LAPORAN PEMANTAUAN KEPATUHAN SASARAN

BALITA TIDAK NAIK BERAT BADAN MENDAPAT MAKANAN TAMBAHAN TELUR AYAM
KABUPATEN BANDUNG BARAT TAHUN 2024

DESA : CITAPEN PUSKESMAS : PATARUMAN

TANGGAL ..... BULAN ............ S/D TANGGAL ..... BULAN ............
NO NAMA ALAMAT UMUR NAMA ORANG TUA HARI KE- * KET
(BULAN)
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 M. ANWAR PTR 04/ 06 57 MUKHLIS/
2 M. AL-GHAZZALI PTR 04/ 06 56 RENDI /
3 SITI FATIMAH AZZAHRA PTR 01/ 06 52 AGUS /
4 M. RAYYAN Z PTR 02/ 06 52 ANAN /
5 REIHAN PTR 01/ 06 49 TUGI / YENI
6 ARKAN PTR 06/ 06 49 SOPANDI /
7 ARYA ALI AKBAR PTR 02/ 06 48 YANA / YENI
8 M. GIAS AL JAJULI PTR 02/ 06 47 BULDAN / NURAENI
9 ANISA PUTRI ADINDA PTR 04/ 06 21 IRFAN / KARISMA
10 JAIZ UMAR SYAFIQ PTR 02/ 06 10 / AMELIA
11 DEANDRA SUBAKTI PTR 01/ 06 7 ADAM / DEVI
12 REYNAL RAMADHAN ARRAYID PTR 04/ 06 6 / SITI
13 DADAN PERIATNA PTR 08/ 01 56 DIAN RANA /
14 FELIA AILEEN MADANI PTR 07/ 01 54 M. DANI /
15 M. AZZAM PTR 01/ 01 46 M.YUSUF
16 MUHAMMAD RIZIQ ALGHIFARI PTR 03/ 01 45 DEDI /
17 MUHAMMAD ALFAN FIRDAUS PTR 07/ 01 44 INDRI HERMAWAN /
18 NAUFAL SYAHREZA ALFARIZKI PTR 02/ 01 38 DERI DESTIAN /

19 ALYUSHA YAVIZAN PTR 02/ 01 37 AGUS MUHLISON /

20 SHAKILA AZKA MAHARANI PTR 05/ 01 34 AYI GUN GUN /
21 AL-HAFIZ FATURRAHMAN PTR 07/ 01 27 M. NASIRUL /
22 ANALISA OFEELIA LUBNA.W PTR 08/ 01 26 YUDIS YULIAN /
23 DESTRIANA AZAHRA HUMAIRA PTR 01/ 01 26 EDI MULYANA
24 RUMAISHA HANA RIZKIA PTR 01/ 01 25 M. RANDI /

