PWS KB TK PUSKESMAS

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : APRIL 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 25 26 27
1 Kapuh 155 7 3 10 6.45 115 3 118 76.13 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 0.96618 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 kapuh utara/sei talang 385 0 0 0 0.00 108 0 108 28.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 surau anjuang 263 5 3 8 3.04 90 3 93 35.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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 1 1 2 1.25 0 0 0 0 0 0 0 0 10 1 11 6.875 0 0 0 0
8 batu kalang 660 3 3 6 0.91 281 3 284 43.03 0 0 0 0 0 0 0 0 0 0 0 0 3 3 6 0.90909
9 pulau karam 336 2 1 3 0.89 222 1 223 66.37 0 0 0 0 0 0 0 0 1 0 1 0.29762 2 1 3 0.89286
10 carocok 150 6 0 6 4.00 103 0 103 68.67 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 2.66667
11 nanggalo 367 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
12 sungai tawar 190 1 1 2 1.05 91 1 92 48.42 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 1.05263
13 taluak raya 145 0 0 0 0.00 97 0 97 66.90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 sako 288 8 1 9 3.13 252 1 253 87.85 0 0 0 0 0 0 0 0 1 0 1 0.34722 8 0 8 2.77778
15 batu hampar 156 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
16 pustu mandeh 140 2 0 2 1.43 82 2 84 60.00 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 1.42857
17 poskesri mandeh 102 3 3 6 5.88 80 3 83 81.37 0 0 0 0 0 0 0 0 0 0 0 0 3 1 4 3.92157
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 1 1 1.51515
20 pustu sungai pinang 123 2 0 2 1.63 81 0 81 65.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 poskesri sungai pinang 99 4 1 5 5.05 69 1 70 70.71 0 0 0 0 0 0 0 0 0 0 0 0 4 1 5 5.05051
TOTAL 4482 44 17 61 1.36 2068 19 2087 46.56 0 0 0 0 0 0 0 0 12 1 13 0.29 25 10 35 0.78

Diketahui Tarusan , 27 april 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 :APRIL 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 80 3 54 3 57 79.1666667 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 kapuh utara/sei talang 104 105 0 0 0 0 0.0 0 0 0 0.0 0 0 0 #DIV/0!
5 surau anjuang 201 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
7 simpang 0 0 0 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0.0
8 batu kalang 144 0 0 0 0 0 0.0 0 0 0 #DIV/0! 0 0 0 0.0
9 pulau karam 55 0 0 0 0 0 0.0 0 0 0 #DIV/0! 0 0 0 0.0
10 carocok 0 0 0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
11 nanggalo 50 30 7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
12 sungai tawar 53 95 6 2 0 2 3.8 0 0 0 0.0 0 0 0 0.0
13 taluak raya 44 34 0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0
14 sako 23 32 4 23 0 23 100.0 32 0 32 100.0 4 0 4 0.0
15 batu hampar 61 0 0 0 0 0 0.0 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 2 4 6 9.2 0 0 0 0.0 0 0 0 0.0
18 sungai nyalo 67 0 0 0 5 5 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 81 0 81 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 25 173 9 182 13.9 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, 27 April2019
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 : APRIL 2019

No DESA Lama PIL suntik IUD Implan MOW MOP kondom Total efek Sa komplikegaga DO aktif aktif aktif
/Baru mping kasi lan gakin 4T
1 Kapuh Lama 9 68 3 30 3 1 2 116 0 0 0 0 116 0 0
Baru 0 3 0 0 0 0 0 3 0 0 0 0 3 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 41 95 12 36 5 0 8 197 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 surau anjuang Lama 12 68 6 5 0 0 0 91 0 0 0 0 91 0 0
Baru 0 3 0 0 0 0 0 3 0 0 0 0 3 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 66 0 2 13 0 1 84 0 0 0 1 83 0 0
Baru 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0
8 batu kalang Lama 5 248 8 9 11 0 0 281 0 0 0 0 281 0 0
Baru 3 0 0 0 0 0 0 3 0 0 0 0 3 0 0
9 pulau karam Lama 13 132 13 34 30 0 0 222 0 0 0 0 222 0 0
Baru 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0
10 carocok Lama 10 72 4 9 6 0 2 103 0 0 0 0 103 0 0
Baru 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0
12 sungai tawar Lama 19 119 5 32 13 2 1 191 0 0 0 0 191 0 0
Baru 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0
13 taluak raya Lama 3 59 1 10 20 97 0 190 0 0 0 0 190 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 sako Lama 27 203 5 8 4 4 1 252 0 0 0 0 252 23 32
Baru 0 1 0 0 0 0 0 1 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0
16 pustu mandeh Lama 5 8 0 0 0 0 0 13 0 0 0 0 13 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 poskesri mandeh Lama 15 67 0 0 0 0 0 82 0 0 0 0 82 0 0
Baru 1 2 0 0 0 0 0 3 0 0 0 0 3 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 61 2 3 2 0 3 81 0 0 0 0 81 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 poskesri sungai pinang Lama 17 53 1 0 2 0 0 73 0 0 0 0 73 0 0
Baru 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0
22 puskesmas Lama 1 5 0 1 0 0 0 7 0 0 0 0 7 0 0
Baru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TOTAL Lama 255 1583 71 195 123 104 18 2349 0 0 0 0 2348 23 32
TOTAL Baru 4 12 0 1 0 0 0 17 0 0 0 1 17 0 0

