DAFTAR HADIR

PENYULUHAN INDIVIDU DI POSYANDU RW 12 PANGGUNG

No Nama Alamat Tandatangan

1 Naherti/ponco M 4/14 1

2 Aryanti/ Suwanto 5/14 2

3 Nurfani/ Sumertono 4/14 3

4 Ratnawati/Saefusdin 3/14 4

5 Istiana/M.Tohirin 1/14 5

6 Suparni/Nurohim 1/14 6

7 Heni/Safrudin 3/14 7

8 Suhada 5/14 8

9 Taufik/Susanti 1/14 9

Petugas,

.
 DAFTAR HADIR
PENYULUHAN INDIVIDU DI POSYANDU RW 13 PANGGUNG

No Nama Alamat Tandatangan

1 darmi/Retno 4/13 1

2 Cahya/Sofa 7/13 2

3 Lutfiana/Untung 2/13 3

4 Nuryati/Edwin 4/13 4

5 Lili/M.Arif 4/13 5

6 Sunarti/Tarsito 5/13 6

7 rohimah/Abdul latif 7/13 7

8 Nurhalimah/slamet 4/13 8

9 Mundiri A./Arifin 7/13 9

10 Ernawati/Edi 4/13 10

Petugas,

.
 DAFTAR HADIR
PENYULUHAN INDIVIDU DI POSYANDU RW 1 PANGGUNG

No Nama Alamat Tandatangan

1 Dhini / Rusdianto 4/1 1

2 Amelia/M.Kurnia 3/1 2

3 Widi/Setio 6/1 3

4 fina/ hendra 7/1 4

5 Elsa/dedi 4/1 5

6 Sri W/ Arif S 1/1 6

Petugas,

.
 DATA BAYI 0 - 6 BULAN
KELURAHAN PANGGUNG KEC. TEGAL TIMUR

POSY NO NAMA NAMA ORTU TGL LAHIR ALAMAT ASI

RW I 1 Dhini / Rusdianto 4/26/2013 4/1
2 Amelia/M.Kurnia 4/9/2013 3/1
3 Widi/Setio 5/6/2013 6/1
4 fina/ hendra 6/30/2013 7/1
5 Elsa/dedi Aug-13 4/1
6 Sri W/ Arif S 8/9/2013 1/1
Rw II 7 Widiastuti/Tobari 5/28/2013 3/2
8 Eda W/Slamet 5/25/2013 2/2
9 Nur Aeni/Ahmad 6/29/2013 9/2
10 Eli R/Sunarto 8/27/2013 4/2
RW III 11 Warsiti/M.badar 5/15/2013 3/3
12 Eni taryah/Driyan 4/15/2013 8/3
13 lestari B/Samuji 7/19/2013 4/3
14 Yuni W/Agil M 7/2/2013 9/3
15 Endang S/Suherman 5/31/2013 4/3
16 Eka S/Wardi 4/30/2013 3/3
17 Dwi H/Syarifudin 6/30/2013 5/3
18 Purwati/Carsono 7/21/2013 5/3
19 Nur umi/Herry 7/20/2013 5/3
20 Ria R/Doni R 6/20/2013 1/3
21 Wiwi A/Arif 8/11/2013 8/3
22 sri L/Supriyanto 5/13/2013 7/3
23 Restu G/Abdul Rahmat 5/18/2013 7/3
24 Anisa B/Moh.Iskak 6/17/2013 5/3
25 Sariyem/Slamet 6/4/2013 8/3
26 Feti/jeni May-13 9/3
27 Catur/m.Arif 6/21/2013 4/3
RW IV 28 Nuroyanah/Kasmuid 4/11/2013 6/4
29 nur Indah/Budi A 4/29/2013 9/4
30 Toyibah/Dedi i 7/22/2013 7/4
31 Pipit/Wahidin 7/22/2013 7/4
32 Dian N/M.arif May-13 8/4
33 Fathkhatur/M.Sukron 5/8/2013 3/4
34 Nanik Sri/M.Munif 7/17/2013 3/4
35 Ayu/Hakim 6/17/2013 1/4
36 umi/Arif S 4/29/2013 5/4
37 Nur Aeni/Indra S 7/23/2013 8/4
38 Febriana/Yusrizal 8/7/2013 6/4
39 Lidia/Irfan 4/26/2013 2/4
40 Ani S/Jumanto 5/11/2013 2/4
41 Mardiana/Teguh 6/16/2013 6/4
42 Eka S/Tahruni 7/23/2013 3/4
43 Puspita/Kasmani 7/2/2013 7/4
44 Bintang/Didik 6/29/2013 7/4
RW V 45 Desi Claudia 4/6/2013 2/5
46 Agustina 7/24/2013 3/5
47 Sri Dewi u/Hari 4/18/2013 9/6
48 Endang S/Agus 5/24/2013 2/6
49 Ulfatun C/Adi S 8/28/2013 2/6
50 Tomi R/Tedi H 4/20/2013 5/6
51 Happy/ Budiharjo 7/27/2013 1/6
