| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
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1 | ||||||||||||||||||||||||||
2 | FORM PELAPORAN KEMATIAN DATA VERVAL KADER POSYANDU | |||||||||||||||||||||||||
3 | Desa : Jatimulyo | |||||||||||||||||||||||||
4 | ||||||||||||||||||||||||||
5 | NO | NIK | NAMA LENGKAP | ALAMAT | TEMPAT DAN TANGGAL LAHIR | TEMPAT DAN TANGGAL MENINGGAL | NAMA PELAPOR | NIK PELAPOR | NAMA DAN NO HP KELUARGA YANG DAPAT DIHUBUNGI | |||||||||||||||||
6 | 1 | 2 | 3 | DUSUN | RT | RW | 4 | 5 | 6 | 7 | 8 | |||||||||||||||
7 | 1 | 3509164203160001 | KAVITA REVALINA PUTRI | DUSUN DARUSSALAM | 1 | 1 | 2/6/1981 | 7/3/2022 | YASIR | 81333659270 | ||||||||||||||||
8 | 2 | 3509166002810001 | UMI KULSUM | DUSUN DARUSSALAM | 1 | 1 | 7/1/1963 | 6/17/2022 | WIWIN DAYANI | 8563665313 | ||||||||||||||||
9 | 3 | 3509164107630524 | RUSIATI | DUSUN DARUSSALAM | 2 | 1 | 7/1/1953 | 7/17/2023 | WIWIN DAYANI | 8563665313 | ||||||||||||||||
10 | 4 | 3509160107530417 | TOMIN | DUSUN DARUSSALAM | 2 | 1 | 6/8/1995 | 7/28/2023 | WIWIN DAYANI | 8563665313 | ||||||||||||||||
11 | 5 | 3509160806950002 | AHMAD AMSEH | DUSUN DARUSSALAM | 2 | 1 | 2/7/1946 | 1/27/2020 | SITI NUR AZIZAH | 85895236070 | ||||||||||||||||
12 | 6 | 3509160702460001 | LULUT BUDIONO | DUSUN DARUSSALAM | 3 | 1 | 4/16/1976 | 12/18/2012 | SOLEHATI | 85801655057 | ||||||||||||||||
13 | 7 | 3509161604760002 | MADON | DUSUN DARUSSALAM | 3 | 1 | 3/17/1965 | 5/25/2020 | SOLEHATI | 85801655057 | ||||||||||||||||
14 | 8 | 3509165703650005 | RATMINAH | DUSUN DARUSSALAM | 3 | 1 | 6/1/1966 | 12/1/2020 | SUINAH | 85801655057 | ||||||||||||||||
15 | 9 | 3509160106660003 | NIRAM | DUSUN DARUSSALAM | 3 | 1 | 4/3/1943 | 8/7/2016 | BUHAR | 85801655057 | ||||||||||||||||
16 | 10 | 3509164304430001 | MANISAH | DUSUN DARUSSALAM | 3 | 1 | 3/2/1954 | 11/12/2005 | SENITI | 85895236070 | ||||||||||||||||
17 | 11 | 3509160203540004 | KUSTARI | DUSUN DARUSSALAM | 3 | 1 | 4/3/1960 | 11/20/2022 | SENITI | 85895236070 | ||||||||||||||||
18 | 12 | 3509164304600006 | SUTILAH | DUSUN DARUSSALAM | 3 | 1 | 7/29/1965 | 4/27/2024 | SENITI | 85895236070 | ||||||||||||||||
19 | 13 | 3509160107630356 | SAMSURI | DUSUN DARUSSALAM | 4 | 1 | 7/1/1938 | 5/11/2021 | ASIROH | 81230691141 | ||||||||||||||||
20 | 14 | 3509164107380251 | JUWARIYAH | DUSUN DARUSSALAM | 10 | 2 | ||||||||||||||||||||
21 | 15 | 3509162805040005 | MOH. GHIO HANDOYO | DUSUN DARUSSALAM | 10 | 2 | 1/7/1932 | 2/14/2012 | 82132757848 | |||||||||||||||||
