JUNI 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
L P L P L P L P S D/S L P L P L P L P
1 PARKIT .001 5 5 23 21 22 24 26 27 153 100 5 5 23 21 22 24 26 27
CAMAR .002 1 1 2 9 17 11 17 25 83 100 1 1 2 9 17 11 17 25
3 GELATIK A .003 8 8 10 15 31 24 49 71 216 100 8 8 10 15 31 24 49 71
4 GELATIK B .003 4 2 6 5 11 8 32 39 107 100 4 2 6 5 11 8 32 39
5 ELANG .004 7 9 3 7 11 12 48 27 124 100 7 9 3 7 11 12 48 27
6 MERPATI .005 3 1 1 2 5 10 12 17 51 100 3 1 1 2 5 10 12 17
7 GARUDA .006 0 1 1 2 5 6 10 18 43 100 0 1 1 2 5 6 10 18
8 CENDRAWASIH .007 2 2 4 2 7 6 26 29 78 100 2 2 4 2 7 6 26 29
9 ANGSA .008 2 0 3 4 3 7 23 18 60 100 2 0 3 4 3 7 23 18
1 KIJANG .009 1 2 2 0 3 3 9 13 33 100 1 2 2 0 3 3 9 13
11 KUTILANG .011 1 1 2 2 4 5 8 6 29 100 1 1 2 2 4 5 8 6
12 PANDA A .012 3 9 18 23 24 18 34 43 172 100 3 9 18 23 24 18 34 43
13 PANDA B .012 2 2 13 10 23 12 62 45 169 100.59 2 2 13 10 23 12 62 45
14 RUSA 013 8 5 18 16 32 31 47 43 200 100 8 5 18 16 32 31 47 43
15 MURAI .014 2 7 6 4 7 11 21 21 79 100 2 7 6 4 7 11 21 21
16 MERAK .015 4 3 4 3 9 7 29 31 90 100 4 3 4 3 9 7 29 31
17 KANCIL 016 2 1 3 5 15 8 13 29 76 100 2 1 3 5 15 8 13 29
18 KELINCI 017 3 6 8 6 30 12 46 46 157 3 6 8 6 30 12 46 46
CAMAR B .018 2 5 5 3 7 11 19 18 70 2 5 5 3 7 11 19 18
20 KANGURU A .019 6 9 28 14 23 16 43 51 190 6 9 28 14 23 16 43 51
21 KANGURU B .019 10 8 9 5 23 21 57 63 196 10 8 9 5 23 21 57 63
22 NURI 20 7 8 17 14 26 29 57 26 184 7 8 17 14 26 29 57 26
23 BANGAU 23 2 4 5 4 8 5 13 12 53 2 4 5 4 8 5 13 12
JUMLAH 85 99 191 176 346 297 701 718 85 99 191 176 346 297 701 718

B. SURVEILANS
BULAN = JUNI

NAMA ALAMAT LAHIR

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 = JUNI
ALAMAT UMUR
NAMA BUMIL HAMIL
SUAMI ISTRI (Thn) KE
N0
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 = JUNI
NAMA ALAMAT UMUR
BUMIL HAMIL
N0 SUAMI ISTRI (Thn) KE

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 JUNI 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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 PARKIT 5 5 23 21 22 24 26 27 5 5 23 21 22 24 26 27 5
2 CAMAR 1 1 2 9 17 11 17 25 1 1 2 9 17 11 17 25 1
3 GELATIK A 8 8 10 15 31 24 49 71 8 8 10 15 31 24 49 71 8
GELATIK B 4 2 6 5 11 8 32 39 4 2 6 5 11 8 32 39 4
4 ELANG 7 9 3 7 11 12 48 27 7 9 3 7 11 12 48 27 7
5 MERPATI 3 1 1 2 5 10 12 17 3 1 1 2 5 10 12 17 3
6 GARUDA 0 1 1 2 5 6 10 18 0 1 1 2 5 6 10 18 0
7 CENDRAWASIH 2 2 4 2 7 6 26 29 2 2 4 2 7 6 26 29 2
8 ANGSA 2 0 3 4 3 7 23 18 2 0 3 4 3 7 23 18 2
9 KIJANG 1 2 2 0 3 3 9 13 1 2 2 0 3 3 9 13 1
11 KUTILANG 1 1 2 2 4 5 8 6 1 1 2 2 4 5 8 6 1
12 PANDA A 3 9 18 23 24 18 34 43 3 9 18 23 24 18 34 43 3
PANDA B 2 2 13 10 23 12 62 45 2 2 13 10 23 12 62 45 2
13 RUSA 8 5 18 16 32 31 47 43 8 5 18 16 32 31 47 43 8
14 MURAI 2 7 6 4 7 11 21 21 2 7 6 4 7 11 21 21 2
15 MERAK 4 3 4 3 9 7 29 31 4 3 4 3 9 7 29 31 4
16 KANCIL 2 1 3 5 15 8 13 29 2 1 3 5 15 8 13 29 2
17 KELINCI 3 6 8 6 30 12 46 46 3 6 8 6 30 12 46 46 3
18 CAMAR B 2 5 5 3 7 11 19 18 2 5 5 3 7 11 19 18 2
19 KANGURU A 6 9 28 14 23 16 43 51 6 9 28 14 23 16 43 51 6
KANGURU B 10 8 9 5 23 21 57 63 10 8 9 5 23 21 57 63 10
20 NURI 7 8 17 14 26 29 57 26 7 8 17 14 26 29 57 26 7
21 BANGAU 2 4 5 4 8 5 13 12 2 4 5 4 8 5 13 12 2
JUMLAH 85 99 191 176 346 297 701 718 85 99 191 176 346 297 701 718 83
LAPORAN BULANAN POSYANDU
 KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN JUNI
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
1 2 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 PARKIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
2 CAMAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
3 GELATIK A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
GELATIK B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
4 ELANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
5 MERPATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
6 GARUDA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 CENDRAWASIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
8 ANGSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
9 KIJANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11 KUTILANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
12 PANDA A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
PANDA B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
13 RUSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
14 MURAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
15 MERAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
16 KANCIL 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 3
18 CAMAR B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
19 KANGURU A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
KANGURU B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
20 NURI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85
JUNI TAHUN 2021
D. IMUNISASI
JENIS IMUNISASI
NAMA
DPT POLIO
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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 PARKIT 0 0 1 1 1 1 2 1 0 0 1 1 1 1 2 1 0
2 CAMAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 GELATIK A 0 0 0 0 1 1 4 5 0 0 0 0 1 1 4 5 0
GELATIK B 0 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0 0
4 ELANG 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0 1
5 MERPATI 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
7 CENDRAWASIH 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1
8 ANGSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 KIJANG 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
12 PANDA A 0 0 2 2 0 0 0 0 0 0 2 2 0 0 0 0 2
 PANDA B 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0
13 RUSA 0 0 0 1 1 0 3 2 0 0 0 1 1 0 3 2 0
14 MURAI 0 0 1 0 0 4 1 0 0 0 1 0 0 4 1 0 0
15 MERAK 0 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0 0
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 KELINCI 0 0 0 1 1 0 1 0 0 0 1 1 1 0 1 0 0
18 CAMAR B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 KANGURU A 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0
KANGURU B 0 0 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1
20 NURI 0 0 1 1 1 0 1 3 0 0 1 1 1 0 1 3 1
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 8 8 14 10 16 14 0 0 9 8 14 10 16 13 6

