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DAFTAR PESERTA JAMINAN BALI MANDARA BANJAR DINAS PUKUH DESA TIGA KECAMATAN SUSUT KABUPATEN BANGLI NO
NO KARTU KELUARGA
NO KTP/NIK
1 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
2 5106012308060344 5106012308060457 5106011204100002
3 5106010411050002 5106011607030002 5106012408030002 5106010402080001 5106013008080001 5106015410040002 5106016705040002 5106017108090002 5106015212040002 5106018808080001 5106015306080001 5106014807040003 5106010606060002 5106010501080001 5106012501060001 5106012808040003 5106016807030002 5106010608070003 5106015611040001 5106011311090001 5106014903080002 5106017012050002 5106014107070033 5106014704070001 5106011707070001 5106016711040005
5106012308060424 5106012308060425 5106012308060426
51060126003100004 51060126003100004 5106011504100010 5106010801070004 5106012308060430 5106012308060430 5106012308060429 5106010806100022 5106012308060391 5106012308060449 5106012308060365
STATUS JENIS NAMA ANGGOTA KELUARGA KELUAR KELAMIN GA
4
6
5
I KADEK PARTA
ANAK
I GEDE GAMA ARDIAWAN
ANAK
I WYN LIANG JUNIARTA
ANAK
I KDK BUDIARTAWAN
ANAK
I GEDE KARTIKA
ANAK
NI LUH MARGIANI
ANAK
NI PUTU WANGI
ANAK
NI KADEK SUARNI
ANAK
NI LUH DIANI
ANAK
NI KADEK MURNIATI
ANAK
NI LUH SUDRIANI
ANAK
NI WAYAN JULIANI
ANAK
I NENGAH LAEDRA
ANAK
I KADEK ARI PUTRA
ANAK
I PUTU OGIANA
ANAK
I ADE AGA PUTRA
ANAK
NI WAYAN SUGIANTARI
ANAK
I KADE SANDI AGUS
ANAK
NI LUH RASNI
ANAK
I GEDE ARTANADI
ANAK
L L L L L
L L L L L L
NI KM ELIN SANDRI MAHARANI ANAK NI KADEK RESMINI
ANAK
NI WYN MARISA JELIANTI
ANAK
NI MD DWI MIRNAWATI
ANAK
I KADEK ARDANA
ANAK
NI WAYAN SULANDRI
ANAK
L
TANGGAL LAHIR
TAHU UM N UR
7 04-11-2005
2005
16
7/16/2003
2003
18
2003
18
2008
13
2008
13
2004
17
2004
17
2009
12
2004
17
2008
13
2008
13
2004
17
2006
15
2008
13
2005
16
2004
17
2003
18
2007
14
2004
17
2009
12
2008
13
2005
16
2007
14
2007
14
2004
17
2004
17
24-06-2003 04-02-2008 30-08-2008 P 14-10-2004 P 27-05-2004 P 31-08-2009 P 12-12-2004 P 28-08-2008 P 13-06-2008 P 08-07-2004 KB 06-06-2006 05-01-2008 25-01-2005 8/25/2004 P 28-07-2003 06-08-2007 P 16-11-2004 11/13/2009 P 09-03-2008 P 30-12-2005 P 01-07-2007 P 07-04-2007 17-07-2004 P 27-11-2004
27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
5106012308060460 5106011905100014 5106012308060397 5106012308060400 5106012308060402
5106011312120002 5106012903160003
5106012308060419 5106010801070015 5106012308060431
5106010611050002 5106015309090001 5106015012060001 5106011208030003 5106014103070004 5106015607050002 5106016307030004 5106015205070001 5106012210090003 5106014909030002 5106016909090001 5106012209050003 5106010210080001 5106010509080001 5106014104040002 5106017007030003 5106014708030003 5106010505080001 5106011509090001
I WAYAN RUDITA
ANAK
NI NGH DWI WULANDARI
ANAK
NI KM TARISNA
ANAK
I KM MULIAWAN
ANAK
NI PUTU LISTYA WATI
ANAK
NI KADEK JULIANI
ANAK
NI WAYAN PURIANI
ANAK
NI KADEK BINTARI
ANAK
I KOMANG RADINTA
ANAK
NI KETUT SERI YANTI
ANAK
NI KOMANG MERSINTA
ANAK
I WYN JASA SETIAWAN
ANAK
I KADEK SUKERATA
ANAK
I KADEK ARDIKA
ANAK
NI KADEK NARWI
ANAK
NI WAYAN WULANDARI
ANAK
NI LUH SUNDRIANI
ANAK
I KADEK SUMADIA
ANAK
I GD BUDIASA ANGGA P
ANAK
L P P L P P P P L P P L L L P P P L L
06-11-2005 13-09-2009 12-06-2006 12-08-2003 01-03-2007 16-07-2005 31-12-2003 12-05-2007 22-10-2009 09-09-2003 29-09-2009 22-09-2005 02-10-2008 05-09-2008 01-04-2004 7/30/2003 07-08-2003 05-05-2008 15-07-2009
2005
16
2009
12
2006
15
2003
18
2007
14
2005
16
2003
18
2007
14
2009
12
2003
18
2009
12
2005
16
2008
13
2008
13
2004
17
2003
18
2003
18
2008
13
2009
12
DAFTAR PESERTA JAMINAN BALI MANDARA BANJAR DINAS PUKUH DESA TIGA KECAMATAN SUSUT KABUPATEN BANGLI NO
NO KARTU KELUARGA
NO KTP/NIK
NAMA ANGGOTA KELUARGA
JENIS KELAMIN
1 1
2 5106012308060344
3 5106011607740004 5106015603770001 5106015206000002 5106010411050002
4
6
2
3
4
6
5106012308060457
5106010212100002
5106010301070013
5106012409100005
I KETUT NGEPIL
L
NI NYOMAN SASIH NI WAYAN MAGI I KADEK PARTA
L
5106013112680089 5106016512820004 5106011607030002 5106015508170002
I NENGAH BADERA
L
5106011603800001 5106015008860005 5106015908110001 5106015207130001
I NYM GIMBAR AP, SPD
NI KADEK SUNIASIH I GEDE GAMA ARDIAWAN
L
NI LUH EKA MURNIAWATI P NI KDK DWI PARNIKA PUTRI
5106013112450086 I KETUT SUKA 5106017112490043 NI WAYAN ASIN 5106012202700002 I NYOMAN LIMUN
L
106012909860003 I NYOMAN ADNYANA 5106015707910001 NI WAYAN ARIASTI 5106011803130003 I GEDE RISKY WIDANA
L
46 45L
1977
43 42P
2000
20 19P
2005
15 14L
1968
52 51L
1981
39 38P
7/16/2003
2003
17 16L
15-08-2017
2017
3 2P
KB 16-03-1980 P 10-08-1986 P 19-08-2011 P
1980
40
1986
34
2011
9
31-12-1945 31-12-1949 22-02-1970
1945
75
1949
71
1970
50
KB 29-09-1986 P 17-07-1991 18-03-2013
1986
34
1991
29
2013
7
23-09-1984 20-12-1997 13-07-2019
1984
36
1997
23
2019
1
KB 31-12-1968 P 25-12-1981
5106012305940003 I WAYAN SUDIASA 5108076012970002 NI KDK SUDARI
L
P L
L
P L
TAHU UM N UR
1974
P
NI KDK PARAMITA AP
BAYI NI KDK SUDARI
7 KB 16-07-1974 P 16-03-1977 P 12-07-2000 04-11-2005
L
NI KADEK GITA LESTARI
TANGGAL LAHIR
7
8
9
10
11
12
5106012308060347
5106013011100016
5106012308060348
5106012308060350
5106011204100002
5106012904100002
5106013103460001 I WAYAN GIET 5106017112460073 NI WAYAN AGET
L
5106012802760004 5106017006780003 5106010209950004 5106014304030002 5106014401150002 5106017112750127
I KETUT TAMAN
L
5106011607710001 5106014709740002 5106014409000002 5106016112110001
I WAYAN LABA
L
NI KDK MAWAR SRI WIDIASTUTI NI KM JESICA PUTRI NI NENGAH SAWI
L
NI KETUT MISI NI KOMANG SUDENI NI KT BELLA APRILLIA
5106013112520119 I WAYAN PURNA 5106017112550147 NI WAYAN WATIN