22 | 16 | 3509162408430002 | SAMSUDIN | DUSUN DARUSSALAM | 11 | 2 | 5/4/1954 | 5/5/2022 | 85704305363 | |||||||||||||||||
23 | 17 | 3509164405540001 | AMINATUN | DUSUN DARUSSALAM | 12 | 2 | 12/21/1943 | 11/11/2012 | 85704305363 | |||||||||||||||||
24 | 18 | 3509161212430001 | KASERI | DUSUN DARUSSALAM | 12 | 2 | 8/5/1945 | 1/18/2021 | 85704305363 | |||||||||||||||||
25 | 19 | 3509164508450001 | RASMI | DUSUN DARUSSALAM | 12 | 2 | 11/7/1960 | 8/30/2025 | HOIRIYAH | 85604998838 | ||||||||||||||||
26 | 20 | 3509164711600004 | SITI MARWIYAH | DUSUN DARUSSALAM | 12 | 2 | ||||||||||||||||||||
27 | 21 | 3509162003020005 | KHUSNUL KHULUQI | DUSUN DARUSSALAM | 12 | 2 | 9/19/1950 | 1/14/2021 | USWATUN HASANAH | 85784662749 | ||||||||||||||||
28 | 22 | 3509166909500001 | UMI FADILAH | DUSUN DARUSSALAM | 12 | 2 | 5/18/1942 | 1/1/2015 | ROHISOTUL | 82334441490 | ||||||||||||||||
29 | 23 | 3509161805420001 | SALIMIN | DUSUN DARUSSALAM | 12 | 2 | 3/25/1965 | 8/13/2023 | MASRIFAH | 81517029495 | ||||||||||||||||
30 | 24 | 3509162503650001 | AHMAD FAUZI | DUSUN DARUSSALAM | 12 | 2 | 6/18/1973 | 3/5/2025 | DELA MAULIDA | 81455049337 | ||||||||||||||||
31 | 25 | 3509161806730002 | HUDORI | DUSUN DARUSSALAM | 12 | 2 | 7/1/1939 | 6/5/2021 | RIDA UMAMA | 81339164331 | ||||||||||||||||
32 | 26 | 3509160107390069 | SAMINGUN | DUSUN DARUSSALAM | 13 | 2 | 9/13/1949 | 10/12/2020 | RIVATUL FUADAH | 85233939253 | ||||||||||||||||
33 | 27 | 3509165309490001 | MUKIYAH | DUSUN DARUSSALAM | 13 | 2 | 8/7/1971 | 7/18/2021 | anwar | 81334729177 | ||||||||||||||||
34 | 28 | 3509164708710001 | SITI HOTIMAH | DUSUN DARUSSALAM | 14 | 2 | 3/8/1962 | 5/10/2023 | anwar | 81334729177 | ||||||||||||||||
35 | 29 | 3509160803620001 | SOMADI ZUHRI | DUSUN DARUSSALAM | 14 | 2 | 6/7/1972 | 12/14/2025 | zidan fasabi | 82132487182 | ||||||||||||||||
36 | 30 | 3509164706720002 | SITI ROMLAH | DUSUN DARUSSALAM | 14 | 2 | 7/12/1960 | 1/13/2026 | abdur rohim | 85745802650 | ||||||||||||||||
37 | 31 | 3509165207600007 | WARSIMAH | DUSUN DARUSSALAM | 15 | 2 | 7/1/1956 | 1/1/2015 | ayahrul anam | 82331130093 | ||||||||||||||||
38 | 32 | 3509164107560166 | WASINGAH | DUSUN DARUSSALAM | 15 | 2 | 10/14/1951 | 5/9/2022 | ELOK PURI | 85792094733 | ||||||||||||||||
39 | 33 | 3509165410510001 | MUSINAH | DUSUN DARUSSSALAM | 15 | 2 | 4/12/1996 | 5/4/2020 | PAIRIN | 85204981236 | ||||||||||||||||
