This document was exported from Numbers. Each table was converted to an Excel worksheet.

All other
objects on each Numbers sheet were placed on separate worksheets. Please be aware that formula
calculations may differ in Excel.

Numbers Sheet Name Numbers Table Name

Pehanggo
Tabel 1
Amokuni.
Tabel 1
Tawanga.
Tabel 1
Amololu
Tabel 1
Undolo
Tabel 1
Lalombai
Tabel 1
Tondowatu
Tabel 1
Uete
Tabel 1
Aukora
Tabel 1
 as converted to an Excel worksheet. All other
worksheets. Please be aware that formula

Excel Worksheet Name

Pehanggo - Tabel 1

Amokuni. - Tabel 1

Tawanga. - Tabel 1

Amololu - Tabel 1

Undolo - Tabel 1

Lalombai - Tabel 1

Tondowatu - Tabel 1

Uete - Tabel 1

Aukora - Tabel 1
Puskesmas : Sanggona
Desa : Pehanggo
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

No. Nama Balita Tanggal Lahir Tanggal Pengukuran Umur (Bulan) Tinggi
Ayah Ibu Berat Badan/Panjan Sangat Pendek Pendek Normal
Badan
g badan
1 muh.al fajar Satrian Nawar 28/03/2015 11/1/2019 55 14 94 √
2 naela apriani Toni Saputra Hastuti 4/1/2015 11/1/2019 55 14.2 96 √
3 Herbiansyah Harianto Arni 21/04/2015 11/1/2019 54 14.5 104 √
4 Aira Abbas Mirna 1/5/2015 KOLUT
5 anugreah Arsad Nurdawa 5/6/2015 11/1/2019 53 13.2 97 √
6 muh.aidil Masdin Nuraeni 17/05/2015 11/1/2019 53 14 100 √
7 M.Hasrul Jamaluddin Mardiana 29/05/2015 11/10/2019 53 13.9 98 √
8 naura Ali Yuli 6/9/2015 11/10/2019 53 14 97 √
9 Muh.Haikal Rifki Rima 10/6/2015 11/10/2019 49 13.7 97 √
10 muh.al fais Muhtar Haslinda 10/10/2015 11/1/2019 48 14.2 102 √
11 anggun Yusran Harlina 11/2/2015 11/1/2019 47 12.7 93 √
12 Mirna Iwan Ana 13/12/2015 11/10/2019 46 12.8 96 √
13 Ainun Hasrianto Nur Aisyah 21/01/2016 11/1/2019 45 12.4 94 √
14 Habil Har Alin 3/5/2016 11/1/2019 43 13.7 96.5 √
15 Nur Hani Nurdin Oyah Hasanah 15/03/2016 11/1/2019 43 12.6 92 √
16 Mutmainah Jumaldin Nursia 13/04/2016 11/1/2019 42 12 90 √
17 Ferdiansyah Gusti Nur 5/5/2016 11/10/2019 42 12.6 90 √
18 Nur Fatin Anjaya Nurmiana 5/8/2016 11/1/2019 41 12.1 94 √
19 Ikhwan sidiq M.Ahmad Rusli Nurjana 5/12/2016 11/10/2019 41 12.9 90 √
20 Ainun Muslim M. Akrianto Suria 6/1/2016 11/10/2019 41 12.2 92 √
21 Alzena Aira Fatimah Harjono Misra 6/3/2016 11/10/2019 41 12.6 91 √
22 Aqila deri Takim Baharuddin Sarlina 23/09/2016 11/1/2019 37 12.2 90 √
23 Sahida Azizah Hasrun Hadija 10/2/2016 11/5/2019 37 11.8 90 √
24 Niswa Mistang Herlina 31/10/2016 11/1/2019 36 11.4 87 √
25 Akifa Ulia Hafid Clara Fatmawati 11/2/2016 11/5/2019 36 11.7 92 √
26 Muh. An Nur Jumaldin Rosmiati 11/5/2016 11/10/2019 36 12 89 √
27 Natasya Jamaludin Mardiana 4/13/2017 11/10/2019 30 10.6 84 √
28 Muh. Alfarizi Kaswin Rosdiana 4/20/2017 11/5/2019 30 11.6 85 √
29 Alsyah Nur Fatihah Elimanto Jumarni 7/22/2017 11/1/2019 27 9.3 82 √
30 Annas Mualaf Abbas Mirna 12/08//2017 KOLUT
31 Aisila Suci Pratiwi Sawal Irawati 9/12/2017 11/1/2019 25 8.7 76 √
32 Selsi Sahara Sahira Jamuri Fitriani 9/15/2017 11/1/2019 25 9.3 81.5 √

