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LAPORAN HASIL PELACAKAN K3JH (KARTU KEWASPADAAN KESEHATAN JEMA’AH HAJI)

TAHUN 2013 / 1434 H

No.

UrutN o. Po rs i N ama J ama ah Na ma a ya h

Umur

(th)Tgl.Lahir

Jenis

kel.Alamat Kab / kota Diagnosis (1) Diagnosis () Diagnosis (!)

Diagnosis

(")

Diagnosis

(#)   Ka te go ri

PAT$A DA$U%ALA&

1 H. Subali H. Damanhuri 50 04-07-1963 L Jalan Sawo Kota Prabumulih Sehat an!iri

" #enn$ Harie% ar&u'$ 55 31-1"-196( L Jalan )am*oma% Kota Prabumulih Sehat an!iri

3 er$ +urlela . Salim 4( 0"-05-1965 P Jalan )am*oma% Kota Prabumulih Sehat an!iri

4 ,mr$ aini Ka%im 64 ""-1"-1949 L Jalan KH.,.Dahlan Kota Prabumulih Sehat Senilit$ an!iri

5 Julia!i at Sahari 40 10-07-1973 L Jalan #elitun Kota Prabumulih D /b%era%i

6 Sumiati Darian 53 1(-10-1960 P Jalan #elitun Kota Prabumulih H$*erten%i Hi*er'ole%terol /b%era%i

7 +urha$ati H. )ohi!in 51 "(-05-196" P Jalan Jen!eral Su!irman Kota Prabumulih H$*erten%i H$i*ertiroi! iwa$at ,%ma #ron2iale /b%era%i

( Dum$ati H. ,en Satoni 6" 15-1"-1951 L Jalan Jen!eral Su!irman Kota Prabumulih rolitia%i% Senilit$ an!iri

9 ai&ah H. )owi!in 56 1"-06-1957 P Jalan Jen!eral Su!irman Kota Prabumulih H$*erten%i /b%era%i

10 Suwar!i . ,li Lanan 49 09-06-1964 L Jalan .,. Kartini Kota Prabumulih Sehat na!iri

11 n!an Su*ar!i 47 04-01-1966 P Jalan .,. Kartini Kota Prabumulih H$*er2hole%terol an!iri

1" H.,. Hari% H.. +ur 71 11-04-194" L Jalan Jen!eral Su!irman Kota Prabumulih eumatoi! oat H$*er2hole%terol Senilit$ /b%era%i

13 +i%nati o!e' 55 "0-10-195( P Jalan Jen!eral Su!irman Kota Prabumulih H$*erten%i H$*er2hole%terol eumatoi! oat an!iri

14 )ah&an Soini 60 30-09-1953 L . Sumur )ini Kota Prabumulih H$*erten%i eumato! oat /b%era%i

15 Hil$ana ,li arwah 59 1(-0(-1954 P . Sumur )ini Kota Prabumulih H$*erten%i an!iri

16 ,b!ul Karim H. ahi!in 69 "5-10-1944 L Jalan ,li Le'at Kota Prabumulih H$*er2hole%terol eumatoi! oat Senilit$ /b%era%i

17 a%lin!a mar #a'i 55 16-1"-195( P Jalan ,li Le'at Kota Prabumulih D eumatoi! oat an!iri

1( uha$a H. Ko!ir 61 01-01-195" P Jalan #u'it Lebar Kota Prabumulih H$*erten%i Senilit$ /b%era%i

19 Sutarmin Pairan 56 09-10-1957 L Jalan #u'it Lebar Kota Prabumulih ertio Senilit$ an!iri

"0 8u%%amaerah ,r%u 53 07-03-1950 P Jalan ,%am Pa$a Kota Prabumulih Sehat an!iri

"1 Samirah H.!ulah Sa$uti 6( 10-0"-1945 P Jalan ,%am Pa$a Kota Prabumulih Haemorhoi! Senilit$ H$*ertrili%eri! /b%era%i

