Pus Dimong

FORMAT PEN
TAHU
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
DESA : BETEK
NO NIK KK / No KK NIK ISTRI Nama Tanggal Lahir NIK SUAMI
1 351908080905024 2 351908460572000 1 Sumarni 06/05/1972 351908060872000 4

2 351908010197018 3 351908690864000 1 Eny Sukatmiarsih 29/08/1964 351908081156000 1
3 351908010197018 5 351908410169000 1 Mulyat 01/01/1969 351908030565000 1
4 351908010197019 1 351908600575000 1 Rohmi 20/05/1975 351908051064000 1
5 351908010197100 4 351908620774000 1 Purwat 22/07/1974 351908290371000 2
6 351908010197100 8 351908107660000 1 Djamitun 21/07/1966 351908101163000 1
7 351908010198397 4 351908550970000 1 Aminin 15/09/1970 351908091163000 1
8 351908010198772 8 351908420954000 2 Supart 02/09/1954 351908120852000 1
9 351908010610022 2 351908420873000 2 Murniat 02/08/1973 351908271167000 1
10 351908020305009 9 351908640980000 2 Sri Hartat 24/09/1980 351908271176000 1

11 351908030315000 1 357703541280000 5 Wahyu Sri Astut 14/12/1980 351908160671000 1
12 351908040107000 8 351908500273000 3 Hartni 10/02/1973 351908060572000 4
13 351908040909063 4 351908480676000 5 Sumini 08/06/1976 351908070277000 2
14 351908050313000 4 351908600389000 1 Supartningsih 20/03/1989 351908130281000 1

15 351908060606018 1 351908590285000 3 Nova Eka Yunita 19/02/1985 351908150575000 1
16 351908060715000 2 350724700687000 6 Yuni Marginingsih 30/06/1987 350724100781000 5
17 351908100998117 9 351908690680000 1 Kartni 29/06/1980 351908100978000 1

18 351908101108046 9 351908540684000 1 Duwi Agustningrum 23/08/1981 351908281075000 4
19 351908111109074 6 351908540684000 1 Juniatk 14/06/1984 351908201084000 4

20 351908120302022 3 351908520772000 4 Yuliana Endang S 12/07/1972 351908280670000 3
21 351908120514000 5 351908550170000 2 Sulisiyani 15/01/1970
22 351908130206005 2 351908420674000 2 Sri Ponirah 02/06/1974 351908060970000 2
23 351908140103001 0 351908600279000 2 Laminah 20/02/1979 351908011074000 3
24 361908160112000 1 351908641078000 2 Dian Herawat 24/10/1978 351908200582000 1
25 351908160408016 1 351908501082000 6 Sri Rahayu 10/10/1982 351908140182000 2

26 351908160408016 2 351908560378000 1 Mahmudah 16/03/1978 351908291078000 4
27 351908170914000 2 351908600191000 2 Sri Puji Astutk 20/01/1991 352106090889000 1
28 351908180106001 4 351908520583000 2 Nur Ani Salamah 12/05/1983 351908270968000 2
29 351908180897019 3 351908600568000 1 Laminem 20/05/1968 351908311265000 1
30 351908190208007 8 351908600875000 2 Warsini 20/08/1975 351908091175000 1
31 351908210205003 6 351908620478000 3 Nur Lailiyah 22/04/1978 351908070277000 1

32 351908211010042 3 351908710889000 2 Iman Apua 31/08/1989 351908090289000 6
33 351908220312000 2 351914490190000 2 Ristyah 09/02/1990 351907150786000 2
34 351908230408017 3 351908700684001 2 Partni 30/06/1984 351908090973000 2
35 351908520214000 1 351907461174000 1 Reni 06/11/1974 351907111058000 1
36 351908250915000 1 351908530394000 1 Fitriana 13/03/1994 351908090395000 2

37 351908260214000 1 351908620787000 1 Samini 22/07/1987 351907050590000 1
38 351908260509029 7 351908470686000 1 Reni Sulistyana 07/06/1986 351908130873000 1
39 351908270199023 2 351908651078000 2 Listya Ariyant 25/10/1978 351908090172000 1
40 351908270511268 1 351908480682000 1 Tatk Sulistyowat 08/06/1982 351908040879000 2

41 351908270511289 0 351908590788000 2 Hartni 19/07/1988 351908150485000 4
42 351908280798118 3 351908700663001 9 Supiyah 30/06/1963 351908300660001 6
43 351908291197019 4 351908550574000 1 Sri Wartni 15/05/1974 351908050760000 1
44 351908140814000 3 351908581088000 1 Maria Oktavia 18/10/1988 352010160889000 2
RT 02
1 351908010197020 3 351908710769000 1 Chusmiyat 7/31/1969 351908080770000 1
2 351908010197021 1 351908630764000 1 Sajekt 7/23/1964 351908010755000 4
3 351908010198014 9 351908661263000 1 Warsini 12/26/1963

4 351908010198015 1 351908630969000 1 Sumilah 9/23/1969 351908160864000 2
5 351908010198160 9 351908700959000 1 Karyatun 9/30/1959 351908300649001 0
6 351908010198162 2 351908410969000 1 Pujiat 1/1/1969 351908020869000 1

7 351908010198168 8 351908711268000 5 Sulastri 12/31/1968 351908161263000 1
8 351908010198169 0 351908460669000 1 Yuni Tri Hastut 6/6/1969 351908300967000 1
9 351908010198624 7 351908440671000 3 Jamirah 6/4/1971 351908031064000 1
10 351908010198780 4 351908450573000 2 sriyatun 5/5/1973 351908131267000 1
11 351908041208051 8 351908451183000 1 tri astut 11/5/1983 351908101082000 4
12 351908050509021 5 351908700675000 4 patukah 6/30/1975 351908301257000 3
13 351908060206002 7 351908430182000 1 maryat 1/3/1982 351908011272000 2
14 351908060214000 3 351907430185000 3 wulan ika s 1/3/1985 351908290183000 1
15 351908070410013 3 351908541184000 3 dian ekawat 11/14/1984 351908190481000 2

16 351908071005027 3 351908411276000 1 lilik suryani 12/1/1976 351908160672000 3
17 351908110208005 5 351908541286000 1 dewi haryant 12/14/1986 351908020986000 3
18 351908110609040 7 351908451285000 2 sit marfuah 12/5/1985 351908130182000 2
19 351908110898015 2 351908550756000 1 rusmini 7/15/1956 351908050643000 1
20 351908120413000 1 351908411086000 2 Maria Magdalina 10/1/1986 317508310190000 2

21 351908130612000 1 351908460864000 2 Aminah 8/6/1964 351908051074000 1
22 351908140415000 3 351908410156000 1 lasmini 1/1/1956
23 351908140598760 2 351908460777000 1 Sri Utami 7/6/1977 351908090265000 1

24 351908141111000 1 351908490685000 1 dewi indriyani 6/9/1985 351908180481000 1
25 351908150805021 3 351908710772000 1 Wara setyorinie 7/31/1972 351908090864000 2
26 351908150812000 2 351908530689000 3 Yuni ekawat 6/13/1989 351908211289000 1
27 351908170412000 1 351908630690000 1 Sit masruroh 6/23/1990 351908030881000 1
28 351908150676000 1 351908671183000 2 Sri Wahyuni 11/27/1983 351908150676000 1
29 351908191108049 0 351908501188000 1 Pujiatun 11/10/1988 351908200784000 3
30 351908210212000 2 351908690891000 3 Nurul Evi S 8/29/1991 351907150490000 1
31 351908220713000 5 351908600280000 1 Ferra Sri Hartni 2/20/1980
32 351908231201004 5 351905581279000 1 Sulis Anjarwat 12/18/1979 351908190177000 1
33 351908280104003 6 351908420473000 3 Tuminah 4/2/1973 351908030169000 3

34 351908280212000 1 351908460283000 1 Wartni 2/6/1983 351908081177000 2
35 351908290898678 3 351908501070000 4 Marminem 10/10/1970 351908110169000 3
36 351908300197101 1 351908420856010 1 Ruth Suyatmi 8/2/1956

37 351908301105032 3 351908480768000 1 Yuliani 7/8/1968
RT 03
1 351908010198119 6 351908480773000 1 Sumari 7/8/1973 351908130269000 1
2 351908010198119 8 351908311255000 3
3 351908010198120 2 351908300634000 8
4 351908010198162 6 351908550862000 1 Kustni 8/15/1962 351908250760000 3
5 351908010198166 0 351908700658002 1 Warikem 6/30/1958 351908300650002 0
6 351908010198273 6 351908700653004 3 Poniyem 6/30/1953 351908300653006 1
7 351908010198399 2 351908410276000 1 Sulamiyah 2/1/1976 351908230777000 1
8 351908010198608 7 351908520566000 2 Kinem 5/12/1966 351908311259000 7

9 351908010198608 9 351908600369000 1 Sumiat 3/20/1969 351908221267000 2
10 351908010198726 8 351908700676001 8 Partni 6/30/1976 351908200369000 2
11 351908010198728 6 351908700639004 5 Atn 6/30/1939

12 351908010198773 1 351908500177000 3 Nuryat 1/10/1977 351908030875000 1
13 351908010199010 5 351908450376000 1 Sujiat 3/5/1976 351908100865000 5
14 351908020806024 2 351908630578000 1 Endang Susilowat 5/23/1978 351908050679010 0

15 351908020898399 0 351908550559000 1 Sumiatun 5/15/1959 351908180949000 1
16 351908030807042 8 351908600382000 1 Lilis Nurchayatun 3/20/1982 351908200273000 1
17 351908050608023 7 351908671079000 2 Sarminah 10/27/1979 351908131077000 1
18 351908051098120 1 351908411067000 1 Semi 10/1/1967 351908300657004 5
19 351908060607031 3 351908580767000 2 Musiani 7/18/1967 351908131167000 1
20 351908070915000 3 351908660290000 1 Arif Yuhana 2/26/1990

21 351908090297021 0 351908700668000 1 Suyani 6/30/1968 351908300960000 1
22 351908091208052 5 351908500683000 1 Parmi 6/10/1983 351908090884000 3

23 351908091298119 3 351908651062000 1 Jikem 10/25/1962
24 351908101012001 1 350624530289000 2 Novi Kusumadewi 2/13/1989 351908090787000 1
25 351908120798772 9 351908700651003 6 Rajiah 6/30/1951 351908300625003 4
26 351908140814000 2 351908550392000 1 Est Sulistani 3/15/1992 351908310391000 1

27 351908141114000 1 351908580588000 1 Lailatul Mukaromah 5/18/1988 350202120785000 1
28 351908150804028 1 351908511081000 1 Ida Purwat 10/11/1981 351908070578000 3
29 351908210513000 4 351908711082000 1 Erlyn Widyawat 10/31/1982 351909140786000 2

30 351908210706022 0 351908530678000 3 Wasri 6/13/1978 351908250481000 3
31 351908240407023 4 351908690375000 2 Retno Wardani 3/29/1975 351908201070000 3
32 351908241210003 6 351908501048000 1 Soeparmi 10/10/1948

33 351908250110002 6 351908551186000 1 Dyah Sulistyowat 11/15/1986 351908011084000 1
34 351908260314000 1 351908410989000 2 Dwi Siswat 9/1/1989 351908080488000 2
35 351908260698760 7 351908701258000 3 Warni 12/30/1958 351908110155000 1
36 351908270511261 8 351908510784000 1 Purmini 7/11/1984
37 351908270511284 3 351908541087000 1 Ika Tri Rahayu 10/14/1987 351908060985000 2
38 351908270911000 7 351908441065000 3 Siyem 10/4/1965 351908150268000 1
39 351908280410016 6 351908591278000 1 Nur Wahyuningsih 12/19/1978 351908201275000 1
40 351908281003026 0 351908581155000 1 Partni 11/18/1955 351908120354000 1
41 351908301109077 3 351908480884000 3 Hayin Farida 8/8/1984 351908151182000 1
42 351908301109077 4 351719480391000 2 Zuliana 3/8/1991 351908280685000 4
43 351908280198399 8 351908481170000 1 Sutyem 11/8/1970 351908300668000 9
RT 04
1 351908010198015 4 351908560172000 1 Nurhasanah 16/01/1972 351908061166000 1

2 351908010198015 8 351908631072000 1 Kasiyat 23/10/1972 351908160172000 1
3 351908010198016 6 351908700665001 4 Tarinem 30/06/1965 351908311254000 2
4 351908010198016 7 351908410663000 1 Sunart 01/06/1963 351908300657001 1
5 351908010198118 4 351908410570000 1 Misri 01/05/1970 351908020165000 1

6 351908010198161 8 351908410569000 1 Wart 01/05/1969 351908090163000 1
7 351908010198162 1 351908420365000 1 Wakirah 02/03/1965 351908301259000 3
8 351908010198397 3 351908470776000 3 Astutk 07/07/1976 351908100573000 1
9 351908010198607 9 351908410170000 3 Karminah 01/01/1970 351908311264000 4

10 351908010198608 1 351908470477000 3 Kamini 07/04/1977 351908020973000 2
11 351908010198760 4 351908711264000 8 Djami 31/12/1964 351908311257000 7
12 351908041103026 4 351908550177000 1 Sit Roliyah 15/01/1977 351908061274000 1
13 351908041109073 5 351908631186000 1 Suwart 23/11/1986 351908160684001 0

14 351908041213000 1 327605700668000 7 Lasmini 30/06/1968 351907300670000 9
15 351908070414000 3 331006420486000 2 Ninik Aryani 02/04/1986 351908010383000 1
16 351908070998161 7 351908441268000 1 Partni 04/12/1968 351908250864000 2
17 351908071005027 0 351908610782000 1 Maryani 21/07/1982 351908110771010 0

18 351908080313000 2 351908490691000 2 Yuni Indarwat 09/06/1991 351908120480000 4
19 351908090811000 9 351908460781000 1 Winart 06/07/1981 351908171182000 2
20 351908091214000 2 320105600196000 7 Sit 20/01/1996 351908060991000 1
21 351908100309012 4 351908561187000 1 Rina Utama 16/11/1987 351908111184000 1
23 351908131113000 1 351908700790000 1 Sumarni 30/07/1990 352008311290000 1
25 351908180810034 7 351908551279000 1 Darsini 15/12/1979 351908140385000 3
26 351908180915000 1 351908430164000 2 Suryani 03/01/1964
27 351908190809060 4 351908480386000 1 Purwat 08/03/1986 351908130978000 1

28 351908210212001 6 351908430287000 1 Sulasri 03/02/1987 351908080685000 3
29 351908290305006 2 351908530383000 1 Sit Chomsiyah 13/03/1983 351908280873000 1
30 351908290910038 3 351908610682000 3 Supart 21/06/1982 351908200380000 5
32 351908300810035 7 351908560985000 1 Susilowat 16/09/1985 351908090582000 5
33 351908310599025 4 351908690978000 2 Wiwin Winarni 29/09/1978 351908281172000 3
RT 05
1 351908010198163 3 351908530969000 1 Partni 13/09/1969 351908200564000 4

2 351908010198163 4 351908570771000 1 Suryaningsih 17/07/1971 351908121267000 1
3 351908010198164 0 351908410674000 1 Kart 01/06/1974 351908010665000 2
4 351908010198165 0 351908450175000 1 Suparmiasih 05/01/1975 351908030571000 2
5 351908010198165 6 351908700664003 0 Darsini 30/06/1964 351908040854000 1
6 351908010198165 7 351908511172000 1 Sujiat 11/11/1972 351908011264000 1

7 351908010198169 5 351908550565000 1 Salbiah 15/05/1965 351908240453000 2
8 351908010198728 5 351908510576000 4 Endang Istni 05/11/1976 351908300666001 7

9 351908020207003 7 351908700677000 6 Sukari 30/06/1977 351908301168000 1
10 351908020506014 3 351908630470000 2 Sri Yatun 23/04/1970 351908100166000 3
11 351908020598169 1 351908520374000 3 Suminem 03/12/1974 351908311275000 5
12 351908040707035 9 351908621080000 2 Yeni P 22/10/1980 351908070979000 1
13 351908040815000 1 351908580784000 2 Supiyah 18/07/1984 351908080472000 1
14 351908050112000 4 351908640680000 1 Sutari 24/06/1980 351908200170000 2

15 351908050498165 1 351908530475000 2 Ismiratun 13/04/1975
16 351908050913000 1 351908590370000 2 Pani 19/03/1970 351908160358000 2

17 351908060899015 4 351908410273000 2 Lestari 02/01/1973 351908141276000 2
18 351908060905023 8 351908300404000 2 Mamik S 05/11/1982 351908200975010 0
19 351908070109000 5 351908470985000 2 Rumiatn 09/07/1985 351908061182000 2

20
21 351908081206035 2 351908570985000 1 Darmini 17/09/1985 351908010176000 1
22 351908100112000 5 351908540688000 4 Sit Aminah 14/06/1988 351908140687000 1
23 351908120503011 1 351908570875000 4 Eni Tugiart 17/08/1975 351908020266000 3
24 351908120798163 9 351908410663000 4 Warsi 06/01/1963 351908050754000 1
25 351908140514000 3 352004541190000 2 Deni Purwat 14/11/1990 351908200684000 2

26 351908150513000 1 332213561295000 2 Catur K 16/12/1995 351908110788000 1
27 351908160212000 2 351908450881000 2 Sant 08/05/1981 351908160978000 1
28 351908161202010 5 351908520654000 4 Sudarmi 06/12/1954 351908120650000 3
29 351908180198166 2 351908680462000 1 Sulistyani 28/04/1962 351908061059000 1
30 351908181011000 3 351908540189000 1 Yant 14/01/1989 351908060387000 1
31 351908190309013 9 351908630188000 1 Lanjar Ismiat 23/01/1988 351908130869000 2
32 351908250113000 4 351908670493000 1 Wahyu Ningsih 27/04/1993 351914030493000 2
33 351908260112001 6 351908410671000 1 Suliyat 06/01/1971 351908240470000 3
34 351908261114000 1 351908680387000 1 Sumarmi 28/03/1987 351914100387000 1
35 351908270511288 6 351908480972000 3 Sumarsih 09/08/1972 351908240470000 4
36 351908281107000 2 351908650171000 1 Panikem 25/01/1971
37 351908290513000 1 351908570686000 1 Wika Paristri 17/06/1986 357302290987000 4
RT 06
1 351908010198013 6 351908550768000 4 Karminah 15/07/1968 351908151066000 4
2 351908010198013 7 351908100444000 1 Yatrun 04/10/1944

3 351908010198014 4 351908700669000 3 Siyem 30/06/1969 351908051271000 1
4 351908010198017 2 351908520869000 5 Suyat 08/12/1969 351908270565000 1