3
33 Atika Asfa NurFadila Saldin Suci Ramadan 10/15/2017 11/10/2019 24 11 82 √
34 Kinan Idil Elsa 11/2/2017 11/1/2019 23 9.4 78 √
35 Muh. Imam saputra Karel Hastuti 11/15/2017 11/1/2019 23 11.2 81 √
36 Muhammad fatan Arfan Marni 11/29/2017 11/1/2019 23 12 84 √
37 Nurul Ilmi Wandi Kamsiah 3/10/2018 11/10/2019 20 10.1 80 √
38 Hilwa Syahira Muhidin Sinta Mansur 3/11/2018 PINDAH
39 Alif Munandar Cah Yana Jusnawati 4/16/2018 11/1/2019 18 10.9 77 √
40 Ramadani Basir Ratih 7/10/2018 11/10/2019 16 8.8 75 √
41 Athaya Raska Yasmardin Susianti 8/20/2018 11/1/2019 14 7.9 73 √
42 Muh. Al Sandi Basran Jumrah 10/29/2018 11/10/2019 12 8.8 73 √
43 Nur Aisyah Abbas Mirnawati 11/15/2018 KOLUT
44 Muh. Aflahul Naufal Haris Marwatin 12/29/2018 11/1/2019 10 10.2 70 √
45 Agil Harpin Sarlina 1/16/2019 11/1/2019 9 64 √
46 Muh. Ilham Arsad Nur Dawia 1/20/2019 11/1/2019 9 8.1 67 √
47

Kepala Puskesmas Sanggona Sanggona, .....November 2019

Bidan Desa Pehanggo

Jafar Aripin, SKM Clara Fatmawati, Amd.keb

Nip.19720220 199603 1 007

4
Ket.

L
P
L

L
L
L
P
L
L
P
P
P
L
P
P
L
P
L
P
P
P
P
P
P
L
P
L
P

P
P

5
P
P
L
L
P

L
P
P
L

L
L
L

6
Puskesmas : Sanggona
Desa : Amokuni
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Umur Tinggi

No. Nama Balita Tanggal Lahir Berat Badan/Pa Sangat
Ayah Ibu Pengukuran (Bulan) Pendek Normal
Badan njang Pendek
badan

1 Ikmal Musdin Erni 3/5/2016 11/11/2019 44 13.5 96 √

2 Firman Ashari Marwia 4/1/2016 11/11/2019 43 11.8 92 √
3 Aura wawan Ningsih 22/06/2016 11/11/2019 40 12.2 89 √
4 Harlianti Mirwan Isna 27/06/2016 11/11/2019 40 12.5 90 √
5 Novri Al Pratama Ramdan Tia 17/11/2016 11/11/2019 35 11.9 91 √
6 Ciara reski Samawati 19/11/2016 11/11/2019 35 10.9 87 √
7 Atika Jumardin Windy Ayu L 1/12/2017 11/11/2019 33 11.2 85 √
8 Farel Yusrin Rani 8/14/2017 11/11/2019 26 11 84 √
9 Alisa Putri Asmin Rosmina 11/23/2017 11/11/2019 23 10 82 √
10 Arisa Ardin Yanti 12/8/2017 11/11/2019 23 10.3 84 √
11 Liansyah Musdin Erni 5/9/2018 11/11/2019 18 10.2 77 √
12 Muh. Abdu Rafka Jasrin Sri Hartuti 12/15/2018 11/11/2019 10 8 69 √
13 Arsila Asnul Santi 2/11/2019 11/11/2019 9 7.4 69 √
14 Elsa Burhan Neni 3/12/2019 11/11/2019 7 7 65 √
15
16

7
Ket.

L
L
P
P
L
P
P
L
P
P
L
L
P
P

8
Puskesmas : Sanggona
Desa : Tawanga
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pa Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek
Badan njang Pendek
badan

1 Nelsa Igong nining 11/8/2014 10/28/2019 59 15 101

2 Acita Limbran Srilianti 19/11/2014 10/28/2019 59 15.7 100
3 Revan Pudin Emi 28/11/2014 10/28/2019 59 16 103
4 Nur Amelia Donti Darmia 27/12/2014 10/28/2019 58 14.8 99
5 Gina M.Sahrul Gita 1/9/2015 10/28/2019 57 15 93 √
6 M.Jumarwan Jusrin Jusri 23/01/2015 PINDAH KE PALOPO
7 Anisa Nurfitra Lassuka Nining 3/3/2015 10/28/2019 55 14 102
8 Rava Asmol Asmawati 22/03/2015 10/28/2019 55 14.9 99
9 Lepin Lasmin Anti 24/03/2015 10/28/2019 55 15 101
10 Acilia Aldesya Arson Hernis 27/04/2015 10/28/2019 54 13.9 99
11 Siti Fatima M.Fadlan Nurwati 15/05/2015 10/28/2019 53 14 100
12 Sima Sahira Irsanto esi 25/06/2015 10/28/2019 52 13.5 93 √
13 Naila Tarman Neliawati 13/07/2015 10/28/2019 51 13.7 97
14 Nasya Haswianto Rini 8/8/2015 10/28/2019 50 14.2 94 √
15 Rehan Marsuji Witriani 29/08/2015 10/29/2019 48 13.7 95
16 Ilmi Arca Apriani 23/10/2015 10/28/2019 48 13.2 95
17 Reila Aprilia Udin Gita 26/10/2015 10/28/2019 48 13.6 100
18 Iksan Sarwan nini 21/11/2015 10/28/2019 47 14 93 √
19 Nila Mirton Satria 24/11/2015 10/28/2019 47 12.9 90 √
20 silfian dilim Yana 12/3/2015 10/28/2019 46 12.4 94
21 Sakila Arman Arisda 12/11/2015 10/28/2019 46 13.1 95

