SEPTEMBER TAHUN 2021

NO NAMA RW S K
POSYANDU 0-5 BLN 6-11 BLN 12 - 24 BLN 25 - 59 BLN 0-5 BLN 6-11 BLN 12 - 24 BLN 25 - 59 BLN 0 - 5 BLN
L P L P L P L P S D/S L P L P L P L P L
1 PARKIT .001 3 0 10 6 15 14 51 32 131 100 3 0 10 6 15 14 51 32 3
2 CAMAR .002 7 2 3 8 8 14 26 20 88 100 7 2 3 8 8 14 26 20 5
3 GELATIK A .003 8 2 4 8 23 25 62 57 189 100 8 2 4 8 23 25 62 57 7
4 GELATIK B .003 4 2 8 7 11 8 32 38 110 100 4 2 8 7 11 8 32 38 3
5 ELANG .004 6 3 8 7 7 8 42 31 112 100 6 3 8 7 7 8 42 31 6
6 MERPATI .005 0 0 4 0 1 1 9 12 27 100 0 0 4 0 1 1 9 12 0
7 GARUDA .006 2 0 1 1 7 4 8 19 42 100 2 0 1 1 7 4 8 19 2
8 CENDRAWASIH .007 3 3 2 2 5 4 24 29 72 100 3 3 2 2 5 4 24 29 3
2 ANGSA .008 4 2 4 3 4 6 20 19 62 100 4 2 4 3 4 6 20 19 4
1 KIJANG .009 2 0 0 0 3 2 11 13 31 100 2 0 0 0 3 2 11 13 0
11 KUTILANG .011 1 1 2 2 4 5 8 6 29 100 1 1 2 2 4 5 8 6 1
12 PANDA A .012 9 5 10 14 25 20 31 44 158 100 9 5 10 14 25 20 31 44 7
13 PANDA B .012 1 2 5 3 22 15 64 45 157 100 1 2 5 3 22 15 64 45 0
14 RUSA 013 8 6 19 17 32 30 44 43 199 100 8 6 19 17 32 30 44 43 6
15 MURAI .014 0 1 1 6 10 9 22 23 72 100 0 1 1 6 10 9 22 23 0
16 MERAK .015 1 3 5 6 9 7 32 33 96 100 1 3 5 6 9 7 32 33 1
KANCIL 016 1 3 3 3 7 8 22 28 75 100 1 3 3 3 7 8 22 28 1
18 KELINCI 017 4 2 4 5 19 11 49 40 134 100 4 2 4 5 19 11 49 40 2
CAMAR B .018 4 6 2 5 4 12 25 23 81 100 4 6 2 5 4 12 25 23 4
20 KANGURU A .019 7 4 22 20 31 12 77 30 203 100 7 4 22 20 31 12 77 30 7
21 KANGURU B .019 6 3 21 14 14 20 66 60 204 100 6 3 21 14 14 20 66 60 5
22 NURI 20 8 4 10 9 23 22 57 26 159 100 8 4 10 9 23 22 57 26 8
23 BANGAU 23 2 2 4 2 7 5 14 11 47 100 2 2 4 2 7 5 14 11 2
JUMLAH 91 56 152 148 291 262 796 682 91 56 152 148 291 262 796 682 75

B. SURVEILANS
BULAN = SEPTEMBER
ALAMAT LAHIR UMUR
NAMA (Bulan)
NO NAMA BALITA ORANG TUA
POSYANDU RW RT Tgl Bln Thn

16
17
18
19
20
21
22
23
24
25
26
27
28

C. KIA I. KUNJUNGAN KIA

BULAN = SEPTEMBER
NAMA UMUR
ALAMAT UMUR KEHAMILAN
N0 BUMIL HAMIL
(Bln)
SUAMI ISTRI (Thn) KE
POSYANDU RW RT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
C. KIA I. KUNJUNGAN KIA
BULAN = SEPTEMBER
NAMA UMUR
ALAMAT UMUR KEHAMILAN
BUMIL HAMIL
N0 (Thn) KE (Bln)
SUAMI ISTRI
POSYANDU RW RT
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
 LAPORAN BULANAN POSYANDU
KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN SEPTEMBER TAHUN 2021
A. SKDN
NAMA S K
RW POSYANDU 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN
L P L P L P L P L P L P L P L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 PARKIT 3 0 10 6 15 14 51 32 3 0 10 6 15 14 51 32 3 0
2 CAMAR 7 2 3 8 8 14 26 20 7 2 3 8 8 14 26 20 5 1
3 GELATIK A 8 2 4 8 23 25 62 57 8 2 4 8 23 25 62 57 7 2
GELATIK B 4 2 8 7 11 8 32 38 4 2 8 7 11 8 32 38 3 2
4 ELANG 6 3 8 7 7 8 42 31 6 3 8 7 7 8 42 31 6 3
5 MERPATI 0 0 4 0 1 1 9 12 0 0 4 0 1 1 9 12 0 0
6 GARUDA 2 0 1 1 7 4 8 19 2 0 1 1 7 4 8 19 2 0
7 CENDRAWASIH 3 3 2 2 5 4 24 29 3 3 2 2 5 4 24 29 3 3
8 ANGSA 4 2 4 3 4 6 20 19 4 2 4 3 4 6 20 19 4 2
9 KIJANG 2 0 0 0 3 2 11 13 2 0 0 0 3 2 11 13 0 0
11 KUTILANG 1 1 2 2 4 5 8 6 1 1 2 2 4 5 8 6 1 1
12 PANDA A 9 5 10 14 25 20 31 44 9 5 10 14 25 20 31 44 7 4
PANDA B 1 2 5 3 22 15 64 45 1 2 5 3 22 15 64 45 0 2
13 RUSA 8 6 19 17 32 30 44 43 8 6 19 17 32 30 44 43 6 6
14 MURAI 0 1 1 6 10 9 22 23 0 1 1 6 10 9 22 23 0 1
15 MERAK 1 3 5 6 9 7 32 33 1 3 5 6 9 7 32 33 1 3
16 KANCIL 1 3 3 3 7 8 22 28 1 3 3 3 7 8 22 28 1 3
17 KELINCI 4 2 4 5 19 11 49 40 4 2 4 5 19 11 49 40 2 1
18 CAMAR B 4 6 2 5 4 12 25 23 4 6 2 5 4 12 25 23 4 5
19 KANGURU A 7 4 22 20 31 12 77 30 7 4 22 20 31 12 77 30 7 4
KANGURU B 6 3 21 14 14 20 66 60 6 3 21 14 14 20 66 60 5 3
20 NURI 8 4 10 9 23 22 57 26 8 4 10 9 23 22 57 26 8 4
21 BANGAU 2 2 4 2 7 5 14 11 2 2 4 2 7 5 14 11 2 2
JUMLAH 91 56 152 148 291 262 796 682 91 56 152 148 291 262 796 682 75 50
LAPORAN BULANAN POSYANDU
 KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN SEPTEMBER TAHUN 2021
NAMA O B
RW POSYANDU 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN
L P L P L P L P L P L P L P L P L P
1 2 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
1 PARKIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
2 CAMAR 0 0 0 0 0 0 0 0 2 1 0 2 0 2 1 0 7 2
3 GELATIK A 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 8 2
GELATIK B 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 4 2
4 ELANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3
5 MERPATI 0 0 0 0 0 0 0 0 0 0 3 0 0 1 2 2 0 0
6 GARUDA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
7 CENDRAWASIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3
8 ANGSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2
9 KIJANG 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 0
11 KUTILANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
12 PANDA A 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 9 5
PANDA B 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 0 1 2
13 RUSA 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 8 6
14 MURAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
15 MERAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3
16 KANCIL 0 0 0 0 0 0 0 0 1 0 1 2 0 0 0 1 1 3
17 KELINCI 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 4 2
18 CAMAR B 0 0 0 0 0 0 0 0 0 1 0 2 0 2 1 0 4 6
19 KANGURU A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 4
KANGURU B 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 6 3
20 NURI 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 8 4
21 BANGAU 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 2 2
JUMLAH 0 0 0 0 1 1 0 2 15 4 4 6 0 5 4 3 91 56
SEPTEMBER TAHUN 2021 D. IMUNISASI
JENIS IMUNISASI
NAMA
DPT POLIO HIPATITIS
RW POSYANDU BCG
I II III I II III IV I
L P L P L P L P L P L P L P L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 PARKIT 1 1 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0 0
2 CAMAR 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1 0
3 GELATIK A 0 0 2 2 1 1 1 0 0 0 2 2 1 1 1 0 0 0
GELATIK B 1 0 1 0 0 2 0 0 1 0 1 0 0 0 2 0 0 0
4 ELANG 1 0 1 0 1 1 1 2 1 0 1 0 1 1 1 2 1 0
5 MERPATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 GARUDA 0 0 0 0 0 0 0 0 0 0 0 0 0 o 0 0 0 0
7 CENDRAWASIH 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
8 ANGSA 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1 0
9 KIJANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 KUTILANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 PANDA A 1 0 2 0 2 0 0 0 1 0 2 0 0 2 0 0 0 0
 PANDA B 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 0 0
13 RUSA 2 0 1 1 2 3 2 0 2 0 0 1 2 3 2 0 1 1
14 MURAI 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0 0 0 0
15 MERAK 0 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0 0 1
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 KELINCI 0 1 2 1 2 0 0 0 0 1 2 0 0 0 0 0 0 0
18 CAMAR B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 KANGURU A 0 0 2 2 3 0 1 1 0 0 2 2 3 0 1 1 1 0
KANGURU B 1 2 1 1 0 0 1 0 1 2 1 1 0 0 1 0 0 0
20 NURI 1 0 0 1 1 0 0 1 0 0 1 1 1 0 1 3 1 1
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 11 6 15 11 14 8 9 6 9 6 15 10 10 8 12 8 7 3

