ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBK
8
NoNamaJenis KelaminJenjangKelasNISNNIKTempat Lahir Tgl LahirUsia (Ulang tahun terakhir)AlamatNo. HPDisabilitasHasil Pemeriksaan FisikKesimpulanIMUNISASI MRIMUNISASI DT
9
Faktor Resiko Gula Darah AnakResiko MalariaGejala Depresi AnakRiwayat Imunisasi Rutin Anak SekolahResiko HepatitisFaktor Resiko TBPenyakit Kusta Anak SekolahPenyakit SkabiesGiziTekanan DarahTelingaMataJumlah Gigi Karies
10
BB (kg)TB (cm)Indeks Massa Tubuh (kg/m2)IMT/U (SD)Status GizimmHgKlasifikasiTajam PendengaranSerumenInfeksi (cairan)Mata Juling / Pupil PutihTajam PenglihatanPenggunaan Kacamata
11
PLYaTidakYaTidakYa (1/2/3/4)Ya (1/2/3)YaTidakYa (1/2/3/4)Ya (1/2/3/4)YaTidakYaTidakGizi Buruk
< -3SD
Gizi Kurang
-3SD sampai < -2SD
Gizi Baik
-2SD sampai +1SD
Gizi Lebih
> +1SD sampai +2SD
Obesitas
> +2SD
Normal: Sistolik dan diastolik < persentil 90Prahipertensi: Sistolik dan diastolik ≥ persentil 90 tetapi <persentil 95, atau 120/80 mmHg tetapi < persentil 95Hipertensi tingkat 1: Sistolik dan diastolik diantara persentil 95 dan persentil 95 +12 mmHg
atau 130/80 mmHg -138/89 mmHg
Hipertensi tingkat 2: Sistolik atau Diastolik ≥ persentil
95 + 12 mmHg atau ≥140/90 mmHg
NormalCuriga GangguanTidak AdaAdaTidak AdaAdaNormalCurigaNormalCuriga GangguanTidakYaTidak AdaKaries (1/2/3/>3)RujukTidak RujukImunisasi Yang di TerimaTanggal ImunisasiNo. BatchImunisasi Yang di TerimaTanggal ImunisasiNo. Batch
12
1Abizar MalikLSD131800523673174032612180002Jakarta12/26/2018Jalan bukit cinere raya no. 7 Rt. 06 Rw. 028584514581011111
90/60
1111<3108/10/2026
13
2Adistia Indira KamaniaPSD13276096609180001Jakarta9/26/2018Jl H Jidi RT. 006, RW. 001, No. 41A
087875729100
111111
14
3Adzriel Rafiq AlfarizqyLSD131965575123276092808190001
Tangerang Selatan
8/28/2019Jl. Masjid 1 rt002 rw002, cinere8571959505911111111
108/89
1111111110/08
15
4Afnan al-ayyubiLSD13209901931Jakarta2/21/2020Jl. Lestari gandul no 14
16
5Aginantara Ananda AdhaLSD13197664019Serang8/11/2019Jl.cinere raya RT.02 RW 12 no.9
17
6Ainun fatahillahPSD13276094308190002Jakarta8/3/2019Jl persatuan cinere gang bangku rt 02/03 nomor 10
085891108691
11111
98/60
1111111110/8
18
7Aira aprilia meccaPSD 31962090053276094504190002Depok,4/5/2019
Jl masjid cinere, rt 002/rw 002 , kec, cinere kel, cinere no rumah 36
81401632988111111111
90/60
1111113110/08
19
8Aisyah Nuha ZahiraPSD13193113642Depok7/3/2019Jalan madura cinere depok Rt02/Rw011 depok no17
20
9AKSA FATIH SULAIMANSYAHLSD1Jakarta11/28/2019
Alamat Rumah : Kebagusan Besar no.29A RT/RW.001/005
Domisili : PLN GANDUL RT/RW 025/05 no.71C
21
10Aleeya nafeesa ramadhanPSD1Depok5/20/2019Jl.madrasah 1,RT.26 RW.03, No.36