"" Samri Johar 56 1"-1"-1957 L Jalan unun Kemala Kota Prabumulih a%triti% eumatoi! oat an!iri

"3 milia . 8u%u 51 11-11-196" P Jalan unun Kemala Kota Prabumulih :a. amae , /b%era%i

"4 ainu!in ,bu ,mi! 75 1(-03-193( L Kom*le'% DK) Kota Prabumulih H$*erten%i Senilit$ /b%era%i

"5 ar$am Sam%un 60 17-06-1953 P Kom*le'% DK) Kota Prabumulih ertio Senilit$ /b%era%i

"6 u%ma!i ,riin 59 0(-0(-1954 L Jalan #aru 7( Kota Prabumulih H$*er2hole%terol , #ron2hiti% /b%era%i

"7 Ku%naini H. #u%lan 54 15-0(-1959 L Jalan Suri*.amban

Kota Prabumulih H$*ertrili%eri! /b%era%i

"( ,%i%wan ,;ilihan 43 16-06-1970 L Jalan Kaulinan Kota Prabumulih Sehat an!iri

"9 Da%ri . &en 50 1"-03-1963 L Jalan Jambu Kota Prabumulih Seha an!iri

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tNo.

UrutN o. Po rs i N ama J ama ah Na ma a ya h

Umur

(th)Tgl.Lahir

Jenis

kel.Alamat Kab / kota Diagnosis (1) Diagnosis () Diagnosis (!)

Diagnosis

(")

Diagnosis

(#)  Ka te go ri

30 +irwani% +ur%al 4" 15-01-1971 P Jalan Jambu Kota Prabumulih H$*ereri2emia ob%era%i

31 +uri;ah ,$unin :e' ,min 65 "7-07-194( P Jalan amban Kota Prabumulih H$*ertiroi! H$*er2hole%terol anuan Jantun Senilit$ /b%era%i

3" Poni;o )u'iran 55 05-06-195( L Jalan ,%am Pa$a Kota Prabumulih H$*erten%i H$*er2hole%terol /b%era%i33 Haitin ari 55 15-06-195( P Jalan ,%am Pa$a Kota Prabumulih ertio a%triti% Senilit$ /b%era%i

34 Danu Prawira.S Poni;o 35 "7-1"-197( L Jalan ,%am Pa$a Kota Prabumulih D H$*er2hole%terol /b%era%i

35 8u%man 8u!o .8u!o 59 1(-0(-1954 P Jalan Perwira Kota Prabumulih Sehat an!iri

36 +urha%anah . !an 57 05-05-1956 L Jalan Perwira Kota Prabumulih

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59 a2'$ aha!ri S$am%u!in 53 16-09-1960 L Jalan entawai Kota Prabumulih #PH Sehat an!iri

60 Henn$ 8o!ha Sina ,nwar S$am 3( 05-05-1975 P Jalan entawai Kota Prabumulih Sehat an!iri

61 Halimah )u%a'!iah ,nwar S$am 5" 04-03-1961 P Jalan ra$a Kota Prabumulih Sehat an!iri

6" Hami! Jahri Jahri 61 05-03-1951 L Jalan Sumatera Kota Prabumulih H$*er2hole%terol hematoi! D. ,leri /b%era%iNo.

UrutN o. Po rs i N ama J ama ah Na ma a ya h

Umur

(th)Tgl.Lahir

Jenis

kel.Alamat Kab / kota Diagnosis (1) Diagnosis () Diagnosis (!)

