FORMAT PENGKAJIAN KEPE

desa/ dusun/ RW/RT : Desa AlamEndah/R

Pelaksana Survey
AGAMA PENDIDIKAN KOMPONEN PENG

sarana air ketersedia

T penyskit yang paling
No Nama KK Umur TK/ T S T
SM
SM status perkawinan
bersih di jenis sumber air an jamban jenis jamban
sering di derita keluarga 6
aksept jenis kontrasepsi yang
A/S T lingkunga bersih yang yang digunakan or KB dipakai
I K H B PA SD S M SM
MK/
A/S PT
PT
BS
n ruma digunakan
bulan terakhir
UD P MK/
D P STM
STM

a b c d a b a b c d a b a b c a b c d e f g a b a

1 Risna Gunawan 35 1 1 1 1 1 1 1 1 1
2 Wahyu Wahyudin 35 1 1 1 1 1 1 1 1 1
3 Ophid 63 1 1 1 1 1 1 1 1 1
4 Aat 47 1 1 1 1 1 1 1 1
5 Suriyadi 1 1 1 1 1 1 1 1
6 Didi R 1 1 1 1 1 1 1 1
7 Misrat 68 1 1 1 1 1 1 1 1
8 Rukmana 68 1 1 1 1 1 1 1 1
9 Udis 59 1 1 1 1 1 1 1 1
10 Suherman 26 1 1 1 1 1 1 1 1
11 Darsono 61 1 1 1 1 1 1 1 1
12 Dewi 34 1 1 1 1 1 1 1 1
13 Akim 62 1 1 1 1 1 1 1 1
14 Sobandi 74 1 1 1 1 1 1 1 1
15 Agus 54 1 1 1 1 1 1 1 1 1
16 Rahmi 60 1 1 1 1 1 1 1 1
17 y 45 1 1 1 1 1 1 1 1
18 Hendi supriatna 40 1 1 1 1 1 1 1 1 1 1
19 Oleh Hamdani 44 1 1 1 1 1 1 1 1 1 1
20 Deni Irawan 33 1 1 1 1 1 1 1 1 1 1
21 Tatan Rustandi 41 1 1 1 1 1 1 1 1 1 1
22 Eye 63 1 1 1 1 1 1 1 1 1
23 Ade Wawan 24 1 1 1 1 1 1 1 1 1
24 Tarmini 75 1 1 1 1 1 1 1 1 0
25 Imat 48 1 1 1 1 1 1 1 1 1
26 Darmana 54 1 1 1 1 1 1 1 1 0
27 Yayat Syarif 54 1 1 1 1 1 1 1 1 1
28 Tarna 35 1 1 1 1 1 1 1 1 1
29 Ade Rusmana 65 1 1 1 1 1 1 1 1 0
30 Nandang Supriatna 52 1 1 1 1 1 1 1 1 1
31 Ade Supriatna 35 1 1 1 1 1 1 1 1 1
32 Rohana 65 1 1 1 1 1 1 1 1 0
33 Yudi Mulyana 43 1 1 1 1 1 1 1 1 1
34 Rukmana 87 1 1 1 1 1 1 1 1 0
35 Jenal Aditya 45 1 1 1 1 1 1 1 1 1
36 H. Yaya 60 1 1 1 1 1 1 1 1 0
37 Agus 41 1 1 1 1 1 1 1 1 1
38 Rahmat Supriadi 39 1 1 1 1 1 1 1 1 1
39 Rosmiat 69 1 1 1 1 1 1 1 1 0
40 Dede Sutsna 59 1 1 1 1 1 1 1 1 0
41 Abun 60 1 1 1 1 1 1 1 1 1
42 Dede 42 1 1 1 1 1 1 1 1 1
43 Dedi 53 1 1 1 1 1 1 1 1 0
44 O. Sutsna 58 1 1 1 1 1 1 1 1 0
45 Yanto 32 1 1 1 1 1 1 1 1 1
46 Edi 55 1 1 1 1 1 1 1 1 1
47 Ents 75 1 1 1 1 1 1 1 1 0
48 Dedi Suryadi 34 1 1 1 1 1 1 1 1 1
49 bubun 42 1 1 1 1 1 1 1 1 1
50 yunia 25 1 1 1 1 1 1 1 1 1
51 rahayuna 55 1 1 1 1 1 1 1 1 0
52 reza 26 1 1 1 1 1 1 1 1 1
53 ojang 49 1 1 1 1 1 1 1 1 1
54 candra 30 1 1 1 1 1 1 1 1 1
55 ai sudana 57 1 1 1 1 1 1 1 1 0
56 novita sari 20 1 1 1 1 1 1 1 1 1
57 jandi 50 1 1 1 1 1 1 1 1 0
58 nandi 63 1 1 1 1 1 1 1 1 0
59 iwan 30 1 1 1 1 1 1 1 1 1
60 wawan 18 1 1 1 1 1 1 1 1 0
61 aripin 70 1 1 1 1 1 1 1 1 0
62 rudi 28 1 1 1 1 1 1 1 1 1
63 mulyana 35 1 1 1 1 1 1 1
