MEI TAHUN 2021

NO NAMA RW S K
POSYANDU 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
1 PARKIT .001 5 5 23 21 22 24 26 27 153 99.346 5 5 23 21 22 24 26 27 5
CAMAR .002 0 1 2 9 17 11 17 25 82 100 0 1 2 9 17 11 17 25 0
3 GELATIK A .003 7 7 9 14 30 23 52 72 214 100 7 7 9 14 30 23 52 72 7
4 GELATIK B .003 4 2 6 5 11 8 32 39 107 100 4 2 6 5 11 8 32 39 4
5 ELANG .004 6 8 2 6 10 11 49 27 119 100 6 8 2 6 10 11 49 27 6
6 MERPATI .005 2 1 1 2 5 10 12 17 50 100 2 1 1 2 5 10 12 17 2
7 GARUDA .006 0 1 1 2 5 6 10 18 43 100 0 1 1 2 5 6 10 18 0
8 CENDRAWASIH .007 1 0 4 2 7 6 26 29 75 100 1 0 4 2 7 6 26 29 1
9 ANGSA .008 2 0 3 4 3 7 23 18 60 100 2 0 3 4 3 7 23 18 2
1 KIJANG .009 1 2 2 0 3 3 9 13 33 100 1 2 2 0 3 3 9 13 1
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 2 9 17 22 24 18 35 43 170 100 2 9 17 22 24 18 35 43 2
13 PANDA B .012 2 2 13 10 23 12 63 46 171 100 2 2 13 10 23 12 63 46 2
14 RUSA 013 6 4 18 16 32 30 48 44 198 100 6 4 18 16 32 30 48 44 6
15 MURAI .014 1 6 6 4 7 11 21 21 77 100 1 6 6 4 7 11 21 21 1
16 MERAK .015 4 3 4 3 9 7 30 31 91 100 4 3 4 3 9 7 30 31 4
17 KANCIL 016 2 0 3 5 15 8 13 29 75 100 2 0 3 5 15 8 13 29 2
18 KELINCI 017 3 5 8 6 30 12 50 46 160 100 3 5 8 6 30 12 50 46 3
CAMAR B .018 1 5 5 3 7 11 19 18 69 100 1 5 5 3 7 11 19 18 1
20 KANGURU A .019 4 7 28 14 23 16 44 52 188 100 4 7 28 14 23 16 44 52 4
21 KANGURU B .019 9 5 9 5 23 21 57 65 194 100 9 5 9 5 23 21 57 65 9
22 NURI 20 7 8 15 13 26 29 60 26 184 100 7 8 15 13 26 29 60 26 7
23 BANGAU 23 2 4 5 4 8 5 13 12 53 100 2 4 5 4 8 5 13 12 2
JUMLAH 72 86 186 172 344 294 717 2299.3 72 86 186 172 344 294 717 724 70

B. SURVEILANS
BULAN = MEI
ALAMAT LAHIR UMUR
NAMA (Bulan)
ORANG TUA
NO NAMA BALITA
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 = MEI UMU
ALAMAT UMUR KEHAMI
NAMA BUMIL HAMIL
(Bln)
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 = MEI
UMU
NAMA ALAMAT UMUR KEHAMI
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 MEI 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 S D/S 11 12 13 14 15 16 17 18 19 20
1 PARKIT 5 5 23 21 22 24 26 99.3464 225.34641 5 5 23 21 22 24 26 27 5 4
2 CAMAR 0 1 2 9 17 11 17 100 157 0 1 2 9 17 11 17 25 0 1
3 GELATIK A 7 7 9 14 30 23 52 100 242 7 7 9 14 30 23 52 72 7 7
GELATIK B 4 2 6 5 11 8 32 100 168 4 2 6 5 11 8 32 39 4 2
4 ELANG 6 8 2 6 10 11 49 100 192 6 8 2 6 10 11 49 27 6 8
5 MERPATI 2 1 1 2 5 10 12 100 133 2 1 1 2 5 10 12 17 2 1
6 GARUDA 0 1 1 2 5 6 10 100 125 0 1 1 2 5 6 10 18 0 1
7 CENDRAWASIH 1 0 4 2 7 6 26 100 146 1 0 4 2 7 6 26 29 1 0
8 ANGSA 2 0 3 4 3 7 23 100 142 2 0 3 4 3 7 23 18 2 0
9 KIJANG 1 2 2 0 3 3 9 100 120 1 2 2 0 3 3 9 13 1 2
11 KUTILANG 1 1 2 2 4 5 8 100 123 1 1 2 2 4 5 8 6 1 1
12 PANDA A 2 9 17 22 24 18 35 100 227 2 9 17 22 24 18 35 43 2 9
PANDA B 2 2 13 10 23 12 63 100 225 2 2 13 10 23 12 63 46 2 2
13 RUSA 6 4 18 16 32 30 48 100 254 6 4 18 16 32 30 48 44 6 4
14 MURAI 1 6 6 4 7 11 21 100 156 1 6 6 4 7 11 21 21 1 6
15 MERAK 4 3 4 3 9 7 30 100 160 4 3 4 3 9 7 30 31 4 3
16 KANCIL 2 0 3 5 15 8 13 100 146 2 0 3 5 15 8 13 29 2 0
17 KELINCI 3 5 8 6 30 12 50 100 214 3 5 8 6 30 12 50 46 3 5
18 CAMAR B 1 5 5 3 7 11 19 100 151 1 5 5 3 7 11 19 18 1 5
19 KANGURU A 4 7 28 14 23 16 44 100 236 4 7 28 14 23 16 44 52 4 7
KANGURU B 9 5 9 5 23 21 57 100 229 9 5 9 5 23 21 57 65 9 5
