PWS KB TK PUSKESMAS

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : NOVEMBER 2019

Peserta KB Baru Peserta KB Aktif Kegagalan Komplikasi Drop Out Peserta KB Pasca Salin
No Desa Jumlah Bulan Kumulatif Bulan Kumulatif Bulan Kumulatif Bulan Kumulatif Bulan Kumulatif Bulan Kumulatif
PUS Lalu Ini Jml % Lalu Ini Jml % Lalu Ini Jml % Lalu Ini Jml % Lalu Ini Jml % Lalu Ini Jml %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 26 27
1 Kapuh 155 2 3 33 21.29 140 2 142 91.61 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00
2 sabai nan aluih 207 0 0 0 0.00 152 0 152 73.43 0 0 0 0 0 0 0 0 0 2 2 0.966184 0 0 0 0
3 gurun panjang 247 0 0 0 0.00 194 0 194 78.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 sungai talang 385 5 2 8 2.08 111 2 113 29.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0.77922
5 surau anjuang 263 7 4 11 4.18 92 4 96 36.50 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0.76046
6 kampung pansur 116 0 0 0 0.00 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 simpang 160 1 1 2 1.25 5 1 6 3.75 0 0 0 0 0 0 0 0 11 1 12 7.5 0 0 0 0
8 batu kalang 660 2 3 5 0.76 194 2 196 29.70 0 0 0 0 0 0 0 0 0 0 0 0 15 2 17 2.57576
9 pulau karam 336 5 4 9 2.68 226 5 231 68.75 0 0 0 0 0 0 0 0 1 1 2 0.595238 3 0 3 0.89286
10 carocok 150 3 0 3 2.00 104 1 105 70.00 0 0 0 0 0 0 0 0 0 0 0 0 5 1 6 4
11 nanggalo 367 5 0 5 1.36 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 sungai tawar 190 4 2 6 3.16 193 1 194 102.11 0 0 0 0 0 0 0 0 0 0 0 0 4 2 6 3.15789
13 taluak raya 145 1 1 2 1.38 97 1 98 67.59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 sako 288 2 0 2 0.69 254 0 254 88.19 0 0 0 0 0 0 0 0 1 0 1 0.347222 8 0 8 2.77778
15 batu hampar 156 0 3 3 1.92 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 pustu mandeh 140 0 2 2 1.43 82 0 82 58.57 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 1.42857
17 poskesri mandeh 102 0 0 0 0.00 86 2 88 86.27 0 0 0 0 0 0 0 0 0 0 0 0 4 2 6 5.88235
18 sungai nyalo 127 0 0 0 0.00 50 0 50 39.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 mudik air 66 0 0 0 0.00 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 pustu sungai pinang 123 3 1 4 3.25 82 0 82 66.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 poskesri sungai pinang 99 6 0 6 6.06 71 0 71 71.72 0 0 0 0 0 0 0 0 0 0 0 0 6 0 6 6.06061
TOTAL 4482 46 26 72 1.61 2133 21 2154 48.06 0 0 0 0 0 0 0 0 13 2 15 0.33 47 12 59 1.32
Diketahui Tarusan 28-Nov 2019
Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Darleni, Amd.Keb

Nip. 19810610 200604 1 010 Nip. 196701011988032008
 PWS KB TK PUSKESMAS
PROVINSI : SUMATERA BARAT
KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : November 2019

PUS ALKI Peserta KB Aktif Gakin Peserta KB Aktif 4T Psrta KB Aktif Peny Kronis
No Desa PUS PUS 4T (anemia/LILA<23,5cm/ Bulan Kumulatif Bulan Kumulatif Bulan Kumulatif
Gakin penyakit kronis/IMS Lalu Ini Jml % Lalu Ini Jml % Lalu Ini Jml %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

