AGUSTUS 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 2
CAMAR .002 5 2 2 4 11 7 21 16 68 100 5 2 2 4 11 7 21 16 5
GELATIK A .003 4 2 4 7 23 25 62 57 184 100 4 2 4 7 23 25 62 57 4
4 GELATIK B .003 5 2 6 5 11 8 32 39 108 100 5 2 6 5 11 8 32 39 5
5 ELANG .004 6 3 6 7 5 11 44 32 114 100 6 3 6 7 5 11 44 32 6
6 MERPATI .005 3 1 1 2 5 10 12 17 51 100 3 1 1 2 5 10 12 17 3
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 1 4 1 1 5 4 24 29 69 100 1 4 1 1 5 4 24 29 1
9 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 1 2 1 3 3 9 13 34 100 2 1 2 1 3 3 9 13 2
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 5 7 9 10 25 20 31 44 151 100 5 7 9 10 25 20 31 44 5
13 PANDA B .012 2 2 6 7 21 14 72 46 170 100 2 2 6 7 21 14 72 46 2
14 RUSA 013 8 5 19 17 32 30 45 44 200 100 8 5 19 17 32 30 45 44 5
15 MURAI .014 0 2 1 5 10 9 22 23 72 100 0 2 1 5 10 9 22 23 0
16 MERAK .015 3 3 4 5 8 8 30 39 100 100 3 3 4 5 8 8 30 39 2
KANCIL 016 0 2 5 6 15 8 13 29 78 100 0 2 5 6 15 8 13 29 0
18 KELINCI 017 2 4 7 5 25 10 47 40 140 100 2 4 7 5 25 10 47 40 2
CAMAR B .018 4 6 2 5 4 12 25 23 81 100 4 6 2 5 4 12 25 23 2
20 KANGURU A .019 6 2 9 10 30 16 81 47 201 100 6 2 9 10 30 16 81 47 3
21 KANGURU B .019 7 1 13 11 18 26 71 60 207 100 7 1 13 11 18 26 71 60 6
22 NURI 20 7 8 17 14 26 29 57 26 184 100 7 8 17 14 26 29 57 26 7
23 BANGAU 23 2 2 4 2 7 5 15 12 49 100 2 2 4 2 7 5 15 12 2
JUMLAH 82 62 135 136 314 284 800 712 2525 82 62 135 136 314 284 800 712 69

B. SURVEILANS
BULAN = AGUSTUS
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 = AGUSTUS UMUR
ALAMAT UMUR KEHAMILAN
NAMA BUMIL HAMIL
KE (Bln)
N0 SUAMI ISTRI (Thn)

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 = AGUSTUS
UMUR
NAMA ALAMAT UMUR KEHAMILAN
BUMIL HAMIL
KE (Bln)
N0 SUAMI ISTRI (Thn)

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 AGUSTUS 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 2 0
2 CAMAR 5 2 2 4 11 7 21 16 5 2 2 4 11 7 21 16 5 2
3 GELATIK A 4 2 4 7 23 25 62 57 4 2 4 7 23 25 62 57 4 1
GELATIK B 5 2 6 5 11 8 32 39 5 2 6 5 11 8 32 39 5 2
4 ELANG 6 3 6 7 5 11 44 32 6 3 6 7 5 11 44 32 6 3
5 MERPATI 3 1 1 2 5 10 12 17 3 1 1 2 5 10 12 17 3 1
6 GARUDA 2 0 1 1 7 4 8 19 2 0 1 1 7 4 8 19 2 0
7 CENDRAWASIH 1 4 1 1 5 4 24 29 1 4 1 1 5 4 24 29 1 3
8 ANGSA 4 2 4 3 4 6 20 19 4 2 4 3 4 6 20 19 4 2
9 KIJANG 2 1 2 1 3 3 9 13 2 1 2 1 3 3 9 13 2 1
11 KUTILANG 1 1 2 2 4 5 8 6 1 1 2 2 4 5 8 6 1 1
12 PANDA A 5 7 9 10 25 20 31 44 5 7 9 10 25 20 31 44 5 7
PANDA B 2 2 6 7 21 14 72 46 2 2 6 7 21 14 72 46 2 2
13 RUSA 8 5 19 17 32 30 45 44 8 5 19 17 32 30 45 44 5 3
14 MURAI 0 2 1 5 10 9 22 23 0 2 1 5 10 9 22 23 0 1
15 MERAK 3 3 4 5 8 8 30 39 3 3 4 5 8 8 30 39 2 3
16 KANCIL 0 2 5 6 15 8 13 29 0 2 5 6 15 8 13 29 0 2
17 KELINCI 2 4 7 5 25 10 47 40 2 4 7 5 25 10 47 40 2 4
18 CAMAR B 4 6 2 5 4 12 25 23 4 6 2 5 4 12 25 23 2 6
19 KANGURU A 6 2 9 10 30 16 81 47 6 2 9 10 30 16 81 47 3 1
KANGURU B 7 1 13 11 18 26 71 60 7 1 13 11 18 26 71 60 6 1
20 NURI 7 8 17 14 26 29 57 26 7 8 17 14 26 29 57 26 7 8
21 BANGAU 2 2 4 2 7 5 15 12 2 2 4 2 7 5 15 12 2 2
JUMLAH 82 62 135 136 314 284 800 712 82 62 135 136 314 284 800 712 69 54
LAPORAN BULANAN POSYANDU
 KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN AGUSTUS 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 1 0 1 0 0 0 1 0 2 0
2 CAMAR 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 5 2
3 GELATIK A 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 4 2
GELATIK B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 0 0 0 0 0 3 1
6 GARUDA 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 0
7 CENDRAWASIH 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 4
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 0 0 0 0 0 0 0 0 2 1
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 0 0 0 0 0 0 0 0 5 7
PANDA B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
13 RUSA 0 0 0 0 0 0 0 0 3 2 0 0 0 0 0 0 8 5
14 MURAI 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 2
15 MERAK 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 3 3
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
17 KELINCI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4
18 CAMAR B 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 6
19 KANGURU A 0 0 0 0 0 0 0 0 3 1 0 0 0 0 0 0 6 2
KANGURU B 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 7 1
20 NURI 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 7 8
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
JUMLAH 0 0 0 0 0 4 0 0 12 6 3 2 2 1 2 2 82 62
 D. IMUNISASI
AGUSTUS TAHUN 2021
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 0 0 1 1 4 5 0 0 0 0 1 1 4 5 0 0
GELATIK B 0 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0 0 0
4 ELANG 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0 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 0 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 1 0 0 1 0 0 0 0 1 0 0 0 0 0
13 RUSA 0 0 0 1 1 0 3 2 0 0 0 1 1 0 3 2 0 1
14 MURAI 0 0 1 0 0 4 1 0 0 0 1 0 0 4 1 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 2 1 0 0 0 0 0 0 2 1 0 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 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1 0
KANGURU B 1 2 1 1 0 0 1 0 1 2 1 1 0 0 1 0 0 0
20 NURI 0 0 1 1 1 0 1 3 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 8 7 10 4 14 8 16 11 8 7 10 4 12 10 16 10 6 3

