LAPORAN HASIL IMUNISASI BAYI KOTA AMBON

Puskesmas : Benteng
Bulan / Tahun : Februari/ 2016

Nama BAYI YANG DI IMUNISASI BOSTER

IDL
HBO BCG Polio 1 DPT/ Hb1 Polio 2 DPT/ Hb2 Polio 3 DPT/ Hb3 Polio 4 Campak DPT/Hib Campak
No Posyandu Sasaran
L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml

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 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
KELURAHAN BENTENG 389

1 MUTIARA I 1 0 1 0 0 0 0 1 1 1 1 2 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 1 1 2 0 0 0 0 0 0 1 0 1
2 MUTIARA II 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 1 3 0 0 0 0 0 0 2 0 2
3 MUTIARA III 1 0 1 2 0 2 0 0 0 0 1 1 0 0 0 2 4 6 0 0 0 1 1 2 0 0 0 2 1 3 1 2 3 0 0 0 2 1 3
4 MUTIARA IV 1 1 2 1 0 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 1 2 0 0 0 2 1 3 1 2 3 0 0 0 2 0 2
5 MUTIARA V 1 1 2 2 2 4 1 0 1 0 1 1 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 2 2 4 0 1 1 0 0 0 2 0 2
6 MUTIARA VI 1 1 2 0 0 0 0 0 0 1 2 3 0 0 0 1 1 2 0 0 0 1 1 2 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1
7 MUTIARA VII 4 5 9 2 3 5 1 0 1 1 2 3 0 0 0 1 1 2 0 0 0 2 0 2 0 0 0 2 2 4 1 0 1 0 0 0 1 1 2
8 MUTIARA VIII 6 5 11 3 3 6 0 0 0 1 0 1 0 0 0 1 2 3 0 0 0 2 2 4 0 0 0 3 4 7 0 1 1 0 0 0 0 1 1
9 MUTIARA IX 3 1 4 3 2 5 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 3 3 0 0 0 1 2 3 2 3 5 0 0 0 0 0 0
10 MUTIARA X 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 2 0 0 0 0 0 0 0 1 1
11 MUTIARA XI 0 0 0 0 1 1 0 0 0 1 1 2 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 1 3 4 2 0 2 0 0 0 1 1 2
12 MUTIARA XII 1 0 1 0 1 1 0 1 1 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 0 0 0 1 1 2
13 MUTIARA XIII 1 1 2 1 0 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 3 3 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1
14 GERHANA 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 0 0 0 0 0 0 1 0 1 0 2 2 0 0 0 0 0 0
15 GELATIK 1 1 2 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 2 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0
16 TOTAL 22 18 40 16 12 28 2 2 4 6 11 17 0 0 0 10 14 24 0 0 0 11 15 26 0 0 0 22 19 41 7 11 18 0 0 0 14 6 20
17 KUMULATIF 70 44 10 34 17 44 12 40 10 74 31 0 44
18 % 17,99 11,31 2,57 8,74 4,37 11,31 3,08 10,28 2,57 19,02 7,96 0 11,31
 Nama BAYI YANG DI IMUNISASI BOSTER
IDL
HBO BCG Polio 1 DPT/ Hb1 Polio 2 DPT/ Hb2 Polio 3 DPT/ Hb3 Polio 4 Campak DPT/ Hib Campak
No Posyandu Sasaran
L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml L P Jml

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 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
KELURAHAN WAINITU 238

1 BERINGIN I 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
2 BERINGIN II 2 1 3 0 1 1 0 1 1 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
3 BERINGIN III 1 1 2 0 0 0 0 0 0 2 0 2 3 1 4 2 1 3 2 0 2 1 0 1 2 0 2 2 3 5 0 0 0 0 0 0 2 4 6
4 BERINGIN IV 0 0 0 0 0 0 0 0 0 1 0 1 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
5 BERINGIN V 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 1 0 1 0 0 0 0 0 0
6 BERINGIN VI 3 3 6 3 2 5 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 2 3 5 1 2 3 0 0 0 2 3 5
7 BERINGIN VII 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 1 0 1 0 0 0 0 1 1 0 1 1 0 0 0 0 1 1
8 BERINGIN VIII 0 0 0 0 0 0 0 0 0 1 1 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 2 3 0 0 0 0 0 0 1 1 2
9 BERINGIN IX 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 0 0 0 1 1 2
10 TOTAL 8 7 15 3 3 6 0 1 1 5 1 6 3 2 5 3 3 6 2 0 2 2 1 3 2 0 2 6 10 16 2 3 5 0 0 0 6 10 16
11 KUMULATIF 31 14 3 11 5 11 4 6 7 24 17 0 22
12 % 13,02 5,88 1,26 4,62 2,10 4,62 1,68 2,52 2,94 10,08 7,14 0 9,24

