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DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG

DATA IBU HAMIL PUSKESMAS BRATI


BULAN : JANUARI TAHUN : 2017

FAKTOR RISIKO BUMIL


PRIMIGRAVIDA
ALAMAT LENGKAP GOL. JML JARAK KEK : ANEMIA TINGGI
NO NAMA BUMIL NIK HPL
(DESA/KEL, RT, RW) Darah ANAK > PERSALINAN < 2 LILA < Hb < 11 BADAN <
< 20 thn > 35 thn 4 thn 23,5 cm g/dl 145 cm

1 Sarifah Habibatul Menduran Rt 02/05 3315145404960004 O 27/8/2017 1 1


2 Sri Ambarwati Menduran Rt 07/02 3315144306900001 B 9/9/2017 1
3 Nailil Ma'rifah Menduran Rt 08/01 3324085101900006 B 20/8/2017 1 1 1
4 Siti Maunah Menduran Rt 01/01 3322113591290003 O 4/8/2017 1 1
5 Nur Khalimah Menduran Rt 02/01 3319064103970002 B 25/5/2017 1 1
6 Herwati Menduran Rt 04/07 3315146702920003 O 30/7/2017 1 1
7 Maya Puji Menduran Rt 01/06 3315145201920001 O 10/8/2017 1
8 Nur Fandhilah Menduran Rt 06/06 3315145512920004 O 8/8/2017
9 Dewi Ria Menduran Rt 03/03 3315145203990004 B 20/3/2017
10 Haryanti Menduran Rt 03/05 3315143305950001 B 18/7/2017
11 Siti Ambarwati Jangkungharjo Rt 06/01 3315146504970001 O 12/8/2017
12 Siti Nurkhayati Jangkungharjo Rt 08/04 3315144106850001 B Juli 2017 1
13 Sri Wahyuni Jangkungharjo Rt 06/03 3315145306990004 O 18/7/2017 1
14 Siti Zumaroh Jangkungharjo Rt 02/01 3315146710890002 A 13/8/2017
15 Sri Mulyani Jangkungharjo Rt 03/01 3315145603880004 A 12/8/2017
16 Nur Ulis Safaah Jangkungharjo Rt 06/01 3315145907910001 A 28/2/2017
17 Aprilia Jangkungharjo Rt 04/02 331513590450010 B 21/8/2017 1
18 Ayu Lestari Temon Rt 04/03 3315144610980002 O 12/7/2017 1 1 1
19 Siti Aisyah Temon Rt 02/02 3315147012780001 O 8/9/2017 1
20 Wanda Ayu Temon Rt 03/06 3315067006980006 A 15/9/2017 1 1
21 Siti Aminah Temon Rt 03/06 3315146309740001 O 17/5/2017 1
22 Jumiati Temon Rt 03/01 3315146201840004 O 27/8/2017 1
23 Deni Wiji Temon Rt 02/02 3315145503920006 A 4/9/2017
24 Siti Sutiah Lemahputih Rt 08/01 3315146709800001 O Juli 2017 1
25 Ngatmi Lemahputih Rt 01/01 3315126211920001 A 12/8/2017
26 Eka Maliyani Lemahputih Rt 06/02 3315146705900003 O 1/9/2017
27 Nursiah Lemahputih Rt 06/02 3315144302900005 A 19/8/2017
28 Anis Fitriati Lemahputih Rt 04/02 3315146805900001 O 2/8/2017
29 Ismiyatun Lemahputih Rt 01/04 3315145605840001 B 8/9/2017
30 Musyafatul Lailatin Lemahputih Rt 02/04 3315146001980001 B 8/9/2017 1
31 Devi Puput Lemahputih Rt 03/04 3315145609970001 O 9/6/2017 1
32 Sri Rahayu Temon Rt 01/04 3315145008780003 O 5/9/2017 1
33 Paing Pujiyanti Temon Rt 02/02 3315145508920002 O 24/8/2017
34 Slamet Winarsih Temon Rt 03/01 3315144604910003 O 2/9/2017
35 Siti Alfiatun Temon Rt 02/01 3315147112890014 O 9/8/2017
36 Rini Riyanti Temon Rt 03/01 3315146009890002 AB 10/9/2017
37 Siti Sholekah Temon Rt 04/04 3315146306870003 B 21/9/2017
38 Tri Harsiwi Karangsari Rt 02/03 3315144805920001 A 20/8/2017
39 Sugiyanti Karangsari Rt 01/03 3315144208840003 O 12/7/2017
40 Pingki Karangsari Rt 01/05 3204306503910001 B 25/5/2017 1
41 Nurhalimah Karangsari Rt 04/05 3315145809970001 O 17/9/2017
42 Yeni S Karangsari Rt 02/01 3315146803900001 A 27/3/2017 1
43 Sulastri Karangsari Rt 02/01 3315144406820002 O 17/7/2017 1
44 Rofiatul Ulya Karangsari Rt 04/02 3315146001950001 A 17/5/2017
45 Karwati Karangsari Rt 04/02 3315144810870003 A 19/5/2017
46 Ninik Purwanti Karangsari Rt 03/01 3315146110920001 O 13/5/2017
47 Narsafiah Karangsari Rt 02/01 3315146205910001 O 24/4/2017
48 Miatul aini Kronggen Rt 03/08 3315146310940004 A 2/8/2017
49 Susilowati Kronggen Rty 02/07 3315146710900002 AB 19/6/2017
50 Nurul Hamidah Kronggen Rt 06/02 3315144504900001 O 8/8/2017 1
51 Nining Sri Astutik Katekan 04/05 3315141202520002 O 4/7/2017
52 Listyowati Katekan Rt 02/05 331514450160003 A 4/8/2017
53 Ria Agneswara Tegalsumur Rt 05/02 3315146208980002 O 22/8/2017
54 Endang Sri Lestari Tegalsumur Rt 05/02 3315145609850002 A 9/9/2017 1
55 Yamti Tegalsumur Rt 01/01 3315146711890001 O 18/9/2017
56 Jumiati Tegalsumur Rt 03/04 3315147005970002 O 4/10/2017
57 Endah Tegalsumur Rt 06/06 3315145110900006 A 25/7/2017

TOTAL : 4 3 0 2 10 13 1
19
FAKTOR RISIKO BUMIL

HIPERTENSI >
140 mmHg,> 90
mmHg
0
FAKTOR RISIKO BUMIL

RIWAYAT
RIWAYAT RIWAYAT KELAINAN
HIPERTENSI PADA PENYAKIT RIWAYAT NIFAS RIWAYAT SAKIT KELAINAN JML KELAINAN
KEHAMILAN PERSALINAN LETAK &
KEHAMILAN KRONIS KOMPLIKASI KELUARGA JANIN BESAR JANIN POSISI
BURUK KOMPLIKASI JANIN
SEBELUMNYA
1
1
0 0 1 1 0 0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : FEBRUARI TAHUN : 2017

ALAMAT LENGKAP GOL.


