LAPORAN KESEHATAN IBU DAN ANAK

PUSKESMAS : EBAN
BULAN : DESEMBER 2014

SASARAN RIIL CAKUPAN PEMERIKSAAN KESEHATAN IBU

NEO BAYI BALITA APRAS FE TT PEMERIKSAAN LAB.
NO DESA/ KEL.

r
um

da
BUMIL BULIN BUFAS PUS WUS BUTEKI K4

n
Um
PRT PMS

ta
L P L P L P L P 1 2 3 1 2 3 4 5 HB DDR URINE

S
KI

KI
1 KELURAHAN EBAN 18 6 6 2 5 22 8 75 83 19 16 249 276 60 3 3 8 3 2 0 1 0 1 4 0 0 0

2
2 KELURAHAN SALLU 13 3 3 3 0 22 12 79 71 8 13 265 604 30 1 2 2 1 3 0 0 1 0 0 0 0 0

2
3 HAULASI 6 2 2 1 1 6 11 30 27 0 0 124 170 30 1 2 1 0 1 0 1 1 0 2 0 0 0

1
4 FATUTASU 8 1 1 0 1 7 7 30 31 0 0 141 119 20 1 3 2 3 0 0 0 0 0 3 0 0 0

3
5 FATUNISUAN 16 5 5 1 3 14 15 47 50 11 11 210 298 33 1 4 2 1 0 1 2 1 1 4 0 0 0

3
6 SUANAE 9 0 0 0 0 15 6 28 27 8 5 130 180 30 4 0 0 1 0 0 0 0 0 0 0 0 0

0
7 LEMON 2 1 1 0 1 3 6 17 8 8 7 54 112 11 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 SAENAM 9 2 2 2 0 6 4 15 23 4 11 68 113 22 3 3 2 3 1 1 1 0 2 0 0 3 0 0 0

9 FATUNENO 13 0 0 0 0 7 11 62 40 5 7 272 315 52 0 0 0 0 3 1 0 0 0 0 0 0 0 0 0

10 NOEPESU 11 4 4 1 3 11 14 39 65 7 9 182 251 43 1 1 3 1 0 2 0 0 0 0 0 0 0 0 0

11 MANUSASI 8 0 0 0 0 7 4 33 32 10 10 96 115 26 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0

12 NOELTOKO 4 0 0 0 0 2 4 35 22 7 5 71 123 39 1 1 2 1 1 0 0 0 0 0 0 1 0 0 0

13 SATAB 3 0 0 0 0 2 4 17 12 1 2 51 76 14 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0

JUMLAH 120 24 24 10 14 124 106 507 491 88 96 1913 2752 410 21 16 20 20 20 14 7 1 6 3 2 18 0 0 0

Kel. Eban 42.6 32.3 80
Kel. Sallu 42.6 43.1 70
Haulasi 42.6 42.8 60
Fatutasu 42.6 31 50
Fatunisuan 42.6 54.8 40
Suanae 42.6 42.8i 30 Column C
Column D
20
Column E
10
0
 60
50
40
30 Column C
Lemon 42.6 7.1 Column D
20
Saenam 42.6 33.3 Column E
10
Fatuneno 42.6 48.7
Noepesu 42.6 51.3 0
Manusasi 42.6 68.1
Noeltoko 42.6 60
Pusk. Eban 42.6 39.4
80
70
Desa T C 60
Kel. Eban 42.6 27.9 70
50
Kel. Sallu 42.6 32 60
Haulasi 42.6 50 40
50
Fatutasu 42.6 36.6 30
40
Fatunisuan 42.6 33.3
30 20
Suanae 42.6 40.9
Column C
Lemon 42.6 13.32 20 10
Column D
Saenam 42.6 25 10 0
Fatuneno 42.6 58.5
0
Noepesu 42.6 38.4
Manusasi 42.6 52.1
Noeltoko 42.6 43.7
Pusk. Eban 42.6 37.6

KN 3
80
Desa T C
Kel. Eban 42.6 36 70
Kel. Sallu 42.6 45.8 60
Haulasi 42.6 45
50
Fatutasu 42.6 33.3
Fatunisuan 42.6 48.5 40
Suanae 42.6 45 30 Column C
Lemon 42.6 7.1 Column D
20
10
0
 40
30 Column C
Column D
20
Saenam 42.6 40
Fatuneno 42.6 47.3 10
Noepesu 42.6 55.5 0
Manusasi 42.6 68.1
Noeltoko 42.6 57.1
Pusk. Eban 42.6 44.08

70
Fe 3 T C
Kel. Eban 42.6
60 42.6
Kel. Sallu 42.6 47.1
50
Haulasi 42.6 45.4
Fatutasu 42.6
40 43.3
Fatunisuan 42.6 38.4
30
Suanae 42.6 50 Column C
Lemon 42.6
20 20 Column D
Saenam 42.6 6.2
10
Fatuneno 42.6 60.9
Noepesu 42.60 41
Manusasi 42.6 60.8
Noeltoko 42.6 62.5
Pusk. Eban 42.6 43.1

Deteksi Rest
250
Desa T C
Kel. Eban 42.6 78.5
Kel. Sallu 42.6 63.6 200
Haulasi 42.6 100
Fatutasu 42.6 6.3 150
Fatunisuan 42.6 62.5
Suanae 42.6 25 100 Column C
Lemon 42.6 0 Column D
Saenam 42.6 66.6 50

0
 100 Column C
Column D
50
Fatuneno 42.6 62.5
Noepesu 42.6 75 0
Manusasi 42.6 200
Noeltoko 42.6 166.6
Pusk. Eban 42.6 75.5