25 ALISHA FATIMAH AZZAHRA PTR 03/ 01 24 HASAN ALI /

26 MUHAMMAD MAULADI PTR 03/ 01 24 M.RIZAL /
27 MUHAMMAD RAFIQ MUSTHAFA PTR 02/ 01 21 RAIHAN.A /
28 MUHAMMAD SABIL SHIDIQ ARSALAN PTR 04/ 01 20 PERMANA /
29 DHAFA ARSHAKA RAMADHAN PTR 06/ 01 19 RUBI RAHARJA /
30 ADZRIEL ALFA RIZKI PTR 07/ 01 17 RAHMAT /
31 ARSAD PTR 08/ 01 13 ANDRE.S /
32 ZIANA TRISULA PUTRI PTR 08/ 01 13 EDI /
33 MEYSA ERNISABILA PTR 03/ 01 12 ERWIN /
34 AZKIYA NURSYIFA PTR 03/ 01 11 BAMBANG /
35 ALMAHYRA HUMAIRA H PTR 06/ 01 7 INDRA /
36 AMINATUZZAHRA PTR 04/ 01 6 AHMAD /
37 MUHAMAD SIGIT AL GHAZALI PTR 08/ 01 5 UJANG MUKANDAR/
38 MUHAMAD RAJIB PTR 05/ 05 55 DUDU.D /
39 MUTIARA PTR 05/ 05 54 ROTIBIN /
40 M. KAHFI PTR 05/ 05 53 ADE LILI /
41 VIRENDRA KAHIRULLAH PTR 05/ 05 53 DENA /
42 DELISHA F PTR 05/ 05 52 DENI /
43 AZKA PTR 05/ 05 50 INDRA /
44 HABIL PTR 03/ 05 48 NANA /
45 GRIZELLA PTR 05/ 05 48 ANDRE /
46 MUHAMMAD ZULHAM IBRAHIM PTR 02/ 05 41 KOMARUDIN /
47 DEVANDRA ALFARIZI ABAS PTR 04/ 05 40 ZAINAL ARIFIN
48 LAILY LATIFA TUSSIRI PTR 04/ 05 27 SAEPUDIN /
49 CHIKO RIZKY ADITYA PTR 03/ 05 26 MOCH SLAMET /
50 BALQIS ALISHA S PTR 04/ 05 24 ZAINAL ARIFIN /
51 ARSYILA PTR 01/ 05 22 YUDI DEWANTARA /
52 HABRIZI AL AYYUBI PURWANDY PTR 05/ 05 21 TEDI PURWADI /
53 BIANCA HANA SYAHREENA PTR 03/ 05 21 WINGKI HARTANA
54 ZANISYA NAZHALEYA PTR 03/ 05 21 M. ZAM ZAM /
55 SABIA PTR 04/ 05 17 / EKA NURDIANTI
56 SASKIA NUR AMALIA PTR 02 / 05 16 DANNY.HARDIANA /
57 NAZIA YUMNA ASSYIFA PTR 02/ 05 13 MUHAMAD RIDWAN /
58 SYAHRIL NUR UMAR PTR 04/05 9 AHMAD CAHYADI /
59 QIANA MAHREN PTR 05/ 05 9 MAHERUDIN. /
60 ARSYILA NURSIFA PTR 03/ 05 7 ASEP KOMARA /
61 HANIF ARKAN AL FATTAH PTR 06/13 55 Ice / kusworo
62 GHAIDA PTR 05/13 55 ASEP BADRU
63 ALMIRA HAFIDZAH RIZKIA SAHLAN PTR 02/13 47 NENG NANI
64 SULTHAN FAEYZA SHAKEEL PTR 06/13 46 Prangki / Febi
65 VALRIGA ALGHIFARY PTR 04/13 42 EUIS LILAH
66 SHAFIYA NOOREN ALMAHIRA AZIZ PTR 05/13 42 UUS FAIZAH
67 SHAKILA NADHIFA AZZAHRA PTR 03/13 39 HANY RAHMAWATI
68 M AYDAN PTR 02/13 38 USMID
69 KANA AGNETA HUMAIRA PTR 03/13 37 FAISHAL
70 SHEEZA NAHDA HERMAWATI PTR 04/13 35 ELIS ERNAWATI
71 LOKA CHANDRA WICAKSANA PTR 02/13 34 SENO CHANDRA
72 AMMAR ABQORI SHODIQ PTR 01/13 34 JAMALUDIN SHODIQ
73 ALFARIZKY PTR 07/13 33 ALDHY
74 TISHA PTR 03/13 32 HERU LESMANA
