1/5 8224473957 CoronaVac 19/10/2021 C202106115
46 P-T2LQYSFW 3514222204950001 HUSNULLAH 25 UMUM SANGGARAN TAMBAK 8124485348 CoronaVac 19/10/2021 c202106115
47 P-SE2JXWG4 3514235911960001 SITI MAGHFIRO 25 UMUM PERUM GRAHA INDAH BLOK U-20 8520343722 CoronaVac 19/10/2021 C202106115
48 P-TIOR23DS 3514166111990001 SITI ZAENAB 26 UMUM DSN SENTUL 2/3 8193504483 CoronaVac 19/10/2021 C202106115
49 P-SSAJHBM8 1256206005940001 IDA JAYANTI 27 UMUM JL PILANGSARI 1/1 PEKOREN 8573621555 CoronaVac 19/10/2021 C202106115
50 P-TWXJG9CU 3514235010940001 SITI CHOIRIYAH 27 UMUM DSN PANDANSARI 1/2 8967757074 CoronaVac 19/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
51 P-SLAP6CTN 3514214406920004 HOIRIYAH 29 UMUM DSN KLENGGOAN 8121684247 CoronaVac 19/10/2021 C202106115
52 P-TS1QTADH 3575024508920002 SITI MAISAROH 29 UMUM KARANGWINGKO 3/6 8575588488 CoronaVac 19/10/2021 C202106115
53 P-U3IE0RBX 3514077008900001 SITI AMINAH 31 UMUM KLUWUT KRAJAN 3/4 8585278546 CoronaVac 19/10/2021 C202106115
54 P-SR6DABH3 3211181009900003 HENDRIK PRASTIANA 31 UMUM PERUM JATIHURIP BLOK 8 8211960060 CoronaVac 19/10/2021 C202106115
55 P-TK05T1BQ 3514180706900004 MUHAMAD HAJIR 31 UMUM DSN SEKARAN WONOJATI 8563589311 CoronaVac 19/10/2021 C202106115
56 J-0006IPX2 3514150606890002 BUDI SANTOSO 32 UMUM Pekoren, Rembang, KAB. PASURUAN, Jawa Timu8575588957 CoronaVac 19/10/2021 C202106115
57 Q-000920D4 3575027110880001 SOFIA KURNIAWATI 33 UMUM PERUM PESONA CANDI PERMAI 2 BLOK H-31 8564667444 CoronaVac 28/06/2021 C202106115
58 P-SZCFC5OJ 3518101710870001 HARI SUBIANTORO 34 UMUM DSN GERONGAN 4/6 8533452058 CoronaVac 19/10/2021 C202106115
59 P-TQSRC5MB 3514070808870007 SAIFULLOH 34 UMUM DUSUN KARANGPOH KLUWUT 8593664361 CoronaVac 19/10/2021 C202106115
60 P-SFQQJW4E 3575015707860002 LUKMAWATI 35 UMUM JL GATOTSUBROTO 3/6 8224482623 CoronaVac 19/10/2021 C202106115
61 P-SHLLDPST 3575015208850003 FENI AGUSTIN 36 UMUM PERUM GRAHA INDAH 1 NO 28 8123007225 CoronaVac 19/10/2021 C202106115
62 P-SW039HD6 3575015806830003 SRI WAHYUNI 38 UMUM JL HALMAHERA GG 9 8523050113 CoronaVac 19/10/2021 C202106115
63 P-SV62CJW9 3514236512820006 SITI ELMIYAH 39 UMUM RAKET KAWIS REJO 3/3 8523264001 CoronaVac 19/10/2021 C202106115
64 P-TITQ5UIH 3575012007820003 NUR HOLIS 39 UMUM JL. SULTAN AGUNG NO.61 KRAMPYANGAN 8155699099 CoronaVac 19/10/2021 C202106115
65 S-AF8D6DAC 3514170101820009 SAIFUDIN ZUHRI 39 UMUM PILANG POHJENTREK 8233513044 CoronaVac 19/10/2021 C202106115
66 P-S77OW8H6 3514200708820006 SOGOL 39 UMUM CANGKRING MALANG BEJI 8223482804 CoronaVac 19/10/2021 C202106115
67 P-TSN4QO3Z 3514172505810002 WIDI PRAYETNO 40 UMUM WARUNGDOWO TIMUR 8123491975 CoronaVac 19/10/2021 C202106115
68 P-SHQH405E 3575010610800001 SLAMET RIYADI 41 UMUM PERUM GRAHA INDAH BLOK 1 NO 28 8123007225 CoronaVac 19/10/2021 C202106115
69 P-TJPZGWVB 3514014804800005 SRI UTAMI 41 UMUM JL A DAHLAN 8223478648 CoronaVac 19/10/2021 C202106115
70 P-SPCZYYYX 3514187006780010 HALIMATUS SA'DIYAH 43 UMUM SEKARPUTIH 1/1 8139526595 CoronaVac 19/10/2021 C202106115
71 P-T7M64S5L 3514234906770003 SITI ANISAH 44 UMUM BUDUG SAMBIREJO 8135794862 CoronaVac 19/10/2021 C202106115
72 P-SFOGC6M4 3575011407770006 SIVA BAYU ALAM 44 UMUM JL. GATOT SUBROTO BUKIR 8214281523 CoronaVac 19/10/2021 C202106115
73 P-TRIRSAK5 3575026810760001 HENI PURWANTI 45 UMUM DUSUN BLUSUK PARASREJO 8224592566 CoronaVac 19/10/2021 C202106115
74 P-SUIK57TV 3514145504750002 IDA MULYANTI 46 UMUM JL DUYUNG 35 BANGIL 8570417052 CoronaVac 19/10/2021 C202106115
75 P-S3S5H9AN 3514174708730001 HENI KUSWANTI 48 UMUM susukanrejo pohjentrek 8566802497 CoronaVac 19/10/2021 C202106115
76 P-TKGD8A3O 3514231906710001 SYAMSUL ARIF 50 RENTAN MANIKREJO 8510086051 CoronaVac 19/10/2021 C202106115
77 P-SMCZ3C4O 3514142703700002 GUNARNO 51 RENTAN JL MANGGA GG IKAN MAS RT 5 RW 2 8523038373 CoronaVac 19/10/2021 C202106115
78 P-T80WTH7L 3514231005690003 FAUJAN 52 RENTAN DSN BUDUG 1/7 SAMBIREJO 8135794862 CoronaVac 19/10/2021 C202106115
79 P-TQBSP5DC 3575032512670002 HERU SUKARIYADI 54 RENTAN JL.IMAM BONJOL BUGUL LOR 8233552764 CoronaVac 19/10/2021 C202106115
80 P-SNXVMLCD 1471092805610001 MOCH. IKROM 60 LANSIA PERUM KEBONCANDI PERMAI BC 41 8123108042 CoronaVac 19/10/2021 C202106115
81 S-882AF1A3 3507052407500001 HADI WASONO 71 LANSIA JL SEMERU SELATAN 2/1 8585069743 CoronaVac 19/10/2021 C202106115

Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003

Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-18-2021 INDUK
1 Q-0001D13H 3575012310900004 ACH ZAINUL 31 UMUM SEBANI GADINGREJO 8573852184 Astrazeneca 08/06/2021 ABV6522 18/10/2021 A1076
2 P-181SAF69 3575011505020005 MUHAMMAD HAMZAH ZAKARIA 19 UMUM JL SLAMET RIYADI 8953671674 Astrazeneca 18/10/2021 A1076
3 P-8FJBENZ0 3575012710020002 YULFIAN AKHMAD NANDA SETIA 19 UMUM JL GATOT SUBROTO 3/4 8561610683 Astrazeneca 18/10/2021 A1076
4 P-2D6QT2X3 3575014205980003 AINUL YAQIN 22 UMUM JL HANGTUAH 8384905443 Astrazeneca 18/10/2021 A1076
5 P-7LJNAMMO 3575011405990001 MISBAKHUL MUNIR 22 UMUM JL GATOT SUBROTO 3/1 8561610683 Astrazeneca 18/10/2021 A1076
6 P-2965CLJQ 3575010702950002 RAHMAD HIDAYAT 26 UMUM JL HANGTUAH IV 8113777705 Astrazeneca 18/10/2021 A1076
7 P-0ZLMCUTK 3514181708890006 ABDUL ROZIQ 32 UMUM KEBONCANDI 3/3 GONDANGWETAN 8113777705 Astrazeneca 18/10/2021 A1076
8 P-2701XQ24 3514070509880001 MUHAMMAD JUFRI 33 UMUM KENDANG UTARA WONOREJO 8121633887 Astrazeneca 18/10/2021 A1076
9 P-40L0WGPA 3575015608880001 FRISTA DWI AGUSTYAS 33 UMUM JL SLAMET RIYADI 3/4 8123259161 Astrazeneca 18/10/2021 A1076
10 S-DA221205 3575013004860001 M. FALIHIN 35 UMUM JL HANGTUAH 4/3 GADINGREJO 8125981120 Astrazeneca 18/10/2021 A1076
11 P-1WEGWV1B 3507092505850006 EKO APRI LESTARI 36 UMUM LEBAKSARI SELATAN 8121750960 Astrazeneca 18/10/2021 A1076
12 P-0OH85O6J 3575016102840002 SUCI AMALIA 37 UMUM KETUG MLAGI 5/3 KARANG KETUG 8113777705 Astrazeneca 18/10/2021 A1076
13 P-0GHZDZNZ 3575010107830041 MUNIR 38 UMUM TAMBAAN 5/3 PANGGUNGREJO 8121633046 Astrazeneca 18/10/2021 A1076
14 P-1IZ0ZDPB 3575015106830001 RENY ANGGRAINI 38 UMUM JL SLAMET RIYADI NO 35 8389215880 Astrazeneca 18/10/2021 A1076
15 P-1EWGH3XR 3575011405820001 M. HUSEN 40 UMUM JL HALMAHERA 8781903275 Astrazeneca 18/10/2021 A1076
16 P-17D1RKRP 3575015007790007 SULAMI 42 UMUM KETUG MLAGI 5/3 KARANG KETUG 8778041340 Astrazeneca 18/10/2021 A1076
17 P-5FONMGA1 3575016507790004 YULIATI 42 UMUM JL HANGTUAH 1/4 GADINGREJO 8581503006 Astrazeneca 18/10/2021 A1076
18 P-4FZME78F 3575012410000001 MUKHAMMAD IGO FAURIZI 42 UMUM JL GATOT SUBROTO 1/5 KARANG KETUG 8384872573 Astrazeneca 18/10/2021 A1076
19 P-5MLBPV8M 3575016101760001 CICIK MIRAWATI 44 UMUM JL SEBANI 1/6 8113777705 Astrazeneca 18/10/2021 A1076
20 P-2P84JJSE 3575015304750003 ASMAUL KHUSNA 46 UMUM JL SLAMET RIYADI 3/3 GENTONG 8580695540 Astrazeneca 18/10/2021 A1076
21 P-2G9PLB35 3514161002740001 KHOLILI 47 UMUM JL SLAMET RIYADI 2/4 GENTONG 8531473978 Astrazeneca 18/10/2021 A1076
22 P-1UIY4OQN 3575014609720004 MAIMUNAH 49 UMUM JL HANGTUAH GADINGREJO 8384975411 Astrazeneca 18/10/2021 A1076
23 P-2VSDCNBS 3575010101730006 MOCHAMAD SAID 50 RENTAN JL SLAMET RIYADI 3/3 GENTONG 8580695540 Astrazeneca 18/10/2021 A1076
24 P-ACZBH4QM 3575014107630124 IKYANAH 58 RENTAN JL BANDA GADINGREJO 8222897333 Astrazeneca 18/10/2021 A1076
25 Q-000X20NH : 3575010101090001 MUHAMMAD ARDAN ARDIANSYA 12 REMAJA JL SLAMET RIYADI 3/1 SEBANI 8314289066 BIOFARMA 13/09/2021 202108118H 18/10/2021 C202106115
26 Q-0010GZMW : 3575010807090001 NAUFAL MIRZA MUHAMMAD 12 REMAJA JL SLAMET RIYAID 2/1 SEBANI 8585964960 BIOFARMA 20/09/2021 202108118H 18/10/2021 C202106115
27 Q-000VS4UI : 3517155910080001 EVELYNE GUSTIAN WIJAYA 13 REMAJA DESA DARUREJO 8810263822 BIOFARMA 09/09/2021 2021071371 18/10/2021 C202106115
28 Q-000YFC8Q : 3575012503070003 AYU RISKI MAULIDIAH 14 REMAJA JL. HANGTUAH GG IV KELURAHAN GADINGREJ8581503006 BIOFARMA 15/09/2021 20210811H 18/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
29 Q-000X12VK : 3575011801060001 SHAHRUL HAJ 15 REMAJA JL. KYAI SEPUH GG. 21 8883085403 BIOFARMA 13/09/2021 202108118H 18/10/2021 C202106115
30 Q-000RMPIW : 3575026402040001 LAILATUL MAGHFIROH 17 UMUM JL DR WAHIDIN SH 5/2 PURWOREJO 8823173782 BIOFARMA 31/08/2021 24202221 18/10/2021 C202106115
31 Q-000VX3M0 : 3514145110990001 PUTRI SUKMA HIDAYAH 22 UMUM MENDALAN 133 BANGIL 8958042652 BIOFARMA 10/09/2021 202108118H 18/10/2021 C202106115
32 Q-000XGL76 : 3575014712980001 NUR HAMIDA 23 UMUM JL HANGTUAH 1/4 GADINGREJO 8384975411 BIOFARMA 14/09/2021 202108118H 18/10/2021 C202106115
33 Q-000E9WGD : 3514152712970001 SUGENG IRAWAN 24 UMUM MENDALAN 133 RT 2 RW 1 BANGIL 8585022405 BIOFARMA 12/07/2021 24200421 18/10/2021 C202106115
34 Q-00034J8X : 3575011504830005 JUMA'ALI 38 UMUM JL IRIAN JAYA NO 07 8575583351 BIOFARMA 17/06/2021 24001821 18/10/2021 C202106115
35 Q-000RATW1 : 3575014401770002 RINI HANDAYANI 44 UMUM JL IRIAN JAYA 1/2 GADINGRJEO 8565538177 BIOFARMA 30/08/2021 24202221 18/10/2021 C202106115
36 Q-000S7XHQ : 3575010608770002 ABD. AZIS 44 UMUM JL BANDA 3/3 GADINGREJO 8821790233 BIOFARMA 01/09/2021 2021071371 18/10/2021 C202106115
37 Z-000B1DQB : 3575015010590001 ENOK WINATINI 61 LANSIA JL GATOT SUBROTO 8573645175 BIOFARMA 18/09/2021 202108118H 18/10/2021 C202106115
38 Z-000AXBCY : 3575010606510003 RB. ABD KADIR 70 LANSIA JL URIP SUMOHARJO 2/2 BUKIR 8123421238 BIOFARMA 16/09/2021 202108118H 18/10/2021 C202106115
39 P-1IF6WO60 : 3575014205050003 KUSNUL KHOTIMAH 16 REMAJA JL HANGTUAH IV 8528085541 BIOFARMA 18/10/2021 C202106115
40 P-8PSBIYUT : 3575012206050001 MUKHAMMAD ZAKY 16 REMAJA JL KARYA BAKTI GENTONG 8785591405 BIOFARMA 18/10/2021 C202106115
41 P-A57KCQS9 : 3575012402040004 MUHAMMAD ROYS ARIF ZAWAID 17 UMUM JL KYAI SEPUH 1/6 8383340200 BIOFARMA 18/10/2021 C202106115
42 S-D28196DC : 3575014107590112 SARANI 62 LANSIA JL HALMAHERA GADINGREJO 8125946847 BIOFARMA 18/10/2021 C202106115
43 S-04D4B02A : 3575011202480001 FATAH 73 LANSIA JL HANGTUAH 1/4 GADINGREJO 8113777705 BIOFARMA 18/10/2021 C202106115
1 Q-000R9DQK 3575024805080001 FETTY LUFIYANING TYAS 13 REMAJA JL HANG TUA 5/5 NGEMPLAKREJO 8384604428 CoronaVac 30/08/2021 24202221 G 18/10/2021 C202106115
2 Q-000UTTWT 3575014107080005 NAURA NAZWA ALIFIAH 13 REMAJA RT 002 RW 002 8573119633 CoronaVac 07/09/2021 202108118H 18/10/2021 C202106115
3 Z-000AX9PK 3575010710500001 M. SAKIR 74 LANSIA JL SLAMET RIYADI 2/1 SEBANI 8389870033 CoronaVac 16/09/2021 202108118H 18/10/2021 C202106115
4 P-BHK7PDFM 3514172603860001 AGUS SISWANTO 35 UMUM WARUNG DOWO SELATAN 8225721823 CoronaVac 18/10/2021 C202106115
5 P-0AH2OWTV 3575014101750006 SUGIATI 46 UMUM SEBANI 3/5 8585932297 CoronaVac 18/10/2021 C202106115
6 P-6U4KNDX4 3575017005970001 MIA AMBARWATI 24 UMUM SEBANI 3/5 8570713410 CoronaVac 18/10/2021 C202106115
1 Q-000WYTLM 3575014205090004 YELENA MARYAMAH 12 REMAJA JL GATOT SUBROTO 8967690503 CoronaVac 13/09/2021 202108123H 18/10/2021 C202106115
2 Q-0000SJZF 3575012310000002 MOHAMMAD RIZAL ROIKHAN 21 UMUM JL URIP SUMOHARJO 8961676773 CoronaVac 02/06/2021 24002621 18/10/2021 C202106115
3 Q-000VJE2B 3575015201800006 USWATUN CHASANAH 41 UMUM JL URIP SUMOHARJO 1/3 BUKIR 8533586122 CoronaVac 09/09/2021 202108118H 18/10/2021 C202106115
4 Q-000VINIQ 3575012202030001 AKHMAD THORIQIL HIDAYAH 18 UMUM JL URIP SUMOHARJO 1/3 BUKIR 8953384303 CoronaVac 09/09/2021 2021207137 18/10/2021 C202106115
5 Q-000RGZV5 3575010712020003 YUDHA DWI SAPUTRA 19 UMUM JL URIP SUMOHARJO 8961811381 CoronaVac 30/08/2021 24202221 G 18/10/2021 C202106115
6 P-5GRUGHU9 3575014205090003 MELISA SOFIA WARDANI 12 REMAJA JL. URIP SUMOHARJO 2/3 - BUKIR 8575536935 CoronaVac 18/10/2021 C202106115
7 P-5R80DH0U 3575010806770001 SUPRIYONO 44 UMUM JL. URIP SUMOHARJO 1/2 - BUKIR 8967991050 CoronaVac 18/10/2021 C202106115
8 P-92V5IET7 3575014909830001 EVI KRISTANTI 38 UMUM JL. URIP SUMOHARJO 1/3 - BUKIR 8214268077 CoronaVac 18/10/2021 C202106115
9 P-AEJU6BQZ 3575011003960002 MOCHAMMAD DANI ISMAIL 25 UMUM JL. GATOT SUBROTO 5/7 - BUKIR 8213108965 CoronaVac 18/10/2021 C202106115
10 P-9WLJEMZB 3575011710760002 SLAMET HARYADI 45 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 8233024714 CoronaVac 18/10/2021 C202106115
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
11 P-91RRSNG0 3575014505800007 IMA HIDAYATI 41 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 8880503659 CoronaVac 18/10/2021 C202106115
12 P-7K9FYZGW 3575011212820001 SELAMET SALIM 39 UMUM JL.RADEN PATAH GG. PRAMUKA 7/5 - PURWO 8383047283 CoronaVac 18/10/2021 C202106115
13 P-6KSVBRA5 3575010907850002 MOCHAMMAD SAICHU 36 UMUM JL. GATOT SUBROTO 2/7 - BUKIR 8233404852 CoronaVac 18/10/2021 C202106115
14 P-4E7TJQZI 3575016002910002 MARIA ISTIQOMAH 30 UMUM JL. GATOT SUBROTO 1/6 - BUKIR 8383492903 CoronaVac 18/10/2021 C202106115
15 P-3JFQYQ5D 3575011209770004 MOTOHHIRIN 44 UMUM JL. URIP SUMOHARJO 2/2 - BUKIR 8533461494 CoronaVac 18/10/2021 C202106115
16 P-2CJ04PCK 3575012912750002 BAMBANG ALI LEWO 46 UMUM JL. GATOT SUBROTO 3/5 - BUKIR 8967690503 CoronaVac 18/10/2021 C202106115
17 P-0JQISBO3 3575017006850005 SULAIMA 36 UMUM JL. GATOT SUBROTO 3/5 - BUKIR 8967690503 CoronaVac 18/10/2021 C202106115
18 P-XGQT2NVC 3575015006790007 SITI HINDUN 42 UMUM JL URIP SUMOHARJO BUKIR 8533494408 CoronaVac 18/10/2021 C202106115
19 P-X4RLCHFR 3575015505760007 MIMA NUR ZAKIYAH 45 UMUM JL URIP SUMOHARJO RW 01 RT 003 BUKIR 8969943687 CoronaVac 18/10/2021 C202106115
20 P-82F1IDBH 3575014506850002 TUTIK FAUZIA 36 UMUM JL. GATOT SUBROTO 3/7 - BUKIR 8223278952 CoronaVac 18/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Q-000AUBKY 3575016505950003 MEI DINA ISTI NURMALA 26 UMUM JL.KARYA BAKTI P 31-34 8122181961 Astrazeneca 03/07/2021 ABY1911 16/10/2021 A1076 -
2 Q-000OEDXU 3575014306020001 QUDSYAH 19 UMUM PERUM PULAU MAS 9B 8125959102 Astrazeneca 21/08/2021 K004A 16/10/2021 A1076 -
3 Q-C0C6C6CA 3575016801790001 ELY KRISTINA 42 UMUM jl. anyelir 3/15 8213961445 Astrazeneca 27/04/2021 CTMAV51 16/10/2021 A1076 -
4 S-0E02B0BD 3575012305580002 SENTOT SULASMONO 61 LANSIA jl banda 4/2 8155456441 Astrazeneca 16/10/2021 A1076
5 P-ZBP9BCAR 3507084304610002 SRI ASIH 60 LANSIA WAJAK MALANG 16/5 8123320205 Astrazeneca 16/10/2021 A1076
6 S-893BAA22 3573050411540003 HARUN WARSITO 67 LANSIA JL KEDAWUNG 8A MALANG 8123210033 Astrazeneca 16/10/2021 A1076
7 P-ZOL3N5QS 3575036209670001 ISYUNARTI 54 RENTAN JL KH HASYIM ASYARI, JAWA TIMUR, KOTA P 8123429954 Astrazeneca 16/10/2021 A1076
8 P-BMS54S4N 3575016807900001 SINTA DEWI ARUMSARI 31 UMUM JL BANDA 4/2 8585946809 Astrazeneca 16/10/2021 A1076
9 P-CWWJBYMM 3575010206760001 MUCHAMAD KHOZEN 45 UMUM JL GATOT SUBROTO 2/5 SEBANI 8214192013 Astrazeneca 16/10/2021 A1076
10 P-EF3YAYMX 3575016104860003 ARLIA 35 UMUM JL HANGTUAH 2/3 8578432717 Astrazeneca 16/10/2021 A1076
11 P-ZBC9AI5T 3575012309760002 SYROJUL MUNIR 45 UMUM JL. MULYOREJO 02/06 SEBANI KOTA PASURUA 8978544805 Astrazeneca 16/10/2021 A1076
12 P-TCFS7PXP 3575014202960003 ELVINA ROMAWATI 25 UMUM jl banda 4/2 8580407440 Astrazeneca 16/10/2021 A1076
13 Q-00109R55 3575011608060001 BAGAS PUTRA TEGUH PRASETYO 15 REMAJA Jl. Banda, Gadingrejo 8384668227 CoronaVac 18/09/2021 202108118H 16/10/2021 C202106115
14 Q-000UWBO1 3575010509670003 SYAMSUL MA'ARIF 54 RENTAN JL HANGTUAH 4/4 GADINGREJO 8113777705 CoronaVac 08/09/2021 2021071371 16/10/2021 C202106115
15 Q-000TK7Q6 3514155109950001 WARDA MAULIDA LAILI NAILUL FARI 26 UMUM GAYAM RT 01/02 8100000000 CoronaVac 04/09/2021 202107132 16/10/2021 C202106115
16 Q-000ZT5RA 3575014407920001 SALMA SAHIRA 29 UMUM JL KYAI SEPUH / GENTONG 8191333151 CoronaVac 18/09/2021 202108118H 16/10/2021 C202106115
17 Q-000JMXD0 3514150812990001 AHMAD YULAD F RAMADANI 22 UMUM PEJATEN DS. PAJARAN KEC. REMBANG 8588855532 CoronaVac 27/07/2021 24004321 16/10/2021 C202106115
18 Q-000UWAEB 3575027107750001 SITI NURDIANINGSIH 44 UMUM JL KH ACHMAD DAHLAN 8312210428 CoronaVac 08/09/2021 2021071371 16/10/2021 C202106115
19 P-9CXJWFTG 3575012610080001 DIMASLIKHAN 13 REMAJA jl gatot subroto 2/5 SEBANI 8214192013 CoronaVac 16/10/2021 C202106115
20 P-CDG6UPCO 3575015206040001 CINDY DWI NOVITASARI 17 REMAJA JL SLAMET RIYADI 2/1 GENTONG 8585278784 CoronaVac 16/10/2021 C202106115

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 P-4DVXBIP1 3575011210650001 MUCHTADIR 56 RENTAN JL GATOT SUBROTO 1/4 8113777705 Astrazeneca 15/10/2021 PW40166
2 P-4WN2XFX1 3575015007640002 SITI FATONAH 57 RENTAN JL GATOT SUBROTO 3/4 8133415252 Astrazeneca 15/10/2021 PW40166
3 P-BBBHQQLU 3575014112700002 SALAMAH 51 RENTAN JL HANGTUAH 2/3 GADINGREJO 8961263219 Astrazeneca 15/10/2021 PW40166
4 P-4HJCAXQO 3575012604720002 ABD. GHOFAR 49 UMUM GADINGREJO PASURUAN 8213465010 Astrazeneca 15/10/2021 PW40166
5 P-4JZUWPHE 3575010101800041 ASHARI 41 UMUM JL HALMAHERA 3/5 8570686394 Astrazeneca 15/10/2021 PW40166
6 P-4SU8FOJM 3575012112820004 SOLIKHIN 39 UMUM SEBANI RT 3 RW 6 8193663169 Astrazeneca 15/10/2021 PW40166
7 P-4NBFODM4 3575011603800004 CHOIRUR ROFI' 41 UMUM JL HANGTUAH 1/3 8223439567 Astrazeneca 15/10/2021 PW40166
8 P-53NX5NW9 3575011706880001 SAIFUL HUDA 33 UMUM JL HALMAHERA 8190303649 Astrazeneca 15/10/2021 PW40166
9 P-DINRMXDG 3575016808990002 NADIFATUL AMALIA 22 UMUM JL KYAI SEPUH GENTONG 8223023060 Astrazeneca 15/10/2021 PW40166

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Q-000ASQ6D 3575011306620001 SUTARNO 59 RENTAN JL URIP SUMOHARJO 8135961783 Astrazeneca 03/07/2021 ABY1911 14/10/2021 PW40166
2 Q-000AW9P7 3575014310000002 LENNA ERDY ANDRIANI 21 UMUM JL SLAMET RIYADI GG 12 8574879436 Astrazeneca 03/07/2021 ABY1911 14/10/2021 PW40166
3 P-D00RWGZW 3575017006700007 CHOLISA 51 RENTAN jl hangtuah gadingrejo 8138720745 Astrazeneca 14/10/2021 PW40166
4 P-2AYT4IRT 3575010107630139 KATIN 59 RENTAN JL BANDA 4/3 GADINGREJO 8225700197 Astrazeneca 14/10/2021 PW40166
5 P-E19KXVQZ 3575013108680001 MACHIN 53 RENTAN jl hangtuah gadingrejo 8130720745 Astrazeneca 14/10/2021 PW40166
6 P-0VBEAOVG 3575016503670001 NURWATI 54 RENTAN JL SLAMET RIYADI GENTONG 8560607746 Astrazeneca 14/10/2021 PW40166
7 P-6FRNQGJX 3575010107830180 SYA'RONI 36 UMUM JL HANGTUAH II 8785032180 Astrazeneca 14/10/2021 PW40166
8 P-6BFVXNSK 3575014711790001 ROFIATUN NAIMAH 42 UMUM JL HANGTUAH 2 8785032180 Astrazeneca 14/10/2021 PW40166
9 P-CZV7IZFX 3575014107760095 ASMANI 44 UMUM JL BANDA RT03/RW03 GADINGREJO 8113777705 Astrazeneca 14/10/2021 PW40166
10 P-7N23YQNP 3575016010970003 AYU OKI UTARI 24 UMUM JL SLAMET RIYADI 4/2 SEBANI 8135742774 Astrazeneca 14/10/2021 PW40166
11 P-8HSU4ON6 3575011811930001 JUNAEDI ABDULLAH 28 UMUM JL SLAMET RIYADI 4/2 SEBANI 8313241605 Astrazeneca 14/10/2021 PW40166
12 P-9RO04DC6 3575015809790001 KHILMIYAH 42 UMUM JL URIP SUMOHARJO 2/2 BUKIR 8123259395 Astrazeneca 14/10/2021 PW40166
13 P-DL7N4LDE 3575025406830005 SITI ARIANI 38 UMUM jambangan 3 8585227179 Astrazeneca 14/10/2021 PW40166
14 P-DYHBRGBW 3575024611730001 SITI KURNIA 48 UMUM JL JAMBANGAN 3 8135897903 Astrazeneca 14/10/2021 PW40166
15 P-BIEWRQGP 3575010107010021 MAULANA 21 UMUM jl banda gadingrejo 8125940869 Astrazeneca 14/10/2021 PW40166
16 P-N5BJSQ9A 3575030803920002 MOKHAMAD IMAMMUDIN 29 UMUM JL SUNAN AMPEL 2/6 PETAMANAN 8578563311 Astrazeneca 14/10/2021 PW40166
17 P-M3KQZUUI 3575016304830003 NURUL ISNAINI 38 UMUM JL HALMAHERA 3/5 GADINGREJO 8113777705 Astrazeneca 14/10/2021 PW40166
18 P-MOJUPX1O 3575011010840007 M. SAYCHON 37 UMUM JL HALMAHERA 3/5 GADINGREJO 8135171374 Astrazeneca 14/10/2021 PW40166
19 P-CCNMNIX5 3575014602730001 ETY KUSUMA DEWI 48 UMUM jl gatot subroto bukir 8525227501 Astrazeneca 14/10/2021 PW40166
20 P-IMFEUEDQ 3514150806860004 SOLTON 35 UMUM SEBANI PASURUAN 8531189779 Astrazeneca 14/10/2021 PW40166
21 P-K4ZQ7AF7 3575012705840001 MOKHAMAD AFAN 37 UMUM JL JOLONDRIYO 2/5 8953172279 Astrazeneca 14/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
22 P-7W1G6RP9 3575014107010062 TINA 20 UMUM JL HANGTUAH RT01/RW04 GADINGREJO 8953662451 Astrazeneca 14/10/2021 PW40166
23 P-BZSDRHCG 3514165907790006 KUSDIAWATI 42 UMUM JL BANDA 3/2 GADINGREJO 8570709538 Astrazeneca 14/10/2021 PW40166
24 P-6VS0WQML 3575010107780120 SAIKHU ROHMAN 41 UMUM JL HANGTUAH5/4 GADINGREJO 8311469806 Astrazeneca 14/10/2021 PW40166
25 P-TD8DIGP1 3575010606710002 MUKHLAS 47 UMUM JL BANDA 4/2 GADINGREJO 8123408112 Astrazeneca 14/10/2021 PW40166
26 P-VG92SWWQ 3575015606770003 MUSYRIFAH 44 UMUM JL BANDA 4/2 GADINGREJO 8123408112 Astrazeneca 14/10/2021 PW40166
27 P-VWCTJGI6 3575010401750001 AHMAD FAUZI 46 UMUM JL URIP SUMOHARJO 1/2 BUKIR 8113777705 Astrazeneca 14/10/2021 PW40166

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Q-000AUYWN 3575036810650001 ZUMROTUL ULIYAH 56 RENTAN JL PATIMURA BUGULKIDUL 8226474089 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
2 Q-000AYZFP 3575034402630001 SULASTRI 57 RENTAN JL JEND S PARMAN 8969963466 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
3 Q-000AXUBV 3575036004680001 SITI KOMARIAH 56 RENTAN JL.HOS COKRO AMINOTO RW 07 RT 001 8133388355 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
4 Q-10F479E1 3520017008830001 YULIA KRISTIANI 38 UMUM PERUM LUMBUNGPADI REGENCY SEBANI 8563202363 Astrazeneca 27/04/2021 CTMAV51 13/10/2021 PW40166
5 Q-000AXLPE 3575034107810059 ASTUTIK 31 UMUM JL JEND S PARMAN 8969963466 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
6 Q-000AXUBM 3575035903830003 ENDAH YANI 39 UMUM JL JEND S PARMAN 8969963466 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
7 Q-000AXLPN 3575034107880086 SUNDARI 34 UMUM JL JEND S PARMAN 800000000 Astrazeneca 03/07/2021 ABY1911 13/10/2021 PW40166
8 P-EAYUM730 3575024709670001 NUR AINI 54 RENTAN JL KH WACHID HASYM 4/6 KEBONSARI 8956010908 Astrazeneca 13/10/2021 PW40166
9 P-7YIUI6IL 3575010107740027 AKHMAD SHOKHE 45 UMUM JL HALMAHERA 3/3 GADINGREJO 8214061340 Astrazeneca 13/10/2021 PW40166
10 P-CZFN7BGD 3514064707900002 NILNATUL CHASANAH 31 UMUM DSN SIDO MULYO KEJAYAN 8968156731 Astrazeneca 13/10/2021 PW40166
11 P-ILIP0KWM 3575012111740003 MOCH. CHOTIB 47 UMUM JL GATOT SUBROTO 2/4 BUKIR 8222900560 Astrazeneca 13/10/2021 PW40166
12 P-4FGDHCF7 3575012406020002 MOCH. YUSUF SAPUTRA 19 UMUM JL HALMAHERA 8585046647 Astrazeneca 13/10/2021 PW40166
13 P-TB4ZXZAF 3575011412980001 CHUMAIDI 23 UMUM JL HALMAHERA GADINGREJO 8570768381 Astrazeneca 13/10/2021 PW40166
14 P-TBI8NEAD 3514202012930002 ACHMAD ULUM 28 UMUM CURAHWULU DS KARANGLO GRATI 8152742061 Astrazeneca 13/10/2021 PW40166
15 P-TCNJDUJA 3575012708890007 ABDULLAH AMIN 32 UMUM JL BANDA GADING REJO 8121643010 Astrazeneca 13/10/2021 PW40166
16 P-TCF7PUCJ 3575016502020002 LAILATUL ISNAINI 19 UMUM JL HANGTUAH GADINGREJO 8311592318 Astrazeneca 13/10/2021 PW40166
17 P-TCGZINPO 3575015407040002 SITI ZULAIKHA 18 UMUM JL HALMAHERA 8311174829 Astrazeneca 13/10/2021 PW40166
18 P-TDT3ZKAR 3575011206870004 NUROKHIM 36 UMUM JL HALMAHERA XI 8113777705 Astrazeneca 13/10/2021 PW40166
19 P-TDQZDUPN 3575014710910001 NUR ROFI'ANI 30 UMUM JL HALMAHERA 5/5 GADINGREJO 8133599773 Astrazeneca 13/10/2021 PW40166
20 P-72JLCVIY 3575015912820001 ZULAICHAH 39 UMUM JL HANGTUAH 8319274744 Astrazeneca 13/10/2021 PW40166
21 P-77WHXE51 3575015203850003 ZUNDAH 36 UMUM JL HANGTUAH 8319274744 Astrazeneca 13/10/2021 PW40166

Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
22 P-CDVIM9S1 3527010706970003 ABDUS SALIM 24 UMUM DSN TENGGINAH 8770338257 Astrazeneca 13/10/2021 PW40166
23 P-FIWHC4S5 3575011205830005 SUPRAPTO 38 UMUM JL SLAMET RIYADI GENTONG 8581598074 Astrazeneca 13/10/2021 PW40166
24 P-LLJWZ1UI 3575016706900001 SITI MUNAWAROH 31 UMUM JL HANGTUAH GADINGREJO 8311174832 Astrazeneca 13/10/2021 PW40166
25 P-PFNNBGYF 3575015212020002 AIDAH FAUZIYAH 19 UMUM JL URIP SUMOHARJO BUKIR 8569554276 Astrazeneca 13/10/2021 PW40166
26 P-4IUDBKYO 3575012501020002 MOCH. CHOLIS 19 UMUM JL HALMAHERA GG 9 8770150340 Astrazeneca 13/10/2021 PW40166
27 S-17ADC156 3575010604570001 TADJID EDI SASMITO 64 LANSIA JL HALMAHERA 4/6 KARANGANYAR 8113777705 CoronaVac 13/10/2021 202108172F
28 P-M4WFR0MC 1102036007970001 JULIANA KARTIKA 24 UMUM ASRAMA YON ZIPUR 10 8227676215 CoronaVac 13/10/2021 202108172F
29 Q-000S55X6 3575026705830002 SILVIANI 38 UMUM JL TEUKU UMAR 3/1 TEBAM 8224546366 CoronaVac 01/09/2021 2021071371 13/10/2021 202108172F
30 Q-000YEZOG 3514232208810002 SAMSUL HUDA 40 UMUM JARANGAN REJOSO 8212883238 CoronaVac 15/09/2021 2021071321 13/10/2021 202108172F
31 Q-000YF0A9 3514236101800002 NANIK SULIATI 41 UMUM JARANGAN REJOSO 8122032543 CoronaVac 15/09/2021 2021071321 13/10/2021 202108172F
32 Q-000XZ07H 3515055305940003 CHISNIYAH ISMY 27 UMUM JL SOEKARNO HATTA 6/1 GADINGREJO 8224569992 CoronaVac 15/09/2021 202108118H 13/10/2021 202108172F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-12-2021 INDUK
1 Q-000AVASS 3575024101630019 SYAICHUNA 58 RENTAN JL HANGTUAH 1O 8133383355 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
2 Q-000AV32F 3575012109700001 ABDUL JALIL 51 RENTAN JL SLAMET RIYADI GG 16 RT 02 RW 04 GENTO 8510360009 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
3 Q-000AXUCK 3575036103960005 KHOIRUN NISAK 25 UMUM JL PATIMURA BUGUL KIDUL 8515620424 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
4 P-B4ISSESH 3575012609690001 ABD. QODIR JAILANI 52 RENTAN JL SLAMET RIYADI RT03/RW02 GENTONG 8584344446 Astrazeneca 12/10/2021 PW40166
5 P-C2TDVWRU 3575011110650001 AS'AD 56 RENTAN JL HALMAHERA GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
6 P-1T43TBGT 3575035502960002 HILDA NAHDIYAH FIRDAUS 25 UMUM JAMBANGAN 3 8572933813 Astrazeneca 12/10/2021 PW40166
7 P-1QVKDLYW 3575021209940001 WAHYU PRASETYO 27 UMUM JAMBANGAN 3 8223031201 Astrazeneca 12/10/2021 PW40166
8 P-2DL9EIQG 3575010107820140 M. SIROTUDDIN 39 UMUM JL HANGTUAH GADINGREJO 8593240817 Astrazeneca 12/10/2021 PW40166
9 P-2F0ZREUN 3575016912970005 MUSTABSIRO 24 UMUM JL IRIAN JAYA RT01/RW02 GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
10 P-2J9VA6YO 3575014101770019 SUMARO 47 UMUM JL IRIAN JAYA GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
11 P-2PSSMAQK 3575015005010004 KHOIROTUN NISAK 20 UMUM JL IRIAN JAYA GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
12 P-3C81NW8O 3506141405790004 SISWANTO 42 UMUM JL BANDA 5/2 GADINGREJO 8588247868 Astrazeneca 12/10/2021 PW40166
13 P-3PFPMBID 3507091510780001 SAMIRIN 43 UMUM JL SLAMET RIYADI 3/3 GENTONG 8123182226 Astrazeneca 12/10/2021 PW40166
14 P-2B7PY44U 3575012904880001 SOFIYAN 33 UMUM JL BANDA RT04/RW03 GADINGREJO 8506692949 Astrazeneca 12/10/2021 PW40166
15 P-64L5GH5Y 3575011707920001 WAHYULLOH 29 UMUM JL GATOT SUBROTO RT01/RW05 SEBANI 8525930444 Astrazeneca 12/10/2021 PW40166
16 P-4C1TXSNI 3578064902840001 SITI UMUL KOTIJAH 37 UMUM JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
17 S-4AEE2BA9 3507074512930005 LAILA AMROTUS SAADAH 28 UMUM JL GATOT SUBROTO 1/5 SEBANI 8214110442 Astrazeneca 12/10/2021 PW40166
18 P-6KYP6APT 3575011410800001 FATCHUL HUDA 41 UMUM JL SLAMET RIYADI 2/4 GENTONG 8123456929 Astrazeneca 12/10/2021 PW40166
19 P-7TK2YJYR 3575014612860001 JUMAIYAH 35 UMUM JL ERLANGGA 2/5 PURWOREJO 8953662451 Astrazeneca 12/10/2021 PW40166
20 P-AVXH3JHH 3575015406770001 MASLACHAH 44 UMUM jl slamet riyadi 3/2 GENTONG 8773707837 Astrazeneca 12/10/2021 PW40166
21 P-C46U8PNQ 3575015303790002 UMI KULSUM 47 UMUM JL HALMAHERA GG9 RT02/RW05 GADINGREJO8113777705 Astrazeneca 12/10/2021 PW40166
22 P-EHK8XJOS 3575014406810003 ALFIYAH 40 UMUM JL HALMAHERA XI GADINGREJO 8575547297 Astrazeneca 12/10/2021 PW40166
23 P-EJFTMNTY 3514034609840001 MISNATI 37 UMUM DUSUN GONDOSULI RT02/RW02 PUSPO 8787966069 Astrazeneca 12/10/2021 PW40166
24 P-1USFGELB 3575020901960002 DANNY PRASANDY KURNIAWAN 25 UMUM JAMBANGAN 3 8214308619 Astrazeneca 12/10/2021 PW40166
25 P-2R69SB2Z 3575010711820001 M. FAUZAN 39 UMUM JL HALMAHERA GG9 RT03/05 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
26 P-30YXU7N6 3575014101870019 JUROH 34 UMUM JL HALMAHERA 3/5 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
27 P-387D1LUN 3575016112830002 NADIFA 38 UMUM JL SLAMET RIYADI 1/2 SEBANI 8135227403 Astrazeneca 12/10/2021 PW40166
28 P-3FVKLOEV 3575011103730004 ABDUL KHAMID 48 UMUM JL SLAMET RIYADI 5/2 SEBANI 8126893323 Astrazeneca 12/10/2021 PW40166
29 Y-0135Y1E3 3575017007830002 BAWON NURHAYATI 38 UMUM JL. MOJOWANGI NO.145 8564647109 Astrazeneca 12/10/2021 PW40166
30 P-EQ4VP5IY 3514150209000001 MOCHAMMAD MUDAKKIR NAILI 21 UMUM KETAPAN 1/8 PEKOREN 8161547128 Astrazeneca 12/10/2021 PW40166
31 Q-000RBH17 3575014408060002 NURIAH SOBAH 15 REMAJA JL HALMAHERA 3/3 8311804190 CoronaVac 30/08/2021 24202221 12/10/2021 202108172F
32 Q-000RFPKE 3575012611070005 M. FAIZ HIZBULLOH 14 REMAJA JL KYAI SEPUH 3/1 8385016204 CoronaVac 30/08/2021 24202221 12/10/2021 202108172F
33 Q-000SH7IE 3520131511060002 RYAN NAUFAL NOVIYANTO 15 REMAJA jl sentiak perum kbka GENTONG 8780791396 CoronaVac 02/09/2021 2021071371 12/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 Q-000X3TPZ 3514174706080002 YASMIN OLIVIA AFKARINA 13 REMAJA JL SLAMET RIYADI 3/2 GENTONG 8575504680 CoronaVac 13/09/2021 202108118H 12/10/2021 202108172F
35 Q-000S5I5X 3575010808690001 NUR ARIFIN 54 RENTAN JL GATOT SUBROTO 2/4 BUKIR 8560704435 CoronaVac 01/09/2021 2021071371 12/10/2021 202108172F
36 Q-000E35Z5 3575026708730001 NUR AFIFAH 48 UMUM JL.DR.WAHIDIN GG MANGGIS 8956001364 CoronaVac 09/07/2021 24200421 12/10/2021 202108172F
37 Q-000UT3VO 3575015908930002 AGUSTINA NURWINDA 28 UMUM JL HALMAHERA 3/3 8564648785 CoronaVac 07/09/2021 2021071371 12/10/2021 202108172F
38 Q-000VESAV 3575014705760003 SUNANIK 43 UMUM JL SLAMET RIYADI 2/2 GENTONG 8213188221 CoronaVac 09/09/2021 2021071371 12/10/2021 202108172F
39 Q-000VOG25 3575011101000002 MOH. RAFI MUZAHY 21 UMUM JL KYAI SEPUH 2/6 GENTONG 8233283315 CoronaVac 09/09/2021 202108118H 12/10/2021 202108172F
40 Q-000VOHWI 3575016311030001 HANNAH AL HAYA 18 UMUM JL KYAI SEPUH 2/6 GENTONG 8576367097 CoronaVac 09/09/2021 202108118H 12/10/2021 202108172F
41 Q-000XNF7C 3575011604030001 UDAY SYUHADAH 18 UMUM JL MULYOREJO 2/6 SEBANI 8983916242 CoronaVac 14/09/2021 202108118H 12/10/2021 202108172F
44 P-3XPP9BNR 3575014610060001 LYSSA NUR RAMADHANY 15 REMAJA PERUM KRATON INDAH 8578118659 CoronaVac 12/10/2021 202108172F
45 P-FSJIXO4P 3514200706670002 AKHMAD MUNIR 54 RENTAN KEDAWUNG WETAN 8212283827 CoronaVac 12/10/2021 202108172F
46 P-28HUY5VG 3575014104930001 MUSRIFAH 28 UMUM JL BANDA 8223311929 CoronaVac 12/10/2021 202108172F
10-12-2021 PUSTU GADING 2
1 P-7M5MGO1C : 3575014502070003 AIRIN ANGGRAINI 14 REMAJA JL HALMAHERA GG 9 8214154770 BIOFARMA 12/10/2021 202108172F
2 P-9FRQ354D : 3575012703070002 TONTON SUSANTO 14 REMAJA JL HALMAHERA GG9 8578092035 BIOFARMA 12/10/2021 202108172F
3 P-DGNDATJV : 3575015907640004 NGATIMAH 57 RENTAN JL HALMAHERA GADINGREJO 8113777705 BIOFARMA 12/10/2021 202108172F
4 P-5UEMZ5TI : 3575014712870004 KHUSNUL KHOTIMAH 34 UMUM JL HANGTUA 3/3 8810270084 BIOFARMA 12/10/2021 202108172F
5 P-6ASACHEB : 3575015903830004 MARIA ULFAH 38 UMUM JL HALMAHERA 8315326339 BIOFARMA 12/10/2021 202108172F
6 P-MENKJRAN : 3575016812950003 SITI FATIMAH 26 UMUM JL HANGTUAH 813777705 BIOFARMA 12/10/2021 202108172F
7 Z-0005WAAQ : 3575014110620003 RODILAH 62 LANSIA JL HALMAHERA GG 9 - BIOFARMA 30/06/2021 24003521 12/10/2021 202108172F
8 Z-0005VMA2 : 3575014101600054 SATUMI 61 LANSIA JL HALMAHERA GG 9 - BIOFARMA 30/06/2021 24003521 12/10/2021 202108172F
9 Q-000VF4KA : 3575014207690005 ANISAH 52 RENTAN JL HALMAHERA 4/5 GADINGREJO 8233884377 BIOFARMA 09/09/2021 2021071371 12/10/2021 202108172F
10 Q-000VF38P : 3575012604890002 AKHMAD ANDIK 32 UMUM JL HALMAHERA 4/5 GADINGREJO 8560771536 BIOFARMA 09/09/2021 2021071371 12/10/2021 202108172F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-11-2021 INDUK
1 Q-000B02YS 3575015508680004 DEWI KHUSNAH 53 RENTAN JL.HALMAHERA GG. IX / 40 RT 2 RW 5 GADING 8223030067 Astrazeneca 03/07/2021 ABY1911 11/10/2021 PW40166
2 Q-000AWKNN 3575010209650003 SUGENG IRIANTO 56 RENTAN JL.HALMAHERA GG. IX / 40 8223030066 Astrazeneca 03/07/2021 ABY1911 11/10/2021 PW40166
3 Q-000AW4CA 3575010810010001 MUKHAMMAD ILHAM FILAHI 20 UMUM JL SLAMET RIYADI GG 12 B RT 01 RW 03 GEN 8123170477 Astrazeneca 03/07/2021 ABY1911 11/10/2021 PW40166
4 Q-000AWYY5 3575011607900002 SETIAWAN RUSDIANA 31 UMUM JL SLAMET RIYADI GG 12 B GENTONG GADINF 8570788446 Astrazeneca 03/07/2021 ABY1911 11/10/2021 PW40166
5 Q-000AWULA 3575014110720001 MARIDAH 49 UMUM JL KYAI SEPUH RT 1 RW 6 GENTONG 8135903420 Astrazeneca 03/07/2021 ABY1911 11/10/2021 PW40166
6 Q-000N89TJ 3575014109960001 MADISA CATUR SELVINA 25 UMUM JL.SLAMET RIYADI RT 001 RW 004 GENTONG 8223457451 Astrazeneca 15/08/2021 D005A 11/10/2021 PW40166
7 P-7EYLCAX4 3514205309620001 KOTIJAH 59 RENTAN DSN ADIROGO 1/6 KEDAWUNG KULON 8787850159 Astrazeneca 11/10/2021 PW40166
8 P-6P6CS9QH 3575016109650001 SUHARIYAH 58 RENTAN SLAMET RIYADI 1/1 GENTONG 8113777705 Astrazeneca 11/10/2021 PW40166
9 P-GFQ6J6VJ 3575026808650002 MARFUAH 56 RENTAN JL JAMBANGAN 4/2 8570711231 Astrazeneca 11/10/2021 PW40166
10 P-AOCSHX47 3575014906630001 CHOTIDJAH 58 RENTAN JL HALMAHERA 5/4 GADINGREJO 8113777705 Astrazeneca 11/10/2021 PW40166
11 P-FG4QHCFX 3575010107680112 SUPENO 53 RENTAN JL HANGTUAH GADINGREJO 8214148347 Astrazeneca 11/10/2021 PW40166
12 P-MR6OXG5M 3575020107630106 SUJAK 58 RENTAN JL BANDA 4/2 GADINGREJO 8222941639 Astrazeneca 11/10/2021 PW40166
13 P-49YXX2ZY 3575014405750003 PUJI ASTUTI 47 UMUM JL BANDA NO 12 RT03/RW02 GADINGREJO 8589549952 Astrazeneca 11/10/2021 PW40166
14 P-89CEVQ6W 3575011011750004 ADOLF VAN JOOST 46 UMUM JL HASANUDIN 1/4 KARANGANYAR 8133479854 Astrazeneca 11/10/2021 PW40166
15 P-2JSNS5UD 3575014107840145 WIWIN WULANDARI 38 UMUM JL HALMAHERA RT02/03 GADINGREJO 8230125932 Astrazeneca 11/10/2021 PW40166
16 P-7Q5HUVBI 3514206707880004 FENI YULIYANTI 33 UMUM KARANG KLIWON 2/1 GRATI 8233073880 Astrazeneca 11/10/2021 PW40166
17 P-HQUB39LT 3575021408020001 DWI AGUS KURNIAWAN 19 UMUM JL JAMBANGAN 4/2 8135904204 Astrazeneca 11/10/2021 PW40166
18 P-FYZA4F35 3575026607760001 YULIATI 45 UMUM KEBONAGUNG 3/3 8213007980 Astrazeneca 11/10/2021 PW40166
19 P-GP6XNKSV 3575026509950002 IKA SEPTIANI 26 UMUM JL JAMBANGAN 4/2 PURWOREJO 8580677773 Astrazeneca 11/10/2021 PW40166
20 P-H4ZRGMJJ 3575020906810001 MOCH SOLIKIN 41 UMUM JL JAMBANGAN 4/2 8510085005 Astrazeneca 11/10/2021 PW40166
21 P-8IDRE4J2 3575015007020002 RIZQIATUL MAHFIROH 19 UMUM JL HANGTUAH 3/3 GADINGREJO 8573093039 Astrazeneca 11/10/2021 PW40166
22 P-8T0JF4Z1 3575016602820001 ASTUTIK 39 UMUM JL HANGTUAH 3/3 GADINGREJO 8573093039 Astrazeneca 11/10/2021 PW40166
23 P-9Q2TH81D 3575013007860001 MOCHAMMAD MURSID 35 UMUM JL SOEKARNO HATTA 1/1 GADINGREJO 8138621947 Astrazeneca 11/10/2021 PW40166
24 P-A81BQCEC 3575010705830002 AHMAD HASAN 38 UMUM JL HALMAHERA XI 8133086691 Astrazeneca 11/10/2021 PW40166
25 P-AGFC3QJS 3575012008810002 EKO BAGUS MADI PUTRANTO 40 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8983961400 Astrazeneca 11/10/2021 PW40166
26 P-BKRRWS2I 3575011705800008 IWAN MAULANA 41 UMUM KETUG MLAGI 5/3 KARANG KETUG 8778041340 Astrazeneca 11/10/2021 PW40166
27 P-CAGL3LCJ 3575011709010001 MUHAMMAD ARIEF SISWANTO 20 UMUM KETUG MLAGI 5/3 KARANG KETUG 8775522397 Astrazeneca 11/10/2021 PW40166
28 P-CO87HGYF 3575016312910002 GIARTI 30 UMUM JL BANDA 3/2 GADINGREJO 8579164922 Astrazeneca 11/10/2021 PW40166
29 P-CVZUSJIP 3509034508760004 KARTINI NINGSIH SETIYOWATI 45 UMUM JL TEUKU UMAR 3/1 SEBANI 8820099844 Astrazeneca 11/10/2021 PW40166
30 P-D3EGOQXF 3575010103750002 SANUSI 46 UMUM JL SLAMET RIYADI 8573081774 Astrazeneca 11/10/2021 PW40166
31 P-D8KV1L4G 3575015707910003 SHOLIKHAH 30 UMUM JL HANGTUAH 1/3 GADINGREJO 8383250477 Astrazeneca 11/10/2021 PW40166
32 P-DEZVYMP1 3575015905810001 RIKA NURUL MUFIDAH 40 UMUM PERUM KARYA BAKTI BLOK B 16 8574599847 Astrazeneca 11/10/2021 PW40166
33 P-DMMJYIKU 3206281403020001 SANDI MAULANA 19 UMUM KP CISEUREUH 8212167596 Astrazeneca 11/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 P-HGHF7MMZ 3575021908720002 MUCHAMAD SALIM 49 UMUM JL JAMBANGAN 4/2 8213007974 Astrazeneca 11/10/2021 PW40166
35 P-2DZH7KJR 3575015111750002 MARFIAH ROHMAH 48 UMUM JL HAGTUAH GG 2 GADINGREJO 8233888622 Astrazeneca 11/10/2021 PW40166
36 P-BN0LIKHQ 3575030209980001 ACHMAD NUR IKSAN 23 UMUM JL. MT HARYONO GG 16B 8225391476 Astrazeneca 11/10/2021 PW40166
37 Q-000HYIOQ 3575012712970003 IVANO BRAMIRSYAD PRATAMA 24 UMUM HATIVE BESAR 8577583721 CoronaVac 17/07/2021 24200621 11/10/2021 202108172F
38 Q-000M3PE4 3575011008010002 M. WAHYU HIDAYAT 20 UMUM JL.HANGTUAH RT.03 RW.04 KEL. 8953649491 CoronaVac 10/08/2021 24201921 11/10/2021 202108172F
39 Q-000RMO5B 3575014304070002 SHINTA FIANTIKA MAULIDIA 14 REMAJA JL BANDA 5/2 8573190729 CoronaVac 31/08/2021 24202221 11/10/2021 202108172F
40 Q-000SIW1D 3575014208870002 SITI RUBAIYAH 31 UMUM JL HANGTUAH 1/3 8180840416 CoronaVac 02/09/2021 2021071371 11/10/2021 202108172F
41 Q-000UEK3B 3575015607660002 NGATINAH 55 RENTAN JL SLAMET RIYADI 2/4 GENTONG 8125239966 CoronaVac 07/09/2021 2021071371 11/10/2021 202108172F
42 Q-000UYPFA 3575011609740004 MUKHAMMAD SLAMET 47 UMUM 8589532534 CoronaVac 08/09/2021 2021071371 11/10/2021 202108172F
43 Q-000VL5QE 3575010107890101 MUHAMMAD RIFA'I 31 UMUM JL HALMAHERA 2/3 8383479893 CoronaVac 09/09/2021 202108118H 11/10/2021 202108172F
44 S-C2AA1BAF 3575014107590009 KUSMIATI 62 LANSIA GENTONG 1/5 8886059548 CoronaVac 11/10/2021 202108172F
45 S-E8D7BDCC 3514200712580001 KANAPI 63 LANSIA DSN ADIROGO 1/6 KEDAWUNG KULON 8133411079 CoronaVac 11/10/2021 202108172F
46 P-OBDSRJQ6 3575015511080002 BELLA RACHMAWATI 13 REMAJA JL IRIAN JAYA 4/1 8595171312 CoronaVac 11/10/2021 202108172F
47 P-4Q2J6ZC9 3575014207910002 IKE ROSITA 30 UMUM GENTONG 1/3 8880359326 CoronaVac 11/10/2021 202108172F
48 S-DC41AA28 3514160710900008 MUHAMMAD SHOLAHUDIN 31 UMUM DSN. JOPATI 012/004 KETANGIREJO 8575530230 CoronaVac 11/10/2021 202108172F
10-11-2021 KELURAHAN SEBANI
1 S-8A28A9A9 3575014106540001 MURTI NINGSIH 68 LANSIA JL SLAMET RIYADI 4/2 SEBANI 8113777705 BIOFARMA 11/10/2021 202108143H
2 S-19241FEF 3575010106570001 MUNIP 65 LANSIA sebani 3/6 8113577770 BIOFARMA 11/10/2021 202108143H
3 S-AB71D53D 3575010805560001 MUDJIONO 70 LANSIA JL SLAMET RIYADI 1/1 8113777705 BIOFARMA 11/10/2021 202108143H
4 S-E647E3BA 3575021201550002 SUKARMAN 66 LANSIA Sebani 2/1 Pasuruan 8113777705 BIOFARMA 11/10/2021 202108143H
5 S-FEC15BF1 3575014806540001 SIFAK'ATI 66 LANSIA JL SLMAET RIYADI 1/2 SEBANI 8113577770 BIOFARMA 11/10/2021 202108143H
6 S-5C552B9C 3575010101500011 ISMAD SUMONO 70 LANSIA JL SLAMET RIYADI 2/4 SEBANI 8113777705 BIOFARMA 11/10/2021 202108143H
7 P-QUR7V3PW 3575016702040004 SHONIA TITA AMELINA 17 UMUM SEBANI PASURUAN 8133501552 BIOFARMA 11/10/2021 202108143H
8 P-QNCFZOKA 3575014601040001 AISATUL WIDAD 17 UMUM KRAPYAKREJO 8223400410 BIOFARMA 11/10/2021 202108143H