5 351908010198118 2 351908450771000 4 Sutnah 07/05/1972 351908170769000 4
6 351908010198272 7 351908460570000 1 Sit Umirowiyatun 05/06/1970 351908051067000 1

7 351908010198273 3 351908411270000 1 Sumirah 12/01/1970 351908300660002 4
8 351908010198397 7 351908711269000 4 Sri Utami 31/12/1969 351908060966000 2
9 351908010198398 0 351908670167000 1 Lamini 27/01/1967 351908011262000 2

10 351908010198608 0 351908610776000 1 Atn Setyowat 21/07/1976 351908020374000 1
11 351908010199005 5 351908660873000 2 Patminingsih 26/08/1973 351908131069000 2
12 351908010709049 1 351908470484000 4 Yun Wahyuningsih 04/07/1984 351908280177000 5

13 351908020207003 6 351908430477000 1 Lindri Safitri 04/03/1977 351908050775000 6
14 351908020711000 7 351908610589000 2 Sit Samsiyah 21/05/1989 351908190888000 1

15 351908021009067 9 351908411281000 1 Sit Nurohmah 12/01/1981 351908101075000 6
16 351908021014000 6 351908421050000 1 Sringatun 10/02/1950
17 351908021209078 4 351908491185000 2 Anik Supriat 11/09/1985 351908230184000 1

18 351908031005026 3 351908450769000 8 Umiyat 07/05/1969 351908010766000 1
19 351908051108046 1 351908701274000 2 Lely Dyah P 30/12/1974 351908150975000 3
20 351908081204002 0 351908650277000 1 Suparmi 25/02/1977 351908300477000 1

21 351908090505010 0 351908480873010 0 Windart 08/08/1973 351908010173000 1
22 351908100214000 3 351908601189000 1 Diyah Rochanis 20/11/1989 352010240687000 1
23 351908101115000 2 351915471179000 1 Fera Qonita 11/07/1979 351908030183000 1
24 351908110509022 2 351908590383000 1 Rifa'atn 19/03/1983 351908251276000 1
25
351908110512000 1 351908590684000 2 Siyamsih 19/06/1984
26 351908120503011 5 351908500282000 2 Triana 02/10/1982 351908020765000 1
27
28 351908131299013 0 351908650476000 1 Hari Murtni 25/04/1976 351908020874000 1

29 351908140103000 9 351908600579000 1 Suwari 20/05/1979 351908190271000 2
30 351908150805021 2 351908450481000 2 Jumiat 04/05/1981 351908290878010 0
31 351908160910036 7 351908560481000 1 Sugiat 16/04/1981 351908100579000 1
32 351908170910037 0 351908670680000 2 Munawaroh 27/06/1980 351908300576000 1
33 351908171012000 2 351908631253000 1 Parni 23/12/1953
34 351908190809060 3 351908600678000 1 Sumini 20/06/1978 351908130376000 2
35 351908200114000 1 351907460189000 1 Asmining 01/06/1989 351908230974000 1
36 351908200704019 6 351908521268000 2 Rusmiat 12/12/1968 351908150265000 2
37 351908221111000 3 351908500677000 1 Yatni 06/10/1977 351908300680000 1

38 351908230212000 9 351908670780000 1 Dwi Purwant 27/07/1980 351908200978000 3
39 351908230309014 6 351908530989000 1 Suliyat 13/09/1989 351908040487000 3
40 351908230506016 3 351908670978000 2 Eni Nurnayat 27/09/1978 351908030571000 1

41 351908231105003 7 351908511176000 1 Sumarni 11/11/1976 351908060174000 1
42 351908270511265 4 351908540278000 4 Partni 14/02/1978 351908010578000 1

43 351908270511285 4 351908520185000 2 Sofiah 01/12/1985 351908250584000 1
44 351908280298608 2 351908520471000 4 Sit Umiat 04/12/1971 351908120863000 2
45 351908280706023 0 351908551281000 1 Lilis Sa'adah 15/12/1981
46 351908290512000 1 351908640704000 1 Martni 25/01/1983 351908311275000 2
47 351908290998013 8 351908530977000 1 Tarmi 13/09/1977 351908110874000 1

48 351908310112000 5 351908531089000 1 Rahayu 13/10/1989 351908060789000 2
49 351908010198273 1 351908441176000 1 Rusmini 11/04/1976 351908270176000 1
50 315908251198397 8 351908650767000 3 Umiyat 25/07/1967 351908281164000 1
RT 07
1 351908010100051 5 351908511258000 2 Saminem 11/12/1958

2 351908010198166 9 351908700662001 9 Saliyem 6/30/1962 351908170860000 2
3 351908010198609 1 351908601078000 1 Nurul Khotin 10/20/1978 351908030870000 1
4 351908010198625 2 351908630965000 1 Sit Maryam 9/23/1965 351908121256000 2
5 351908010198625 8 351908711256001 4 Samsiyah 12/31/1956 351908311248000 6
6 3519088010198728 3 351908500268000 1 Sri Suryat 2/10/1968
7 351908020798274 2 351908700653005 6 Kabibah 6/30/1953
8 351908090115000 1 352215660685000 4 Dewi Suryant 6/26/1985 352215120580000 7
9 351908091110045 8 351908431275000 1 Imelda Wiwin 12/3/1975 3519088310571000 1

10 351908110314000 1 351908540675000 1 Sit Julaikah 6/14/1975
11 351908111104028 4 351908521077000 1 Gunart 6/5/1976 351908011269000 3
12 351908150310010 3 351908700488000 1 Eni Romalia 4/30/1988 351908160685000 3

13 351908161014000 2 351908490580000 2 Sutni 5/9/1980 351908170472000 2
14 351908161215000 3 351908470292000 1 Purwat 2/7/1993 351908161215000 3
15 351908180515000 1 351908450692000 3 Ari Saputri 6/5/1992 351908091191000 1
16 351908180609044 7 351908011007000 2 Anis Sunani 10/12/1982 351908160880000 1
17 351908200109003 4 351908701286000 1 Laelatul Masruroh 12/30/1986 351908220284000 1

18 351908210212001 2 351908570781010 0 Dewi Anita 7/17/1981 351908020371000 4
19 351908211004026 8 351908700879000 1 Tri Agustna 8/30/1979 351908190874000 3
20 351908211114000 3 351908570195000 1 Zuqni Qurotul U 1/17/1995 351908050989000 2

21 351908220714000 3 351908460889000 1 Mamik Tri S 8/6/1989 351908110287000 2
22 351908230308000 5 351908550176000 5 Nurul Munawaroh 1/15/1976 351908290766000 3
23 351908230308000 6 351908640275000 1 Sit Munari 2/22/1975 351908151276000 1
24 351908230308000 7 351908440569000 3 Kasiyah 5/4/1969 351908251267000 3
25 351908230308000 9 351908480763000 2 Samirah 7/8/1963 351908170560000 1

26 351908240713000 2 351908500587000 1 Sit Masula 5/10/1987 351912210880000 1
27 351908250110002 7 351908640278000 1 Martwi 2/24/1978 351908160375000 2
28 351908250512000 3 351908450772000 1 Lis Wahyuni 7/5/1972 351908030169000 2
29 351908251115000 6 180202690693000 3 Tri Surani 6/29/1993 351908301092000 1

30 351908270511273 1 351908470582000 4 Pujiat 5/7/1982 351908240973000 3
31 351908280207010 2 351908500482000 1 Susiana 4/10/1982 351908260282000 1
32 351908281014000 1 351908520184000 1 Zainatul Musriani 1/12/1984 351908130177000 2
33 351908290609048 0 351908550979000 1 Suryani 9/15/1979 351908090781000 2

34 351908311204030 8 351908701268000 4 Sit Samsiyah 12/30/1968
RT 08
1 351908010100051 0 351908610362000 2 Nyanem 21/03/1962 351908020651000 1
2 351908010198167 0 351908560970000 1 Wiwik Widart 16/09/1970 351908230858000 1
3 351908010198167 9 351908711263000 4 Sumiat 31/12/1963

4 351908010984000 7 351908410658000 2 Sukesi 01/06/1958 351908311254000 5
5 351908010198625 3 351908580660000 2 Srimini 18/08/1966 351908220466000 1
6 351908010199004 9 351908700645006 9 Tukinem 30/06/1945 351908131238000 1
7 351908010199021 7 351908701254000 4 Tuminem 30/12/1954
8 351908010199021 8 351908550968000 2 Sit Kusmiat 15/09/1968 351908271268000 1
9 351908010199050 9 351908711265001 2 Minarsih 31/12/1965 351908300662005 1
10 351908020309010 7 351908520776000 3 Part 07/12/1976 351908110779000 2
11 351908021014000 2 352204600891000 1 Porini 20/06/1991 351908160784000 1

12 351908040110000 2 351908471087000 2 Iswant 10/07/1987 351908081283000 4
13 351908050908038 4 351908580478000 2 Harini Al Fatmatul 18/04/1978 351908080672000 1
14 351908070105000 6 351908700777000 2 Sumiyat 30/07/1977 351908231275000 1
15 351908070198400 8 351908651285000 2 Amsaroh 25/12/1985 350213279286000 1

16 351908110609041 0 351908540382000 3 Anjarwat 14/03/1982 351908250882000 4
17 351908150310010 4 351908610986000 1 Samatun 21/09/1986 351908280884000 1
18 351908151199050 8 351908470555000 2 Istkomah 05/07/1965 351908100553000 1
19 351908190799005 1 351908470574000 3 Sri Sumart 05/07/1971 351908150770000 1
20 351908201112000 5 351908490984000 1 Catur Sept H 09/09/1984 351908050483000 2
21 351908210104003 0 351908550267000 1 Nuraini 15/02/1967 351908150462000 1
22 351908210212001 5 351908430586000 1 Sit Marchammah 05/03/1986 351908290681000 2

23 351908220814000 1 351908590286000 2 Wahyu Peni 19/02/1966 340103190576000 1
24 351908230913000 1 351908610786000 2 Samsul Hidayah 21/07/1986 330121171183000 6
25 351908240407023 5 351908700784000 2 Dahlia Tri W 30/07/1984 351908030271000 1
26 351908240899046 3 351908420673000 1 Murtni 06/02/1973 351908040467000 2
27 351908241210002 2 351908411269000 2 Suyatmi 12/01/1969

28 351908250504016 0 351908580873000 3 Nurjanah 18/08/1973 351908150673000 4
29 351908250612000 7 351908440684000 2 Tant Sudaryant 06/04/1984 351908100677000 2

30 351908251100051 3 351908680985000 2 Sri Murtatk 28/09/1985 351908231276000 1
31 351908261112000 3 352003620692000 3 Khotm Wulatul 22/06/1992 351908240687000 1

32 351908270511279 0 351908621080000 3 Indah Sulistyowat 22/10/1980 351908101277000 5
33 351908270711000 7 351908630785000 2 Mira Tunusikah 02/03/1980 351908030280000 1
34 351908270912000 4 351908210605000 3 Robiyatun 03/03/1976 351908100974000 2
35 351908271112000 2 351908670708000 2 Nubina 20/08/1987 351908061081000 3

36 351908300307019 0 351908641174000 2 Sri Mariyat 24/11/1974 351908201264000 2
37 351908300598167 4 351908700660001 7 Watyah 30/06/1960 351908300655001 9
39 351908301014000 1 351909570789000 5 Nur Wahyudi 17/07/1989 351909060383000 2
40 351908311204030 9 351908580468000 2 Khomsatun 18/04/1968
41 351908311208054 9 351908480173000 2 Arminingsih 01/08/1973 351908011270000 3

41 3519080101990250 351908640370000 2 Dwi Endang S 24/03/1970 351908160773000 2
42 351908110609040 8 351908440480000 1 Yeni Retno W 04/04/1980 351908230680000 1
RT 09
1 351908010198609 3 351908581061000 2 Suyat 18/10/1961 351908050653000 1
2 351908010198761 3 351908131169000 2 Sunarmi 12/31/1969 351908080466000 1

3 351908010198761 4 351908450568000 4 Sulami 5/5/1968 351908170761000 1
4 351908010199025 5 351908500692000 2 Sit Nuraini 23/06/1971 351908241068000 1

5 351908010199057 1 351908610569000 2 Sit Fatmah 21/05/1969 351908110961000 2
6 351908020209004 9 351908430186000 1 Mar'atul Fikriyah 3/1/1966 351908100675000 2
7 351908020309010 8 351908570882000 2 Ita Noor Aini 17/08/1982 351908090284000 2
8 351908020608022 8 351908490680000 1 Nurul Hidayat 9/6/1980 351908250382000 3

9 351908021013000 3 351909690989000 4 Dwi Yuliana 29/09/1989 351908220283000 1
10 351908021111000 1 351908530876000 1 Darwat 13/08/1976 351908041074000 2
11 351908050413000 3 351909600887000 1 Suprihatn 20/08/1987 351908020585000 1
12 351908051010039 0 351908710188000 2 Ade Munarwat 31/01/1988 351908200787000 1
13 351908051114000 1 357703620584000 2 Ika Sundari 22/05/1984
14 351908060608024 6 351908470380000 2 Utami 7/3/1980 351908120370000 4
15 351908080998273 9 351908610867000 1 Siyami 21/08/1967 351908150859000 1
16 351908100498761 5 351908700653004 2 Sukart 30/06/1953 351908150452000 2

17 351908101108046 7 351908680982000 3 Welas Asih 28/09/1982 351908240472000 3
18 351908110609040 9 351908500979000 2 Kholipah 10/9/1979 351908131177000 1

19 351908110614000 4 351803671089000 1 Khoirul M N 27/10/1989 351908080389000 1
20 351908110997102 1 351908700659002 4 Samiyen 30/06/1959 351908151157000 1
21 351908121211000 6 351908411082000 1 Sit Masruroh 1/10/1982 351908280582000 4
22 351908130298609 5 351908480177000 1 Ismiatun 8/1/1977 351908300664002 4
23 351908140509024 4 351908521276000 1 Sri Kusnari 12/12/1976 351908041173000 1
24 351908140514000 2 351908540987000 1 Anik Nuraeni 14/09/1987 351004200580000 4

25 351908140514000 4 351908140514000 4 Robiyah 10/6/1974 351908300664001 4
26 351908140612000 7 351908550982000 2 Lutviyah I 15/09/1982
27 351908150904024 0 351908440474000 2 Samiat 4/4/1974 351908170975000 2

28 351908160603014 3 351908511261000 1 Sasmiat 11/12/1961 351908010457000 3
30 351908161215000 2 351908690581000 2 Winart 29/05/1981 351908020973000 3

31 351908190514000 1 351908190514000 1 Maratul R 14/04/1984 351910100879000 5
32 351908190809060 5 351908430281000 5 Nuryant 3/2/1981 351908030880000 2
33 351908191108049 1 351908430677000 1 Kusnul Khotmah 3/6/1977 351908060177000 1

34 351908211010042 2 351908650187000 2 Dwi Handayani 25/01/1987 351908031284000 1
35 351908220514000 1 351908711270000 3 Putkah 31/12/1970
36 351908231211001 0 351908510482000 2 Maslikah 11/4/1982 351908200176000 2
37 351908240112000 7 351908511186000 1 Noviana D 11/11/1986 351908120583000 1

38 351908240197102 3 351908660675000 1 Indun Muawiyah 26/06/1975 351908060870000 1
39 351908250498773 6 351908700369000 1 Indart 30/03/1969
40 351908270212000 5 351908681283000 2 Sit Khotjah 28/12/1983 351908080381000 1
41 351908270511266 4 351908490792000 1 Bidayatus Zharo 9/7/1990 351908211184000 1

42 351908270511268 2 351908270511268 2 Mujiah 3/6/1979 351908290968000 2
43 351908271014000 2 351907591185000 4 Alfiyani 19/11/1985 351907100576001 0
44 351908280313000 1 351908540883000 2 Abidah Nuryana 14/08/1983 351908240181000 2
45 351908280509032 2 351908710383000 1 Widayant 31/03/1983 351908171280000 1

46 351908281107000 8 351908420371000 1 Sit Muaroh 2/3/1971 351908220768000 1
FORMAT PENDATAAN PUS
TAHUN 2017
Nama Tanggal Lahir NIK Anak Nama JK Tanggal Lahir
Satu 06/08/1972 351908311200000 2 Alfin Sofyan Anwari L 31/12/2000