AGUSTUS 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 10 6 66 46
2 CAMAR 0 0 0 0 0 0 0 0 0 31 0 12 10 0 2 4 32 23
3 GELATIK A 23 11 2 4 0 0 9 4 34 14 15 15 1 1 4 7 85 82
GELATIK B 3 0 2 0 0 0 10 0 15 0 15 0 2 0 6 5 45 47
4 ELANG 4 0 0 0 0 0 1 0 30 3 1 7 0 5 6 7 49 43
5 MERPATI 2 28 0 0 0 0 0 0 3 35 0 11 0 9 1 2 15 14
6 GARUDA 2 11 0 0 0 0 0 0 3 6 3 0 15 0 1 1 8 19
7 CENDRAWASIH 8 11 0 1 0 0 1 2 20 15 3 8 23 28 1 1 30 34
8 ANGSA 3 0 1 0 0 0 2 0 25 0 18 0 0 0 4 3 24 25
9 KIJANG 0 0 0 0 0 0 4 3 15 4 2 3 0 5 2 1 12 16
11 KUTILANG 0 8 0 0 0 0 2 0 6 0 0 12 0 8 2 2 7 11
 12 PANDA A 5 0 0 0 0 0 4 0 90 0 0 10 0 0 9 10 56 64
PANDA B 5 3 2 0 1 0 0 0 17 18 9 7 1 0 6 7 93 60
13 RUSA 5 3 3 2 2 2 0 0 32 38 45 26 0 0 19 17 77 74
14 MURAI 3 0 2 0 3 0 3 0 30 0 6 0 6 0 1 5 32 32
15 MERAK 5 0 0 8 0 0 3 0 35 0 27 0 10 0 4 5 38 40
16 KANCIL 3 0 3 0 0 0 3 0 27 0 23 0 0 0 5 6 13 29
17 KELINCI 0 11 0 11 0 2 0 7 42 31 0 25 0 7 7 5 72 50
18 CAMAR B 2 0 0 0 0 0 0 0 30 0 0 10 0 0 2 5 29 35
19 KANGURU A 10 0 3 0 0 0 1 0 20 80 5 75 5 0 9 10 81 47
KANGURU B 10 0 5 0 0 0 10 0 50 0 10 0 8 0 13 11 89 86
20 NURI 10 0 5 0 0 0 10 0 50 0 10 0 8 0 8 8 72 61
21 BANGAU 1 2 0 0 0 0 0 0 3 15 0 19 0 0 4 2 22 17
JUMLAH 118 95 28 26 6 4 63 16 611 308 231 242 89 63 126 130 1047 955

