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FORM MIGRASI PESERTA

JENIS PESERTA
NAMA INSTANSI/BADAN/PERUSAHAAN
KODE VIRTUAL ACCOUNT
BANK 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
1 3604061102077106 3604060910730001 SANWANI
2 3604064507790003 HADRIAH
3 3604065908980002 ROFAIDA
4 3604061110000003 ROYADI
5 3604088802080001 AMELIYA
6 3604062103160013 3604052806460001 M ANAS
7 3604055201730002 MAFAJAH
8 3604054610010005 FATMAWATI
9 3604050211070001 MUHAMAD AD FIZARUL AKBAR
10 3604060809110002 3604061010750001 SUBABAY
11 3604060809110002 3604065605840001 EKAWATI
12 3604060809110002 3604063007110001 RIKI RAMADAN
13 3604062711100002 3604060605860003 HAMBALI
14 3604062711100002 3604064505890004 FATMAWATI B
15 3604062711100002 3604060503120001 IBNU ZAELANI
16 3604062006140005 3604060706780001 SAFARI
17 3604062006140005 3604065003880004 EEN ERNAWATI
18 3604062006140005 3604066508140002 INDAH PRATIWI
19 3604060208180001 3672080510810011 HOLILI
20 3604060208180001 3604066506810001 SAMINAH
21 3604060208180001 3604063005130001 AHMAD AUFUR ROHIM
22 3604061102073672 3604060512740001 RIYANA
23 3604065007800001 NURHAYATI
24 3604062707970002 RUJI
25 3604067007980004 MELAWATI
26 3604065512110002 ALIYA AZZAHRA
27 3604062809180004 3604063011830001 MAD SANAN
28 3603115202920008 SITI ROHMAH
29 3604061211140001 NANDA HARYANI
30 3604063011090022 3604060303830003 EKA
31 3604064809810004 IIS SURYANAH
32 3604066509090002 MARIYAM
33 3604062702110004 DARUS RIZKIANKA
34 3604061109120012 3604061305850004 YANA MULYANA
35 3604064510860002 ERNIAH
36 3604062508100001 NURUL PUTRA RAMADHANI
37 3604061605140001 ALVI AL FADILAH
38 3604062504160011 3604040104820259 A. BUCHORI SOLEH
39 3604062504160011 3604065209970001 NURLELAH
40 3604062504160011 3604062506150003 JIHAD MARDO
41 3604062805130022 1801181604850001 SAPRI
42 3604062805130022 3604065805920001 ROSITAH
43 3604062805130022 3604065501120002 NATASYA SAPUTRI
44 3604312202930003 JAKA RAHAYU
45 3604066202930001 ROSNANI
46 3604062310860001 ROHMAN
47 3604064510900004 MAESAROH
48 3604061007940003 ASEP
49 3604064702970001 JANDAWATI
50 3604060607100005 3604060403800006 KUSNENI
51 3604064603890004 TUTI
52 3604064609070001 USI
53 3604060810180003 3604121501920002 SAMSUL BAHARI
54 3604064107880004 SUADAH
55 3604061102071984 3604062007730003 YAKUB
56 3604064502760001 SOLEKAH
57 3604060211970001 ISKANDAR
58 3604066501070001 ISTIQOMAH
59 3604066101150001 MAULIDIA NUR DIANI
60 3604060711090014 3604060207770003 SYARIFUDIN
61 3604064306850004 HALIMAH
62 3604060401070007 MUHAMAD FIKRI
63 3604066405080008 LINA MARLINA
64 3604060906090001 3604061501870003 MUS'AD
65 3604064910890003 SANIMAH
66 3604060810100001 ROISUL IBAD
67 3604061102072148 3604061607820001 SAYUNI
68 3604065902770001 NADIROH
69 3604062512060002 NURIL ANWAR
70 3604062111140001 HADI ROHADI
71 3604062510180009 3604062509870001 HABUDIN
72 3604064703940012 SUNARIYAH
73 3604061102073650 3604062806040000 ANDI
74 3604065208940002 TASI MUSLIMAH
75 3604061102072610 3604061008720002 JUMANI
76 3604065012860005 NURJANAH
77 3604066804930001 LILIS SUMIYATI
78 3604060408950001 ROHMATULLAH
79 3604064909010001 MARWIAH
80 3604066412020002 ASMAWATI
81 3604062806100002 LUKMAN AFANDI
82 3604062202160002 360406520490001 saritilawati
83 3604060610090004 3604061203830005 andri suryani
84 3604066608860002 fatimah
85 3604066608860002 fatimah
86 3604066508090001 vanesa zahra indriyani
87 36040606170490007 3604060606730001 yusuf
88 3604066600030003 aliyah
89 3604062411020002 maryudi
90 3604060212080001 rizki maulana
91 3604061600100001 aziz rohim
92 3604063008150001 hafis al dari
93 3604060112090052 3604060470840002 zaenal mustakin
94 3604064308840006 jumayah
95 3604060505080001 mahjuni
96 3604061011140003 nofal saputra
97 3604061506100004 3604060810830008 Udi wahyudi
98 3604066810860001 linda nurmala sari
99 3604064107080002 gia amalia nurwahyuni
100 3604066905100001 citra inti sari
101 3604062809150001 aju ahya ubaidilah
102 3604062205170001 3604066111860006 suryani
103 3604066111860006 maimunah
104 3604066006150004 selvi indriyani
105 3604060104140002 3672016270990008 mulyani
106 3672016104920006 hosi'ah
107 3640670051400002 fitriyani
108 3604061408140004 3604062706790003 mufti
109 3604066102810002 hasi.ah
110 3604060507120001 rizki wahyudi
111 3604061901100006 3604061607760004 caslari
112 3604066711870003 susilawat
113 3604065600110001 balgis dwi yana
114 3604065011120001 tara maharani
115 3604061506100016 3604061903890001 sahrudin
116 3604064702870003 rohayat
117 3604063009090001 eno firmansah
118 3604061102076158 3604061707860001 mukmin
119 3604066004870001 hajijah
120 3604066511060001 melisah
121 3604066006110002 alisa minayat
122 3604061102076676 3604061611760001 sabirin
123 3604065807760001 mahdiyah
124 3604066612980001 ifah holifah
125 3604066502070002 ujniyah
126 3604002301130001 muhamad mahrus

