LAPORAN KEMATIAN IBU

KABUPATEN TAPANULI TENGAH

PUSKESMAS.............................
BULAN/TAHUN : /

No DESA Persalinan Perdarahan Infeksi Eklampsi Abortus Partus Macet Emboli Obstetrik
Normal Sec Jlh Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat
1 PANDAN 7 1 8 0 0 0 0 0 0 0 0 1 0 0 0

2 PANDAN WANGI 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0

3 LUBUK TUKKO 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0

4 LUBUK TUKKO BARU 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0

5 SIBULUAN INDAH 6 1 7 0 0 0 0 0 0 0 0 0 0 0 0

6 SIBULUAN BARU 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0

7 SIBULUAN RAYA 5 0 5 0 0 0 0 0 0 0 0 0 0 0 0

8 SIBULUAN TERPADU 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

9 SIBULUAN NAULI 4 1 5 0 0 0 0 0 0 0 0 1 0 0 0

10 SIHAPORAS NAULI 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

11 AEK TOLANG 6 1 7 0 0 0 0 1 0 0 0 0 0 0 0

12 PASAR BARU 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL 48 4 52 0 0 0 0 1 0 0 0 2 0 0 0

Mengetahui :
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 Sebab Lain Kematan Berdasarkan Kelompok Ibu
Jlh Kasus Jlh Mat Ibu Hamil Ibu Mlahirkan Ibu Nifas
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

1 0 0 0 0 Placenta Previa
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

1 0 0 0 0

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
REKAPITULASI LAPORAN PWS KIA
KABUPATEN TAPANULI TENGAH
PUSKESMAS.......................................
BULAN/TAHUN : /

Neonatus
Sasaran Komplikasi Neonatus Tertangani Kunjungan Bayi Lengkap
KN1 KN Lengkap
No Desa Kumulatf Kumulatf Kumulatf
Bln Lalu Bln Ini Bln Lalu Bln Ini Bln Lalu Bln Ini Bln Lalu Bln Ini
Neo/ Bayi Balita Abs % Abs % Abs %
Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk
1 PANDAN 100 434 6 4 3 5 27 34 27.0 34.0 6 4 3 5 27 34 27.0 34.0 1 1 1 0 3 2 30.0 20,0 2 1 1

2 PANDAN WANGI 47 205 1 2 1 2 10 14 21,27 29,78 1 2 1 2 10 14 21,27 29,78 0 0 0 0 1 0 20,0 0.0 1 2 1

3 LUBUK TUKKO 55 240 3 2 2 1 16 14 29,09 25.5 3 2 2 1 16 14 29,09 25.5 0 1 0 0 0 2 0.0 40,0 1 2 2

4 LUBUK TUKKO BARU 62 270 3 3 2 2 15 16 24,19 25,80 3 3 2 2 15 16 24,19 25,80 0 0 0 0 1 0 16,66 0.0 1 2 1

5 SIBULUAN INDAH 86 375 5 4 3 4 25 26 29,06 30,23 5 4 3 4 25 26 29,06 30,23 1 1 1 0 3 2 33,33 22,22 2 2 2

6 SIBULUAN BARU 40 173 1 1 2 2 9 8 22,5 20.0 1 1 2 2 9 8 22,5 20.0 0 0 0 0 0 0 0.0 0.0 1 1 1

7 SIBULUAN RAYA 47 207 1 1 3 2 12 13 25,53 27,65 1 1 3 2 12 13 25,53 27,65 0 0 0 0 1 1 20,0 20,0 1 1 1

8 SIBULUAN TERPADU 26 114 0 2 1 1 7 6 26,92 23,07 0 2 1 1 7 6 26,92 23,07 0 0 0 0 0 0 0.0 0.0 0 1 1

9 SIBULUAN NAULI 53 230 4 2 2 3 17 17 32,07 32,07 4 2 2 3 17 17 32,07 32,07 1 0 0 1 1 1 20,0 20.0 1 2 2

10 SIHAPORAS NAULI 17 73 1 1 1 1 8 9 47,05 52,94 1 1 1 1 8 9 47,05 52,94 0 0 0 0 0 0 0.0 0.0 0 1 2

11 AEK TOLANG 73 319 5 3 3 4 23 23 31,50 31,50 5 3 3 4 23 23 31,50 31,50 1 1 1 0 3 2 42,85 28,57 2 2 2

12 PASAR BARU 28 123 1 1 1 1 8 9 28,57 32,14 1 1 1 1 8 9 28,57 32,14 0 0 0 0 0 0 0.0 0.0 1 0 0

TOTAL 634 2764 31 26 24 28 175 189 27,60 29,81 31 26 24 28 175 189 27,60 29,81 4 4 3 1 10 9 15,87 14,28 13 17 16

Mengetahui :
Pimpinan Puskesmas
dr. RIKKY NELSON HARAHAP
NIP. 19801014 201101 1 005
Kunjungan Bayi Lengkap Kunjungan Balita Lengkap

Kumulatf Kumulatf
Bln Ini Bln Lalu Bln Ini
Abs % Abs %
Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr
2 21 18 21.0 18.0 7 6 6 6 71 75 16,35 17,28

