identitas keluarga (version 1)

7/23/2019 Identitas Keluarga (Version 1)

1/45

Format Tabulasi RW 09

Format Identitas Keluarga

Identitas Kepala Keluarga

RT UMUR (tahun)

LakiLaki !"R

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3/45


Identitas Kepala Keluarga

No UMUR RT

01 02 03 04 05 06 07 0 0! 10

' %&0

& &'&

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+ *'*

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"umla#

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kiLaki

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empuan


4/45

No RT R

01 02 03 04 05 06 07 0 0! 10 Total

' LakiLaki

& !erempuan

"umla#

No %gamaRT R

01 02 03 04 05 06 07 0 0! 10 Total

' Islam

& Katholik

* !rotestan

+ indu

1udha

"umla#

NoRT R

01 02 03 04 05 06 07 0 0! 10 Total

' Mela2u

& 1atak* Minang

+ 1eta3i

4unda

5a3a

, Madura

. Flores

9 1ima

'0 Manado

'' #mbon

"umla#

"enisKelamin

&u'u(angsa


5/45

No )endidi'anRT R

01 02 03 04 05 06 07 0 0! 10 Total

'

&

*+ 46

4M!

4M#

, !T

"umla#

No )e'er*aan RT R

01 02 03 04 05 06 07 0 0! 10 Total

' !$4

&

* Wirausaha+ 1uruh

"umla#

1elum4ekolah

1elumTamat 46

Tidak

Tamat 46

Kar2a3an43asta

!ela7ar8Mahasis3a

Tidak1eker7a

# !rodukti:('. thn)

1 $on!rodukti:


6/45

No RT R

01 02 03 04 05 06 07 0 0! 10 Total

' #

& 1

* #1

+ ;

Tidak Tahu

"umla#

NoRT R

01 02 03 04 05 06 07 0 0! 10 Total

' % Rp ' &00000

& - Rp ' &00000

"umla#

NoRT R

01 02 03 04 05 06 07 0 0! 10 Total

' Kepala KK

& Istri

*

"umla#

NoRT R

01 02 03 04 05 06 07 0 0! 10 Total

+olongan,ara#

)eng#asilanKeluarga)er-ulan

)engam-ilKeputusan

,alam

Keluarga

Keluarga2ang lain

"umla#%nggotaKeluarga


7/45

' ' +

& - +

"umla#


8/45

R$ 0!

Total .


9/45

0!

.

0!

.

0!

.


10/45

0!

.

0!

.


11/45

0!

.

0!

.

0!

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0!

.


12/45


13/45


Identitas %nggota Keluarga

No UMUR RT

01 02 03 04 05 06 07 0 0!

' %&0 &. &. ., ''' *& &. . ''9

& &'& &' & '. & & '0 , '. &

* &*0 & , . , '+ '+ '+ &'

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9 0 ' 0 0 0 0 0 ' 0 0

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LakiLaki

!e

rempuan


14/45

NoRT

01 02 03 04 05 06 07 0 0! 10

' LakiLaki +* ++ '&+ '' 0 0 9 '&+ '9 '0

& !erempuan 9+ '09 &', &+0 ., ,+ &09 &0, *'+ '.,

"umla# '*, '* *+' *9' '*, '&+ *0+ **' +.* &9*

NoRT

01 02 03 04 05 06 07 0 0! 10

' Istri + +9 9 ''& +. *. 99 '0+ '& 99

& #nak . .9 &', &+ . . ', &'* *'& '.'

* Menantu 0 0 + ' 0 0 . 0 * *

+ #dik8Kakak ' * & 0 * + & '

Ibu8Mertua & . 0 0 0 , + '


15/45

No )endidi'an RT

01 02 03 04 05 06 07 0 0! 10

'&' &0 + +' && ', 0 +9 ,9 9

&&' &+ +' * &+ &+ +, * +.