22
11Alesha Nashwa HumairaPSD13193000363276096310190001Depok10/23/2019Jl. h jidi rt6/rw185716287937111111111
78/58
111111>3110/08
23
12Alfarezi ArdiansyahLSD13276091607180002Jakarta7/16/2018Jl.H rosyid RT 002 RW 001
085773393852
11111
90/60
1111112110/8
24
13Al-Ghifari Zeanozhidny Ar-RahmanLSD13202125568Jakarta1/23/2020Jln sengon RT 01 RW 0311111
100/69
111111>3110/08
25
14ALHIRA RYCCA ALSAVAPSD131991246333276095607190001Depok7/16/2019Jl PLN GG h.muhajir rt12/03 no.73
089677826044
11111
90/60
1111111110/8
26
15Aliya putri maulidaPSD131983894503278096512190002Depok12/25/2019Jln.persahabatan no.26B82124958955111111111
106/60
1111111110/08
27
16ALTAN ARSYAD WIDODOLSD13276090108190002DEPOK8/1/2019Jl.H.Mujar RT.001/RW.004 No.74
085891365947
11111
90/60
1111112110/8
28
17AMMAR RADEVA AKALANKALSD1319557381883276090803190001DEPOK3/8/2019Jl.H.Muhajir RT.12 RW.03
085184546897
11111
122/65
111111>3110/8
29
18Annasya Adreena SailaPSD131957667673276096608190002Jakarta8/26/2019Jl. Masjid 1 RT. 02 RW. 02 No. 30
0881012194552
11111
81/59
1111112110/8
30
19ANNISA SYAQILA RAHMADANIPSD13304196904200002
BANJARNEGARA
4/29/2020JLN.GARDU LAMA RT.012/RW.003
082260563532
11111
112/70
1111111110/8
31
20APIP AHWAL SAIDLSD13189989242DEPOK12/4/2018JL. Lereng Indah RT 01 RW 12
32
21Aretha Kalea MedinaPSD13276096410190001Depok10/24/2019Jln persatuan RT 04 RW 03
085771667366
11111
88/70
1111113110/8
33
22ARSHAKA ZAYN MAHFUDZLSD131986715233175091805190017Jakarta5/18/2019JLN.H.JAERAN RT 05 RW 01 NO.6
089630996165
11111
83/54
1111111110/8
34
23Arsya AkbarLSD13190853353Jakarta6/21/2019Jl. Masjid 1 Cinere RT/RW 001/002
35
24Atta Yazid AriyantoLSD131976468093276092304190001Bantul4/23/2019Jl. Persahabatan RT3/RW2 No.10m
082220044585
11111
90/60
1111111110/8
36
25Aysha aylaniPSD13197855729Kebumen8/22/2019Jln SD inpres rt 02 RW 05 no 33A
37
26Ayu Hayati PutriPSD13674046408190003
Tangerang Selatan
8/24/2019Jl PLN Gang Masjid Nurul Amin RT :14/0385716706313111111111
90/60
11111131MR10/08
38
27AZQILA INARA ARISYAPSD1Depok4/15/2020Jalan masjid 1 RT.002 / RW.002 NO.11111119118
120/80
111111>3
39
28AZURA YASHBI KHAWLAPSD13275126206190001Jakarta6/22/2019Jln. Haji jaeran, gg hji usman, rt 07 rw 01, 36a89560611183011111
90/60
11111121mr10/08
40
29Azzahra SyifanniPSD13276095703190003Jakarta3/17/2019
Jl. PLN RAYA gang baru no 61 H Rt. 12/03 kec Cinere kel Gandul Kota depok
81516695241111111111111121MR10/08
41
30Bilal Asqalani AzisLSD131940545833674052911190001
Tangerang Selatan
11/29/2019Jl pulo panjang rt.002/rw.00885882431420111111111
90/67
1111111110/08
42
31cahaya cinta arunaPSD131949577863276096003190004depok3/20/2019jalan h rosid rt 04/018128900951511111111122
