P1 P2 P3 Program Puskesmas Sukorambi Bulan Januari Juli 2016

1. Nama Program

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2. Nama Pemegang Program

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3. Perencanaan (P1)
a. Data Umum apa saja yang dibutuhkan untuk perencaan program
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b. Data khusus apa saja yang diutuhkan untuk perencanaan program
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C. RUK ( Rincian Usulan Kegiatan )
UPAYA
KESEHATAN
GENERIK

KEGIATA
N

TUJUAN

SASAR
AN

TARG
ET

KEBUTUHAN SUMBER DAYA

DANA

d. RPK (Rincian Pelaksanaan Kegiatan)

ALAT

TENAGA

INDIKATOR
KEBERHASI
LAN

SUMBER
PEMBIAYAA
N

UPAYA
KESEHATAN
GENERIK

SASARAN

TARGET

VOLUME
KEGIATA
N

RINCIAN
PELAKSAN
AAN

LOKASI

TENAGA

4. Penggerakan Pelaksanaan (P2)

a. Bagaimana Pencapaian Kegiatan pada program ?
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b. Apa saja masalah yang dihadapi ?
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JADWAL

SUMBER
PEMBIAYA
AN

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c. Rencana tindak lanjut untuk masalah yang dihadapi
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5. Pengawasan Pengendalian Penilaian (P3)
NO

Jenis Kegiatan

Hasil Cakupan
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