*' & &' '0 ' 9 + 0

+ 46 && ' ., ' '* ** +, , *

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4M# & +, '0' ''* +0 *0 . 90 '*+ ,

, !T & &9 &, ** '+ & *' +& +&

"umla# '* '* *+' *9' '*, '&' *0' **' +.* &9,

No )e'er*aanRT

01 02 03 04 05 06 07 0 0! 10

' !$4 ' * 0 & ' & . . .

& &. *' + 0 *+ & . , ,' ,

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+ 1uruh & * , + ' * * + 0

+& +, ''& ' * +, .. '&0 ' .,

* * .' '0 &. &+ .+ .+ '+,

' '* , &. '9 ++ +0 .& .

1elum4ekolah

1elumTamat 46

TidakTamat 46

Kar2a3an43asta

!ela7ar8Mahasis3a

Tidak1eker7a

# !rodukti:('. thn)

!rodukti:


16/45

"umla# ',& '* *+' *9' '*, '&+ *0& **' +.* &9*

No RT

01 02 03 04 05 06 07 0 0! 10

' # '* '' +' *+ . ' *0 + &+ '9

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Ti a Ta u 0 9* &0 &0. . '' '** &.' '*

"umla# '*, '* *+' *9' '*, '&+ &99 **' +.* &9

No

RT

01 02 03 04 05 06 07 0 0! 10

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& 4edang '* . '* ** . '' ' &' . '*

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"umla# '*, &&* +' &' '9 ' *&' ++, +.* +0&

No

RT

01 02 03 04 05 06 07 0 0! 10

'616 0 + , & ' 0 0 ' & &

& Malaria 0 0 0 0 0 0 0 0 0 0

* 6iare ' 0 & ' ' 0 0 0 & .

+


17/45

0 0 0 ' 0 0 0 0 ' 0

epatitis 0 0 ' 0 0 ' 0 0 0 0

, !M4 0 0 0 0 0 0 0 0 0 0

. 6ll ' + '. +* . '' 0 &' '* '

"umla# '. . &. +, '0 '& 0 && '. &

No )engo-atanRT

01 02 03 04 05 06 07 0 0! 10

' $akes ', . &, '* . '& .+ && ' &

& $on $akes ' ' & 9

"umla# ', . &. '+ '0 '& 9* && ' &

No RT

01 02 03 04 05 06 07 0 0! 10

' Transport ' *

& 1ia2a ' &

"umla# 0 0 ' ' & 0 9 0 0 0

No )em-aaran RT01 02 03 04 05 06 07 0 0! 10

' 5#MK"4M#4 '* 0 , + '' '0 & '

& $on '' * ' '+ * . .& '& '* &

"umla# ', . &. '+ '0 '& 9* && ' &

NoRT

1atuk- '00 hari

%lasan tida'Ke Na'es

Kese#atan&arana


18/45

01 02 03 04 05 06 07 0 0! 10

' R4 9 . '* * * '+ '0 '0

& !KM * 0 , + + &, , * 9

* 43asta 0 . ' *' ' & ,

"umla# ', . &. 0 '0 '& 9* && ' &

Terde'at


19/45

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10 Total .

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0 0 000

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& ', 0,

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&9* &,*


20/45

R$ 0!

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9 *+9

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&9+ '0000

R$ 0!

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.+* *'+.

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21/45

R$ 0!

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9 '&,

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22/45

&,&, .*+

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&9& +0

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9 &0&

**+ '0000

R$ 0!

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'9 '00

0 000

' +'.

' 0&9


23/45

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& 0*

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'0 '.09

'.9 &,.+

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24/45

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25/45

Tabel Tabulasi !14 RW 09

entilasi &um-er %ir Minum Kondisi %ir "am-an

1ersih Kotor Tanah


26/45

Tabel Tabulasi RW 09

em-uangan &ampa# Ke-iasaan &e#ari#ari

Tdk1ersih

-'0 m %'0 m

empat!enampungan4a

mpa

Kali

4embarangan

6ibakar

Aa Tidak Aa Tidak 1aik


27/45

)ero'o' )ero'o'

;lahraga6alam4eminggu

mlhKeluargaAangMe

rokok

Lama Merokok

mlah1atangRokok!

er0a

Aa Tidak C & - & C ' thn - ' thn C batang- batang Aa Tidak

'

&

*

+

,

.