JUNI TAHUN 2021 G. KB

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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 PARKIT 14 7 0 0 0 0 0 0 34 18 39 2 0 0 0 0 0
2 CAMAR 0 0 0 0 0 0 0 0 0 31 0 12 10 0 0 0 0
3 GELATIK A 23 11 2 4 0 0 9 4 34 14 15 15 1 1 0 0 0
GELATIK B 3 0 2 0 0 0 10 0 15 0 15 0 2 0 0 0 0
4 ELANG 4 0 0 0 0 0 1 0 30 3 1 7 0 5 0 0 0
5 MERPATI 2 28 0 0 0 0 0 0 3 35 0 11 0 9 0 0 0
6 GARUDA 2 11 0 0 0 0 0 0 3 6 3 0 15 0 0 0 0
7 CENDRAWASIH 8 11 0 1 0 0 1 2 20 15 3 8 23 28 0 0 0
8 ANGSA 3 0 1 0 0 0 2 0 25 0 18 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
11 KUTILANG 0 8 0 0 0 0 2 0 6 0 0 12 0 8 0 0 0
 12 PANDA A 5 0 0 0 0 0 4 0 90 0 0 10 0 0 0 0 0
PANDA B 5 3 2 0 1 0 0 0 17 18 9 7 1 0 0 0 0
13 RUSA 5 3 3 2 2 2 0 0 32 38 45 26 0 0 0 0 0
14 MURAI 3 0 2 0 3 0 3 0 30 0 6 0 6 0 0 0 0
15 MERAK 5 0 0 8 0 0 3 0 35 0 27 0 10 0 0 0 0
16 KANCIL 3 0 3 0 0 0 3 0 27 0 23 0 0 0 0 0 0
17 KELINCI 0 11 0 11 0 2 0 7 42 31 0 25 0 7 0 0 0
18 CAMAR B 2 0 0 0 0 0 0 0 30 0 0 10 0 0 0 0 0
19 KANGURU A 10 0 3 0 0 0 1 0 20 80 5 75 5 0 0 0 0
KANGURU B 10 0 5 0 0 0 10 0 50 0 10 0 8 0 0 0 0
20 NURI 10 0 5 0 0 0 10 0 50 0 10 0 8 0 0 0 0
21 BANGAU 1 2 0 0 0 0 0 0 3 15 0 19 0 0 0 0 0
JUMLAH 118 95 28 26 6 4 63 16 611 308 231 242 89 63 0 0 0

