FORM MIGRASI PESERTA

JENIS PESERTA
INSTANSI/BADAN/PERUSAHAAN
KODE VIRTUAL ACCOUNT
K TEMPAT PEMBAYARAN IURAN
TANGGAl REGISTRASI
NOMOR PKS
KODE PKS
MASA BERLAKU
KODE TANGGUNGAN
KODE KC
KODE DATI2

No No KK NIK/KITAS/KITAP Nama Lengkap

1 2 3 4
7406071903080014 740607017610014 KAMALUDDIN
7406071903080014 7406074402920002 NURMAYAN
7406071903080014 7406076402960001 NURMALASAR
7406071903080014 740607540299003 HARNIKAYANGSARI

7406072003080186 7406070712700002 BUDIRMAN

7406072003080186 7406074201810002 ST. NURBAYA
7406072003080186 7406075304990001 RISNAWATI
7406072003080186 7406072006040001 ADRIAN
7406072003080186 7406074508080002 RIRIN RIANA
7406072003080186 740607112400002 JAWARIA

7406070612120005 7406071607870002 MUSLIADI

7406070612120005 7406075010930005 HASMRANI
7406070612120005 7406074511120001 REGINA AMELIA

7406070308160001 7406012301670001 MUSTABI

7406070308160001 740601604810002 HAISYA
7406070308160001 7406015811010001 NUR HESTY RAMADHANI
7406070308160001 7406015006110001 NUR AQIFA KIRANI

740607200080099 7406070107650049 KALWING

740607200080099 7406074107570033 KONRENG
740607200080099 7406076804950002 IRIANTIKA

7406073110160004 7406071906900001 MIRWADI

7406073110160004 7406076004920003 HAMDAR
7406073110160004 7406071101150001 DIHAR SAMUDRAH

740607200300193 7406071708780002 AGUS

740607200300193 7406076205870003 HARNI
740607200300193 7406070510100002 REHANG
7406071311080965 7406072001500001 SALENG
7406071311080965 7406075505690001 KARTINI
7406071311080965 7406074709830002 SUHARNI
7406071311080965 7406071003860001 SABIR
7406071311080965 7406070705890001 NASTU
7406071311080965 7406075010040001 RISNIA

7406072210120005 7406071706710001 HUSAIN DARWIS

7406072210120005 7406071706710001 HASNA
7406072210120005 7406071506920001 ARMAN
7406072210120005 7406072812930001 SAINAL
7406072210120005 7406076812950002 EVI ANDINI
7406072210120005 7406076800500003 RINA

7406072003080140 7406070107550038 MUSAKKAR

7406072003080140 7406076008650001 NURNELIANA
7406072003080140 7406071805620001 MUSMULIADI
7406072003080140 7406072603890001 ANSAR
7406072003080140 7406074301920002 MATAHARI

7406071512150001 74060741007620013 HJ. MINATANG

7406071204110061 74060701077600589 BAHTIAR

7406071204110061 7406074107800067 KURNIA
7406071204110061 7406074905040002 AYU EKA SAPUTRI
7406071204110061 7406075411130001 ALYA LAELATUL HIKMA

7406072003080147 7406070107630012 DG. PARANI

7406072003080147 7406075508780001 RUKMAWATI
7406072003080147 7406075206030002 A. LISNA DWI ARYANTI

7406070104140006 74060010308870002 SUDURMAN

7406070104140006 7406074907910001 ERNA WATI
7406070104140006 7406074108080003 ANATASIA PUTRI
7406070104140006 7406075412120002
7406070104140006 7406075011150001 NUR KAHIRA

7406072103080098 7406070412780002 YUSDAR

7406072103080098 7406074712790001 SUAIBA
7406072103080098 7406075808030001 ANNA YULIDAR
7406072103080098 7406076904050001 NINA ZAKINAH
7406072103080098 7406075811730002 NIKMA

7406070709170003 7406010107890018 MARADONA

7406070709170003 7406074107940003 RISNA WATI
7406070709170003 7406011611150001

7406070609170002 7406072201760001 MAKMUR ADAM

7406070609170002 7406074711810001 TIMANG
7406070609170002 7406075412570001 HJ. NISA

740607200308102 7406073112800001 SAMIL

740607200308102 7406076802850003 HERIA
740607200308102 740607405130001 RANIA SAMIL

7406072003080115 7406070107480030 M. YUSUF

7406072003080115 7406075106550001 SENATANG
7406070607170004 7406074509780001 HERNAWATI
7406070607170004 7406076707940001 INARISKA
7406070607170004 7406074110070001 NUR ASISA
7406070607170004 7406070608100001 AKMAL
7406070607170004 7406076212130001 NURLELA

7406072003080174 7406074107310010 HJ. REMMANG

7406072003080174 740607410757021 TANG

7406072607160003 740601507900002 USMAN

7406072607160003 7406014203950001 KASMIKA
7406072607160003 7406072607160001 ALFANDI RIFKI MUMTAZ

7406072003080108 7406070701760001 USMAN

7406072003080108 7406074703710001 MUKIMIN
7406072003080108 7406072303090001 ALGI FARIL
7406072003080108 7406074109160001 MAGFIRA
7406072003080108 7406074107580012 HJ. HAMSIA

7406070503150001 7406070404880001 JUMARDIANTO, SE

7406070503150001 7308214612914001 IRMA, S.PD
7406070503150001 7406074204170001 ADIBA FAIHA ATMARINI. J

7406072003080171 7406070107490013 ALIMUDDIN

7406072003080171 7406074107510009 NUHAYA

7406072003080109 7406070107390008 DG. MATTAWANG

7406072003080109 7406074107760043 HASMI
7406072003080109 7406074201800002 SUMARNI

7406072003080113 7406070107610018 NURDIN

7406072003080113 7406074107630017 MARYAM
7406072003080113 7406076704870001 DASMAWATI
7406072003080113 7406075505880001 NISMAWATI
7406072003080113 7406072605910003 RISAL
7406072003080113 7406074107960007 SUGIRA

