0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
( ______________________________ ) ( ________________________)
NIP : NIP :
LAPORAN BULANAN PENYAKIT DIARE KOTA / KABUPATEN ______________________
PROPINSI NUSA TENGGARA BARAT TAHUN 2015
Bulan : ___________________
JML. PENDUDUK TARGET
K A D E R Jlh.Penderita Semua Umur
di Kader TOTAL Penderita Sarkes dan Kader
NO PUSKESMAS 0 - < 6 Bulan Jlh.penderita diberi ≥ 6 Bln - ˂ 1 Thn Jlh.penderita diberi 1 - 4 Tahun Jlh.penderita diberi 5 - 9 Tahun Jlh.penderita 10 - 14 Tahun Jlh.penderita 1 5- 19 Tahun Jlh.penderita ˃ 20 Tahun Jlh.penderita Jllh.Pemakaian Kader
Jlh.Balita diberi diberi diberi diberi
Penderita Penderita Penderita Penderita Penderita Penderita Penderita
ORALIT ZINC ORALIT ZINC ORALIT ZINC di Kader ORALIT Zinc L P
L P Balita Semua Umur L P L P L P L P ORALIT L P ORALIT L P ORALIT L P ORALIT L P
1 2 3 4 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
( ______________________________ ) ( ________________________)
NIP : NIP :
LAPORAN BULANAN PENYAKIT DIARE KABUPATEN BIMA
PUSKESMAS WERA
BULAN : februari 2021
TARGET SARANA KESEHATAN
JUMLAH 0 - < 6 Bln 6 Bln - ˂ 12 bulan 1 2 Bulan - 59 Bulan Terapi 0-59 Bulan di Sarkes
NO PUSKESMAS PENDUDUK Jumlah
Balita Semua Gol. Umur
Jlh.Penderita diberi Jlh.Penderita diberi Jlh.Penderita diberi Balita di
Pederita Penderita Penderita Sarkes Hanya Oralit +
MATI MATI MATI Hanya Zinc RL
Oralit Zinc Oralit + Oralit Zinc Oralit + Oralit Zinc Oralit + Oralit Zinc
RL RL RL
L P L P L P L P L P Saja Saja Zinc L P L P Saja Saja Zinc L P L P Saja Saja Zinc
1 2 3 4 5 6 7 8 9
1 TAWALI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
2 NUNGGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
3 WORA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
4 HIDIRASA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 SANGIANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
6 NTOKE 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
7 BALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
8 NANGAWERA 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
9 TADEWA 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0
10 RANGGASOLO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 MANDALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 2 1 0 0 3 0 0 0 3 5 0 0 8 0 0 0 11 11 0 0 0
Mengetahui,
1 TAWALI 6 0 0 2 1 0 0 0 1 0 0 1 0 0 0 1 1 0 0 6 1 36 2 42 0 2 4 4 0 0 0 0
2 NUNGGI 6 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 3 0 18 0 24 0 0 2 2 0 0 0 0
3 WORA 6 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 18 0 0 2 1 0 0 0 0
4 HIDIRASA 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 3 0 18 0 18 0 0 0 3 0 0 0 0
5 SANGIANG 6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 12 0 0 1 1 0 0 0 0
6 NTOKE 12 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 3 0 18 0 30 0 0 3 2 0 0 0 0
7 BALA 6 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 4 0 24 0 30 0 0 3 2 0 0 0 0
8 NANGAWERA 12 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 12 0 24 0 0 0 4 0 0 0 0
9 TADEWA 6 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 3 0 18 0 24 0 0 2 2 0 0 0 0
10 RANGGASOLO 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 6 0 0 1 0 0 0 0 0
11 MANDALA 6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 12 0 0 2 0 0 0 0 0
JUMLAH 66 0 0 6 5 0 0 4 3 0 0 2 1 0 0 3 6 0 0 29 1 174 2 240 0 2 20 21 0 0 0 0
1 2 20 21 22 23 24 25 26 27 28 29 30 31
1 TAWALI 0 0 0 0 0 0 0 0 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 4
2 NUNGGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
3 WORA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
4 HIDIRASA 0 0 0 0 0 0 0 0 0 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
5 SANGIANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
6 NTOKE 0 0 0 0 0 0 0 0 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 2
7 BALA 0 0 0 0 0 0 0 0 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 2
8 NANGAWERA 0 0 0 0 0 0 0 0 0 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
9 TADEWA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
10 RANGGASOLO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
11 MANDALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
JUMLAH 0 0 0 0 0 0 0 0 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 21 650 0
1 TAWALI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
2 NUNGGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
3 WORA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