Mengetahui
Kepala Puskesmas Waringinkurung

dr Hj Ina Azani
Nip: 19710427 200701 2 004
Jenis Status
HUBKEL Tgl Lahir
Ke1amin Kawin

1=
Peserta 1=BK,
2= 2=K, Alamat Tempat Tinggal RT
Suami 1=L, 3=CH,
Tempat Lahir dd/mm/yyyy
3 = Istri 2=P 4=CM
4= 5 = TDK
Anak TAU

5 6 7 8 9 10 11
2 SERANG 09-10-1973 1 2 KP.SUKA MAJU 005
1 SERANG 7/5/1979 2 2 KP.SUKA MAJU 005
4 SERANG 19-08-1999 2 1 KP.SUKA MAJU 005
4 SERANG 11-10-2000 1 1 KP.SUKA MAJU 005
4 SERANG 2/26/2008 2 1 KP.SUKA MAJU 005
2 SERANG 26-06-1946 1 2 KP.JAMBU KECIL 005
1 SERANG 18-11-1982 2 2 KP.JAMBU KECIL 005
4 SERANG 06-10-2001 2 1 KP.JAMBU KECIL 005
4 SERANG 02-11-2007 1 1 KP.JAMBU KECIL 005
2 SERANG 10/10/1975 2 2 KP CAKAR 8
3 SERANG 1/5/1984 1 2 KP CAKAR 8
4 SERANG 30/07/2011 2 1 KP CAKAR 8
2 SERANG 05/06/1986 2 2 KP NAGREG 2
3 SERANG 05/05/1989 1 2 KP NAGREG 2
4 SERANG 03/05/2012 2 1 KP NAGREG 2
2 SERANG 06/07/1978 2 2 KP GURAIT 5
3 SERANG 03/10/1988 1 2 KP GURAIT 5
4 SERANG 05/10/1981 1 1 KP GURAIT 5
2 SERANG 5/10/1981 2 2 KP PEDALI 4
3 SERANG 25/06/1981 1 2 KP PEDALI 4
4 SERANG 30/05/2013 2 1 KP PEDALI 4
2 SERANG 12/5/1974 2 2 KP.PALA 010
3 SERANG 7/20/1980 1 2 KP.PALA 010
4 SERANG 7/27/1997 2 1 KP.PALA 010
4 SERANG 07/30/1998 1 1 KP.PALA 010
4 SERANG 12/15/2011 1 1 KP.PALA 010
2 SERANG 11/30/1983 2 2 KP.PALA 010
3 SERANG 02/12/1992 1 2 KP.PALA 010
4 SERANG 11/12/2014 1 1 KP.PALA 010
2 SERANG 03/03/1983 2 2 KALISIGONG 002
3 SERANG 9/8/1981 1 2 KALISIGONG 002
4 SERANG 9/25/2008 1 1 KALISIGONG 002
4 SERANG 2/27/2011 2 1 KALISIGONG 002
2 SERANG 5/13/1985 2 2 SIWALIK 002
3 SERANG 10/5/1986 1 2 SIWALIK 002
4 SERANG 8/25/2010 2 1 SIWALIK 002
4 SERANG 5/16/2014 2 1 SIWALIK 002
2 SERANG 4/1/1982 2 2 KP BOBUL 002
3 SERANG 9/5/1997 1 2 KP BOBUL 002
4 SERANG 6/25/2015 2 1 KP BOBUL 002
2 SERANG 04/16/1985 2 2 KP BOBUL 002
3 SERANG 5/18/1992 1 2 KP BOBUL 002
4 SERANG 11/15/2012 1 1 KP BOBUL 002
2 SERANG 2/22/1993 2 2 KP BOBUL 002
3 SERANG 2/22/1993 1 2 KP BOBUL 002
2 SERANG 10/23/1986 2 2 KP BOBUL 002
3 SERANG 10/5/1990 1 2 KP BOBUL 002
2 SERANG 7/10/1994 2 2 KP BOBUL 002
3 SERANG 2/7/1997 1 2 KP BOBUL 002
2 SERANG 3/4/1980 2 2 KP.MARUGA 005
3 SERANG 3/6/1989 1 2 KP.MARUGA 005
4 SERANG 9/6/2007 1 1 KP.MARUGA 005
2 SERANG 1/15/1992 L 2 SIDILEM 004
3 SERANG 7/1/1990 P 2 SIDILEM 004
2 SERANG 7/20/1973 L 2 SIDILEM 003
3 SERANG 1/2/1979 P 2 SIDILEM 003
4 SERANG 7/8/1997 L 1 SIDILEM 003
4 SERANG 5/25/2007 P 1 SIDILEM 003
4 SERANG 1/21/2015 L 1 SIDILEM 003
2 SERANG 7/2/1977 L 2 SIDILEM 003
3 SERANG 6/3/1985 P 2 SIDILEM 003
1 SERANG 1/4/2007 L 1 SIDILEM 003
1 SERANG 5/24/2008 P 1 SIDILEM 003
