LB-3 Gizi'20

FORMULIR REKAPITULASI SKDN
PUSKEMAS : RAWAT INAP SIDOMULYO

KECAMATAN : SIDOMULYO
BULAN : JANUARI
TAHUN : 2020
Jumlah SKDN BALITA KURUS
Sasaran Jumlah Balita Jumlah Balita Jumlah Balita Jumlah balita Naik Σ balita BB tidak naik Σ balita BB tidak naik Σ balita bawah garis Jumlah Balita Kurus Jumlah Balita Kurus
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M/D
No Desa Jumlah Balita(S) Jumlah Balita Kurus
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)
')
)
)
S)
'
D
/S
/D
/D
/S
Proyeksi ditimbang (D) punya KMS Baru (B) (O) Terkoreksi (D') Berat Badannya (N) badannya 1 kali (T1) badannya 2 kali (2T) merah (BGM) ( Proyeksi ) dapat PMT
/D
%
T/
'
(D
(K
(N
(D
(N
% (BG
(T
(2
%
%
%
%
%
%
%
L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P
1 BANDAR DALAM 355 189 166 355 143 144 287 80.8 143 144 287 80.8 3 3 6 0 0 0 140 141 281 79.2 140 141 281 97.9 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
2 CAMPANG TIGA 283 146 137 283 112 118 230 81.3 112 118 230 81.3 1 6 7 5 7 12 106 105 211 74.6 85 78 163 70.9 77.3 21 27 48 22.7 7 8 15 7.1 0 0 0 0.0 0 0 0 3 4 7 3 4 7 100.0
3 TALANG BARU 176 93 83 176 89 79 168 95.5 93 83 176 100.0 2 1 3 3 4 7 84 74 158 89.8 82 72 154 91.7 97.5 2 2 4 2.5 1 1 2 1.3 0 1 1 0.6 0 0 0 0 1 1 0 1 1 100.0
4 SUKA BANJAR 387 200 187 387 195 181 376 97.2 195 181 376 97.1576 1 2 3 5 4 9 189 175 364 94.1 184 170 354 94.1 97.3 5 5 10 2.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 86 104 190 99.0 86 104 190 99.0 2 2 4 2 2 4 82 100 182 94.8 80 97 177 93.2 97.3 2 3 5 2.7 1 1 2 1.1 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 85 87 172 80.8 108 105 213 100 7 2 9 0 0 0 78 85 163 76.5 77 82 159 92.4 97.5 1 3 4 2.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 65 72 137 72.5 65 72 137 72.5 4 2 6 6 7 13 55 63 118 62.4 52 60 112 81.8 94.9 3 3 6 5.1 1 2 3 2.5 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 73 58 131 87.3 76 74 150 100.0 1 1 2 5 4 9 67 53 120 80.0 67 53 120 91.6 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 160 160 320 84.7 160 160 320 84.7 9 8 17 14 13 27 137 139 276 73.0 125 129 254 79.4 92.0 12 10 22 8.0 8 5 13 4.7 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 60 63 123 92.5 60 63 123 92.5 0 2 2 4 3 7 56 58 114 85.7 52 54 106 86.2 93.0 4 4 8 7.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 69 68 137 89.5 82 73 155 101.3 1 1 2 0 0 0 68 67 135 88.2 68 67 135 98.5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 157 156 313 95.4 165 163 328 100.0 6 2 8 0 0 0 151 154 305 93.0 142 148 290 92.7 95.1 9 6 15 4.9 4 2 6 2.0 0 0 0 0.0 0 0 0 1 0 1 1 0 1 100.0
13 SIDODADI 683 346 337 683 396 393 789 115.5 396 393 789 115.5 5 5 10 16 16 32 375 372 747 109.4 270 273 543 68.8 72.7 105 99 204 27.3 0 0 0 0.0 1 1 2 0.3 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 288 289 577 103.2 288 289 577 103.2 7 4 11 15 13 28 266 272 538 96.2 257 259 516 89.4 95.9 9 13 22 4.1 8 9 17 3.2 0 1 1 0.2 0 0 0 0 1 1 0 1 1 100.0
15 SIDOREJO 662 332 330 662 284 269 553 83.5 284 269 553 83.5 10 9 19 10 10 20 264 250 514 77.6 255 240 495 89.5 96.3 9 9 18 3.5 10 13 23 4.5 0 0 0 0.0 0 0 0 0 2 2 0 2 2 100.0
16 SIDOMULYYO 481 244 237 481 205 186 391 81.3 245 235 480 99.8 3 4 7 4 5 9 198 177 375 78.0 192 172 364 93.1 97.1 6 5 11 2.9 1 1 2 0.5 1 1 2 0.5 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2467 2427 4894 92.0 2558 2526 5084 95.5 62 54 116 89 88 177 2316 2285 4601 86.5 2128 2095 4223 86.3 91.8 188 189 377 8.2 41 42 83 1.8 2 4 6 0.1 0 0 0 4 8 12 4 8 12 100.0
Mengetahui
Ka. UPT Puskesmas Rawat Inap Koordinator Gizi
Sidomulyo
dr. Rocky J.D. Sihombing Tri Hendras P, SKM