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-09-2021 INDUK
1 Q-000AVASS 3575024101630019 SYAICHUNA 58 RENTAN JL HANGTUAH 1O 8133383355 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
2 Q-000AV32F 3575012109700001 ABDUL JALIL 51 RENTAN JL SLAMET RIYADI GG 16 RT 02 RW 04 GENTO 8510360009 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
3 Q-000AXUCK 3575036103960005 KHOIRUN NISAK 25 UMUM JL PATIMURA BUGUL KIDUL 8515620424 Astrazeneca 03/07/2021 ABY1911 12/10/2021 PW40166
4 P-B4ISSESH 3575012609690001 ABD. QODIR JAILANI 52 RENTAN JL SLAMET RIYADI RT03/RW02 GENTONG 8584344446 Astrazeneca 12/10/2021 PW40166
5 P-C2TDVWRU 3575011110650001 AS'AD 56 RENTAN JL HALMAHERA GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
6 P-1T43TBGT 3575035502960002 HILDA NAHDIYAH FIRDAUS 25 UMUM JAMBANGAN 3 8572933813 Astrazeneca 12/10/2021 PW40166
7 P-1QVKDLYW 3575021209940001 WAHYU PRASETYO 27 UMUM JAMBANGAN 3 8223031201 Astrazeneca 12/10/2021 PW40166
8 P-2DL9EIQG 3575010107820140 M. SIROTUDDIN 39 UMUM JL HANGTUAH GADINGREJO 8593240817 Astrazeneca 12/10/2021 PW40166
9 P-2F0ZREUN 3575016912970005 MUSTABSIRO 24 UMUM JL IRIAN JAYA RT01/RW02 GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
10 P-2J9VA6YO 3575014101770019 SUMARO 47 UMUM JL IRIAN JAYA GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
11 P-2PSSMAQK 3575015005010004 KHOIROTUN NISAK 20 UMUM JL IRIAN JAYA GADINGREJO 8192888104 Astrazeneca 12/10/2021 PW40166
12 P-3C81NW8O 3506141405790004 SISWANTO 42 UMUM JL BANDA 5/2 GADINGREJO 8588247868 Astrazeneca 12/10/2021 PW40166
13 P-3PFPMBID 3507091510780001 SAMIRIN 43 UMUM JL SLAMET RIYADI 3/3 GENTONG 8123182226 Astrazeneca 12/10/2021 PW40166
14 P-2B7PY44U 3575012904880001 SOFIYAN 33 UMUM JL BANDA RT04/RW03 GADINGREJO 8506692949 Astrazeneca 12/10/2021 PW40166
15 P-64L5GH5Y 3575011707920001 WAHYULLOH 29 UMUM JL GATOT SUBROTO RT01/RW05 SEBANI 8525930444 Astrazeneca 12/10/2021 PW40166
16 P-4C1TXSNI 3578064902840001 SITI UMUL KOTIJAH 37 UMUM JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
17 S-4AEE2BA9 3507074512930005 LAILA AMROTUS SAADAH 28 UMUM JL GATOT SUBROTO 1/5 SEBANI 8214110442 Astrazeneca 12/10/2021 PW40166
18 P-6KYP6APT 3575011410800001 FATCHUL HUDA 41 UMUM JL SLAMET RIYADI 2/4 GENTONG 8123456929 Astrazeneca 12/10/2021 PW40166
19 P-7TK2YJYR 3575014612860001 JUMAIYAH 35 UMUM JL ERLANGGA 2/5 PURWOREJO 8953662451 Astrazeneca 12/10/2021 PW40166
20 P-AVXH3JHH 3575015406770001 MASLACHAH 44 UMUM jl slamet riyadi 3/2 GENTONG 8773707837 Astrazeneca 12/10/2021 PW40166
21 P-C46U8PNQ 3575015303790002 UMI KULSUM 47 UMUM JL HALMAHERA GG9 RT02/RW05 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
22 P-EHK8XJOS 3575014406810003 ALFIYAH 40 UMUM JL HALMAHERA XI GADINGREJO 8575547297 Astrazeneca 12/10/2021 PW40166
23 P-EJFTMNTY 3514034609840001 MISNATI 37 UMUM DUSUN GONDOSULI RT02/RW02 PUSPO 8787966069 Astrazeneca 12/10/2021 PW40166
24 P-1USFGELB 3575020901960002 DANNY PRASANDY KURNIAWAN 25 UMUM JAMBANGAN 3 8214308619 Astrazeneca 12/10/2021 PW40166
25 P-2R69SB2Z 3575010711820001 M. FAUZAN 39 UMUM JL HALMAHERA GG9 RT03/05 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
26 P-30YXU7N6 3575014101870019 JUROH 34 UMUM JL HALMAHERA 3/5 GADINGREJO 8113777705 Astrazeneca 12/10/2021 PW40166
27 P-387D1LUN 3575016112830002 NADIFA 38 UMUM JL SLAMET RIYADI 1/2 SEBANI 8135227403 Astrazeneca 12/10/2021 PW40166
28 P-3FVKLOEV 3575011103730004 ABDUL KHAMID 48 UMUM JL SLAMET RIYADI 5/2 SEBANI 8126893323 Astrazeneca 12/10/2021 PW40166
29 Y-0135Y1E3 3575017007830002 BAWON NURHAYATI 38 UMUM JL. MOJOWANGI NO.145 8564647109 Astrazeneca 12/10/2021 PW40166
30 P-EQ4VP5IY 3514150209000001 MOCHAMMAD MUDAKKIR NAILI 21 UMUM KETAPAN 1/8 PEKOREN 8161547128 Astrazeneca 12/10/2021 PW40166
31 Q-000RBH17 3575014408060002 NURIAH SOBAH 15 REMAJA JL HALMAHERA 3/3 8311804190 CoronaVac 30/08/2021 24202221 12/10/2021 202108172F
32 Q-000RFPKE 3575012611070005 M. FAIZ HIZBULLOH 14 REMAJA JL KYAI SEPUH 3/1 8385016204 CoronaVac 30/08/2021 24202221 12/10/2021 202108172F
33 Q-000SH7IE 3520131511060002 RYAN NAUFAL NOVIYANTO 15 REMAJA jl sentiak perum kbka GENTONG 8780791396 CoronaVac 02/09/2021 2021071371 12/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 Q-000X3TPZ 3514174706080002 YASMIN OLIVIA AFKARINA 13 REMAJA JL SLAMET RIYADI 3/2 GENTONG 8575504680 CoronaVac 13/09/2021 202108118H 12/10/2021 202108172F
35 Q-000S5I5X 3575010808690001 NUR ARIFIN 54 RENTAN JL GATOT SUBROTO 2/4 BUKIR 8560704435 CoronaVac 01/09/2021 2021071371 12/10/2021 202108172F
36 Q-000E35Z5 3575026708730001 NUR AFIFAH 48 UMUM JL.DR.WAHIDIN GG MANGGIS 8956001364 CoronaVac 09/07/2021 24200421 12/10/2021 202108172F
37 Q-000UT3VO 3575015908930002 AGUSTINA NURWINDA 28 UMUM JL HALMAHERA 3/3 8564648785 CoronaVac 07/09/2021 2021071371 12/10/2021 202108172F
38 Q-000VESAV 3575014705760003 SUNANIK 43 UMUM JL SLAMET RIYADI 2/2 GENTONG 8213188221 CoronaVac 09/09/2021 2021071371 12/10/2021 202108172F
39 Q-000VOG25 3575011101000002 MOH. RAFI MUZAHY 21 UMUM JL KYAI SEPUH 2/6 GENTONG 8233283315 CoronaVac 09/09/2021 202108118H 12/10/2021 202108172F
40 Q-000VOHWI 3575016311030001 HANNAH AL HAYA 18 UMUM JL KYAI SEPUH 2/6 GENTONG 8576367097 CoronaVac 09/09/2021 202108118H 12/10/2021 202108172F
41 Q-000XNF7C 3575011604030001 UDAY SYUHADAH 18 UMUM JL MULYOREJO 2/6 SEBANI 8983916242 CoronaVac 14/09/2021 202108118H 12/10/2021 202108172F
44 P-3XPP9BNR 3575014610060001 LYSSA NUR RAMADHANY 15 REMAJA PERUM KRATON INDAH 8578118659 CoronaVac 12/10/2021 202108172F
45 P-FSJIXO4P 3514200706670002 AKHMAD MUNIR 54 RENTAN KEDAWUNG WETAN 8212283827 CoronaVac 12/10/2021 202108172F
46 P-28HUY5VG 3575014104930001 MUSRIFAH 28 UMUM JL BANDA 8223311929 CoronaVac 12/10/2021 202108172F
10-09-2021 PUSTU GENTONG
1 S-38566937 3575010107520029 ABD ROKIB 69 LANSIA GENTONG RT 1 RW 3 8113777705 CoronaVac 09/10/2021 202108172F
2 S-C1A17411 3575011709590001 YAGUS SALEH 62 LANSIA GENTONG RT 1 RW 4 8585248095 CoronaVac 09/10/2021 202108172F
3 S-6E52BF55 3575014101570005 YANAH 64 LANSIA JL SLAMET RIADI GG 13 - CoronaVac 09/10/2021 202108172F
4 P-PW7LVXDJ 3575011012620002 SAFAK 58 RENTAN GENTONG 3/1 8569312707 CoronaVac 09/10/2021 202108172F
5 P-PYNMFPV9 3575010607680003 ATIM DURIYATNO 53 RENTAN GENTONG RT 3 RW 3 8213008380 CoronaVac 09/10/2021 202108172F
6 P-Q2TZ9CC2 3575010101600011 MOH. AMIN 59 RENTAN JL SLAMET RIYADI 8311541103 CoronaVac 09/10/2021 202108172F
7 P-Q3CHT83S 3575011612670001 MUKHAMMAD SOLEH 54 RENTAN JL SLAMET RIYADI 8133342397 CoronaVac 09/10/2021 202108172F
8 P-Q4L46D40 3575014503710004 JUMAINAH 50 RENTAN GENTONG 1 / 3 8213008380 CoronaVac 09/10/2021 202108172F
9 P-PXXWYU94 3575010607680002 ABD MUJIB 53 RENTAN gentong rt 3 rw 3 8213008380 CoronaVac 09/10/2021 202108172F
10 P-PX39PNIC 3575011710820001 YOYOK SISWANTO 39 UMUM GENTONG RT 1 RW 3 8133219230 CoronaVac 09/10/2021 202108172F
11 P-PZ70I4VW 3575016901970001 LUSIANA 24 UMUM GENTONG RT 1 RW 3 8569312707 CoronaVac 09/10/2021 202108172F
12 P-0VZHAZHR 3575014104720003 SA'IDAH 49 UMUM JL SLAMET RIYADI 8523303301 CoronaVac 09/10/2021 202108172F
13 P-Q0IRK9RC 3575010201940002 IRWAN PRATAMA 27 UMUM JL SLAMET RIYADI 8128146913 CoronaVac 09/10/2021 202108172F
14 P-Q10LO1CQ 3575011310920001 PUJI ATMOKO 29 UMUM JL SLAMET RIYADI 8525227511 CoronaVac 09/10/2021 202108172F
15 P-Q1HLFT5D 3575015707830001 NUR FATIMAH 38 UMUM GENTONG 1/3 8967874599 CoronaVac 09/10/2021 202108172F
16 P-Q2CPGYKY 3575014501800001 AMIATI 41 UMUM GENTONG RT 2 RW 2 8564892923 CoronaVac 09/10/2021 202108172F
1 P-OUSUB2ZK 3514195410990006 DEWI ASTUTIK 22 UMUM JL. Gatot Subroto RT03 RW05 - Bukir 8133671758 CoronaVac 09/10/2021 202108172F
2 P-OKRNFANQ 3575016809910001 UCIK SETYARINI 30 UMUM JL. Gatot Subroto RT03 RW05 - Bukir 8950801319 CoronaVac 09/10/2021 202108172F
3 P-CTIZQCIL 3575016709900001 KHUSNUL KHOTIMAH 31 UMUM JL. Slamet Riyadi RT01 RW06 - Sebani 8952336276 CoronaVac 09/10/2021 202108172F
4 Q-000RTLC2 3575016808880005 RINA KRISDIANTINI 33 UMUM JL URIP SUMOHARJO RT02/RW03 BUKIR 8131529040 CoronaVac 31/08/2021 24202321 G 09/10/2021 202108172F
5 Q-000SSHB4 3514182501080002 ACHMAD YANUAR 13 REMAJA JL GATOT SUBROTO 1/4 BUKIR 8820098636 CoronaVac 01/09/2021 2021071371 09/10/2021 202108172F
6 Q-000VRQTM 3575013105080002 MOCHAMAD REIFAN ALI 13 REMAJA JALAN GATOT SUBROTO RT 1 RW 4 BUKIR 8224593726 CoronaVac 09/09/2021 2021071371 09/10/2021 202108172F
10-09-2021 MTs NAHDLATUN WATON
1 Q-000WC7HH 3514164512080001 SITI AISYAH 13 REMAJA KEBONSAWAH KRATON 8384975606 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
2 Q-000WDESP 3575010403090001 SINTA FARKHIYAH 12 REMAJA JL HANGTUAH GADINGREJO 8135905648 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
3 Q-000WCTM4 3575015306060001 MAYA ZAKIYAH 15 REMAJA JL HANGTUAH GADINGREJO 8383400490 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
4 Q-000WCHPM 3575014206080001 AISYA 13 REMAJA JL HANGTUAH 8953671990 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
5 Q-000WKDKV 3575026903080003 SHOFIA RAHMADINA 12 REMAJA JL HALMAHERA 8312027815 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
6 Q-000WC50H 3575015007070003 NABILATUL RIZQIYA 14 REMAJA JL HANGTUAH GADINGREJO 8574921064 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
7 Q-000WCTLU 3575024705080001 URIFATUL LAILIA 13 REMAJA JL HANGTUAH X GADINGREJO 8898907600 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
8 Q-000WBZWZ 3514164605090003 IQLIL ANIQIYAH 12 REMAJA KEBONSAWAH KRATON 8788799394 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
9 Q-000WCK3Z 3514162711080003 AKHMAD RAFI ZULFIKAR 13 REMAJA KEBONSAWAH 4/7 KRATON 8810369933 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
10 Q-000WDE09 3514162206080001 M. ARDIANSYAH PUTRA 13 REMAJA Kebon sawah 8213212104 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
11 Q-000WG5V5 3575016806080003 NIKMATUS SOLIKHAH 13 REMAJA JL HANGTUAH GADINGREJO 8815540955 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
12 Q-000WCTXE 3575016704080006 BAKHRIYA 13 REMAJA JL HANGTUAH 8385091913 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
13 Q-000WG6B1 3514161110080002 RIZKY MAULANA 13 REMAJA KEBONSAWAH KALIREJO 8224287302 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
14 Q-000WDLFV 3575016111070001 ZAIDA MANELA 14 REMAJA JL HANGTUAH 8191817137 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
15 Q-000WE8F8 3575011605080004 WILDAN KAMADANI 13 REMAJA JL HANGTUAH GADINGREJO 8573022018 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
16 Q-000WEQNM 3575012205080002 MOKHAMMAD SYAHRUL KAMAL 13 REMAJA JL HANGTUAH GADINGREJO 8193222516 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
17 Q-000WEUZO 3575013009070001 MUHAMMAD YUSRIL 14 REMAJA JL HANGTUAH GADINGREJO 8779442053 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
18 Q-000WCKJ4 3575010809080004 MOCHAMMAD ALI KHAMDAN 13 REMAJA J HANGTUAH GADINGREJO 8382404566 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
19 Q-000WGI24 3514162208070001 ABD. ROCHMAN 14 REMAJA GUMENG KALIREJO 8570851704 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
20 Q-000WGI1Y 3575012808080001 MUHAMMAD ALI BAHRUDIN 13 REMAJA JL HANGTUAH 8311060499 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
21 Q-000WGHYB 3575012111070002 MOKHAMAD RIZAL 14 REMAJA JL HANGTUAH 8523138039 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
22 Q-000WG5RQ 3575010410080001 SALMAN ALFARIZI 13 REMAJA JL HANGTUAH 8385010616 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
23 Q-000WETCX 3575012905080001 MOCHAMMAD CHAMDANI 13 REMAJA JL HANGTUAH GADINGREJO 8384610086 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
24 Q-000WE914 3575011603980003 ACHMAT BAIHAQI 13 REMAJA JL HANGTUAH GADINGREJO 8574823834 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
25 Q-000WE2H0 3575011706080003 MUHAMMAD KEVIN DARMADI 13 REMAJA JL HANGTUAH 8585340120 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
26 Q-000WIHS7 3575010507070002 MOCHAMMAD FARIKH ANWAR 14 REMAJA JL HANGTUAH GADINGREJO 8574843855 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
27 Q-000WE87G 3575012503080002 ALFAN FIQRIL HAKIM 13 REMAJA JL HANGTUAH GADINGREJO 8383105364 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
28 Q-000WBXPK 3575014202080002 FATIMATUZ ZAHRA 13 REMAJA JL HANGTUAH GADINGREJO 8853356015 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
29 Q-000RN13L 3575011607070001 ACHMAD ALFIN ROZABI 14 REMAJA TAMBAAN 03/01 8319281439 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
30 Q-000WE4U5 3575010109060001 ACH FATKHUR ROKHMAN 15 REMAJA JL HANGTUAH 8969976861 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
31 Q-000WDIUL 3575011408070002 MOCHAMMAD RAJALI ALFI SYAHRIN 14 REMAJA JL HANGTUAH TAMBAAN 8213291990 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
32 Q-000WGHUZ 3575010301080002 ABDUL ROCHIM 13 REMAJA JL HANGTUAH GADINGREJO 8961283288 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
33 Q-000WE6SB 3575011508090001 TAFIQ HIDAYAT 12 REMAJA JL HANGTUAH GADINGREJO 8573278462 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
34 Q-000WE20P 3575010705070002 LUTFI ILHAMSYAH 14 REMAJA JL HALMAHERA GADINGREJO 8585010614 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
35 Q-000WH633 3575011410060003 ANDRIAN MAULANA MARWAN 15 REMAJA JL HALMAHERA TAMBA'AN 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
36 Q-000WDIRR 3575012708080003 ACHMAD GHILMANUS SABIL 13 REMAJA JL HALMAHERA GG 9 8314947143 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
37 Q-000WHUVD 3575012910070002 ABDUL HALIM 14 REMAJA JL HANGTUAH GADINGREJO 8384849037 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
38 Q-000WETGN 3575010208090003 MUHAMMAD FAHRI 12 REMAJA JL HANGTUAH GADINGREJO 8125941295 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
39 Q-000WGQKJ 3575011503070002 MUCHAMMAD ALI 14 REMAJA JL HANGTUAH GADINGREJO 8383411805 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
40 Q-000WG5SE 3575041507080001 MOCHAMAD NIKO 13 REMAJA JLHANGTUAH GADINGREJO 8880912326 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
41 Q-000WDC3S 3575012809080002 MUHAMMAD RIZKI RAMADHANI 13 REMAJA JL HALMAHERA 8849755823 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
42 Q-000WG76S 3575011902070003 MUHAMMAD KHOIRUL ANAM 14 REMAJA JL HALMAHERA TAMBA'AN 8383430558 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
43 Q-000WH752 3514164711070004 AMIRATUS SOLIHAH 14 REMAJA TAMBAAN GADINGREJO 8384975538 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
44 Q-000WKQA4 3575015402080001 MAYA NABILA 13 REMAJA JL HALMAHERA TAMBA'AN 8213277317 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
45 Q-000WHW9D 3575015501080001 MADINATUL MUNAWAROH 13 REMAJA JL HANGTUAH GADINGREJO 8823015857 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
46 Q-000WE6G3 3575012307080002 ACHMAD HARUN 13 REMAJA JL HANGTUAH GADINGREJO 8384859862 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
47 Q-000WGOFN 3575017012060003 AINUR ROFIQO 15 REMAJA JL HANGTUAH 8961400211 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
48 Q-000WH67O 3575015507060001 KHUSNATUL KARIMAH 15 REMAJA JL HANGTUAH GADINGREJO 8222956030 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
49 Q-000WH6QP 3575014908010005 DEWI SURYANTI AGUSTIN 15 REMAJA JL HANGTUAH GADINGREJO 8382330224 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
50 Q-000WG5QK 3575016002070004 AINUN ROHMA 14 REMAJA JL HANGTUAH GADINGREJO 8313947442 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
51 Q-000WG5PJ 3575016110070002 ANITA 14 REMAJA JL HANGTUAH 8383107325 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
52 Q-000WGQFS 3575011206060005 MOCHAMMAD FARIZI 15 REMAJA APARTEMEN PANTAI MAS TAMBA'AN 8382404609 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
53 Q-000WGIT1 3575011706070002 MUHAMMAD TAUFEK 14 REMAJA JL HANGTUAH GADINGREJO 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
54 Q-000WGHW2 3575012101060001 MUHAMAD ADAM FIRDAUS 15 REMAJA JL HANGTUAH GADINGREJO 8311441421 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
55 Q-000WG5OL 3575014403080002 SHOFIYAH 13 REMAJA JL HALMAHERA GADINGREJO 8585010614 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
56 Q-000WK74F 3514161707070002 HELMALIANA PUTRI 14 REMAJA KEBUNSAWAH KALIREJO 8773801434 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
57 Q-000WIBL2 3575015309070001 NIDA AZZAHRA RAMADHAN 14 REMAJA JL HANGTUAH 8951527609 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
58 Q-000WHATS 3575046008060001 NUR DIANA 15 REMAJA TAMBAAN GADINGREJO 8122903709 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
59 Q-000WIFN8 3575034202080004 MAHFURO 14 REMAJA TAMBAAN GADINGREJO 8213837908 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
60 Q-000WHAC3 3575015409060004 MUFARROKHATUL ISMA 15 REMAJA JL HALMAHERA GADINGREJO 8311060499 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
61 Q-000WHVJV 3514165801070001 MUNIROTUL ARAFAH 14 REMAJA KISIK KALIREJO 8560767539 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
62 Q-000WGKN1 3575010101060002 MOCHAMMAD ILHAM KHAMDANI 15 REMAJA JL HALMAHERA TAMBA'AN 8880491698 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
63 Q-000WIW5V 3575016305070001 UMMU ZAKIYAH 14 REMAJA JL HANGTUAH 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
64 Q-000WIL9K 3575015003060001 FATIMATUS ZAHROH 15 REMAJA JL HALMAHERA 8311441442 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
65 Q-000WJTYT 3575016911050003 MUSRIFAH 16 REMAJA JL HANGTUAH 8133412137 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
66 Q-000WG5PE 3575014107060009 ZAKIATUL FACHIROH 15 REMAJA JL HANGTUAH GADINGREJO 8560741572 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
67 Q-000WGI1D 3575012110070002 MUHAMMAD SIROZUDIN 14 REMAJA JL HANGTUAH 8575505550 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
68 Q-000WLS3I 3575010107050020 SAMSUDIN 16 REMAJA JL HANGTUAH 8573139653 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
69 Q-000WKBGK 3575011911040005 M. ALI WAFA 17 REMAJA JL HANGTUAH 8313282437 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
70 Q-000WKXAH 3575017005070002 MUTIMFIA 14 REMAJA JL HANGTUAH GADINGREJO 8574534742 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
71 Q-000WHUO7 3575016808050002 LAILI NOR AFIFAH 16 REMAJA JL HALMAHERA 8574832567 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
72 Q-000WH7AS 3575014510020001 DINDA PUTRI RAMADANI 14 REMAJA JL HANGTUAH GADINGREJO 8312516607 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
73 Q-000WJY7O 3514164603080002 NABILA 13 REMAJA GUMENG KRATON 8384668223 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
74 Q-000WFBJB 3575015810070001 FITRI SILVIANY 14 REMAJA JL HALMAHERA GADINGREJO 8319479185 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
75 Q-000WFLGW 3514165504060001 DINI MAULIDIA 15 REMAJA KISIK KALIREJO 8313947049 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
76 Q-000WG83F 3575014107060007 SITI ZAIRINA 15 REMAJA JL HANGTUAH GADINGREJO 8380411710 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
77 Q-000WJ71K 3514164609060005 NURUL A'YUNI 15 REMAJA JL HANGTUAH GADINGREJO 8383430373 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
78 Q-000WJOYX 3575026003060001 SITI NUR AINI 15 REMAJA JL HANGTUAH 8384813310 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
79 Q-000WH8NJ 3575015805070003 ROUDOTUL HIKMAH 14 REMAJA JL HANGTUAH 8786676373 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
80 Q-000WK6AX 3575011912050001 MUCHAMMAD NABAWI 16 REMAJA JL HANGTUAH 8318566489 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
81 Q-000WINEQ 3575015010060003 ERNI KURNIA RAMADHANI 15 REMAJA JL HALMAHERA TAMBAAN 8383428120 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
82 Q-000WI038 3575011407050005 MOKHAMMAD AFIF YUSRO 16 REMAJA JL TAMBAAN 8383429393 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
83 Q-000WK692 3575014508050001 ALWIYAH NUR AINI 16 REMAJA JL HANGTUAH GADINGREJO 8382355144 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
84 Q-000WHA0S 3575012410070002 ALDI GILANG ROMADHON 14 REMAJA JL HALMAHERA TAMBA'AN 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
85 Q-000WJ15R 3575016503070004 MAULIDIYAH 14 REMAJA JL HANGTUAH 8121728006 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
86 Q-000WIP1K 3575016509060004 NURIATUL FADHILLAH 15 REMAJA TAMBAAN GADINGREJO 8311103306 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
87 Q-000WIVCT 3575014406060001 FERA FAIZAH 15 REMAJA JL HANGTUAH 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
88 Q-000WG5Q3 3575045007080001 YULIA ROHMA 13 REMAJA JL HALMAHERA GADINGREJO 8380120819 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
89 Q-000WIY4A 3575015805060003 LAILATUL QOMARIA 15 REMAJA JL HANGTUAH GADINGREJO 8213195907 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
90 Q-000WKQC0 3575011310060004 MUHAMMAD IQBAL ROMADHON 15 REMAJA TAMBAAN GADINGREJO 8315594885 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
91 Q-000WKR28 3575040102040001 ABDUL ROKHMAN 17 REMAJA TAMBAAN GADINGREJO 8311441409 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
92 Q-000WJU6B 3575014906050001 SHOFIYAH MADINA 16 REMAJA JL HANGTUAH 8570616040 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
93 Q-000WL76X 3514160204070006 AKH. FAYRUZZEN MAULIDI 14 REMAJA GUMENG KRATON 8125960490 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
94 Q-000WIEOX 3575015402060004 IRKHAMNA 15 REMAJA JL HANGTUAH TAMBA'AN 8315375568 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
95 Q-000WK62J 3514165404100004 NOR AINI 13 REMAJA GUMENG KRATON 8383153181 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
96 Q-000WIJD5 3575016004030005 INDAH LESTARI 17 REMAJA J HANGTUAH 8313488867 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
97 Q-000WINOM 3575014806060002 WAHYUNI SUFAYYAH 15 REMAJA JL HANGTUAH 8191320301 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
98 Q-000WHU7O 3514165002070002 ISNAINILLAH 14 REMAJA DUSUN KEBON SAWAH 8533560149 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
99 Q-000WLCMP 3514160510050003 M.SYAHRUL ROMADHONI 16 REMAJA KRAMAT GONDANGWETAN 8311441444 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
100 Q-000WH6TU 3575015107060001 SITI AZIZAH 15 REMAJA JL HANGTUAH GADINGREJO 8783707823 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
101 Q-000WI0R4 3575015505060004 ZAHRA ZAHNIA PUTRI 15 REMAJA JL HANGTUAH GADINGREJO 8383275231 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
102 Q-000WIBWH 3575016811060002 NURUL HIDAYATI 15 REMAJA JL HANGTUAH TAMBA'AN 8979002961 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
103 Q-000RN164 3575010303050002 M. ARIEL HIDAYATULLOH 16 REMAJA JL. HANGTUAH III RT 04 RW 01 TAMBAAN 8953648579 Biofarma 31/08/2021 24202221 T 09/10/2021 202108172F
104 Q-000WLCX2 3575022905060002 M. NASICHUDIN 15 REMAJA JL HANGTUAH 8952988555 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
105 Q-000WL8LY 3575011203060001 M. ZEFRI ABDILLAH 15 REMAJA JL HANGTUAH 8381820542 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
106 Q-000WKSY2 3575011305060001 NURDIN 15 REMAJA JL HANGTUAH 8953950479 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
107 Q-000WLBT7 3575011308060001 M. KHOIRU RIZKY 15 REMAJA JL HANGTUAH 8180840416 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
108 Q-000WKU93 3575013105070002 M. MAULANA SYADIR 14 REMAJA JL HANGTUAH 8311441412 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
109 Q-000WG5CH 3575012708070002 MUCHAMMAD ALI MAKHROBI 14 REMAJA JL HANTUAH 8313282437 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
110 Q-3C230421 3575045708710001 SITI AMINAH 50 RENTAN JL HANGTUAH 8585266474 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
111 Z-E9A459F5 3575012606740002 MUHAMMAD MUNIRUDDIN 47 UMUM JL HALMAHERA NO 45 8180565655 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
112 Q-000WKUV1 3575010706030002 M. GHOZALI 18 UMUM JL HANGTUAH 8113777705 Biofarma 11/09/2021 202108118H 09/10/2021 202108172F
113 P-OK6IYXY2 3575014512610001 PAENI 60 LANSIA Jl. Hangtuah rt 04 rw 03 8318524654 Biofarma 09/10/2021 202108172F
114 P-OJ2YXB3J 3575016505070006 NURUL BAHRIYA 14 REMAJA Jl. Halmahera Gg. IX 8313949405 Biofarma 09/10/2021 202108172F
115 P-OI37GCZK 3575011208050004 EVA WULANDARI 16 REMAJA Jl. Hangtuah rt 04 rw 02 8533493401 Biofarma 09/10/2021 202108172F
116 P-OVZVSSVY 3575012911050002 MUKHAMMAD SAMSUL MUBARROK 16 REMAJA JL. HANGTUAH GG 4 RT 02 RW 04 8573025475 Biofarma 09/10/2021 202108172F
117 P-OJ59PQMJ 3514166512080008 KHOMARIYAH 13 REMAJA gadingrejo rt 01 rw 04 8383173527 Biofarma 09/10/2021 202108172F
118 P-OTUT4PQU 3514164611070003 FITRI NOLATUL HOLIYA 14 REMAJA KEBONSAWAH RT 02 RW 07 8314095417 Biofarma 09/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
119 P-OHC1QIMH 3575014806070003 ADIFA NOFITA 14 REMAJA Jl. Hangtuah Gg 4 rt 02 rw 04 8823188386 Biofarma 09/10/2021 202108172F
120 P-OU3OIA8D 3575016504050004 FIDROTUL MAULIDIA 16 REMAJA JL. HALMAHERA Gg. V/69, PANGGUNGREJO, 8581527337 Biofarma 09/10/2021 202108172F
121 P-OUJMBOL5 3575012807050001 WAFIK SUBADHA 16 REMAJA JL. HANGTUAH GG 4 RT 02 RW 04 8233066572 Biofarma 09/10/2021 202108172F
122 P-OVAFRWQ6 3575012704060005 M. SUKRON HABIBI 15 REMAJA HL. HANGTUAH GG 4 RT 02 RW 04 8383105817 Biofarma 09/10/2021 202108172F
123 P-L8QW5AM0 3575031412060001 MUKHAMMAD DIMAS RUR 15 REMAJA gadingrejo rt 004 rw 002 8311441425 Biofarma 09/10/2021 202108172F
124 P-OG2DE48A 3514166605070001 NUR AINI 14 REMAJA Kebonsawah rt 01 rw 007 8573139644 Biofarma 09/10/2021 202108172F
125 P-OEIPIBRK 3575015204050003 RANI RAHMAWATI 16 REMAJA Jl. Halmahera rt 04 rw 03 Kelurahan Tambaan 8214130146 Biofarma 09/10/2021 202108172F
126 P-OOFZ6MFD 3575014510060005 SAKINATUL FITRIAH 15 REMAJA JL. HALMAHERA GG 9 RT 01 RW 05 8593126895 Biofarma 09/10/2021 202108172F
127 P-ORY8L3WL 3575012204050002 M.AZIDDAN MAULANA 16 REMAJA JL. HALMAHERA Gg.9, GADINGREJO, PASURUA 8385038498 Biofarma 09/10/2021 202108172F
128 P-OQZHZ9AA 3575011705080003 AFIF RISKI 13 REMAJA JL. HALMAHERA GG 9 RT 05 RW 05 8135992299 Biofarma 09/10/2021 202108172F
129 P-OSESF40S 3514163012060002 M. SAIFI 15 REMAJA JL. HANGTUAH RT 05 RW 07 8384172267 Biofarma 09/10/2021 202108172F
130 P-OSS3FHN2 3575010105060001 MUHAMMAD ALI FIKRI 15 REMAJA JL. HALMAHERA Gg. 9, GADINGREJO, PASURU 8389851023 Biofarma 09/10/2021 202108172F
131 P-OP7ITBFQ 3575011607080003 M. ILHAM 13 REMAJA JL. HALMAHERA RT 2 RW 3, TAMBAAN, PASUR 8983396276 Biofarma 09/10/2021 202108172F
132 P-LQIDIFPR 3575014905060002 ALFIRA REZA MAULIDIYA 15 REMAJA Jl. Halmahera rt 03 rw 05 Kelurahan Gadingrejo 8138394922 Biofarma 09/10/2021 202108172F
133 P-NTJI1WAP 3575016106060002 ILFI NURDIANA 15 REMAJA Jl. Halmahera Gg 7 rt 01 rw 05 kelurahan Gadingre 8776329761 Biofarma 09/10/2021 202108172F
134 P-OATWKZPC 3575015702070002 WARSITA SARI 14 REMAJA Jl. Hangtuah rt 04 rw 04 Kelurahan Gadingrejo 8312515641 Biofarma 09/10/2021 202108172F
135 P-OPYAJQS4 3514165112070001 LAILATUL ILMIYAH 14 REMAJA KEBON SAWAH, RT 4 RW 1, KALIREJO, PASUR 8384849048 Biofarma 09/10/2021 202108172F
136 P-OQU7AGGM 3514161304060004 MUHAMMAD YUSRIL MAHENDRA 15 REMAJA KEBONSAWAH, RT 3 RW 7, KALIREJO, PASURU 8311450857 Biofarma 09/10/2021 202108172F
137 P-ON96BTHM 3575015205060004 DIAN SAFITRI 15 REMAJA JL. HANGTUAH GG 2 RT 01 RW 03 8574843854 Biofarma 09/10/2021 202108172F
138 P-OLRNRDJH 3575011702090002 ACHMAD SAIFUL ANWAR 12 REMAJA JL. HANGTUAH RT 4 RW 4, GADINGREJO 8574535730 Biofarma 09/10/2021 202108172F
139 P-OMV6OLYA 3514160807080003 MUHAMMAD IWANUR ROHMAN 13 REMAJA KEBONSAWAH, RT 4 RW 7, KALIREJO, PASURU 8590311873 Biofarma 09/10/2021 202108172F
140 P-PKPMDNUH 3575015202050001 SITI KHOIRIYAH 16 REMAJA JL. HANGTUAH, GADINGREJO 8318524654 Biofarma 09/10/2021 202108172F
141 P-IKNTXAJ5 3575035109970002 NINDYA WAHYUWI CAHYANINGRUM 24 UMUM JL DR WAHIDIN S HUSODO IV / 28 8223348731 Biofarma 09/10/2021 202108172F
142 P-AMK8SI2G 3575024611860001 ARDIYAH PRATIWI 35 UMUM Jl. KH Ahmad Dahlan Gg 15 No. 1 rt 005 rw 005 8215777965 Biofarma 09/10/2021 202108172F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-08-2021 INDUK
1 Q-0001J5KI 3575032204960002 INDRA IWANTO 25 UMUM JL DIPONEGORO NO. 62 8199998171 Astrazeneca 09/06/2021 ABV652 08/10/2021 PW40166
2 Q-000AV33A 3575012503610003 ARIFIN 60 LANSIA JL GATOT SUBROTO RW 07 RT 001,GADINGRE 8121634915 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
3 Q-000B0PEO 3575010105690001 WARSITO 53 RENTAN JL URIP SUMOHARJO 8510162443 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
4 Q-000AX29I 3575017112700001 MUDJIATI 51 RENTAN JL URIP SUMOHARJO 8510162443 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
5 Q-000AWSC1 3514185207980001 ZUMROTUN NAFISA 24 UMUM JL URIP SUMOHARJO 8579170379 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
6 Q-000AWYWP 3575011411770001 ARIF NOVIANTO 44 UMUM JL URIP SUMOHARJO, BUKIR 8100000000 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
7 Q-000AWF64 3505077012920004 WIDIASTUTIK 29 UMUM JL SLAMET RIYADI GG.12 B, 1/3, GENTONG, G 8586098689 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
8 Q-000AW4FC 3575011205760003 DWI NARTO 45 UMUM JL SLAMET RIYADI, GADINGREJO, GENTONG 8125939988 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
9 Q-000ASRNV 3575023005980005 KEVIN JONATHAN HARNANTA 23 UMUM PERUM KARYA BAKTI N-25, JAWA TIMUR, KOT 8225754918 Astrazeneca 03/07/2021 ABY1911 08/10/2021 PW40166
10 Q-000E1FSP 3575021405010002 MOCH. WICAKSONO RACHMATILLA 20 UMUM JL KI HAJAR DEWANTARA 8123135761 Astrazeneca 13/07/2021 ABY1911 08/10/2021 PW40166
11 P-LNZ9IMA1 3575012801740002 SLAMET 52 RENTAN JL HALMAHERA RT02/RW05 GADINGREJO 8113777705 Astrazeneca 08/10/2021 PW40166
12 P-JABCAPT6 3514164405860004 SULISTIYANINGSIH 35 UMUM KEDONDONG SEMARE KRATON 8523112634 Astrazeneca 08/10/2021 PW40166
13 P-L3DZ7MHD 3575016508820001 ST AMANI 44 UMUM JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8786452405 Astrazeneca 08/10/2021 PW40166
14 P-KRAYPEM6 3575014110970001 SITI SOLIKHA 24 UMUM JL HALMAHERA RT01/RW 10 TRAJENG PANGG 8135919127 Astrazeneca 08/10/2021 PW40166
15 P-AWQWZRFO 6473016908890006 NURUL JANAH 32 UMUM JL HANGTUAH RT04/RW04 GADINGREJO 8570616537 Astrazeneca 08/10/2021 PW40166
16 P-E6KAG0U9 3575015708850008 ASIYAH 36 UMUM JL HALMAHERA RT 02/05 GADINGREJO 8113777705 Astrazeneca 08/10/2021 PW40166
17 P-K9J77DI1 3514160809020001 AKHMAD MUDAKKIR 19 UMUM JL HANGTUAH RT04/RW03 GADINGREJO 8969620560 Astrazeneca 08/10/2021 PW40166
18 P-LDASVO1I 3575014204850003 MALIKHA 39 UMUM JL HALMAHERA RT03/RW05 GADINGREJO 8113777705 Astrazeneca 08/10/2021 PW40166
19 P-LGJWV2OK 3575012004980003 M. SAIFUL ANWAR 23 UMUM JL GATOT SUBROTO RT02/RW04 BUKIR 8132678707 Astrazeneca 08/10/2021 PW40166
20 P-LHKRJPCM 3518084409890001 MUJI RAHAYU 32 UMUM JL TRIMO KEMANTREN REJO,REJOSO 8570706614 Astrazeneca 08/10/2021 PW40166
21 P-LL6UK08T 3514231105850001 MOHAMMAD GHOFUR 36 UMUM JL TRIMO KEMANTRENREJO REJOSO 8570706614 Astrazeneca 08/10/2021 PW40166
22 P-LNN7HZAL 3575010307000007 AHMAD HIDAYAT RAHMATULLOH 21 UMUM JL HANGTUAH 1/4 8113777705 Astrazeneca 08/10/2021 PW40166
23 P-LN949PWQ 3575011605890001 MUHAMMAD SAHI 32 UMUM JL HANGTUAH 1/4 8385336193 Astrazeneca 08/10/2021 PW40166
24 P-LMQNBOUJ 3514160802720002 FATHURROHMAN 49 UMUM JL HANGTUA 8969620560 Astrazeneca 08/10/2021 PW40166
25 P-LP6X7TUF 3575036802740002 RUWAIDAH 47 UMUM JL SEMANGKA II BLOKG4 NO20 BUGUL KIDUL 8233131083 Astrazeneca 08/10/2021 PW40166
26 P-LQJUNC8J 3575016907910001 SITI AISYAH 29 UMUM JL HALMAHERA GG9 RT01/RW05 GADINGREJO 8133222119 Astrazeneca 08/10/2021 PW40166
27 P-LN3TA0X3 3575014107780093 NUR ROCHMAH 46 UMUM JL HALMAHERA RT02/RW05 GADINGREJO 8113777705 Astrazeneca 08/10/2021 PW40166
28 P-LTDD2BBJ 3514164204890017 RIF'ATUL KHUSNIA 32 UMUM JL BANDA GG TERATAI 8510706374 Astrazeneca 08/10/2021 PW40166
29 Z-0000HBQK 3575016108680002 TASLIMAH 66 LANSIA NGAGLIK PASURUAN 8385199008 CoronaVac 12/06/2021 24002621 08/10/2021 202108172F
30 Z-0005E717 3575014107530095 SULAMI 66 LANSIA JL BANDA 11 - CoronaVac 24/06/2021 24003521 08/10/2021 202108172F
31 Q-000AWRQY 3575012610760003 YUSA ISWAHYUDI 45 UMUM JL GATOT SUBROTO 004/002 GADINGREJO, P 8123334533 CoronaVac 03/07/2021 24200821 08/10/2021 202108172F
32 Q-000AVLFY 3575030409900002 MUHAMMAD SUKRON 31 UMUM JL JEND S PARMAN 8133625852 CoronaVac 03/07/2021 24003521 08/10/2021 202108172F
33 Q-000B70BO 3575015606760003 WINARSIH 45 UMUM JL GATOT SUBROTO, PETAHUNAN 8585900017 CoronaVac 05/07/2021 24003521 08/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34Q-000E96XZ 3575010302070003 ZIDANE LAUDZA'I GHAZAM 14 REMAJA JL GATOT SUBROTO, 8575596017 CoronaVac 10/07/2021 24200421 08/10/2021 202108172F
35Q-000ENNO1 3575011807020001 ZAINUDIN ZIDAN 19 UMUM JL HALMAHERA GG IXB /66 GADINGREJO 8953363990 CoronaVac 15/07/2021 24200421 08/10/2021 202108172F
36K-0000VWCT 3575010503030005 UMAR FAROK 18 UMUM KEL SINGONEGARAN , KEC BANYUWANGI ,KA 8580642685 CoronaVac 29/08/2021 24202221 08/10/2021 202108172F
37Q-000T8R46 3575011004800001 ACHMAT KHUSAIRI 41 UMUM JL HALMAHERA 4/5 GADINGREJO 8113777705 CoronaVac 03/09/2021 2021071371 08/10/2021 202108172F
38Q-000T8PUC 3575014107720070 SULIKHAH 49 UMUM JL BANDA 4/2 GADINGREJO 8235820152 CoronaVac 03/09/2021 2021071371 08/10/2021 202108172F
39Q-000UWBPJ 3575015011900001 ERLIN KARLINA 31 UMUM JL SLAMET RIYADI 1/5 GENTONG 8574608573 CoronaVac 08/09/2021 2021071371 08/10/2021 202108172F
40Q-000VMZ9I 3575031102700001 MUNADJI 51 RENTAN JL SEMANGKA 8/6 BUGUL KIDUL 8233131083 CoronaVac 09/09/2021 202108118H 08/10/2021 202108172F
41Q-000VEE33 3575011507900001 MUCH MA'RUF 31 UMUM JL GATOT SUBROTO 3/4 BUKIR GADINGREJO 8575524214 CoronaVac 09/09/2021 2021071371 08/10/2021 202108172F
42Q-000VXFCQ 3575010107680068 ABU BAKAR 53 RENTAN JL BANDA 6/2 GADINGREJO 8838510264 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
43Q-000VXFSU 3575016206650001 ENDAH WAHIDAH 56 RENTAN JL BANDA 6/2 GADINGREJO 8113777705 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
44Q-000VXBFB 3575015510650004 CHABIBAH 56 RENTAN JL SLAMET RIYADI 3/1 SEBANI 8364661619 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
45Q-000VXK24 3575010107640048 MUNIR ZA 57 RENTAN JL BANDA 6/2 GADINGREJO 8113777705 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
46Q-000VXBHI 3575010812650001 ZAINUDIN 56 RENTAN JL BANDA 5/2 GADINGREJO 8838510264 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
47Q-000VX82S 3575015001950003 SITI RUKHAYATIN MASRUFA 26 UMUM JL HALMAHERA 5/5 GADINGREJO 8966543797 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
48Q-000VX5YF 3575015309010002 PUTRI NABILATUL KASIATI 20 UMUM JL BANDA 5/2 GADINGREJO 8823566569 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
49Q-000VX83O 3575016105810001 ROFIK KUSNIAWATI 40 UMUM JL BANDA 5/2 GADINGREJO 8823566569 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
50Q-000VX5FM 3575014308790001 ANIK WIDYANINGSEH 42 UMUM JL SLAMET RIYADI RW 04 RT 001 8123114322 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
51Q-000VX5UQ 3505101004740008 PRIYANTO 47 UMUM JL SLAMET RIYADI 1/4 GENTONG 8123114322 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
52Q-000VY6J1 3575022904860004 KHAIRUL ANAM 35 UMUM JL HANG TUA 4/3 GADINGREJO 8537710472 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
53Q-000VXXNO 3575016708910001 KHOIROTUN NISA' 30 UMUM JL HANG TUA 4/3 GADINGREJO 8223346362 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
54Q-000VX7XC 3575017009990002 SEPTIA AULIANSYAH 22 UMUM JL SLAMET RIYADI 1/4 GENTONG 8585248095 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
55Q-000VXFTQ 3575010909770003 SAIFUL ROCHMAN 44 UMUM JL BANDA 6/2 GADINGREJO 8787843712 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
56Q-000VXJWM 3514200101890017 SIGIT JANUAR 32 UMUM SEMAMBUNG 4/4 GRATI 8570619819 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
57Q-000VX842 3518036004960006 APRILINA PURI RAHAYU 25 UMUM JL KYAI SARQOWI 2/3 TEMBOKREJO 8574883209 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
58Q-000VXXWS 3575016212900003 MISRIATI 31 UMUM JL BANDA 4/2 GADINGREJO 8564873889 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
59Q-000VX5SE 3575014909920002 ERNI ANDONI 29 UMUM JL SLAMET RIYADI 2/4 GENTONG 8223136826 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
60Q-000VY6AR 3575010505890002 IMAMUL MUTTAQIN 32 UMUM JL HALMAHERA 1/5 GADINGREJO 8383549442 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
61Q-000VXT5F 3575010107920086 SUHADAK 29 UMUM JL HALMAHERA 1/5 GADINGREJO 8383549442 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
62Q-000VY4OA 3575010206950004 ACH ABD WAFI 26 UMUM JL HANG TUA 4/4 GADINGREJO 8124767009 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
63Q-000VXVRM 3526175809810001 HOIRIYAH 40 UMUM JL HANG TUA 1/3 GADINGREJO 8539071703 CoronaVac 10/09/2021 202108118H 08/10/2021 202108172F
64S-B1DAF41F 3575014107550110 JUHAR NANIK 66 LANSIA JL IRIAN JAYA GG ANGGREK RT02/RW02 GAD 8113777705 CoronaVac 08/10/2021 202108172F
65S-B5375736 3575010107520060 TIAMIN 69 LANSIA JL IRIAN JAYA RT01/RW02 GADINGREJO 8113777705 CoronaVac 08/10/2021 202108172F
66S-D58B3BBB 3575014107550061 SOEMIANI 66 LANSIA JL BANDA RT03/RW02 GADINGREJO 8113777705 CoronaVac 08/10/2021 202108172F
67P-BA9WLE3R 3575014909090001 RIZKA KAMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 CoronaVac 08/10/2021 202108172F
68P-99I85G3J 3575014909090002 RIZKIA AMELIA RAMADHANI 12 REMAJA JL IRIAN JAYA GG ANGGREK RT01/RW02 GAD 8383391858 CoronaVac 08/10/2021 202108172F
69P-LTVK3C9B 3514235012760003 MARIA DESEMBER YANI 45 UMUM JL HANGTUAH RT 4 RW 3 8113777705 CoronaVac 08/10/2021 202108172F
10-08-2021 KELURAHAN GENTONG
1 S-3533E274 3575010709580001 MAHFUD 62 LANSIA JL SLAMET RIYADI 8225775527 CoronaVac 08/10/2021 202108172F
2 S-A78BE4A9 3575016104430001 LISA SUPARSIAH 78 LANSIA PERUM KARYA BAKTI B 16 8223319647 CoronaVac 08/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
3 S-F02C5DC4 3514204310470001 WIDANINGRUM 74 LANSIA KEDAWUNG WETAN 8133315976 CoronaVac 08/10/2021 202108172F
4 S-3C612F5B 3575011006570002 AJI HANDOKO 64 LANSIA JL SLAMET RIYADI 813777705 CoronaVac 08/10/2021 202108172F
5 P-LJ7XUUA7 3575012103650001 SUWANDI 56 RENTAN JL SLAMET RIYADI 813777705 CoronaVac 08/10/2021 202108172F
6 Q-000VG9ZV 3575016209720001 SUSILOWATI 49 UMUM JL SLAMET RIYADI 3/2 SEBANI 8565555376 CoronaVac 08/10/2021 202108172F
7 P-L2ETLWRI 3575011011740006 MOCHAMAT SLAMET 47 UMUM JL SLAMET RIYADI 8510229997 CoronaVac 08/10/2021 202108172F
8 Q-000VXFWV 3575010705720001 MOKH BASARUDIN 49 UMUM JL SLAMET RIYADI 2/4 GENTONG 8311991675 CoronaVac 08/10/2021 202108172F
9 P-KWCB2APA 3575015503900001 IDA ARIANI 31 UMUM JL SLAMET RIYADI 8779408251 CoronaVac 08/10/2021 202108172F
10 P-LANADTS5 3575011701730002 SUDIANTO 48 UMUM JL SLAMET RIYADI 8125240561 CoronaVac 08/10/2021 202108172F
11 P-GEOHPIPL 3575010710610001 MUCHYI 60 LANSIA JL KYAI SEPUH 001/006 GENTONG 8223420020 CoronaVac 08/10/2021 202108172F