52 Miranti/Witna Y 7/23/2013 6/6
53 Fatiyatun/Norman 7/30/2013 5/6
54 Wiidia N/Dedi W 6/7/2013 2/6
55 Yohana 8/21/2013 3/6
 56 Eli V/Beni Jul-13 3/6
57 Siti Jariyah/Hasan 7/30/2013 3/6
58 Heni P/Bustanul 5/30/2013 3/6
59 Fitri/Irfanto 7/13/2013 5/6
60 Gilang Pramita/tri sucipto 6/20/2013 1/6
61 Galang Pramita/tri sucipto 6/20/2013 1/6
62 Ade I/Rian 5/21/2013 1/6
63 Suyuliani/Rusdianto 8/18/2013 2/6
64 Ririn N/Badrudin 6/21/2013 5/6
65 Bangkit R/M.Bahar 8/28/2013 3/6
66 Iliartini/Agus W 8/18/2013 1/6
67 Titin P/Deny 7/24/2013 7/6
68 Puput M Sri Wanti/Samhaji 5/9/2013 18/7
69 Selulura Muawanah/Heru B 5/28/2013 5/7
70 Azra K Evi R/Bambang 5/17/2013 5/7
71 Tristanti/ erwin 5/21/2013 19/7
72 Yuli/Susanto 5/25/2013 19/7
73 Siti Nuraisyah/Ade P 4/24/2013 19/7
74 Zahra Afifatul A/Santoso 7/19/2013 4/7
75 Firdaus Dian W/Aji M 7/12/2013 11/7
76 Citra/Maulana 4/16/2013 13/7
77 Azzza Wati/Sudarsono 5/15/2013 4/7
78 Faqihul H Sumarti/Kasir 7/13/2013 3/7
79 Faishal H Sumarti/Kasir 7/13/2013 3/7
80 Ale Lismiati/Yuni S 7/19/2013 9/7
81 Julekha/Bahrusalim 6/25/2013 8/7
82 Eli R/Risqi N 7/7/2013 7/7
83 Fitria S/Slamet S 7/13/2013 3/7
84 Susmiyati/Supeno 7/21/2013 19/7
85 Febriana/Yusrizal 8/7/2013 1/7
86 Yuliana/Sugiarto 7/20/2013 6/7
87 Hafis Tarini/Andri 5/9/2013 17/7
88 Tarni/Gunawan 4/24/2013 1/8
89 Yumna Yuni/Imron 5/26/2013 6/8
90 Adinda S Feri N/Jeni 4/23/2013 1/8
91 Leni/Adil 7/25/2013 6/8
92 Afrah Sondang/ Heri 7/1/2013 4/8
RW IX 93 M. Dedi Ayu retno/dedi suhayadi 5/3/2013 11/9
94 Santi/heru E 6/8/2013 5/9
95 M. Arkhan Kusriyanti/karyanto 6/30/2013 13/9
96 adelia Ponco A/Sugeng 5/8/2013 6/9
97 Amalia/Dede 5/19/2013 1/9
98 firli Khusnul K/Bambang 6/22/2013 1/9
99 Endang/Slamet 6/30/2013 3/9
100 rifan Wahyu D/Ali Topo 7/2/2013 1/9
101 Yuniar Kalih Olivianti/Andri A 7/17/2013 3/9
102 Rafina Tri Yuliana/Rudi H 7/7/2013 6/9
103 Faizin R Azizah/Hendra G 7/16/2013 10/9
104 areska FadilaNuratika/Ari 7/4/2013 12/9
105 Nur Khasanah/Bambang 7/28/2013 3/9
106 Runita/Riyanto 9/11/2013 6/9
107 Fadlan Lisa Sugiarti/Cecep 9/2/2013 6/9
108 Fadli Lisa Sugiarti/Cecep 6/9
109 Rifka/m.cahyanto 9/2/2013 10/9
110 darsini/Slamet M 9/13/2013 14/9
111 Ely/Arif 8/21/2013 7/9
112 Fuad hasyim Hikmah/Sekar 5/25/2013 11/9
113 Zafran Sodirin 7/16/2013 2/9
114 Aisyah/Arif Budi 8/28/2013 2/9
115 qindi Alfian Tuti/Miftah 6/15/2013 14/9
 116 falen Dwi/junaedi 5/18/2013 13/9
117 Rafael Herlan 5/18/2013 1/9
118 Firly airani/Bambang 6/22/2013 1/9
119 friska Dwi A/sukriyanto 4/5/2013 1/9
120 Adit Alkha/M.Anwar 4/20/2013 1/9
121 Tania Agustin/karyoto 4/10/2013 14/9
RW X 122 Noviatun Imroh/ Topik 5/13/2013 6/10
123 Tri Angel Warsiti/karnuno 6/19/2013 11/10