1 15 14 31,91 29,78 5 4 4 3 56 48 27,31 2341.0

2 18 22 32.7 40.0 6 8 5 6 74 75 30,83 31,25

2 14 20 22,58 32,25 3 4 2 3 37 40 13,70 14,81

2 25 24 29,06 27,90 10 11 8 10 100 106 26,66 28,26

1 12 17 30.0 42,5 1 2 1 1 21 23 12,13 13,29

1 15 12 31,91 25,53 5 6 3 4 59 68 28,50 32,85

0 10 9 38,46 34,61 4 2 2 1 32 24 28,07 21,05

1 16 21 30,18 39,62 4 3 1 2 38 35 16,52 15,21

2 11 8 64,70 47,05 1 2 7 6 27 17 36,98 23,28

1 20 21 27,39 28,76 5 3 3 2 54 49 16,92 15,36

1 9 10 32,14 35,71 2 1 1 1 25 37 20,32 30,08

16 188 197 29,65 31,07 53 52 43 45 596 589 21,56 21,30

Pengelola KIA
NELLYDA SILABAB
NIP. 19740112 200604 2 028
REKAPITULASI LAPORAN PWS KIA IBU
KABUPATEN TAPANULI TENGAH
PUSKESMAS.............................
BULAN/TAHUN : /

Sasaran K1 K4 Deteksi Resiko Tinggi

Persalinan oleh Tenaga Persalinan di Fasilitas
Kumulatf Kumulatf Penanganan Komplikasi (PK)
Kesehatan (PN) Kesehatan (Pf)
Oleh Tenaga Kesehatan Oleh Masyarakat
No Desa
Bln Bln
Bumil Bulin Lalu Bln Ini Lalu Bln Ini
Abs % Abs % Kumulatf Kumulatf Kumulatf Bln Bln Kumulatf
Bln Bln Bln Bln
Lalu Bln Ini Lalu Bln Ini Lalu Bln Ini Lalu
Abs % Abs % Abs % Lalu Ini Abs %

1 PANDAN 110 105 8 12 59 53,63 7 9 47 47,72 2 0 4 18,18 0 0 0 0 10 8 51 48,57 10 8 51 48,57 2

2 PANDAN WANGI 52 49 3 5 26 50.0 3 4 19 36,53 1 0 1 10,0 0 0 0 0 3 3 21 42,85 3 3 21 42,85 0

3 LUBUK TUKKO 61 58 4 8 38 62,29 3 4 24 39,34 1 0 2 16,66 0 0 0 0 5 3 25 43,10 5 3 25 43,10 1

4 LUBUK TUKKO BARU 68 65 4 7 37 54,41 4 5 27 39,70 1 0 2 14,28 0 0 0 0 6 4 25 38,46 6 4 25 38,46 0

5 SIBULUAN INDAH 95 91 8 10 54 56,84 7 8 40 42,10 2 0 4 21,05 0 0 0 0 9 7 42 46,15 9 7 42 46,15 2

6 SIBULUAN BARU 44 42 2 5 21 47,72 2 4 14 31,81 0 0 0 0.0 0 0 0 0 2 4 15 35,71 2 4 15 35,71 0

7 SIBULUAN RAYA 52 50 2 6 26 50.0 1 4 21 40,38 0 0 0 0.0 0 0 0 0 2 5 23 46.0 2 5 23 46.0 0

8 SIBULUAN TERPADU 29 27 2 4 15 51,72 2 2 9 31,03 1 0 1 16,66 0 0 0 0 2 2 11 40,74 2 2 11 40,74 0

9 SIBULUAN NAULI 58 55 5 6 34 58,62 4 5 25 43,10 1 0 2 16,66 0 0 0 0 6 5 28 50,90 6 5 28 50,90 1

10 SIHAPORAS NAULI 18 18 2 2 14 77,77 1 2 11 61,11 0 0 1 25,0 0 0 0 0 2 2 13 72,22 2 2 13 72,22 0

11 AEK TOLANG 81 77 7 8 50 61,72 6 6 40 49,38 2 0 5 31,25 0 0 0 0 8 7 40 51,94 8 7 40 51,94 2

12 PASAR BARU 31 30 2 2 21 67,74 2 2 11 35,48 1 0 2 33,33 0 0 0 0 2 2 15 50.0 2 2 15 50.0 0

TOTAL 698 666 49 75 444 63,61 42 55 330 47,27 12 0 24 17,14 0 0 0 0 57 52 364 54,65 57 52 364 54,65 8

Mengetahui :
Pimpinan Pusk.

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 Bulan Ini
Kunjungan Nifas Lengkap
Penanganan Komplikasi (PK) (KF)

Ibu Nifas+Vit A

Asi Eksklusif
Ket

Fe3
Kumulatf Kumulatf
Bln
Bln Ini Lalu Bln Ini
Abs % Abs %

1 3 2,85 10 8 51 48,57 9 8 4

0 1 2,04 3 3 21 42,85 4 3 1

0 1 1,72 5 3 25 43,10 4 3 1

0 1 1,53 6 4 25 38,46 5 4 1

1 3 3,29 9 7 42 46,15 8 7 2

0 0 0.0 2 4 15 35,71 4 4 1

0 2 4.0 2 5 23 46.0 4 5 1

0 0 0.0 2 2 11 40,74 2 2 1

1 1 1,81 6 5 28 50,90 5 5 2

0 0 0.0 2 2 13 72,22 2 2 1

1 3 3,89 8 7 40 51,94 6 7 2

0 0 0.0 2 2 15 50.0 2 2 1

4 15 2,25 57 52 364 54,65 55 52 18

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
REKAPITULASI LAPORAN -KIA (IBU)
KABUPATEN TAPANULI TENGAH
PROPINSI SUMATERA UTARA
PUSKESMAS
BULAN/TAHUN : /

Sasaran Bumil dpt Buku Komp. Mat. Komp. Mat. Komp. Mat.
No Desa Bumil Anemi Bumil KEK Jlh Tabulin
Bumil Bulin Bumil Komp KIA Ditemukan Ttangani Dirujuk