Suprapto 08/11/1956 351908501094000 1 Elen Pramana Dina S P 10/10/1994
Sikin 03/05/1965
Trimo 05/10/1964 351908670295000 1 Istrokah P 27/02/1995
Zudianto 29/03/1971 351908481086000 1 Jesica Anggraini P 08/10/1996
Sudarno 10/11/1963 351908561296000 2 Sri Tri Rahayu P 16/12/1996
351908140107000 1 Sri Dimas Bayu A L 14/01/2007
351908471208000 2 Sri Five Nurvahyani P 07/12/2008
Sudarto 09/11/1963 351908511191000 2 Indah Novita P 11/11/1991
351908101210000 1 Desta Tridira Putra L 10/12/2010
Kasirin 12/08/1952 351908281085000 1 Puguh Supriyadi L 28/10/1985
351908631291000 4 Dini Choirina P 23/12/1991
351908420412000 1 Dhanis Gea Putri A P 02/04/2012
Sudiro 27/11/1967 351908230697000 2 Junaidi Bima P W L 23/06/1997
351908570603000 2 Nur Ajeng Prasetyo W P 17/06/2003
Sidiq Suwantoro 27/11/1976 351908671205000 1 Nadia Tifara Sidiq P 27/12/2005
Tamiyo 16/06/1971 357703550709000 3 CCinta Ayu Rahmia P P 15/07/2009
Pujianto 06/05/1972 351908610413000 1 Adna Agatha Fujian Y S P 21/04/2013
Ismail 07/02/1977 351908080402000 3 Ferry Nur Rokhim L 08/04/2002
351908620809000 2 Erlina Suci Amalia P 22/08/2009
Supriyanto 13/02/1981 351908470913000 1 Eiliya Azlin Septana P 07/09/2013
Ebiet Eko Sutkno 15/05/1975 351908660110000 1 Atayana Khafidzah S P 26/01/2010
351908480214000 1 Az-zahra Khalifah S P 08/02/2014
Agus Purwanto 10/07/1981 350724490908000 6 Mutara Kusuma R P 09/09/2008
350724040511000 3 Mahesa Wira Kusuma L 04/05/2011
Sutajab 10/09/1978 351908670301000 1 Nafiliyatuzzakiyah P 27/03/2001
Pujianto 28/10/1975 351908221201000 2 Nursidik Alianto L 22/12/2001
351908570312000 1 Zizi Sayidina Alianto P 17/03/2012
Fatkurahman 20/10/1984 351908490712000 1 Kamaliyatul Fauziyah A P 09/07/2012
Supadi 28/06/1970 351908200499000 2 Martnus Enddy A P L 20/04/1999
351908630995000 1 Lisa Septani Putri P 23/09/1995
Suparmin 06/09/1970 351908580705000 1 Wanda Widya A P 18/07/2005
Warjuki 01/10/1974
Wahyudi Rahman 20/05/1982 351908200203000 2 Muhammad Raka Y L 20/02/2003
351908180413000 2 Muhammad Muslih F L 18/04/2013
Hari Cahyono 14/01/1982
Kicuk Aris Dianto 29/10/1978 351908451005000 1 Arisma Putri R P 05/10/2005
Adita Candra K 09/08/1989 351908240515000 2 Khaizan Azka El Gibran L 24/05/2015
Suwardi 27/09/1968 351908520904000 1 Alif Wahyu N L 12/09/2004
Kamto 31/12/1965 351908630804000 1 Nesya Dwi Agustna P 23/08/2004
Suprianto 09/11/1975 351908110998000 4 Anggi Septawan L 11/09/1998
351908100408000 4 Aldo Nurcahyanto L 10/04/2008
Iskak 07/02/1977
Eko Setyawan 09/02/1989 351908450310000 3 Zekina Setyaning P 05/03/2010
Achmad Nasirudin 13/07/1986 351908070812000 1 Fildan Haidir L 07/08/2012
Bambang Budianto 09/09/1973 351908060100000 2 Ramadhani Rizqianto L 06/02/2000
351908080608000 4 Faris Fadrian 08/06/2008
Sudarpo 11/10/1958 351907201290000 4 Munirul Ichwan L 20/12/1990
351907651203000 1 Muflichatul Karimah P 25/12/2003
Akbar Sampurna A 09/03/1995
Agus Rokhani 05/05/1990 351908270115000 1 Aditya Rafa Hamizan L 27/01/2015
Suwito 13/08/1973 351908121008000 1 Faris Alfa Reza L 12/10/2008
Lasidi 09/01/1972 351908031298000 2 Eka Budi Prayoga L 02/12/1998
351908200904000 1 Doni Gemilang S L 20/09/2004
Ibnu Biantoro 04/08/1979 351908311211000 1 Ahmad Fauzan F B L 31/12/2011
Didik Purnomo 15/04/1985 351908030511000 1 Arosyiid Abi P L 03/05/2011
Moh. Sholeh 30/06/1960 351908530993000 2 Mami Ulil Azizah P 13/09/1993
Suwarno 05/07/1960 351908570290000 1 Eli Ernawat P 17/02/1990
351908650398000 2 Neni Herlina P 25/03/1998
351908650398000 1 Nina Herlina P 25/03/1998
Arianto 18/08/1989 351908211114000 1 Nufandi Zidha P L 21/11/2014
Sarji 7/8/1970 35190812059703 2 Nur Cahyo Odi S L 5/12/1997

351908290408000 1 Nur Rifan L 4/29/2008
Panimun 7/1/1955 351908550385000 1 Ipuk Setyo Rahayu P 3/15/1985
351908090395000 1 Fajar Bayu P L 3/9/1995
351908610486000 1 Maria Maqdalina P 4/21/1986
Salim 8/16/1964 351908130595000 1 Yusuf Azizal Alim L 5/13/1995
Suparman 6/30/1949 351908010680000 1 Heru Sugianto L 6/1/1980
351908010183000 2 Purwanto L 1/1/1983
351908430886000 1 Kusyant P 8/3/1986
Tarjiono 8/2/1969 351908030594000 2 Jainal Tohirin L 5/3/1994
Paiman 12/16/1963 351908651192000 1 Endah Setyo Rahyu P 11/25/1992
Bambang Siswanto 9/30/1967 351908110707000 1 Galah Awang K L 7/11/2007
Partman 10/3/1964 351908490193000 1 sit mutoharoh p 1/9/1993
Maryanto 12/13/1967
warsito 10/10/1982 351908431007000 1 felliarta aurida p 10/3/2007
juari 12/30/1957 351908680701000 1 indah ayuningtyas p 7/28/2001
lugiantoro 12/1/1972 351908411215000 2 nikyesa p 12/4/2015
andhi kusuma 1/29/1983 351908570413000 1 khanza aqilla p 4/17/2013
351908180714000 1 kenzo algazha l 7/18/2014
suharto 4/19/1981
samidi 6/16/1972 351908050702000 1 devran abin k l 7/5/2002
351908180608000 1 sabhara tegar l 6/18/2008
351908670213000 1 lidia happy y p 2/27/2013
darwanto 9/2/1986 351908250108000 1 jahfal habib p L 1/25/2008
ari siswanto 1/13/1982 351908010509000 1 raditya nur z L 5/1/2009
351908200315000 1 Nafis Fazil l 3/20/2015
Karmun 6/5/1943 351908460887000 1 betty wulandari k L 8/6/1987
351908170890000 1 choirul huda k L 8/17/1990
351908211194000 1 Damanhuri k L 11/21/1994
Dimas Raga S 1/31/1990 351908651012000 2 Indi malika A P 10/25/2012
Matori 10/5/1974 351908640101000 3 marya ulfa P 1/24/2001
351908500903000 4 Sept nur bet p 9/10/2003
351908500490000 1 indah tri rahayu p 4/10/1990
351908300795000 1 Danang Wijanarko L 7/30/1995
Pardo 2/9/1965
Tri Harno 4/18/1981
Budhi Hartojo 8/9/1964 351908050315000 1 Erlangga raditya L 3/5/2015
hermanto 12/21/1989 351908700313000 1 Anayra herka s P 3/30/2013
Prasetyo andrianto 8/3/1981 351908230312000 1 Wisnu Raffi S L 3/23/2012
Kusnendar 6/15/1976 351908470710000 1 Olivia Zahra L 7/7/2010
Arga Ari Aji 7/20/1984 351908060912000 1 Azzam Rizqullah L 9/6/2012
Bayu Segara 4/15/1990 351908150312000 1 Alip Ega Raditya L 3/15/2012
351908130512000 3 Yodha Masaccio J L 5/13/2012
351908130212000 2 Yoga Masaccio J L 5/13/2012
Agustnus S 1/19/1977 351908500102000 1 Frista Arin M P 1/10/2002
351908210814000 1 Satria Abiyasa L 8/21/2014
Tohari 1/3/1969 351908210296000 1 Sulistyo Sejat L 2/21/1996
Suprapto 11/8/1977 351908510604000 2 Sheirlly A p 6/11/2004
351908691012000 1 Deva Aulia A P 10/29/2012
Kajad 1/11/1969 351908290292000 4 Yogik Iskandar L 2/29/1992
351908510812000 1 Jelita Ramadana p 8/11/2012
351908680786000 1 Galuh Tri Y p 7/28/1986
351908310701000 4 Dika Yulianto L 7/31/2001
Yasmidi 2/13/1969 351908430793000 1 Yest Marsela M P 7/3/1993