SEPTEMBER TAHUN 2021

G. KB J. VITAMIN A
ALAT KONTRASEPSI
JML SASARAN
RW NAMA IUD MOW MOP IMPLANT SUNTIK PIL KONDOM
POSYANDU JUMLAH PESERTA 6 - 11 BLN 12-59 BLN
P S P S P S P S P S P S P S L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 PARKIT 14 7 0 0 0 0 0 0 34 18 39 2 0 0 0 0 0 0
2 CAMAR 0 0 0 0 0 0 0 0 0 31 0 12 10 0 0 0 0 0
3 GELATIK A 23 11 3 4 2 4 3 3 25 22 15 15 1 1 0 0 0 0
GELATIK B 2 0 0 0 0 0 0 0 15 0 20 0 3 0 0 0 0 0
4 ELANG 4 0 0 0 0 0 1 0 30 3 1 7 0 5 0 0 0 0
5 MERPATI 2 28 0 0 0 0 0 0 3 35 0 11 0 9 0 0 0 0
6 GARUDA 2 11 0 0 0 0 0 0 3 6 3 0 15 0 0 0 0 0
7 CENDRAWASIH 8 11 0 1 0 0 1 2 20 15 3 8 23 28 0 0 0 0
8 ANGSA 3 0 1 0 0 0 2 0 25 0 18 0 0 0 0 0 0 0
9 KIJANG 0 0 0 0 0 0 4 3 15 4 2 3 0 5 0 0 0 0
11 KUTILANG 0 8 0 0 0 0 2 0 6 0 0 12 0 8 0 0 0 0
 12 PANDA A 5 0 0 0 0 0 4 0 90 0 0 10 0 0 0 0 0 0
PANDA B 1 0 0 0 0 0 0 0 13 21 9 7 1 0 0 0 0 0
13 RUSA 5 3 3 2 0 0 3 2 35 42 47 27 0 0 0 0 0 0
14 MURAI 1 0 0 2 0 0 1 0 15 0 20 0 3 0 0 0 0 0
15 MERAK 5 0 0 8 0 0 3 0 35 0 27 0 10 0 0 0 0 0
16 KANCIL 3 0 3 0 0 0 3 0 27 0 23 0 0 0 0 0 0 0
17 KELINCI 0 11 0 11 0 2 0 7 42 31 0 25 0 7 0 5 0 0
18 CAMAR B 2 0 0 0 0 0 0 0 30 0 0 10 0 0 0 0 0 0
19 KANGURU A 7 0 3 0 0 0 3 0 22 46 10 49 0 7 0 0 0 0
KANGURU B 10 0 5 0 0 0 10 0 50 0 10 0 8 0 0 0 0 0
20 NURI 10 0 5 0 0 0 10 0 50 0 10 0 8 0 0 0 0 0
21 BANGAU 1 2 0 0 0 0 0 0 3 15 0 19 0 0 0 0 0 0
JUMLAH 108 92 23 28 2 6 50 17 588 289 257 217 82 70 0 0 0 0