7406071104170001 7406010107770055 SATIRE

7406071104170001 7406074711790001 RUGYA
7406071104170001 7406070404170001 MUHAMMAD RUSYAID

7406072504110002 7406070706730001 AMIN

7406072504110002 7406076410800001 SUHAEMI

7406072003080136 7406070107820017 ASRIL

7406072003080136 7406074107790019 HERNI
7406072003080136 7406071209960003 BUKARDI
7406072003080136 7406077007040001 TIARA ASRINI
7406072003080136 7406074905110001 INDRI SYARINI

7406072403160002 7406075202960001 FITRIANI

7406076005150001 RAISAH SYAZWANA ARFI

7406072403080018 7406070107610022 WAHE

7406072403080018 740607-107610022 NYAMENG
7406072403080018 7406074107630031 ROSNAWATI
7406072403080018 7406072401990001 RUSLAN
7406072403080018 7406070207040001 RISKI GUNAWAN

7406071311080965 740702001600001 SALENG

7406071311080965 740705505690001 KARTINI
7406071311080965 7407074709830002 SUHARNI
7406071311080965 7407010038600001 SABIR
7406071311080965 7407070705890001 NASMI
7406071311080965 7407071010040001 RISMA

7406071512150002 7406074107580011 NAMIRA

7406072003080047 7406072505790001 BAHARUDDI

7406072003080047 7406074107920017 NURBAYA
7406072003080047 7406072907050001 M. ARYA
7406072003080047 7406074603070001 MAWAR
7406072003080047 7406076505100001 NUR SALSABILA
7406072003080047 7406072907120001 M. ZULFIKAR

740607200308044 7406070107820038 KASMIR

740607200308044 7406074312830001 HERNI. S.PD
740607200308044 7406070112040001 HAEKAL RAHMAT NAIR
740607200308044 7406070808080001 ARIEL AYATUL HIDAYAT
740607200308044 7406074611160001 ARSYIFA KHA YYIRAH MARYAM

7406072003080160 7406070107680015 TAHANG

7406072003080160 7406076610740001 MUSFIRA
7406072003080160 7406070504990003 AMISYAR
7406072003080160 7406071009050001 ANSAR

7406072003080016 7406070107820016 SUDIRMAN

7406072003080016 7406074302870001 MUSDALIFA
7406072003080016 7406076412100002 SULFADILLILA

7406072003080167 7406072307740001 MUSDAR

7406072003080167 7406075304750001 SUMARNI
7406072003080167 7406074403050001 FITRA AMANDA
7406072003080167 7406074709130001 NUR AQILA
7406072003080167 7406071505170001 MUH. AUFAN

7406071404140001 7406070107890006 NASRUL

7406071404140001 7406015304950001 SUKMAWATI
7406071404140001 7406076806130001 ABEL

7406072908170001 7406070501870001 WARIS

7406072908170001 7406074202980001 ERA AJRIANI
7406072908170001 7406076810140001 ZALFAH TALINA

7406071311080317 7406072502600001 MAING

7406071311080317 7406077003700001 ROS
7406071311080317 7406075708860001 RUSNI
7406071311080317 7406070512880001 RUSTAN

7406071130150005 7406010107630085 HASSE

7406071130150005 7406071410760130 HASNAWATIHADADE
7406071130150005 7406012602870002 BAHARUDDIN
7406071130150005 7406015309990001 NENENG FEBRIANA
7406071130150005 7406012604030003 FAISAL
7406071130150005 7406071309080001 RAMADHAN

7406072905120001 7406070107660048 YELI

7406072905120001 74060741078300046 ROSNAENI
7406072905120001 7406074610100002 NURUL HUSNA AL-FAYANA

7406072611130002 7406072612890001 AGUS

7406072611130002 7406075506920002 SUSIANTI
7406072611130002 7406076002130001 AFNAN ADILAH FATIN
7406072611130002 7406075308160001 ATIKA SAHRA RATIFA

7406072003080169 7406070107670013 BAHAR. B

7406072003080169 7406074107610014 BUNGKO
7406072003080169 7406076401920001 MILA SARI
7406072003080169 7406070502940001 KAMALUDDIN
7406072003080169 7406071601990001 BAHRUN ARUDDIN

7406072003080041 7406071503810002 RAIS

7406072003080041 7406076507840001 HASNA
7406072003080041 7406075301040001 NOVITA SARI
7406072003080041 7406074210050002 MUH. NABILA ALIF
7406072003080041 7406072310100001 MUH. ALFUQRAN

7406071311120003 7406012804810001 SYAMSUL ALAM

7406071311120003 7406074305780001 JUNAENI
7406071311120003 740607802160001 SYAKILA AZZAHRAH

7406072003080125 7406070107800019 MUKSIN

7406072003080125 7406075011830001 NURHIDAYA

7406072503110018 7406072604680001 MUH. ARIF BIN TAYYE

7406072503110018 7406075506710001 MASNIATI
7406072503110018 7406072605890002 ASMARDIANSYAH
7406072503110018 7406072008960001 ALI IMRAN
7406072503110018 7406071102990001 AMRI AMRAN
7406072503110018 7406075310980001 JUMRIANI
7406072503110018 7406075203000001 KAMLIANA
7406072503110018 7406070505020001 AHMAD RISAL
7406072503110018 7406070101040006 AHMAD AMSANI