JUNI 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 4 10 90 4 10 90 100 125 20
2 CAMAR 6 2 38 5 7 36 50 50 40
3 GELATIK A 14 14 72 14 14 72 130 140 42
GELATIK B 2 6 25 2 6 25 141 140 32
4 ELANG 11 14 25 11 14 25 107 116 35
5 MERPATI 0 4 18 0 4 18 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 3 2 17 3 2 17 125 143 42
9 KIJANG 0 3 8 0 3 8 88 101 75
 11 KUTILANG 1 2 13 2 1 13 30 37 20
12 PANDA A 10 13 75 10 15 77 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 26 6 3 26 50 70 39
17 KELINCI 11 9 55 11 8 56 120 149 31
18 CAMAR B 7 7 27 7 7 27 20 21 20
19 KANGURU A 9 9 76 9 9 76 30 33 10
KANGURU B 5 14 56 5 14 56 120 157 30
20 NURI 13 15 71 13 15 71 50 50 38
21 BANGAU 0 6 22 0 6 22 28 21 9
JUMLAH 136 164 926 136 169 927 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN JUNI 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
L P L P L P L P L P L P
1 PARKIT .001 0 0 25 26 0 0 22 24 0 0 26 27 164 154
2 CAMAR .002 0 0 3 10 0 0 17 11 0 0 17 25 88 76
3 GELATIK A .003 0 0 18 23 0 0 31 24 0 0 49 71 185 180
4 GELATIK B .003 0 0 10 7 0 0 11 8 0 0 32 39 227 209
5 ELANG .004 0 0 10 16 0 0 11 12 0 0 48 27 135 120
6 MERPATI .005 0 0 4 3 0 0 5 10 0 0 12 17 78 66
7 GARUDA .006 0 0 1 3 0 0 5 6 0 0 10 18 72 62
 8 CENDRAWASIH .007 0 0 6 4 0 0 7 6 0 0 26 29 90 80
9 ANGSA .008 0 0 5 4 0 0 3 7 0 0 23 18 128 110
10 KIJANG .009 0 0 3 2 0 0 3 3 0 0 9 13 68 56
11 KUTILANG .011 0 0 3 3 0 0 4 5 0 0 8 6 58 46
12 PANDA A .012 0 0 21 32 0 0 24 18 0 0 34 43 158 150
13 PANDA B .012 0 0 15 12 0 0 23 12 0 0 63 45 125 116
14 RUSA .013 0 0 26 21 0 0 32 31 0 0 47 43 190 175
15 MURAI .014 0 0 8 11 0 0 7 11 0 0 21 21 84 80
16 MERAK .015 0 0 8 6 0 0 9 7 0 0 29 31 115 105
17 KANCIL .016 0 0 5 6 0 0 15 8 0 0 13 29 65 58
18 KELINCI .017 0 0 11 9 0 0 30 12 0 0 46 46 215 185
19 CAMAR B .018 0 0 7 8 0 0 7 11 0 0 19 18 115 101
20 KANGURU A .019 0 0 34 23 0 0 23 16 0 0 43 51 210 200
21 KANGURU B .019 0 0 19 13 0 0 23 21 0 0 57 63 275 140
22 NURI .020 0 0 24 22 0 0 26 29 0 0 57 26 188 178
23 BANGAU .023 0 0 7 8 0 0 8 5 0 0 13 12 55 49
JUMLAH 0 0 273 264 0 0 338 292 0 0 689 706 3088 2696
DATA HASIL KEGIATAN POSYANDU
BULAN JUNI TAHUN 2021
format 7
JUMLAH BAYI YANG DI IMUNISASI
NAMA
N0 POSYANDU RW BCG 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
1 PARKIT .001 0 0 1 1 1 1 2 1 0 0 1 1 1 1 2 1
2 CAMAR .002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 GELATIK A .003 0 0 0 0 1 1 4 5 0 0 0 0 1 1 4 5
4 GELATIK B .003 0 0 0 0 2 0 1 0 0 0 0 0 2 0 1 0
5 ELANG .004 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0
6 MERPATI .005 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
8 CENDRAWASIH .007 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0
 9 ANGSA .008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 KIJANG .009 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
12 PANDA A .012 0 0 2 2 0 0 0 0 0 0 2 2 0 0 0 0
13 PANDA B .012 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0
14 RUSA .013 0 0 0 1 1 0 3 2 0 0 0 1 1 0 3 2
15 MURAI .014 0 0 1 0 0 4 1 0 0 0 1 0 0 4 1 0
16 MERAK .015 0 0 0 1 1 0 1 0 0 0 0 1 1 0 1 0
17 KANCIL .016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 KELINCI .017 0 0 0 1 1 0 1 0 0 0 1 1 1 0 1 0
19 CAMAR B .018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 KANGURU A .019 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
21 KANGURU B .019 0 0 1 1 1 1 1 1 0 0 1 1 1 1 1 1
22 NURI .020 0 0 1 1 1 0 1 3 0 0 1 1 1 0 1 3
23 BANGAU .023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 8 8 14 10 16 14 0 0 9 8 14 10 16 13
DATA HASIL KEGIATAN POSYANDU
BULAN JUNI TAHUN 2021
format 7
D F JML
I E IBU JUMLAH AKSEPTOR KB
P M
JML E T K I S D
E
NAMA IBU R A N O M U A
P M M I N
I B Y N I P N
N0 D O O U L
POSYANDU RW K L U L L
P
T JML
W
HAMIL