AGUSTUS TAHUN 2021 F. KPPASI E. LANSIA

JML SASARAN JML YG HADIR JUMLAH SASARAN
NO NAMA 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 1 3 8 1 3 8 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 7 4 43 7 4 43 75 100 15
13 RUSA 12 10 93 12 10 93 79 132 100
14 MURAI 2 9 26 2 9 26 125 125 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 10 13 72 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 138 167 842 139 163 842 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN AGUSTUS 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 2 0 10 6 0 0 15 14 1 0 50 32 164 154 6
2 CAMAR .002 1 0 6 6 0 0 11 7 0 0 21 16 88 76 4
3 GELATIK A .003 1 1 7 8 1 1 22 24 1 1 61 56 185 180 14
4 GELATIK B .003 0 0 11 7 0 0 11 8 0 0 32 39 227 209 6
5 ELANG .004 0 0 12 10 0 0 5 11 0 0 44 32 135 120 11
6 MERPATI .005 0 0 4 3 0 0 5 10 0 0 12 17 78 66 0
7 GARUDA .006 0 0 3 1 1 0 6 4 0 0 8 19 72 62 1
 8 CENDRAWASIH .007 1 2 1 3 0 0 5 4 0 1 24 28 90 80 3
9 ANGSA .008 0 0 8 5 0 0 4 6 0 0 20 19 128 110 2
10 KIJANG .009 0 0 4 2 0 0 3 3 0 0 9 13 68 56 1
11 KUTILANG .011 0 0 3 3 0 0 4 5 0 0 8 6 58 46 2
12 PANDA A .012 0 0 14 17 0 0 25 20 0 0 31 44 158 150 10
13 PANDA B .012 0 0 8 9 0 0 21 14 0 0 72 46 125 116 7
14 RUSA .013 3 2 24 20 0 0 32 30 0 0 45 44 190 175 12
15 MURAI .014 0 2 1 5 0 0 10 9 0 0 22 23 84 80 2
16 MERAK .015 1 0 6 8 0 0 8 8 0 0 30 39 115 105 9
17 KANCIL .016 0 0 5 8 0 0 15 8 0 0 13 29 65 58 6
18 KELINCI .017 0 0 9 9 0 0 25 10 0 0 47 40 215 185 6
19 CAMAR B .018 2 0 4 11 0 0 4 12 0 0 25 23 115 101 7
20 KANGURU A .019 3 1 12 11 0 0 30 16 0 0 81 47 210 200 10
21 KANGURU B .019 1 0 19 12 0 0 18 26 0 0 71 60 275 140 7
22 NURI .020 0 0 24 22 0 0 26 29 0 0 57 26 188 178 13
23 BANGAU .023 0 0 6 4 0 0 7 5 0 0 15 12 55 49 0
JUMLAH 15 8 201 186 2 1 305 278 2 2 783 698 3088 2696 139
DATA HASIL KEGIATAN POSYANDU
BULAN AGUSTUS TAHUN 2021
format 7
JUMLAH BAYI YANG DI IMUNISASI
NAMA
N0 POSYANDU RW 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 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 0 0 1 1 4 5 0 0 0 0 1 1 4 5 1
4 GELATIK B .003 0 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0 0
5 ELANG .004 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0 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 0 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 1 0 0 1 0 0 0 0 1 0 0 0 1
14 RUSA .013 0 0 0 1 1 0 3 2 0 0 0 1 1 0 3 2 1
15 MURAI .014 0 0 1 0 0 4 1 0 0 0 1 0 0 4 1 0 0
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 2 1 0 0 0 0 0 0 2 1 0 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 1 1 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1
21 KANGURU B .019 1 2 1 1 0 0 1 0 1 2 1 1 0 0 1 0 2
22 NURI .020 0 0 1 1 1 0 1 3 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 8 7 10 4 14 8 16 11 8 7 10 4 12 10 16 10 9
DATA HASIL KEGIATAN POSYANDU
BULAN AGUSTUS TAHUN 2021
format 7
D F JML
I E IBU JUMLAH AKSEPTOR KB
P M
JML E T E K I S D
NAMA IBU R A N O M U A
P M M I N
I B Y N I P N
O O U
N0 POSYANDU RW K L U D L L
P W
T L JML JML BALITA
HAMIL

S E O A D I A
S BALITA YG MEMILIKI
A T U M N K I
I N KMS
(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 39 29 39
3 GELATIK A .003 14 14 14 86 2 30 13 0 6 11 48 0 93 91 93
 4 GELATIK B .003 6 6 6 37 2 15 10 0 2 0 15 0 54 54 54
5 ELANG .004 11 11 11 39 5 8 1 0 0 0 33 0 61 53 61
6 MERPATI .005 0 0 0 19 9 11 0 0 0 28 38 0 21 30 21
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 31 38 31
9 ANGSA .008 2 2 2 20 0 18 2 0 1 0 25 0 32 30 32
10 KIJANG .009 1 1 1 11 5 5 7 0 0 0 19 0 16 18 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 70 81 70
13 PANDA B .012 7 7 7 47 1 16 0 1 2 3 35 0 101 69 101
14 RUSA .013 12 12 12 103 0 71 0 4 5 3 70 0 104 96 104
15 MURAI .014 2 2 2 35 6 6 3 3 2 0 30 0 33 39 33
16 MERAK .015 9 9 9 27 10 27 3 0 8 0 35 0 45 55 45
17 KANCIL .016 6 6 6 36 0 23 3 0 3 0 27 0 33 45 33
18 KELINCI .017 6 6 6 53 7 25 7 2 11 11 73 0 81 59 81
19 CAMAR B .018 7 7 7 34 0 10 0 0 0 0 30 0 35 46 35
20 KANGURU A .019 10 10 10 85 5 80 1 0 3 0 100 0 126 75 126
21 KANGURU B .019 7 7 7 64 8 10 10 0 5 0 50 0 109 98 109
22 NURI .020 13 13 13 86 8 10 10 0 5 0 50 0 107 77 107
23 BANGAU .023 0 0 0 22 0 19 0 0 0 2 18 0 28 21 28
JUMLAH 138 139 139 1005 0 152 473 79 10 54 95 919 0 1331 1194 1331
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : AGUSTUS
RW / Kelurahan : DEPOK Petugas yang membina :