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : FEBRUARI
TAHUN : 2020
')
M/D
')
)
)
')
)
)
'
D
'/S
/D
/S
/S
/D
/D
Proyeksi ditimbang (D) punya KMS Baru (B) (O) Terkoreksi (D') Berat Badannya (N) badannya 1 kali (T1) badannya 2 kali (2T) merah (BGM) ( Proyeksi ) dapat PMT %
T/
(D
(K
(N
(D
% (BG
(N
(T
(2
%
%
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 180 171 351 98.9 180 171 351 98.9 3 2 5 11 7 18 166 162 328 92.4 165 160 325 92.6 99.1 1 2 3 0.9 1 0 1 0.3 1 0 1 0.3 0 0 0 1 1 2 1 1 2 100.0
2 CAMPANG TIGA 283 146 137 283 130 140 270 95.4 130 140 270 95.4 2 3 5 16 24 40 112 113 225 79.5 93 88 181 67.0 80.4 19 25 44 19.6 7 8 15 6.7 0 0 0 0.0 0 0 0 1 3 4 1 3 4 100.0
3 TALANG BARU 176 93 83 176 89 80 169 96.0 93 83 176 100.0 2 2 4 3 4 7 84 74 158 89.8 82 73 155 91.7 98.1 2 1 3 1.9 0 1 1 0.6 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 195 183 378 97.7 195 183 378 97.7 4 2 6 8 6 14 183 175 358 92.5 177 169 346 91.5 96.6 6 6 12 3.4 0 0 0 0.0 0 1 1 0.3 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 89 105 194 101.0 89 105 194 101.0 3 4 7 2 1 3 84 100 184 95.8 80 99 179 92.3 97.3 4 1 5 2.7 0 2 2 1.1 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 101 104 205 96.2 108 108 216 101.4 6 0 6 0 0 0 95 104 199 93.4 94 100 194 94.6 97.5 2 3 5 2.5 0 1 1 0.5 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 76 72 148 78.3 76 72 148 78.3 6 2 8 6 4 10 64 66 130 68.8 58 64 122 82.4 93.8 5 2 7 5.4 2 0 2 1.5 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 72 70 142 94.7 76 74 150 100.0 0 1 1 3 9 12 69 60 129 86.0 68 60 128 90.1 99.2 1 0 1 0.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 187 177 364 96.3 185 174 359 95.0 10 8 18 12 13 25 165 156 321 84.9 153 146 299 82.1 93.1 12 10 22 6.9 8 5 13 4.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 67 67 134 100.8 66 65 131 98.5 2 2 4 9 9 18 56 56 112 84.2 52 53 105 78.4 93.8 4 3 7 6.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 76 71 147 96.1 80 73 153 100.0 2 0 2 1 4 5 73 67 140 91.5 66 62 128 87.1 91.4 7 5 12 8.6 1 0 1 0.7 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 163 158 321 97.9 165 163 328 100.0 3 2 5 3 1 4 157 155 312 95.1 145 149 294 91.6 94.2 12 6 18 5.8 3 4 7 2.2 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
13 SIDODADI 683 346 337 683 374 372 746 109.2 374 372 746 109.2 8 8 16 8 8 16 358 356 714 104.5 263 269 532 71.3 74.5 95 87 182 25.5 0 0 0 0.0 1 1 2 0.3 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 301 296 597 106.8 301 296 597 106.8 8 5 13 4 6 10 289 285 574 102.7 278 275 553 92.6 96.3 11 10 21 3.7 3 8 11 1.9 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
15 SIDOREJO 662 332 330 662 300 295 595 89.9 300 295 595 89.9 8 11 19 10 10 20 282 274 556 84.0 271 262 533 89.6 95.9 11 12 23 4.1 11 9 20 3.6 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYYO 481 244 237 481 234 223 457 95.0 243 237 480 99.8 6 2 8 10 7 17 218 214 432 89.8 213 210 423 92.6 97.9 5 4 9 2.1 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2634 2584 5218 98.0 2661 2611 5272 99.1 73 54 127 106 113 219 2455 2417 4872 91.5 2258 2239 4497 86.2 92.3 197 177 374 7.7 36 38 74 1.5 2 2 4 0.1 0 0 0 2 4 6 2 4 6 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : MARET
TAHUN : 2020
M/D')
)
')
)
')
D'
)
)
dapat PMT %
'/S
Proyeksi ditimbang (D) punya KMS Baru (B) (O) Terkoreksi (D') Berat Badannya (N) badannya 1 kali (T1) badannya 2 kali (2T) merah (BGM) ( Proyeksi )
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(N
(D
(T
(2
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 141 135 276 77.7 143 144 287 80.8 1 3 4 6 6 12 134 126 260 73.2 128 122 250 90.6 96.2 6 4 10 3.8 0 0 0 0.0 1 0 1 0.4 0 0 0 1 1 2 0 0 0 0.0
2 CAMPANG TIGA 283 146 137 283 103 113 216 76.3 112 118 230 81.3 1 1 2 2 1 3 100 111 211 74.6 88 92 180 83.3 85.3 12 19 31 14.7 5 5 10 4.7 0 0 0 0.0 0 0 0 7 5 12 7 5 12 100.0
3 TALANG BARU 176 93 83 176 88 80 168 95.5 93 83 176 100.0 1 1 2 6 4 10 81 75 156 88.6 81 73 154 91.7 98.7 0 1 1 0.6 0 1 1 0.6 0 1 1 0.6 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 186 173 359 92.8 195 181 376 188 1 3 4 2 1 3 183 169 352 91.0 177 164 341 95.0 96.9 6 5 11 3.1 0 0 0 0.0 0 1 1 0.3 0 0 0 0 2 2 0 2 2 100.0
5 BANJAR SURI 192 99 93 192 90 100 190 99.0 86 104 190 99.0 1 4 5 1 2 3 88 94 182 94.8 87 91 178 93.7 97.8 1 3 4 2.2 0 1 1 0.5 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 87 86 173 81.2 108 105 213 100 1 2 3 0 0 0 86 84 170 79.8 83 80 163 94.2 95.9 2 4 6 3.5 0 0 0 0.0 0 0 0 0.0 0 0 0 1 0 1 1 0 1 100.0
7 BUDI DAYA 189 96 93 189 50 40 90 47.6 65 72 137 72.5 3 1 4 0 0 0 47 39 86 45.5 45 36 81 90.0 94.2 2 3 5 5.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 59 56 115 76.7 76 74 150 100.0 1 0 1 4 4 8 54 52 106 70.7 54 52 106 92.2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 171 169 340 89.9 160 160 320 84.7 12 8 20 16 15 31 143 146 289 76.5 129 129 258 75.9 89.3 14 17 31 10.7 0 12 12 4.2 1 2 3 1.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 50 50 100 75.2 60 63 123 92.5 4 0 4 0 0 0 46 50 96 72.2 46 50 96 96.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 74 71 145 94.8 82 73 155 101.3 2 1 3 2 3 5 70 67 137 89.5 52 52 104 71.7 75.9 16 17 33 24.1 0 1 1 0.7 1 0 1 0.7 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 150 141 291 88.7 165 163 328 100.0 0 5 5 0 0 0 150 136 286 87.2 146 170 316 108.6 110.5 4 6 10 3.5 2 3 5 1.7 0 0 0 0.0 0 0 0 0 1 1 0 1 1 100.0
13 SIDODADI 683 346 337 683 247 240 487 71.3 396 393 789 115.5 8 8 16 8 8 16 231 224 455 66.6 173 171 344 70.6 75.6 58 53 111 24.4 0 0 0 0.0 1 1 2 0.4 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 279 270 549 98.2 288 289 577 103.2 0 0 0 5 10 15 274 260 534 95.5 264 514 778 141.7 145.7 10 10 20 3.7 6 3 9 1.7 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
15 SIDOREJO 662 332 330 662 258 260 518 78.2 284 269 553 83.5 9 11 20 8 6 14 241 243 484 73.1 229 233 462 89.2 95.5 11 9 20 4.1 10 7 17 3.5 0 0 0 0.0 0 0 0 2 1 3 0 0 0 0.0
16 SIDOMULYYO 481 244 237 481 224 215 439 91.3 245 235 480 99.8 7 3 10 5 6 11 212 206 418 86.9 206 200 406 92.5 97.1 6 6 12 2.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2257 2199 4456 83.7 2558 2526 5084 95.5 52 51 103 65 66 131 2140 2082 4222 79.3 1988 2229 4217 94.6 99.9 148 157 305 7.2 23 33 56 1.3 4 5 9 0.2 0 0 0 11 10 21 8 8 16 76.2
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : APRIL
TAHUN : 2020
M/D')
)
')
)
')
)
D'
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(D
(N
(T
(2
%
%
%
%
1 BANDAR DALAM 355 189 166 355 2 3 5 1.4 143 144 287 80.8 2 3 5 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
2 CAMPANG TIGA 283 146 137 283 4 1 5 1.8 112 118 230 81.3 4 1 5 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
3 TALANG BARU 176 93 83 176 1 3 4 2.3 93 83 176 100.0 1 3 4 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 6 1 7 1.8 195 181 376 188 6 1 7 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 2 1 3 1.6 86 104 190 99.0 2 1 3 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 5 0 5 2.3 108 105 213 100 5 0 5 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 2 2 4 2.1 65 72 137 72.5 2 2 4 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 2 1 3 2.0 76 74 150 100.0 2 1 3 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 4 6 10 2.6 160 160 320 84.7 4 6 10 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 1 4 5 3.8 60 63 123 92.5 1 4 5 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 1 1 2 1.3 82 73 155 101.3 1 1 2 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 4 4 8 2.4 165 163 328 100.0 4 4 8 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
13 SIDODADI 683 346 337 683 7 6 13 1.9 396 393 789 115.5 7 6 13 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 5 3 8 1.4 288 289 577 103.2 5 3 8 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
15 SIDOREJO 662 332 330 662 7 3 10 1.5 284 269 553 83.5 7 3 10 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYYO 481 244 237 481 5 3 8 1.7 245 235 480 99.8 5 3 8 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 58 42 100 1.9 2558 2526 5084 95.5 58 42 100 0 0 0 0 0 0 0.0 0 0 0 0.0 #DIV/0! 0 0 0 ### 0 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 #DIV/0!
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : MEI
TAHUN : 2020
M/D')
)
')
)
')
)
D'
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(D
(N
(T
(2
%
%
%
%
1 BANDAR DALAM 355 189 166 355 8 5 13 3.7 143 144 287 80.8 5 3 8 0 0 0 3 2 5 1.4 3 2 5 38.5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
2 CAMPANG TIGA 283 146 137 283 5 5 10 3.5 112 118 230 81.3 1 4 5 0 0 0 4 1 5 1.8 4 1 5 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
3 TALANG BARU 176 93 83 176 3 4 7 4.0 93 83 176 100.0 2 1 3 0 0 0 1 3 4 2.3 1 3 4 57.1 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 10 2 12 3.1 195 181 376 188 4 1 5 0 0 0 6 1 7 1.8 6 1 7 58.3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 3 3 6 3.1 86 104 190 99.0 1 2 3 0 0 0 2 1 3 1.6 2 1 3 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 5 0 5 2.3 108 105 213 100 2 0 2 0 0 0 3 0 3 1.4 3 0 3 60.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 4 4 8 4.2 65 72 137 72.5 2 2 4 0 0 0 2 2 4 2.1 2 2 4 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 5 3 8 5.3 76 74 150 100.0 3 2 5 0 0 0 2 1 3 2.0 2 1 3 37.5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 9 11 20 5.3 160 160 320 84.7 5 5 10 0 0 0 4 6 10 2.6 4 6 10 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 5 5 10 7.5 60 63 123 92.5 4 1 5 0 0 0 1 4 5 3.8 1 4 5 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 1 3 4 2.6 82 73 155 101.3 0 2 2 0 0 0 1 1 2 1.3 1 1 2 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 7 6 13 4.0 165 163 328 100.0 3 5 8 0 0 0 4 1 5 1.5 4 1 5 38.5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
13 SIDODADI 683 346 337 683 14 13 27 4.0 396 393 789 115.5 7 7 14 0 0 0 7 6 13 1.9 7 6 13 48.1 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 10 9 19 3.4 288 289 577 103.2 5 6 11 0 0 0 5 3 8 1.4 5 3 8 42.1 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
15 SIDOREJO 662 332 330 662 15 5 20 3.0 284 269 553 83.5 8 2 10 0 0 0 7 3 10 1.5 7 3 10 50.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYO 481 244 237 481 12 8 20 4.2 245 235 480 99.8 7 5 12 0 0 0 5 3 8 1.7 5 3 8 40.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 116 86 202 3.8 2558 2526 5084 95.5 59 48 107 0 0 0 57 38 95 1.8 57 38 95 47.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JUNI
TAHUN : 2020
M/D')
)
')
)
')
)
D'
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(D
(N
(T
(2
%
%
%
%
1 BANDAR DALAM 355 189 166 355 71 54 125 35.2 143 144 287 80.8 4 4 8 62 47 109 5 3 8 2.3 5 3 8 6.4 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
2 CAMPANG TIGA 283 146 137 283 30 37 67 23.7 112 118 230 81.3 12 7 19 0 0 0 18 30 48 17.0 18 25 43 64.2 89.6 0 5 5 10.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
3 TALANG BARU 176 93 83 176 16 22 38 21.6 93 83 176 100.0 1 1 2 12 18 30 3 3 6 3.4 3 3 6 15.8 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 36 31 67 17.3 195 181 376 188 5 5 10 20 25 45 11 1 12 3.1 6 1 7 10.4 58.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 15 16 31 16.1 86 104 190 99.0 3 2 5 1 2 3 11 12 23 12.0 11 12 23 74.2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 26 15 41 19.2 108 105 213 100 0 4 4 24 11 35 2 0 2 0.9 2 0 2 4.9 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 31 19 50 26.5 65 72 137 72.5 2 2 4 27 15 42 2 2 4 2.1 2 2 4 8.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 27 51 78 52.0 76 74 150 100.0 2 1 3 22 18 40 3 32 35 23.3 3 2 5 6.4 14.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 58 59 117 31.0 160 160 320 84.7 7 11 18 21 25 46 30 23 53 14.0 30 23 53 45.3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 16 24 40 30.1 60 63 123 92.5 1 0 1 0 0 0 15 24 39 29.3 14 22 36 90.0 92.3 1 2 3 7.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 15 10 25 16.3 75 73 148 96.7 1 2 3 0 1 1 14 7 21 13.7 14 7 21 84.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 32 37 69 21.0 165 163 328 100.0 2 3 5 27 29 56 3 5 8 2.4 3 5 8 11.6 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
13 SIDODADI 683 346 337 683 47 38 85 12.4 335 334 669 98.0 6 5 11 0 0 0 41 33 74 10.8 32 27 59 69.4 79.7 9 6 15 20.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 59 49 108 19.3 288 289 577 103.2 6 8 14 0 0 0 53 41 94 16.8 48 37 85 78.7 90.4 5 4 9 9.6 1 0 1 1.1 1 0 1 1.1 0 0 0 0 0 0 0 0 0 #DIV/0!
15 SIDOREJO 662 332 330 662 58 57 115 17.4 284 269 553 83.5 3 4 7 0 0 0 55 53 108 16.3 53 50 103 89.6 95.4 2 3 5 4.6 0 0 0 0.0 0 0 0 0.0 0 0 0 1 0 1 0 0 0 0.0
16 SIDOMULYO 481 244 237 481 49 43 92 19.1 245 235 480 99.8 6 1 7 0 0 0 43 42 85 17.7 41 42 83 90.2 97.6 1 1 2 2.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 586 562 1148 21.6 2490 2467 4957 93.1 61 60 121 216 191 407 309 311 620 11.6 285 261 546 47.6 88.1 18 21 39 6.3 1 0 1 0.2 1 0 1 0.2 0 0 0 1 0 1 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JULI
TAHUN : 2020
M/D')
)
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D'
)
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(N
(D
(T
(2
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 127 144 271 76.3 143 144 287 80.8 2 2 4 66 60 126 59 82 141 39.7 59 52 111 41.0 78.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
2 CAMPANG TIGA 283 146 137 283 28 22 50 17.7 112 118 230 81.3 8 4 12 0 0 0 20 18 38 13.4 16 14 30 60.0 78.9 2 2 4 10.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
3 TALANG BARU 176 93 83 176 83 75 158 75.0 93 83 176 100.0 2 1 3 64 52 116 17 22 39 22.2 14 21 35 22.2 89.7 2 1 3 7.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 166 128 294 76.0 195 181 376 188 5 1 6 125 96 221 36 31 67 17.3 31 26 57 19.4 85.1 5 5 10 14.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 86 98 184 95.8 86 104 190 99.0 3 4 7 2 3 5 81 91 172 89.6 81 90 171 92.9 99.4 0 1 1 0.6 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 40 44 84 39.4 108 105 213 100 1 2 3 0 0 0 39 42 81 38.0 37 41 78 92.9 96.3 2 1 3 3.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 46 47 93 49.2 65 72 137 72.5 3 3 6 7 7 14 36 37 73 38.6 37 36 73 78.5 100.0 1 1 2 2.7 0 0 0 0.0 1 0 1 1.4 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 58 59 117 78.0 76 74 150 100.0 1 2 3 18 15 33 39 42 81 54.0 39 42 81 69.2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 115 108 223 59.0 160 160 320 84.7 6 9 15 45 59 104 64 40 104 27.5 58 35 93 41.7 89.4 6 5 11 10.6 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 56 52 108 81.2 60 63 123 92.5 1 5 6 22 21 43 33 26 59 44.4 31 26 57 52.8 96.6 2 2 4 6.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 64 60 124 81.0 75 73 148 96.7 2 0 2 4 4 8 58 56 114 74.5 57 56 113 91.1 99.1 1 0 1 0.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 138 130 268 81.7 165 163 328 100.0 4 3 7 102 90 192 32 37 69 21.0 28 34 62 23.1 89.9 4 3 7 10.1 2 1 3 4.3 1 0 1 1.4 0 0 0 1 0 1 1 0 1 100.0
13 SIDODADI 683 346 337 683 122 128 250 36.6 335 334 669 98.0 8 8 16 0 0 0 114 120 234 34.3 75 86 161 64.4 68.8 39 34 73 31.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 279 277 556 99.5 288 289 577 103.2 4 3 7 80 79 159 195 195 390 69.8 188 186 374 67.3 95.9 7 9 16 4.1 1 2 3 0.8 1 0 1 0.3 0 0 0 1 0 1 1 0 1 100.0
15 SIDOREJO 662 332 330 662 243 237 480 72.5 284 269 553 83.5 8 7 15 17 14 31 218 216 434 65.6 209 206 415 86.5 95.6 9 10 19 4.4 7 10 17 3.9 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYO 481 244 237 481 132 108 240 49.9 245 235 480 99.8 6 3 9 3 2 5 123 103 226 47.0 120 102 222 92.5 98.2 3 1 4 1.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 1783 1717 3500 65.8 2490 2467 4957 93.1 64 57 121 555 502 1057 1164 1158 2322 43.6 1080 1053 2133 60.9 91.9 83 75 158 6.8 10 13 23 1.0 3 0 3 0.1 0 0 0 2 0 2 2 0 2 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : AGUSTUS
TAHUN : 2020
M/D')
)
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)
')
D'
)
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(N
(D
(T
(2
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 176 166 342 96.3 143 144 287 80.8 3 3 6 14 13 27 159 150 309 87.0 156 147 303 88.6 98.1 3 3 6 1.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 1 1 0 1 1 100.0
2 CAMPANG TIGA 283 146 137 283 128 135 263 92.9 112 118 230 81.3 5 1 6 16 24 40 107 110 217 76.7 88 85 173 65.8 79.7 19 25 44 20.3 7 8 15 6.9 0 0 0 0.0 0 0 0 1 5 6 0 0 0 0.0
3 TALANG BARU 176 93 83 176 88 80 168 75.0 93 83 176 100.0 1 2 3 3 4 7 84 74 158 89.8 82 73 155 92.3 98.1 1 2 3 1.9 1 2 3 1.9 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 199 182 381 98.4 195 181 376 188 5 1 6 33 54 87 161 127 288 74.4 154 121 275 72.2 95.5 7 6 13 4.5 0 0 0 0.0 1 0 1 0.3 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 85 105 190 99.0 86 104 190 99.0 3 4 7 3 1 4 79 100 179 93.2 74 98 172 90.5 96.1 4 3 7 3.9 1 1 2 1.1 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 104 102 206 96.7 108 105 213 100 2 2 4 0 0 0 102 100 202 94.8 102 100 202 98.1 100.0 0 0 0 0.0 2 1 3 1.5 0 0 0 0.0 0 0 0 2 1 3 0 0 0 0.0
7 BUDI DAYA 189 96 93 189 102 82 184 97.4 65 72 137 72.5 5 3 8 56 35 91 41 44 85 45.0 38 41 79 42.9 92.9 3 3 6 7.1 0 1 1 1.2 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 65 60 125 83.3 76 74 150 100.0 0 2 2 11 14 25 54 44 98 65.3 53 44 97 77.6 99.0 1 0 1 1.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 187 177 364 96.3 160 160 320 84.7 10 8 18 12 13 25 165 156 321 84.9 152 144 296 81.3 92.2 13 12 25 7.8 8 5 13 4.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 66 67 133 100.0 60 63 123 92.5 0 0 0 13 11 24 53 56 109 82.0 51 54 105 78.9 96.3 2 2 4 3.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 74 71 145 94.8 75 73 148 96.7 3 0 3 6 6 12 65 65 130 85.0 61 61 122 84.1 93.8 4 4 8 6.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 162 157 319 97.3 165 163 328 100.0 1 2 3 23 25 48 138 130 268 81.7 130 120 250 78.4 93.3 8 10 18 6.7 4 4 8 3.0 0 0 0 0.0 0 0 0 1 0 1 0 0 0 0.0
13 SIDODADI 683 346 337 683 214 216 430 63.0 335 334 669 98.0 6 5 11 0 0 0 208 211 419 61.3 140 141 281 65.3 67.1 68 70 138 32.9 0 0 0 0.0 0 0 0 0.0 0 0 0 68 70 138 68 70 138 100.0
14 SIDOWALUYO 559 280 279 559 293 277 570 102.0 288 289 577 103.2 5 7 12 48 44 92 240 226 466 83.4 230 226 456 80.0 97.9 10 14 24 5.2 6 4 10 2.1 1 0 1 0.2 0 0 0 1 0 1 1 0 1 100.0
15 SIDOREJO 662 332 330 662 298 291 589 89.0 284 269 553 83.5 4 6 10 10 9 19 284 276 560 84.6 273 264 537 91.2 95.9 11 12 23 4.1 8 10 18 3.2 0 1 1 0.2 0 0 0 0 1 1 0 1 1 100.0
16 SIDOMULYO 481 244 237 481 229 223 452 94.0 245 235 480 99.8 7 1 8 5 6 11 217 216 433 90.0 211 211 422 93.4 97.5 6 5 11 2.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2470 2391 4861 91.3 2490 2467 4957 93.1 60 47 107 253 259 512 2157 2085 4242 79.7 1995 1930 3925 80.7 92.5 160 171 331 7.8 37 36 73 1.7 2 1 3 0.1 0 0 0 73 78 151 69 72 141 93.4
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : SEPTEMBER
TAHUN : 2020
M/D')
)
')
)
')
)
D'
)
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(N
(D
(T
(2
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 168 159 327 92.1 143 144 287 80.8 3 3 6 2 2 4 163 154 317 89.3 160 151 311 95.1 98.1 3 3 6 1.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 1 1 0 1 1 100.0
2 CAMPANG TIGA 283 146 137 283 108 116 224 79.2 112 118 230 81.3 5 2 7 1 3 4 102 111 213 75.3 84 85 169 75.4 79.3 18 26 44 20.7 6 11 17 8.0 1 1 2 0.9 0 0 0 1 6 7 1 6 7 100.0
3 TALANG BARU 176 93 83 176 83 75 158 75.0 93 83 176 100.0 2 1 3 5 3 8 76 71 147 83.5 75 68 143 90.5 97.3 1 3 4 2.7 1 1 2 1.4 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 178 168 346 89.4 195 181 376 188 4 1 5 1 1 2 173 166 339 87.6 169 161 330 95.4 97.3 4 5 9 2.7 0 0 0 0.0 0 0 0 0.0 0 0 0 2 3 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 87 104 191 99.5 86 104 190 99.0 4 3 7 3 1 4 80 100 180 93.8 77 97 174 91.1 96.7 3 3 6 3.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 100 94 194 91.1 108 105 213 100 4 2 6 0 0 0 96 92 188 88.3 94 89 183 94.3 97.3 2 4 6 3.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 63 61 124 65.6 65 72 137 72.5 4 2 6 5 4 9 54 55 109 57.7 52 54 106 85.5 97.2 2 1 3 2.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 67 62 129 86.0 76 74 150 100.0 1 1 2 9 12 21 57 49 106 70.7 56 49 105 81.4 99.1 1 0 1 0.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 115 108 223 59.0 160 160 320 84.7 6 9 15 45 59 104 64 40 104 27.5 58 35 93 41.7 89.4 6 5 11 10.6 0 0 0 0.0 2 0 2 1.9 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 54 55 109 82.0 60 63 123 92.5 0 0 0 3 4 7 51 51 102 76.7 51 51 102 93.6 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 71 65 136 88.9 75 73 148 96.7 1 1 2 5 4 9 65 60 125 81.7 60 56 116 85.3 92.8 5 4 9 7.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 145 145 290 88.4 165 163 328 100.0 4 3 7 0 0 0 141 142 283 86.3 132 133 265 91.4 93.6 9 9 18 6.4 4 4 8 2.8 0 0 0 0.0 0 0 0 0 1 1 0 1 1 100.0
13 SIDODADI 683 346 337 683 247 241 488 71.4 335 334 669 98.0 5 6 11 8 8 16 234 227 461 67.5 173 171 344 70.5 74.6 61 56 117 25.4 0 0 0 0.0 1 1 2 0.4 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 280 282 562 100.5 288 289 577 103.2 7 5 12 5 5 10 268 272 540 96.6 263 265 528 94.0 97.8 5 7 12 2.2 4 6 10 1.9 1 0 1 0.2 0 0 0 1 0 1 1 0 1 100.0
15 SIDOREJO 662 332 330 662 275 269 544 82.2 284 269 553 83.5 7 6 13 2 1 3 266 262 528 79.8 260 255 515 94.7 97.5 6 7 13 2.5 6 8 14 2.7 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYO 481 244 237 481 161 141 302 62.8 245 235 480 99.8 5 2 7 2 2 4 154 137 291 60.5 151 135 286 94.7 98.3 3 2 5 1.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2202 2145 4347 81.7 2490 2467 4957 93.1 62 47 109 96 109 205 2044 1989 4033 75.8 1915 1855 3770 86.7 93.5 129 135 264 6.5 21 30 51 1.3 5 2 7 0.2 0 0 0 4 11 10 2 8 10 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : OKTOBER
TAHUN : 2020
No Desa Jumlah Balita (S) Jumlah Balita Kurus
M/D')
)
)
')
')
D'
)
)
)
dapat PMT %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(N
(K
(D
(N
(T
(2
%
%
%
%
%
1 BANDAR DALAM 355 189 166 355 167 161 328 92.4 143 144 287 80.8 4 5 9 6 4 10 157 152 309 87.0 153 148 301 91.8 97.4 4 4 8 2.6 0 0 0 0.0 0 0 0 0.0 0 0 0 0 1 1 0 1 1 100.0
2 CAMPANG TIGA 283 146 137 283 113 119 232 82.0 112 118 230 81.3 5 5 10 2 6 8 106 108 214 75.6 87 88 175 75.4 81.8 19 20 39 18.2 7 8 15 7.0 0 0 0 0.0 0 0 0 0 4 4 0 4 4 100.0
3 TALANG BARU 176 93 83 176 83 76 159 75.0 93 83 176 100.0 1 2 3 5 4 9 77 70 147 83.5 75 68 143 89.9 97.3 2 2 4 2.7 1 2 3 2.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
4 SUKA BANJAR 387 200 187 387 185 176 361 93.3 195 181 376 188 3 3 6 8 8 16 174 165 339 87.6 165 156 321 88.9 94.7 9 9 18 5.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
5 BANJAR SURI 192 99 93 192 93 99 192 100.0 86 104 190 99.0 3 3 6 2 1 3 88 95 183 95.3 86 90 176 91.7 96.2 2 5 7 3.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
6 KOTA DALAM 213 108 105 213 90 90 180 84.5 108 105 213 100 0 2 2 0 0 0 90 88 178 83.6 86 84 170 94.4 95.5 4 4 8 4.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
7 BUDI DAYA 189 96 93 189 69 57 126 66.7 65 72 137 72.5 3 1 4 9 6 15 57 50 107 56.6 54 48 102 81.0 95.3 3 2 5 4.7 1 1 2 1.9 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
8 SIRING JAHA 150 77 73 150 70 65 135 90.0 76 74 150 100.0 2 2 4 6 9 15 62 54 116 77.3 62 54 116 85.9 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
9 SUAK 378 195 183 378 160 160 320 84.7 160 160 320 84.7 9 8 17 14 13 27 137 139 276 73.0 125 129 254 79.4 92.0 12 10 22 8.0 8 5 13 4.7 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
10 SUKA MAJU 133 66 67 133 56 58 114 85.7 60 63 123 92.5 1 0 1 4 3 7 51 55 106 79.7 51 54 105 92.1 99.1 0 0 0 0.0 0 0 0 0.0 1 3 4 3.8 0 0 0 0 0 0 0 0 0 #DIV/0!
11 SUKA MARGA 153 78 75 153 71 67 138 90.2 75 73 148 96.7 3 0 3 1 6 7 67 61 128 83.7 63 58 121 87.7 94.5 4 3 7 5.5 1 1 2 1.6 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 SELORETNO 328 164 164 328 150 146 296 90.2 165 163 328 100.0 5 1 6 0 0 0 145 145 290 88.4 135 136 271 91.6 93.4 10 9 19 6.6 5 4 9 3.1 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
13 SIDODADI 683 346 337 683 214 216 430 63.0 335 334 669 98.0 5 3 8 0 0 0 209 213 422 61.8 140 147 287 66.7 68.0 69 72 141 33.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
14 SIDOWALUYO 559 280 279 559 288 279 567 101.4 288 279 567 101.4 4 8 12 9 8 17 275 263 538 96.2 267 253 520 91.7 96.7 8 10 18 3.3 6 9 15 2.8 1 0 1 0.2 0 0 0 1 0 1 1 0 1 100.0
15 SIDOREJO 662 332 330 662 276 267 543 82.0 284 269 553 83.5 6 8 14 4 2 6 266 257 523 79.0 260 248 508 93.6 97.1 6 9 15 2.9 6 9 15 2.9 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
16 SIDOMULYO 481 244 237 481 159 144 303 63.0 245 235 480 99.8 6 1 7 2 1 3 151 142 293 60.9 148 139 287 94.7 98.0 3 3 6 2.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0 0 0 0 #DIV/0!
JUMLAH 5322 2713 2609 5322 2244 2180 4424 83.1 2490 2457 4947 93.0 60 52 112 72 71 143 2112 2057 4169 78.3 1957 1900 3857 87.2 92.5 155 162 317 7.6 35 39 74 1.8 2 3 5 0.1 0 0 0 1 5 6 1 5 6 100.0
Mengetahui
Ka. UPTD. Puskesmas Rawat Inap Koordinator Gizi
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : NOVEMBER
TAHUN : 2020

M/D')
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dapat PMT
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Proyeksi ditimbang (D) punya KMS Baru (B) (O) Terkoreksi (D') Berat Badannya (N) badannya 1 kali (T1) badannya 2 kali (2T) merah (BGM) ( Proyeksi ) %
'/S
/D
/S
/S
/D
/D
T/
% (BG
(D
(K
(N
(D
(N
(T
(2
%
%
%
%
L P L+P L P L+P L P L+P
%
L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P
1 BANDAR DALAM 355 189 166 355 165 163 328 92.4 143 144 287 80.8 2 3 5 0 0 0 163 160 323 91.0 163 160 323 98.5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 2 2 4 2 2 4 100.0
2 CAMPANG TIGA 283 146 137 283 112 118 230 81.3 112 118 230 81.3 5 4 9 2 6 8 105 108 213 75.3 86 90 176 76.5 82.6 19 18 37 17.4 6 7 13 6.1 0 0 0 0.0 0 0 0 1 3 4 1 3 4 100.0
3 TALANG BARU 176 93 83 176 83 76 159 75.0 93 83 176 100.0 1 2 3 6 4 10 76 70 146 83.0 75 68 143 89.9 97.9 1 2 3 2.1 0 2 2 1.4 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
4 SUKA BANJAR 387 200 187 387 183 171 354 91.5 195 181 376 188 4 4 8 2 0 2 177 167 344 88.9 173 160 333 94.1 96.8 4 7 11 3.2 0 0 0 0.0 0 0 0 0.0 0 0 0 1 2 3 1 2 3 100.0
5 BANJAR SURI 192 99 93 192 89 92 181 94.3 86 104 190 99.0 1 2 3 1 1 2 87 89 176 91.7 86 90 176 97.2 100.0 1 1 2 1.1 0 0 0 0.0 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
6 KOTA DALAM 213 108 105 213 97 97 194 91.1 108 105 213 100 0 2 2 0 0 0 97 95 192 90.1 96 91 187 96.4 97.4 1 4 5 2.6 0 0 0 0.0 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
7 BUDI DAYA 189 96 93 189 61 49 110 58.2 65 72 137 72.5 5 2 7 5 5 10 51 42 93 49.2 48 38 86 78.2 92.5 3 4 7 7.5 0 0 0 0.0 0 0 0 0.0 0 0 0 2 2 4 2 2 4 100.0
8 SIRING JAHA 150 77 73 150 71 69 140 93.3 76 74 150 100.0 1 2 3 5 5 10 65 62 127 84.7 64 61 125 89.3 98.4 1 1 2 1.6 0 0 0 0.0 0 0 0 0.0 0 0 0 1 0 1 1 0 1 100.0
9 SUAK 378 195 183 378 160 160 320 84.7 160 160 320 84.7 9 10 19 21 16 37 130 134 264 69.8 134 119 253 79.1 95.8 6 5 11 4.2 4 6 10 3.8 2 1 3 1.1 0 0 0 1 1 2 1 1 2 100.0
10 SUKA MAJU 133 66 67 133 63 59 122 91.7 60 63 123 92.5 0 1 1 3 3 6 60 55 115 86.5 60 55 115 94.3 100.0 0 0 0 0.0 0 0 0 0.0 1 3 4 3.5 0 0 0 1 1 2 1 1 2 100.0
11 SUKA MARGA 153 78 75 153 67 68 135 88.2 75 73 148 96.7 1 1 2 2 5 7 64 62 126 82.4 63 62 125 92.6 99.2 3 1 4 3.2 3 3 6 4.8 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
12 SELORETNO 328 164 164 328 148 145 293 89.3 165 163 328 100.0 3 1 4 0 0 0 145 144 289 88.1 136 136 272 92.8 94.1 9 8 17 5.9 4 3 7 2.4 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
13 SIDODADI 683 346 337 683 216 210 426 62.4 335 334 669 98.0 4 6 10 0 0 0 212 204 416 60.9 143 141 284 66.7 68.3 60 72 132 31.7 0 0 0 0.0 0 0 0 0.0 0 0 0 1 3 4 1 3 4 100.0
14 SIDOWALUYO 559 280 279 559 279 276 555 99.3 288 279 567 101.4 5 3 8 10 6 16 264 267 531 95.0 255 258 513 92.4 96.6 9 9 18 3.4 6 3 9 1.7 0 0 0 0.0 0 0 0 1 2 3 1 2 3 100.0
15 SIDOREJO 662 332 330 662 276 267 543 82.0 284 269 553 83.5 8 5 13 5 7 12 263 255 518 78.2 254 248 502 92.4 96.9 9 7 16 3.1 4 6 10 1.9 0 0 0 0.0 0 0 0 2 1 3 2 1 3 100.0
16 SIDOMULYO 481 244 237 481 155 149 304 63.2 245 235 480 99.8 3 4 7 4 1 5 148 144 292 60.7 146 141 287 94.4 98.3 2 3 5 1.7 0 0 0 0.0 0 0 0 0.0 0 0 0 3 0 3 3 0 3 100.0
JUMLAH 5322 2713 2609 5322 2225 2169 4394 82.6 2490 2457 4947 93.0 52 52 104 66 59 125 2107 2058 4165 78.3 1982 1918 3900 88.8 93.6 128 142 270 6.5 27 30 57 1.4 3 4 7 0.2 0 0 0 21 22 43 21 22 43 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : DESEMBER
TAHUN : 2020