Ambon, 4 Maret 2016

Mengetahui
Pimpinan Puskesmas Korim Puskesmas

drg. V. Leatemia Zubaidah Latif A.Mk

Nip 19600226 199011 2001 Nip 19821106 200604 2016
s
 LAPORAN HASIL IMUNISASI TT

Puskesmas : Benteng
Bulan / Tahun : Februari / 2016

IMUNISASI BUMIL STATUS IMUNISASI WUS

NO POSYANDU SASARAN TT - 1 TT - 2 TT - 3 TT - 4 TT - 5 TT - 1 TT - 2 TT - 3 JUMLAH KET
Abs % Abs % Abs % Abs % Abs % Abs % Abs % Abs % WUS
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

KELURAHAN BENTENG 428

1 MUTIARA I 1 1 0 0 0
2 MUTIARA II 1 1 0 1 0
3 MUTIARA III 2 1 1 0 1
4 MUTIARA IV 0 1 0 2 0
5 MUTIARA V 5 4 0 2 0
6 MUTIARA VI 2 0 0 0 0
7 MUTIARA VII 0 2 2 0 0
8 MUTIARA VIII 1 2 0 0 1
9 MUTIARA IX 0 2 2 0 0
10 MUTIARA X 2 2 0 0 0
11 MUTIARA XI 0 0 3 0 0
12 MUTIARA XII 5 2 0 2 2
13 MUTIARA XIII 2 2 0 0 0
14 GERHANA 1 0 0 0 0
15 GELATIK 0 0 0 0 1
16 TOTAL 22 20 8 7 5
17 KUMULATIF 42 9,81 30 7,00 17 3,97 13 3,03 9 2,10
18
 IMUNISASI BUMIL STATUS IMUNISASI WUS
NO POSYANDU SASARAN TT - 1 TT - 2 TT - 3 TT - 4 TT - 5 TT - 1 TT - 2 TT - 3 JUMLAH KET
Abs % Abs % Abs % Abs % Abs % Abs % Abs % Abs % WUS
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

KELURAHAN WAINITU 262

1 BERINGIN I 2 2 0 0 0
2 BERINGIN II 0 1 0 0 0
3 BERINGIN III 0 1 0 2 0
4 BERINGIN IV 1 0 0 1 1
5 BERINGIN V 1 1 0 0 0
6 BERINGIN VI 0 0 1 0 0
7 BERINGIN VII 0 2 1 0 0
8 BERINGIN VIII 2 0 0 0 0
9 BERINGIN IX 1 1 0 0 0
10 TOTAL 7 8 2 3 1
11 KUMULATIF 15 5,72 12 4,58 6 2,29 5 1,90 2 0,76
12

Ambon, 4 Maret 2016

Mengetahui
Pimpinan Puskesmas Benteng Korim Puskesmas

drg. V. Leatemia Zubaidah Latif A.Mk

Nip 1960-226 199011 2001 Nip 19821106 200604 2016
 LAPORAN KEJADIAN IKUTAN PASCA IMUNISASI ( KIPI )

Puskesmas : Benteng
Bulan / Tahun : Februari / 2016

NO IDENTITAS KASUS DI DUGA KIPI IMUNISASI YANG DIDAPAT KRONOLOGI

NAMA TGL NAMA SINGKAT YG DI KETERANGAN
ALAMAT JENIS PELAKSANAAN TANGGAL NO BATH
ANAK LAHIR/UMUR ORANG TUA ALAMI PENDERITA

Ambon, 4 Maret 2016

Mengetahui
Pimpinan Puskesmas Benteng

drg. V. Leatemia
Nip 1960-226 199011 2001