2 SERANG 1/15/1987 L 2 TIGA MAYA 007
3 SERANG 10/9/1989 P 2 TIGA MAYA 007
1 SERANG 10/8/2010 L 1 TIGA MAYA 007
2 SERANG 7/16/1982 L 2 TIGA MAYA 006
3 SERANG 2/19/1977 P 2 TIGA MAYA 006
4 SERANG 12/25/2006 L 1 TIGA MAYA 006
4 SERANG 11/21/2014 L 1 TIGA MAYA 006
2 SERANG 8/25/1987 L 2 KAWARON 008
3 SERANG 3/7/1994 P 2 KAWARON 008
2 SERANG 8/31/1991 2 2 KP. SANDAHAN KIDUL 012
3 SERANG 6/12/1994 1 2 KP. SANDAHAN KIDUL 012
2 SERANG 10-08-1972 2 2 KP. SAGA 007
3 SERANG 10-12-1986 1 2 KP. SAGA 007
4 SERANG 28-04-1993 1 1 KP. SAGA 007
4 SERANG 04-08-1995 2 1 KP. SAGA 007
4 SERANG 09-09-2001 1 1 KP. SAGA 007
4 SERANG 17-07-2002 1 1 KP. SAGA 007
4 SERANG 28-06-2010 2 1 KP. SAGA 007
2 serang 2/2/1995 p 2 kp.kolelet 003
2 serang 3/12/1983 L 2 kp gunung buah 014
3 serang 8/15/1996 P 2 kp gunung buah 014
3 serang 8/15/1996 p 2 kp gunung buah 014
4 serang 8/25/2009 P 1 kp gunung buah 014
2 serang 8/6/1973 L 2 kp gunung buah 014
3 serang 8/25/1993 p 2 kp gunung buah 014
4 serang 11/24/2002 L 1 kp gunung buah 014
4 serang 12/2/2008 L 1 kp gunung buah 014
4 serang 8/16/2010 L 1 kp gunung buah 014
4 serang 8/8/2015 L 1 kp gunung buah 014
2 serang 7/7/1984 L 2 kp gunung buah 014
3 serang 7/19/1987 p 2 kp gunung buah 014
4 serang 6/5/2008 L 1 kp gunung buah 014
4 serang 11/10/2014 L 1 kp gunung buah 014
2 serang 10/8/1984 L 2 kp libudak 012
3 serang 10/28/1986 p 2 kp libudak 012
4 serang 7/1/2008 P 1 kp libudak 012
4 serang 5/29/2010 P 1 kp libudak 012
4 serang 8/28/2015 L 1 kp libudak 012
2 serang 5/20/1982 L 2 kp kelapa kurung 004
3 serang 6/20/2015 p 2 kp kelapa kurung 004
4 serang 11/21/1986 p 1 kp kelapa kurung 004
2 serang 9/27/1988 p 2 kp kelapa kurung 004
3 cilegon 4/21/1992 p 2 kp kelapa kurung 004
4 serang 5/30/2014 p 1 kp kelapa kurung 004
2 serang 6/27/1979 L 2 kp lebak 005
3 serang 2/21/1981 p 2 kp lebak 005
4 serang 7/5/2012 L 1 kp lebak 005
2 serang 7/16/1975 L 2 kp lebak 005
3 serang 11/27/1987 p 2 kp lebak 005
4 serang 1/10/2010 L 4 kp lebak 005
4 serang 11/10/2013 L 4 kp lebak 005
2 serang 3/19/1989 p 2 kp pasir dangdor 002
3 serang 2/7/1987 p 2 kp pasir dangdor 002
4 serang 9/30/2009 p 4 kp pasir dangdor 002
2 Serang 7/17/1986 L 2 kp setu 02
3 serang 4/20/1987 P 2 kp setu 02
4 serang 11/25/2006 P 4 kp setu 02
4 serang 5/10/2011 P 4 kp setu 02
2 serang 11/18/1975 L 2 kp sambikiting 015
3 serang 7/18/1978 P 2 kp sambikiting 015
4 serang 12/28/1999 P 4 kp sambikiting 015
4 serang 2/25/2007 P 4 kp sambikiting 015
4 serang 1/23/2013 L 4 kp sambikiting 015
Kode Kode
RW Kode Pos Kecamata Nama Kecamatan Kode Desa Nama Desa Faskes Tk.I
n

