#REF!

1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 #REF!
1.2

0.8

#REF!

0.6

0.4

0.2

0
 PUSKESMAS WAYABULA
KECAMATAN MOROTAI SELATAN BARAT
FORMULIR PEMANTAUAN STATUS GIZI BALITA 0-59 BULAN OKTOBER 2018

Umur Tinggi BB 1 BB 2 Diagnosa

No. Nama Anak Jenis Nama KK Desa Agama Tanggal Lahir Kategori Status Gizi BGM/ Kategori Keluarga
Kelamin Badan BB Bulan Ini Bulan Bulan Dokter/ Gizi Kurang Miskin/ Tidak Miskin
Tahun Bulan (TB) Lalu Lalu Bidan
1 aprilian L Tutuhu Kristen 5/4/2016 30 83 9 BGM, Pendek,Kurus Miskin
2 marsel senin L Tutuhu Kristen 19/3/2017 19 70.5 7.3 Sangat Pendek Miskin
3 apriani keirin P Tutuhu Kristen 20/3/2018 7 67.8 5.4 BGM,Sangat kurus Miskin
4 iksanputra L Tutuhu Kristen 28/8/2018 2 50 3.1 BGM, Sangat pendek Miskin
5 jefrianto L Raja Kristen 24/8/2015 38 87 9 BGM,Pendek, Sangatkurus Miskin
6 elfira P Raja Kristen 4/7/2016 27 79.5 7.6 BGM, Pendek, Sangatkurus Miskin
7 novanto L Raja Kristen 23/11/2017 11 65 7.2 S. Pendek Miskin
8 novitania P Raja Kristen 27/11/2016 23 68 8 S. Pendek Miskin
9 jenifer P Raja Kristen 19/7/2017 15 66.8 7 S. Pendek Miskin
10 juliana L Raja Kristen 2/7/2017 15 66.6 7 S. Pendek Miskin
11 oliviahito P Tutuhu Kristen 5/10/2014 48 89.6 12 S. Pendek Miskin
12 adira P TN. SAFRUDIN Bobula Islam 16/12/2015 34 84.6 11.2 Pendek Miskin
13 m.toriq L TN.SAFRUDIN Bobula Islam 21/6/2014 52 95.9 14 Pendek Miskin
14 adifa aira P TN. HAMID M Wayabula Islam 14/2/2017 20 75 7.8 Pendek Tidak Miskin
15 m.mahmud alfi L TN.M.AMIN Wayabula Islam 21/3/2016 31 84.5 10.4 Pendek Tidak Miskin
16 natasya P Wayabula Kristen 24/1/2016 33 84 10.5 Pendek Miskin
17 jelo L Wayabula Kristen 18/1/2017 21 75 9.5 sangat pendek Miskin
18 Rina Halil P TN.WANDI Wayabula Islam 29/12/2017 9 65 5.6 kurus Miskin
19 Hasan rence L TN.KADER RENCE Bobula Islam 3/7/2015 39 88.8 11.5 pendek Miskin

Pengelola Program Gizi Morotai, 31 Oktober 2018

Mengetahui,
Kepala Puskesmas

JABIATI, S.Gz WAYYAMA WABULA

NRPK : NIP. 19750404200212 2010