BBLR/Neo Rest/Komplikasi
Desa T C 90
Kel. Eban 42.6 55.5 80
Kel. Sallu 42.6 85.7
70
Haulasi 42.6 33.3
60
Fatutasu 42.6 0
Fatunisuan 42.6 40 50
Suanae 42.6 33.3 40
Column C
Lemon 42.6 50 30
Column D
Saenam 42.6 50 20
Fatuneno 42.6 50 10
Noepesu 42.6 40
0
Manusasi 42.6 0
Noeltoko 42.6 0
Pusk. Eban 42.6 36.5

100
Desa T 90
C Total Faskes
Kel. Eban 10080 100 22 22 100
Kel. Sallu 10070 100 22 22 100
Haulasi 10060 100 9 9 100
Fatutasu 10050 22.2 9 2 22.2
Fatunisuan 10040 70.6 17 12 70.6 T
Suanae 10030 88.9 9 8 88.9 C
Lemon 10020 100 1 1 100
10
0
i i
ba n a l l u l a s ta s u ua n na e on am eno es u s a s toko ba n
E S s a m n n p l E
l. l. a u atu ni Su Le ae tu oe nu oe k.
 50
40 T
30 C
20
Saenam 10010 100 6 6 100
Fatuneno 100 0 94.7 19 18 94.7
Noepesu 100 100n 20 i 20 100 i
ba a l l u l a s ta s u ua n na e mon nam eno es u s a s toko ba n
Manusasi 100 l86.7
. E S 15u 13
u 86.7i s a e e n ep u el .E
Ke Kel
. Ha Fat tun Su L Sa Fatu No a n No us k
Noeltoko 100 100 9 a
9 F 100 M P
Pusk. Eban 100 89.9 158 142 89.9
BU
HASIL PEMERIKSAAN LAB.

HB < PRT PMS

11,5 GR
DDR URINE
% (+) (+ )
(+)

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
Column C
Column D
Column E
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS : EBAN
BULAN : DESMBER 2014

DETEKSI DINI
FAKTOR RISIKO BUMIL RISIKO DAN KOMPLIKASI OBSTETRI
KOMPLIKASI
JUMLAH
NO DESA/ KEL. BUMIL
RESTI DITANGANI RUJUKAN
HB < LILA < UMUR < UMUR > SPACING PARITAS > TB<145c BB < 45 NAKES MASY JUMLAH JENIS KOMPLIKASI
11,5 gr % 23,5 cm 20 THN 35 thn < 2 thn 5 anak m kg HIDUP MATI RUJUK RUJUK
KE PUSK KE RS

1 KELURAHAN EBAN 0 0 0 0 0 0 0 0 0 1 0 1 KPD 0 0 0 1

2 KELURHAN SALU 0 1 0 0 0 0 0 1 0 0 0 1 PERPANJANGAN KALA II 0 0 0 1
3 HAULASI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 FATUTASU 0 3 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0
5 FATUNISUAN 0 1 0 1 0 1 0 0 1 1 0 1 PANGGUL SEMPIT 0 0 1 0
6 SUANAE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 LEMON 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 SAENAM 3 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
9 FATUNENO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 NOEPESU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 MANUSASI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 NOELTOKO 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 3 7 0 1 0 1 0 4 1 2 0 3 0 0 0 1 2
p

KET
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

AN
TEMPAT BERSALIN PENOLONG PERSALINAN VIT.A NIFAS KEMATIAN MATERNAL

IN
RSAL
NO DESA/ KEL. KLINIK RUMAH DUKUN DTT /
RS PUSK POLNDS BERSALIN DLL DOKTER BIDAN PERAWAT TERLATIH KEL 1 2 HAMIL BERSALIN NIFAS PENYEBAB

L PE
NON
TOTA APN APN
1 KELURAHAN EBAN 6 1 4 0 0 1 1 4 0 0 1 0 6 6 0 0 0 0
2 KELURAHAN SALLU 3 1 2 0 0 0 1 2 0 0 0 0 3 3 0 0 0 0
3 HAULASI 2 0 2 0 0 0 0 2 0 0 0 0 2 2 0 0 0 0
4 FATUTASU 1 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0
5 FATUNISUAN 5 1 4 0 0 0 1 4 0 0 0 0 5 5 0 0 0 0
6 SUANAE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 LEMON 1 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0
8 SAENAM 2 0 2 0 0 0 0 2 0 0 0 0 2 2 0 0 0 0
9 FATUNENO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 NOEPESU 4 0 4 0 0 0 0 4 0 0 0 0 4 4 0 0 0 0
11 MANUSASI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 NOELTOKO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 24 3 20 0 0 1 3 20 0 0 1 0 24 24 0 0 0 0
ERNAL

TEMPAT PENOLONG

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

LAHIR HIDUP LAHIR MATI BBLR BAYI DIBERI KN 1 KN 2 KN 3 KN LENGKAP VIT.A BAYI VIT.A BALITA NEONATAL DGN KOMPLIKASI
TOTAL
NO DESA/ KEL. PERSALI HB O
L P L P L P IMD SALF VIT. K 0 - 7 L P L P L P L P L P L P JLH JENIS KOMPLIKASI DITANGANI
NAN MATA Hari HIDUP

1 KEL.EBAN 6 2 5 0 0 0 3 4 6 6 4 2 6 2 3 2 3 2 3 0 0 0 0 3 PREMATUR,BBLR 3

2 KEL. SALLU 3 3 0 0 0 0 0 3 3 3 3 3 0 3 0 3 0 3 0 0 0 0 0 0 0 0

3 HAULASI 2 1 1 0 0 0 0 2 2 2 2 1 1 1 0 1 0 1 0 0 0 0 0 1 PNEUMONI 0

4 FATUTASU 1 0 1 0 0 0 0 1 1 1 1 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0

5 FATUNISUAN 5 1 3 0 1 0 0 4 4 4 4 1 3 1 3 1 3 1 3 0 0 0 0 0 0 0

6 SUANAE 0 0 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 LEMON 1 0 1 0 0 0 0 1 1 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0