SEPTEMBER TAHUN 2021 F. KPPASI E. LANSIA

NO NAMA JML SASARAN JML YG HADIR JUMLAH SASARAN
UMUR
POSYANDU BUSUI BUSUI
BUMIL 0 - 6 7 - 24 BUMIL 0 - 6 7 - 24 45 - 59 Thn 60 - 69 Thn
BULAN BULAN BULAN BULAN L P L
1 2 3 4 5 6 7 8 9 10 11
1 PARKIT 6 3 45 6 3 45 100 125 20
2 CAMAR 4 8 23 4 8 23 50 50 40
3 GELATIK A 14 14 72 14 14 72 130 140 42
GELATIK B 6 8 29 6 8 29 141 140 32
4 ELANG 11 14 25 11 14 25 107 116 35
5 MERPATI 0 4 15 0 4 15 20 30 5
6 GARUDA 1 1 11 1 1 11 26 26 29
7 CENDRAWASIH 3 0 19 3 0 19 130 125 68
8 ANGSA 2 6 17 2 3 17 125 143 42
9 KIJANG 2 2 5 2 2 5 88 101 75
 11 KUTILANG 1 2 13 2 1 13 30 37 20
12 PANDA A 10 14 63 10 14 63 20 32 10
PANDA B 6 5 41 6 5 41 75 100 15
13 RUSA 8 16 96 8 16 96 79 132 100
14 MURAI 5 1 19 5 1 19 125 125 75
15 MERAK 9 7 20 9 7 20 0 0 0
16 KANCIL 6 3 33 6 3 33 50 70 39
17 KELINCI 6 9 44 6 9 44 120 149 31
18 CAMAR B 7 7 27 7 7 27 20 21 20
19 KANGURU A 9 0 43 10 13 72 30 33 10
KANGURU B 7 9 55 7 9 55 120 157 30
20 NURI 13 15 71 13 15 71 50 50 38
21 BANGAU 0 4 18 0 4 18 28 21 9
JUMLAH 136 152 804 138 161 833 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN SEPTEMBER TAHUN 2021
format 6
JUMLAH PENGUNJUNG
NAMA BALITA IBU
N0 POSYANDU RW 0 - 11 BULAN 12 - 24 BULAN 25 - 60 BULAN WUS
BARU LAMA BARU LAMA BARU LAMA PUS HAMIL
L P L P L P L P L P L P
1 PARKIT .001 0 0 12 6 0 0 15 14 0 0 51 32 164 154 6
2 CAMAR .002 2 3 8 7 0 2 8 12 1 0 25 20 88 76 4
3 GELATIK A .003 1 0 11 10 0 0 23 25 0 0 62 57 185 180 14
4 GELATIK B .003 1 0 11 9 0 0 11 8 0 0 32 38 227 209 6
5 ELANG .004 0 0 14 10 0 0 7 8 0 0 42 31 135 120 11
6 MERPATI .005 3 0 1 0 0 1 1 0 2 2 7 10 78 66 0
7 GARUDA .006 0 0 3 1 0 0 7 4 0 0 8 19 72 62 1
 8 CENDRAWASIH .007 0 0 5 5 0 0 5 4 0 0 24 29 90 80 3
9 ANGSA .008 0 0 8 5 0 0 4 6 0 0 20 19 128 110 2
10 KIJANG .009 2 0 0 0 0 0 3 2 0 0 11 13 68 56 2
11 KUTILANG .011 0 0 3 3 0 0 4 5 0 0 8 6 58 46 2
12 PANDA A .012 2 1 17 18 0 0 25 20 0 0 31 44 158 150 10
13 PANDA B .012 1 0 5 5 0 0 22 15 0 0 64 45 125 116 6
14 RUSA .013 2 0 25 23 0 0 32 30 0 0 44 43 190 175 8
15 MURAI .014 0 0 1 7 0 0 10 9 0 0 22 23 84 80 5
16 MERAK .015 0 0 6 9 0 0 9 7 0 0 32 33 115 105 9
17 KANCIL .016 2 2 2 4 0 0 7 8 0 1 22 27 65 58 6
18 KELINCI .017 2 1 6 6 0 0 19 11 0 0 49 40 215 185 6
19 CAMAR B .018 0 3 6 8 0 2 4 10 1 0 24 23 115 101 7
20 KANGURU A .019 0 0 29 24 0 0 31 12 0 0 77 30 210 200 10
21 KANGURU B .019 1 0 26 17 0 0 14 20 0 0 66 60 275 140 7
22 NURI .020 0 0 18 13 0 0 23 22 0 0 57 26 188 178 13
23 BANGAU .023 0 0 6 4 0 0 7 5 0 0 14 11 55 49 0
JUMLAH 19 10 223 190 0 5 284 252 4 3 778 668 3088 2696 138
DATA HASIL KEGIATAN POSYANDU
BULAN SEPTEMBER TAHUN 2021
format 7

NAMA
N0 POSYANDU RW DPT JUMLAH BAYI YANGPOLIO
DI IMUNISASI
I II III I II III IV
BCG
L P L P L P L P L P L P L P L P L
CAMPAK
1 PARKIT .001 1 1 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0
2 CAMAR .002 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 0
3 GELATIK A .003 0 0 2 2 1 1 1 0 0 0 2 2 1 1 1 0 0
4 GELATIK B .003 1 0 1 0 0 2 0 0 1 0 1 0 0 0 2 0 1
5 ELANG .004 1 0 1 0 1 1 1 2 1 0 1 0 1 1 1 2 1
6 MERPATI .005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 GARUDA .006 0 0 0 0 0 0 0 0 0 0 0 0 0 o 0 0 0
8 CENDRAWASIH .007 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1
 9 ANGSA .008 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 0
10 KIJANG .009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 KUTILANG .011 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 PANDA A .012 1 0 2 0 2 0 0 0 1 0 2 0 0 2 0 0 1
13 PANDA B .012 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 1
14 RUSA .013 2 0 1 1 2 3 2 0 2 0 0 1 2 3 2 0 1
15 MURAI .014 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0 0 1
16 MERAK .015 0 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0 0
17 KANCIL .016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 KELINCI .017 0 1 2 1 2 0 0 0 0 1 2 0 0 0 0 0 0
19 CAMAR B .018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 KANGURU A .019 0 0 2 2 3 0 1 1 0 0 2 2 3 0 1 1 3
21 KANGURU B .019 1 2 1 1 0 0 1 0 1 2 1 1 0 0 1 0 2
22 NURI .020 1 0 0 1 1 0 0 1 0 0 1 1 1 0 1 3 0
23 BANGAU .023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 11 6 15 11 14 8 9 6 9 6 15 10 10 8 12 8 12
DATA HASIL KEGIATAN POSYANDU
BULAN SEPTEMBER TAHUN 2021
format 7
JML
D F IBU JUMLAH AKSEPTOR KB
I E
JML P M
NAMA IBU E T E K I S D
R A N O M U A
P M M
N0 POSYANDU RW I B Y N I P
O O
I N N JML JML BALITA
K L D L U T L
U L P W BALITA YG MEMILIKI
HAMIL

S E O A D I A
S KMS
A T U M N K I
I N (S) (K)
L P L

1 PARKIT .001 6 6 6 48 0 41 0 0 0 7 52 0 79 52 79
2 CAMAR .002 4 4 4 31 10 12 0 0 0 0 31 0 44 44 44
3 GELATIK A .003 14 14 14 86 2 30 6 6 7 11 47 0 97 92 97
 4 GELATIK B .003 6 6 6 37 3 20 0 0 0 0 15 0 55 55 55
5 ELANG .004 11 11 11 39 5 8 1 0 0 0 33 0 63 49 63
6 MERPATI .005 0 0 0 19 9 11 0 0 0 28 38 0 14 13 14
7 GARUDA .006 1 1 1 12 15 3 0 0 0 11 9 0 18 24 18
8 CENDRAWASIH .007 3 3 3 19 51 11 3 0 1 11 35 0 34 38 34
9 ANGSA .008 2 2 2 20 0 18 2 0 1 0 25 0 32 30 32
10 KIJANG .009 2 2 2 7 5 5 7 0 0 0 19 0 16 15 16
11 KUTILANG .011 1 2 2 14 8 12 2 0 0 8 6 0 15 14 15
12 PANDA A .012 10 10 10 77 0 10 4 0 0 0 90 0 75 83 75
13 PANDA B .012 6 6 6 46 1 16 0 0 0 0 34 0 92 65 92
14 RUSA .013 8 8 8 112 0 74 5 0 5 3 77 0 103 96 103
15 MURAI .014 5 5 5 20 3 20 1 0 2 0 15 0 33 39 33
16 MERAK .015 9 9 9 27 10 27 3 0 8 0 35 0 47 49 47
17 KANCIL .016 6 6 6 36 0 23 3 0 3 0 27 0 33 42 33
18 KELINCI .017 6 6 6 53 7 25 7 2 11 11 73 0 76 58 76
19 CAMAR B .018 7 7 7 34 0 10 0 0 0 0 30 0 35 46 35
20 KANGURU A .019 9 10 10 85 7 59 3 0 3 0 68 0 137 66 137
21 KANGURU B .019 7 7 7 64 8 10 10 0 5 0 50 0 107 97 107
22 NURI .020 13 13 13 86 8 10 10 0 5 0 50 0 98 61 98
23 BANGAU .023 0 0 0 22 0 19 0 0 0 2 18 0 27 20 27
JUMLAH 136 138 138 994 0 152 474 67 8 51 92 877 0 1330 1148 1330
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : SEPTEMBER
RW / Kelurahan : DEPOK Petugas yang membina :