1 PANDAN 110 105 22 12 1 1 1 0 0 0

2 PANDAN WANGI 52 49 10 5 0 0 0 0 0 0
3 LUBUK TUKKO 61 58 12 8 0 0 0 0 0 0
4 LUBUK TUKKO BARU 68 65 14 7 0 0 0 0 0 0
5 SIBULUAN INDAH 95 91 19 10 1 1 1 0 0 0
6 SIBULUAN BARU 44 42 9 5 0 0 0 0 0 0
7 SIBULUAN RAYA 52 50 10 6 0 0 0 0 0 0
8 SIBULUAN TERPADU 29 27 6 4 0 0 0 0 0 0
9 SIBULUAN NAULI 58 55 12 6 1 1 1 0 0 0
10 SIHAPORAS NAULI 18 18 4 2 0 0 0 0 0 0
11 AEK TOLANG 81 77 16 8 1 1 1 0 0 0
12 PASAR BARU 31 30 6 2 0 0 0 0 0 0

TOTAL 698 666 140 444 4 4 4 0 0 0

Mengetahui Pengelola KIA

Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP NELLYDA SILABAN

NIP. 19801014 201101 1 005 NIP. 19740112 200604 2 028
 Jlh Dasolin Jlh Posyandu Jlh Kader Posy

0 3 12
0 1 4
0 2 8
0 2 8
0 2 8
0 2 8
0 1 4
0 1 4
0 3 12
0 1 4
0 2 8
0 1 4

0 21 84

P. 19740112 200604 2 028

REKAPITULASI LAPORAN PWS - KIA (NEONATAL)
KABUPATEN TAPANULI TENGAH
PUSKESMAS.............................
BULAN/TAHUN : /

Sasaran Neo Komplikasi Ditemukan Neo Komplikasi Tertangani HB0 Vit K

No Desa Bln lalu Bln Ini Bln lalu Bln Ini Bln lalu Bln Ini Bln lalu
Bayi Neo Rest Abs % Abs % Abs %
L P L P L P L P L P L P L P
1 PANDAN 100 10 1 1 1 0 5 50,0 1 1 1 0 5 50,0 6 4 3 5 61 61,0 6 4

2 PANDAN WANGI 47 5 0 0 0 0 1 20,0 0 0 0 0 1 20,0 1 2 1 2 24 51,06 1 2

3 LUBUK TUKKO 55 5 0 1 0 0 2 40,0 0 1 0 0 2 40,0 3 2 2 1 30 54,54 3 2

4 LUBUK TUKKO BARU 62 6 0 0 0 0 1 16,66 0 0 0 0 1 16,66 3 3 2 2 31 50,0 3 3

5 SIBULUAN INDAH 86 9 1 1 1 0 5 55,55 1 1 1 0 5 55,55 5 4 3 4 50 58,13 5 4

6 SIBULUAN BARU 40 4 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 2 17 42,5 1 1

7 SIBULUAN RAYA 47 5 0 0 0 0 2 40,0 0 0 0 0 2 40,0 1 1 3 2 25 53,19 1 1

8 SIBULUAN TERPADU 26 3 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 1 13 50,0 0 2

9 SIBULUAN NAULI 53 5 1 0 0 1 2 40,0 1 0 0 1 2 40,0 4 2 2 3 34 64,15 4 2

10 SIHAPORAS NAULI 17 2 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 15 88,23 1 1

11 AEK TOLANG 73 7 1 1 1 0 5 71,42 1 1 1 0 5 71,42 5 3 3 4 48 65,75 5 3

12 PASAR BARU 28 3 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 17 60,71 1 1

TOTAL 634 63 4 4 3 1 23 36,50 4 4 3 1 23 36,50 31 26 24 28 364 57,41 31 26

Mengetahui Pengelola KIA

Pimpinan Puskesmas
dr. RIKKY NELSON HARAHAP NELLYDA SILABAN
NIP. 19801014 201101 1 005 NIP. 19740112 200604 2 0
 Vit K IMD
Bln Ini Bln lalu Bln Ini
Abs % Abs %
L P L P L P
3 5 61 61,0 2 3 2 5 29 27,61
1 2 24 51,06 1 1 1 2 9 18,36
2 1 30 54,54 2 1 2 1 14 24,13
2 2 31 50,0 1 1 2 2 13 20,0
3 4 50 58,13 2 1 2 4 9 9,89
2 2 17 42,5 0 1 2 2 8 19,04
3 2 25 53,19 0 0 3 2 11 22,0
1 1 13 50,0 0 1 1 1 5 18,51
2 3 34 64,15 2 1 2 2 14 25,45
1 1 15 88,23 0 0 0 0 3 16,66
3 4 48 65,75 2 1 3 4 21 27,27
1 1 17 60,71 0 0 1 1 6 20,0

24 28 364 57,41 12 11 21 26 138 20,72

Pengelola KIA
NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN USAHA-KIA
KAB. TAPANULI TENGAH
PUSKESMAS..............................
BULAN/TAHUN : /

Jlh Persalinan HB Fe Bumil TT Bumil Jlh Kematan

Jlh
No Desa
Bumil
Bumil (Thn) Bulin (Thn) Bufas (Thn)
Nakes Dukun < 8gr 8-10gr >10gr Fe 1 Fe2 Fe3 TT1 TT2 TT3
<20 20-34 ≥ 35 <20 20-34 ≥ 35 <20