9

'0

"ml

Total

.

RT

anan

4ehat

Merok

okdid

alam

ruma

h


28/45

I6"$TIT#4 #$//;T# K"LU#R/#

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ UMUR

No UMUR RT

01 02 03 04 05 06 07 0 0!

' 0&. hr 0 0 0 0 0 0 0 0 '

& &. bln 0 & & ' 0 ' 0 & 0

* bln' th * * & + * ' & 0 *

+ 'th&th ' & . & ' , ' .

&thth * . , & * '* '* &

'0th '* , & *' '0 . '9 &, *

, '''th 9 * &' & , ' '. &*

. '&0th * &+ ' , . & &*

9 &'& & '. & & '0 , '. &

'0 &*0 + , . , '+ '+ '+ &'

'' *'* + * 9 ' , * *

'& *+0 0 & 0 & ' ' ' ' 0

'* +'+ 0 ' 0 0 0 0 0 ' 0

'+ +0 0 0 0 0 0 0 0 0 0

' ' 0 ' 0 0 0 0 0 ' 0

' 0 0 0 0 0 0 0 ' 0 0

', ' 0 0 0 0 0 0 ' 0 0

'. ,0 0 0 ' 0 0 0 0 0 0

'9 -,0 0 0 ' 0 0 0 0 0 0

5umlah +. ++ '&* '' 0 +9 9 '&+ '9

"enisKelamin

LakiLaki


29/45

No UMUR RT

01 02 03 04 05 06 07 0 0!

' 0&. hr ' 0 0 0 0 0 ' 0 '

& &. bln ' * * ' 0 ' ' ' *

* bln' th & 0 ' * 0 & *

+ 'th&th + ' * ' & , +

&thth 9 '* & . ' ', ',

'0th . '* && &* '0 '0 ' ', **

, '''th '' &* '9 . & &* &.. '&0th '+ && '9 + & '+ '' &+

9 &'& . * &* &+ + & ' +,

'0 &*0 '* ' & &. 9 '& && &. *0

'' *'* '* '+ & & 9 , & &0 *0

'& *+0 '& '0 '9 '9 9 , '9 &0 &,

'* +'+ + 9 '0 &+ 9 '* &'

'+ +0 * + '' '0 '0 * ' ',

' ' * * , * '* 9

' 0 ' * * & & *

', ' ' + & ' 0 & & ' &

'. ,0 ' 0 & ' ' 0 ' '

'9 -,0 * ' 0 ' 0 0 &

5umlah '0* '09 &'. &+0 ., ,+ &09 &0, *'+

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 #$//;T# K"LU#R/# 1"R6#4#RK#$ 5"$I4 K"L#MI$

$o RT

' & * + , . 9 '0

' LakiLaki +, ++ '&+ '' 0 0 9 '&+ '9 '0

& !erempuan '0+ '09 &', &+0 ., ,* &09 &0, *'+ '.,

5umlah '' '* *+' *9' '*, '&* *0+ **' +.* &9*

"enisKelamin

!erempuan

5enisKelamin


30/45

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ U1U$/#$ K"LU#R/#

NoRT

01 02 03 04 05 06 07 0 0! 10

' Istri +9 +9 9 ''& +. *. 99 '0+ '& 99

& #nak 9, .9 &', &+ . .+ ', &'* *'& '.'

* Menantu 0 0 + ' 0 0 . 0 * *

+ #dik8Kakak ' * & 0 * + & '

Ibu8Mertua * . 0 0 0 , + '


31/45

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ !"$6I6IK#$

No )endidi'an RT

01 02 03 04 05 06 07 0 0! 10

'*& &0 + +' && '9 & +9 ,9 9

& &* &+ +' * &+ &+ +, * ++

* & & &' '0 ' 9 + 0

+ 46 '. ' ., ' '* ** +, , *

4M! ', ' + 0 '' '' * + .' *&

4M# *9 +, '0' ''* +0 *0 . 90 '*+ ,

, !T &0 &9 &, ** '+ & *' +& +&

5umlah '' '* *+' *9' '*, '&* *0+ **' +.* &9*

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ !"K"R5##$

No )e'er*aan RT

01 02 03 04 05 06 07 0 0! 10

' !$4 ' * 0 & ' & . . .