L
5106010302770004 5106014204800001 5106012408030002 5106012607100001
L
I WAYAN DARMA
I KADEK SUASTIKA
5106011011830007 I NYOMAN SUDIASA 5106016210880008 NI NYM SUARTINI 5106017006100003 NI LUH ARDANI
L L L
NI KDK SISKA JUNIANTARI
13
5106012308060353
5106013112690124 I WYN SUTAR 5106017112700168 NI NGH MANIS
75
1946
74
2/28/1976 6/30/1978 9/2/1995 P 4/3/2003 P 14-01-2015 P 12/31/1975
1976
44
1978
42
1995
25
2003
17
2015
5
1975
45 gangguan jiwa
KB 16-07-1974 P 07-09-1974 P 04-09-2000 P 21-12-2011
1974
46
1974
46
2000
20 hamil
2011
9
31-12-1955 31-12-1957
1955
65
1957
63
KB 03-02-1977 P 02-04-1980 24-06-2003 26-07-2010
1977
43
1980
40
2003
17
2010
10
KB 11-10-1983 P 22-10-1988 P 30-06-2010 p 03-06-2017
1983
37
1988
32
2010
10
2017
3
KB 31-12-1969 P 31-12-1976
1969
51
1976
44
KB P
P
NI KETUT RUPANI I WYN LIANG JUNIARTA
1945
P
NI WYN ASRIANI I GD SUMERDIKA
31-12-1945 17-12-1946
L
14
15
16
17
18
19
20
5106010106150001
5106012308060352
5106012308060354
5106012308060355
5106012308060423
5106012308060356
5106011103150001
5106013112320025 I WYN TEKEN 5106017112350062 NI KETUT BIRIT 5106015601750003 NI KETUT NYARMINI
L
5106010103940001 I KADEK ARMAWAN 5106016711950003 NI WAYAN PITRIANI 5106011307150001 I PT ADI MURDANA P
L
5106014102540002 NI KETUT GUNI 5106014809770001 NI WYN SADRI 5106010504790004 I NGH TUMBUH
80
1943
77
1975
45 epilepsi
01-03-1994 27-11-1995 14-07-2015
1994
26
1995
25 hamil
2015
5
01-02-1954 08-09-1975 05-04-1979
1954
66
1975
45
1979
41
KB 31-12-1970 P 31-12-1972 27-08-1997
1970
50 HT
1972
48
1997
23
01-07-1955 01-07-1960
1955
65 HT
1960
60
KB 03-03-1980 P 03-03-1984 P 06-11-2002 04-02-2008
1980
40
1984
36
2002
18
2008
12
KB 31-12-1950 P 12/31/1965 15-12-1993
1950
70
1965
55
1993
27
14-07-1982 20-04-1988
1982
38
1988
32
P L P P L L
5106010107550547 I KETUT CEMPED 5106014107600955 NI NYOMAN SARWI
L
5106010303800001 5106014303840006 5106014611020003 5106010402080001
L
L
P
NI WAYAN PINTI NI WAYAN GATRIANI I KDK BUDIARTAWAN
1940
P P
5106013112700102 I NENGAH KUNDRI 5106017112720111 NI KETUT SRIWA 5106010807970007 I WAYAN MERTAYASA
I WAYAN SUWENA
31-12-1940 31-12-1943 16-03-1975
L
5106013112500148 I WAYAN RIDIS 5106017112650194 NI PUTU TIMTIM 5106010107930381 I NYOMAN BAGIADA
L
5106011407820004 I NENGAH SUBUR
L
L
NI KDK NURATNI, SE
16
P
21
22
23
5106011307110004
5106012308060357
5106012707120002
5106011803800002 5106013112850004 5106013008080001 5106016502150001
I WAYAN YARNA
L
NI NYOMAN DERI I GEDE KARTIKA
L
NI KDK DESI ADELIA
5106013112600182 I WAYAN TANTRA 5106017112640118 NI NYOMAN CEBLONG
L
5106010609830005 I NENGAH GEBLOH, 5106016001890003 NI MADE KAMINI 5106015010120001 LUH PT OKTHAVIANI
L
NI KDK DWI EPAYANI
24
25
5106012308060424
5106012308060358
5106013101190001
5106010407810005 I WAYAN BAWA 5106014309870005 NI NENGAH DARMINI 5106015410040002 NI LUH MARGIANI
L
I KDK JAYA KUSUMA
L
I WAYAN SUTARMA
L
5106013112650196 5106017112730169 5106012002950001 5106014104990003
NI WAYAN PARMI I MADE SENTANA
L
NI LUH APRILIASARI
5106011811930001 I MADE SENTANA 5107067112010018 NI WYN PADMI DEWI
27
5106012308060359
5106012308060425
1980
40
1985
35
2008
12
2015
5
KB 12/31/1960 P 12/31/1964
1960
60
1960
60
KB P P P
06-09-1983 20-01-1989 10-10-2011 31-05-2017
1983
37
1989
31
2011
9
2017
3
KB 04-07-1981 P 03-09-1987 P 14-10-2004 13-03-2013
1981
39
1987
33
2004
16
2013
7
KB 01-07-1960 P 01-07-1964 03-07-1997 P 06-05-1999
1960
60
1964
56 GDS
1997
23
1999
21
08-10-1996 31-12-2001 01-11-2018
1996
24
P P
2001
19
2018
2
31-12-1945 31-12-1957
1945
75
P
1957
63
KB 07-01-1983
1983
37
L
NI PT RESTU NAYLA HANDAYANI
26
KB 18-03-1980 P 12/31/1985 30-08-2008 P 25-02-2015
5106013112450093 I WAYAN SARNA 5106017112470063 NI NYOMAN SARWI
L
5106010701830001 I WAYAN DAWEG
L
5106017101830003 5106016705040002 5106017108090002 5106015603110001
28
29
30
31
32
33
5106012308060360
5106012308060426
5106011705100018
5106012912110007
5106012308060363
5106012308060364
P P P P
NI NYOMAN NGARPI NI PUTU WANGI NI KADEK SUARNI NI KOMANG MAWAR I WYN LANDUH ARTANA
L
5106011212550006 5106017112550145 5106013112730104 5106010903740001
I NYOMAN KARI
L
I NENGAH MERTA
L L
5106010606810006 5106014303850010 5106015212040002 5106014107340119
I KETUT GAMBU
L
NI NENGAH MUDANI NI LUH DIANI I KADEK REPAN
L
5106013112490031 I WAYAN URIP 5106017112530043 NI NENGAH RENTET 5106017112370018 NI WAYAN KARMI
L
5106012404810004 5106014412840003 5106014912120002 '5106015507170001
I WAYAN SUBAGIA, SP
L
5106013112640106 5106017112760007 5106012606920002 5106015611000003
I WAYAN KETEN
NI KOMANG MURNI, SPd NI WYN DEVITA PRIMAYANI NI KDK PRISHANIA KIRANI
L
NI WAYAN GENTEN I WAYAN TAMPI
L
NI NENGAH TINI
5106010202760002 I NYOMAN MUDRA
1983
37
2004
16
2009
11
2011
9
2018
2
12-12-1955 12/31/1955 31-12-1973 09-03-1974
1955
65 HT
1955
65 Tiroid
1973
47 sakit
1974
46
KB 01-07-1980 P 01-07-1983 P 12-12-2004 20-03-2012
1980
40
1983
37
2004
16
2012
8
KB 31-12-1950 P 31-12-1963 P 12/31/1937
1950
70
1963
57
1937
83
KB P P P
24-04-1981 04-12-1984 12/9/2012 15-07-2017
1981
39
1984
36
2012
8
2017
3
KB 31-12-1964 P 31-12-1976 20-05-1992 P 16-11-2000
1964
56
1976
44
1992
28
2000
20
KB 02-02-1976
1976
44
P
NI KETUT TETEG I WAYAN NASIB
01-07-1983 27-05-2004 31-08-2009 16-03-2011 01-04-2018
L
5106017112780070 NI NENGAH LEMUH 5106013112020017 I WAYAN MADIANA 5106018808080001 NI KADEK MURNIATI 34
35
36
37
38
39
40
5106012007110001
5106012308060368
5106010801070002
5106012308060427
5106010801070003
5106010801070001
51060126003100004
5106010408860002 5108016112880001 5106015306080001 5106013103150001 5106017009610003
I WAYAN GEBAN
P
L
L