NO NAMA BUMIL NIK
(DESA/KEL, RT, RW) Darah

1 Muyasaroh Menduran Rt 07/01 3315144501950002 B


2 Mufid Silatul Menduran Rt 05/02 3315145703910004 B
3 Suparmi Menduran Rt 05/04 3315142308790002 A
4 Maspiatin Menduran Rt 05/05 3315144603850005 B
5 Ana Darwati Menduran Rt 01/06 3315136407930008 AB
6 Esti Utami Menduran Rt 04/06 3315146304890001 B
7 Dwi Purwaningsih Menduran Rt 07/06 3315146912890001 O
8 Endang Titik Menduran Rt 04/03 3315145911900001 A
9 Rini Wahyuningsih Menduran Rt 01/03 3315144509830002 B
10 Umi Nuraini Jangkungharjo Rt 06/01 3315146812970002 O
11 Anik Puji Jangkungharjo Rt 02/03 3315145303920003 B
12 Desi Jangkungharjo Rt 07/01 3315144703930001 A
13 Siti Wulandari Jangkungharjo Rt 09/02 3315145805920002 O
14 Siti Rohmatun Jangkungharjo Rt 03/01 3315146109940002 A
15 Lastri Jangkungharjo Rt 09/02 3315144107820026 A
16 Ima Utari Jangkungharjo Rt 09/04 3315144802940001 A
17 Siti Nur Sholekah Jangkungharjo Rt 07/02 3315145710990001 O
18 Siti Nur F Jangkungharjo Rt 09/02 3315145502960003 A
19 Ana Royani Jangkungharjo Rt 01/02 3315144502980001 A
20 Siti Ngarofah Jangkungharjo Rt 01/02 3315067006860006 O
21 Siti Nurkayati Jangkungharjo Rt 02/03 3315146002840001 B
22 Noor Fatiah Jangkungharjo Rt 03/01 3315646907960005 O
23 Siti Latifah Temon Rt 01/06 3315140701990001 O
24 Sulistiyani Temon Rt 01/01 3315146203940001 O
25 Rukayah Temon Rt 02/06 3315124503880003 B
26 Nur Faizah Temon Rt 02/06 3315146611960004 A
27 Sri Rejeki Lemahputih Rt 02/01 3315146610910002 B
28 Pujiyem Lemahputih Rt 05/02 3315144502950003 B
29 Ngatiyem Lemahputih Rt 04/04 3315144607800003 AB
30 Wiji Hartuti Lemahputih Rt 03/02 3315114705930003 B
31 Rahayuningrum Lemahputih Rt 03/02 3315146308970001 AB
32 Siti Sholekah Tirem Rt 04/04 3315146306870003 B
33 Lia Kurniawati Tirem Rt 02/05 3315135612910008 B
34 Lutfiasih Tirem Rt 02/06 3315146207920001 O
35 Lutfiatul Hikmah Karangsari Rt 01/04 3315145907910005 O
36 Umi Muslikah Karangsari Rt 01/05 3372044903880002 B
37 Anik Susi Karangsari Rt 03/07 3315146601940003 O
38 Juharni Karangsari Rt 01/02 3315147007890005 A
39 Awit Karangsari Rt 01/01 3315146304910001 A
40 Siti Zulijna Kronggen Rt 01/03 3315148110950001 O
41 Nur Inayah Kronggen Rt 06/02 3315146011840001 A
42 Siti Mustafiah Kronggen Rt 02/04 3315145605870001 O
43 Siti Harjiyanti Kronggen Rt 04/01 3315145106860003 AB
44 Siti Munarsih Katekan Rt 02/05 3315144402810001 O
45 Putri Welas Katekan Rt 07/02 331514611010005 O
46 Isponiati Katekan Rt 02/06 3315145916790001 B
47 Karisatun Katekan Rt 02/06 3315146002920007 O
48 Siti Muzazanah Katekan Rt 03/06 dlm proses A
49 Deni Nilawati Katekan Rt 05/02 3315145209940005 O
50 Siti Zumaidah Katekan Rt 02/03 3315147112780066 B
51 Sutini Tegalsumur Rt 03/02 3315145803760002 O
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL JML JARAK KEK : ANEMIA TINGGI


ANAK > PERSALINAN < 2 LILA < Hb < 11 BADAN <
< 20 thn > 35 thn 4 thn 23,5 cm g/dl 145 cm

22/9/2017 1
22/9/2017 1 1
7/9/2017 1
18/9/2017 1 1
17/9/2017 1 1
1/10/2017
15/9/2017
17/5/2017 1
31/8/2017 1
29/9/2017 1
7/6/2017 1 1
22/9/2017
12/9/2017
6/9/2017
1/6/2017
28/9/2017
27/8/2017
17/9/2017 1 1
21/9/2017
14/8/2017
27/9/2017
29/9/2017
28/7/2017 1
16/9/2017 1
29/9/2017
12/10/2017 1
28/8/2017
1/4/2017
4/4/2017
30/3/2017
30/6./2017
21/9/2017 1
23/7/2017 1
22/10/2017 1
17/10/2017
11/8/2017
21/7/2017
25/10/2017
14/8/2017
10/11/2017
23/7/2017
8/8/2017
28/9/2017
15/9/2017
20/9/2017
13/6/2017
19/4/2017
10/8/2017
14/9/2017
9/8/2017
7/9./2017
1 0 1 1 4 13 1
8
FAKTOR RISIKO BUMIL

RIWAYAT
HIPERTENSI > HIPERTENSI RIWAYAT RIWAYAT
PADA PENYAKIT RIWAYAT NIFAS
140 mmHg,> 90 KEHAMILAN PERSALINAN
KEHAMILAN KRONIS KOMPLIKASI
mmHg BURUK KOMPLIKASI
SEBELUMNYA

1
0 0 0 0 1 0
KTOR RISIKO BUMIL

KELAINAN
RIWAYAT SAKIT KELAINAN JML KELAINAN
LETAK &
KELUARGA JANIN BESAR JANIN POSISI JANIN
0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : MARET TAHUN : 2017

ALAMAT LENGKAP GOL.