64 kumar 78 1 1 1 1 1 1 1 1 0
65 oman 54 1 1 1 1 1 1 1 1 1
66 het 23 1 1 1 1 1 1 1 1 1
67 khoenudin 27 1 1 1 1 1 1 1 1 1
68 ani 59 1 1 1 1 1 1 1 1 0
69 taryana 42 1 1 1 1 1 1 1 1 1
70 nandar 45 1 1 1 1 1 1 1 1 1
71 dede 21 1 1 1 1 1 1 1 1 0
72 aan 62 1 1 1 1 1 1 1 1 1
73 ade 56 1 1 1 1 1 1 1 1 0
74 rukayah 42 1 1 1 1 1 1 1 1 0
75 dede sutsna 33 1 1 1 1 1 1 1 1 1
76 deni yudiansah 22 1 1 1 1 1 1 1 1 1
77 asep suparman 35 1 1 1 1 1 1 1 1 1
78 budi mubarokah 28 1 1 1 1 1 1 1 1 1
79 juju sugandi 66 1 1 1 1 1 1 1 1 0
80 risna gunawan 35 1 1 1 1 1 1 1 1 1 1
81 jujum 70 1 1 1 1 1 1 1 1 0
82 dadang 43 1 1 1 1 1 1 1 1 1
83 jajang diniat 43 1 1 1 1 1 1 1 1 0
84 udis 58 1 1 1 1 1 1 1 1 0
 85 ayi suhardi 36 1 1 1 1 1 1 1 1 1
86 herman r 41 1 1 1 1 1 1 1 1 1
87 nandang epi 35 1 1 1 1 1 1 1
88 komar 76 1 1 1 1 1 1 1 1 0
89 heri 24 1 1 1 1 1 1 1 1 0
90 dindin mulyana 47 1 1 1 1 1 1 1 1 1
91 aat sapaat 44 1 1 1 1 1 1 1 1 0
92 didi rosidi 46 1 1 1 1 1 1 1 1 1
93 opid 63 1 1 1 1 1 1 1 1 0
94 hidayat 37 1 1 1 1 1 1 1 1 1
95 didin 57 1 1 1 1 1 1 1 1 0
96 misbah 38 1 1 1 1 1 1 1 1 1
97 ttk 60 1 1 1 1 1 1 1 1 0
98 tarmidin 40 1 1 1 1 1 1 1 1 1
99 ade suryana 52 1 1 1 1 1 1 1 1 1
100 ade. W 55 1 1 1 1 1 1 1 1 0
101 erus 44 1 1 1 1 1 1 1 1 1
102 alit tarna 42 1 1 1 1 1 1 1 1 1
103 wiana 22 1 1 1 1 1 1 1 1 0
104 anwar sanusi 35 1 1 1 1 1 1 1 1 0
105 engkos 42 1 1 1 1 1 1 1 1 1
106 ayi sudana 57 1 1 1 1 1 1 1 1 0
107 dedi junaedi 29 1 1 1 1 1 1 1 1 1
108 kama 66 1 1 1 1 1 1 1 1 0
109 dedi rustandi 53 1 1 1 1 1 1 1 1 0
110 icang sopandi 62 1 1 1 1 1 1 1 1 0
111 esih 55 1 1 1 1 1 1 1 1 0
112 hendrik 39 1 1 1 1 1 1 1 1 1
113 ule cukiman 41 1 1 1 1 1 1 1 1 1
114 eli wijaya 41 1 1 1 1 1 1 1 1 1
115 Euis hartni 64 1 1 1 1 1 1 1 1 0
116 Erik permana 33 1 1 1 1 1 1 1 1 1
117 M Ade winata 43 1 1 1 1 1 1 1 1 1
119 Deni mulyana 33 1 1 1 1 1 1 1 1 1
120 Dede hermawan 1 1 1 1 1 1 0
121 dindin mulyana 33 1 1 1 1 1 1 1 1 1
122 Dede sopiah 27 1 1 1 1 1 1 1 1 0
123 Bandi 74 1 1 1 1 1 1 1 1 0
124 Kuwat mujamil 39 1 1 1 1 1 1 1 1 1
125 Subur mulyadi 49 1 1 1 1 1 1 1 1 1
126 Wawan sutawan 57 1 1 1 1 1 1 1 1 1
127 enjang supriatna 34 1 1 1 1 1 1 1 1 1
128 Roni 22 1 1 1 1 1 1 1 1
129 Khoerudin 27 1 1 1 1 1 1 1 1 1
132 Dedi mulyadi 37 1 1 1 1 1 1 1 1 1
133 Eman 37 1 1 1 1 1 1 1 1 1
134 Met 37 1 1 1 1 1 1 1 1 0
135 Aam muarif 28 1 1 1 1 1 1 1 1 1
136 Rukayat 42 1 1 1 1 1 1 1 1 1
137 Momo R 60 1 1 1 1 1 1 1 1 0
138 Arman 41 1 1 1 1 1 1 1 1 1
139 Odih 60 1 1 1 1 1 1 1 1 0
ORMAT PENGKAJIAN KEPERAWATAN KOMUNITAS