A. SKDN D. IMUNISASI
UMUR NO JENIS
S K N T O B D = N+T+O+B
BALITA
L P L P L P L P L P L P L P IMUNISASI
0 - 5 Bulan 91 56 91 56 75 50 0 0 0 0 15 4 91 56 1 BCG
6 - 11 Bulan 152 148 152 148 130 128 14 12 0 0 4 6 152 148 2 DPT 1
JUMLAH 243 204 243 204 205 178 14 12 0 0 19 10 243 204 3 DPT 2
12 - 24 Bulan 291 262 291 262 228 207 55 44 1 1 0 5 291 262 4 DPT 3
25 - 59 Bulan 796 682 796 682 625 541 153 125 0 2 4 3 796 682 5 POLIO 1
 JUMLAH 1087 944 1087 944 853 748 208 169 1 3 4 8 1087 944 6 POLIO 2
TOTAL 1 + 2 1330 1148 1330 1148 1058 926 222 181 1 3 23 18 1330 1148 7 POLIO 3

G. KB H. PENANGGULANGAN DIARE I. KUNJUNGAN KIA K. ASI EKSLUSIF

NO KONTRASEPSI JUMLAH PESERTA JML BALITA JUMLAH NO. URAIAN JUMLAH UMUR
PEMERINTAH SWASTA MENDERITA ORALIT KUNJUNGAN
1 IUD 108 92 DIARE YANG 1 K1 0 - 5 bulan
2 MOW 23 28 L P DIBERIKAN 2 K4 6 bulan
3 MOP 2 6 3 N2 pada
4 IMPLANT 50 17 4 LINAKES bulan ini
JUMLAH 183 143
5 SUNTIK 588 289
6 PIL 257 217
7 KONDOM 82 70
JUMLAH 927 576
TOTAL 1110 719 Mengetahui
Pembina Wilayah Posyandu
Hal yang perlu dilaporkan :
PUS = 2696
WUS = 3088
BUSUI = 994 ( ...................)

JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU

JUMLAH BAYI LAHIR / MENINGGAL
TAHUN 2021

JUMLAH PENGUNJUNG
 BALITA IBU

HAMIL

BUSUI
N0 BULAN 0 - 11 BULAN 12 - 24 BULAN 25 - 60 BULAN WUS

BARU LAMA BARU LAMA BARU LAMA PUS

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

1 JANUARI 13 8 244 225 1 0 336 300 4 705 671 3088 2696 144 1142

2 FEBRUARI 17 22 234 233 3 0 327 298 2 0 713 692 3088 2696 129 1124

3 MARET 4 8 250 240 0 3 335 285 0 0 697 704 3088 2696 136 1124

4 APRIL 2 1 254 249 0 0 337 292 0 0 706 706 3088 2696 136 1183

5 MEI 0 0 255 249 0 0 336 289 0 0 704 712 3088 2696 132 1094

6 SEPTEMBER 19 10 223 190 0 5 284 252 4 3 778 668 3088 2696 138 994

7
8
9
10
11
12
J UM L A H 55 49 1460 1386 4 8 1955 1716 10 3 4303 4153 18528 16176 815 6661

DATA HASIL KEGIATAN POSYANDU

TAHUN 2021

JML
D F
I E
P
E T
R A
 D F
I E IBU JUMLAH AKSEPTOR KB
JML P M
E T E K I S D
IBU R A O M U A
N P M M I
I N P N N
N0 BULAN K
B
L
Y
D
I
L O O U T L JML JML BALITA
U L P W

HAMIL
S E O A D I A BALITA YG MEMILIKI
S
A T U M N K I KMS
I N
(S) (K)
L P L
1 JANUARI 144 144 144 1142 135 474 89 2 2 93 903 0 1324 1238 1324