8 SAENAM 2 2 0 0 0 0 0 2 2 2 2 2 0 2 0 2 0 2 0 0 0 0 0 0 0 0

9 FATUNENO 0 0 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 NOEPESU 4 1 3 0 0 0 0 4 4 4 4 3 1 3 1 3 1 3 1 0 0 0 0 0 0 0

11 MANUSASI 0 0 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 NOELTOKO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JUMLAH 24 10 14 0 1 0 3 21 23 23 21 12 13 12 9 12 9 12 9 0 0 0 0 4 0 3
TAL DGN KOMPLIKASI

DITANGANI DIRUJUK
MATI KE PUSK KE RS

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

KEL.PERSLINAN KUNJUNGAN NIFAS ASI EKSKLUSIF PERIKSA BUSUI

NO DESA/ KEL. NIFAS
IMATURUS ABORTUS IUFD NIFAS 1 NIFAS 2 NIFAS 3
LENGKAP 0 1 2 3 4 5 B B+L

1 KELURAHAN EBAN 0 0 0 6 6 6 6 7 3 3 4 3 1 7 60

2 KELURAHAN SALLU 0 0 0 3 3 3 3 3 3 1 3 5 2 3 30

3 HAULASI 0 0 0 2 2 2 2 2 0 3 2 1 1 2 30

4 FATUTASU 0 0 0 1 1 1 1 1 4 0 3 0 0 1 10

5 FATUNISUAN 0 0 1 5 5 5 5 4 0 2 0 2 1 4 31

6 SUANAE 0 0 0 0 0 0 0 0 2 2 0 2 1 0 30

7 LEMON 0 0 0 0 1 1 1 1 0 0 1 0 0 1 11

8 SAENAM 0 0 0 2 2 2 2 2 1 2 1 3 0 2 22

9 FATUNENO 0 0 0 0 0 0 0 0 5 3 2 2 2 0 52

10 NOEPESU 0 0 0 4 4 4 4 4 3 3 2 2 1 4 43

11 MANUSASI 0 0 0 0 0 0 0 0 1 1 1 1 1 0 26

12 NOELTOKO 0 0 0 0 0 0 0 0 0 2 0 1 1 0 39

13 SATAB 0 0 0 0 0 0 0 0 0 2 2 0 0 0 14

JUMLAH 0 0 1 23 24 24 24 24 22 24 21 22 11 24 398
KET
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

KEMATIAN NEONATAL 0 - 7 HR KEMATIAN NEONATAL 8 - 28 HR KEMATIAN BAYI KEMATIAN BALITA

NO DESA/ KEL.
L P PENYEBAB L P PENYEBAB L P PENYEBAB L P PENYEBAB

1 KELURAHAN EBAN 0 0 0 0 0 0 0 0 0 0 0 0

2 KELURAHAN SALLU 0 0 0 0 0 0 0 0 0 0 0 0

3 HAULASI 0 0 0 0 1 PNEUMONIA 0 0 0 0 0 0

4 FATUTASU 0 0 0 0 0 0 0 0 0 0 0 0

5 FATUNISUAN 0 0 0 0 0 0 0 0 0 0 0 0

6 SUANAE 0 0 0 0 0 0 0 0 0 0 0 0

7 LEMON 0 0 0 0 0 0 0 0 0 0 0 0

8 SAENAM 0 0 0 0 0 0 0 0 0 0 0 0

9 FATUNENO 0 0 0 0 0 0 0 0 0 0 0 0

10 NOAPESU 0 0 0 0 0 0 0 0 0 0 0 0

11 MANUSASI 0 0 0 0 0 0 0 0 0 0 0 0

12 NOELTOKO 0 0 0 0 0 0 0 0 0 0 0 0

13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0

JUMLAH 0 0 0 0 1 0 0 0 0 0 0 0
KET
LAPORAN KESEHATAN IBU DAN ANAK
PUSKESMAS :: EBAN
BULAN : DESEMBER 2014

KUNJUNGAN BAYI KUNJUNGAN BALITA DDTK BALITA KONTAK I DDTK APRAS KONTAK I PELAYANAN MTBS
NO DESA/ KEL. 8X 2X 2X JML BAYI SAKIT YG DILAYANI MTBS JML BALITA SAKIT
I II III IV L P JML L P JML
TIMBANG VIT.A DETEKSI L P L P L P

1 KELURAHAN EBAN 3 7 3 2 13 13 13 2 0 2 1 1 2 0 0 0 0 4 2

2 KELURAHAN SALLU 3 3 2 1 6 6 6 0 1 1 0 0 0 0 0 0 0 0 0

3 HAULASI 2 3 0 1 2 2 2 1 0 1 0 0 0 0 1 0 1 1 2

4 FATUTASU 3 0 1 0 8 8 8 0 0 0 0 0 0 0 0 0 0 0 0

5 FATUNISUAN 4 3 4 4 8 6 5 0 1 1 2 0 2 0 0 0 0 0 0

6 SUANAE 2 0 2 0 2 2 2 0 0 0 0 1 1 2 1 2 1 3 1

7 LEMON 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 SAENAM 4 3 2 1 2 2 2 1 0 1 1 0 1 0 0 0 0 0 1

9 FATUNENO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 NOEPESU 2 2 4 4 11 11 9 0 0 0 0 0 0 1 0 1 0 0 0

11 MANUSASI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 NOELTOKO 0 0 0 0 3 3 3 0 0 0 0 0 0 0 0 0 0 3 1

13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JUMLAH 23 21 18 13 55 53 50 4 2 6 4 2 6 3 2 3 2 11 7
 YG DILAYANI MTBS
L P

