DATA LANSIA UNTUK VAKSIN COVID 19  
DESA SURUHKALANG

Puskesmas Jaten 1
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NAMA *
NIK *
JENIS KELAMIN *
TANGGAL LAHIR *
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DUSUN *
RT ( Rukun Tetangga ) *
RW ( Rukun Warga ) *
No. HP (08XXXXX) *
JENIS PEKERJAAN *
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