2 FEBRUARI 129 129 129 1124 129 474 87 2 49 89 902 0 1358 1256 1359

3 MARET 136 136 136 1124 152 473 79 10 54 95 919 0 131 1276 1319

4 APRIL 136 136 136 1183 152 473 79 10 54 95 919 0 1319 122 1319

5 MEI 132 132 132 1094 152 473 79 10 54 95 919 0 1319 1276 1319

6 SEPTEMBER 136 138 138 994 152 474 67 8 51 92 877 0 1330 1148 1330

7
8
9
10

J UM L A H 0 815 815 6661 0 872 2841 480 42 264 559 5439 0 6781 6316 7970

DATA HASIL KEGIATAN POSYANDU

 TAHUN 2021

JUMLAH BAYI YANG DI IMUNISASI

N0 BULAN BCG DPT POLIO CAMPAK
I II III I II III IV
L P L P L P L P L P L P L P L P L

1 JANUARI 10 5 16 12 12 6 15 15 10 5 12 13 6 18 15 6

2 FEBRUARI 13 11 16 16 11 6 9 13 13 11 16 16 13 6 9 15 12

3 MARET 12 8 12 10 17 14 9 10 12 8 10 1 16 15 10 10 22

4 APRIL 2 1 12 9 13 5 18 16 2 2 12 9 13 7 18 16 11

5 MEI 0 1 12 6 12 10 16 17 3 1 11 9 13 7 17 16 12

6 SEPTEMBER 11 6 15 11 14 8 9 6 9 6 15 10 10 8 12 8 12

10

11

12
JUMLAH 48 32 83 64 79 49 76 77 49 33 64 57 78 49 84 80 75
 N T O
BLN 6 - 12 BLN 12 - 24 BLN 25 - 59 BLN 0 - 5 BLN 6 - 11 BLN 12-24 BLN 25 - 59 BLN 0 - 5 BLN 6 - 12 BLN 12 - 24 BLN 25 - 59 BLN 0 - 5 BLN 6 - 12 BLN
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
0 9 5 11 9 36 20 0 0 1 1 4 5 15 12 0 0 0 0 0 0 0 0 0 0 0
1 3 6 8 12 22 18 0 0 0 0 0 0 3 2 0 0 0 0 0 0 0 0 2 1 0
2 4 8 15 15 35 35 0 0 0 0 8 10 27 22 0 0 0 0 0 0 0 0 1 0 0
2 8 7 10 8 30 29 0 0 0 0 1 0 2 9 0 0 0 0 0 0 0 0 1 0 0
3 8 7 7 6 30 23 0 0 0 0 0 2 12 8 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 2 8 0 0 1 0 0 0 5 2 0 0 0 0 0 0 0 0 0 0 3
0 1 1 5 4 6 19 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0
3 2 2 3 3 20 24 0 0 0 0 2 1 4 5 0 0 0 0 0 0 0 0 0 0 0
2 4 3 2 3 15 14 0 0 0 0 2 3 5 5 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 1 8 10 0 0 0 0 0 1 3 3 0 0 0 0 0 0 0 0 2 0 0
1 2 2 2 3 6 4 0 0 0 0 2 2 2 2 0 0 0 0 0 0 0 0 0 0 0
4 10 14 20 18 24 41 0 0 0 0 5 2 7 3 0 0 0 0 0 0 0 0 2 1 0
2 5 3 21 14 63 42 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 2 1 0 0
6 19 17 30 28 41 40 0 0 0 0 2 2 3 3 0 0 0 0 0 0 0 0 2 0 0
1 1 6 6 6 13 17 0 0 0 0 4 3 9 6 0 0 0 0 0 0 0 0 0 0 0
3 4 4 8 5 25 24 0 0 1 2 1 2 7 9 0 0 0 0 0 0 0 0 0 0 0
3 2 1 4 6 16 18 0 0 0 0 3 2 6 9 0 0 0 0 0 0 0 0 1 0 1
1 4 5 15 11 43 38 0 0 0 0 4 0 6 2 0 0 0 0 0 0 0 0 2 1 0
5 2 3 4 10 21 18 0 0 0 0 0 0 3 5 0 0 0 0 0 0 0 0 0 1 0
4 18 15 26 11 71 25 0 0 4 5 5 1 6 5 0 0 0 0 0 0 0 0 0 0 0
3 17 12 11 17 61 56 0 0 4 2 3 3 5 4 0 0 0 0 0 0 0 0 1 0 0
4 7 7 16 17 37 18 0 0 3 2 6 4 20 8 0 0 0 0 1 1 0 0 0 0 0
 2 4 2 4 3 9 8 0 0 0 0 3 2 4 2 0 0 0 0 0 0 1 1 0 0 0
50 130 128 228 207 625 541 0 0 14 12 55 44 153 125 0 0 0 0 1 1 0 2 15 4 4

UR BGM 2T GAKIN/
an) BB TB NON
L P (Kg) (Cm) GAKIN
L B L B
V V
V V
V V
V VV
V V
V V
V V
V V
V V
V V
V V
V V
V V
 UMUR JUMLAH KUNJUNGAN
KEHAMILAN GAKIN/
(Bln) NON UNRAIAN
GAKIN
K1 K4 N2 LINAKES
 UMUR JUMLAH KUNJUNGAN
KEHAMILAN GAKIN/
(Bln) NON UNRAIAN
GAKIN
K1 K4 N2 LINAKES
021

N T
6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 11 BLN 12-24 BLN 25-59 BLN
L P L P L P L P L P L P L P
21 22 23 24 25 26 27 28 29 30 31 32 33 34
9 5 11 9 36 20 0 0 1 1 L 5 15 12
3 6 8 12 22 18 0 0 0 0 0 0 3 2
4 8 15 15 35 35 0 0 0 0 8 10 27 22
8 7 10 8 30 29 0 0 0 0 1 0 2 9
8 7 7 6 30 23 0 0 0 0 0 2 12 8
0 0 1 0 2 8 0 0 1 0 0 0 5 2
1 1 5 4 6 19 0 0 0 0 2 0 2 0
2 2 3 3 20 24 0 0 0 0 2 1 4 5
4 3 2 3 15 14 0 0 0 0 2 3 5 5
0 0 3 1 8 10 0 0 0 0 0 1 3 3
2 2 2 3 6 4 0 0 0 0 2 2 2 2
10 14 20 18 24 41 0 0 0 0 5 2 7 3
5 3 21 14 63 42 0 0 0 0 1 1 1 1
19 17 30 28 41 40 0 0 0 0 2 2 3 3
1 6 6 6 13 17 0 0 0 0 4 3 9 6
4 4 8 5 25 24 0 0 1 2 1 2 7 9
2 1 4 6 16 18 0 0 0 0 3 2 6 9
4 5 15 11 43 38 0 0 0 0 4 0 6 2
2 3 4 10 21 18 0 0 0 0 0 0 3 5
18 15 26 11 71 25 0 0 4 5 5 1 6 5
17 12 11 17 61 56 0 0 4 2 3 3 5 4
7 7 16 17 37 18 0 0 3 2 6 4 20 8
4 2 4 3 9 8 0 0 0 0 3 2 4 2
130 128 228 207 625 541 0 0 14 12 55 44 153 125
HUN 2021
D PETUGAS YG HADIR
6 - 12 BLN 12-24 BLN 25-59 BLN PKK PLKB MEDIS KETERANGAN
L P L P L P L P L P
53 54 55 56 57 58 59 60 61 62 63 64
10 6 15 14 51 32 10 0 1 0 0 0
3 8 8 14 26 20 10 0 1 0 2 0
4 8 23 25 62 57 10 0 0 0 3 0
8 7 11 8 32 38 12 0 2 0 3 0
8 7 7 8 42 31 15 0 0 0 3 0
4 0 1 1 9 12 10 0 0 0 3 0
1 1 7 4 8 19 10 0 1 0 3 0
2 2 5 4 24 29 11 0 0 0 3 0
4 3 4 6 20 19 6 0 0 0 2 0
0 0 3 2 11 13 6 0 0 0 0 0
2 2 4 5 8 6 6 0 0 0 2 0
10 14 25 20 31 44 10 0 1 0 3 0
5 3 22 15 64 45 10 0 0 0 3 0
19 17 32 30 44 43 10 0 0 0 2 0
1 6 10 9 22 23 10 0 0 0 2 0
5 6 9 7 32 33 8 0 0 0 2 0
3 3 7 8 22 28 10 0 0 0 2 0
4 5 19 11 49 40 10 0 1 0 2 0
2 5 4 12 25 23 10 0 0 0 1 0
22 20 31 12 77 30 10 0 1 0 2 0
21 14 14 20 66 60 10 0 1 0 2 0
10 9 23 22 57 26 10 0 0 0 2 0
4 2 7 5 14 11 6 0 0 2 0
152 148 291 262 796 682 220 0 9 2 47 -
 H.P. DIARE
JML. BALITA DIARE