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-07-2021 INDUK
1 Q-000AUUWE 3575016906020001 SAVINA DWI CHRISDIYANTI 19 UMUM URIP SUMOHARJO 8953661495 Astrazeneca 03/07/2021 ABY1911 07/10/2021 PW40166
2 Q-000E1FYP 3575012502940004 MUCHAMMAD FAROUK 27 UMUM DSN. SANAN 8574953654 Astrazeneca 13/07/2021 ABY1911 07/10/2021 PW40166
3 P-AC4WXGK2 3575016703680002 MUSRIFAH 53 RENTAN JL IRIAN JAYA 2/2 GADINGREJO 8213188218 Astrazeneca 07/10/2021 ABY1312
4 P-9NDNMP0G 3575010610770001 MOKHAMAD SOLEH 44 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8213188218 Astrazeneca 07/10/2021 ABY1312
5 P-AQG2UEFC 3514062103900001 ROJIL GHUFRON 31 UMUM JL HANGTUAH 2/3 GADINGREJO 8380411670 Astrazeneca 07/10/2021 ABY1312
6 P-B2YGWA8Q 3514161404860011 MUHAMMAD SOLIKIN 35 UMUM KEDONDONG SEMARE KRATON 8523615300 Astrazeneca 07/10/2021 ABY1312
7 P-B9KLOYHC 3575014107800057 SANAFIYAH 41 UMUM JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 07/10/2021 ABY1312
8 P-BBNQP1QL 3575015606000004 MAULIDIYAH 21 UMUM JL BANDA 5/2 GADINGREJO 8113777705 Astrazeneca 07/10/2021 ABY1312
9 P-BDZHTL8Q 3575010805880001 WAHYU ARIANTO 33 UMUM JL SLAMET RIYADI 2/4 GENTONG 8135876627 Astrazeneca 07/10/2021 ABY1312
10 P-BOFFPEQ9 3575011512770001 SYAMSUDIN 45 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8784626426 Astrazeneca 07/10/2021 ABY1312
11 P-BSH0EEB7 3575014510850001 ZUBAIDAH 36 UMUM JL IRIAN JAYA GADINGREJO 8383391858 Astrazeneca 07/10/2021 ABY1312
12 P-BW73F8CI 3575011109000001 MOCH IKSIR 21 UMUM JL IRIAN JAYA GADINGREJO 8233314709 Astrazeneca 07/10/2021 ABY1312
13 P-CEOHULBH 3575011602860001 RUSTAM MADJI 35 UMUM JL IRIAN JAYA GADINGREJO 8383391858 Astrazeneca 07/10/2021 ABY1312
14 P-CIVRI3OG 3575010107990043 NAFISA 22 UMUM JL HALMAHERA 3/5 GADINGREJO 8389716184 Astrazeneca 07/10/2021 PW40166
15 P-49YRUO1G 3503105005760002 MUSAROPAH 45 UMUM DUSUN SUWARU RT 11 RW 5 KRANDEGAN,GA 8560659329 Astrazeneca 07/10/2021 PW40166
16 P-CV634VSV 3514200204990003 MUHAMMAD IHWAN 22 UMUM DSN KRAJAN 3/1 REBALAS 8573635690 Astrazeneca 07/10/2021 PW40166
17 P-D2AAYRJH 3514234101740006 KHATAMAH 47 UMUM PEJAMBON 6/2 KEMANTRENREJO 8579541189 Astrazeneca 07/10/2021 PW40166
18 P-DB33IBG2 3514236111760001 KHAMIDAH 45 UMUM PEJAMBON 3/2 KEMANTREN REJO 8121652760 Astrazeneca 07/10/2021 PW40166
19 P-DOE5OQZZ 3575014407760001 KHOIROTUN 45 UMUM JL HALMAHERA 3/5 GADINGREJO 8113777705 Astrazeneca 07/10/2021 PW40166
20 P-E1A7Q4UN 3575014107880122 NUR ASIAH 33 UMUM JL JOLONDRIO 2/4 KRAPYAKREJO 8113777705 Astrazeneca 07/10/2021 PW40166
21 P-E9T8G8XW 3575015601900002 RIZA ALFIA 31 UMUM JL IRIAN JAYA GADINGREJO 8218741626 Astrazeneca 07/10/2021 PW40166
22 P-5XOH1YOE 3514164606980002 FARIDAH 23 UMUM KISIK 2/5 KALIREJO 8383323907 Astrazeneca 07/10/2021 PW40166
23 Q-000NKXV8 3514072106060001 ZIDANIL RIZQI 15 REMAJA SUMBERSIRAH - WONOREJO 8554901279 Biofarma 17/08/2021 24202221 07/10/2021 202108172F
24 Q-000UY08J 3575014610060003 SUHAILA NURIA HUSNI 15 REMAJA JL GATOT SUBROTO KEC. GADINGREJO 8573190687 Biofarma 08/09/2021 202108118H 07/10/2021 202108172F
25 Q-000UZ1AA 3575012701040002 MOCHAMAD AZHRIL ILHAM 17 REMAJA Jl.Kyai sepuh no.193 8383334192 Biofarma 08/09/2021 2021071371 07/10/2021 202108172F
26 Q-000VE1RV 3575015408060001 M. IRHAM ADITYA MAULANA 15 REMAJA jl slamet riyadi 3/2 sebani 8822625493 Biofarma 09/09/2021 2021071371 07/10/2021 202108172F
27 Q-000EAVVB 3575011408670002 SUGIYONO 54 RENTAN JL URIP SUMOHARJO BUKIR 8133126943 Biofarma 14/07/2021 24200421 07/10/2021 202108172F
28 Q-000NKZWJ 3514175005670002 ASRUFI 54 RENTAN DESA WARUNGDOWO 8385253827 Biofarma 17/08/2021 24202221 07/10/2021 202108172F
29 Q-000UXBPS 3575014107700050 RUWAIDAH 51 RENTAN JL HANGTUAH 3/3 GADINGREJO 8113777705 Biofarma 08/09/2021 2021071371 07/10/2021 202108172F
30 Q-000VPMNP 3575014101690024 MISMAH 52 RENTAN JL HANGTUAH 2/3 GADINGREJO 8113777705 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
31 Q-000VN0N7 3575012107650001 ABD. MUHAMAD 56 RENTAN jl slamet riyadi 1/5 GENTONG 8523280977 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
32 Q-000861FF 3575016504740002 ISTIANTIN 47 UMUM JL A YANI Gading 5/1 812171331 Biofarma 26/06/2021 24200821 07/10/2021 202108172F
33 Q-000B8H6X 1505084910941001 NUR AIDA SAPUTRI 27 UMUM JL. ASTER 3 BLOK A9 NO 10 8127895367 Biofarma 05/07/2021 24003521 07/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 Q-000BJLM0 1571020807910021 AKHMAD ADIE KURNIAWAN 30 UMUM JL. ASTER 3 BLOK A9 NO 10 8127277399 Biofarma 06/07/2021 24003521 07/10/2021 202108172F
35 Q-000CSM36 3514092811840001 SYAFIIL ANAM 37 UMUM DUSUN kutuan 8523024736 Biofarma 08/07/2021 242000221 07/10/2021 202108172F
36 Q-000E9NAU 3575010107840153 AMIN WAHYUDI 37 UMUM JL BANDA RT4 RW2 GADING 8786452331 Biofarma 12/07/2021 24200421 07/10/2021 202108172F
37 Q-000MBZ2F 3514145604030002 SAFIRA SALSABILLA ALFIATU 18 UMUM KOLURSARI BANGIL 8899606232 Biofarma 11/08/2021 24201921 07/10/2021 202108172F
38 Q-000NKZ48 3514170108020002 MUCHAMAD IWAN WAHYU 19 UMUM DS. WARUNGDOWO 8385253827 Biofarma 17/08/2021 24202221 07/10/2021 202108172F
39 Q-000NL0HP 3514176410920001 SITI FATIMAH 29 UMUM DESA SAMBISIRAH 8575505391 Biofarma 17/08/2021 24202221 07/10/2021 202108172F
40 Q-000SPKQI 3575012905900002 ACHMAD ZAELANI 31 UMUM JL HALMAHERA 4/5 GADINGREJO 8789551346 Biofarma 02/09/2021 2021071371 07/10/2021 202108172F
41 Q-000SYG5R 3575014310910004 NIA KHUSNIAH 30 UMUM JL HANG TUA 1/4 GADINGREJO 8123683224 Biofarma 03/09/2021 2021071371 07/10/2021 202108172F
42 Q-000UFHED 3514165101970001 RATNA ANINDIA PRATIWI 24 UMUM JL KYAI SEPUH GADINGREJO 8223322722 Biofarma 07/09/2021 2021071371 07/10/2021 202108172F
43 Q-000V2D1H 3575015302920004 AMINAH 29 UMUM JL HANGTUAH 8385198812 Biofarma 08/09/2021 2021071371 07/10/2021 202108172F
44 Q-000UX5M1 3514136211980001 ERDINA NOVIA PUTRI 23 UMUM JL HANGTUAH 3/3 GADINGREJO 8113777705 Biofarma 08/09/2021 2021071371 07/10/2021 202108172F
45 Q-000V1NPL 3575025205900001 MAJIDATUL ASMARIA 31 UMUM JL. HANGTUAH X A/22 KEL. NGEMPLAKREJO 8193706030 Biofarma 08/09/2021 2021071371 07/10/2021 202108172F
46 Q-000VKEIX 3575015303800001 KHUSNUL KHOTIMAH 41 UMUM JL GATOT SUBROTO 1/4 BUKIR 8113777705 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
47 Q-000VI0W0 3575014810030002 PUTRI RAHMA ALIYA 18 UMUM jl irian jaya 2/2 GADINGREJO 8575548311 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
48 Q-000VG95G 3575014805020001 AULIA FILLAILY 19 UMUM JL IRIAN JAYA 2/2 GADINGREJO 8573664604 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
49 Q-000VEEL6 3575015110730002 LULUK FARIDA 48 UMUM jl banda 2/2 gadingrejo 8133324002 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
50 Q-000VEZWQ 3575015403030001 MARINI TRI AMANDA 19 UMUM JL GATOT SUBROTO 4/7 BUKIR 8813343784 Biofarma 09/09/2021 2021071371 07/10/2021 202108172F
51 K-00016CDJ 3514070701950006 DENI KHOIRUL BASAR 26 UMUM JL URIP SUMOHARJO 1/3 BUKIR 8383537804 Biofarma 09/09/2021 2021071371 07/10/2021 202108172F
52 Q-000VEDKF 3575012506830004 RAMLIN 38 UMUM jl halmahera 2/3 gadingrejo 8810264835 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
53 Q-000VERWG 3507315408840002 LI,ANI 37 UMUM JL IRIAN JAYA GADINGREJO 8785194304 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
54 Q-000VJJG6 3575014210910001 MAULIA PRATIWI 30 UMUM PERUM GRIYA FORTUNA SEBANI 8224707924 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
55 Q-000VIHL9 3575014107800107 SUSIANA 41 UMUM JL BANDA 6/2 GADINGREJO 8113777705 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
56 Q-000VJIBF 3575015411810001 SITI MARIYAM 40 UMUM JL SLAMET RITADI 1/2 GENTONG 8560728604 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
57 Q-000VG946 3575016512820006 SUMIATI 39 UMUM JL.GATOT SUBROTO 02/04 BUKIR GADINGREJO 8953660503 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
58 Q-000VGA6K 3575016710990003 LAILATUL NAFISAH 22 UMUM JL KYAI SEPUH 1/5 GENTONG 8385075669 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
59 N-08C12C41 3575015709890001 KHOLFIAH 32 UMUM JL GATOT SUBROTO 5/2 PETAHUNAN 8233467133 Biofarma 07/10/2021 202108172F
60 P-FVD3OBFC 3575016801830002 RINI KRISTIANA 38 UMUM JL SLAMET RIADI 3/1 SEBANI 8585277861 Biofarma 07/10/2021 202108172F
10-07-2021 PUSTU
1 Q-000VITKO 3575010303010001 INDRA MAULANA 20 UMUM JL GATOT SUBROTO 3/4 BUKIR 8957027799 Biofarma 09/09/2021 2021071371 07/10/2021 202108172F
2 Q-000VIMCI 3575016207850004 EVI YULIANI 36 UMUM JL URIP SUMOHARJO 1/8 BUKIR 8953040104 Biofarma 09/09/2021 2021071371 07/10/2021 202108172F
3 Q-000VILT8 3575014509900003 SITI CHOLILAH 31 UMUM JL URIP SUMOHARJO 3/2 BUKIR 8128993000 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
4 Q-000VIT3T 3575012001010008 SAMSUL ARIF 20 UMUM JL GATOT SUBROTO 1/3 BUKIR 8983360567 Biofarma 09/09/2021 2021207137 07/10/2021 202108172F
5 Q-000VFZ6R 3575014812730001 NANIK WAHYUNI 47 UMUM JL URIP SUMOHARJO BUKIR GADINGREJO 8311315519 Biofarma 09/09/2021 202108118H 07/10/2021 202108172F
6 Q-000N7A9A 3575016003970004 IRMA NIRWANDANI 24 UMUM JL. URIP SUMOHARJO KEL. BUKIR 8953336636 Biofarma 15/08/2021 24201921 P 07/10/2021 202108172F
7 P-GN7YIIW5 3575012804700001 SUPARTO 51 RENTAN JL KYAI SEPUH 001/005 GENTONG 8560750690 Biofarma 07/10/2021 202108172F
8 P-HXRAR4ZN 3575011001800001 MOHAMAD SOLEH 42 UMUM JL SLAMET RIADI 002/003 GENTONG 8585966311 Biofarma 07/10/2021 202108172F
9 P-GK2S691R 3514182505880003 M.ATOK ILLAH 33 UMUM JL SLAMET RIADI 002/003 GENTONG 8213188101 Biofarma 07/10/2021 202108172F
10 P-GLEPFDTR 3575015704790001 SRI UTAMI 42 UMUM JL KYAI SEPUH 001/005 GENTONG 8560750690 Biofarma 07/10/2021 202108172F
11 P-GF4AILHV 3575016012930001 IRA NUR AFIYA 28 UMUM JL SLAMET RIADI 002/003 GENTONG 8213188101 Biofarma 07/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
12 S-947AE586 3575012512560001 ASY'ARI 66 LANSIA JL URIP SUMOHARJO 8965295633 Biofarma 07/10/2021 202108172F
13 S-C450DEB7 3575010109410001 SODIQ 80 LANSIA BUKIR 03/06 8965298331 Biofarma 07/10/2021 202108172F
14 S-7D7970A6 3575010107480086 SOLEH 73 LANSIA BUKIR PASURUAN 8113777705 Biofarma 07/10/2021 202108172F
15 S-AE99A4F3 3575010107420018 SUPII 83 LANSIA JL URIP SUMOHARJO 8965498331 Biofarma 07/10/2021 202108172F
16 S-86084BF6 3575016202560001 SRI SUPRIHATIN 65 LANSIA JL URIP SUMOHARJO - Biofarma 07/10/2021 202108172F
17 P-GDLCUOED 3575016109090001 ISNAINI YOVITA SYAFITRI 12 REMAJA bukir 2/1 bukir 8953960721 Biofarma 07/10/2021 202108172F
18 P-IOFIA6JL 3575010210640001 SUKAEDI 52 RENTAN JL URIP SUMOHARJO 8223091170 Biofarma 07/10/2021 202108172F
19 P-5R4XVHTN 3575010107820030 MOKHAMAD CHAIRUDIN 39 UMUM jl gatot subroto 3/7 bukir 8213260401 Biofarma 07/10/2021 202108172F
20 P-IN0SL0U5 3575012511720003 SUGIANTO 49 UMUM JL URIP SUMOHARJO 8510385387 Biofarma 07/10/2021 202108172F
21 P-IPT7QQ7L 3575010509740001 MUAJI 47 UMUM JL URIP SUMOHARJO 811135777 Biofarma 07/10/2021 202108172F
22 P-GPFHRYNI 3575014609070001 MAYADA ALYA PUSPITA 14 REMAJA JL SLAMET RIADI 002/003 GENTONG 8223236588 Biofarma 07/10/2021 202108172F
10-07-2021 LAPAS
1 P-I4OOSKJI 3575031301610001 TRISNO WIBOWO 60 LANSIA LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
2 P-FZ2JUL4J 3578062107700001 SUGENG PRASTOWO 51 RENTAN LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
3 P-GUANRJ9Q 3508170104700018 SAFI'I 51 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
4 P-HUC26CP4 3575011006690002 ABDUL HUFRON 52 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
5 P-I1W1PXYI 3578061609690003 AHMAD ANSORI 52 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
6 P-I35PBFL0 3514211605630001 RIANG KULUP PRAYUDA 58 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
7 P-I3OC3ASX 3578140708680003 UNTUNG SUNYOTO 53 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
8 P-I870RNN4 3510162907670003 GANGSAR HADI PRAYITNO 54 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
9 P-J81YCR98 3575022011660001 YOKO DHARMAWAN 55 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
10 P-J9TBEDWI 3514102006690007 HERI YULIANTO 52 RENTAN LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
11 P-0WE0ZBDA 3514201008890004 MAHMUDI 41 UMUM LAPAS KELAS IIB PASURUAN 8223322022 Astrazeneca 07/10/2021 PW40166
12 P-1XGRDO9F 3514233001950001 MOH. RIDWAN 25 UMUM DSN SEDENGAN 8223344789 Astrazeneca 07/10/2021 PW40166
13 P-3VG6DCUG 3578041302720003 ARI TRIASMORO 49 UMUM GUNUNG ANYAR 8223344789 Astrazeneca 07/10/2021 PW40166
14 P-5FHFHAUQ 3575030807800002 MUKH. TURMUDI 41 UMUM JL PATIMURA BUGUL KIDUL 8223344789 Astrazeneca 07/10/2021 PW40166
15 P-6NKHSSU9 3514162502020001 MUHAMMAD ROHMAN 19 UMUM DSN KRAJAN 8223344789 Astrazeneca 07/10/2021 PW40166
16 P-7DLJAIQR 3575021202720001 SADIMAN 48 UMUM LAPAS KELAS IIB PASURUAN 8133174159 Astrazeneca 07/10/2021 PW40166
17 P-7S8CZ8TH 3575011002820002 SELAMET 45 UMUM JL HALMAHERA 8223344789 Astrazeneca 07/10/2021 PW40166
18 P-8S1HM37D 3575032008860001 WAHYU PUTRA PERDANA 35 UMUM PERUM PESONA CANDI 8223344789 Astrazeneca 07/10/2021 PW40166
19 P-A0RIR1E2 3574020203770006 SAMSUL KHOIRI 44 UMUM LAPAS KELAS IIB PASURUAN 8122247474 Astrazeneca 07/10/2021 PW40166
20 P-BBCKG7TD 3573022301850003 AGUNG M. MUSTOFA 36 UMUM JL B.S RIYADI 8223344789 Astrazeneca 07/10/2021 PW40166
21 P-BOFBJ5AM 3578241012950001 SATRIA PUTRA ABDI 26 UMUM BANTENGAN RT 13 RW 05 KEC 8128076465 Astrazeneca 07/10/2021 PW40166
22 P-C02X4Y3O 3514080608940004 AGUS SUPRIYANTO 27 UMUM DUSUN KRAJAN 8223344789 Astrazeneca 07/10/2021 PW40166
23 P-COQKX5FK 3514062709010001 AHMAD GESANG ARRUMAN 20 UMUM LAPAS KELAS II B KOTA PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
24 P-CQNTZPPM 3514192703970002 AHMAD HIDAYATULLAH 24 UMUM LAPAS KELAS 2B PASURUAN 8531393977 Astrazeneca 07/10/2021 PW40166
25 P-CVS9BSSD 3575030612970001 AS. RIZAL FIRDIANSAH 24 UMUM JL CEMARA 12/5 8223344789 Astrazeneca 07/10/2021 PW40166
26 P-D2KITKQV 3514091503960002 M. ARIFUR ROHMAN 25 UMUM DSN KRANGKONG 2/7 8223344789 Astrazeneca 07/10/2021 PW40166
27 P-D3KTFXG2 3517111805950001 DYAN PRANOTO 26 UMUM DUSUN GRUMEK 8223344789 Astrazeneca 07/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
28 P-D5CUR0IR 3526052505910001 GHUFRON ALFAQIH 30 UMUM LAPAS KELAS IIB PASURUAN 8581523205 Astrazeneca 07/10/2021 PW40166
29 P-DL9BRAT6 3578092906890004 FARID HERLAMBANG 32 UMUM JL KEPUTIH TEGAL 8223344789 Astrazeneca 07/10/2021 PW40166
30 P-DOUSH7HQ 3575030608880001 MUKHAMAD SAIKHU 33 UMUM JL SULAWESI 8223344789 Astrazeneca 07/10/2021 PW40166
31 P-E3DTMI2W 3578080910960003 YOGA PRIANSYAH PUTRA 25 UMUM LAPAS KELAS IIB PASURUAN 8573104170 Astrazeneca 07/10/2021 PW40166
32 P-E5IZXRTG 3517060201970004 ZULFIKAR NURRAHMAD 24 UMUM DSN PENANGGALAN JOMBANG 8223344789 Astrazeneca 07/10/2021 PW40166
33 P-EAX1E44H 3510072905940003 YONGKY HARDIANSYAH 27 UMUM LAPAS KELAS IIB PASURUAN 8574980278 Astrazeneca 07/10/2021 PW40166
34 P-EHIM2MH8 3526140605850005 SAYEDI 36 UMUM LAPAS KELAS 2B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
35 P-EKYRTKYD 3514201308880005 AGUS SUSIANTO 33 UMUM DSN BANYUBIRU PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
36 P-EPMQBR1J 3578311204010001 DIMAS APRILIAN WIJAYANTO 20 UMUM JL MADE SELATAN 8223344789 Astrazeneca 07/10/2021 PW40166
37 P-EXEK4I32 3575011107800003 ERWIN HARVIANTO 41 UMUM LAPAS KELAS IIB PASURUAN 8575548523 Astrazeneca 07/10/2021 PW40166
38 P-F75MPAEJ 3575010608950002 GALIH BAGASKARA 26 UMUM JL SLAMET RIYADI 8223344789 Astrazeneca 07/10/2021 PW40166
39 P-FBAGCQ2Y 3575023004800002 JOSEPH APRIANTO BUDIONO 41 UMUM JL KARTINI NO. 90 PASURUAN 8133401611 Astrazeneca 07/10/2021 PW40166
40 P-FCGUUHJ8 3514061208880004 GOPOR 33 UMUM DSN ASEM JAJAR 12/5 8223344789 Astrazeneca 07/10/2021 PW40166
41 P-FKKIXPAE 3514101012010004 MOCH. ROZIQIN 23 UMUM PRIGEN PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
42 P-FNND716K 3575010107730089 JUWARI 48 UMUM JL HANGTUAH 8223344789 Astrazeneca 07/10/2021 PW40166
43 P-FOQB1H8M 3578050903910003 MARTIN YUWANDI 30 UMUM LAPAS KELAS IIB PASURUAN 8211078585 Astrazeneca 07/10/2021 PW40166
44 P-FPBG9PP5 3507093105860005 TEGUH DWI SANTOSO 35 UMUM DSN JATIRENGGO 8223344789 Astrazeneca 07/10/2021 PW40166
45 P-FQBVNZGK 3515042207800001 PEPPY CAHYA SETRIADI SU'UD 41 UMUM LAPAS KELAS IIB PASURUAN 8121690260 Astrazeneca 07/10/2021 PW40166
46 P-FQMDYALG 3578262710780004 RONI DWIFAYANTO 43 UMUM KEPUTIH TANGGUL BARU 8223344789 Astrazeneca 07/10/2021 PW40166
47 P-FRX5XE8R 3578042002000011 TOMMY VEGA RINALDY 21 UMUM JL BENDUL MERISI 8223344789 Astrazeneca 07/10/2021 PW40166
48 P-FS0BUYGT 3514031908910001 SUMANTOKO 30 UMUM LAPAS KELAS IIB PASURUAN 8122818680 Astrazeneca 07/10/2021 PW40166
49 P-FSZ8VQB5 3578101712940007 SYAHRUL GUNAWAN 27 UMUM JL KAPAS MADYA 8223344789 Astrazeneca 07/10/2021 PW40166
50 P-FUARLP5Z 3578283006950002 DIDIK BAHRIANTO 26 UMUM JL TAMBAK MAYOR BARU 8223344789 Astrazeneca 07/10/2021 PW40166
51 P-FUIPABQD 3507250706970001 WINARNO 24 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
52 P-FWLEMGJK 3509212010940002 HAFIN FATORROHMAN 27 UMUM PERUM JEMBER PERMAI 8223344789 Astrazeneca 07/10/2021 PW40166
53 P-FXKAKVSL 3576020107850035 ERWIEN YULIANTO 36 UMUM PURWOTENGAH MOJOKERTO 8223344789 Astrazeneca 07/10/2021 PW40166
54 P-FXNWI6D2 3578112112000003 ALFIN MOCH. SOFIRIN 21 UMUM LAPAS KELAS IIB PASURUAN 8123391265 Astrazeneca 07/10/2021 PW40166
55 P-FY6INFKB 3514072205720001 JAMHURI 49 UMUM SAMBISIRA WONOREJO 8223344789 Astrazeneca 07/10/2021 PW40166
56 P-G198VGKF 3575021808010005 MUHAMMAD NUR JALIS 20 UMUM JL RA KARTINI PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
57 P-G2MQH1GX 3526010107860228 EDY SUSANTO 35 UMUM LAPAS II B PASURUAN 8161534868 Astrazeneca 07/10/2021 PW40166
58 P-G3GDCGWF 3578221110010002 ERWIN SANTOSO 20 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
59 P-G5PFGV7Y 3525133007900002 MANGKU SISWANTO 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
60 P-G6REJ1ZU 3524232308000002 VIQI DWI ANDINI 21 UMUM LAPAS KELAS IIB PASURUAN 8133055622 Astrazeneca 07/10/2021 PW40166
61 P-G7XV7IET 3515132809810014 MUSTAQIM 40 UMUM LAPAS KELAS IIB PASURUAN 8969645842 Astrazeneca 07/10/2021 PW40166
62 P-G8NIMNQ3 3516160603830003 WIDODO 38 UMUM DSN KEDUNGGAGAK 1/2 8223344789 Astrazeneca 07/10/2021 PW40166
63 P-GAKW0QVT 3578060602840001 MOCH. SYAFIÌ 37 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
64 P-GBKTVDFJ 3515120903890002 YUDI PRASETIA 32 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
65 P-GCALPGP3 3515181711950005 WAHYU HIDAYAT 26 UMUM BERBEK III 8223344789 Astrazeneca 07/10/2021 PW40166
66 P-GCVAQBS6 3578100912980005 DENI SETIAWAN 23 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
67 P-GDFQZLQA 3575020605820003 AGUNG RIZAKI 39 UMUM PERUM TIARA CANDI 8223344789 Astrazeneca 07/10/2021 PW40166
68 P-GEHTEHZJ 3575010606790006 M. KHAMID 42 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
69 P-GGWI6THX 3578100412970001 RIZKI PRAYOGI 24 UMUM KAPAS MADYA 8223344789 Astrazeneca 07/10/2021 PW40166
70 P-GHJP5ZE1 3515162611930006 WILDAN WAHYU CAHYONO 28 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
71 P-GI1JKVB0 3515133010930001 ADI TIYOK IRWANTO 28 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
72 P-GIRD7RRO 3575022111940002 NUR HIDAYAT 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
73 P-GJILMILU 3515080812850001 ASRUL TAYEB 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
74 P-GK34EZEN 3514190602910001 M. AHYAR 30 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
75 P-GKMGCUJJ 3575032901940005 DIMAS PUDJI LAKSONO 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
76 P-GLHAMSDM 3514182803940001 SAFAIN 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
77 P-GLUFF318 3514191501960006 FAIZIN 25 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
78 P-GMLS1GZJ 3528020604000001 HOLILUR RAHMAN 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
79 P-GN3CS7GM 3514202403950001 BURATEN 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
80 P-GN4CC39K 3310250803870002 BERNADIUS DIMAS SETIYOAJI 34 UMUM LAPAS KELAS IIB PASURUAN 8223655939 Astrazeneca 07/10/2021 PW40166
81 P-GOZGMCLL 3575010912910002 GUSNADI 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
82 P-GPBMHTOS 3514012501940003 WALIYADI 27 UMUM LAPAS KELAS IIB PASURUAN 8585012114 Astrazeneca 07/10/2021 PW40166
83 P-GPHRXIQN 3526120603940002 MOH. TOYYIB 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
84 P-GQBGKK26 3578161701960004 MOCH HOSEN 25 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
85 P-GQU7GVG8 3575031703970004 M. AMI'N FALAHUDDIN 24 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
86 P-GR768EBW 3578061907950012 RUSDI ALIANSYAH 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
87 P-GS3IZESI 3514111808780001 HARTONO 43 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
88 P-GS6XUAC9 3573031902820008 OSCAR YASVAN DRIANTO 39 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
89 P-GSLNV9NI 3507061209850001 CONDRO CATUR SETIONO 36 UMUM LAPAS II PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
90 P-GSWONQWV 3508151507990002 AHMAD FATONI 22 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
91 P-GT1SLDNX 3514141211870001 SLAMET TOYANI 34 UMUM LAPAS II PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
92 P-GTQ510GO 3578281903960001 AMRI YAHYA 25 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
93 P-GTY6V7PX 3571012708730002 EDY MUSGIANTO 48 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
94 P-GUTTDT02 3578150306860001 MOCHAMAD SUPRIYADI 35 UMUM LAPAS KELAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
95 P-GVKOIARG 3578052208960003 BAYU DWI AGUS WIRANATA 25 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
96 P-GVNOIFPP 3578291707870001 SALUKI 34 UMUM LAPAS KELAS IIB PASURUAN 8233880849 Astrazeneca 07/10/2021 PW40166
97 P-GX3V4E4G 3523021610830002 ERICK ARYA SAPUTRA 38 UMUM LAPAS KELAS IIB PASURUAN 8563077055 Astrazeneca 07/10/2021 PW40166
98 P-GY8MPTXH 3506211402940001 SURYA ARDHANA FEBRI ANDIKA 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
99 P-H0EYM6D7 3506150804980001 AKHMAD LUBISAL FAHMI 23 UMUM JL MANYAR SURABAYA 8223344789 Astrazeneca 07/10/2021 PW40166
100 P-H1JBQZ6B 3575021603800007 MOCH SHOLEH 41 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
101 P-H2ACM4QC 3578032404970004 MUCHLIS HIDAYAT 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
102 P-H4AGRL9D 3514220203850013 IMAM HANAFI 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
103 P-H6KCACLO 3575022006850002 SETIA RAHARDJO 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
104 P-H7NOT5PR 3526010409910003 INDRA KUSUMA 30 UMUM LAPAS II PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
105 P-H9USIINK 3575030204940003 DENI AGUNG PRIONO 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
106 P-HBCHAKM9 3525062409980001 SEPTIAN RYAN HIDAYAH 23 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
107 P-HCE5FN0B 3526121711880001 MOH. FAISOL 33 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
108 P-HCUM7SQ3 3575012707910001 KHOIRUL RIJAL 30 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
109 P-HDE4QKBE 3515132605970003 M.FAISAL AMIR 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
110 P-HDXUZ0OV 3514222407840004 SUGIYANTO 37 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
111 P-HGO3VING 3515011008800002 EKO ISWANTO 41 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
112 P-HIKCP4LF 3514202602000001 ACHMAD UBAIDILLAH 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
113 P-HJ32IQ5U 3575032409010002 MUCHAMMAD FARCHAN 20 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
114 P-HJPBBEPC 3514230710940001 MUKHAMMAD SUDARSONO 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
115 P-HKTSKJVQ 1219021309900003 DEDE SETIAWAN 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
116 P-HLBZG6WX 3514070511990003 M.IRFAN 22 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
117 P-HLXGJX2X 3578111403830002 SONNY ISKANDAR 38 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
118 P-HMPNW4V1 3309051909839002 JOKO HARIANTO 38 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
119 P-HO01WLQU 3575011903780005 CATUR BAYU SETIAWAN 43 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
120 P-HOI3MHNU 3578131408760006 LO TJIEN HOK, AGUS SUGIHARTO 45 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
121 P-HP5G8PGS 3515082107820001 ADI WIYONO 39 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
122 P-HPJYM6F2 3578161410910003 TRI MARDIONO 30 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
123 P-HQ1K1VTU 3575012209970001 SOFIAN SOEHARSONO 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
124 P-HQTHZTLU 3575021310890005 MAULUDIN 32 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
125 P-HRAHY90H 3514192008880004 SISWANDI 33 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
126 P-HRT6IHXP 3578041612940002 DEPRI HANDOKO 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
127 P-HSBUX7JU 3575031811780001 MAHBUB HABIBI 43 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
128 P-HSUQNAVA 3517042606000003 BAHRUL ULUM 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
129 P-HTCFPSWW 3514122807790003 SUSIANTO 42 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
130 P-HTQBUVEM 3514192909980004 FAROUK FAKRUDI 23 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
131 P-HUVF07FW 3510081006850005 WOWOK MAHENDRA 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
132 P-HVE3WCD4 3527040107802661 H. HOIRI 41 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
133 P-HYCKBIXS 3514083009720002 SUPARDI 30 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
134 P-HYRMUKEJ 3575011210910001 HADI SULISTIYO 30 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
135 P-I02HFBX6 3515150205790003 GUNAWAN DIRGANG HANDOKO 42 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
136 P-I16I19FF 3573051207950005 MUHAMMAD CAHYONO 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
137 P-I2KADXTC 3526140609830003 NASIR 38 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
138 P-I48P7TZI 3515180101730028 MUHAMMAD ALI 48 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
139 P-I5A8SCKR 3514200111890001 RUDY 32 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
140 P-I5SC0Q46 3575032703970002 ADAM RIFANDO 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
141 P-I6HWQEQ8 3514051109900001 HERMANTO 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
142 P-I6ZOB3G6 3575022111990005 USMAN EFFENDI 22 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
143 P-I8VX3LIR 3514202509720002 MUSTOFAH 49 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
144 P-I9QEVNXY 3578121312900002 BERRY PRIMAPRANATA 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
145 P-IB3MTG6Y 3573022803920003 AHMAD RIZKI GUSTI HOLLE 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
146 P-ICSDQCTB 3514010803930001 IMAM SOFYAN 28 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
147 P-ID5142OR 3514091012850005 AKHMAD KHUSEN 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
148 P-IDRCEKFB 3578162806780005 SYAIFUL ARIEF 43 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
149 P-IE4HQSAG 3526180107950184 RUDIYANTO 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
150 P-IEH711SO 3578100211860003 FERRI SUNJOYO 35 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
151 P-IES3OBFX 3578171606830004 ARIES 38 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
152 P-IF6I9DS2 3514161307830012 SAIKHULLOH 38 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
153 P-IFKX0YMQ 3515071601820008 SUROSO 39 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
154 P-IFW1OH5S 3578131201980005 RIZAL SYAHRUR ROMADHON 23 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
155 P-IGBTPMA8 3578271305000004 MOCH. WAHYU NUGROHO 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
156 P-IGOWN1WO 6402032209900001 SURYA PRATAMA PUTRA 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
157 P-IH5SJBZN 3578020301010001 YORVANDO RAMA KIRANA 20 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
158 P-IHMUNR1J 3578071909800001 ABDULKADIR 41 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
159 P-IIJVDFLL 3514160609850010 ZAINUL MUTTAKIN 36 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
160 P-IIWZW1E1 3575030507840002 RACHMAT SUBEKHI 37 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
161 P-IJC2IZFJ 3575011908900002 JUNAEDI 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
162 P-IJMMV047 3515072212920006 M SAMSUL ARIF 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
163 P-IJYP0Y8A 3526151404940001 ADITIA KURNIAWAN 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
164 P-IKJY4FWB 2171122110990001 M.ROJABI FIDHOTI UNSYA 22 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
165 P-IL1ZMLBI 3514121008800006 INDRA ARIANTO 41 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
166 P-ILEP9YWM 3575030407000003 M. NUR SALIM 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
167 P-ILTOEAEG 3578192304950001 ADI CANDRA PRADANA 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
168 P-IMBO0ZIA 3515132110930001 RENDY ZULKARNAIN 28 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
169 P-IMKRS7LM 3575011205990001 ANANG MA'RUF 22 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
170 P-IN4KS3JT 3573030811870003 DEPPY SUGENG WAHONO 34 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
171 P-INHNQTCO 3514221812980001 MISTO 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
172 P-IO7SIL6I 3578162503900001 TOSIN 31 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
173 P-IRLSOPOW 3515140110920001 ANGGA CAHYANTO 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
174 P-J3IKSVV9 3514050912010001 SAMSUL ARIFIN 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
175 P-J3REILKL 3514220111010004 MUHAMMAD SYAHRONI 20 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
176 P-J3WC3THV 3514120108940003 ANDIKA PRASTYA 27 UMUM LAPAS KELAS IIB PASURUAN 8139466087 Astrazeneca 07/10/2021 PW40166
177 P-J42FI0M3 3575023010940001 JEFRI ANDI SETIAWAN 27 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
178 P-J4MUH7WL 3575031405000003 MOCHAMAD SHOLEH 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
179 P-J5H7M57J 3515080202880002 DWI FEBRY ARIYANTO 33 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
180 P-J60QF0OB 3578072105780001 HADI PURNOMO 43 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
181 P-J6CEWEEU 3514131906860002 ANDHI ARDIANSYAH 35 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
182 P-J6KOKJ50 3515081804920005 MOCH. ARIF RACHMAN 29 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
183 P-J6SQZ7JU 3514061502990002 M. FAIZIN 22 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
184 P-J763BEGZ 3514231601820002 SAMSUDIN 39 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
185 P-J7FJET0U 3514090909900007 FADHUL ISLAM 31 UMUM LAPAS IIB PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
186 P-J7OS1YR5 3514200302000005 RISKY PRASTIYAWAN BUDI ANTON 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
187 P-J8PLD1CQ 3514060606950004 FAHRUL ROZI 26 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
188 P-J91SQQBU 3514171408980002 MUHAMMAD HIBAH TULLOH 24 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
189 P-JAAGC5HG 3315172301000001 AHMAD RIFAI 21 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
190 P-JAKML1WQ 3502161209750001 MISNANTO 46 UMUM LAPAS II B PASURUAN 8223344789 Astrazeneca 07/10/2021 PW40166
191 35090115109700001 EKO WAHYUDI 52 RENTAN LAPAS KELAS 2B PASURUAN 8123498669 Astrazeneca 07/10/2021 PW40166
192 3514112601970001 ANDRE WAHYU 24 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
193 3575022997800001 MUKHLAS ARDIANTO 40 UMUM LAPAS KELAS 2B PASURUAN 81252046765 Astrazeneca 07/10/2021 PW40166
194 3578030202950006 ALDI WIDYA ROMADHON 27 UMUM LAPAS KELAS 2B PASURUAN 83830342461 Astrazeneca 07/10/2021 PW40166
195 3578032109990001 DEDY SYAIFUL ANAM 43 UMUM LAPAS KELAS 2B PASURUAN 87849047786 Astrazeneca 07/10/2021 PW40166
196 3575010904980001 DENI MUSLIM 40 UMUM LAPAS KELAS 2B PASURUAN 85649498537 Astrazeneca 07/10/2021 PW40166
197 3575010107700046 DENI EKA KURNIAWAN 32 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
198 3573522207800001 ERWIN WAHYU 44 UMUM LAPAS KELAS 2B PASURUAN 81233633863 Astrazeneca 07/10/2021 PW40166
199 3516082411860001 AFANDI 39 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
200 3575030107990051 DANI MARDIYAN 25 UMUM LAPAS KELAS 2B PASURUAN 82233447899 Astrazeneca 07/10/2021 PW40166
201 3578153010870005 GATOT SETIAWAN 34 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
202 3514162709950001 SOLEFUDIN 26 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
203 3508150102920005 MUHAMMAD SHODIQIN 29 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
204 3578062703850001 MOCH RIO WIJAYA BIN SUYANTO 36 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
205 3526122810980001 FAUZI 33 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
206 3575012606930001 DONY SETIAWAN 28 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166
207 3514162703880008 RUSDIANTO 33 UMUM LAPAS KELAS 2B PASURUAN Astrazeneca 07/10/2021 PW40166