99/84
1111111110/08
43
32Clemira Shakayla MaritzaPSD13197104771Depok6/24/2019Jalan Masjid 1 no 2 RT 006 RW 00111111
120/80
1111112
44
33Daffi Nuril AdliLSD131971015063276090404190001Jakarta4/4/2019Jl. H Jaeran No. 26 RT. 05 RW. 018963077465611111
78/63
111111110/08
45
34Definzi Farezqi MuliawanLSD131919259093201010808190012Bogor8/8/2019
Jl. Pangkalan Jati 1 No 36 Gang Haji Amat Kunte RT 001 RW 007
081934198990
11111
90/60
1111111110/8
46
35Dendi Arta ramdaniLSD13276093005190002Depok5/30/2019Jalan persahabatan RT 03/02 no.21 cinere
085775027015
11111
100/79
1111111110/8
47
36Dhefin rizqi el ghifariLSD131956392913276092604190002Jakarta4/26/2019Jl. Persahabatan cinere RT.03/02 NO.5
089510278034
11111
90/60
1111112110/8
48
37Dhika Dwi Abi WicaksonoLSD131966101163212130912190001Cinere depok12/9/2019Jl, H, jidi rt 06/RW 01
081311185072
111111111
90/60
1111111110/8
49
38ERPIYANA YULIA HARTATIPSD13276095707190001Depok7/17/2026Jl madrasah no 80 rt 0026 re 003
08984889741
11111
84/56
1111113110/8
50
39Fahira Ramadhani AhnafPSD132092447703276096604200002Depok4/26/2020Jl. Raya PLN RT. 24 RW. 06 no.3689541294738011111
93/67
111111110/08
51
40Fahrizel khiar alvileoLSD13276091701190001
Tanggerang Selatan
1/17/2019Jl PLN GG H Muhajir rt 12/03
0895352658099
11111
117/65
1111111110/8
52
41Fann Zayyan Rabbani AuliaLSD13276091301200003Depok7/13/2020Jl masjid 1 rt 01 rw 02 no 138577731905311111
97/68
111111110/08
53
42Farhan Abqary SyafiqLSD131907956153276090411190001Jakarta11/4/2019Jalan SD inpres RT 02 RW 05
081294732045
11111
90/65
1111113110/8
54
43Fatih FirmansyahLSD1Depok9/14/2019Jln PLN GG jarak rt14/0311111
90/73
1111111
55
44FAZIA ROFIQ FADILAHPSD1Jakarta3/12/2019Jln.PLN RAYA, RT 012, Rw 03, No :94 D
56
45Ghania Putri AleshaPSD13195880299Depok11/26/2019Jl Lestari rt 34 rw 07 nomor 30
57
46Gilang ramadhanLSD131937685483276090110090004Depok5/14/2009Jl.masjid 1 RT 05 RW 01 no 118521213427411111
84/58
1111113110/8
58
47HAMAS ADITYA HABIBILSD1CINERE12/10/2018jalan haji husman RT (07) RW (01) 65
59
48Inara pudsi raisaPSD131955263513276094607190005Bandung7/6/2019Persahabatan 38 RT 06rw 02
085894047370
11111
90/60
1111112110/8
60
49Indriani PutriPSD1Depok8/17/2018Jln pln raya gandul Gg Tower, RT 12/ RW 03, No 8411111
103/86
1111116110/8
61
50
JOHNSON HALOMOAN SITANGGANG
LLSD13198528182Depok10/22/2026JL. Bukit Cinere raya No 180 A11111
94/82
1111113110/8
62
51Kalisya sanari idrisPSD13194377798Jakarta5/21/2019Jl. Persahabatan rt03/rw02 no: 5c
63
52Khanza Lativa AyraPSD13276095203190001depok3/12/2019jl cinere raya no 10 rt002/rw012 cinere depok
082298176631
11111
90/60