75 QAHIRA EL SAQUEENA PTR 07/13 32 Dona Saputra
76 ARSHAKA VIRENDRA DIKRIAWAN PTR 03/13 31 DIKA HARDIE H.
77 DEVANO ADISTYA SUPRIADI PTR 07/13 30 SITI AISYAH
78 ABIZAR ZHAFIANLA TALIAK PTR 04/13 29 ASEP MULYANA
79 CLUI SHEVA PTR 01/13 24 CEPI IRWAN NOPERA
80 QIYORA VIRA AZIZAH PTR 03/13 20 SILVIA INDIRA
81 KAZUMI ATHAYA PTR 07/13 12 Benny a
82 KAYLA NADIRA KUSUMAH PTR 07/13 12 Teguh
83 DARA FAREEHA PTR 07/13 11 Muhammad saepudin
84 ZIFANA PTR 03/11 57 WAWAN
85 MAULANA AHMAD SYA'BAN PTR 03/11 54 DINDIN
86 M. HANIF PTR 01/11 50 RISTA
87 SYAQILA PUTRI PTR 01/11 49 SENO
88 ALESHA NUHA PTR 02/11 39 SEVI
89 ALVARO PTR 01/11 6 EVI SUSANTI
90 ADREENA NATALEA A.H PTR 02 /11 27 CALLISTA
91 KHAILAS JABBAR PRATAMA PTR 02/11 25 FADLI
92 RICARD KALFANI SURYA PTR 03/11 25 PIETER SURYA PUTRA
93 HAUFFAN HAZA PTR 02/11 27 DESTA / SHELLI
94 MUHAMMAD GIBRAN ARTANABIL PTR 01/11 22 ASTRI JULIANI
95 RAZENDRA ADNAN ALFARIS PRANDANA PTR 03/11 19 RIVAN PRANDANA
96 ALFAREZEL PTR 02/11 8 SULTHON / RASEN
97 LAILA AMINATU SA'DIYAH PTR 03/11 17 SOPYANI
98 ABIMANYU W T PTR 02/11 13 IRKHAM MAHMUD
99 NADIRA INDRI MAULIDA PTR 01/11 12 ASEP KURNIA
100 KANITA PTR 01/11 6 IRPAN / DEIS
101 KEYLA PTR 05/08 55 DEDEN.S
102 NUR AL MIRA PTR 04/08 54 CARTIKA
103 NAZMA NURUL PTR 04/08 46 AHMAD HUSEN
104 HAFIZAL R PTR 02/08 39 Ahmad s
105 NAFIS TSABIT S PTR 03/08 37 ALDI SEPTIADI
106 DAFANKA PTR 04/08 33 SUSILAWATI
107 MUHAMAD FATIH ALFARESKY PTR 03/08 30 DEVI
108 M RIZQI MAULANA PTR 04/08 26 ASEP
109 ASLAN M PTR 01/08 26 m mulyadi
110 ATHALA NIZAM PTR 04/08 21 NENDAH KURNIA
111 MUHAMMAD SYAFIQ PTR 01/08 15 NENDEN . S
112 M.RAIDAN HAUFANZA PTR 04/08 11 CECEP MA\'RUP
113 NADHIRA KANZA PTR 04/08 10 SRI RAHAYU
114 ALLEA DZAQIRA PTR 02/08 8 AI .ELAH
115 ABIYAN KALIEF PTR 04/08 7 Haru darul
116 AHMAD MAULANA .SYAFI\'I PTR 01/08 5 YULINAR
117 ARSYAD PTR 03/02 55 AGUS K
118 KHUMAIRAH B PTR 07/02 52 HENDRIYANTO
119 AZHAR A PTR 03/02 52 ATEP
120 SABIRA PTR 01/02 50 JANURDI
121 SANDI PTR 02/02 49 SUMARNA
122 CALIANA PTR 05/02 48 M. ABDUL KOSIM
123 YUKE PTR 02/02 48 RIDWAN M
124 ADILLA NISYA PTR 05/02 48 DENI
125 M. ADNAN PTR 08/02 48 ROCHMANA
126 RIKI NOVEAL FEBRIAN PTR 04//02 47 AGUS
127 MOCHAMAD LUTHFI PERMANA PTR 06/02 47 Ayi amirodin
128 M. GHILZAH PTR 06/02 45 PRAKASA