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

1 PARKIT .001 4 4 4 100 0 41 0 0 0 7 52 0 76 77

2 CAMAR .002 6 5 5 43 10 12 0 0 0 0 31 0 37 46
3 GELATIK A .003 14 14 14 86 2 30 13 0 6 11 48 0 98 118
 4 GELATIK B .003 2 2 2 31 2 15 10 0 2 0 15 0 53 54
5 ELANG .004 11 11 11 39 5 8 1 0 0 0 33 0 69 55
6 MERPATI .005 0 0 0 22 9 11 0 0 0 28 38 0 21 30
7 GARUDA .006 1 1 1 12 15 3 0 0 0 11 9 0 16 27
8 CENDRAWASIH .007 3 3 3 19 51 11 3 0 1 11 35 0 39 39
9 ANGSA .008 3 3 3 19 0 18 2 0 1 0 25 0 31 29
10 KIJANG .009 0 0 0 11 5 5 7 0 0 0 19 0 15 18
11 KUTILANG .011 1 2 2 14 8 12 2 0 0 8 6 0 15 14
12 PANDA A .012 10 10 10 92 0 10 4 0 0 0 90 0 79 93
13 PANDA B .012 7 7 7 47 1 16 0 1 2 3 35 0 100 69
14 RUSA .013 12 12 12 103 0 71 0 4 5 3 70 0 105 95
15 MURAI .014 2 2 2 35 6 6 3 3 2 0 30 0 36 43
16 MERAK .015 9 9 9 27 10 27 3 0 8 0 35 0 46 44
17 KANCIL .016 6 6 6 29 0 23 3 0 3 0 27 0 33 43
18 KELINCI .017 11 11 11 64 7 25 7 2 11 11 73 0 87 70
19 CAMAR B .018 7 7 7 34 0 10 0 0 0 0 30 0 33 37
20 KANGURU A .019 9 9 9 85 5 80 1 0 3 0 100 0 100 90
21 KANGURU B .019 5 5 5 70 8 10 10 0 5 0 50 0 99 97
22 NURI .020 13 13 13 86 8 10 10 0 5 0 50 0 107 77
23 BANGAU .023 0 0 0 28 0 19 0 0 0 2 18 0 28 25
JUMLAH 136 136 136 1096 0 152 473 79 10 54 95 919 0 1323 1290
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : JUNI
RW / Kelurahan : DEPOK Petugas yang membina :

A. SKDN
UMUR D. IMUNISASI
BALITA NO JENIS
S K N T O B D = N+T+O+B
L P L P L P L P L P L P L P IMUNISASI
0 - 5 Bulan 85 99 85 99 83 95 0 0 0 0 0 0 85 95 1 BCG
6 - 11 Bulan 191 176 191 176 183 166 3 3 0 0 0 0 186 169 2 DPT 1
JUMLAH 276 275 276 275 266 261 3 3 0 0 0 0 271 264 3 DPT 2
12 - 24 Bulan 346 297 346 297 318 281 20 11 0 0 0 0 338 292 4 DPT 3
25 - 59 Bulan 701 718 701 718 640 662 49 44 0 0 0 0 689 706 5 POLIO 1
 JUMLAH 1047 1015 1047 1015 958 943 69 55 0 0 0 0 1027 998 6 POLIO 2
TOTAL 1 + 2 1323 1290 1323 1290 1224 1204 72 58 0 0 0 0 1298 1262 7 POLIO 3

G. KB H. PENANGGULANGAN DIARE I. KUNJUNGAN KIA

NO KONTRASEPSI JUMLAH PESERTA JML BALITA JUMLAH NO. URAIAN JUMLAH
PEMERINTAH SWASTA MENDERITA ORALIT KUNJUNGAN
1 IUD 118 95 DIARE YANG 1 K1
2 MOW 28 26 L P DIBERIKAN 2 K4
3 MOP 6 4 3 N2
4 IMPLANT 63 16 4 LINAKES
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 = 1096 ( ...................)

JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU

JUMLAH BAYI LAHIR / MENINGGAL
TAHUN 2021

JUMLAH PENGUNJUNG
 BALITA IBU

HAMIL
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

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

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

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

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

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

7
8
9
10
11
12
J UM L A H 36 39 1510 1460 4 3 2009 1756 6 0 4214 4191 18528 16176 813

DATA HASIL KEGIATAN POSYANDU

TAHUN 2021

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

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

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

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

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

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

6 JUNI 136 136 136 1096 152 473 79 10 54 95 919 0 1323 1290

7
8
9
10

J UM L A H 0 813 813 6763 0 872 2840 492 44 267 562 5481 0 6774 6458

DATA HASIL KEGIATAN POSYANDU

 TAHUN 2021

JUMLAH BAYI YANG DI IMUNISASI

N0 BULAN BCG 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

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

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

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

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

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

6 JUNI 0 0 8 8 14 10 16 14 0 0 9 8 14 10 16 13

10

11

12
JUMLAH 37 26 76 61 79 51 83 85 40 27 58 55 82 51 88 85
 N T O
0 - 5 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
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
5 5 20 21 22 24 20 25 0 0 3 0 0 0 6 2 0 0 0 0 0 0 0 0 0 0
1 1 2 9 17 11 17 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 8 10 15 29 22 45 65 0 0 0 0 2 2 4 6 0 0 0 0 0 0 0 0 0 0
4 2 6 5 10 8 30 30 0 0 0 0 1 0 2 9 0 0 0 0 0 0 0 0 0 0
7 9 3 5 11 12 45 27 0 0 0 2 0 0 3 0 0 0 0 0 0 0 0 0 0 0
3 1 1 2 5 10 12 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 1 2 5 6 10 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 2 4 2 7 6 26 28 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
2 0 3 4 3 7 20 16 0 0 0 0 0 0 3 2 0 0 0 0 0 0 0 0 0 0
1 2 2 0 3 3 9 10 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0
1 1 2 2 4 5 8 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 9 18 22 24 18 30 42 0 0 0 1 0 0 4 1 0 0 0 0 0 0 0 0 0 0
2 2 13 10 23 12 60 43 0 0 0 0 0 0 3 2 0 0 0 0 0 0 0 0 0 0
8 5 18 16 30 30 45 40 0 0 0 0 2 1 2 3 0 0 0 0 0 0 0 0 0 0
2 7 6 4 7 11 21 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 3 4 3 9 7 25 30 0 0 0 0 0 0 4 1 0 0 0 0 0 0 0 0 0 0
2 1 3 5 15 8 13 25 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0
3 6 8 3 25 10 40 40 0 0 0 0 5 2 6 6 0 0 0 0 0 0 0 0 0 0
2 5 5 3 7 11 19 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 9 28 14 20 15 40 50 0 0 0 0 3 1 3 1 0 0 0 0 0 0 0 0 0 0
10 8 9 5 22 20 50 60 0 0 0 0 1 1 7 3 0 0 0 0 0 0 0 0 0 0
7 8 17 14 20 25 55 26 0 0 0 0 6 4 2 0 0 0 0 0 0 0 0 0 0 0
 2 4 5 4 8 5 13 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 95 183 166 318 281 640 662 0 0 3 3 20 11 49 44 0 0 0 0 0 0 0 0 0 0

