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DISTRIBUSI VAKSIN KE PUSKESMAS BULAN OKTOBER 2017

NO TGL PUSKESMAS BCG POLIO IPV Td MR Rutin COMBO HB UNJ


1 10/2/2017 Pasekan 30 40 10 40 0 40 0
2 10/2/2017 Jatibarang 20 30 0 10 20 30 0
3 10/2/2017 Gantar 20 50 0 20 0 50 50
4 10/4/2017 Cipancuh 20 20 0 0 0 30 0
5 10/5/2017 Wanakaya 10 20 10 0 0 20 0
6 10/5/2017 Krangkeng 20 50 0 40 0 50 0
7 10/5/2017 Cemara 40 50 0 40 0 50 30
8 10/5/2017 Jatisawit 10 30 10 10 0 30 0
9 10/5/2017 Terisi 50 100 0 50 0 100 50
10 10/5/2017 Bd.Hj Maemunah 0 10 0 10 5 10 10
11 10/5/2017 Margadadi 20 50 15 20 20 80 100
12 10/6/2017 Tugu 20 40 0 20 30 40 40
13 10/6/2017 Balongan 20 50 10 30 0 50 100
14 10/6/2017 Sindang 10 50 10 0 0 50 50
15 10/6/2017 BPS Hj Cartini 0 10 0 10 0 0 0
16 10/6/2017 Patrol 40 80 10 0 0 40 100
17 10/9/2017 Anjatan 20 50 4 20 0 40 50
18 10/9/2017 Bugis 30 50 10 30 30 60 70
19 10/9/2017 Gabus Wetan 30 50 10 20 30 50 50
20 10/9/2017 Juntinyuat 30 80 10 20 0 70 50
21 10/9/2017 Sidamulya 30 40 5 40 0 40 40
22 10/9/2017 Cidempet 20 30 5 30 0 30 50
23 10/9/2017 Kandanghaur 30 30 10 0 0 50 50
24 10/9/2017 Kroya 30 50 0 50 0 50 50
25 10/10/2017 Pasekan 0 0 0 0 40 0 0
26 10/12/2017 Kedokan bunder 20 50 0 20 20 60 0
27 10/11/2017 Tambi 30 30 10 10 0 30 50
28 10/11/2017 Karangampel 15 40 10 30 0 60 50
29 10/11/2017 Sukagumiwang 20 40 7 40 0 30 50
30 10/12/2017 Temiyang 30 60 0 30 0 50 0
31 10/12/2017 Widasari 10 50 10 40 0 50 50
32 10/12/2017 Haurgeulis 40 70 30 0 50 70 50
33 10/12/2017 Drunten Wetan 20 30 0 20 20 30 50
34 10/12/2017 Kertasemaya 20 60 10 30 30 50 100
35 10/13/2017 Kertawinangun 30 20 20 0 0 40 40
36 10/13/2017 Bongas 50 80 40 50 50 80 80
37 10/16/2017 Sliyeg 0 30 0 20 0 30 0
38 10/16/2017 Kiajaran Wetan 20 40 0 20 0 30 0
39 10/16/2017 RSUD Indramayu 0 0 0 0 0 0 200
40 10/18/2017 Kedungwungu 20 30 10 30 0 30 20
41 10/18/2017 Sukagumiwang 0 0 0 0 50 0 0
42 10/18/2017 Losarang 30 60 0 30 0 60 20
43 10/19/2017 Bangodua 30 0 0 20 0 30 20
44 10/19/2017 Kerticala 30 40 5 30 0 40 100
45 10/19/2017 RSUD. Pantura 0 40 0 0 0 0 200
46 10/19/2017 Lohbener 10 50 10 20 0 50 100
47 10/19/2017 Cikedung 40 50 7 50 20 50 50
48 10/19/2017 Pondoh 15 40 0 0 0 40 20
49 10/23/2017 RS Bhayangkara Im 10 10 5 10 10 20 50
50 10/25/2017 Plumbon 20 50 10 20 30 50 0
51 10/25/2017 Lelea 50 20 5 20 0 50 0
52 10/30/2017 Balongan 20 50 10 0 0 50 0
53 10/30/2017 Temiyang 10 50 10 20 0 50 0
54
55
56
57
58

JUMLAH 1,140 2,150 338 1,070 455 2,190 2,240


PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
BCG
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Dosis
Masuk Keluar No Batch Ex.Date KUM VVM
Sisa Des 16 037G5164 Mar-17 5170 A 20
1 1/4/2017 Jatisawit 20 " " 5150
2 1/4/2017 Balongan 20 " " 5130
3 1/4/2017 Karangampel 10 " " 5120
4 1/4/2017 Temiyang 30 " " 5090
5 1/4/2017 Tambi 30 " " 5060
6 1/4/2017 Babadan 30 " " 5030
7 1/5/2017 Tugu 20 " " 5010
8 1/5/2017 Anjatan 30 " " 4980
9 1/5/2017 Kertasemaya 20 " " 4960
10 1/5/2017 Cipancuh 30 " " 4930
11 1/5/2017 Jatibarang 10 " " 4920
12 1/5/2017 Sliyeg 20 " " 4900
13 1/5/2017 Sukra 30 " " 4870
14 1/5/2017 Bugis 30 " " 4840
15 1/6/2017 Pasekan 30 " " 4810
16 1/6/2017 Sidamulya 40 " " 4770
17 1/9/2017 Sukagumiwang 20 " " 4750
18 1/9/2017 Sindang 10 " " 4740
19 1/9/2017 Gabus Wetan 30 " " 4710
20 1/9/2017 Juntinyuat 30 " " 4680
21 1/9/2017 Margadadi 20 " " 4660
22 1/9/2017 Kedokan bunder 20 " " 4640
23 1/9/2017 Patrol 40 " " 4600
24 1/9/2017 Cikedung 20 " " 4580
25 1/9/2017 Terisi 70 " " 4510
26 1/9/2017 RS PMC Indramayu 10 " " 4500
27 1/10/2017 Kiajaran Wetan 20 " " 4480
28 1/10/2017 Losarang 0 " " 4480
29 1/10/2017 Drunten Wetan 0 " " 4480
30 1/10/2017 Widasari 10 " " 4470
31 1/10/2017 dr.Rizal, Sp.A 20 " " 4450
32 1/10/2017 Kertawinangun 30 " " 4420
33 1/10/2017 Bongas 20 " " 4400
34 1/11/2017 Babadan II 30 " " 4370
35 1/11/2017 Cidempet 20 " " 4350
36 1/11/2017 Kandanghaur 60 " " 4290
37 1/12/2017 Tukdana 30 " " 4260
38 1/12/2017 Pondoh 30 " " 4230
39 1/12/2017 Kedungwungu 20 " " 4210
40 1/16/2017 Kerticala 0 " " 4210
41 1/16/2017 Krangkeng 20 " " 4190
42 1/17/2017 RB Ratu Adelin 0 " " 4190
43 1/19/2017 Balongan 0 " " 4190
44 1/19/2017 Haurgeulis 50 " " 4140
45 1/23/2017 Cantigi 10 " " 4130
46 1/25/2017 Cemara 40 " " 4090
47 1/25/2017 RSP. Balongan 20 " " 4070

