LAPORAN

Puskesmas : Morokrembangan
Bulan :
Total KK Puskesmas :
Kelurahan :

INDIKATO

No Nama KK Alamat ASI

Persalin Menimb Cuci
Eksklus
an ang Tangan
if

1 HERLIYANTO Tambak Asri 15/4 0 0 1 1

2 SUBANDI Tambak Asri 19/8 0 0 1 1
3 SISWANTO Tambak Asri 19/8 0 0 0 1
4 KUSNAN Tambak Asri 19/7 0 0 0 1
5 MUDJI Tambak Asri 19/7 0 0 0 1
6 PARTO Tambak Asri 19/10 0 0 0 1
7 KARBOLA Tambak Asri 19/15 0 0 1 1
8 SUNOTO Tambak Asri 19/17 0 0 0 1
9 DINO Tambak Asri 19/17 0 1 0 1
10 HERI PRIYANTO Tambak Asri 19/17A 0 0 0 1
11 SAMIJAH Tambak Asri 19/20 0 0 0 1
12 MUNARI Tambak Asri 19/21 0 0 0 1
13 DWI ISNU Tambak Asri 19/23 0 0 0 1
14 ADJI SUPRIYANTO Tambak Asri 19/23 0 0 0 1
15 TUGIONO Tambak Asri 19/25 0 0 0 1
16 SUMARTO Tambak Asri 19/25A 0 0 0 1
17 SUMIATUN Tambak Asri 19/27 0 1 0 1
18 MOCH. NANDOR Tambak Asri 19/31 0 0 0 1
19 ROCHMAN LAILI Tambak Asri 19/31 0 0 1 1
20 M. SULTON SUJARWO Tambak Asri 19/31 0 0 1 1
21 SUTRISNO Tambak Asri 19/30 0 0 1 1
22 SUWITO Tambak Asri 19/32 0 0 0 1
23 KARSADI Tambak Asri 19/33 0 0 0 1
24 SUPATIKNO Tambak Asri 19/34 0 0 0 1
25 HARIADJI Tambak Asri 19/36 0 0 0 1
26 ABDUL ARIS Tambak Asri 19/38 0 0 1 1
27 MUHTADIN Tambak Asri 19/40 0 0 1 1
28 NGANTI Tambak Asri 20/ 0 0 0 1
29 MUSNAH Tambak Asri 20/41 0 0 0 1
30 EDY YANTO Tambak Asri 20/41 0 0 0 1
31 LILIS SUDORIYAH Tambak Asri 20/39 0 0 0 1
32 SARDI Tambak Asri 20/40 0 0 0 1
33 DWI SUSILO Tambak Asri 20/40 0 0 1 1
34 SUPARNO Tambak Asri 26/36 0 0 1 1
35 TONDO Tambak Asri 20/34 0 0 0 1
36 SUTRISNO Tambak Asri 20/34 0 0 0 1
37 FENDY Tambak Asri 20/33 0 0 1 1
38 WAWAN. S Tambak Asri 20/30 0 0 1 1
39 WIDI. N Tambak Asri 20/21 1 0 0 1
40 ILYARNO Tambak Asri 20/21 0 0 0 1
41 SETYO Tambak Asri 20/19 0 0 0 1
42 YITNO Tambak Asri 20/2 0 0 1 1
43 JAMIL Tambak Asri 20/7 0 0 1 1
44 WINARDI Tambak Asri 20/14 0 0 0 1
45 SUPRAPTO Tambak Asri 20/16 0 0 0 1
46 SURTI Tambak Asri 20/16 0 0 0 1
47 SURICO Tambak Asri 167 0 0 0 1
48 BUDIONO Tambak Asri 10/2 0 1 0 1
49 SISTANTOYO Tambak Asri 169 0 1 0 1
50 AGUS SISWO Tambak Asri 18/8 0 1 0 1
51 MARIAH Tambak Asri 19/06 0 0 1 1
52 SAINGGIN Tambak Asri 19/7 0 0 1 1
53 AGUS SUGIANTO Tambak Asri 19/11 0 0 0 1
54 IWAN Tambak Asri 19/15 0 0 0 1
55 SAIFULLAH Tambak Asri 19/12 0 0 0 1
56 WAGITO Tambak Asri 20/35 0 0 0 1
57 SUWANDI Tambak Asri 26/20 0 0 0 1
58 RUSYANTO Tambak Asri 0 0 0 1
59 BASONI Tambak Asri 26/17 0 0 0 1
60 M. ARIF Tambak Asri 26/20 0 0 0 1
61 DEDY. F Tambak Asri 26/14 0 0 0 1
62 MATKUR Tambak Asri 26/ 0 0 0 1
63 JUNAIDI Tambak Asri 26/ 0 0 1 1
64 MOHAMAD Tambak Asri 23/17 0 1 0 1
65 SAHRUN Tambak Asri 23/ 0 1 0 1
66 ARIS SUKARTI Tambak Asri 153 0 0 1 1
67 NGARIP Tambak Asri 20/40 0 0 0 1
68 AKUP Tambak Asri 21/53 0 0 0 1
69 MASKUR Tambak Asri 19/34 0 0 0 1
70 KUSUMA EDI Tambak Asri 23/9 0 0 0 1
71 HIDAYAT Tambak Asri 23/20 0 0 0 1
72 SUMINOK Tambak Asri 23/24 0 0 0 1
73 ACHMAD MUNIR Tambak Asri 24/4C 0 0 0 1
74 MATSUTJI Tambak Asri 21/33 0 0 0 1
75 SUWARNO Tambak Asri 21/23 0 0 0 1
76 GATOT TRIYONO Tambak Asri 21/11 0 0 0 1
77 MARDIONO Tambak Asri 21/21 0 0 0 1
78 SUPARMAN Tambak Asri 22/51 0 0 0 1
79 KASTURI Tambak Asri 21/30 0 0 0 1
80 BURAHIMA ARIFIN Tambak Asri 21/12 0 0 0 1
81 SOEYANTO EDHI. W Tambak Asri 21/9 0 0 0 1
82 AHDOL KALAR Tambak Asri 21/27 0 0 0 1
83 SUTRISNO Tambak Asri 21/28 0 0 0 1
84 DJUMAIN, SH Tambak Asri 179 0 0 0 1
85 BUDIYANTO Tambak Asri 21/2 0 0 0 1
86 HERI SUJITO Tambak Asri 21/11 0 0 0 1
87 MAR'ATIN Tambak Asri 21/4 0 0 0 1
88 SUNARTO Tambak Asri 171 0 0 0 1
89 TIKNAN Tambak Asri 16/18 0 0 0 1
90 GIGIK PITOYO Tambak Asri 16/9 0 0 0 1
91 KUSAIRI Tambak Asri 16/15C 0 0 0 1
92 SUDIRMAN Tambak Asri 15/07 0 0 0 1
93 SUTRISNO Tambak Asri 15/09 0 0 0 1