M/D')
)
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)
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D'
)
)
%
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/D
/S
/S
dapat PMT
/D
/D
T/
% (BG
(D
(K
(N
(D
(N
(T
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%
%
%
%
%
L P L+P L P L+P L P L+P
%
L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P L P L+P
1 BANDAR DALAM 355 189 166 355 163 157 320 90.1 143 144 287 80.8 4 7 11 0 0 0 159 150 309 87.0 159 150 309 96.6 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 2 2 4 2 2 4 100.0
2 CAMPANG TIGA 283 146 137 283 113 101 214 75.6 112 118 230 81.3 4 1 5 5 5 10 104 95 199 70.3 86 81 167 78.0 83.9 18 14 32 16.1 8 6 14 7.0 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
3 TALANG BARU 176 93 83 176 83 76 159 75.0 93 83 176 100.0 2 1 3 5 4 9 76 71 147 83.5 75 68 143 89.9 97.3 1 3 4 2.7 0 1 1 0.7 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
4 SUKA BANJAR 387 200 187 387 180 175 355 91.7 195 181 376 97.2 2 5 7 0 5 5 178 165 343 88.6 175 161 336 94.6 98.0 3 4 7 2.0 0 0 0 0.0 0 0 0 0.0 0 0 0 1 2 3 1 2 3 100.0
5 BANJAR SURI 192 99 93 192 93 94 187 97.4 96 90 186 96.9 2 3 5 1 2 3 90 89 179 93.2 87 88 175 93.6 97.8 3 1 4 2.2 0 1 1 0.6 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
6 KOTA DALAM 213 108 105 213 100 101 201 94.4 108 105 213 100 2 2 4 0 0 0 98 99 197 92.5 95 95 190 94.5 96.4 3 4 7 3.6 0 0 0 0.0 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
7 BUDI DAYA 189 96 93 189 77 77 154 81.5 65 72 137 72.5 8 7 15 8 7 15 61 63 124 65.6 56 58 114 74.0 91.9 5 5 10 8.1 2 0 2 1.6 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
8 SIRING JAHA 150 77 73 150 64 67 131 87.3 76 74 150 100.0 1 1 2 12 7 19 51 59 110 73.3 51 59 110 84.0 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
9 SUAK 378 195 183 378 115 108 223 59.0 160 160 320 84.7 6 9 15 45 59 104 64 40 104 27.5 58 35 93 41.7 89.4 6 5 11 10.6 4 6 10 9.6 2 0 2 1.9 0 0 0 1 2 3 1 2 3 100.0
10 SUKA MAJU 133 66 67 133 64 62 126 94.7 60 63 123 92.5 0 0 0 1 1 2 63 61 124 93.2 63 54 117 92.9 94.4 0 0 0 0.0 0 0 0 0.0 1 3 4 3.2 0 0 0 1 1 2 1 1 2 100.0
11 SUKA MARGA 153 78 75 153 62 61 123 80.4 75 73 148 96.7 1 0 1 3 5 8 58 56 114 74.5 54 53 107 87.0 93.9 4 3 7 6.1 2 3 5 4.4 0 0 0 0.0 0 0 0 1 1 2 1 1 2 100.0
12 SELORETNO 328 164 164 328 149 150 299 91.2 165 163 328 100.0 2 2 4 0 3 3 147 145 292 89.0 140 138 278 93.0 95.2 7 7 14 4.8 3 4 7 2.4 0 0 0 0.0 0 0 0 2 2 4 2 2 4 100.0
13 SIDODADI 683 346 337 683 247 240 487 71.3 335 334 669 98.0 2 3 5 0 0 0 245 237 482 70.6 165 162 327 67.1 67.8 80 75 155 32.2 0 0 0 0.0 2 2 4 0.8 0 0 0 1 3 4 1 3 4 100.0
14 SIDOWALUYO 559 280 279 559 290 281 571 102.1 288 279 567 101.4 7 4 11 9 11 20 274 266 540 96.6 264 254 518 90.7 95.9 10 12 22 4.1 8 5 13 2.4 0 0 0 0.0 0 0 0 2 1 3 1 2 3 100.0
15 SIDOREJO 662 332 330 662 269 262 531 80.2 284 269 553 83.5 10 9 19 5 6 11 254 247 501 75.7 244 243 487 91.7 97.2 10 4 14 2.8 7 8 15 3.0 0 0 0 0.0 0 0 0 2 1 3 2 1 3 100.0
16 SIDOMULYO 481 244 237 481 164 152 316 65.7 245 235 480 99.8 8 2 10 2 2 4 154 148 302 62.8 151 147 298 94.3 98.7 3 1 4 1.3 0 0 0 0.0 0 0 0 0.0 0 0 0 3 0 3 3 0 3 100.0
JUMLAH 5322 2713 2609 5322 2233 2164 4397 82.6 2500 2443 4943 92.9 61 56 117 96 117 213 2076 1991 4067 76.4 1923 1846 3769 85.7 92.7 153 138 291 7.2 34 34 68 1.7 5 5 10 0.2 0 0 0 22 21 43 21 22 43 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI BAYI BARU LAHIR DAN BAYI DAPAT ASI EKSKLUSIF

BULAN : JANUARI
TAHUN : 2020
Jumlah BAYI BARU LAHIR BAYI ASI EKSKLUSIF

Sasaran Bayi Jumlah bayi baru lahir Jumlah bayi umur Jumlah bayi ASI
No Desa Bayi Baru Lahir Bayi Mendapat IMD Jumlah bayi BBLR
Baru Lahir ditimbang 6 bulan Eksklusif
(proyeksi) L P L+P L P L+P % L P L+P L P L+P % L P L+P L P L+P %
1 BANDAR DALAM 71 3 3 6 2 1 3 50.0 3 3 6 0 1 1 16.7 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 14 13 27 3 0 3 11.1
3 TALANG BARU 35 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 3 1 4 1 1 2 50.0 3 1 4 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 0 3 3 0 1 1 33.3 0 3 3 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 7 2 9 2 1 3 33.3 7 2 9 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 0 2 1 0 1 50.0 2 0 2 0 0 0 0.0 9 9 18 2 1 3 16.7
8 SIRING JAHA 31 0 1 1 0 1 1 0.0 0 1 1 0 1 1 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 2 6 8 1 5 6 75.0 2 6 8 0 0 0 0.0 19 18 37 4 8 12 32.4
10 SUKA MAJU 29 0 2 2 0 1 1 50.0 0 2 2 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 8 7 15 1 1 2 13.3
12 SELORETNO 70 6 2 8 3 1 4 50.0 6 2 8 1 0 1 12.5 16 15 31 0 0 0 0.0
13 SIDODADI 142 5 5 10 4 4 8 80.0 5 5 10 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 7 4 11 2 4 6 54.5 7 4 11 2 1 3 27.3 28 26 54 0 0 0 0.0
15 SIDOREJO 140 5 6 11 3 2 5 45.5 5 6 11 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 3 4 7 1 1 2 28.6 3 4 7 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 48 42 90 23 26 49 54.4 48 42 90 3 3 6 6.7 266 249 515 10 10 20 3.9

Mengetahui
Sidomulyo
dr. Rocky J.D.Sihombing Tri Hendras P, SKM

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : FEBRUARI
TAHUN : 2020

1 BANDAR DALAM 71 3 2 5 3 0 3 60.0 3 2 5 1 0 1 20.0 18 17 35 5 3 8 22.9
2 CAMPANG TIGA 58 0 3 3 0 0 0 0.0 0 3 3 0 0 0 0.0 14 13 27 1 8 9 33.3
3 TALANG BARU 35 2 2 4 0 2 2 50.0 2 2 4 0 0 0 0.0 9 8 17 3 4 7 41.2
4 SUKA BANJAR 79 3 3 6 3 0 3 50.0 3 3 6 0 1 1 16.7 19 18 37 1 0 1 2.7
5 BANJAR SURI 39 0 3 3 0 1 1 33.3 0 3 3 0 0 0 0.0 10 9 19 2 1 3 15.8
6 KOTA DALAM 45 5 0 5 3 0 3 60.0 5 0 5 0 0 0 0.0 11 10 21 6 5 11 52.4
7 BUDI DAYA 40 2 0 2 0 0 0 0.0 2 0 2 0 0 0 0.0 9 9 18 0 1 1 5.6
8 SIRING JAHA 31 1 0 1 1 0 1 0.0 1 0 1 0 0 0 0.0 7 7 14 2 2 4 28.6
9 SUAK 78 3 3 6 3 3 6 100.0 3 3 6 1 0 1 16.7 19 18 37 3 6 9 24.3
10 SUKA MAJU 29 2 2 4 1 1 2 50.0 2 2 4 0 0 0 0.0 7 6 13 2 10 12 92.3
11 SUKA MARGA 32 2 0 2 2 0 2 100.0 2 0 2 0 0 0 0.0 8 7 15 1 0 1 6.7
12 SELORETNO 70 3 2 5 3 2 5 100.0 3 2 5 0 0 0 0.0 16 15 31 1 3 4 12.9
13 SIDODADI 142 8 8 16 6 7 13 81.3 8 8 16 0 0 0 0.0 34 32 66 3 1 4 6.1
14 SIDOWALUYO 119 8 5 13 5 2 7 53.8 8 5 13 0 0 0 0.0 28 26 54 3 5 8 14.8
15 SIDOREJO 140 5 2 7 2 2 4 57.1 5 2 7 0 0 0 0.0 33 31 64 3 3 6 9.4
16 SIDOMULYO 101 5 3 8 3 2 5 62.5 5 3 8 0 0 0 0.0 24 23 47 3 1 4 8.5
JUMLAH 1109 52 38 90 35 22 57 63.3 52 38 90 2 1 3 3.3 266 249 515 39 53 92 17.9

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : MARET
TAHUN : 2020

1 BANDAR DALAM 71 11 3 14 0 0 0 0.0 1 3 4 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 2 2 4 0 0 0 0.0 2 2 4 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 1 1 2 1 0 1 50.0 1 1 2 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 4 4 8 1 1 2 25.0 4 4 8 1 0 1 12.5 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 1 1 2 0 1 1 50.0 1 1 2 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 1 2 3 0 2 2 66.7 1 2 3 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 1 3 1 0 1 33.3 2 1 3 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 1 1 2 0 1 1 0.0 1 1 2 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 3 3 6 3 3 6 100.0 3 3 6 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 4 0 4 2 0 2 50.0 4 0 4 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 2 1 3 2 1 3 100.0 2 1 3 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 0 5 5 0 3 3 60.0 0 5 5 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 8 8 16 5 7 12 75.0 8 8 16 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 6 8 14 4 4 8 57.1 6 8 14 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 5 4 9 3 2 5 55.6 5 4 9 0 2 2 22.2 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 7 1 8 2 1 3 37.5 7 1 8 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 58 45 103 24 26 50 48.5 48 45 93 1 2 3 3.2 266 249 515 0 0 0 0.0

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : APRIL
TAHUN : 2020
1 BANDAR DALAM 71 2 3 5 0 0 0 0.0 2 3 5 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 4 1 5 1 0 1 20.0 4 1 5 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 1 3 4 0 2 2 50.0 1 3 4 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 6 1 7 3 0 3 42.9 6 1 7 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 2 1 3 2 0 2 66.7 2 1 3 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 5 0 5 3 0 3 60.0 5 0 5 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 2 4 0 1 1 25.0 2 2 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 2 1 3 1 1 2 0.0 2 1 3 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 4 6 10 3 6 9 90.0 4 6 10 2 0 2 20.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 1 4 5 1 2 3 60.0 1 4 5 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 4 4 8 3 2 5 62.5 4 4 8 0 1 1 12.5 16 15 31 0 0 0 0.0
13 SIDODADI 142 7 6 13 5 3 8 61.5 7 6 13 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 5 3 8 2 1 3 37.5 5 3 8 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 7 3 10 3 1 4 40.0 7 3 10 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 5 3 8 3 2 5 62.5 7 1 8 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 58 42 100 31 22 53 53.0 60 40 100 2 1 3 3.0 266 249 515 0 0 0 0.0
CATT: BBLR Desa Suak karena kembar bb 1500 gr dan 1800 gr, Desa Seloretno ( tidak ada keterangan )
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : MEI
TAHUN : 2020
1 BANDAR DALAM 71 5 3 8 2 1 3 37.5 5 3 8 0 1 1 12.5 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 1 4 5 0 1 1 20.0 1 4 5 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 2 1 3 0 1 1 33.3 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 4 1 5 2 0 2 40.0 4 1 5 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 1 2 3 1 2 3 100.0 1 2 3 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 2 0 2 1 0 1 50.0 2 0 2 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 2 4 0 1 1 25.0 2 2 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 3 2 5 2 1 3 0.0 3 2 5 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 5 5 10 5 5 10 100.0 5 5 10 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 4 1 5 4 0 4 80.0 4 1 5 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 0 2 2 0 1 1 50.0 0 2 2 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 3 5 8 3 3 6 75.0 3 5 8 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 7 7 14 5 3 8 57.1 7 7 14 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 5 6 11 3 3 6 54.5 5 6 11 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 8 2 10 4 1 5 50.0 8 2 10 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 7 5 12 5 3 8 66.7 7 5 12 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 59 48 107 37 26 63 58.9 59 48 107 0 1 1 0.9 266 249 515 0 0 0 0.0
CATT: PENIMBANGAN HANYA DI LAKUKAN TERHADAP BAYI BARU LAHIR SAJA, EFEK PANDEMI COVID 19.
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JUNI
TAHUN : 2020
1 BANDAR DALAM 71 4 4 8 3 3 6 75.0 4 4 8 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 2 2 4 0 1 1 25.0 2 2 4 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 1 1 2 1 0 1 50.0 1 1 2 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 5 5 10 5 4 9 90.0 5 5 10 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 3 2 5 1 2 3 60.0 3 2 5 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 0 2 2 0 1 1 50.0 0 2 2 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 2 4 2 1 3 75.0 2 2 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 2 1 3 1 1 2 0.0 2 1 3 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 2 6 8 5 5 10 125.0 2 6 8 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 1 0 1 1 0 1 100.0 1 0 1 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 2 3 1 2 3 100.0 1 2 3 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 2 3 5 2 2 4 80.0 2 3 5 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 6 5 11 3 6 9 81.8 6 5 11 1 0 1 9.1 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 6 8 14 4 5 9 64.3 6 8 14 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 3 4 7 3 2 5 71.4 3 4 7 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 6 1 7 4 0 4 57.1 6 1 7 1 0 1 14.3 24 23 47 0 0 0 0.0
JUMLAH 1109 46 48 94 36 35 71 75.5 46 48 94 2 0 2 2.1 266 249 515 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JULI
TAHUN : 2020
1 BANDAR DALAM 71 2 2 4 2 2 4 100.0 2 2 4 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 5 0 5 1 0 1 20.0 5 0 5 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 4 1 5 2 1 3 60.0 4 1 5 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 2 2 4 0 1 1 25.0 2 2 4 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 1 2 3 0 2 2 66.7 1 2 3 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 1 3 4 1 3 4 100.0 1 3 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 0 1 1 0 1 1 0.0 0 1 1 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 2 3 5 2 3 5 100.0 2 3 5 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 1 5 6 1 5 6 100.0 1 5 6 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 2 0 2 2 0 2 100.0 2 0 2 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 4 3 7 4 2 6 85.7 4 3 7 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 8 8 16 5 7 12 75.0 8 8 16 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 4 3 7 2 3 5 71.4 4 3 7 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 4 6 10 1 2 3 30.0 4 6 10 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 6 3 9 5 3 8 88.9 6 3 9 1 0 1 11.1 24 23 47 0 0 0 0.0
JUMLAH 1109 48 43 91 29 36 65 71.4 48 43 91 1 0 1 1.1 266 249 515 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : AGUSTUS
TAHUN : 2020
1 BANDAR DALAM 71 3 3 6 3 2 5 83.3 3 3 6 1 0 1 16.7 18 17 35 2 3 5 14.3
2 CAMPANG TIGA 58 0 2 2 0 2 2 100.0 0 2 2 0 0 0 0.0 14 13 27 1 1 2 7.4
3 TALANG BARU 35 1 2 3 1 1 2 66.7 1 2 3 0 0 0 0.0 9 8 17 2 0 2 11.8
4 SUKA BANJAR 79 5 1 6 4 0 4 66.7 5 1 6 1 0 1 16.7 19 18 37 5 9 14 37.8
5 BANJAR SURI 39 4 0 4 1 0 1 25.0 4 0 4 0 0 0 0.0 10 9 19 4 3 7 36.8
6 KOTA DALAM 45 2 2 4 2 1 3 75.0 2 2 4 0 0 0 0.0 11 10 21 2 1 3 14.3
7 BUDI DAYA 40 2 2 4 1 1 2 50.0 2 2 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 0 1 1 0 1 1 100.0 0 1 1 0 0 0 0.0 7 7 14 1 0 1 7.1
9 SUAK 78 3 3 6 3 3 6 100.0 3 3 6 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 0 0 0 0 0 0 #DIV/0! 0 0 0 0 0 0 #DIV/0! 7 6 13 9 4 13 100.0
11 SUKA MARGA 32 3 0 3 2 0 2 66.7 3 0 3 0 0 0 0.0 8 7 15 1 1 2 13.3
12 SELORETNO 70 1 2 3 1 2 3 100.0 1 2 3 0 0 0 0.0 16 15 31 0 3 3 9.7
13 SIDODADI 142 6 5 11 4 4 8 72.7 6 5 11 0 1 1 9.1 34 32 66 3 1 4 6.1
14 SIDOWALUYO 119 5 7 12 3 3 6 50.0 5 7 12 0 0 0 0.0 28 26 54 3 5 8 14.8
15 SIDOREJO 140 4 6 10 3 4 7 70.0 4 6 10 0 0 0 0.0 33 31 64 6 5 11 17.2
16 SIDOMULYO 101 7 1 8 6 1 7 87.5 7 1 8 0 0 0 0.0 24 23 47 3 3 6 12.8
JUMLAH 1109 46 37 83 34 25 59 71.1 46 37 83 2 1 3 3.6 266 249 515 42 39 81 15.7
Mengetahui
Sidomulyo
NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : SEPTEMBER
TAHUN : 2020