7407070401090684 7407070107750005 HASMAWIR

7407070401090684 7407076511820001 RAHMAWATI
7407070401090684 7407070405030001 HARPIAN ADRIANZA
7407070401090684 7407072403060001 HENDRI JUPRIADI

7406072003080151 7406071810550001 CUNDU

7406072003080151 7406074107560009 HASIA
7406072003080151 7406070105700001 TIARA
7406072003080151 7406074812800001 DAHLIA
7406072003080151 7406070107840016 SUKIRMAN
7406072003080151 7406070403900001 SUPARDI
7406072003080151 7406071601920001 KARMAN
7406072003080151 7406076907070001 HIKMA DILLA

7406072003080052 7406077112500003 SENNANG

7406072003080052 7406074808780001 MUSDALIFA
7406072003080048 7406070205680001 HERMAN
7406072003080048 7406075009810001 RAHMA NIAR
7406072003080048 7407064307970001 ANITA SAPUTRI
7406072003080048 7406072011980001 ANDIKA SAPUTRA
7406072003080048 7406075808030001 AYU LESTARI
7406072003080048 7406075110050001 AMELIA AMANDA

7406072003080058 7406073112400001 YALLA

7406072003080058 7406077112500002 DAPARATING
7406072003080058 7406070105900001 AMIRULLAH
7406072003080058 7406070308930001 NASARULLAH
7406072003080058 7406070504990002 NASARILLAH

7406072003080054 740607070666OOO2 BADE

7406072003080054 7406074708700002 ROSMIATI
7406072003080054 7406071904920001 BASRI
7406072003080054 7406072309030001 SANDI

7406070804110055 7406070107610034 SYARIFUDDIN

7406070804110055 7406074107690045 NURHAYATI
7406070804110055 7406070401870001 MUSTANG
7406070804110055 7406075506930002 SITTI HALIDA
7406070804110055 7406075407950002 HARNIDA
7406070804110055 7406071111990001 MUSLIMING

7406072003080014 7406070107640010 SUYUTI

7406072003080014 7406076004710001 RAHMATANG
7406072003080014 7406074304920001 SURIANT

7406072003080186 7406070712700002 BUDIRMAN

7406072003080186 7406074201810002 ST. NURBAYA
7406072003080186 7406075304990001 RISNAWATI
7406072003080186 7406072006040001 ADRIANI
7406072003080186 7406074508080002 RIRIN RIANA
7406072003080186 7406077112400002 JAHARIA

7406072003080022 7406074107700051 RUSNIATI

7406072003080022 7406072701940001 RESPIANTO
7406072003080022 7406075508020001 RANSISKA RINI ANGRAENI

7406072003080165 7406070107550009 DG. MASSIKI

7406072003080165 7306074108600001 NAHARE
7406072003080165 7406070304950001 NAHARUDDIN

7406072003080033 7406070206620001 NUDDING

7406072003080033 7406075404570001 BUNGA ROSI
7406072003080033 7406071304880001 IRWAN NUDDIN, A.MD.KEB
7406072003080033 7406076201940001 FITRIANINGSI
7406072003080033 7406071710950001 ILMAN
7406072003080033 7406074107980005 ROSNAWATI
7406072003080033 7406077005000001 SITTI RAHMAWATI
7406072003080033 7406076011020002 NURLIANA
7406072003080033 7406070111030001 HENRA
7406072003080033 7406070608100003 ARIF

7406072403110004 7406073112810001 MAHIR

7406072403110004 7406077112830002 SUMARNI
7406072403110004 7406073107040002 FERDI ADRIANSA
7406072403110004 7406071408090001 AFGAN MAULANA SARI
7406072403110004 7406071812110001 MUHAMMAD KHO IRUN NIZAM

7406071803110001 7406073112600002 ABD. SALAM

7406071803110001 7406077112050001 ROSI
7406071803110001 7406074105800001 NURMIATI
7406071803110001 7406074902850001 NURBAYA
7406071803110001 7406070305990001 TAHANG

7406071105810001 MANSUR
7406075001830002 HERMAWATI
7406077908020001 ANDINI
7406072502050002 ARJUN
7406072502050002 WULAN
7406071908100001 AFGAN RAMADAN

7406073112120002 7406071107660001 AMIR

7406072002170001 7406192809920001 AMIR

7406072002170001 7406075709950001 FITRIANI
7406072002170001 7406072803170001 ADRIAN

7406071903080025 7406072109640001 BAHARUDDIN

7406071903080025 740607410770078 NURSAYANG
7406071903080025 7406075203860001 SAMSIAR
7406071903080025 7406070502900003 KAMSIL
7406071903080025 7406074206980002 NILA PURNAMA
7406071903080025 7406072108010003 IKBAL SAPUTRA
7406071903080025 7406075108040001 NIKAR

7406071903080013 7406070107660008 TIMBANG

7406071903080013 7406075702680001 TONDENG
7406071903080013 7406074805060001 PUTRI MEILANI

7406071903080020 7406070107620018 NURUNG

7406071903080020 7406074107640009 RAHMATANG
7406071903080020 7406070508990001 RISMAN

7406071605160002 7406011112860001 SUHARMAN

7406071605160002 7406014107850057 MARLINA
7406071605160002 7406015205130002 SALSABILA

7406072103080017 7406071903700001 NAHARUDDIN

7406072103080017 7406075305750001 HASNA
7406072103080017 7406070606990001 HAIKAL
7406072103080017 7406075408090003 MERI AGUSTINA

7406071903080028 7406072105710001 AMIRUDDIN MUHAMADIA

7406071903080028 7406075408780001 SUNAENA
7406071903080028 7406074402000001 MIRNA YANTI. A
7406071903080028 7406070101060001 M. AFDHAL