NI NENGAH RANCIS
5106010107430645 I NENGAH GEJIR 5106014107450519 NI NYOMAN KAWI 5106012606900002 I NENGAH BUDIASA
L
5106010107760679 5106015909760001 5106011601020001 5106015304020009
L L
NI KADEK DIANA PUTRI
L L
5106011205820003 I NYOMAN GAMBA 5106016907880001 NI NENGAH NURIANTI
L
12
KB 04-08-1988 P 31-12-1988 P 13-06-2008 31-03-2015 P 31-12-1967
1988
32
1988
32
2008
12
2015
5
1967
53
01-07-1943 01-07-1945 26-06-1990
1943
77 HT
1945
75 HT
1990
30
KB 01-07-1976 P 19-09-1976 16-01-2002 P 13-04-2006
1976
44
1976
44
2002
18
2006
14
07-06-1979 15-03-2008
1979
41
2008
12
12-05-1982 29-07-1988
1982
38
1988
32
31-12-1941 31-12-1982 27-07-1993 15-11-2014
1941
79 HT
1982
38
1993
27
2014
6
06-12-1974
1974
P L P
NI NENGAH BUDIANTI I GD CANDRA WIGUNA
5106010610740001 I NYOMAN BUDIASA
2008
P
NI NYOMAN WASIH I KETUT AMAN
18
L
5106010709790003 I NENGAH NUARSA 5106011503080001 I PUTU ADIMARTA
5106017112570097 5106013112820060 5106046707930007 5106011511140001
2002
P
NI WAYAN PAGI I GEDE ARTA WIDIANA
42
P
NI LUH SUDRIANI
I WYN KUAT SETIAWAN
1978
L
NI LUH AYU SASTRINI I GD ANGGA DWI PUTRA
31-12-1978 07-09-2002 28-08-2008
L
46 HT
5106014804850003 NI KETUT SARININGSIH NI KOMANG KARTINI
5106014807040003 5106010606060002 5106011001120001 5106016001150002 5106012308060371
41
5106010608100003
NI WAYAN JULIANI I NENGAH LAEDRA I NYN SUJANA PUTRA
L L
NI KT SIMPEN RATNA DEWI
5106010107450422 I NYOMAN BALIK 5106014107460387 NI NYOMAN NEMU
L
5106012205750006 I KETUT SUTEJA 5106016307990001 NI WAYAN DEWI AL 5106010501080001 I KADEK ARI PUTRA
L
43
44
5106011504100010
5106010801070004
5106012308060430
5106011008850002 5106014707860006 5106012808040003 5106011505130002
I KETUT WILA
I KDK BUDIASTANA
L L
5106010510800002 5106015311810001 5106016807030002 5106010608070003
I NYOMAN YARNAYASA
L
L
NI NYOMAN SUARDANI
L
LUH MD RIANATA MULIANI
L
NI WAYAN GANTI
L
2004
16
2006
14
2012
8
2015
5
1945
75 HT
P
31-12-1945 31-12-1946
1946
74 HT
21-01-1975 23-07-1999 05-01-2008 26-07-2015
1975
45
1999
21
2008
12
2015
5
12-07-1983 P 07-09-1982 25-01-2005 P 07-04-2016 KB 31-12-1940 P 31-12-1945
1983
37
1982
38
2005
15
2016
4
1940
80 HT
1945
75
10-08-1985 07-07-1986 8/25/2004 KB 15-07-2012
1985
35
1986
34
2004
16
2012
8
`05-10-1981 13-11-1981 28-07-2003 06-08-2007
1981
39
1981
39
2003
17
2007
13
P P
NI NENGAH KASNIASIH NI WAYAN SUGIANTARI I KADE SANDI AGUS
37 SC 3x
P
NI LUH SRIBA I ADE AGA PUTRA
1983
P
I KADEK DADI
I NENGAH LAMEG
35 sakit
L
5106011207830001 5106014709840002 5106012501060001 5106014104160002 5106013112400110 5106017112440049
I PUTU OGIANA
1985
P
08-04-1985 07-01-1983 08-07-2004 06-06-2006 10-01-2012 20-04-2015
P
NI KM MANDIRA
42
P P P KB
L
45
46
47
5106012308060374
5106011204100004
5106011411130001
5106017012550008 NI NENGAH RUMA 5106011011990001 I KADEK WARDANA
P
49
50
5106012308060376
5106012308060377
5106013112600077 I NYOMAN LONGOB 5106017112650062 NI KETUT DINI
L
5106011408850002 I KM SUARNATA 5108064808850008 KADEK VINI
L
5106012308060378
L
5106013112700137 5106017112700176 5106010704930001 5106012109980004 5106014303020004
I NENGAH LAMI
L
5106010701740001 5106014101700002 5106011505020003 5106011502110001
I NYOMAN NADI
L L
NI NYM TRISIA K DEWI
L
NI NYOMAN ARIASIH I KADEK BUDIAWAN I KM ANDIKA SAPUTRA YANA
L L
5106014107390192 NI NENGAH REBIN 51
5106012308060381
5106013112690128 I NYOMAN KEBUT 5106017112700177 NI NENGAH KOYOGAN 5106015911000001 NI KADEK WIRAYANTI
1999
21
12/31/1960 12/31/1965
1960
60 HT
1965
55
14-08-1985 08-08-1985
1985
35
P 1985 P 07-03-2018 2018
35 2
01-07-1942 01-07-1945
1942
76 HT
1945
75 HT
31-12-1970 P 31-12-1970 07-04-1993 KB 21-09-1998 P 03-03-2002
1970
50
1970
50
1993
27
1998
22
2002
18
07-01-1974 P 07-01-1970 KB 15-05-2002 15-02-2011
1974
46
1970
50 HT
2002
18
2011
9
P
NI KETUT SRIATI I MD ALIT DWIPAYANA
65
P
5106010107420429 I NYOMAN RENES 5106014107450520 NI WAYAN LEKET
I GD EKA BUDAYANA
1955
L
NI PUTU BRIELLA MARCELINA
48
30-12-1955 10-11-1999
P
01-07-1939
1939
81
31-12-1969 31-12-1970 19-11-2000
1969
51
P P
1970
50
2000
20
L
52
510601270160003
5106012604900001 I WAYAN SURADNYA 5106015107950004 NI WYN JULIANTARI 5106013010130001 I WAYAN RIPAN
L
26-04-1990 11-07-1995 30-10-2013
1990
30
1995
25
2013
7
31-12-1949 12/30/1965 04-12-1997
1949
71
1965
55
1997
23
KB 01-07-1952 P 01-07-1957
1952
68
1957
63
20-08-1976 18-05-1980 18-03-1998 05-07-2002
1976
44
1980
40
1998
22
2002
18
1976
44
1980
40
02-02-1979 06-01-1983 16-11-2004 05-02-2010
1979
41
1983
37
2004
16
2010
10
1988
32
1988
32
2009
11
P
03-03-1988 04-03-1988 11/13/2009 01-07-1967
1967
53
P
31-12-1967
1967
53
P L
bayi Ni WYN JULIATARI
KB 53
54
55
5106012308060379
5106012300860384
5106012308060385
5106013112490064 I KETUT KERTI 5106017012550010 NI NYOMAN MISI 5106010412970004 I KETUT ARDIANA
L
5106010107520563 I NYOMAN JAMBE 5106014107570654 NI NENGAH NYELEM
L
5106012008760002 5106015805800006 5106011803980004 5106014507020002
L
I WAYAN WARI
5106012308060429
5106010202790003 5106014601830001 5106015611040001 5106014502100001
L
P
NI WYN RENYIH ARIANTI I GEDE ARTAWAN
L P
NI KADEK ARTINI
5106014107760643 NI WAYAN PINI 5106010612800004 I NYOMAM LAMIASA 57
P
I WAYAN SADAR
L
KB P 01-07-1976 01-07-1980
L P P P
NI KETUT SAGET NI LUH RASNI NI KDK RUMIASTINI
KB 58
59
510601011200010
5106010806100022
5106010303880003 5106014403880001 5106011311090001 5106014107670440
I NENGAH ALEP
L P
NI NENGAH BANGEN I GEDE ARTANADI NI NYM TRIMIN
5106017112670049 NI NENGAH REMPUH
L
5106012008860004 I KETUT MARDIANA 5106015004960002
L
NI WYN IRNA MARIANI
5106014903080002 NI KM ELIN SANDRI MAHARANI I PUTU ROY MULIADI
5106012907720001 I KETUT NGAWIT 60
61
62