A. SKDN
UMUR D. IMUNISASI
BALITA
S K N T O B D = N+T+O+B NO JENIS
L P L P L P L P L P L P L P IMUNISASI
0 - 5 Bulan 82 62 82 62 69 54 0 0 0 0 12 6 82 62 1 BCG
6 - 11 Bulan 135 136 135 136 122 127 6 5 0 0 3 2 135 136 2 DPT 1
JUMLAH 217 198 217 198 191 181 6 5 0 0 15 8 217 198 3 DPT 2
12 - 24 Bulan 314 284 314 284 260 241 45 33 0 4 2 1 314 284 4 DPT 3
25 - 59 Bulan 800 712 800 712 679 613 104 85 0 0 2 2 800 712 5 POLIO 1
 JUMLAH 1114 996 1114 996 939 854 149 118 0 4 4 3 1114 996 6 POLIO 2
TOTAL 1 + 2 1331 1194 1331 1194 1130 1035 155 123 0 4 19 11 1331 1194 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 118 95 DIARE YANG 1 K1 0 - 5 bulan
2 MOW 28 26 L P DIBERIKAN 2 K4 6 bulan
3 MOP 6 4 3 N2 pada
4 IMPLANT 63 16 4 LINAKES bulan ini
JUMLAH 215 141
5 SUNTIK 611 308
6 PIL 231 242
7 KONDOM 89 63
JUMLAH 931 613
TOTAL 1146 754 Mengetahui
Pembina Wilayah Posyandu
Hal yang perlu dilaporkan :
PUS = 2696
WUS = 3088
BUSUI = 1005 ( ...................)

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 JUNI 0 0 273 264 0 0 338 292 0 0 689 706 3088 2696 136 1096

7 JULI 0 0 204 186 0 0 307 279 0 0 785 700 3088 2696 136 1096

8 AGUSTUS 15 8 201 186 2 1 305 278 2 2 783 698 3088 2696 139 1005

9 AGUSTUS
10 AGUSTUS
11
12
J UM L A H 51 47 1915 1832 6 4 2621 2313 8 2 5782 5589 24704 21568 1088 8864

DATA HASIL KEGIATAN POSYANDU

TAHUN 2021
D F
I JML
E
P
E T
R A
I B
 D F
I E
P IBU
M JUMLAH AKSEPTOR KB
E T E K I S D
JML O M U A
R A N P
IBU N P M M I N N
I B Y I
K D L O O U T L
L U
N0 BULAN L P W

HAMIL
S E O A D I A JML JML BALITA
S
A T U M N K I BALITA YG MEMILIKI
I N
KMS
(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 JUNI 136 136 136 1096 152 473 79 10 54 95 919 0 1323 1290 1323

7 JULI 136 136 136 1096 123 466 81 10 52 88 911 0 1318 1186 1318

8 AGUSTUS 138 139 139 1005 152 473 79 10 54 95 919 0 1331 1194 1331

9 AGUSTUS
10

J UM L A H 0 1088 1088 8864 0 1147 3779 652 64 373 745 7311 0 9423 8838 10612

DATA HASIL KEGIATAN POSYANDU

 TAHUN 2021

JUMLAH BAYI YANG DI IMUNISASI

BCG CAMPAK
N0 BULAN DPT POLIO
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 JUNI 0 0 8 8 14 10 16 14 0 0 9 8 14 10 16 13 10