&*& *' + 0 *+ & 9 , ,' ,

* Wirausaha &0 && , , '. '9 ' &0

+ 1uruh & * , + ' * * + 0

+9 +, ''& ' * +, .. '&0 ' .,

* * .' '0 &. &+ .+ .+ '+,

1elum4ekolah

1elum

Tamat 46

Tamat 46

Kar2a3an43asta

!ela7ar8Mahasis3a

Tidak1eker7a

# !rodukti:('. thn)


32/45

& '* , &. '. ++ +0 .& .

"umla# '' '* *+' *9' '*, '&* *0+ **' +.* &9*

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ /;L;$/#$ 6#R#

No RT

01 02 03 04 05 06 07 0 0! 10

' # '& '' +' *+ . ' *' + &+ '9

& 1 '* *+ 0 ' ', &+ ++ + *&

* #1 , '0 '& &, + + &' '. '. ',

+ ; ++ ** +. & & *' + 9' '0

Tidak Tahu , 9* &0 &0. . '+ '** &.' '0

umla# '' '* *+' *9' '*, '&* *0+ **' +.* &9*

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ 4T#TU4 K"4"#T#$

No RT

01 02 03 04 05 06 07 0 0! 10

' 1aik '.. &' +&* +,+ '. '& *&* +& *0 *,

& 4edang '& . '* ** . '' .' &' . '*

* 1uruk 0 ' '+ & ' '& ' , '*

umla# &0 &&* +' &' '9 ',+ +' ++, + +0&

1 $on!rodukti:

+olongan,ara#

&tatusKese#atan

6 -ulanTera'#ir


33/45

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 #$//;T# K"LU#R/# 1"R6#4#RK#$ 5"$I4 !"$A#KIT

$o RT

' & * + , . 9 '0

' 616 0 + , & ' 0 * ' & &

& Malaria 0 0 0 0 0 0 0 0 0 0

* 6iare ' 0 & ' ' 0 & 0 & .

+


34/45

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 #$//;T# K"LU#R/# 1"R6#4#RK#$ #L#4#$ TI6#K K" $#K"4

$o RT

' & * + , . 9 '0

' Transport 0 0 ' 0 0 0 * 0 0 0

& 1ia2a 0 0 0 ' & 0 0 0 0

5umlah 0 0 ' ' & 0 9 0 0 0

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ !"M1#A#R#$

No )em-aaran RT

01 02 03 04 05 06 07 0 0! 10

' 5#MK"4M#4 '& '+ + '' '0 * '

& $on '' * ' *& & . ,* '& '& &

umla# ', . &, + . '& .+ && ' &

6I4TRI1U4I FR"KU"$4I I6"$TIT#4 K"LU#R/# 1"R6#4#RK#$ 4#R#$# K"4"#T#$ T"R6"K#T

No RT

01 02 03 04 05 06 07 0 0! 10

' R4 9 . '* + * * ** '+ 9 '0

& !KM * 0 , & + + & , 9

#lasan tidakKe $akes

Kese#atan&arana

Terde'at


35/45

* 43asta 0 , ', ' & ' ' ,

umla# ', . &, + . '& .+ && ' &


36/45

R$ 0!

10 Total .

0 ' 0'0

'+ '+ RT 0' %bln 0 &

& &* &+0 -bln +

, +& +*.

'& '' ''99

&0 '9 &0++ RT 0& %bln & *

'& '*9 '++9 -bln '

' '*& '*,

, '&& '&,&

' ''0 ''+, RT 0* %bln & ,

+ +.0 -bln * +

* '' ''

0 & 0&' RT 0+ '*

0 0 000 ''

0 & 0&'

0 ' 0'0 RT 0

0 ' 0'0 +

0 ' 0'0

0 ' 0'0 RT 0 *

'0 99 '0000 *

RT 0, 9

'+

RT 0. *

,


37/45

R$ 0!