NO NAMA BUMIL NIK
(DESA/KEL, RT, RW) Darah

1 Galih F Menduran Rt 06/05 3315145507860004 B


2 Sulastri Menduran Rt 01/04 3315134108800004 A
3 Iva Sofiana Menduran Rt 06/04 3315124905980002 O
4 Siti Zaenatun Menduran Rt 02/03 3315144101860002 A
5 Marta Triyoga Menduran Rt 03/01 3315144802890050 B
6 Intan Fernia Menduran Rt 05/01 3315145811950001 A
7 Harmoni Menduran Rt 05/01 3315145509900003 B
8 Heni Indrawati Menduran Rt 05/01 3315145307870001 O
9 Yuliati Menduran Rt 05/02 3315135512830001 AB
10 Siti Anisah Menduran Rt 02/02 3315144704810002 O
11 Siti Zaenab Menduran Rt 01/02 3315146702880001 B
12 Dessy Peruanti Menduran Rt 07/02 3315146112910002 B
13 Hefi Dian Jangkungharjo Rt 08/03 3525176806960001 O
14 Siti Nur Khasanah Jangkungharjo Rt 09/04 3315145310890002 O
15 Siti Laelatul Jangkungharjo Rt 08/01 3315144111950001 B
16 Siti Rahmawati Jangkungharjo Rt 09/01 3315145109960001 O
17 Umi Daryati Jangkungharjo Rt 04/02 3315145801920002 O
18 Nurul Hidayah Jangkungharjo Rt 03/03 3315145202940001 O
19 Uswatun Jangkungharjo Rt 02/03 3315065905890001 A
20 Siti R Jangkungharjo Rt 05/02 3315124502960001 AB
21 Yulianti Jangkungharjo Rt 08/04 3315144909940001 O
22 Susanti Jangkungharjo Rt 04/02 3315145603940003 B
23 Kunarni Temon Rt 02/04 3315144203830006 B
24 Supriyani Lemahputih Rt 03/01 3315145106910001 O
25 Nursiti Lemahputih Rt 05/02 3315147112620074 A
26 Sukarmi Lemahputih Rt 07/02 3315114705920004 B
27 Sarti Lemahputih Rt 04/02 dlm proses O
28 Siti Handayani Tirem Rt 02/06 3315106106950002 A
29 Sri Parjayanti Tirem Rt 02/06 3315146012930002 A
30 Asri Yuliani Tirem Rt 04/03 3315145207930002 A
31 Rasminah Tirem Rt 04/03 3604115207830001 A
32 Jumiati Tirem Rt 02/04 3315145402890004 A
33 Mintarsih Tirem Rt 02/05 3315144304880001 B
34 Murtiati Tirem Rt 03/05 3315145802880001 O
35 Umirah Tirem Rt 02/05 3326095001880002 A
36 Yuliatun Karangsari Rt 04/06 3315147006870003 O
37 Listiani Karangsari Rt 02/05 3315145003900001 O
38 Sri Wati Karangsari Rt 02/04 3315146009890005 A
39 Puput Andriani Karangsari Rt 03/04 3315146202870001 B
40 Kunarti Karangsari Rt 02/03 3315145507910002 O
41 Maryati Karangsari Rt 02/03 3315147006790002 A
42 Siti Sholekah Karangsari Rt 03/07 3315146202870001 B
43 Siti Sundari Karangsari Rt 03/07 3315126505980002 B
44 Anik Srigiyani Kronggen Rt 01/0 3315156306840001 B
45 Sri Mulyani Kronggen Rt 01/0 dlm proses B
46 Nur Hasanah Kronggen Rt 01/0 3315144609890003 O
47 Suti Kronggen Rt 01/0 3315146208780001 A
48 Sri Wiwid Kronggen Rt 01/0 3315145001920002 B
49 Yunita Kronggen Rt 01/0 3315044111920002 O
50 Pujiati Kronggen Rt 05/03 3315144505850007 B
51 Susi Yanti Katekan Rt 02/05 3315146711940001 B
52 Sri Wahyuni Katekan Rt 02/05 3315144670990002 B
53 Sumiyatun Katekan Rt 02/05 3315144406890003 B
54 Sukiswati Katekan Rt 02/05 3315175405850003 B
55 Siti Kolifatun Katekan Rt 02/05 3315147009990005 A
56 Mira Katekan Rt 02/05 3315145005800001 O
57 Rohmah Katekan Rt 02/05 3315144510820001 O
58 Ngatmini Katekan Rt 02/05 3315144412830003 O
59 Mamik Septiana Tegalsumur Rt 02/01 3315145609960001 O
60 Naning Putri Tegalsumur Rt 03/02 3315144410960002 O
61 Sri Astutik Tegalsumur Rt 01/03 3315145706890003 O
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL JML JARAK KEK : ANEMIA TINGGI


ANAK > PERSALINAN < 2 LILA < Hb < 11 BADAN <
< 20 thn > 35 thn 4 thn 23,5 cm g/dl 145 cm

27/11/2017 1 1
19/11/2017 1 1
25/8/2017 1 1
30/6/2017 1
9/9/2017 1 1
14/10/2017 1
9/10/2017 1
3/8/2017 1
26/7/2017 1 1
9/9/2017 1
20/6/2017 1
20/10/2017
17/6/2017
Agustus 2017 1
31/10/2017
2/10/2017
21/7/2017 1 1
29/10/2017
30/10/2017
29/10/2017
21/9/2017 1
24/9/2017
Agustus 2017
Oktober 2017
1/7/2017 1
11/1/2017
Juli 2017
22/9/2017
12/10/2017
13/11/2017
12/10/2017
7/10/2017
9/10/2017
15/10/2017
2/11/2017
25/9/2017
21/10/2017
14/10/2017
3/11/2017
24/11/2017
2/10/2017 1
27/9/2017
27/7/2017 1
12/9/2017
8/10/2017
22/11/2017
3/9/2017 1
8/11/2017
19/8/2017
Februari 2017
22/6/2017
27/8/2017
23/6/2017
20/8/2017 1 1
16/5/2017
20/11/2017
28/10/2017
30/9/2017
13/10/2017
17/10/2017
19/10/2017
2 1 1 0 7 14 1
13
FAKTOR RISIKO BUMIL

RIWAYAT
HIPERTENSI > HIPERTENSI RIWAYAT RIWAYAT
PADA PENYAKIT RIWAYAT NIFAS
140 mmHg,> 90 KEHAMILAN PERSALINAN
KEHAMILAN KRONIS KOMPLIKASI
mmHg BURUK KOMPLIKASI
SEBELUMNYA

1
1

0 0 0 0 2 0
KTOR RISIKO BUMIL

KELAINAN
RIWAYAT SAKIT KELAINAN JML KELAINAN
LETAK &
KELUARGA JANIN BESAR JANIN POSISI JANIN
0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : APRIL TAHUN : 2017

ALAMAT LENGKAP GOL.