KOMPONEN PENGKAJIAN SISTEM NILAI DAN WAKTU KELUARGA

Keyakin konsep Waktu Anggota keluarga siapa anggota status
anggot an agama berkumpul semua keluar rumah, keluarga yang kepemilikan
anggota bila Ya, anggot keluarga menduk anggota keluarga pukul ? sering keluar
ada a
keluarga apakah a yang ung dirumah rumah
ibu apaka keluar jenis imunisasi hasil
umur melahirkan di bila ada, sudah yang penderit keluar menduk perilaku
jenis kontrasepsi yang hamil h ada ga yang sudah penimbangan
kehamila fasilitas lamanya imunis mengala a ga ung sehat
dipakai dalam nutek yang didapatkan KMS, BB
n kesehatan menyusui asi mi mengko yang kesehata
keluar i memp terakhir anak
ganggua nsumsi dipasu n
ga unyai
n jiwa obat ng
balita

b c d e f g a b a b c a b c d e a b a b c d a b a b a b c d e a b c d a b a b a b a b a b a b c d a b c d a b c d a b c

1 0 0 0 0 0 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1
1 1 0 0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
 1 0 0 0 0 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1
1 0 1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1 1 1
0 0 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 1 1 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 1 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
 1 0 0 0 0 1 1 1 1 1 1
1 1 1 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
0 1 1 1 1 1 1
0 1 1 1 1 1 1
0 1 1 1 1 1 1
0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1
0 0 0 0 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1
1 0 0 0 0 1 1 1 1
0 0 0 0 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1
0 0 0 0 1 1 1 1 1
0 0 0 0 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1
 LINGKUNGAN FISIK PERUMAHAN PEMBUANGAN SAMPAH KANDAN
tipe rumah Lantai Ada ada Apakah pencahayaan kondisi kondisi kondisi jarak rumah Halama Lokasi (ada) pemanfaatan dimana keluarga Penampu bila ada, apakah ada kepemilik
jendela jendela dibuka dalam rumah ventilasi pencaha kebersih dengan n pekarangan membuang sampah ngan keadaann pemilahan an
disetiap di setiap setiap di siang hari rumah yaan an tetangga Sekitar Sampah ya sampah kandang
kamar rumah hari rumah rumah rumah Sementar organik, ternak
a anorganik,
dan limbah

a b c a b c a b c d a b a b a b a b c a b c a b a b a b c a b a b c a b c d e a b c d a b a b a b a

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 11 1 1 1 1 1 1
1 1 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 11 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 0 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 0 1 1 1 1 1 0 1 1 1 0
1 1 1 1 0 1 1 1 1 1 0 1 1 1 0
 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 0 1 0 1 1 1 1 1 0 1 1 1 0
1 1 0 1 0 1 1 1 1 1 0 1 1 1 0
1 1 0 1 0 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 0 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 0 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
 KANDANG TERNAK POLITIK DAN KEBIJAKAN PEMERINTAH PELAYANAN KESEHATAN
kepemilik bila ada, Kondisi Jarak ke Penangan Peraturan Kelompok Desa/ RW Pelaksanaa Support Kebutuhan Fasilitas Dana Sarana kesehatan kebiasaan keluarga u/ kebiasaan Sumber pendanaan Sarana transportasi ke
an letak kandang rumah an limbah desa kerja siaga n bagi kader akan kesehatan kesehatan terdekat minta tolong bila sakit keluarga kesehatan keluarga pelayanan kes kel
kandang kandang ternak terkait kesehatan POSYAND kesehatan petugas masyaraka sebelum ke
ternak kesehatan U kesehatan t dikelola sarana
bersama pelayanan
secara kesehatan
mandiri

b a b a b a b a b a b a b a b a b a b a b a b a b a b c d a b c d a b a b c d a b c