111111>3110/8
64
53Kheyra fatharaniPSD131989806663276094210190001Depok10/2/2019Jl.haji jaeran RT 003 / RW 0189601872376111111111
90/60
1111111MR10/08
65
54LEON AGNI AL ESTULSD131838671883312150711180002
TANGERANG SELATAN
11/7/2018Jl.H.JiDI89601331773111111111
132/80
1111111
66
55M RAFASYA HAFISLSD1JAKARTA8/8/2019Jln mushola RT01 RW02 Cinere
67
56MAHREEN SHAFANA ALMAHYRAPSD13196527458DEPOK12/25/2019JL. BENGKALIS NO. 126 RT 002 RW 011
68
57MUBAROK FALAH QADDAFILSD103276091106190002Jakarta6/11/2019Jl. Persahabatan No 26 RT 04 RW 02857102351281111111
90/65
1111111110/08
69
58Muchammad Nur CahyoLSD13190972163Jakarta12/25/2019Jl PLN Raya GG Musholla Nurul Iman RT 12 RW 03
70
59Muhammad Dhika WicaksonoLSD131970033693305142008190001Kebumen8/20/2019Jln Masjidi 1 Rt 05 ,RW 02 cinere
085810841839
11111
90/60
1111113110/8
71
60Muhammad Nofri Aslan lieLSD13276090301190003Jakarta1/3/2019Jl. Masjid nurul amin rt 14/03 no 102
081385788659
11111
85/62
1111113110/8
72
61MUHAMMAD RIFKI FHADILAHLSD131922175993276092409190002JAKARTA9/24/2019JLN H JIDI RT 007/001 NO 53
0895606008424
11111
112/69
1111111110/8
73
62Muhammad wildanLSD131928389593276041010190002Cinere depok10/10/2019Jln h jaeran cinere depok8128515539211111
90/60
1111112110/08
74
63Muhammad Zidan Al-farizqiLSD1Depok3/7/2020Jl.masjid Nurul amin gandul pln
75
64Myesha Ayunindya RizkiPSD13202591099Depok5/21/2020Jl. H. Rosyid no 7 k11111
81/62
111111>3110/8/2026
76
65Najwa Khatimah KhairinaPSD1Depok2/21/2020JL. PLN (Gang Baru) RT 12/03
77
66Nayla Azkia PutriPSD131978877213276095311190001Jakarta11/13/2019Jl.raya gandul gg.ikhlas rt.023 rw.006 no.18
085213124909
11111
90/80
1111111110/8
78
67Nazia shafiullaPSD131805513953276095211180001Depok11/12/2018Jl. Masjid 1 cinere no. 78 Rt. 001/002
089668724031
11111111111111110/08
79
68nazifa putri karnoPSD131924003403276095010190001depok10/10/2019jl madura rt.01/11 no 24 cinere depok
0895415000434
11111
120/80
1111113110/8
80
69Nazwa khoirunisa aksanPSD13197124143276095007190004Jakarta7/10/2019Jln. H. Rosyid RT. 01 RW. 01 No. 26856915569171111111
102/53
1111111110/08
81
70Nur Fatihah AisyahPSD131952427423302036307190002Depok7/23/2019Jln.sengon RT03/RW 03 no.33
087777005827
11111
90/60
1111112110/8
82
71Pangeran Aldhana AnggoroLSD131998504963276092408190001Jakarat8/24/2019Jl melati Gg H Murtaba
085946704748
11111
90/60
1111111110/8
83
72Qonita Isma TaqiyyahPSD132049236263276036302200002Jakarta2/23/2020JL Masjid Nurul Yaqin No 169
081380244069
111111
90/60
1111112110/8
84
73Queenzha azzahraPSD13276095401200002Depok1/14/2020
Jln pln gandul gang tower rt 12 rw 003 no 84 (pager item)
088293344568
11111
90/60
1111111110/8