1 PANDAN 8 0 12 0 0 12 12 7 9 5 3 0 0 0 0 0 0 0 0
2 PANDAN WANGI 3 0 5 0 0 5 5 2 4 1 1 0 0 0 0 0 0 0 0
3 LUBUK TUKKO 3 0 8 0 0 8 8 3 4 2 1 0 0 0 0 0 0 0 0
4 LUBUK TUKKO BARU 4 0 7 0 0 7 7 3 5 2 1 0 0 0 0 0 0 0 0
5 SIBULUAN INDAH 7 0 10 0 0 10 10 5 8 3 2 0 0 0 0 0 0 0 0
6 SIBULUAN BARU 4 0 5 0 0 5 5 2 4 1 1 0 0 0 0 0 0 0 0
7 SIBULUAN RAYA 5 0 6 0 0 6 6 3 4 1 1 0 0 0 0 0 0 0 0
8 SIBULUAN TERPADU 2 0 4 0 0 4 4 1 2 1 1 0 0 0 0 0 0 0 0
9 SIBULUAN NAULI 5 0 6 0 0 6 6 2 5 1 1 0 0 0 0 0 0 0 0
10 SIHAPORAS NAULI 2 0 2 0 0 2 2 2 2 1 1 0 0 0 0 0 0 0 0
11 AEK TOLANG 7 0 8 0 0 8 8 4 6 2 1 0 0 0 0 0 0 0 0
12 PASAR BARU 2 0 2 0 0 2 2 1 2 1 1 0 0 0 0 0 0 0 0
 TOTAL 52 0 75 0 0 75 75 35 55 21 15 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
Jlh Kematan Penanganan Kasus Rist Rujukan Kasus Rist Jlh Dukun Jlh TK

Bufas (Thn) Neonatal Bayi Neonatal Neonatal

Obstetri Obstetri DTT DT TK Guru Murid
20-34 ≥ 35 L P L P L P L P

0 0 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 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 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 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 0 0 1 0 1 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 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 4 3 1 4 3 1 0 0 0 0 0

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN MATERNAL
KAB. TAPANULI TENGAH
PUSKESMAS...............................
BULAN/TAHUN : /

Persalinan Kegiatan Keseha

No Desa Perdarahan Infeksi Jln Lahir
Jlh SC Vacum Normal Dukun
Jlh Kasus Jlh Mat Rujuk Bumil Bulin Bufas Jlh Kasus
1 PANDAN 8 1 0 7 0 0 0 0 0 0 0 0
2 PANDAN WANGI 3 0 0 3 0 0 0 0 0 0 0 0
3 LUBUK TUKKO 3 0 0 3 0 0 0 0 0 0 0 0
4 LUBUK TUKKO BARU 4 0 0 4 0 0 0 0 0 0 0 0
5 SIBULUAN INDAH 7 1 0 6 0 0 0 0 0 0 0 0
6 SIBULUAN BARU 4 0 0 4 0 0 0 0 0 0 0 0
7 SIBULUAN RAYA 5 0 0 5 0 0 0 0 0 0 0 0
8 SIBULUAN TERPADU 2 0 0 2 0 0 0 0 0 0 0 0
9 SIBULUAN NAULI 5 1 0 4 0 0 0 0 0 0 0 0
10 SIHAPORAS NAULI 2 0 0 2 0 0 0 0 0 0 0 0
11 AEK TOLANG 7 1 0 6 0 0 0 0 0 0 0 0
12 PASAR BARU 2 0 0 2 0 0 0 0 0 0 0 0

TOTAL 52 4 0 48 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 Kegiatan Kesehatan Maternal
Infeksi Jln Lahir Eklamsi/Pre Abortus Partus Lama Lain-Lain
Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Rujuk Curatase Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat

0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 1 0 Placenta Previa
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 0 1 0 0 0

0 0 0 0 0 0 0 0 0 0 0

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 0 0 0 0 2 0 1 0

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN VIT A DAN CAK. IMUNISASI
KAB. TAPANULI TENGAH
PUSKESMAS............................
BULAN/TAHUN : /

Cakupan Imunisasi
Cak. Vit K Injeksi Cak. Vit A 0-7 hari >7 hari DPT3 Campak
No Desa Bayi
Bln Lalu Bln Ini Bln Lalu Bln Ini Bln Lalu Bln Ini Bln Lalu Bln Ini Bln Lalu Bln Ini
Abs % Abs % Abs % Abs %
L P L P L P L P L P L P L P L P L P L P L
1 PANDAN 6 4 3 5 61 61,0 0 0 6 4 3 5 61 61,0 0 0 0 0 0 0 4 5 2 2 44 44,0 3 3 2
2 PANDAN WANGI 1 2 1 2 24 51,06 0 0 1 2 1 2 24 51,06 0 0 0 0 0 0 2 3 1 1 31 65,95 3 3 1
3 LUBUK TUKKO 3 2 2 1 30 54,54 0 0 3 2 2 1 30 54,54 0 0 0 0 0 0 3 3 1 1 33 60,0 2 3 1
4 LUBUK TUKKO BARU 3 3 2 2 31 50,0 0 0 3 3 2 2 31 50,0 0 0 0 0 0 0 3 2 2 1 41 66,12 4 3 2
5 SIBULUAN INDAH 5 4 3 4 50 58,13 0 0 5 4 3 4 50 58,13 0 0 0 0 0 0 2 2 1 2 32 37,20 3 3 2
6 SIBULUAN BARU 1 1 2 2 17 42,5 0 0 1 1 2 2 17 42,5 0 0 0 0 0 0 2 2 1 1 25 62,5 2 2 1
7 SIBULUAN RAYA 1 1 3 2 25 53,19 0 0 1 1 3 2 25 53,19 0 0 0 0 0 0 2 1 1 2 26 55,31 2 2 1
8 SIBULUAN TERPADU 0 2 1 1 13 50,0 0 0 0 2 1 1 13 50,0 0 0 0 0 0 0 1 1 1 0 15 57,69 1 1 0
9 SIBULUAN NAULI 4 2 2 3 34 64,15 0 0 4 2 2 3 34 64,15 0 0 0 0 0 0 3 4 2 2 39 73,58 4 4 2
10 SIHAPORAS NAULI 1 1 1 1 15 88,23 0 0 1 1 1 1 15 88,23 0 0 0 0 0 0 1 2 1 0 17 100 2 1 0
11 AEK TOLANG 5 3 3 4 48 65,75 0 0 5 3 3 4 48 65,75 0 0 0 0 0 0 5 4 1 1 36 49,31 7 6 2
12 PASAR BARU 1 1 1 1 17 60,71 0 0 1 1 1 1 17 60,71 0 0 0 0 0 0 2 2 1 1 21 75,0 2 2 1
TOTAL 31 26 24 28 364 57,41 0 0 31 26 24 28 364 57,41 0 0 0 0 0 0 30 33 15 14 362 57,09 35 33 15
Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 TT Bumil
Campak Sasara TT1 TT2
n
Bln Ini Bumil Bln Bln Bln Bln
Abs % Lalu Ini Abs % Abs %
P Lalu Ini