351908640401000 1 Pupung Puspita P 4/24/2001
Gumbreng 12/31/1955 351908230280000 1 Gunawan Wibisono L 2/23/1980
351908630993000 1 Rumit Setyani P 9/23/1993
Sardji 6/30/1927 351908580101000 1 Khomariyah P 1/16/2000
Sumardi 7/25/1960 351908700687000 3 Yuni Marginingsih P 6/30/1987
Adi Suparno 6/30/1950 351908660792000 1 Leni Sefi Herlinawat P 7/26/1992
Madi 6/30/1953 351908430495000 1 Sukent P 4/3/1995
Ahmad Yahmin 7/23/1977 351908120703000 3 Bagus Zakaria L 7/12/2003
351908150509000 1 Bayu Aji Saputra L 5/15/2009
Samirin 12/31/1959 351908690589000 2 Juwika Setyaningsih P 5/29/1989
Soewardi 12/22/1967 351908021202000 1 Krisna Bayu P W L 12/2/2002
Marwan 3/20/1969 351908620995000 1 Lusi Septaningrun P 9/22/1995
351908200505000 2 Leo Prasetyawan L 5/20/2005
351908700694000 4 Rosita P 12/10/1993
Suwarto 8/3/1975 351908511297000 1 Desi Murlinda Ayu S P 12/11/1997
Markam 8/10/1965 351908630594000 1 Erika Susant P 5/23/1994
351908530108000 4 Friska Dewi N P 1/13/2008
Iswahyudi 6/5/1979 351908100706000 1 Firman Juliar L 7/10/2006
Salam 9/19/1949 351908630891000 1 Endah Purwat P 8/23/1991
Sukirin 2/20/1973 351908660707000 1 Khafria Wahyuningrum P 7/26/2007
Hariyanto 10/13/1977 351908110604000 3 Rian Bagus C L 6/11/2004
351908680814000 1 Ayumna Tabina A P P 8/28/2014
Samirin 6/30/1957 351908490882000 1 Puji Astut P 8/9/1982
351908571091000 1 Tri Nurhayat P 10/17/1991
Rohmat 11/13/1967 351908610295000 2 Elsita Lisnawat P 2/21/1995
351908100900000 2 Dimas Yuda Pratama L 9/10/2000
351908150410000 2 Aril Waskito Aji L 4/15/2010
Edi Suryanto 9/30/1960 351908501196000 1 Eriana Sulistyani P 11/10/1996
351908290104000 1 Edwin Sulistyanto L 1/29/2004
Muhammad Ismail 8/9/1984 351908491105000 1 Intan Permata Sari P 11/9/2005
351908710393000 1 Ratna Indah Setyorini P 3/31/1993
Widiyantoro 7/9/1987 351908511213000 1 Chelsea Salsabilla A P 12/11/2013
Taman 6/30/1925 351908311271000 1 Harsono L 12/31/1971
351908690493000 1 Sri Hartni P 4/29/1993
Muhammad Riduan 3/31/1991 351908230514000 2 Kenzo Mayvero D L 5/23/2014
Sujarno 10/27/1983
Supriadi 5/7/1978 351908680705000 1 Nadia Wahyu W P 7/29/2005
351908020914000 1 Tetuko Wahyu S L 9/2/2014
Teguh Purwanto 7/14/1986 351908080613000 1 Naufal Khairul A L 6/8/2013
Heru Prasetyo 4/25/1981 351908650404000 1 Yoga Wahyu Nur H L 4/25/2004
Priyono 10/20/1970 351908181095000 2 Jerry Yusuf Ardya A L 10/18/1995
351908540397000 2 Sella Marda Piscesa P 3/14/1997
351908180307000 1 Ahmad Soefyan P S L 18-03-1007
351908550877000 1 Rumiat P 8/15/1977
Teguh Susanto 10/1/1984 351908110907000 2 Aditya bagus Pratama L 9/11/2007
Arik Priambodo 4/8/1988 351908570314000 1 Mahira Hasna P P 3/17/2014
Tamin 1/11/1955 351908490290000 2 Winart P 2/9/1990
351908670111000 1 Keyla Rizka Zilvana P 1/27/2011
Rely Anton P 9/6/1985 351908020411000 2 Agha Bevan Reskianto L 4/2/2011
Sahar 2/15/1968 351908440769000 2 Ines Har Anita P 7/4/1996
Rantok 12/20/1975 351908040702000 1 Eko Wijayanto L 7/4/2002
Salam 3/12/1954 351908580980000 1 Nurul Rohmah P 9/18/1980
Nanang Nurcahyo 11/15/1982 351908301207000 3 Alvin Nur Musyaffa L 12/30/2007
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Heru Cahyono 25/03/1982 351908490808000 2 Alifia Khoirunnisa P 9/8/2008
Moch Klasin 22/02/1983 351908190412000 2 Senatrya Widyatmika L 19/04/2012
Umar 4/10/1974 351908530298000 1 Fitri Noer L P 13/02/1998
Qodarul Muntaha 2/5/1985 351908070913000 1 Nahim Minhajul Mufid L 7/9/2013
Deni Wahyu Utomo 20/07/1987
357703540912000 1 Chundrike Dyah A P 14/09/2012
Suparlan 12/3/1970 351908111102000 1 Rehan Maulana L 11/11/2002
351908530708000 2 Zahra Hilda Yulia P 13/07/2008
Radi 15/08/1959 351908040888000 2 Yogik Hermato L 4/8/1988
351908450898000 1 Denik Ageng P P 5/8/1998
Sunaryo 15/04/1952 351908550394000 1 Atk Restana P 15/03/1994
Rochim 24/04/1972 351908100703000 3 Hamim Wafi A L 10/7/2003
351908541007000 2 NafisRiyadhul J P 14/10/2007
Dwi Endro S 13/11/1977 351908161205000 2 Muhammad Yudha L 16/12/2005
Hawwin M 8/3/1989 351908571014000 2 Zidna Khuliatal A P 17/10/2014
Wakidjo 15/11/1957 351908650898000 1 Tutk Rahmawat P 25/08/1998
Suyadi 28/05/1982 351908280312000 3 Azka Athaya R L 28/03/2012
Subakir 30/06/1964 351908070900000 4 Samsul Mu'arif L 7/9/2000
351908480102000 1 Alfi Salamah P 8/1/2002
Ayis Gunaris 4/11/1973 351908490799000 3 Ningtyas Gunaimanah P 9/7/1999
351908191203000 1 Haidar Rozaan A L 19/12/2003
Andik Dwi E 20/05/1980 351908501213000 1 Faiza Alya D P 10/12/2013
Tohir 30/06/1964
351908041109000 2 Alfino Yusuf L 4/11/2009
351908470511000 3 Alfina Lailatul P 7/5/2011
Habib Mahruf 17/09/1975 351908110799000 1 Awalul Roziqqi L 11/7/1999
Jumadi 1/4/1957 351908650584000 3 Eli Ningsih P 25/05/1984
351908101087000 3 Jatmoko L 10/10/1987
351908081191000 3 Zaini L 8/11/1991
351908650503000 1 Risma Anggriani P 25/05/2003
Abdul Fatah 2/9/1973 351908150702000 4 Muhammad Nailil F L 15/07/2002
Joko Sugeng 10/08.1979 351908510914000 1 Naura Almira P 11/9/2014
Anwarudin 3/8/1980 351908020604000 2 Pratama Wahyu L 2/6/2004
351908200411000 2 Panji Fian L 20/04/2011
351908261112000 1 Afriza Rizky L 26/11/2012
Sapto Hari P 6/1/1977 351908021108000 1 Faisal Ahmad L 2/11/2008
Yogi Seiaji 3/12/1984 351908660811000 1 Chania Putri L 26/08/2011
351908230399000 1 Ahmat Sanusi L 23/03/1999
Winoto 20/01/1976 351908501103000 4 Fara Aulia A P 10/11/2003
351908080609000 4 Bagus Ilham L 8/6/2009
Wahyu Kusuma 12/5/1983
Budiono 6/8/1970 351908270297000 1 Awangku Muhammad L 27/02/1997
351908700654001 4 Fara Nur Arifa P 24/01/2000
351908160396000 1 Samsul Hadi L 16/03/1996
351908230900000 3 Amarudin L 23/09/2000
Bararudin 8/3/1981 351908020806000 1 Muhammad Aviecena L 2/8/2006
351908150113000 1 Muhammad Roji L 15/01/2013
Suhardi 21/11/1984 351908190211000 1 Zairyl Abdul R L 19/02/2011
Sunaryo 29/09/1968 351908030606000 2 Syeh Muhammad G L 3/6/2006
351908580213000 1 Rani Alvum M P 18/02/2013
Sumiran 10/5/1976 351907251105000 2 Irfan Abdul L L 25/11/2005
351908480715000 1 Nabilla Himmatur P 8/7/2015
Mohammad S 24/01/1981 351908150805000 1 Dhika Firmansyah L 15/08/2005
351908540209000 2 Varin Rizky M P 14/02/2009
Edi Purwanto 17/12/1980 351908090708000 1 Muhammad Wahyu F L 9/7/2008
Sugiyatm 22/07/1968 351908541099000 2 Nur Halimah P 14/10/1999
351908550108000 1 Ririn Fiani P 15/01/2008
Metode KB Ket (kronis,Gakin)
S -
Menopause
S -
PIL
S -
PIL
PIL
Menopause
Hamil
Suntk
MOW
Suntk
Suntk
Suntk
Tidak KB
PIL
Tidak KB
IUD
Janda
Suntk
IUD
Suntk
Suntk
Suntk
Suntk
Implant
Suntk
Suntk
Suntk
Implant
Implant
Suntk
Tidak KB
Tidak KB
Suntk
Suntk
Suntk
IUD
Suntk
Menopause
Kondom
Suntk
Suntk
Menopause
Menopause
Menopause
Tidak KB
Menopause
Suntk
suntk
IUD
pil
suntk
suntk
suntk
IUD
IUD
Suntk
Menopause
Suntk
Menopause
Menopause
Suntk
Suntk
Suntk
iud
suntk
IUD
IUD
Janda
tdk Kb
suntk
MOW
Menopause
janda
Suntk
Menopause
Menopause
Menopause
MOW
Menopause
Suntk
IUD
Menopause
MOW
Suntk
Menopause
Pil
Suntk
Menopause
Suntk
Janda
Suntk
Suntk
Menopause
Suntk
Menopause
Tidak KB
Tidak KB
Suntk
Hamil
Suntk
MOW
Pindah
IUD
Menopause
Suntk
Suntk
Menopause
Tidak KB
Menopause
Suntk
Suntk
Suntk
Tidak Kb
Tidak Kb
Menopause
Menopause
Tidak Kb
PIL
Suntk
MOW
Suntk
Suntk
Menopause
IUD
Suntk
MOW
Suntk
IUD
Suntk
Suntk
Hamil
Suntk
Suntk
Suntk
IUD
Menopause
Suntk
Suntk
Suntk
Suntk
Suntk
Tidak KB
Tidak KB
Pil
Blm KB
Kondom
Menopause
Tidak KB
Menopause
Tidak KB
Tidak KB Hypertensi
Suntk
Suntk
Suntk
Suntk
Tidak KB
Tidak KB
Pil
Pil
Tidak KB
Suntk
Suntk
Suntk
Suntk
MOW
Tidak KB
Suntk
Suntk
MOW
MOW
Suntk
Suntk
Suntk
Tidak KB
Suntk
MOW
Tidak KB
Suntk
MOW
Menopause
Suntk
Tidak KB TKW
MOW
Tidak KB
Suntk
Tidak KB
Menopause
Tidak KB
Tidak KB
Suntk
MOW
Suntk
Suntk
Menopause
IUD
Suntk
IUD
PIL
Suntk
Suntk
Tidak KB
PIL
Tidak KB
Suntk Janda
IUD
Suntk
Suntk
IUD
Tidak KB
Menopause
Suntk
Suntk
Suntk
Suntk
Suntk
IUD
Tidak KB
MOW
Tidak KB
Suntk
MOW
Tidak KB
MOW
Suntk
Suntk
IUD
Menopause
Menopause
Menopause
Implant
Menopause
Menopause
Menopause
Menopause
Suntk
Tidak KB
Janda
Suntk
PIL
Suntk
Suntk
Suntk
Suntk
Suntk
Suntk
Suntk
Tidak KB
Suntk
MOW
PIL
Suntk
Menopause
Suntk
Implant
Suntk
Suntk
Suntk
Hamil
Suntk
Janda
Suntk
Menopause
Menopause
Menopause
Menopause
Menopause
Menopause
Menopause
Suntk
Tidak KB Jantung
Menopause
Implant
Menopause
Suntk
PIL
Suntk
Tidak KB
Hamil
Suntk
Suntk
Tidak KB
Suntk
Suntk
Suntk
Suntk
Suntk
Menopause
-
Tidak KB
Tidak KB
Suntk
Suntk
Suntk
Suntk
PIL
-
Suntk
Suntk
PIL
Suntk
Menopause
Suntk
Suntk
Suntk
Menopause
PIL
PIL
Suntk
-
PIL
Suntk
PIL
Menopause
Suntk
PIL
Suntk
Tidak KB
Suntk
Tidak KB
PIL
IUD
Tidak KB
PIL
Suntk
Suntk
Suntk
Suntk
Suntk
Suntk
Suntk
TAHUN 2017
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
DESA : DEMPELAN
NO NO KK NIK ISTRI NAMA TGL LAHIR NIK SUAMI NAMA TGL LAHIR NIK ANAK NAMA ANAK L/P
1 3519080101985325 3519086309760001 SULIYEM 23/09/1976 3519081212690004 WARSITO 12/12/1969 3519082210940002 OKI MANSYURUDIN L
3519082509080001 FAJAR YUDHA .P L
3519085703110001 CANTIQA QHOLILA .G P
2 3519081006140001 3519085410920001 AYU CAHYATI 14/10/1992 3519071204840004 DODIK SETIAWAN 12/04/1984 3519082106140003 AZKA RASIKH ABBASY L
3 35190826050500126 3519085705810002 YAYUK LINDAWATI 17/05/1981 3519081011750004 MUH. MUJIB, ST 10/11/1975 3519081703050001 SATRIA IRZA.S L
351908690910001 ZAHRA SALSABILATSANI P
4 35190813071000282 3519086101850002 UTAMI WULANDARI 21/01/1985 3519081705830001 SUNARDI 17/05/1983 3519080304100001 MOCH RIZKY SAIFUDDIN L
5 3519082702120006 3519084404870001 SURYANI 04/04/1987 3519080303790001 SUTIKNO 03/03/1979 3519080108070002 ALLIN PUTRA .K L
6 35190801019805313 3519085809800002 SITI PRIHATIN 18/09/1980 3519080709730002 WARNO 07/09/1973 3519082512070001 ADITIA RANGGA .S L
7 35190817011100026 3519086707920002 YULIANI 27/07/1992 351908201288003 NAR ARIFIN 20/12/1988 3519085012100002 ALIFIA PUTRI .N P
8 35190801019805314 3519084801720001 NURUL HIDAYAH 08/01/1972 3519081509710001 SUWITO 15/09/1971 3519081411970002 ANANTA NUR .W L
3519086404110001 SELVI NURWITA .H P
9 351908250609464 3519084708820002 MUTIKAH 07/08/1982 3519081009740001 SUNARYO 10/09/1974 3519080306020001 IRFAN ARLIAN .R L
- NAYAFITRI SYAFIA .Z P
10 35190809111000456 3519086605760003 SUGIARTI 26/05/1976 3519082504750003 TINUS WIBISONO 25/04/1975 3519084312020002 ARMY SURYA G.W L
3519082210090001 ALREZKY DANU G.W L
11 3519080501120006 3519085108890001 AGUSTIN FITRIYANI 11/08/1989 351913070389002 SAMSI HIDAYAT 07/03/1989 - ZASKIA DEWI .R P
12 35190826050900296 351908500877002 JARWATI 10/08/1977 3519082610710001 SURATMAN 26/10/1971 3519080110070001 LANANG RAMADHAN L
13 35190822021000074 3519086410850003 TRI PURWANTI 24/10/1985 3519081005840001 HERU SETIYAWAN 10/05/1984 3519085503100001 JUWANITA PUTRI .S P
14 3519080509060280 3519086709830001 SRIYANI 17/09/1983 3519083107740002 MUJIONO 31/07/1974 3519080708060001 ARJUNA RADITYA EKA.S L
3519081604130001 RAFI' EVAN R L
15 35190801019803930 3519084101800001 HARTINI 01/01/1980 3519083112650005 PARMAN 31/12/1965 3519080805980001 SHANDY FIRMANSYAH L
3519084203050001 MAISYAROH ROSITAWATI P
16 3519082705112812 3519086008730003 SARINI 10/08/1973 3519080703670002 SULAIMAN 07/03/1967 3519081704970004 ANJAS ADY MARTA L
17 3519080910120001 3519065405910002 ATIK SANJAYA 14/05/1991 3519081107830002 ROMDHON FITRIADI11/07/1983 3519085808140001 SYAWALYA AINUN .M P
- MAHESWARI P
18 3519083007070413 3519085006750002 WIJI ASTUTIK 10/06/1975 3519081303730003 SUYOTO 13/03/1973 3519081309040003 MUH. HAMID FAUZAN L
19 3519082002120038 3519081303780001 SULASTRI 20/03/1978 3519081303760001 SAMIKUN 13/03/1975 3519081309120001 MUH. ERIKHO .P L
- LIKA TUNJUNG SARI P
20 3519083001140002 3519085902900001 HERI MURTININGSIH 19/02/1990 3519070510890002 ONGGO DWI .P 05/10/1989 3519081103140001 MARIO ANGGORO .P L
21 35190806020500001 3519086508790002 WIJI UTAMI 25/08/1979 3519080405700001 SUKARTONO 01/05/1970 3519086108090002 WIDYA RAMADANI P
22 3519080605050097 3519086404750100 RAHMI MEIGA 24/04/1975 3519080611680001 SUTARYONO 06/11/1968 3519086412050001 AMANAH AULIA P
3519086901150001 AZZAHRA ASYILA .R P
23 3519080210130001 3519086405820001 INDAH SULISTYOWATI 24/05/1982 35190306038100031ABID AMIRUL .M 06/03/1981 - - -
24 3519082207110007 3519087112870002 DEFI MARWATI 31/12/1987 3519082008820001 AGUS RIANTO 20/08/1982 3519082906110002 MUH. VIDIC .A L
25 3519083007130001 351908604910001 WIWIK WIJAYANTI 24/04/1991 351913807860001 SAIFUL ROSID 18/08/1986 3519082911130001 FARIZ NAUFAL .P L
26 3519082206860203 3519086809800002 SURYATI 28/09/1980 3519080105820002 HARTONO 01/05/1982 3519080306060001 GILANG SURYA .P L
3519086703130001 KAYLA AZZAHRA P
27 1201029900578 1201024104770002 01/04/1977 1201020512700002 SUGITO 05/12/1970
28 3519081305150004 3519085307890001 KUSWINARSIH 13/07/1989 3520081501880002 BASUKI ROHMAD 15/01/1988 - ELMAIKA QAHLAN P
29 35190822031100219 3519086608810002 RINI DWI SUSILOWATI 26/07/1981 3519081705750002 KOMARUDIN 17/05/1975 3519085808090002 ALFITA ANASTYA .F P
3519086010100001 ALMIRA ADELIA.F P
- ALISSA ANANDITA .F P
30 3519080504070206 3519084109830001 SRIATUN 01/09/1983 3519072810820003 HERU SUSENO 28/10/1982 3519086711060002 MICHEEL ANGELINE P
3519081903140001 DANENDRA NAUFAL L
31 3519080403400080 3519085003790001 AMINASIH 10/03/1979 3519082101760001 YAKUP 21/01/1976 3519086810990002 ANNIK MATURRODHIYYA P
3519084106050001 DHITA FUDHILA SAADAT P
- DHIFA FIDHILLA SAKDIYAH P
32 35190801080800344 3519084504790003 MARIANI 05/04/1979 3519081807740005 SAMUJI 18/07/1974 3519080511050001 ILHAMD FIDIYASA .P L
33 3519081203070144 3519086005810001 RINI YUNIASTUTI 20/05/1981 3519082704750001 AGUS PRASETYO 27/04/1975 3519085004070001 CINDY ANIZZA BULAN .P P
- ILYAS MAULANA B.P L
34 35190802020900048 3519084405850004 NURYANTI 04/05/1985 3519082507820004 SUPARMANTO 25/07/1982 3519084601090003 SEVIRA LUVIANTI P
35 3519081109130001 3519146008900001 RIDA MUSTIKANING 20/08/1990 3519081810910004 SUYADI 18/10/1991 3519082607140001 AIDAN RAFIF .R L
36 3519080101010019 3519085204770001 NAPSIAH 12/04/1977 3519082002710002 WARSONO 20/02/1971 3519086111980002 HIKMAH LAILATUL .Z P
3519084601090002 WAFA' IMROATUL .A P
3519080709120001 MUH. ROYYAAN .M L
37 3519081406050138 3519086107720001 PARTINI 21/07/1972 3519081103710002 NANANG SUGIYATNO11/03/1971 3519085211000001 ALIFIA NURAINI P
3519082808060001 ARIF NUGROHO L
3519082212130001 ADITIA NOUVAL .K L
38 3519080206982515 3519084601690002 SUPARMI 06/01/1969 3519080204640001 SUPARDI 02/04/1964 3519080407940001 SONY AJI PRASETYO L
3519080203030002 ERWIN DWI KURNIAWAN L
3519086210120003 DINAR PUTRI NUR. F P
39 35190820011100121 3519086203780004 DAMINI 22/03/1978 3519080203710007 GUNAWAN 02/03/1971 3519081003990001 MUH. ALI UDIN L
40 35190829061000267 3519084812850001 SRIANA 08/12/1985 3519081104810002 LAMIDI 11/04/1981 3519080906100003 ARIS FIANTO L
41 3519080101000136 3519084603690002 RUMINI 06/03/1969 3519083006640034 SUKIMIN 30/06/1964 3519080505900003 SUGENG RIYADI L
3519086510920001 LILIS CALISTA P
3519080510960004 WALOYO UTOMO L
3519084607010003 LILIK KUSUMAWATI P
3519081605080001 RAGIL BAGUS .P L
42 3519080406090355 3519087105830002 SRI HARMINI 31/05/1983 3519080102720006 SUWANTO 01/02/1972 3519085109070002 GIESTA HERDIANA .S P
- NAURA ANASTASYA .G P
43 3519082304080172 3519086011800002 ISTINI 20/11/1980 3519080201790001 SETIAWAN 02/01/1979 3519081807010003 DANI PRASETYAWAN L
3519086010110001 DEVITA BUNGA .R P
44 3519082702040074 3519084505810004 SUS SETYOWATI 05/05/1981 3519081211620002 SOEYANTO 12/11/1982 3519086104020001 EKA APRILIA .P P
3519085508100002 AFWA RISKIAH. R P
351908512130001 SURYA RAHMAT .T L
45 3519081602120006 3519084501820001 NUR WAHYUNI 05/01/1982 3519070604800005 PRIYONO 06/04/1980 3519086601120001 KEFANI ALIFAH .N P
46 35190802081000320 3519085701830001 PUJI ASTUTIK 17/01/1983 3519080607810002 SUTONO 06/07/1981 3519082807100001 DAVA ARIEL BRILLIYAN. P L
47 35190820100900715 3519080501850001 WINARNI 3519081810830001 WIRATNO 18/01/1983 3519085706090001 VEIRA CHELSEA NAVISTA P
48 3519082104050050 3519084601810002 ATIK SUHARYANTI 06/01/1981 3519080504770002 MUJIANTO 05/04/1977 3519085103060001 PRATIWI FEBRIANTI P
49 3519083011120002 3519086410830001 TITIK HASIATI 24/10/1983 3519080509830001 RIDWAN 05/09/1983 3519080204140001 FERDIAN WIBAWA .H L
50 3519083112140001 3520074104960001 TRI WAHYUNI 01/04/1996 3519081803890001 GUNAWAN 18/03/1989 - - -
51 35190820100900718 3519085207860001 YATI 12/07/1986 3519080808810001 SUHARTO 08/08/1981 3519084910090001 NASYWA SYAFIRA .R P
52 3519081105090220 3519084701740004 YAYUK SULISTYANINGSIH 07/01/1974 3519080604760002 ANDIK SUSILO .U 06/04/1976 3519086504010003 ALYA NAZMA .A P
53 3519083007090570 3519086403890001 SUSARININGSIH 24/03/1989 3519080207750001 PANGAT 02/07/1976 3519084910090002 AYUDYA PUTRI .N.S P
3519081611110001 ANWAN NUR FADHILA L
54 3519081106130007 3519086606930002 SRI ARUPIN 26/06/1993 3501100806870004 KATNI 08/06/1987 3519080310130001 RISKY SAPUTRA L
55 3519083112080548 3519084104730003 SARTI 01/04/1973 3519082512630001 TUKIMIN 25/12/1963 - - -
56 3519081610120001 3519085908910002 TRI AGUSTINA 19/08/1991 3519042502870001 TRIMONO 25/02/1987 3519082105130001 GALIH PRATAMA L
57 3519082202100073 3519085211780002 MARTINI 12/11/1978 3519082501780001 SUTAJI 25/01/1978 3519081110990003 IMAM SUGIANTO L
3519086303130001 CITRA URBANINGRUM P
58 35190801019805338 3519084402780002 GEMI 04/02/1978 3519083005690001 LASIMIN 30/05/1969 3519080507990001 YASIN YUSUF L
3519082212090001 ADDI NUGROHO L
59 351908260307180 3519085802780006 SUPRIATI 18/02/1978 3519081411690002 SURADI 14/11/1978 3519086401020001 ANNA RACHMAWATI P
3519086303130001 TSANIATUS SA'DIYAH P
60 3519080708120007 3519084706840002 JUMIATI 07/06/1984 359042603900005 ENDRO DWI .S 26/03/1990 - - -
61 3519082102120046 3519086604870001 SURYANTI 26/04/1987 3519080106860002 MEDIYAWAN 01/06/1986 3519087007110001 JULIA ZAHWA ANMEDYAN P
62 35190805051000180 3519085110830003 PARISAH 11/10/1983 3519080505790007 NYAMAT 05/05/1979 3519080501090001 ANDIKA PUTRA .P L
63 35190820060700351 3519085802760001 ENDANG SUSILOWATI 18/02/1976 3519082106790002 DJUDJUN SOELAEMA21/06/1979 3519081707040001 IQBAL MALIK IBRAHIM L
3519082201100003 AKBAR RAFSANJANI L
64 3519081201090012 3519086805860003 NURUL INDRAWATI 28/05/1986 3519082812800003 JAELANI 28/12/1980 3519080809070004 JAUWAN RAFID AL-FARISI L
3519080909070003 JAUWAN RAFIS AL-FARISI L
3519086508120001 AIRA AZKA AL-FARISI P
65 3519081706050149 3519086611840001 SRIYANI 20/11/1984 3519081808780002 HERIYANTO 18/08/1978 3519081105050001 BAGAS PUTRA .P L
3519084304140002 AKIFA NAYLA PUTRI P
66 3519080206140003 3519086812810002 PARTINI 28/12/1981 3519080401760001 WAHYU TRIADI 04/01/1976 3519084212140001 GITA PRAWESTI P
67 35190827109802529 35190863057601000KOMSIATUN 23/05/1976 3519080107710002 TRIAMARGO 01/07/1971 3519082608030003 ACHAMD FAUZAN L
3519086303100001 FADHILAH KARIMATUL .A P
68 351908084985329 3519086709720002 SITI SUMARIAH 27/08/1972 3519081902710001 JUMADI BRAWOTO 19/02/1971 3519082808940001 MOCH. MAULIDI L
3519081005000001 RIZAL ALWI L
3519085309110001 DIYAH LUFIATUL NAIMAH P
69 3519081905050118 3519084202820002 PATEMI 02/02/1982 3519081503770003 SLAMET 15/03/1977 3519081008040001 AHMAD RIFKI ILHAMI L
3519086704120001 CITRA ROHMATUL .H P
70 3519080810150002 6112096805870006 KAMISDAH 25/08/1987 3519081604830005 MUHYI PURWANTO 16/04/1983 3519082703100002 HENDRA EKA .S L
71 1201029803931 1201025008770001 SUMARSIH 10/08/1977 1201022501660001 PARNO 21/01/1966 1201026811960002 NOVI KADARWATI P
1201020501980002 IRWAN FAJAR .J L
TGL LAHIR METODE KB KET(KRONIS,
GAKIN)
22/10/1994
25/09/2008 SUNTIK
17/03/2011
21/06/2014 IMPLAN
17/03/2005
SUNTIK
29/09/2010
4/3/2010 IMPLAN
01/08/2007 IMPLAN PBI
25/12/2007 - PBI
10/12/2010 SUNTIK
14/11/1997 SUNTIK
24/04/2011
03/06/2002 IMPLAN
10/03/2014
03/12/2002 SUNTIK
22/10/2009
10/08/2012 SUNTIK
15/03/2010 SUNTIK
07/08/2006 SUNTIK
16/04/2013
08/05/1998 SUNTIK PBI
02/03/2005
17/04/1997 IUD
18/08/2014 -
-
13/09/2004 SUNTIK
13/09/2012 SUNTIK
31/08/1999
11/03/2014 IMPLAN
24/12/2005 SUNTIK
29/01/2015
- -
6/29/2011 SUNTIK
29/11/2013 SUNTIK
03/06/2008 -
27/03/2013
30/01/2016 SUNTIK
18/07/2009 MOW
20/10/2010
26/07/2015
27/11/2006 SUNTIK
19/03/2004
28/10/1999 SUNTIK
01/06/2005
01/06/2005
05/11/2005 SUNTIK
10/04/2007 SUNTIK
17/08/2012
06/01/2009 SUNTIK
26/07/2014 SUNTIK
21/11/1998 IMPLAN
06/01/2009
07/09/2012
12/11/2000 SUNTIK
28/08/2006
22/12/2013
04/07/1994 SUNTIK
02/03/2003
22/10/2012
09/06/2010 IUD
05/05/1990 SUNTIK
15/10/1992
05/10/1996
05/07/2001
16/05/2008
11/09/2007 SUNTIK
09/08/2014
18/07/2001 SUNTIK
20/10/2011
15/08/2010
05/12/2013
26/01/2012 SUNTIK
28/07/2010 SUNTIK
17/06/2009 SUNTIK
11/03/2006 MOW
02/04/2014 SUNTIK
- SUNTIK
25/04/2001 SUNTIK
09/10/2009 SUNTIK
16/11/2011
03/10/2013 SUNTIK
- SUNTIK
21/05/2013 SUNTIK
23/03/2013
05/07/1999 SUNTIK
22/12/2009
24/01/2002 SUNTIK
17/10/2010
- -
30/07/2011 IMPLAN
05/01/2009 SUNTIK
17/07/2004 MOW
22/01/2010
08/09/2007 SUNTIK
08/09/2007
25/08/2012
03/04/2014 IMPLAN
03/04/2014
02/12/2004 IMPLAN
26/08/2003 IMPLAN
23/03/2010
28/08/1994 SUNTIK
10/05/2000
13/09/2011
10/08/2004 SUNTIK
27/04/2012
27/03/2010 IMPLAN
05/01/1998
FORMAT PENDAT
TAHUN 20
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
DESA : DIMONG
NO NO KK NIK ISTRI NAMA TGL LAHIR NIK SUAMI