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
10-06-2021 INDUK
1 Q-000ATSDK 3575010205870002 RODEYAN HAMZA 34 UMUM JL. SLAMET RIYADI GG.12 B 8123325000 Astrazeneca 03/07/2021 317710P 06/10/2021 ABY1312
2 Q-000AUBQJ 3575016609900004 ANGGUN YULIANA 31 UMUM JL. SLAMET RIYADI GG.12 B 8212001003 Astrazeneca 03/07/2021 ABY1911 06/10/2021 ABY1312
3 Z-000AG2Y3 3575016909640003 SULASTRI 64 LANSIA JL HANGTUAH 4/4 GADINGREJO 8385198812 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
4 Q-000UZT4J 3575017112070001 SILVI AMELIA 14 REMAJA JL HANGTUAH 2/4 GADINGREJO 8384660281 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
5 Q-000RUPGR 3575010410080002 RIO RAMADHANI 13 REMAJA JL IRIAN JAYA 1/2 GADINGREJO 8820093533 CoronaVac 31/08/2021 24202321 G 06/10/2021 202108172F
6 Q-000RGZCA 3575014403070002 SANTI HUNAINAH 14 REMAJA JL BANDA 5/2 GADINGREJO 8772539408 CoronaVac 30/08/2021 24202221 G 06/10/2021 202108172F
7 Q-000RNIPS 3517105408050001 NURIANA ALDILA 16 REMAJA JL MANCAR BARAT 7/2 PETERONGAN JOMBAN8155974882 CoronaVac 31/08/2021 24202321 G 06/10/2021 202108172F
8 Q-000V2HIR 3575012008690002 MUSLIMIN 54 RENTAN JL HALMAHERA 1/5 GADINGREJO 8575522226 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
9 Q-000U0YWU 3514181803940001 ABDUL ROCHMAN 27 UMUM JL HALMAHERA 3/3 GADINGREJO 8123054812 CoronaVac 06/09/2021 2021071371 06/10/2021 202108172F
10 Q-000V1JKD 3514195411980001 SRI ARISAH 23 UMUM JL URIP SUMOHARJO 3/3 BUKIR 8233241504 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
11 Q-000UEJYZ 3575015206850008 USWATUN CHASANAH 36 UMUM JL IRIAN JAYA 3/2 GADINGREJO 8125953274 CoronaVac 07/09/2021 2021071371 06/10/2021 202108172F
12 Q-000UWBRF 3575016606800005 KUSBANDIYAH 41 UMUM JL SLAMET RIYADI 1/1 SEBANI 8783511454 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
13 Q-000TBD0Q 3578042501790006 EKO PRASETYO 42 UMUM JL GATOT SUBROTO 37 2/5 BUKIR 8223000774 CoronaVac 04/09/2021 2021071371 06/10/2021 202108172F
14 Q-000UIFBV 3514162001030005 SALMAN ALFARIZI 18 UMUM jl hangtuah 4/2 gadingrejo 8124925411 CoronaVac 07/09/2021 2021071371 06/10/2021 202108172F
15 Q-000REJD5 3575010506960002 RACHMAD JUNIANTO 25 UMUM JL KYAI SEPUH GADINGREJO 8232950038 CoronaVac 30/08/2021 24202221 G 06/10/2021 202108172F
16 Q-000UKVTB 3514164106840002 ZULAIKHAH 37 UMUM JL HANGTUAH 2/4 GADINGREJO 8580640406 CoronaVac 07/09/2021 2021071371 06/10/2021 202108172F
17 Q-000U0YS3 3575015707960002 NUR MAULIDIA RATNANINGSIH 25 UMUM JL HALMAHERA 3/3 GADINGREJO 8121634741 CoronaVac 06/09/2021 2021071371 06/10/2021 202108172F
18 Q-000UEDYJ 3575014107730058 SLAMET 48 UMUM jl banda 5/2 GADINGREJO 8113777705 CoronaVac 07/09/2021 2021071371 06/10/2021 202108172F
19 Q-000TZRIA 3575011104960001 KHOIRUL HADI 25 UMUM JL HANGTUAH 1/3 GADINGREJO 8113777770 CoronaVac 06/09/2021 2021071371 06/10/2021 202108172F
20 Q-000TCT13 3575011509030001 MUHAMMAD ARIS 18 UMUM JL A YANI 62 8139020647 CoronaVac 04/09/2021 2021071371 06/10/2021 202108172F
21 Q-000U1L35 3514165508790005 FARIDA 42 UMUM JL HANGTUAH 4/3 GADINGREJO 8113777770 CoronaVac 06/09/2021 2021071371 06/10/2021 202108172F
22 P-1KQVPFQS 3575014609690001 TOWILA 52 RENTAN JL BANDA 4/3 GADINGREJO 8564873889 Astrazeneca 06/10/2021 ABY1312
23 P-1NYQGAMS 3575014101620020 CHOTIJAH 59 RENTAN JL HANGTUAH 3/2 TAMBAAN 8113777705 Astrazeneca 06/10/2021 ABY1312
24 P-2RFMURB3 3514182104710004 AINUL YAKIN 50 RENTAN KICI TIMUR 2/3 WONOSARI 8523953432 Astrazeneca 06/10/2021 ABY1312
25 P-5V1PCADX 3575014111710002 KARTIKA MAWARSARI 50 RENTAN JL SLAMET RIYADI 2/4 GENTONG 8312224641 Astrazeneca 06/10/2021 ABY1312
26 P-0PZHDWMK 3575020107750058 M. ALI 46 UMUM JL LAKS MARTADINATA 4/8 NGEMPLAK 8133132315 Astrazeneca 06/10/2021 ABY1312
27 P-0YARCEPN 3575016806760002 YUN ISWATI 45 UMUM JL KYAI SEPUH 8129942035 Astrazeneca 06/10/2021 ABY1312
28 P-1ESQJNEH 3575014608810005 KHUSNIA ATIM 40 UMUM JL HANGTUAH 2/4 GADINGREJO 8823188386 Astrazeneca 06/10/2021 ABY1312
29 P-2FPSPAPK 3575014202800002 KHUMAIROH 41 UMUM JL HALMAHERA 5/5 GADINGREJO 8113777705 Astrazeneca 06/10/2021 ABY1312
30 P-33CDP1EX 3575017107990001 NABILA NURUL ISTIQOMAH 22 UMUM JL URIP SUMOHARJO 2/2 GADINGREJO 8385113027 Astrazeneca 06/10/2021 ABY1312
31 P-3E3TKTM8 3575015002000004 FITRI MUFIDAH 21 UMUM JL HANGTUAH 4/3 GADINGREJO 8311103239 Astrazeneca 06/10/2021 ABY1312
32 P-3KKRDG3O 3575014607840002 ST. SLAMI 40 UMUM JL HANGTUAH 8113777705 Astrazeneca 06/10/2021 ABY1312
33 P-3MW0TX0A 3575010102860004 SURYO HANDOKO 35 UMUM JL HANGTUAH 1/4 GADINGREJO 8953505478 Astrazeneca 06/10/2021 ABY1312
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
34 P-3NEV7Q0E 3514174211980001 SITI FATIMAH 23 UMUM JL HANGTUAH 8233103303 Astrazeneca 06/10/2021 ABY1312
35 P-44JJKMZG 3575010201850002 ZAINAL MAHMUDI 36 UMUM JL HALMAHERA GADINGREJO 8560778047 Astrazeneca 06/10/2021 ABY1312
36 S-8508EBCD 3514146806910001 HESTI SOFIARINI 30 UMUM SEKAR INDAH 2 EE/11 8564971850 Astrazeneca 06/10/2021 ABY1312
37 P-KMCSLROA 3575014701790002 HULAIYAH 42 UMUM JL HANGTUAH 3/4 GADINGREJO 8573062490 Astrazeneca 06/10/2021 ABY1312
38 P-1WGEOGJQ 3575011201800004 M. MAHRUS 41 UMUM JL HANGTUAH 8880524750 Astrazeneca 06/10/2021 ABY1312
39 P-1SDQPYMX 3575015708970003 SALAMAH 26 UMUM JL HANGTUAH 1/3 GADINGREJO 8194544619 Astrazeneca 06/10/2021 ABY1312
40 P-28KX3UUR 3575010107970051 MUHAMAD IRVAN 24 UMUM JL HALMAHERA 5/5 GADINGREJO 8579118445 Astrazeneca 06/10/2021 ABY1312
41 P-3KNRHY5O 3575016711910005 CHUSNIYAH 30 UMUM JL HANGTUAH 1/3 GADINGREJO 8113777705 Astrazeneca 06/10/2021 317710P
42 P-2FFCISV6 3575015605740002 ANI 47 UMUM JL HALMAHERA 8113777705 Astrazeneca 06/10/2021 317710P
43 P-2YEMUI8K 3575015901870002 NUR KHASANAH 34 UMUM JL HALMAHERA 8560778047 Astrazeneca 06/10/2021 317710P
44 P-0XD69EOW 3514140411040003 MUHAMMAD SAHRONI 17 REMAJA KALUR SARI 8384165746 CoronaVac 06/10/2021 202108172F
45 P-2ZAD0BLP 3575020707060003 MOCHAMAD SUCHEL 15 REMAJA JL LAKS MARTADINATA 4/8 8383457848 CoronaVac 06/10/2021 202108172F
46 J-0003F646 3575016603060003 NESIA NURUL MUKHAROMAH 15 REMAJA JL URIP SUMOHARJO 2/2 BUKIR 8384895096 CoronaVac 06/10/2021 202108172F
47 P-0RGQV15S 3575012102070001 MUCHAMMAD SAFARUDIN 14 REMAJA JL HALMAHERA 5/5 GADINGREJO 8113777705 CoronaVac 06/10/2021 202108172F
48 P-2LNH1KBN 3575015304040002 MUSYAWAROH 17 REMAJA JL HANGTUAH GG 6 8311441426 CoronaVac 06/10/2021 202108172F
49 P-3S1GRR5E 3575032701090002 ALDIANSYAH 12 REMAJA JL HANGTUAH 8776597766 CoronaVac 06/10/2021 202108172F
50 P-1C5KIIM4 3575014809930002 ALFIYAH 28 UMUM JL HANGTUAH GADINGREJO 8778524390 CoronaVac 06/10/2021 202108172F
51 P-5V4N0POA 3575016311030002 LAYLA RIMADHANI 18 UMUM JL SLAMET RIYADI 8783707834 CoronaVac 06/10/2021 202108172F
10-06-2021 PUSTU
1 Z-000A4IWJ 3575013006580003 DJAYUS 63 LANSIA JL SLAMET RIYADI 1/2 SEBANI 8588357510 CoronaVac 02/09/2021 2021071371 06/10/2021 202108172F
2 Q-000V24UG 3575014809980001 IKA NURUL WAHYUNI 23 UMUM JL SLAMET RIYADI 3/1 SEBANI 8570885870 CoronaVac 08/09/2021 2021071371 06/10/2021 202108172F
3 P-DKGO1W69 3575014107680007 SULASTRI 56 RENTAN JL SLAMET RIYADI 8951373263 CoronaVac 06/10/2021 202108172F
4 P-DKJYKEEB 3575011002620001 EDY DIRGANTORO 59 RENTAN KOTA PASURUAN 8113777705 CoronaVac 06/10/2021 202108172F
5 P-BQSIVU6Z 3575010405700001 SUKISTO HADI 51 RENTAN JL SLAMET RIADI 003/003 8133003131 CoronaVac 06/10/2021 202108154G
6 P-BJFFR2KW 3575010403670001 MUSTOFA HUDA 54 RENTAN JL SLAMET RIADI 003/003 GENTONG 8786697250 CoronaVac 06/10/2021 202108154G
7 P-D79AREQE 3575012707870001 MOCHAMAD SUHADA 34 UMUM JL SLAMET RIYADI 8951373263 CoronaVac 06/10/2021 202108172F
8 P-DG2XQZJO 3575017105900001 SULASTRI 31 UMUM SEBANI GADINGREJO 8580423605 CoronaVac 06/10/2021 202108172F
9 S-56DD00D3 3575016311830003 RATNANINGSIH 38 UMUM JL SLAMET RIYADI 8968240313 CoronaVac 06/10/2021 202108172F
10 P-DLWTD1HZ 3514131201830004 MUHAMMAD IKHWAN 38 UMUM SEBANI GADINGREJO 8533825277 CoronaVac 06/10/2021 202108172F
11 P-DNRH8HAG 3575034505950002 IKA AYU WULANDARI 26 UMUM JL TEUKU UMAR 8574832611 CoronaVac 06/10/2021 202108172F
12 P-DP36XJSC 3575031906850001 MUHAMMAD RUSDI 36 UMUM JL TEUKU UMAR 8564533841 CoronaVac 06/10/2021 202108172F
13 P-DSVH4DK9 3575013003960002 KATON SUPRAYUGI 25 UMUM JL SLAMET RIYADI 8786610172 CoronaVac 06/10/2021 202108172F
14 P-AV79F4CW 3575012907930001 M. LUTFI MARDI CAHYO 28 UMUM JL URIP SUMOHARJO RT 2 RW 2 8969932232 CoronaVac 06/10/2021 202108172F
15 P-BZPRWYQ5 3575025307950001 ANGGRAENI MARDIANTI 26 UMUM JL URIP SUMOHARJO RT 3 RW 3 8223471726 CoronaVac 06/10/2021 202108172F
16 P-CCEAFNRO 3575010406800004 MUKTAR 41 UMUM RW MONGINSIDI 8573121188 CoronaVac 06/10/2021 202108172F
17 P-CRMFKL7T 3575015102920001 ALFIYAH FARISSONA 29 UMUM JL URIP SUMOHARJO 8222999262 CoronaVac 06/10/2021 202108172F
18 P-D2XH5URU 3514160209900002 KHOIRON 31 UMUM JL URIP SUMOHARJO 8385879484 CoronaVac 06/10/2021 202108172F
19 P-D9DY2XVV 3575012003890002 NUR HUDA 32 UMUM BUKIR PASURUAN 8581672221 CoronaVac 06/10/2021 202108172F
20 P-DBQB3I7M 3575010311790001 MUHAMMAD MUNIR 42 UMUM JL GATOT SUBROTO 8113777705 CoronaVac 06/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
21 P-DEKRWCY2 3575015004730004 NUR KHASANAH 48 UMUM JL GATOT SUBROTO 8383460134 CoronaVac 06/10/2021 202108172F
22 P-DI9DL076 3575012311780001 JOKO NURSIYO 43 UMUM JL GATOT SUBROTO 8383460132 CoronaVac 06/10/2021 202108172F
23 P-5RIKF3M4 3575014507850002 YULIASTUTIK 36 UMUM JL KYAI SEPUH 002/005 GENTONG 8969986171 CoronaVac 06/10/2021 202108154G
24 P-2S46Q6TR 3513144310940003 FAIQOTUL HIKMAH 27 UMUM PERUM LUMBUNG PADI NO.85 004/001 SEBANI 8523086521 CoronaVac 06/10/2021 202108154G
10-06-2021 PONDOK BAYT AL HIKMAH
1 Q-00030XPT 3575012009930004 ABDUL MUKTHI CHIFDHI 28 UMUM JL MENARA NO 29 PASURUAN 8133348000 BIOFARMA 17/06/2021 24002421 06/10/2021 202108172F
2 Q-000N94FH 3514012505930003 NUR AFIDIN 28 UMUM DSN. SEMAMBUNG RT/RW: 05/12 DESA. CAPA 8578580447 BIOFARMA 15/08/2021 24202221 06/10/2021 20210172F
3 Q-000RQXK7 3271066908050007 ARWA SPICA KAAMILIYYA 16 REMAJA PERUM CITRA GARDEN C3/21 SIDOARJO 8133554252 BIOFARMA 31/08/2021 24201921 06/10/2021 202108172F
4 Q-000UENBW 3574042108050006 ACHMAD ALFIAN MIFTAHUL YASAR 16 REMAJA PP. BAYT AL-HIKMAH RT 7 RW 2 8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
5 Q-000UENFL 3508151002060003 AFIF ALI SHOFIYAH MASKUR 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8336954571 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
6 Q-000UETTR 3507051612050006 AHMAD KIBAR ALQUDSI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8123337763 BIOFARMA 07/09/2021 202107132 06/10/2021 20210172F
7 Q-000UETU4 3508050710050001 DAFFA' DHIYA' ULHAQ 16 REMAJA PP BAYT AL-HIKMAH RT 7 RW 2 8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
8 Q-000UETUV 3517090803060001 HAIKAL ACHMAD ARRIFI 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133509742 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
9 Q-000UETZA 3574012003050003 MUHAMMAD SHOLEH LATIEF 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
10 Q-000UF0WA 3514202410050002 MUHAMMAD FAKHRI RAMADHANI 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
11 Q-000UF0WE 3575012703060001 EMHA ARIES NAILURROCHMAN 15 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8123316077 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
12 Q-000UF1H3 5101010602060002 AHMAD RAFI FAUZI 15 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8123980633 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
13 Q-000UF1IY 3514092909060001 RAIHAN NAUVAL AHMAD 15 REMAJA PONPES BAYT AL - HIKMAH 8125983401 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
14 Q-000UF1TG 3514112201060005 FREANDY WAHYU SAPUTRA 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133045207 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
15 Q-000UF3ET 3513242809050001 ANIEF FADHIL KHAIR 16 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8523162361 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
16 Q-000UF4IX 3578171302060005 MOH. IRSYAD ROBBANI K S 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8523041289 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
17 Q-000UF4JF 3516060110050001 AKHMAD NUR MUZZAMMIL 16 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8574907151 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
18 Q-000UFIZV 3578071111050004 MUHAMMAD HISYAM NURWAKHYUD 16 REMAJA PONPES BAYT AL - HIKMAH 8219948288 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
19 Q-000UFJTB 3514202312050002 NAUFAL HUSNI MA'AFI 16 REMAJA PONPES BAYT AL - HIKMAH 8125909363 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
20 Q-000UFKJE 3514232803060003 MUKHAMAD RIZKI ADITIYA 15 REMAJA PONPES BAYT AL - HIKMAH 8121691750 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
21 Q-000UFNEP 3575031803040002 AZMI RIZQULLAH RABBANI 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133564116 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
22 Q-000UFNI6 3509120611050002 M JOVAN FAZERIN INZAGHI 16 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8510027611 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
23 Q-000UFOTP 3508211402040003 MOH. FAIRUZ ABADI 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8225186556 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
24 Q-000UFOTX 3525162603060002 MUHAMMAD DANIYAL WAHIDY 15 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
25 Q-000UFQ0P 3508030111050002 SYAFA REZZA FITRA WAHYU RAMA 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 07/09/2021 2021081118 06/10/2021 20210172F
26 Q-000UFQGZ 3517080406030003 AHMAD SUKRON FAISAL ASHARI 18 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8573350526 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
27 Q-000UFQO5 3514201505060001 MUHAMMAD AZRIEL IRKHAM 15 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
28 Q-000UFXV7 3514160402050002 M. AMINURROHMAN 16 REMAJA DSN. BENDUNGAN 01/06 DS. BENDUNGAN KEC8775241215 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
29 Q-000UFY41 3515011704040004 MUKHAMMAD USMAN IRYANTO 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8585506570 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
30 Q-000UFZL1 3514111109040001 YAHYA HARIST AL BAIHAQI 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8523478631 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
31 Q-000UG4W2 3527030505045828 MOH. NAJMI MILADI 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8775081888 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
32 Q-000UG9WP 3514242003060001 ACHMAD ARROFI` SYAFAR PRATAM 15 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8554665390 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
33 Q-000UGK4L 3514182105060001 ADITYA PANJI PRATAMA 16 REMAJA PONPES BAYT AL - HIKMAH 8155322469 BIOFARMA 07/09/2021 2021081118 06/10/2021 20210172F
34 Q-000UGKFP 3525102406040001 MUHAMMAD ALVIAN DARYL HIKAM 17 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8123022823 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
35 Q-000UGKVI 3513231311040002 ISWARA ZAKATA 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8523641968 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
36 Q-000UGLF8 3510230602050001 CHEVA NAWAREZA ZUHRI 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8232966789 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
37 Q-000UGLN3 3216181810040003 HALIM ASRIHI GUNAWAN 17 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8232966789 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
38 Q-000UGQAX 3510070406030003 MUHAMAD ALAN RABBANI 18 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8233412686 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
39 Q-000UGS0Y 3575031911030002 MUHAMMAD RIZQI RAMADHANI 18 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8233047814 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
40 Q-000UGUFQ 3514210404050003 BRAMASTA BRILIANDIKA ILHAM 16 REMAJA GUNUNGAN RT/RW. 001/014 NGULING 8223013579 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
41 Q-000UGVQ6 3525100809030004 MOHAMMAD AINUL ATHO' 18 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8564937498 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
42 Q-000UGY3V 3508170601050002 REVALINO ALFANDI 16 REMAJA PONPES AL BAYT 8135759077 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
43 Q-000UGY41 3514211407050001 SYAMSUL ARIFIN 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8232966789 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
44 Q-000UGYV5 3515152903050004 IBNU HAKIM SYAH 16 REMAJA SIDOPURNORT/RW. 012/005 SIDOKEPUNG 8213224821 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
45 Q-000UH63D 3514131405040002 NAZARUDDIN DAFFA AKMAL 17 UMUM SELOKAMBANG RT/RW. 001/009 GUNUNGGANG8123392381 BIOFARMA 07/09/2021 2021071307 06/10/2021 20210172F
46 Q-000UH63F 5171041604050005 FACHRIZAL ILHAM MAULANA 16 REMAJA Jalan buana mas indah, B. 26, denpasar barat, kota8123925846 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
47 Q-000UH6N6 3514111209040003 MUHAMMAD LUFYN AULIA RAHMAN 17 UMUM JL. PESANTREN GG. PODORUKUN 21 DS. PAN 8575517077 BIOFARMA 07/09/2021 2021071371 06/10/2021 202108172F
48 Q-000UH87P 3514202003050001 MUHAMMAD SAKHAWI AMIN 16 REMAJA Kedawung, rt/rw 06/02, kedawung kulon, kec. Grati8139946026 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
49 Q-000UH8KK 3514202509050003 M.FIRMAN ARDI ANSYAH 16 REMAJA JL GRATI TUNUN KRESEK GRATI 8786452392 BIOFARMA 07/09/2021 202171371 06/10/2021 20210172F
50 Q-000UHA1D 3514182312040001 FALIANSYAH AL AJIBA 17 UMUM BAYEMAN, GONDANGWETAN, PASURUAN 8523028442 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
51 Q-000UHA1F 3514201912040001 KAHFI NURVITO AL GHOZALI 17 UMUM KRAJAN IIN05/02 CUKURGONDANG KEC. GRATI8154568597 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
52 Q-000UHAUF 3575011405030001 MOCHAMAD RIFQI MUDZAKY 18 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8223238393 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
53 Q-000UHCDV 3529060709060001 WIRA ADRINA 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133057620 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
54 Q-000UHCL5 3575022312040001 CHOIRUL ANAM 17 UMUM PERUM PUCANG INDAH LESTARI II C-9 RT/RW.8510123736 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
55 Q-000UHLWT 3512082305040002 AHMAD FAIRUZ ZAKI WIDYATNA 17 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8123527315 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
56 Q-000UHM92 3514221109030001 RUDY DEWANTO IBRAHIM 18 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8533852400 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
57 Q-000UHQNL 3575011803050003 MUHAMMAD HADI 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8564937498 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
58 Q-000UHQUT 3514060203050005 FAWWAZ DIMAS FAHRIZA 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8823572314 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
59 Q-000UI1UP 3514072402050001 WAHYU BEKTI SAPUTRA 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8232966789 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
60 Q-000UI31T 3508141310030001 SARWO IDI SYAHYOGO 18 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8211199919 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
61 Q-000UI8JJ 3577012909040002 MUHAMMAD KRISNANDA VILOVAN S 17 UMUM BUKIR, GADINGREJO, KOTA PASURUAN 8214179539 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
62 Q-000UI98O 3514202706040004 MUKHAMMAD FIKRY HAIKAL 17 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8564937498 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
63 Q-000UIAVS 3507230606050001 MOH ZAKY AUFANI 16 REMAJA JL. RAYA KEPUHARJO 17 12/05 DS. KEPUHAR 8133488792 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
64 Q-000UIEYX 3509031912010005 HAFIZ AHMAD SIDDIQ 20 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8564937498 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
65 Q-000UIM53 3510092710040004 RAVINDRA RABEL SUMARNA 17 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8232966789 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
66 Q-000UIM8I 3509190309040003 MUHAMMAD JAYA WIJAYA 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8233639393 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
67 Q-000UIRHH 3508081102040001 MOHAMMED FARRIL ZHARIF ZIDANE 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8135896883 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
68 Q-000UIVKC 3271062301040006 MUHAMMAD ARFA HABIBULLAH 17 UMUM PERUM BUDI AGUNG JL. MANGLIED E-6 KEL. 8787051332 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
69 Q-000UIZCP 3525103007040001 ARYANATA AL MAAHI 17 UMUM PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8564937498 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
70 Q-000UJ2J5 3514092010030010 ABIYYU ARFAN YUDHISTIRA 18 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8131081185 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
71 Q-000UJIAW 3517030409030004 ACHMAD MUFDZILUL ALBAB 18 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8123196833 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
72 Q-000UJIDH 3514210902040001 MUHAMMAD TSABITUL HIKAM 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133307012 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
73 Q-000UKI43 3526014306040008 SITI FATIMAH NURMALASARI 17 UMUM BAYT AL IKMAH KELURAHAN KERAMPYANGAN8210789574 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
74 Q-000UKM4W 3514215601060001 AULIA FINA ADELLAH 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133051521 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
75 Q-000UKNLL 3514134206060003 GHANIYYAH IZAH WERDANA 15 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8133598712 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
76 Q-000UKR6M 3574034610050001 ALIFFINA INDIRA RAMADHANI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8523665140 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
77 Q-000UKVG8 3578224611060002 NAJWA NAJIHAH 15 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8223147502 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
78 Q-000UKXBT 3312115409050001 KEISYA NAJELIA FATONI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8214071376 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
79 Q-000ULDMM 3573024608050002 AL SYAFIRA ANANDA ARIFTIAN PUT 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 857333812 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
80 Q-000ULOJG 3509195206060004 NABILA IZZATUL AZRA SHALEH 15 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8133432050 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
81 Q-000ULQ1X 3527035304050003 AQILAIQA RANIADILA 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8775032837 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
82 Q-000ULX9O 3508104210050002 NADHIFAH ABDILLAH 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8525709205 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
83 Q-000UM5OC 3514086206050002 AZZAHRA IZZATUN NISA' 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8123451488 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
84 Q-000UM6FK 5102066101050002 INDAH NUR LATIFAH 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8123707555 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
85 Q-000UMAWO 3507140309050001 ALIN ALFAFA SANY 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8133375116 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
86 Q-000UMJTX 3511025707040001 NABILA AZZAHRO SHIAM MUBAROK 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133111777 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
87 Q-000UMKCM 5104015009040002 NURUL INTAN EMMELIA SETYAWATI 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8124668978 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
88 Q-000UMNSV 3514215709050001 DIVA LARASATI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8319002600 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
89 Q-000UMO73 3514176006050003 ALYA AZ ZAHRA 16 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8123102077 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
90 Q-000UMP2M 3574026602060002 CINTAMANI ZAHROTUL QUDSY 15 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8523217941 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
91 Q-000UMS7V 3514174605040002 KHODIJAH SUKMA FADHILAH 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8123931675 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
92 Q-000UMSK1 3514026410040002 NAURAH MUTIARA OKTAFIA 17 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8133378690 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
93 Q-000UMTIU 3514067101050002 ZAHRA ZYANKA EFENDI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8213107537 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
94 Q-000UMUDH 3573054812050003 JUNICHA ASYA'DIYAH PUTRI 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8523083744 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
95 Q-000UMVJD 3515086402050002 NAJWA PUTRI AULIA 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8124953404 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
96 Q-000UN5BL 3573036208040001 HANNA KHONSAUL ADIBAH 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8533463981 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
97 Q-000UN799 3514165310040002 YESI RAHMAWATI 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133480733 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
98 Q-000UNA5Z 3514214206050003 BETA ARISTA 16 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8133212256 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
99 Q-000UNAYK 3514206112050001 TSANIA MUTIARA SALIMAH 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
100 Q-000UNCC0 3514055104040003 MILKAARTY AYUNINGRUM 17 UMUM PONPES BAYT AL HIKMAH KRAMPYANGAN KO 8121714181 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
101 Q-000UNCY3 3201017011050004 UMMI KULSUM 16 REMAJA CIBINONG BOGOR 8128986309 BIOFARMA 07/09/2021 2021071371 06/10/2021 202108172F
102 Q-000UNCZ2 3322034408060001 NAZILLA DWI HAPSARI 15 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
103 Q-000UNDKL 3321114506060005 FATMA HANIF 15 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
104 Q-000UNDX5 3509174905050002 VELLYANA TRIARRIBAH PUTRI HANA 16 REMAJA CURAH KATES JEMBER 8233063167 BIOFARMA 07/09/2021 2021071371 06/10/2021 202108172F
105 Q-000UNE17 3575016809040003 SILATUL FAJRI 17 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8933690777 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
106 Q-000UNFHE 3514167005040001 AISYAH NUR WAHYUNI 17 UMUM PONPES BAYT AL - HIKMAH KOTA PASURUAN 8578489733 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
107 Q-000UNGON 3514016712040002 INTAN SABILAH RAHAYU PUTRI 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8525792589 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
108 Q-000UNGT0 3525164605050001 RAHMA MAULIDAH 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8951447551 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
109 Q-000UNHOK 3575015604050003 WULAN MAULIDIA 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
110 Q-000UO2C2 3514145607050002 KHIKMATUL FINA MAFAZA 16 REMAJA JL. NENER, 001/001, MANARUWI BANGIL PASU 8214080008 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
111 Q-000UO35U 3575034205050001 MAULIDAH SYARIFAH 16 REMAJA BLANDONGAN, 001/003, BLANDONGAN BUGUL 8510075603 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
112 Q-000UOR2J 3575015407040001 JIHAN KARIMAH PUTRI 17 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8233235151 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
113 Q-000UORAQ 3514015209940001 SRI WAHYUNI 27 UMUM PURWODADI PASURUAN 8575543871 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
114 Q-000UP1DX 3514205008040003 DIANA LUTFIYAH 17 UMUM ponpes bayt Al-Hikmah 8233743850 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
115 Q-000UP7KL 3514234301010001 NAILUL HASANAH 20 UMUM ARJOSARI RT/RW 2/3 8953846651 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
116 Q-000UPF8J 3514060812030003 SYAKRONI ARIF HIDAYAT 18 UMUM KURUNG, KEJAYAN KAB. PASURUAN 8122873570 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
117 Q-000UPFRE 3575032103040006 MOH. HAIKALUSSOMADANI PRATAM 17 UMUM BLANDONGAN, BUGUL KIDUL KOTA PASURUAN8578927217 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
118 Q-000UQ3JZ 3509195111950006 MUNA INAS MABRUROH 26 UMUM TEGAL BESAR RT/RW 4/3 8982341717 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
119 Q-000UQ5EI 3514196608010003 NAILUL IZAH 20 UMUM LEBAK WINONGAN 8385253841 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
120 Q-000UQ8LB 3514236607040001 ISNAINI NUR FARIKHAH 17 UMUM ponpes bayt al-hikmah 8129060088 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
121 Q-000UQE3N 3508104603050005 SOFIE AULIA DAMAYANTI 16 REMAJA ponpes bayt Al-Hikmah 8233727300 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
122 Q-000UQNQ8 3514206002060005 NAILA RAHMATIKA 15 REMAJA SUMBER, 004/001, SUMBERDAWESARI, GRATI 8785219561 BIOFARMA 07/09/2021 2021071371 06/10/2021 202108172F
123 Q-000UQOW0 3573044803060002 NABILA SHARFINA 'IZZATI 15 REMAJA PONPES BAYT AL HIKMAH KRAMPYANGAN KO 8122200197 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
124 Q-000UQP1D 3525107103060002 IGNACIA MAULIMAYA IRMANSAH 15 REMAJA BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8529886300 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
125 Q-000UQPBU 3514237110050001 ALFI RAMADHANI HERWIDI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8223277593 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
126 Q-000UQPPC 3575025203960002 MAULANIA SAFIRA 25 UMUM JL.KH. ABDUL CHAMID XII/61-C KEL.KEBONS 8569513656 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
127 Q-000URDB0 3510132012030002 MOHAMMAD AFKAR KHADAFI 18 UMUM BAYT ALHIKMAH KELURAHAN KRAMPYANGAN 8525933424 BIOFARMA 07/09/2021 202108118H 06/10/2021 20210172F
128 Q-000URE7G 3525102111030001 FADHLUL IZZUDDIN 18 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8953352898 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
129 Q-000URICW 3514021808030002 AGUS SHODIQIN 18 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8133434567 BIOFARMA 07/09/2021 202107132I 06/10/2021 20210172F
130 Q-000UT14C 3509044410060001 CHOIRUNNISA ARTHI DIBYANTARI 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8138002008 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
131 Q-000UTFQC 3578036710040002 NABILAH ZAHROTAL HAYAH 17 UMUM PONPES BAYT AL HIKMAH KRAMPYANGAN KO 8968723259 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
132 Q-000UTG5F 3509114906050003 ALAYDA AF'IDATUN NISA 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8135764647 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
133 Q-000UTH4T 3508214106050001 FASHA CAHYA CAMILA MUKHLAS 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8133777552 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
134 Q-000UTHJE 3509066505050003 16 REMAJA PONPES BAYT AL - HIKMAH KOTA PASURUAN 8135847656 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
135 Q-000UTHKL 3575026207040001 TIZA AMALIA 17 UMUM Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 8193681686 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
136 Q-000UTVRG 3575036704040001 AMELIA SYAHRIA MAULIDA 17 UMUM PONPES BAYT AL HIKMAH KRAMPYANGAN KO 8123279476 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
137 Q-000UTWDK 3575026311050003 ANDINI PUTRI ZAHIRA 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
138 Q-000UTX3A 3578025512050001 NUR SAKINATUL MAÙNAH 16 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8578521829 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
139 Q-000UU7Y7 3509046605040001 NISYAFINA QHARIR DIBYANTARI 17 UMUM pondok pesantren al-bayt hikmah 8138002008 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
140 Q-000UU8TA 3575025506050001 SALSABILA EKA RAHMADANTI 16 REMAJA ponpes bayt al-hikmah 8223004305 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
141 Q-000UUGJD 3578154301050008 ZAHRA NADIYA HIME D.SP 16 REMAJA ponpes bayt al-hikmah 8121631679 BIOFARMA 07/09/2021 202108118H 06/10/2021 202108172F
142 Q-000UUS5F 3514082501990001 AGUNG SULASWANTO 22 UMUM KERTOSARI PURWOSARI PASURUAN 8575324473 BIOFARMA 07/09/2021 2021071371 06/10/2021 20210172F
143 Z-000AERF8 3172064108051001 AZKA FELANDRI 16 REMAJA Jl. Patiunus No.25, Krampyangan, Kec. Bugulkidul 817888252 BIOFARMA 07/09/2021 202107132I 06/10/2021 202108172F
144 3511115803060003 CHELSEA IMALIA SAFIRA PUTRI 15 REMAJA JL BRIGPOL SUDARLAN 8523049222 BIOFARMA 15/07/2021 202108118H 06/10/2021 202108172F
145 3507241002090002 AHMAD IKMAL 12 REMAJA PERUM TAMAN BAYANGKARA 85234133600 BIOFARMA 15/09/2021 202108118H 06/10/2021 202108172F
146 35183230107090002 MOCH YUSUF DANISWARA 12 REMAJA PROBOLINGGO 82147119869 BIOFARMA 06/10/2021 202108172F
147 JASMIN SHAKIRA 15 REMAJA TARAKAN 82219786810 BIOFARMA 06/10/2021 202108172F
148 M NANDA ARIF SULAIMAN 12 REMAJA GRESIK 8155231136 BIOFARMA 06/10/2021 202108172F
149 3515086405060007 SAYLA RIZKYAH MAHFUDZ 14 REMAJA 85785110931 BIOFARMA 06/10/2021 202108172F
150 3551425803050002 ZULFA SYAFAKOH 17 REMAJA 81334140576 BIOFARMA 06/10/2021 202108172F
151 P-1BK3HPV4 3215260403090001 MUHAMMAD WAFDAN ZUFAR NAWW 12 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8564846251 BIOFARMA 06/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
152 P-5JP70EPB 3513122305050003 MOH. ABDURRAHMAN HIDAYATULL 16 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8233680871 BIOFARMA 06/10/2021 202108172F
153 P-5TGBMXHH 3526012309090002 RUSYDAN RAFA HUSAIN 12 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8233820663 BIOFARMA 06/10/2021 202108172F
154 P-62NO0ZAA 3578041010080001 DAMAR ZULFIAN SETO ADIBOWO 13 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8151118444 BIOFARMA 06/10/2021 202108172F
155 P-6NUIGV6Z 3514192003090001 AKHMAD JAVIER ATHAILLAH 12 REMAJA WINONGAN PASURUAN 8123150896 BIOFARMA 06/10/2021 202108172F
156 P-C6MLM7CM 3515071405060002 MUKHAMMAD ROBERTH AL FADHI 15 REMAJA PP. BAYT AL-HIKMAH KRAMPYANGAN RT 7 RW8560812793 BIOFARMA 06/10/2021 202108172F
157 P-PPC3U4Q7 3507182310080001 ALI NUR AZHAR 13 REMAJA TR 4 RW 18 MANGLIAWAN PAKIS MALANG 8133375416 BIOFARMA 06/10/2021 202108172F
158 P-PVIDW03Q 3573023003070004 ARSYA NUR MUHAMMAD 14 REMAJA BAYT AL HIKMAH BUGUL KIDUL 8785956100 BIOFARMA 06/10/2021 202108172F
159 35070522010700004 EXSELIO RAMA DWI SEPTIANO 15 REMAJA DAMPIT MALANG 8123358118 BIOFARMA 06/10/2021 202108172F
160 3676016504040002 NAFISAH 17 REMAJA GADINGREJO 82231284321 BIOFARMA 06/10/2021 202108172F
Mengetahui Pasuruan, 06-10-2021


