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LAPORAN HASIL IMUNISASI BAYI KOTA AMBON

Puskesmas : Benteng
Bulan / Tahun : Juni/ 2016

Nama BAYI YANG DI IMUNISASI BOST


HBO BCG Polio 1 DPT/ Hb1 Polio 2 DPT/ Hb2 Polio 3 DPT/ Hb3 Polio 4 Campak DPT/Hib
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

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
KELURAHAN BENTENG 389

1 MUTIARA I 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 1 1 0
2 MUTIARA II 2 0 2 0 0 0 0 0 0 0 1 1 1 1 2 1 0 1 0 0 0 0 0 0 1 0 1 3 1 4 0
3 MUTIARA III 0 0 0 2 0 2 1 0 1 1 0 1 2 0 2 3 0 3 2 0 2 0 1 1 1 3 4 1 2 3 1
4 MUTIARA IV 1 0 1 0 0 0 1 0 1 1 0 1 1 0 1 2 2 4 1 2 3 0 1 1 0 1 1 0 0 0 1
5 MUTIARA V 4 4 8 1 0 1 1 1 2 3 2 5 3 1 4 1 1 2 1 1 2 2 0 2 2 0 2 0 4 4 0
6 MUTIARA VI 2 4 6 1 1 2 1 1 2 3 1 4 3 2 5 1 0 1 1 0 1 0 1 1 0 0 0 3 1 4 3
7 MUTIARA VII 0 2 2 2 0 2 2 0 2 3 0 3 3 2 5 1 2 3 1 1 2 0 2 2 0 1 1 3 3 6 1
8 MUTIARA VIII 1 5 6 0 3 3 0 2 2 2 2 4 3 2 5 2 1 3 6 1 7 5 0 5 0 1 1 3 4 7 1
9 MUTIARA IX 3 2 5 0 0 0 0 0 0 1 1 2 1 4 5 0 4 4 0 2 2 2 1 3 2 0 2 0 3 3 0
10 MUTIARA X 2 3 5 0 2 2 0 2 2 1 0 1 1 0 1 0 0 0 0 0 0 0 1 1 0 3 3 1 2 3 0
11 MUTIARA XI 1 1 2 0 1 1 0 1 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 2 0 1 1 0
12 MUTIARA XII 3 0 3 2 0 2 2 0 2 0 1 1 0 1 1 1 1 2 2 1 3 1 1 2 1 2 3 4 0 4 0
13 MUTIARA XIII 1 0 1 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 1 1 0
14 GERHANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 1 0 1 0
15 GELATIK 0 0 0 0 0 0 0 0 0 1 1 2 2 1 3 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0
16 TOTAL 21 22 43 8 7 15 8 7 15 16 10 26 20 15 35 13 11 24 15 9 24 11 9 20 9 12 21 19 24 43 7
17 KUMULATIF 227 122 109 115 116 109 81 103 52 235
18 % 58,35 31,36 28,02 29,56 29,82 28,09 20,82 26,47 13,36 60,41 14,65
Nama BAYI YANG DI IMUNISASI BOST
HBO BCG Polio 1 DPT/ Hb1 Polio 2 DPT/ Hb2 Polio 3 DPT/ Hb3 Polio 4 Campak DPT/ Hib
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

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
KELURAHAN WAINITU 238

1 BERINGIN I 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
2 BERINGIN II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 2 1 0 1 0 0 0 0 0 0 1 0 1 0
3 BERINGIN III 0 0 0 0 0 0 0 0 0 1 0 1 1 1 2 0 1 1 0 1 1 0 2 2 0 1 1 2 1 3 0
4 BERINGIN IV 1 0 1 0 0 0 0 0 0 2 0 2 2 0 2 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0
5 BERINGIN V 0 0 0 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
6 BERINGIN VI 2 2 4 0 1 1 2 0 2 2 1 3 3 2 5 3 1 4 2 2 4 2 2 4 0 1 1 0 1 1 0
7 BERINGIN VII 3 1 4 2 1 3 3 1 4 0 0 0 0 1 1 0 2 2 1 2 3 2 1 3 1 1 2 3 1 4 0
8 BERINGIN VIII 0 0 0 0 0 0 0 0 0 2 1 3 2 1 3 0 0 0 1 0 1 1 0 1 0 0 0 0 1 1 0
9 BERINGIN IX 0 0 0 0 0 0 1 0 1 1 0 1 0 1 1 0 1 1 0 0 0 3 0 3 3 0 3 0 0 0 0
10 TOTAL 6 4 10 2 3 5 6 2 8 8 2 10 8 7 15 4 6 10 6 5 11 8 5 13 4 3 7 6 4 10 0
11 KUMULATIF 86 45 39 42 39 33 26 34 21 76
12 % 36,13 18,90 16,38 17,64 16,38 13,86 10,92 14,28 8,82 31,93 10,50