9
22 Muh. Nizam Al fajar Dinar Siti Halipa 4/11/2016 10/28/2019 42 12.5 KELUAR DAERAH
23 Zaki Budi Seli 4/12/2016 10/28/2019 42 12.9 92
24 M.Sabil Risanto sinarti 19/07/2016 10/28/2019 39 12 90
25 Zakir Elbifaat Beni Faad Elisriyani 31/07/2016 10/28/2019 39 13.2 89
26 Ayu Ningsih Wahyu Indah 9/4/2016 10/28/2019 37 11.6 92
27 Muh.Arsanu Nurhadi Susi 15/09/2016 10/28/2019 37 12.6 92
28 Ahmad Falen Inko Amriullah Yulin 11/18/2016 10/28/2019 35 11.7 88 √
29 Muh.Asfayad Al Rasyid Arjun Nurmiatin 15/12/2016 10/28/2019 34 13.6 90
30 Malik Merlin Ayu 13/12/2016 10/28/2019 34 12 91
31 Asrey Samsudin Nurmiati 15/12/2016 10/28/2019 34 12.1 89
32 Ayuki Mardia Asaiti Nila 22/12/2016 10/28/2019 34 12 87 √
33 Neila Igong Nila 1/9/2017 10/28/2019 33 11.6 87
34 Sabki Hamsasih Said Priska 21/01/2017 10/28/2019 33 12.1 88
35 Ananda Aan Melia 2/4/2017 10/28/2019 32 10.9 88
36 Niska Nana Nini 3/4/2017 10/28/2019 31 11.5 86
37 Ijar Idrawan Harnisal 3/12/2017 10/28/2019 31 11,,4 86.5
38 Imam Haidar Al. Arton Nurhayati 16/04/2017 10/28/2019 30 10.4 86
39 Klara Jusran Herlianti 5/1/2017 10/28/2019 29 11.8 85
40 Imam Rijalul Haq Bahrun Derlianti 5/23/2017 10/28/2019 29 11 84 √
41 Rifda Agusti Agustang Sri Yurnanengsih 6/27/2017 10/28/2019 28 11 86
42 Naura Adwan Niartin 6/30/2017 10/30/2019 28 11.2 85
43 M. Wadrianto Darmawan Muliati 7/7/2017 10/28/2019 27 10.8 86
44 Respika Marson E. Asrida 7/25/2017 PINDAH KE MOWEWE
45 Filma Ramadan Fitriani 9/1/2017 10/28/2019 25 10.5 79 √
46 Milka Harmun Asnami 9/8/2017 10/28/2019 25 10.6 81
47 Sista Supri Pode 9/29/2017 10/29/2019 25 10.7 79 √
48 Atika Sahra Agus S. Asriani 11/5/2017 10/28/2019 23 9.9 80
49 Nur Kaifah Gani Asrianti 11/8/2017 10/28/2019 23 10.5 82
50 Salkia Marno Tias 11/24/2017 10/28/2019 23 11 82.5
51 Sakiyah Azhara Kamaruddin Marniatin 1/24/2018 10/28/2019 21 9.9 78
52 Habib Hariadi Rosniatin 1/29/2018 10/28/2019 21 10.5 80
53 Akmar Ending Suharti 1/30/2018 10/30/2019 21 9.3 77 √
54 Tiara Aco Irna 2/18/2018 10/28/2019 20 9.6 80

10
55 Arsil Juslan Heni 2/25/2018 10/28/2019 20 10 80
56 Muh. Jufran Jusrin Jusri 2/27/2018 PINDAH KE PALOPO
57 Ilham Marsuji Witriani 3/20/2018 10/28/2019 19 9.7 78
58 Muh. Rizky Asidiq M. Fredy Susliani Sensa 3/27/2018 10/28/2019 19 8.5 80
59 Salwa Artaman Nurianti 4/24/2018 10/28/2019 18 9 73 √
60 Halif Hasgita Nardiana 5/9/2018 10/28/2019 17 9.2 75 √
61 Nur Aisyah Ramadani Rustam Lilis Indriyanti 5/25/2018 10/28/2019 17 9.2 77.5
62 Muh. Buana Takdir Risman Selpin 7/12/2018 10/28/2019 15 9.4 76
63 Adrila Adianto Ani 7/22/2018 10/28/2019 15 10.6 77
64 Muh. Dirga Dedy Riski 7/25/2018 10/28/2019 15 8.5 79
65 Dilan Ardila Dedi Dewi 8/9/2018 10/28/2019 14 7.8 72 √
66 Jiran Jamaluddin Minarti 9/6/2018 10/28/2019 13 9.5 73.5
67 Salman Merlin Ayu 9/21/2018 10/28/2019 13 8.4 73
68 Muh. Lutfi Afdila Aritno Lilis Riani 10/27/2018 10/28/2019 12 8.5 74
69 Abdurrahman sahe M.Hamdirahman Ania Monika 12/1/2018 10/28/2019 10 8 69
70 Muh. Abizar Alghi Aswar Anita 12/16/2018 10/28/2019 10 7.8 68 √
71 Derifa Nasir Qania Edi Neni 1/16/2019 10/28/2019 9 9.2 67
72 Naila Rusmanto Asnawati 2/3/2019 10/28/2019 8 7.3 64
73 Muh. Alfat Jupri Lia 4/4/2019 10/28/2019 6 7.4 63
74 Muh. Rapi Alfarizi Dedy Epi 5/2/2019 10/28/2019 5 6.5 63
75 Dilpa Gunawan Yuri 5/20/2019 10/28/2019 5 8.4 62
76 Muh. Alif Alfais Arif Iis 6/6/2019 10/28/2019 4 4.5 57 √
77 Hildayanti Hendra Indah 6/9/2019 10/28/2019 4 5.9 61
78 Elpa Pipin Epin 6/15/2019 10/28/2019 4 5.7 60
79 Sidan Ebifaat Beni Faad Elisriyani 7/17/2019 10/28/2019 3 6.3 56
80 Ikram Iksan Indri 7/18/2019 10/28/2019 3 6.6 58