124 Agila Noviani/mugiatno 6/16/2013 10/10
125 Agela Noviani/mugiatno 6/16/2013 10/10
126 M.Nurma R Yuli H/Riyiko 5/21/2013 6/10
127 Sakira J Dian murti/ardiansyah 7/31/2013 2/10
128 Amanda F puji Rahayu/heru Y 7/27/2013 3/10
129 Fira F Siti Mutajiroh/Aris h 8/13/2013 2/10
130 Damayanti/Asep 9/18/2013 3/10
131 Salsabil riko/Winda 4/27/2013 2/10
132 Fahmi Ayman/mansyur 4/3/2013 6/10
133 M.Yasasi Dian A/Sahroni 6/12/2013 4/10
134 Desinta H/Abu 7/28/2013 7/10
RW XI 135 Anugrah Wariyah/Edi M 5/17/2013 4/11
RW XII 136 Arya Y Yuili A/Agus S 6/22/2013 1/12
137 M.Alfin Eva M/Pranoto 6/4/2013 12/12
138 Sasongko Susiyani/Joko P 6/20/2013 5/12
139 Istiqomah/Sunardi 5/30/2013 6/12
140 Novi D Susilowati/Roni W 7/14/2013 12/12
141 Susiani I/Hadi W 5/8/2013 5/12
142 Athoya R Solicha/Wardoyo 8/10/2013 13/12
143 A.Latibul Winarvi/Hafifudin 8/20/2013 10/12
144 Fahan Wike R/Agus 8/25/2013 7/12
145 Nunik N Siti B/Ramdon 8/22/2013 12/12
146 Dhia L Fika puspasari/Ade I 8/7/2013 9/12
147 Indah P/Fuad 7/29/2013 2/12
148 Sri Sunarti/Arema 8/28/2013 10/12
149 Eva Nauli/heri P 8/20/2013 9/12
150 Titik K/Fahniza 7/31/2013 2/12
151 Arzeta A Jumrotul/Herman 9/5/2013 12/12
152 Annisa Endang S/Sohitul 9/13/2013 5/12
153 Naufal Dwi/Angga 4/18/2013 9/12
154 Zevan Risnanto 5/3/2013 6/12
155 Hanun Sahidin 4/21/2013 5/12
156 Dika Dwi F/Ghofi 5/23/2013 7/12
157 M.Tatang Santoso/winasih 4/5/2013 2/12
158 Astrid Dwi A/Rosidin 5/12/2013 4/12
159 Syahla Soraya/Teguh 7/8/2013 9/12
160 Anggita Gilang 6/4/2013 9/12
161 Nafisah Suwardo 5/17/2013 6/12
162 Cika Aprilia/tasripin 4/8/2013 12/12
163 Asni aufa/Asep 5/18/2013 12/12
164 Nur Azizah Nur azizah/Saidin 5/22/2013 4/12
165 Nizam H Bambang 4/28/2013 4/12
RW XIII 166 Fadil A darmi/Retno 5/3/2013 4/13
167 Farel A Cahya/Sofa 6/13/2013 7/13
168 M. Riski Lutfiana/Untung 5/5/2013 2/13
169 M. Albi R Nuryati/Edwin 7/11/2013 4/13
170 Catur Lili/M.Arif 6/26/2013 4/13
171 Risjayanto Sunarti/Tarsito 5/30/2013 5/13
172 Azzwa rohimah/Abdul latif 6/30/2013 7/13
173 Galih RamdoNurhalimah/slamet 7/18/2013 4/13
174 Ach.RamadniMundiri A./Arifin 7/14/2013 7/13
175 M.Lukmanul Ernawati/Edi 8/25/2013 4/13
 176 Nisa N. Arnita/Sadi 9/4/2013 4/13
177 St.Nur fadila Susi/Cakono 9/10/2013 5/13
178 M.Rajab Wawan 5/15/2013 1/13
RW XIV 179 Damar Nur Naherti/ponco M 6/19/2013 4/14
180 Nafisa Putri Aryanti/ Suwanto 5/28/2013 5/14
181 Nurfani/ Sumertono 7/14/2013 4/14
182 Ratnawati/Saefusdin 5/28/2013 3/14
183 Istiana/M.Tohirin 8/9/2013 1/14
184 Suparni/Nurohim 8/18/2013 1/14
185 Heni/Safrudin 8/21/2013 3/14
186 Aulia N Suhada 4/15/2013 5/14
187 Andika R Taufik/Susanti 4/17/2013 1/14
Tegal, September 2013