129 AYRA ZIKRA KIRANA PTR 07/02 44 EVI KURNIA
130 M. SHAQUILLE AL HAFIZH PTR 05/02 42 DEDE DAHLAN
131 GIBRELLA NUR ADREENA PTR 08/02 42 Yudi nurpian
132 M ARFA AL HAFIDZ PTR 04/02 42 YADI
133 M ATAR RAZKA PTR 05/02 42 OTANG
134 RAHMA NADA ALMEERA PTR 06/02 37 Suhendar
135 ALMIRA SHANUM ANINDYA PTR 03/02 35 Rizqi Maulana
136 RYHAN PTR 04/02 35 IYAN
137 MUHAMAD FEBRIYANSAH PTR 03/02 32 OHA SOPIAN
138 SHADIRA PUTRI PTR 04/02 32 SINTA
139 FATHIA NATAN SULAEMAN PTR 01/02 31 TANTAN SULAEMAN
140 ARZANKA IRSYAD JAWDAN PTR 01/02 27 Ade saepudin
141 SAFIA ZAHRA PTR 03/02 27 AGUS
142 KANZA KHUMAIRAH PTR 03/02 26 BUDI WAHYUDIN
143 NUR ALIMAN PTR 05/02 23 ASEP SUPARMAN
144 SULAIMAN JAZULI PTR 04/02 23 YADI MULYADI
145 GRACE PTR 03/02 22 MUHAMAD FAUJI
146 NABILLA CICILIA PTR 05/02 22 Adi kurniawan
147 MUHAMMAD ZAID KHOERLULLOH PTR 01/02 21 ADI SUPARDI
148 FAZILLA SHANIKA PTR 01/02 19 JANURDIN
149 GHAZZY RAZZAN ALBIANSYAH PTR 05/02 18 ANDI
150 ABIEL PTR 04/02 18 ANGGIANSAH
151 MUHAMMAD FALDIANSYAH PTR 03/02 14 RISKI GUNAWAN
152 KANIA ADZKIYA NURSYIFA PTR 04/02 12 IMAM SUHAEMI
153 YUMNA SALMA ALMAHYRA PTR 06/02 11 IDEN PERMANA
154 TALITHA DEVIANA HUMAIRAH PTR 04/02 10 PIRMANSYAH
155 ARAZKA XABIRU ALHAFIZ PTR 03/02 9 BUDI MAULANA
156 NAURA NUR ASYIFA MECCA PTR 02/02 8 SARTUM
157 MUHAMAD CHAERIL AZMI PTR 05/02 7 DENI
158 MUHAMMAD HAFIDZ APRILLIZIO PTR 03/02 6 NASRUDIN
159 AZRI PTR 03 /10 57 DEAN / NOVI
160 ZAPIRA PTR 02/ 10 46 DENI / TITA KURNIATI
161 BILQIS AQNIA PTR 03/ 10 45 ENDAN / SUMI RODIAH
162 CHIKA NINDYA PTR 02/ 10 44 DEDEN.H / DEWI
163 ALIYAH KHOERUNISA PTR 04/ 10 34 GUNAWAN / SUSI
164 DEVIA ZAHRANY.FEBRIANTO PTR 04/ 10 33 IWAN.F / YUYU
165 FELIX EL-HAZ PTR 04/ 10 26 ERLAN / MUTIARA
166 DELISHA PTR 03/ 10 24 ADE / SENI.PATONAH
167 M RAFFA AL FARIQ PTR 04/ 10 23 INDRA / SAMSIAH
168 HANACARAKA ULUL ALBAB PTR 06/ 10 21 YANA / KARTIKA
169 QINARA RAURA PUTRI PTR 03 /10 21 USEP / NENDEN
170 ELNARA ZAILA N PTR 01/ 10 21 ALIST / SEPTIANI
171 AARON REINALDO KWOK PTR 06/ 10 20 SURYANTO / NENENG
172 NAILA KAMILAH PTR 03/ 10 17 YOGI / SOLIHAH
173 ALLEA MADRIAH PTR 01/ 10 10 ENJANG.S / RIKA
174 ARASKA GIBRAN MAHEER PTR 03/ 10 7 DEAN / NOVI
175 YUZA ANISAH PERMANA PTR 01/09 48 INDRA PERMANA / SUSI
176 YURA ANISAH PERMANA PTR 01/09 48 INDRA PERMANA / SUSI