Mengetahui Ambon, 30 Juni 2016


Pimpinan Puskesmas Korim Puskesmas

drg. V. Leatemia Zubaidah Latif A.Mk


Nip 19600226 199011 2001 Nip 19821106 200604 2016
BOSTER
IDL
DPT/Hib Campak
P Jml L P Jml L P Jml

35 36 37 38 39 40 41 42

0 0 0 0 0 0 1 1
1 1 0 0 0 1 1 2
0 1 0 0 0 1 1 2
0 1 0 0 0 0 0 0
0 0 0 0 0 0 4 4
0 3 0 0 0 2 1 3
1 2 0 0 0 3 2 5
1 2 0 0 0 3 3 6
0 0 0 0 0 0 3 3
0 0 0 0 0 1 2 3
0 0 0 0 0 0 1 1
1 1 0 0 0 2 0 2
0 0 0 0 0 0 1 1
0 0 0 0 0 1 0 1
1 1 0 0 0 0 1 1
5 12 0 0 0 14 21 34
57 0 172
14,65 0 44,21
BOSTER
IDL
DPT/ Hib Campak
P Jml L P Jml L P Jml

35 36 37 38 39 40 41 42

0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1
0 0 0 0 0 2 1 3
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
2 2 0 0 0 0 1 1
2 2 0 0 0 2 1 3
0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0
4 4 0 0 0 5 4 9
25 0 67
10,50 0 28,15

6
LAPORAN HASIL IMUNISASI TT

Puskesmas : Benteng
Bulan / Tahun : Juni / 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
Abs % Abs % Abs % Abs % Abs % Abs % Abs % Abs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

KELURAHAN BENTENG 428

1 MUTIARA I 0 2 0 0 0
2 MUTIARA II 1 2 1 0 0
3 MUTIARA III 1 0 0 0 0
4 MUTIARA IV 0 1 0 0 0
5 MUTIARA V 2 5 0 1 1
6 MUTIARA VI 1 0 0 0 0
7 MUTIARA VII 2 0 2 0 1
8 MUTIARA VIII 0 1 0 1 0
9 MUTIARA IX 0 0 0 0 0
10 MUTIARA X 0 2 1 3 0
11 MUTIARA XI 1 2 0 1 0
12 MUTIARA XII 3 4 1 0 1
13 MUTIARA XIII 0 2 1 0 0
14 GERHANA 1 0 0 1 0
15 GELATIK 1 1 1 0 0
16 TOTAL 13 22 7 7 3
17 KUMULATIF 125 29,20 122 28,50 60 14,01 34 7,94 24 5,60
IMUNISASI BUMIL STATUS IMUNISASI WUS
NO POSYANDU SASARAN TT - 1 TT - 2 TT - 3 TT - 4 TT - 5 TT - 1 TT - 2 TT - 3
Abs % Abs % Abs % Abs % Abs % Abs % Abs % Abs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

KELURAHAN WAINITU 262

1 BERINGIN I 1 1 1 1 1
2 BERINGIN II 3 0 1 1 0
3 BERINGIN III 2 0 1 1 0
4 BERINGIN IV 2 0 0 0 0
5 BERINGIN V 0 2 1 1 0
6 BERINGIN VI 0 0 0 0 0
7 BERINGIN VII 0 0 0 0 0
8 BERINGIN VIII 0 1 0 0 0
9 BERINGIN IX 1 0 0 0 0
10 TOTAL 9 4 4 4 1
11 KUMULATIF 39 14,88 34 12,97 20 7,63 18 6,87 8 3,05

Mengetahui Ambon, 30 Juni 2016


Pimpinan Puskesmas Benteng Korim Puskesmas

drg. V. Leatemia Zubaidah Latif A.Mk


Nip 1960-226 199011 2001 Nip 19821106 200604 2016
ASI WUS
TT - 3 JUMLAH KET
% WUS
19 20 21
ASI WUS
TT - 3 JUMLAH KET
% WUS
19 20 21

2016
mas

A.Mk
604 2016
LAPORAN KEJADIAN IKUTAN PASCA IMUNISASI ( KIPI )

Puskesmas : Benteng
Bulan / Tahun : JUNI/ 2016

NO IDENTITAS KASUS DI DUGA KIPI IMUNISASI YANG DIDAPAT KRONOLOGI


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

Ambon, 30 Juni 2016


Mengetahui
Pimpinan Puskesmas Benteng

drg. V. Leatemia
Nip 1960-226 199011 2001
N IKUTAN PASCA IMUNISASI ( KIPI )

KETERANGAN

Mengetahui
Pimpinan Puskesmas Benteng

drg. V. Leatemia
Nip 1960-226 199011 2001