1 3519084312870001 PURNINDASARI 03/12/1987 3519081605780001
2 3519086208690001 SAMINI 22/08/1969 3519082905600001
3 3519086509690001 SUWATI 25/09/1969 3519080112640002

4 3519085003800001 HARMINAH 10/03/1980 3519081803720001
5 3519087107840003 IDA SUNARTI 31/07/1984 3519081705820001
6 3519086109790001 LASMINI 21/09/1979 3519082303730002

7 3519085902820001 SULISTIANI 19/02/1982 3519080808690001
8 3519086406830002 SRIANINGSIH 24/06/1983 3519081707740002
9 3519085710790004 SRI GUMANTI 17/10/1979 3519082206830001

10 3519084302800001 SUNARTI 03/02/1980 3519080203810001
11 3519086404830002 ATIK 24/04/1983 3519081803700002
12 3519087006680051 MISRI 30/06/1968 3519080505660003
13 3519084812800001 KASIANI 08/12/1980 3519080805800005
14 3519086307730003 SUNARSIH 23/07/1992 3519082808660002
15 3519084503770002 TUMINAH 05/03/1977 3519081504720001
16 3519084812680004 KASINEM 08/12/1968 3519080703660002

17 3519085503830001 WARTINI 15/03/1983 3519081808790003
18 3519085703800002 SRI RAHAYUNINGSIH 17/03/1980 3519082803780001
19 3519085205680002 LASMINI 12/05/1968 3519080707560002

20 3519082106760002 SULIKAH 17/06/1976 3519082106760002
21 3519084906910003 DEINOVIA 09/06/1991 3519150812860002

22 3519155409850002 YULI LESTARI 24/09/1985 3519151801840001
23 3519084301840001 MURTIANI 03/01/1984 3519023105810002
24 3519084912890002 LINA NURJANAH 09/12/1989 3519082310810002
25 3519086304890001 TATIK RAHAYU 23/04/1989 3519082401900001
26 3519084804880003 YUYUN DWI .A 08/04/1988 3519082407850003
27 3519126109880003 ERNAWATI 21/09/1988 3519081906870001
28 3519086806840002 HETTY .M 18/06/1984 3519080906820001
29 3519085405780002 PURWANTI 14/05/1978 3519081902730001
30 3519087004710001 SARIYEM 30/04/1971 3519081510620001
31 3519085808840003 SRI WINDARTI 18/08/1984 3519082411830001

32 3519076111840005 UMI ROHMATIN 11/11/1984 3519072503810003
33 3519084803800002 SUDARSIH 08/03/1980 3519081011700002
1 3519085103890001 MUNAWAROH 11/03/1989 3519080503750001

2 3519085905690001 SUMARMI 19/05/1969 3519080707680001
3 3519085708800002 TUSMIATIK 17/08/1980 3519081207770001
4 3314122308880007 MUDMAINAH 03/08/1988 3519082008790005

5 3519085904790001 SRI ASTUTIK 19/04/1979 3519080912800003
6 3519084406900002 DWI PURWANTI 04/06/1990 3519081206890003
7 3519085002950002 RIKA NURHUDAIFAH 10/02/1995 3505212208920001
8 3519086306780002 SINAH 23/06/1978 3519080509770002
9 3519086107840004 RATNA SRI WAHYUNI 21/07/1984 3519080412830007
10 3519084401830001 IKA SRI ASTUTI 04/01/1983 3519080703830001

11 3519086405760002 HARUMI 24/05/1976 3519080705750001
12 3518035008860012 BINTI ZULAIKAH 10/08/1985 3518030906770003
13 3519084603750001 SUMARMI 06/03/1975 3505221508730002

14 3519086508740001 AGUSTINA RIRIN .H 25/08/1974 3519082810710001
15 3519086804770001 ISTIANI 28/04/1977 3519080707770005
16 3519086302840001 UMIATUN 13/02/1984 3519120306820002
17 3519086001920003 YUNDARI 20/01/1992 3519081511840001
18 3519085410830002 PUJI ASTUTIK 14/10/1983 3519080802820002
19 3519084912810003 SUMARNI 09/12/1981 3519081408820005
20 3519085207710002 SUMINI 12/07/1971 3519080703650001
21 3519085910890002 DEWI LESTARI 19/10/1989 3519080908820002
22 3519085509720002 KARTINEM 15/09/1972 3519081511690002
23 3519085412800003 KHUSNUL KHOTIMAH 14/12/1980 3519080402740001

24 3519084909750001 SUDARTI 09/09/1975 3519080708680001
25 3519086906720001 SUYATMI 29/06/1972 3519083006630008
26 3519036110900003 RELI DWIYANTI 21/10/1990 3519081708880001

27 3519085510850001 SUTINI 15/10/1985 3519080406920003
28 3519086208920001 ATIK WIJAYANTI 20/08/1992 3519080707860001
29 3519087011800001 JINEM 30/11/1980 3519080604820001
30 3519084712750001 SAMINI 07/12/1975 3519083006650001
31 3519084908760001 SUNITI 09/08/1976 3519082605710002
32 3519084204760001 BATIN 02/04/1979 3519081905700001
33 3529014612820001 SRI WAHYUNI 06/12/1982 3519082100370002

34 3519085707820004 NIKMATUL MAISAROH 17/07/1982 3519083101700001
35 3519084310810101 SUMARYANI 03/10/1981 3519080907790003
36 3519086005780001 BIBIT PUJI LESTARI 20/05/1978 3519082902760001
37 3577016910910003 A'AM HAROCHMANIAH 29/10/1991 3519080601870003
38 3303056802740001 SULIS ANJAYANI 25/02/1974 3303050902760002
1 3519084404800002 SURATI 04/04/1980 3519081101800001

2 3519086104750001 YUMARO 21/04/1975 3519081904700001
3 3519085007740001 LASMINI 10/07/1974 3519080103650001
4 3519084610860002 HARTINI 06/10/1986 3519082311820002

5 3519087007870002 INDAH NUR YULIATIN 30/07/1987 3519082408890001
6 3519084211730001 NANIK YULIATI 02/01/1973 3519082510720001
7 3519105205900001 BINTI MAHMUDA 12/05/1990 3519082704830001

8 3519086308820001 UMI KHASANAH 13/08/1982 3519081404710001
9 3209306310880003 LINA LESTIANA 23/10/1988 351908100900001

10 3519086502700001 SUMIRAH 25/02/1970 3519080808660001
11 3519085203920001 HARI PURWANTI 12/03/1992 3519051303920004

12 3519084210800002 ANISSAH 02/10/1980 3519080104810002
13 3519084804860005 SRI UNTARI 08/04/1986 3519512612830003

14 3519085112730001 PARTINI 11/12/1973 3519080610690001
15 3519085507780008 SITI KASANAH 15/07/1978 3519080403700004
16 3519085508790001 SUPARMI 15/08/1979 3519080318100001

17 3519085604810002 MUJIYATI 16/04/1981 3519082608730002
18 3519085807710001 PURWANTINI 18/07/1971 3519080711640001
19 3519085310720001 SITI MUAWANAH 13/10/1972 3519082802730001
20 3519085302700001 WANTI 13/02/1970 3519080403650001
21 3519086703730003 RENI AKHIR MUJIHARI 27/03/1973 3519080304690001
22 3519085502730004 SUGIARTI 15/02/1973 3519081204700002

23 3519084105930001 TRI MEI NINGSIH 01/05/1983 3519082205830001
24 3519085802690001 FARIDA MIATI.S 18/02/1969 3519081706670001
25 3519084508770001 SUTARNI 05/08/1977 3519080704660002
26 3519081207700001 MURTINI 14/04/1975 3519081207700001

27 3519085201740001 SUNARTI 12/01/1974 3519081506630002
28 3519080806700002 MARINTEN 15/01/1978 3519080806700002
29 3519086605880001 PUJIASIH 26/05/1988 3519081808810001

30 3519084101770004 MARTUTIK RAHAYU 01/01/1977 3519080709700006
31 3519155308870001 NENI 13/08/1987 641010104860002
32 3519084109680001 MARYAM 01/09/1968 3519080210610001
33 3519084608850002 DENI SETIANINGSIH 06/08/1985 3519082011800001

34 3519085412690001 KASINEM 14/12/1969 3519083006640015
35 3519085207830001 SUMIATUN 12/07/1983 3519080908700001
146
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TAHUN 2017
NAMA TGL LAHIR NIK ANAK NAMA ANAK L/P TGL LAHIR
SUPRIANTO 16/05/1978 351908105100001 SYAHTARA PRINDA .T L 31/05/2010
SUTAJI 29/05/1960 3519080507880002 EKO BUDI SANTOSO L 05/07/1988
3519086505010001 ANITA DWI LESTARI P 25/05/2001
SUBUR 01/12/1964 6471031810910004 EDI PURWANTO L 18/10/1991
RASIM 18/03/1972 3519084403000002 VIQIH AL FINAH L 04/03/2000
3519086711030001 FITRI RAHMAWATI P 27/01/2003
- AKBAR ARJUNA P.A L 14/03/2015
DARWANTO 17/05/1982 3519086705090001 AZKA ZUMALA .M P 27/05/2009
- ZULFA NUT .M P 22/04/2015
ROHMADI 23/03/1973 3519080902050002 BAGAS ADI .S L 09/02/2005
SUJARWO 08/08/1969 3519084809010002 NINIS SEPTI FATIKASARI P 08/09/2001
- DAVID KHAVIANO L -
SAMINO 17/07/1974 3519081908090001 FADLI BAGUS MARSENO L 19/08/2009
3519086905110001 SEFIA MEILANA .P P 19/05/2011
3519087006640056 TASMINEM P 30/06/1954
SUHARDI 22/06/1983 3519082701050002 MARCHEL SURYA .S L 27/01/2005
JARWO 02/03/1981 3519086705130002 CELIN MEISYA .A P 27/05/2013
PAIMUN 18/03/1970 3519080104030002 BAYU ADI PUTRA L 01/04/2003
SAIMUN 05/05/1966 3519080611900001 RUDIK NOVATAH L 06/11/1990
SARIONO 08/05/1980 3519086002070001 RISMA FEBRIANA .P P 20/02/2007
3519085103400001 REIFA DIAH RAMADHANI P 02/09/2009
WASIRIN 28/08/1996 3519080510920002 ARIO NASTY PRAMUDI L 05/10/1992
3519085612080001 AMANINA KAYASA .P P 16/12/2009
KASMIKO 15/04/1972 3519085006040001 RENDHA PUSPITA .W P 10/06/2004
3519081707130002 KAHFI INSANA .R L 17/07/2013
SUDARNO 07/03/1966 3519081712110001 FAJAR BENIH .S L 17/12/2011
DARMAN 18/08/1979 3519086911030001 ELSA NOVIA .W P 29/11/2003
HERI KUNARTO 28/03/1978 3519086311040001 CALYA ANINDYA .P P 23/11/2004
3519080612050004 DESTIO BINTANG .A L 06/12/2005
3519083105100001 KURNIA AKBARA .N L 31/05/2010
KUSNO 07/07/1956 3519085501920001 SULIS PURWANTI P 15/01/1992
REBIYANTO 21/06/1976 3519085001970001 MELINA SAHUMI .W P 10/01/1997
3519087005030001 MARDIKA AYU .A P 30/05/2003
3519080209040001 ALFIN TEGUH .P L 02/09/2004
DIDIK YATMIKO 08/12/1986 3519082412120001 RIDHO IQBAL .J L 24/12/2012
GAGUK SUPRIANTO 18/01/1984 3519152812110001 RAFA PRATAMA .Y L 28/12/2011
ANDOKO 31/05/1981 3519082707110001 HENDY DIMAS .F L 27/07/2011
JOKO SUWITO 23/10/1981 3519081908120001 MUH. RUSTHON .G L 19/08/2012
BAMBANG RONI .W 24/01/1990 3519084307140001 NAURA AUFALYA .A P 03/07/2015
SULISTYAWAN 24/07/1985 3519081305090002 FAUZAN EKA .M L 13/05/2009
SUKENDAR 24/07/1985 3519086812090001 ERDHINA RAISSYA .V P 28/12/2009
SUBIARTO 16/06/1987 3519084612130001 MADIA ARTA .G L 06/12/2009
SUROYO 09/06/1982 3519081005010003 ALMAS IKO .F L 10/05/2001
3519080106070003 RADIT FANTU .N L 01/06/2007
SUPARMAN 15/10/1962 3519084308910001 RIRIN PUJI .L P 03/08/1991
3519085104000001 YUYUN MANDASARI P 11/04/2000
SUGENG HARIYANTO 24/11/1983 3519085411030001 YECHINTA DEVI .R P 14/11/2003
SUYANTO 25/03/1981 3519085508120002 DELIA AGUSTINA P 15/08/2012
NYONO 10/11/1970 3519081204040001 WILI KHASPRILA P 12/04/2004
WITO 05/03/1975 3519082203080002 ERFAN EKA YULIANTO L 22/03/2008

DARNO 07/07/1968 3519081708960001 BAGUS DWI NURCAHYO L 17-8-10-1996
SULARNO 12/07/1977 3519083010070001 MAHFUDZ SOFYAN .R L 30/10/2007
3519086101150003 MAHFUDZOH AFIF .M L 11/01/2015
IMAM MUSLIM .M 20/08/1979 - - - -
BUDI UTOMO 09/12/1980 3519081503040002 RADHIKA SILANAL W.U L 15/03/2004
EKO MUJIANTO 12/06/1989 3519084404100001 GIANA APRILIA .M P 04/04/2010
AGUS HARYONO 22/08/1992 3519085207140001 ALVIANI NUR .R P 12/07/2014
SUPARLAN 05/09/1977 3519086206000001 WENNI LESTARI P 22/06/2000
WINARKO 04/12/1983 3519084205070002 AZ-ZAHRA ZULEYKA .R P 02/05/2007
3519080512120002 ALVARO INZAGHI L 05/12/2012
SUKARDI 07/03/1983 - - - -
SUNARDI 07/05/1975 3519082807000002 WISNU MAHENDRA L 28/07/2000
3519085103070001 SASHA RINDI P 11/03/2007
SOLIKIN 09/06/1977 3518033007100003 MOH. ABDULAH FAKIH L 30/07/2010
3519084411140002 HUURUL QURROTA A'YUN P 04/11/2014
WIDIANTO 15/08/1973 3519086607970001 JENI AYU SAPUTRI P 25/07/1997
UNARDI 28/10/1971 3519084105960001 ROSALINA DYAH PUTRI .M P 01/05/1996
STEFANUS 07/07/1977 3519080907020001 BAYU SURYA .P L 09/07/2002
AGUS SUGIANTO 03/06/1982 3519087005030002 SEVIRA PUTRI .M P 30/05/2003
BUDIANTO 15/11/1984 3519080206100001 REHAN ADITYA B.P L 02/06/2010
WASIS SETIYO .P 08/02/1982 3519085412080002 IRSYA NUR AFIFAH P 14/02/2008
SUGIANTO 14/08/1982 3519081301140001 YOGA ADI SATRIYA L 13/01/2014
SUPARDI 07/03/1965 3519085508970001 AGUSTINA P 15/08/1997
SURATMAN 09/08/1982 3519083009100002 SEPTIAN AJI .S L 30/09/2010
MARSIKUN 15/11/1969 3519081507960001 ARIF WAHYU .S L 15/07/1996
3519082107050001 DAVA RIZKI ARDANA L 21/07/2005
3519085011090001 NOFITA DIA SAPITRI P 21/07/2009
- RIO ADITYA L 11/02/2005
SUNARDI 04/02/1974 3519080804020002 SIGIT BACHTIAR L 08/04/2002
SUPARNO 07/08/1968 3519082011970002 PUGUH PRIAMBODO L 20/11/1997
3519084702080004 NABELA VIFATMASARI P 07/02/2008
DASAR 30/06/1963 3519084508920001 PITRI AGUSTINA P 05/08/1992
3519084608000002 EVIA AGUSTIN P 06/08/2000
AGUS WIBOWO 17/08/1988 3519086308130002 FARREN AULIA PUTRI .W P 23/08/2013
MARIJAN 04/06/1982 3519086909110001 SEPTI PERMATASARI P 28/09/2011
DONA SOIM 07/07/1986 - - - -
SUMINO 06/04/1982 3519085406120002 AURELIA WAHYU .R P 14/06/2012
SUKIMIN 30/06/1965 3519084402970001 SRIATUN P 04/02/1997
ARIFUDIN ULIYAH 26/05/1971 3519082606990001 MUH. RIZKI GINANJAR L 26/06/1999
3519080508070002 AHMAD FATONI A.S L 05/08/2007
PANIMIN 19/05/1970 3519080806000001 TONI PRANATA L 08/06/2000
3519081701050002 ADI BUDI UTOMO L 17/07/2005
3519080606140001 MOH. TEGAR L 05/05/2014
SARWO EDI 21/03/1973 - SYAHRUL AJI .D L 21/05/2015
MUJIONO 31/10/1970 3519085010050001 OKTA RUWIYANTI .D P 10/10/2005
AGUS HARIANTO 09/07/1979 3519080904050003 RIZAL ADI .P L 09/04/2005
BUDI SANTOSO 29/02/1976 3519080906970001 BIMA ADITYA .P L 09/06/1997
SUMIWAN 06/01/1987 - - - -
SUWARNI 09/02/1976 3303052102130001 ARKAN FAEYZA .N L 21/02/2013
KARNANTO 11/01/1980 3519085204050001 SHAFA EKA ANDRIAN P 12/04/2005