177 IKHSAN MAULANA SETIAWAN PTR 02/09 48 SURATNO / YUYUN
178 FAHIRA SALMA PTR 01/09 46 ESA NURJAMAN / N.SARI
179 MUHAMMAD RAYHAN AL FATIH PTR 04/09 45 RAMDAN / MEIDA
180 ASHEEQA PUTRI JAKARIA PTR 04/09 44 JAKARIA / SENDA
 ASEP YAHYA / IIS
181 NATALIA HUMAIRAH PTR 02/09 11 MARDIAH
182 MUHAMMAD HASAN ASY-SYAUQI PTR 03/09 43 DENI RAMDANI / HILDA
183 MUHAMAD BILAL JAELANI PTR 02/09 38 SYARIEF HIDAYAT / YENI
184 MUHAMMAD RAMDAN FIRDAUS PTR 05/09 30 SOLEH MULYANA / OLIS
185 ALYNA LISTIANI PTR 05/09 23 SONI SETIAWAN / LISNA
186 M. AL FATIH PTR 03/09 45 JENAL / FRIDA
187 ZAYD ASHRAF FAAZ PTR 02/09 12 AZWIN / REFANI
188 BERLIANA AWAN NURFAUZI PTR 02/09 12 PUJI YUDIAWAN / PERA
189 FAKHIRA AULIA NURAZIZAH PTR 04/09 11 ABDUL WAHAB SARONI
190 ELZAN DWI PARELA PTR 01/09 10 RISAL YONGKI / WINA
191 ARCELIO ARKANA RAMADHAN PTR 01/09 7 SUPRIYADI / MITA
192 ANINDIRA HASNA RAMADANI PTR 04/09 6 U LUKMAN HAKIM / NIA
193 KENZIE PTR 02/04 56 DEDI
194 SAFIRA DAMAYANTI PTR 02/04 56 ADE
195 AZKIA PTR 01/04 48 ACEP
196 KHANZA PTR 03/04 52 TRIDIAN
197 AZKA BIMA PTR 02/04 58 FAHMI
198 TSALIS PTR 06/04 50 KOSWARA
199 REVALIA PTR 05/04 50 ROMI
200 RIZKY HARIS PTR 01/04 50 OMAN
201 DAISHA PTR 04/04 30 ASEP
202 ARKANA PTR 01/04 43 OKI
203 GIBRAN PTR 03/04 48 BURHAN
204 FAKHRI PTR 02/04 45 SOPIAN
205 RAISA NAURA C PTR 01/04 44 DIAN PANTASI
206 ANDARA PTR 04/04 42 ANDRI
207 BILQIS ILMI AGHNIA PTR 02/04 37 HENDRA RAHMAWAN
208 GAISA PTR 06/04 36 dendi
209 NAHLA PTR 02/04 49 TEGUH
210 ANINDITA PTR 01/04 35 DIMAN
211 HANIYA PTR 04/04 35 HENDRIK P
212 NADIRA PTR 01/04 29 NETI
213 SHANIKA PTR 02/04 29 erik
214 SALSABILA PTR 01/04 28 SALIMAN
215 HAIBAZIA ALMAHYRA PTR 02/04 27 NAUFAL
216 ALWI PTR 03/04 25 Andriawan
217 KIRAN FAHIMA ELHAM PTR 05/04 25 DIDIN
218 ASHALINA AZAHRA PTR 02/04 24 Luki nugraha
219 RAFKA PTR 05/04 13 SILPI
220 DENAYA SAHIRA AGNIA PTR 04/04 13 SURYANI
221 FARASHA AYNA ZUNAIRA PTR 06/04 9 Aceng
222 KAYLA ZAHRA PTR 03/04 8 Sansan
223 MUHAMMAD RASYA PUTRA PTR 01/04 7 YUYUS
224 HISYAM PTR 04/04 7 FITRI
225 FATHAN PTR 06/03 50 JUNAEDI
226 HANIN MARYAM PTR 02/03 51 OKI
227 MUHAMMAD SYAFIQ SYADIDUL AZMI PTR 05/03 44 SUPARMAN
228 NAHLA SABYAN M PTR 02/03 44 HARDI JULISMAN
229 ALIF HANIF SHARKAN PTR 02/03 44 LUKMAN PERMANA
230 KENZIO R ALFARIZI PTR 07/03 41 ASEP KOSASIH