Diagnosis

(")

Diagnosis

(#)  Ka te go ri

63 u%mi%a . )ani 55 "0-05-195( P Jalan Sumatera Kota Prabumulih H$*er2hole%terol H$*ertrili%eri! /b%era%i

64 Sri Hoiriah at Lihan 64 041"-194( P Kota Prabumulih H$*erten%i D a%triti% /b%era%i

65   *uyung Ha%an 60 15-03-1953 L Jalan elati Kota Prabumulih D H$*erten%i /b%era%i66 Junai!i Sai! 40 07-07-1973 L Jalan Dian ell$ )< Kota Prabumulih H$*erten%i /b%era%i

67 8ani ,n!riani u%toa "9 06-05-19(4 P Jalan Dian ell$ )< Kota Prabumulih Sehat an!iri

6( ,li /;an e;a% "3 13-03-1990 L Jalan Dian ell$ )< Kota Prabumulih KP Du*le' #PH Po%t /* /b%era%i

LUK&AN AK+&

69 Dr%.

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91 Suhartono Suma!i 44 1"-06-1969 L Jalan ,li Ha%an Kota Prabumulih Sehat an!iri

9" eni :hri%rina ,%!i Di!i 4" "4-1"-1971 P Jalan ,li Ha%an Kota Prabumulih :$%ta /um :holeli%thia%i% /b%era%i

LAPORAN HASIL PELACAKAN K3JH PUSKESMAS PRABUMULIH BARAT

TAHUN 2013 / 1434 H

No.

Urut No.Porsi Na ma Ja maah Nama ayahUmur

(th)

Tgl .Lahir Jenis

kel.

asil Pela,akanTangggal

Ke-atangan

Tanggal

emeriksaanKeterangan

N.K!J %ehat Dema m*er,ak 

ber,ak   Lainlain

PAT$A DA$U%ALA&

1 600053639 H. Subali H. Damanhuri 50 04-07-1963 L KH53(957 ? - - - 30 /'t "013 14 +o*."013

" 600053344 #enn$ Harie% ar&u'$ 55 31-1"-196( L KH53(943 ? - - - 30 /'t "013 14 +o*."013

3 600053346 er$ +urlela . Salim 4( 0"-05-1965 P KH53(944 ? - - - 30 /'t "013 14 +o*."013

4 6000566(4 ,mr$ aini Ka%im 64 ""-1"-1949 L KH53(94( ? - - - 30 /'t "013 14 +o*."013

5 600053704 Julia!i at Sahari 40 10-07-1973 L KH539040 ? - - - 30 /'t "013 14 +o*."013

6 600053704 Sumiati Darian 53 1(-10-1960 P KH539039 ? - - - 30 /'t "013 14 +o*."013

7 600054464 +urha$ati H. )ohi!in 51 "(-05-196" P KH53(9(( ? - - - 30 /'t "013 14 +o*."013

( 600054465 Dum$ati H. ,en Satoni 6" 15-1"-1951 L KH53(95( ? - - - 30 /'t "013 14 +o*."013

9 600054466 ai&ah H. )owi!in 56 1"-06-1957 P KH53(9(9 ? - - - 30 /'t "013 14 +o*."013

10 600057503 Suwar!i . ,li Lanan 49 09-06-1964 L KH53(946 ? - - - 30 /'t "013 14 +o*."013

11 60005750" n!an Su*ar!i 47 04-01-1966 P KH53(947 ? - - - 30 /'t "013 14 +o*."013

1" 60005361( H.,. Hari% H.. +ur 71 11-04-194" L KH53(949 ? - - - 30 /'t "013 14 +o*."013

13 60005437" +i%nati o!e' 55 "0-10-195( P KH53(956 ? - - - 30 /'t "013 14 +o*."013

14 60005(537 )ah&an Soini 60 30-09-1953 L KH53(950 ? - - - 30 /'t "013 14 +o*."013

15 60005(539 Hil$ana ,li arwah 59 1(-0(-1954 P KH53(95" ? - - - 30 /'t "013 14 +o*."013

16 600055541 ,b!ul Karim H. ahi!in 69 "5-10-1944 L KH53(954 ? - - - 30 /'t "013 14 +o*."013

17 60005554" a%lin!a mar #a'i 55 16-1"-195( P KH53(941 ? - - - 30 /'t "013 14 +o*."013

1( 600056100 uha$a H. Ko!ir 61 01-01-195" P KH53(953 ? - - #atu' Pile' 30 /'t "013 14 +o*."013