Sanggona, .....Oktober 2019

Bidan Desa Tawanga

11
Status Gizi

Ket.
Normal

√ P
√ P
√ L
√ P
P

√ P
√ L
√ L
√ P
√ P
P
√ P
P
√ L
√ P
√ P
L
P
√ L
√ P

12
DAERAH
√ L
√ L
√ L
√ P
√ L
L
√ L
√ L
√ L
P
√ P
√ L
√ P
√ P
√ L
√ L
√ P
L
√ P
√ P
√ L

P
√ P
P
√ P
√ P
√ P
√ P
√ L
L
√ P

13
√ L

√ L
√ L
P
L
√ P
√ L
√ L
√ L
L
√ P
√ L
√ L
√ L
L
√ P
√ P
√ L
L
√ P
L
√ P
√ P
√ L
√ L

14
Puskesmas : Sanggona
Desa : Amololu
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Umur Tinggi

No. Nama Balita Tanggal Lahir Berat Badan/Pa Sangat
Ayah Ibu Pengukuran (Bulan) Pendek Normal
Badan njang Pendek
badan

1 Sasmiati Saprudin Arni 12/11/2014 11/5/2019 58 15 102 √

2 Faris Ade Pratama Barnas Nini 23/02/2015 11/5/2019 56 15 103 √
3 M.Rihul Fahmi Abidin Warni 31/03/2015 11/5/2019 55 14.7 103 √
4 Ghina Alesya Iskandar Juharni 4/20/2015 11/5/2019 54 13.9 95 √
5 Farisa Khaerani Juhardin Nani 7/6/2015 11/5/2019 51 14 96 √
6 M.Reski Irwan Isra 21/05/2015 11/6/2019 53 15 98 √
7 Adeva Mardona Altian 30/05/2015 11/5/2019 53 14.5 101 √
8 Ilham Munirwanto Sucianti 6/8/2015 11/5/2019 52 14.6 98 √
9 Naila Hasran Milarni 20/06/2015 11/5/2019 52 17 96 √
10 Muh. Asril Ashari Sasmita 10/10/2015 11/5/2019 48 13.7 96 √
11 Kaisar Alisman Erni 22/11/2015 11/6/2019 47 13.6 92 √
12 Kaisan Alisman Erni 22/11/2015 11/6/2019 47 14 95 √
13 M.Nur Al Razaq Masrun Sama 20/03/2016 11/5/2019 43 11.9 90 √
14 Rafipah Mutalib Asnila 5/2/2016 11/6/2019 42 13.1 93 √
15 Rifka Astika Ridwan Hartati 5/8/2016 11/5/2019 41 13 94 √
16 Akira Nurdin Nurlina 29/05/2016 11/5/2019 41 13.8 96 √
17 Ahmad Dinejat Jabar Dawati 22/09/2016 11/6/2019 37 13 90 √
18 Adelia Sahara Alimin Yuliana 16/11/2016 11/5/2019 35 12.2 90 √
19 Sabki Hamsasih Said Priska 21/01/2017 11/5/2019 33 15 88 √
20 Muh. Fattahillah Satrin Hartati 5/5/2017 11/5/2019 30 11 84 √
21 Sesi Sisilia Ramadani Asnul Alpianti 15/06/2017 11/5/2019 28 10.2 81 √

15
22 Rahmad Alamsyah Sarip Junawati 7/30/2017 11/5/2019 27 13.6 96 √
23 Muh. Fajar Setiawan Marlin Nurul Hikmah 9/26/2017 11/5/2019 25 12.1 80 √
24 Napila Azhara Muh. Jalil Hasriatin 10/9/2017 11/5/2019 24 11.3 80 √
25 Sahira Herman Muliana 10/9/2017 11/5/2019 24 10.9 81 √
26 Erin Al Patunisan Pais Miara 1/30/2018 11/6/2019 21 9.3 82 √
27 Muh. Azril Ataru Masaruddin Titi N. 10/9/2018 11/5/2019 12 9 73 √
28 Fardan Zulhanan Armon L Samsinar 1/15/2019 11/5/2019 9 8.2 69 √
29 Muh. Alfatir Ahmad Yuni 2/11/2019 11/5/2019 8 7.8 68 √
30 Areta Sakuina Markoni S. Hardian 6/21/2019 11/5/2019 4 7 66 √
31 Muh. Alshar Asmin Hajar Suwarsi 6/23/2019 11/5/2019 4 6.4 62 √
32 Muh. Asan Sumardin T. Ati 6/23/2019 11/5/2019 4 7.7 60 √
33 Eliza Arisman Sultin 8/6/2019 11/5/2019 2 6 56 √