SUWITO 19/04/1970 3519085303970001 NITA ARUM PUTRI P 13/03/1997
3519086501050001 FADILA DWI ARUM .P P 25/01/2005
SUJITO 01/03/1965 3519085201940001 DANI NURAINI .S P 12/01/1994
3519084106010001 ANDINI WAHYU .N P 01/06/2001
BAGUS IRAWAN 23/11/1982 3519082201150001 MIKAIL GILANG .N L 22/01/2015
AGUS SUNARTO 24/08/1989 3519083001090001 SYAHRIL WAHYU .R L 30/01/2009
SUPARLAN 25/10/1972 3519080405950001 RIKI YOGA NAINAKI L 04/05/1995
3519086410070003 OKTAVIANA KAYLA TRI .A P 24/10/2007
SURATNO 27/04/1983 3519080503120002 ALVIN ARGYANAQA L 05/03/2012
SURADI 14/04/1971 3519086101050001 YUYUN SURYA .A L 21/01/2005
3519083006100001 MUH. KHOIRUL .A L 30/06/2010
SUGENG RIYADI 10/01/1990 3519080408130001 NAYLA RAHMADANI .P P 04/08/2013
SARMIN 08/08/1966 3519082111930001 ROQIM MUSTOFA L 21/11/1993
3519081704050001 NUR ARIFIN L 17/04/1995
DIKA ARNA 13/03/1992 3519085102150002 ICHA REGINA PUTRI .A P 11/02/2015
JOKO PATMIN 01/04/1981 3519080411050002 DIMAS ARI .P L 04/11/2005
3519081905130001 FAIZAL DWI HUTOMO L 19/05/2013
HARTONO 26/12/1983 3519081907130003 MUH. CHOIRUL AKBAR L 19/07/2013
SUWAJI 06/10/1969 3519086010020002 RULI ARUM SARI P 20/10/2002
PARTONO 04/03/1970 3519080303000004 HUSAIN ABDUL .R L 03/03/2000
3519084705110003 MAYDA LUTFIANA.A P 07/05/2011
CHOIRUL MUSTOFA 03/01/1981 3519082002050002 FERDIAN NUGRAHA .C L 20/02/2005
HARIANTO 26/08/1973 3519081405980001 AOLENDRA HARDIANTO L 14/05/1998
3519080708000001 ALDIANSYAH PUTRA .H L 07/03/2000
3519084206040002 ANISA JUNAINDAH .P P 02/06/2004
3519080402120001 AL MAULANA .N L 04/02/2012
SARDI 07/11/1964 - - - -
SUPRIYONO 28/02/1973 3519085909990003 DEWI AZAM P 19/09/1999
SUYADI 04/03/1965 3519084903920001 RISTA VINDU .P P 09/03/1992
3519086003080001 MELANI P 20/03/2008
SARMAN 03/04/1969 3519086203050001 RIVIA MARSADAH P 22/03/2005
3519086701110002 SHAFA RAUDHATUL .J P 27/01/2011
SUTOPO 12/04/1970 3519085308970001 AYU DINAR LESTARI P 13/08/1997
EKO WAJAR .S 22/05/1983 3519086112070001 DESTIA ALIFTA .P P 21/12/2007
3519084712110001 AZIZA PUTRI AZALIA P 07/12/2011
RIDO 17/06/1967 3519087007000004 ANGGRAINI MUDHUASIH P 30/07/2000
3519082306060002 MIDHONO ADI KOTTANA L 23/06/2006
SARIYONOHADI 07/04/1966 3519084311990003 VIANTA MANDALIKA L 03/11/1999
3519086708080001 RADHIDHA RINGGANDANI P 27/08/2008
LAMIJO 12/07/1970 3519081808960001 BAYU PRASETYA L 18/08/1996
SUGINO 15/06/1963 3519085711950001 YULI HANDAYANI P 17/11/1995
3519081805120001 ADITYA ZHAKY .N L 18/05/2012
SUMINO 08/06/1970 3519086904010003 DHEA NOVITA P 29/04/2001
3519085601130001 AYUNDA RETNO .P P 16/01/2013
AGUS PURWANTO 18/08/1981 3519081410110001 REVAN SYAHPUTRA .P L 14/10/2011
SABARUDIN 07/09/1970 3519080509990002 MOH. TORENCE .D L 05/09/1999
SUPARIYANTO 01/04/1986 3519080808140001 FAYREL ATTARIZZCALIEF .A L 08/08/2014
PARMAN 02/10/1961 3519085303880002 ENI PUJI .A P 13/03/1988
3519082010940001 AGUS DWI JATMIKO L 20/10/1994
SUPARNO 29/11/1980 3519085208080001 NADIA P 12/08/2008
KAERAN 30/06/1964 3519085011020002 IDA JESYCA ROMADANI P 10/11/2002
SUWANDI 09/08/1979 3519085710020001 SINTA KUSUMA DEWI P 17/10/2002
3519085506030002 SELVI WINDA .S P 15/06/2003
METODE KB
SUNTIK
SUNTIK
SUNTIK
MOW
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
MOW
SUNTIK
SUNTIK
IUD
SUNTIK
IUD
SUNTIK
IAS
SUNTIK
HAMIL
SUNTIK
PIL
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IUD
IUD
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IAS
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
PIL
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IAS
IAS
SUNTIK
SUNTIK
HAMIL
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IAT
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IUD
SUNTIK
IUD
SUNTIK
IUD
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
FORMAT PENDATAAN P
TAHUN 2017
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
POLINDES : SENDANGREJO
DESA : SENDANGREJO RT 01
NO NIK KK NIK ISTRI NAMA TGL LAHIR NIK SUAMI
1 3519043004890003 3519085910890001 FITRI RETNOWATI 10/19/1989 3519043004890003

2 3519072407780001 3519086906840001 IPIT SURYANI 6/19/1984 3519072407780001
3 3519081410680001 3519084106710002 ATIK MIRANTI 9/7/1975 3519081410680001
4 3519081605660002 3519084301760001 WIJI ASTUTIK 1/3/1976 3519081605660002
5 3519082304720002 3519085112740003 PARTINI 12/11/1974 3519082304720002
6 3519082108740002 351908500880002 SULASTRI 8/10/1980 3519082108740002
7 351908120582006 3519085911830007 TUTIK RAHAYU 11/10/1983 3519081205820006
8 35190801208740001 3519086706730001 KARTI 6/27/1973 3519081208740001
9 3519102707790002 3519102707790002 SUPARTINAH 2/3/1969 3519102707790002

10 3519081605530001 3519085111700002 EKA HARI WINARTI 11/11/1970 3519081605530001
11 3519081306710002 3519085602750001 TRI WULANINGSIH 2/16/1975 3519081306710002
12 3519082407760001 3519084709770003 SUNARIYAH 9/7/1977 3519082407760001

13 351908200380002 3519115601810000 DWI NUR SANTI 1/16/1981 3519082003800002
14 3519080307810002 3519085807850001 ISNAWATI 7/18/1985 3519080307810002
15 3519081303680001 3519084505730001 JUWARTI 5/5/1973 3519081303680001
TAHUN 2017
NAMA TGL LAHIR NIK ANAK NAMA JK TGL LAHIR
BAYU DWI SETIAWAN 4/30/1989 3519086409140001 AZZAHRA ASYILA RAHMA P 9/24/2014

SUKADI 7/24/1978 3519086409140001 NATANEYLA AINUN MAHYA P 6/5/2009
BRIAN ABRISAM PRABASWARA L 5/17/2015
SUGIANTO 10/14/1968 3519080910950001 HERRY SAPUTRA L 10/9/1995
PUTRI RAHAYU NINGTYAS P 5/9/2001
SUTAWA 5/15/1966 3519085309030002 KHARISMA ASRA DEWI P 9/13/2003
3519085803140001 MARITIA DEWI WIJAYANTI P 3/18/2014
IMAM ARIFIN 4/23/1972 3519084508960001 AFIFAH CHOIRUN NISA P 8/5/1996
3519082504090002 ALFINO FATTHIR SATRIA L 4/25/2009
SARNO 8/21/1974 3519085509030003 IMELIA MIESYA ANGGELIA P P 9/15/2003
RAVEL RIZKI MAILANO L 5/3/2010
MOKHHAMAD JUNAEDI 5/12/1982 3519082503060002 GILANG SAPUTRA L 3/25/2006
3519086903100001 ANANDA DWI ALVARETA P 3/29/2010
SUGIYONO 8/12/1974 3519082907990004 SHOLIKIN L 7/29/1999
3519082205010001 ADI KUSNANTO L 5/22/2001
3519085512040001 DILA WIDAYANTI P 12/15/2004
TOTOK WAHYUGINANTO 7/27/1979
SUDJITO 5/16/1953 3519081906940001 NOVIAN WASKITO YUWONO L 6/19/1994
AGUS SUPRAPTO 6/13/1971 3519082906020001 FAIZ DANANG PRIAGUNG L 6/29/2002
3519043004890001 FARA DILLA SEKAR RAMADHANTI P 9/16/2009
3519081602120001 FADLAN SATRIA PAMUNGKAS L 2/16/2012
BAMBANG YULI PRASETYO 7/24/1976 3519084307090001 LUTHFIONA PUSPA AZAILA P 7/3/2009
IMAM ARIFIN 3/20/1980
EKO SUPRIYTNO 7/3/1981 3519082804100002 ALFIAN IKBAR KOISANO L 4/28/2010
DIDIK TRI HARIYANTO 3/13/1968 3519082210020001 ARIF RAHMAN PRAYOGO L 10/28/2002
3519082811110001 RIKI SAPUTRA L 11/28/2011
METOD KET(KRO
NIS,
E KB GAKIN)
SUNTIK
SUNTIK
SUNTIK BPJS
BPJS
SUNTIK BPJS
SUNTIK BPJS PBI
SUNTIK
SUNTIK
SUNTIK BPJS PBI
SUNTIK
MOW
PIL
SUNTIK
SUNTIK
NO NO KK NIK ISTRI NAMA
1 3519064405910002 RISKA AYUNING .S
2 3519085111700004 SUNARSIH KABUPATEN

3 3519085601860001 MURTIANI PUSKESMAS
4 3515165807810003 TARI YULIANA DESA
5 3519085012770001 PURWATI TGL LAHIR NIK SUAMI

04/05/1991 3519080802890001
6 3519086405890004 ELA FITRI .S
7 3519085302720002 MENIK 11/11/1970 3519081510660003
16/01/1986 3519081003840002
18/07/1981 3515163006760002
8 3519086307890001 SITA KRISTINA .W 10/12/1977 3519082209750001
9 3519085005830002 MURNI
10 3519085604770001 SUDARMI 24/05/1989 3519080902810001
13/02/1972 3519081209630002
11 3519086511830002 SUMARSIH
12 3519085705830002 NURUL HIDAYATI
13 3519084304860001 TITIN DIAN .W 23/07/1989 3519080904870001
10/05/1983 3519082307820002
16/04/1977 3519080304660001
14 351908650388002 RATNA ANNISTIA
15 3519084710730002 WINARTIN 25/11/1983 3519080911800002
17/05/1983 3519081511840001
16 3519084705710003 MULYATI 03/04/1986 3519083005830002
17 3519085204730003 PUJIATI
25/03/1988 3519082406830002
18 3519086712870003 ANGGID .N 07/10/1973 3519082004720001
19 3519085801890001 NURJANAH 07/05/1971 3519081507620003

20 3519086712870004 SRIANI
21 3519084505890001 ANA MAHMUDAH 12/04/1973 3519080907730004
22 3519086707740001 TUTIK PURWATI
27/12/1987 3519081011840001
23 3519084604890001 DIA YUNANI
24 3519084404950001 NOVI FITRIANA 18/01/1989 3519081012840001
25 3519086605750004 SUPIANI 17/12/1987 3519081301840002
26 3519080102840001 SUNARTININGSIH 05/05/1989 3519081006830003
27/07/1974 3519082002690001
27 3519080306830001 PURWATI
28 3519086610880001 SRI MURNI 06/04/1989 3519080404840001
29 3519085012750002 SUPARTI 04/04/1995 3519082206860001
26/05/1975 3519081708710003
30 3519086010850001 LILIA OKTISARI 21/02/1984 3519080901790003
31
23 23/06/1983 3519080905860002
24 26/10/1988 3519083008820001
25 10/12/1975 3519080307690002
26
27 20/10/1985 3519082805850001
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
TAHUN 2017
: MADIUN
: DIMONG
: SIRAPAN
NAMA TGL LAHIR NIK ANAK NAMA ANAK L/P TGL LAHIR
FEBRI WIJAYANTO08/02/1989 3119065609100006 SEPTIANA EKA .P.W P 16/09/2010
- KAYLA DWI .P.W P 13/09/2014
SUNARYO 15/10/1966 3519080304960004 ELHAM SULISTYO.P L 03/04/1996
RUDI KURNIAWAN 10/03/1984 3519080607080002 AFFAN KURNIAZAIN.A L 06/07/2008
DONNY LENGKONG 30/06/1976 3515161105020004 VAHRIZAL RIZKI A.P L 11/05/2002
SUWANDI 22/09/1975 3519086906970001 DELA P 6/29/1997
3519085604060001 INTAN AYU .K P 4/16/2006
MUJIONO 09/02/1981 3519085805100001 RISQI AYU N.A P 18/05/2010
SARWO 12/09/1963 3519080105920001 FAJAR HUSNAN M.Y L 01/05/1992
3519085203000001 LILIS M.H P 12/03/2000
3519086801020001 SOPYA HERLINA P 28/01/2002
WAWAN SETYO 09/04/1987 3519081606120002 KEYLA SETYA .W P 16/06/2012
SUYONO 23/07/1982 3519080611060001 YONI MUKTIYAR .R L 06/11/2006
SARWO WASISNO 03/04/1966 3519084111000001 PANDAN A.S P 01/11/2000
3519080801150001 DINAR SATRIA A.F L 08/01/2015
SUYANTO 09/11/1980 3519085511090001 AURA AL-ISRAA .N P 15/11/2009
ZAINAL ARIFIN 15/11/1984 3519081308040003 RYAN EXA .F L 13/08/2004
BUDI UTOMO 30/05/1983 3519081003050002 GERY WAHYU .U L 10/03/2005
3519084704090001 THYRZA B.A P 07/04/2009
3519082212120002 KENZIALVARO L 12/09/2009
ARIS SETIAWAN 24/05/1983 3519085209090002 GISYA LAVERDA .A P 12/09/2009
RUSDIANTO 20/04/1972 3519084308990002 RYESTIAN ANGGIA .R P 03/08/1999
3519081112080002 REYHAN YUSUF A.R L 11/12/2008
DJUMALI 15/07/1962 3519083001940001 DIDIT WAHYUDI L 30/01/1994
3519085103040001 RULLY DWI .W P 3/11/2004
SADINO 09/07/1973 3519082204030001 ANDI SETIAWAN L 22/04/2003
3519081310070002 DIKA AKBAR .A L 13/10/2007
HARWAN GALOH 10/11/1984 3519082001110002 MUH. LANGID .D L 20/01/2012
3519085609140001 ANDHERA FATMA.T P 16/09/2014
DIDIK WALUYO 10/12/1984 3519081706090001 REFKI JUNIAR .P L 17/06/2009
SUPENO 13/11/1984 3519286606110002 DEVA HAYU .A L 16/06/2011
SUMANTO 10/06/1983 3519086703090001 ASSYAFIATUL .A P 27/03/2009
SUKAMNO 20/02/1965 3519081305960001 DWIKY MEILANI .P P 13/05/1996
3519086710030002 SHINTA RAHMAWATI P 27/10/2003
SETYO CAHYONO 22/06/1986 3519086110080001 YUNA YOVITA .W P 21/10/2008
WAHYU .K.B.P 04/04/1984 3519085404130001 NAFISA GHISSANI .A P 14/04/2013
RIYANTO 17/08/1971 3519080207960001 LEO JUNI .A L 02/07/1996
SUPARDI 09/01/1979 3519085904010001 SULIMA ADIANANDA P 19/04/2001
3519088404120001 MIFTHAUL J.S .R P 24/04/2012
SUKENDRO 09/05/1986 3519085005100003 ANDIN SELIYA .R P 10/05/2010
DARNO 30/08/1982 3519084506100001 DEVITA SUFATUL .U P 05/06/2010
KARDIONO 03/07/1969 3519084709990001 PITA SEPTIANA P 07/09/1999
3519084401100001 ICHA NUR AMIRA P 04/01/2010
TARNO 28/05/1985 3519081806080001 AJUJ NAFRIZALIA H.T L 18/06/2008
METODE KB
SUNTIK
PIL
SUNTIK
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IUD
SUNTIK
MOW
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IUD
SUNTIK
IUD
MOW
SUNTIK
SUNTIK
SUNTIK
MOW
SUNTIK
SUNTIK
SUNTIK
SUNTIK
IUD
SUNTIK
PIL
SUNTIK
TAHUN 2017
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
DESA : TANJUNGREJO
NO NO KK NIK ISTRI NAMA TGL LAHIR NIK SUAMI NAMA
1 3519080101985325 3671054101780013 Mirzawat 01/01/1978 3671052503770004 mariyanto
3519085903730001 Sart 19/03/1973 3519080807740005 Kaman