231 MUHAMMAD ELFAN SHALEH PTR 04/03 41 AHMAD SOLEH
232 M. REZVAN SETIAWAN PTR 05/03 41 RENDI SETIAWAN
233 M SHAZAD PTR 07/03 41 SANDI. S
234 ARKA NURDAFFA PTR 04/03 38 ACEP SUPRIATNA
235 GHERISA HAURA KHADIJAH PTR 02/03 38 NURUL FAHMI
236 AYRA CINTA MAULIDINA PTR 05/03 36 DANI MUSTOPA
237 KIRANA PTR 05/03 35 ali yusup
238 NAYRA ALINA PTR 04/03 32 DARUS SUPADLI
239 MUHAMAD RAMZAN KADYROV PTR 04/03 32 YADI CAHYADI
240 ASYIFA NUR RAHMA PTR 04/03 30 DATING
241 MUHAMMAD NABIL PTR 07/03 29 MUHAMMAD SIDIK
242 NABILA SALSABILA PTR 04/03 27 DEDEN SURYAMAN
243 MAQIL.HAFIZHAN DURROHMAN PTR 01/03 23 KIKI ABDUL ROHMAN
244 M FARIS NUGRAHA PTR 04/02 18 AGUS H / TITIN
245 AISYAH TSABITA PTR 06/03 20 Windi royadi
246 M HAFIDZ AL FARIZI PTR 07/03 8 AAN / LIA
247 GHUMAISA SAFIYYA ASY SYARIFAH PTR 02/03 17 NURUL FAHMI
248 MUHAMMAD ANGGA FADILAH PTR 06/03 11 HENDRIK
249 KAYLA NADHIFA ALMAIRA PTR 03/03 20 Iyan hadiyana
250 ALDI SURYA PTR 04/03 7 Deden
251 FAUQIYYA SHANIYYAH PTR 03/12 55 SAHRUL
252 RAYQA KHALISA PUTRI PTR 03/12 54 RIAN
253 AMAR GANI PTR 02/12 52 SUDARYONO
254 M.HAMZAH SHIDIQ PTR 01/12 51 DIKI SUPARMAN
255 M.SALMAN PTR 04/12 47 RIAN ANDRIANSYAH
256 RAZVAN ZAYDAN FAQIH PTR 03/12 46 DANI HAMDANI
257 THUFAIL YAZID HAMZAH PTR 01/12 46 EFRI
258 ARJUNA SYAKIR PTR 03/12 46 IRFAN
259 KHAIRIN ZENATA PTR 01/12 45 NURKHOLIK
260 MUHAMAD AGMAR NADHIB PTR 04/12 42 RIAN SOPANDI
261 YUSUF SYAIFUL AHSAN PTR 01/12 37 WAHYUDI
262 SULAIMAN SALIM ABDILAH PTR 04/12 34 TAUFIK BARKAH
263 YAZID MAULAA AZ-ZAJULLI HAROMAINI PTR 03/12 34 M SAHRUL
264 M RAIHAN ABDUL HAMBALI PTR 04/12 31 RUDIAN HERMAWAN
265 FARSHAD PTR 02/12 25 DEDEN TRILAKSANA
266 CALLIA RAFANIA PUTRI PTR 04/12 24 SANDI
267 DAVINDRA KAIFAN PTR 01/12 23 EKO
268 JIBRIL ADNAN KURNIAWAN PTR 03/12 20 FERI
269 MUHAMMAD SULTAN ALVARO PTR 04/12 16 Didin solehudin
270 SITI ALIKA PTR 04/12 14 Hendra
271 M.DELVIO RAYYANSYAH PTR 02/12 13 HERRI HARDIANSYAH
272 RASYA MUHAMAD ATTAYA PTR 02/12 13 Hamdani
273 HAFIDZAH ANNISA NUR IZZATI PTR 03/12 10 Sartono
274 KHALISA YUMNA PTR 01/07 55 RUDI
275 PERTIWI RAHAYU LESTARI PTR 06/07 54 ACENG
276 AHMAD PANJI PTR 02/07 53 RAHMAN
277 MUHAMAD VIRGI PTR 07/07 52 EGI
278 FAHREZA A PTR 03/07 52 Sindi
279 M.DAVIN F PTR 03/07 50 DEDE YANA
280 M NAZMI PTR 06/07 24 jajang / julia