16
KET.

P
L
L
P
P
L
L
L
P
L
L
L
L
P
P
P
L
P
L
L
P

17
L
L
P
P
L
L
L
L
P
L
L
P

18
Puskesmas : Sanggona
Desa : Undolo
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pa Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek
Badan njang Pendek
badan

1 Rasya Hardiyanti Hardin Titin 25/11/2014 11/6/2019 59 15.8 110

2 Humaria Saparudin Rasma 6/1/2015 11/6/2019 53 14 104
3 M.Dirgantara Tesran Riksen 27/06/2015 11/6/2019 PINDAH KE LIKU WALANAPO KEC, UEESI
4 M.Adli Naufal Dersan Irdan 27/07/2015 11/6/2019 51 15 105
5 Ainun Asmad Masriani 24/01/2016 11/6/2019 45 13.8 95
6 M.Ripal Arkari Hasni 15/03/2016 11/6/2019 43 14 91 √
7 Muh. Al Habsi Bastian Nurwati 31/03/2016 11/6/2019 43 13 94
8 Anisa Ramadani Mirzan Mariani 18/06/2016 11/6/2019 40 11.4 88 √
9 Sahir Didi Nining 27/09/2016 11/6/2019 37 12.1 90
10 Aila Novita Jusrin Siti Mardiana 11/10/2016 11/6/2019 35 11 87 √
11 M.Arifatul Al Qafi Makbul Indriani 3/28/2017 11/6/2019 31 13 90
12 Muh. Syaram Saripuddin Arnis Susandra 9/21/2017 11/6/2019 25 11.6 84
13 Has Gino Wirdan Hasni 11/14/2017 11/6/2019 23 11 84
14 Adra Asrul Aziz Senaltin 5/27/2018 11/6/2019 17 10.7 79
15 Naila Sahra Mansur Rahim 11/25/2018 11/6/2019 11 7.4 70
16 Ulfa Khairunnisa Sukarman Nurhikma 1/5/2019 11/6/2019 10 7.5 66 √

19
Status Gizi

KET.
Normal

√ L
P
KEC, UEESI L
√ L
√ P
L
√ L
P
√ L
P
√ L
√ L
√ L
√ L
√ P
P

20
Puskesmas : Sanggona
Desa : Lalombai
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pa Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek Normal
Badan njang Pendek
badan

1 Aktam Masrun Yanti 26/12/2014 11/7/2019 58 16 105 √

2 Igil Sterling Renal Atrina 1/1/2015 11/12/2019 58 16 103 √
3 Nur Amelia S. Amal S. Andriani 14/06/2015 11/7/2019 52 14.7 99 √
4 Ainun Nasruddin Fitriani 7/6/2015 11/7/2019 52 15 100 √
5 Wandi Iksin Nurtina 11/7/2015 11/7/2019 48 14 97 √
6 Ranti Ridwan Atriani 27/11/2015 11/12/2019 47 14 95 √
7 Caca Adara Putri Hasrun Leli 21/01/2016 11/7/2019 45 13.1 93 √
8 Silvia Nur Islami Mansyur Merana 22/01/2016 11/7/2019 45 13.9 94 √
9 Alpian Toli Minartin 14/04/2016 11/7/2019 42 13.4 95 √
10 Pirli Taslim Hasma 5/17/2016 11/12/2019 41 14 96 √
11 Muh. Alif Sabara Risal Nilam 29/10/2016 11/7/2019 36 18.5 93 √
12 Rafka Darson Asniatin 11/6/2016 11/7/2019 36 12.3 87 √
13 Rahel Siara Salma 26/02/2017 11/7/2019 32 12.7 86 √
14 Muh. Rifki Alsar Renaldi Desi Ratnasari 5/15/2017 11/12/2019 29 11.8 84 √
15 Alisia Cahaya Azhara Sumardin Astina 6/7/2017 11/7/2019 29 11 87 √
16 Julian Azmi K. Sarwan Selna 7/17/2017 11/7/2019 27 11.2 84 √
17 Asri Maharani Toli Minartin 7/20/2017 11/12/2019 27 12 86 √
18 Saska Roger Erlina 7/23/2017 11/7/2019 27 8.5 81 √
19 Elva Cahaya Sulfika Elisarno Cica 10/11/2017 11/7/2019 24 10.1 83 √
20 Gafran Stain Heswin Novita 11/25/2017 11/7/2019 23 10.2 84 √
21 Muhammad ILaL Nasruddin Fitriani 11/28/2017 11/7/2019 23 10.5 84 √

21
22 Muh.Fahim Irfan K. M. Irfan Rusni 7/16/2018 11/7/2019 15 9.4 76 √
23 Abrisam Aspin Hena 9/25/2018 11/7/2019 13 9.3 73 √
24 Isas Bashar Ukas Harniatin 10/13/2018 11/7/2019 12 10.3 71 √
25 Abiyan Novriadi M. Rizal Muliana 11/15/2018 11/7/2019 11 10,,8 70 √
26 Muh. Satsat Manrapi Yani 6/16/2019 11/7/2019 4 7 61 √
27 Sakir Sarno Ipin 9/7/2019 11/7/2019 2 5.2 55 √
28 Hasan Tasiri Maeni 10/5/2019 11/7/2019 1 3.4 48 √
29 Husein Tasiri Maeni 10/5/2019 11/7/2019 1 3.7 49 √
30