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Q-000ASQ81 3575013007710002 YOYOK PRIBADI 50 RENTAN JL URIP SUMOHARJO RT 02 RW 02 GADINGRE 8123719066 Astrazeneca 03/07/2021 ABY1911 05/10/2021 ABY131
2 Q-000ASQ64 3575010906730003 RACHMAD DHARMAWAN 48 UMUM JL URIP SUMOHARJO RT 02 RW 02 BUKIR 8133335484 Astrazeneca 03/07/2021 ABY1911 05/10/2021 ABY131
3 Q-000K14OJ 3523164703910004 MARLIA ATNINENGSIH 30 UMUM JL SLAMET RIYADI GG 12, GENTONG 8579086865 Astrazeneca 29/07/2021 ABY1911 05/10/2021 ABY131
4 Q-000AUBQR 3575016703790002 SULISTIANI 42 UMUM JL IRIAN JAYA NO.2 8586570413 Astrazeneca 03/07/2021 ABY1911 05/10/2021 ABY131
5 Q-000AW1F0 3575014706030003 ANDINI VIA BERLIANA 18 UMUM JL IRIAN JAYA NO.2 8384832079 Astrazeneca 03/07/2021 ABY1911 05/10/2021 ABY131
6 P-0SK06KDM 3575014107690099 HASANAH 52 RENTAN JL HANGTUAH 8133536474 Astrazeneca 05/10/2021 ABY1312
7 P-EVT1KI74 3575010710690001 MARDIONO 52 RENTAN jl banda 4/3 gadingrejo 8121736416 Astrazeneca 05/10/2021 ABY1312
8 P-0X8BYJ80 3575012707650001 SAIFUL AHADI 56 RENTAN JL URIP SUMOHARJO 3/8 BUKIR 8222895776 Astrazeneca 05/10/2021 ABY1312
9 P-2NDJKNG4 3575022110710001 SUNADI 50 RENTAN JL SLAMET RIYADI 8788148496 Astrazeneca 05/10/2021 ABY1312
10 P-1MQV7GV8 3575014101670031 SYAFI'ANA 54 RENTAN JL SLAMET RIYADI RT02/RW03 GENTONG 8113777705 Astrazeneca 05/10/2021 ABY1312
11 P-46WPIPWJ 3575010107630133 SAHRUL 58 RENTAN JL HANGTUAH RT02/RW04 GADINGREJO 8564646822 Astrazeneca 05/10/2021 ABY1312
12 P-4BQ1GD8H 3575014107600167 CHOFIYAH 58 RENTAN jl hangtuah gadingrejo 8113777705 Astrazeneca 05/10/2021 ABY1312
13 P-0APSXS53 3514165008960003 MUDAIFA 25 UMUM kalimas utara 3/2 kraton 8233143654 Astrazeneca 05/10/2021 ABY1312
14 P-0C162FT6 3514161709910002 M. ARFIN 30 UMUM KALIMAS UTARA 8364991633 Astrazeneca 05/10/2021 ABY1312
15 P-0HBV7DYI 3514166606940001 NATIJATUL ILMIA 27 UMUM KALIMAS UTARA 8374631802 Astrazeneca 05/10/2021 ABY1312
16 P-0N1VP59N 3575015011000001 KUNIJAKIYA 21 UMUM JL BANDA GADINGREJO 8585066508 Astrazeneca 05/10/2021 ABY1312
17 P-0PGYPDFB 3514165506830001 NUR ROCHMAH 38 UMUM JL HANGTUAH 2/3 GADINGREJO 8123359918 Astrazeneca 05/10/2021 ABY1312
18 P-0OSKKFLS 3575010712760006 M. JUPRI 45 UMUM JL HANGTUAH 8123359918 Astrazeneca 05/10/2021 ABY1312
19 P-17JFH4FE 3507252004980001 HAFIIDZ AGUS WARDHANA 23 UMUM LAWANG MALANG 8960715289 Astrazeneca 05/10/2021 ABY1312
20 P-1KPY23G1 3575011208780007 MAHMUDI 43 UMUM JL HANGTUAH 2/4 GADINGREJO 8586354438 Astrazeneca 05/10/2021 ABY1312
21 P-1YE6FZVZ 3514134304030001 TRIA FAUZIATUN NISA' 18 UMUM DSN BANGGLE GUNUNGGANGSIR BEJI 8135934535 Astrazeneca 05/10/2021 ABY1312
22 P-263L74M0 3514166302930001 LAILIL FITRIYAH 28 UMUM KALIMAS UTARA 8574533956 Astrazeneca 05/10/2021 ABY1312
23 P-23OZISJI 3514162609010003 MUHAMMAD RIKY YAKUB 20 UMUM TAMBAK REJO KRATON 8570686294 Astrazeneca 05/10/2021 ABY1312
24 P-2CCX9MS8 3573025906840006 ANITASRA DEWITYA 37 UMUM JL SLAMET RIYADI 1/5 GENTONG 8128185477 Astrazeneca 05/10/2021 ABY1312
25 P-2JXR6FG7 3514165004800017 ENI ERNAWATI 41 UMUM KALIREJO KRATON 8593300775 Astrazeneca 05/10/2021 ABY1312
26 P-2KEFJBDE 3515136005870005 MEINITA RAMADHANY 34 UMUM JL JERUK III NO11 SIDOARJO 8383389500 Astrazeneca 05/10/2021 ABY1312
27 P-2QGK2P2E 3575010101880009 SOLIKHAN 34 UMUM JL HANGTUAH 1/4 GADINGREJO 8560724563 Astrazeneca 05/10/2021 ABY1312
28 P-2NIQ186D 3575015205020003 WIRDA UTAMI 19 UMUM JL HANGTUAH 4/4 GADINGREJO 8816985979 Astrazeneca 05/10/2021 ABY1312
29 P-2V47H2CD 3575014508770003 JUMIATI 44 UMUM JL HALMAHERA GG 9 RT01/RW05 GADINGREJO8113777705 Astrazeneca 05/10/2021 ABY1312
30 P-35ANK7Y0 3514144201870003 LAILATUL HIKMAH 34 UMUM JL KOLURSARI 2/4 BANGIL 8383460187 Astrazeneca 05/10/2021 ABY1312
31 P-31PZ3FPY 3575015004950001 RINA WULANDARI 26 UMUM JL SLAMET RIYADI GG II RT02/RW03 GENTONG8596439210 Astrazeneca 05/10/2021 ABY1312
32 P-43DLMEAY 3575014107950086 AMININ 26 UMUM gadingrejo 1/4 gadingrejo 8312336785 Astrazeneca 05/10/2021 ABY1312
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 P-3XM77IJ8 3514161003860001 NAIM 35 UMUM gadingrejo 1/4 gadingrejo 8779418248 Astrazeneca 05/10/2021 ABY1312
34 P-4PASUTRQ 3575012004970001 KHOIRUL ANAM 24 UMUM JL BANDA GG TERATAI 8113777705 Astrazeneca 05/10/2021 ABY1312
35 P-0KK8FC55 3575012004810002 ADI CAHYONO 40 UMUM JL SLAMET RIYADI 8233665147 Astrazeneca 05/10/2021 ABY1312
36 P-0LUD5E8Z 3575010303020004 ABDUL AZIS 19 UMUM JL BANDA 4/2 8232966792 Astrazeneca 05/10/2021 ABY1312
37 P-0OCS10FM 3575014107840117 SITI ROMLAH 37 UMUM JL BANDA RT03/RW03 GADINGREJO 8533099946 Astrazeneca 05/10/2021 ABY1312
38 P-26V46PRI 3575010303880001 MUKHAMAD SAIFUL 33 UMUM JL SLAMET RIYADI 8133377917 Astrazeneca 05/10/2021 ABY1312
39 P-1UTJI94B 3575011310950006 KHAIRUL ANAM 26 UMUM BUKIR 2/1 BUKIR 8123762018 Astrazeneca 05/10/2021 ABY1312
40 P-1DMS6CID 3575014107940050 NUR CHOFIFAH 27 UMUM NGAGLIK 6/2 GADINGREJO 8313488729 Astrazeneca 05/10/2021 ABY1312
41 P-1TEF08G1 3514164604860005 ROSITA 35 UMUM JL BANDA GG MAWAR RT05/RW02 GADINGREJ8138833731 Astrazeneca 05/10/2021 ABY1312
42 P-1S3N1Z1L 3514166212780003 KHOTIMAH 46 UMUM KEBON SAWAH 8773801434 Astrazeneca 05/10/2021 ABY1312
43 P-20MUBGLF 3514163004010002 KUSAINI 21 UMUM TAMBAKREJO 8573203924 Astrazeneca 05/10/2021 ABY1312
44 P-2D3TYA79 3575013105850002 AKHMAD JAELANI 36 UMUM JL SLAMET RIYADI GG 17 RT 01/RW 05 GENTO 8233388983 Astrazeneca 05/10/2021 ABY1312
45 P-2VQYT6FG 3201145104790001 MULYANAH 42 UMUM KP CILETUH ILIR KARACAK 8314023616 Astrazeneca 05/10/2021 ABY1312
46 P-2TBOMXKR 3575011004720005 BAKIR 49 UMUM JL HALMAHERA 1/5 GADINGREJO 8113777705 Astrazeneca 05/10/2021 ABY1312
47 P-31LJIJTS 3506221404860001 BENI SLAMET 35 UMUM JL KOLURSARI 4/2 BANGIL 8384612662 Astrazeneca 05/10/2021 ABY1312
48 P-392VLE8C 3514070509900003 MUHAMMAD MUKLAS 31 UMUM JL SUROYO 2/5 WONOREJO 8567000551 Astrazeneca 05/10/2021 ABY1312
49 P-3S2ZZREK 3575017110910001 SITI MARYAM 30 UMUM JL HALMAHERA 8574920924 Astrazeneca 05/10/2021 ABY1312
50 P-4FJMDTL2 3575014107930109 SOLICHA 27 UMUM jl hangtuah gadingrejo 8180816909 Astrazeneca 05/10/2021 ABY1312
51 P-4HRIBASM 3575014107930051 IRMA ALFIYA 28 UMUM jl hangtuah 1/3 gadingrejo 8560741572 Astrazeneca 05/10/2021 ABY1312
52 Q-000UENBZ 3575010603080003 MUKHAMAD KARIM BENZEMA 13 REMAJA RT 003 RW 007 8785107934 BIOFARMA 07/09/2021 202108118H 05/10/2021 202108154G
53 Q-000UENHH 3575014511710001 SITI AISYAH 50 RENTAN JL HANGTUAH 1/3 GADINGREJO 8113777705 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
54 Q-000UPTTY 3575034107680093 MISTIN 53 RENTAN JL LETJEN SUTOYO 3/1 MANDARANREJO 8578400409 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
55 Q-0007TTNV 3575016208620001 PIPIN SUPRIHATIN 59 RENTAN JL IRIAN JAYA 8113777705 BIOFARMA 24/06/2021 24002621 Ga 05/10/2021 202108172F
56 Q-000EM2IA 3575016102980001 MARDIYAH 23 UMUM JL SLAMET RIYADI GG.VIII GENTONG 8383275230 BIOFARMA 14/07/2021 24200421 Ga 05/10/2021 202108154G
57 Q-000UEFDS 3575010503970004 MOKH RIZQI SYAWALLUDI 24 UMUM JL BANDA 3/2 GADINGREJO 8570674899 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
58 Q-000EM4Z8 3507052806890002 RUDI HARTONO 32 UMUM JL SLAMET RIYADI RT 3 RW 2 GENTONG 8383446018 BIOFARMA 14/07/2021 24200421 Ga 05/10/2021 202108154G
59 Q-000UF282 3514141512960003 RYAN HIDAYAT 25 UMUM JL NAGKA 1/6 BANGIL 8821786374 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
60 Q-000UJ2JA 3575014107940109 CHALIMAH 26 UMUM JL HALMAHERA 9 GADINGREJO 8983455880 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
61 Q-000RO64B 3575015807970002 DEWI ROSIDA 24 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8953222012 BIOFARMA 31/08/2021 24202321 Ga 05/10/2021 202108154G
62 Q-000UENH8 3575032607790004 ANTO SULISTIO 42 UMUM JL SLAMET RIYADI 2/2 GENTONG 8383493240 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
63 Q-000UF2B5 3575012705810003 BUDIANTO 40 UMUM JL URIP SUMOHARJO 1/1 BUKIR 8123371601 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
64 Q-000UTH55 3575024701890003 HOFI'A 32 UMUM jl laks martadinata 2/7 NGEMPLAKREJO 8135807253 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
65 Q-000UGZCX 3575030101830012 ABDUL KARIM SODIQ 38 UMUM JL KH SAMANHUDI 3/3 PURWOREJO 8123222011 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
66 Q-000UEU4O 3575012611010002 TRIFANDI RAMADANI 20 UMUM JL SLAMET RIYADI 3/3 GENTONG 8570728735 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
67 Q-000UF23J 3575012711870001 ACHMAD SAIFUDDIN 34 UMUM JL URIP SUMOHARJO 3/2 BUKIR GADINGREJO 8214366554 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
68 Q-000UGKFQ 3575015103810002 MIFTAKHUL JANNAH 40 UMUM jl hangtuah 2/3 gadingrejo 8121691483 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
69 Q-000HKG66 3575010103780003 HERRY MUDJI SUSANTO 43 UMUM JL HANGTUAH II 4/3 GADINGREJO 8585026030 BIOFARMA 16/07/2021 Vaksin I, K 05/10/2021 202108154G
70 Q-000UEUHA 3575014107920111 SITI UMROH 31 UMUM JL HANGTUAH 3/4 GADINGREJO 8786583481 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
71 Q-000U0SCO 3575011206950003 FAJAR JUNIAWAN 26 UMUM JL BANDA 5/2 GADINGREJO 8384846069 BIOFARMA 06/09/2021 2021071371 05/10/2021 202108154G
72 Q-000UIM7Y 3575010605820001 EDI ISMANTO 39 UMUM jl slamet riyadi 2/4 SEBANI 8123329086 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
73 Q-000UFGKE 3575012212040002 TAUFIQ AKBAR EFENDI 17 UMUM JL SLAMET RIYADI 2/3 GENTONG GADINGREJO8570693340 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
74 Q-000RUKSL 3575014201750001 ENIK KUSWATI 39 UMUM JL IRIAN JAYA GADINGREJO 8113777705 BIOFARMA 31/08/2021 24202321 Ga 05/10/2021 202108154G
75 Q-000UF3AT 3575014503780006 ISMAWARTI 43 UMUM JL URIP SUMOHARJO 1/1 BUKIR GADINGREJO 8158471794 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
76 Q-000UHA3Z 3575014808740005 KASIYEM 47 UMUM JL BANDA 3/2 GADINGREJO 8523609756 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
77 Q-000UGL1I 3575014107920043 SITI FATIMAH 29 UMUM JL KH SAMAN HUDI 3/3 PURWOREJO 8233524784 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
78 Q-000U2ZE4 3575015703020003 HALIMA SINTIA 19 UMUM JL HALMAHERA 2/5 GADINGREJO 8578527613 BIOFARMA 06/09/2021 2021071371 05/10/2021 202108154G
79 Q-000UF28I 3575010905950003 MOCHAMMAD LUKMAN 25 UMUM JL HALMAHERA 3/5 GADINGREJO 8214162470 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
80 Q-000UIR3G 3575014107840150 SITI CHOTIJAH 37 UMUM JL HANGTUAH 4/4 GADINGREJO 8387946336 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
81 Q-000TLSCR 3575015308020004 VENY AGUSTIN 19 UMUM BUKIR PASURUAN 8121687555 BIOFARMA 04/09/2021 2021071321 05/10/2021 202108154G
82 Q-000TC9P6 3575014107840064 FITROTUN NAZILAH 37 UMUM NGAGLIK GADINGREJO 8311102158 BIOFARMA 04/09/2021 2021071371 05/10/2021 202108154G
83 Q-000U0NQU 3575034710960004 NILA DEVIANA 25 UMUM JL BANDA 5/2 GADINGREJO 8311815622 BIOFARMA 06/09/2021 2021071371 05/10/2021 202108154G
84 Q-000TAVIW 3575016110840001 DJUARIYAH 37 UMUM JL SLAMET RIYADI 3/4 SEBANI 8384681807 BIOFARMA 04/09/2021 2021071371 05/10/2021 202108154G
85 Q-000UFVQQ 3575012005800009 ACHMAD YONO 41 UMUM JL SLAMET RIYADI RT03/RW04 SEBANI 8384681807 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
86 Q-000HZX07 3575035907860002 INDA PUJI LESTARI 35 UMUM JL. LETJEN SUTOYO RW 01 RT 003 8500000000 BIOFARMA 17/07/2021 24201421 Ka 05/10/2021 202108154G
87 Q-000SQA8E 3575016108990005 IFA INDAH SARI 22 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8574861317 BIOFARMA 02/09/2021 2021071371 05/10/2021 202108154G
88 Q-000UENGT 3575010302780001 KIKI FEBRIAN MUCHTI 43 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8533103270 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108172F
89 Q-000UEDYX 3575014606970003 NURIL FITRIA 24 UMUM JL GATOT SUBROTO 4/7 BUKIR 8123982035 BIOFARMA 07/09/2021 2021071371 05/10/2021 202108154G
90 Q-000BTFZJ 3575011808840006 ABDUL BASIT 37 UMUM SEBANI 3/4 8532766295 BIOFARMA 06/07/2021 24003521 Ga 05/10/2021 202108154G
91 Q-000HDJOF 3575010107770013 SLAMET 43 UMUM JL SLAMET RIYADI SEBANI 8123361383 BIOFARMA 15/07/2021 24200421 Ga 05/10/2021 202108154G
92 Q-000HDJQ8 3575016704830001 NURUL KHASANAH 38 UMUM JL SLAMET RIYADI SEBANI 8123361383 BIOFARMA 15/07/2021 24200421 Ga 05/10/2021 202108154G
93 Q-000T9KJS 3575016905990001 MEI DIAH RAGAWATI 21 UMUM jl kyai sepuh 2/6 GENTONG 8233510939 BIOFARMA 04/09/2021 2021071371 05/10/2021 202108154G
94 S-93F67103 3575014107590081 KASIYATI 62 LANSIA JL BANDA 4/6 GADINGREJO 813777705 BIOFARMA 05/10/2021 202108154G
95 P-3SYE6FRJ 3575010107610070 SUPARDI 60 LANSIA GADINGREJO RT 4 RW 2 8564622619 BIOFARMA 05/10/2021 202108154G
96 S-C2A220D8 3575015708600001 SUHARNING TATIK 61 LANSIA JL HANGTUAH 8123359918 BIOFARMA 05/10/2021 202108154G
97 P-5VDCRAHK 3514132010050003 REVI JIHAD FISABILILLAH 16 REMAJA JL TENGIRI I/407 BENDOMUNGAL 8214091580 BIOFARMA 05/10/2021 202108172F
98 P-1EV7TECF 3514152706050001 MUHAMMAD THORIQ UTOMO 16 REMAJA SUMBERBOTO 8573190158 BIOFARMA 05/10/2021 202108154G
99 P-1HQNNQX0 3575012002050001 ROHMAT 16 REMAJA JL HANGTUAH GADINGREJO 8113777705 BIOFARMA 05/10/2021 202108154G
100 P-1DZ0ILQR 3575012411060004 MUKHAMMAD ALI MUFLIKH 15 REMAJA JL NGAGLIK RT06/RW02 GADINGREJO 8312279829 BIOFARMA 05/10/2021 202108154G
101 P-0NVBAZHS 3575015606860006 ZULAIKHA 35 UMUM JL HANGTUAH 3/3 8820095071 BIOFARMA 05/10/2021 202108154G
102 P-4G3J7542 3575015511780002 PUDJI RAHAYU 43 UMUM JL HASANUDIN IX NO 53 RT01/RW07 KARANGA8963507550 BIOFARMA 05/10/2021 202108154G
103 P-1OKYHKYJ 3575014110040001 ROCHMA 17 UMUM JL HANGTUAH 1/4 GADINGREJO 8316404707 BIOFARMA 05/10/2021 202108154G
104 P-53W1K0G6 3575037105790008 MARIYATI 42 UMUM jl letjen sutoyo 7/1 mandaranrejo 8224544598 BIOFARMA 05/10/2021 202108172F
105 P-5GS9ZBLU 3575013005700001 CHAMBALI 51 RENTAN BUKIR 2/6 GADINGREJO 8579747484 BIOFARMA 05/10/2021 202108154G
106 P-5IBAB6Y6 3575010107650053 BUNARI 56 RENTAN BUKIR 5/7 GADINGREJO 8574921135 BIOFARMA 05/10/2021 202108154G
107 P-6FQ5HK2N 3575010408050001 MUKHAMAD TEGAR ARDIANSYAH P 16 REMAJA bukir 2/5 gadingrejo 8123351088 BIOFARMA 05/10/2021 202108154G
108 P-70OU9K5K 3575014909810001 ANA SHOFEATI 41 UMUM JL JOLON DRIYO 2/5 8113777705 BIOFARMA 05/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
109 P-76IF9SU2 3575014510740001 UMI KULSUM 47 UMUM SEBANI GADINGREJO 8113777705 BIOFARMA 05/10/2021 202108154G
110 P-7A4Z3GVG 2171022410030001 KAMIL AZZUHAIR 18 UMUM BATAM SEKUPANG 8576189507 BIOFARMA 05/10/2021 202108154G
111 P-7OQI8IZM 3575014102010001 SARIFATUL FITRIYAH 20 UMUM SEBANI GADINGREJO 8564992623 BIOFARMA 05/10/2021 202108154G
112 P-YIUUW1UM 3575010208840001 SAMSUL ARIFIN 37 UMUM JL. SIMPANG SLAMET RIYADI 3/1 SEBANI 8533870512 BIOFARMA 05/10/2021 202108154G
113 S-38B5F224 3514204408480002 MALICHA 73 LANSIA DS KRAWAN 004/004 KEDAWUNG WETAN 8224480949 BIOFARMA 05/10/2021 202108154G
114 P-33SIFKIQ 3575014506610002 DJUKAISI 59 RENTAN JL SLAMET RIADI 003/003 GENTONG 8968766298 BIOFARMA 05/10/2021 202108154G
115 P-2OBVVEZ0 3514206708730001 SUKAEMI 48 UMUM DS KRAWAN 001/004 KEDAWUNG WETAN 8580669268 BIOFARMA 05/10/2021 202108154G
116 P-4ORXUT5T 3575016207040001 IMROATUS SHOLIKHAH 17 UMUM JL SLAMET RIADI 003/003 GENTONG 8572626988 BIOFARMA 05/10/2021 202108154G
117 P-71KEM7NE 3575011001940002 AKHMAD BAIDOWI 27 UMUM JL SLAMET RIADI 003/003 GENTONG 8978396481 BIOFARMA 05/10/2021 202108154G
118 P-7D9VK4L1 3575014512820001 KHUSNUL MUAROFAH 39 UMUM JL SLAMET RIADI 003/003 GENTONG 8214349257 BIOFARMA 05/10/2021 202108154G