1 BANDAR DALAM 71 3 3 6 3 2 5 83.3 3 3 6 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 5 2 7 1 2 3 42.9 5 2 7 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 2 1 3 2 0 2 66.7 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 3 5 8 3 5 8 100.0 3 5 8 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 4 0 4 1 0 1 25.0 4 0 4 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 4 1 5 2 0 2 40.0 4 1 5 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 1 2 3 1 2 3 100.0 1 2 3 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 2 2 4 1 2 3 75.0 2 2 4 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 2 4 6 2 4 6 100.0 2 4 6 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 0 0 0 0 0 0 #DIV/0! 0 0 0 0 0 0 #DIV/0! 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 4 3 7 3 1 4 57.1 4 3 7 0 1 1 14.3 16 15 31 0 0 0 0.0
13 SIDODADI 142 5 6 11 4 5 9 81.8 5 6 11 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 7 5 12 4 3 7 58.3 7 5 12 0 1 1 8.3 28 26 54 0 0 0 0.0
15 SIDOREJO 140 7 6 13 3 3 6 46.2 7 6 13 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 5 2 7 5 2 7 100.0 5 2 7 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 55 43 98 36 32 68 69.4 55 43 98 0 2 2 2.0 266 249 515 0 0 0 0.0
Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : OKTOBER
TAHUN : 2020
1 BANDAR DALAM 71 4 5 9 2 1 3 33.3 4 5 9 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 5 5 10 3 2 5 50.0 5 5 10 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 1 2 3 1 1 2 66.7 1 2 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 2 5 7 1 5 6 85.7 2 5 7 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 2 1 3 0 0 0 0.0 2 1 3 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 0 2 2 0 2 2 100.0 0 2 2 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 1 3 1 0 1 33.3 2 1 3 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 2 2 4 1 2 3 75.0 2 2 4 1 0 1 25.0 7 7 14 0 0 0 0.0
9 SUAK 78 4 2 6 4 2 6 100.0 4 2 6 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 1 0 1 1 0 1 100.0 1 0 1 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 3 0 3 3 0 3 100.0 3 0 3 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 5 1 6 3 0 3 50.0 5 1 6 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 5 3 8 5 2 7 87.5 5 3 8 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 4 8 12 2 5 7 58.3 4 8 12 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 6 8 14 4 3 7 50.0 6 8 14 0 1 1 7.1 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 6 1 7 4 1 5 71.4 6 1 7 2 0 2 28.6 24 23 47 0 0 0 0.0
JUMLAH 1109 52 46 98 35 26 61 62.2 52 46 98 3 1 4 4.1 266 249 515 0 0 0 0.0
Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : NOVEMBER
TAHUN : 2020

1 BANDAR DALAM 71 2 3 5 2 3 5 100.0 2 3 5 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 4 2 6 2 1 3 50.0 4 2 6 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 1 2 3 1 1 2 66.7 1 2 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 1 4 5 1 4 5 100.0 1 4 5 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 0 2 2 0 1 1 50.0 0 2 2 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 0 2 2 0 2 2 100.0 0 2 2 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 2 4 1 2 3 75.0 2 2 4 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 1 2 3 1 1 2 66.7 1 2 3 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 2 4 6 2 4 6 100.0 2 4 6 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 0 1 1 0 1 1 100.0 0 1 1 0 0 0 0.0 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 3 1 4 2 1 3 75.0 3 1 4 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 4 6 10 3 4 7 70.0 4 6 10 0 1 1 10.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 5 3 8 3 1 4 50.0 5 3 8 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 8 5 13 2 3 5 38.5 8 5 13 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 3 4 7 3 4 7 100.0 3 4 7 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 37 44 81 24 34 58 71.6 37 44 81 0 1 1 1.2 266 249 515 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : DESEMBER
TAHUN : 2020

No Desa Sasaran Bayi Jumlah bayi baru lahir Jumlah bayi umur Jumlah bayi ASI
Bayi Baru Lahir Bayi Mendapat IMD Jumlah bayi BBLR
1 BANDAR DALAM 71 4 7 11 4 5 9 81.8 4 7 11 0 0 0 0.0 18 17 35 0 0 0 0.0
2 CAMPANG TIGA 58 4 1 5 1 1 2 40.0 4 1 5 0 0 0 0.0 14 13 27 0 0 0 0.0
3 TALANG BARU 35 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0
4 SUKA BANJAR 79 3 2 5 3 2 5 100.0 3 2 5 0 0 0 0.0 19 18 37 0 0 0 0.0
5 BANJAR SURI 39 1 0 1 1 0 1 100.0 1 0 1 0 0 0 0.0 10 9 19 0 0 0 0.0
6 KOTA DALAM 45 3 1 4 1 1 2 50.0 3 1 4 0 0 0 0.0 11 10 21 0 0 0 0.0
7 BUDI DAYA 40 2 1 3 2 1 3 100.0 2 1 3 0 0 0 0.0 9 9 18 0 0 0 0.0
8 SIRING JAHA 31 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 7 7 14 0 0 0 0.0
9 SUAK 78 3 5 8 3 5 8 100.0 3 5 8 0 0 0 0.0 19 18 37 0 0 0 0.0
10 SUKA MAJU 29 0 0 0 0 0 0 #DIV/0! 0 0 0 0 0 0 #DIV/0! 7 6 13 0 0 0 0.0
11 SUKA MARGA 32 1 0 1 1 0 1 100.0 1 0 1 0 0 0 0.0 8 7 15 0 0 0 0.0
12 SELORETNO 70 2 2 4 1 2 3 75.0 2 2 4 0 0 0 0.0 16 15 31 0 0 0 0.0
13 SIDODADI 142 2 3 5 1 3 4 80.0 2 3 5 0 0 0 0.0 34 32 66 0 0 0 0.0
14 SIDOWALUYO 119 7 4 11 3 2 5 45.5 7 4 11 0 0 0 0.0 28 26 54 0 0 0 0.0
15 SIDOREJO 140 10 9 19 4 5 9 47.4 10 9 19 0 0 0 0.0 33 31 64 0 0 0 0.0
16 SIDOMULYO 101 8 2 10 5 1 6 60.0 8 2 10 0 0 0 0.0 24 23 47 0 0 0 0.0
JUMLAH 1109 53 39 92 32 30 62 67.4 53 39 92 0 0 0 0.0 266 249 515 0 0 0 0.0
Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI IBU HAMIL DAN IBU NIFAS

BULAN : JANUARI
TAHUN : 2020
Jumlah IBU HAMIL Jumlah IBU NIFAS
Sasaran Jumlah % Ibu hamil % Ibu Hamil Sasaran Jumlah

NO DESA Ibu Hamil Jumlah Jumlah % Jumlah Jumlah Ibu Hamil Ibu Hamil ibu hamil mendapat mendapat Ibu Nifas Jumlah Ibu Nifas
%
(proyeksi) Ibu Hamil Ibu Hamil Ibu Hamil Ibu Hamil Ibu Hamil KEK KEK akhir TTD min TTD min (proyeksi) Ibu Nifas dapat
Periksa HB Anemia Anemia Periksa LILA KEK dapat MT dapat MT TW 3 90 tablet 90 tablet Vitamin A
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 7 0 0.0 7 0 0 #DIV/0! 3 3 100.0 71 6 6 100.0
2 CAMPANG TIGA 61 5 0 0.0 5 0 0 #DIV/0! 3 3 100.0 58 3 3 100.0
3 TALANG BARU 37 1 0 0.0 4 0 0 #DIV/0! 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 5 1 20.0 5 0 0 #DIV/0! 4 4 100.0 79 4 4 100.0
5 BANJAR SURI 41 5 3 60.0 4 1 0 0 3 3 100.0 39 3 3 100.0
6 KOTA DALAM 47 4 0 0.0 4 0 0 #DIV/0! 3 3 100.0 45 9 9 100.0
7 BUDI DAYA 42 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 40 2 2 100.0
8 SIRING JAHA 32 5 0 0.0 4 0 0 #DIV/0! 1 1 100.0 31 1 1 100.0
9 SUAK 82 7 3 42.9 7 0 0 #DIV/0! 7 7 100.0 78 8 8 100.0
10 SUKA MAJU 30 4 0 0.0 4 0 0 #DIV/0! 3 3 100.0 29 2 2 100.0
11 SUKA MARGA 33 4 0 0.0 3 0 0 #DIV/0! 1 1 100.0 32 2 2 100.0
12 SELORETNO 73 13 0 0.0 6 1 1 100 7 7 100.0 70 8 8 100.0
13 SIDODADI 151 12 0 0.0 12 0 0 #DIV/0! 10 10 100.0 142 10 10 100.0
14 SIDOWALUYO 124 5 0 0.0 12 0 0 #DIV/0! 10 10 100.0 119 11 11 100.0
15 SIDOREJO 147 8 0 0.0 11 1 1 100 8 8 100.0 140 10 10 100.0
16 SIDOMULYYO 105 2 0 0.0 8 0 0 #DIV/0! 6 6 100.0 101 7 7 100.0
JUMLAH 1162 90 7 7.8 99 3 2 66.7 75 75 100.0 1109 89 89 100.0

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : FEBRUARI
TAHUN : 2020

%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 8 0 0 8 0 0 #DIV/0! 7 7 100.0 71 5 5 100.0
2 CAMPANG TIGA 61 5 0 0 5 0 0 #DIV/0! 3 3 100.0 58 3 3 100.0
3 TALANG BARU 37 3 0 0 3 0 0 #DIV/0! 3 3 100.0 35 4 4 100.0
4 SUKA BANJAR 83 17 0 0 10 0 0 #DIV/0! 7 7 100.0 79 6 6 100.0
5 BANJAR SURI 41 6 3 50 4 0 0 #DIV/0! 3 3 100.0 39 4 4 100.0
6 KOTA DALAM 47 4 0 0 4 0 0 #DIV/0! 3 3 100.0 45 5 5 100.0
7 BUDI DAYA 42 3 0 0 3 0 0 #DIV/0! 3 3 100.0 40 2 2 100.0
8 SIRING JAHA 32 5 0 0 3 0 0 #DIV/0! 2 2 100.0 31 1 1 100.0
9 SUAK 82 7 0 0 7 1 1 100 7 7 100.0 78 6 6 100.0
10 SUKA MAJU 30 2 0 0 0 0 0 #DIV/0! 4 4 100.0 29 4 4 100.0
11 SUKA MARGA 33 1 0 0 2 0 0 #DIV/0! 2 2 100.0 32 2 2 100.0
12 SELORETNO 73 13 1 7.7 6 0 0 #DIV/0! 7 7 100.0 70 5 5 100.0
13 SIDODADI 151 1 0 0 4 4 0 0 14 14 100.0 142 16 16 100.0
14 SIDOWALUYO 124 0 0 #DIV/0! 16 0 0 #DIV/0! 13 13 100.0 119 13 13 100.0
15 SIDOREJO 147 8 0 0 11 1 0 0 10 10 100.0 140 7 7 100.0
16 SIDOMULYYO 105 15 0 0 7 0 0 #DIV/0! 10 10 100.0 101 8 8 100.0
JUMLAH 1162 98 4 4.1 93 6 1 16.7 98 98 100.0 1109 91 91 100.0

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : MARET
TAHUN : 2020

%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 7 0 0.0 7 1 1 100 7 7 100.0 71 4 4 100.0
2 CAMPANG TIGA 61 8 0 0.0 8 3 3 100 5 5 100.0 58 4 4 100.0
3 TALANG BARU 37 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 35 2 2 100.0
4 SUKA BANJAR 83 17 1 5.9 9 2 0 0 8 8 100.0 79 8 8 100.0
5 BANJAR SURI 41 4 3 75.0 2 0 0 #DIV/0! 2 2 100.0 39 2 2 100.0
6 KOTA DALAM 47 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 45 3 3 100.0
7 BUDI DAYA 42 3 0 0.0 3 0 0 0 3 3 100.0 40 3 3 100.0
8 SIRING JAHA 32 5 0 0.0 2 0 0 #DIV/0! 3 3 100.0 31 2 2 100.0
9 SUAK 82 7 0 0.0 7 0 0 #DIV/0! 7 7 100.0 78 6 6 100.0
10 SUKA MAJU 30 2 0 0.0 0 0 0 #DIV/0! 5 5 100.0 29 4 4 100.0
11 SUKA MARGA 33 9 0 0.0 4 0 0 #DIV/0! 5 5 100.0 32 3 3 100.0
12 SELORETNO 73 12 0 0.0 6 1 1 100 6 6 100.0 70 5 5 100.0
13 SIDODADI 151 0 0 #DIV/0! 16 4 4 100 14 14 100.0 142 16 16 100.0
14 SIDOWALUYO 124 0 0 #DIV/0! 0 0 0 #DIV/0! 10 10 100.0 119 14 14 100.0
15 SIDOREJO 147 13 1 7.7 11 2 0 0 8 8 100.0 140 8 8 100.0
16 SIDOMULYYO 105 22 0 0.0 12 1 1 100 10 10 100.0 101 8 8 100.0
JUMLAH 1162 115 5 4.3 93 14 10 71.4 99 99 100.0 1109 92 92 100.0

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : APRIL
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 7 0 0.0 7 1 0 0 8 8 100.0 71 5 5 100.0
2 CAMPANG TIGA 61 1 0 0.0 1 0 0 #DIV/0! 4 4 100.0 58 5 5 100.0
3 TALANG BARU 37 1 0 0.0 3 0 0 #DIV/0! 3 3 100.0 35 4 4 100.0
4 SUKA BANJAR 83 0 0 #DIV/0! 10 3 0 0 8 8 100.0 79 7 7 100.0
5 BANJAR SURI 41 2 1 50.0 3 0 0 #DIV/0! 2 2 100.0 39 3 3 100.0
6 KOTA DALAM 47 2 0 0.0 2 0 0 #DIV/0! 2 2 100.0 45 5 5 100.0
7 BUDI DAYA 42 3 0 0.0 3 0 0 0 3 3 100.0 40 4 4 100.0
8 SIRING JAHA 32 5 0 0.0 3 1 0 0 3 3 100.0 31 3 3 100.0
9 SUAK 82 10 0 0.0 10 2 0 0 9 9 100.0 78 9 9 100.0
10 SUKA MAJU 30 0 0 #DIV/0! 0 0 0 #DIV/0! 0 0 #DIV/0! 29 5 5 100.0
11 SUKA MARGA 33 4 0 0.0 3 0 0 #DIV/0! 2 2 100.0 32 2 2 100.0
12 SELORETNO 73 10 0 0.0 6 0 0 #DIV/0! 4 4 100.0 70 8 8 100.0
13 SIDODADI 151 0 0 #DIV/0! 15 4 4 100 12 12 100.0 142 13 13 100.0
14 SIDOWALUYO 124 3 1 33.3 8 0 0 #DIV/0! 9 9 100.0 119 8 8 100.0
15 SIDOREJO 147 10 2 20.0 9 2 0 0 7 7 100.0 140 10 8 80.0
16 SIDOMULYYO 105 9 0 0.0 9 0 0 #DIV/0! 8 8 100.0 101 8 8 100.0
JUMLAH 1162 67 4 6.0 92 13 4 30.8 84 84 100.0 1109 99 97 98.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN :MEI
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 7 0 0.0 7 0 0 #DIV/0! 6 6 100.0 71 8 8 100.0
2 CAMPANG TIGA 61 6 0 0.0 6 1 1 100 4 4 100.0 58 5 5 100.0
3 TALANG BARU 37 2 0 0.0 3 0 0 #DIV/0! 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 14 0 0.0 7 0 0 #DIV/0! 7 7 100.0 79 6 6 100.0
5 BANJAR SURI 41 4 2 50.0 4 0 0 #DIV/0! 3 3 100.0 39 3 3 100.0
6 KOTA DALAM 47 10 0 0.0 10 0 0 #DIV/0! 12 12 100.0 45 2 2 100.0
7 BUDI DAYA 42 6 0 0.0 6 0 0 0 4 4 100.0 40 4 4 100.0
8 SIRING JAHA 32 7 0 0.0 3 0 0 #DIV/0! 4 4 100.0 31 5 5 100.0
9 SUAK 82 10 0 0.0 10 0 0 #DIV/0! 10 10 100.0 78 10 10 100.0
10 SUKA MAJU 30 2 0 0.0 2 1 0 0 5 5 100.0 29 5 5 100.0
11 SUKA MARGA 33 5 0 0.0 4 0 0 #DIV/0! 2 2 100.0 32 2 2 100.0
12 SELORETNO 73 12 0 0.0 6 0 0 #DIV/0! 6 6 100.0 70 8 8 100.0
13 SIDODADI 151 0 0 #DIV/0! 14 4 4 100 16 16 100.0 142 14 14 100.0
14 SIDOWALUYO 124 2 0 0.0 12 0 0 #DIV/0! 10 10 100.0 119 11 11 100.0
15 SIDOREJO 147 5 1 20.0 11 1 0 0 8 8 100.0 140 10 10 100.0
16 SIDOMULYYO 105 9 0 0.0 9 0 0 #DIV/0! 9 9 100.0 101 12 12 100.0
JUMLAH 1162 101 3 3.0 114 7 5 71.4 109 109 100.0 1109 108 108 100.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JUNI
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 10 0 0.0 10 1 0 0 4 4 100.0 71 8 8 100.0
2 CAMPANG TIGA 61 6 0 0.0 6 0 0 #DIV/0! 6 6 100.0 58 4 4 100.0
3 TALANG BARU 37 2 0 0.0 3 0 0 #DIV/0! 2 2 100.0 35 2 2 100.0
4 SUKA BANJAR 83 9 0 0.0 4 0 0 #DIV/0! 5 5 100.0 79 10 10 100.0
5 BANJAR SURI 41 2 1 50.0 4 0 0 #DIV/0! 3 3 100.0 39 5 5 100.0
6 KOTA DALAM 47 2 2 100.0 2 0 0 #DIV/0! 2 2 100.0 45 2 2 100.0
7 BUDI DAYA 42 4 0 0.0 4 0 0 #DIV/0! 4 4 100.0 40 4 4 100.0
8 SIRING JAHA 32 4 0 0.0 2 0 0 #DIV/0! 2 2 100.0 31 3 3 100.0
9 SUAK 82 9 0 0.0 9 0 0 #DIV/0! 9 9 100.0 78 8 8 100.0
10 SUKA MAJU 30 1 0 0.0 5 0 0 #DIV/0! 5 5 100.0 29 1 1 100.0
11 SUKA MARGA 33 2 0 0.0 2 1 1 100 3 3 100.0 32 3 3 100.0
12 SELORETNO 73 11 0 0.0 6 0 0 #DIV/0! 5 5 100.0 70 5 5 100.0
13 SIDODADI 151 14 0 0.0 14 4 4 100 15 15 100.0 142 11 11 100.0
14 SIDOWALUYO 124 3 0 0.0 11 0 0 #DIV/0! 8 8 100.0 119 14 14 100.0
15 SIDOREJO 147 7 2 28.6 11 2 0 0 11 11 100.0 140 7 7 100.0
16 SIDOMULYYO 105 16 0 0.0 8 0 0 #DIV/0! 8 8 100.0 101 7 7 100.0
JUMLAH 1162 102 5 4.9 101 8 5 62.5 92 92 100.0 1109 94 94 100.0

Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : JULI
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 11 0 0.0 11 1 0 0 4 4 100.0 71 4 4 100.0
2 CAMPANG TIGA 61 5 0 0.0 5 2 2 100 5 5 100.0 58 5 5 100.0
3 TALANG BARU 37 1 0 0.0 3 0 0 #DIV/0! 2 2 100.0 35 3 3 100.0
4 SUKA BANJAR 83 17 0 0.0 10 0 0 #DIV/0! 7 7 100.0 79 5 5 100.0
5 BANJAR SURI 41 3 2 66.7 5 0 0 #DIV/0! 4 4 100.0 39 4 4 100.0
6 KOTA DALAM 47 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 45 3 3 100.0
7 BUDI DAYA 42 4 0 0.0 4 0 0 #DIV/0! 4 4 100.0 40 4 4 100.0
8 SIRING JAHA 32 3 0 0.0 2 0 0 #DIV/0! 1 1 100.0 31 1 1 100.0
9 SUAK 82 8 0 0.0 9 0 0 #DIV/0! 8 8 100.0 78 5 5 100.0
10 SUKA MAJU 30 4 0 0.0 4 0 0 #DIV/0! 3 3 100.0 29 6 6 100.0
11 SUKA MARGA 33 3 0 0.0 3 1 1 100 2 2 100.0 32 2 2 100.0
12 SELORETNO 73 14 0 0.0 7 0 0 #DIV/0! 7 7 100.0 70 7 7 100.0
13 SIDODADI 151 12 3 25.0 12 5 5 100 13 13 100.0 142 16 16 100.0
14 SIDOWALUYO 124 4 0 0.0 7 0 0 #DIV/0! 10 10 100.0 119 7 7 100.0
15 SIDOREJO 147 5 2 40.0 10 2 0 0 11 11 100.0 140 10 10 100.0
16 SIDOMULYYO 105 8 0 0.0 9 0 0 #DIV/0! 8 8 100.0 101 9 9 100.0
JUMLAH 1162 105 7 6.7 104 11 8 72.7 92 92 100.0 1109 91 91 100.0

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Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : AGUSTUS
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 6 0 0.0 6 0 0 #DIV/0! 11 11 100.0 71 1 1 100.0
2 CAMPANG TIGA 61 3 0 0.0 3 0 0 #DIV/0! 8 8 100.0 58 2 2 100.0
3 TALANG BARU 37 2 0 0.0 4 0 0 #DIV/0! 4 4 100.0 35 3 3 100.0
4 SUKA BANJAR 83 16 0 0.0 8 0 0 #DIV/0! 11 11 100.0 79 6 6 100.0
5 BANJAR SURI 41 4 2 50.0 4 0 0 #DIV/0! 5 5 100.0 39 4 4 100.0
6 KOTA DALAM 47 5 0 0.0 5 1 1 100 4 4 100.0 45 4 4 100.0
7 BUDI DAYA 42 4 0 0.0 4 0 0 #DIV/0! 4 4 100.0 40 4 4 100.0
8 SIRING JAHA 32 4 0 0.0 2 0 0 #DIV/0! 2 2 100.0 31 1 1 100.0
9 SUAK 82 8 0 0.0 9 0 0 #DIV/0! 6 6 100.0 78 6 6 100.0
10 SUKA MAJU 30 4 0 0.0 4 0 0 #DIV/0! 0 0 #DIV/0! 29 0 0 #DIV/0!
11 SUKA MARGA 33 2 0 0.0 0 0 1 #DIV/0! 3 3 100.0 32 3 3 100.0
12 SELORETNO 73 12 0 0.0 6 0 0 #DIV/0! 6 6 100.0 70 3 3 100.0
13 SIDODADI 151 10 0 0.0 10 5 5 100 10 10 100.0 142 11 11 100.0
14 SIDOWALUYO 124 4 0 0.0 9 0 0 #DIV/0! 10 10 100.0 119 12 12 100.0
15 SIDOREJO 147 14 2 14.3 12 0 0 #DIV/0! 14 14 100.0 140 10 10 100.0
16 SIDOMULYYO 105 9 0 0.0 9 0 0 #DIV/0! 9 9 100.0 101 8 8 100.0
JUMLAH 1162 107 4 3.7 95 6 7 116.7 107 107 100.0 1109 78 78 100.0
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : SEPTEMBER
TAHUN : 2020

(proyeksi) Ibu Hamil Ibu Hamil Ibu Hamil Ibu Hamil Ibu Hamil KEK KEK akhir TTD min TTD min (proyeksi) Ibu Nifas dapat %
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 6 0 0.0 6 1 0 0 6 6 100.0 71 6 6 100.0
2 CAMPANG TIGA 61 7 0 0.0 7 1 1 100 7 7 100.0 58 7 7 100.0
3 TALANG BARU 37 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 16 0 0.0 8 2 0 0 8 8 100.0 79 8 8 100.0
5 BANJAR SURI 41 3 2 66.7 3 0 0 #DIV/0! 4 4 100.0 39 4 4 100.0
6 KOTA DALAM 47 4 0 0.0 4 0 0 #DIV/0! 4 4 100.0 45 5 5 100.0
7 BUDI DAYA 42 4 0 0.0 4 1 0 0 3 3 100.0 40 3 3 100.0
8 SIRING JAHA 32 10 0 0.0 5 0 0 #DIV/0! 5 5 100.0 31 4 4 100.0
9 SUAK 82 8 0 0.0 6 0 0 #DIV/0! 5 6 120.0 78 6 6 100.0
10 SUKA MAJU 30 4 0 0.0 4 0 0 #DIV/0! 0 0 #DIV/0! 29 0 0 #DIV/0!
11 SUKA MARGA 33 4 0 0.0 4 0 0 #DIV/0! 3 3 100.0 32 2 2 100.0
12 SELORETNO 73 14 0 0.0 8 1 1 100 6 6 100.0 70 6 6 100.0
13 SIDODADI 151 8 0 0.0 8 0 0 #DIV/0! 8 8 100.0 142 11 11 100.0
14 SIDOWALUYO 124 3 0 0.0 16 0 0 #DIV/0! 9 9 100.0 119 12 12 100.0
15 SIDOREJO 147 15 3 20.0 13 0 0 #DIV/0! 16 16 100.0 140 13 13 100.0
16 SIDOMULYYO 105 8 0 0.0 8 0 0 #DIV/0! 8 8 100.0 101 7 7 100.0
JUMLAH 1162 117 5 4.3 107 6 2 33.3 95 96 101.1 1109 97 97 100.0

Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : OKTOBER
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 9 0 0.0 9 1 0 0 8 8 100.0 71 9 9 100.0
2 CAMPANG TIGA 61 10 0 0.0 10 0 0 #DIV/0! 5 5 100.0 58 10 10 100.0
3 TALANG BARU 37 2 0 0.0 3 0 0 #DIV/0! 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 13 0 0.0 6 0 0 #DIV/0! 7 7 100.0 79 7 7 100.0
5 BANJAR SURI 41 4 2 50.0 4 0 0 #DIV/0! 4 4 100.0 39 3 3 100.0
6 KOTA DALAM 47 3 0 0.0 3 0 0 #DIV/0! 2 2 100.0 45 2 2 100.0
7 BUDI DAYA 42 4 0 0.0 4 0 0 #DIV/0! 3 3 100.0 40 3 3 100.0
8 SIRING JAHA 32 6 0 0.0 2 1 0 0 4 4 100.0 31 4 4 100.0
9 SUAK 82 5 0 0.0 7 0 0 #DIV/0! 6 6 100.0 78 6 6 100.0
10 SUKA MAJU 30 2 0 0.0 2 0 0 #DIV/0! 0 0 #DIV/0! 29 1 1 100.0
11 SUKA MARGA 33 3 0 0.0 3 0 0 #DIV/0! 3 3 100.0 32 3 3 100.0
12 SELORETNO 73 16 0 0.0 9 1 1 100 7 7 100.0 70 6 6 100.0
13 SIDODADI 151 8 0 0.0 8 0 0 #DIV/0! 9 9 100.0 142 8 8 100.0
14 SIDOWALUYO 124 3 0 0.0 9 0 0 #DIV/0! 11 11 100.0 119 12 12 100.0
15 SIDOREJO 147 13 1 7.7 8 0 0 #DIV/0! 13 13 100.0 140 13 13 100.0
16 SIDOMULYYO 105 8 0 0.0 9 0 0 #DIV/0! 8 8 100.0 101 7 7 100.0
JUMLAH 1162 109 3 2.8 96 3 1 33.3 93 93 100.0 1109 97 97 100.0

Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : NOVEMBER
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 3 0 0.0 3 11 11 100 4 4 100.0 71 5 5 100.0
2 CAMPANG TIGA 61 4 0 0.0 4 10 10 100 7 7 100.0 58 6 6 100.0
3 TALANG BARU 37 3 0 0.0 3 10 10 100 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 5 0 0.0 5 11 11 100 5 5 100.0 79 5 5 100.0
5 BANJAR SURI 41 2 1 50.0 2 10 10 100 4 4 100.0 39 2 2 100.0
6 KOTA DALAM 47 4 0 0.0 4 10 10 100 4 4 100.0 45 2 2 100.0
7 BUDI DAYA 42 3 0 0.0 3 10 10 100 5 5 100.0 40 4 4 100.0
8 SIRING JAHA 32 4 0 0.0 2 10 10 100 2 2 100.0 31 3 3 100.0
9 SUAK 82 8 0 0.0 9 10 10 100 7 7 100.0 78 6 6 100.0
10 SUKA MAJU 30 0 0 #DIV/0! 0 10 10 100 1 1 100.0 29 1 1 100.0
11 SUKA MARGA 33 4 0 0.0 1 10 10 100 2 2 100.0 32 2 2 100.0
12 SELORETNO 73 12 0 0.0 4 10 10 100 8 8 100.0 70 4 4 100.0
13 SIDODADI 151 9 0 0.0 9 11 11 100 8 8 100.0 142 10 10 100.0
14 SIDOWALUYO 124 5 0 0.0 10 11 11 100 11 11 100.0 119 8 8 100.0
15 SIDOREJO 147 12 1 8.3 11 10 10 100 12 12 100.0 140 13 11 84.6
16 SIDOMULYYO 105 8 0 0.0 9 10 10 100 8 8 100.0 101 7 7 100.0
JUMLAH 1162 86 2 2.3 79 164 164 100.0 91 91 100.0 1109 81 79 97.5

Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

BULAN : DESEMBER
TAHUN : 2020
%
1 2 3 4 5 (6=5/4)*100 7 8 9 (10=9/8)*100 11 12 (13=12/11)*100 14 15 16 (17=16/15)*100
1 BANDAR DALAM 74 4 0 0.0 4 11 11 100 7 7 100.0 71 10 10 100.0
2 CAMPANG TIGA 61 4 0 0.0 4 10 10 100 5 5 100.0 58 5 5 100.0
3 TALANG BARU 37 3 0 0.0 2 10 10 100 3 3 100.0 35 3 3 100.0
4 SUKA BANJAR 83 8 1 12.5 3 11 11 100 5 5 100.0 79 5 5 100.0
5 BANJAR SURI 41 2 1 50.0 1 10 10 100 2 2 100.0 39 1 1 100.0
6 KOTA DALAM 47 3 0 0.0 3 10 10 100 6 6 100.0 45 4 4 100.0
7 BUDI DAYA 42 2 0 0.0 2 10 10 100 3 3 100.0 40 3 3 100.0
8 SIRING JAHA 32 5 0 0.0 2 10 10 100 3 3 100.0 31 2 2 100.0
9 SUAK 82 7 0 0.0 7 10 10 100 7 7 100.0 78 8 8 100.0
10 SUKA MAJU 30 1 0 0.0 1 10 10 100 1 1 100.0 29 0 0 #DIV/0!
11 SUKA MARGA 33 2 0 0.0 2 10 10 100 2 2 100.0 32 1 1 100.0
12 SELORETNO 73 6 0 0.0 3 10 10 100 3 3 100.0 70 4 4 100.0
13 SIDODADI 151 10 0 0.0 10 11 11 100 9 9 100.0 142 5 5 100.0
14 SIDOWALUYO 124 15 0 0.0 15 11 11 100 14 14 100.0 119 11 11 100.0
15 SIDOREJO 147 15 1 6.7 17 10 10 100 19 19 100.0 140 19 19 100.0
16 SIDOMULYYO 105 9 0 0.0 8 10 10 100 9 9 100.0 101 10 10 100.0
JUMLAH 1162 96 3 3.1 84 164 164 100.0 98 98 100.0 1109 91 91 100.0

Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI BAYI KURANG DARI 6 BULAN MENDAPAT ASI EKSKLUSIF
PROVINSI : LAMPUNG
KABUPATEN/KOTA : LAMPUNG SELATAN
PUSKESMAS : RAWAT INAP SIDOMULYO
BULAN : FEBRUARI
TAHUN : 2020
Jumlah FEBRUARI
sasaran 0 bulan 1 bulan 2 bulan 3 bulan 4 bulan 5 bulan 0-5 bulan
No Desa bayi umur Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah
< 6 bulan bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih %
direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk
1 2 3 4 5 6=5/4*100 7 8 9=8/7*100 10 11 12=11/10*100 13 14 15=14/13*100 16 17 18=17/16*100 19 20 21=20/19*100 22 23 24=23/22*100
1 BANDAR DALAM 35 26 26 100 26 25 96.2 25 22 88.0 22 13 59.1 13 9 69.2 9 8 88.9 26 8 30.8
2 CAMPANG TIGA 27 27 27 100.0 27 23 85.2 23 20 87.0 20 19 95.0 19 18 94.7 18 17 94.4 27 9 33.3
3 TALANG BARU 17 17 17 100.0 17 15 88.2 15 13 86.7 13 10 76.9 10 8 7.0 8 7 87.5 17 7 41.2
4 SUKA BANJAR 37 38 38 100.0 38 6 15.8 6 6 100.0 6 4 66.7 4 3 75.0 3 1 33.3 38 1 2.6
5 BANJAR SURI 19 19 5 26.3 5 5 100.0 5 4 80.0 4 3 75.0 3 3 100.0 3 3 100.0 19 3 15.8
6 KOTA DALAM 21 21 11 52.4 11 11 100.0 11 11 100.0 11 11 100.0 11 11 100.0 11 11 100.0 21 11 52.4
7 BUDI DAYA 18 18 18 100.0 18 18 100.0 18 12 66.7 12 8 66.7 8 5 62.5 5 1 20.0 18 1 5.6
8 SIRING JAHA 14 14 14 100.0 14 13 92.9 13 13 100.0 13 11 84.6 11 10 90.9 10 4 40.0 14 4 28.6
9 SUAK 37 25 25 100.0 25 20 80.0 20 17 85.0 17 14 82.4 14 12 85.7 12 9 75.0 15 9 60.0
10 SUKA MAJU 13 27 27 100.0 27 27 100.0 27 21 77.8 21 17 81.0 17 14 82.4 14 12 85.7 27 12 44.4
11 SUKAMARGA 15 1 1 100.0 1 1 100.0 1 1 100.0 1 1 100.0 1 1 100.0 1 1 100.0 1 1 100.0
12 SELORETNO 31 33 29 87.9 29 24 82.8 24 18 75.0 18 12 66.7 12 6 50.0 6 4 66.7 33 4 12.1
13 SIDODADI 66 56 56 100.0 56 56 100.0 56 45 80.4 45 30 66.7 30 15 50.0 15 4 26.7 56 14 25.0
14 SIDOWALUYO 54 70 70 100.0 70 55 78.6 55 40 72.7 40 30 75.0 30 12 40.0 12 8 66.7 70 8 11.4
15 SIDOREJO 64 49 49 100.0 49 49 100.0 49 39 79.6 39 20 51.3 20 14 70.0 14 6 42.9 49 6 12.2
16 SIDOMULYO 47 37 37 100.0 37 37 100.0 37 22 59.5 22 13 59.1 13 9 69.2 9 4 44.4 37 4 10.8
PUSKESMAS 515 478 450 94.1 450 385 85.6 385 304 79.0 304 216 71.1 216 150 69.4 150 100 66.7 468 92 19.7
Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI BAYI KURANG DARI 6 BULAN MENDAPAT ASI EKSKLUSIF
PROVINSI : LAMPUNG
BULAN : AGUSTUS
TAHUN : 2020
Jumlah FEBRUARI
sasaran 0 bulan 1 bulan 2 bulan 3 bulan 4 bulan 5 bulan 0-5 bulan

No Desa
bayi umur Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah
< 6 bulan bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih % bayi bayi masih %
direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk direcall ASI Eksk
1 2 3 4 5 6=5/4*100 7 8 9=8/7*100 10 11 12=11/10*100 13 14 15=14/13*100 16 17 18=17/16*100 19 20 21=20/19*100 22 23 24=23/22*100
1 BANDAR DALAM 35 20 20 100 20 18 90.0 18 14 77.8 14 10 71.4 10 5 50.0 5 5 100.0 20 5 25.0
2 CAMPANG TIGA 27 25 25 100.0 25 17 68.0 17 9 52.9 9 3 33.3 3 2 66.7 2 2 100.0 25 2 8.0
3 TALANG BARU 17 17 17 100.0 17 17 100.0 17 17 100.0 17 16 94.1 16 14 87.5 14 2 14.3 17 2 11.8
4 SUKA BANJAR 37 38 38 100.0 38 36 94.7 38 30 78.9 30 23 76.7 23 17 73.9 17 14 82.4 38 14 36.8
5 BANJAR SURI 19 19 17 89.5 17 14 82.4 14 11 78.6 11 9 81.8 9 7 77.8 7 7 100.0 19 7 36.8
6 KOTA DALAM 21 12 12 100.0 12 12 100.0 12 9 75.0 9 8 88.9 8 7 87.5 7 3 42.9 12 3 25.0
7 BUDI DAYA 18 18 18 100.0 18 18 100.0 18 18 100.0 18 18 100.0 18 0 0.0 0 0 #DIV/0! 18 0 0.0
8 SIRING JAHA 14 6 6 100.0 6 6 100.0 6 6 100.0 6 4 66.7 4 2 50.0 2 1 50.0 6 1 16.7
9 SUAK 37 0 0 #DIV/0! 0 0 #DIV/0! 0 0 #DIV/0! 0 0 #DIV/0! 0 0 #DIV/0! 0 0 #DIV/0! 0 0 #DIV/0!
10 SUKA MAJU 13 20 20 100.0 20 20 100.0 20 18 90.0 18 16 88.9 16 13 81.3 13 13 100.0 20 13 65.0
11 SUKAMARGA 15 15 15 100.0 15 15 100.0 15 15 100.0 15 14 93.3 14 14 100.0 14 2 14.3 15 2 13.3
12 SELORETNO 31 34 34 100.0 34 33 97.1 33 33 100.0 33 30 90.9 30 26 86.7 26 20 76.9 20 3 15.0
13 SIDODADI 66 55 55 100.0 55 55 100.0 55 54 98.2 54 30 55.6 30 15 50.0 15 4 26.7 55 4 7.3
14 SIDOWALUYO 54 78 54 69.2 54 49 90.7 49 47 95.9 47 47 100.0 47 14 29.8 14 8 57.1 78 8 10.3
15 SIDOREJO 64 15 15 100.0 15 15 100.0 15 15 100.0 15 15 100.0 15 15 100.0 14 11 78.6 15 11 73.3
16 SIDOMULYO 47 55 55 100.0 55 55 100.0 55 54 98.2 54 50 92.6 50 46 92.0 46 6 13.0 55 6 10.9
PUSKESMAS 515 427 401 93.9 401 380 94.8 382 350 91.6 350 293 83.7 293 197 67.2 196 98 50.0 413 81 19.6
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI VITAMIN A BALITA DAN GARAM IODIUM
PROVINSI : LAMPUNG
BULAN : FEBRUARI
TAHUN : 2020
Jumlah VITAMIN A GARAM IODIUM