2 43 4-,95 110 5 5 44 40,0 4 3 34 30,90

1 33 70,21 52 2 1 18 34,61 2 1 13 25,0
2 33 60,0 61 3 2 21 34,42 2 1 15 24,51
2 38 61,29 68 3 2 24 35,29 2 1 16 23,52
2 37 43,02 95 4 3 27 28,42 3 2 19 20,0
1 21 52,5 44 2 1 16 36,36 1 1 11 25,0
1 29 61,70 52 2 1 11 21,15 2 1 11 21,15
2 17 65,38 29 1 1 14 48,27 1 1 7 24,13
2 43 81,13 58 4 1 33 56,89 3 1 19 32,75
1 19 111,7 18 1 1 11 61,11 1 1 8 44,44
2 40 54,79 81 4 2 27 33,33 3 1 18 22,22
1 20 71,42 31 1 1 12 38,70 1 1 10 32,25
19 373 58,83 698 32 21 212 30,37 25 15 156 22,34
Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KEG. NEONATAL ( 0-28 HARI)
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

BBLR Tetanus Neonatorum Asfiksia Cacat Bawaan Infeksi

Jlh Lahir Jlh Lahir
No Desa Hidup Mat
Mat Mat Mat Mat
Kasus Kasus Kasus Kasus Kasus
0-7 hari 8-28 hari 0-7 hari 8-28 hari 0-7 hari 8-28 hari 0-7 hari 8-28 hari
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P
1 PANDAN 3 5 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 PANDAN WANGI 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 0 0 0 0
3 LUBUK TUKKO 2 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
4 LUBUK TUKKO BARU 2 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 0 0 0 0
5 SIBULUAN INDAH 3 4 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
6 SIBULUAN BARU 2 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 0 0 0 0
7 SIBULUAN RAYA 3 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 0 0 0 0
8 SIBULUAN TERPADU 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
9 SIBULUAN NAULI 2 3 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
10 SIHAPORAS NAULI 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
11 AEK TOLANG 3 4 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
12 PASAR BARU 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

TOTAL 24 28 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

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
Infeksi Lain-lain

Ket
Mat Mat
Kasus
0-7 hari 8-28 hari 0-7 hari 8-28 hari
L P L P L P L P L P

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 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 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 0 0 0

0 0 0 0 0 0 0 0 0 0

Pengelola KIA
NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KEG. & KEMATIAN BAYI (29 HARI S/D 1 TAHUN)
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

Kunj. Bayi ASI ISPA Diare/disentri Campak

Sasaran Kunj. Bayi I
No Desa IV Eksklusif
Bayi Kasus Mat Kasus Mat Kasus Mat
Abs % Abs % Abs % Abs % Abs %
L P L P L P L P L P L P L P L P L P
1 PANDAN 100 14 10 3 2 2 2 1 1 32 32,0 0 0 0 0 1 0 15 15,0 0 0 0 0 0 0 0 0 0 0