0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 0 1
0 1 1 1 1 1
0 1 1 1 0 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 0 1
1 1 1 1 1 1 1 1 1
0 1 1 1 0 1
1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 0 1
0 1 1 1 0 1
0 1 1 1 0
1 1 1 1 1 1 1 0 1
1 1 1 1 1 1 1 1
1 1 1 0
0 1 1 1 0 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 0 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 0
0 1 1 1 0 1
0 1 1 1 1
0 1 1 1 0
0 1 1 1 0
0 1 1 1 0
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 0 1
0 1 1 1 1 1
0 1 1 1 0 1
0 1 1 0 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
0 1 1 1 1 1
TAN MASALAH KESEAHATAN KHUSUS IBU MENYUSUI
Sarana transportasi ke Jrk rmh dgn saran kes Penyakit yg srg diderita keluarga dlm 6 bln masalah kes umum degeneratif dlm 6 bln Masalah kesehatan keturunan Buteki ibu lamanya menyusui Alasannya (Bila Tidak) menurut ibu apa
pelayanan kes kel terakhir terakhir meneteki (YA) ASI eksklusif
ananya
(YA)

d a b c d a b c d e f g h a b c d e f g a b c d e f a b a b a b c d a b c d a b c

1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 1 1 0 0
1 1 1 1 1 1 0
1 1 1 1 0
1 1 1 1 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 1 1 1 1 0
1 1 1 1 1 1 0
1 1 1 1 1 0
1 1 1 0 0
1 1 1 0 0
1 1 1 1 0 1 1 1 1
1 1 1 1 0 0
1 1 1 0 1
1 1 1 0 1
1 1 1 0 0
1 1 0 0 0
1 1 1 0 0
1 1 0 0 0
1 1 0 0 1 1 1 1
1 1 1 0 0
1 1 1 0 0
1 1 0 0 1 1 1 1
1 1 0 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 0 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 1 1 0
1 1 1 1 0 0
1 1 1 1 0 0
1 1 0 0 0
1 1 1 0 0
1 1 1 0 0
1 1 1 0 0
1 1 0 0 0
1 1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 1 0 0
1 1 0 0 0
1 1 1 1 1 0 0
1 1 1 0 0 0
1 1 1 0 0 0
1 1 1 0 0 0
1 1 1 1 1 1 0 0
1 1 0 0 0
1 1 0 0 0
1 1 0 0 0
1 1 0 0 0
1 0 0 0
1 1 0 0 0
1 1 0 0 0
1 1
1 1 1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1 1 1 1 1 1
1 1 1
1 1 1 1
1 1 1 1 1
1 1 1
1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1
1 1 1 1
1 1
1 1 1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1 1 1
1 1 1
1 1
1 1
1 1 0
1 1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 1 1 0
1 1 0
1 1 0
1 1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 1 1 0
1 1 1 0
1 1 1 1 0
 BALITA ANAK DAN REMAJA
anggota setiap Anak ibu Jenis imunisasi yg sudah alasannya BB anak berada pada Anak Usia anak saat Pendidikan anak Kegiatan anak Anak yang sudah jika sudah, Ibu Anak banyaknya anak
keluarga bulan sudah didptkn (TIDAK) (berdasarkan KMS) sekolah/ ini (YA) diluar Sekolah menderita berobat? berobat memberik mengalami menggosok gigi dalam
berusia balita imunisasi remaja penyakit (YA) kemana an masalah sehari
balita dibawa ke dalam suplemen/ gigi
psyandu keluarga vit
tambahan

a b a b a b a b c d e a b c a b c d a b a b c a b c d a b c a b a b a b a b a b a

1 1 1 1 1 1 1 0
1 1 1 1 1 1 0
1 1 0
1 1 1 1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 0
1 1 1 1 1 1 1 0
1 1 1 1 1 1 1
1 1 0
1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1
1 1 1 1 1 1 0 1
1
0 1 1 1 1 1 0
0 1 1 1 1 1 1 0
0 1 1 1 1 1 1 0
 1 1 1 1 1 1 1 1 1 1 1 0
0 0
0 0
0 0
0 0
0 1 1 1 1 1 1 0
0 1 1 1 1 1 0
0 1 1 1 1 1 1 0
0 0
0 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
0 1 1 1 1 1 0
0 1 1 1 1 1 0
0 0
0 1 1 1 1 1 1 1 1 1 0
0 0
0 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
0 0
0 1 1 1 1 1 0
0 1 1 1 1 1 0
0 0
0 1 1 1 1 1 1 1 0
0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
0
0 0
0 0
1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
0 1 1 1 1 0
1 1 1 1 1 1 1 1 1 0
0 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
0 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 0
0 0
0 0
0 1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 0
0 0
1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 0 1 1
0
0
0
0
0
0
1 1 1 1 1 1 1 1 1 0
0
0
0
0
1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
0
0
0
1 1 1 1 1 0 0
1 1 1 1 1 0 0
1 1 1 1 1 0 0
0
 0
0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0

1 1 1 1 1 1 1 1 1 1 1 1 1 0 0

1 1 1 1 1 0 0
1 1 1 1 1 0 0
1 1 1 1 1 1 1 0 0

1 1 1 1 1 0 0

1 1 1 1 1 0 0
1 1 1 1 1 0 0

1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0

1 1 1 1 1 0 0
1 1 1 1 1 0 0
1 1 1 1 1 0 0

1 1 1 1 1 0 0

1 1 1 1 1 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 1 1 0 0
1 1 1 1 1 1 0 0
 1 1 1 1 1 1 0 0
1 1 1 1 0 0