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 P-35H8CL9Y 3575015607670001 KAMSATUN 54 RENTAN JL BANDA 2/2 GADINGREJO 8133448644 Astrazeneca 04/10/2021 ABY1312
2 P-DNHMOD1E 3575014506620003 HARI CHANIFAH 59 RENTAN JL SLAMET RIYADI 2/4 GENTONG 8314611665 Astrazeneca 04/10/2021 ABY1312
3 P-KOG01A62 3575014810670003 CHOSIYAH 54 RENTAN JL HANGTUAH 1/4 GADINGREJO 8113777705 Astrazeneca 04/10/2021 ABY1312
4 P-47DNUSED 3575032607030001 SITI MAIMUNAH 18 UMUM JL MT HARYONO 2/5 BUGUL LOR 8383172276 Astrazeneca 04/10/2021 ABY1312
5 P-BU1FJOC4 3575015601010003 MARIA ULFA 20 UMUM JL HANGTUA 1/4 GADINGREJO 8113777705 Astrazeneca 04/10/2021 ABY1312
6 P-9GO6RHK8 3575036108850001 ENI SUMARNI 36 UMUM JL URIP SUMOHARJO 1/1 BUKIR 8778673579 Astrazeneca 04/10/2021 ABY1312
7 P-CG63OCED 3575011004720002 SUDARTO 49 UMUM JL SLAMET RIYADI 2/3 GENTONG 8572749642 Astrazeneca 04/10/2021 ABY1312
8 P-G26CLDT4 3575014306800001 ELFINA 40 UMUM JL; HALMAHERA 5/5 GADINGREJO 8585068831 Astrazeneca 04/10/2021 ABY1312
9 P-3B4CQ17Z 3575011606830001 HERMAN WAHYUDI 38 UMUM JL SLAMET RIYADI 2/4 GENTONG 8224554913 Astrazeneca 04/10/2021 ABY1312
10 P-5GNF1JNY 3514146006000001 YOVINDA FI RIZQILLAH 21 UMUM JL KEPITING 8/1 GEMPENG BANGIL 8570619836 Astrazeneca 04/10/2021 ABY1312
11 Q-000ASQ8Z 3575015308900001 RIKE WAHYUNINGROOM 31 UMUM PERUM KARYA BHAKTI L 1-2 GADING REJO8123508001 Astrazeneca 03/07/2021 ABY1911 04/10/2021 ABY131
12 Q-000AVV6W 3575010304720001 SUGENG HARIYONO 49 UMUM JL. SINONGGO GANG. I NO. 23 RT. 02 RT. 8573325571 Astrazeneca 03/07/2021 ABY1911 04/10/2021 ABY131
13 Q-000AT7CB 3575031610900001 MAULANA OKTARIAN FAIZAL 31 UMUM PERUM KARYA BHAKTI L 1-2 8564653141 Astrazeneca 03/07/2021 ABY1911 04/10/2021 ABY131
14 Q-000U1CW4 3575025008610002 MUSRIFAH 60 LANSIA JL HALMAHERA 2/3 GADINGREJO 8113777705 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
15 Q-000TZQK9 3575014708610001 JULAIKHA 60 LANSIA JL HANG TUA 3/3 GADINGREJO 8193708650 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
16 Z-0000T2TA 3575014101480014 LASMININGSIH 73 LANSIA JL SUKARNO HATTA 8124422352 Biofarma 18/06/2021 24002621 10/04/2021 202108154G
17 Q-000RPRFO 3575011001070003 FLAFIO NUR HIDAYATULLAH 14 REMAJA JL IRIAN JAYA ANGGREK GADINGREJO 8231475575 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
18 Q-000RNYQF 3575016111050002 AISYAH INDAH NUR NABILA 16 REMAJA JL BANDA GADINGREJO 8385157941 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
19 Q-000RPZ08 3575012402070002 RIZAL 14 REMAJA JL IRIAN JAYA ANGGREK GADINGREJO 8579153956 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
20 Q-000RMPIE 3575024203080001 SAFIRATUN NAJAH 13 REMAJA JL LAKS MARTADINATA 3/8 NGEMPLAKREJ8319154401 Biofarma 31/08/2021 24202221 10/04/2021 202108154G
21 Q-000TA5DL 3575020904040002 AISYAH AULIA MAHARANI 17 REMAJA JL LAKS. MARTADINATA 4/2 NGEMPLAKRE 8775620127 Biofarma 04/09/2021 2021071371 10/04/2021 202108154G
22 Q-000TA5BO 3575026104040001 IKA MAULIDATUL CHIFDIYAH 17 REMAJA JL LKS MARTADINATA RT03/8 PANGGUNG 8884802580 Biofarma 04/09/2021 2021071371 10/04/2021 202108154G
23 Q-000TALIM 3575025708040002 AYU AGUSTINA 17 REMAJA JL LAKS MARTADINATA XX 3/8 PANGGUNG8382187060 Biofarma 04/09/2021 2021071371 10/04/2021 202108154G
24 Q-000TZ1TF 3575015707040002 YULIA FAREZA 17 REMAJA JL SLAMET RIYADI 2/4 GENTONG 8533560163 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
25 Q-000U0S1F 3575010203050002 MUHAMMAD SAIFUL 16 REMAJA JL BANDA 5/2 GADINGREJO 8384846069 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
26 Q-000RGM5V 3575015805060001 NUR FADHILAH 15 REMAJA JL HANG TUA 4/3 GADINGREJO 8523708506 Biofarma 30/08/2021 24202221 10/04/2021 202108154G
27 Q-000TALUG 3524175302080001 CHOIRUN NISYA 13 REMAJA JL BANDA 82 2/2 GADINGREJO 8951926100 Biofarma 04/09/2021 2021071371 10/04/2021 202108154G
28 Q-000TI81P 3575020304620001 M. YUNUS ILYAS 59 RENTAN PURUTREJO 06/01 8213251117 Biofarma 04/09/2021 202107132I 10/04/2021 202108154G
29 Q-000RG6GS 3575014101650038 HANIFAH 56 RENTAN JL BANDA GG MAWAR 5/2 GADINGREJO 8113777705 Biofarma 30/08/2021 24202221 10/04/2021 202108154G
30 Q-000TYYGS 3575011302680001 SLAMET SUWANDI 53 RENTAN JL GATOT SWUBROTO 2/4 BUKIR 8223258423 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
31 Q-000TZJBG 3575014706720005 MISTRI 51 RENTAN JL HANGTUAH GADINGREJO 8133646462 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
32 Q-000TCAFR 3575015209700002 LIBA NUR HANANA 51 RENTAN PERUM KARYA BAKTI 2/7 GADINGREJO 8578527668 Biofarma 04/09/2021 2021071371 10/04/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
33 Q-000TZ1WK 3575011106710004 SUROSO 50 RENTAN JL SLAMET RIYADI 8135798501 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
34 Q-000RAOQP 3575015211680003 SRI HARYANINGSIH 53 RENTAN JL GATOT SUBROTO 1/6 BUKIR 8520350915 Biofarma 30/08/2021 24202221 10/04/2021 202108154G
35 Z-000A64HA 3173040112710005 WINTOKO 54 RENTAN PERUM KARYA BAKTI 3/8 GENTONG 8127091423 Biofarma 02/09/2021 2021071371 10/04/2021 202108154G
36 Q-000TZ8B9 3575015905630001 SALAMAH 58 RENTAN JL SLAMET RIYADI 3/3 GENTONG 8770479026 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
37 Q-000TZPO5 3575014401650002 NINIK SURYANI 56 RENTAN JL HANG TUA 1/3 GADINGREJO 8133646462 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
38 Q-000TZQDY 3575010107860177 R. HADI SANTOSO WALUYO BAS 35 UMUM JL SLAMET RIYADI 2/4 SEBANI 8573138082 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
39 Q-000TZPB3 3575036401830001 HAMIDA 38 UMUM JL SLAMET RIYADI 2/4 SEBANI 8573138082 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
40 Q-000CKTND 3575012004000001 welly dragon prasetyo 21 UMUM jl.halmahera rt.01 rw.06 pasuruan 8223185425 Biofarma 08/07/2021 24200821 10/04/2021 202108154G
41 Q-000TJ6HR 3575035409870002 HOIRIYAH 36 UMUM BUGUL LOR PANGGUNGREJO 8770141897 Biofarma 04/09/2021 24202621 10/04/2021 202108154G
42 Q-000U1CF7 3575014712020001 FARAHDILA FITRI 19 UMUM JL SLAMET RIYADI 8383425354 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
43 Q-000U0SOO 3575015709010001 SILVIYA TRI HARTATIK 20 UMUM JL GATOT SUBROTO 1/2 BUKIR 8383417569 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
44 Q-000TZ1UM 3575011903920001 MUKHAMMAD YUSUF 29 UMUM JL GATOT SUBROTO 2/5 SEBANI 8993475597 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
45 Q-000TZEM4 3575016909820001 ERNA WAHYUNI 39 UMUM JL SLAMET RIYADI 2/2 GENTONG 8564616590 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
46 Q-000TZ1V2 3575015003770006 SRI LESTARI 44 UMUM JL GATOT SUBROTO 3/4 BUKIR 8225700108 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
47 Q-000TZ05E 3575011104750001 ABU HASIM 45 UMUM JL SLAMET RIYADI 3/3 GENTONG 8587693047 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
48 Q-000SZU5M 3578094111780003 NOFITA LARASATI 43 UMUM JL KYAI SEPUH 4/1 GADINGREJO 8135764066 Biofarma 03/09/2021 2021071371 10/04/2021 202108154G
49 Q-000RRE7I 3575015704720004 SUMILAH 49 UMUM JL MLAGI 3/3 KARANGKETUG 8128641454 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
50 Q-000TZQ9Z 3575014304670006 KHALIMAH 46 UMUM JL. HANGTUAH 4/ 4 GADINGREJO 8133646462 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
51 Q-000CENC0 3514074107820009 HANIFA 39 UMUM JL NANAS I - BUGUL KIDUL 8223020659 Biofarma 08/07/2021 24200421 10/04/2021 202108154G
52 Q-000U25KR 3575012110810005 BUDI SUGIANTO 40 UMUM JL KYAI SEPUH 8224490848 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
53 Q-000S6NQC 3575011210000002 MUHAMMAD AMINUR RIZQY 21 UMUM JL HALMAHERA 5/5 GADINGREJO 8155438150 Biofarma 01/09/2021 2021071371 10/04/2021 202108154G
54 Q-000U623Y 3575015203930001 UMI ROSMAWATI 28 UMUM JL KYAI SEPUH 3/1 GADINGREJO 8880356204 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
55 Q-000U3GU7 3575012108740001 ABD. ROKHMAN 47 UMUM JL IRIAN JAYA 4/1 GADINGREJO 8113777705 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
56 Q-000U5974 3509206005890003 MIKE ARDILLA RAHMAWATI 32 UMUM JL GATOT SUBROTO 1/5 BUKIR 8775789313 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
57 Q-000U0SD6 3575015505760010 HALIMAH 45 UMUM JL GATOT SUBROTO 1/2 BUKIR 8383460067 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
58 Q-000TZ093 3575016410740008 KHUSNUL KHOIRIYAH 47 UMUM SLAMET RIYADI 3/3 GENTONG 8135798501 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
59 Q-000SZAV5 3575015107930005 SUGIYANTI 31 UMUM JL BANDA 5/2 GADINGREJO 8124925404 Biofarma 03/09/2021 2021071371 10/04/2021 202108154G
60 Q-000U0RQM 3575015904840002 SITI AMINAH 37 UMUM JL SLAMET RIYADI 3/2 GADINGREJO 8822625493 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
61 Q-000TZ87H 3575015507820004 MISNAYU 39 UMUM JL. SLAMET RIYADI 8214349257 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
62 Q-000TZPJ3 3575015010780002 MAIMUNAH 44 UMUM JL HANG TUA 1/3 GADINGREJO 8113777705 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
63 Q-000TZTH4 3575012405970004 ACHMAD RIFA'I 24 UMUM JL IRIAN JAYA 4/1 GADINGREJO 8199936600 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
64 Q-000U0VDW 3575011107900005 RIFAI 31 UMUM JL URIP SUMOHARJO 1/1 BUKIR 8988919146 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
65 Q-000U27VL 3575014107840125 SITI FATIMAHTUZ ZAHRO 36 UMUM JL HANG TUA 4/4 GADINGREJO 8113777705 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
66 Q-000RHAMN 3575014806980005 SITI KHOIRIYAH 23 UMUM JL HANGTUAH 1/3 GADINGREJO 8191840038 Biofarma 30/08/2021 24202221 10/04/2021 202108154G
67 Q-000RPVQR 3575014601910002 ANDI KHOIRUN NISA 30 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8564987555 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
68 Q-000TZ09Q 3575015408750002 ALIMAH KASIATI 46 UMUM JL SLAMET RIYADI 8133003131 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
69 Q-000RFJ8B 3575012505790004 MAKSUM 42 UMUM JL HANG TUA 4/3 GADINGREJO 8523728506 Biofarma 30/08/2021 24202221 10/04/2021 202108154G
70 Q-000TZ8NB 3575013103810001 EDIK SUSANTO 40 UMUM JL SLAMET RIYADI 2/4 GENTONG 8822624645 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
71 Q-000U0S67 3575014103890003 SITI SOLICHA 34 UMUM JL BANDA 5/2 GADINGREJO 8133895255 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
72 Q-000U6V72 3514161708950006 M. AINUL YAQIN 26 UMUM JL BANDA 6/2 GADINGREJO 8823785040 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
73 Q-000U1PU5 3575010805020005 RIFQI MAULANA 19 UMUM JL TEUKU UMAR 3/1 SEBANI 8135961786 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
74 Q-000TZELT 3575015707810001 NETTY HERAWATI 40 UMUM JL SLAMET RIYADI 1/4 GENTONG 8956316846 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
75 Q-000TZ1U8 3575016205030003 KHARISMA MAULIDIA SHOKHEH 18 UMUM JL GATOT SUBROTO 3/4 BUKIR 8225700108 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
76 Q-000TZTIZ 3575012308010004 SYARIFATUL MUYASSAROH 20 UMUM JL HANGTUAH 4/4 GADINGREJO 8575580412 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
77 Q-000U0NRD 3575014107840063 NURHASANAH 37 UMUM JL BANDA 5/2 GADINGREJO 8133895255 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
78 Q-000I7OVG 3575015606890006 IZZUN NADIYAH 32 UMUM JL IRIAN JAYA GG ANGGREK GADING 8231475575 Biofarma 19/07/2021 24200421 10/04/2021 202108154G
79 Q-000TZQ00 3575015107850005 WIDYA LESTARI 36 UMUM JL SLAMET RIYADI 8224554913 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
80 Q-000SZHSA 3575014107730126 RUKIYATI 48 UMUM JL BANDA 5/2 GADINGREJO 8124925404 Biofarma 03/09/2021 2021071371 10/04/2021 202108154G
81 Q-000U115C 3575013108980003 ANANG MAKRUF 23 UMUM JL HALMAHERA 5/5 GADINGREJO 8383357891 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
82 Q-000SIXDQ 3575014805980001 RATIH TRI NINGSIH 23 UMUM JL GATOT SUBROTO 5/7 BUKIR 8233494696 Biofarma 02/09/2021 2021071371 10/04/2021 202108154G
83 Q-000U2C03 3575014403780003 CHAMIDAH 43 UMUM JL HANGTUAH 4/4 GADINGREJO 8564851506 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
84 Q-000ROO46 3575014107010066 SITI MUFIDAH 20 UMUM JL HANGTUAH GADINGREJO 8594503645 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
85 Q-000ROYHC 3514165403910004 ASLACHA 30 UMUM JL HANGTUAH GADINGREJO 8385198635 Biofarma 31/08/2021 24202321 10/04/2021 202108154G
86 Q-000U05BP 3575011410850002 HARIYANTO 36 UMUM JL HANG TUA 4/3 GADINGREJO 8776263212 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
87 Q-000U56MB 3575014305980003 ANIS CHOIRIYAH 23 UMUM GADINGREJO 5/5 8121691483 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
88 Q-000TZ8LM 3575015509870008 NUR AINI 34 UMUM JL SLAMET RIYADI 2/4 GENTONG 8822624645 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
89 Z-000A64HB 3173045106770002 TSUWAIBATUL ISLAMIYAH 44 UMUM PERUM KARYA BAKTI 3/8 GENTONG 8136236942 Biofarma 02/09/2021 2021071371 10/04/2021 202108154G
90 Q-000U6V7Q 3575015108960002 AMALIA INDAHSA 25 UMUM JL BANDA 6/2 GADINGREJO 8810361220 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
91 Q-000U6T2L 1671144310830006 DIAN OKTAFIANI 38 UMUM JL SLAMET RIYADI 3/3 GENTONG 8233511597 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
92 Q-000U6XY2 1671140807810004 SUPRIYANTO 40 UMUM JL SLAMET RIYADI 3/3 GADINGREJO 8233511597 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
93 Q-000U1L49 3575014709840002 SUMIATI 37 UMUM JL HANG TUA 4/4 GADINGREJO 8560784023 Biofarma 06/09/2021 2021071371 10/04/2021 202108154G
94 Q-000RNV27 3575010908070001 AKHMAD THIFAL ULAYYA 14 REMAJA JL URIP SUMOHARJO 1/3 BUKIR 8213917283 Biofarma 31/08/2021 24202321 04/10/2021 202108154G
95 Q-000SUX8D 3575015503990001 NADIYA JIHAN NADILA 22 UMUM JL. GATOT SUBROTO 001/004 BUKIR, GAD 8821791432 Biofarma 02/09/2021 2021071321 04/10/2021 202108154G
96 Q-000TYS4I 3575014506800001 SUMARTININGSIH 41 UMUM BUKIR 1/2 GADINGREJO 8121691483 Biofarma 06/09/2021 2021071371 04/10/2021 202108154G
97 S-4E3C4480 3575014107570025 FATA BASAMA 64 LANSIA jl urip sumoharjo 8953091010 Biofarma 04/10/2021 202108154G
98 P-KWKCQY2S 3575014905700001 NURYATI 51 RENTAN JL GATOT SUBROTO 8821791432 Biofarma 04/10/2021 202108154G
99 P-LJIOHQ1O 3575013012670001 BUNYANI 55 RENTAN BUKIR GADINGREJO 8579123970 Biofarma 04/10/2021 202108154G
100 P-KZ8T6GTJ 3575015111020001 NUR SAFINA ROMADHONA 19 UMUM JL GATOT SUBROTO 8821791432 Biofarma 04/10/2021 202108154G
101 P-L7AZITFE 3575015712870001 DEWI NAFISAH 34 UMUM JL URIP SUMOHARJO 8953091010 Biofarma 04/10/2021 202108154G
102 P-LAWAMR5K 3514050404880002 SAMSUL HUDA 33 UMUM JL URIP SUMOHARJO 8585076342 Biofarma 04/10/2021 202108154G
103 P-LEKVG5YA 3575010309870001 PRASETYA ARI WIBOWO 34 UMUM JL URIP SUMOHARJO 8223421076 Biofarma 04/10/2021 202108154G
104 P-LO9626UI 3575015005930002 MUNAWARO 28 UMUM BUKIR RT 2 RW 6 8311804699 Biofarma 04/10/2021 202108154G
105 P-R9J89JS7 3575011308070002 ALFA FIKRI AFIXENA 14 REMAJA JL HALMAHERA 8591859467 Biofarma 04/10/2021 202108154G
106 P-PA4KARIG 3575010107920031 MACHMUD 29 UMUM jl hangtuah 8113777705 Biofarma 04/10/2021 202108154G
107 P-PQFPDVKV 3575014510840003 MUSLICHA 37 UMUM JL HALMAHERA 8113777705 Biofarma 04/10/2021 202108154G
108 P-QFENBOHL 3575014812800003 SITI MUKMINA TUZUCRIA 41 UMUM JL HANGTUAH 8133322422 Biofarma 04/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
109 P-QM17UVVH 3575012207770004 SUGIMAN 44 UMUM JL HANGTUAH 8133322422 Biofarma 04/10/2021 202108154G
110 Q-000T9OUK 3575014308790006 SITI MAIMUNAH 42 UMUM JL HANGTUAH GADINGREJO 8384660281 Biofarma 04/09/2021 2021071371 04/10/2021 202108154G
111 Q-000RFIOT 3575015101930001 DIAN FARISMA 28 UMUM JL HALMAHERA 3/3 GADINGREJO 8586066011 Biofarma 30/08/2021 24202221 04/10/2021 202108154G
112 Q-0003ESG9 3575014808660005 ENDANG SUNARIYATI 55 RENTAN JL HALMAHERA GG XI 8113777705 Biofarma 19/06/2021 24002621 04/10/2021 202108154G
113 P-OP6OPGYE 3575014107700002 MARIYANAH QIPTIYAH 55 RENTAN SEBANI RT 2 RW 1 8580333319 Biofarma 04/10/2021 202108154G
114 P-R14C1I5I 3575016210630001 AMINAH 58 RENTAN JL SLAMET RIYADI 8213141124 Biofarma 04/10/2021 202108154G
115 P-PNDCPLRC 3514201412810001 ARIS KUSDIANTORO 40 UMUM JL SLAMET RIYADI 8573390652 Biofarma 04/10/2021 202108154G
116 P-PUHH36UZ 3575014301880001 IKA DEWI RAHAYU 33 UMUM JL SLAMET RIYADI 8573390652 Biofarma 04/10/2021 202108154G
117 P-QA5CCBR6 3575014908880006 ANITA SARI 33 UMUM JL SLAMET RIYADI 8239729404 Biofarma 04/10/2021 202108154G
118 P-QJ95OCE1 3575014412860004 NUR AZIZAH 35 UMUM JL SLAMET RIYADI 8523229094 Biofarma 04/10/2021 202108154G
119 P-QUJZVJH6 3575011601780004 AKHMAD RIYANTO 43 UMUM JL SLAMET RIYADI 8214057427 Biofarma 04/10/2021 202108154G
120 P-RL0SSWOB 3575011111850001 AKHMAD ARIFIN 36 UMUM JL SLAMET RIYADI 8968779558 Biofarma 04/10/2021 202108154G
121 Q-0009XOAP 3575010107610002 MULYADI 60 LANSIA JL SLAMET RIYADI SEBANI 8113777705 Biofarma 30/06/2021 24003521 04/10/2021 202108154G
122 Q-000E9VWJ 3575010803940004 MOH FATKHUR RIZAL 27 UMUM JL. SLAMET RIYADI RT 01 RW 6 SEBANI 8967749141 Biofarma 12/07/2021 24200421 04/10/2021 202108154G
123 Q-000T8PZA 3575016102980002 ROSIDA MARYA HASANAH 23 UMUM JL SLAMET RIYADI 2/3 SEBANI 8221957910 Biofarma 03/09/2021 2021071371 04/10/2021 202108154G
124 Q-000SAHPM 3514236406060002 OLIVIA YENNI NUR AYNI 15 REMAJA REJOSO RT 3 RW 7 8783893221 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
125 Q-000SD9ZU 3514204212060002 INAS ERVIAN NADA ZALFA 15 REMAJA GRAHA CANDI BLOK L16 8956162839 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
126 Q-000SCXLO 3578245309060004 OLIVIA ESTHER WIJAYA 15 REMAJA JL SUKARNO HATTA NO 83 8384006886 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
127 Q-000SDA0J 3578012905060001 DANIEL JIBRIL CAHYONO 15 REMAJA DARMOYUDO UTAMA NO 20 PURWOREJO 8133263134 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
128 Q-000S1XTD 3575016406060001 ALIVIA ZAHRA NINDYA PUTRI 15 REMAJA KARANGKETUG 3/3 8523876158 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
129 Q-000S9QPA 3575034602060001 SILMA ALEYDA ZHAHIRA 15 REMAJA JL DR WAHIDIN SH 7/3 8121674721 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
130 Q-000S65AC 3575014702060001 ZAKIA DIVA RAHMANY 15 REMAJA BUKIR JL GATOT SUBROTO RT 01 RW 06 8953090224 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
131 Q-000S2QSE 3575015207060001 SITI NUR AZIZAH 15 REMAJA KARANGKETUG RT 4 RW 3 8823017134 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
132 Q-000HZQS8 3575011803060001 PRANA ADIGUNA SULTONI 15 REMAJA JL JOLONDRIO KELURAHAN KRAPYAKREJ 8223338722 Biofarma 17/07/2021 24201421 04/10/2021 202108172F
133 Q-000S4VLX 3575014402060001 NAILIL MUNA 15 REMAJA JL GATOT SUBROTO 5/2 PETAHUNAN 8573017024 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
134 Q-000SDE57 3514141505060003 JISENSTIV HOSE MANUEL SUSA 15 REMAJA JL A YANI BLOK B/03, BANGIL 8213265334 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
135 Q-000SCS7C 3514181104060005 DAVID GUNAWAN 15 REMAJA PERUM KEBON CANDI A 70 8785193655 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
136 Q-000SDL0J 3575024807050001 CYNTHIA AMARA 16 REMAJA JL BENGAWAN SOLO 47 RT 002/ RW 005 8121713000 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
137 Q-000SB2YR 3671093105050001 EDRICO PUTRA PRAMANA 16 REMAJA PURUTREJO RT 4 RW 4 8953606549 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
138 Q-000SAVCM 3575026312050003 DIYAH EKA RAHMAWATI 16 REMAJA JL. KH. AHMAD DAHLAN 1A NO 5 2/2 POH 8223020696 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
139 Q-000L599U 3575010911050002 DIMAS SUNGKONO 16 REMAJA RUSUNAWA, PETAHUNAN 1/6 8133797135 Biofarma 01/09/2021 24004621 04/10/2021 202108172F
140 Q-000SDKZ3 3514182009050004 JONATHAN FERDIN KARAN 16 REMAJA PERUM KEBUN CANDI FG 29 8780791305 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
141 Q-000SD5WU 3508071012050004 YEHEZKIEL YOGA ADI WIJAYA 16 REMAJA PERUM PAS BLOK F2 NO 3 8951583578 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
142 Q-000S5LN9 3575015611050002 FITRI NABILA MAHBUBAH 16 REMAJA KRAPYAKREJO RT 04 RW 01 GADINGREJO8573640662 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
143 Q-000S31SE 3575011811050001 ANAS AHMAD NASHRULLAH 16 REMAJA PETAHUNAN RT 4 RW 3 8585348591 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
144 Q-000S7W91 3575035106060003 ROHIMATUL MASRUROH 16 REMAJA JL KH HASYIM ASYARIM BAKALAN 8384846211 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
145 Q-000S7A0V 3575025002040001 ROSITA WULANDARI 16 REMAJA DS WARUNGDOWO PONDOK ASRI BLOK 1 8979011870 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
146 Q-000SDKZI 3575025211050001 VENITA AILEN ANTON 16 REMAJA DARMOYUDO RT 7 RW 1 8510150071 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
147 Q-000SCDPI 3575036708050002 REGITA ANANDA CITRA LAKSAN 16 REMAJA JL DR WAHIDIN SUDIROHUSODO GG 10/178177991838 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
148 Q-000L5XZ4 3575012409050001 AKHMAD TRI CAHYO NUGROHO 16 REMAJA JL. GATOT SUBROTO, BUKIR, 4/7 8121674413 Biofarma 05/08/2021 24004621 04/10/2021 202108172F
149 Q-000S7FPS 3575026804050002 HIMMNAH 16 REMAJA JL PERUM PUCANG INDAH LESTARI E-3 8133127373 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
150 Q-000S2PMW 3575020808050001 MUHAMMAD JAZULI AINURRIZQI 16 REMAJA Wirogunan RT 01 RW 05 8953666628 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
151 Q-000L4V8K 3575014111050003 INA NUR AINI WAYA 16 REMAJA PAKAL JAYA 03/07 GADINGREJO 8312377468 Biofarma 05/08/2021 24004621 04/10/2021 202108172F
152 Q-000HETRK 3575012202050003 WILDAN ALI REZA 16 REMAJA randusari 02/05 8573053040 Biofarma 15/07/2021 24201421 04/10/2021 202108172F
153 Q-000S4VLA 3575014512050003 ZAHRANIA NAISHEYLA PUSPITA 16 REMAJA JL. GATOTSUBROTO NO. 15 8121796032 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
154 Q-000S3SMX 3575030309050001 MAULANA KUNNANDA AL BUCHO 16 REMAJA JL MERCURIUS BLOK G 40 PERUM GRAHA 8123838223 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
155 Q-000L4KWS 3575015002050001 NABILA MUMTAZAH 16 REMAJA JL HASANUDIN VI/42 KARANGANYAR 7/3 8810369136 Biofarma 05/08/2021 24004621 04/10/2021 202108172F
156 K-0000ECVI 3575027006050001 OCHA PUTRI JUNIARTANTI 16 REMAJA JL. JAMBANGAN 2 NO 14E, 06/02, PURWOR8125057184 Biofarma 05/08/2021 24004621 04/10/2021 202108172F
157 Q-000S9ETL 3575014706050001 SERLINA PUTRI CAHYANINGSIH 16 REMAJA PERUM GRAHA INDAH BLOK M9 8313488751 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
158 Q-000S26RQ 3575010411050001 RAHMAT HIDAYAT 16 REMAJA KRAPYAKREJO RT 5 RW 1 8133316046 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
159 Q-000TZHM1 3575015404050001 NAZWA HYLDA SYAFIRA 16 REMAJA JL GATOT SUBROTO RT 3 RW 1 KEL KRAP 8214299835 Biofarma 06/09/2021 24202321 04/10/2021 202108172F
160 Q-000SBH3D 3575025406050006 MICHELLE CAROLINE HADI 16 REMAJA PURWOREJO RT 2 RW 7 8383333140 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
161 Q-000SCMW6 3575017009050005 ELIANA NOVITA 16 REMAJA JL GAJAH MADA NO 20 8951571623 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
162 Q-000SCDMB 3578121604050002 TENG CHONG HAO 16 REMAJA JL KH WAHID HASYIM NO 58A SURABAYA 8223222957 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
163 Q-000SBPTQ 3575015502050002 ZIYADATUL MAFAID 16 REMAJA JL MULYOREJO RT 002/RW 006 SEBANI 8953950020 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
164 Q-000SDKZD 3575015310050002 JOCELYN ANASTASIA WAHYUDI 16 REMAJA JL SLAMET RIYADI GANG 12 8223415029 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
165 Q-000S55IL 3575027107050002 DIANDRY RACHMA ARIANTI 16 REMAJA JL ERLANGGA SELATAN NO 22 PURWORE 8311914989 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
166 Q-000S53LS 3575012904050004 MUCHAMMAD FIKRI MAULUDIN 16 REMAJA Jl. Gatotsubroto RT 01 / RW 04 Petahunan 8953381324 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
167 Q-000S2KUZ 3575026711050002 IKA ALIA KARIMAH 16 REMAJA WIROGUNAN RT 1 RW 5 8135912966 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
168 Q-000S4EVF 3514164910050021 OKTAVINA RAHMADANI 16 REMAJA JL SLAMET RIYADI 1/2 8383593328 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
169 Q-000S4BVO 3575015610050001 NUR FARADILA SALMA 16 REMAJA Jl. Sriwijaya Karangketug Rt 07/ Rw 03 8157367447 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
170 Q-000S24ZP 3575032607050001 NADZIR WAHYU 16 REMAJA JL PATIMURA NO 338 3/3 8968545469 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
171 Q-000S2GC5 3514166312050002 NAILUN NAJAH 16 REMAJA KRATON RT 3 RW 3 8581529497 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
172 Q-000S3UDC 3575016809050001 RISALATUL MUAWWANAH 16 REMAJA JL. GATOT PETAHUNAN 2/3, PETAHUNAN, 8953040587 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
173 Q-000S7A1G 3514224206040004 ZAKIATUL PAHIROH 17 REMAJA PASIR PANJANG, LEKOK 8233255537 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
174 Q-000SDL0L 3514234411040004 SHIERLY INTANIA 17 REMAJA JL SUKARNO HATTA NO 45 8967972621 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
175 Q-000S7ZQ6 3575015706040001 FANIYA FADILIYA 17 REMAJA JL. JOLONDRIYO KRAPYAKREJO 3/4 KRAP 8823122016 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
176 Q-000SDPED 3575024201040005 FATIMATUZ ZAHRO 17 REMAJA JL. ERLANGGA , PURWOREJO 8515813673 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
177 Q-000S53RJ 3575030101040001 MOCHAMAD PANDU WILANTARA 17 REMAJA PERUMAHAN SUNAN AMPEL BLOK E12 P 8214676631 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
178 Q-000S7A8B 3575024509040004 DANELLA NUR RIZKY 17 REMAJA JL PANGLIMA SUDIRMAN GG PUCANGAN N8570484764 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
179 Q-000S3JGL 3216022412040001 MAULANA RAIHAN TSANY 17 REMAJA GENTONG RT 2 RW 8 8133837691 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
180 Q-000S2VGJ 3575017003040004 FIRLIYANA MAVIRO ANUGERAH 17 REMAJA PERUM GRAHA INDAH BLOK AA. 3 NO 27 8383435951 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
181 Q-000S3N6F 3575015511040004 JIHAN FITRIANI 17 REMAJA JL GATOT SUBROTO GADINGREJO PASUR8785107934 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
182 Q-000S9CYO 3575014305040004 MEI WULANSARI 17 REMAJA JL GATOT SUBROTO RT.01 RW.02 KEL PE 8383385278 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
183 Q-000E3RT0 3575010204030003 RAKHMAD IMAM PRASETYO 17 REMAJA JL SLAMET RIYADI RT.005 RW.002 KEL.SEB8564927605 Biofarma 13/07/2021 24202321 04/10/2021 202108172F
184 Q-000S6UY6 3575026910040001 ZUHRUFA MUWAFIQI 17 REMAJA JL. KH DEWANTARA, WIROGUNAN 8387490717 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
185 Q-000S4VHO 3575014305040005 SILVI QUTRUN NADA 17 REMAJA JL GATOT SUBROTO PETAHUNAN 8311946042 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
186 Q-000SAACQ 3575016007050001 NELI ANGGIANI 17 REMAJA JL GATOT SUBROTO RT 2 RW 2 PETAHUN 8953390395 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
187 Q-000S7A41 3575025211040005 NOFA ANDRIANA EKA SUCI 17 REMAJA JL KH AHMAD DAHLAN GG 19 8/5 POHJEN 8574865882 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
188 Q-000S7A41 3575025211040005 NOFA ANDRIANA EKA SUCI 17 REMAJA JL KH AHMAD DAHLAN GG 19 8/5 POHJEN 8574865882 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
189 Q-000S4DPG 3575024704040002 FRISKA SHINTA MAULIDYA WIJA 17 REMAJA JL KH AHMAD DAHLAN GANG 13 8570614650 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
190 Q-000SD4BD 3575022309040001 ANDRIAN TITUS HERYANTO 17 REMAJA PERUM PAPAN BESTARI BB 09 RT 004/ RW8953941440 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
191 Q-000SC4JI 3575024909040002 FLORENSIA EXA AUDREY 17 REMAJA JL PANGLIMA SUDIRMAN 11/72E 8880570468 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
192 Q-000SW352 3575016702040001 AMELIA FEBRIANTI 17 REMAJA JL GATOT SUBROTO RT 004/ RW 007 GAD 8232975036 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
193 Q-000SAUKJ 3575014702040001 LAILUL MUNAWAROH 17 REMAJA JL SLAMET RIYADI RT/RW 3/3 SEBANI, GA 8817041592 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
194 Q-000SDKZS 3575034806040004 RAHEL ANDREA ARABELLA 17 REMAJA JL ANJASMORO NO 9 PASURUAN 8216061626 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
195 Q-000SDA0E 3575015211040001 MELLY KURNIAWATI PRASETYO 17 REMAJA PERUM KARYA BAKTI BLOK A/12 8314379847 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
196 Q-000S99GM 3575013006040008 ARLIAN MAULANA 17 REMAJA JL. GATOT SUBROTO, GADING REJO, 1/8 8580679624 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
197 Q-000S5MYB 3516036007040002 MIEKE CINDY ASTUTIK 17 REMAJA JL DR WAHIDIN SH GG 11 NO 15 RT 01 RW 8952400721 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
198 Q-000S2BRN 3575015905040002 KHARINA ARIFIA 17 REMAJA JL GATOT SUBROTO RT 1 RW 5 KEL.RAND 8560769594 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
199 Q-000S2CQ7 3575014812040002 DEBBY FITRI PUSPITA SARI 17 REMAJA KETUGLAGI RT 7 RW 3 8573095240 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
200 Q-000S3XTG 3575024201040003 SHELVI AMALIA PUTRI 17 REMAJA PERUM TAMAN ASRI 2 2/7 8585900543 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
201 Q-000S5G2X 3575024508040002 FERISZKA PRAMITANANDA 17 REMAJA PURWOREJO RT 7 RW 8 8121687960 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
202 Q-000S4BNH 3575016901040001 AMILAH SHOLIHAH 17 REMAJA JL SLAMET RIYADI 3/4 SEBANI 8384682491 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
203 Q-000S4BTR 3575012902040001 MOH. WARIT SAPUTRA 17 REMAJA JL. SLAMET RIYADI 5/2 SEBANI, GADINGRE8585267788 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
204 Q-000SCDA4 3575036911040002 DEVI SANDIKA SARI 17 REMAJA PERUM SEKAR INDAH 2 BAKALAN 8953950349 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
205 Q-000S7X8A 3575015208040004 IMTIYAS 17 REMAJA JL. SLAMET RIYANI GG. 4 2/1, GENTONG, 8570755263 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
206 Q-000S3W5P 3575021010040005 RIZKY RAMADANI 17 REMAJA PURUTREJO RT 4 RW 3 8233102540 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
207 Q-000S2PAD 3575016710040001 KHOIRUN NISA' 17 REMAJA JLN GATOT SUBROTO, GADINGREJO 8213521220 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
208 Q-000HTMVB 3575035603040001 ARDELIA ZAHRA DAMAYANTI 17 REMAJA SEKARGADUNG 8124980880 Biofarma 17/07/2021 2401621 04/10/2021 202108172F
209 Q-000P7NKD 3575016310040001 ZHEYLA CALISTA RAMADHANI 17 REMAJA PERUM KRATON INDAH BLOK D KEC. GAD 8573368091 Biofarma 24/08/2021 24202221 04/10/2021 202108172F
210 Q-000SCDA0 3575024912040003 SHERLY WIDYANINGSIH EFFEND 17 REMAJA PERUM GRIYA PERMATA TEMBOK B2 8214130667 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
211 Q-000SCMWB 3514186911030001 LEVINA PURNAMASARI 18 UMUM JL RAYA BROMO NO 19A RANGGEH 8233898407 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
212 Q-000SCXLT 3575022611030005 KEVIN WIJAYA 18 UMUM JL SUKARNO HATTA NO 95 8383372088 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
213 Q-000SEZUA 3575017011030002 DEWI SAFITRI 18 UMUM BUKIR RT 2 RW 4 8132670707 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
214 Q-000S7VNU 3575026911030001 FANY PUTRI KHOIRINA 18 UMUM JL SULTAN AGUNG 2 8385771472 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
215 Q-000SAK2O 3575036805030001 ELIZABETH NATASYA 18 UMUM BUGUL KIDUL RT 8 RW 6 8214361555 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
216 Q-000S4VNI 3575014806030004 CHYNTIA SARI 18 UMUM JL GATOT SUBROTO, PETAHUNAN 8573211061 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
217 Q-000S9QOC 3575010411030001 MUHAMMAD AZMI AULIA' ROHMA 18 UMUM JL GATOT SUBROTO 4/4 8383434104 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
218 Q-000S31OW 3575020912030004 M. FATUR ROKHMAN 18 UMUM JL. KH. MANSYUR RT 2 RW 1, TEMBOKRE 8787705952 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
219 Q-000S4G7I 3575011310030001 MOKHAMMAD KHOIRI YAHYA 18 UMUM JL. Gatot Subroto Gg. 03 RT 01/ RW 03 8977963325 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
220 Q-000S5GWB 3575016711030001 FITRIYAH NURAINI 18 UMUM JL. SLAMET RIYADI 2/3 SEBANI, GANDING 8883032528 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
221 Q-000S8W41 3575011508030001 AMELIA YUSRO 18 UMUM JL GATOT SUBROTO O602 PETAHUNAN 8573173301 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
222 K-0000YCHS 3575014706030001 SRI ISNAENI 18 UMUM JL MULYOREJO SEBANI RT 02 RW 06 8885668606 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
223 Q-000S5602 3575011511030001 MUCHAMMAD ANDIKA RAMADAN 18 UMUM JL SLAMET RIYADI 1/3 8776550918 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
224 Q-000S2P4A 3575015705030003 VIKE MEY CINDI IRANI 18 UMUM jl. gatot subroto 4/2 8595171551 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
225 Q-000S7W97 3575035306020002 ROUDOTUL ASHFIAK 18 UMUM LINGK. KRAJAN RT 001/ RW 002 KEPEL BU 8820092277 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
226 Q-000SDE5G 3514186306030001 AURA BELVA KASIHBUNDA 18 UMUM PONDOK CANDRA BLOKC1/7, RANGGE 8383372088 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
227 Q-000SBPUI 3575014506030003 FIRA DWI YUNIAR 18 UMUM JL SLAMET RIYADI RT 001/ RW 005 GENTO 8383068953 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
228 Q-000S26NK 3575016402030004 LUK LUK ULNUR HIDAYATI 18 UMUM JL URIP SUMOHARJO GADINGREJO KOTA 8585369381 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
229 Q-000S3TKY 3514174410030002 AYU ISMAWATI 18 UMUM sukorejo, nduyo 8573170025 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
230 Q-000S4I2I 3575016007030001 SILVIA WAHYUNINGTIAS 18 UMUM JL. GATOT SUBROTO 3/6 RANDUSARI, GA 8585284037 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
231 Q-000SCXKZ 3575012609030002 MOKHAMAD IZUL AK ROMI 18 UMUM JL GATOT SUBROTO PETAHUNAN RT 1 RW8950801322 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
232 Q-000S4WUB 3505204806030002 PUTRI PRATAMA 18 UMUM JL KH AHMAD DAHLAN 5/4 8819101277 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
233 Q-000EBN34 3575035611030004 ANGEL MONIKE 18 UMUM JL.KH HASYIM ASY'ARI GG.SEKARSONO 4 8133203015 Biofarma 14/07/2021 242001421 04/10/2021 202108172F
234 3514174210030002 MIFTAHUL JANNAH 18 UMUM DUSUN SUKO 83894581388 Biofarma 13/09/2021 20210811H 04/10/2021 202108172F
235 Q-000S9RDG 3575020411030001 WILDAN RAHMAT RAMDANI 18 UMUM JL APEL VII BLOK D8-4 BUGUL KIDUL 8113781112 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
236 Q-000S3MC4 3575016310030001 RENTIKA NAJWA AULIA 18 UMUM jl gatot subroto kel.petahunan 8953960058 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
237 Q-000S2WM7 3514071007020004 MUHAMMAD IRFAN WAHYUDI 19 UMUM Perumnas Bugul, Jl. Nanas 1 8224569165 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
238 Q-000ST7X3 3514227108010004 NUR ASYIFAH 20 UMUM PASIRIAN 1/3 TAMBAK LEKOK 8133310771 Biofarma 02/09/2021 24202321 04/10/2021 202108172F
239 Q-000SD5XX 3514055401000003 NIKMATUL UDZMAH 21 UMUM DUSUN MANGGUAN JAWA 2/1 8121735470 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
240 Q-000SD5XP 3514066908000004 KHOLILATUL INAYAH 21 UMUM MRACAK KURUNG KEJAYAN 8155389357 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
241 Q-000SD5Y5 3514094910990003 ZAIMATUL ISLAMIAH 22 UMUM DUSUN CURAH WULUH MOJOTENGAH 8578502962 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
242 Q-000SDA7R 3514164401990001 JAMILATUL QOMARIYAH 22 UMUM JL DAWANMAS BENDUNGAN KRATON 8384668185 Biofarma 01/09/2021 24202321 04/10/2021 202108172F
243 Z-000A25JE 3514175104650001 LILIK PRIYANI SULISTYONINGSIH 56 RENTAN PERUM PURI CANDI C44 KELURAHAN PUR8133048048 Biofarma 01/09/2021 24202521 04/10/2021 202108172F
244 P-S7BM8Y1P 3575010404900002 MUKHAMMAD ARIF ROMA DHON 31 UMUM JL URIP SUMOHARJO 8591754616 CoronaVac 04/10/2021 202108154G
245 P-77SHPC4S 3575035705890002 RITA MONIKA 32 UMUM JL ANJASMORO 006/006 BUGUL LOR 8223399104 CoronaVac 04/10/2021 202108154G
246 P-L45KAMPY 3509114803930002 ELAFATUL ROHMAH 28 UMUM PERUM NUANSA CANDI II 003/007 PETAHU 8525817771 CoronaVac 04/10/2021 202108154G
247 P-814DAHJG 3514174404880001 IVA ACHDIANI 33 UMUM DS PANDEAN 001/001 PLERET 8533492800 CoronaVac 04/10/2021 202108154G
248 P-9A7QOKQL 3575016406960003 RIZZA JAWWARA HAQ 25 UMUM PERUM KRATON INDAH 001/004 KARANGK 8384940311 CoronaVac 04/10/2021 202108154G


