ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBS
8
NoNamaJenis KelaminJenjangKelasNISNNIKTempat Lahir Tgl LahirUsia (Ulang tahun terakhir)AlamatNo. HPDisabilitasHasil Pemeriksaan FisikKesimpulanIMUNISASI MRIMUNISASI DTIMUNISASI 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
YaTidakYaTidakYa (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. BatchTanggal ImunisasiNo. BatchImunisasi Yang di TerimaTanggal ImunisasiNo. BatchImunisasi Yang di TerimaTanggal ImunisasiNo. Batch
12
1ZEA ALMAIRA NOEGROHOP131740543012000043/1/2020jl galur III089669521609VV00V00VV18120104/711111111
13
2Chantya Rayya Nurhafizho (NIK TIDAK VALID)P131750848081900146/8/2019
JL MADURA UJUNG RT 11/09
81225249955VV00V00VV25125111/871111111
14
3Khadeejah Ayesha MeidinaP1317305520419000612/4/2019
JL MADRASAH PLN GANDUL
85748395919VV00V00VV2312189/681111111mr
14/08/2026
0125N174B
15
4Ayunda Lulu MaknunaP1327609530220000113/02/2020JL ANGGREK086363664820VV00V00VV28128110/70VVVVVVVmr
14/08/2026
0125N174B
16
5Aisyah Malika Febriyantip132760447022000012020-07-02Jl H Midi81517993994VV00V00VV2412290/601111113mr
14/08/2026
0125N174B
17
6Daffa Sutan AzrilL1327604541220000125/10/2019 Jl Galuh rt 005/006881011745748VV00V00VV2112290/601111113mr
14/08/2026
0125N174B
18
7Aruna MaulidaP136740644121800124/12/2018
JL LAPANGAN BOLA PERUM LINCOLN
85767807848VV00V00VV20120102/671111111mr
14/08/2026
0125N174B
19
8Ratu Allesha HidayatP1327604660819000326/08/2019
JL GALUR KRUKUT KP UTAN
83890944222VV00V00VV1912095/631111112mr
14/08/2026
0125N174B
20
9Kinara Nafasya JP1327609670619000127/06/2019
JL MELUR PANGKALAN JATI
85222208010VV00V00VV2112296/601111112
21
10Nasha Inara1
22
11Qiandra Sheeza Putri SarbiniP132760946022000022020-06-02
jl Madura Ujung rt 002 rw 11
83806711007VV00V00VV2112290/601111111mr
14/08/2026
0125N174B
23
12Khalisa Anindya Putri1
24
13Aisyah Nur AilahP1327601630420000523/04/2026Jl Limo Raya no 3588213993132VV00V00VV211221111111mr
14/08/2026
0125N174B
25
14Kamila AnantariP1327601650320000325/03/2020KAVLING PELITA81905678082VV00V00VV2812890/60VVVVVVVmr
14/08/2026
0125N174B
26
15Miqdad Al Barraq1
27
16Kenzo Radhytsa Gunawan1
28
17Shofiyah Wamira AlaydrusP1317507630819000523/08/2019JL H MENDIK RT 2085892782094VV00V00VV1811890/601111113
29
18Zea Almaira Noegroho1
30
19Aisyah Livia DjuanP1332608551119000115/11/2019JL MATALIH HTR RT 02/0685884872637VV00VV00VV2112490/60111111>3MR
14/08/2026
0125N174B
31
20Jovanka Adera GunawanL136740647032000022020-07-03jl h jaim rt 01/rw048997119640VV00V00VV19118115/731111111mr
14/08/2026
0125N174B
32
21Raisya Aqila LavaniP1327604560619000116/06/2019Jl Kuta Raya Blok 0581282005524VV00V00VV18120123/721111111mr
14/08/2026
0125N174B
33
22Muhammad Dzuhairi Arshaq KamilL132760409081900032019-09-08jl Pinang II No 72 Limo81212290808VV00V00VV2112290/601111112mr
14/08/2026
0125N174B
34
23Aira Lalita Kaip13276045101200002Tangsel
35
24Fatih Indras RamadhanL1317404260519000926/05/2019JL CINERE RAYA NO 6085691879318VV00V00VV1811892/60111111MR
14/08/2026
0125N174B
36
25Gendis Humaira Salsabilap1340407710120000131/01/2020Jl Cabe V Grenhouse D681234560116VV00V00VV1811790/601111111mr
14/08/2026
0125N174B
37
26Muhammad Azraqi AlfarabiL132760916081900218/08/2019
Jl Enggano No 5 Rt 01/Rw 11
89660579090VV00V100VV17118100/701111111mr
14/08/2026
0125N174B
38
27Kirana Anindita ZhafiraP1327609560319000316/03/2019JL H SAABUN NO 188992498866VV00V000VV2312290/60VVVVVV>3MR
14/08/2026
0125N174B
39
28Haneena Tsaniya BatsnaP1317406621019000122/10/2019GREEN NATURE CINERE81285378511VV00V00VV1811886/6311111>3
40
29Ai'zzah Nailul Magfifiroh1
41
30Ananda SakhaP1327605021219001002/12/2019WISMA ALI082211383960VV00V000VV2812890/60VVVVVVVmr
14/08/2026
0125N174B
42
31Al Raskha Sabda AlamL1137106310120000201/01/2020Jl Bhakti 1 No 5385263856435VV00V00VV1810579/591111111mr
14/08/2026
0125N174B
43
32Rasyid Al Malik RL1327609251019000225/10/2019VV00V00VV22122117/951111112mr
14/08/2026
0125N174B
44
33Khalisa Anandya PutriP1320622460319000506/03/2019Jl Haji Rinan Bawah mo 12385721503121VV00V00VV1811890/601111111mr
14/08/2026
0125N174B
45
34KENNAN BARRA RAID ASADELL1327609240420000124/04/2020JL CINERE RAYA089686666176VV00V000VV2712990/60VVVVVVVmr
14/08/2026
0125N174B
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