1 1 1 1 0 0

1 1 1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 1 1 0 0
1 1 1 1 0 0
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 0 0
1 1 1 1 1 1 0 0
1 1 1 1 1 1 0 0
1 1 1 0 0
1 1 1 1 1 1 0 0

1 1 1 1 1 1 1 1 1 1 1 1 1 0 0
1 1 1 1 0 0
MAJA USIA LANJUT ( 60 TAHUN )
banyaknya anak Gigi anak Gangguan Penggunaan waktu Kebiasaan anak Lansia keluhan Jenis penyakit Upaya yang Penggunaan waktu Posyandu Lansia
menggosok gigi dalam pernah anak luang anak dalam penyakit telah dilakukan senggang Lansia Lansia Rajin
sehari diperiksak dalam keluarga Lansia mengikuti
an ke kegiatan POSYAND
pelkes belajar U Lansia

b c d a b a b a b c d a b c a b a b a b c d e f g h i j k l a b c a b c d a b a b

1 0 1 1 1 0
1 0 1 1 1 0
0 1 1 1 1 1 0
1 0 0 1 1 1 1 1 1 1 1 0
1 0 0
1 0 0
1 0 0
1 0 1 1 1 1 1 1 1 0
1 0 1 1 1 1 1 1 1 0
1 0 0
1 0 1 1 1 0
1 1 0 1 1 0
1 0 0
1 0 0 1 1 0
1 0 1 1 0
0 0 1 1 1 1 1 1 1 1 1 0
0
1 0 0 1 0
1 0 0 1 0
1 0 0 1 0
1 0 0 1 0
1 1 1 1 1 1
0
1 1 1 1 1 1 1 0
0
1 0 0 1 1 0 0
1 0 0 1 1 0 0
1 0 1 1 1 0 0
1 1 1 1 1 1 1 0
1 1 1 1 1 0 0
1 0 1 1 1 0 0
1 1 0 1 1 0 1 1 1 1 1 1 0
1 1 0 1 1 0 0
1 1 1 1
1 1 1 1 1 0 0
1 1 1 1 1 1 0
1 0 0 1 1 0 0
1 0 0 1 1 0 0
1 1 1 1 1 1 1 0
1 1 1 1 1 0 0
1 1 1 1 1 0 1 1 1 1 1 1 1 0
0
1 0 0 1 1 0 0
0
1 0 0 1 1 0 0
0
1 1 1 1 1 1 0
0
1 1 0 1 0
1 1 0 1 0
0
0
1 1 0 1 0
1 1 0 1 0
1 1 0 1 0
0
0
1 1 1 1 1 0
1 1 0 1 0
0
1 0 1 0
0
1 0 1
1 1 1 1

1 1 1 1

1 1 0 1

1 0 0 1

1 1 1

1 0 0 1 1 1 1
1 0 0 1
1 0 0 1
1 0 0 1
1 1 1 1 1 1 0

1 0 0 1

1 0 0 1
1 0 0 1 1 0 1 0
1 0 0 1

1 0 0 1
1 1 1 1 1 0
1 0 0 1
1 0 0 1

1 0 0 1
1 0 0 1

1 0 0 1
1 0 0 1
1 0 0 1
1 1 1 1 1 1 0
1 0 0 1
1 0 1 0

1 0 0 1
1 0 0 1
1 0 0 1
1 0 0 1 1 1 1 1 1 1 0
1 0 0 1
1 0 0 1

1 0 0 1

1 1 1 1 1 1 0
1 0 0 1
1 0 0 1
1 0 0 1
1 0 0 1

1 0 0 1
1 0 0 1
1 0 0 1
1 0 0 1
1 0 0 1
1 1 1 1 1 1 0
1 0 0 1
1 0 0 1 1 1 1 1 1 1 0
 TERDAPAT USIA DEWASA (18-55 TAHUN) KOMUNIKASI /INFORMASI DAN TRANSPORTASI EKO
Alasannya Usia kondisi keluhan / diagnosa keterlibata terlibat di/ke (YA) Sarana Alat penunjang tempat menyampaikan Informasi yang Sarana Jarak ke sumber penghasilan
(TIDAK) dewasa usia medis usia dewasa n keluarga Komunika komunikasi dan informasi sering Trransportasi sarana
setelah dewasa (sakit) dalam si dan informasi disampaikan yang dimiliki pelayanan
lulus saat ini penangana informasi keluarga kesehatan
sekolah n masalah
kesehatan

a b c a b a b a b c d a b a b c d a b a b c d a b c d a b c a b c a b a b c d e f