7406071903080023 7406070107680011 SEDE

7406071903080023 7406074107720050 NAGAWATI
7406071903080023 7406074909090002 LINDA AYUINGSI
 7406071903080023 7406076903090001 HASRIYANI NINGSI

7406071903080016 7406070712790002 HASANUDDIN

N 7406071903080016 7406075108810001 SALWIA
7406071903080016 7406071801050001 ZULFIKAR
7406071903080016 7406075602080001 CELSI

7406071803110005 7406073112820001 HARIPUDDIN

7406071803110005 7406077112790008 NADIMAN
7406071803110005 7406071209030001 RESKI
7406071803110005 7406070912080001 RENDI
7406071803110005 7406075109120001 NUR FERANTI

7406071208160002 7406072505780003 RAHMAN

7406071208160002 7406074107830043 NASIRA
7406071208160002 7406074602050002 ELSA
7406071208160002 7406075802090001 ELSI
7406071208160002 7406075406160001 SAFIRA RAMADANI

7406072801100001 7406070203780001 KASMANG

7406072801100001 7406074807800001 HASNA
7406072801100001 7406074111000003 RISK NVOANTI
7406072801100001 7406071404020001 ANDIKA EKA SAPUTRA
7406072801100001 7406070202040002 ARWAN
7406072801100001 7406075111130001 HAURA NABILA

7406072003080003 7406070108730002 A. HAMKA TAHIR

7406072003080003 7406076606800001 HALIJA
7406072003080003 7406070112010001 MUH. INSAN HAMKA
7406072003080003 7406074520030001 SITI NURPADILLAH
7406072003080003 7406074412050003 NUR AMALIA
7406072003080003 7406071307080001 M. HAERUL AMRI HAMKA

7406071903080024 7406073112550003 DG. MANAMBUNG

7406071903080024 7406077112750001 CAHAYA
7406071903080024 7406070707990003 PERDIANSYAH
7406071903080024 7406071611010001 RISAL ARDIANSYAH
7406071903080024 7406072607060003 RESKI

7406071901170006 7406070606660001 NASARUDDIN

7406071901170006 7406074107770082 MISNA
7406071901170006 7406070905110001 MUH. MIRSAN

7406071209170002 7406070109890002 DARWIS

7406071209170002 7406074303890001 HERLINDA
7406071209170002 7406072511140001 LUTFIKAL AZKA

7406070911150001 7406076808730001 SULAEHA SULTAN

7406070911150001 7401251505690001 ARWIN BAHTIAR
7406070911150001 7406076005010001 INDIRA PUTRI UTAMI

7405011803080179 7405010107720016 ANTO

7405011803080179 7406075603820002 SUHARNI
7405011803080179 7406076801030001 SELVIAN
7405011803080179 7406070607070001 REVI FAHRENZA

7406072003080209 7406074107740054 NURBAYA

7406072003080209 7406072305970001 MUH. ARDIANSAR

7406072403080014 7406073112570001 CANDU. M

7406074107580027 HJ. MARYAM

7406072612120004 7406070910700001 SUHARDI

7406074107770077 RAHMA
7406076901040001 IRMA
7406076901040002 RIDA ASTUTI
7406072105050001 SAHRUL
 Jenis Status
HUBKEL Tgl Lahir
Ke1amin 2awin

1=P 1=BK, 2=K,

1=LAKI- Alamat Tempat Tinggal
2=S 3=CH,
LAKI
3=I Tempat Lahir dd/mm/yyyy 4=CM
2=PERE
4=A 5 = TDK
MPUAN
5=T TAU

5 6 7 8 9 10
2 RAKADUA 0-07-1961 1 2 KESSIE
3 KESSIE 04-02-1992 2 2 KESSIE
4 KESSIE 24-02-1996 2 1 KESSIE
4 KESSIE 14-02-1999 2 1 KESSIE

2 LAMEO-MEONG 12/07/1970 1 2 PABBIRING

3 PABBIRING 01/02/1981 2 2 PABBIRING
4 PABBIRING 13-04-1999 2 1 PABBIRING
4 PABBIRING 20-06-2004 1 1 PABBIRING
4 PABBIRING 06/05/2004 2 1 PABBIRING
4 RAKADUA 31-12-1940 2 1 PABBIRING

2 BONE 16-07-1987 1 2 PABIBIRING

3 PABBIRING 10-10-1993 2 2 PABIBIRING
4 PABBIRING 05-11-2012 2 1 PABIBIRING

2 BONE 23-0-1967 1 2 PABBIRING

3 BOEPINANG 25-04-1981 2 2 PABBIRING
4 BOEPINANG 18-11-2001 2 1 PABBIRING
4 BOEPINANG 22-07-2011 2 1 PABBIRING

2 PABBIRING 01-07-1985 1 2 PABBIRING

3 PABBIRING 01-07-1957 2 2 PABBIRING
4 PABBIRING 28-04-1995 2 1 PABBIRING

2 PBBIRING 19-06-1990 1 2 PABBIRING

3 PBBIRING 20-04-1992 2 2 PABBIRING
4 PBBIRING 11-01-2015 1 1 PABBIRING

2 PABBIRING 17-08-1978 1 2 PABBIRING

3 PABBIRING 12--05-1987 2 2 PABBIRING
4 PABBIRING 05-10-2010 1 1 PABBIRING
2 BEPINANG 20-01-1960 1 2 PABBIRING
3 PABBIRING 15-05-1969 1 2 PABBIRING
4 PABBIRING 07-09-1983 2 1 PABBIRING
4 PABBIRING 10-05-1986 1 1 PABBIRING
4 PABBIRING 07-05-1989 1 1 PABBIRING
4 PABBIRING 10-10-2004 2 1 PABBIRING

