FORMULIR PENDATAAN PROGRAM KELUARGA HARAPAN (PKH)
TAHUN
2016
Dusun :
Desa :
Medan Krio
Kecamatan :
Sunggal
|
NO
|
Nama Kepala Keluarga
|
Nama – nama Anggota Keluarga
|
Nomor Kartu Keluarga
(No.KK)
|
Nomor Induk Kependudukan
(NIK)
|
Jumlah Anggota keluarga
|
|
1
|
2
|
3
|
4
|
5
|
6
|
|
1.
|
Samiran
|
|
1207231609093651
|
1207231707690006
|
5
|
|
|
|
Muliani
|
|
1207234510690001
|
|
|
|
|
Pani Dewi Triana
|
|
120723803960006
|
|
|
|
|
Priska Dila Miranda
|
|
1207234811010001
|
|
|
|
|
Pinky Wuriranti
|
|
1207234706030004
|
|
|
2
|
Samsu Ardani
|
|
1207231609094244
|
1207232012720003
|
5
|
|
|
|
Mariana
|
|
1207234409760002
|
|
|
|
|
Zulhaimi Akbar
|
|
1207232102020003
|
|
|
|
|
Zamasari Raudah
|
|
1207236504060001
|
|
|
|
|
Muhammad Khoiru
Nazaru
|
|
1207231402140003
|
|
|
3
|
Sutrisno
|
|
1207231609094810
|
1207230306670003
|
5
|
|
|
|
Kusrini
|
|
12072337112760021
|
|
|
|
|
Siti Mardiyah
|
|
1207236502010006
|
|
|
|
|
Siti Hadijah Ramadani
|
|
1207236607120004
|
|
|
|
|
Junaidi
|
|
1207231708740008
|
|
|
4
|
Suwantah
|
|
1207231609094638
|
1207230209710001
|
5
|
|
|
|
Nur’aini
|
|
1207234304720003
|
|
|
|
|
Fifi Mita Sari
|
|
1207235702990006
|
|
|
|
|
Abdul Khaliq
|
|
1207230905030004
|
|
|
|
|
Sultan Iskandar
|
|
1207230209090002
|
|
|
5
|
Ali Saman Siregar
|
|
1207232305120009
|
1207230709640008
|
9
|
|
|
|
Zubaidah
|
|
1207237112630025
|
|
|
|
|
Vivi Wulandari
|
|
1207236802660009
|
|
|
|
|
Uci Prima Siregar
|
|
1207234209990004
|
|
|
|
|
Wahyu Putra siregar
|
|
1207231308910006
|
|
|
|
|
Ageng Nugraha
|
|
1207231208920006
|
|
|
|
|
Arif Wibowo
|
|
1207232012940011
|
|
|
|
|
Amdika Rizki
|
|
1207232911960011
|
|
|
|
|
Lulu Pratiwi
|
|
1207236411970005
|
|
|
|
|
|
|
|
|
Dusun :
Desa :
Medan Krio
Kecamatan :
Sunggal
|
NO
|
Nama Kepala
Keluarga
|
Nama – nama
Anggota Keluarga
|
Nomor Kartu
Keluarga
(No.KK)
|
Nomor Induk
Kependudukan
(NIK)
|
Jumlah
Anggota keluarga
|
|
1
|
2
|
3
|
4
|
5
|
6
|
|
6
|
Tony
|
|
120723160903981
|
1207230603820003
|
5
|
|
|
|
Poni
|
|
1207237112630004
|
|
|
|
|
Daniah
|
|
1207236812930008
|
|
|
|
|
Resa Pongga
|
|
1207230605960007
|
|
|
|
|
Alfi Sauri
|
|
1207230608980002
|
|
|
7
|
Sutardi
|
|
1207232607100003
|
1207230101560009
|
4
|
|
|
|
Suyati
|
|
1207235211680004
|
|
|
|
|
Sulastri Ningsih
|
|
1207234303820018
|
|
|
|
|
Suhendra
|
|
1207232303860007
|
|
|
8
|
Sabirun
|
|
1207231004130017
|
1207230308800011
|
|
|
|
|
Sri Jaharti
|
|
1207234801820007
|
|
|
|
|
Wahyu Rizki Ananda
|
|
1207232409030007
|
|
|
|
|
M. Rajid Rafikri
|
|
1207233008040010
|
|
|
|
|
Yoga Agustion
|
|
1207232008070008
|
|
|
|
|
Qori Sasmita Sari
|
|
1207235901100003
|
|
|
9
|
Suriyanto Yayak
|
|
1207231609095473
|
1207231503660002
|
7
|
|
|
|
Sabariah
|
|
1207236407680003
|
|
|
|
|
Eko Hartanto
|
|
1207232105910010
|
|
|
|
|
Rani Indawani
|
|
1207236710930003
|
|
|
|
|
Elis Mayani
|
|
1207234803970004
|
|
|
|
|
Widya Hakiki
|
|
1207236510044008
|
|
|
|
|
Rahmat
|
|
1207231001180014
|
|
|
10
|
Rachman
|
|
12072310101100096
|
1207232010730005
|
6
|
|
|
|
Endang Pujiastuti
|
|
1207235609760006
|
|
|
|
|