* √ = Patuh dikonsumsi X = Tidak dikonsumsi

BANDUNG BARAT, .......................... 2024
MENGETAHUI,
KEPALA DESA ........................

.................................................
.................................................
 LAPORAN PEMANTAUAN KEPATUHAN SASARAN
BALITA UNDERWEIGHT MENDAPAT MAKANAN TAMBAHAN TELUR AYAM
KABUPATEN BANDUNG BARAT TAHUN 2024

DESA : PATARUMAN PUSKESMAS : PATARUMAN

TANGGAL ..... BULAN ............ S/D TANGGAL ..... BULAN ............
NO NAMA ALAMAT UMUR
(BULAN) NAMA ORANG TUA HARI KE- * KET
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
1 M. AZWAN PTR 04/ 06 57 BUNYAMIN
2 LULU. HILYYAH AZKIA PTR 06/ 06 53 USEP
3 AQILA HILYATUNISA PTR 01/ 09 51 TATANG / RITA
4 SYAFIQ NUR R PTR 02/01 57 IWAN N/
5 WIDIA PUTRI PTR 01/01 44 DEDEN/
6 JASMIN NUR H PTR 01/ 01 34 SUHENDAR /
7 MUHAMMAD FAJRI AR RASYID PTR 02/ 01 32 RUSMANA /
8 DZAKIYAH HASNA ALIFAH PTR 07/01 30 RULI JAWSUN EKA/
9 ABDILLAH KHOIRUL KHISOLLI PTR 01/ 01 28 GUNTUR GUNTIAR/
10 MUHAMMAD ARSHAQ FAIZ PTR 06/01 13 HARI CAHYADI/
11 MUHAMMAD NUR ALFIN PTR 03/01 8 ROHIMAT /
12 SYAKIERA HUMAIRA AZZAHRA PTR 03/01 7 ANGGI.MANSYUR /
13 M RIDWAN A PTR 03/05 35 ERFAN ARIANSYAH/
14 ELNARA PTR 06/13 31 HERU PERMANA/
15 KAIVAN ESHAR RAMADHAN PTR 06/13 30 TEZA RAMADHAN/
16 DZAFINA ZALFA ALMAHYRA PTR 04/13 8 KABUL / SUPATMI
17 ADHITAMA PTR 02/11 51 NOPAN/TETI
HALWATUZAHRA NUR
18 RAMADHANI PTR 03/08 42 SUKARNA /
19 AL KAHFI MAULANA YUSUF PTR 03/02 35 WAHYUDI/
20 SANDY RASYID HIBATULLAH PTR 03/02 17 SONI /
M. AKBAR /SUCI
21 MOHAMMED EL FHATIH PTR 02/02 10 NUR
22 ARDIAZ KUSUMA AJI PTR 02/10 48 NURODIN / NIA
23 ARSYA ALGHANI PTR 02/10 29 NURODIN / NIA
24 ABIZARD NABIL MUTAQQIN PTR 01/09 54 HENDAR G / ANI
25 NAURA ALSHAMIRA PUTRI PTR 05/04 28 ROCHMAT/
26 SITI ANISA ZHASKIYAH PTR 05/03 23 YAYA SAHRIA/
27 MUHAMAD FAREL PTR 05/07 54 SUMANTRI/
28 MUHAMMAD HUSAIN M PTR 06/07 44 YANA SUPRIATNA/
29 ADAM F PTR 03/07 35 DEDE RIKI/
30 NAISHWA IZORA PTR 02/07 27 BUDIYANTO/
RAHMA NURSYIFA PUTRI
31 SUGANDA PTR 05/07 27 ADE SUGANDA/
32 VAMELLA S PTR 02/07 26 INDRA /
33 M ANUGRAH.I PTR 02/ 07 19 WAWAN/

BANDUNG BARAT, .......................... 2024

MENGETAHUI,
KEPALA DESA ........................

.................................................
.................................................
 LAPORAN PEMANTAUAN KEPATUHAN SASARAN
IBU HAMIL BERESIKO MENDAPAT MAKANAN TAMBAHAN TELUR AYAM
KABUPATEN BANDUNG BARAT TAHUN 2024
DESA : PATARUMAN PUSKESMAS : PATARUMAN
BULAN KE-1 (TANGGAL ..... BULAN ............ S/D TANGGAL ..... BULAN ............ )
UMUR USIA
NO NAMA ALAMAT (TAHUN) NAMA SUAMI KEHAMILAN HAMIL
KE- HARI KE- * KET
(BULAN)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

1 DEA DELISA PTR 05/10 21 Thn CAHYA. M.AJI 7 2

2 SILVI RAHMAYANI PTR 03/09 24 Thn RENDI 4 1

3 SITI WAHYUNI PTR 06/07 26 Thn TEDI 6 2

4 LUSIANA PTR 03/05 29 Thn YADI 3 1

5 RATNA PTR 02/02 29 Thn SYARIF 4 2

6 TASYA PTR 04/01 19 Thn ROHMANSYAH 3 1

7 WIWIN PTR 06/06 30 Thn IPAN 6 3

8 KHOIRUNISA PTR 04/12 22 Thn GALIH 6 1

9 ROHAETI PTR 04 /03 35 Thn Ana haeruman 2 3

10 RISKA PTR 03 /11 22 Thn RIZAL 7 1

11 ELISA PTR 03/10 39 Thn AEP SAEPULOH 2 2

SUMARDI
12 NURHASANAH PTR 02/02 32 Thn HARJA 3 3
* √ = Patuh dikonsumsi X = Tidak dikonsumsi
BANDUNG BARAT, .......................... 2024
MENGETAHUI,
KEPALA DESA ........................

.................................................