2 PANDAN WANGI 47 10 8 4 5 0 1 1 1 29 61,70 0 0 0 0 1 1 14 29,78 0 0 0 0 0 0 0 0 0 0

3 LUBUK TUKKO 55 15 12 3 4 1 0 2 2 38 69,09 0 0 0 0 1 1 13 23,63 0 0 0 0 0 0 0 0 0 0

4 LUBUK TUKKO BARU 62 16 13 7 6 1 0 1 1 28 45,16 0 0 0 0 1 1 16 25,80 0 0 0 0 0 0 0 0 0 0

5 SIBULUAN INDAH 86 12 14 4 5 1 1 2 2 30 34,88 0 0 0 0 1 2 27 31,39 0 0 0 0 0 0 0 0 0 0

6 SIBULUAN BARU 40 8 7 2 2 0 1 1 1 36 90,0 0 0 0 0 1 0 18 45,0 0 0 0 0 0 0 0 0 0 0

7 SIBULUAN RAYA 47 10 11 3 2 1 0 2 2 38 80,85 0 0 0 0 1 1 20 42,55 0 0 0 0 0 0 0 0 0 0

8 SIBULUAN TERPADU 26 6 8 2 4 1 0 1 1 13 50,0 0 0 0 0 1 0 5 19,23 0 0 0 0 0 0 0 0 0 0

9 SIBULUAN NAULI 53 13 15 2 3 1 1 2 1 34 64,15 0 0 0 0 1 1 24 45,28 0 0 0 0 0 0 0 0 0 0

10 SIHAPORAS NAULI 17 4 6 1 2 1 0 1 0 23 135,2 0 0 0 0 0 1 13 76,47 0 0 0 0 0 0 0 0 0 0

11 AEK TOLANG 73 16 17 2 3 1 1 1 1 31 42,46 0 0 0 0 1 1 23 31,50 0 0 0 0 0 0 0 0 0 0

12 PASAR BARU 28 6 4 2 1 0 1 1 0 15 53,57 0 0 0 0 0 1 13 46,42 0 0 0 0 0 0 0 0 0 0

 TOTAL 634 130 125 35 39 10 8 16 13 309 48,73 0 0 0 0 10 10 181 28,54 0 0 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
Campak Infeksi Menginits Demam Berdarah Lain-Lain
Kasus Mat Kasus Mat Kasus Mat Ket
Abs % Abs % Abs % Abs % Abs % Abs % Abs %
L P L P L P L P L P L P
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 44 44,0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 43 91,48 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 50 90,90 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 39 62,90 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 46 50,0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 32 80,0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 35 74,46 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 20 76,92 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 47 88,67 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 25 147,05 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 46 63,01 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 26 92,85 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 18 419 66,08 0 0 0 0

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KEG. & KEMATIAN BALITA (1 S/D 5 THN)
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

Kunj. Balita Kunj. ISPA Diare/disentri Campak

Sasaran I Balita IV
No Desa Kasus Mat Kasus Mat Kasus Mat
Balita Abs % Abs % Abs % Abs % Abs % Abs
L P L P L P L P L P L P L P L P
1 PANDAN 434 38 23 8 6 2 2 47 10,82 0 0 0 0 1 1 22 5,06 0 0 0 0 0 0 0 0 0 0 0
2 PANDAN WANGI 205 23 16 6 7 1 1 36 17,56 0 0 0 0 1 1 21 10,24 0 0 0 0 0 0 0 0 0 0 0
3 LUBUK TUKKO 240 13 15 3 4 1 2 50 20,83 0 0 0 0 1 1 16 6,66 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK TUKKO BARU 270 22 24 8 9 1 1 42 15,55 0 0 0 0 1 1 16 5,92 0 0 0 0 0 0 0 0 0 0 0
5 SIBULUAN INDAH 375 24 19 5 7 3 2 64 17,06 0 0 0 0 2 1 31 8,26 0 0 0 0 0 0 0 0 0 0 0
6 SIBULUAN BARU 173 12 13 3 2 1 1 36 20,80 0 0 0 0 1 1 20 11,56 0 0 0 0 0 0 0 0 0 0 0
7 SIBULUAN RAYA 207 14 11 4 7 1 2 32 15,45 0 0 0 0 1 1 23 11,11 0 0 0 0 0 0 0 0 0 0 0
8 SIBULUAN TERPADU 114 10 8 3 5 1 1 20 17,54 0 0 0 0 1 1 12 10,52 0 0 0 0 0 0 0 0 0 0 0
9 SIBULUAN NAULI 230 16 18 4 6 2 3 61 26,52 0 0 0 0 1 2 28 12,17 0 0 0 0 0 0 0 0 0 0 0
10 SIHAPORAS NAULI 73 13 11 2 2 1 1 33 45,20 0 0 0 0 1 1 20 27,39 0 0 0 0 0 0 0 0 0 0 0
11 AEK TOLANG 319 28 24 5 8 1 2 54 16,92 0 0 0 0 1 1 24 7,52 0 0 0 0 0 0 0 0 0 0 0
12 PASAR BARU 123 14 10 2 2 1 1 23 18,69 0 0 0 0 1 1 17 13,82 0 0 0 0 0 0 0 0 0 0 0
 TOTAL 2764 227 192 53 65 16 19 515 0 0 0 0 13 13 225 8,14 0 0 0 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr.Rikky N Harahap
NIP.19801014 201101 1 005
ak Infeksi Menginits Demam Berdarah Lain-Lain
Kasus Mat Kasus Mat Kasus Mat Ket
% Abs % Abs % Abs % Abs % Abs % Abs %
L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 68 15,66 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 60 29,26 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 46 19,16 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 41 15,18 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 60 16,0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 36 20,80 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 50 24,15 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 24 21,05 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 48 20,86 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 36 49,31 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 53 16,61 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 26 21,13 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 23 495 17,90 0 0 0 0

Pengelola KIA

Nellyda Silaban
NIP.19740111 200604 2 028
LAPORAN KEMATIAN AKBAL
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

Malaria Tipus Kelainan Saluran Cerna

Jlh Kematan
No Desa Kasus Mat Kasus Mat Kasus Mat
AKBAL Abs % Abs % Abs % Abs % Abs % Abs
L P L P L P L P L P L P
1 PANDAN 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 PANDAN WANGI 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 LUBUK TUKKO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 LUBUK TUKKO BARU 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 SIBULUAN INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 SIBULUAN BARU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 SIBULUAN RAYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 SIBULUAN TERPADU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 SIBULUAN NAULI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 SIHAPORAS NAULI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 AEK TOLANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 PASAR BARU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
n Cerna Infeksi Menginits
Sasaran Bln Lalu Bln Ini Ket
% Balita Abs %
L P L P
0 434 0 0 0 0 0 0