Rahmad Hidayat
|
|
1207230204010004
|
|
|
|
|
Abdul Nazril
|
|
1207230710020008
|
|
|
|
|
Nurhayati
|
|
1207236706030007
|
|
|
|
|
Riki Andhika
|
|
1207232806090008
|
|
|
NO
|
Nama Kepala Keluarga
|
Nama – nama Anggota Keluarga
|
Nomor Kartu Keluarga
(No.KK)
|
Nomor Induk Kependudukan
(NIK)
|
Jumlah Anggota keluarga
|
|
1
|
2
|
3
|
4
|
5
|
6
|
|
11
|
Tugio
|
|
0201120603874
|
0201123112370034
|
5
|
|
|
|
Sariem
|
|
0201127112500129
|
|
|
|
|
Sakirin
|
|
0201123112850033
|
|
|
|
|
Hamidah
|
|
0201127112920013
|
|
|
|
|
Nuramini
|
|
0201127112950013
|
|
|
12
|
Mukiyem
|
|
1207231609094191
|
1207235303370001
|
4
|
|
|
|
Sunarmen
|
|
1207231111750003
|
|
|
|
|
Ernawati
|
|
1207235206810003
|
|
|
|
|
Muhammad Fahri Al
Farizi
|
|
1207230702070005
|
|
|
13
|
Suparjan
|
|
1207231609094108
|
1207230707470002
|
3
|
|
|
|
Paisem
|
|
1207235505630007
|
|
|
|
|
Marianto
|
|
1207230102910008
|
|
|
14
|
Susanto
|
|
0201120802028
|
0201122510770006
|
4
|
|
|
|
Nurmawati
|
|
0201124806820002
|
|
|
|
|
Eka Fitriya
|
|
0201124112080003
|
|
|
|
|
Fitri Octavia
|
|
0201126410060004
|
|
|
15
|
Nur Ahmal
|
|
1207231609095207
|
1207233112630057
|
3
|
|
|
|
Juariyah
|
|
1207235412510001
|
|
|
|
|
Ali Imbran
|
|
1207230404880092
|
|
|
16
|
Priyatna Adiyansah
|
|
1207232004120015
|
1205090101830002
|
4
|
|
|
|
Isah Safitri Lubis
|
|
1207235510830001
|
|
|
|
|
Aqila Whafida
|
|
1207236711090007
|
|
|
|
|
Meysha Fahira
|
|
1207234310120004
|
|
|
17
|
Mulyadi
|
|
1207232401110003
|
1207231708720016
|
4
|
|
|
|
Sunarti
|
|
1207235408750004
|
|
|
|
|
Jeffriy Nugrah Pratama
M
|
|
1207230504030007
|
|
|
|
|
Adinda Chairani
|
|
1207235001050004
|
|
|
18
|
Sarmo
|
|
0201121000618
|
0201123112430060
|
2
|
|
|
|
Kamisah
|
|
0201127112420146
|
|
|
19
|
Budi Dharma
|
|
1207232107110014
|
1207230101750020
|
5
|
|
|
|
Dewi Setia Ningsih
|
|
12072366065780005
|
|
|
|
|
Muhammad Suykur Kadava
|
|
1207231709010007
|
|
|
|
|
Ahmad Rafli
|
|
1207232611040006
|
|
|
|
|
Muhammad Asraf
|
|
1207230111080005
|
|
Dusun :
Desa :
Medan Krio
Kecamatan : Sunggal
Dusun :
Desa :
Medan Krio
Kecamatan : Sunggal
|
NO
|
Nama Kepala Keluarga
|
Nama – nama Anggota Keluarga
|
Nomor Kartu Keluarga
(No.KK)
|
Nomor Induk Kependudukan
(NIK)
|
Jumlah Anggota keluarga
|
|
1
|
2
|
3
|
4
|
5
|
6
|
|
20
|
Isamayanto
|
|
0201120506150
|
0201120908740002
|
4
|
|
|
|
Junaida S
|
|
0201125304800012
|
|
|
|
|
Havizah Fitriani
|
|
0201124505030006
|
|
|
|
|
Khairul Nizam
|
|
0201122206070003
|
|
|
21
|
Edi Rahmansyah Putra
|
|
1207231609095666
|
1207232801810005
|
3
|
|
|
|
Mutia Khalista
|
|
1207235303840001
|
|
|
|
|
Putri Chesya Adeliya
|
|
1207236101070001
|
|
|
22
|
Suwono
|
|
1207231609094057
|
1207230101560003
|
4
|
|
|
|
Sunarseh
|
|
1207234605620001
|
|
|
|
|
Surya Ramadhani
|
|
1207232303940008
|
|
|
|
|
Ari Kuswanto
|
|
1207230304970004
|
|
Klasifikasi Pendataan :
1.
Keluarga Sangat miskin
2.
Lansia
3.
Anaknya bersekolah
4.
Ibu Hamil
5.
Disabilitas Medan Krio, Februari 2016
6.
Ada Balita
7.
Rumah yang tdk Layak Huni Pendata,
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