Diketahui Tarusan, 27 April 2019

Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Darleni, Amd.Keb

Nip. 19810610 200604 1 010 Nip. 196701011988032008
 LAPORAN KB BULAN APRIL TAHUN 2019
KB kapuh sb.n.alh gr.pjg kph.utra 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 116 152 0 108 91 0 83 281 223 103 88 191 190 252 55 0 82 50 55 81 73 2274
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 9 17 0 10 12 0 2 5 13 10 8 19 3 27 17 0 15 21 17 10 17 232
c suntikan 68 128 0 74 68 0 66 248 132 72 66 119 59 203 28 0 67 29 28 61 53 1569
d implant 30 4 0 2 5 0 2 9 35 9 9 32 10 8 10 0 0 0 10 3 0 178
e MOW 3 1 0 13 0 0 13 11 30 6 0 13 20 4 0 0 0 0 0 2 2 118
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 3 0 0 0 3 0 1 3 1 0 0 1 0 1 0 0 3 0 1 0 1 18
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 1 0 0 0 0 4
c suntikan 3 0 0 0 3 0 1 0 0 0 0 1 0 1 0 0 2 0 1 0 1 13
d implant 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. jumlah kunjungan akseptor KB lama 19 0 0 3 0 0 5 0 5 1 0 0 0 3 2 13 0 6 1 18 6 82
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 2 0 3 1 0 0 0 0 0 5 0 6 0 10 3 30
c suntikan 19 0 0 3 0 0 3 0 2 0 0 0 0 3 2 8 0 0 1 8 3 52
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 15 0 0 0 6 0 4 2 0 0 0 0 34 73
8. jumlah alat kontrasepsi yang diterima bulan ini 0 0 0 0 0 0 0 0 0 0 0 10 5 5 10 0 0 0 30
9. jumlah alat kontrasepsi yang dikeluarkan bulan ini 0 0 0 2 6 3 0 1 0 0 0 4 2 2 2 0 0 18 0 40
10. jumlah sisa alat kontrasepsi bulan ini 0 0 0 8 5 12 0 3 0 6 6 10 3 3 10 0 16 0 82

Diketahui
Kepala Puskesmas Tarusan, 27 April2019
Pengelola KB Puskesmas

Jon Marta Hendra, SKM

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

PROVINSI : SUMATERA BARAT

KABUPATEN : PESISIR SELATAN
PUSKESMAS : TARUSAN
BULAN : APRIL 2019

No Desa MUTASI ALOKON

STOK AWAL PENERIMAAN PENGGUNAAN SISA

PIL STK IUD KDMINP SPT PIL STK IUD KDMINP SPT PIL STK IUD KDMINP 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 0 0 10 20 0 0 0 20 20 20 0 0 0 20 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 kapuh utara/sei talang 2 5 0 1 0 0 0 0 0 0 0 0 0 3 0 0 0 0 2 2 0 1 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 7 4 0 0 0 0 0 0 0 0 0 0 2 4 0 0 0 0 5 0 0 0 0 0

8 batu kalang 11 4 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 8 4 0 0 0 0

9 pulau karam 6 2 0 3 2 0 0 5 0 0 0 0 3 2 0 0 1 0 3 0 0 3 1 0

10 carocok 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 1

13 taluak raya 0 3 0 0 0 3 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 10 0 0 0 10 0 4 0 0 0 4 4 6 0 0 0 6

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 5 0 0 0 0 1 2 0 0 0 0 0 3 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 pustu sungai pinang 3 0 0 0 0 0 20 30 0 0 0 0 7 12 0 0 0 0 16 18 0 0 0 0

21 pasa sungai pinang 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0

TOTAL 38 24 0 4 2 4 32 70 0 0 0 30 36 47 0 0 1 24 39 39 0 4 1 7

Diketahui Tarusan, 27 April 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 : MAI 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 Mai 2018

Kepala Puskesmas Pengelola KB Puskesmas

Jon Marta Hendra, SKM Reni Fitrianti SST

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