JUMLAH 1100 4070 A 20

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
POLIO
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Dosis
Masuk Keluar No Batch Ex.Date KUM VVM
Sisa Des 16 2052716 May-18 5660 A 10
1 1/4/2017 Jatisawit 30 " " 5630
2 1/4/2017 Balongan 50 " " 5580
3 1/4/2017 Karangampel 50 " " 5530
4 1/4/2017 Temiyang 60 " " 5470
5 1/4/2017 Tambi 20 " " 5450
6 1/4/2017 Babadan 0 " " 5450
7 1/5/2017 Tugu 40 " " 5410
8 1/5/2017 Anjatan 40 " " 5370
9 1/5/2017 Kertasemaya 50 " " 5320
10 1/5/2017 Cipancuh 30 " " 5290
11 1/5/2017 Jatibarang 70 " " 5220
12 1/5/2017 Sliyeg 50 " " 5170
13 1/5/2017 Sukra 50 " " 5120
14 1/5/2017 Bugis 60 " " 5060
15 1/6/2017 Pasekan 40 " " 5020
16 1/6/2017 Sidamulya 40 " " 4980
17 1/9/2017 Sukagumiwang 40 " " 4940
18 1/9/2017 Sindang 50 " " 4890
19 1/9/2017 Gabus Wetan 50 " " 4840
20 1/9/2017 Juntinyuat 50 " " 4790
21 1/9/2017 Margadadi 80 " " 4710
22 1/9/2017 Kedokan bunder 50 " " 4660
23 1/9/2017 Patrol 80 " " 4580
24 1/9/2017 Cikedung 20 " " 4560
25 1/9/2017 Terisi 100 " " 4460
26 1/9/2017 RS PMC Indramayu 10 " " 4450
27 1/10/2017 Kiajaran Wetan 40 " " 4410
28 1/10/2017 Losarang 60 " " 4350
29 1/10/2017 Drunten Wetan 30 " " 4320
30 1/10/2017 Widasari 60 " " 4260
31 1/10/2017 dr.Rizal, Sp.A 30 " " 4230
32 1/10/2017 Kertawinangun 40 " " 4190
33 1/10/2017 Bongas 40 " " 4150
34 1/11/2017 Babadan II 50 " " 4100
35 1/11/2017 Cidempet 30 " " 4070
36 1/11/2017 Kandanghaur 70 " " 4000
37 1/12/2017 Tukdana 30 " " 3970
38 1/12/2017 Pondoh 40 " " 3930
39 1/12/2017 Kedungwungu 20 " " 3910
40 1/16/2017 Kerticala 0 " " 3910
41 1/16/2017 Krangkeng 50 " " 3860
42 1/17/2017 RB Ratu Adelin 0 " " 3860
43 1/19/2017 Balongan 0 " " 3860
44 1/19/2017 Haurgeulis 70 " " 3790
45 1/23/2017 Cantigi 10 " " 3780
46 1/25/2017 Cemara 50 " " 3730
47 1/25/2017 RSP. Balongan 10 " " 3720

JUMLAH 1940 3720 A 10

Mengetahui Pengelola Cold Chain


Kasie Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
IPV
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis
Sisa Des 16 IPU010A15 Nov-17 997 A 10
1 1/4/2017 Jatisawit 8 " " 989
2 1/4/2017 Balongan 10 " " 979
3 1/4/2017 Karangampel 8 " " 971
4 1/4/2017 Temiyang 5 " " 966
5 1/4/2017 Tambi 7 " " 959
6 1/4/2017 Babadan 5 " " 954
7 1/5/2017 Tugu 5 " " 949
8 1/5/2017 Anjatan 8 " " 941
9 1/5/2017 Kertasemaya 10 " " 931
10 1/5/2017 Cipancuh 40 " " 891
11 1/5/2017 Jatibarang 5 " " 886
12 1/5/2017 Sliyeg 8 " " 878
13 1/5/2017 Sukra 12 " " 866
14 1/5/2017 Bugis 13 " " 853
15 1/6/2017 Pasekan 7 " " 846
16 1/6/2017 Sidamulya 50 " " 796
17 1/9/2017 Sukagumiwang 0 " " 796
18 1/9/2017 Sindang 8 " " 788
19 1/9/2017 Gabus Wetan 8 " " 780
20 1/9/2017 Juntinyuat 9 " " 771
21 1/9/2017 Margadadi 10 " " 761
22 1/9/2017 Kedokan bunder 10 " " 751
23 1/9/2017 Patrol 10 " " 741
24 1/9/2017 Cikedung 7 " " 734
25 1/9/2017 Terisi 13 " " 721
26 1/9/2017 RS PMC Indramayu 0 " " 721
27 1/10/2017 Kiajaran Wetan 5 " " 716
28 1/10/2017 Losarang 8 " " 708
29 1/10/2017 Drunten Wetan 4 " " 704
30 1/10/2017 Widasari 0 " " 704
31 1/10/2017 dr.Rizal, Sp.A 0 " " 704
32 1/10/2017 Kertawinangun 10 " " 694
33 1/10/2017 Bongas 8 " " 686
34 1/11/2017 Babadan II 0 " " 686
35 1/11/2017 Cidempet 5 " " 681
36 1/11/2017 Kandanghaur 10 " " 671
37 1/12/2017 Tukdana 5 " " 666
38 1/12/2017 Pondoh 7 " " 659
39 1/12/2017 Kedungwungu 8 " " 651
40 1/16/2017 Kerticala 4 " " 647
41 1/16/2017 Krangkeng 0 " " 647
42 1/17/2017 RB Ratu Adelin 0 " " 647
43 1/19/2017 Balongan 0 " " 647
44 1/19/2017 Haurgeulis 7 " " 640
45 1/23/2017 Cantigi 50 " " 590
46 1/25/2017 Cemara 40 " " 550
47 1/25/2017 RSP. Balongan 0 " " 550