1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 1 1 1 1 1 1 1 1 1
 EKONOMI REKREASI PENGKAJIAN DESA/RW SIAGA
penghasilan Kebutuan Keluarga alokasi Alokasi apaakah Sarana rekreasi Sarana rekreasi Kemudaha Jarak Persepsi Kalau Perlu Cara keluarga Adanya Dimana Tenaga Kesediaan
rata-rata dasar menabung kesehatan dana ada dana yang dimiliki di masyarakat n tempat masyaraka bermanfaat adanay membawa ke sarana perlu terlatih masyarakat
perbulan sehari-hari pendidikan rekreasi keluarga mengakses rekreasi t tentang sarana tempat transporta disiapkan untuk untuk
terpenuhi rekreasi rekreasi kesehatan pelayanan si bagi kendaraan bencana di menjadi
penderita tersebut masyaraka petugas
di desa t penanggulan
gan GADAR

a b c a b a b a b a b a b a b c a b c a b a b a b a b c a b a b c a b a b a b a

1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1
N DESA/RW SIAGA
Kesediaan kemana keluarga apakah Kesediaan
masyarakat mencari DORA perlu masyaraka
untuk bila adanya t menjadi
menjadi membutuhksn bank pendonor
petugas darah di darah
penanggulan desa
gan GADAR

b a b c a b a b

0 1 1 0
0 1 1 0
0 1 1 1
0 1 1 0
0 1 1 0
0 1 1 0
0 1 1 0
0 1 1 0
0 1 1 0
0 1 1 0
0 1 1 1
0 1 1 0
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 1
1 1 1
1 1 1
 1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
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0 1 1 1
1 1 1
0 1 1 1
1 1 1
1 1 1
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1 1 1
1 1 1
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0 1 1 1
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1 1 1
1 1 1
0 1 1 s 0
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 1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 1 1 0
1 1 1
1 1 1
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1 1 1
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1 1 1
1 1 1
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1 1
1 1 1
0 1 1
0 1 1 1
1 1 1
1 1 1
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1 1 1
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 1 1 1
1 1 1
1 1 1
0 1 1 0
1 1 1
1 1 1
1 1 1
1 1 1
0 1 1 0
1 1 1
1 1 1
1 1 1
0 1 1 0
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
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0 1 1 0
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 1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 1 1 0
1 1 1
1 1 1
1 1 0
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 1 1 1
1 1 1
0 1 1 1
 KOMPOSISI KELUARGA

UMUR JK AGAMA
NO NAMA KK HUBUNGAN KELUARGA
0- 5 TH 6-12 TH 13-17 TH 18-59 TH > 60 TH L P I K

1 Risna Gunawan 1 1 KK 1
Reni M 1 1 Anak 1
Adelia Nur riski 1 1 Anak 1
2 Wahyu wahyudin 1 1 1
Rosikah 1 1 1
Nur hayat 1 1 1
3 Ophin 1 1 1
Iing 1 1 1
Agus Supriatna 1 1 1
4 Aat Sapaat 1 1 1
Kokom komala 1 1 1
Pendi 1 1 1
5 Suryadi 1
1
1
6 Didi R 1 1 1
Atikah 1 1 1
Asep permadi 1 1 1
7 Misrat 1 1 1
Wiah 1 1
8 Rukmana 1 1 1
Suarnah 1 1 1
9 Udis 1 1 1

10 Suherman 1 1 1
Lilis lisnawati 1 1 1
Renaldi 1 1 1
11 Darsono 1 1 1
Yoyoh 1 1
Dewi 1 1
Asri 1 1
Yanti 1 1
12 Dewi 1
13 Akim 1 1 1
Fatimah 1 1
14 Sobandi 1
15 Agus 1 1 1
Tita 1 1
Asep firmansaya 1 1
16 Rahmi 1 1 1
Laila 1 1