40 | 34 | 3509165204960003 | YATI ZAIDAH A | DUSUN DARUSSALAM | 16 | 2 | 7/1/1996 | 2/6/2019 | DINA | 85784661554 | ||||||||||||||||
41 | 35 | 3509164107960350 | FADILATUL HASANAH | DUSUN DARUSSALAM | 16 | 2 | 4/11/1962 | 8/10/2018 | BARIZI | 85648382353 | ||||||||||||||||
42 | 36 | 3509161104620001 | MOH. NAWAWI | DUSUN DARUSSALAM | 16 | 2 | ||||||||||||||||||||
43 | 37 | 3509165111470001 | PARSIYAH | DUSUN DARUSSALAM | 16 | 2 | 9/5/1950 | 3/4/2025 | ULFI ZUNAIROH | 85704822581 | ||||||||||||||||
44 | 38 | 3509164509500001 | SUGIYEM | DUSUN DARUSSALAM | 17 | 2 | ||||||||||||||||||||
45 | 39 | 3509161012480002 | TUKIMAN | DUSUN DARUSSALAM | 17 | 2 | ||||||||||||||||||||
46 | 40 | 3509206812770005 | AL MUSTATI'AH | DUSUN DARUS SALAM | 17 | 2 | 3/17/1977 | 4/3/2026 | SAURI | 81910862704 | ||||||||||||||||
47 | 3509165703770002 | SULIYATI | DUSUN DARUSSALAM | 17 | 2 | 3/12/1951 | 1/1/2021 | INSIROHUL | 85204857761 | |||||||||||||||||
48 | 3509165203510005 | FAIZAH | DUSUN DARUSSALAM | 17 | 2 | 3/5/1955 | 5/28/2024 | SIGIT ARIS M | 81554239741 | |||||||||||||||||
49 | 3509164503550007 | LASINEM | DUSUN DARUSSALAM | 18 | 2 | 11/16/1960 | 4/14/2026 | BUDI | 82132376628 | |||||||||||||||||
50 | 3509161611600001 | SUPARDI | DUSUN DARUSSALAM | 18 | 2 | 4/21/1950 | 3/17/2020 | MAJIDUN | 82338098029 | |||||||||||||||||
51 | 3509166104500001 | WARSIH | DUSUN DARUSSALAM | 4 | 2 | |||||||||||||||||||||
52 | 3509164107650262 | SA'DIMAH | DUSUN DARUSSALAM | 5 | 2 | 4/11/1967 | 9/20/2022 | IDA ROYANI | 85134364293 | |||||||||||||||||
53 | 3509165104670002 | SENITI | DUSUN DARUSSALAM | 5 | 2 | 11/8/1946 | 8/21/2020 | SITI ROHANA | 85645819531 | |||||||||||||||||
54 | 3509160811460002 | SAIMAN | DUSUN DARUSSALAM | 5 | 2 | 7/16/1953 | 4/8/2025 | MUHAMMAD SYAFI'I | 85235091606 | |||||||||||||||||
55 | 3509195607530002 | SANIA | DARUSSALAM | 5 | 2 | |||||||||||||||||||||
56 | 9106015204780002 | MUSRIFAH | DUSUN DARUSSALAM | 5 | 2 | |||||||||||||||||||||
57 | 3509162609180002 | MUHAMMAD RIZAL AMINULLOH | DUSUN DARUSSALAM | 6 | 2 | 4/10/1958 | 2/11/2010 | SUTINAH | 81946251010 | |||||||||||||||||
58 | 3509161004580001 | MISDHI | DUSUN DARUSSALAM | 6 | 2 | 11/5/1955 | 3/5/2022 | JUMINA | 85730287223 | |||||||||||||||||
59 | 3509160511550003 | MAHAT | DUSUN DARUSSALAM | 6 | 2 | 1/7/1950 | 3/1/2000 | SUTINAH | 81946251010 | |||||||||||||||||
60 | 3509164210530001 | BARNAH | DUSUN DARUSSALAM | 6 | 2 | 5/18/2000 | 12/12/2016 | MASFHUFAH | 85288791932 | |||||||||||||||||