0 205 0 0 0 0 0 0

0 240 0 0 0 0 0 0

0 270 0 0 0 0 0 0

0 375 0 0 0 0 0 0

0 173 0 0 0 0 0 0

0 207 0 0 0 0 0 0

0 114 0 0 0 0 0 0

0 230 0 0 0 0 0 0

0 73 0 0 0 0 0 0

0 319 0 0 0 0 0 0

0 123 0 0 0 0 0 0

0 2764 0 0 0 0 0 0

Pengelola KIA

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KB
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /
`
Peserta Baru Peserta KB Aktf Kegagalan Komplikasi Drop Out
No Desa Jlh PUS Kumulatf Kumulatf Kumulatf Kumulatf
Bln lalu Bln Ini Bln lalu Bln Ini Bln lalu Bln Ini Bln lalu Bln Ini Bln lalu
Jlh % Jlh % Jlh % Jlh %
1 PANDAN 858 2 3 19 2,21 2 3 705 82,16 0 0 0 0 0 0 0 0 0

2 PANDAN WANGI 405 1 5 12 2,96 1 5 224 55,30 0 0 0 0 0 0 0 0 0

3 LUBUK TUKKO 474 2 4 15 3,16 2 4 305 64,34 0 0 0 0 0 0 0 0 0

4 LUBUK TUKKO BARU 533 2 4 14 2,62 2 4 387 72,60 0 0 0 0 0 0 0 0 0

5 SIBULUAN INDAH 743 2 6 22 2,96 2 6 435 58,54 0 0 0 0 0 0 0 0 0

6 SIBULUAN BARU 342 1 2 7 2,04 1 2 253 73,97 0 0 0 0 0 0 0 0 0

7 SIBULUAN RAYA 409 1 6 15 3,66 1 6 230 56,23 0 0 0 0 0 0 0 0 0

8 SIBULUAN TERPADU 226 1 1 4 1,76 1 1 198 87,61 0 0 0 0 0 0 0 0 0

9 SIBULUAN NAULI 455 2 1 14 3,07 2 1 449 98,68 0 0 0 0 0 0 0 0 0

10 SIHAPORAS NAULI 145 1 0 3 2,6 1 0 201 138,6 0 0 0 0 0 0 0 0 0

11 AEK TOLANG 631 2 4 15 2,37 2 4 474 75,11 0 0 0 0 0 0 0 0 0

12 PASAR BARU 243 1 2 6 2,46 1 2 188 77,36 0 0 0 0 0 0 0 0 0

TOTAL 5464 18 38 174 3,18 18 38 3547 64,91 0 0 0 0 0 0 0 0 0

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 Drop Out Peserta Pasca Persalinan
Kumulatf Kumulatf
Bln Ini Bln lalu Bln Ini
Jlh % Jlh %
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 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 0 0 0 0 0 0

0 0 0 0 0 0 0

Pengelola KB
NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KB
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

Peserta Aktf Gakin Peserta KB Aktf 4T

PUS ALKI ( Anemia/LILA
No Desa PUS Gakin PUS4T Kumulatf Kumulatf
<23,5cm/Peny. Kronis/IMS Bln lalu Bln Ini Bln lalu Bln Ini
Jlh % Jlh
1 PANDAN 358 116 0 0 2 222 62,01 0 0 216
2 PANDAN WANGI 162 49 0 0 2 68 41,97 0 2 57
3 LUBUK TUKKO 50 39 0 0 0 64 128 0 0 65
4 LUBUK TUKKO BARU 213 64 0 0 2 81 38,02 0 1 79
5 SIBULUAN INDAH 321 82 0 0 4 116 36,13 0 0 113
6 SIBULUAN BARU 68 41 0 0 1 45 66,17 0 0 44
7 SIBULUAN RAYA 148 108 0 0 3 44 29,72 0 2 42
8 SIBULUAN TERPADU 101 74 0 0 1 31 30,69 0 0 30
9 SIBULUAN NAULI 136 100 0 0 1 86 63,23 0 0 84
10 SIHAPORAS NAULI 93 71 0 0 0 39 41,93 0 0 39
11 AEK TOLANG 124 63 0 0 2 86 69,35 0 0 84
12 PASAR BARU 82 40 0 0 1 43 52,43 0 0 42

TOTAL 1856 847 0 0 19 927 49,94 0 5 590

Mengetahui
Pimpinan Puskesmas
dr. RIKKY NELSON HARAHAP
NIP. 19801014 201101 1 005

M
KB Aktf 4T Peserta KB Penykit Kronis
Kumulatf Kumulatf
Bln lalu Bln Ini
% Jlh %
93,96 0 0 0 0

116,3 0 0 0 0

166,6 0 0 0 0

123,4 0 0 0 0

137,8 0 0 0 0

87,80 0 0 0 0

38,88 0 0 0 0

39,18 0 0 0 0

84,0 0 0 0 0

59,15 0 0 0 0

93,65 0 0 0 0

105,0 0 0 0 0

69,65 0 0 0 0

Pengelola KB
NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN KB
KAB. TAPANULI TENGAH
PUSKESMAS.................
BULAN/TAHUN : /

No Desa Lama/Baru PIL Suntk IUD Implant MOW MOP Kondom Total Efek Samping Komplikasi