17 y 1
18 Hendi supriatna 1 1 1
Tati 1 1 1
 Dini 1 1 1
Muh ikhsan 1 1 1
19 Oleh Hamdani 1 1 1
Nayasita 1 1
Windi 1 1
Ari syahriana 1 1
Fitriani a 1 1
20 Deni Irawan 1 1 1
Rina M 1 1
Reva amelia 1 1
21 Tatan Rustandi 1 1 1
Siti rukmana 1 1
Aditia krisna 1 1
Fazril yudistira 1 1
Hilma sylvia 1 1
22 Eye 1
23 Ade Wawan 1 1 1
Rika 1 1
24 Tarmini 1 1 1
25 Imat 1 1 1
Darmini 1 1
26 Darmana 1 1 1
Warsita 1 1
Supartni 1 1
Dariyani 1 1
Kusnadi 1 1
27 Yayat Syarif 1 1 1
Elis 1 1
Bayu rahmat 1 1
28 Tarna 1 1 1
Wina herlina 1 1
Fitria 1 1
29 Ade Rusmana 1 1 1
Omas 1 1
30 Nandang Supriatna 1 1 1
Yani 1 1
Hendi supriadi 1 1
Agus irfan 1 1
Ratna 1 1
31 Ade Supriatna 1 1 1
Eva 1 1
Advan 1 1
Devran mo f 1 1
32 Rohana 1 1 1
Julaiha 1 1
Feri kurniawan 1 1
33 Yudi Mulyana 1 1 1
Sit nurjanah 1 1
Renata 1 1
Keysa novita 1 1 1
andi juandi 1 1
36 Rukmana 1
37 Jenal Aditya 1 1 1
Yani suryani 1 1
Tia aprilin 1 1
Jeni juliah 1 1
Rida agustn 1 1
38 H. Yaya 1 1
Hj. Encar 1 1
39 Agus 1
wiwin 1
kiki 1
40 Rahmat Supriadi 1 1 1
41 Rosmiat 1 1
42 Dede Sutsna 1 1
Ani suryani 1
Sinta nurjanah 1 1 1
43 Abun 1 1
sit aisah 1 1
Muh Anjas 1 1
Hendra adita 1 1
Hendri adita 1 1
Rian renaldi 1 1
44 Dede 1 1
Ent 1 1
Riyant 1
Silva 1
45 Dedi 1 1 1
46 O. Sutsna 1 1
47 Yanto 1 1
Yayah 1 1
Dani 1
Fadli Angga 1 1 1
48 Edi 1 1
49 Ents 1 1 1
ani 1 1
50 Dedi Suryadi 1 1 1
Yant yuliant 1 1
51 bubun 1 1
Wewen 1 1
Romi hermawan 1 1
Andra 1 1
Andri 1
Sena 1 1 1
52 yunia 1 1
53 rahayuna 1 1
Ai cuhayat 1
Fani 1 1 1
reza 1 1
54 ojang 1 1
Ita rosita 1 1
Deni 1
Chairul azis 1
55 candra 1 1 1
Nuri 1 1
Halimah 1 1
56 ai sudana 1 1 1
57 novita sari 1
58 jandi 1
Riswan 1 KK 1
susan 1 istri 1
59 nandi 1 anak 1
Ipang 1
Ridwan 1
60 iwan 1 1 1
61 wawan 1 1
62 aripin 1 1
Rudi sopandi 1 1
63 rudi 1
64 mulyana 1 1 1
Imas 1 1
Desi 1 1
65 kumar 1
66 oman 1
Et 1
Sandi 1 1 1
67 het 1 1
68 khoenudin 1 1
69 ani 1 1
70 taryana 1 1 1
Tut kartka 1 1
Rika 1 1
Renaldi 1 1
71 nandar 1
Ponem marina 1
risma uspita 1
amelia puter 1
72 dede 1 1
Enung 1
Agus 1
73 aan 1 1 1
74 ade 1 1
75 rukayah 1 1
76 dede sutsna 1 1 1
77 deni yudiansah 1 1
Sri hayat 1 1
Ismail pahri 1 1 1
78 asep suparman 1 1
Kartni 1 1
Sandi 1 1 1
79 budi mubarokah 1 1
Sant Kurniat 1
Dani purnama 1 1 1
80 juju sugandi 1 1
Empon 1 1 1
risna gunawan 1 1
81 jujum 1 1
Kokom 1 1
82 dadang 1 1
Imas mariah 1 1 1
Dimas 1 1
Dea nanda 1 1
Dias padilah 1 1
83 jajang diniat 1
Mariam 1 1 1
Agung sopiandi 1 1
Fitri nur anisa 1 1
84 udis 1 1
85 ayi suhardi 1 1 1
Yeli 1 1
Adel melisa 1 1
 Kevin mohamad 1 1
86 herman r 1 1
Nina 1 1 1
Hendiana H 1 1
Cep Nazril 1 1
Lisna amelia 1 1
87 nandang epi 1 1 1
Nenden rosmiat 1 1
Rifki nurfizal 1 1 1
Zalfa saniah 1 1
88 komar 1 1 1
Yayah 1 1
89 heri 1 1
nunung 1 1
90 dindin mulyana 1
Fitriani a nuraini 1
Kapahaikal 1
Rapa pidiansah 1 1 1
91 aat sapaat 1 1
92 didi rosidi 1 1
93 opid 1 1
94 hidayat 1 1 1
Cucun 1 1
Sulis solawat 1 1
Habibah cucu 1 1
95 didin 1 1 1
Lilis 1 1
Budi haryana 1 1
Anisa anggraini 1 1 1
96 misbah 1 1
Sant S 1 1 1
Neila neliant 1 1
97 ttk 1 1
Dedi sopandi 1 1 1
98 tarmidin 1 1
Marnikah 1 1
Yogi iskandar 1 1
99 ade suryana 1 1 1
Aan karwat 1 1
Cep dadang 1 1 1
anisa 1 1
100 ade. W 1 1
Damah 1 1 1
101 erus 1 1
Wat 1 1
Irman 1 1
102 alit tarna 1 1
Aas suamiat 1 1 1
Rizal hermawan 1 1
Halid adiansyah 1 1 1
Kaila 1 1
103 wiana 1 1
Fitri indriani 1 1 1
104 anwar sanusi 1 1
Wawade sartka 1 1
Edoh 1 1
105 engkos 1 1 1
 Imas 1 1
Acep 1 1
Ast 1 1
106 ayi sudana 1 1 1
Yani hayat 1 1
Feri kurniawan 1 1
Riki derajad 1
107 dedi junaedi 1
Lina 1
Kalista diana 1
108 kama 1 1 1
Rosmiat 1 1
109 dedi rustandi 1 1 1
Ratmini 1 1
Ir DWI Utm 1 1
Rizal muhamad 1 1
Alya sri 1 1
110 icang sopandi 1 1 1
YTI 1 1
111 esih 1 1 1
112 hendrik 1 1 1
Kaent dewi 1 1
Mikael 1 1
113 ule cukiman 1 1 1
yayah 1 1 1
agus 1 1
Ade iwah 1 1
Ahmad mustofa 1 1
Sant 1 1
114 Eli wijaya 1 1
Ima marlina 1 1
Rizki 1 1
Wawan 1 1
Fina 1 1
Aditya 1 1
sania 1 1
115 Euis hartni 1 1
elah 1 1
nanda 1 1
muh lutfi 1 1
rafli amin 1 1
116 Erik permana 1 1
ai muliani 1 1
117 M Ade winata 1 1
eni susilawat 1 1
Riki derajad 1 1
Kevin mohamad 1 1
118 Deni mulyana 1 1
seni purnama 1 1
tfani N.R 1 1
119 Dede hermawan 1 1
Reza 1 1
120 dindin mulyana 1 1 1
Lilis 1 1 1
Fahri 1 1 1
121 Dede sopian 1 1
dadang 1 1
122 Bandi 1 1
Anda 1 1
Imam 1 1
123 Kuwat mujamil 1 1
Aan 1 1
Dimas 1 1
Sigit 1 1
Sabilah 1 1
124 Subur mulyadi 1 1
nendeh 1 1
Lisna 1 1
muh lutfi 1 1
Anih 1 1
125 Wawan sutawan 1 1
rani 1 1
Dino 1 1
Erina 1 1
126 enjang supriatna 1 1
ttn 1 1
Cynta 1 1
127 Roni 1 1
Linda 1 1
Tasya 1 1
128 Khoerudin 1 1
Winart 1 1
Sit nazwa 1 1
129 Dedi mulyadi 1 1
Irma 1 1
Teni 1 1
Fajar 1 1
130 Eman 1 1
At 1 1
Sit 1 1
Risma yant 1 1
131 Met 1 1
Sandi 1 1
Agus 1 1
Esin 1 1
132 Aam muarif 1 1
Dewi 1 1
amelia puteri 1 1
133 Rukayat 1 1
Iis suyani 1 1
Rismaya 1 1
Deri 1 1
Aminah 1 1
134 Momo R 1 1
Entar 1 1
135 Arman 1 1
Kartka 1 1
Rehan 1 1
Tasa 1 1
136 Odih 1 1
Damah 1 1
Agus 1 1
SI KELUARGA