63
510601210910001
5106012308060389
5106012308060388
5106012903160002
5106017112730066 NI WAYAN WASNI 5106011705940001 I NYM WILANDIVA 5106015706970009 NI KDK SUCIANTI
L L
5106012308060391
5106013012570003 I NENGAH REDAM 5106017012590010 NI NENGAH SARDI 5106017112300063 NI WAYAN WANTI
L
5106010806910001 I NYM SULENDRA 5107015003960002 NI NGH SUDEWI ARISANTI
L
L
24
2008
12
2017
3
1972
48
1973
47
1994
26
1996
24
9/26/1974 P 25-09-1974 KB 31-01-1999
1974
46
1974
46
1999
21
KB 30-12-1957 P 31-12-1959 P 12/31/1930
1957
63
1959
61
1930
90
08-08-1991 10-03-1993 18-07-2016
1991
29
1993
27
2016
4
11-04-1975 30-07-1978 21-04-2001 30-12-2005 09-09-2010
1975
45
1978
42
2001
19
2005
15
2010
10
31-12-1955 31-12-1959
1955
65
1959
61
P P L P P P
NI NENGAH OLAS NI LUH LANDRI NI KADEK RESMINI I KOMANG BUDAYASA
1996
31-12-1973 17-05-1994
P L
I WAYAN DITA
34
L
5106012508740002 I NENGAH TAMBUN 5106016809740001 NI WAYAN REKIN 5106013101990001 I NENGAH MERDANA
5106011104750001 5106017007780001 5106016104010004 5106017012050002 5106010909100003
1986
P
NI WYN NIRMALA PRATIWI
64
20-08-1986 P 10-04-1996 P 09-03-2008 05-06-2017 KB 01-07-1972
L KB
65
5106012308060390
5106013112550140 I KETUT GUNA 5106017112590098 NI WAYAN PATRI
L P
5106011307150002
5106010704920003 I KETUT DARMAWAN
L
NI WAYAN RATI KENANGA
66
\ 5106013006110001
5106010404880001 5106014808940006 5106016211110001 5106010903160001
I NYOMAN SUARDIKA
L
NI NGH MERTAKANI NI L MANUH ANGRENI
5106012308060393
5106010107300195 I KETUT DIARTI
68
5106012308060392
5106017112670056 NI WAYAN SUNADI 5106010209920004 I KT MUSTIKA WIRAWAN
70
71
5106012308060449
5106013011100017
KB 04-04-1988 P 08-08-1994 P 22-11-2011
1988
32
1994
26
2011
9
01-07-1930
1930
90 sesak
31-12-1967 02-10-1992 22-12-2013
1967
53
1992
28
2013
7
KB 25-03-1984 P 10-08-1988 P 01-07-2007 21-11-2015
1984
36
1988
32
2007
13
2015
5
KB 07-05-1978 P 02-07-1980 11-04-2002 P 07-04-2007
1978
42 sakit
1980
40
2002
18
2007
13
KB 31-12-1972 P 31-12-1976 P 10-11-2002 17-07-2004
1972
48
1976
44
2002
17 hamil
2004
15
1942
77 HT
L P L P
NI PT RENI MUSTIKA LESTARI
5106011307110001
28 5
I KDK SURYA CANDRA
67
69
KB 07-04-1992 1992 P 12-07-2015 2015
5106012503840006 5106015008880001 5106014107070033 5106012111150003
I MADE DWI ANTIKA P
I MADE KELVIN RADITYA
L
5106010705780001 5106014207800002 5106011104020001 5106014704070001
I MADE SUASTIKA
L
5106013112720303 5106017112760062 5106015006000004 5106011707070001
I WAYAN RANGKEP
L
NI KETUT SUARMI NI WYN MARISA JELIANTI
NI MADE JULIASTUTI I PT SAMPAN PRASETIA
L
NI MD DWI MIRNAWATI
L
NI NYOMAN GANDA NI WAYAN PARMITI I KADEK ARDANA
5106017012460003 NI KETUT REMBUN
L
P
30-12-1942
73
74
75
76
77
5106012308060394
5106012308060365
5106010801070009
5106012308060460
5106011905100014
5106010709730002 I NENGAH NIKA 5106014702770001 NI NENGAH SARWI 5106012401010003 I NENGAH ARNAWA
L
5106013112800061 5106014103860001 5106016711040005 5106012303170001
L
I KETUT MUDRI
L
NI WAYAN DANI NI WAYAN SULANDRI I KDK WARTIKA PUTRA
L
5106010107530737 I KETUT TURUH 5106014107590497 NI WAYAN CIDRA
L
5106010405740003 5106017112790056 5106010611050002 5106015309090001
I WAYAN RANGIN
L
5106010312800001 5106010606870001 5106015012060001 5106017007100002
I NYM GENJUR ARTANA
L
NI NGH DWI WULANDARI
L
NI NYOMAN SUPARTI NI KM TARISNA NI NYM WINA LESTARI bayi NI NYM SUPARTI
78
80
5106012308060397
5106012308060399
5106012504720001 I KETUT BADENG 5106014105740001 NI WAYAN SIRIT 5106011208030003 I KM MULIAWAN
1973
46
1977
42
2001
18
KB 31-12-1980 P 31-12-1980 P 27-11-2004 23-03-2017
1980
39
1980
39
2004
15
2017
2
01-07-1953 01-07-1959
1953
66 HT
1959
60 HT
KB 04-05-1974 P 31-12-1978 06-11-2005 P 13-09-2009
1974
45
1978
41
2005
14
2009
10
KB P P P P
03-12-1980 06-06-1987 12-06-2006 30-07-2010 13-10-2018
1980
39
1987
32
2006
13
2010
9
2018
1
KB 25-04-1972 P 01-05-1974 12-08-2003
1972
47
1974
45
2003
16
1960
59
1960
59
1959
60
P
NI WAYAN GANTI I WAYAN RUDITA
KB 07-09-1973 P 07-01-1977 24-01-2001
L L
5106014107600749 NI NENGAH KENJIR 5106010107600710 I NENGAH MULIH
P L
01-07-1960 01-07-1960
5106010107590452 I NYOMAN DANA
L
KB 01-07-1959
5106014701650002 NI KETUT SRUNI 5106010701950001 I WAYAN SUMERTA 81
82
83
5106012308060401
5106010801070011
5106012308060400
5106012308060400 83a
84
5106013011100019
KK 5106012308060402 5106012308060402
85
5106011312120002
P
L
5106012609780003 5106015004780001 5106014103070004 5106014402100001 5106015605140002
I WAYAN KUMPUL
L
5106010612820004 5106015708810001 5106011407990002 5106015607050002
I NYOMAN BUDIARTA
5106010303810002 5106014508840001 5106016108100003 NIK 5106010811730001 5106017112800069 5106016307030004 5106015205070001 5106012210090003 5106013112600184 5106017112630172
I NYOMAN RUMAJA
NI PUTU LISTYA WATI NI MD WIDIANTARI
L
NI NENGAH RUKTI
L
NI KADEK JULIANI
L
NI KADEK SUGIANI NI WYN SRI WAHYUNI
L
NI NENGAH NGARPI NI WAYAN PURIANI NI KADEK BINTARI I WAYAN SALIN
24 ASMA
07-01-1965 08-02-1965
1965
54
1965
54
26-09-1978 10-04-1978 01-03-2007 04-02-2010 16-05-2014
1978
41
1978
41 MENYUSUI
2007
12
2010
9
2014
5
KB 06-12-1982 P 17-08-1981 14-07-1999 P 16-07-2005
1982
37
1981
38
1999
20
2005
14
KB 01-07-1981 P 05-08-1984 P 21-03-2010
1981
38
1984
35
2010
9
KB P P P
1973
46
1980
39
2003
16
2007
12
2009
10
1960
59
P
08-11-1973 31-12-1980 31-12-2003 12-05-2007 22-10-2009 31-12-1960 31-12-1963
1963
56
25-05-1993 1/17/1995
1993
26
P
1995
24
KB P P P
L L
NI NYOMAN SUANTI
5106010602930004 I KOMANG BUDIARTA 5106045701950002 NI WAYAN WENI
1995
P
NI KM SEKAR WANGI
I KOMANG RADINTA
54 SAKIT
P
NI WAYAN KARENI
I KETUT NGELAH
1965
L
5106010701650002 I KETUT SALIN 5106014802650001 NI WAYAN SUCIATI