10 Total .

0 * 0', RT '0 '

& ' 09& '*

. &9 '

* * &00

'' '&, ,&,

'9 ',0 9,*

'0 '0 9''+ '&9 ,*.

'. ',* 990

&0 &0* '''

' '. '0.

' '. 90+

' '' +

'* 9& &

'0 + *

*, &'&

& ', 09,

' '* 0,+

* &' '&0

'., ',+. '0000

RW 09

Total D

90 *+

',+, ++

&,0, '0000


38/45

R$ 0!

Total .

.+ *'&

',09 *'*

'9 0,0

&, '00

** '&&

+. ',,

'0 0*,

' 0

&,0, '00

R$ 0!

Total .

&+9+ 9&'*

'' *9,

9, *+0 0

0 0

&,0, '00


39/45

R$ 0!

Total .

+&9 '.

*.& '+''

0 &&&

*9, '+,

*,+ '*.&

,+, &,0

*'. '',

&,0, '0000


40/45

++' '&9

&,0, '00

R$ 0!

Total .

&+' .90

&99 ''0

'*. '0

9 &'0&

'+0 *9*

&,0, '00

R$ 0!

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*+0' 9&++

&0.

,0 '90

*,9 '00


41/45

RW 09

Total D

&& ,9'

0 0

', '&

' 0*

& 0,&

& 0,&

0 0

&*+ .+',&,. '00

RW 09

Total .

265 !532

'* ++,

&,. '0000


42/45

RW 09

Total D

+ *0,,

9 9&*

'* '00

R$ 0!

Total .

,& &,',

'9* ,&.*

& '00

R$ 0!

Total .

'0 +000

.9 **.


43/45

,0 &+&

& '00


44/45

No UMUR R

01 02 03 04 05

' 0 *+ &. ., ''' *&

& &'& & '. & &

* &*0 + , . , '++ *'* + * 9 '

*+0 0 & 0 & '

+'+ 0 ' 0 0 0

, +0 0 0 0 0 0

. ' 0 ' 0 0 0

9 0 0 0 0 0 0

'0 ' 0 0 0 0 0

'' ,0 0 0 ' 0 0

'& -,0 0 0 ' 0 0

' %&0 *9 +* . 9. *&& &'& . * &* &+ +

* &*0 '* ' & &. 9

+ *'* '* '+ & & 9

*+0 '& '0 '9 '9 9

+'+ + 9 '0 &+

, +0 * + '' '0 '0

. ' * * ,

9 0 ' * * &

'0 ' ' + & ' 0

'' ,0 ' 0 & ' ''& -,0 * ' 0 ' 0

"umla# '+9 '* *+' *9' '*,

"enisKelamin

LakiLaki

!erempuan


45/45

T R$ 0!

06 07 0 0! 10 Total .

&. + . ''9 , + &++

'0 , '. & , '&& +'

'+ '+ &' ' ''0 +0, , * * + ',0

' ' ' 0 * '' 0+'

0 0 ' 0 0 & 00,

0 0 0 0 0 0 000

0 0 ' 0 0 & 00,

0 ' 0 0 0 ' 00+

0 ' 0 0 0 ' 00+

0 0 0 0 0 ' 00+

0 0 0 0 0 ' 00+

&. .+ , ''+ , &+' & ' +, '. ',* *9

'& && &. *0 &0 &0* ,0

, & &0 *0 ' '. .+

, '9 &0 &, ' '. .+

9 '* &' ' '' +&9

* ' ', '* 9& *+0

* '* 9 '0 + &*,

& * *, '*,

& & ' & & ', 0*

0 ' ' ' '* 0+.0 & * &' 0,.

'&+ *0+ **' +.* &9* &,0 '00

identitas keluarga (version 1)

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