drg. Rinta S.
NIP. 19601025 200003 2 001
 DATA BUMIL KELURAHAN PANGGUNG
KECAMATAN TEGAL TIMUR

POSY NO NAMA USIA IBU ANAK KE- ALAMAT USIA HAMIL HPL
RW 1 1 Annisa/Amanu 36 1 7/1 30 mg 11/3/2013
RW II 2 Dian/M.arifin 36 1 8/2 32 mg 11/3/2013
3 Kamalia/Suroso 28 1 11/2 36 mg 10/20/2013
4 Windi/Nurosyid 23 1 2/2 30 mg 11/20/2013
RW III 5 Siti Rahayu/Rizal 35 6 2/3 39 mg 9/1/2013
6 Wiwi.A/Trio 20 2 9/3 39 mg 9/27/2013
RW IV 7 Sunarsih/Fatoni 26 2 4/4 36 mg 10/16/2013
8 Rosita/ indara 19 1 4/4 32 mg 11/4/2013
9 novita/Saefulo 23 1 1/4 32 mg 11/26/2013
10 Siolihati / Surahman 26 1 1/4 34 mg 11/6/2013
11 Musliha/Sapto 21 1 2/4 33 mg 11/17/2013
RW V 12 Daerahwati/Yusuf 39 4 7/5 35 mg 10/2/2013
13 Suparmi/taryono 40 1 9/5 32 mg 10/27/2013
14 Nurul K/Suwirto 20 1 9/5 28 mg 11/1/2013
RW VI 15 Wulan/ ego 25 1 1/6 30 mg 11/1/2013
16 tanti/Nasori 26 2 1/6 30 mg 12/20/2013
17 Mukti/Abdul rozak 25 2 1/6 37 mg 10/12/2013
RW VII 18 Rizki Putri/Arif 20 1 8/7 36 mg 10/22/2013
19 Ratih/haji 18 1 19/7 36 mg 10/1/2013
20 Dian p/Khusni 23 1 1/7 32 mg 11/6/2013
21 Sri Yuliani/Imam 25 2 9/7 36 mg 10/25/2013
22 Asih W/Agug W 27 2 9/7 36 mg 10/24/2013
23 Endang/deni 38 3 3/7 35 mg 10/30/2013
RW VIII 24 Dianasari/Sigit P 33 3 2/8 36 mg 10/1/2013
25 Siti Tumaninah/Abdul 27 2 2/8 30 mg 11/20/2013
RW IX 26 Sofingatun/ Joko S 20 1 1/9 27 mg 12/11/2013
27 rihar/Feri 20 1 11/9 28 mg 11/1/2013
28 Ana/ rojikin 35 4 1/9 37 mg 10/11/2013
29 Miskiyah/Bambang 42 4 2/9 37 mg 10/12/2013
30 Atun K/Rawin 25 2 3/9 36 mg 10/1/2013
31 Ani S/Prasetyo 23 1 8/9 30 mg 12/1/2013
32 Agustina/Bona 16 1 1/9 34 mg 11/2/2013
33 Halimah/Rudi 38 4 2/9 34 mg 10/14/2013
34 Ega/hendri 23 1 12/9 32 mg 10/1/2013
35 Nita C/ Argo 20 1 8/9 29 mg 10/27/2013
36 Linda L/fadil 17 1 6/9 32 mg 10/1/2013
37 Tri W/Diryono 33 3 2/9 32 mg 10/1/2013
38 Nur Baeti/ Rudiyanto 24 3 28 mg 11/1/2013
RW XA 39 Indah P/Mulus 28 2 9/10 28 mg 11/1/2013
40 Ermi H/Tatang 36 4 10/10 28 mg 11/20/2013
RW XB 41 Mustika/pendi 30 2 4/10 31 mg 12/9/2013
42 Imah/Deni L 36 2 5/10 28 mg 10/1/2013
RW XI 43 Yevi M/Agung 22 1 2/11 31 mg 11/1/2013
RW XII 44 Ari / Faizal 25 1 6/12 34 mg 12/3/2013
45 Wasitah/ Karnadi 30 2 6/12 32 mg 11/10/2013
46 Devi D/Hendri 27 1 5/12 28 mg 11/15/2013
47 Liana / Iman 23 1 10/12 29 mg 11/1/2013
48 Dewi /Siswo 29 1 12/12 34 mg 11/27/2013
RW XIII 49 Fitroh / Kristanto 32 2 4/13 34 mg 11/25/2013
50 Nur Atika/Ardi 22 1 6/13 32 mg 10/30/2013
51 Afi S/Agus 26 2 2/13 30 mg 10/4/2013
RW XIV 52 Mafrokhatun/aminudin 27 2 5/14 34 mg 10/28/2013
53 rodiarsih/Billy 28 1 4/14 37 mg 10/6/2013
54 Ria F/feri 24 1 5/14 30 mg 11/9/2013
55 Ani O/Arif F 21 1 1/14 36 mg 10/4/2013
Tegal, September 2013
drg. Rinta S.
NIP. 19601025 200003 2 001
 DAFTAR HADIR
PERTEMUAN PERENCANAAN PUSKESMAS
UPTD PUSKESMAS TEGAL TIMUR