NO NAMA BUMIL NIK
(DESA/KEL, RT, RW) Darah

1 Atik Maftukah Menduran Rt 07/01 3315146504900002 A


2 Dhimyati Menduran Rt 07/06 3315146405820001 A
3 Karsini Menduran Rt 03/04 3315144808880002 O
4 ayu Wulandari Menduran Rt 03/04 3315147010920002 B
5 Sholekah Menduran Rt 07/04 3315146507860007 O
6 Dwi Diyah Tutik Menduran Rt 04/04 3315145208860003 O
7 Fitri Tri J Menduran Rt 02/05 3315134804890006 A
8 Tri Puji Lestari Menduran Rt 01/03 3315146506870002 O
9 Listiana Menduran Rt 04/03 3315136605960004 AB
10 Ginarsih Menduran Rt 03/07 3315145706850002 O
11 Siti Nur Alifah Jangkungharjo Rt 05/04 3315145102900006 A
12 Yustika Putri Jangkungharjo Rt 05/03 3315145806990002 B
13 Rulina Oktafia Jangkungharjo Rt 07/01 3315144410950001 A
14 Siti Sa'adah Jangkungharjo Rt 02/02 3315145111900004 A
15 Linawati Jangkungharjo Rt 06/03 3315146111920001 O
16 Umayasari Jangkungharjo Rt 01/02 3315145803920001 B
17 Santi Widawati Jangkungharjo Rt 04/04 3315134106960004 A
18 Santi Purwaningsih Jangkungharjo Rt 06/03 3315144107970015 B
19 Farida Nuliya Jangkungharjo Rt 07/03 3315146012850005 O
20 Ngatmiyati Jangkungharjo Rt 04/03 3315146103830001 O
21 Indah Dwi L Jangkungharjo Rt 03/03 3315145406950003 B
22 Nurijah Jangkungharjo Rt 03/03 3315146402870001 O
23 Suparmi Temon Rt 04/01 3315044712830001 O
24 Siti Qomariah Temon Rt 04/01 3315144909870002 B
25 Tarjinah Temon Rt 04/01 3315146306750003 B
26 Anita Temon Rt 04/01 3315144101900006 A
27 Siti Zulaikah Temon Rt 04/01 3315145004930003 O
28 Nia Susilowati Temon Rt 04/01 dlm proses O
29 Siti Sholekatun Temon Rt 04/01 dlm proses B
30 Sutanti Temon Rt 04/01 3315144604910005 A
31 Sutiyem Temon Rt 04/01 3315141807074665 A
32 Wahyuti Temon Rt 04/01 3315046310900001 O
33 Fitriana Temon Rt 04/01 3315135402880003 B
34 Ngatemi Lemahputih Rt 09/01 3315145210820001 B
35 Ita Susilowati Lemahputih Rt 04/02 3315147112880033 B
36 Sumarti Tirem Rt 03/04 3315145503870005 A
37 Reva Yuliani Tirem Rt 03/04 3315146507950001 A
38 Dwi Yanti Tirem Rt 03/05 3315146604920001 O
39 Enik Rusmiyati Tirem Rt 01/04 3315145006870002 A
40 Kusmiasih Tirem Rt 01/01 3315144905880002 A
41 Triningsih Tirem Rt 03/05 3315145010810002 A
42 Nur Fitriana Karangsari Rt 03/05 3315145104910001 B
43 Ulfatun Nikmah Karangsari Rt 03/05 3316154211950002 B
44 Rohimah Karangsari Rt 03/03 3315144902890004 O
45 Siti Musrifah Karangsari Rt 02/04 dlm proses A
46 Sunarsih Karangsari Rt 05/07 3315144603840004 A
47 Sulastri Karangsari Rt 01/01 3315144406820001 A
48 Munasyaroh Karangsari Rt 04/02 335066307930004 A
49 Asfiatun Kronggen Rt 01/08 3315145206790005 O
50 Sruning Wahyu Kronggen Rt 01/07 3315145804000001 AB
51 Nurul Fitriyah Kronggen Rt 01/07 3315145902960002 A
52 Dewi Sentiya Kronggen Rt 01/07 3315145412960001 B
53 Suti Munarti Kronggen Rt 04/03 3315147112940 O
54 Sunarsih Kronggen Rt 01/10 3315125806860001 O
55 Nurul aini Kronggen Rt 02/10 3315155111980005 B
56 Sofiatun Kronggen Rt 02/04 3301204908910004 O
57 Fitri Indah Sari Kronggen Rt 04/10 dlm proses O
58 Hartanti Katekan Rt 03/02 3315146028820002 A
59 Jumiasih Katekan Rt 06/02 3315145702890003 O
60 sri Ngatminem Katekan Rt 01/02 3315146106870001 A
61 Kiki wahyuni Katekan Rt 04/02 3314014503920004 O
62 Nettik Katekan Rt 03/02 3315145507980002 O
63 Maslikah Katekan Rt 03/06 3319144107900002 B
64 Sulasmi Katekan Rt 02/05 3315124512890002 B
65 Mahsunah Katekan Rt 02/06 3315145406870001 O
66 Eka Maryati Tegalsumur Rt 02/04 3315146305970002 O
67 Riyanti Tegalsumur Rt 02/05 3315144606900001 A
68 Raminah Tegalsumur Rt 01/06 3315146910760001 B
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL JML JARAK KEK : ANEMIA TINGGI


ANAK > PERSALINAN < 2 LILA < Hb < 11 BADAN <
< 20 thn > 35 thn 4 thn 23,5 cm g/dl 145 cm

22/11/2017 1
12/12/2017 1
Juni 2017 1 1
3/8/2017 1
20/12/2017 1 1
Oktober 2017 1 1
5/10/2017 1
11/10/2017
8/11/2017 1 1
9/12/2017
24/11/2017
21/11/2017
22/7/2017 1 1 1
Juli 2017 1
22/9/2017 1
29/4/2017 1
27/11/2017 1
18/11/2017 1 1
2/8/2017 1
10/11/2017 1
11/10/2017
16/11/2017 1
1/9/2017 1 1 1
30/10/2017 1
24/5/2017
2/12/2017
24/4/2017
4/11/2017 1
23/11/2017 1
1/11/2017
1/9/2017
1/11/2017
17/7/2017 1
Mei 2017
18/7/2017
16/9/2017
16/12/2017
19/11/2017 1
2/10/2017
15/10/2017
13/12/2017 1
8/12/2017
10/12/2017
15/6/2017
22/11/2017 1
13/10/2017
14/7/2017
24/11/2017
5/12/2017 1
5/10/2017
9/5/2017 1
30/6/2017
17/10/2017 1
2/10/2017
5/10/2017
22/11/2017
22/10/2017
30/7/2017
12/12/2017
27/8/2017
19/12/2017
24/5/2017
Mei 2017
1/9/2017
15/5/2017
20/11/2017
8/10/2017
8/10/2017
2 2 0 6 7 20 0
14
FAKTOR RISIKO BUMI

RIWAYAT
HIPERTENSI > HIPERTENSI RIWAYAT RIWAYAT
PADA PENYAKIT
140 mmHg,> 90 KEHAMILAN PERSALINAN
KEHAMILAN KRONIS
mmHg BURUK KOMPLIKASI
SEBELUMNYA

1
0 0 1 0 1
FAKTOR RISIKO BUMIL

KELAINAN
RIWAYAT NIFAS RIWAYAT SAKIT KELAINAN JML KELAINAN
LETAK &
KOMPLIKASI KELUARGA JANIN BESAR JANIN POSISI JANIN
0 0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : MEI TAHUN : 2017

ALAMAT LENGKAP (DESA/KEL, GOL.