2
3 3519084106800001 Yuni eka 01/06/1980 3519081811840001 Setyo dwi
4
5 3521106406870003 Karjuniat 24/06/1987 3519081805780001 Andika
6 3519082304030001 Kristna 10/09/1975 3519080912750003 Sukari
7
8 3519085504700002 Indart 15/04/1970 3519081602640002 Sutkno
9 6207025906910002 Yunia dev 19/06/1991 6207020103850002 Slamet
10 3519084709910001 Endah P 07/09/1991 3519082209880002 Septan D
11
12 3519085201720004 Sumaryani 12/01/1972 3519081312690002 Supriyan
13 ni to
14 3519086110930001 Kartka 21/10/1995 3519081104830002 Jiyanto
15 3519087101800003 Yatni 31/01/1980 3519081105720005 Roni S
16
17
18 3519084705710001 Yunani 07/05/1971 3519080807710001 Gunawan
19
20 3519085707690004 Yuliastut 17/07/1969 3519082006680002 djoget
21
22 3519087006820002 Emy Y 30/06/1982 3519081507760002 Eko joni
23
24 3519084410780001 kusrini 04/10/1978 3519080501760001 Suharto
25 3519076008850003 Puspitasa 20/08/1985 3519082006810001 Heri agus
26 ri
27 3519085611020001 Purwat 10/07/1984 3519081608720004 warjianto
28
29 3519084812720001 Punart 08/12/1972 3521141509600001 Sutrisno
30 3519086910730001 Murtning 29/10/1973 3519081311740003 moh.hari
31 sih anto
32 3519084302720002 Sit H 03/02/1972 3519080501690001 Indra S
33
34 3519085102730001 Hart S 11/03/1973 3519082303720003 Siman
35
36 3507235205910001 ni"matul 12/05/1991 3519081008870001 Samsudin
37 3519084504850003 Rini susa 05/04/1985 3519080202750001 Supratoyo
38 nt
39 3519085901690001 Sri kartni 19/01/1969 3519081710670001 Winto
40
41 3519106106920001 Yuniawat 21/06/1992 3519081703920001 Maryanto
42 3519084202710002 Rosi wah 02/02/1971 3519081907680005 Sudjiono
43 yu I
44 3521096010710005 Sri mur 20/10/1971 3521092207650001 Sukri I
45 yani
46
47 3519086103890002 Sulistyo 21/03/1989 3519082609820004 Dwintoro
48 wat
49 3519085104740002 Sumiat 13/04/1974 3519081369720001 Wajiran
50
51 3519084301840004 Suyant 03/01/1984 3519080403830002 joko
52 3519086308710002 Sri harta 23/08/1971 3519080404570001 Alimin
53 tk
54
55 3519085703790001 Anik dwi 17/03/1973 3519083001730001 Slamet
56
57 3519085901870001 Puri dyah 19/01/1987 3519081105840003 Ervan S
58
59 3519085606810002 Robiant 16/06/1981 3519081712840003 Ragil I
60 3519084103790005 Heny S 01/03/1979 3519083005790001 Bangun M
61
62 3519084406770001 Giart 04/06/1977 3519083006690015 Sukimin
63 3519087008720001 Warsiatun 30/08/1972 3519081003710001 Suprianto
64 3519086305750002 Dewi R 23/05/1975 3519080510690001 Sumarso
65 no
66 3519084505840003 Nuryaend 05/05/1984 3519081712800002 Dwi w
67 ah
68 3519085410740001 Muji l 14/10/1974 3519080411670001 Sulistyo
69 no
70 3519085008880001 Hety N 10/08/1988 3506242609860003 Ahmad F
71 3519085304740001 Retno nyi 13/04/1974 3519080107750003 Yuli
72 3519086204780001 Titn P 22/04/1978 3519081808740003 Agus A
73
74 3519083006920002 Susmini 07/10/1971 3519081907680002 Slamet
75 3519055011920002 Dwi les 10/11/1992 3519080405680005 Wahyudi
76
77 3519037003940002 Yuli wiji 30/03/1994 3519082697920001 yeni S
78 3519084804710001 Sukesi 08/04/1971 3519083006640026 Suparno
79 3519036005880003 Mei kart 20/05/1986 3519082606820001 Hendri
80
81 3519085508820003 Tri agustn 15/08/1982 3619090906750001 Bandono
82 3590668107100001 Sulastri 28/10/1971 3519081609710001 Sugeng H
83
84 3519085205790005 Sit S 12/05/1978 3519081002780003 Nurkam
85 bali
86 3519084502770003 Sri utami 05/02/1977 3519083009730003 Ponco S
87
88 3619066106910002 Yunita A 21/06/1991 3619070909060002 David D
89 3619086607800001 Sumiat 26/06/1978 3619082204760002 Singgih S
90 3519085001700001 Umiat 10/01/1970 3519080710620001 Sumardi
91 3519085902820003 Etk maria 19/02/1982 3519083105790001 Winarno
92 3519085901760001 Puji R 19/01/1976 3519081007742001 Suwaji
93 3519086401790001 Piningsih 24/01/1979 3519080810710001 Supriono
94 3519085704900004 Nia canda 17/04/1990 3519081301830001 Dedi eri
95 3519084507860003 Mira A 05/07/1986 5319082502850002 Agung A
96 3519084710690001 Suminem 01/10/1969 5319083107600001 Suwarno
97 3519086409720001 lasmiatk 24/09/1972 3519080108660002 Darsono
98
99 3519087010710002 Mariatun 30/10/1971 3519082106560002 Lamirin
100
101 3519084208780001 Sujiat 02/08/1978 3519081007720001 Sudarto
102 3619084810820001 Ninik E 09/10/1982 3619060702780002 Aris V
103
104 3519084103810001 Sri ratna 01/03/1981 3519082704780002 Ari dwi
105
106 3519084510710002 Warsini 05/10/1971 3519083107670002 Sutrisno
107
108 3519085309700002 Sri Mur 13/09/1970 3519081604690005 Sujono
109
110
111
112 3519087107770001 Kasiat 31/07/1977 3519080207770002 Samingin
113 3519085111790001 Marfuah 11/11/1979 3519080401790002 Jarwandi
114 3519074502750002 Pent Tri 05/02/1975 3519080207720001 Herwa
115 wan
116 3519085008870001 Andrie K 10/08/1987 3519083112860002 Choirul A
117 3519084805710003 Sri M 08/05/1971 3519082611640001 Bintoro
118 3519085703700001 Giyem S 17/03/1970 3519080507600004 Suprpno
119 3519086111720001 Tri rahayu 21/11/1972 3519080908650002 Didik puji
120 3519084709730001 Dyah S 07/09/1973 3519080904670004 Sunaryo
121
122 3519085110720002 Sit M 11/10/1972 3519081304740001 Tasmun
123 3519084808750001 Nuryat 08/08/1975 3519080504720006 Sarmin
124
125 3519084409720001 Kasiat 04/09/1972 3519082506720001 Slamet
126
127 3519075011900008 Nurkilah 10/11/1990 3519800611800002 Joko W
128 3519084304840001 Lasmini 03/04/1984 3519080608870004 Suroto
129 3519087000690034 Darsih 30/06/1969 3519082504600001 Samidi
130
131
132 3519086011730002 Jarwat 20/12/1973 3519080112700002 Pardi
133
134 3519084612780003 Supadmi 06/12/1978 3519080804690001 Sugiono
135 3172024502870009 Herliana 05/02/1987 3519082104810001 Dwi Arif
136
137 3519085312790001 Eny sri 13/12/1979 3519082107740002 Muh yak
138 un
139 3519086510720001 Sri marsi 25/10/1972 3519081412610001 Setyo C
140 3519084510710001 Winart 05/10/1971 3519082408650002 Imam S
141
142
143 3519084203830001 Emi wahy 02/03/1983 3519080302760001 Tri hari
144 3519085007730002 Waljinah 10/07/1973 3519080107020001 Sungkono
145
146 6474026606770003 Supartni 26/06/1977 6474020108540003 Sunyoto
147 ngsih
148 3519080708610003 Supartni 21/06/1970 3519080708610003 Supriyan
149 ngsih t0
150 3519086606710001 Atk R 26/06/1971 3519080411820001 Juwoto
151
152
153 5103064407140012 Indah Y 04/01/1974 3519081108670001 Yasa agus
154
155
156
157 3519086105690001 Maya L 21/05/1969 3519080401670001 Pardiono
158
159 3519086102770001 Leny ut 21/02/1977 3519082009630001 Ratmin
160
161 3519084912710001 Ismi 09/12/1971 3519080703660001 Saman
162 3519084201770001 Ramtni 02/01/1977 3519082405730001 Paryanto
163
164 3519084609730100 Hentk D 06/09/1973 3519080211670001 Sutkto
165
166 3519084505790003 Brina S 05/05/1979 3519083108770001 Yusuf
167 3519085211890001 Reni N 12/11/1998 3519082012820001 Sudarso
168 no
169 3519084307930002 Danik P 03/07/1993 3577021205890001 Sugeng
170 3519086880382002 Dhiah A 28/03/1982 3519080805790001 Agus S
171
172 3519084406700002 Suminten 04/06/1970 3519080105680004 Marmanto
173 3519085306800001 Suyant 13/06/1980 3519082802700002 Suprianto
174
175 3519084709700001 Pinarsih 07/09/1970 3519083006690003 Suwondo
176 3577016006910001 Tiyas A 20/06/1991 3519080108910002 Andre G
177 3510084105710002 Sit K 01/05/1971 3510088270460001 Iskak
178 3519086212900002 Dwi R 22/12/1990 3519101009860001 Andik P
179 3519084709730001 Endang S 07/09/1978 3519080201770002 Syarif H
180
181
182 3519086509810005 Lastrini 25/09/1981 3519080907770006 Sukamto
183 ngsih
184 3519084911800001 Warsini 09/11/1980 3519082102800001 Winandar
185 3519084903920002 Fitri W 09/03/1992 3519080204900001 Tri H
186 3519084202730001 Sumarni 02/02/1973 3519081103670001 Gambiyo
187 to
188 3519085010820005 Sri Murya 10/10/1982 3519082503740002 Suparno
189
190 3519086405790001 Subihart 24/06/1979 3519080711780002 Edi S
191
192 3519084206680001 Suhart 02/06/1968 3519082209660001 Edy S
193
194 3519085602720002 Umi D 16/05/1972 3519080105740002 Purjiono
195
196 3519084807920001 Puji Anni 08/07/1992 3519081104920002 Heru R
197 3519084512710100 Ana D 05-15-1971 3519082809670001 Sunarto
198
199 3519085110680002 Yulianik 11/10/1968 3519080106560002 Mingun
200
201 3519085701740001 Jumini 17/01/1974 3519082102650004 Supardjan
202
203 3519084507790002 Suri lela 05/07/1979 3519081704720001 Eko edy
204
205 3519086906840001 Fit senri 29/06/1984 3519083110850002 Sigit P
206 3519084204890001 Junita L 02/04/1989 3519081512880001 Gatot W
207 3279044307820001 Robitoh 03/07/1982 3279042007790002 Subani
208 3519086710880001 Dewi aji 27/10/1988 3519081706790002 Giyono
209
210 3519085202680003 Sit M 12/02/1968 3519082505620001 Nyono
211 3519086608760001 Suindah 26/08/1975 3519083003760002 Sunardi
212
213 3519086412780001 Dwi Nart 24/12/1978 3519081905750003 Suprayit
214
215 3519087101840001 Srirahayu 31/01/1984 3519082712830002 Catur P
216 3519084201730001 Sumirah 02/01/1973 3519081003680001 Budi S
217
218 3519085605870002 Parmi 16/05/1987 3519081905810001 Budi M
219
220 3519085303790002 Sulistyo 18/03/1979 3519080601710002 Suyanto
221 wat
222 3519084606960001 Yuriza F 06/06/1996 3519081611920001 Rizki P
223 3519084501860001 Rury U 05/01/1986 3519110103860004 Endra K
224 3519086008720004 Sutnah 10/08/1972 3519082710650001 Edy P
225
226 3519085506800006 Nurgiant 15/06/1980 3519081407870002 Sunaryo
227
228 3519084110720001 Suwarni 01/10/1972 3519081607680001 Sumadi
229
230
231 3519085707820005 Nunik W 17/07/1982 3519082106790003 Syamsul
232 3519087007740001 LASTARI 30/07/1974 3519082510740001 Sunarko
233
234 3519086109730001 Unik dwi 21/09/1973 3519082511710002 Sumarno
235 3519084606780002 Nanik W 06/06/1978 3519082507750003 Nanang S
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
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271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
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291
292
293
294
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296
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319
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323
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331
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333
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342
343
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355
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358
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784
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T PENDATAAN PUS
TAHUN 2017
TGL LAHIR NIK ANAK NAMA ANAK L/P TGL LAHIR METODE KB
25/03/1977 3671056701990004 Maya fitri p 27/01/1999 SUNTIK
3671035056080002 Mayza more andhea p 15/05/2008
08/07/1974 3519084703010001 Mery puspita p 07/03/2001 SUNTIK
3519085511070001 Rest nur fadhillah p 15/11/2007 Gakin
18/11/1984 3519080406070001 Kurnia aldhi alfian L 04/06/2007 IUD
3519080406070002 Kusuma artha firman L 04/06/2007
18/05/1978 3519086611130001 Salsabila quaneisha P 26/11/2013 SUNTIK
09/12/1975 3519082304030001 Moch.wijayanto L 23/04/2003 SUNTIK
3519086711070001 Vella ayu setyowat P 27/11/2007
16/02/1964 3519084209010001 Maharani puspa p 02/09/2001 TIDAK KB
01/03/1985 TIDAK KB
22/09/1988 3519080801130001 Devanno galang L 08/01/2013 SUNTIK
3519087004140001 Davina indriyas P 30/04/2014
13/12/1969 3519084601950004 Lisnawat P 06/01/1995 TIDAK KB
3519085606040001 Adinda listy P 16/06/2004
11/04/1983 3519080907130004 Valerian putra L 09/07/2013 TIDAK KB
11/05/1972 3519083004000005 Alwi aprilian santoso L 30/04/2000 SUNTIK
3519081105040003 Adji cahyo nugroho L 11/05/2004 Gakin
3519082308090001 Aryo trie wibowo L 23/08/2009
08/07/1971 3519080509930002 Fredy sapta yunu L 05/09/1993 SUNTIK
Sabrana dini P 20/11/2000
20/06/1968 3519080404940002 Ar rauuf abi huzaifah L 04/04/1994 SUNTIK
3519083008100001 Ihlima hanifa P 25/01/2004 askes
15/07/1976 3519087003040001 Santana marshanda P 30/03/2004 SUNTIK
3519083008100001 Bimasakt nawang L 30/08/2010
05/01/1976 3519085108010002 Vani ragil P 11/05/2001 SUNTIK
20/06/1981 3519081203120001 Very maretha prama L 12/03/2012 IMPLANT
16/08/1972 3519085611020001 Jihan aprilia P 16/11/2002 SUNTIK

3519085608120001 Azzahra putri w P 16/08/2012 askes
15/09/1960 TIDAK KB
13/11/1974 3519082502990001 Bayu febrianto L 25/02/1999 SUNTIK
3519084710060001 Saskia dwi P 07/10/2006
05/01/1969 3519080566990001 Andrianto P L 05/06/1999 TIDAK KB
3519081604070001 Mutara dyah rasty P 16/04/2007
23/03/1972 3519084308010002 Firly nisaun L 03/08/2001 Kondom
3519086205030001 Firla niswatn P 22/05/2003
10/06/1987 TIDAK KB
02/02/1975 3519085006060003 Filla affity ahunnaya P 10/06/2006 IUD
17/10/1967 3519085106970001 Ike karwinto P P 11/06/1997 TIDAK KB

3519086810010001 Fitri karwinto putri p 28/10/2001
17/03/1992 TIDAK KB
19/07/1968 3519082207010001 Danang setya budi L 22/07/2001 TIDAK KB
22/07/1965 3521092609900003 Tyasandhi sepiyanto L 26/09/1990 TIDAK KB
3521096912040002 Dwisindhyamelia L 29/12/2004

26/09/1982 3519082106040002 Rico candra L 21/06/2004 SUNTIK
13/09/1972 35190867090200001 Septa suci P 27/09/2002 SUNTIK

3519080506100001 Farid anang L 05/06/2010
04/03/1983 3519082004090001 Rizky mandala L 20/04/2009 IUD
04/04/1957 3519081601880001 Ali harmoko L 16/01/1988 IMPLANT
3519084807890002 Nanik yunitasari P 06/07/1989
3519086007920001 Vivi yuliana mest P 20/07/1992
30/01/1973 3519081102030001 Riza arvian pratama L 11/02/2003 MOW
3519085901080001 Pradita rekna P 19/01/2008
11/05/2005 3519084204050001 Reyosa lintang Brilian P 02/04/2005 SUNTIK
3519082201100002 Zheryan putra briliant L 22/01/2010
17/12/1984 TIDAK KB
30/05/1979 3519082412980001 Henanta mualifiana L 24/12/1998 MOP
3519088481040001 Miftahul nurazizah P 08/01/2004
30/06/1969 3519081409030001 Dwi anis septan L 14/09/2003 SUNTIK
10/03/1971 3519082901080001 Risma riantkasari P 29/01/2008 SUNTIK
05/10/1969 3519082411950001 Dewa yogantara L 24/11/1995 SUNTIK
3519082908050001 Bima yogantara L 29/08/2005
17/12/1980 Rifqi putra L 19/04/2009 IUD
04/11/1967 3519083112920001 Aka wahyu diantoro L 31/12/1992 SUNTIK

3519853060300001 Shinta wahyu P 13/06/2003
26/09/1986 35190881801140002 Ahmad Fauzi L 18/01/2014 TIDAK KB
01/07/1975 3519086001920002 Punda mika P 20/01/1992 TIDAK KB
18/08/1974 3519084705020001 khonita eko L 07/05/2002 SUNTIK
3519062401060001 Rafid dwi putra L 24/01/2006
19/07/1968 3519083006920002 Candra bayu L 30/06/1992 MOW
04/06/1980 3519012070300002 Feri wahyu p L 12/07/2003 SUNTIK
3519082112070001 Muhammad gilang L 21/12/2007
26/06/1992 TIDAK KB
30/06/1964 3519081009970001 Septan dwi L 10-0901997 SUNTIK
25/05/1982 3519035703050001 Nadia zahrotunisa P 17/03/2005 SUNTIK
3519080905140001 Azka mayza virendra L 09/05/2014
09/08/1975 IUD
16/09/1971 3519086712960002 Prita S P 27/12/1996 SUNTIK
3519080404050001 Puguh gilang L 04-042005
10/02/1978 3519085202000002 Netta nurvitasari P 12/02/1978 PIL
3519080860900001 Rehan putra N L 08/08/2009
30/09/1973 3519085208050001 Anggita eka W P 12/08/2005 MOW
3519084212080002 Devi dwi anjani P 02/12/2008
09/09/1986 3619081306120001 Bharata yudha L 13/06/2012 SUNTIK
22/04/1976 3619081006040002 Anang mei L 10/05/2004 TIDAK KB
07/10/1962 3519080209960002 Septan dwi susanto L 02/09/1996 SUNTIK
31/05/1979 3519086605080001 Aurel felecia P 26/05/2008 IMPLANT
10/07/1974 3519083006032002 Ardan Satria pratama L 30/06/2003 IMPLANT
08/10/1971 3519081409100001 Septan dwi L 14/09/2010 IMPLANT
13/01/1983 3519084804110002 Jihan aprilia P 08/04/2011 TIDAK KB
25/02/1985 3519086507100001 Nafisa agumi L 25/07/2010 IUD
31/07/1960 3519085204980001 Aprilia dwi P 12/04/1998 SUNTIK
01/08/1966 3519085406930001 Dara riant P 14/06/1993 SUNTIK
3519086105000001 Silvia Meilina P 21/05/2000
21/06/1956 3519084206910002 Lina ika wat P 02/06/1991 SUNTIK
3519082508980001 Agung setawan L 25/08/1998
10/07/1972 3519085311970001 Betty pastka P 13/11/1997 TIDAK KB
07/02/1978 3619085303206001 Niki berlian P 13/03/2006 IUD
3619081610100002 MOH risky afandi L 15/10/2010
27/04/1978 3519080906040001 Muh syailendra L 09/06/2004 TIDAK KB
3529081812090002 Muh krisna M L 18/12/2009
31/07/1967 3519080908960002 Yudik wahyu L 09/08/1996 MOW
3519081510050001 Afrizal wahyu H L 15/10/2006
16/04/1969 3519083012930001 Dehan gusmar L 30/12/1993 IUD
3519085202960004 Aster astreani P 12/02/1996
3519086107970004 Kharisma cahya P 21/07/1997
3519084809980001 Melat lakshita P 08/09/1998
02/07/1977 3519087007990001 Yuli astutk P 30/07/1999 TIDAK KB
04/01/1979 3519081703060001 Raihan maulana L 17/03/2006 TIDAK KB
02/07/1972 3519080701140001 Jericho immanuel L 07/01/2014
31/12/1986 3519082508130001 M.Bryan adrian L 25/08/2013 SUNTIK