Kepala Puskesmas Sanggona Sanggona, .....November 2019

Jafar Aripin, SKM

Nip.19720220 199603 1 007

22
KET.

L
L
P
P
L
P
P
P
L
P
L
L
L
L
P
L
L
P
P
L
L

23
L
L
L
L
L
L
L
L

24
Puskesmas : Sanggona
Desa : Tondowatu
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pa Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek
Badan njang Pendek
badan
1 Luna Rusli Gustia 13/10/2014 10/8/2019 59 16 106
2 Muharam Irman Suwarti 25/10/2014 11/8/2019 60 17 110
3 M.Nasar Musran Rianti 28/10/2014 10/20/2019 59 14.2 99 √
4 Nurhasanah Nur Hadi Nursanliatna 29/11/2014 11/8/2019 59 20 108
5 Rapid Muslan Nurlaela 12/4/2014 11/8/2019 59 15.6 105
6 Arlia Saskia Arianto Aci 29/12/2014 11/3/2019 58 15 98 √
7 Jaldin Pajala Bone 1/4/2015 10/20/2019 57 15 105
8 Cika Aisyah.S Wahyudin Isna 2/5/2015 11/8/2019 57 15.7 106
9 Musfira Hasanah Rahmat Rina 2/8/2015 11/8/2019 57 16 102
10 M.Afgan Asran Irna 26/02/2015 11/3/2019 56 16.2 102
11 Alikra Marno Yal 23/03/2015 11/3/2019 55 14 96 √
12 M.Danil Rahmatang Sulari 26/04/2015 10/20/2019 53 14.4 102
13 Adam Suwardin Neni 23/05/2015 11/8/2019 53 13 101
14 Alisa Imran Narni 6/6/2015 10/20/2019 52 15 99
15 Naomi Insya Ramadani Suleman Lisdayanti 7/1/2015 11/3/2019 52 13.8 96
16 Akila Irfan Hasrinda 27/10/2015 11/3/2019 48 14.2 98
17 Algip Iksan Iskawati 11/12/2015 11/8/2019 47 14.2 97
18 Nurul Rahma P Agung dwi Herlina 29/12/2015 11/8/2019 46 15 95
19 Abdul Hakim Maedi Suri 23/01/2016 11/8/2019 45 14 94
20 Muh. Alpin Anton.H Eka 20/02/2016 10/20/2019 44 12.1 91 √
21 Lional Tasman Asni 3/4/2016 11/8/2019 44 15.6 93

25
22 Muh.Rikal Jamal Sarianti 27/03/2016 11/3/2019 43 13 91 √
23 Adira Nisa Ardani Ical Rosmida 18/05/2016 10/20/2019 41 12.5 91
24 Anandi Irman Fitriani 18/05/2016 11/8/2019 41 13.2 92
25 Muh. Jinong Nur Salim Sarifa 6/8/2016 11/8/2019 41 14 95
26 Adiba Maharani Akas Darmawati 6/10/2016 10/20/2019 40 14.7 94
27 Sahira Arwan Juniatin 19/06/2016 10/20/2019 40 12.5 94
28 Alfa Ramadani Iqbal Neti 22/06/2016 11/3/2019 40 14 93
29 Amar Fais Ramadan Rasdiman Isna 7/2/2016 11/8/2019 40 15 89.5 √
30 Anggun Ajisman Hasna 06/07/2016 11/8/2019 40 11.3 88 √
31 Ayla Isran Dian 7/7/2016 11/3/2019 39 12.1 90
32 Ijal Pajala Bone 7/7/2016 11/3/2019 39 12.4 93
33 Salwa Nur Fatimah Sulaeman Hernawati 31/07/2016 10/20/2019 38 13 91
34 Muh. Arhab Edison Samsiar 17/08/2016 11/8/2019 38 12 92
35 Nurul Reski Arafah Arianto Maslianti 27/08/2016 11/3/2019 38 12.5 92
36 Dzakiyah Talita Wika Pebrianto Hardianti 21/09/2016 10/20/2019 36 11.9 91
37 Sita Isman Marianti 11/10/2016 11/3/2019 35 11.7 87 √
38 Sandi Alfatih Etis Weni 25/11/2016 10/20/2019 34 12.4 88 √
39 Azirah Fauzia Agus Wati 17/01/2017 11/3/2019 33 11.9 88
40 Rifky Hamzah Aliudin Lisnawati 1/23/2017 11/3/2019 33 11.2 86 √
41 Jibdal Asdin Riasni 2/1/2017 10/8/2019 32 12 84 √
42 Muh. Ferbiansyah Musran Rianti 2/5/2017 10/20/2019 33 10.7 85 √
43 Muh. Alim Erdin Siti Sul 22/03/2017 10/8/2019 30 13 87
44 Muh. Sultan Alfatih Asrimin Sarlian 4/2/2017 11/3/2019 31 12 88
45 Rahel Rida Lia 4/17/2017 10/8/2019 29 11.2 83 √
46 Renita K.Rahma Bastian Raya 6/11/2017 10/20/2019 28 9.6 81.4 √
47 Utriani Jusran B. Nana 6/30/2017 11/3/2019 28 13 85
48 Isnah Hasan Anwar St. Hanifah 7/7/2017 11/3/2019 27 9.4 82 √
49 Muh. Fajran Prakasa Tawakal Nurjana 8/18/2017 11/8/2019 26 12 81 √
50 Muh. Ibnu Alfais Aswin Tian 9/15/2017 11/3/2019 25 9.7 80 √
51 Afifa Talita Suryanto Luli K 10/9/2017 11/3/2019 24 11.7 85
52 Nurma Novita Sari Nardin Mayangsari 11/2/2017 11/3/2019 24 12 85
53 Muh. Candra Samsakir Usti 11/9/2017 10/8/2019 22 12 84
54 Najwa Atmarini Irwan Hesrin 11/17/2017 10/8/2019 22 9.6 79