1 Kapuh 72 81 3 67 1 68 94.4 0 0 0 0.00 0 0 0 0

2 sabai nan aluih 58 46 0 35 0 35 60.3 20 0 20 43.5 0 0 0 0
3 gurun panjang 21 28 3 0 0 0 0.0 0 0 0 0.0 0 0 0 0
4 sungai talang 104 105 0 0 5 5 4.8 0 0 0 0.0 0 0 0 #DIV/0!
5 surau anjuang 201 0 0 0 4 4 0.0 0 0 0 0.0 0 0 0 0.0
6 kampung pansur 0 0 0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
7 simpang 0 0 0 0 8 8 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0.0
8 batu kalang 144 0 0 0 3 3 2.1 0 0 0 #DIV/0! 0 0 0 0.0
9 pulau karam 55 0 0 0 5 5 9.1 0 0 0 #DIV/0! 0 0 0 0.0
10 carocok 0 0 0 0 3 3 0.0 0 0 0 0.0 0 0 0 0.0
11 nanggalo 50 30 7 0 5 5 10.0 0 0 0 0.0 0 0 0 0.0
12 sungai tawar 53 95 6 3 1 4 7.5 0 0 0 0.0 0 0 0 0.0
13 taluak raya 44 34 0 0 1 1 2.3 0 0 0 0.0 0 0 0 0.0
14 sako 23 32 4 23 3 26 113.0 32 0 32 100.0 4 0 4 0.0
15 batu hampar 61 0 0 0 3 3 4.9 0 0 0 0.0 0 0 0 0.0
16 pustu mandeh 140 0 0 23 0 23 0.0 0 0 0 0.0 0 0 0 0.0
17 poskesri mandeh 65 0 0 9 0 9 13.8 0 0 0 0.0 0 0 0 0.0
18 sungai nyalo 67 0 0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
19 mudik air 66 0 0 7 0 7 10.6 0 0 0 #DIV/0! 0 0 0 0.0
20 pustu sungai pinang 59 30 5 82 0 82 0.0 2 0 2 0.0 0 0 0 0.0
21 poskesri sungai pinang 99 30 0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
TOTAL 1310 430 25 182 42 224 17.1 54 0 54 12.6 4 0 4 16.0
formula indikator
% PUS Miskin Ber-KB = (jml PUS gakin Ber-KB/jml PUS gakin)x100%
Diketahui Tarusan, 28 November 2019
Kepala Puskesmas Pengelola KB Puskesmas
Jon Marta Hendra, SKM Darleni, Amd.Keb
Nip. 19810610 200604 1 010 Nip. 196701011988032008
 REKAPITULASI KOHORT KB TK PUSKESMAS TARUSAN

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : November 2019

efek
Lama / kompli kegagal aktif aktif
No DESA PIL suntik IUD Implan MOW MOPkondom Total Sampi DO aktif
Baru kasi an gakin 4T
ng
1 Kapuh Lama 12 90 3 31 3 1 2 142 0 0 0 1 119 0 0
Baru 0 3 0 0 0 0 0 3 0 0 0 0 10 0 0
2 sabai nan aluih Lama 17 127 2 4 1 0 0 151 0 0 0 0 151 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0
3 gurun panjang Lama 42 93 12 36 5 0 8 196 0 0 0 0 197 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 kapuh utara/sei talang Lama 10 74 9 2 13 0 0 108 0 0 0 0 108 0 0
Baru 0 3 0 2 0 0 0 1 0 0 0 0 0 0 0
5 surau anjuang Lama 12 80 6 5 0 0 0 103 0 0 0 0 96 0 0
Baru 0 3 0 2 0 0 0 3 0 0 0 0 2 0 0
6 kampung pansur Lama 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 simpang Lama 2 69 0 2 13 0 1 87 0 0 0 1 85 0 0
Baru 0 1 0 5 0 0 0 1 0 0 0 0 1 0 0
8 batu kalang Lama 13 248 8 9 11 0 0 289 0 0 0 0 289 0 0
Baru 3 0 0 0 0 0 0 3 0 0 0 0 2 0 0
9 pulau karam Lama 13 131 13 39 31 0 1 231 0 0 0 0 230 0 0
Baru 0 0 0 3 1 0 1 4 0 0 0 0 3 0 0
10 carocok Lama 10 73 5 9 6 0 2 105 0 0 0 0 104 0 0
Baru 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0
11 nanggalo Lama 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Baru 0 0 2 3 0 0 0 5 0 0 0 0 0 0 0
12 sungai tawar Lama 19 122 5 32 13 2 1 194 0 0 0 0 193 0 0
Baru 0 2 1 1 0 0 0 4 0 0 0 0 0 0 0
13 taluak raya Lama 3 60 1 10 4 20 0 98 0 0 0 0 98 0 0
Baru 0 1 0 1 0 0 0 2 0 0 0 0 0 0 0
14 sako Lama 27 204 5 8 5 4 1 254 0 0 0 0 254 23 32
Baru 0 2 0 2 0 0 0 4 0 0 0 0 0 0 0
15 batu hampar Lama 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Baru 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0
16 pustu mandeh Lama 2 8 0 0 0 0 0 10 0 0 0 0 13 0 0
Baru 0 2 0 0 0 0 0 2 0 0 0 0 0 0 0
17 poskesri mandeh Lama 16 69 0 0 0 0 0 85 0 0 0 0 85 0 0
Baru 1 1 0 0 0 0 0 2 0 0 0 0 2 0 0
18 sungai nyalo Lama 21 29 0 0 0 0 0 50 0 0 0 0 50 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 mudik air Lama 18 29 0 10 0 0 0 57 0 0 0 0 57 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 pustu sungai pinang Lama 10 63 2 3 2 0 3 83 0 0 0 0 82 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 poskesri sungai pinang Lama 18 54 1 0 2 0 0 75 0 0 0 0 75 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 puskesmas Lama 0 5 0 0 0 0 1 6 0 0 0 0 0 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lama 265 1628 72 200 109 27 20 2324 0 0 0 0 2286 23 32
TOTAL
Baru 4 18 3 25 1 0 1 40 0 0 0 1 17 0 0

