LAPORAN PELAKSANAAN KEGIATAN

1. DASAR PENUGASAN : Surat tugas Kepala Puskesmas Mangulewa,tanggal, / /2021

Nomor : 879/MGLW/ / /2021

2. MAKSUD/TUJUAN :Perjalanan Dinas Dalam Rangka Kunjungan dan konseling

Orang Dengan Gangguan Jiwa (ODGJ )

3. SASARAN/YANG DITEMUI :Orang Dengan Gangguan Jiwa Berat ( ODGJ )

4. TEMPAT DAN WAKTU : Kelurahan Mangulewa,21 /05 /2021

5. HASIL KEGIATAN :
a. Nama : Ny. Y.N
b. Umur : 28 Tahun
c. Riwayat ODGJ :
Dialami sejak beberapa hari yang lalu,pasien mengatakan mempunyai suami anggota
DPR . Dia menggendong anaknya kemana mana dan mengatakan kalau anak itu adalah
anaknya bersama anggota DPR. Pasien juga merasa kalau dia yang paling cantik disekitar
tempat tinggalnya.
d. Pemeriksaan Fisik :
Saat dilakukan kunjungan pasien nampak rapi dan bersih, kooperatif saat di tanya tetapi
kadang kadang juga pasien berontak
TTV : TD : 100/70 mmHg
6. PERMASALAHAN YANG DIHADAPI :
Pasien kadang berontak tidak mau minum obat
7. KESIMPULAN/SARAN PERBAIKAN :
1. Dari hasil anamnese pasien mengalami waham kebesaran dan halusinasi penglihatan
2. Menganjurkan keluarga agar menjaga pasien agar tidak jalan jalan dan teratur saat
minum obat
3. Menganjurkan keluarga selalu memberi support kepada pasien agar pasien dapat
menjalani semuanya dengan baik.

Mangulewa, 21 Mei 2021

MENGETAHUI
Kepala Puskesmas Mangulewa Yang Melaksanakan Tugas,

ANGELA MERICI BHOKI 1. Dr. Maria Fransiska Itu

NIP. 19780110 200012 2 005
2. Fridolinus Wonga
 LAPORAN PELAKSANAAN KEGIATAN

1. DASAR PENUGASAN : Surat tugas Kepala Puskesmas Mangulewa,tanggal, / /2021

Nomor : 879/MGLW/ / /2021

2. MAKSUD/TUJUAN :Perjalanan Dinas Dalam Rangka Kegiatan Pendataan

Orang Dengan Gangguan Jiwa ( ODGJB )

3. SASARAN/YANG DITEMUI :Orang Dengan Gangguan Jiwa ( ODGJB )

4. TEMPAT DAN WAKTU :Desa / Kel.: .............................., / /2021

5. HASIL KEGIATAN :
a. Nama /Umur : 1....................................../.......Tahun

2...................................../........Tahun

b. Riwayat ODGJ :

1............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
2............................................................................................................................................
..............................................................................................................................................
c. Pemeriksaan Fisik :
1............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
2............................................................................................................................................
..............................................................................................................................................
....................................................................................................................................
d. PERMASALAHAN YANG DIHADAPI :
1...............................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
2...............................................................................................................................................
.................................................................................................................................................
.......................................................................................................................................

e. KESIMPULAN/SARAN PERBAIKAN :
1...............................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
2...............................................................................................................................................
.................................................................................................................................................
.......................................................................................................................................
......................,................................2021
MENGETAHUI
Kepala Puskesmas Mangulewa Yang Melaksanakan Tugas,

...................................
ANGELA MERICI BHOKI
NIP. 19780110 200012 2 005
 LAPORAN PELAKSANAAN KEGIATAN

1. DASAR PENUGASAN : Surat tugas Kepala Puskesmas Mangulewa,tanggal, / /2021

Nomor : 879/MGLW/ / /2021

2. MAKSUD/TUJUAN :Perjalanan Dinas Dalam Rangka Kegiatan Pendataan

Orang Dengan Gangguan Jiwa Berat ( ODGJB )

3. SASARAN/YANG DITEMUI :Orang Dengan Gangguan Jiwa Berat ( ODGJB )

4. TEMPAT DAN WAKTU :Desa.............................., / /2021

5. HASIL KEGIATAN :
a. Nama /Umur : 1. ...................................../...... Tahun

2. ..................................../....... Tahun

3. .................................../ ....... Tahun

b. Riwayat ODGJ :

1..........................................................................................................................................

2............................................................................................................................................

3......................................................................................................................................

c. Pemeriksaan Fisik :
1............................................................................................................................................

2............................................................................................................................................

3........................................................................................................................................

d. PERMASALAHAN YANG DIHADAPI :

1...............................................................................................................................................

2...............................................................................................................................................

3.............................................................................................................................................

e. KESIMPULAN/SARAN PERBAIKAN :
1...............................................................................................................................................

2...............................................................................................................................................

3...............................................................................................................................................
......................,..............................2021
MENGETAHUI
Kepala Puskesmas Mangulewa Yang Melaksanakan Tugas,

ANGELA MERICI BHOKI ..................................

NIP. 19780110 200012 2 005
 LAPORAN PELAKSANAAN KEGIATAN

1. DASAR PENUGASAN :Surat tugas Kepala Puskesmas Mangulewa,tanggal,21 /05/2021

Nomor : 879/MGLW/ /05/2021

2. MAKSUD/TUJUAN :Perjalanan Dinas Dalam Rangka Kegiatan Kunjungan Rumah

dan konseling Orang Dengan Gangguan Jiwa ( ODGJ )

3. SASARAN/YANG DITEMUI :Penderita Diabetes Melitus

4. TEMPAT DAN WAKTU :Desa...............................Dusun........................., / /2018

5. HASIL KEGIATAN :
a. Nama :
b. Umur :
c. Alamat :
d. Riwayat DM :
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
a. Pemeriksaan Fisik :
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
6. PERMASALAHAN YANG DIHADAPI :
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................

7. KESIMPULAN/SARAN PERBAIKAN :
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................

......................,................................2018
MENGETAHUI
Kepala Puskesmas Mangulewa Yang Melaksanakan Tugas,

1. .....................................

ANGELA MERICI BHOKI 2. .....................................

NIP. 19780110 200012 2 005
 LAPORAN PELAKSANAAN KEGIATAN

1. DASAR PENUGASAN :Surat tugas Kepala Puskesmas Mangulewa,tanggal,21 /05/2021

Nomor : 879/MGLW/ / /2021

2. MAKSUD/TUJUAN :Perjalanan Dinas Dalam Rangka Kegiatan Pendataan

Orang Dengan Gangguan Jiwa Berat (ODGJB )
 3. SASARAN/YANG DITEMUI :Orang Dengan Gangguan Jiwa Berat ( ODGJB )

4. TEMPAT DAN WAKTU :Desa/ Kel : ............................., / /2021

5. HASIL KEGIATAN :
e. Nama :
f. Umur : Tahun
g. Riwayat ODGJ :
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
h. Pemeriksaan Fisik :
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
..............................................................................................................................................
6. PERMASALAHAN YANG DIHADAPI :
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................

7. KESIMPULAN/SARAN PERBAIKAN :
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................

......................,................................2021
MENGETAHUI
Kepala Puskesmas Mangulewa Yang Melaksanakan Tugas,

ANGELA MERICI BHOKI .....................................

NIP. 19780110 200012 2 005