7 JULI 0 0 1 0 8 9 16 17 0 0 1 0 8 9 17 18 9

8 AGUSTUS 8 7 10 4 14 8 16 11 8 7 10 4 12 10 16 10 9

9 AGUSTUS

10 AGUSTUS

11

12
JUMLAH 45 33 87 65 101 68 115 113 48 34 69 59 102 70 121 113 91
 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 8 5 12 11 45 28 0 0 1 1 3 3 5 4 0 0 0 0 0 0 0 0 1 0 1
2 1 4 11 7 21 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
1 4 7 12 13 31 31 0 0 0 0 10 11 30 25 0 0 0 0 0 0 0 0 1 1 0
2 6 5 10 8 30 36 0 0 0 0 1 0 2 3 0 0 0 0 0 0 0 0 0 0
3 6 7 3 9 20 19 0 0 0 0 2 2 24 13 0 0 0 0 0 0 0 0 0 0 0
1 1 2 4 8 12 14 0 0 0 0 1 2 0 3 0 0 0 0 0 0 0 0 0 0 0
0 1 1 6 4 8 18 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
3 0 0 4 2 22 26 0 0 0 0 1 2 2 2 0 0 0 0 0 0 0 0 0 1 1
2 4 3 4 6 20 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 1 3 3 9 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 2 3 4 6 4 0 0 0 0 1 1 2 2 0 0 0 0 0 0 0 0 0 0 0
7 9 10 20 18 25 40 0 0 0 0 5 2 6 4 0 0 0 0 0 0 0 0 0 0 0
2 6 7 21 14 72 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 19 17 31 29 43 44 0 0 0 0 1 1 2 0 0 0 0 0 0 0 0 0 3 2 0
1 1 4 8 7 19 20 0 0 0 0 2 2 3 3 0 0 0 0 0 0 0 0 0 1 0
3 4 5 7 8 25 30 0 0 0 0 1 0 5 9 0 0 0 0 0 0 0 0 1 0 0
2 5 6 10 6 12 25 0 0 0 0 5 2 1 4 0 0 0 0 0 0 0 0 0 0 0
4 7 5 20 10 43 36 0 0 0 0 5 0 4 4 0 0 0 0 0 0 0 0 0 0 0
6 2 5 4 12 25 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
1 7 8 27 14 75 46 0 0 2 2 3 2 6 1 0 0 0 0 0 0 0 0 3 1 0
1 10 9 14 23 68 58 0 0 3 2 4 3 3 2 0 0 0 0 0 0 0 0 1 0 0
8 17 14 26 25 48 21 0 0 0 0 0 0 9 5 0 0 0 0 0 4 0 0 0 0 0
 2 4 2 5 3 12 10 0 0 0 0 2 2 3 2 0 0 0 0 0 0 0 0 0 0 0
54 122 127 260 241 679 613 0 0 6 5 45 33 104 85 0 0 0 0 0 4 0 0 12 6 3

UR BGM 2T GAKIN/
lan) 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
KEHAMILAN GAKIN/
NON JUMLAH KUNJUNGAN
(Bln)
GAKIN UNRAIAN
K1 K4 N2 LINAKES
 UMUR
KEHAMILAN GAKIN/ JUMLAH KUNJUNGAN
(Bln) NON
GAKIN UNRAIAN
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
8 5 12 11 45 28 0 0 1 1 L 3 5 4
1 4 11 7 21 16 0 0 0 0 0 0 0 0
4 7 12 13 31 31 0 0 0 0 10 11 30 25
6 5 10 8 30 36 0 0 0 0 1 0 2 3
6 7 3 9 20 19 0 0 0 0 2 2 24 13
1 2 4 8 12 14 0 0 0 0 1 2 0 3
1 1 6 4 8 18 0 0 0 0 0 0 0 1
0 0 4 2 22 26 0 0 0 0 1 2 2 2
4 3 4 6 20 19 0 0 0 0 0 0 0 0
2 1 3 3 9 13 0 0 0 0 0 0 0 0
2 2 3 4 6 4 0 0 0 0 1 1 2 2
9 10 20 18 25 40 0 0 0 0 5 2 6 4
6 7 21 14 72 46 0 0 0 0 0 0 0 0
19 17 31 29 43 44 0 0 0 0 1 1 2 0
1 4 8 7 19 20 0 0 0 0 2 2 3 3
4 5 7 8 25 30 0 0 0 0 1 0 5 9
5 6 10 6 12 25 0 0 0 0 5 2 1 4
7 5 20 10 43 36 0 0 0 0 5 0 4 4
2 5 4 12 25 23 0 0 0 0 0 0 0 0
7 8 27 14 75 46 0 0 2 2 3 2 6 1
10 9 14 23 68 58 0 0 3 2 4 3 3 2
17 14 26 25 48 21 0 0 0 0 0 0 9 5
4 2 5 3 12 10 0 0 0 0 2 2 3 2
122 127 260 241 679 613 0 0 6 5 45 33 104 85
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
2 4 11 7 21 16 10 0 1 0 2 0
4 7 23 25 62 57 10 0 0 0 3 0
6 5 11 8 32 39 12 0 2 0 3 0
6 7 5 11 44 32 15 0 0 0 3 0
1 2 5 10 12 17 10 0 0 0 3 0
1 1 7 4 8 19 10 0 1 0 3 0
1 1 5 4 24 29 11 0 0 0 3 0
4 3 4 6 20 19 6 0 0 0 2 0
2 1 3 3 9 13 6 0 0 0 0 0
2 2 4 5 8 6 6 0 0 0 2 0
9 10 25 20 31 44 10 0 1 0 3 0
6 7 21 14 72 46 10 0 0 0 3 0
19 17 32 30 45 44 10 0 0 0 2 0
1 5 10 9 22 23 10 0 0 0 2 0
4 5 8 8 30 39 8 0 0 0 2 0
5 6 15 8 13 29 10 0 0 0 2 0
7 5 25 10 47 40 10 0 1 0 2 0
2 5 4 12 25 23 10 0 0 0 1 0
9 10 30 16 81 47 10 0 1 0 2 0
13 11 18 26 71 60 10 0 1 0 2 0
17 14 26 29 57 26 10 0 0 0 2 0
4 2 7 5 15 12 6 0 0 2 0
135 136 314 284 800 712 220 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 1 1 0 3 0 4 0 1 1 2
2 1 1 0 0 1 0 0 0 1 0 0 0 1
4 3 1 0 1 0 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 1 1 1 0 0 0 5 0 0 0 0
1 0 3 2 1 0 0 2 0 7 0 0 0 0
1 0 1 0 0 0 0 0 0 1 1 0 0 1
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 1 1 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 6 15 11 9 9 0 23 0 70 3 1 4 4
VITAMIN 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
10 6 66 45 2 4 3 0 0 0 3 0 0 0
2 4 32 23 1 2 5 2 0 1 5 2 0 1
4 7 85 82 0 0 7 7 0 0 7 7 0 0
6 5 43 47 2 4 5 2 0 1 5 2 0 1
6 7 49 43 0 0 6 8 0 0 6 8 0 0
1 2 15 14 0 0 3 1 0 0 3 1 0 0
1 1 8 19 0 0 0 1 0 0 0 1 0 0
1 1 30 34 0 0 1 0 0 0 1 0 0 0
4 3 24 25 0 0 4 2 0 0 4 2 0 0
2 1 12 16 0 0 1 2 0 0 1 2 0 0
2 2 7 11 0 0 1 1 0 0 1 1 0 0
 9 10 55 64 1 2 5 7 1 1 5 7 1 1
6 7 93 60 0 0 2 2 0 0 2 2 0 0
19 17 77 74 0 0 8 5 0 0 8 5 0 0
1 5 32 32 0 0 2 7 0 0 2 7 0 0
4 5 38 40 0 0 4 3 0 0 4 3 0 0
5 6 13 29 1 2 0 2 0 1 0 2 0 1
7 5 72 50 3 6 2 4 1 1 2 4 1 1
2 5 29 35 0 0 2 5 0 0 2 5 0 0
9 10 81 47 2 4 6 2 3 2 6 2 3 2
13 11 89 86 2 4 7 1 2 0 7 1 2 0
8 8 72 61 0 0 7 8 0 0 7 8 0 0
4 2 22 17 0 0 2 2 0 0 2 2 0 0
126 130 1044 954 14 28 83 74 7 7 83 74 7 7