Diketahui Tarusan, 28 November2019

Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Darleni, Amd.Keb

Nip. 19810610 200604 1 010 Nip. 196701011988032008
 LAPORAN KB BULAN NOVEMBER TAHUN 2019
KB kapuh sb.n.alh gr.pjg sei.talang s.anjg kp.pnsr simpang bt.klg pl.krm crocok nanggalo sei.twr tl.raya sako bt.hmpr pu.mndh po.mndh sei.nyalo M.air pu.s.png po.s.png TOTAL
1. jumlah peserta KB aktif 129 152 0 109 96 0 85 193 225 104 88 193 190 254 55 0 87 50 55 83 75 2327
a IUD 3 2 0 9 6 0 0 8 13 4 4 5 1 5 0 0 0 0 0 2 1 63
b pil 12 17 0 10 12 0 2 13 13 10 8 19 3 27 17 0 17 21 17 10 18 246
c suntikan 90 128 0 74 73 0 67 248 132 73 66 121 59 204 28 0 70 29 28 62 54 1606
d implant 31 4 0 2 5 0 2 9 35 9 9 32 10 8 10 0 0 0 10 3 0 179
e MOW 3 1 0 13 0 0 13 11 30 6 0 13 20 5 0 0 0 0 0 2 2 119
f MOP 1 0 0 0 0 0 0 0 0 0 0 2 97 4 0 0 0 0 0 0 0 104
g kondom 2 0 0 0 0 0 0 0 0 2 1 1 0 1 0 0 0 0 0 3 0 10
h lain-lain 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. jumlah kunjungan akseptor KB baru 2 0 0 8 3 0 1 3 4 0 0 0 1 0 0 2 1 0 0 1 3 49
a IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b pil 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 2 5
c suntikan 2 0 0 3 3 0 1 2 2 0 0 0 1 0 0 2 0 0 0 1 1 18
d implant 0 0 0 5 4 0 8 3 3 0 0 0 1 0 0 0 0 0 0 0 0 24
e MOW 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
f MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g lain-lain 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
3. jumlah kunjungan akseptor KB lama 8 0 0 1 0 0 5 0 2 0 0 16 23 6 0 13 21 6 1 1 8 113
a IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b pil 0 0 0 0 0 0 4 0 2 0 0 0 1 0 0 1 4 6 0 0 3 21
c suntikan 8 0 0 1 0 0 1 0 2 0 0 16 22 6 0 12 17 0 1 1 5 92
d implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g lain-lain( kondom ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. jumlah tempat klinik pelayanan KB milik pemerintah 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 20
5. jumlah tempat klinik pelayanan KB milik dokter swasta 0 0 0 0 0 0
6. jumlah tempat klinik pelayanan KB milik bidan swasta 1 1 0 0 0 1 3
7. jumlah persediaan sisa alat kontrasepsi bulan lalu 0 0 0 1 11 0 0 4 0 0 0 5 2 0 0 0 0 34 57
8. jumlah alat kontrasepsi yang diterima bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 5 10 0 0 0 15
9. jumlah alat kontrasepsi yang dikeluarkan bulan ini 0 0 0 2 6 0 0 2 0 0 0 1 2 0 2 0 0 18 0 33
10. jumlah sisa alat kontrasepsi bulan ini 0 0 0 8 5 0 0 2 0 0 6 4 0 3 10 0 16 0 54