YANG
HIPATITIS CAMPAK TT JUMLAH MENDAPAT
ORALIT
II III I II
L P L P L P L P L P L P L P
21 22 23 24 25 26 27 28 29 30 31 32 33 34
1 0 0 0 0 1 0 1 0 1 0 0 0 0
0 0 1 0 0 1 0 0 0 3 0 0 0 0
1 1 4 5 0 0 0 3 0 4 0 1 1 2
2 1 1 0 1 1 0 0 0 1 0 0 0 1
4 3 1 0 1 1 0 3 0 4 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 3 0 0 0 0
0 0 1 0 0 0 0 1 0 3 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 1 1 0 4 0 4 0 0 0 0
 0 0 0 2 1 0 0 0 0 6 0 0 0 0
2 3 2 0 1 1 0 2 0 6 0 0 0 0
0 0 0 1 1 0 0 1 0 4 0 0 0 0
1 0 1 0 0 1 0 2 0 5 0 0 0 0
0 0 0 0 0 0 0 1 0 2 0 0 0 0
0 0 0 0 0 0 0 0 0 8 0 0 0 0
0 0 0 0 0 0 0 0 0 7 0 0 0 0
0 0 1 0 3 2 0 3 0 5 0 0 0 0
1 1 0 0 2 0 0 1 0 3 1 0 1 0
1 0 1 3 0 1 0 2 0 4 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 9 13 11 12 10 0 24 0 73 2 1 4 3
ITAMIN A K. ASI EKSLUSIF
BUFAS JML SASARAN MASIH LULUS ASI
MENDPT VIT.A

JML YG DIBERI VIT A

6 Bln pd ASI 6 Bln pd
SASARAN

0 - 5 BLN Bln ini AKSLUSIF Bln ini

12-59 BLN 12-59 BLN 0 - 5 Bln
L P L P L P L P L P L P
21 22 23 24 25 26 27 28 29 30 31 32 33 34
0 0 0 0 2 4 3 0 0 0 3 0 0 0
0 0 0 0 1 2 5 2 0 1 5 2 0 1
0 0 0 0 0 0 7 7 0 0 7 7 0 0
0 0 0 0 0 4 5 2 0 1 5 2 0 1
0 0 0 0 0 0 6 8 0 0 6 8 0 0
0 0 0 0 0 0 3 1 0 0 3 1 0 0
0 0 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 0 0 0 1 0 0 0 1 0 0 0
0 0 0 0 0 0 4 2 0 0 4 2 0 0
0 0 0 0 2 4 1 0 0 0 2 0 0 0
2 0 0 0 0 0 1 1 0 0 1 1 0 0
 0 0 0 0 1 2 5 7 1 1 5 7 1 1
0 0 0 0 1 2 1 2 2 0 1 2 2 0
0 0 0 0 2 4 8 6 1 1 8 6 1 1
0 0 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 0 0 0 4 3 0 0 4 3 0 0
0 0 0 0 1 2 0 2 0 1 0 2 0 1
0 0 0 0 3 6 2 4 1 1 2 4 1 1
0 0 0 0 0 0 2 5 0 0 2 5 0 0
0 0 0 0 2 4 7 4 0 0 5 6 0 0
0 0 0 0 2 4 7 1 2 0 7 1 2 0
0 0 0 0 0 0 7 8 0 0 7 8 0 0
0 0 0 0 0 0 2 2 0 0 2 2 0 0
2 0 0 0 17 38 81 69 7 6 80 71 7 6

N JML YG HADIR KETERANGAN

UMUR
> 70 Thn 45-59 Thn 60-69 Thn > 70 Thn
P L P L P L P L P
12 13 14 15 16 17 18 19 20 21
22 13 10 45 35 7 4 2 2 -
48 10 30 20 25 5 5 0 0 -
50 15 12 25 50 6 10 4 7 -
39 14 10 0 0 0 0 0 0 -
39 10 15 25 30 6 20 0 4 -
8 3 5 2 0 0 7 0 5 -
13 13 21 2 3 3 3 2 5 -
57 21 28 0 0 0 0 0 0 -
45 19 21 0 0 0 0 0 0 -
89 55 68 0 0 0 0 0 0 -
22 1 12 20 25 18 20 0 6 -
20 5 4 5 20 2 5 2 5 -
20 1 10 11 20 6 15 1 10 -
75 35 42 10 48 18 31 1 22 -
75 1 55 2 87 1 55 0 30 -
0 0 0 0 0 0 0 0 0 0
38 3 5 4 27 1 10 0 3 -
35 4 6 0 0 0 0 0 0 -
23 13 10 2 8 0 1 0 5 -
12 2 5 10 33 4 6 1 2 -
30 5 8 5 10 3 10 0 2 -
37 10 20 10 20 10 15 3 7 -
8 3 2 0 0 0 0 0 0 0
805 256 399 198 441 90 217 16 115 -

JUMLAH PETUGAS
YANG HADIR JUMLAH BAYI
BUSUI KADER PLKB MEDIS LAHIR MENINGGAL
L P L P L P L P L P
48 - 10 0 1 0 0 1 1 0 0
31 - 10 0 1 0 2 0 1 0 0
86 - 10 0 0 0 3 0 0 0 0
37 - 12 0 2 0 3 0 0 0 0
39 - 15 0 0 0 3 0 0 0 0
19 0 10 0 0 0 3 0 0 0 0
12 - 10 0 1 0 3 0 0 0 0
 19 - 11 0 0 0 3 0 0 0 0
20 - 6 0 0 0 2 0 0 0 0
7 - 6 0 0 0 0 2 0 0 0
14 - 6 0 0 0 2 0 0 0 0
77 - 10 0 1 0 3 1 0 0 0
46 - 10 0 0 0 3 1 0 0 0
112 - 10 0 0 0 2 1 1 0 0
20 - 10 0 0 0 2 0 0 0 0
27 - 8 0 0 0 2 0 0 0 0
36 - 10 0 0 0 2 1 0 0 0
53 - 10 0 1 0 2 2 1 0 0
34 - 10 0 0 0 1 0 0 0 0
85 - 10 0 1 0 2 1 1 0 0
64 - 10 0 1 0 2 1 1 0 0
86 - 10 0 0 0 2 0 0 0 0
22 - 6 0 0 2 0 0 0 0
994 - 220 0 9 2 47 11 6 0 0

021
BALITA YANG
MENDERITA DIARE
HEPATITIS B Mendapat
I II III ORALIT
CAMPAK P L P L P L PJUMLAH L P L P
1 0 0 1 0 0 0 0 0 0 0
1 1 0 0 0 1 0 0 0 0 0
0 0 0 1 1 4 5 0 1 1 2
1 0 0 2 1 1 0 0 0 0 1
1 1 0 4 3 1 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 0 0
 0 1 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 2 0 0 0 0 0 0 0
0 0 0 0 0 0 2 0 0 0 0
1 1 1 2 3 2 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 0
1 0 1 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 1 0 0 0 0 0
0 0 0 1 1 0 0 1 0 1 0
1 1 1 1 0 1 3 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0
10 7 3 15 9 13 11 2 1 4 3

PENIMBANGAN BALITA IMUNISASI

TT IBU
L BALITA JML YG JML YG JML YG JML YG HAMIL
MEMILIKI DITIMBANG NAIK (N) MENDAPAT MENDAPAT
KMS
(D) (N) VIT A PMT
P L P L P L P L P I II