IA
AN 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
11 - 6 0 0 0 0 0 0 0 0
14 - 6 0 0 0 2 0 0 0 0
77 - 10 0 1 0 3 1 0 0 0
47 - 10 0 0 0 3 0 0 0 0
103 - 10 0 0 0 2 0 0 0 0
35 - 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
1005 - 220 0 9 2 47 7 5 0 0

021
BALITA YANG
MENDERITA DIARE
CAMPAK HEPATITIS B JUMLAH Mendapat
I II III ORALIT
P L P L P L P 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
1 0 0 1 1 4 5 0 1 1 2
1 0 0 2 1 1 0 0 0 0 1
0 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
1 0 0 0 0 0 1 0 0 0 0
0 0 1 1 0 3 2 0 0 0 0
0 0 0 1 0 1 0 1 0 0 1
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
1 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
9 6 3 15 6 15 11 3 1 4 4

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 67 44 76 51 79 52 1 1
29 39 29 38 29 34 27 39 29 0 3
91 93 91 51 52 89 89 93 91 3 4
 54 54 54 51 51 49 52 54 54 0 1
53 61 53 35 38 55 50 61 53 3 4
30 21 30 20 25 16 16 21 30 0 0
24 18 24 17 23 9 20 18 24 0 0
38 31 38 27 31 31 35 31 38 0 3
30 32 30 32 30 28 28 32 30 1 3
18 16 18 16 18 14 17 16 18 0 0
14 15 14 12 11 9 13 15 14 0 0
81 70 81 59 75 64 74 70 81 4 4
69 101 69 101 69 99 67 101 69 0 5
96 104 96 98 93 96 91 104 96 2 7
39 33 39 28 32 33 37 33 39 0 1
55 45 55 38 46 42 45 45 55 2 5
45 33 45 27 39 18 35 33 45 1 2
59 81 59 72 55 79 55 81 59 0 8
46 35 46 33 46 31 40 35 46 0 7
75 126 75 112 69 90 57 126 75 3 5
98 109 98 98 91 102 97 109 98 1 3
77 107 77 98 68 80 69 107 77 2 4
21 28 21 23 17 26 19 28 21 0 0
1194 1331 1194 1153 1052 1170 1084 1331 1194 23 70

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
8 7 8 POLIO 4 16 10 L P L P
10 4 9 HEPATITIS 1 6 3 45-60 Tahun 1664 1923 198 441
14 8 10 HEPATITIS 2 15 6 60-69 Tahun 785 805 90 217
16 11 11 HEPATITIS 3 15 11 > 70 Tahun 256 399 16 115
8 7 12 CAMPAK 9 9
 10 4 13 TT I 0 23 F. KPPASI
12 10 14 TT 2 0 70 PESERTA JML
SASARAN YG HADIR
I EKSLUSIF BUMIL 138 139
SASARAN MASIH ASI E BUSUI 0-6 BLN 167 163
L P L P BUSUI 7-24 BLN 855 855
83 74 83 74
SASARAN LULUS ASI E J. VITAMIN
L P L P SASARAN Jml.VIT A yg
7 7 7 7 UMUR diberikan
L P L P
6 - 11 bulan 126 130 126 130
12 - 59 bulan 1047 955 1044 954
Bufas - 14 - 28