2 PABBIRING 17-06-1971 1 2 PABBIRING

3 PABBIRING 06-06-1975 2 2 PABBIRING
4 PABBIRING 15-06-1992 1 1 PABBIRING
4 PABBIRING 28-12-1993 1 1 PABBIRING
4 KABAENA 28-12-1995 2 1 PABBIRING
4 PABBIRING 18-05-2000 2 1 PABBIRING

2 PABIRING 01-07-1955 1 2 PABBIRING

3 PABIRING 20-08-165 2 2 PABBIRING
4 PABIRING 18-05-1982 1 1 PABBIRING
4 PABIRING 26-03-1980 1 1 PABBIRING
4 PABIRING 03-01-1992 2 1 PABBIRING

2 PABBIRING 01-07-1962 2 4 PABBIRING

2 PABBIRING 01-07-1976 1 2 PABBIRING

3 PABBIRING 02-07-1980 2 2 PABBIRING
4 BANGKA 09-05-2004 2 1 PABBIRING
4 PABBIRING 14-11-2013 2 1 PABBIRING

2 PABBIRING 01-07-1963 1 2 PABBIRING

3 PABBIRING 5-08-1978 2 2 PABBIRING
4 PABBIRING 12-06-2003 2 1 PABBIRING

2 BOEPINANG 03-08-1967 1 2 PABBIRING

3 BONE 07-03-1993 2 2 PABBIRING
4 PABBIRING 01-08-2006 2 1 PABBIRING
4 PABBIRING 14-12-2012 2 1 PABBIRING
4 PABBIRING 10-11-2015 2 1 PABBIRING

2 BONE 04-12-1978 1 2 PABBIRING

3 PABBIRING 07-12-1979 2 2 PABBIRING
4 PABBIRING 18-03-2003 2 1 PABBIRING
4 PABBIRING 29-04-2005 2 1 PABBIRING
1 PABBIRING 18-11-1973 2 1 PABBIRING

2 LEMO-LEMO 01-07-1989 1 2 PABBIRING

3 PABBIRING 01-07-1994 2 2 PABBIRING
2 MARAUKE 16-11-2016 1 1 PABBIRING
PABBIRING
2 BOERA 22-01-1976 1 2 PABBIRING
3 BONE 07-11-1981 2 2 PABBIRING
5 BONE 14-12-1957 2 4 PABBIRING

2 PABBIRING 1 2 PABBIRING
3 PINRANG 2 2 PABBIRING
4 PINRANG 2 1 PABBIRING

2 PABBIRING 01-07-1948 1 2 PABBIRING

3 BONE 11-06-1955 2 2 PABBIRING
2 PABBIRING 05-09-1978 2 2 PABBIRING
4 PABBIRING 27-07-1994 2 1 PABBIRING
4 BOMBANA 01-10-2007 2 1 PABBIRING
4 PABBIRING 06-08-2010 1 1 PABBIRING
4 PABBIRING 22-12-2013 2 1 PABBIRING

2 PABBIRING 01-07-1931 2 4 PABBIRING

4 BAJOE 01-07-1957 2 4 PABBIRING

2 PABBIRING 15-07-1990 1 2 PABBIRING

3 BARANGGA 02-03-1995 2 2 PABBIRING
4 PABBIRING 26-07-2016 1 1 PABBIRING

2 PABBIRING 05-11-1975 1 2 PABBIRING

3 PABBIRING 07-03-1976 2 2 PABBIRING
4 PABBIRING 23-03-2009 1 1 PABBIRING
4 PABBIRING 01-09-2016 2 1 PABBIRING
5 PABBIRING 01-07-1958 2 1 PABBIRING

2 PABBIRING 04-04-1988 1 2 PABBIRING

3 PABBIRING 06-12-1991 2 2 PABBIRING
4 PABBIRING 02-04-2017 2 1 PABBIRING

2 BONE 01-07-1949 1 2 PABBIRING

3 PABBIRING 01-07-1951 2 2 PABBIRING

2 PABBIRING 01-07-1939 1 4 PABBIRING

3 PABBIRING 01-07-1976 2 1 PABBIRING
4 PABBIRING 02-01-1980 2 1 PABBIRING

2 PABBIRING 01-07-1961 1 2 PABBIRING

3 PABBIRING 01-07-1963 2 2 PABBIRING
4 PABBIRING 27-04-1987 2 1 PABBIRING
4 PABBIRING 15-06-1988 2 1 PABBIRING
4 PABBIRING 26-06-1991 1 1 PABBIRING
4 PABBIRING 01-07-1996 2 1 PABBIRING

2 BOERA 01-07-1977 1 2 PABBIRING

3 PABBIRING 07-11-1979 2 2 PABBIRING
4 BOMBANA 04-04-2017 1 1 PABBIRING

2 SUMATRA 07-06-1973 1 2 PABBIRING

3 PABBIRING 24-10-1980 2 2 PABBIRING

2 BOEARA 01-07-1981 1 2 PABBIRING

3 PABBIRING 01-07-1979 2 2 PABBIRING
4 PABBIRING 12-09-1996 1 1 PABBIRING
4 PABBIRING 30-07-2004 2 1 PABBIRING
4 PABBIRING 09-05-2011 2 1 PABBIRING

2 PABBIRING 10-02-1996 2 2 PABBIRING

4 PABBIRING 20-05-2015 2 1 PABBIRING

2 PABBIRING 01-07-1961 1 2 PABBIRING

3 PABBIRING 01-07-1963 2 2 PABBIRING
4 PABBIRING 29-11-1993 2 1 PABBIRING
4 PABBIRING 24-01-1999 1 1 PABBIRING
4 PABBIRING 02-07-2004 1 1 PABBIRING