Jumlah
Persen
PORAN PHBS

DIKATOR PERILAKU SEHAT RUMAH TANGGA PHBS GHS

Diet Tidak
Air Jamban Sayur Aktifitas Meroko Klasifika
PSN Skor Klasifikasi Skor Klasifikasi Skor
Bersih Sehat dan Fisik k dlm si
Buah rumah

1 1 1 0 1 0 6 TS 5 TS 1 TS
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 6 TS 4 1
1 1 1 1 1 0 6 TS 4 2
1 1 1 1 0 0 6 TS 5 1
1 1 1 1 0 0 5 TS 4 1
1 1 1 1 0 1 6 TS 4 2
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 1 1 7 TS 5 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 1 1 7 TS 5 2
1 1 1 0 1 1 7 TS 5 2
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 0 5 TS 4 1
1 1 1 0 1 1 7 TS 5 2
1 1 1 0 1 0 6 TS 5 1
1 1 1 0 0 1 6 TS 5 1
1 1 1 0 0 0 5 TS 5 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 1 1 6 TS 4 2
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 1 5 TS 4 1
1 1 1 0 0 0 4 TS 4 0
1 1 1 0 0 0 4 TS 4 0

487

Kader

.............................................
 REKAP LAPORAN PHBS
Puskesmas :
Bulan :
Total KK Puskesmas :

INDIKATOR PERILAKU SEHAT

Jumlah
No Kelurahan KK Hasil ASI Menimban Cuci Jamban
disurvei Persalinan Air Bersih
Eksklusif g Tangan Sehat

Nama Jml
Kelurahan %
Jml
%
Jml
%
Jml
%
Jml
%
Jml
Total KK
%
AN PHBS

U SEHAT RUMAH TANGGA PHBS GHS

Tidak
Diet Sayur Aktifitas
PSN Merokok Skor Klasifikasi Skor Klasifikasi Skor Klasifikasi
dan Buah Fisik
dlm rumah