NO NAMA BUMIL NIK
RT, RW) Darah

1 Sri Rejeki Menduran Rt 01/01 3301215511760002 B


2 Ria Ervina Menduran Rt 03/04 3315146102880003 O
3 Siti Mutaminah Menduran Rt 04/04 3315145406800004 O
4 Sri Handayani Menduran Rt 02/05 3315145512800001 B
5 Dewi Ekowati Menduran Rt 07/02 3315145411830001 O
6 Siti Nur Azizah Menduran Rt 03/02 3315144608910004 O
7 Endang Susilowati Menduran Rt 01/01 3315144604780003 B
8 jumiatun Menduran Rt 06/04 3315146801830001 O
9 miftakul hidayati Menduran Rt 02/05 3315144650380001 O
10 fini noviyani Menduran Rt 07/04 3315134611930003 AB
11 Sulistyowati Jangkungharjo Rt 07/01 3315145011950005 B
12 kusmi Jangkungharjo Rt 04/02 3315146205840002 A
13 sri kartini Jangkungharjo Rt 01/01 3315146202920002 A
14 siti nurjanah Jangkungharjo Rt 07/01 3315146605950001 B
15 siti nur kamidah Jangkungharjo Rt 02/01 3315136002920002 O
16 nur lilik Jangkungharjo Rt 05/01 3315136602880001 B
17 nur umaiyah Jangkungharjo Rt 05/01 3315144301880001 O
18 Sumiyatun Temon Rt 01/02 3315144208820002 O
19 siti rohmah Temon Rt 01/01 3321105011920003 A
20 nur siti Temon Rt 01/01 3315146004960002 A
21 parni Temon Rt 03/02 3315145204770001 A
22 tryas putri Temon Rt 03/04 3315105312930001 AB
23 riyanti Temon Rt 04/05 Dlm Proses O
24 latifah asmul Temon Rt 02/06 3315025907960005 O
25 Vivi Nilasari Lemahputih Rt 03/03 3315146511970001 O
26 Jumiyati Lemahputih Rt 02/03 3315145602790003 O
27 Sumilah Lemahputih Rt 07/02 3315144801910002 A
28 Dian Agustina Tirem Rt 03/01 3315144708940001 A
29 Wiwik lestari Tirem Rt 03/05 3315146402930003 A
30 Nurvinda Umi Tirem Rt 03/06 3315181126406920003 O
31 Ngatemi Tirem Rt 02/02 3315145507840003 A
32 Murminah Karangsari Rt 03/05 3315145707900002 O
33 Wiji Lestari Karangsari Rt 03/04 3315146210880003 O
34 Sumiyati Karangsari Rt 03/04 3315145601860001 A
35 Jumiati Kronggen Rt 02/08 3315146711880002 A
36 Siti Kuliyah Kronggen Rt 03/09 Dlm Proses A
37 Rina Kronggen Rt 01/06 3315146900990002 O
38 Hermin Kronggen Rt 01/06 3315134111860001 B
39 Rustini Kronggen Rt 03/06 3315154606810007 O
40 Eni Restiwi Kronggen Rt 01/07 3315146807910002 AB
41 Nikmatul Kronggen Rt 02/08 3315145908940002 O
42 Lailasari Kronggen Rt 04/08 3315146805870002 A
43 Jamiyem Kronggen Rt 01/01 3315145608850001 O
44 Monica Kronggen Rt 03/01 Dlm Proses O
45 Mifatah Khoiriyah Kronggen Rt 02/02 3315145710850002 O
46 Isponi Umayah Kronggen Rt 05/10 3315144804960002 O
47 Sri Murtini Kronggen Rt 06/02 3315145404870004 A
48 Siti Aminatun Kronggen Rt 02/02 3315145510820005 A
49 Sri Haryanti Kronggen Rt 04/01 Dlm Proses O
50 Muhidoh Kronggen Rt 05/02 3315144711280050 O
51 Endang Kronggen Rt 02/02 3315145401870003 O
52 Wiji Lestari Katekan Rt 04/01 3315124110930002 AB
53 Siti Solekah Katekan Rt 03/04 3315146211830001 O
54 Anik Miftakur Katekan Rt 04/06 3315144705980001 A
55 Siti Futikat Katekan Rt 03/06 3315144103880004 O
56 Mar'atus Solikah Katekan Rt 05/06 3318015009960001 A
57 Ika Wulandari Katekan Rt 07/02 3315124411940001 O
58 Nina Setiatanti Katekan Rt 05/02 3315144502890001 A
59 Ngatini Tegalsumur Rt 01/01 3315145902950001 B
60 Susilowati Tegalsumur Rt 01/01 3315146202990001 O
61 Siti Isaroh Tegalsumur Rt 03/06 3315146108860003 A
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL JML ANAK JARAK PERSALINAN KEK : LILA ANEMIA Hb


< 20 thn > 35 thn >4 < 2 thn < 23,5 cm < 11 g/dl

22/7/2017 1 1
5/10/2017 1
18/9/2017 1 1
27/8/2017 1 1
16/12/2017 1
4/1/2017 1
29/8/2017 1 1 1
20/11/2017 1
29/8/2017
28/8/2017
15/12/2017
20/9/2017 1
18/12/2017
30/12/2017
31/12/2017
8/12/2017
9/12/2017 1
9/11/2017
10-Jan-17
1/7/2017
9/12/2017
21/12/2017
9/9/2017
10/12/2017
13/12/2017 1
15/7/2017
30/12/2017 1
17/6/2017 1
8/12/2017
8/6/2017
24/9/2017
15/1/2017
14/1/2017
17/1/2017
31/12/2017
22/9/2017
10/6/2017
9/8/2017
14/10/2017
31/12/2017
22/1/2018
4/11/2017
10/6/2017
2/6/2017
14/6/2017
22/7/2017
24/12/2017
18/6/2017
1/6/2017
7/10/2017
28/11/2017
5/10/2017
10/7/2017
26/8/2017
17/9/2017
21/10/2017
25/11/2017
4/12/2017
15/10/2017 1
9/12/2017
24/12/2017
0 4 2 0 3 10
6
KO BUMIL FAKTOR

TINGGI HIPERTENSI > RIWAYAT HIPERTENSI RIWAYAT RIWAYAT


PENYAKIT
BADAN < 140 mmHg,> 90 PADA KEHAMILAN KEHAMILAN PERSALINAN
KRONIS
145 cm mmHg SEBELUMNYA BURUK KOMPLIKASI

1 1
1 0 0 0 0 2
FAKTOR RISIKO BUMIL

KELAINAN
RIWAYAT NIFAS RIWAYAT SAKIT KELAINAN JML KELAINAN LETAK & POSISI
KOMPLIKASI KELUARGA JANIN BESAR JANIN JANIN
0 0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : JUNI TAHUN : 2017

ALAMAT LENGKAP (DESA/KEL, GOL.


NO NAMA BUMIL NIK
RT, RW) Darah

1 Eli Baitul A Menduran Rt 05/01 3315064707950005 O


2 Septi Eliyanti Menduran Rt 04/01 3315146409850001 O
3 Muntia Dewi Menduran Rt 01/01 3315145002840003 O
4 Sulasmi Menduran Rt 04/02 3315146308860001 O
5 Susilowati Menduran Rt 03/02 3315144211850002 O
6 Sela Migiyani Menduran Rt 07/02 3315136212950006 B
7 Laelatul M Menduran Rt 07/02 3315134807900001 AB
8 Nur Fadilah Menduran Rt 11/04 3315146805850003 B
9 Ika Fitri Menduran Rt 07/04 3315144712860001 B
10 Dwi Sri Asih Menduran Rt 06/05 3315144412920001 B
11 Kusmiatun Menduran Rt 09/04 3315145310840001 O
12 Junia P Menduran Rt 04/06 3315145406920002 B
13 Sri Puji L Menduran Rt 09/04 3315146109900003 O
14 Desiliana Puji A Menduran Rt 03/06 O
15 Siti Risa Dianti Jangkungharjo Rt 08/02 3315144506960001 O
16 Nurul Khoiriyah Jangkungharjo Rt 04/01 3315146912950002 O
17 Kustiyani Jangkungharjo Rt 09/03 3315146502890001 O
18 Rika Mulyani Jangkungharjo Rt 02/03 3315146009910001 O
19 Ngatmini Temon Rt 04/03 3315145301850003 A
20 Kosih Temon Rt 02/03 3202014408880003 O
21 Siti Rukayatun Temon Rt 01/01 3315045402930005 B
22 Metik Ambar Temon Rt 02/01 3315146603950002 O
23 Siti Rochayatun Temon Rt 01/05 3315146207960001 O
24 Marsini Temon Rt 01/03 3315144409890002 O
25 Siti Aminatun Temon Rt 02/06 3315145908840001 A
26 Alfiana Temon Rt 03/04 dlm proses O
27 Dian Victoria Lemahputih Rt 06/02 3315144909930005 O
28 Hartini Lemahputih Rt 03/04 3315144802790001 O
29 Ipah Lemahputih Rt 02/01 3304095510880001 A
30 Gudel Nurkhayatun Lemahputih Rt 04/03 3315144106950002 A
31 Khoiriyah Lemahputih Rt 08/01 3315144703810001 A
32 Pujiyati Karangsari Rt 01/03 3315135812910005 O
33 Tri Astutik Karangsari Rt 03/04 3315144709960002 A
34 Kristina Karangsari Rt 03/07 3315144806960004 O
35 Yunita Devi Karangsari Rt 01/02 3315146406980002 O
36 Binti zinatul Kronggen Rt 05/02 3315145906910004 O
37 Suci Ayu Kronggen Rt 05/08 3315144708910003 O
38 Devi Atmini Kronggen Rt 03/09 3315144106900004 A
39 Siti Nurkhasanah Kronggen Rt 01/09 dlm proses O
40 Sri wahyuni Kronggen Rt 01/07 3315144811950001 B
41 Tuswitarni Katekan Rt 04/01 3315114612880002 A
42 Isti Umi Katekan Rt 03/04 3315145109890003 A
43 Futirin Katekan Rt 04/06 3315144910820003 O
44 Devi Puji Lestari Katekan Rt 03/06 3315146611980003 B
45 Linda Ayu Mekarsari Tegalsumur Rt 05/02 3315145404960003 A
46 Sri Mulyati Tegalsumur Rt 04/02 3315146910990001 AB
47 Esri Jayati Tegalsumur Rt 01/06 3315146009910003 A
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL TINGGI
JML ANAK JARAK PERSALINAN KEK : LILA ANEMIA Hb BADAN <
< 20 thn > 35 thn >4 < 2 thn < 23,5 cm < 11 g/dl 145 cm

