ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBSBTBUBVBWBX
8
NoNamaJenis KelaminJenjangKelasNISNNIKTempat Lahir Tgl LahirUsia (Ulang tahun terakhir)NIK ORANG TUA/IBUNAMA LENGKAP ORANG TUA/IBUAlamatNo. HPDisabilitasHasil Pemeriksaan FisikCO ANALYZERKesimpulanIMUNISASI
9
Faktor Resiko Gula Darah AnakResiko MalariaGejala Cemas RemajaTalasemiaGejala Depresi RemajaKesehatan Produksi PutraKesehatan Produksi PutriTingkat Aktifitas FisikKelayakan Tes KebugaranPerilaku MerokokFaktor Resiko HepatitisFaktor Resiko TBPenyakit Kusta Anak SekolahPenyakit SkabiesGiziKimia DarahTekanan DarahTelingaGigi (Jumlah Karies)Kebugaran (Kelas 7-9)
10
BB (kg)TB (cm)Indeks Massa Tubuh (kg/m2)IMT/U (SD)Status GiziHasil Pemeriksaan mmHgKlasifikasiGangguan TelingaSerumen TelingaInfeksi (Cairan) TelingaTajam PenglihatanMata SehatPenggunaan KacamataWaktuKlasifikasi
11
PLYaTidakYaTidakYa (1/2/3/4)Ya (1/2/3)Ya (1/2)Ya (1/2/3)Ya (1/2/3)Ya (1/2/3)0/1/2/3/4/5/6 hariYa (1/2/3/4)Ya (1/2)Ya (1/2/3/4/5/6/7/8)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
GDSHBNormal: 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
KananKiriKananKiriKananKiriMata Kanan 6/6-6/9Mata Kanan <6/9Mata Kiri 6/6-6/9Mata Kiri <6/9KananKiriTidakYaNormalKaries (1,2,3,>3)Baik sekali/ BaikCukupKurang/Kurang sekaliHasil CO Analyzer (1,2,3,4,5,>5)RujukTidak RujukImunisasi Yang di TerimaTanggal ImunisasiNo. Batch
12
1ACHMAD MUSHTHOFASMPVII136533470v00000040200vv61165.09015124/70vvvvvv4
13
2Adiba Marine RamadhaniSMPVII3133227059v0000000000vv50165.010712121/79vvvvvv
14
3ADITYA ANGGARASMPVII3138543110v0000000000vv47157.010315103/70vvvvv12
15
4Afikah qairanivSMPVII3138846728
3602265702130001
17-02-2013133602265204800005JL HJ JEMAN8567811215VV0000260000VV43.6144.514913.698/62VTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVV0V
16
5Ahmad AlaydrusSMPVII3118528502v00000020000vv42158.08013101/58vvvvvv
17
6AHMAD ALFAN HADIANSYAHSMPVII31328203463315025705800006v0000020000vv38.2153.08512.2115/74vvvvvv3
18
7AKBAR YOBET PRAKOSOvSMPVII132542176
3315021408130001
GROBOGAN14-08-2013133315025705800006JL PINTU AIRVV0000000000VV36,25145.0105104107/68TIDAKTIDAKTIDAKVVVVVVV2
19
8ALIF IBNU NAUFALSMPVII3139143318v00000030200vv45141.010113120/97vvvvvv2
20
9ALYA AFIQAH RANIAVSMPVII146528670
3276095905140001
19-05-2014123201184604900001
JL PANGKALAN JATI II, GG JAMBU
85810613869VV00000000000VV36.35147.012210.882/49VTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKvvvvv2v
21
10AMAR EL SHAARAWY ANWARvSMPVII135702828vv0000040000vv52162.012713112/80vvvvvvv3
22
11Ammar Al Harits HidayatSMPVII3124790818v0000060000vv39147.010313104/69>5
23
12AQILLA FARISYAH AZ-ZAHRASMPVII3148706706v00001 260000vv71163.011112130/78vvvvvv
24
13ARKA MUAZZAMSMPVII3144408093v0000060200vv34136.01081493/59vvvvvv2
25
14ARSYAFIN PUTRA PRATAMASMPVII3132365227v1000050000vv46155.07811,2106/67vvvvv22
26
15Arzelita Zaskia AdibaSMPVII3131137098v00001 200000vv50153.07813109/80vvvvvv
27
16BINTANG AGUNG SAPUTRASMPVII3120572600312057260015-11-201214
JL MASJID AL AKHYAR
87896080176VV00000060000VV61,6157.09615,3114/81VTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVVV0
28
17BISMA RAJA ABIYASASMPVII3130357883v00000000000vv44162.012010126/82vvvvvvv3
29
18BUNGA MAHARANI WAHYUDISMPVII3138407126v00031210200vv40155.011115,4110/72vvvvvv
30
19CAHAYA SALSABILAvSMPVII132994946vv00001 200001vv42155.09710hpv03/09/202640102125vvvvv2v
31
20CHAESAR ADHA MAULANASMPVII3132378122v0000040200vv47160.012016114/61vvvvvv5
32
21Defany kanaya sahiraSMPVII3137115632v00001 240200vv42155.010114112/65vvvvv1
33
22Dimas AnggaraVSMPVII3135079751
3276091502130002
15-02-2013133201395608950001
JL AL HIDAYAH
88212792774VV0000030200VV57,35164.010512,6123/88VVTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVV1V2
34
23FARID ATAUR RAHMANSMPVII3135270799v00000000059.4165.57912.6121/71TIDAKTIDAKTIDAKTIDAKTIDAKTIDAKvvvvv2v3