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 Z-000A899I 3575010505590003 AKHMAD SUGIANTO 62 LANSIA JL SLAMET RIYADI 2/4 GENTONG 8135347995 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
2 Q-000TA59G 3575015105080003 NURUL AINI 13 REMAJA JL BANDA 6/2 GADINGREJO 8585277857 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
3 Q-000TC82O 3575014107780142 NAFISAH 43 UMUM JL BANDA 6/2 GADINGREJO 8346243769 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
4 Q-000S541Q 3514145706060001 AURELLIA SHAFIRA RIZKY EKA P 15 REMAJA PERUM TAMAN PERMATA INDAH 8573091760 Biofarma 01/09/2021 2021071371 02/10/2021 202108154G
5 Q-000TBDNM 3575015310790003 LULUK FARIDA 42 UMUM JL BANDA GG MAWAR 6/2 GADINGREJO 8772943259 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
6 Q-000TBDPN 3575015705780003 WAHYUNI 43 UMUM JL BANDA 6/2 GADINGREJO 8113777705 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
7 Q-000TCAGG 3575010804820002 HADI PRAYITNO 39 UMUM JL BANDA 3/2 GADINGREJO 8523308752 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
8 Q-000TB387 3514162704960004 MOCHAMAD WAHYUDI EFENDI 25 UMUM JL SLAMET RIYADI 3/3 GENTONG 8579084155 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
9 Q-000TA59T 3575014106060001 TYAS NIRMALA SARI 15 REMAJA JL SLAMET RIYADI GENTONG 8950805921 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
10 Q-000TELZ5 3575012212990003 MOCHAMAD GALI ALFITRA SALA 22 UMUM JL URIP SUMOHARJO 1/2 BUKIR 8224557391 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
11 Q-000TCQI4 3575012102760001 SUGIANTO 48 UMUM JL CANDI DASA BLOK X 8222939704 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
12 K-0001173B 3514066908910001 FATLUKHA 30 UMUM JL URIP SUMOHARJO 2/3 GADINGREJO 8311914552 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
13 Q-000TB52N 3514183011910005 M. ALIF SURYA MAULANA 29 UMUM JL SLAMET RIYADI 2/1 GADINGREJO 8222816969 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
14 Q-000TCBZA 3575015611070003 NADIA ZAHWA AMALIYAH 14 REMAJA PERUM KARYA BHAKTI 1/7 GENTONG 8523234458 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
15 Q-000T9MZ8 3575014511950001 SELVIA MUFIDAH 26 UMUM JL SLAMET RIYADI 2/1 GENTONG 8968817709 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
16 Q-000TBWC6 3575014604920003 JUWARIYAH 29 UMUM NGAGLIK PASURUAN 6/2 GADINGREJO 8383030929 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
17 Q-000SXQVO 3575031102050004 MOCHAMMAD NUR HIDAYATULL 16 REMAJA JL MT HARIYONO 1/5 BUGUL LOR 8777184446 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
18 Q-000TB3SK 3575016004990001 DWI AYU KRISTANTI 22 UMUM JL SLAMET RIYADI 3/4 GADINGREJO 8579788680 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
19 Q-000TCSXX 3575012111010002 MUCHAMMAD RAFLI FAKHRUDIN 20 UMUM JL KYAI SEPUH 1/6 GENTONG 8121507335 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
20 Q-000TAM0W 3575036602830003 ILMIYAH WAHDANIYAH 38 UMUM JL IMAM BONJOL VII 2/7 BUGUL LOR 8233398744 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
21 Q-000TALTF 3575030908810004 ACHMAD KHANIF 40 UMUM JL IMAM BONJOL VII BUGUL LOR 8785676778 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
22 Q-000TDFW2 3575014507790005 YULIANTINI 42 UMUM JL SOEKARNO HATTA 1/1 GADINGREJO 8191345292 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
23 Q-000TCRQQ 3514156309900002 KHOTIMAH 32 UMUM 8225700584 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
24 Q-000T8PXA 3575014107800085 TOMIMAH 41 UMUM JL BANDA 4/2 GADINGREJO 8953221917 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
25 Q-000TBCVL 3575016701990001 NAKHILAH SAFITRI 22 UMUM JL SLAMET RIYADI 3/4 GADINGREJO 8585085724 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
26 Q-000TC03V 3578085006990004 YUNITA ANDRIANI 22 UMUM JL BANDA GG MAWAR 5/2 GADINGREJO 8573104041 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
27 Q-000TF7R8 3575011508770007 SONI HARI SANTOSO 42 UMUM JL SLAMET RIYADI 1/4 GENTONG 8580643057 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
28 Q-000RNEKC 3575016704050001 NUR AINI 16 REMAJA JL HANGTUAH GADINGREJO 8121728005 Biofarma 31/08/2021 24202321 02/10/2021 202108154G
29 Z-000A8C7F 3575011010590001 MUCHAMMAD TAUCHID 62 LANSIA JL BANDA 6/2 GADINGREJO 8311102158 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
30 Q-000TC9PL 3575015507730001 JANATI 48 UMUM JL NGAGLIK RT06/RW02 GADINGREJO 8230127015 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
31 Q-000TMQI0 3575014412790001 SULISTYOWATI 42 UMUM JL KYAI SEPUH 2/2 GENTONG 8575535288 Biofarma 04/09/2021 2021081501 02/10/2021 202108154G
32 Q-000TACAC 3575011404060001 ALFAN SAHRUFUDDIN 15 REMAJA JL BANDA GG MAWAR 6/2 GADINGREJO 8389838069 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
33 Q-000SKWAF 3575010105830009 SUMARTO 38 UMUM JL KYAI SEPUH GADINGREJO 8785604842 Biofarma 02/09/2021 2021071371 02/10/2021 202108154G
34 Q-000TBDI6 3575016806690001 ATIK RIATI 52 RENTAN JL KYAI SEPUH 6/2 GENTONG 8233303580 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
35 K-0001L1XZ 3575016405050003 DIANA DWI ASTUTI 16 REMAJA JL KYAI SEPUH NO 14, GADING 8383316859 Biofarma 01/09/2021 24202521 02/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
36 Q-000SXJ5I 3575010404070002 AKMAL FARREL ANANZA 14 REMAJA JL BANDA 3/2 GADINGREJO 8155438192 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
37 Q-000SXSNC 3575015608620002 ASIA 59 RENTAN JL BANDA 6/2 GADINGREJO 8124211732 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
38 Q-000TBNKO 3575016807930003 ERNI RATNASARI 28 UMUM JL HALMAHERA 5/5 GADINGREJO 8133666196 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
39 Q-000RPPOU 3514165310020001 ASRI PUSPITA 19 UMUM JL KYAI SEPUH GADINGREJO 8123038440 Biofarma 31/08/2021 24202321 02/10/2021 202108154G
40 Q-000TCSNU 3575016104670001 ASFIYAH 54 RENTAN JL SLAMET RIYADI 3/4 GADINGREJO 8533520717 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
41 Q-000TH1UG 3575035706840002 AZIZA YUNIARTI 37 UMUM JL MT HARYONO GG XVIII 8223163950 Biofarma 04/09/2021 202107132I 02/10/2021 202108154G
42 Q-000TASUF 3575010606800008 BUDI TRIYONO 41 UMUM JL SOEKARNO HATTA GADINGREJO 8133170865 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
43 Q-000TBYFQ 3575010303970002 IKBAL TORIQ 24 UMUM JL GATOT SUBROTO RT04/RW02 PETAHUN 8515792991 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
44 Q-000TDEQC 3575010209760001 LUQMAN ROKHIM 45 UMUM JL SLAMET RIYADI 2/3 GENTONG 8573374793 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
45 Q-000C8KOZ 3575010107790103 NUR HASAN 42 UMUM JL IRIAN JAYA ANGGREK PASURUAN 8232597541 Biofarma 07/07/2021 24003521 02/10/2021 202108154G
46 Q-000TEU2N 3575024501780003 ANI SULFIA 43 UMUM perum taman asri 2/7 purworejo 8133476468 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
47 Q-000SZM10 3575011609660001 MUCHAMAD RUSDI 55 RENTAN JL BANDA 3/3 GADINGREJO 8113777705 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
48 Q-000THJGA 3575017008780001 SITI CHOFIDAH 43 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8563365162 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
49 Q-000RBUFW 3575016505060001 INTAN REGITA CAHYANI 15 REMAJA JL URIP SUMOJARJO 2/3 BUKIR 8968769739 Biofarma 30/08/2021 24202221 02/10/2021 202108154G
50 Q-000TB536 3575011411990001 DWI ADIANTO 22 UMUM JL SLAMET RIYADI 4/2 SEBANI 8223230052 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
51 Q-0008IXIO 3575014701810002 LIS BANDRIYAH 40 UMUM BUKIR GADINGREJO 8533047406 Biofarma 26/06/2021 24200821 02/10/2021 202108154G
52 Q-000RN9FX 3575016911050002 DINDA DWI SYAFITRI 16 REMAJA JL BANDA 6/2 NGAGLIK GADINGREJO 8953970770 Biofarma 31/08/2021 24202321 02/10/2021 202108154G
53 Q-000TACDD 3514162608070001 SYECH AZHUMAT KHAN 14 REMAJA JL BANDA 4/2 GADINGREJO 8214130336 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
54 Q-000TC04Z 3514204408900005 SRI WAHYUNI 31 UMUM JL BANDA RT05/RW02 GADINGREJO 8383273734 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
55 Z-000A8DU7 3575011902570002 SUWARNO 64 LANSIA JL BANDA 5/2 GADINGREJO 8778563210 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
56 Q-000TD7MF 3575034912860001 AFIDAH ROHMAH 35 UMUM NGEMPLAKREJO 1/8 8223258596 Biofarma 04/09/2021 2021007132 02/10/2021 202108154G
57 Q-000TAHK3 3575016311910001 LILIK MALIKHA 30 UMUM BANDA 5/2 GADINGREJO 8785591492 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
58 Q-000RMWYU 3575016004050003 NUR LAILATUL MAULUDIA 16 REMAJA JL SLAMET RIYADI SEBANI 8525948751 Biofarma 31/08/2021 24202221 Ga 02/10/2021 202108154G
59 Q-000S4WE6 3507276410050002 NADHYRA AYU ZAHRA DARINDRA 16 REMAJA JL GATOT SUBROTO 1/4 BUKIR 8785588089 Biofarma 01/09/2021 2021071371 02/10/2021 202108154G
60 Q-000T8PRY 3575016308870001 SITI AISAH 34 UMUM JL HALMAHERA 2/3 GADINGREJO 8123448480 Biofarma 03/09/2021 2021071371 02/10/2021 202108154G
61 Q-000SW3OE 3575014107680107 JUNAINA 53 RENTAN JL HANGTUAH 1/3 GADINGREJO 8537710472 Biofarma 02/09/2021 2021071371 02/10/2021 202108154G
62 Q-000SLBIJ 3575010107670048 SOFYAN 54 RENTAN JL HANG TUAH 1/3 GADINGREJO 8537710472 Biofarma 02/09/2021 2021071371 02/10/2021 202108154G
63 Q-000TE4OC 3575034909920001 ROBBIATUL ADAWIYAH 29 UMUM JL APEL 3 BUGUL KIDUL RT 05/05 8574919007 Biofarma 04/09/2021 2021071321 02/10/2021 202108154G
64 Q-000TALUQ 3575010304040004 MOHAMAD ALI RIDHO 17 UMUM JL SLAMET RIYADI 1/1 SEBANI 8956302521 Biofarma 04/09/2021 2021071371 02/10/2021 202108154G
65 P-3UUCUU1N 3514166206950003 ZULAIFATUL MAULIDIA 26 UMUM SEDODOL SELATAN 2/4 PLINGGISAN 8133355288 Biofarma 02/10/2021 202108154G
66 S-71514197 3575011612620002 MOH. IKROM 62 LANSIA jl slamet riyadi 1/1 gentong 8135839502 Biofarma 02/10/2021 202108154G
67 P-HJ7BMYQ5 3575016305010004 SAILATU RISQIYAH 20 UMUM JL BANDA 3/4 GADINGREJO 8810248173 Biofarma 02/10/2021 202108154G
68 S-95ECC56E 3578145708580003 SUGIARTI 63 LANSIA PERUM PAKAL RESIDENCE PAKAL SURAB 8533527382 Biofarma 02/10/2021 202108154G
69 S-9450E47A 3578140112560001 SISWANTO 65 LANSIA PAKAL RESIDENCE B20 RT05/RW03 SURA 8581543165 Biofarma 02/10/2021 202108154G
70 P-HJFHIZLP 3575010105050001 MUHAMMAD ALFARIZI MUSTHOF 16 REMAJA JL HASANUDIN IX NO 53 RT01/RW07 KAR 8885638663 Biofarma 02/10/2021 202108154G
71 P-M911CVQD 3575010603060002 MUKHAMAD RANGGA SAPUTRA 15 REMAJA JL GATOT S RT 2 RW 6 BUKIR 8223625778 Biofarma 02/10/2021 202108154G
72 S-162E7A96 3575010909570003 TEGUH EKO PURWANTO 64 LANSIA JL. URIP SUMOHARJO RW 02 RT 003 8383308617 Biofarma 02/10/2021 202108154G
73 P-LE5CFSKE 3575015005680003 ST. CHOTIDJAH 53 RENTAN JL. GATOT SUBROTO BUKIR 8113777705 Biofarma 02/10/2021 202108154G
74 P-LONL0MPM 3514194609030001 ULFATUN NADHIROH 18 UMUM DSN WULU 2/3 MENDALAN 8580335788 Biofarma 02/10/2021 202108154G
75 P-MO2KB9WJ 3575010711930001 MUHAMMAD IRFAN 28 UMUM JL. GATOT SUBROTO 5/7 GADINGREJO 8193700705 Biofarma 02/10/2021 202108154G
76 P-31L4D4LD 3507276410050001 NADISCA AYU ZAHRA DARINDRA 16 REMAJA JL GATOT SUBROTO 1/4 BUKIR 8785588089 Biofarma 02/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
77 P-O6FV6UI8 3575010710920001 KUKUH DWI CAHYO 29 UMUM JL URIP SUMOHARJO BUKIR 8963516977 Biofarma 02/10/2021 202108154G
78 P-OTVRFOKB 3575014409960002 TOIFA 25 UMUM JL HANGTUAH VI 8113777705 Biofarma 02/10/2021 202108154G
79 P-PAWEQ7KD 3575014801820005 LATIFAH 39 UMUM JL HALMAHERA NO.18 8785907657 Biofarma 02/10/2021 202108154G
80 P-PYR5XC6I 3575014311730001 JUARIYAH 48 UMUM JL KYAI SEPUH GENTONG 8968376960 Biofarma 02/10/2021 202108154G
81 P-KCAOKBI7 3575016203850003 NUR IMAMA 36 UMUM JL KYAI SEPUH GENTONG 8564819168 Biofarma 02/10/2021 202108154G
82 P-QR6K1VMI 3575013105810001 JAINUL ARIFIN 40 UMUM JL KYAI SEPUH GENTONG 8810268037 Biofarma 02/10/2021 202108154G
83 P-JRLRDNAY 3514180102820009 FAUZAN 39 UMUM JL KYAI SEPUH 001/005 GENTONG 8564819168 Biofarma 02/10/2021 202108154G
84 P-RV18LM8S 3514196408970004 SYAFITRI IDAHYANINGSIH 24 UMUM dusun bandaran kidul 8383253078 Biofarma 02/10/2021 202108154G
85 P-SCNEM9FB 3514114301010002 DEWI PURWANTI 20 UMUM jl banda gadingrejo 8580635680 Biofarma 02/10/2021 202108154G
86 P-SW8A1Q2P 3575011512970002 MUHAMMAD IRSYAD 24 UMUM jl kyai sepuh gentong 8810267991 Biofarma 02/10/2021 202108154G
87 P-TCB2SB9Q 3514164308090002 AULIANISA RANA ZAHIRA 12 REMAJA JL URIP SUMOHARJO 1/8 BUKIR 8133433283 Biofarma 02/10/2021 202108154G
88 P-U3FY1KMD 3514114204830003 JULAICHAH 38 UMUM JL BANDA 3/3 GADINGREJO 8580635680 Biofarma 02/10/2021 202108154G
89 P-SIYHI0DI 3575012507000005 MOCHAMAD BAHARUDDIN FIRM 21 UMUM SEBANI 1/4 8953970716 Biofarma 02/10/2021 202108154
90 P-S7O17R4C 3575011510840003 MOH. JUNAIDI 37 UMUM JL GATOT SUBROTO 8383454875 Biofarma 02/10/2021 202108154
91 P-SMJW3V0T 3524084207860001 YANIS MUYASAROH 35 UMUM SEBANI PASURUAN 8585560883 Biofarma 02/10/2021 202108154
92 P-UTANSP2H 3575010107850072 AKHMAD MUJAMIL 36 UMUM SEBANI 3/5 8783511622 Biofarma 02/10/2021 202108154
93 P-61MJ8GZM 3575015305920001 NURUL MILAWATI 29 UMUM JL. SLAMET RIYADI SEBANI 8969951038 CoronaVac 02/10/2021 202108154G
94 P-N6EHYMZB 3575015204730004 SITI MACHMUDAH 48 UMUM JL. SLAMET RIYADI SEBANI 8787768862 CoronaVac 02/10/2021 202108154G
95 P-9JBHAL7K 3517094501870002 AINUR RAHMAWATI 34 UMUM PERUM LUMBUNG PADI NO 12 SEBANI 8222882704 CoronaVac 02/10/2021 202108154G
96 P-AEXSGM9M 3514065212830002 DIAN MAYA FANTI 38 UMUM JL. SLAMET RIYADI SEBANI 8311705638 CoronaVac 02/10/2021 202108154G
97 P-CJIR2SN8 3514167112960002 SITI FATIMAH 25 UMUM SEBANI RT 2 RW 5 8573133447 CoronaVac 02/10/2021 202108154G
98 P-MFKMCYJ9 3575025703090002 ANNISA MAULIDIYAH 12 REMAJA PERUM LUMBUNG PADI REGENCY 8223223105 CoronaVac 02/10/2021 202108154G
99 P-ITH4SAF3 3575024805840009 UMROTUL FAROKHA 37 UMUM PERUN LUMBUNG PADI 8113532184 CoronaVac 02/10/2021 202108154G
100 P-RRY16EVG 3575011008730001 AGUS IMRON 48 UMUM SEBANI PASURUAN 8817180526 CoronaVac 02/10/2021 202108154G
101 P-DRBU7PRH 3575016606900003 NUR DHUCHA 31 UMUM SEBANI RT 3 RW 4 8532766295 CoronaVac 02/10/2021 202108154G
102 Q-000T8Q4Z 3575015012840001 HARTININGSIH 37 UMUM JL TEUKU UMAR 1/1 SEBANI 8523699778 CoronaVac 03/09/2021 2021071371 02/10/2021 202108154G
103 Q-000TEO9Q 3575014803810001 NURUL ANISAH 40 UMUM JL GATOT SUBROTO 004/007 BUKIR GADI 8969956727 CoronaVac 04/09/2021 24201921 R 02/10/2021 202108154G
104 Q-000HZPL5 3575014505750002 SOLIKHA 46 UMUM JL.SLAMET RIADI 1/6 SEBANI 8578524760 CoronaVac 17/07/2021 24200421 G 02/10/2021 202108154G
105 Z-0000JHPC 3575015708590003 SITI FATIMAH 62 LANSIA JL SLAMET RIADI NO 8383406030 CoronaVac 14/06/2021 24002621 G 02/10/2021 202108154G
106 Q-0008IYA4 3575014101960011 ANGGA PRASETYO 25 UMUM JL SLAMET RIYADI 8573190673 CoronaVac 26/06/2021 24200821 G 02/10/2021 202108154G
107 P-A25X1P0A 3514161112960002 SLAMET WAHYUDI 25 UMUM dsn krajan 3/2 kraton 8564962483 Astrazeneca 02/10/2021 ABY1312
108 P-DPQVUWXD 3575014506790005 SUPARMI 50 RENTAN KARANG KETUK 5/3 KARANG KETUK 8328641454 Astrazeneca 02/10/2021 ABY1312
109 P-APM6R7KU 3575011002770003 MUHAMMAD FUAD 44 UMUM jl kyai sepuh 21 gentong 8125266000 Astrazeneca 02/10/2021 ABY1312
110 P-BGN1JM9N 3575014607840004 MUSLICHA 37 UMUM JL KYAI SEPUH 3 GADINGREJO 8785604842 Astrazeneca 02/10/2021 ABY1312
111 P-C58T848C 3514132206890003 EDI SANTOSO 32 UMUM KEDANTEN WONOKOYO 8585125908 Astrazeneca 02/10/2021 ABY1312
112 P-EXCVVYHB 3575014909680002 SUPIK 53 RENTAN KARANG KETUK 3 KARANG KETUK 8135709022 Astrazeneca 02/10/2021 ABY1312
113 P-FR7YTKX1 3575010101660003 PONARI 54 RENTAN JL SLAMET RIYADI 2/3 GENTONG 8953384393 Astrazeneca 02/10/2021 ABY1312
114 P-WYSHEG4Q 3575011112940002 SLAMET RIYADI 27 UMUM JL SLAMET RIYADI 8953258375 Astrazeneca 02/10/2021 ABY1312
115 P-GB7EXRAL 3575015408830001 ASMAUL KHUSNAH 38 UMUM JL SLAMET RIYADI 2/3 GENTONG 8515719083 Astrazeneca 02/10/2021 ABY1312
116 P-GPUUZ1HT 3575011208020004 AKHMAD DICKY ROSYADI 19 UMUM JL SLAMET RIYADI 3/1 SEBANI 8233134050 Astrazeneca 02/10/2021 ABY1312
117 P-GZQ5SJRH 3514161611760004 NUR WAGIAN 45 UMUM BENDUNGAN 5/5 KRATON 8113777705 Astrazeneca 02/10/2021 ABY1312
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
118 P-GVEALHOB 3575010811690001 KASIRAN 52 RENTAN JL KYAI SEPUH 1/5 GENTONG 8533520440 Astrazeneca 02/10/2021 ABY1312
119 P-I3S1ILAK 3514160311950003 MOHAMAD ROCHMAN 26 UMUM jl jolondriyo 3/4 krapyak 8822859958 Astrazeneca 02/10/2021 ABY1312
120 P-6UTGTAV6 3575017006760001 SUROYA 46 UMUM KRAPYAKREJO RT03/RW04 KRAPYAK REJ 8133387694 Astrazeneca 02/10/2021 ABY1312
121 P-DDEEL3OP 3575010709960001 MOKHAMAD SAIFUL RIZAL 25 UMUM JL SLAMET RIADI RT03/RW03 GENTONG G 8969950212 Astrazeneca 02/10/2021 ABY1312
122 P-CGVRVT3Q 3575016512650001 TASLIMAH 55 RENTAN JL SLAMET RIYADI 8969950212 Astrazeneca 02/10/2021 ABY1312
123 P-H9OKQAXF 3575012209830003 ROHMAD HIDAYAT 38 UMUM JL TEUKU UMAR SEBANI 8384943982 Astrazeneca 02/10/2021 ABY1312
124 P-GXCRSEPS 3575010107760141 M. MUARI 44 UMUM JL BANDA GADING REJO 8230169238 Astrazeneca 02/10/2021 ABY1312
125 P-JPNHHN88 3575016204830002 RAUDLATUL CHASANAH 38 UMUM JL SLAMET RIYADI RT02/RW04 GENTONG 8961667642 Astrazeneca 02/10/2021 ABY1312
126 P-JQKP8BAN 3575012503790001 ABDULLAH 42 UMUM JL SLAMET RIYADI 8960605118 Astrazeneca 02/10/2021 317710P
127 P-KIB6HW6O 3575011804030003 MUHAMMAD FARHAN AJI SAPUT 18 UMUM SEBANI PASURUAN 8131460933 Astrazeneca 02/10/2021 317710P
128 P-LCHBR71C 3575010210770001 SATIM 43 UMUM JL BANDA GG MAWAR 8233189927 Astrazeneca 02/10/2021 317710P
129 P-LNN8TEAK 3575014702760001 SITI FATIMAH 46 UMUM JL BANDA GG MAWAR 8233189927 Astrazeneca 02/10/2021 317710P
130 P-JESK8WBB 3575016908730001 KARMIATI 49 UMUM JL KYAI SEPUH 1/5 GENTONG 8533524400 Astrazeneca 02/10/2021 ABY1312
131 P-M9XNUFDY 3575026804890002 TITIN SURYATIN 32 UMUM JL VETERAN GG 2/50 RT02/RW01 BUGUL K 8121394213 Astrazeneca 02/10/2021 ABY1312
132 P-MFA3ARNO 3575022812940001 ASEP NURZAMAN 27 UMUM JL WAHIDIN SH GG MANGGIS 8133522593 Astrazeneca 02/10/2021 ABY1312
133 P-LTAZVKK4 3514164709720017 SUPIANI 49 UMUM BENDUNGAN SELATAN RT01/RW06 BENDU 8113777705 Astrazeneca 02/10/2021 ABY1312
134 P-MSRSP1I2 3575025405780001 LILIK RISMAWATI 43 UMUM JL KYAI SEPUH GG20 RT02/RW05 GENTO 8560659311 Astrazeneca 02/10/2021 ABY1312
135 P-NN22PX8W 3511114411790001 ARSIANA VESTALIA NOVIYANTI, 42 UMUM jl kyai sepuh 4/1 gadingrejo 8123438894 Astrazeneca 02/10/2021 ABY1312
136 P-FFGINA16 3575016503760003 YULISNAWATI 45 UMUM JL SLAMET RIYADI 1/4 GENTONG 8384813323 Astrazeneca 02/10/2021 ABY1312
137 P-0HZP3C1E 3575016304720001 KHUMAIYAH 49 UMUM JL GATOT SUBROTO RT02/RW06 BUKIR G 8224573958 Astrazeneca 02/10/2021 ABY1312
138 P-J8N8H4YE 3575015109950001 LINDA AMILIYAH 26 UMUM jl jolondriyo 3/4 krapyak 8822859958 Astrazeneca 02/10/2021 ABY1312
139 P-JL8JYNST 3575012201830003 ALI MURTADHO 38 UMUM jl banda 3/3 gadingrejo 8113777705 Astrazeneca 02/10/2021 ABY1312
140 P-74EKCH5S 3514133008960001 KOKO GHOFUR AGUSTIN 25 UMUM kepuhrejo beji 8775705709 Astrazeneca 02/10/2021 ABY1312
141 S-2D1DF42D 3575035105990002 SITI NUR JANNAH 22 UMUM DSN BINTINGAN KEPEL BUGUL KIDUL 8383250656 Astrazeneca 02/10/2021 ABY1312
142 P-9UA2HZNZ 3575011304590001 IRSYAD RIYADI 59 RENTAN JL SLAMET RIYADI 3/3 GENTONG 8133655290 Astrazeneca 02/10/2021 ABY1312
143 P-BAGSZHYN 3575014108830004 RINI AGUSTIN 38 UMUM JL HANGTUAH RT03/RW03 GADINGREJO 8822664958 Astrazeneca 02/10/2021 ABY1312


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003
Kategori : UMUM
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
1 P-4CAT1U7U 3514230505740002 MADI KUSUMAHADI SETIAWAN 47 UMUM BABATAN/ SAMBIREJO 8123253684 Astrazeneca 01/10/2021 ABY1312
2 P-AKHBOUAF 3575010107890041 MIFTACHUDIN 32 UMUM JL BANDA 6/2 GADINGREJO 8385199008 Astrazeneca 01/10/2021 ABY1312
3 P-AYOPD5M2 3514130607770005 SUYONO SARIFUDIN 44 UMUM WONOKOYO 1/2 BEJI 8573339761 Astrazeneca 01/10/2021 ABY1312
4 P-A7XND9RF 3575014105820006 MUSRIFAH 39 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8213327966 Astrazeneca 01/10/2021 ABY1312
5 P-DOHX0KSM 3575011702950001 SETIAWAN FEBRIANTO 26 UMUM JL SLAMET RIYADI 3/2 SEBANI 8575555679 Astrazeneca 01/10/2021 ABY1312
6 P-E8COATLA 3575016608950002 INDAH SETIAWATI 26 UMUM JL GATOT SUBROTO 4/6 KARANGKETUG 8311102213 Astrazeneca 01/10/2021 ABY1312
7 P-FRBQNHML 3575030607880002 MOCHAMAD ANTON 33 UMUM JL MT HARIYONO 5/3 MANDARANREJO 8123421103 Astrazeneca 01/10/2021 ABY1312
8 P-H0EAJIGY 3575012401010002 M. KHUSAERI 20 UMUM JL IRIAN JAYA 1/2 GADINGREJO 8193848174 Astrazeneca 01/10/2021 ABY1312
9 P-GHZ3OL2T 3514161010000002 M. ARIF 21 UMUM KEBONSAWAH 1/7 KALIREJO 8533493408 Astrazeneca 01/10/2021 ABY1312
10 P-HCED25NA 3575011203970002 MUKHAMMAD NAUFAL 24 UMUM JL GATOT SUBROTO 3/1 PETAHUNAN 8133493429 Astrazeneca 01/10/2021 ABY1312
11 P-I6JKZWX1 3514114404860006 RUSYANA 35 UMUM DSN JEDUNG 1/10 SEBANI PANDAAN 8234231975 Astrazeneca 01/10/2021 ABY1312
12 P-IWXGBSCI 3514124409770001 WIDYA KRISTIANTI 44 UMUM KAJANG II 3/12 KEPULINGAN GEMPOL 8533440201 Astrazeneca 01/10/2021 ABY1312
13 P-JE0S9XTP 3575031407920001 MUHAMMAD HIDAYAT 29 UMUM DSN DADAPAN 3/1 GONDANGWETAN 8585266661 Astrazeneca 01/10/2021 ABY1312
14 P-8OH63X4U 3514165808960003 SITI ATIMAH 25 UMUM JL BANDA 6/2 GADINGREJO 8351990086 Astrazeneca 01/10/2021 ABY1312
15 P-L9AEF4NI 3575011009670001 SAMSUL HUDA 54 RENTAN JL SLAMET RIYADI 2/2 GENTONG 8113777705 Astrazeneca 01/10/2021 ABY1312
16 S-39531017 3514161206600046 SOLIKHAN 61 LANSIA KALIMAS UTARA 2/2 BENDUNGAN KRATON 8573301683 Astrazeneca 01/10/2021 ABY1312
17 P-44CCDCN9 3514205901900008 LISMANA 31 UMUM TANAM DELEM 2/5 GRATI 8193813747 Astrazeneca 01/10/2021 ABY1312
18 P-7KK44IZ7 3508184602880001 ROHIMA 33 UMUM BENDUNGAN 1/6 KRATON 8384669453 Astrazeneca 01/10/2021 ABY1312
19 P-9ISJJT1O 3575010107910064 DIMAS ARIF FIRMANSYA 33 UMUM TAMBAAN 1/5 8580712053 Astrazeneca 01/10/2021 ABY1312
20 P-BAKPI4IA 3575011712960004 MOCH MAKSUM 25 UMUM JL HALMAHERA 3/5 GADINGREJO 8852143202 Astrazeneca 01/10/2021 317710P
21 P-C4ZG57VI 3575016706700001 SITI KHUMAIYAH 51 RENTAN JL HANG TUA 3/3 GADINGREJO 8113777705 Astrazeneca 01/10/2021 317710P
22 P-D0XC3B04 3575016801950001 RISA ARIANTI 26 UMUM JL HANGTUA 3/3 GADINGREJO 8113777705 Astrazeneca 01/10/2021 317710P
23 P-DNAVJZTV 3514165005700001 WAKIAH 51 RENTAN BENDUNGAN 1/6 KRATON 8772120568 Astrazeneca 01/10/2021 317710P
24 P-H5TSQLIB 3575014107770085 RUBAIYAH 44 UMUM JL BANDA 4/2 GADINGREJO 8113777705 Astrazeneca 01/10/2021 ABY1312
25 P-GLNXEY8T 3575010706870001 FANI PRAMUDITA 34 UMUM JL SLAMET RIYADI 2/3 GENTONG 8969961633 Astrazeneca 01/10/2021 ABY1312
26 P-HRP4ZRTQ 3575010911850001 MOH YAZID 36 UMUM JL KYAI SEPUH 28 GENTONG 8573395350 Astrazeneca 01/10/2021 ABY1312
27 P-FZN95DBA 3514135308960001 DEWI ROMLA 25 UMUM JL HANG TUA 2/3 GADINGREJO 8573300432 Astrazeneca 01/10/2021 ABY1312
28 P-NEAJRVRB 3514220712940003 HUSNAN 27 UMUM SEMONGKRONG 2/3 LEKOK 8233510676 Astrazeneca 01/10/2021 ABY1312
29 S-D8DD9367 3514222607960001 NASHAN 25 UMUM DSN SEMONGKRONG 2/9 LEKOK 8123173565 Astrazeneca 01/10/2021 ABY1312
30 P-NWFTBDH1 3514226801000001 SUMARNI 21 UMUM DSN SEMONGKRONG 1/6 LEKOK 8236428192 Astrazeneca 01/10/2021 ABY1312
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
31 P-O6ZNWLQX 3514220906940001 ABDUL WAHID 27 UMUM DSN SEMONGKRONG 1/6 LEKOK 8122826281 Astrazeneca 01/10/2021 ABY1312
32 P-OSYM1HX1 3575015708800002 SULIS AGUSTIN 41 UMUM JL A YANI 5/3 KARANGKETUG 8706109822 Astrazeneca 01/10/2021 ABY1312
33 P-P7OUZIHN 3575015310930001 RIZQIYAH 28 UMUM JL IRIAN JAYA 7/1 GADINGREJO 8515874475 Astrazeneca 01/10/2021 ABY1312
34 P-TRF5FMHR 3514142510950004 KHOIRUL ANWAR 26 UMUM PANDELAKAN RACI BANGIL 8585640450 Astrazeneca 01/10/2021 ABY1312
35 P-PD5PY1BJ 3575011611790003 SAIFUL 42 UMUM JL HNAG TUA 4/4 GADINGREJO 8136025619 Astrazeneca 01/10/2021 ABY1312
36 P-PM2Q5STF 3575012412840001 AKHMAD NASIR 37 UMUM SEBANI 3/1 8223146367 Astrazeneca 01/10/2021 ABY1312
37 P-RKGIE9V0 3514160504850006 MUCHAMMAD GOFUR 42 UMUM BENDUNGAN 1/6 KRATON 8348177686 Astrazeneca 01/10/2021 ABY1312
38 P-SUFADXI3 3514164204770005 SUHERNI 44 UMUM BENDUNGAN 1/6 KRATON 8384530411 Astrazeneca 01/10/2021 ABY1312
39 P-SHGX0R3Y 3514161506990001 VICKY DARMAWAN 22 UMUM BENDUNGAN 1/6 KRATON 8384530411 Astrazeneca 01/10/2021 ABY1312
40 P-EQWY0XJ8 3514165707950003 BADRIYAH HANDAYANI 26 UMUM KALIMAS UTARA 2/2 BENDUNGAN 8576463520 Astrazeneca 01/10/2021 ABY1312
41 P-FHRV3LZK 3514145512010005 SAIDATUL FITRIYAH 20 UMUM JL MT HARYONO 5/3 MANDARANREJO 8123421103 Astrazeneca 01/10/2021 ABY1312
42 P-3U7WLV9H 3575034607870004 SUHARTINI 34 UMUM MANGGUAN 2/1 PASREPAN 8224569160 Astrazeneca 01/10/2021 ABY1312
43 P-HQ5RIYTS 3514060111990009 MUCH. MARUF 22 UMUM JOPATI 12/4 KEJAYAN 8585692641 Astrazeneca 01/10/2021 ABY1312
44 P-KFKKFTXU 3518085812910004 ADI NINGRUM 30 UMUM JL ANJASMORO 1/5 KERTOSNO 8123442410 Astrazeneca 01/10/2021 ABY1312
45 P-N48N5U8L 3575011304990002 IMAM 22 UMUM JL HALMAHERA 3/5 GADINGREJO 8318524416 Astrazeneca 01/10/2021 ABY1312
46 P-64UHRZL5 3575012908750004 SUWANDI 46 UMUM JL HALMAHERA 1/5 GADINGREJO 8113777705 Astrazeneca 01/10/2021 ABY1312
47 P-37TIJRDA 3575025507020003 FARAH PUTRI DZIKRIYAH 19 UMUM JL RA KARTINI 2/4 BANGILAN 8582663727 Astrazeneca 01/10/2021 ABY1312
48 P-8WY6CAY6 3514160406890008 MUHAMMAD SUGIANTO 32 UMUM BENDUNGAN 1/6 KRATON 8384669453 Astrazeneca 01/10/2021 ABY1312
49 P-68GUZKGM 3575015110040001 ISTIQOMAH 17 REMAJA JL URIP SUMOHARJO 2/1 BUKIR 8951467938 CoronaVac 01/10/2021 202108154G
50 P-M7ZYXD7N 3575015012060001 FAIZAH 15 REMAJA JL HALMAHERA 3/5 8318524416 CoronaVac 01/10/2021 202108154G
51 P-MMSWIUBE 3575014910050003 NIA RAMADHANI 16 REMAJA JL HALMAHERA 3/5 8318524416 CoronaVac 01/10/2021 202108154G
52 S-9E18F7E4 3575010107490018 ATMOHADI 72 LANSIA JL SLAMET RIYADI 1/3 GENTONG 8978865722 CoronaVac 01/10/2021 202108154G
53 P-EGDU5FB1 3575017012040001 MUSRIFAH 17 REMAJA JL HANGTUA 4/3 8113777705 CoronaVac 01/10/2021 202108154G
54 P-RIULB6CW 3514234108950002 DEFI AGUSTIYANINGSIH 26 UMUM JL HALMAHERA GG. 9 8560651549 CoronaVac 01/10/2021 202108154G
55 P-QG5NXJEI 3575015205900002 NUR FADILAH 31 UMUM JL HALMAHERA 3/5 8523077649 CoronaVac 01/10/2021 202108154G
56 P-S4IHJFER 3575014203890002 HUSNUL KHOTIMAH 32 UMUM JL HALMAHERA 8133689565 CoronaVac 01/10/2021 202108154G
57 P-PGCHSQ5J 3575014107950041 MUSRIFAH 26 UMUM JL HANGTUAH 4/4 8591896818 CoronaVac 01/10/2021 202108154G
58 P-PWCXCXXG 3507304404040006 APRILIA SUSANTI 17 REMAJA 8384551226 CoronaVac 01/10/2021 202105154G
59 P-OPPCJ0E0 3575014107760124 SOLICHAH 45 UMUM 3/3 8560658609 CoronaVac 01/10/2021 202108154G
60 P-8KLDWOB5 3527046710890004 TOYYIBEH 32 UMUM JL HANGTUAH 1/4 8113777770 CoronaVac 01/10/2021 202108154G
61 P-Y5TPEW22 3575011612840001 IMAM BAIDLAWI 38 UMUM JL HANGTUAH 8133689565 CoronaVac 01/10/2021 202108154G
62 P-YBT7J24F 3575014101010008 MILATUL ISLAMI 20 UMUM JL HALMAHERA 8135790683 CoronaVac 01/10/2021 202108154G
63 P-YBXXBWN7 3575014107980057 YULIANA 26 UMUM JL HANGTUAH 8135912339 CoronaVac 01/10/2021 202108154G
64 P-XOO3TPKL 3575011611800002 ABDUL SYAKUR 41 UMUM JL HALMAHERA 8786160941 CoronaVac 01/10/2021 202108154G
65 P-A1HN0DZV 3575010604040001 NOVITA 17 REMAJA JL GATOT SUBROTO 4/1 KRAPYAKREJO 8899695972 CoronaVac 01/10/2021 202108154G
66 P-VHTLIJ7R 3575011708730001 ABD. GHOFUR 48 UMUM SEBANI 3/5 8580688271 CoronaVac 01/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
67 P-6BGZUEFT 3575014408710002 TINARSIH 47 UMUM SEBANI 1/6 8121745699 CoronaVac 01/10/2021 202108154G
68 P-A0RDKL2J 3575011810000001 MOCH ANDI MASHURI 21 UMUM BUKIR 1/1 PASURUAN 8384671013 CoronaVac 01/10/2021 202108154G
69 P-F3KO8CDA 3508196012870003 DIAN ROSMIATI 34 UMUM WORO KOYO TIMUR 1/1 BEJI 8133659998 CoronaVac 01/10/2021 202108154G
70 Q-000SZDGN 3575016605750001 LILIK MULYANA 47 UMUM JL KYAI SEPUH 45 8954005469 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
71 Q-000SXJQP 3575014107850138 WIWIK 36 UMUM JL BANDA 6/2 8111030540 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
72 Q-000SXX1C 3575016910000001 LUTFIA 21 UMUM JL BANDA 5/2 8594578440 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
73 Q-000SXTFN 3575014107000031 NURUL MUFIDA 21 UMUM JL BANDA 6/2 8787651683 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
74 Q-000T8PNQ 3575011310030004 MUKHAMMAD SADDAM RISKY 18 UMUM JL HALMAHERA 5/5 8383350488 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
75 Q-000T8PWG 3575014805780003 SUNARSIH 45 UMUM JL BANDA 4/2 8953221917 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
76 Q-000SXTSF 3575010212800002 JUARIAH 38 UMUM JL BANDA 5/2 8578440394 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
77 Q-000T8Q0T 3575015103850002 IKA KURNIAWATI 37 UMUM JL SLAMET RIYADI 1/1 SEBANI 8580642677 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
78 Q-000SYF7K 3575015812070001 BILQIIS KAYLLA PUTRI REGINA 14 REMAJA JL SLAMET RIYADI 1/1 8570615868 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
79 Q-000SXXT1 3575010107830081 FAUZI 38 UMUM JL BANDA 6/2 8819171743 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
80 Q-000SXYCJ 3514184204940001 LAILATUL KIBTIYAH 29 UMUM JL BANDA 6/2 8819717434 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
81 Q-000SXXNL 3575011703010007 MUKHAMAD FATKHUR ROZI 20 UMUM JL BANDA 5/2 8580713805 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
82 Q-000RFJAB 3575014101690030 MISNAH 52 RENTAN JL HALMAHERA 2/3 8193693947 CoronaVac 30/08/2021 24202221 - 01/10/2021 202108154G
83 Q-000RB4IT 3575015207050003 BILA DWI AULYA 16 REMAJA JL BANDA 4/2 8880568457 CoronaVac 30/08/2021 24202221 - 01/10/2021 202108154G
84 Q-000SXVZX 3575014107680080 SARIYAMI 56 RENTAN JL BANDA 5/2 8113777705 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
85 Q-000SXWGG 3514225408860002 HALIMAH 35 UMUM MIMBO 2/2 JATIREJO LEKOK 8970357442 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
86 Q-000SXV56 3575014107840144 JUARIYAH 37 UMUM JL BANDA 5/2 8113777705 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
87 Q-000SXO9Z 3575014107800109 RIZA UMAMI 40 UMUM JL BANDA 5/2 8113777705 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
88 Q-000SZNMC 3575012401620001 ABD. ROHIM 59 RENTAN JL HANG TUA 1/3 8113777705 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
89 Q-000SYKPY 3575033001040001 MUHAMMAD RAIHAN YAHYA 17 REMAJA PERUMAHAN PONDOK SURYA KENCANA NO 8124971151 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
90 Z-000A454B 3575010101600026 JUMINO 63 LANSIA JL BANDA 3/3 8523675835 CoronaVac 02/09/2021 2021071371 01/10/2021 202108154G
91 Q-000SXSW2 3575015311020001 NUR LUAILIK 19 UMUM JL HALMAHERA 4/5 8583422453 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
92 Q-000T8PFD 3575010411020003 MOCHAMAD FAUZI 19 UMUM JL BANDA 4/2 8191344185 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
93 Q-000T8Q7N 3575010703690002 MUHAMMAD 52 RENTAN JL HALMAHERA 3/5 8133115825 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
94 Q-000SNQVM 3575010206810004 SRIFAN 40 UMUM JL SLAMET RIYADI RT03/RW01 SEBANI 8565502426 CoronaVac 02/09/2021 2021071371 01/10/2021 202108154G
95 Q-000SZEFK 3575015805010002 DHENISA RESHI PRESTIA 20 UMUM JL KYAI SEPUH 3/1 8972289828 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
96 Q-000SZHNK 3575014805750002 SITI UMIYAH 46 UMUM JL SINONGGO 2/1 8190725485 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
97 Q-000T8Q29 3575014911900002 SITI LAILAH 31 UMUM JL HANG TUA 1/3 8313221218 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
98 Q-000ENOSN 3575016110880005 SITI MAHMUDAH 33 UMUM JL HALMAHERA 66 XI 8368916689 CoronaVac 15/07/2021 24200421 01/10/2021 202108154G
99 Q-000T8R6W 3575014107770092 MARIYA ULFA 44 UMUM JL BANDA 6/2 8385102645 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
100 Q-000SZTRR 3575014304070001 AMELIA LESTARI 14 REMAJA JL SLAMET RIYADI 1/4 GENTONG 8580643057 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
101 Q-000T8PVJ 3575012911010002 MIFTAFUL HUDA 20 UMUM JL BANDA 4/2 8953221917 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
102 Q-000T8POV 3575016807010004 SITI AISYAH 20 UMUM JL HALMAHERA 4/5 8589250065 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
Dosis I Dosis 2
Kelomp
Umur
Vaksinasi Vaksinasi
103 Q-000T8QCD 3575034611960002 ASMANIA 25 UMUM JL IMAM BONJOL 8/4 BUGUL LOR 8565503514 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
104 Q-000SZJV2 3575011102650001 ETIK BUDI HANDAYANI 56 RENTAN JL TIMOR TIMUR 3/1 8316726065 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
105 Q-000ELMNT 3575012806750001 IWAN SETIAWAN 46 UMUM JL SLAMET RIYADI SEBANI 8781407777 CoronaVac 14/07/2021 24200421 - 01/10/2021 202108154G
106 Q-000O2U95 3514211808920001 AGUS EDI SAPUTRO 29 UMUM NGOPAK RT 2 RW 7 ARJOSARI 8313241344 CoronaVac 19/08/2021 24004221 01/10/2021 202108154G
107 Q-000SYE0J 3514234501950002 MIRZAH FATMAWATI 26 UMUM ARJOSARI 2/7 NGOPAK 8313241344 CoronaVac 03/09/2021 2021071371 01/10/2021 202108154G
108 Q-000EQPRW 3316055403840003 SITI WAHYUNI 36 UMUM JL URIP SUMOHARJO RT 3 RW 1 BUKIR 8578580138 CoronaVac 15/07/2021 24200421 - 01/10/2021 202108154G
109 G-0133IP2G 3575014307650001 SALAMAH 56 RENTAN JL URIP SUMOHARJO 8785686442 CoronaVac 21/06/2021 24002621 - 01/10/2021 202108154G
110 Q-000ELXUK 3575016302780002 YENI KURNIASIH 43 UMUM Jl. Urip Sumoharjo RT.02 RW.01 Desa Bukir, 8574596909 CoronaVac 14/07/2021 24200421 - 01/10/2021 202108154G
111 Q-000EB3DV 3575012904750001 IMAM BUKHORI 46 UMUM Jl. Urip Sumoharjo RT.02 RW.01 Desa Bukir, 8574596909 CoronaVac 14/07/2021 24200421 - 01/10/2021 202108154G
112 Z-0000JHPC 3575015708590003 SITI FATIMAH 62 LANSIA JL SLAMET RIADI NO 8383406030 CoronaVac 14/06/2021 24002621 - 01/10/2021 202108154G
113 Q-0008IYA4 3575014101960011 ANGGA PRASETYO 25 UMUM JL SLAMET RIYADI 8573190673 CoronaVac 26/06/2021 24200821 - 01/10/2021 202108154G


NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003

Vaksinasi Oktober 21

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LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN ANAK-ANAK (6-11 TAHUN) KOTA PASURUAN

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LAPORAN CAPAIAN VAKSINASI COVID-19 SASARAN HAMIL KOTA PASURUAN

TARGET CAPAIAN SELISIH

PUSKESMAS KEBONSARI UNTUK BUMIL MASUK KE MASYARAKAT UMUM

JANUARI 2021 PEBRUARI 2021 MARET 202

ATAS) KOTA PASURUAN

JANUARI 2021 PEBRUARI 2021 MARET 202

JANUARI 2021 PEBRUARI 2021 MARET 202

UN) KOTA PASURUAN

JANUARI 2021 PEBRUARI 2021 MARET 202

JANUARI 2021 PEBRUARI 2021 MARET 202

MARET 2021 APRIL 2021 MEI 2021

MARET 2021 APRIL 2021 MEI 2021

MARET 2021 APRIL 2021 MEI 2021

MARET 2021 APRIL 2021 MEI 2021

2021 JUNI 2021 JULI 2021 AGU

2021 JUNI 2021 JULI 2021 AGU

2021 JUNI 2021 JULI 2021 AGU

2021 JUNI 2021 JULI 2021 AGUSTUS 2021

AGUSTUS 2021 SEPTEMBER 2021

AGUSTUS 2021 SEPTEMBER 2021

AGUSTUS 2021 SEPTEMBER 2021

AGUSTUS 2021 SEPTEMBER 2021 OKTOBER 2022

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

10-23-2021 INDUK & PUSTU SEBANI

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

10-22-2021 PUSTU BUKIR

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

72 P-7AQD1NUD 3575010107010062 JUNAEDI 20 UMUM JL BANDA 8214110116 Astrazeneca 21/10/2021 A1076

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

NIP. 19900501 201903 1 003 NIP. 19721016 199603 2 003

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

6 P-4SU8FOJM 3575012112820004 SOLIKHIN 39 UMUM SEBANI RT 3 RW 6 8193663169 Astrazeneca 15/10/2021 PW40166

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

7 P-6FRNQGJX 3575010107830180 SYA'RONI 36 UMUM JL HANGTUAH II 8785032180 Astrazeneca 14/10/2021 PW40166

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

20 P-72JLCVIY 3575015912820001 ZULAICHAH 39 UMUM JL HANGTUAH 8319274744 Astrazeneca 13/10/2021 PW40166

21 P-77WHXE51 3575015203850003 ZUNDAH 36 UMUM JL HANGTUAH 8319274744 Astrazeneca 13/10/2021 PW40166

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 06-10-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 05-10-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz

Mengetahui Pasuruan, 04-10-2021

drg GETHA NUR HAMZAH FARIDA KUSUMAWATI, A.Md.Gz