Sasaran Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Sasaran RT
Jumlah RT
No Desa balita bayi 6-11 bayi 6-11 balita balita balita balita mengon
% % % %
umur bulan bulan dpt 12-59 bln 12-59 bln 6 -59 bln 6 -59 bln sumsi Garam
RT diperiksa
6-59 bulan Vitamin A dpt vit.A dpt vit.A Beriodium
1 2 3 4 5 6= 5/4*100 7 8 9= 8/7*100 10 11 12= 11/10*100 13 14 15 16=15/14*100
1 BANDAR DALAM 322 35 35 100.0 287 282 98.3 322 317 98.4
2 CAMPANG TIGA 256 27 27 100.0 229 203 88.6 256 230 89.8
3 TALANG BARU 159 17 17 100.0 142 136 95.8 159 153 96.2
4 SUKA BANJAR 349 37 38 102.7 312 308 98.7 349 346 99.1
5 BANJAR SURI 174 19 19 100.0 155 158 101.9 174 177 101.7
6 KOTA DALAM 193 21 21 100.0 172 172 100.0 193 193 100.0
7 BUDI DAYA 170 18 18 100.0 152 152 100.0 170 170 100.0
8
9
SIRING JAHA
SUAK
135
342
14
37
14
38
100.0
102.7
121
305
121
330
100.0
108.2
135
342
135
368
100.0
107.6
NIHIL
10 SUKA MAJU 120 13 13 100.0 107 108 100.9 120 121 100.8
11 SUKAMARGA 139 15 15 100.0 124 121 97.6 139 136 97.8
12 SELORETNO 296 31 31 100.0 265 260 98.1 296 291 98.3
13 SIDODADI 617 66 176 266.7 551 545 98.9 617 721 116.9
14 SIDOWALUYO 505 54 58 107.4 451 482 106.9 505 540 106.9
15 SIDOREJO 598 64 42 65.6 534 490 91.8 598 532 89.0
16 SIDOMULYO 434 47 46 97.9 387 369 95.3 434 415 95.6
PUSKESMAS 4809 515 608 118.1 4294 4237 98.7 4809 4845 100.7
Mengetahui
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI VITAMIN A BALITA DAN GARAM IODIUM
PROVINSI : LAMPUNG
BULAN : AGUSTUS
TAHUN : 2020
Jumlah VITAMIN A GARAM IODIUM

Sasaran Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Sasaran RT
Jumlah RT
No Desa balita bayi 6-11 bayi 6-11 balita balita balita balita mengon
% % % %
umur bulan bulan dpt 12-59 bln 12-59 bln 6 -59 bln 6 -59 bln sumsi Garam
RT diperiksa
6-59 bulan Vitamin A dpt vit.A dpt vit.A Beriodium
1 2 3 4 5 6= 5/4*100 7 8 9= 8/7*100 10 11 12= 11/10*100 13 14 15 16=15/14*100
1 BANDAR DALAM 322 35 35 100.0 287 282 98.3 322 317 98.4 50 50 50 100
2 CAMPANG TIGA 256 27 27 100.0 229 209 91.3 256 236 92.2 50 50 50 100
3 TALANG BARU 159 17 17 100.0 142 138 97.2 159 155 97.5 50 50 50 100
4 SUKA BANJAR 349 37 37 100.0 312 310 99.4 349 347 99.4 50 50 50 100
5 BANJAR SURI 174 19 19 100.0 155 155 100.0 174 174 100.0 50 50 50 100
6 KOTA DALAM 195 21 21 100.0 174 172 98.9 195 193 99.0 50 50 50 100
7 BUDI DAYA 170 18 18 100.0 152 152 100.0 170 170 100.0 50 50 50 100
8 SIRING JAHA 135 14 14 100.0 121 121 100.0 135 135 100.0 50 50 50 100
9 SUAK 346 41 38 92.7 305 315 103.3 346 353 102.0 50 50 50 100
10 SUKA MAJU 120 13 14 107.7 107 107 100.0 120 121 100.8 50 50 50 100
11 SUKAMARGA 139 15 15 100.0 124 122 98.4 139 137 98.6 50 50 50 100
12 SELORETNO 296 31 30 96.8 265 257 97.0 296 287 97.0 50 50 50 100
13 SIDODADI 617 66 66 100.0 551 430 78.0 617 496 80.4 50 50 50 100
14 SIDOWALUYO 505 54 54 100.0 451 441 97.8 505 495 98.0 50 50 50 100
15 SIDOREJO 598 64 60 93.8 534 522 97.8 598 582 97.3 50 50 50 100
16 SIDOMULYO 434 47 46 97.9 387 380 98.2 434 426 98.2 50 50 50 100
PUSKESMAS 4815 519 511 98.5 4296 4113 95.7 4815 4624 96.0 800 800 800 100
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI HASIL PEMANTAUAN PERTUMBUHAN BALITA DI PUSKESMAS
PROVINSI : LAMPUNG
PUSKESMAS/KECAMATAN : RAWAT INAP SIDOMULYO/SIDOMULYO
BULAN/TAHUN : JANUARI/2020.
Jumlah Balita Diukur STATUS GIZI INDEKS BB/U STATUS GIZI INDEKS TB/U STATUS GIZI INDEKS BB/TB
ta
ali
B
an
ar
as
ANTROPOMETRI Gizi Buruk Gizi Kurang Gizi Baik Gizi Lebih Sangat Pendek Pendek
S
Normal Sangat Kurus Kurus Normal Gemuk
ah
ml
No Desa
Ju
L P L+P L P L+P L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P % L P L+P %
1 BANDAR DALAM 189 166 355 143 144 287 0 0 0 0.0 0 1 1 0.3 143 143 286 99.7 0 0 0 0.0 0 1 1 0.3 0 0 0 0.0 143 143 286 99.7 0 1 1 0.3 0 0 0 0.0 143 143 286 99.7 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 112 118 230 0 0 0 0.0 3 4 7 3.0 109 114 223 97.0 0 0 0 0.0 0 0 0 0.0 3 4 7 3.0 109 114 223 97.0 0 0 0 0.0 3 4 7 3.0 109 114 223 97.0 0 0 0 0.0
3 TALANG BARU 93 83 176 89 78 167 0 0 0 0.0 0 1 1 0.6 89 77 166 99.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 89 78 167 100.0 0 0 0 0 0 1 1 0.6 89 77 166 99.4 0 0 0 0.0
4 SUKA BANJAR 200 187 387 184 170 354 0 0 0 0.0 0 0 0 0.0 184 170 354 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 184 170 354 100.0 0 0 0 0 0 0 0 0.0 184 170 354 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 86 104 190 0 0 0 0.0 0 0 0 0.0 86 104 190 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 86 104 190 100.0 0 0 0 0 0 0 0 0.0 86 104 190 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 81 80 161 0 0 0 0.0 0 0 0 0.0 81 80 161 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 81 80 161 100.0 0 0 0 0 0 0 0 0.0 81 80 161 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 65 72 137 0 0 0 0.0 0 0 0 0.0 65 72 137 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 65 72 137 100.0 0 0 0 0 0 0 0 0.0 65 72 137 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 67 53 120 0 0 0 0.0 0 0 0 0.0 67 53 120 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 67 53 120 100.0 0 0 0 0 0 0 0 0.0 67 53 120 100.0 0 0 0 0.0
9 SUAK 195 183 378 158 145 303 0 0 0 0.0 12 10 22 7.3 146 135 281 92.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 158 145 303 100.0 0 0 0 0 0 0 0 0.0 158 145 303 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 60 63 123 0 0 0 0.0 0 0 0 0.0 60 63 123 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 60 63 123 100.0 0 0 0 0 0 0 0 0.0 60 63 123 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 69 68 137 0 0 0 0.0 0 0 0 0.0 69 68 137 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 69 68 137 100.0 0 0 0 0 0 0 0 0.0 69 68 137 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 157 156 313 0 0 0 0.0 0 0 0 0.0 157 156 313 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 157 156 313 100.0 0 0 0 0 1 0 1 0.3 156 156 312 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 396 393 789 0 0 0 0.0 0 0 0 0.0 396 393 789 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 396 393 789 100.0 0 0 0 0 0 0 0 0.0 396 393 789 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 288 289 577 0 0 0 0.0 0 1 1 0.2 287 288 575 99.7 1 0 1 0.2 0 0 0 0.0 0 1 1 0.2 288 288 576 99.8 0 0 0 0 0 1 1 0.2 288 288 576 99.8 0 0 0 0.0
15 SIDOREJO 332 330 662 284 268 552 0 0 0 0.0 0 0 0 0.0 284 268 552 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 284 268 552 100.0 0 0 0 0 0 2 2 0.4 284 266 550 99.6 0 0 0 0.0
16 SIDOMULYYO 244 237 481 205 186 391 0 0 0 0.0 1 1 2 0.5 204 185 389 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 205 186 391 100.0 0 0 0 0 0 0 0 0.0 205 186 391 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2444 2387 4831 0 0 0 0.0 16 18 34 0.7 2427 2369 4796 99.3 1 0 1 0.0 0 1 1 0.0 3 5 8 0.2 2441 2381 4822 99.8 0 1 1 0.02 4 8 12 0.2 2440 2378 4818 99.7 0 0 0 0.00
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NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : FEBRUARI/2020.
a
lit
Ba
n
ra
sa
Sa
ANTROPOMETRI Gizi Buruk Gizi Kurang Gizi Baik Gizi Lebih Sangat Pendek Pendek Normal Sangat Kurus Kurus Normal Gemuk
h
la
No Desa
m
Ju
1 BANDAR DALAM 189 166 355 110 171 281 0 0 0 0.0 1 0 1 0.4 109 171 280 99.6 0 0 0 0.0 0 1 1 0.4 0 0 0 0.0 110 170 280 99.6 0 1 1 0.4 0 0 0 0.0 110 170 280 99.6 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 112 118 230 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0
3 TALANG BARU 93 83 176 89 80 169 0 0 0 0.0 0 0 0 0.0 89 80 169 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 89 80 169 100.0 0 0 0 0 0 0 0 0.0 89 80 169 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 195 183 378 0 0 0 0.0 0 0 0 0.0 195 183 378 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 195 183 378 100.0 0 0 0 0 0 0 0 0.0 195 183 378 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 89 105 194 0 0 0 0.0 0 0 0 0.0 89 105 194 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 89 105 194 100.0 0 0 0 0 0 0 0 0.0 89 105 194 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 101 104 205 0 0 0 0.0 0 0 0 0.0 101 104 205 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 101 104 205 100.0 0 0 0 0 0 0 0 0.0 101 104 205 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 76 72 148 0 0 0 0.0 0 0 0 0.0 76 72 148 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 76 72 148 100.0 0 0 0 0 0 0 0 0.0 76 72 148 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 68 60 128 0 0 0 0.0 0 0 0 0.0 68 60 128 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 68 60 128 100.0 0 0 0 0 0 0 0 0.0 68 60 128 100.0 0 0 0 0.0
9 SUAK 195 183 378 187 177 364 0 0 0 0.0 11 10 21 5.8 176 167 343 94.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 67 67 134 0 0 0 0.0 0 0 0 0.0 67 67 134 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 67 67 134 100.0 0 0 0 0 0 0 0 0.0 67 67 134 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 76 71 147 0 0 0 0.0 0 0 0 0.0 76 71 147 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 76 71 147 100.0 0 0 0 0 0 0 0 0.0 76 71 147 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 163 158 321 0 0 0 0.0 1 0 1 0.3 162 158 320 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 163 158 321 100.0 0 0 0 0 1 0 1 0.3 162 158 320 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 374 372 746 0 0 0 0.0 0 0 0 0.0 374 372 746 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 374 372 746 100.0 0 0 0 0 0 0 0 0.0 374 372 746 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 301 296 597 0 0 0 0.0 1 0 1 0.2 300 296 596 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 301 296 597 100.0 0 0 0 0 0 0 0 0.0 301 296 597 100.0 0 0 0 0.0
15 SIDOREJO 332 330 662 300 295 595 0 0 0 0.0 0 0 0 0.0 300 295 595 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 300 295 595 100.0 0 0 0 0 0 0 0 0.0 300 295 595 100.0 0 0 0 0.0
16 SIDOMULYYO 244 237 481 234 223 457 0 0 0 0.0 1 0 1 0.2 233 223 456 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 234 223 457 100.0 0 0 0 0 0 0 0 0.0 234 223 457 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2542 2552 5094 0 0 0 0.0 16 13 29 0.6 2526 2539 5065 99.4 0 0 0 0.0 0 1 1 0.0 1 3 4 0.1 2541 2548 5089 99.9 0 1 1 0.02 2 3 5 0.1 2540 2548 5088 99.9 0 0 0 0.00
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : MARET/2020.
ta
ali
B
an
ar
as
S
ah
ml
No Desa
Ju
1 BANDAR DALAM 189 166 355 141 135 276 0 0 0 0.0 0 0 0 0.0 141 135 276 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 141 135 276 100.0 0 0 0 0.0 1 1 2 0.7 140 134 274 99.3 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 103 113 216 0 0 0 0.0 7 5 12 5.6 96 108 204 94.4 0 0 0 0.0 0 0 0 0.0 7 5 12 5.6 96 108 204 94.4 0 0 0 0.0 7 5 12 5.6 96 108 204 94.4 0 0 0 0.0
3 TALANG BARU 93 83 176 88 80 168 0 0 0 0.0 0 1 1 0.6 88 79 167 99.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 177 164 341 0 0 0 0.0 1 0 1 0.3 176 164 340 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 177 164 341 100.0 0 0 0 0 0 2 2 0.6 177 162 339 99.4 0 0 0 0.0
5 BANJAR SURI 99 93 192 90 100 190 0 0 0 0.0 0 0 0 0.0 90 100 190 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 90 100 190 100.0 0 0 0 0 0 0 0 0.0 90 100 190 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 87 86 173 0 0 0 0.0 0 0 0 0.0 87 86 173 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 87 86 173 100.0 0 0 0 0 1 0 1 0.6 86 86 172 99.4 0 0 0 0.0
7 BUDI DAYA 96 93 189 50 40 90 0 0 0 0.0 0 0 0 0.0 50 40 90 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 50 40 90 100.0 0 0 0 0 0 0 0 0.0 50 40 90 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 54 52 106 0 0 0 0.0 0 0 0 0.0 54 52 106 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 54 52 106 100.0 0 0 0 0 0 0 0 0.0 54 52 106 100.0 0 0 0 0.0
9 SUAK 195 183 378 187 177 364 0 0 0 0.0 12 10 22 6.0 175 167 342 94.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 67 67 134 0 0 0 0.0 0 0 0 0.0 67 67 134 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 67 67 134 100.0 0 0 0 0 0 0 0 0.0 67 67 134 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 74 71 145 0 0 0 0.0 1 0 1 0.7 73 71 144 99.3 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 150 141 291 0 0 0 0.0 0 1 1 0.3 150 140 290 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 150 141 291 100.0 0 0 0 0 0 1 1 0.3 150 140 290 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 247 240 487 0 0 0 0.0 58 53 111 22.8 189 187 376 77.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 247 240 487 100.0 0 1 1 0.2 0 0 0 0.0 247 239 486 99.8 0 0 0 0.0
14 SIDOWALUYO 280 279 559 279 270 549 0 0 0 0.0 0 0 0 0.0 279 270 549 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 279 270 549 100.0 0 0 0 0 0 0 0 0.0 279 270 549 100.0 0 0 0 0.0
15 SIDOREJO 332 330 662 258 260 518 0 0 0 0.0 0 0 0 0.0 258 260 518 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 258 260 518 100.0 0 0 0 0 2 1 3 0.6 256 259 515 99.4 0 0 0 0.0
16 SIDOMULYYO 244 237 481 224 215 439 0 0 0 0.0 1 0 1 0.2 223 215 438 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 224 215 439 100.0 0 0 0 0 0 0 0 0.0 224 215 439 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2276 2211 4487 0 0 0 0.0 80 70 150 3.3 2196 2141 4337 96.7 0 0 0 0.0 0 0 0 0.0 7 5 12 0.3 2269 2206 4475 99.7 0 1 1 0.02 11 10 21 0.5 2265 2200 4465 99.5 0 0 0 0.00
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
PUSKESMAS/KECAMATAN : RAWAT INAP SIDOMULYO / SIDOMULYO
BULAN/TAHUN : APRIL / 2020.
ta
ali
B
an
ar
as
S