19 600053(30 Sutarmin Pairan 56 09-10-1957 L KH53(911 ? - - - 30 /'t "013 14 +o*."013

"0 600053(3" 8u%%amaerah ,r%u 53 07-03-1950 P KH53(951 ? - - - 30 /'t "013 14 +o*."013

"1 600053(31 Samirah H.!ulah Sa$uti 6( 10-0"-1945 P KH53(933 ? - - - 30 /'t "013 14 +o*."013

"" 600055(10 ainu!in ,bu ,mi! 75 1(-03-193( L KH53(959 ? - - - 30 /'t "013 14 +o*."013

"3 600055(09 ar$am Sam%un 60 17-06-1953 P KH53(991 ? - - - 30 /'t "013 14 +o*."013

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"4 600056197 u%ma!i ,riin 59 0(-0(-1954 L KH53(945 ? - - - 30 /'t "013 14 +o*."013

"5 600054543 Ku%naini H. #u%lan 54 15-0(-1959 L KH539036 ? - - - 30 /'t "013 14 +o*."013

"6 600053(94 ,%i%wan ,;ilihan 43 16-06-1970 L KH539037 ? - - #atu' Pile' 30 /'t "013 14 +o*."013

"7 60005601" Da%ri . &en 50 1"-03-1963 L KH53(996 ? - - - 30 /'t "013 14 +o*."013

"( 600056011 +irwani% +ur%al 4" 15-01-1971 P KH53(997 ? - - - 30 /'t "013 14 +o*."013No.

Urut No.Porsi Na ma Ja maah Nama ayah

Umur

(th)Tgl.Lahir

Jenis

kel.

Ha%il Pela2a'anTangggal

Ke-atangan

Tanggal

emeriksaan

Keterangan

N. K!J %ehat Demam*er,ak 

ber,ak   Lainlain

"9 600054997 +uri;ah ,$unin :e' ,min 65 "7-07-194( P KH53(99" ? - - - 30 /'t "013 15 +o*."013

30 60005(36( Poni;o )u'iran 55 05-06-195( L KH53903" ? - - - 30 /'t "013 15 +o*."013

31 60005(369 Haitin ari 55 15-06-195( P KH539034 ? - - - 30 /'t "013 15 +o*."013

3" 60005(371 Danu Prawira.S Poni;o 35 "7-1"-197( L KH53903( ? - - - 30 /'t "013 15 +o*."013

33 600054(04 8u%man 8u!o .8u!o 59 1(-0(-1954 P KH53(995 ? - - - 30 /'t "013 15 +o*."013

34 600054(06 +urha%anah . !an 57 05-05-1956 L KH53(994 ? - - - 30 /'t "013 15 +o*."013

35 60005(3(1 onima% Dehani 63 15-05-1950 P KH539000 ? - - - 30 /'t "013 15 +o*."013

36 600054304 ainal oe!ahar oe!ahar 55 01-07-195( L KH539030 ? - - - 30 /'t "013 15 +o*."013

37 600054305 +elwita S$am%ir 50 01-07-1963 P KH5390"9 ? - - - 30 /'t "013 15 +o*."013

3( 600053(74 Darman%$ah #u%tamil Jamal 59 "5-11-1954 L KH539035 ? - - - 30 /'t "013 15 +o*."013

39 600053(75 ,%minah #rutal enta;im 55 "5-1"-195( P KH53(94" ? - - - 30 /'t "013 15 +o*."013

40 600055"3" ul$ono Si!i' 44 16-11-1969 L KH53(999 ? - - - 30 /'t "013 15 +o*."013

41 600055"35 Suhar$ati H. Ku%ri 43 ""-0(-1970 P KH53(99( ? - - - 30 /'t "013 15 +o*."013

4" 60005393( Sunami Si!i' 6( 0(-06-1945 P KH53(993 ? - - - 30 /'t "013 15 +o*."013

43 600055740 Su!irman ,ri 67 06-06-1946 L KH539031 ? - - - 30 /'t "013 15 +o*."013