4 HIDIRASA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 SANGIANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
6 NTOKE 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
7 BALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
8 NANGAWERA 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
9 TADEWA 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0
10 RANGGASOLO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 MANDALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 2 1 0 0 3 0 0 0 3 5 0 0 8 0 0 0 11 11 0 0 0
Mengetahui,
1 TAWALI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
2 NUNGGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
3 WORA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
4 HIDIRASA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 SANGIANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
6 NTOKE 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
7 BALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
8 NANGAWERA 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
9 TADEWA 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0
10 RANGGASOLO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
2 NUNGGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
3 WORA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
4 HIDIRASA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 SANGIANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 0 0 0
6 NTOKE 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
7 BALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
8 NANGAWERA 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 2 2 0 0 0
9 TADEWA 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0
10 RANGGASOLO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 MANDALA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 2 1 0 0 3 0 0 0 3 5 0 0 8 0 0 0 11 11 0 0 0
Mengetahui,
nya Oralit +
RL
nc Zinc
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
K A D E R Jlh.Penderita
Semua Umur
TOTAL
Penderita SISA STOK DI
0 - < 6 Bulan 6 Bln - ˂ 12 bulan 1 2 Bulan - 59 Bulan 5 - 9 Tahun 10 - 14 Tahun 1 5- 19 Tahun ˃ 20 Tahun Jllh.Pemakaian Kader di Kader Sarkes dan
Jlh.Balit PUSKESMAS
Jlh.penderita diberi Jlh.penderita diberi Jlh.penderita diberi Jlh.pen Jlh.pend Jlh.pen Kader
a di Jlh.pende
Penderita Penderita Penderita derita Penderita erita Penderita derita Penderita
Oralit Oralit + Penderita Oralit + Kader rita diberi Oralit Zinc L P ORALIT ZINC
ORALIT ZINC ORALIT ZINC ORALIT ZINC diberi diberi diberi L P
L P + Zinc L P Zinc L P Zinc L P Oralit L P Oralit L P Oralit L P Oralit
20 21 22 23 24 25 26 27 28 29 30 31
0 0 0 0 0 0 0 0 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 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 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 2
0 0 0 0 0 0 0 0 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 2
0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 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 21 650 0
Pengelola Diare
RAHMAWATI, AMK
NIP : 19791231 200604 2 054
Jumlah Penderita semua
S AR AN A K E S E H AT AN umur di Sarkes
PEMERIKSAAN
LAB.
Jlh.pemakaian 0-59 bulan di Sarkes
5 - 9 Tahun 10 - 14 Tahun 15 - 19 Tahun ˃ 20 Tahun Jlh.Penderita ≥ 5 Tahun diberi
Jlh pemakaian ≥ 5 Tahun di
Total Pemakaian Kolom 10 + 16
Sarkes ( KHOLERA )
(Sachet/Tablet/botol)
Penderita MATI
6 RL PEND MATI PEND MATI PEND MATI PEND MATI Oralit RL
Zinc ORALIT RL ORALIT Zinc RL P'RIKSA POST
L P L P L P L P L P L P L P L P L P L P
10 11 12 13 14 15 16 17 18 19
6 0 0 2 1 0 0 0 1 0 0 1 0 0 0 1 1 0 0 6 1 36 2 42 0 2 4 4 0 0 0 0
6 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 3 0 18 0 24 0 0 2 2 0 0 0 0
6 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 18 0 0 2 1 0 0 0 0
0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 3 0 18 0 18 0 0 0 3 0 0 0 0
6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 12 0 0 1 1 0 0 0 0
12 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 3 0 18 0 30 0 0 3 2 0 0 0 0
6 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 4 0 24 0 30 0 0 3 2 0 0 0 0
12 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 12 0 24 0 0 0 4 0 0 0 0
6 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 3 0 18 0 24 0 0 2 2 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 6 0 0 1 0 0 0 0 0
6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 12 0 0 2 0 0 0 0 0
66 0 0 6 5 0 0 4 3 0 0 2 1 0 0 3 6 0 0 29 1 174 2 240 0 2 20 21 0 0 0 0
PENGELOLA DIARE