4 2

0 0

1 2

0 0

0 0

3 1

0 0

0 1

0 0

0 0

0 0

3 1

0 0

11 7
LAPORAN KELUARGA BERENCANA
PUSKESMAS : EBAN
BULAN : OKTOBER 2015

JML JLH PPM AKSEPTOR BARU AKSEPTOR ULANGAN AKSEPTOR AKTIF

NO DESA/ KEL. Perkiraan
PUS IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL
permint.masy
1 NOEPESU 287 0 0 0 0 1 0 0 1 0 0 0 1 10 0 1 11 3 0 1 1 127 0 54
2 FATUNENO 271 0 0 0 0 1 0 0 1 0 0 0 5 14 0 1 20 3 0 0 5 82 0 29
3 KEL.EBAN 495 0 0 0 0 0 0 0 0 0 0 0 2 40 0 2 44 0 0 3 4 121 0 80
4 KEL.SALLU 430 0 0 0 0 0 0 1 1 0 0 0 1 25 0 0 26 4 0 4 12 165 1 51
5 SUANAE 172 0 0 0 0 0 0 0 0 0 0 0 4 11 0 1 16 0 0 0 4 43 0 28
6 LEMON 79 0 0 1 0 0 0 0 1 0 0 0 1 4 0 0 5 0 0 1 5 21 0 1
7 FATUNISUAN 351 0 0 0 0 1 0 0 1 0 0 0 3 20 0 1 23 6 0 2 1 98 0 31
8 HAULASI 170 0 0 1 0 0 0 0 1 0 0 0 1 10 0 0 11 4 0 1 1 45 0 21
9 NOELTOKO 120 0 0 1 0 1 0 0 2 0 0 0 0 6 0 2 6 0 0 2 0 27 0 19
10 FATUTASU 213 0 0 0 0 0 0 0 0 0 0 0 0 19 0 1 20 0 0 0 6 74 0 20
11 MANUSASI 169 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 10 0 0 0 1 86 0 6
12 SAENAM 115 0 0 0 0 1 0 0 1 0 0 0 0 7 0 0 7 0 1 1 0 45 0 4
13 SATAB 51 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 0 14 0 1
JUMLAH 2,923 0 0 3 0 5 0 1 9 0 0 0 18 179 0 9 202 20 1 12 40 944 1 344

CATATAN : 1 ) PELAYANAN AKSEPTR DARI LUAR WILAYAH

(MASUK DALAM PELAYANAN KB SUNTIK DI PUSK ) 3 ) PELAYANAN ULANG IMPLANT ( AFF DAN PASANG ) 4) PELAYANAN PASANG IMPLANT (AKSEPTOR BARU )
Bonleu : 6 Orang Neopesu : 1 Orang Sallu : 1 orang
Oelmuke : 2 Orang Fatuneno : 1 Orang
Fatumnutu : 1 Orang Eban : 2 Orang 5 ) AKSEPTOR YANG DILAYANI DI PUSKESMAS,
2 ) PELAYANAN GANTI CARA Suanae : 1 Orang DIMASUKAN KE DESA MASING-MASING
Noepesu : Suntk ke implant : 1 Orang Fatunisuan : 1 Orang PENGELUARAN OBAT TETAP DI HITUNG DI PUSKEAMAS
 Implant ke pill : 1 Orang Fatutasu : 1 Orang
Eban : Suntk ke pill : 1 Orang

LAPORAN KELUARGA BERENCANA

PUSKESMAS : EBAN
BULAN : NOPEMBER 2015

JML JLH PPM AKSEPTOR BARU AKSEPTOR ULANGAN AKSEPTOR AKTIF

NO DESA/ KEL. Perkiraan
PUS IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL
permint.masy
1 NOEPESU 287 0 0 0 0 1 0 0 1 0 0 0 0 14 0 0 14 3 0 1 1 128 0 54
2 FATUNENO 271 0 0 0 0 2 0 0 2 0 0 0 5 16 0 0 21 2 0 0 5 83 0 29
3 KEL.EBAN 495 0 0 0 1 2 0 0 3 0 0 0 1 40 0 0 41 0 0 3 4 122 0 80
4 KEL.SALLU 430 0 0 0 1 3 0 0 4 0 0 0 2 14 0 0 16 4 0 4 12 167 1 51
5 SUANAE 172 0 0 0 0 1 0 0 1 0 0 0 2 10 0 0 12 0 0 0 4 43 0 28
6 LEMON 79 0 0 0 0 0 0 0 0 0 0 0 2 3 0 0 5 0 0 1 4 21 0 1
7 FATUNISUAN 351 0 0 0 0 1 0 0 1 0 0 0 0 9 0 0 9 6 0 2 1 98 0 31
8 HAULASI 170 0 0 0 0 1 0 0 1 0 0 0 2 14 0 0 16 4 0 1 1 47 0 21
9 NOELTOKO 120 0 0 1 0 2 0 0 3 0 0 0 0 7 0 2 7 0 0 2 0 28 0 19
10 FATUTASU 213 0 0 0 0 1 0 0 1 0 0 0 0 13 0 0 13 0 0 0 6 75 0 20
11 MANUSASI 169 0 0 0 1 0 0 0 1 0 0 0 2 5 0 0 7 0 0 0 2 86 0 6
12 SAENAM 115 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 18 0 1 1 0 45 0 4
13 SATAB 51 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 5 0 0 0 0 14 0 1
JUMLAH 2,923 0 0 1 3 14 0 0 18 0 0 0 16 168 0 2 184 19 1 12 40 944 1 344