JUMLAH 447 IPU010A15 Nov-17 550 10

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
Td
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis
Sisa Des 16 410416 Feb-19 5880 A 10
1 1/4/2017 Jatisawit 20 " " 5860
2 1/4/2017 Balongan 20 " " 5840
3 1/4/2017 Karangampel 20 " " 5820
4 1/4/2017 Temiyang 30 " " 5790
5 1/4/2017 Tambi 40 " " 5750
6 1/4/2017 Babadan 0 " " 5750
7 1/5/2017 Tugu 10 " " 5740
8 1/5/2017 Anjatan 0 " " 5740
9 1/5/2017 Kertasemaya 30 " " 5710
10 1/5/2017 Cipancuh 30 " " 5680
11 1/5/2017 Jatibarang 10 " " 5670
12 1/5/2017 Sliyeg 20 " " 5650
13 1/5/2017 Sukra 30 " " 5620
14 1/5/2017 Bugis 0 " " 5620
15 1/6/2017 Pasekan 40 " " 5580
16 1/6/2017 Sidamulya 0 " " 5580
17 1/9/2017 Sukagumiwang 30 " " 5550
18 1/9/2017 Sindang 10 " " 5540
19 1/9/2017 Gabus Wetan 0 " " 5540
20 1/9/2017 Juntinyuat 40 " " 5500
21 1/9/2017 Margadadi 20 " " 5480
22 1/9/2017 Kedokan bunder 30 " " 5450
23 1/9/2017 Patrol 0 " " 5450
24 1/9/2017 Cikedung 0 " " 5450
25 1/9/2017 Terisi 0 " " 5450
26 1/9/2017 RS PMC Indramayu 50 " " 5400
27 1/10/2017 Kiajaran Wetan 20 " " 5380
28 1/10/2017 Losarang 30 " " 5350
29 1/10/2017 Drunten Wetan 20 " " 5330
30 1/10/2017 Widasari 50 " " 5280
31 1/10/2017 dr.Rizal, Sp.A 0 " " 5280
32 1/10/2017 Kertawinangun 0 " " 5280
33 1/10/2017 Bongas 0 " " 5280
34 1/11/2017 Babadan II 0 " " 5280
35 1/11/2017 Cidempet 20 " " 5260
36 1/11/2017 Kandanghaur 10 " " 5250
37 1/12/2017 Tukdana 30 " " 5220
38 1/12/2017 Pondoh 40 " " 5180
39 1/12/2017 Kedungwungu 20 " " 5160
40 1/16/2017 Kerticala 40 " " 5120
41 1/16/2017 Krangkeng 20 " " 5100
42 1/17/2017 RB Ratu Adelin 0 " " 5100
43 1/19/2017 Balongan 0 " " 5100
44 1/19/2017 Haurgeulis 0 " " 5100
45 1/23/2017 Cantigi 10 " " 5090
46 1/25/2017 Cemara 0 " " 5090
47 1/25/2017 RSP. Balongan 0 " " 5090

JUMLAH 790 410416 Feb-19 5090 A 10

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
CPK
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Dosis
Masuk Keluar No Batch Ex.Date KUM VVM
Sisa Des 16 2530915 Jun-18 4250 A 10
1 1/4/2017 Jatisawit 20 " " 4230
2 1/4/2017 Balongan 20 " " 4210
3 1/4/2017 Karangampel 30 " " 4180
4 1/4/2017 Temiyang 30 " " 4150
5 1/4/2017 Tambi 20 " " 4130
6 1/4/2017 Babadan 0 " " 4130
7 1/5/2017 Tugu 20 " " 4110
8 1/5/2017 Anjatan 20 " " 4090
9 1/5/2017 Kertasemaya 50 " " 4040
10 1/5/2017 Cipancuh 30 " " 4010
11 1/5/2017 Jatibarang 20 " " 3990
12 1/5/2017 Sliyeg 20 " " 3970
13 1/5/2017 Sukra 30 " " 3940
14 1/5/2017 Bugis 20 " " 3920
15 1/6/2017 Pasekan 20 " " 3900
16 1/6/2017 Sidamulya 20 " " 3880
17 1/9/2017 Sukagumiwang 30 " " 3850
18 1/9/2017 Sindang 20 " " 3830
19 1/9/2017 Gabus Wetan 20 " " 3810
20 1/9/2017 Juntinyuat 30 " " 3780
21 1/9/2017 Margadadi 20 " " 3760
22 1/9/2017 Kedokan bunder 30 " " 3730
23 1/9/2017 Patrol 0 " " 3730
24 1/9/2017 Cikedung 20 " " 3710
25 1/9/2017 Terisi 50 " " 3660
26 1/9/2017 RS PMC Indramayu 10 " " 3650
27 1/10/2017 Kiajaran Wetan 40 " " 3610
28 1/10/2017 Losarang 20 " " 3590
29 1/10/2017 Drunten Wetan 20 " " 3570
30 1/10/2017 Widasari 40 " " 3530
31 1/10/2017 dr.Rizal, Sp.A 20 " " 3510
32 1/10/2017 Kertawinangun 30 " " 3480
33 1/10/2017 Bongas 20 " " 3460
34 1/11/2017 Babadan II 30 " " 3430
35 1/11/2017 Cidempet 20 " " 3410
36 1/11/2017 Kandanghaur 40 " " 3370
37 1/12/2017 Tukdana 30 " " 3340
38 1/12/2017 Pondoh 10 " " 3330
39 1/12/2017 Kedungwungu 20 " " 3310
40 1/16/2017 Kerticala 0 " " 3310
41 1/16/2017 Krangkeng 20 " " 3290
42 1/17/2017 RB Ratu Adelin 0 " " 3290
43 1/19/2017 Balongan 0 " " 3290
44 1/19/2017 Haurgeulis 50 " " 3240
45 1/23/2017 Cantigi 10 " " 3230
46 1/25/2017 Cemara 30 " " 3200
47 1/25/2017 RSP. Balongan 20 " " 3180