26
55 Humma Rabiah Suriadin Hasnawati 12/20/2017 11/3/2019 22 10 82
56 Hafiz Pardin Septi Eka 2/28/2018 11/8/2019 20 12.1 80
57 Abian Sufaru Sumardin Neni 3/5/2018 10/8/2019 19 9.8 80
58 Muh. Ragil Jamal Sriyanti 3/8/2018 11/3/2019 19 10.2 80
59 Fitra Khairunisah Asnur Sais Hartini 3/23/2018 11/8/2019 19 9.3 77
60 Andi Nadira Almair Andi Surahman Ratna 4/25/2018 11/8/2019 18 10 79
61 Halwa Maritza Gohing Muh. Ray Iqbal Hardiyanti 5/11/2018 10/8/2019 16 9.5 76
62 Ainun Gusran G. Endang 5/14/2018 10/8/2019 16 9.2 74
63 Saidatun Nafisa Lia Marlina 6/27/2018 10/20/2019 15 8.2 73.2
64 Afdilla Pratama Tahir Tamrin Tahir Rini Astari 8/2/2018 11/8/2019 15 9.3 73.6 √
65 Riska Rizal Meli 8/14/2018 10/20/2019 14 8 72
66 Tania Dwi Tri Triawan Sarwinisa 8/27/2018 10/8/2019 13 7.3 69 √
67 Muh. Abizar Arfan Agusrin Rasmayanti 11/14/2018 10/8/2019 10 8.7 71
68 Ulmaira Rusli Gustia 11/29/2018 11/8/2019 11 7.3 71
69 Refan Prasetya Erwin Tania 12/5/2018 11/2/2019 10 8 67 √
70 Kibas Darmin Aslina 12/23/2018 11/2/2019 10 7.7 68 √
71 Asisa Saraswati M. Sarif Sunarti 1/29/2019 10/8/2019 8 7.6 68
72 Rania Riky Irda 2/6/2019 11/2/2019 10 7.3 67.2
73 Anis Rahayu Dewi Pardin Septi Eka W. 3/21/2019 10/8/2019 6 8.3 65
74 Sahira Rusman Jaya Epi Sulpita Sari 3/25/2019 10/8/2019 6 6.8 64
75 Arsya Ramadani Iqbal Neti 4/6/2019 11/2/2019 6 6.6 63
76 Aleta Sabiyan Safar Martina 4/8/2019 10/8/2019 6 7.2 65
77 Muayat Zakir Rahmat Asriani 5/4/2019 11/2/2019 5 6.6 60 √
78 Hiro Septian R. Israman Suharti 5/30/2019 11/8/2019 5 8 64
79 Muh. Afnan Sutrianto Ninda 7/1/2019 10/8/2019 3 6.3 60
80 Apis Rapiudin Ritna 7/14/2019 10/8/2019 2 59 56
81 Ana Wulandari Gunawan Rasmawati 9/26/2019 11/8/2019 1 5 51
82 Muh. Aftar Ismail Afdin Hernawati 9/19/2019 11/8/2019 1 5.4 52

27
Status Gizi

KET.
Normal

√ P
√ L
L
√ P
√ L
P
√ L
√ P
√ P
√ L
L
√ L
√ L
√ P
√ P
√ P
√ L
√ P
√ L
L
√ L

28
 L
√ L
√ L
√ L
√ P
√ P
√ P
L
L
√ L
√ P
√ L
√ L
√ P
√ P
P
L
√ P
L
L
L
√ L
√ L
L
P
√ P
P
L
L
√ P
√ P
√ L
√ P

29
√ P
√ L
√ L
√ L
√ P
√ P
√ P
√ P
√ P
P
√ P
P
√ L
√ P
L
L
√ P
√ P
√ P
√ P
√ P
√ P
L
√ L
√ L
√ L
√ P
√ L

30
Puskesmas : Sanggona
Desa : Uete
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pan Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek
Badan jang badan Pendek
(cm)