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 1 2 47 1 1 0 0

236 0 1 2 32 1 1 0 0

220 0 9 2 47 7 5 0 0

0 1789 0 14 16 456 35 33 0 0

PENIMBANGAN BALITA
 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

1290 1324 1287 1252 1229 0 0 1324 1287 19 62

1186 1318 1186 1012 900 0 0 1318 1186 19 62

1194 1331 1194 1153 1052 1170 1084 1331 1194 23 70

0 9959 10564 9988 8955 8483 2346 2237 10564 9988 175 541
 BALITA YANG
MENDERITA DIARE
CAMPAK JUMLAH
HEPATITIS B 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

8 6 7 14 7 16 15 4 2 5 4

7 2 0 7 8 17 19 4 2 2 6

9 6 3 15 6 15 11 3 1 4 4

94 76 195 101 57 117 115 33 24 33 38

 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 D L P L P L P L P L P L P L P
0 0 0 1 0 3 0 10 6 15 14 51 32 131 10 0 1 0 0 - 1 1 0 0 1 0 0 0 1 1
0 0 0 0 0 5 2 2 4 11 7 21 16 68 10 0 1 0 20 1 1 1 0 0 0 1 0 1 1
0 1 1 1 1 4 2 4 7 23 25 62 57 184 10 0 0 0 30 0 0 0 0 1 1 4 5 0 0
0 0 0 5 2 6 5 11 8 32 39 108 12 0 2 0 30 0 0 0 0 2 0 1 0 0 0
0 0 0 0 0 6 3 6 7 5 11 44 32 114 15 0 0 0 30 0 0 1 0 4 3 1 0 0 0
0 0 0 0 0 3 1 1 2 5 10 12 17 51 10 0 0 0 30 0 0 0 0 0 0 0 0 0 0
0 1 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
1 0 0 0 1 1 4 1 1 5 4 24 29 69 11 0 0 0 30 0 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 1 2 1 3 3 9 13 34 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 5 7 9 10 25 20 31 44 151 10 0 1 0 30 1 0 2 0 2 0 0 0 1 0
0 0 0 0 0 2 2 6 7 21 14 72 46 170 10 0 0 0 30 0 0 0 0 1 0 0 1 0 0
0 0 0 0 0 8 5 19 17 32 30 45 44 200 10 0 0 0 20 0 0 0 1 1 0 3 2 0 0
1 0 0 0 0 0 2 1 5 10 9 22 23 72 10 0 0 0 20 0 0 1 0 0 4 1 0 0 0
0 0 0 0 0 3 3 4 5 8 8 30 39 100 8 0 0 0 20 0 0 0 1 1 0 1 0 0 0
0 0 0 0 0 0 2 5 6 15 8 13 29 78 10 0 0 0 20 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 4 7 5 25 10 47 40 140 10 0 1 0 20 2 1 0 0 0 0 0 0 2 1
0 0 0 0 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 6 2 9 10 30 16 81 47 201 10 0 1 0 20 1 1 1 0 0 0 1 0 1 1
0 0 0 0 0 7 1 13 11 18 26 71 60 207 10 0 1 0 20 1 2 1 1 0 0 1 0 1 2
0 0 0 0 7 8 17 14 26 29 57 26 184 10 0 0 0 20 0 0 1 1 1 0 1 3 0 0
0 0 0 0 0 2 2 4 2 7 5 15 12 49 6 0 0 2 0 0 0 0 0 0 0 0 0 0 0
2 2 1 2 2 82 62 135 136 314 284 800 712 2525 220 0 9 2 47 - 8 7 10 4 14 8 16 11 8 7
 H.P. DIARE G. KB
ALAT KONTRASEPSI
POLIO HIPATITIS CAMPAK
TT JUMLAH
YG DAPAT IUD MOW MOP IMPLANT
ORALIT JUMLAH PESERTA
II III IV I II III I II
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
0 0 1 1 4 5 0 0 1 1 4 5 1 1 0 3 0 4 0 1 1 2 23 11 2 4 0 0 9 4
0 0 2 0 1 0 0 0 2 1 1 0 0 1 0 0 0 1 0 0 0 1 3 0 2 0 0 0 10 0
1 0 4 3 1 0 1 0 4 3 1 0 1 0 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 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 5 0 0 0 0 5 3 2 0 1 0 0 0
0 1 1 0 3 2 0 1 1 0 3 2 1 0 0 2 0 7 0 0 0 0 5 3 3 2 2 2 0 0
1 0 0 4 1 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 1 3 0 2 0 3 0 3 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
0 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
1 0 0 0 1 0 1 0 0 0 1 0 1 1 0 3 0 5 0 0 0 0 10 0 3 0 0 0 1 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
10 4 12 10 16 10 6 3 15 6 15 11 9 9 0 23 0 70 3 1 4 4 118 95 28 26 6 4 63 16
 J. VITAMIN A K. ASI EKSLUSIF F. KPPASI
SEPSI