No Nama Jabatan Tandatangan

1 dr. Luluk Kepala Puskesmas 1

2 drg. Rinta S Anggota 2
3 dr. Aminah C Anggota 3
4 Purwo hadi S, S.ST Sekretaris 4
5 Agus P, SKM Anggota 5
6 Rokhimah, Amd Anggota 6
7 Fauziah, SKM Anggota 7
8 Suharni, AMK Anggota 8
9 Susilowati, Amd.Keb Anggota 9
10 Juni Darsusalam, AMK Anggota 10
11 Mustakhiroh, AMK Anggota 11
12 Katharina H, AMK Anggota 12
13 Dewi F, Amd.Keb Anggota 13
14 Wiwit S, Amd Anggota 14
15 Choerul A, S.Farm,Apt Anggota 15
16 Dwi H, AMK Anggota 16

Mengetahui Tegal,
Kepala Puskesmas Tegal Timur Petugas,

dr. Luluk
NIP. 19731015 200501 2 007
 DAFTAR PENERIMAAN TRANSPORT KADER DALAM RANGKA KEGIATAN PEMANTAPAN LKB
PUSKESMAS TEGAL TIMUR

PPH Ps. Jumlah

Jumlah
No Nama Kader Biaya Total 21 Yang Tanda Tangan
Kegiatan 3% Diterima

1 Saroso 1 20,000 20,000 600 19,400 1

2 Munawir 1 20,000 20,000 600 19,400 2

3 Sawaludin 1 20,000 20,000 600 19,400 3

4 Tuti Widodo 1 20,000 20,000 600 19,400 4

5 Dwi Asmiati 1 20,000 20,000 600 19,400 5

6 M. Fauzi 1 20,000 20,000 600 19,400 6

7 Eka Agustina 1 20,000 20,000 600 19,400 7

8 Wiji Astuti 1 20,000 20,000 600 19,400 8

9 Nunung 1 20,000 20,000 600 19,400 9

10 Sahuri 1 20,000 20,000 600 19,400 10

11 Mike 1 20,000 20,000 600 19,400 11

12 Ekowati 1 20,000 20,000 600 19,400 12

13 Kartini 1 20,000 20,000 600 19,400 13

14 Martono 1 20,000 20,000 600 19,400 14

15 santi 1 20,000 20,000 600 19,400 15

16 Chosida R 1 20,000 20,000 600 19,400 16

TOTAL 320,000 320,000 9,600 310,400

Mengetahui Tegal,
Kepala Puskesmas Tegal Timur Petugas,

dr. Luluk
NIP. 19731015 200501 2 007