CATATAN : 1 ) PELAYANAN AKSEPTR DARI LUAR WILAYAH

(MASUK DALAM PELAYANAN KB SUNTIK DI PUSK ) 3 ) PELAYANAN ULANG IMPLANT ( AFF DAN PASANG ) 5) PELAYANAN PASANG IMPLANT (AKSEPTOR BARU )
Bonleu : 12 Orang Haulasi : 1 orang Tidak ada
Oelmuke : 1 Orang
Atambua : 1 Orang 6 ) AKSEPTOR YANG DILAYANI DI PUSKESMAS,
2 ) PELAYANAN GANTI CARA 4 ) PELAYANAN AFF IUD DIMASUKAN KE DESA MASING-MASING
Haulasi : Implant ke suntk 2 0rang FATUNENO : 1 ORANG PENGELUARAN OBAT TETAP DI HITUNG DI PUSKEAMAS
Implant ke pill 2 orang
 Eban : Pill Ke suntk : 1 Orang

LAPORAN KELUARGA BERENCANA

PUSKESMAS : EBAN
BULAN : DESEMBER 2015

JML JLH PPM AKSEPTOR BARU AKSEPTOR ULANGAN AKSEPTOR AKTIF

NO DESA/ KEL. Perkiraan
PUS IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL
permint.masy
1 NOEPESU 287 0 0 0 0 0 0 0 0 0 0 0 5 21 0 0 26 3 0 1 1 128 0 54
2 FATUNENO 271 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 11 2 0 0 5 83 0 29
3 KEL.EBAN 495 0 0 0 0 1 0 0 1 0 0 0 3 39 0 1 43 0 0 3 4 122 0 80
4 KEL.SALLU 430 0 0 0 0 1 0 0 2 0 0 0 6 19 0 0 25 4 0 4 12 169 1 49
5 SUANAE 172 0 0 0 0 0 0 0 1 0 0 0 2 8 0 0 10 0 0 0 4 43 0 28
6 LEMON 79 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 3 0 0 1 4 21 0 1
7 FATUNISUAN 351 0 0 0 0 1 0 0 1 0 0 0 1 15 0 0 16 6 0 2 1 99 0 31
8 HAULASI 170 0 0 0 0 0 0 0 1 0 0 0 2 13 0 2 17 4 0 1 1 48 0 20
9 NOELTOKO 120 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 5 0 0 2 0 28 0 19
10 FATUTASU 213 0 0 0 0 1 0 0 1 0 0 0 0 12 0 0 12 0 0 0 6 75 0 20
11 MANUSASI 169 0 0 0 0 0 0 0 0 0 0 0 1 9 0 0 10 0 0 0 2 86 0 6
12 SAENAM 115 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1 17 0 1 1 0 46 0 3
13 SATAB 51 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 0 14 0 1
JUMLAH 2,923 0 0 0 0 4 0 0 7 0 0 0 21 173 0 4 198 19 1 12 40 962 1 341

CATATAN : 1 ) PELAYANAN AKSEPTR DARI LUAR WILAYAH

(MASUK DALAM PELAYANAN KB SUNTIK DI PUSK ) 3 ) PELAYANAN ULANG IMPLANT ( AFF DAN PASANG ) 5) PELAYANAN PASANG IMPLANT (AKSEPTOR BARU )
Bonleu : 6 Orang Haulasi : 1 orang Tidak ada
Oelmuke : 1 Orang
Fatunutu : 1 Orang 6 ) AKSEPTOR YANG DILAYANI DI PUSKESMAS,
2 ) PELAYANAN GANTI CARA 4 ) PELAYANAN AFF IUD DIMASUKAN KE DESA MASING-MASING
Saenam : Implant ke suntk 1 0rang 0 PENGELUARAN OBAT TETAP DI HITUNG DI PUSKEAMAS
Sallu Implant ke suntk 2 orang
Haulasi Implant ke suntk : 1 orang
 JML

186
119
208
237
75
28
137
72
47
100
93
49
15
1,366

DI PUSKEAMAS
 JML

187
119
208
239
75
28
137
74
49
101
93
49
15
1,374

DI PUSKEAMAS
JML

187
119
209
239
75
27
139
74
49
101
94
51
15
1,376
DI PUSKEAMAS
LAPORAN KELUARGA BERENCANA
PUSKESMAS EBAN
BULAN BULAN OKTOBER 2015

AKSEPTOR PUTUS KB MENURUT KARAKTERISTIK

NO DESA/ KEL. IBU KB DGN KONDISI 4 TERLALU KET
IUD MOP MOW PIL SNTK KNDM IMPL JML KK MISKIN
IKUT KB UMR < 20 UMUR > 35 ANAK > 3 INPASING
< 2 THN

1 NOEPESU 0 0 0 0 0 0 0 0 9 0 3 1 0
2 FATUNENO 0 0 0 0 0 0 0 0 15 0 2 2 6
3 KEL.EBAN 0 0 0 0 0 0 0 0 18 0 11 8 0 -
4 KEL.SALLU 0 0 0 0 0 0 0 0 20 0 13 5 0
5 SUANAE 0 0 0 0 0 0 0 0 9 0 6 3 0
6 LEMON 0 0 0 0 0 0 0 0 4 0 2 2 0
7 FATUNISUAN 0 0 0 0 0 0 0 0 17 0 6 5 0
8 HAULASI 0 0 0 0 0 0 0 0 10 0 0 0 0
9 NOELTOKO 0 0 0 0 0 0 0 0 2 0 2 2 0
10 FATUTASU 0 0 0 0 0 0 0 0 13 0 3 4 0
11 MANUSASI 0 0 0 0 0 0 0 0 3 0 3 2 0
12 SAENAM 0 0 0 0 0 0 0 0 5 0 3 2 0
13 SATAB 0 0 0 0 0 0 0 0 3 0 2 3 0
JUMLAH 0 0 0 0 0 0 0 0 128 0 56 39 6