61 | 3509165805000002 | KHOIRUN NIMAH | DUSUN DARUSSALAM | 7 | 2 | 12/26/1979 | 7/15/2018 | MAISAROH | 81515832694 | |||||||||||||||||
62 | 3509162612790002 | IRFAN HASANI | DUSUN DARUSSALAM | 7 | 2 | 7/1/1954 | 6/10/2019 | UMI HANIK | 85204982868 | |||||||||||||||||
63 | 3509164107540081 | MA,RIFAH | DUSUN DARUSSALAM | 7 | 2 | 5/19/1938 | 10/25/2012 | LABISATUL MUZAYANAH | 85812144014 | |||||||||||||||||
64 | 3509165905380001 | RUQOYAH | DUSUN DARUSSALAM | 7 | 2 | 7/15/1983 | 5/21/2021 | RONIAH | 81455061395 | |||||||||||||||||
65 | 3509161507830003 | MUHAMMAD SAIFUL | DUSUN DARUSSALAM | 7 | 2 | 5/12/1950 | 6/15/2015 | RONIAH | 81455061395 | |||||||||||||||||
66 | 3509165205500004 | MUNGINAH | DUSUN DARUSSALAM | 7 | 2 | 11/21/1966 | 7/14/2021 | BUYONO | 82338553815 | |||||||||||||||||
67 | 3509166411660002 | FATIMAH | DUSUN DARUSSALAM | 8 | 2 | 4/5/1953 | 7/20/2024 | SOHIB | 85755218149 | |||||||||||||||||
68 | 3509164504530002 | KAMSINI | DUSUN DARUSSALAM | 8 | 2 | 2/28/1996 | 12/28/2024 | RIO RIZKIAWAN | 82230550320 | |||||||||||||||||
69 | 3509165505960004 | ANA RIZKI HOIROH | DUSUN DARUSSALAM | 8 | 2 | 1/14/1960 | 7/9/2024 | NANANG | 82131825019 | |||||||||||||||||
70 | 3509161401600004 | IMAM NAWAWI | DUSUN DARUSSALAM | 8 | 2 | 7/1/1943 | 9/21/2024 | JUWARIAH | 81455049109 | |||||||||||||||||
71 | 3509160107430298 | TULUS | DUSUN DARUSSALAM | 9 | 2 | 7/1/1940 | 2/9/2026 | ST ROJIAH | 81252901527 | |||||||||||||||||
72 | 3509160107400183 | MA'LAN | DUSUN DARUSSALAM | 9 | 2 | 8/18/1982 | 5/11/2024 | SAMPURNO | 85129507290 | |||||||||||||||||
73 | 3509165808820002 | USWATUN HASANAH | DUSUN DARUSSALAM | 9 | 2 | 7/7/1977 | 5/7/2023 | SITI FATIMAH | 81249287997 | |||||||||||||||||
74 | 3509162707770004 | NUR HAMID | DUSUN DARUSSALAM | 9 | 2 | |||||||||||||||||||||
75 | 3509164709650004 | MISRI | DUSUN BRINGINSARI | 1 | 3 | 6/16/1940 | 1/1/2015 | |||||||||||||||||||
76 | 3509165606400002 | KATINEM | DUSUN BRINGINSARI | 1 | 3 | 4/16/1937 | 1/1/2015 | |||||||||||||||||||
77 | 3509161604370001 | NUR HADI | DUSUN BRINGINSARI | 1 | 3 | 7/1/1964 | 1/13/2026 | |||||||||||||||||||
78 | 3509164107640091 | MISNATI | DUSUN BRINGINSARI | 1 | 3 | |||||||||||||||||||||
79 | 3509160312920002 | AHMAD ZAINUDIN | DUSUN BRINGINSARI | 1 | 3 | 6/4/1961 | 3/5/2023 | SUMILAH | 85608457003 | |||||||||||||||||
80 | 3509160406610003 | TOMI TUMIRAN | DUSUN BRINGINSARI | 10 | 3 | 1/2/1940 | 2/11/2021 | RIA ANGGRAENI | 85608457003 | |||||||||||||||||