52 79 52 59 34 0 0 79 52 1 1
44 44 44 38 37 0 0 44 44 0 3
92 97 92 61 60 0 0 97 92 3 4
 55 55 55 51 46 0 0 55 55 0 1
49 63 49 51 39 0 0 63 49 3 4
13 14 13 3 8 0 0 14 13 0 0
24 18 24 14 24 0 0 18 24 0 0
38 34 38 28 32 0 0 34 38 0 3
30 32 30 25 22 0 0 32 30 1 3
15 16 15 11 11 0 0 16 15 0 0
14 15 14 11 10 2 0 15 14 0 0
83 75 83 61 77 0 0 75 83 4 4
65 92 65 89 61 0 0 92 65 0 6
96 103 96 96 91 0 0 103 96 2 6
39 33 39 20 30 0 0 33 39 1 4
49 47 49 38 36 0 0 47 49 2 5
42 33 42 23 28 0 0 33 42 1 2
58 76 58 64 55 0 0 76 58 0 8
46 35 46 31 36 0 0 35 46 0 7
66 137 66 122 55 0 0 137 66 3 5
97 107 97 94 88 0 0 107 97 1 3
61 98 61 68 46 0 0 98 61 2 4
20 27 20 19 15 0 0 27 20 0 0
1148 1330 1148 1077 941 2 0 1330 1148 24 73

PLKB = ORANG MEDIS = 47 ORANG

PKK = 220 ORANG

E. LANSIA
JUMLAH NO JENIS JUMLAH JUMLAH JUMLAH
L P IMUNISASI L P UMUR SASARAN YANG HADIR
11 6 8 POLIO 4 12 8 L P L P
15 11 9 HEPATITIS 1 7 3 45-60 Tahun 1664 1923 198 441
14 8 10 HEPATITIS 2 15 9 60-69 Tahun 785 805 90 217
9 6 11 HEPATITIS 3 13 11 > 70 Tahun 256 399 16 115
9 6 12 CAMPAK 12 10
 15 10 13 TT I 0 24 F. KPPASI
10 8 14 TT 2 0 73 PESERTA JML
SASARAN YG HADIR
I EKSLUSIF BUMIL 136 138
SASARAN MASIH ASI E BUSUI 0-6 BLN 152 161
L P L P BUSUI 7-24 BLN 840 840
81 69 80 71
SASARAN LULUS ASI E J. VITAMIN
L P L P SASARAN Jml.VIT A yg
7 6 7 6 UMUR diberikan
L P L P
6 - 11 bulan 0 0 2 0
12 - 59 bulan 0 0 0 0
Bufas - 17 - 38

Depok, . . . . . . . . . . . . . . . .
Ketua Pokja 4

( ...................)

JUMLAH PETUGAS
YANG HADIR JUMLAH BAYI
 JUMLAH PETUGAS
YANG HADIR JUMLAH BAYI

KADER PLKB MEDIS LAHIR MENINGGAL

L P L P L P L P L P

227 0 0 2 87 0 7 0 0

227 0 1 2 87 11 13 0 0

225 0 1 2 84 13 5 0 0

225 0 0 2 19 2 1 0 0

209 0 1 2 53 0 0 0 0

220 0 9 2 47 11 6 0 0

0 1333 0 12 12 377 37 32 0 0
 PENIMBANGAN BALITA IMUNISASI
TT IBU
L BALITA JML YG JML YG JML YG JML YG HAMIL
MEMILIKI DITIMBANG NAIK (N) MENDAPAT MENDAPAT
KMS
(D) (N) VIT A PMT
P L P L P L P L P I II

1238 1324 1238 1104 1037 1324 1238 27 80

1255 1319 1278 1063 1019 1176 1153 1319 1278 29 71

1276 1306 1262 1066 1022 0 0 1306 1262 29 74

1244 1323 1268 1083 1027 0 0 1323 1268 8 63

1276 1319 1275 1222 1197 0 0 1319 1275 21 59

1148 1330 1148 1077 941 2 0 1330 1148 24 73

0 7437 7921 7469 6615 6243 1178 1153 7921 7469 138 420
 BALITA YANG
MENDERITA DIARE
CAMPAK HEPATITIS B JUMLAH Mendapat
I II III ORALIT
P L P L P L P L P L P