44 600054114 Sa%ili omin 79 03-01-1934 L KH53(960 ? - - - 30 /'t "013 15 +o*."013

45 600054904 Saerah H. Ja'ar 55 13-05-195( P KH5390"7 ? - - - 30 /'t "013 15 +o*."013

46 600054903 ,hma! iai H.,liiah 61 "(-06-195" L KH5390"( ? - - - 30 /'t "013 15 +o*."013

AL&UNA'A$

47 60003(515 H. Do!!$ #u!h$ono H. Ka!ar;o 61 05-0"-195" L KH5390"6 ? - - - 30 /'t "013 1( +o*."013

4( 600057"56 San'ut= S*!. u%tari 4( 03-07-1965 L KH53(934 ? - - - 30 /'t "013 1( +o*."013

49 600057"57 iana=S.S) at La%im 41 "(-0(-197" P KH5390"" ? - - - 30 /'t "013 1( +o*."013

50 600057490 uhama! #ur!an 69 ""-"0-1945 L KH53(93( ? - - - 30 /'t "013 1( +o*."01351 600057491 +urharowi an%$ur 6( 14-09-1945 P KH5390"4 ? - - - 30 /'t "013 1( +o*."013

5" 600053(50 :han!ra i'a Herlin Herli% 36 13-04-1977 L KH53(93( ? - - - 30 /'t "013 1( +o*."013

53 600053(51 Drh.+ora u%tina %man

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56 60005(4"3 a2'$ aha!ri S$am%u!in 53 16-09-1960 L - ? - - - 30 /'t "013 1( +o*."013 Jemaah bera!a !i Ja'arta

57 60005(4"4 Henn$ 8o!ha Sina ,nwar S$am 3( 05-05-1975 P - ? - - - 30 /'t "013 1( +o*."013 Jemaah bera!a !i Ja'arta

5( 60005(4"( Halimah )u%a'!iah ,nwar S$am 5" 04-03-1961 P KH53(933 ? - - - 30 /'t "013 1( +o*."013

59 60005(494 Hami! Jahri Jahri 61 05-03-1951 L KH53(931 ? - - - 30 /'t "013 1( +o*."013

60 60005(495 u%mi%a . )ani 55 "0-05-195( P KH5390"5 ? - - - 30 /'t "013 1( +o*."013No.

Urut No.Porsi Na ma Ja maah Nama ayah

Umur

(th)Tgl.Lahir

Jenis

kel.

Ha%il Pela2a'anTangggal

Ke-atangan

Tanggal

emeriksaan

Keterangan

N. K!J %ehat Demam*er,ak 

ber,ak   Lainlain

61 6000534(3 Sri Hoiriah at Lihan 64 041"-194( P - ? - - - 30 /'t "013 1( +o*."013 Jemaah bera!a !ilemba' @HP ti!a' a'tiA

6" 60005(546 #u$un :an!ra Ha%an 60 15-03-1953 L KH5390"3 ? - - - 30 /'t "013 1( +o*."013

63 6000534(7 Junai!i Sai! 40 07-07-1973 L - ? - - - 30 /'t "013 1( +o*."013 Jemaah bera!a !i Pen!o*o @HP ti!a' a'tiA

64 600053490 8ani ,n!riani u%toa "9 06-05-19(4 P - ? - - - 30 /'t "013 1( +o*."013 Jemaah bera!a !i Pen!o*o @HP ti!a' a'tiA

65 6000541"" ,li /;an e;a% "3 13-03-1990 L KH5390"1 ? - - - 30 /'t "013 1( +o*."013

LUK&AN AK+&

66 Dr%.

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No.

UrutNo.Porsi Nama Jamaah Nama ayah Umur

(th)

Tgl.LahirJenis

kel.