LAPORAN KELUARGA BERENCANA

PUSKESMAS EBAN
BULAN BULAN NOPEMBER 20

AKSEPTOR PUTUS KB MENURUT KARAKTERISTIK

NO DESA/ KEL. KET
NO DESA/ KEL. IBU KB DGN KONDISI 4 TERLALU KET
IUD MOP MOW PIL SNTK KNDM IMPL JML KKIKUT
MISKIN
KB UMR < 20 UMUR > 35 ANAK > 3 INPASING
< 2 THN
1 NOEPESU 0 0 0 0 0 0 0 0 8 0 7 2 0
2 FATUNENO 0 0 0 0 1 0 0 1 13 0 9 7 0
3 KEL.EBAN 0 0 0 0 0 0 0 0 15 0 7 6 0 -
4 KEL.SALLU 0 0 0 0 0 0 0 0 15 0 9 7 0
5 SUANAE 0 0 0 0 0 0 0 0 7 0 4 3 0
6 LEMON 0 0 0 0 0 0 0 0 2 2 2 2 0
7 FATUNISUAN 0 0 0 1 0 0 0 1 8 0 1 1 0
8 HAULASI 0 0 0 0 0 0 0 0 10 0 0 0 0
9 NOELTOKO 0 0 0 0 1 0 0 1 2 0 2 2 0
10 FATUTASU 0 0 0 0 0 0 0 0 1 0 1 1 0
11 MANUSASI 0 0 0 0 0 0 0 0 3 0 2 1 0
12 SAENAM 0 0 0 0 0 0 0 0 10 0 7 3 0
13 SATAB 0 0 0 0 0 0 0 0 4 0 3 3 0
JUMLAH 0 0 0 1 2 0 0 3 98 2 54 38 0
LAPORAN KELUARGA BERENCANA
PUSKESMAS EBAN
BULAN DESEMBER 2015

AKSEPTOR PUTUS KB MENURUT KARAKTERISTIK

NO DESA/ KEL. IBU KB DGN KONDISI 4 TERLALU KET
IUD MOP MOW PIL SNTK KNDM IMPL JML KKIKUT
MISKIN
KB UMR < 20 UMUR > 35 ANAK > 3 INPASING
< 2 THN
1 NOEPESU 0 0 0 0 0 0 0 0 18 0 13 3 5
2 FATUNENO 0 0 0 0 0 0 0 0 7 0 2 1 0
3 KEL.EBAN 0 0 0 0 0 0 0 0 15 0 11 5 0 -
4 KEL.SALLU 0 0 0 0 0 0 0 0 8 0 6 0 0
5 SUANAE 0 0 0 0 0 0 0 0 7 0 4 2 0
6 LEMON 0 0 0 0 0 0 0 0 1 0 1 0 0
7 FATUNISUAN 0 0 0 0 0 0 0 0 15 0 5 2 0
8 HAULASI 0 0 0 0 0 0 0 0 10 0 3 4 0
9 NOELTOKO 0 0 0 0 0 0 0 0 2 0 0 0 0
10 FATUTASU 0 0 0 0 0 0 0 0 9 0 3 6 0
11 MANUSASI 0 0 0 0 0 0 0 0 4 0 4 0
12 SAENAM 0 0 0 0 0 0 0 0 8 0 4 0 0
13 SATAB 0 0 0 0 0 0 0 0 3 0 3 2 0
JUMLAH
LAPORAN KELUARGA BERENCANA
PUSKESMAS : EBAN
BULAN : Oct-15

EFEK SAMPING KOMPLIKASI KB GAGAL KB

NO DESA/ KEL.
IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML

1 NOEPESU 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 FATUNENO 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 KEL.EBAN 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 KEL.SALLU 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 SUANAE 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 LEMON 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 FATUNISUAN 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 HAULASI 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 NOELTOKO 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 FATUTASU 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 MANUSASI 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 SAENAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

LAPORAN KELUARGA BERENCANA

PUSKESMAS : EBAN
BULAN : Nov-15
 EFEK SAMPING KOMPLIKASI KB GAGAL KB
NO DESA/ KEL.
IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML

1 NOEPESU 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 FATUNENO 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 KEL.EBAN 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 KEL.SALLU 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 SUANAE 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 LEMON 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 FATUNISUAN 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 HAULASI 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 NOELTOKO 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 FATUTASU 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 MANUSASI 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 SAENAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

LAPORAN KELUARGA BERENCANA

PUSKESMAS : EBAN
BULAN : Nov-15

EFEK SAMPING KOMPLIKASI KB GAGAL KB

NO DESA/ KEL.
IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML

1 NOEPESU 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 FATUNENO 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 KEL.EBAN 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 KEL.SALLU 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 SUANAE 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 LEMON 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 FATUNISUAN 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 HAULASI 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 NOELTOKO 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 FATUTASU 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 MANUSASI 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 SAENAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAPORAN KELUARGA BERENCANA
PUSKESMAS : EBAN
BULAN : OKTOBER 2015 :

PERSEDIAAN ALAT / OBAT KB

NO DESA/ KEL. SISA BULAN LALU TERIMA BULAN INI KELUAR BULAN INI SISA AKHIR BULAN INI
IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK

1 NOEPESU 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 1

2 FATUNENO 0 0 0 10 28 0 0 0 0 0 0 0 0 0 0 0 0 5 15 0 0 0 0 0 5 13

3 KEL.EBAN 0 0 0 2 50 72 0 0 0 0 0 149 0 10 0 0 0 2 89 0 8 0 0 0 0 110

4 KEL.SALLU 0 0 0 4 3 0 0 0 0 0 0 20 0 0 0 0 0 1 11 0 0 0 0 0 3 12

5 SUANAE 0 0 0 4 7 0 0 0 0 0 0 10 0 0 0 0 0 4 10 0 0 0 0 0 0 7

6 LEMON 0 0 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 FATUNISUAN 0 0 0 5 0 0 0 0 0 0 0 15 0 0 0 0 0 0 15 0 0 0 0 0 2 0

8 HAULASI 0 0 0 2 7 0 0 0 0 0 0 15 0 0 0 0 0 0 11 0 0 0 0 0 2 11

9 NOELTOKO 0 0 0 0 4 0 0 0 0 0 0 3 0 0 0 0 0 0 7 0 0 0 0 0 0 0

10 FATUTASU 0 0 0 0 4 0 0 0 0 0 0 13 0 0 0 0 0 0 17 0 0 0 0 0 0 0

11 MANUSASI 0 0 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 SAENAM 0 0 0 0 6 0 0 0 0 0 0 15 0 0 0 0 0 0 9 0 0 0 0 0 0 12

13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JUMLAH 0 0 0 27 110 72 0 0 0 0 0 240 0 0 0 0 0 12 184 0 8 0 0 0 12 166

MENGETAHUI EBAN,06 11/1/2015

KEPALA PUSKESMAS EBAN PENGELOLA KB
 CLARA M.TH BOLENG.S.kep.Ns. MELANIA PILIS
NIP.19681003 198801 2 002 NIP.19730813 200604 2 027

PUSKESMAS : EBAN
BULAN : OKTOBER 2015 :

PERSEDIAAN ALAT / OBAT KB

NO DESA/ KEL. SISA BULAN LALU TERIMA BULAN INI KELUAR BULAN INI SISA AKHIR BULAN INI
IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK
1 NOEPESU 0 0 0 0 1 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 0 0 0 0 0 0
2 FATUNENO 0 0 0 5 13 0 0 0 0 0 0 15 0 0 0 0 0 5 14 0 0 0 0 0 0 14
3 KEL.EBAN 0 0 0 0 110 72 2 0 0 0 0 60 0 0 0 0 0 0 86 0 0 0 0 0 0 84
4 KEL.SALLU 0 0 0 3 12 0 0 0 0 0 0 20 0 0 0 0 0 3 15 0 0 0 0 0 0 17
5 SUANAE 0 0 0 5 7 0 0 0 0 0 0 0 0 0 0 0 0 2 7 0 0 0 0 0 3 0
6 LEMON 0 0 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 FATUNISUAN 0 0 0 2 0 0 0 0 0 0 0 10 0 0 0 0 0 0 10 0 0 0 0 0 2 0
8 HAULASI 0 0 0 2 5 0 0 0 0 0 0 10 0 0 0 0 0 1 11 0 0 0 0 0 1 4
9 NOELTOKO 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 8 0 0 0 0 0 0 7
10 FATUTASU 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 12 0 0 0 0 0 0 8
11 MANUSASI 0 0 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 SAENAM 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 17 160 72 2 0 0 0 0 160 0 0 0 0 0 11 186 0 0 0 0 0 6 134

MENGETAHUI EBAN,06 12/1/2015

KEPALA PUSKESMAS EBAN PENGELOLA KB
 CLARA M.TH BOLENG.S.kep.Ns. MELANIA PILIS
NIP.19681003 198801 2 002 NIP.19730813 200604 2 027

PUSKESMAS : EBAN
BULAN : DESEMBER 2015

PERSEDIAAN ALAT / OBAT KB

NO DESA/ KEL. SISA BULAN LALU TERIMA BULAN INI KELUAR BULAN INI SISA AKHIR BULAN INI
IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK KNDM IMPL IUD MOP MOW PIL SNTK
1 NOEPESU 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 5 10 0 0 0 0 0 0 6
2 FATUNENO 0 0 0 0 14 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 0 0 0 0 0 13
3 KEL.EBAN 0 0 0 0 84 72 0 0 0 0 97 76 0 10 0 0 0 7 90 0 0 0 0 0 90 70
4 KEL.SALLU 0 0 0 0 17 0 0 0 0 0 3 0 0 0 0 0 0 3 11 0 0 0 0 0 0 6
5 SUANAE 0 0 0 3 0 0 0 0 0 0 0 10 0 0 0 0 0 2 4 0 0 0 0 0 1 6
6 LEMON 0 0 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 FATUNISUAN 0 0 0 2 0 0 0 0 0 0 0 15 0 0 0 0 0 1 16 0 0 0 0 0 1 0
8 HAULASI 0 0 0 1 4 0 0 0 0 0 0 10 0 0 0 0 0 1 10 0 0 0 0 0 0 4
9 NOELTOKO 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5
10 FATUTASU 0 0 0 0 8 0 0 0 0 0 0 10 0 0 0 0 0 0 12 0 0 0 0 0 0 6
11 MANUSASI 0 0 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 SAENAM 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 11 0 0 0 0 0 0 1
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 6 134 72 0 0 0 0 100 160 0 10 0 0 0 19 177 0 0 0 0 0 92 117

MENGETAHUI EBAN,06 2/1/2016

KEPALA PUSKESMAS EBAN PENGELOLA KB
CLARA M.TH BOLENG.S.kep.Ns. MELANIA PILIS
NIP.19681003 198801 2 002 NIP.19730813 200604 2 027
IR BULAN INI
KNDM IMPL
0 0

0 0

72 2

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

72 2
IR BULAN INI
KNDM IMPL
0 0
0 0
72 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
72 0
IR BULAN INI
KNDM IMPL
0 0
0 0
72 6
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
72 6
DATA SARANA DAN KETENAGAAN
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