I WYN DEDI ARTAWAN
07-01-1965 07-01-1995
L
5106011312120002 5106011312120002
5106014909030002 NI KETUT SERI YANTI 5106010707150001 I GD REDANANTA PRAMAYOGA
P
09-09-2003 07-07-2015
2003
16
2015
4
23-09-2017
2017
2
31-12-1958 31-12-1976 05-06-2000
1958
61
1976
43
2000
19
11-06-1974 01-07-1974 07-08-1997 29-09-2009 24-08-2015
1974
45
1974
45
1997
22
2009
10
2015
4
KB 31-12-1963 P 31-12-1973 13-06-1995 11-04-2000
1963
56
1973
46
1995
24
2000
19
KB 12-12-1955 P 12-12'1960
1955
64
1960
59
KB P P P
02-02-1987 12-08-1995 03-12-2014 28-06-2017
1987
32
1995
24
2014
5
2017
2
KB 04-07-1990 P 07-05-1992 P 04-12-2013
1990
29
1992
27
2013
6
L
NI KDK DIVYA SAHILA
86
87
510601230860451
5106011204100001
5106011204100001 88
5106012308060405
5106012308060405 89
90
5106012303100012
51060111911140001 51060111911140001 51060111911140001
91
5106012602130004 5106012602130004
5106013112580144 I KETUT PUNIA 5106017112760073 NI MADE SARI 5106014506000004 NI MADE JUNIASIH
L
5106011106740003 5106014107740602 5106014708970005 5106016909090001 5106012410150001
I KETUT GADING
L
I KT NGARDIAWAN YOGI SAPUTRA
L
5106013112630153 5106017112730113 5106011306950001 5106011104000003
I NYOMAN SAMPUN
L
P P
P P P
NI NYOMAN LUMUR NI KADEK SUCI NI KOMANG MERSINTA
NI NYOMAN SUWI I WAYAN CAKRA I NENGAH DASTRA
L L
5106011212550004 I NENGAH TERUS 5106015212600001 NI KETUT GEBROD
L
5106010202870005 I WAYAN WINDRA 5106015208960002 NI KT LUH SERIANI 5106014312140002 NI WYN DANIA ULANDARI
L
NI KDK GITA PUSPITAYANI
5106010407900001 I NENGAH BINTAR 5106014705920001 NI KETUT SUKARI 5106014412130002 NI PT DIAN LESTARI
L
92
5106010801070012 5106011602170002 5106011602170002
93
5106012903160003 5106012903160003
5106013112570120 5106017112630171 5106010405900001 1807225102950001
I WAYAN MURDI
L
NI NENGAH SEKEN I NYOMAN BADUNG MADE PUPUT PITRIANI
5106012109820002 I NENGAH BAKTIASA 5106016407880003 NI WAYAN RESTINI 5106012209050003 I WYN JASA SETIAWAN
L L
KB 31-12-1957 P 31-12-1963 04-05-1990 1994
1957
62
1963
56
1990
29
21-09-1982 24-07-1988 22-09-2005 04-08-2018
1982
37
1988
31
2005
14
07-01-1960 07-01-1962 07-01-1917
1960
59
1962
57
1917
102
KB P P P
15-06-1983 30-12-1989 27-03-2015 04-06-2018
1983
36
1989
30
2015
4
2018
1
01-07-1945 01-12-1935
1945
74
P
1935
84
31-12-1950
1950
69
01-07-1946
1946
73
1997
22
1997
22
1999
20
L P L
I KD ANGGA SAPUTRA
94
95
5106010801070013
5106011704140001 5106011704140001
5106010701600001 I KETUT ADA 5106014701650001 NI WAYAN DINI 5106010701170001 I WAYAN TANGUN
L
5106011506830004 I WAYAN SUBUR 5106047012890015 NI WAYAN RENTINI 5106016703150002 NI KDK SARI ASTUTI
L
P L
NI KM SANTI ARIANI
96
KK 5106012308060409
NIK 5106010107350279 I KETUT BEDU 5106014107350345 NI KETUT SALIN
L
L
97
5106010801070014
5106013112480084 I WAYAN KANIS
98
5106012308060414
5106017112600195 NI KETUT RITI
5106012806970005 I KM SARWA ARIAWAN 5108087006990003 NI LUH JUNI YANTI
P
L P
22-01-1997 30-06-1999
99
5106012308060415 5106012308060415
100
5106012308060416 5106012308060416
101
102
5106012308060417
5106011108100005
5106012112780001 5106015906780001 5106016604030002 5106010210080001
I WAYAN SELAMET
I KADEK SUKERATA
L
5106013112810037 5106017112830058 5106010701010056 5106010509080001
I NENGAH PAGIADA
L
L
NI KT SUPADMI NI WAYAN SUITI
NI NYOMAN MEKIR I GEDE RASIANA I KADEK ARDIKA
L L
5106013112630156 I WAYAN BOLBOL 5106017112690137 NI NYM NGELAH
L
5106010701880001 I WAYAN SUARNA 5106014801930001 NI NENGAH SURTINI 5106012210100002 I WAYAN SUPARTA
L L
I KADEK SATYA
103
104
KK 5106012308060418
5106012308060419
5106012308060419
105
5106012807170002 5106012807170002
NIK 5106013112450094 I WAYAN MENTIL 5106017112480098 NI NENGAH LAMA
5106010701780002 5106014701790002 5106011908990001 5106014104040002 5106010511100001
I WAYAN BOTOL
L
L
NI WAYAN SIMPEN I WYN LENDRA AGUSTINA
L
NI KADEK NARWI I KM NOPA KARDIKA
5106010808860007 I WAYAN RASTA 5107025206920001 IA CINDYA PRAWESTI P 5106017112580502 NI MADE SERONI
L
KB 21-12-1978 P 19-06-1978 P 26-04-2003 02-10-2008
1978
41
1978
41
2003
16
2008
11
KB 31-12-1981 P 31-12-1983 07-01-2001 05-09-2008
1981
38
1983
36
2001
18
2008
11
KB 31-12-1963 P 31-12-1969
1963
56
1969
50
KB 07-01-1988 P 08-01-1993 22-10-2010 21-03-2018
1988
31
1993
26
2010
9
2018
1
KB 12/31/1945 P 31-12-1955
1945
74
1955
64
KB 07-01-1978 P 07-01-1979 19-08-1999 P 01-04-2004 05-11-2010
1978
41
1979
40
1999
20
2004
15
2010
9
08-08-1986 12-06-1992 31-12-1958
1986
33
1992
27
1958
61
L L P
106
5106012308060421
5106011406190001
107
5106012111130001 5106012111130001
5106013112400113 I WAYAN MENTIK 5106017112610100 NI NGH KENYOG
L
5106013112630238 I WAYAN RIMPIN 5106044107621490 NI WAYAN SUANTI 5106041407880002 I WYN SUKADANA
L
5106010405940008 I NENGAH PARNA 5106046106960007 NI KADEK YUDIANTI
L
5106013008130002 108
5106012308060439
109
110
111
KK 5106012308060438
5106010801070015
5106010801070015
112
5106012308060431
I PUTU ARDIANA
L
L
58
12/31/1961 12/31/1961 7/14/1988
1961
58
KB 04-05-1994 P 21-06-1996 29-09-2013
1994
25
1996
23
2013
6
KB 07-01-1960 P 07-01-1960
1960
59
1960
59
07-01-1988 07-11-1992
1988
31
1992
27
31-12-1960 31-12-1961 07-01-1993
1960
59
1961
58
1993
26
7/1/1967 7/1/1968 7/21/2000 7/30/2003 5/26/2012
1967
52
1968
51
2000
19
2003
16
2012
7
KB 31-12-1977
1977
42
P
L P L L
NI NENGAH REMBEN I KT SUKANADI JULIANTARA
1961
L
5106010701880002 I NYOMAN SUDANA 5106015711920001 NI LUH ANGGRENI
I NENGAH MALEN
79
P
L
5106010107670503 5106014107680905 5106010107000396 5106017007030003 5106016605120001
1940
P
5106010701600003 I NYOMAN MERTA 5106014701600002 NI WYN NYEMBLONG