26/11/1964 3519085403050001 Mega susant P 14/03/2010 TIDAK KB
05/07/1960 3519087007940001 Yulia sukma K P 30/07/1994 TIDAK KB
09/08/1965 3519085407020001 Clarissa Diktriani P 14/07/2002 SUNTIK
09/04/1967 3519082702500001 Dio permana L 27/02/2005 PIL
3519084307080001 Nadine julia H P 03/07/2007
13/04/1974 3519081502070001 Alfin syahendra L 15/02/2007 SUNTIK
05/04/1972 3519084102990001 Febriana nursafitri P 01/02/1999 SUNTIK
3519081502010001 Fahry Nursaputra L 15/02/2014
25/06/1972 3519081601950002 Yoga perindra P L 16/06/1996 SUNTIK
3519080541060002 Karindra bintang P 14/10/2006
06/11/1980 3519086002140001 Vanessa cornelia P 20-022014 IUD
06/08/1970 TIDAK KB
25/04/1960 3519080706870001 Iwan darmadiono L 07/06/1987 PIL
3519086708920001 Ratna iin darmiat P 21/08/1992
3519086808980001 Fira fufita W P 28/08/1998
01/12/1970 3519082404970001 Ersha ardia P 24/04/1997 SUNTIK
3519081309040001 Rifky arsa L 13/09/2004
08/04/1969 3519086601090001 Syifana ari sandy P 26/01/2006 SUNTIK
21/04/1981 3519084801120001 Nadia aulia P 08/01/2012 TIDAK KB
3519081906140001 Dhimas al ghozaibi L 19/06/2014
21/07/1974 3519080905040001 Daffa afrizal L 09/05/2004 SUNTIK
3519082104120001 Azzam ahsan L 21/04/2012
14/12/1961 3519081909920001 Dony setyamarta L 19/09/1992 SUNTIK
24/08/1965 3519085201910001 Sukma janeka P 12/01/1991 SUNTIK
3519082510980001 M.Rohmat fajar L 25/10/1998
3519084902060001 Khofifah nissa P 09/02/2006
03-0201976 TIDAK KB
03/05/1970 3519080107020001 Nur rahmat H L 01/07/2002 PIL
3519085205040003 Inda rizky P 12/05/2004
01/08/1964 6474026810000008 Oktaviani ayundasari P 28/10/2000 SUNTIK
6474020101090001 Chusnul amin L 01/01/2009
07/08/1961 3519086604920002 Chaterin aprilia P 26/04/1992 SUNTIK
3519083007000001 Kevin dennis L 30/07/2000
04/11/1982 3519080701960002 Luky ardika L 07/01/1996 SUNTIK
3519083010970001 Pendi satria L 30/10/1997
3519082212070001 Sadewa Tri L 22/12/2007
11-18-1967 5103066511940004 Dewanty putri P 25/11/1994 SUNTIK
5103060806000005 Devrizal agung L 08/06/2000
5103064110020001 Devina octavia P 01/10/2002
5103062808080001 Dennizar agung L 28/08/2008
04/01/1967 3519085803950001 Emmi dian P 18/03/1995 TIDAK KB
3519081208010002 Prima Dhian L 12/08/2001
20/09/1963 3519084510980002 Ranita ayu P 05/10/1998 SUNTIK
3519086110090001 Icha dwi P 21/10/2009
07/03/1966 3519081409990001 Dwi ismanto L 14/09/1999 SUNTIK
24/05/1973 3519087004000001 Diyan apriliant P 30/04/2000 SUNTIK
3519085911080001 Alfiant kurnia P 19/11/2008
02/11/1967 3519086301970002 Olivia ramanda P 23/01/1997 SUNTIK
3519086012020001 Salsabila ramanda P 20/12/2002
31/08/1977 TIDAK KB
20/12/1982 3519085401140001 Nabila seina P 14/01/2014 Kondom
12/06/1989 3577023108140001 Fahrizal Ilham L 31/08/2014 IUD

08/05/1979 3519086907050001 Naura putri P 29/07/2005 SUNTIK
3519085104130002 Naswa putri P 11/04/2013
01/05/1968 3519083008020001 Ady supriyana L 30/06/2002 SUNTIK
28/02/1970 3519085407020002 Ni"matul M P 14/07/2002 TIDAK KB
3519085810120001 Nina Nurhasah P 18/10/2012
30/06/1968 3519081612950001 Djubi setawan L 15/12/1995 PIL
01/08/1991 SUNTIK
27/04/1969 3510081812950001 Ahmad Nur L 18/12/1995 PIL
10/09/1986 SUNTIK
02/01/1977 3519084601060001 Khansa nabila P 06/01/2006 SUNTIK
3519084601060002 Khansa nafadila P 06/01/2006
3519085401130001 Mysha chanda P 14/01/2013
09/07/1977 TIDAK KB
21/02/1980 3519081611100001 Dimas nendra L 16/11/2010 SUNTIK

02/04/1990 3519081802140001 Abdul Rohman L 18/02/2014 SUNTIK
11/03/1967 3519080404940001 Mahendri Dwi P L 04/04/1994 IUD
25/03/1974 3519080504020002 Firanda bagus s l 05/04/2002 TIDAK KB

3519082012070002 Andika Yogi P L 20/12/2007
07/11/1978 3519086502020002 Wahyu Fit Rotunnisa P 25/02/2002 SUNTIK
3519081606140001 Muh.Affan L 15/06/2014
22/09/1966 3519081201000001 Herdika Dikyanto L 12/11/2000 SUNTIK
3519081503060001 Hendrika dysta A L 15/03/2006
01/05/1974 3519085911990001 Noviya illa muthi P 19/11/1999 SUNTIK
3519085812040001 Defia Umniatul P 18/12/2004
11/04/1992 3519086102150001 Elena sheril P 21/02/2015 SUNTIK
28/09/1967 3519081005010002 Defri Andika L 10/05/2001 SUNTIK
3519086009060001 Ditha adelia A P 20/09/2006
01/06/1956 3519082303920001 Rohmanto Wawan L 23/03/1992 SUNTIK
3519082006060001 Yudy Cahya L 20/06/2006
21/02/1965 3519080212950001 Agus purwanto L 02/12/1995 SUNTIK
3519081705080001 Rudi setawan L 17/05/2008
17/04/1972 3519082206980001 Yoga saputra L 22/06/1998 SUNTIK
3519085809010001 Syndy anggraini P 18/09/2001
31/10/1985 3519084103090001 Sifia fallah syifa P 01/03/2009 Kondom
15/12/1988 3519084807100001 Olivia ganeta P 08/07/2010 SUNTIK
20/07/1979 3279042408090002 Alfian rizqi R L 24/08/2006 PIL
17/05/1979 3519082710080002 Yoga prasetya l 27/10/2008 SUNTIK
3519082307140001 Yovi setyo nur cahyo L 23/07/2014
25/05/1962 3519081011960002 Rony andry L 10/11/1996 SUNTIK
30/03/1975 3519086104090001 Inardin nur P 21/04/2009 SUNTIK
3519081404140002 Fahmi binuril L 14/04/2014
19/05/1975 3519082811030001 Candra fitriawan L 28/11/2003 SUNTIK
3519080306140001 Arjunandra Surya L 03/06/2014
27/12/1983 3519084908110002 Prajna putri P P 09/08/2011 IUD
10/03/1968 3519084202960001 Indriyani P 02/02/1996 SUNTIK
3519082004080001 Andry dwi L 20/04/2008
19/05/1981 3519082704080001 Nicky nurrohman L 27/04/2008 Kondom
3519087010110001 Jenny indah P 30/10/2011
06/01/1971 3519081506010001 Hafid listyantoro L 15/06/2001 SUNTIK
16/11/1992 Tidak KB
01/03/1986 3519085402130001 Naomi cleverynda P 14/02/2013 IUD
27/10/1965 3519080412950001 Riyan agung L 04/12/1995 MOW
3519083011070001 Romy Agung L 01/11/2007
14/07/1987 3519085207090001 Galuh ambarwat P 12/07/2008 SUNTIK
3519083004130001 Diva Aktor L 30/04/2013
16/07/1968 3519080507730003 Safeli Rahman L 05/07/1993 IUD
3519086502990001 Istqomah P 25/02/1999
3519085704070001 Nurul qoriyah P 17/04/2007
21/06/1979 3519082607090001 Ahlil ichsan L 26/07/2009
25/10/1974 3519085410970001 Megarani Putri P 14/10/1997 SUNTIK
3519086409030001 Maharani nurromah P 24/09/2003
25/11/1971 SUNTIK
23/07/1975 3519084604990001 Zona Rozzaqul P 06/04/1999 SUNTIK
3519082012030003 Naufal bertha L 20/12/2003
FORMAT
T
KABUPATEN : MADIUN
PUSKESMAS : DIMONG
DESA : TULUNGREJO
NO NIK KK/NO KK NIK ISTRI NAMA TGL LAHIR NIK SUAMI

1 3519080101010103 3519085707730001 SUMIRAH 7/17/1973 3519082211720001
2 3519080101982947 3519085808710002 SUPARSIH 8/18/1971 3519080101600005

3 3519080101983027 3519086908690004 PARSUMI 8/29/1969 3519082606700001
4 3519082502150006 3519086501900001 SISKA WAHYU 1/25/1990 3315111008900007
5 3519080101990156 3519085408700002 MUJIATI 8/14/1970 3519082310680002
6 3519081809810003 SURYA DWI L 4/14/1993 3519101206900001

7 3519080602120016 3519085404880001 APRILIYA 4/14/1988 3519081809810003
8 3519081310110001 3519084202910001 FEBRIANA A 2/2/1991 3519111310890001
9 3519081612080538 3519086204010002 INA WINARSIH 9/2/1981 3519080411770001
10 3519081308030207 3519080812740001 SUMARMI 6/13/1979 3519080812740001
11 351908180509025 3519086010870001 NANIK WIJAYANTI 10/20/1987 3519081703830001

12 3519082004983017 3519086406750001 SRI WAHYUNI 6/24/1975 3519082806700002
13 3519082407984332 3519087006720010 JARMINI 6/30/1972 3519083006640017

14 3519082308160003 3519086303920001 SITI NUR ROHMAH 3/23/1992 3519012806910004
15 3519082610090729 3519084807720003 PANTES 7/8/1972 3519080202630004
16 3519082703120005 3519086206860001 TRI WAHYUNI 6/22/1986 3519082502840001
17 3519082804040130 3519084412780001 SETYORINI 12/4/1978 3519081705730004
TAHUN 2017
NAMA TGL LAHIR NIK ANAK NAMA JK

AGUNG HARIYANTO 11/22/1972 3519082601010002 AS'AD UBAIDILAH L
SYALWA HIDAYATI P
BUDI SANTOSO 1/1/1960 3519081910930005 ARDITA YUDHA L
SUYONO 6/26/1970 3519086108940002 ONES DEVIANA P
ROFIQ 8/10/1990 3519081905190002 NAWILIS L
ARIS WIBOWO 10/23/1968 3519086704920002 VIVI APRILIA P
3519082910030001 FAJAR RAMA L
KRISTIANTO AGUNG S 3/12/1990 - -
JARWANTO 9/18/1981 3519081804110001 FRANANDA ATHA L
AGUS SUTIONO 10/13/1989 3519081005120001 HAFIST HIRARKI L
ACHMAD TOHIR 11/4/1977 3519086204010002 IFNII P
3519083012070002 ACHMAD KHOZINATUL L
AGUS RIANTO 12/8/1974 3519084309000001 INTAN SEPTYANINGRUM P
3519085810100001 REVINA NUR O P
HERI SETIAWAN 3/17/1983 3519080301530001 DINI RAHMAWATI P
SUMARDIYONO 6/28/1970 3519081002960001 BAGUS PRIHANTOKO L
3519080701060002 SIGIT PURNAMA L
SUKARMAN 6/30/1964 3519086905990001 MEI YULI ASTUTIK P
FAIZUL ROHMAN 6/28/1991 3519082612160002 ARVINO ALKHALIF L
SUMIDJAN 2/2/1963 3519086603100001 SHIFA KALYCA P
SISWANTO 2/25/1984 3519085610120001 KHANZA RAFIFA SALSABILA P
WAKIDI 5/17/1973
TGL LAHIR METODE KB KET(KRONIS,GAKIN)
1/26/2001 MOP -
11/29/2006
10/19/1993 - -
8/21/1994 - -
5/19/2015 KONDOM -
4/2/1992 MOW -
3/29/2003
- - -
4/18/2011 SUNTIK -
5/10/2012 SUNTIK -
4/22/2001 SUNTIK -
12/30/2001
9/3/2000 SUNTIK
10/18/2010
1/3/2006
2/10/1996 IUD
1/7/2006
5/29/1999 MOW
12/28/2016 KONDOM
3/26/2010 -
10/16/2012 SUNTIK

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FORMAT PEN

NO NIK KK / No KK NIK ISTRI Nama Tanggal Lahir NIK SUAMI

1 351908080905024 2 351908460572000 1 Sumarni 06/05/1972 351908060872000 4

7 351908010198397 4 351908550970000 1 Aminin 15/09/1970 351908091163000 1

8 351908010198772 8 351908420954000 2 Supart 02/09/1954 351908120852000 1

9 351908010610022 2 351908420873000 2 Murniat 02/08/1973 351908271167000 1

10 351908020305009 9 351908640980000 2 Sri Hartat 24/09/1980 351908271176000 1

14 351908050313000 4 351908600389000 1 Supartningsih 20/03/1989 351908130281000 1

16 351908060715000 2 350724700687000 6 Yuni Marginingsih 30/06/1987 350724100781000 5

17 351908100998117 9 351908690680000 1 Kartni 29/06/1980 351908100978000 1

19 351908111109074 6 351908540684000 1 Juniatk 14/06/1984 351908201084000 4

25 351908160408016 1 351908501082000 6 Sri Rahayu 10/10/1982 351908140182000 2

31 351908210205003 6 351908620478000 3 Nur Lailiyah 22/04/1978 351908070277000 1

35 351908520214000 1 351907461174000 1 Reni 06/11/1974 351907111058000 1

36 351908250915000 1 351908530394000 1 Fitriana 13/03/1994 351908090395000 2

40 351908270511268 1 351908480682000 1 Tatk Sulistyowat 08/06/1982 351908040879000 2

44 351908140814000 3 351908581088000 1 Maria Oktavia 18/10/1988 352010160889000 2

1 351908010197020 3 351908710769000 1 Chusmiyat 7/31/1969 351908080770000 1

2 351908010197021 1 351908630764000 1 Sajekt 7/23/1964 351908010755000 4

3 351908010198014 9 351908661263000 1 Warsini 12/26/1963

6 351908010198162 2 351908410969000 1 Pujiat 1/1/1969 351908020869000 1

15 351908070410013 3 351908541184000 3 dian ekawat 11/14/1984 351908190481000 2

19 351908110898015 2 351908550756000 1 rusmini 7/15/1956 351908050643000 1

20 351908120413000 1 351908411086000 2 Maria Magdalina 10/1/1986 317508310190000 2

22 351908140415000 3 351908410156000 1 lasmini 1/1/1956

23 351908140598760 2 351908460777000 1 Sri Utami 7/6/1977 351908090265000 1

32 351908231201004 5 351905581279000 1 Sulis Anjarwat 12/18/1979 351908190177000 1

33 351908280104003 6 351908420473000 3 Tuminah 4/2/1973 351908030169000 3

35 351908290898678 3 351908501070000 4 Marminem 10/10/1970 351908110169000 3

36 351908300197101 1 351908420856010 1 Ruth Suyatmi 8/2/1956

1 351908010198119 6 351908480773000 1 Sumari 7/8/1973 351908130269000 1

8 351908010198608 7 351908520566000 2 Kinem 5/12/1966 351908311259000 7

11 351908010198728 6 351908700639004 5 Atn 6/30/1939

14 351908020806024 2 351908630578000 1 Endang Susilowat 5/23/1978 351908050679010 0

18 351908051098120 1 351908411067000 1 Semi 10/1/1967 351908300657004 5

19 351908060607031 3 351908580767000 2 Musiani 7/18/1967 351908131167000 1

20 351908070915000 3 351908660290000 1 Arif Yuhana 2/26/1990

22 351908091208052 5 351908500683000 1 Parmi 6/10/1983 351908090884000 3

26 351908140814000 2 351908550392000 1 Est Sulistani 3/15/1992 351908310391000 1

29 351908210513000 4 351908711082000 1 Erlyn Widyawat 10/31/1982 351909140786000 2

32 351908241210003 6 351908501048000 1 Soeparmi 10/10/1948

1 351908010198015 4 351908560172000 1 Nurhasanah 16/01/1972 351908061166000 1

5 351908010198118 4 351908410570000 1 Misri 01/05/1970 351908020165000 1

8 351908010198397 3 351908470776000 3 Astutk 07/07/1976 351908100573000 1

9 351908010198607 9 351908410170000 3 Karminah 01/01/1970 351908311264000 4

11 351908010198760 4 351908711264000 8 Djami 31/12/1964 351908311257000 7

12 351908041103026 4 351908550177000 1 Sit Roliyah 15/01/1977 351908061274000 1

13 351908041109073 5 351908631186000 1 Suwart 23/11/1986 351908160684001 0

17 351908071005027 0 351908610782000 1 Maryani 21/07/1982 351908110771010 0

26 351908180915000 1 351908430164000 2 Suryani 03/01/1964

27 351908190809060 4 351908480386000 1 Purwat 08/03/1986 351908130978000 1

1 351908010198163 3 351908530969000 1 Partni 13/09/1969 351908200564000 4

4 351908010198165 0 351908450175000 1 Suparmiasih 05/01/1975 351908030571000 2

5 351908010198165 6 351908700664003 0 Darsini 30/06/1964 351908040854000 1

6 351908010198165 7 351908511172000 1 Sujiat 11/11/1972 351908011264000 1