JUMLAH 1070 3180 A 10

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
COMBO
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis
Sisa Des 16 5043515 Oct-17 6450 A 5
1 1/4/2017 Jatisawit 40 " " 6410
2 1/4/2017 Balongan 70 " " 6340
3 1/4/2017 Karangampel 70 " " 6270
4 1/4/2017 Temiyang 50 " " 6220
5 1/4/2017 Tambi 50 " " 6170
6 1/4/2017 Babadan 0 " " 6170
7 1/5/2017 Tugu 30 " " 6140
8 1/5/2017 Anjatan 40 " " 6100
9 1/5/2017 Kertasemaya 70 " " 6030
10 1/5/2017 Cipancuh 30 " " 6000
11 1/5/2017 Jatibarang 70 " " 5930
12 1/5/2017 Sliyeg 50 " " 5880
13 1/5/2017 Sukra 50 " " 5830
14 1/5/2017 Bugis 60 " " 5770
15 1/6/2017 Pasekan 40 " " 5730
16 1/6/2017 Sidamulya 40 " " 5690
17 1/9/2017 Sukagumiwang 40 " " 5650
18 1/9/2017 Sindang 50 " " 5600
19 1/9/2017 Gabus Wetan 30 " " 5570
20 1/9/2017 Juntinyuat 80 " " 5490
21 1/9/2017 Margadadi 80 " " 5410
22 1/9/2017 Kedokan bunder 20 " " 5390
23 1/9/2017 Patrol 80 " " 5310
24 1/9/2017 Cikedung 20 " " 5290
25 1/9/2017 Terisi 100 " " 5190
26 1/9/2017 RS PMC Indramayu 10 " " 5180
27 1/10/2017 Kiajaran Wetan 40 " " 5140
28 1/10/2017 Losarang 60 " " 5080
29 1/10/2017 Drunten Wetan 30 " " 5050
30 1/10/2017 Widasari 60 " " 4990
31 1/10/2017 dr.Rizal, Sp.A 20 " " 4970
32 1/10/2017 Kertawinangun 40 " " 4930
33 1/10/2017 Bongas 50 " " 4880
34 1/11/2017 Babadan II 50 " " 4830
35 1/11/2017 Cidempet 30 " " 4800
36 1/11/2017 Kandanghaur 70 " " 4730
37 1/12/2017 Tukdana 30 " " 4700
38 1/12/2017 Pondoh 50 " " 4650
39 1/12/2017 Kedungwungu 20 " " 4630
40 1/16/2017 Kerticala 40 " " 4590
41 1/16/2017 Krangkeng 50 " " 4540
42 1/17/2017 RB Ratu Adelin 0 " " 4540
43 1/19/2017 Balongan 0 " " 4540
44 1/19/2017 Haurgeulis 70 " " 4470
45 1/23/2017 Cantigi 10 " " 4460
46 1/25/2017 Cemara 40 " " 4420
47 1/25/2017 RSP. Balongan 20 " " 4400

JUMLAH 2050 5043515 Oct-17 4400 A 5

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jan-17
PENCATATAN STOCK VAKSIN
HB-Unj
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Dosis
Masuk Keluar No Batch Ex.Date KUM VVM
Sisa Des 16 3654515 Nov-17 7500 A 1
1 1/4/2017 Jatisawit 100 " " 7400
2 1/4/2017 Balongan 10 " " 7390
3 1/4/2017 Karangampel 50 " " 7340
4 1/4/2017 Temiyang 100 " " 7240
5 1/4/2017 Tambi 50 " " 7190
6 1/4/2017 Babadan 70 " " 7120
7 1/5/2017 Tugu 30 " " 7090
8 1/5/2017 Anjatan 50 " " 7040
9 1/5/2017 Kertasemaya 100 " " 6940
10 1/5/2017 Cipancuh 30 " " 6910
11 1/5/2017 Jatibarang 100 " " 6810
12 1/5/2017 Sliyeg 100 " " 6710
13 1/5/2017 Sukra 100 " " 6610
14 1/5/2017 Bugis 70 " " 6540
15 1/6/2017 Pasekan 100 " " 6440
16 1/6/2017 Sidamulya 30 " " 6410
17 1/9/2017 Sukagumiwang 50 " " 6360
18 1/9/2017 Sindang 50 " " 6310
19 1/9/2017 Gabus Wetan 20 " " 6290
20 1/9/2017 Juntinyuat 100 " " 6190
21 1/9/2017 Margadadi 100 " " 6090
22 1/9/2017 Kedokan bunder 50 " " 6040
23 1/9/2017 Patrol 100 " " 5940
24 1/9/2017 Cikedung 20 " " 5920
25 1/9/2017 Terisi 50 " " 5870
26 1/9/2017 RS PMC Indramayu 100 " " 5770
27 1/10/2017 Kiajaran Wetan 40 " " 5730
28 1/10/2017 Losarang 100 " " 5630
29 1/10/2017 Drunten Wetan 100 " " 5530
30 1/10/2017 Widasari 100 " " 5430
31 1/10/2017 dr.Rizal, Sp.A 10 " " 5420
32 1/10/2017 Kertawinangun 60 " " 5360
33 1/10/2017 Bongas 40 " " 5320
34 1/11/2017 Babadan II 30 " " 5290
35 1/11/2017 Cidempet 50 " " 5240
36 1/11/2017 Kandanghaur 100 " " 5140
37 1/12/2017 Tukdana 50 " " 5090
38 1/12/2017 Pondoh 40 " " 5050
39 1/12/2017 Kedungwungu 20 " " 5030
40 1/16/2017 Kerticala 30 " " 5000
41 1/16/2017 Krangkeng 100 " " 4900
42 1/17/2017 RB Ratu Adelin 100 " " 4800
43 1/19/2017 Balongan 100 " " 4700
44 1/19/2017 Haurgeulis 100 " " 4600
45 1/23/2017 Cantigi 0 " " 4600
46 1/25/2017 Cemara 30 " " 4570
47 1/25/2017 RSP. Balongan 0 " " 4570
48 22/1/2016 Haurgeulis 0 " " 4570
49 22/1/2016 Cipancuh 0 " " 4570
50 29/1/2016 Jatibarang 0 " " 4570

JUMLAH 2930 3654515 Nov-17 4570 A 1

Mengetahui Pengelola Cold Chain


Kasi. Surveilans Dan Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jul-17
PENCATATAN STOCK VAKSIN
MR
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis

7/13/2017 PROPINSI 20,000 012N6109 Nov-18 20000 A 10


7/25/2017 PROPINSI 10,108 012N6133 Nov-18 30108 A 10
1 7/27/2017 Kertasemaya 500 " " 29,608
2 7/28/2017 Temiyang 555 " " 29,053
3 7/28/2017 Karangampel 915 " " 28,138
4 7/28/2017 Lohbener 731 " " 27,407
5 7/28/2017 Sindang 637 " " 26,770
6 7/28/2017 Losarang 571 " " 26,199
7 7/28/2017 Bangodua 488 " " 25,711
8 7/28/2017 Margadadi 1,075 " " 24,636
9 7/28/2017 Gantar 958 " " 23,678
10 7/28/2017 Kedungwungu 795 " " 22,883
11 7/28/2017 Cipancuh 394 " " 22,489
12 7/28/2017 Tukdana 519 " " 21,970
13 7/28/2017 Cikedung 537 " " 21,433
14 7/28/2017 Balongan 668 " " 20,765
15 7/28/2017 Sidamulya 391 " " 20,374
16 7/28/2017 Widasari 608 " " 19,766
17 7/28/2017 Bugis 1,037 " " 18,729
18 7/29/2017 Pondoh 509 " " 18,220
19 7/29/2017 Anjatan 802 " " 17,418
20 7/29/2017 Cemara 418 " " 17,000
21 7/29/2017 Plumbon 963 " " 16,037
22 7/29/2017 Cidempet 621 " " 15,416
23 7/29/2017 Tambi 420 " " 14,996
24 7/29/2017 Juntinyuat 893 " " 14,103
25 7/29/2017 Krangkeng 590 " " 13,513
26 7/29/2017 Haurgeulis 706 " " 12,807
27 7/31/2017 Kerticala 489 " " 12,318
28 7/31/2017 Pasekan 505 " " 11,813
29 7/31/2017 Kroya 540 " " 11,273
30 7/31/2017 Kertawinangun 838 " " 10,435
31 7/31/2017 Sukagumiwang 532 " " 9,903
32 7/31/2017 Babadan 250 " " 9,653
33 7/31/2017 Cantigi 337 " " 9,316
34 7/31/2017 Jatisawit 480 " " 8,836
35 7/31/2017 Tugu 327 " " 8,509
36 7/31/2017 Lelea 400 " " 8,109
37 7/31/2017 Kandanghaur 900 " " 7,209
38 7/31/2017 Kaplongan 420 " " 6,789
39 7/31/2017 Jatibarang 1,010 " " 5,779
40 8/1/2017 Patrol 1,209 " " 4,570
41 8/1/2017 Terisi 970 " " 3,600
42 8/2/2017 Kiajaran Wetan 290 " " 3,310
43 8/2/2017 Gabus Wetan 423 " " 2,887
44 8/2/2017 Bongas 308 " " 2,579
45 8/2/2017 Sliyeg 395 " " 2,184
46 8/2/2017 Sukra 716 " " 1,468
47 8/3/2017 Drunten Wetan 250 " " 1,218
48 8/3/2017 Kedokan bunder 730 " " 488
49 8/4/2017 Wanakaya 445 " " 43
8/7/2017 PROPINSI 3,492 068S15378Z Aug-21 3,535

JUMLAH 3,492 30,065 3,535 A 10

Mengetahui Pengelola Cold Chain


Kasie Surveilans & Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Jul-17
PENCATATAN ALAT SUNTIK
MR
J U M L A H Sisa Kondisi
NO Tanggal Diterima Dipergunakan
dari di
Masuk Keluar No Batch Ex.Date KUM VVM

7/13/2017 PROPINSI 20,000 012N6109 Nov-18 20000 A


7/25/2017 PROPINSI 10,108 012N6133 Nov-18 30108 A
1 " " 30108
2 " " 30108
3 " " 30108
4 " " 30108
5 " " 30108
6 " " 30108
7 " " 30108
8 " " 30108
9 " " 30108
10 " " 30108
11 " " 30108
12 " " 30108
13 " " 30108
14 " " 30108
15 " " 30108
16 " " 30108
17 " " 30108
18 " " 30108
19 " " 30108
20 " " 30108
21 " " 30108
22 " " 30108
23 " " 30108
24 " " 30108
25 " " 30108
26 " " 30108
27 " " 30108
28 " " 30108
29 " " 30108
30 " " 30108
31 " " 30108
32 " " 30108
33 " " 30108
34 " " 30108
35 " " 30108
36 " " 30108
37 " " 30108
38 " " 30108
39 " " 30108
40 " " 30108
41 " " 30108
42 " " 30108
43 " " 30108
44 " " 30108
45 " " 30108
46 " " 30108
47 " " 30108
48 " " 30108
49 " " 30108
50 " " 30108
51 " " 30108

JUMLAH 0 30108 A

Mengetahui Pengelola Cold Chain


Kasie Surveilans & Imunisasi Kabupaten

H. MASHURI,SKM DWI PRANSTYONO, SKM


NIP:19620808 198302 1 006 NIP: 19660215 199003 1 010
MR
Dosis

10
10
10

Cold Chain

TYONO, SKM
5 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Oct-17
PENCATATAN STOCK VAKSIN
BIAS Td
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis

10/31/2016 PROPINSI 3770 "0412016 Jul-19 3,770 A 10


1 11/1/2017 Cipancuh 0 " " 3,770
2 11/1/2017 Jatisawit 60 " " 3,710
3 11/2/2017 Pasekan 50 " " 3,660
4 11/2/2017 Terisi 110 " " 3,550
5 11/2/2017 Sliyeg 60 " " 3,490
6 11/2/2017 Kertasemaya 130 " " 3,360
7 11/2/2017 Jatibarang 110 " " 3,250
8 11/2/2017 Cikedung 70 " " 3,180
9 11/6/2017 Plumbon 100 " " 3,080
10 11/6/2017 Tambi 50 " " 3,030
11 11/6/2017 Kedungwungu 70 " " 2,960
12 11/6/2017 Sukagumiwang 80 " " 2,880
13 11/6/2017 Tukdana 60 " " 2,820
14 11/6/2017 Balongan 100 " " 2,720
15 11/6/2017 Kiajaran Wetan 50 " " 2,670
16 11/6/2017 Patrol 130 " " 2,540
17 11/6/2017 Tugu 40 " " 2,500
18 11/6/2017 Gabus Wetan 90 " " 2,410
19 11/6/2017 Anjatan 80 " " 2,330
20 11/6/2017 Margadadi 140 " " 2,190
21 11/6/2017 Bongas 60 " " 2,130
22 11/6/2017 Sidamulya 60 " " 2,070
23 11/6/2017 Kedokan bunder 50 " " 2,020
24 11/6/2017 Babadan 70 " " 1,950
25 11/7/2017 Temiyang 70 " " 1,880
26 11/7/2017 Bugis 120 " " 1,760
27 11/7/2017 Wanakaya 60 " " 1,700
28 11/7/2017 Drunten Wetan 50 " " 1,650
29 11/7/2017 Cidempet 70 " " 1,580
30 11/7/2017 Kroya 70 " " 1,510
31 11/8/2017 Karangampel 100 " " 1,410
32 11/8/2017 Kandanghaur 90 " " 1,320
33 11/8/2017 Krangkeng 50 " " 1,270
34 11/9/2017 Gantar 130 " " 1,140
35 11/8/2017 Losarang 60 " " 1,080
36 11/13/2017 Bangodua 60 " " 1,020
37 11/13/2017 Kertawinangun 80 " " 940
38 11/13/2017 Juntinyuat 100 " " 840
39 11/13/2017 Cantigi 60 " " 780
40 11/13/2017 Kaplongan 40 " " 740
41 11/14/2017 Kerticala 60 " " 680
42 11/14/2017 Lelea 50 " " 630
43 11/14/2017 Lohbener 60 " " 570
44 11/14/2017 Widasari 70 " " 500
45 11/14/2017 Pondoh 80 " " 420
46 11/15/2017 Cemara 60 " " 360
47 11/15/2017 Haurgeulis 80 " " 280
48 11/20/2017 Sindang 70 " " 210
49 11/20/2017 Plumbon 20 " " 190
50 11/20/2017 Jatibarang 10 " " 180
51 11/21/2017 Sukra 110 " " 70
52 11/23/2017 Kroya 50 " " 20
53 12/7/2017 Karangampel 10 " " 10

JUMLAH 3,760 10 A 10

Plt. Kasie Surveilans Dan Imunisasi Pengelola Cold Chain


Kabupaten
H. DEDE SETIAWAN,SKM.M.H.Kes DWI PRANSTYONO, SKM
NIP:19730428 199303 1 006 NIP: 19660215 199003 1 010
PENGEMBANGAN PROGRAM IMUNISASI

BULAN Oct-17
PENCATATAN STOCK VAKSIN
BIAS DT
J U M L A H Sisa Kondisi
NO Tanggal Diterima dari Dipergunakan di
Masuk Keluar No Batch Ex.Date KUM VVM Dosis

10/31/2016 PROPINSI 4276 "0400417 Jun-20 4,276 A 10


1 11/1/2017 Cipancuh 50 " " 4,226
2 11/1/2017 Jatisawit 60 " " 4,166
3 11/2/2017 Pasekan 60 " " 4,106
4 11/2/2017 Terisi 120 " " 3,986
5 11/2/2017 Sliyeg 80 " " 3,906
6 11/2/2017 Kertasemaya 130 " " 3,776
7 11/2/2017 Jatibarang 100 " " 3,676
8 11/2/2017 Cikedung 80 " " 3,596
9 11/6/2017 Plumbon 100 " " 3,496
10 11/6/2017 Tambi 50 " " 3,446
11 11/6/2017 Kedungwungu 70 " " 3,376
12 11/6/2017 Sukagumiwang 80 " " 3,296
13 11/6/2017 Tukdana 70 " " 3,226
14 11/6/2017 Balongan 100 " " 3,126
15 11/6/2017 Kiajaran Wetan 50 " " 3,076
16 11/6/2017 Patrol 150 " " 2,926
17 11/6/2017 Tugu 40 " " 2,886
18 11/6/2017 Gabus Wetan 90 " " 2,796
19 11/6/2017 Anjatan 80 " " 2,716
20 11/6/2017 Margadadi 140 " " 2,576
21 11/6/2017 Bongas 60 " " 2,516
22 11/6/2017 Sidamulya 70 " " 2,446
23 11/6/2017 Kedokan bunder 60 " " 2,386
24 11/6/2017 Babadan 70 " " 2,316
25 11/7/2017 Temiyang 80 " " 2,236
26 11/7/2017 Bugis 130 " " 2,106
27 11/7/2017 Wanakaya 60 " " 2,046
28 11/7/2017 Drunten Wetan 40 " " 2,006
29 11/7/2017 Cidempet 70 " " 1,936
30 11/7/2017 Kroya 70 " " 1,866
31 11/8/2017 Karangampel 100 " " 1,766
32 11/8/2017 Kandanghaur 100 " " 1,666
33 11/8/2017 Krangkeng 40 " " 1,626
34 11/9/2017 Gantar 140 " " 1,486
35 11/8/2017 Losarang 60 " " 1,426
36 11/13/2017 Bangodua 60 " " 1,366
37 11/13/2017 Kertawinangun 80 " " 1,286
38 11/13/2017 Juntinyuat 100 " " 1,186
39 11/13/2017 Cantigi 60 " " 1,126
40 11/13/2017 Kaplongan 40 " " 1,086
41 11/14/2017 Kerticala 60 " " 1,026
42 11/14/2017 Lelea 50 " " 976
43 11/14/2017 Lohbener 70 " " 906
44 11/14/2017 Widasari 70 " " 836
45 11/14/2017 Pondoh 80 " " 756
46 11/15/2017 Cemara 50 " " 706
47 11/15/2017 Haurgeulis 80 " " 626
48 11/20/2017 Sindang 70 " " 556
49 11/20/2017 Plumbon 20 " " 536
50 11/20/2017 Jatibarang 10 " " 526
51 11/21/2017 Sukra 100 " " 426
52 11/23/2017 Kroya 0 " " 426
53 12/7/2017 Karangampel 0 " " 426

JUMLAH 3,850 426 A 10

Plt. Kasie Surveilans Dan Imunisasi Pengelola Cold Chain


Kabupaten
H. DEDE SETIAWAN,SKM.M.H.Kes DWI PRANSTYONO, SKM
NIP:19730428 199303 1 006 NIP: 19660215 199003 1 010
PENERIMAAN VAKSIN DARI PROPINSI
DINAS KESEHATAN KABUPATEN INDRAMAYU TAHUN 2017