81 | 3509160201400003 | MUJIONO | DUSUN BRINGINSARI | 10 | 3 | 3/5/1945 | 8/30/2024 | RIA ANGGRAENI | 85608457003 | |||||||||||||||||
82 | 3509164503450001 | PONIYEM | DUSUN BRINGINSARI | 10 | 3 | 3/2/1955 | 11/8/2025 | MUTLIKAH | 85735820631 | |||||||||||||||||
83 | 3509160203550003 | MUJIO | DUSUN BRINGINSARI | 10 | 3 | 8/17/1985 | 1/1/2025 | SA,DIYAH | 81252074602 | |||||||||||||||||
84 | 3509165708850005 | SAENAH | DUSUN BRINGINSARI | 10 | 3 | 8/13/1953 | 1/1/2017 | SRI MUKODIMAH | 81331546648 | |||||||||||||||||
85 | 3509165308530003 | DJUMINAH | DUSUN BRINGINSARI | 10 | 3 | |||||||||||||||||||||
86 | 3509160111650003 | BASORI | DUSUN BRINGINSARI | 11 | 3 | 10/10/1945 | 11/17/2012 | GINEM | 85798203938 | |||||||||||||||||
87 | 3509161010450005 | NGADIRAN | DUSUN BRINGINSARI | 11 | 3 | 3/2/1952 | 5/21/2023 | MANIDIN | 87783345536 | |||||||||||||||||
88 | 3509164203520002 | SAYATI | DUSUN BRINGINSARI | 11 | 3 | 4/12/1966 | 4/7/2016 | ELVA AROFAH | 85230576952 | |||||||||||||||||
89 | 3509161204660002 | M. RUSDI | DUSUN BRINGINSARI | 11 | 3 | 11/3/1953 | 7/20/2022 | KHOIRIYAH | 85204884822 | |||||||||||||||||
90 | 3509160311530001 | SUMAIDI | DUSUN BRINGINSARI | 11 | 3 | 7/1/1975 | 10/8/2021 | JAINURI | 85235083366 | |||||||||||||||||
91 | 3509164107750335 | SAMINEM | DUSUN BRINGINSARI | 11 | 3 | 10/12/1956 | 3/21/2021 | BADRIYAH | 85775445203 | |||||||||||||||||
92 | 3509165210560001 | SUP MUNTAMAH | DUSUN BRINGINSARI | 12 | 3 | 9/20/1948 | 3/26/2024 | AGUS RIDWAN | 81236260949 | |||||||||||||||||
93 | 3509161002500001 | ROHMAD | JATI MULYO | 2 | 3 | 12/8/1955 | 9/10/2023 | AGUS RIDWAN | 81236260949 | |||||||||||||||||
94 | 3509164107610075 | SITI BAIYINA | JATI MULYO | 2 | 3 | 8/18/1950 | 12/15/2022 | MARDIYAH | 83178260362 | |||||||||||||||||
95 | 3509165808500002 | LAILIYAH | DUSUN BRINGINSARI | 2 | 3 | |||||||||||||||||||||
96 | 3509166310400001 | MULYANI | DUSUN BRINGINSARI | 2 | 3 | 7/1/1974 | 1/1/2025 | WIDARTIK | 85784664560 | |||||||||||||||||
97 | 3509160107740107 | PAIDI | DUSUN BRINGINSARI | 2 | 3 | 7/1/1950 | 11/5/2023 | NUR HAYATI | 81230174718 | |||||||||||||||||
98 | 3509160107500405 | NGADENAN | DUSUN BRINGINSARI | 2 | 3 | 3/8/1967 | 10/30/2012 | SITI JARIYAH | 82143635698 | |||||||||||||||||
99 | 3509160803670001 | HERI SUTIONO | DUSUN BRINGINSARI | 3 | 3 | 7/10/1960 | 5/25/2021 | BUHASYIM | 85330795257 | |||||||||||||||||
100 | 3509164107600326 | SARINAH | DUSUN BRINGINSARI | 3 | 3 | 2/1/1951 | 7/1/2023 | SUKEDI | 85233153675 | |||||||||||||||||