UMUR BGM 2T GAKIN/

(Bulan) 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
AN KIA

UMUR
KEHAMILAN GAKIN/
AMIL NON JUMLAH KUNJUNGAN
KE (Bln)
GAKIN UNRAIAN
K1 K4 N2 LINAKES
AN KIA

UMUR
KEHAMILAN GAKIN/ JUMLAH KUNJUNGAN
AMIL NON
KE (Bln)
GAKIN UNRAIAN
K1 K4 N2 LINAKES
HUN 2021

N T
6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 11 BLN 12-24 BLN 25-59 BLN
P L P L P L P L P L P L P L P
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
5 20 21 22 24 20 25 0 0 3 0 L 0 6 2
1 2 9 17 11 17 25 0 0 0 0 0 0 0 0
8 10 15 29 22 45 65 0 0 0 0 2 2 4 6
2 6 5 10 8 30 30 0 0 0 0 1 0 2 9
9 3 5 11 12 45 27 0 0 0 2 0 0 3 0
1 1 2 5 10 12 17 0 0 0 0 0 0 0 0
1 1 2 5 6 10 18 0 0 0 0 0 0 0 0
2 4 2 7 6 26 28 0 0 0 0 0 0 0 1
0 3 4 3 7 20 16 0 0 0 0 0 0 3 2
2 2 0 3 3 9 10 0 0 0 0 0 0 0 3
1 2 2 4 5 8 6 0 0 0 0 0 0 0 0
9 18 22 24 18 30 42 0 0 0 1 0 0 4 1
2 13 10 23 12 60 43 0 0 0 0 0 0 3 2
5 18 16 30 30 45 40 0 0 0 0 2 1 2 3
7 6 4 7 11 21 21 0 0 0 0 0 0 0 0
3 4 3 9 7 25 30 0 0 0 0 0 0 4 1
1 3 5 15 8 13 25 0 0 0 0 0 0 0 4
6 8 3 25 10 40 40 0 0 0 0 5 2 6 6
5 5 3 7 11 19 18 0 0 0 0 0 0 0 0
9 28 14 20 15 40 50 0 0 0 0 3 1 3 1
8 9 5 22 20 50 60 0 0 0 0 1 1 7 3
8 17 14 20 25 55 26 0 0 0 0 6 4 2 0
4 5 4 8 5 13 12 0 0 0 0 0 0 0 0
95 183 166 318 281 640 662 0 0 3 3 20 11 49 44
TAHUN 2021
D PETUGAS YG HADIR
6 - 12 BLN 12-24 BLN 25-59 BLN PKK PLKB MEDIS KETERANGAN
P L P L P L P L P L P
52 53 54 55 56 57 58 59 60 61 62 63 64
5 23 21 22 24 26 27 10 0 0 0 0 0
1 2 9 17 11 17 25 10 0 0 0 2 0
8 10 15 31 24 49 71 10 0 0 0 3 0
2 6 5 11 8 32 39 12 0 0 0 3 0
9 3 7 11 12 48 27 15 0 0 0 3 0
1 1 2 5 10 12 17 10 0 0 0 3 0
1 1 2 5 6 10 18 10 0 1 0 3 0
2 4 2 7 6 26 29 11 0 0 0 3 0
0 3 4 3 7 23 18 6 0 0 0 2 0
2 2 0 3 3 9 13 6 0 0 0 0 0
1 2 2 4 5 8 6 6 0 0 0 2 0
9 18 23 24 18 34 43 10 0 0 0 3 0
2 13 10 23 12 63 45 10 0 0 0 3 0
5 18 16 32 31 47 43 10 0 0 0 2 0
7 6 4 7 11 21 21 10 0 0 0 2 0
3 4 3 9 7 29 31 8 0 0 0 2 0
1 3 5 15 8 13 29 10 0 0 0 2 0
6 8 3 30 12 46 46 10 0 0 0 2 0
5 5 3 7 11 19 18 10 0 0 0 1 0
9 28 14 23 16 43 51 10 0 0 0 2 0
8 9 5 23 21 57 63 10 0 0 0 2 0
8 17 14 26 29 57 26 10 0 0 0 2 0
4 5 4 8 5 13 12 6 0 0 2 0
95 186 169 338 292 689 706 220 0 1 2 47 -
 H.P. DIARE
JML. BALITA DIARE
YANG
HIPATITIS CAMPAK TT JUMLAH MENDAPAT
ORALIT