Diketahui
Kepala Puskesmas Tarusan, 28 November 2019
Pengelola KB Puskesmas

Jon Marta Hendra, SKM Darleni, Amd.Keb

Nip. 19810610 200604 1 010 Nip. 196701011988032008
 REKAPITULASI LAPORAN BULANAN LOGISTIK ALOKN & BHP KAB/KOTA

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : November 2019

MUTASI ALOKON
No Desa STOK AWAL PENERIMAAN PENGGUNAAN SISA
PIL STK IUD KDM INP SPT PIL STK IUD KDM INP SPT PIL STK IUD KDM INP SPT PIL STK IUD KDM INP SPT
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
1 Kapuh 0 0 0 0 0 0 0 10 0 0 1 10 0 10 0 0 1 10 0 0 0 0 0 0
2 sabai nan aluih 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 gurun panjang 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 sungai talang 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0
5 surau anjuang 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 kampung pansur 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 simpang 6 2 0 0 0 0 0 5 0 0 0 5 4 2 0 0 0 2 2 0 0 0 0 0
8 batu kalang 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 pulau karam 0 7 0 2 1 7 0 0 0 0 2 0 0 2 0 0 3 2 0 5 0 2 0 5
10 carocok 2 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 3 0 0 0 0 0
11 nanggalo 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 sungai tawar 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 taluak 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
14 sako 4 0 0 0 0 0 0 5 0 0 0 5 0 0 0 0 0 0 4 5 0 0 0 5
15 batu hampar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 pustu mandeh 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 poskesri mandeh 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 sungai nyalo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 mudik air 2 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 0 0 0 0
20 pustu sungai pinang 0 0 0 0 0 0 0 15 0 0 0 15 0 9 0 0 0 9 0 6 0 0 0 6
21 poskesri sungai pinang 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 16 13 0 2 1 7 0 35 0 0 3 35 6 23 0 0 4 23 13 20 0 2 0 16

Diketahui Tarusan, 28 November 2019

Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Darleni, Amd.Keb

Nip. 19810610 200604 1 010 Nip. 196701011988032008
 PERMINTAAN OBAT

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : Agustus 2018

PERMINTAAN OBAT

NO DESA STOK AWAL PENGGUNAAN SISA PERMINTAAN OBAT

PIL STK IUD KDM INP SPT PIL STK IUD KDMINP SPT PIL STK IUD KDM INP SPT PIL STK IUD KDMINP SPT

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

1 Kapuh 0 0 0 0 3 0 4 20 0 10 3 20 0 0 0 0 0 0 20 20 0 10 0 20

2 simpang 4 0 0 8 0 0 4 0 0 1 0 0 3 3 0 7 0 3 20 20 0 10 0 20

3 pulau karam 0 0 0 4 2 0 3 3 0 0 0 3 17 7 0 4 2 7 20 20 0 10 0 20

4 pustu mandeh 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20 0 10 0 20

5 pustu sungai pinang 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 20 20 0 10 0 20

6 puskesmas 0 0 0 0 0 0 0 0 0 0 0 3 5 0 0 0 0 0 100 100 0 0 0 100

TOTAL 4 0 0 12 5 0 11 33 0 11 3 26 25 10 0 11 2 10 200 200 0 50 0 200

Diketahui Tarusan, 28 Agustus 2018

Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Reni Fitrianti SST

Nip. 19810610 200604 1 010 Nip. 19760925 200501 2 008