1 Jihan Bene Indah 10/11/2014 PINDAH KE TONGAUNA KEC.UEESI

2 Fitri Armed Lina 11/10/2014 PINDAH KE TONGAUNA KEC.UEESI
3 Arun Sulman Jumartin 26/12/2014 11/8/2019 58 15 102
4 M.Danil Mulianton Seria 1/20/2015 PINDAH KE TONGAUNA KEC.UEESI
5 Febrianti Hasrianto Muliana 3/1/2015 11/8/2019 56 14.7 100
6 M. Al Faizan Anas Ansarina 4/13/2015 PINDAH KE MOROWALI SULTENG
7 M.Rasya Rasman Nurman 17/05/2015 11/8/2019 53 14.6 99
8 Habil Alpianus Sabu Uni 5/25/2015 11/8/2019 53 14.1 98
9 Nur Afika Alexander Yuli 6/5/2015 PINDAH KE MOWEWE
10 M.Rohim Saputra Hasan Suniatin 6/8/2015 11/14/2019 53 13.5 100
11 Fahrul Hengky Fitri 11/2/2015 PINDAH KE TONGAUNA KEC.UEESI
12 Ahmad Safaat Mirwan Surni 1/12/2016 PINDAH KE TONGAUNA KEC.UEESI
13 Nur Safira Karimun Hasmianti 13/02/2016 11/14/2019 45 13.5 94
14 M.Nur Al iklas Nurdin Jayanti 3/2/2016 11/8/2019 43 13 95
15 Friska Sultan Hasrida 3/5/2016 PINDAH KE TONGAUNA KEC.UEESI
16 Alna Saputri Masbul Asni 31/05/2016 11/14/2019 41 12.6 92
17 Aqipa Asrin Ade 17/07/2016 11/14/2019 39 12.4 93
18 Taufik Joni Hasriatin 9/6/2016 PINDAH KE PURAU KEC.UEESI
19 Ilda Zharani Balano Riana 9/11/2016 PINDAH KE MOROMBO
20 Muh.Balqis Pratama Wiharno Yuliani 19/09/2016 11/8/2019 37 12.5 92

31
21 Arsi Ganita Asrul Reviana 16/02/2017 11/14/2019 32 11.6 90
22 Anna Nur Sakinah Yunus Desi 3/30/2017 PINDAH KE TOGAUNA KEC. UEESI
23 Berkah Rahmat Asriani 6/15/2017 PINDAH KE UNAAHA
24 Lisran Busran Arlina 6/18/2017 11/8/2019 28 11 82 √
25 M. Abrisam Amrul Mariam 7/14/2017 PINDAH KE UNAAHA
26 Nur Asifa Jasman Serlin 9/25/2017 PINDAH KE TOGAUNA KEC. UEESI
27 Rafatar Raman Hasrini 9/12/2017 PINDAH KE KOLAKA UTARA
28 Atika Irfan Saputra Saskia 11/15/2017 PINDAH KE UNAAHA
29 Muh. Al Fandi La Temala Asrianti 1/4/2018 11/14/2019 22 10.5 80
30 M. Rezka Fajar Erwin Nur Afifah 4/24/2018 11/14/2019 18 9.9 77
31 Maisa Calista Ramadani Budi Wulandari 5/27/2018 11/8/2019 17 9 76
32 Keisan Kaisar Rikayanti 7/12/2018 PINDAH KE KOLAKA
33 Rayan Kaila Jumadin Samsia 11/14/2018 PINDAH KE TOGAUNA KEC. UEESI
34 Muh. Al Hafiz Hamsir Wina 12/1/2018 11/14/2019 11 8.9 69 √
35 Putri Annum Erwin Melpa 2/26/2019 PINDAH KE TOGAUNA KEC. UEESI
36 Asta Amrin Hartina 4/11/2019 10/28/2019 6 8 60.1 √

32
Status Gizi

KET.
Normal

ESI
ESI
√ L
ESI
√ P
NG
√ L
√ L

√ L
ESI
ESI
√ P
√ L
ESI
√ P
√ P
I

√ L

33
 √ P
SI

SI

√ L
√ L
√ P

SI
L
SI
L

34
Puskesmas : Sanggona
Desa : Aukora
Jumlah Penduduk :

Lampiran
Format Pengukuran Antropometri Balita

Orang Tua Pengukuran Status Gizi

Tanggal Tanggal Umur Tinggi

No. Nama Balita Berat Badan/Pa Sangat
Ayah Ibu Lahir Pengukuran (Bulan) Pendek Normal
Badan njang Pendek
badan

1 Nagita Mursalim Nurhaya 10/10/2014 11/9/2019 60 18 109 √

2 M.Danil M.Anton Soria 20/01/2015 11/9/2019 57 16 110 √
3 Marsya Nur Andarina Asdar Asrina 16/03/2015 11/9/2019 55 15.6 102 √
4 Adriansyah Saripudin Ida 26/09/2015 11/9/2019 49 13.4 97 √
5 Nisma Zulwan Hasna 24/10/2015 11/9/2019 48 13.9 96 √
6 Raya Bambang Tina 12/10/2015 11/9/2019 46 12 93 √
7 Rara Regina Putri Rahman Hasrini 12/11/2015 11/9/2019 46 14 98 √
8 Sakinah Humira Aswa Amrul Mukmin Asrayana 4/5/2017 11/9/2019 31 11.7 84 √
9 Ahmad Arsil Zaky Jamiudin Megawati 9/28/2017 11/9/2019 25 12 84 √
10 Nadifa Munandar Putri 3/6/2019 11/9/2019 8 10.7 √

35
KET.

P
L
P
L
P
P
P
P
L
P

36