Ha%il Pela2a'anTangggal

Ke-atangan

Tanggal

emeriksaan

Keterangan

N. K!J %ehat Demam*er,ak 

ber,ak   Lainlain

(7

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Urut

Nama Jamaah Nama ayah(th) kel. Ke-atangan emeriksaan

KeteranganN.K!J %ehat Dema m

*er,ak 

ber,ak    Lainlain

PAT$A DA$U%ALA&

1 Sumeri i!wan 71 L KH5740"( ? - - - "5 o'tober "014 10 +oember "014

" ar%unah iai 55 P KH533976 ? - - - "5 o'tober "014 10 +oember "014

3 ,lbi!in Siaam 66 L KH540(03 ? - - - "5 o'tober "014 10 +oember "014

4 ar$ani u%iran 71 P KH534035 ? - - - "5 o'tober "014 10 +oember "014

5 Ham!an ro&ali o&ali 65 L KH540(19 ? - - - "5 o'tober "014 10 +oember "014

6 +ani ru%*eni ar!anu 64 P KH53(9"( ? - - - "5 o'tober "014 10 +oember "014

7 Samri Johar 57 L KH53396" ? - - - "5 o'tober "014 10 +oember "014

( , o&a' mu'ti H mu'ti 57 L KH533950 ? - - - "5 o'tober "014 10 +oember "014

9 ulailan ,nwar mu'ni 59 L KH53403" ? - - - "5 o'tober "014 10 +oember "014

10 Sam%inar :i' nan %iro 57 P KH53(913 ? - - - "5 o'tober "014 10 +oember "014

11 Janatia harun 44 P KH533963 ? - - - "5 o'tober "014 10 +oember "014

1" Komaria Sobri 69 L KH540(06 ? - - - "5 o'tober "014 10 +oember "014

13 :e' u$a Junin 66 P KH53(914 ? - - - "5 o'tober "014 10 +oember "014

14 Hanaiah %aroh Ha!e%in 60 P KH540("0 ? - - - "5 o'tober "014 10 +oember "014

15 Hami!ah ,b!ul rahman 53 P KH534041 ? - - - "5 o'tober "014 10 +oember "014

16 u'tamar uhamma! 61 L KH534033 ? - - - "5 o'tober "014 10 +oember "014

17 So$an #a%ir 61 L KH534045 ? - - - "5 o'tober "014 10 +oember "014

1( Herawati a%abu 59 P KH533975 ? - - #atu' Pile'   "5 o'tober "014 10 +oember "014

19 +ahnur ,riin 55 L KH533955 ? - - - "5 o'tober "014 10 +oember "014

"0 +urC aini Soma! 4" P KH533941 ? - - - "5 o'tober "014 10 +oember "014

"1 Suiman Su'i;an 6" L KH534037 ? - - - "5 o'tober "014 10 +oember "014

"" urni oar oar 5( P KH53(9"0 ? - - - "5 o'tober "014 10 +oember "014

"3 ,'hma! heri$anto Suianto 45 L KH533967 ? - - - "5 o'tober "014 10 +oember "014

"4 Junaibah !humami$ ,!nan 4" P KH533977 ? - - - "5 o'tober "014 10 +oember "014

"5 ,'hma! 'omaru!in o2htar 56 L KH533964 ? - - - "5 o'tober "014 10 +oember "014

"6 Su%ilawati %alim 49 P KH540(0" ? - - #atu' Pile'   "5 o'tober "014 10 +oember "014

"7 um%iah )a%ua! (0 P KH533944 ? - - - "5 o'tober "014 10 +oember "014

"( +urmanila So$an 5( P KH533947 ? - - - "5 o'tober "014 11 +oember "104

"9

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34 una!i S$am%u!in 40 L KH533966 ? - - - "5 o'tober "014 11 +oember "104