NO TGL. BCG POLIO POLIO Td DT MR CAMK DPT HB-Hib HB Uniject


SBBK ( bOPV ) ( IPV ) PST KET
1 1-Jan-17 - - - - - - - - -
2 1-Feb-17 - - - - - - - - -
3 14-Mar-17 - 3,000 705 - - - 2,000 3,000 3,000
4 25-Apr-17 3,000 3,000 585 3,000 - - - 3,000 3,000 5 Dosis
5 18-May-17 1,000 3,000 - 2,000 - - - 3,000 3,000
6 15-Jun-17 3,000 3,000 - - - - - 3,000 3,000
7 13-Jul-17 - - - - - 20,000 - - -
8 25-Jul-17 - - - - - 10,108 - - -
9 7-Aug-17 3,000 2,000 1,000 2,000 - 3,492 - 2,000 3,000
10 31-Aug-17 - - - - - 16,580 - - -
11 20-Sep-17 - 3,000 1,000 1,500 - - - 2,000 3,000
12 31-Oct-17 - 3,000 1,000 3,770 4,276 - - 3,000 3,000
13 4-Dec-17 3,000 3,000 1,000 3,000 - - - 3,000 3,000
14

JUMLAH : 13,000 23,000 5,290 15,270 4,276 50,180 2,000 22,000 24,000

DISTRIBUSI VAKSIN DARI KAB. KE PUSKESMAS


DINAS KESEHATAN KABUPATEN INDRAMAYU TAHUN 2017

TANGGAL / BCG POLIO POLIO Td DT MR CAMK / DPT HB-Hib HB Uniject


NO BULAN ( bOPV ) ( IPV ) MR PST KET
1 31-Jan-17 1,100 1,940 447 790 - - 1,070 2,050 2,930
2 28-Feb-17 1,100 2,720 236 860 - - 950 2,260 2,170
4 31-Mar-17 1,150 1,140 175 1,170 - - 990 2,040 1,580
5 30-Apr-17 950 1,860 138 1,050 - - 920 2,000 2,080
6 31-May-17 1,220 2,140 223 1,270 - - 1,000 2,372 2,760
7 30-Jun-17 950 1,630 183 870 - - 740 1,560 2,300
8 31-Jul-17 1,290 2,200 302 1,290 - - 670 2,410 2,800
9 31-Aug-17 980 1,900 223 1,120 - 30,065 - 1,980 2,610
10 31-Aug-17 - - - - - 2,783 - - -
11 30-Sep-17 680 1,480 173 690 - 14,008 - 1,420 1,705
12 31-Oct-17 1,140 2,150 338 1,070 - - 455 2,190 2,240
13 31-Oct-17 - - - 3,760 3,850 - - - - BIAS
14 30-Nov-17 1,025 220 242 1,020 - - 525 2,050 2,475
15 31-Dec-17 - - - - - - 1,990 - - campak
16 31-Dec-17 950 2,003 467 843 - - 660 2,120 2,290 kembali ke
propinsi
JUMLAH : 12,535 21,383 3,147 15,803 3,850 46,856 9,970 24,452 27,940

Plt. Kasie Surveilans Dan Imunisasi Pengelola Cold Chain


Kabupaten

H. DEDE SETIAWAN,SKM.M.H.Kes DWI PRANSTYONO, SKM


NIP:19730428 199303 1 006 NIP: 19660215 199003 1 010
PEMERINTAH KABUPATEN INDRAMAYU
DINAS KESEHATAN
Jl.MT.Haryono
Jl.Veteran No.3
No.09
Tlp.Tlp.
/ Fax.(0234)
/ Fax.(0234)
272125
272125
Indramayu
Indramayu
45212
45212

DAFTAR PERMINTAAN
NO : 443.32 / / P2P.

PERMINTAAN DARI : DINAS KESEHATAN KABUPATEN INDRAMAYU


BULAN : DESEMBER 2017
UNTUK PROGRAM : IMUNISASI

NO JENIS VAKSIN STOK AWAL PENERIMAAN PENGELUARAN STOK AKHIR PERMINTAAN IP VAKS RIIL KETERANGAN
1 2 3 4 5 6 7 8 9
1 BCG 20 dosis/Amp 4,500 1,110 3,390 3,000 4
2 POLIO (bOPV ) 10 ds/vial 4,040 2,050 1,990 3,000 6,5
3 POLIO ( IPV ) 5 Dss/ Vial 1,229 318 911 1,000 -
4 POLIO ( IPV ) 10 Dss/ Vial - - - - -
5 CAMPAK 10 dosis/vial - - - - 3,0
6 DPT-HB Hib 5 dosis/vial 1,980 1,970 10 3,000 3,5
7 Hepatitis B 1 dosis/buah 5,185 2,190 2,995 3,000 1
8 Td 10 dosis/vial 2,620 1,120 1,500 3,000 5,5
9 DT 10 dosis/vial ( BIAS ) -
10 Td 10 dosis/vial ( BIAS ) - - - - -
11 0,05 ml - - - - - -
ADS 0,5 ml - - - - - -
5 ml - - - - - -
12 Safety box 5 liter - - - - - -
2,5 liter - - - - - -

Indramayu , 4 Desember 2017


Pengelola Cold Chain

DWI PRANSTYONO, SKM


NIP : 19660215 199003 1 010
PEMERINTAH KABUPATEN INDRAMAYU
DINAS KESEHATAN
Jl.MT Haryono No 9 Telp ( 0234) 272109 Indramayu (45221)

Pesanan dari : Arsip : KABUPATEN


Untuk Program : Imunisasi
NO ANTIGEN SUMBER JUMLAH NO NO VVM HARGA
BACTH EXP DATE SATUAN
1 BCG Bio Farma Amf 59,950.00
2 POLIO ( ORAL ) " Vial 19,954.00
3 POLIO ( IPV ) Vial 245,025.00
4 Td " Vial 16,500.00
5 Measles & Rubella ( MR ) Bio Farma Vial 149,820.00
6 DPT - HB-Hib " Vial 76,285.00
7 HB UNIJECT " pouch 20,900.00
9 DT SD " Vial 17,798.00
10 Td SD " Vial 16,500.00
11 A D S Sholosot Box
12 SAFETY BOX Box

Yang menyerahkan Vaksin Indramayu, ......................2017


Pel Cold Chain Kab. Yang menerima Vaksin

DWI PRANSTYONO, SKM _________________________


NIP. 19660215 199003 1 010 NIP. ............................