2 BOEPINANG 20-01-1960 1 2 PABBIRING

3 PABBIRING 15-05-1969 2 2 PABBIRING
4 PABBIRING 07-09-1983 2 1 PABBIRING
4 PABBIRING 10-03-1986 1 1 PABBIRING
4 PABBIRING 07-05-1989 1 1 PABBIRING
4 PABBIRING 10-10-2004 2 1 PABBIRING

2 PABBIRING 01-07-1958 2 4 PABBIRING

2 PABBIRING 01-011979 1 2 PABBIRING

3 TANGGETADA 08-11-1988 2 2 PABBIRING
4 BATUPUTIH 29-07-2005 1 1 PABBIRING
4 BATUPUTIH 03-06-2007 2 1 PABBIRING
4 PABBIRING 25-10-2010 2 1 PABBIRING
4 PABBIRING 29-07-2012 1 1 PABBIRING

2 PABBIRING 01-07-1982 1 2 PABBIRING

3 PABBIRING 03-12-1983 2 2 PABBIRING
4 PABBIRING 01-12-2004 1 1 PABBIRING
4 PABBIRING 08-08-2008 1 1 PABBIRING
4 PABBIRING 06-11-2016 2 1 PABBIRING

2 KASTARIB 01-07-1968 1 2 PABBIRING

3 PABBIRING 26-10-1974 2 2 PABBIRING
4 PABBIRING 05-04-1999 1 1 PABBIRING
4 PABBIRING 10-09-2005 1 1 PABBIRING

2 POKURUMBA 01-07-1982 1 2 PABBIRING

3 PABBIRING 03-02-1967 2 2 PABBIRING
4 PABBIRING 24-12-2010 2 1 PABBIRING

2 KESSIE 05-1201974 1 2 PABBIRING

3 POKURUMBA 13-04-1975 2 2 PABBIRING
4 PABBIRING 05-03-2005 2 1 PABBIRING
4 PABBIRING 07-09-2013 2 1 PABBIRING
4 PABBIRING 15-05-2017 1 1 PABBIRING

2 PABBIRING 01-07-198 1 2 PABBIRING

3 POKURUMBA 13-04-1995 2 2 PABBIRING
4 PABBIRING 28-06-2013 1 1 PABBIRING

2 BONE 05-01-1987 1 2 PABBIRING

3 PABBIRING 02-02-1998 2 2 PABBIRING
4 PABBIRING 28-10-2014 2 1 PABBIRING

2 PABBIRING 25-02-2960 1 2 PABBIRING

3 PABBIRING 30-03-1970 2 2 PABBIRING
4 BANGKA 17-08-1986 2 1 PABBIRING
4 BANGKA 05-12-1988 1 1 PABBIRING

2 TIROMAI 01-07-1963 1 2 PABBIRING

3 PABBIRING 17-07-1973 2 2 PABBIRING
4 TIROMAI 26-02-1987 1 1 PABBIRING
4 TIROMAI 13-09-1999 2 1 PABBIRING
4 TIROMAI 26-04-2003 1 1 PABBIRING
4 TIROMAI 13-09-2008 1 1
PABBIRING
2 PABANGKOA 01-07-1985 1 2 PABBIRING
3 PABBIRING 01-07-1983 2 2 PABBIRING
4 TANTAHI 05-10-2010 2 1 PABBIRING

2 RAKADUA 26-12-1989 1 2 PABBIRING

3 PABBIRING 15-06-1992 2 2 PABBIRING
4 PABBIRING 20-02-2013 2 1 PABBIRING
4 PABBIRING 13-08-2016 2 1 PABBIRING

2 PABBIRING 01-07-1957 1 2 PABBIRING

3 PABBIRING 01-07-1961 2 2 PABBIRING
4 PABBIRING 24-01-1992 2 1 PABBIRING
4 PABBIRING 05-02-19994 1 1 PABBIRING
4 PABBIRING 16-01-1999 1 1 PABBIRING

2 PABBIRING 15-03-1981 1 2 PABBIRING

3 SINJAI 25-07-1984 2 2 PABBIRING
4 PABBIRING 13-01-2004 2 1 PABBIRING
4 PABBIRING 02-10-2005 1 1 PABBIRING
4 PABBIRING 23-10-201- 1 1 PABBIRING

2 KASTARIB 28-04-1981 1 2 PABBIRING

3 PABBIRING 03-05-1978 2 2 PABBIRING
4 RAKADUA 08-02-2016 2 1 PABBIRING

2 BOEARA 01-07-1980 1 2 PABBIRING

3 PABBIRING 10-11-1983 2 2 PABBIRING

2 BONE 26-04-1968 1 2 PABBIRING

3 PABBIRING 15-06-1971 2 2 PABBIRING
4 BARANGGA 26-05-1989 1 1 PABBIRING
4 PABBIRING 20-08-1996 1 1 PABBIRING
4 PABBIRING 11-02-1998 1 1 PABBIRING
4 PABBIRING 13-10-1998 2 1 PABBIRING
4 PABBIRING 12-03-2000 2 1 PABBIRING
4 PABBIRING 28-07-2002 1 1 PABBIRING
4 PABBIRING 01-01-2004 1 1 PABBIRING

2 PABBIRING 01-07-1980 1 2 PABBIRING

3 PABBIRING 25-11-1982 2 2 PABBIRING
4 PABBIRING 04-05-2006 1 1 PABBIRING
4 PABBIRING 24-03-2006 1 1 PABBIRING

2 PABBIRING 18-10-1955 1 2 PABBIRING

3 BOEARA 01-07-1956 2 2 PABBIRING
4 PABBIRING 01-05-1970 1 1 PABBIRING
4 PABBIRING 08-12-1980 2 1 PABBIRING
4 PABBIRING 01-07-1984 1 1 PABBIRING
4 PABBIRING 04-03-1990 1 1 PABBIRING
4 PABBIRING 16-01-1992 1 1 PABBIRING
PABBIRING 29-07-2007 2 1 PABBIRING