II III I II
P L P L P L P L P L P L P L P
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
0 1 1 2 1 1 1 0 2 0 1 0 0 0 0
0 0 0 0 0 1 0 0 1 0 5 0 0 0 0
0 1 1 4 5 1 1 0 3 0 4 0 1 1 2
0 2 1 1 0 0 1 0 0 0 1 0 0 0 1
0 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 0 0 0 1 0 0 0 0 3 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 1 1 1 0 0 0 6 0 1 0 0
 0 0 0 0 1 1 1 0 0 0 5 0 0 0 0
1 1 0 3 2 1 0 0 2 0 7 0 0 0 0
0 1 0 1 0 0 0 0 0 0 1 1 0 0 1
1 1 0 1 0 0 1 0 2 0 5 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 1 0 0 0 0 2 0 3 0 0 0 0
0 0 0 0 0 0 0 0 0 0 7 0 0 0 0
0 0 0 0 1 1 1 0 2 0 4 1 0 1 0
1 1 1 1 1 1 0 0 0 0 2 1 0 1 0
1 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 0
7 14 7 16 15 10 8 0 19 0 62 4 2 5 4
J. VITAMIN A K. ASI EKSLUSIF
BUFAS JML SASARAN MASIH LULUS ASI

MENDPT VIT.A
JML YG DIBERI VIT A ASI
6 Bln pd 6 Bln pd
SASARAN

0 - 5 BLN Bln ini AKSLUSIF Bln ini

9 BLN 12-59 BLN 12-59 BLN 0 - 5 Bln
P L P L P L P L P L P L P
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
0 0 0 0 0 0 0 5 5 0 0 5 5 0 0
0 0 0 0 0 0 0 0 1 0 1 0 1 0 1
0 0 0 0 0 0 0 7 7 0 0 7 7 0 0
0 0 0 0 0 0 0 4 2 0 0 4 2 0 0
0 0 0 0 0 0 0 6 8 0 0 6 8 0 0
0 0 0 0 0 0 0 3 1 0 0 3 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 1 0 0 0 1 0 0 0
0 0 0 0 0 0 0 2 0 0 0 2 0 0 0
0 0 0 0 0 0 0 1 2 0 0 1 2 0 0
0 0 0 0 0 0 0 1 1 0 0 1 1 0 0
 0 0 0 0 0 0 0 3 9 0 0 3 9 0 0
0 0 0 0 0 0 0 2 2 0 0 2 2 0 0
0 0 0 0 0 0 0 8 5 0 0 8 5 0 0
0 0 0 0 0 0 0 2 7 0 0 2 7 0 0
0 0 0 0 0 0 0 4 3 0 0 4 3 0 0
0 0 0 0 0 0 0 2 1 0 0 2 1 0 0
0 0 0 0 0 0 0 3 6 0 0 3 6 0 0
0 0 0 0 0 0 0 2 5 0 0 2 5 0 0
0 0 0 0 0 0 0 6 9 0 0 4 9 0 0
0 0 0 0 0 0 0 10 8 0 0 10 8 0 0
0 0 0 0 0 0 0 7 8 0 0 7 8 0 0
0 0 0 0 0 0 0 2 4 0 0 2 4 0 0
0 0 0 0 0 0 0 81 95 0 1 79 95 0 1

E. LANSIA
H SASARAN JML YG HADIR KETERANGAN
UMUR UMUR

60 - 69 Thn > 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
IBU JUMLAH BAYI
YANG HADIR

HAMIL BUSUI KADER PLKB MEDIS LAHIR MENINGGAL

L P L P L P L P L P
4 100 - 10 0 0 0 0 1 1 0 0
5 43 - 10 0 0 0 2 0 0 0 0
14 86 - 10 0 0 0 3 0 0 0 0
2 31 - 12 0 0 0 3 0 0 0 0
11 39 - 15 0 0 0 3 0 0 0 0
0 22 0 10 0 0 0 3 0 0 0 0
1 12 - 10 0 1 0 3 0 0 0 0
 3 19 - 11 0 0 0 3 0 0 0 0
3 19 - 6 0 0 0 2 0 0 0 0
0 11 - 6 0 0 0 0 0 0 0 0
2 14 - 6 0 0 0 2 0 0 0 0
10 92 - 10 0 0 0 3 0 0 0 0
7 47 - 10 0 0 0 3 0 0 0 0
12 103 - 10 0 0 0 2 0 0 0 0
2 35 - 10 0 0 0 2 0 0 0 0
9 27 - 8 0 0 0 2 0 0 0 0
6 29 - 10 0 0 0 2 0 0 0 0
11 64 - 10 0 0 0 2 0 0 0 0
7 34 - 10 0 0 0 1 0 0 0 0
9 85 - 10 0 0 0 2 0 0 0 0
5 70 - 10 0 0 0 2 0 0 0 0
13 86 - 10 0 0 0 2 0 0 0 0
0 28 - 6 0 0 2 0 0 0 0
136 1096 - 220 0 1 2 47 1 1 0 0

HUN 2021
BALITA YANG
MENDERITA DIARE
CAMPAK HEPATITIS B JUMLAH Mendapat
I II III ORALIT
L P L P L P L P L P L P
1 1 0 0 1 1 2 1 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 1 1 4 5 0 1 1 2
0 1 0 0 2 1 1 0 0 0 0 1
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 0
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 0 0 0 0 0 0 0
1 1 2 2 0 0 0 1 0 1 0 0
1 1 0 0 0 0 0 1 0 0 0 0
1 0 0 1 1 0 3 2 0 0 0 0
0 0 0 0 1 0 1 0 1 0 0 1
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 1 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 1 1 0 1 0
1 0 1 1 1 1 1 1 1 0 1 0
0 1 1 1 1 0 1 3 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0
10 8 6 7 14 7 16 15 4 2 5 4