NIK 5106013112600106 I KETUT TEER 5106017112610101 NI NYOMAN NAMI 5106010107930402 I KETUT BUDIASA
31-12-1940 31-12-1961
KB P
L
NI WAYAN WULANDARI
P
NI KADEK MAITA YANTI
P
5106013112770071 I WAYAN BERATA
L
5106012308060431
113
5106011402110012
5106014608840004 NI NYOMAN MURTINI 5106014708030003 NI LUH SUNDRIANI 5106010505080001 I KADEK SUMADIA
P P
115
116
117
118
5106012308060434
5106012308060433
KK 5106011506160003
5106010801070016
5106012107110001
5106010606880002 I NYOMAN DARMAWAN 5106014803900001 NI WAYAN DIARY 5106015405110001 NI WAYAN ARIANI
35
2003
16
2008
11
06-06-1990 08-03-1990 14-05-2011
1990
29
1990
29
2011
8
KB 10-05-1974 P 01-07-1977 27-08-2000
1974
45
1977
42
2000
19
KB 01-07-1958 P 07-01-1966 05-07-1997
1958
61
1966
53
1997
22
12-01-1995 18-08-2000 13-08-2016
1995
24
2000
19
2016
3
31-12-1950 12/31/1941 08-04-1982 07-01-1947
1950
69
1941
78
1982
37
1947
72
KB 31-12-1974 P 31-12-1975 07-01-1995
1974
45
1975
44
1995
24
04-02-2013
2013
6
L P P L
5106011005740001 I NENGAH KUMPUL 5106014107770633 NI WAYAN NYARMI 5106012708000001 I KDK AGUS SUARTAWAN
L
5106010107580747 5106014701660001 5106010507900001 NIK 5106011210890001 5106045808000005 5106015308160002
I WAYAN PAGEH
L
5106013112500173 5106017112610098 5106010804820003 5106010701470001
I NYOMAN GANGSUH
I NENGAH LANUS
L L
5106013112760051 5106014410780001 5106010701950002 5106010701950002
I WAYAN MARA
L
L
NI WAYAN WENTEN I KADEK SUARDANA
L
I WAYAN SUNARTA
L P P
NI WAYAN SUMIATI N WAYAN NISTRIASIH
L P
NI NYOMAN MOSROK I WAYAN SUMERTA
NI WAYAN SUKERTI
L
I WAYAN LASONO I GEDE SUTAWAN
1984
L
I KDK AGUS RADITIA
114
06-08-1984 07-08-2003 05-05-2008
L
119
5106012308060435
5106010511760001 5106016402000003 5106014211110002 5106016610820001
I NENGAH BEJUG
L
NI KOMANG SUPADMI NI WAYAN SARIAGI NI KDK BUNGA LESTARI NI KM INDAH
120
121
5106010801070018
5106010801070017
KK 122
KB P P P P
05-11-1976 26-10-1982 24-02-2000 02-11-2011 02-02-2015
1976
43
1982
37
2000
19
2011
8
2015
4
1952
67
P
1955
64
1998
21
5106013212520118 I KETUT GERUH 5106017112550146 NI KETUT SUDANI 5106010105980011 I KOMANG ARTIKA
L L
12/31/1952 12/31/1955 01-05-1998
5106013112500231 5106010908820005 5106010809920002 NIK 5106011707890004 5106014101890004
KB 31-12-1957 09-08-1982 9/6/1992
1957
62
1982
37
I KETUT WARDANA
L L L
1992
27
I KOMANG SUASTIKA
L
17-07-1989 P 01-01-1989 P 11 -12-2016
1989
30
1989
30
2016
3
I NYOMAN DAGING I NENGAH BANDI
NI NYM LUH SRIANI NI WYN DEVI ANTARI
123
5106012308060444
5106013112450091 I NENGAH LABEK
L
KB 31-12-1945
1945
74
124
5106012308060445
5106010101510001 I WAYAN KASUB 5106014404600001 NI WAYAN REKIN 5106012004900001 I KETUT BUDRU
L
KB 01-01-1951 P 04-04-1960 20-04-1990
1951
68
1960
59
1990
29
5106010303540004 I NENGAH BAGIA 5106016610840002 NI NENGAH SARI 5106010912100002 I WAYAN WERDIYASA
L
KB 03-03-1984 P 15-10-1984 09-12-2010
1984
35
1984
35
2010
9
125
5106012207110003
L
L
126
5106011005170001 5106011005170001
127
5106011009130001 5106011009130001
5106010101930003 I WAYAN MAGENG 5106015308930002 NI WAYAN ALEP 5106012112140001 I GEDE CANDRA WIGUNA 5106010802830001 I GEDE MURKA 5106016302950010 NI WAYAN PURNAMI 5106014101140001 NI WYN MURNIAWATI L
L L L
5106014107340119 NI KETUT JABREG 129
130
5106012308060447
5106013011100020
5106013011100020 131
132
5106012308060437
5106012706160004
L
5106012006800002 5106014605880001 5106011509090001 5106015308130004
L
L
5106010206880004 I NYOMAN SUARDIKA
L
NI WAYAN HERMAYUNI
133
5106012308060448
5106010304760001 I PUTU ARTIKA 5106016212760003 NI KADEK ADITA 5106017101010001 NI LUH PT PADMAWATI
26
2014
5
KB 08-02-1983 P 23-02-1995 P 21-01-2014
1983
36
1995
24
2014
5
01-07-1934
1934
85
KB 31-12-1954 P 31-12-1956
1954
65
1956
63
20-06-1980 06-05-1988 15-07-2009 13-08-2015
1980
39
1988
31
2009
10
2015
4
KB 07-03-1957 P 08-04-1957
1957
62
1957
62
KB 02-06-1988 P 25-03-1991 13-07-2012
1988
31
1991
28
2012
7
1976
43
1976
43
2001
18
P
5106010705570001 I MADE YADNYA 5106014804570001 NI KETUT GEMBLONG
I MD ARYA MARTA NARENDRA
1993
L
NI KADEK WIDIASIH
I PT BOY SATRIA PRATAMA
26
P
NI KETUT SENI I GD BUDIASA ANGGA P
1993
P
5106013112540104 I WAYAN LOTOK 5106017112560115 NI NENGAH SADIA I NGH TOGOG
KB 01-01-1993 P 13-08-1993 21-12-2014
L L L
02-03-2019 KB 03-04-1976 P 22-12-1976 P 31-01-2001
134
135
5106012308060449
5106012308060450
5106013112590084 I NYOMAN SUTEJA 5106017112600164 NI NYOMAN GANTI 5106010107850565 I PUTU ARDANA
L
5106013112520117 I PUTU WISNEM,BE 5106017112600387 NI WYN SRI MEKAR
L
137
5106010609100002
5106010110150001 5106010110150001
138
106012506120001 106012506120001 106012506120001
1959
60
1960
59
1985
34
KB 31-12-1952 P 31-12-1960 P 31-12-1972
1952
67
1960
59
1972
47
KB 01-07-1955 P 01-07-1958 01-07-1927
1955
64
1958
61
1927
92
KB 26-07-1991 P 08-07-1990 11-01-2014
1991
28
1990
29
2014
5
KB 15-04-1982 1982 P 19-04-1987 1987 22-08-2012 2012 P 11-02-2017
37
P L
NI MADE ASRI
136
31-12-1959 31-12-1960 01-07-1985
5106010107550548 I WAYAN GANJRONG 5106014107580440 NI WAYAN SUWI 5106010107270173 I NENGAH PUGER
L
5106012607900002 I KT SIDI SUARJAYA 5106044904880003 NI KETUT ARIANTI 5106011101140002 I GD CANRA SAPUTRA
L
5106011504820004 I NENGAH SUARNATA 5106016504860003 NI WAYAN SUMIARTI 5106012108120001 I GD AGUS RAI DARMAYASA
L
L
L
L
NI KDK FEBI RAHAYU
238 238 KB = 95 238 231 469 113 DAJA L 100 DAJA P = =
247 238 127
7
4 138
Petani lk = 99 Petani Pr = 74 Dagang lk = 7 Dagang Pr = 37 Buruh T lk = 2 Buruh T Pr = 17 Harian Lps Lk = 17 Harian Lps Pr = 2
32
GANTI
DAFTAR PESERTA JAMINAN BALI MANDARA BANJAR DINAS PUKUH DESA TIGA KECAMATAN SUSUT KABUPATEN BANGLI NO
NO KTP/NIK
1 1 2 3 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