SASARAN

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

VIT. A
PESERTA JML SASARAN
6 - 11 BLN 12 - 59 BLN 6 - JML YG DIBERI
11 BLN VIT.
12 - 59 A
BLN 6 Bln pd 0 - 5 Bln Bln ini MIL 0-6 7 - 24
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 10 6 66 46 10 6 66 45 2 4 3 0 0 0 3 0 0 0 6 3 45
0 31 0 12 10 0 2 4 32 23 2 4 32 23 1 2 5 2 0 1 5 2 0 1 4 8 23
34 14 15 15 1 1 4 7 85 82 4 7 85 82 0 0 7 7 0 0 7 7 0 0 14 14 72
15 0 15 0 2 0 6 5 45 47 6 5 43 47 2 4 5 2 0 1 5 2 0 1 6 8 29
30 3 1 7 0 5 6 7 49 43 6 7 49 43 0 0 6 8 0 0 6 8 0 0 11 14 25
3 35 0 11 0 9 1 2 15 14 1 2 15 14 0 0 3 1 0 0 3 1 0 0 0 4 15
3 6 3 0 15 0 1 1 8 19 1 1 8 19 0 0 0 1 0 0 0 1 0 0 1 1 11
20 15 3 8 23 28 1 1 30 34 1 1 30 34 0 0 1 0 0 0 1 0 0 0 3 0 19
25 0 18 0 0 0 4 3 24 25 4 3 24 25 0 0 4 2 0 0 4 2 0 0 2 6 17
15 4 2 3 0 5 2 1 12 16 2 1 12 16 0 0 1 2 0 0 1 2 0 0 1 3 8
6 0 0 12 0 8 2 2 7 11 2 2 7 11 0 0 1 1 0 0 1 1 0 0 1 2 13
90 0 0 10 0 0 9 10 56 64 9 10 55 64 1 2 5 7 1 1 5 7 1 1 10 14 63
17 18 9 7 1 0 6 7 93 60 6 7 93 60 0 0 2 2 0 0 2 2 0 0 7 4 43
32 38 45 26 0 0 19 17 77 74 19 17 77 74 0 0 8 5 0 0 8 5 0 0 12 10 93
30 0 6 0 6 0 1 5 32 32 1 5 32 32 0 0 2 7 0 0 2 7 0 0 2 9 26
35 0 27 0 10 0 4 5 38 40 4 5 38 40 0 0 4 3 0 0 4 3 0 0 9 7 20
27 0 23 0 0 0 5 6 13 29 5 6 13 29 1 2 0 2 0 1 0 2 0 1 6 3 33
42 31 0 25 0 7 7 5 72 50 7 5 72 50 3 6 2 4 1 1 2 4 1 1 6 9 44
30 0 0 10 0 0 2 5 29 35 2 5 29 35 0 0 2 5 0 0 2 5 0 0 7 7 27
20 80 5 75 5 0 9 10 81 47 9 10 81 47 2 4 6 2 3 2 6 2 3 2 10 13 72
50 0 10 0 8 0 13 11 89 86 13 11 89 86 2 4 7 1 2 0 7 1 2 0 7 9 55
50 0 10 0 8 0 8 8 72 61 8 8 72 61 0 0 7 8 0 0 7 8 0 0 13 15 71
 3 15 0 19 0 0 4 2 22 17 4 2 22 17 0 0 2 2 0 0 2 2 0 0 0 4 18
611 308 231 242 89 63 126 130 1047 955 126 130 1044 954 14 28 83 74 7 7 83 74 7 7 138 167 842
 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
11 14 25 107 116 35 39 10 15 25 30 6 20 0 4- 135 120 0 0 0 0
0 4 15 20 30 5 8 3 5 2 0 0 7 0 5- 78 66 0 0 0 0
1 1 11 26 26 29 13 13 21 2 3 3 3 2 5- 72 62 0 0 0 0
3 0 19 130 125 68 57 21 28 0 0 0 0 0 0- 90 80 0 0 0 0
2 3 17 125 143 42 45 19 21 0 0 0 0 0 0- 128 110 0 0 0 0
1 3 8 88 101 75 89 55 68 0 0 0 0 0 0- 68 56 0 0 0 0
2 1 13 30 37 20 22 1 12 20 25 18 20 0 6- 58 46 0 0 0 0
10 14 63 20 32 10 20 5 4 5 20 2 5 2 5- 158 150 1 0 0 0
7 4 43 75 100 15 20 1 10 11 20 6 15 1 10 - 125 116 0 0 0 0
12 10 93 79 132 100 75 35 42 10 48 18 31 1 22 - 190 175 0 0 0 0
2 9 26 125 125 75 75 1 55 2 87 1 55 0 30 - 84 80 0 0 0 0
9 7 20 0 0 0 0 0 0 0 0 0 0 0 0 115 105 0 0 0 0
6 3 33 50 70 39 38 3 5 4 27 1 10 0 3- 65 58 1 0 0 0
6 9 44 120 149 31 35 4 6 0 0 0 0 0 0- 215 185 2 1 0 0
7 7 27 20 21 20 23 13 10 2 8 0 1 0 5- 115 101 0 0 0 0
10 13 72 30 33 10 12 2 5 10 33 4 6 1 2- 210 200 1 1 0 0
7 9 55 120 157 30 30 5 8 5 10 3 10 0 2- 275 140 1 1 0 0
13 15 71 50 50 38 37 10 20 10 20 10 15 3 7- 188 178 0 0 0 0
 0 4 18 28 21 9 8 3 2 0 0 0 0 0 0 55 49 0 0 0 0
139 163 842 1664 1923 785 805 256 399 198 441 90 217 16 115 - 3088 2696 7 5 0 0