KETENAGAAN
JUMLAH SARANA KESEHATAN JUMLAH DUKUN BIDAN TERLATIH
BIDAN PERAWAT
NO PUSKESMAS
DOKTER TDK
PUSK PUSTU POLINDS POSYANDU PUSK POLINDS PUSTU PUSK POLINDS PUSTU TERLATIH TERLATIH APN MTBS LSS KIP/K DDTK

1 KELURAHAN EBAN 1 0 0 3 2 3 0 0 7 0 0 2 0 2 3 3 3 2
2 KELURAHAN SALU 0 0 1 4 0 0 1 0 0 0 0 0 0 1 0 0 0 0
3 HAULASI 0 1 0 2 0 1 0 0 0 0 0 2 0 1 0 0 0 0
4 FATUTASU 0 0 1 2 0 0 1 0 0 0 0 0 0 1 0 0 0 0
5 FATUNISUAN 0 0 1 3 0 0 1 0 0 0 0 2 2 1 0 1 1 0
6 SUANAE 0 0 1 2 0 0 1 0 0 0 0 0 0 1 1 1 1 0
7 LEMON 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 SAENAM 0 0 1 1 0 0 1 0 0 0 0 1 0 1 1 1 1 0
9 FATUNENO 0 1 0 2 0 0 0 1 0 0 0 2 1 1 0 0 0 0
10 NOEPESU 0 0 1 3 0 0 1 0 0 0 0 1 0 1 0 0 0 0
11 MANUSASI 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0
12 NOELTOKO 0 1 0 1 0 0 0 1 0 0 0 1 0 1 1 0 0 0
13 SATAB 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 1 4 7 24 2 4 6 3 7 0 1 12 3 11 6 6 6 2
DATA LOGISTIK KIA
PUSKESMAS : EBAN
BULAN : DESEMBER 2014

BUKU KIA STIKER P4K

NO PUSKESMAS JML IH BARU SISA BUKU BLN TERIMA BLN KELUAR BLN JML IH BARU SISA BUKU BLN TERIMA BLN KELUAR BLN INI SISA BLN INI
SISA BLN INI
BULAN INI LALU INI INI BULAN INI LALU INI

1 EBAN 21 254 0 21 233 21 90 0 21 69

10

11

12

13

JUMLAH 21 254 0 21 233 21 90 0 21 69

Mengetahui Eban, 05 Januari 2015

Kepala Puskesmas Eban Pengelola KIA
Clara M.TH.Boleng,S Kep.NS Melania Pilis
Nip 19681003 198801 2 002 Nip 19730813 200604 2 012
LAPORAN KELUARGA BERENCANA
PUSKESMAS : EBAN
BULAN : DESEMBER 2015

JML JLH PPM AKSEPTOR BARU AKSEPTOR ULANGAN AKSEPTOR AKTIF

NO DESA/ KEL. Perkiraan
PUS IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL JML IUD MOP MOW PIL SNTK KNDM IMPL
permint.masy
1 NOEPESU 287 0 0 0 0 0 0 0 0 0 0 0 5 21 0 0 26 3 0 1 1 128 0 54
2 FATUNENO 271 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 11 2 0 0 5 83 0 29
3 KEL.EBAN 495 0 0 0 0 1 0 0 1 0 0 0 3 39 0 1 43 0 0 3 4 122 0 80
4 KEL.SALLU 430 0 0 0 0 1 0 0 2 0 0 0 6 19 0 0 25 4 0 4 12 169 1 49
5 SUANAE 172 0 0 0 0 0 0 0 1 0 0 0 2 8 0 0 10 0 0 0 4 43 0 28
6 LEMON 79 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 3 0 0 1 4 21 0 1
7 FATUNISUAN 351 0 0 0 0 1 0 0 1 0 0 0 1 15 0 0 16 6 0 2 1 99 0 31
8 HAULASI 170 0 0 0 0 0 0 0 1 0 0 0 2 13 0 2 17 4 0 1 1 48 0 20
9 NOELTOKO 120 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 5 0 0 2 0 28 0 19
10 FATUTASU 213 0 0 0 0 1 0 0 1 0 0 0 0 12 0 0 12 0 0 0 6 75 0 20
11 MANUSASI 169 0 0 0 0 0 0 0 0 0 0 0 1 9 0 0 10 0 0 0 2 86 0 6
12 SAENAM 115 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1 17 0 1 1 0 46 0 3
13 SATAB 51 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 0 14 0 1
JUMLAH 2,923 0 0 0 0 4 0 0 7 0 0 0 21 173 0 4 198 19 1 12 40 962 1 341

CATATAN : 1 ) PELAYANAN AKSEPTR DARI LUAR WILAYAH

(MASUK DALAM PELAYANAN KB SUNTIK DI PUSKES ) 3 PELAYANAN ULANG IMPLANT ( AFF DAN PASANG ) 5) PELAYANAN PASANG IMPLANT (AKSEPTOR BARU )
Bonl : 6 Orang Haulasi : 1 orang Tidak ada
Oe : 1 Orang
Fa : 1 Orang 6 ) AKSEPTOR YANG DILAYANI DI PUSKESMAS,
2 ) PELAYANAN GANTI CARA 4 ) PELAYANAN AFF IUD DIMASUKAN KE DESA MASING-MASING
Sa : Implant ke suntk : 1 Orang 1 0rang 0 PENGELUARAN OBAT TETAP DI HITUNG DI PUSKEAMAS
Sall Implant ke suntk : 1 Orang 2 orang
Ha Implant ke suntk : 1 orang
IF

JML

187
119
209
239
75
27
139
74
49
101
94
51
15
1,376

DI PUSKEAMAS