3 5106011603800001 5106015008860005 5106013112300061 5106017112750127 5106014409000002 5106010302770004 5106015601750003 5106014809770001 5106013112700102 5106017112730169 5106010807970007 5106010107550547 5106017112650194 5106012002950001 5106011212550006 5106017112550145 5106013112730104 5106010107430645 5106014107450519 5106012606900002 5106010709790003 5106017112570097 5106046707930007 5106010610740001 5106014804850003
STATUS JENIS NAMA ANGGOTA KELUARGA KELUAR KELAMIN GA
4 I NYM GIMBAR AP, SPD
KK
NI KDK PARAMITA AP
ISTRI
NI KETUT LAMI NI NENGAH SAWI NI KOMANG SUDENI I WAYAN DARMA
L
KK SAUDARA ANAK KK
NI KETUT NYARMINI
ADIK
NI WYN SADRI
ANAK
I NENGAH KUNDRI
6
5
KK
L
L
NI WAYAN PARMI I WAYAN MERTAYASA
ANAK
I KETUT CEMPED
KK
NI PUTU TIMTIM
ISTRI
I NYOMAN KARANG
ANAK
I NYOMAN KARI
KK
NI KETUT TETEG
ISTRI
I WAYAN NASIB
ANAK
I NENGAH GEJIR
KK
NI NYOMAN KAWI
ISTRI
I NENGAH BUDIASA
ANAK
I NENGAH NUARSA
KK
NI NYOMAN WASIH
KK
NI NENGAH BUDIANTI I NYOMAN BUDIASA NI KETUT SARININGSIH NI KOMANG KARTINI
L L L L L L L L
ISTRI KK ISTRI ISTRI 2
L
TANGGAL LAHIR
JAMINAN TAHU UM KESEHATA N UR N
7 8 KB 16-03-1980 ASKES P 10-08-1986 ASKES P 31-12-1935 P 12/31/1975 KIS/BPJS P 04-09-2000 KB 03-02-1977 P 16-03-1975 P 08-09-1975 KB 31-12-1970 P 7/1/1964 27-08-1997 01-07-1955 P 12/31/1965 03-07-1997 12-12-1955 P 12/31/1955 31-12-1973 01-07-1943 P 01-07-1945 26-06-1990 07-06-1979 P 31-12-1941 P 27-07-1993 06-12-1974 P 08-04-1985 P 07-01-1983
1980
40
1986
34
1935
85
1975
45
2000
20
1977
43
1975
45
1975
45
1970
50
1964 1997
23
1955
65
1965
55
1997
23
1955
65
1955
65
1973
47
1943
77
1945
75
1990
30
1979
41
1941
79
1993
27
1974
46
1985
35
1983
37
28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58
5106010107450422 5106014107460387 5106012205750006 5106016307990001 5106011207830001 5106014709840002 5106013112400110 5106010510800002 5106015311810001 5106013112600077 5106010107420429 5106014107450520 5106014101700002 5106015805800006 5106011803980004 5106010107370265 5106014107670440 5106011705940001
I NYOMAN BALIK NI NYOMAN NEMU I KETUT SUTEJA NI WAYAN DEWI AL I KADEK DADI NI NYOMAN SUARDANI I NENGAH LAMEG
L
KK
ISTRI KK
I NYOMAN RENES
KK
NI WAYAN LEKET
ISTRI
NI NYOMAN ARIASIH
ISTRI
NI WYN RENYIH ARIANTI
ISTRI
21
1983
37
1982
38
1940
80
1981
39
1981
39
1960
60
1942
76
1945
75
1970
50
1980
40
1998
22
1937
83
1967
53
1994
26
01-07-1930 P 01-07-1930 P 31-12-1967 KB 07-05-1978 P 02-07-1980 KB 31-12-1972 KIS/BPJS P 31-12-1976 KIS/BPJS P 30-12-1942 01-07-1953 P 01-07-1959 P 03-07-2000 P 07-01-1965
1930
90
1930
90
1967
53
1978
42
1980
40
1972
48
1976
44
1942
77
1953
66
1959
60
2000
19
1965
54
P KB
ANAK
KK KK ISTRI
NI WAYAN SUNADI
ISTRI
I MADE SUASTIKA
KK
P L
L
ISTRI
I WAYAN RANGKEP
KK
NI NYOMAN GANDA
ISTRI
NI KETUT REMBUN
ISTRI KK
NI WAYAN CIDRA
ISTRI
NI KADEK SUWITRI
ANAK
NI KETUT SRUNI
ISTRI
KB P
L
STRI
NI NYOMAN GASIR
I KETUT TURUH
1999
P P P
ORANG TUA
NI MADE JULIASTUTI
45
P
NI NYM TRIMIN
I KETUT DIARTI
1975
L L
I NENGAH DARSA I NYM WILANDIVA
74
L
L ORANG TUA L
I GEDE ARTAWAN
1946
L
ORANG TUA L
NI NENGAH KASNIASIH I NYOMAN LONGOB
75
P
ISTRI KK
1945
L
ANAK KK
31-12-1945 31-12-1946 21-01-1975 23-07-1999 12-07-1983 KIS/BPJS 07-09-1982 KIS/BPJS 31-12-1940 KIS/BPJS `05-10-1981 13-11-1981 12/31/1960 01-07-1942 01-07-1945 07-01-1970 18-05-1980 18-03-1998 0107-1937 01-07-1967 17-05-1994
P
ISTRI
I NYOMAN YARNAYASA
NI KDK SUCIANTI
5106010107300195 5106014107300229 5106017112670056 5106010705780001 5106014207800002 5106013112720303 5106017112760062 5106017012460003 5106010107530737 5106014107590497 5106014307000007 5106014701650002
KK
L
L
59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89
5106010701960001 5106015004780001 5106014708970005 5106010701170001 5106010107350279 5106013112480084 5106010701010056 5106013112630156 5106017112690137 5106013112450094 5106017112480098 5106011908990001 5106010808860007 5106017112580502 5106041407880002 5106010405940008 5106046106960007 5106010701600003 5106014701600002 5106013112600106 5106017112610101 5106014803900001 5106014107770633 5106014701660001 106017112610098 5106010701470001 5106010701950002 5106016402000003 5106010809920002 5106014101890004 5106013112450091
I WAYAN SUMERTA
ANAK
NI WAYAN KARENI
ISTRI
NI KADEK SUCI
ANAK
I WAYAN TANGUN
SAUDARA
I KETUT BEDU
KK
I WAYAN KANIS
KK
I GEDE RASIANA
ANAK
I WAYAN BOLBOL
KK
NI NYM NGELAH
ISTRI
I WAYAN MENTIL
KK
NI NENGAH LAMA
ISTRI
I WYN LENDRA AGUSTINA
ANAK
I WAYAN RASTA
KK
NI MADE SERONI
ORTU
I WYN SUKADANA I NENGAH PARNA NI KADEK YUDIANTI I NYOMAN MERTA NI WYN NYEMBLONG I KETUT TEER
KK
L P P L L L L L L L L P L L
ISTRI KK
L
ISTRI KK
NI NYOMAN NAMI
ISTRI
NI WAYAN DIARY
ISTRI
NI WAYAN NYARMI
ISTRI
NI WAYAN WENTEN
ISTRI
NI NYOMAN MOSROK
ISTRI
I NENGAH LANUS
ANAK
I WAYAN LASONO
ANAK
P KB P P P P P P
L L P
ISTRI
I KETUT WARDANA
ANAK ISTRI
L
KK
L
I NENGAH LABEK
KB
L
NI KOMANG SUPADMI NI NYM LUH SRIANI
KB P KB P
P KB
07-01-1995 10-04-1978 07-08-1997 07-01-1917 01-07-1945 31-12-1950 KIS/BPJS 07-01-2001 31-12-1963 31-12-1969 12/31/1945 31-12-1955 19-08-1999 08-08-1986 31-12-1958 7/14/1988 04-05-1994 21-06-1996 07-01-1960 07-01-1960 31-12-1960 31-12-1961 08-03-1990 01-07-1977 07-01-1966 KIS/BPJS 12/31/1941 07-01-1947 07-01-1995 26-10-1982 9/6/1992 01-01-1989 31-12-1945 KIS/BPJS
1995
24
1978
41
1997
22
1917
102
1945
74
1950
69
2001
18
1963
56
1969
50
1945
74
1955
64
1999
20
1986
33
1958
61
1994
25
1996
23
1960
59
1960
59
1960
59
1961
58
1990
29
1977
42
1966
53
1941
78
1947
72
1995
24
1982
37
1992
27
1989
30
1945
74
90 91 92 93 94 95 96 97 98 99 100 101 102 103