22/12/2017
3/12/2017 1
19/7/2017 1
2/2/2018 1
5/1/2018 1
6/1/2018 1
26/12/2017 1
6/11/2017
10/1/2018
16/11/2017 1
19/8/2017
16/2/2018
8/11/2017 1 1
26/2/2018
12/8/2017 1
4/2/2018 1
Januari 2018
14/1/2018 1
29/1/2018
1-Sep-18
7/10/2018 1
22/2/2018
23/2/2018 1
29/1/2018
20/1/2018
12/2/2018
2/2/2018
4/2/2018
7/7/2017
Februari 2018
8/2/2018
26/9/2017
27/12/2017
5/1/2018
7/2/2018
28/1/2018 1
1/2/2018 1
10/1/2018
17/1/2018
29/12/2017
11/9/2017
10/11/2017
25/11/2017
5/10/2017
19/1/2018
22/11/2017
24/12/2017
0 0 0 2 5 9 0
10
FAKTOR RISIKO BUMIL

HIPERTENSI > RIWAYAT HIPERTENSI RIWAYAT RIWAYAT


PENYAKIT RIWAYAT NIFAS
140 mmHg,> 90 PADA KEHAMILAN KEHAMILAN PERSALINAN
KRONIS KOMPLIKASI
mmHg SEBELUMNYA BURUK KOMPLIKASI

1
1

1
1

0 0 0 0 5 0
KTOR RISIKO BUMIL

KELAINAN
RIWAYAT SAKIT KELAINAN JML KELAINAN LETAK & POSISI
KELUARGA JANIN BESAR JANIN JANIN

1
0 1 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : JULI TAHUN : 2017

ALAMAT LENGKAP (DESA/KEL, GOL.


NO NAMA BUMIL NIK
RT, RW) Darah

1 Desi Kurniawati Menduran Rt 03/05 3315145912900001 AB


2 Muslihatun Menduran Rt 08/01 3315145707890006 B
3 Solekatun Menduran Rt 04/01 3315144207830001 B
4 Ismiyatun Menduran Rt 03/01 3315115004870001 AB
5 Farisa Yuni Menduran Rt 06/01 3315146206940001 B
6 Ria Aprilia Menduran Rt 05/06 3315146904940001 O
7 Fitriyani Menduran Rt 01/07 3315145703850003 A
8 Siti Nur Azizah Jangkungharjo Rt 01/04 3315146603910001 AB
9 jumiati Jangkungharjo Rt 05/04 3315144204830001 B
10 Sumiati Jangkungharjo Rt 01/04 3315144806960001 A
11 Safrika Jangkungharjo Rt 09/03 3328125102880001 A
12 Ismi Jangkungharjo Rt 02/02 3315145909950001 O
13 Sukini Jangkungharjo Rt 01/02 3315145206850004 B
14 Siti Rofiah Jangkungharjo Rt 05/04 3315145308810002 B
15 Fitri Kusmiyati Jangkungharjo Rt 01/04 3315146503930002 B
16 Ngastiyowati Jangkungharjo Rt 05/04 3315141712080001 B
17 Nia Fitri Lemahputih Rt 03/03 3315145204960004 O
18 Susi Wiranti Lemahputih Rt 03/03 3315146709900002 O
19 Uswatun Hasanah Lemahputih Rt 02/04 3315146805880001 A
20 Siti Asrofah Tirem Rt 2/1 3315144712820004 AB
21 Rini Fitriani Tirem Rt 1/1 3315144507940002 B
22 Asniwati Tirem Rt 4/2 3315145206940001 O
23 Eko T Tirem Rt 1/5 3315146844970002 O
24 Desiyani Tirem Rt 3/5 3315146412980002 O
25 Dwi Astuti Tirem Rt 3/5 3315146905940001 O
26 Gunarti Tirem Rt 2/6 3315144408900001 O
27 Jumiyati Tirem Rt 3/6 3315457028450004 A
28 Nur Hasanah Karangsari Rt 01/02 3315146909880001 O
29 Sawilati Karangsari Rt 03/01 3315145010830003 A
30 Rika Wahyuni Karangsari Rt 03/04 dlm proses O
31 Purwiji Karangsari Rt 01/04 3315144202820002 O
32 Ifatul Umiyati Karangsari Rt 02/04 3315145910960001 O
33 Yayuk S Karangsari Rt 04/07 3315144202890001 A
34 Fitriyani Karangsari Rt 02/07 3315146001880003 O
35 Parsini Kronggen Rt 02/03 3315145904880003 O
36 Ferawati Kronggen Rt 01/03 dlm proses O
37 Sarini Kronggen Rt 01/04 3315144508850001 B
38 Nurus Chabibah Kronggen Rt 05/02 dlm proses O
39 Nisti Nur Laili Kronggen Rt 03/03 3315147112910018 B
40 Uni Ratih Kronggen Rt 01/06 1209204604890004 O
41 Sri Wahyuni Kronggen Rt 02/09 dlm proses AB
42 Etik Yuliyati Katekan Rt 08/02 3315144308860003 O
43 Rini Haryanti Katekan Rt 03/04 3315144906770003 B
44 Apriyani Katekan Rt 01/04 3315145104910004 A
45 Riyanti Katekan Rt 03/02 dlm proses O
46 Wiji Winarsih Tegalsumur Rt 01/04 3315145404940002 O
47 Yasning Tegalsumur Rt 02/06 3315145507810002 O
TOTAL :
FAKTOR RISIKO BUMIL
PRIMIGRAVIDA

HPL TINGGI
JML ANAK JARAK PERSALINAN KEK : LILA ANEMIA Hb BADAN <
< 20 thn > 35 thn >4 < 2 thn < 23,5 cm < 11 g/dl 145 cm

24/01/2018 1
2/12/2017 1 1
13/12/2017
23/12/2017 1
2/3/2018
12/3/2018
4/9/2017
25/2/2018 1
11/2/2018
27/12/2018
25/9/2017
17/2/2018 1 1
2/10/2017 1
7/2/2018
14/11/2017 1
12/12/2017
Desember 2017
26/12/2017
21/3/2018
26/9/2017
19/3/2018
4/3/2018
3/5/2018
11/11/2017
5/2/2018
5/9/2017 1
8/3/2018
24/3/2018 1
2/2/2018
8/2/2018 1
22/1/2018
10/1/2018 1
30/12/2017
23/1/2018
4/1/2018
21/3/2018
4/8/2017 1
3/8/2017
17/11/2017
19/8/2017
27/8/2017 1
20/2/2018
16/9/2017
15/8/2017
Januari 2018
23/1/2018
Desember 2017
1 0 0 2 6 6 0
12
FAKTOR RISIKO BUMIL