12 13 14 15 16 17 18
002 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
002 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
002 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
002 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
002 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
001 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
001 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
001 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
001 42453 3092 WARINGINKURUNG 06.2009 SAMPIR 10062601
3 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
3 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
3 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
2 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
2 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
2 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
4 42453 3092 Waringin Kurung 06.2004 MELATI 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
002 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2005 SASAHAN 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
001 42453 3092 Waringin Kurung 06.2011 Kemuning 10062601
003 42453 3092 Waringin Kurung 06.2006 Sk Dalem 10062601
003 42453 3092 Waringin Kurung 06.2006 Sk Dalem 10062601
003 42453 3092 Waringin Kurung 06.2006 Sk Dalem 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
001 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
002 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
003 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
003 42453 3092 WARINGINKURUNG 06.2002 TELAGA LUHUR 10062601
005 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
005 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
004 42453 3092 WARINGINKURUNG 06-2003 BINANGUN 10062601
001 42453 3092 waringinkurung 06.2010 cokop sulanjana 10062601
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2009 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2010 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2009 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2010 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2009 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2010 sambilawang waringinkurung
001 42453 3092 waringinkurung 06.2011 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
007 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
007 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
007 42453 3092 waringinkurung 06.2008 sambilawang waringinkurung
01 42453 3092 waringinkurung 06.2009 sambilawang waringinkurung
01 42453 3092 waringinkurung 06.2010 sambilawang waringinkurung
01 42453 3092 waringinkurung 06.2011 sambilawang waringinkurung
01 42453 3092 waringinkurung 06.2012 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2012 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2013 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2014 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2015 sambilawang waringinkurung
002 42453 3092 waringinkurung 06.2016 sambilawang waringinkurung
Kode Nama Nomor
Faskes Faskes
Nama Faskes Tk.I Telepon Email NPP Jabatan
Dokter Dokter Peserta
Gigi Gigi

19 20 21 22 23 24 25
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Kewarga
Kelas
Status Negaraa
Rawat
n Asuransi Lainnya
Gaji Pokok
1=Tetap, TMT Kerja + Tunj. No
2=Kontrak 1=Kelas I, (Kary. Tetap No. NPWP Passport
, 3=Paruh 2=Kelas II, Aktif) (Kary. 1=WNI, Nama
Aktif) No. Polis
waktu 2=WNA Asuransi
4=Penerim 3=Kelas III
a Pensiun

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Serang 8 januari 2019
Bidan Koordinator

Eliyanah
Nip: 19701003 199203 2 004