13 16 141 11 5 14 14 5 5 3 4

16 18 16 10 6 11 15 5 5 5 7

18 11 11 17 14 10 9 4 3 5 5

11 10 7 13 5 18 16 4 3 5 5

12 7 10 14 6 16 16 4 3 4 3

10 7 3 15 9 13 11 2 1 4 3

80 69 188 80 45 82 81 24 20 26 27
 0 0
D. IMUNISASI

B D PETUGAS YANG HADIR BCG DPT

6 - 12 BLN 12 - 24 BLN 25 - 59 BLN 0 - 5 BLN 6 - 12 BLN 12 - 24 BLN 25 - 59 BLN PKK PLKB MEDIS KETERANGAN I II III I
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
0 0 0 0 0 3 0 10 6 15 14 51 32 131 10 0 1 0 0 - 1 1 0 0 1 0 0 1 1
2 0 2 1 0 7 2 3 8 8 14 26 20 88 10 0 1 0 20 1 1 1 0 0 0 1 0 1 1
0 0 0 0 0 8 2 4 8 23 25 62 57 189 10 0 0 0 30 0 0 2 2 1 1 1 0 0 0
0 0 0 0 0 4 2 8 7 11 8 32 38 110 12 0 2 0 30 1 0 1 0 0 2 0 0 1 0
0 0 0 0 0 6 3 8 7 7 8 42 31 112 15 0 0 0 30 1 0 1 0 1 1 1 2 1 0
0 0 1 2 2 0 0 4 0 1 1 9 12 27 10 0 0 0 30 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 1 1 7 4 8 19 42 10 0 1 0 30 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 3 3 2 2 5 4 24 29 72 11 0 0 0 30 1 0 1 0 0 0 0 0 0 0
0 0 0 0 0 4 2 4 3 4 6 20 19 62 6 0 0 0 20 1 1 1 0 0 0 1 0 1 1
0 0 0 0 0 2 0 0 0 3 2 11 13 31 6 0 0 0 00 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 2 2 4 5 8 6 29 6 0 0 0 20 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 9 5 10 14 25 20 31 44 158 10 0 1 0 30 1 0 2 0 2 0 0 0 1 0
0 0 0 0 0 1 2 5 3 22 15 64 45 157 10 0 0 0 30 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 8 6 19 17 32 30 44 43 199 10 0 0 0 20 2 0 1 1 2 3 2 0 2 0
0 0 0 0 0 0 1 1 6 10 9 22 23 72 10 0 0 0 20 0 0 0 2 0 1 0 0 0 0
0 0 0 0 0 1 3 5 6 9 7 32 33 96 8 0 0 0 20 0 0 0 1 1 0 1 0 0 0
2 0 0 0 1 1 3 3 3 7 8 22 28 75 10 0 0 0 20 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 4 2 4 5 19 11 49 40 134 10 0 1 0 20 0 1 2 1 2 0 0 0 0 1
2 0 2 1 0 4 6 2 5 4 12 25 23 81 10 0 0 0 10 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 7 4 22 20 31 12 77 30 203 10 0 1 0 20 0 0 2 2 3 0 1 1 0 0
0 0 0 0 0 6 3 21 14 14 20 66 60 204 10 0 1 0 20 1 2 1 1 0 0 1 0 1 2
0 0 0 0 0 8 4 10 9 23 22 57 26 159 10 0 0 0 20 1 0 0 1 1 0 0 1 0 0
0 0 0 0 0 2 2 4 2 7 5 14 11 47 6 0 0 2 0 0 0 0 0 0 0 0 0 0 0
6 0 5 4 3 91 56 152 148 291 262 796 682 2478 220 0 9 2 47 - 11 6 15 11 14 8 9 6 9 6
 H.P. DIARE G. KB
ALAT KONTRASEPSI
POLIO HIPATITIS CAMPAK
TT
JUMLAH
YG DAPAT IUD MOW MOP IMPLANT
ORALIT
II III IV I II III I II JUMLAH PESERTA
L P L P L P L P L P L P L P L P L P L P L P P S P S P S P S
0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 0 0 14 7 0 0 0 0 0 0
1 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0
2 2 1 1 1 0 0 0 1 1 4 5 0 0 0 3 0 4 0 1 1 2 23 11 3 4 2 4 3 3
1 0 0 0 2 0 0 0 2 1 1 0 1 1 0 0 0 1 0 0 0 1 2 0 0 0 0 0 0 0
1 0 1 1 1 2 1 0 4 3 1 0 1 1 0 3 0 4 0 0 1 0 4 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 28 0 0 0 0 0 0
0 0 0 o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 11 0 0 0 0 0 0
1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 3 0 0 0 0 8 11 0 1 0 0 1 2
1 0 0 0 1 0 1 0 0 0 1 0 0 0 0 1 0 3 0 0 0 0 3 0 1 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 2 0
2 0 0 2 0 0 0 0 2 0 0 0 1 1 0 4 0 4 0 0 0 0 5 0 0 0 0 0 4 0
0 0 0 0 0 2 0 0 0 0 0 2 1 0 0 0 0 6 0 0 0 0 1 0 0 0 0 0 0 0
0 1 2 3 2 0 1 1 2 3 2 0 1 1 0 2 0 6 0 0 0 0 5 3 3 2 0 0 3 2
0 2 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 4 0 0 0 0 1 0 0 2 0 0 1 0
0 1 1 0 1 0 0 1 1 0 1 0 0 1 0 2 0 5 0 0 0 0 5 0 0 8 0 0 3 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 3 0 3 0 0 0 3 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 11 0 11 0 2 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 2 0 0 0 0 0 0 0
2 2 3 0 1 1 1 0 0 0 1 0 3 2 0 3 0 5 0 0 0 0 7 0 3 0 0 0 3 0
1 1 0 0 1 0 0 0 1 1 0 0 2 0 0 1 0 3 1 0 1 0 10 0 5 0 0 0 10 0
1 1 1 0 1 3 1 1 1 0 1 3 0 1 0 2 0 4 1 0 1 0 10 0 5 0 0 0 10 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0
15 10 10 8 12 8 7 3 15 9 13 11 12 10 0 24 0 73 2 1 4 3 108 92 23 28 2 6 50 17
 J. VITAMIN A K. ASI EKSLUSIF F. KPPASI
SEPSI

SASARAN

MENDPT
SUNTIK PIL KONDOM 0 - 5 BLN MASIH ASI 6 Bln pd BUSUI
BU- BU-

VIT. A
PESERTA 6 - 11 JML
BLN SASARAN
12 - 59 BLN 6 -JML YG DIBERI
11 BLN 12 -VIT. A
59 BLN 6 Bln pd 0 - 5 Bln Bln ini MIL 0-6 7 - 24 MIL
Bln ini
P S P S P S L P L P L P L P L P L P L P L P Bln Bln
34 18 39 2 0 0 0 0 0 0 0 0 0 0 2 4 3 0 0 0 3 0 0 0 6 3 45
0 31 0 12 10 0 0 0 0 0 0 0 0 0 1 2 5 2 0 1 5 2 0 1 4 8 23
25 22 15 15 1 1 0 0 0 0 0 0 0 0 0 0 7 7 0 0 7 7 0 0 14 14 72
15 0 20 0 3 0 0 0 0 0 0 0 0 0 0 4 5 2 0 1 5 2 0 1 6 8 29
30 3 1 7 0 5 0 0 0 0 0 0 0 0 0 0 6 8 0 0 6 8 0 0 11 14 25
3 35 0 11 0 9 0 0 0 0 0 0 0 0 0 0 3 1 0 0 3 1 0 0 0 4 15
3 6 3 0 15 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 11
20 15 3 8 23 28 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 3 0 19
25 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 0 0 4 2 0 0 2 6 17
15 4 2 3 0 5 0 0 0 0 0 0 0 0 2 4 1 0 0 0 2 0 0 0 2 2 5
6 0 0 12 0 8 0 0 0 0 2 0 0 0 0 0 1 1 0 0 1 1 0 0 1 2 13
90 0 0 10 0 0 0 0 0 0 0 0 0 0 1 2 5 7 1 1 5 7 1 1 10 14 63
13 21 9 7 1 0 0 0 0 0 0 0 0 0 1 2 1 2 2 0 1 2 2 0 6 5 41
35 42 47 27 0 0 0 0 0 0 0 0 0 0 2 4 8 6 1 1 8 6 1 1 8 16 96
15 0 20 0 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 5 1 19
35 0 27 0 10 0 0 0 0 0 0 0 0 0 0 0 4 3 0 0 4 3 0 0 9 7 20
27 0 23 0 0 0 0 0 0 0 0 0 0 0 1 2 0 2 0 1 0 2 0 1 6 3 33
42 31 0 25 0 7 0 5 0 0 0 0 0 0 3 6 2 4 1 1 2 4 1 1 6 9 44
30 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 2 5 0 0 2 5 0 0 7 7 27
22 46 10 49 0 7 0 0 0 0 0 0 0 0 2 4 7 4 0 0 5 6 0 0 9 0 43
50 0 10 0 8 0 0 0 0 0 0 0 0 0 2 4 7 1 2 0 7 1 2 0 7 9 55
50 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 7 8 0 0 7 8 0 0 13 15 71
 3 15 0 19 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 2 2 0 0 0 4 18
588 289 257 217 82 70 0 0 0 0 2 0 0 0 17 38 81 69 7 6 80 71 7 6 136 152 804
 E. LANSIA

BUSUI JUMLAH SASARAN UMUR JML YG HADIR HADIR KETERANGAN WUS PUS
BU- JUMLAH BAYI
MIL 0-6 7 - 24 45 - 59 Thn 60 - 69 Thn > 70 Thn 45 - 59 Thn 60 - 69 Thn > 70 Thn LAHIR MENINGGAL
Bln Bln L P L P L P L P L P L P L P L P
6 3 45 100 125 20 22 13 10 45 35 7 4 2 2- - - 164 154 1 1 0 0
4 8 23 50 50 40 48 10 30 20 25 5 5 0 0- 88 76 0 1 0 0
14 14 72 130 140 42 50 15 12 25 50 6 10 4 7- 185 180 0 0 0 0
6 8 29 141 140 32 39 14 10 0 0 0 0 0 0- 227 209 0 0 0 0
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