AGAMA PENDIDIKAN PEKERJAA

H B TK/PAUD SD T SD SMP T SMP SMA/SMK/STM T SMA/SMK/STM PT T PT BS A B C
1
1
1
1
1 1
1
1
1 1
1
1
1 1
1

1
1 1
1
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1
1 1
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 1
1
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1 1
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1 1
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1 1
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1 1
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1
1
1 1
1
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1
1 1
1
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1 1
1
1 1
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1 1
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1 1
1
1

1
1 1
1

1
1 1
1
1
1
1 1
1
1

1
1 1
1
1
1 1
1
1
1 1
1
1
1 1
1
1
1 1

1
1 1
1
1 1
1
1
1
1
1 1
1
1

1
1 1
1
1
1
1 1
1
 1
1
1
1 1
1
1
1
1 1
1
1 1
1
1 1
1
1

1
1 1
1
1
1
1 1
1
1
1
1 1
1
1 1
1
1
1 1
1
1
1 1
1
1
1
1 1
1
1 1
1
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1 1 1
1
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1 1
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1 1
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1 1
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1 1
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1 1
1
1
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1
1
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 PEKERJAAN KEADAAN FISIK IMUNISASI KB

D E F G H I J K SAKIT SEHAT L TL IUD S P I K T V

1 1
1 1
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 1 1
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