35
24FIKA RAMADHANISMPVII135517602
36
25GILBY SIDQI RABBANISMPVII3138387167v0000003200vv49161.011010113/75vvvvvv3
37
26Hafidz AlfalahSMPVII137879063v0100020000vv49172.09513126/67vvvvvv3
38
27HAFSA CIFFA SUGIONOSMPVII3121584402vv0000150000vv44.1151.012913,3114/87vvvvvvv
39
28HUSNA NURAINISMPVII3140550320v00000110000vv61150.07715120/82vvvvvvv
40
29ISHABEL MARSHAVSMPVII313004763029-3-201313
JL HJ SALEH NO 72
84508781485VV1303232202,3,4VV36159.010712.999/62TIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVV
41
30LINTANG ZAKY SETIAWANSMPVII3145835613v0000000vv34.6151.512110.8117/73TIDAKTIDAKTIDAKTIDAKTIDAKTIDAKvvvvv1v2
42
31Mohammad al fatihSMPVII3132640158vv01.2.30200000vv35.95152.09211.997/63vvvvvvv1
43
32MOHAMMAD AZKA ABDILLAHSMPVII3136312841
44
33Muhamad EvinVSMPVII3120086822
3201211101120002
10-11-201214VV10000000000VV38,9153,58513,1114/77TIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVVV1V2
45
34MUHAMAD UWAIS AL QORNISMPVII3138957329v0000002200vv31148.01071489/60vvvvvvv
46
35MUHAMMAD AFLAH AZHARISMPVII3133199091v0000050200vv40155.08411132/88vvvvvv
47
36MUHAMMAD ARQAN AL-GHIFARIVSMPVII3131529437
3276092904130002
JAKARTA29-04-2013133276095911850001
JL MADRASAH 04/06
81579757122VV01000000000VV44,4156.010714,1120/68VVvTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVVV0V4
48
37MUHAMMAD FATHIR ARRASYIDSMPVII3133959987v0000040000vv39.3152.510015,4114/72vvvvvvv3
49
38MUHAMMAD GALLANG ASLAMSMPVII3137137179v00000000000vv34151.010514.791/62vvvvvvv2
50
39Muhammad Hasan El FatahSMPVII3139965349v0000050000vv64161.010312122/76vvvvvv2
51
40MUHAMMAD IDRISHSMPVII3136735464v0000000000vv63144.011513105/77vvvvvv3
52
41MUHAMMAD KEANU SANTANASMPVII3133011805v00000000000vv59161.09613.711/59vvvvvv3
53
42MUHAMMAD NAUVAL AL-KHATIRISMPVII3133611225v00000010010vv67158.010410112/69vvvvvvv2
54
43
MUHAMMAD NUR KHAIDIR WIRA AL JENAR
SMPVII3137257556v20000010000vv69158.09014127/79vvvvvv12
55
44MUHAMMAD RAKA PERMANA PUTRASMPVII3139022752v0000060000vv35.45150.011111.5134/59vvvvvvv2
56
45MUHAMMAD RAYHAN AKYASSMPVII131010086
57
46MUHAMMAD RIDHO GHIFARISMPVII3130785443V0000040000V45,35161.08614,3114/70
58
47MUHAMMAD RISQY PRASTYOSMPVII3135903529v0000000000vv37148.08510101/72vvvvvv2
59
48MUHAMMAD SHIDQII HAMIDSMPVII3138191492v0000050000vv42155.0879,4111/72vvvvvv
60
49MUHAMMAD UMAR SADDAMSMPVII3137782070v000000600vv35.95150.510712.2106/67vvvvvvv2
61
50NABILAH ZAHWA RAMADHANISMPVII3133090922v0000120200vv381521061690/65vvvvvv
62
51NAFISA IZZANAURA RAFIFASMPVII3134466036v00001250200vv4515314211,6110/64vvvvvvv
63
52NASYA NAZIRA MUMTAZSMPVII3140130718
64
53NAUFAL AFKARSMPVII3139431569v00000553000vv311461181199/70vvvvvvv
65
54NAUFAL BACHTIARSMPVII3130422473
66
55NAURA AZZALEA SALSABILAVSMPVII3143862293
33276047006140001
30-06-201412
327600450080100830005
JL SDN 2 KRUKUT
81284039766VV0000150000VV49.415311111.9104/70VTIDAKTIDAKTIDAKTODAKTIDAKTIDAKVVVVV1V
67
56Pratama Putra PrasetyoSMPVII3134190689
68
57RANDY BUYUNG GADANGSMPVII3131351692
69
58SAID ABDUL ROZAKSMPVII3127797088v0000050000vv43165961596/74vvvvv22
70
59SLAMET WIDODOSMPVII135335658v0000000200vv431548814118/69vvvvvv2
71
60SRI KUPTI SUNDARIvSMPVII133470816
31740651021310001
11-02-2013133174065010780008
JL JATIMURNI, PANGKALAN JATI
81220667793VV01VV28.414010911.5120/70VTIDAKTIDAKTIDAKTIDAKTIDAKTIDAKVVVVVVV
72
61SYAMIL AL FAKHRI HIDAYATSMPVII3143588489v0000050000vv3314210010113/67vvvvvvv3
73
62TITI YUWANASMPVII3133039249V000000200000VV34140
74
fikriv1000010000vv30138103989/66vvvvv12
75
muhammad al fatihv0001230000000vv35152921197/63vvvvvv
76
77
78
79
80
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82
83
84
85
86
87
88
89
90
91
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93
94
95
96
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