35 ,lamlah ,una 6" L KH540(16 ? - - - "5 o'tober "014 11 +oember "104

36 Kartini #urha%in 57 P KH540(1( ? - - - "5 o'tober "014 11 +oember "104

37 a&ili 2o'ro :o'ro 64 L KH53(904 ? - - - "5 o'tober "014 11 +oember "104

3( 8u%miartie aunin 56 P KH5340"5 ? - - - "5 o'tober "014 11 +oember "104

39 Suharman Ha%an 60 L KH533965 ? - - - "5 o'tober "014 11 +oember "104

40 8uni &arti aunin 54 P KH533971 ? - - - "5 o'tober "014 11 +oember "104

41 Kiau% an!rian +ur Kiau% &ainal abi!in 4" L KH53(99( ? - - - "5 o'tober "014 11 +oember "104

4" #eti &uliani Sembirin 47 P KH53(916 ? - - - "5 o'tober "014 11 +oember "104

43 , thamrin ,# ,b!ullah 56 L KH53404( ? - - - "5 o'tober "014 11 +oember "104

44 Khri%anti le%tari ati'a Dahar bah%an 54 P KH533969 ? - - - "5 o'tober "014 11 +oember "104

45 uito herlamban Ka!ir 60 L KH53(903 ? - - - "5 o'tober "014 11 +oember "104

46 Sur$ani Saminun 55 P KH537913 ? - - - "5 o'tober "014 11 +oember "104

47 atma H renamin 65 P KH533951 ? - - - "5 o'tober "014 11 +oember "104

4( o%ita +anan;ab 55 P KH534046 ? - - - "5 o'tober "014 11 +oember "104

49 ,%miri S$ah!in 5( L KH533956 ? - - - "5 o'tober "014 11 +oember "104

50 +uril hu!a %aleh 60 P KH53(9"6 ? - - - "5 o'tober "014 11 +oember "104

51

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69 nun %uherni !i %uhan!a 49 P - ? - - - "5 o'tober "014 - Jamaah bera!a !i Ja'arta

70 ,li mi2hro!; Ha!i %uranto 5" L - ? - - - "5 o'tober "014 - Jamaah bera!a !i Ja'arta

71 Suhena SarCi! 55 P - ? - - - "5 o'tober "014 - uta%i 'e Palemban

&AND+$+

LUK&AN AK+&

7" Sultina Harom 57 P KH533959 ? - - - "5 o'tober "014 1" +oember "014

73 Kom%ia Sa'i!in 5" P KH537930 ? - - - "5 o'tober "014 1" +oember "014

74 li%a rama!ini man%$ah 1( P KH537915 ? - - - "5 o'tober "014 1" +oember "014

75 )etralina !ewi Leiman )S 45 P KH534031 ? - - -

"5 o'tober "014 1" +oember "014

77 man%$ah Ka%min 4( L KH537916 ? - - - "5 o'tober "014 1" +oember "014

7( ,b!ul ra%$i! ari% 71 L KH534047 ? - - - "5 o'tober "014 1" +oember "014

79

(9 S$ainilam at nan 6" P KH537909 ? - - - "5 o'tober "014 1" +oember "014

90 Sumiati Kar%ono $a%lan 5" P KH53(9"5 ? - - - "5 o'tober "014 1" +oember "014

91 >aino ,li mat %ai 50 P KH534044 ? - - - "5 o'tober "014 1" +oember "014

9" atni :hili 4" P KH534050 ? - - #atu' @BA "5 o'tober "014 1" +oember "014

93 :har%an e;o 5( L KH53(90( ? - - - "5 o'tober "014 1" +oember "014

94

8/16/2019 haji_2014

11/12

103 Karim Ha%an 64 L KH5340"4 ? - - - "5 o'tober "014 1" +oember "014

104 +ur%iah

8/16/2019 haji_2014

12/12

137 )anto ma!ura$a H %u;ono 44 L KH540(14 ? - - - "5 o'tober "014 14 +oember "014

13( ,ulia %hahna& Sura2hwan "3 P KH534009 ? - - - "5 o'tober "014 14 +oember "014

139 hai'al %$aui Sura2hwan "0 L KH540(13 ? - - - "5 o'tober "014 14 +oember "014

140 Sura2hwan H na%ir 5" L KH534005 ? - - - "5 o'tober "014 14 +oember "014

141