2021

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

76 77 76 77 67 75 0 0 76 77 2 1
37 46 37 46 37 46 0 0 37 46 1 5
98 118 98 118 92 110 0 0 98 118 3 4
 53 54 53 54 50 45 0 0 53 54 0 1
69 55 69 55 66 53 0 0 69 55 3 4
21 30 21 30 21 30 0 0 21 30 0 0
16 27 16 27 16 27 0 0 16 27 0 0
39 39 39 39 39 38 0 0 39 39 0 3
31 29 31 29 28 27 0 0 31 29 0 0
15 18 15 18 15 15 0 0 15 18 0 0
15 14 15 14 15 14 0 0 15 14 0 0
79 93 79 93 75 91 0 0 79 93 0 6
100 69 101 69 98 67 0 0 101 69 0 5
105 95 105 95 101 91 0 0 105 95 2 7
36 43 36 43 36 43 0 0 36 43 0 1
46 44 46 44 42 43 0 0 46 44 2 5
33 43 33 43 33 39 0 0 33 43 0 0
87 70 87 67 76 59 0 0 87 67 2 3
33 37 33 37 33 37 0 0 33 37 0 7
100 90 100 90 94 88 0 0 100 90 2 4
99 97 99 97 91 93 0 0 99 97 0 2
107 77 107 77 99 73 0 0 107 77 2 4
28 25 28 25 28 25 0 0 28 25 0 0
1323 1290 1324 1287 1252 1229 0 0 1324 1287 19 62

PLKB = ORANG MEDIS = 47 ORANG

PKK = 220 ORANG

MUNISASI E. LANSIA
JUMLAH NO JENIS JUMLAH JUMLAH JUMLAH
NISASI L P IMUNISASI L P UMUR SASARAN YANG HADIR
0 0 8 POLIO 4 16 13 L P L P
8 8 9 HEPATITIS 1 6 7 45-60 Tahun 1664 1923 198 441
14 10 10 HEPATITIS 2 14 7 60-69 Tahun 785 805 90 217
16 14 11 HEPATITIS 3 16 15 > 70 Tahun 256 399 16 115
0 0 12 CAMPAK 10 8
 9 8 13 TT I 0 19 F. KPPASI
14 10 14 TT 2 0 62 PESERTA JML
SASARAN YG HADIR
K. ASI EKSLUSIF BUMIL 136 136
UMUR SASARAN MASIH ASI E BUSUI 0-6 BLN 164 169
L P L P BUSUI 7-24 BLN 1009 1009
0 - 5 bulan 81 95 79 95
6 bulan SASARAN LULUS ASI E J. VITAMIN
pada L P L P SASARAN Jml.VIT A yg
bulan ini 0 1 0 1 UMUR diberikan
L P L P
6 - 11 bulan 0 0 0 0
12 - 59 bulan 0 0 0 0
Bufas - 0- 0

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

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

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

KADER PLKB MEDIS LAHIR MENINGGAL

L P L P L P L P L P

1142 227 0 0 2 87 0 7 0 0

1124 227 0 1 2 87 11 13 0 0

1124 225 0 1 2 84 13 5 0 0

1183 225 0 0 2 19 2 1 0 0

1094 209 0 1 2 53 0 0 0 0

1096 220 0 1 2 47 1 1 0 0

6763 0 1333 0 4 12 377 27 27 0 0

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

1324 1238 1324 1238 1104 1037 1324 1238 27 80

1359 1255 1319 1278 1063 1019 1176 1153 1319 1278 29 71

1319 1276 1306 1262 1066 1022 0 0 1306 1262 29 74

1319 1244 1323 1268 1083 1027 0 0 1323 1268 8 63

1319 1276 1319 1275 1222 1197 0 0 1319 1275 21 59

1323 1290 1324 1287 1252 1229 0 0 1324 1287 19 62

7963 0 7579 7915 7608 6790 6531 1176 1153 7915 7608 133 409
 BALITA YANG
MENDERITA DIARE
CAMPAK HEPATITIS B JUMLAH Mendapat
I II III ORALIT
L P L P L P L P L P L P