PEMERINTAH KABUPATEN INDRAMAYU


DINAS KESEHATAN
Jl.MT Haryono No 9 Telp ( 0234) 272109 Indramayu (45221)

Pesanan dari : Arsip : PUSK/RS/ UPS


Untuk Program : Imunisasi
NO ANTIGEN SUMBER JUMLAH NO NO VVM HARGA
BACTH EXP DATE SATUAN
1 BCG Bio Farma Amf 59,950.00
2 POLIO ( ORAL ) " Vial 19,954.00
3 POLIO ( IPV ) Vial 245,025.00
4 Td " Vial 16,500.00
5 Measles & Rubella ( MR ) Bio Farma Vial 149,820.00
6 DPT - HB-Hib " Vial 76,285.00
7 HB UNIJECT " pouch 20,900.00
9 DT SD " Vial 17,798.00
10 Td SD " Vial 16,500.00
11 A D S Sholosot Box
12 SAFETY BOX Box
Yang menyerahkan Vaksin Indramayu, ......................2017
Pel Cold Chain Kab. Yang menerima Vaksin

DWI PRANSTYONO, SKM _________________________


NIP. 19660215 199003 1 010 NIP. ............................
LAPORAN KETERSEDIAAN VAKSIN
PER 30 JUNI 2017

SISA STOCK PEMAKAIAN TINGKAT KETERSEDIAAN


NO NAMA OBAT SATUAN RATA - RATA ( BULAN )
1 2 4 3 4 5
1 BCG 20 dosis/Amp Amp 2,770 2,463 1.12
2 POLIO (bOPV ) 10 ds/vial Vial 6,070 4,470 1.36
3 POLIO 20 dosis/vial Vial - - -
4 POLIO ( IPV ) 5 Dss/ Vial Vial - - -
5 POLIO ( IPV ) 10 Dss/ Vial Vial - - -
6 CAMPAK 10 dosis/vial Vial 620 1,873 0.33
7 DPT-HB Hib 5 dosis/vial Vial 6,268 4,872 1.29
8 Hepatitis B 1 dosis/buah Pouch 5,880 5,573 1.06
9 Td 10 dosis/vial Vial 4,940 2,606 1.90
10 DT 10 dosis/vial Vial - - -

Indramayu , 26 Juli 2017

DWI PRANSTYONO, SKM


NIP : 19660215 199003 1 010
IMUNISASI
NO NAMA VAKSIN SATUAN STOK PEMAKAIAN PEMAKAIAN SISA STOCK PENERIMAAN PREDIKSI SISA STOK JUMLAH USULAN KETERANAGAN
1-Jan-17 JAN- MAR 2017 RATA-RATA 31 NARET 2017 TAHUN 2017 31-Dec-17 KEBUTUHAN 2018 PENGADAAN 2018
1 2 3 4 5 6 7 8 9 10
1 Hepatitis B vial 7,500 6,680 2,227 3,920 6,000 (10,120) 40,080 50,200
2 BCG amp 5,170 3,350 1,117 1,840 3,000 (5,210) 20,100 25,310
3 Polio 10 ds vial 5,660 5,800 1,933 2,580 6,000 (8,820) 34,800 43,620
4 DT ( BIAS ) vial - 4,500 375 100 4,500 1,225 6,750 5,525
5 Td vial 5,880 2,820 940 3,080 3,000 (2,380) 16,920 19,300
6 IPV vial 997 858 286 849 1,290 (435) 5,148 5,583 5 dosis
7 DPT-HB-Hib vial 6,450 6,350 2,117 3,140 6,000 (9,910) 38,100 48,010
8 Campak /MR vial 4,250 3,010 1,003 3,260 2,000 (3,770) 18,060 21,830
DISTRIBUSI VAKSIN PIN KE PUSKESMAS BULAN MARET 2016

NO PUSKESMAS BCG POLIO TT CAMPK COMBO HB UNJ


1 Balongan 180
2 Plumbon 240
3 Margadadi 260
4 Pasekan 130
5 Sindang 150
6 Babadan 80
7 Cantigi 150
8 Lohbener 150
9 Kiajaran Wetan 110
10 Cidempet 130
11 Krangkeng 150
12 Kedungwungu 130
13 Karangampel 180
14 Kaplongan 90
15 Kedokan bunder 210
16 Juntinyuat 220
17 Pondoh 152
18 Jatibarang 200
19 Jatisawit 130
20 Sliyeg 160
21 Tambi 110
22 Kertasemaya 270
23 Sukagumiwang 170
24 Bangodua 130
25 Kerticala 130
26 Tukdana 110
27 Losarang 180
28 Cemara 70
29 Lelea 100
30 Tugu 120
31 Terisi 240
32 Cikedung 180
33 Kandanghaur 210
34 Kertawinangun 170
35 Gabus Wetan 160
36 Drunten Wetan 90
37 Kroya 130
38 Temiyang 150
39 Anjatan 160
40 Bugis 250
41 Haurgeulis 160
42 Wanakaya 130
43 Cipancuh 110
44 Gantar 260
45 Widasari 160
46 Bongas 110
47 Sidamulya 120
48 Sukra 200
49 Patrol 308
50 RSP. Balongan 10
51 RB Arifa
52 RB Ratu Adelin
53 dr.Rizal, Sp.A Kr Turi
54 RSUD. Pantura
55 Bd.Hj Maemunah
56 RS. Bayangkara

JUMLAH 0 7900 0 0 0 0
KEADAAN VAKSIN PER 30 SEPTEMBER 2017
DINKES KAB. INDRAMAYU

NO ANTIGEN SISA BLN LALU PENERIMAAN KELUAR STOCK KET


1 BCG 6,700 - 680 6,020
2 POLIO ( bOPV ) 4,040 3,000 1,480 5,560
3 POLIO ( IPV ) 1,365 1,000 173 2,192
4 Td 4,510 1,500 690 5,320
5 CAMPAK - - - -
6 DPT-HB-Hib 808 2,000 1,420 1,388
7 HB Uniject 3,470 3,000 1,745 4,725

Indramayu, 10 Oktober 2017


Pengelola Cold Chain

DWI PRANSTYONO, SKM


NIP. 19660215 199003 1 010