HIPERTENSI > RIWAYAT HIPERTENSI RIWAYAT RIWAYAT


PENYAKIT RIWAYAT NIFAS
140 mmHg,> 90 PADA KEHAMILAN KEHAMILAN PERSALINAN
KRONIS KOMPLIKASI
mmHg SEBELUMNYA BURUK KOMPLIKASI

1
0 0 1 0 0 0
KTOR RISIKO BUMIL

KELAINAN
RIWAYAT SAKIT KELAINAN JML KELAINAN LETAK & POSISI
KELUARGA JANIN BESAR JANIN JANIN
0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : AGUSTUS TAHUN : 2017

ALAMAT LENGKAP GOL.


NO NAMA BUMIL NIK HPL
(DESA/KEL, RT, RW) Darah
PRIMIGRAVIDA

1 Dwi Ratna Menduran Rt 03/03 3315144607970001 B 13/2/2018


2 Nurul Badriyah Menduran Rt 01/03 3315136612880001 O 25/12/2017
3 Siti Khotijah Menduran Rt 09/04 3315145412860001 AB 26/3/2018
4 Wiqayati Hasanah Menduran Rt 08/01 3315146606960001 B 22/10/2017
5 Dwiyana Riski Menduran Rt 08/01 3315146702970002 B 24/2/2018
6 Setiyani Menduran Rt 03/02 3315144612860002 B 13/3/2018
7 Nur Laila Menduran Rt 04/04 3315144503790001 O 27/1/2018
8 Siti Aminatul M Menduran Rt 01/01 3315144910990001 A 7/3/2018
9 Siti Marti'ah Menduran Rt 05/02 3315144303820002 O 26/3/2018
10 Siti Nurhayati Menduran Rt 02/05 3315135106860003 A 20/2/2018
11 Atika Fitriyani Jangkungharjo Rt 07/03 3315135603940002 A 9/2/2018
12 Ana Pratiwi Jangkungharjo Rt 08/04 3315145007930001 B 11/3/2018
13 Siti Nur Khasanah Jangkungharjo Rt 08/03 3315147006840003 B 19/3/2018
14 Ambarwati Jangkungharjo Rt 07/03 3315145309790002 O 20/2/2018
15 Pujiwati Jangkungharjo Rt 08/03 3315145604890003 B 3/4/2018
16 Anita Maya Jangkungharjo Rt 02/01 3315145309840001 B 14/3/2018
17 Dita Jangkungharjo Rt 02/01 3315146509980003 O 22/3/2018
18 Maryati Jangkungharjo Rt 06/01 3315146303850001 O 19/3/2018
19 Kusmiyati Jangkungharjo Rt 02/04 3315145911870002 O 19/5/2018
20 Siti Nurjanah Jangkungharjo Rt 05/04 3315146801950003 B 7/4/2018
21 Mujiati Jangkungharjo Rt 06/03 3315145110900004 O 3/4/2018
22 Susi Vitasari Jangkungharjo Rt 01/04 3315145702000001 B 5/3/2018
23 Mulyati Jangkungharjo Rt 08/02 3315145511850004 B 11/3/2018
24 Mujiati Temon Rt 03/02 3315144605970001 B 17/3/2018
25 Ngaminah Temon Rt 04/03 3315146508910002 O 19/1/2018
26 Mei Elsa Temon Rt 03/04 3315115305970001 B 12/12/2017
27 Marni Temon Rt 03/04 3315145803860002 O 27/3/2018
28 Fitria Temon Rt 01/05 3315144005970004 O 20/1/2018
29 Eni Suwartini Temon Rt 03/05 dlm proses A 9/9/2017
30 Mariam Sri Temon Rt 04/05 7471116565920002 O 8/9/2017
31 Ratna Puspita Lemahputih Rt 09/01 3315146611920004 A 9/17/2017
32 Sulasmini Lemahputih Rt 02/04 3315146710940001 A 13/3/2018
33 Mei Agustina Tirem Rt 2/1 3315147088950002 A 12/7/2018
34 Sumiyati Tirem Rt 1/1 3315146503840002 B 17/3/2018
35 Kifatul K Tirem Rt 4/2 3315145907990002 B 5/9/2017
36 Ida Yuliana Tirem Rt 1/5 3315146407940003 O 11/2/2018
37 Siti Munawaroh Tirem Rt 3/5 3315146808840002 B 2/3/2018
38 Wiji Astutik Tirem Rt 3/5 3315144803840004 AB 20/3/2018
39 Sugiyarti Tirem Rt 2/6 3315145105910002 A 29/5/2018
40 Sumarni Tirem Rt 3/6 3315144301730001 O 13/2/2018
41 Wiwik Margiyanti Karangsari Rt 02/05 3315147007940003 A 1/3/2018
42 Martuti Karangsari Rt 02/06 3315147006860001 A 22/3/2018
43 Isnaeni Nur A Karangsari Rt 01/04 3315144911900003 B 10/3/2018
44 Rika Sa'adah Karangsari Rt 01/02 3315146909880001 A 29/3/2018
45 Sri Rahayu Karangsari Rt 02/02 3315145305920001 O 17/2/2018
46 Munirotun Kronggen Rt 04/08 3315145604860005 A 9/12/2017
47 Eka Rahayu Kronggen Rt 05/09 3315145107900001 O 1/2/2018
48 Siti Munadiroh Kronggen Rt 04/08 3315135008890001 A 28/2/2018
49 Siti Supriyatun Kronggen Rt 02/07 3315145306850002 O 17/9/2017
50 Jasmini Kronggen Rt 04/08 3315145103600001 O 12/2/2018
51 Indah Kronggen Rt 03/09 dlm proses A Desember 2017
52 Yunan Linda Kronggen Rt 03/01 3315145902990003 O 8/1/2018
53 Faizatus Sholekah Kronggen Rt 06/02 3315145404870004 B Desember 2017
54 Yanti Kronggen Rt 02/01 3315146204840002 A Desember 2017
55 Norma Suci Kronggen Rt 05/03 dlm proses O 12/3/2018
56 Jihanur Kronggen Rt 03/02 dlm proses A 7/4/2018
57 Masriatun Kronggen Rt 06/02 dlm proses O 8/3/2018
58 Sulastri Kronggen Rt 03/03 O 12/3/2018
59 Fitri Nurjanah Kronggen Rt 02/03 O Okt 2017
60 Rian Mulyati Katekan Rt 08/02 3315144602860001 AB 5/3/2018
61 Putri Yuana Katekan Rt 07/01 3315144305940002 O 17/10/2017
62 Irawati Katekan Rt 01/01 3315144409880000 B 28/12/2017
63 Herwati Katekan Rt 04/03 3315146206830000 B 1/1/2018
64 Sri Martirahayu Tegalsumur Rt 02/05 3315145807780000 A 12/3/2018
65 Tri Setyaningsih Tegalsumur Rt 02/05 3315146409990000 A 26/3/2018
66 Tri Wijiningsih Tegalsumur Rt 01/06 3315145810890000 B 6/4/2018
67 Jumit Tegalsumur Rt 02/06 3315145806430000 O 13/12/2017
68 Sani Tegalsumur Rt 03/04 3315144408910000 O 12/1/2018
TOTAL :
RIWAYAT
HIPERTEN
FAKTOR RISIKO BUMIL JARAK KEK : LILA ANEMIA TINGGI HIPERTEN FAKTOR RISIKO BUMIL
SI PADA
JML SI > 140 KEHAMIL PENYAKIT
PRIMIGRAVIDA PERSALINA Hb < 11 BADAN <
ANAK > 4 N < 2 thn < 23,5 cm mmHg,> KRONIS
g/dl 145 cm 90 mmHg AN
< 20 thn > 35 thn SEBELUM
NYA