ah
ml
No Desa
Ju
1 BANDAR DALAM 189 166 355 2 3 5 0 0 0 0.0 0 0 0 0.0 2 3 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 3 5 100.0 0 0 0 0.0 0 0 0 0.0 2 3 5 100.0 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 4 1 5 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0
3 TALANG BARU 93 83 176 1 3 4 0 0 0 0.0 0 0 0 0.0 1 3 4 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 1 3 4 100.0 0 0 0 0 0 0 0 0.0 1 3 4 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 6 1 7 0 0 0 0.0 0 0 0 0.0 6 1 7 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 6 1 7 100.0 0 0 0 0 0 0 0 0.0 6 1 7 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 2 1 3 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 5 0 5 0 0 0 0.0 0 0 0 0.0 5 0 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 5 0 5 100.0 0 0 0 0 0 0 0 0.0 5 0 5 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 2 2 4 0 0 0 0.0 0 0 0 0.0 2 2 4 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 2 4 100.0 0 0 0 0 0 0 0 0.0 2 2 4 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 2 1 3 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0
9 SUAK 195 183 378 4 6 10 0 0 0 0.0 2 0 2 20.0 2 6 8 80.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 4 6 10 100.0 0 0 0 0 2 0 2 20.0 2 6 8 80.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 1 4 5 0 0 0 0.0 0 0 0 0.0 1 4 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 1 4 5 100.0 0 0 0 0 0 0 0 0.0 1 4 5 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 1 1 2 0 0 0 0.0 0 0 0 0.0 1 1 2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 1 1 2 100.0 0 0 0 0 0 0 0 0.0 1 1 2 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 4 4 8 0 0 0 0.0 0 1 1 12.5 4 3 7 87.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 4 4 8 100.0 0 0 0 0 0 1 1 12.5 4 3 7 87.5 0 0 0 0.0
13 SIDODADI 346 337 683 7 6 13 0 0 0 0.0 0 0 0 0.0 7 6 13 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 7 6 13 100.0 0 0 0 0.0 0 0 0 0.0 7 6 13 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 5 3 8 0 0 0 0.0 0 0 0 0.0 5 3 8 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 5 3 8 100.0 0 0 0 0 0 0 0 0.0 5 3 8 100.0 0 0 0 0.0
15 SIDOREJO 332 330 662 7 3 10 0 0 0 0.0 0 0 0 0.0 7 3 10 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 7 3 10 100.0 0 0 0 0 0 0 0 0.0 7 3 10 100.0 0 0 0 0.0
16 SIDOMULYYO 244 237 481 5 3 8 0 0 0 0.0 0 0 0 0.0 5 3 8 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 5 3 8 100.0 0 0 0 0 0 0 0 0.0 5 3 8 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 58 42 100 0 0 0 0.0 2 1 3 3.0 56 41 97 97.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 58 42 100 100.0 0 0 0 0.00 2 1 3 3.0 56 41 97 97.0 0 0 0 0.00
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : MEI / 2020.
lita
Ba
n
ra
sa
Sa
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 5 3 8 0 0 0 0.0 0 1 1 12.5 5 2 7 87.5 0 0 0 0.0 0 0 0 0.0 0 1 1 12.5 5 2 7 87.5 0 1 1 12.5 0 0 0 0.0 5 2 7 87.5 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 1 4 5 0 0 0 0.0 0 0 0 0.0 1 4 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 1 4 5 100.0 0 0 0 0.0 0 0 0 0.0 1 4 5 100.0 0 0 0 0.0
3 TALANG BARU 93 83 176 2 1 3 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 1 3 100.0 0 0 0 0 0 0 0 0.0 2 1 3 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 4 1 5 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 1 2 3 0 0 0 0.0 0 0 0 0.0 1 2 3 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 1 2 3 100.0 0 0 0 0 0 0 0 0.0 1 2 3 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 2 0 2 0 0 0 0.0 0 0 0 0.0 2 0 2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 0 2 100.0 0 0 0 0 0 0 0 0.0 2 0 2 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 2 2 4 0 0 0 0.0 0 0 0 0.0 2 2 4 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2 2 4 100.0 0 0 0 0 0 0 0 0.0 2 2 4 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 3 2 5 0 0 0 0.0 0 0 0 0.0 3 2 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 3 2 5 100.0 0 0 0 0 0 0 0 0.0 3 2 5 100.0 0 0 0 0.0
9 SUAK 195 183 378 5 5 10 0 0 0 0.0 0 0 0 0.0 5 5 10 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 5 5 10 100.0 0 0 0 0 0 0 0 0.0 5 5 10 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 4 1 5 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 4 1 5 100.0 0 0 0 0 0 0 0 0.0 4 1 5 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 0 2 2 0 0 0 0.0 0 0 0 0.0 0 2 2 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 2 2 100.0 0 0 0 0 0 0 0 0.0 0 2 2 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 3 5 8 0 0 0 0.0 0 0 0 0.0 3 5 8 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 3 5 8 100.0 0 0 0 0 0 0 0 0.0 3 5 8 100.0 0 0 0 0.0
13 SIDODADI 346 337 683 7 7 14 0 0 0 0.0 0 0 0 0.0 7 7 14 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 7 7 14 100.0 0 0 0 0.0 0 0 0 0.0 7 7 14 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 5 6 11 0 0 0 0.0 0 0 0 0.0 5 6 11 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 5 6 11 100.0 0 0 0 0 0 0 0 0.0 5 6 11 100.0 0 0 0 0.0
15 SIDOREJO 332 330 662 8 2 10 0 0 0 0.0 0 0 0 0.0 8 2 10 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 8 2 10 100.0 0 0 0 0 0 0 0 0.0 8 2 10 100.0 0 0 0 0.0
16 SIDOMULYO 244 237 481 7 5 12 0 0 0 0.0 0 0 0 0.0 7 5 12 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 7 5 12 100.0 0 0 0 0 0 0 0 0.0 7 5 12 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 59 48 107 0 0 0 0.0 0 1 1 0.9 59 47 106 99.1 0 0 0 0.0 0 0 0 0.0 0 1 1 0.9 59 47 106 99.1 0 1 1 0.93 0 0 0 0.0 59 47 106 99.1 0 0 0 0.00
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : JUNI / 2020.
lita
Ba
n
ra
sa
Sa
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 71 54 125 0 0 0 0.0 1 0 1 0.8 70 54 124 99.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 71 54 125 100.0 0 0 0 0.0 1 0 1 0.8 70 54 124 99.2 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 30 37 67 0 0 0 0.0 0 0 0 0.0 30 37 67 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 30 37 67 100.0 0 0 0 0.0 0 0 0 0.0 30 37 67 100.0 0 0 0 0.0
3 TALANG BARU 93 83 176 16 22 38 0 0 0 0.0 0 0 0 0.0 16 22 38 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 16 22 38 100.0 0 0 0 0.0 0 0 0 0.0 16 22 38 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 36 31 67 0 0 0 0.0 0 0 0 0.0 36 31 67 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 36 31 67 100.0 0 0 0 0.0 0 0 0 0.0 36 31 67 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 15 16 31 0 0 0 0.0 0 0 0 0.0 15 16 31 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 15 16 31 100.0 0 0 0 0.0 0 0 0 0.0 15 16 31 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 26 15 41 0 0 0 0.0 0 0 0 0.0 26 15 41 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 26 15 41 100.0 0 0 0 0.0 0 0 0 0.0 26 15 41 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 31 19 50 0 0 0 0.0 0 0 0 0.0 31 19 50 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 31 19 50 100.0 0 0 0 0.0 0 0 0 0.0 31 19 50 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 27 21 48 0 0 0 0.0 0 0 0 0.0 27 21 48 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 27 21 48 100.0 0 0 0 0.0 0 0 0 0.0 27 21 48 100.0 0 0 0 0.0
9 SUAK 195 183 378 58 59 117 0 0 0 0.0 0 0 0 0.0 58 59 117 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 58 59 117 100.0 0 0 0 0.0 0 0 0 0.0 58 59 117 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 16 24 40 0 0 0 0.0 0 0 0 0.0 16 24 40 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 16 24 40 100.0 0 0 0 0.0 0 0 0 0.0 16 24 40 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 15 10 25 0 0 0 0.0 0 0 0 0.0 15 10 25 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 15 10 25 100.0 0 0 0 0.0 0 0 0 0.0 15 10 25 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 32 37 69 0 0 0 0.0 0 0 0 0.0 32 37 69 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 32 37 69 100.0 0 0 0 0.0 0 0 0 0.0 32 37 69 100.0 0 0 0 0.0
13 SIDODADI 346 337 683 47 38 85 0 0 0 0.0 9 6 15 17.6 38 32 70 82.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 47 38 85 100.0 0 0 0 0.0 0 0 0 0.0 47 38 85 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 59 49 108 0 0 0 0.0 2 0 2 1.9 57 49 106 98.1 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 59 49 108 100.0 0 0 0 0.0 2 0 2 1.9 57 49 106 98.1 0 0 0 0.0
15 SIDOREJO 332 330 662 58 57 115 0 0 0 0.0 0 0 0 0.0 58 57 115 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 58 57 115 100.0 0 0 0 0.0 1 0 1 0.9 57 57 114 99.1 0 0 0 0.0
16 SIDOMULYO 244 237 481 49 43 92 0 0 0 0.0 0 0 0 0.0 49 43 92 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 49 43 92 100.0 0 0 0 0.0 0 0 0 0.0 49 43 92 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 586 532 1118 0 0 0 0.0 12 6 18 1.6 574 526 1100 98.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 586 532 1118 100.0 0 0 0 0.0 4 0 4 0.4 582 532 1114 99.6 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : JULI / 2020.
lita
Ba
n
ra
sa
Sa
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 176 166 342 0 0 0 0.0 0 0 0 0.0 176 166 342 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 176 166 342 100.0 0 0 0 0.0 0 0 0 0.0 176 166 342 100.0 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 128 136 264 0 0 0 0.0 0 0 0 0.0 128 136 264 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 128 136 264 100.0 0 0 0 0.0 0 0 0 0.0 128 136 264 100.0 0 0 0 0.0
3 TALANG BARU 93 83 176 88 80 168 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 199 182 381 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 85 105 190 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 104 102 206 0 0 0 0.0 0 0 0 0.0 104 102 206 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 104 102 206 100.0 0 0 0 0.0 0 0 0 0.0 104 102 206 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 102 82 184 0 0 0 0.0 1 0 1 0.5 101 82 183 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 102 82 184 100.0 0 0 0 0.0 0 0 0 0.0 102 82 184 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 65 60 125 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0
9 SUAK 195 183 378 187 177 364 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 66 67 133 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 74 71 145 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 162 157 319 0 0 0 0.0 1 0 1 0.3 161 157 318 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 162 157 319 100.0 0 0 0 0.0 1 0 1 0.3 161 157 318 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 214 216 430 0 0 0 0.0 0 0 0 0.0 214 216 430 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 214 216 430 100.0 0 0 0 0.0 0 0 0 0.0 214 216 430 100.0 0 0 0 0.0
14 SIDOWALUYO 280 279 559 293 277 570 0 0 0 0.0 1 0 1 0.2 292 277 569 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 293 277 570 100.0 0 0 0 0.0 1 0 1 0.2 292 277 569 99.8 0 0 0 0.0
15 SIDOREJO 332 330 662 298 291 589 0 0 0 0.0 0 0 0 0.0 298 291 589 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 298 291 589 100.0 0 0 0 0.0 1 0 1 0.2 297 291 588 99.8 0 0 0 0.0
16 SIDOMULYO 244 237 481 229 223 452 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2470 2392 4862 0 0 0 0.0 3 0 3 0.1 2467 2392 4859 99.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 2470 2392 4862 100.0 0 0 0 0.0 3 0 3 0.1 2467 2392 4859 99.9 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : AGUSTUS / 2020.
lita
Ba
n
ra
sa
Sa
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 176 166 342 0 0 0 0.0 1 0 1 0.3 175 166 341 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 176 166 342 100.0 0 0 0 0.0 1 0 1 0.3 175 166 341 99.7 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 128 136 264 0 0 0 0.0 3 3 6 2.3 125 133 258 97.7 0 0 0 0.0 0 0 0 0.0 3 3 6 2.3 125 133 258 97.7 0 0 0 0.0 3 3 6 2.3 125 133 258 97.7 0 0 0 0.0
3 TALANG BARU 93 83 176 88 80 168 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0 0 0 0 0.0 88 80 168 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 199 182 381 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0 0 0 0 0.0 199 182 381 100.0 0 0 0 0.0
5 BANJAR SURI 99 93 192 85 105 190 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0 0 0 0 0.0 85 105 190 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 104 102 206 0 0 0 0.0 2 1 3 1.5 102 101 203 98.5 0 0 0 0.0 2 0 2 1.0 0 0 0 0.0 102 102 204 99.0 0 0 0 0.0 2 1 3 1.5 102 101 203 98.5 0 0 0 0.0
7 BUDI DAYA 96 93 189 102 82 184 0 0 0 0.0 1 0 1 0.5 101 82 183 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 102 82 184 100.0 0 0 0 0.0 0 0 0 0.0 102 82 184 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 65 60 125 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0 0 0 0 0.0 65 60 125 100.0 0 0 0 0.0
9 SUAK 195 183 378 187 177 364 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0 0 0 0 0.0 187 177 364 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 66 67 133 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0 0 0 0 0.0 66 67 133 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 74 71 145 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0 0 0 0 0.0 74 71 145 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 162 157 319 0 0 0 0.0 1 0 1 0.3 161 157 318 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 162 157 319 100.0 0 0 0 0.0 1 0 1 0.3 161 157 318 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 214 216 430 0 0 0 0.0 68 70 138 32.1 146 146 292 67.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 214 216 430 100.0 0 0 0 0.0 68 70 138 32.1 146 146 292 67.9 0 0 0 0.0
14 SIDOWALUYO 280 279 559 293 277 570 0 0 0 0.0 1 0 1 0.2 292 277 569 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 293 277 570 100.0 0 0 0 0.0 1 0 1 0.2 292 277 569 99.8 0 0 0 0.0
15 SIDOREJO 332 330 662 298 291 589 0 0 0 0.0 0 1 1 0.2 298 290 588 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 298 291 589 100.0 0 0 0 0.0 0 1 1 0.2 298 290 588 99.8 0 0 0 0.0
16 SIDOMULYO 244 237 481 229 223 452 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0 0 0 0 0.0 229 223 452 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2470 2392 4862 0 0 0 0.0 77 75 152 3.1 2393 2317 4710 96.9 0 0 0 0.0 2 0 2 0.0 3 3 6 0.1 2465 2389 4854 99.8 0 0 0 0.0 76 75 151 3.1 2394 2317 4711 96.9 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : SEPTEMBER / 2020.
lita
Ba
n
ra
sa
Sa
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 168 159 327 0 0 0 0.0 1 0 1 0.3 167 159 326 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 168 159 327 100.0 0 1 1 0.3 0 0 0 0.0 168 158 326 99.7 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 108 116 224 0 0 0 0.0 2 7 9 4.0 106 109 215 96.0 0 0 0 0.0 0 0 0 0.0 2 7 9 4.0 106 109 215 96.0 0 0 0 0.0 2 7 9 4.0 106 109 215 96.0 0 0 0 0.0
3 TALANG BARU 93 83 176 83 75 158 0 0 0 0.0 0 0 0 0.0 83 75 158 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 83 75 158 100.0 0 0 0 0.0 0 0 0 0.0 83 75 158 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 178 168 346 0 0 0 0.0 0 0 0 0.0 178 168 346 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 178 168 346 100.0 0 0 0 0.0 2 3 5 1.4 176 165 341 98.6 0 0 0 0.0
5 BANJAR SURI 99 93 192 87 104 191 0 0 0 0.0 0 0 0 0.0 87 104 191 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 87 104 191 100.0 0 0 0 0.0 0 0 0 0.0 87 104 191 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 100 94 194 0 0 0 0.0 0 0 0 0.0 100 94 194 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 100 94 194 100.0 0 0 0 0.0 0 0 0 0.0 100 94 194 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 63 61 124 0 0 0 0.0 0 0 0 0.0 63 61 124 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 63 61 124 100.0 0 0 0 0.0 0 0 0 0.0 63 61 124 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 67 62 129 0 0 0 0.0 0 0 0 0.0 67 62 129 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 67 62 129 100.0 0 0 0 0.0 0 0 0 0.0 67 62 129 100.0 0 0 0 0.0
9 SUAK 195 183 378 115 108 223 0 0 0 0.0 2 0 2 0.9 113 108 221 99.1 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 115 108 223 100.0 0 0 0 0.0 0 0 0 0.0 115 108 223 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 54 55 109 0 0 0 0.0 0 0 0 0.0 54 55 109 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 54 55 109 100.0 0 0 0 0.0 0 0 0 0.0 54 55 109 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 71 65 136 0 0 0 0.0 0 0 0 0.0 71 65 136 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 71 65 136 100.0 0 0 0 0.0 0 0 0 0.0 71 65 136 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 145 145 290 0 0 0 0.0 0 1 1 0.3 145 144 289 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 145 145 290 100.0 0 0 0 0.0 0 1 1 0.3 145 144 289 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 247 241 488 0 0 0 0.0 1 1 0 0.0 246 240 486 99.6 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 247 241 488 100.0 0 0 0 0.0 68 0 0 0.0 179 241 420 86.1 0 0 0 0.0
14 SIDOWALUYO 280 279 559 280 282 562 0 0 0 0.0 1 0 1 0.2 279 282 561 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 280 282 562 100.0 0 0 0 0.0 1 0 1 0.2 279 282 561 99.8 0 0 0 0.0
15 SIDOREJO 332 330 662 275 269 544 0 0 0 0.0 0 1 1 0.2 275 268 543 99.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 275 269 544 100.0 0 0 0 0.0 0 1 1 0.2 275 268 543 99.8 0 0 0 0.0
16 SIDOMULYO 244 237 481 161 141 302 0 0 0 0.0 0 0 0 0.0 161 141 302 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 161 141 302 100.0 0 0 0 0.0 0 0 0 0.0 161 141 302 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2202 2145 4347 0 0 0 0.0 7 10 15 0.3 2195 2135 4330 99.6 0 0 0 0.0 0 0 0 0.0 2 7 9 0.2 2200 2138 4338 99.8 0 1 1 0.0 73 12 17 0.4 2129 2132 4261 98.0 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : OKTOBER / 2020.
ta
ali
B
an
ar
S as
ah
ml
Ju
No Desa
1 BANDAR DALAM 189 166 355 167 161 328 0 0 0 0.0 0 1 1 0.3 167 160 327 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 167 161 328 100.0 0 0 0 0.0 1 1 2 0.6 166 160 326 99.4 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 113 119 232 0 0 0 0.0 0 4 4 1.7 113 115 228 98.3 0 0 0 0.0 0 0 0 0.0 0 4 4 1.7 113 115 228 98.3 0 0 0 0.0 0 4 4 1.7 113 115 228 98.3 0 0 0 0.0
3 TALANG BARU 93 83 176 83 76 159 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0
4 SUKA BANJAR 200 187 387 185 176 361 0 0 0 0.0 0 0 0 0.0 185 176 361 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 185 176 361 100.0 0 0 0 0.0 2 3 5 1.4 183 173 356 98.6 0 0 0 0.0
5 BANJAR SURI 99 93 192 93 99 192 0 0 0 0.0 0 0 0 0.0 93 99 192 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 93 99 192 100.0 0 0 0 0.0 0 0 0 0.0 93 99 192 100.0 0 0 0 0.0
6 KOTA DALAM 108 105 213 90 90 180 0 0 0 0.0 0 0 0 0.0 90 90 180 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 90 90 180 100.0 0 0 0 0.0 0 0 0 0.0 90 90 180 100.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 69 57 126 0 0 0 0.0 0 0 0 0.0 69 57 126 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 69 57 126 100.0 0 0 0 0.0 0 0 0 0.0 69 57 126 100.0 0 0 0 0.0
8 SIRING JAHA 77 73 150 70 65 135 0 0 0 0.0 0 0 0 0.0 70 65 135 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 70 65 135 100.0 0 0 0 0.0 0 0 0 0.0 70 65 135 100.0 0 0 0 0.0
9 SUAK 195 183 378 160 160 320 0 0 0 0.0 12 10 22 6.9 148 150 298 93.1 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 160 160 320 100.0 0 0 0 0.0 0 0 0 0.0 160 160 320 100.0 0 0 0 0.0
10 SUKA MAJU 66 67 133 56 58 114 0 0 0 0.0 1 3 4 3.5 55 55 110 96.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 56 58 114 100.0 0 0 0 0.0 0 0 0 0.0 56 58 114 100.0 0 0 0 0.0
11 SUKA MARGA 78 75 153 71 67 138 0 0 0 0.0 0 0 0 0.0 71 67 138 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 71 67 138 100.0 0 0 0 0.0 0 0 0 0.0 71 67 138 100.0 0 0 0 0.0
12 SELORETNO 164 164 328 150 146 296 0 0 0 0.0 0 1 1 0.3 150 145 295 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 150 146 296 100.0 0 0 0 0.0 0 1 1 0.3 150 145 295 99.7 0 0 0 0.0
13 SIDODADI 346 337 683 214 216 430 0 0 0 0.0 69 72 141 32.8 145 144 289 67.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 214 216 430 100.0 0 0 0 0.0 68 0 0 0.0 146 216 362 84.2 0 0 0 0.0
14 SIDOWALUYO 280 279 559 288 279 567 0 0 0 0.0 2 1 3 0.5 286 278 564 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 288 279 567 100.0 0 0 0 0.0 0 0 0 0.0 288 279 567 100.0 0 0 0 0.0
15 SIDOREJO 332 330 662 276 267 543 0 0 0 0.0 0 0 0 0.0 276 267 543 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 276 267 543 100.0 0 0 0 0.0 0 0 0 0.0 276 267 543 100.0 0 0 0 0.0
16 SIDOMULYO 244 237 481 159 144 303 0 0 0 0.0 0 0 0 0.0 159 144 303 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 159 144 303 100.0 0 0 0 0.0 0 0 0 0.0 159 144 303 100.0 0 0 0 0.0
TOTAL 2713 2609 5322 2244 2180 4424 0 0 0 0.0 84 92 176 4.0 2160 2088 4248 96.0 0 0 0 0.0 0 0 0 0.0 0 4 4 0.1 2244 2176 4420 99.9 0 0 0 0.0 71 9 12 0.3 2173 2171 4344 98.2 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : NOVEMBER/ 2020.
lita
Ba
n
ra
sa
Sa
ah