6 13 16 141 11 5 14 14 5 5 3 4

12 16 18 16 10 6 11 15 5 5 5 7

22 18 11 11 17 14 10 9 4 3 5 5

11 11 10 7 13 5 18 16 4 3 5 5

12 12 7 10 14 6 16 16 4 3 4 3

10 8 6 7 14 7 16 15 4 2 5 4

73 78 68 192 79 43 85 85 26 21 27 28
 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
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
0 0 0 0 0 0 5 5 23 21 22 24 26 27 153 10 0 0 0 0 - 0 0 1 1 1 1 2 1 0
0 0 0 0 0 0 1 1 2 9 17 11 17 25 83 10 0 0 0 20 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 8 8 10 15 31 24 49 71 216 10 0 0 0 30 0 0 0 0 1 1 4 5 0
0 0 0 0 0 0 4 2 6 5 11 8 32 39 107 12 0 0 0 30 0 0 0 0 2 0 1 0 0
0 0 0 0 0 0 7 9 3 7 11 12 48 27 124 15 0 0 0 30 0 0 1 0 4 3 1 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 0 0 0 0 0 1 1 2 5 6 10 18 43 10 0 1 0 30 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 2 4 2 7 6 26 29 78 11 0 0 0 30 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 2 0 3 4 3 7 23 18 60 6 0 0 0 20 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 2 2 0 3 3 9 13 33 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 3 9 18 23 24 18 34 43 172 10 0 0 0 30 0 0 2 2 0 0 0 0 0
0 0 0 0 0 0 2 2 13 10 23 12 63 45 170 10 0 0 0 30 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 8 5 18 16 32 31 47 43 200 10 0 0 0 20 0 0 0 1 1 0 3 2 0
0 0 0 0 0 0 2 7 6 4 7 11 21 21 79 10 0 0 0 20 0 0 1 0 0 4 1 0 0
0 0 0 0 0 0 4 3 4 3 9 7 29 31 90 8 0 0 0 20 0 0 0 1 1 0 1 0 0
0 0 0 0 0 0 2 1 3 5 15 8 13 29 76 10 0 0 0 20 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 3 6 8 3 30 12 46 46 154 10 0 0 0 20 0 0 0 1 1 0 1 0 0
0 0 0 0 0 0 2 5 5 3 7 11 19 18 70 10 0 0 0 10 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 6 9 28 14 23 16 43 51 190 10 0 0 0 20 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 10 8 9 5 23 21 57 63 196 10 0 0 0 20 0 0 1 1 1 1 1 1 0
0 0 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 4 5 4 8 5 13 12 53 6 0 0 2 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 85 95 186 169 338 292 689 706 2560 220 0 1 2 47 - 0 0 8 8 14 10 16 14 0
 H.P. DIARE G. KB
ALAT KONTRASEPSI
POLIO HIPATITIS CAMPAK TT JUMLAH
YG DAPAT IUD MOW MOP IMPLANT
ORALIT
I II III IV I II III I II JUMLAH PESERTA
P 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
0 1 1 1 1 2 1 0 0 1 1 2 1 1 1 0 2 0 1 0 0 0 0 14 7 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 5 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
0 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
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 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
0 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 2 0 0 0 0 2 2 0 0 0 1 1 1 0 0 0 6 0 1 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 0 0 0 0 0 0 0 3 0 3 0 0 0 3
0 1 1 1 0 1 0 0 1 1 0 1 0 0 0 0 2 0 3 0 0 0 0 0 11 0 11 0 2 0
0 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 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 2 0 4 1 0 1 0 10 0 3 0 0 0 1
0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 2 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 9 8 14 10 16 13 6 7 14 7 16 15 10 8 0 19 0 62 4 2 5 4 118 95 28 26 6 4 63
 J. VITAMIN A K. ASI EKSLUSIF F. KPPASI
NTRASEPSI

SASARAN

MENDPT
MPLANT SUNTIK PIL KONDOM 0 - 5 BLN MASIH ASI 6 Bln pd BUSUI
BU-
6 - 11JML
BLN SASARAN

VIT. A
MLAH PESERTA 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
Bln ini
S P S P S P S L P L P L P L P L P L P L P L P Bln
0 34 18 39 2 0 0 0 0 0 0 0 0 0 0 0 0 5 5 0 0 5 5 0 0 4 10
0 0 31 0 12 10 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 6 2
4 34 14 15 15 1 1 0 0 0 0 0 0 0 0 0 0 7 7 0 0 7 7 0 0 14 14
0 15 0 15 0 2 0 0 0 0 0 0 0 0 0 0 0 4 2 0 0 4 2 0 0 2 6
0 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
0 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
0 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
2 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
0 25 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 3 2
3 15 4 2 3 0 5 0 0 0 0 0 0 0 0 0 0 1 2 0 0 1 2 0 0 0 3
0 6 0 0 12 0 8 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 2
0 90 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 3 9 0 0 3 9 0 0 10 13
0 17 18 9 7 1 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 2 2 0 0 7 4
0 32 38 45 26 0 0 0 0 0 0 0 0 0 0 0 0 8 5 0 0 8 5 0 0 12 10
0 30 0 6 0 6 0 0 0 0 0 0 0 0 0 0 0 2 7 0 0 2 7 0 0 2 9
0 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
0 27 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 1 0 0 6 3
7 42 31 0 25 0 7 0 0 0 0 0 0 0 0 0 0 3 6 0 0 3 6 0 0 11 9
0 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
0 20 80 5 75 5 0 0 0 0 0 0 0 0 0 0 0 6 9 0 0 4 9 0 0 9 9
0 50 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 10 8 0 0 10 8 0 0 5 14
0 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
0 3 15 0 19 0 0 0 0 0 0 0 0 0 0 0 0 2 4 0 0 2 4 0 0 0 6
16 611 308 231 242 89 63 0 0 0 0 0 0 0 0 0 0 81 95 0 1 79 95 0 1 136 164
PPASI E. LANSIA

BUSUI BUSUI JUMLAH SASARAN UMUR JML YG HADIR HADIR KETERANGAN WUS PUS
BU- JUMLAH BAYI
7 - 24 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 Bln L P L P L P L P L P L P L P L P
90 4 10 90 100 125 20 22 13 10 45 35 7 4 2 2- - - 164 154 1 1 0 0
38 5 7 36 50 50 40 48 10 30 20 25 5 5 0 0- 88 76 0 0 0 0
72 14 14 72 130 140 42 50 15 12 25 50 6 10 4 7- 185 180 0 0 0 0
25 2 6 25 141 140 32 39 14 10 0 0 0 0 0 0- 227 209 0 0 0 0
25 11 14 25 107 116 35 39 10 15 25 30 6 20 0 4- 135 120 0 0 0 0
18 0 4 18 20 30 5 8 3 5 2 0 0 7 0 5- 78 66 0 0 0 0
11 1 1 11 26 26 29 13 13 21 2 3 3 3 2 5- 72 62 0 0 0 0
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