85
74Rafania MumtazahPSD13191806439320233430419002Sukabumi4/3/2019Jalan madura ganga masjid Arrahmah RT 01 RW 11
085721896942
11111
90/60
1111112110/8
86
75Rafiq Ihsan FathullahLSD13276091302190002Cinere Depok2/13/2026Jl.hj jaeran RT 05 RW 01
085697214044
11111
90/60
1111112110/8
87
76Rahmat hidayatLSD131963539603276091903190003Depok3/19/2019Jl.pln gandul no.113 Rt.12 Rw.0382111710683111111111
94/67
1111111110/80
88
77Raihana Yasmina FaihaPSD131947722383276096407190004
Tanggerang Selatan
7/24/2019Jl. Jawa Kav 39 Blok H RT 01 RW 013
085777283328
11111
120/80
1111112110/8
89
78Ranu Raung SejatiLSD131949410353276090507190001Jakarta7/5/2019Jl bukit Cinere no 11 RT 06 RW 2
089680929572
11111
120/80
1111111110/8
90
79Sabda djenar rahinakalla sitorusPSD13204194148Karawang2/20/2020Jln haji jaeran rt 05 rw 0111111
101/69
1111112
91
80SABRINA NOORE RASYIFAPSD131919359263276094509190003Jakarta9/5/2019jl.masjid 1 cinere rt 01/rw 02
083193707150
1113111
90/60
111111>3110/8
92
81Safira Anindya QueenshaPSD131993275133175065911190017Depok11/19/2019Jl. Masjid 1 Rt 06/Rw 01 No 25H
088901747263
11111
91/64
1111111110/8
93
82Sakha fawaz asadelLSD13276012602200002Jakarta2/26/2020Jl masjid 1 rt:02 rw:02 no:2881297695087111111138.7125
71/59
1111111110/08
94
83Salsabillah alzahraPSD13276094508190001Depok8/5/2019Jln mushollah nurul iman rt12 rw0385771952635111111111
90/60
111111
BBBBBBBBBBBB BV VV
>3110/08
95
84Shakila Ciara AzzahraPSD132036429743276095403200005
Tanggerang Selatan
3/14/2020Jl sengon, RT 003/003 no 46C
081400847604
11111
90/65
1111111110/8
96
85SHAQUENA AQILA TRIANA PUTRIPSD132004114803276094203200002Jakarta3/2/2020Jalan Haji Jidi No 18
085697831609
111111
90/63
1111111110/8
97
86SHOFI AISYAH AQILAPSD131909285453276096709190004TANGERANG9/27/2019JL. H. ROSYID NO. 30
085782887282
11111
88/64
1111111110/8
98
87siti khumaeroh ainaPSD1jakarta12/7/2019jl. masjid 1 rt 002/rw 00211111
90/60
1111112110/8
99
88Siti Nadhifa AlmaisaraPSD1Depok12/17/2019Jl.madrasah 1 RT26.RW03
08571978063
11111119119
115/70
1111111
100
89starla eleanor marziaPSD131999835763174055910190003depok10/19/2019jl. persahabatanrt 03 rw 02 no 24
081585783570
11111
90/60
1111111110/8
101
90TRISNA MAULANA SYARIPLSD132070908863276091301200001JAKARTA1/13/2020
Jln. PLN Raya, Gg. Mushollah Nurul Iman, No. 42 RT.12 RW.03
085717949249
11111
120/80
1111111110/8
102
91Zaina Khawla NazafarinPSD13174065208190008Jakarta8/12/2019Jl. Delima Ujung Gang Tower No. 21 L RT 001 RW 00581380889697111111111
90/65
111111>3110/08
103
92Afif Ahwal SaidLSD132760904121800024/12/2018Jl. Lereng Indah RT 01/12
085882563299
11111
90/60
1111111110/8
104
105
106
107