ml
No Desa
Ju
1 BANDAR DALAM 189 166 355 165 163 328 0 0 0 0.0 0 1 1 0.3 165 162 327 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 165 163 328 100.0 0 0 0 0.0 2 2 4 1.2 163 161 324 98.8 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 112 118 230 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0 1 3 4 1.7 111 115 226 98.3 0 0 0 0.0
3 TALANG BARU 93 83 176 83 76 159 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 1 1 2 1.3 82 75 157 98.7 0 0 0 0.0
4 SUKA BANJAR 200 187 387 183 171 354 0 0 0 0.0 0 0 0 0.0 183 171 354 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 183 171 354 100.0 0 0 0 0.0 1 2 3 0.8 182 169 351 99.2 0 0 0 0.0
5 BANJAR SURI 99 93 192 89 92 181 0 0 0 0.0 0 0 0 0.0 89 92 181 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 89 92 181 100.0 0 0 0 0.0 1 1 2 1.1 88 91 179 98.9 0 0 0 0.0
6 KOTA DALAM 108 105 213 97 97 194 0 0 0 0.0 0 0 0 0.0 97 97 194 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 97 97 194 100.0 0 0 0 0.0 1 1 2 1.0 96 96 192 99.0 0 0 0 0.0
7 BUDI DAYA 96 93 189 61 49 110 0 0 0 0.0 0 0 0 0.0 61 49 110 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 61 49 110 100.0 0 0 0 0.0 1 1 2 1.8 60 48 108 98.2 0 0 0 0.0
8 SIRING JAHA 77 73 150 71 69 140 0 0 0 0.0 0 0 0 0.0 71 69 140 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 71 69 140 100.0 0 0 0 0.0 0 2 2 1.4 71 67 138 98.6 0 0 0 0.0
9 SUAK 195 183 378 160 160 320 0 0 0 0.0 2 1 3 0.9 158 159 317 99.1 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 160 160 320 100.0 0 0 0 0.0 2 0 2 0.6 158 160 318 99.4 0 0 0 0.0
10 SUKA MAJU 66 67 133 63 59 122 0 0 0 0.0 1 3 4 3.3 62 56 118 96.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 63 59 122 100.0 0 0 0 0.0 1 1 2 1.6 62 58 120 98.4 0 0 0 0.0
11 SUKA MARGA 78 75 153 67 68 135 0 0 0 0.0 0 0 0 0.0 67 68 135 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 67 68 135 100.0 0 0 0 0.0 1 1 2 1.5 66 67 133 98.5 0 0 0 0.0
12 SELORETNO 164 164 328 148 145 293 0 0 0 0.0 0 0 0 0.0 148 145 293 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 148 145 293 100.0 0 0 0 0.0 1 1 2 0.7 147 144 291 99.3 0 0 0 0.0
13 SIDODADI 346 337 683 216 210 426 0 0 0 0.0 69 72 141 33.1 147 138 285 66.9 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 216 210 426 100.0 0 0 0 0.0 1 3 4 0.9 215 207 422 99.1 0 0 0 0.0
14 SIDOWALUYO 280 279 559 279 276 555 0 0 0 0.0 2 1 3 0.5 277 275 552 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 279 276 555 100.0 0 0 0 0.0 1 2 3 0.5 278 274 552 99.5 0 0 0 0.0
15 SIDOREJO 332 330 662 276 267 543 0 0 0 0.0 0 0 0 0.0 276 267 543 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 276 267 543 100.0 0 0 0 0.0 2 1 3 0.6 274 266 540 99.4 0 0 0 0.0
16 SIDOMULYO 244 237 481 155 149 304 0 0 0 0.0 0 0 0 0.0 155 149 304 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 155 149 304 100.0 0 0 0 0.0 3 0 3 1.0 152 149 301 99.0 0 0 0 0.0
TOTAL 2713 2609 5322 2225 2169 4394 0 0 0 0.0 75 81 156 3.6 2150 2088 4238 96.4 0 0 0 0.0 0 0 0 0.0 1 3 4 0.1 2224 2166 4390 99.9 0 0 0 0.0 20 22 42 1.0 2205 2147 4352 99.0 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
PROVINSI : LAMPUNG
BULAN/TAHUN : DESEMBER / 2020.
ta
ali
nB
ra
sa
Sa
ah
ml
No Desa
Ju
1 BANDAR DALAM 189 166 355 163 157 320 0 0 0 0.0 0 0 0 0.0 163 157 320 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 163 157 320 100.0 0 0 0 0.0 2 2 4 1.3 161 155 316 98.8 0 0 0 0.0
2 CAMPANG TIGA 146 137 283 112 118 230 0 0 0 0.0 1 1 2 0.9 111 117 228 99.1 0 0 0 0.0 0 0 0 0.0 1 1 2 0.9 111 117 228 99.1 0 0 0 0.0 1 1 2 0.9 111 117 228 99.1 0 0 0 0.0
3 TALANG BARU 93 83 176 83 76 159 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 83 76 159 100.0 0 0 0 0.0 1 1 2 1.3 82 75 157 98.7 0 0 0 0.0
4 SUKA BANJAR 200 187 387 180 175 355 0 0 0 0.0 0 0 0 0.0 180 175 355 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 180 175 355 100.0 0 0 0 0.0 1 2 3 0.8 179 173 352 99.2 0 0 0 0.0
5 BANJAR SURI 99 93 192 93 94 187 0 0 0 0.0 0 0 0 0.0 93 94 187 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 93 94 187 100.0 0 0 0 0.0 1 1 2 1.1 92 93 185 98.9 0 0 0 0.0
6 KOTA DALAM 108 105 213 95 95 190 0 0 0 0.0 0 0 0 0.0 95 95 190 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 95 95 190 100.0 0 0 0 0.0 1 1 2 1.1 94 94 188 98.9 0 0 0 0.0
7 BUDI DAYA 96 93 189 77 77 154 0 0 0 0.0 0 0 0 0.0 77 77 154 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 77 77 154 100.0 0 0 0 0.0 1 1 2 1.3 76 76 152 98.7 0 0 0 0.0
8 SIRING JAHA 77 73 150 51 59 110 0 0 0 0.0 0 0 0 0.0 51 59 110 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 51 59 110 100.0 0 0 0 0.0 1 1 2 1.8 50 58 108 98.2 0 0 0 0.0
9 SUAK 195 183 378 185 174 359 0 0 0 0.0 2 0 2 0.6 183 174 357 99.4 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 185 174 359 100.0 0 0 0 0.0 1 2 3 0.8 184 172 356 99.2 0 0 0 0.0
10 SUKA MAJU 66 67 133 64 62 126 0 0 0 0.0 1 3 4 3.2 63 59 122 96.8 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 64 62 126 100.0 0 0 0 0.0 1 1 2 1.6 63 61 124 98.4 0 0 0 0.0
11 SUKA MARGA 78 75 153 62 61 123 0 0 0 0.0 0 0 0 0.0 62 61 123 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 62 61 123 100.0 0 0 0 0.0 1 1 2 1.6 61 60 121 98.4 0 0 0 0.0
12 SELORETNO 164 164 328 149 150 299 0 0 0 0.0 0 1 1 0.3 149 149 298 99.7 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 149 150 299 100.0 0 0 0 0.0 2 2 4 1.3 147 148 295 98.7 0 0 0 0.0
13 SIDODADI 346 337 683 247 240 487 0 0 0 0.0 80 75 155 31.8 167 165 332 68.2 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 247 240 487 100.0 0 0 0 0.0 1 3 4 0.8 246 237 483 99.2 0 0 0 0.0
14 SIDOWALUYO 280 279 559 290 281 571 0 0 0 0.0 2 1 3 0.5 288 280 568 99.5 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 290 281 571 100.0 0 0 0 0.0 2 1 3 0.5 288 280 568 99.5 0 0 0 0.0
15 SIDOREJO 332 330 662 269 262 531 0 0 0 0.0 0 0 0 0.0 269 262 531 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 269 262 531 100.0 0 0 0 0.0 2 1 3 0.6 267 261 528 99.4 0 0 0 0.0
16 SIDOMULYO 244 237 481 164 152 316 0 0 0 0.0 0 0 0 0.0 164 152 316 100.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 164 152 316 100.0 0 0 0 0.0 3 0 3 0.9 161 152 313 99.1 0 0 0 0.0
TOTAL 2713 2609 5322 2284 2233 4517 0 0 0 0.0 86 81 167 3.7 2198 2152 4350 96.3 0 0 0 0.0 0 0 0 0.0 1 1 2 0.0 2283 2232 4515 100.0 0 0 0 0.0 22 21 43 1.0 2262 2212 4474 99.0 0 0 0 0.0
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR REKAPITULASI KASUS GIZI BURUK DI PUSKESMAS
Provinsi : Lampung Selatan

Kabupaten/Kota : Lampung Selatan
Puskesmas/ Kecamatan : Rawat Inap Sidomulyo/Sidomulyo
Bulan/Tahun :Triwulan 1 / 2020
JANUARI FEBRUARI MARET

Total Jumlah Total Total Jumlah Total Total Jumlah Total
Kasus kasus gizi kasus gizi Kasus kasus gizi kasus gizi Kasus kasus gizi kasus gizi
Jumlah (Kumulatif buruk dpt buruk dpt Persentase Jumlah Jumlah Jumlah (Kumulatif buruk dpt buruk dpt Persentase Jumlah Jumlah Jumlah (Kumulatif buruk dpt buruk dpt Persentase Jumlah Jumlah
No Desa
Kasus balita sampai perawatan perawatan mendapat kasus kasus Kasus balita sampai perawatan perawatan mendapat kasus kasus Kasus balita sampai perawatan perawatan mendapat kasus kasus
gizi buruk bulan ini) pertama (Kumulatif perawatan membaik meninggal gizi buruk bulan ini) pertama (Kumulatif perawatan membaik meninggal gizi buruk bulan ini) pertama (Kumulatif perawatan membaik meninggal
bulan ini kali di sampai bulan ini bulan ini bulan ini kali di sampai bulan ini bulan ini bulan ini kali di sampai bulan ini bulan ini
bulan ini bulan ini) bulan ini bulan ini) bulan ini bulan ini)
1 2 3 4=3 5 6=5 7=6/4*100 8 9 10 11=(4+10) 12 13=(6+12)14=13/11*100 15 16 17 18=11+17 19 20=13+1921=20/18*100 22 23
1 BANDAR DALAM
2 CAMPANG TIGA
3 TALANG BARU
4 SUKA BANJAR
5 BANJAR SURI
6 KOTA DALAM
7 BUDI DAYA
IL
8 SIRING JAHA
IH
9 SUAK
N
10 SUKA MAJU
11 SUKA MARGA
12 SELORETNO
13 SIDODADI
14 SIDOWALUYO
15 SIDOREJO
16 SIDOMULYYO
TOTAL
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

Bulan/Tahun : Februari/2020APRIL 2019
APRIL MEI JUNI

No Desa
24 25=18+24 26 27=20+2628=27/25*100 29 30 31 32=25+31 33 34=27+3335=34/32*100 36 37 38 39=32+38 40 41=34+40 42 43 44
1 BANDAR DALAM
2 CAMPANG TIGA
3 TALANG BARU
4 SUKA BANJAR
5 BANJAR SURI
6 KOTA DALAM
7 BUDI DAYA
IL
8 SIRING JAHA
IH
9 SUAK
N
10 SUKA MAJU
11 SUKA MARGA
12 SELORETNO
13 SIDODADI
14 SIDOWALUYO
15 SIDOREJO
16 SIDOMULYYO
TOTAL
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

Bulan/Tahun : ..........................................................
JULI AGUSTUS SEPTEMBER

No Desa
45 46=39+45 47 48=41+4749=48/46*100 50 51 52 53=46+52 54 55=48+5456=55/53*100 57 58 59 60=53+59 61 62=55+6163=62/60*100 64 65
1 BANDAR DALAM
2 CAMPANG TIGA
3 TALANG BARU
4 SUKA BANJAR
5 BANJAR SURI
6 KOTA DALAM
7 BUDI DAYA
IL
8 SIRING JAHA
IH
9 SUAK
N
10 SUKA MAJU
11 SUKA MARGA
12 SELORETNO
13 SIDODADI
14 SIDOWALUYO
15 SIDOREJO
16 SIDOMULYYO
TOTAL
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004

Bulan/Tahun : ..........................................................
0KTOBER NOVEMBER DESEMBER

No Desa
45 46=39+45 47 48=41+4749=48/46*100 50 51 52 53=46+52 54 55=48+5456=55/53*100 57 58 59 60=53+59 61 62=55+6163=62/60*100 64 65
1 BANDAR DALAM
2 CAMPANG TIGA
3 TALANG BARU
4 SUKA BANJAR
5 BANJAR SURI
6 KOTA DALAM
7 BUDI DAYA
IL
8 SIRING JAHA
IH
9 SUAK
N
10 SUKA MAJU
11 SUKA MARGA
12 SELORETNO
13 SIDODADI
14 SIDOWALUYO
15 SIDOREJO
16 SIDOMULYYO
TOTAL
Mengetahui
Sidomulyo

NIP. 19820723 201001 1 014 NIP. 19670115 198903 2 004
FORMULIR PEMANTAUAN PROGRAM PEMBERIAN TTD REMAJA PUTRI DISEKOLAH
Kelas : Triwulan :
Nama Sekolah : Tahun : 2020
Nama Puskesmas Pembina : Puskesmas Rawat Inap Sidomulyo
JANUARI FEBRUARI MARET Jumlah Jumlah Jumlah

No Nama Remaja Putri NIK 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 minggu yg TTD di TTD di
T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M dilalui Terima (T) minum (M)
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
Keterangan :
Isilah Kolom T dan M dengan angka 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika terima TTD dan angka nol (0) jika tidak terima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka nol (0) jika tidak minum TTD
Kolom jumlah mingguyang di lalui diisi dengan jumlah minggu yang dilalui remaja putri umur 12-18 taahun pada triwulan tersebut.
FORMULIR PEMANTAUAN PROGRAM PEMBERIANTTD REMAJA PUTRI DISEKOLAH
Kelas : Triwulan :
APRIL MEI JUNI Jumlah Jumlah Jumlah

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
Keterangan :
T : Terima TTD
M : Minum TTD
Kelas : Triwulan :
JULI AGUSTUS SEPTEMBER Jumlah Jumlah Jumlah

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
Keterangan :
T : Terima TTD
M : Minum TTD
Kelas : Triwulan :
OKTOBER NOVEMBER DESEMBER Jumlah Jumlah Jumlah

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
Keterangan :
T : Terima TTD
M : Minum TTD
FORMULIR 1 PEMANTAUAN PROGRAM TTD REMAJA PUTRI DI PUSKESMAS
TAHUN 2020
Nama Sekolah :
TW 1 TW 1-TW 2 TW 1-TW 3 TW 1-TW 4

Jumlah Jumlah % TTD Jumlah % TTD Jumlah Jumlah % TTD Jumlah % TTD Jumlah Jumlah % TTD Jumlah % TTD Jumlah Jumlah % TTD Jumlah % TTD
Nama Remaja Putri NIK minggu TTD di TTD di minggu TTD di TTD di minggu TTD di TTD di minggu TTD di TTD di
yang terima Di Terima minum Di Minum yang terima Di Terima minum Di Minum yang terima Di Terima minum Di Minum yang terima Di Terima minum Di Minum
lalui dari (T) (T) (M) (M) lalui dari (T) (T) (M) (M) lalui dari (T) (T) (M) (M) lalui dari (T) (T) (M) (M)
No Jan-Mart Jan-Juni Jan-Sept Jan-Des
1 2 3 4 5 6=5/4*100 7 8=7/4*100 9 10 11=10/9*100 12 13=12/9*100 14 15 16=15/14*100 17 18=1/14*100 19 20 21=20/19*100 22 23=22/19*100
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
Keteranga :
Kolom Jumlah minggu yang dilalui diisi dengan jumlah minggu yang dilalui remaja putriumur 12-18 tahun pada Triwulaan tersebut
Kolom Persentase TTD diterima (%) diisi dengan persentasejumlah tablet diterima terhadap jumlah minggu
Kolom Persentase TTD di minum (%) dengan persentasejumlah tablet di minum terhadap jumlah minggu
Catatan Stok :
1. Jumlah TTD sisa Bulan Lalu : Tablet Tanggal :
2. Jumlah TTD yang diterima : Tablet Tanggal :
3. Jumlah Total Stok : Tablet Tanggal :
4Jumlah TTD yang dipakai : Tablet Tanggal :
5. Jumlah TTD Sisa : Tablet Tanggal :
FORMULIR 2 PEMANTAUAN PROGRAM TTD REMAJA PUTRI DI PUSKESMAS
TAHUN 2020
Nama Puskesmas Pembina : UPTD Puskesmas Rawat Inap Sidomulyo
Jumlah TW 1 TW 1- TW 2 TW 1- TW 3 TW 1- TW 4
No Nama Sekolah Siswi Jumlah Mendapat TTD Jumlah Minum TTD Jumlah Mendapat TTD Jumlah Minum TTD Jumlah Mendapat TTD Jumlah Minum TTD Jumlah Mendapat TTD Jumlah Minum TTD
≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100% ≤ 50% 51-80% 81-99% ≥ 100%
1 MTs Sidowaluyo
2 SLTP Satap Suak
3 MTS Alkhoiriyah Suak
4 SMPN Siring Jaha
5 SMPN 2 Suka Banjar
6 MTs Raudlatul Ulum
7 MTs Darul Fatah
8 SMP Satap 3 Campang Tiga
9 MTs Wasilatul Huda
10 SMP Satap Kalimati
11 MTs.Thoriqul Jannah
12 MTs Sidorejo
13 SMPN 1 Sidomulyo
IL
14 SMP Muhammdaiyah
IH
15 SMP Dharma Bina Putra
N
16 SMP IT Alkholis
17 MTs. Alkhoiriyah
18 SMP Yaditama Plus
19 SMAN 1 Sidomulyo
20 SMK Yditama
21 SMK Dharma Putra
22 SMK YP Al Mubarok
23 MA Al Khoiriyah
24 SLTA DBP
25 SMA Muhamaddiyah
26 MA.Matlaul Anwar
27 SMKN 1 Sidomulyo
28
Total
Keterangan :
Kolom Kategori Persentse ( ≤50%,, 51-80%, 81-99%, ≥ 100% ) diisi dengan jumlah rematri umur 12-18 tahun yang masuk Koordinator Gizi
kategori tersebut berdasarkan form 1 Puskesmas.
Catatan Stok :
1. Jumlah TTD sisa Bulan Lalu : Tablet Tanggal : Tri Hendras P, SKM
2. Jumlah TTD yang diterima : Tablet Tanggal : NIP. 19670115 19803 2 004
3. Jumlah Total Stok : Tablet Tanggal :
4Jumlah TTD yang dipakai : Tablet Tanggal :
5. Jumlah TTD Sisa : Tablet Tanggal :

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FORMULIR REKAPITULASI SKDN

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah SKDN BALITA KURUS

dr. Rocky J.D. Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah BAYI BARU LAHIR BAYI ASI EKSKLUSIF

(proyeksi) L P L+P L P L+P % L P L+P L P L+P % L P L+P L P L+P %

1 BANDAR DALAM 71 3 3 6 2 1 3 50.0 3 3 6 0 1 1 16.7 18 17 35 0 0 0 0.0

2 CAMPANG TIGA 58 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 14 13 27 3 0 3 11.1

3 TALANG BARU 35 2 1 3 1 1 2 66.7 2 1 3 0 0 0 0.0 9 8 17 0 0 0 0.0

4 SUKA BANJAR 79 3 1 4 1 1 2 50.0 3 1 4 0 0 0 0.0 19 18 37 0 0 0 0.0

5 BANJAR SURI 39 0 3 3 0 1 1 33.3 0 3 3 0 0 0 0.0 10 9 19 0 0 0 0.0

6 KOTA DALAM 45 7 2 9 2 1 3 33.3 7 2 9 0 0 0 0.0 11 10 21 0 0 0 0.0

7 BUDI DAYA 40 2 0 2 1 0 1 50.0 2 0 2 0 0 0 0.0 9 9 18 2 1 3 16.7

8 SIRING JAHA 31 0 1 1 0 1 1 0.0 0 1 1 0 1 1 0.0 7 7 14 0 0 0 0.0

9 SUAK 78 2 6 8 1 5 6 75.0 2 6 8 0 0 0 0.0 19 18 37 4 8 12 32.4

10 SUKA MAJU 29 0 2 2 0 1 1 50.0 0 2 2 0 0 0 0.0 7 6 13 0 0 0 0.0

11 SUKA MARGA 32 1 1 2 1 1 2 100.0 1 1 2 0 0 0 0.0 8 7 15 1 1 2 13.3

12 SELORETNO 70 6 2 8 3 1 4 50.0 6 2 8 1 0 1 12.5 16 15 31 0 0 0 0.0

13 SIDODADI 142 5 5 10 4 4 8 80.0 5 5 10 0 0 0 0.0 34 32 66 0 0 0 0.0

14 SIDOWALUYO 119 7 4 11 2 4 6 54.5 7 4 11 2 1 3 27.3 28 26 54 0 0 0 0.0

15 SIDOREJO 140 5 6 11 3 2 5 45.5 5 6 11 0 0 0 0.0 33 31 64 0 0 0 0.0

16 SIDOMULYO 101 3 4 7 1 1 2 28.6 3 4 7 0 0 0 0.0 24 23 47 0 0 0 0.0

JUMLAH 1109 48 42 90 23 26 49 54.4 48 42 90 3 3 6 6.7 266 249 515 10 10 20 3.9

dr. Rocky J.D.Sihombing Tri Hendras P, SKM

PUSKEMAS : RAWAT INAP SIDOMULYO

Jumlah BAYI BARU LAHIR BAYI ASI EKSKLUSIF

2 CAMPANG TIGA 58 0 3 3 0 0 0 0.0 0 3 3 0 0 0 0.0 14 13 27 1 8 9 33.3

3 TALANG BARU 35 2 2 4 0 2 2 50.0 2 2 4 0 0 0 0.0 9 8 17 3 4 7 41.2

4 SUKA BANJAR 79 3 3 6 3 0 3 50.0 3 3 6 0 1 1 16.7 19 18 37 1 0 1 2.7