2 PABBIRING 11-12-1950 2 2 PABBIRING

4 PABBIRING 08-08-1978 2 1 PABBIRING
2 GALUNG 02-05-1968 1 2 PABBIRING
3 PABBIRING 10-09-1981 2 2 PABBIRING
4 PABBIRING 03-07-1997 2 1 PABBIRING
4 PABBIRING 20-11-1998 1 1 PABBIRING
4 PABBIRING 18-08-2003 2 1 PABBIRING
4 PABBIRING 11-10-2005 2 1 PABBIRING

2 PABBIRING 31-12-1940 1 2 PABBIRING

3 PABBIRING 31-12-1950 2 2 PABBIRING
4 PABBIRING 01-05-1990 1 1 PABBIRING
4 PABBIRING 03-08-1993 1 1 PABBIRING
4 PABBIRING 05-04-1999 1 1 PABBIRING

2 LAMO-LEMO 07-05-1966 1 2 PABBIRING

3 PABBIRING 07-08-970 2 2 PABBIRING
4 PABBIRING 19-04-1992 1 1 PABBIRING
4 PABBIRING 23-09-2003 1 1 PABBIRING

2 PABBIRING 01-07-1961 1 2 PABBIRING

3 PABBIRING 01-07-1969 2 2 PABBIRING
4 PABBIRING 04-01-1987 1 1 PABBIRING
4 PABBIRING 16-061993 2 1 PABBIRING
4 PABBIRING 14-07-1995 2 1 PABBIRING
4 PABBIRING 11-11-1999 1 1 PABBIRING

2 PABBIRING 01-07-1964 1 2 PABBIRING

3 RAKADUA 10-04-1971 2 2 PABBIRING
2 PABBIRING 03-04-1992 2 1 PABBIRING

2 PABBIRING 07-201970 1 2 PABBIRING

3 PABBIRING 02-01-1981 2 2 PABBIRING
4 PABBIRING 13-04-1999 2 1 PABBIRING
4 PABBIRING 20-06-2004 1 1 PABBIRING
4 PABBIRING 05-08-2008 2 1 PABBIRING
5 PABBIRING 31-12-1940 2 1 PABBIRING

2 PABBIRING 01-07-1970 2 4 PABBIRING

4 PABBIRING 27-01-1994 1 1 PABBIRING
4 PABBIRING 15-08-2002 2 1 PABBIRING
PABBIRING
2 PABBIRING 07/01/1950 1 2 PABBIRING
3 PABBIRING 06/01/1960 2 2 PABBIRING
4 PABBIRING 04/04/1995 1 1 PABBIRING

2 PABBIRING 05/02/1962 1 2 PABBIRING

3 POMALAA 14-03-1967 2 2 PABBIRING
4 BOEPINANG 13-04-1988 1 1 PABBIRING
4 PABBIRING 22-01-1994 2 1 PABBIRING
4 PABBIRING 17-10-1995 1 1 PABBIRING
4 BOEPINAGNG 1/2/1997 2 1 PABBIRING
4 PABBIRING 30-05-2000 2 1 PABBIRING
4 BOEPINANG 1/1/2003 2 1 PABBIRING
4 PABBIRING 17-12-2005 1 1 PABBIRING
4 PABBIRING 6/8/2010 1 1 PABBIRING

2 PABBIRING 31-12-1981 1 2 PABBIRING

3 PABBIRING 31-12-1983 2 2 PABBIRING
4 PABBIRING 31-07-2004 1 1 PABBIRING
4 PABBIRING 14-08-2008 1 1 PABBIRING
4 PABBIRING 18-12-2011 1 1 PABBIRING

2 PABBIRING 31-12-1960 1 2 PABBIRING

3 PABBIRING 31-12-1965 2 2 PABBIRING
4 PABBIRING 1/5/1980 1 1 PABBIRING
4 PABBIRING 9/2/1985 1 1 PABBIRING
4 PABBIRING 3/5/1999 1 1 PABBIRING

2 PABBIRING 11/5/1981 1 2 PABBIRING

3 PABBIRING 10/1/1983 2 2 PABBIRING
4 PABBIRING 19-06-2002 2 1 PABBIRING
4 PABBIRING 25-02-2005 1 1 PABBIRING
4 PABBIRING 3/2/2008 2 1 PABBIRING
4 PABBIRING 19-08-2010 1 1 PABBIRING
PABBIRING
2 TARUSENG 11/7/1966 1 1 PABBIRING

2 MULAENO 28-09-1992 1 2 KESSIE

3 RAKADUA 17-09-1995 2 2 KESSIE
4 RAKADUA 28-03-2017 1 1 KESSIE

2 LAROLEA 21-09-1964 1 2 KESSIE

3 KESSIE 01-07-1970 2 2 KESSIE
4 KESSIE 12-03-1986 2 1 KESSIE
4 KESSIE 05-02-1990 1 1 KESSIE
4 KESSIE 07-06-1998 2 1 KESSIE
4 KESSIE 21-08-2001 1 1 KESSIE
4 KESSIE 11-08-2004 2 1 KESSIE