5106010101510001 5106014404600001 5106016610840002 5106015308930002 5106010802830001 5106016302950010 5106014107340119 5106017112560116 5106014804570001 5106010206880004
I WAYAN KASUB
KK
NI WAYAN REKIN
ISTRI
NI NENGAH SARI
ISTRI
NI WAYAN ALEP
ISTRI
I GEDE MURKA
KK
NI WAYAN PURNAMI
ISTRI
NI KETUT JABREG
ISTRI
NI NENGAH SADIA
ISTRI
NI KETUT GEMBLONG
ISTRI
I NYOMAN SUARDIKA
KK
NI WAYAN HERMAYUNI
5106013112520117 I PUTU WISNEM,BE 5106014107580440 NI WAYAN SUWI 5106010107270173 I NENGAH PUGER
L
L
L
ISTRI KK
L
ISTRI KK
L
KB 01-01-1951 P 04-04-1960 P 15-10-1984 P 13-08-1993 KB 08-02-1983 P 23-02-1995 P 01-07-1934 P 31-12-1956 P 08-04-1957 KB 02-06-1988 P 25-03-1991 KB 31-12-1952 P 01-07-1958 01-07-1927
ASKES/
1951
68
1960
59
1984
35
1993
26
1983
36
1995
24
1934
85
1956
63
1957
62
1988
31
1991
28
1952
67
1958
61
1927
92
NAMA -NAMA PESERTA KB AKTIF DUSUN PUKUH TIGA TAHUN 2020
NO
NAMA PUS
UMUR
KK
1
2
3
4
1
NI NYOMAN SASIH
43
I KETUT NGEPIL
2
NI KADEK SUNIASIH
39
I NENGAH BADERA
3
NI KDK PARAMITA AP
34
I NYM GIMBAR AP, SPD
4
NI WAYAN ARIASTI
29
I NYOMAN ADNYANA
5
NI KDK SUDARI
23
I WAYAN SUDIASA
6
NI WYN ASRIANI
42
I KETUT TAMAN
7
NI KETUT MISI
46
I WAYAN LABA
8
NI KETUT RUPANI
40
I WAYAN DARMA
9
NI NYM SUARTINI
32
I NYOMAN SUDIASA
10
NI NGH MANIS
44
I WYN SUTAR
11
NI WAYAN PITRIANI
25
I KADEK ARMAWAN
12
NI KETUT SRIWA
48
I NENGAH KUNDRI
13
NI WAYAN PINTI
36
I WAYAN SUWENA
14
NI KDK NURATNI, SE
32
I NENGAH SUBUR
15
NI NYOMAN DERI
35
I WAYAN YARNA
16
NI MADE KAMINI
31
I NENGAH GEBLOH,
17
NI NENGAH DARMINI
33
I WAYAN BAWA
18
NI WYN PADMI DEWI
19
I MADE SENTANA
19
NI NYOMAN NGARPI
37
I WAYAN DAWEG
20
NI NENGAH MUDANI
37
I KETUT GAMBU
21
NI KOMANG MURNI, SPd
36
I WAYAN SUBAGIA, SP
22
NI WAYAN GENTEN
44
I WAYAN KETEN
23
NI NENGAH LEMUH
42
I NYOMAN MUDRA
24
NI LUH AYU SASTRINI
32
I WAYAN GEBAN
25
NI WAYAN PAGI
44
I WYN KUAT SETIAWAN
26
NI NENGAH NURIANTI
32
I NYOMAN GAMBA
27
NI NENGAH BUDIANTI
27
I KETUT AMAN
28
NI KETUT SARININGSIH
35
I NYOMAN BUDIASA
29
NI KOMANG KARTINI
37
I NYOMAN BUDIASA
30
NI NYOMAN SUARDANI
38
I KADEK DADI
31
NI LUH SRIBA
34
I KETUT WILA
32
NI NENGAH KASNIASIH
39
I NYOMAN YARNAYASA
33
KADEK VINI
35
I KM SUARNATA
34
NI WYN JULIANTARI
25
I WAYAN SURADNYA
35
NI WYN RENYIH ARIANTI
40
I WAYAN WARI
36
NI KETUT SAGET
37
I WAYAN SADAR
37
NI NENGAH BANGEN
32
I NENGAH ALEP
38
NI WYN IRNA MARIANI
24
I KETUT MARDIANA
39
NI KDK SUCIANTI
40
NI WAYAN REKIN
46
I NENGAH TAMBUN
41
NI NGH SUDEWI ARISANTI
27
I NYM SULENDRA
42
NI NENGAH OLAS
42
I WAYAN DITA
43
NI NGH MERTAKANI
26
I NYOMAN SUARDIKA
44
NI KETUT SUARMI
32
I MADE DWI ANTIKA P
45
NI MADE JULIASTUTI
40
I MADE SUASTIKA
46
NI NYOMAN GANDA
44
I WAYAN RANGKEP
47
NI NENGAH SARWI
43
I NENGAH NIKA
48
NI WAYAN DANI
40
I KETUT MUDRI
49
NI WAYAN GANTI
42
I WAYAN RANGIN
50
NI NYOMAN SUPARTI
33
I NYM GENJUR ARTANA
51
NI WAYAN SIRIT
46
I KETUT BADENG
52
NI WAYAN KARENI
42
I WAYAN KUMPUL
53
NI NENGAH RUKTI
39
I NYOMAN BUDIARTA
54
NI KADEK SUGIANI
36
I NYOMAN RUMAJA
55
NI NENGAH NGARPI
40
I KETUT NGELAH
56
NI WAYAN WENI
25
I KOMANG BUDIARTA
57
NI MADE SARI
44
I KETUT PUNIA
58
NI NYOMAN LUMUR
46
I KETUT GADING
59
NI NYOMAN SUWI
47
I NYOMAN SAMPUN
60
NI KT LUH SERIANI
25
I WAYAN WINDRA
61
NI KETUT SUKARI
28
I NENGAH BINTAR
62
NI WAYAN RESTINI
32
I NENGAH BAKTIASA
63
NI WAYAN RENTINI
31
I WAYAN SUBUR
64
NI LUH JUNI YANTI
21
I KM SARWA ARIAWAN
I NYM WILANDIVA
65
NI KT SUPADMI
42
I WAYAN SELAMET
66
NI NYOMAN MEKIR
37
I NENGAH PAGIADA
67
NI NENGAH SURTINI
27
I WAYAN SUARNA
68
NI WAYAN SIMPEN
41
I WAYAN BOTOL
69
IA CINDYA PRAWESTI P
28
I WAYAN RASTA
70
NI KADEK YUDIANTI
24
I NENGAH PARNA
71
NI LUH ANGGRENI
28
I NYOMAN SUDANA
72
NI NYOMAN MURTINI
36
I WAYAN BERATA
73
NI WAYAN DIARY
30
I NYOMAN DARMAWAN
74
NI WAYAN NYARMI
43
I NENGAH KUMPUL
75
NI WAYAN SUMIATI
20
I WAYAN SUNARTA
76
NI WAYAN SUKERTI
45
I WAYAN MARA
77
NI KOMANG SUPADMI
38
I NENGAH BEJUG
78
NI NYM LUH SRIANI
31
I KOMANG SUASTIKA
79
NI NENGAH SARI
36
I NENGAH BAGIA
80
NI WAYAN ALEP
27
I WAYAN MAGENG
81
NI WAYAN PURNAMI
25
I GEDE MURKA
82
NI KETUT SENI
32
I NGH TOGOG
83
NI WAYAN HERMAYUNI
29
I NYOMAN SUARDIKA
84
NI KADEK ADITA
44
I PUTU ARTIKA
85
NI KETUT ARIANTI
30
I KT SIDI SUARJAYA
86
NI WAYAN SUMIARTI
33
I NENGAH SUARNATA
NO NIK
ALKON YG DIGUNAKAN
5
6
5106015603770001 5106016512820004 5106015008860005 5106015707910001 5108076012970002 5106017006780003 5106014709740002 5106014204800001 5106016210880008 5106017112700168 5106016711950003 5106017112720111 5106014303840006 5106013112850004 5106016001890003 5106014309870005 5107067112010018 5106017101830003 5106014303850010 5106014412840003 5106017112760007 5106017112780070 5108016112880001 5106015909760001 5106016907880001 5106046707930007 5106014804850003 5106014709840002
5106014707860006 5106015311810001 5108064808850008 5106015107950004 5106015805800006 5106014601830001 5106014403880001 5106015004960002 5106016809740001 5107015003960002 5106017007780001 5106014808940006 5106015008880001 5106014207800002 5106017112760062 5106014702770001 5106014103860001 5106017112790056 5106010606870001 5106014105740001 5106015004780001 5106015708810001 5106014508840001 5106017112800069 5106045701950002 5106017112760073 5106014107740602 5106017112730113 5106015208960002 5106014705920001 5106016407880003 5106047012890015 5108087006990003
5106015906780001 5106017112830058 5106014801930001 5106014701790002 5107025206920001 5106046106960007 5106015711920001 5106014608840004 5106014803900001 5106014107770633 5106045808000005 5106014410780001 5106016402000003 5106014101890004 5106016610840002 5106015308930002 5106016302950010 5106014605880001 5106016212760003 5106044904880003 5106016504860003