1 1

1 1 1
1 1
1 1
1 1 1
1 1
1 1

1 1
1

1
1

1 1
1 1
1

1 1

1
1

6 4 0 2 10 15 0 0 0 0
20
RIWAYAT RIWAYAT RIWAYAT
RIWAYAT PERSALIN
OR RISIKO BUMIL KELAINA KELAINA KELAINA
KEHAMIL NIFAS SAKIT N LETAK
AN N JML N BESAR &
AN KOMPLIK KELUARG POSISI
BURUK KOMPLIK JANIN JANIN
ASI A JANIN
ASI

1
1

1
0 3 0 0 0 0 0
DATA INDIKATOR JATENG GAYENG NGINCENG WONG METENG
DATA IBU HAMIL PUSKESMAS BRATI
BULAN : AGUSTUS TAHUN : 2017

NO NAMA BUM
ALAMAT LENIK GOL. Dara HPL FAKTOR RISIKO BUMIL
PRIMIGRAVIDA JML ANAK JARAK PERS
< 20 thn > 35 thn
1 Dwi Ratna Menduran 3.32E+15 B 13/2/2018
2 Nurul BadrMenduran 3.32E+15 O 25/12/2017
3 Siti KhotijaMenduran 3.32E+15 AB 26/3/2018 1
4 Wiqayati HMenduran 3.32E+15 B 22/10/2017
5 Dwiyana RiMenduran 3.32E+15 B 24/2/2018 1
6 Setiyani Menduran 3.32E+15 B 13/3/2018 1
7 Nur Laila Menduran 3.32E+15 O 27/1/2018 1
8 Siti Amina Menduran 3.32E+15 A 7/3/2018 1
9 Siti Marti' Menduran 3.32E+15 O 26/3/2018 1
10 Siti NurhayMenduran 3.32E+15 A 20/2/2018
11 Atika FitriyJangkungha3.32E+15 A 9/2/2018
12 Ana PratiwJangkungha3.32E+15 B ###
13 Siti Nur K Jangkungha3.32E+15 B 19/3/2018
14 AmbarwatiJangkungha3.32E+15 O 20/2/2018 1
15 Pujiwati Jangkungha3.32E+15 B 3/4/2018
16 Anita May Jangkungha3.32E+15 B 14/3/2018
17 Dita Jangkungha3.32E+15 O 22/3/2018
18 Maryati Jangkungha3.32E+15 O 19/3/2018
19 Kusmiyati Jangkungha3.32E+15 O 19/5/2018
20 Siti NurjanJangkungha3.32E+15 B 7/4/2018
21 Mujiati Jangkungha3.32E+15 O 3/4/2018
22 Susi VitasaJangkungha3.32E+15 B 5/3/2018
23 Mulyati Jangkungha3.32E+15 B ###
24 Mujiati Temon Rt 3.32E+15 B 17/3/2018
25 Ngaminah Temon Rt 3.32E+15 O 19/1/2018
26 Mei Elsa Temon Rt 3.32E+15 B ###
27 Marni Temon Rt 3.32E+15 O 27/3/2018
28 Fitria Temon Rt 3.32E+15 O 20/1/2018
29 Eni SuwartiTemon Rt dlm prosesA 9/9/2017
30 Mariam SriTemon Rt 7.47E+15 O 8/9/2017
31 Ratna PuspLemahputih3.32E+15 A 17-Sep
32 Sulasmini Lemahputih3.32E+15 A 13/3/2018
33 Mei AgustiTirem Rt 2 3.32E+15 A ###
34 Sumiyati Tirem Rt 1 3.32E+15 B 17/3/2018 1
35 Kifatul K Tirem Rt 4 3.32E+15 B 5/9/2017
36 Ida YulianaTirem Rt 1 3.32E+15 O ###
37 Siti Muna Tirem Rt 3 3.32E+15 B 2/3/2018
38 Wiji Astuti Tirem Rt 3 3.32E+15 AB 20/3/2018
39 Sugiyarti Tirem Rt 2 3.32E+15 A 29/5/2018
40 Sumarni Tirem Rt 3 3.32E+15 O 13/2/2018
41 Wiwik Marg Karangsari 3.32E+15 A 1/3/2018
42 Martuti Karangsari 3.32E+15 A 22/3/2018
43 Isnaeni NuKarangsari 3.32E+15 B ###
44 Rika Sa'ad Karangsari 3.32E+15 A 29/3/2018
45 Sri RahayuKarangsari 3.32E+15 O 17/2/2018
46 MunirotunKronggen R3.32E+15 A ###
47 Eka Rahay Kronggen R3.32E+15 O 1/2/2018
48 Siti MunadKronggen R3.32E+15 A 28/2/2018
49 Siti Supriy Kronggen R3.32E+15 O 17/9/2017
50 Jasmini Kronggen R3.32E+15 O ###
51 Indah Kronggen Rdlm prosesA Desember 2017
52 Yunan LindKronggen R3.32E+15 O 8/1/2018 1
53 Faizatus S Kronggen R3.32E+15 B Desember 2017
54 Yanti Kronggen R3.32E+15 A Desember 2017
55 Norma SucKronggen Rdlm prosesO ### 1
56 Jihanur Kronggen Rdlm prosesA 7/4/2018
57 Masriatun Kronggen Rdlm prosesO 8/3/2018 1
58 Sulastri Kronggen Rt 03/03 O ###
59 Fitri Nurja Kronggen Rt 02/03 O Okt 2017
60 Rian MulyaKatekan Rt 3.32E+15 AB 5/3/2018
61 Putri Yuan Katekan Rt 3.32E+15 O 17/10/2017
62 Irawati Katekan Rt 3.32E+15 B 28/12/2017
63 Herwati Katekan Rt 3.32E+15 B 1/1/2018
64 Sri Martir Tegalsumur3.32E+15 A ###
65 Tri Setyani Tegalsumur3.32E+15 A 26/3/2018 1
66 Tri Wijinin Tegalsumur3.32E+15 B 6/4/2018
67 Jumit Tegalsumur3.32E+15 O 13/12/2017
68 Sani Tegalsumur3.32E+15 O ###
TOTAL : 6 4 0 2
FAKTOR RISIKO BUMIL
KEK : LILA ANEMIA HbTINGGI BAHIPERTENSRIWAYAT HPENYAKIT RIWAYAT RIWAYAT PRIWAYAT NRIWAYAT S

1 1
1
1
1 1
1
1 1

1
1

1
1
1
1

1 1
1 1

1
1
1

1
1

10 15 0 0 0 0 0 3 0 0
20
KELAINAN KELAINAN KELAINAN LETAK & POSISI JANIN
0 0 0