2 KESSIE 01-07-1965 1 2 KESSIE

3 BUERENGGE 17-02-1968 2 2 KESSIE
4 KESSIE 08-05-2005 2 1 KESSIE

2 KESSIE 01-07-1962 1 2 KESSIE

3 RAKADUA 01-07-1964 2 2 KESSIE
4 KESSIE 05-08-1999 1 1 KESSIE

KESSIE 11-12-1986 1 2 KESSIE

KASTARIB 01-07-1987 2 2 KESSIE
BOMBANA 12-05-2013 2 1 KESSIE

2 RAKADUA 19-03-1970 1 2 KESSIE

3 KESSIE 13-05-1975 2 2 KESSIE
4 KESSIE 06-06-1999 1 1 KESSIE
4 KESSIE 14-08-2009 2 1 KESSIE

2 KESSIE 21-05-1971 1 2 KESSIE

3 TOATI 14-08-1978 2 2 KESSIE
4 TIMBALA 04-02-2000 2 1 KESSIE
4 KESSIE 01-01-2005 1 1 KESSIE

2 EWOLANGKA 01-07-1968 1 2 KESSIE

3 BOEARA 01-07-1972 2 2 KESSIE
4 RAKADUA 09-09-1999 2 1 KESSIE
4 KESSIE 29-03-2009 2 1 KESSIE

2 KESSIE 07-12-1979 1 2 KESSIE

3 TIMBALA 11-08-1981 2 2 TIMBALA
4 TIMBALA 18-01-2005 1 1 TIMBALA
4 TIMBALA 16-02-2009 2 1 TIMBALA

2 KESSIE 31-12-1962 1 2 KESSIE

3 LEMO-LEMO 31-12-1979 2 2 KESSIE
4 KESSIE 12-09-2003 1 1 KESSIE
4 KESSIE 09-12-2008 1 1 KESSIE
4 KESSIE 11-09-2012 2 1 KESSIE

2 KESSIE 25-05-1978 1 2 KESSIE

3 LEMO-LEMO 01-07-1983 2 2 KESSIE
4 KESSIE 06-02-2005 2 1 KESSIE
4 LEMO-LEMO 18-02-2009 2 1 KESSIE
4 KESSIE 14-06-2016 2 1 KESSIE

2 KESSIE 02-03-1978 1 2 KESSIE

3 KESSIE 08-07-1980 2 2 KESSIE
4 KESSIE 01-11-2000 2 1 KESSIE
4 KESSIE 14-04-2002 1 1 KESSIE
4 KESSIE 02-02-2014 1 1 KESSIE
4 KESSIE 11-11-2013 2 1 KESSIE

2 KESSIE 01-08-1973 1 2 KESSIE

3 KESSIE 26-06-1980 2 2 KESSIE
4 KESSIE -1-12-2001 1 1 KESSIE
4 KESSIE 05-10-2003 2 1 KESSIE
4 KESSIE 04-12-2005 2 1 KESSIE
4 KESSIE 13-07-2008 1 1 KESSIE

2 BAJOE 31-12-1955 1 2 PABBIRING

3 RAKADUA 31-12-1975 2 2 PABBIRING
4 BONE 07-07-1999 1 1 PABBIRING
4 KESSIE 16-11-2001 1 1 PABBIRING
4 KESSIE 26-07-2006 1 1 PABBIRING

2 PABBIRING 06-06-1986 1 2 TANTAHI

3 BONE 01-07-1977 2 2 TANTAHI
4 BONE 09-05-2011 1 1 TANTAHI

2 MATTIROWALLIE 01-09-1989 1 2 TARUSENG

3 KESSIE 03-03-1989 2 2 TARUSENG
4 TARUSENG 25-11-2014 1 1 TARUSENG

2 RAKADUA 28-08-1973 1 2 PABBIRING

3 KOLAKA 15-05-1969 2 2 PABBIRING
4 LAMEO-MEONG 20-05-2001 2 1 PABBIRING

2 TINANGGEA 01-07-1972 1 2 PABBIRING

3 KESSIE 16-03-1982 2 2 PABBIRING
4 KESSIE 28-01-2003 2 1 PABBIRING
4 KESSIE 06-07-2007 1 1 PABBIRING

3 TARUSANG 01-07-1974 2 3 TERUSENG

4 TARUSANG 23-05-1997 1 1 TERUSENG

2 PABBIRING 31-12-1957 1 2 TANTAHI

3 PABBIRING 01-07-1958 2 2 TANTAHI

2 SUMATRA 03-10-1970 1 2 PABBIRING

3 PABBIRING 01-07-1977 2 2 PABBIRING
4 PABBIRING 25-01-2004 2 1 PABBIRING
4 PABBIRING 29-01-2004 2 1 PABBIRING
4 PABBIRING 21-05-2005 1 1 PABBIRING

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 Kode
Kecamatan Kode Desa
RT RW Kode Pos Nama Kecamatan
(diisi (diisi petugas)
petugas)

11 12 13 14 15 16
POLEANG BARAT
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POLEANG BARAT
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POLEANG BARAT
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POLEANG BARAT

POLEANG BARAT
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POLEANG BARAT
POLEANG BARAT
POLEANG BARAT
POLEANG BARAT
POLEANG BARAT
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POLEANG BARAT
POLEANG BARAT
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POLEANG BARAT
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POLEANG BARAT
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 Kode Nama
Kode Faskes Tk.I
Nama Desa Nama Faskes Tk.I Faskes Faskes
(diisi petugas) Dokter Gigi Dokter Gigi

17 18 19 20 21
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POLEANG BARAT
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POLEANG BARAT
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 Kelas
Status Rawat
Gaji Pokok
Nomor 1=Tetap, + Tunj.
TMT Kerja (Kary.
Telepon Email NPP Jabatan 2=Kontrak, 1=Kelas I, Tetap
Aktif)
Peserta 3=Paruh (Kary.
2=Kelas II, Aktif)
waktu
4=Penerim 3=Kelas III
a Pensiun

22 23 24 25 26 27 28 29
Kewarga
Negaraan Asuransi Lainnya

No
No. NPWP Passport
1=WNI, Nama
No. Polis
2=WNA Asuransi

30 31 32 33 34