1 PANDAN 702 / 3 177/ 1 66/ 2 4./0 36 / 0 16 / 0 0/0 68 / 0 705 0 0

2 PANDAN WANGI 219/ 5 53 / 2 134 / 2 1./0 7./ 1 4./0 0/0 17 / 0 224 0 0

3 LUBUK TUKKO 301 / 4 110 /1 161/2 2./0 19 / 1 2./0 0/0 6./0 305 0 0

4 LUBUK TUKKO BARU 383 / 4 101 / 2 234/ 2 4./0 26 / 0 5./0 1./0 10./0 387 0 0

5 SIBULUAN INDAH 429 / 6 135/ 2 195 / 2 7./0 50 / 1 7./0 1./0 31 / 1 435 0 0

6 SIBULUAN BARU 251 / 2 78 / 0 107 / 2 7./0 9./ 0 7./0 0/0 45 / 0 253 0 0

7 SIBULUAN RAYA 244 / 6 78 / 1 123/ 3 12./0 15 / 1 2./0 0/0 18 / 1 250 0 0

8 SIBULUAN TERPADU 197 / 1 70 / 0 103/ 1 4./0 10./ 0 1./0 0/0 8./0 198 0 0

9 SIBULUAN NAULI 448/ 1 127 / 0 224/ 1 4./0 48 / 0 14 / 0 1./0 24 / 0 449 0 0

10 SIHAPORAS NAULI 201 / 0 52 / 0 106/ 0 5./0 21 / 0 12./0 0/0 4./0 201 0 0

11 AEK TOLANG 470 / 4 172 / 2 249 / 2 3./0 21/ 0 1. / 0 0/0 13 / 0 474 0 0

12 PASAR BARU 186 / 2 49 / 1 120 / 1 1./0 8./ 0 2./0 0/0 5./ 0 188 0 0

TOTAL 4011/ 38 1200/ 12 1817/ 20 48 / 0 270/ 4 80 / 0 3./0 250/ 2 4049 0 0

Mengetahui Pengelola KB
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP NELLYDA SILABAN

NIP. 19801014 201101 1 005 NIP. 19740112 200604 2 028
Kegagalan DO Aktf Aktf Gakin Aktf 4T

0 0 705 222 216

0 0 224 68 57
0 0 305 64 65
0 0 387 81 79
0 0 435 116 113
0 0 253 45 44
0 0 250 44 42
0 0 198 31 30
0 0 449 86 84
0 0 201 39 39
0 0 474 86 84
0 0 188 43 42

0 0 4049 927 590

REKAPITULASI PENDATAAN PUS
KAB. TAPANULI TENGAH
PUSKESMAS................. PANDAN
BULAN/TAHUN : JUNI

PUS ALKI ( Anemia/LILA <23,5cm/Peny.

No Desa P U S Total P U S Gakin P U S 4T Akseptor KB Total Akseptor KB Gakin
Kronis/IMS

1 PANDAN 858 358 116 0 705 222

2 PANDAN WANGI 405 162 49 0 224 68
3 LUBUK TUKKO 474 50 39 0 305 64
4 LUBUK TUKKO BARU 533 213 64 0 387 81
5 SIBULUAN INDAH 743 321 82 0 435 116
6 SIBULUAN BARU 342 68 41 0 253 45
7 SIBULUAN RAYA 409 148 108 0 250 44
8 SIBULUAN TERPADU 226 101 74 0 198 31
9 SIBULUAN NAULI 455 136 100 0 449 86
10 SIHAPORAS NAULI 145 93 71 0 201 39
11 AEK TOLANG 631 124 63 0 474 86
12 PASAR BARU 243 82 40 0 188 43

TOTAL 5464 1856 847 0 4049 927

Mengetahui
Pimpinan Puskesmas

dr. RIKKY NELSON HARAHAP

NIP. 19801014 201101 1 005
 Akseptor ALKI ( Anemia/LILA
Akseptor KB 4T <23,5cm/Peny. Kronis/IMS

216 0

57 0

65 0

79 0

113 0

44 0

42 0

30 0

84 0

39 0

84 0

42 0

590 0

Pengelola KB

NELLYDA SILABAN
NIP. 19740112 200604 2 028
LAPORAN AMP KEMATIAN BAYI
KABUPATEN TAPANULI TENGAH
PUSKESMAS………………PANDAN
BULAN………………………… JUNI 2017

BBLR Asfiksia T. Neonatorum ISPA Diare Demam Kematan Berdasarkan Umu

Jlh Kematan
Jlh Lahir
No Desa Hidup Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat Jlh Kasus Jlh Mat 0 - 1 Bln

Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr Lk Pr

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

1 PANDAN 3 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 0 0
2 PANDAN WANGI 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 0
3 LUBUK TUKKO 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 1 1 0 0 2 2 0 0 0 0
4 LUBUK TUKKO BARU 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 0
5 SIBULUAN INDAH 3 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 1 2 0 0 2 3 0 0 0 0
6 SIBULUAN BARU 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 0 0
7 SIBULUAN RAYA 3 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 1 1 0 0 1 2 0 0 0 0
8 SIBULUAN TERPADU 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 0 0
9 SIBULUAN NAULI 2 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 1 1 0 0 2 2 0 0 0 0
10 SIHAPORAS NAULI 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0
11 AEK TOLANG 3 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 2 2 0 0 0 0
12 PASAR BARU 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0

TOTAL 24 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 13 0 0 10 10 0 0 16 18 0 0 0 0

Mengetahui : Pengelola KIA

Pimpinan Puskesmas
Kec.

dr. RIKKY NELSON HARAHAP NELLYDA SILABAN

NIP.19801014 201101 1 005 19740112 200604 2 028
J. Lhr Hidup Jan - Mar
L P
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Kematan Berdasarkan Umur
1 Bln-1 Thn 1 - 5 Thn Ket

Lk Pr Lk Pr

33 34 35 36 37

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 0
0 0 0 0
0 0 0 0

0 0 0 0