20 NURI 7 8 15 13 26 29 60 100 258 7 8 15 13 26 29 60 26 7 8
21 BANGAU 2 4 5 4 8 5 13 100 141 2 4 5 4 8 5 13 12 2 4
JUMLAH 72 86 186 172 344 294 717 2299.35 72 86 186 172 344 294 717 724 70 81
LAPORAN BULANAN POSYANDU
 KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN MEI TAHUN 20
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 4
2 CAMAR 0 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 7 7
GELATIK B 0 0 0 0 0 0 0 0 0 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 8
5 MERPATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
6 GARUDA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7 CENDRAWASIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
8 ANGSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
9 KIJANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
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 2 9
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 0 0 0 0 0 0 0 0 6 4
14 MURAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6
15 MERAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
17 KELINCI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 5
18 CAMAR B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5
19 KANGURU A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 7
KANGURU B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 5
20 NURI 0 0 0 0 0 0 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 4
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 85
 D. IMUNISASI
MEI TAHUN 2021
JENIS IMUNISASI
NAMA DPT POLIO HIPATIT
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 0 0 1 1 1 1 2 1 0 0 1 1 1 1 2 1 1 1
2 CAMAR 0 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 0
GELATIK B 0 0 2 0 1 0 2 1 0 0 2 0 1 0 2 1 2 0
4 ELANG 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0 0 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 0 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 0
11 KUTILANG 0 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 1 2 0 2 2 0 0 0 1 2 2
 PANDA B 0 0 1 0 0 1 0 0 0 0 1 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 1
14 MURAI 0 0 1 0 0 4 0 0 1 0 0 4 1 0 1 0 0 4
15 MERAK 0 1 1 0 1 0 1 2 0 1 1 0 1 0 1 2 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 0 0 0 1 0 1 0 0 0 0 0 1 0 1 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 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0
KANGURU B 0 0 1 1 1 0 1 1 0 0 1 0 1 1 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 0 1 12 6 12 10 16 17 3 1 11 9 13 7 17 16 7 10
G. KB J. VITAMIN
MEI TAHUN 2021
ALAT KONTRASEPSI
JML SASARAN
RW NAMA IUD MOW MOP IMPLANT SUNTIK PIL KONDOM
JUMLAH PESERTA
POSYANDU 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 2 4 0 0 9 4 34 14 15 15 1 1 0 0 0 0
GELATIK B 3 0 2 0 0 0 10 0 15 0 15 0 2 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 5 3 2 0 1 0 0 0 17 18 9 7 1 0 0 0 0 0
13 RUSA 5 3 3 2 2 2 0 0 32 38 45 26 0 0 0 0 0 0
14 MURAI 3 0 2 0 3 0 3 0 30 0 6 0 6 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 0 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 10 0 3 0 0 0 1 0 20 80 5 75 5 0 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 118 95 28 26 6 4 63 16 611 308 231 242 89 63 0 0 0 0
F. KPPASI E. LANSIA
MEI TAHUN 2021
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 6 2 36 50 50 40
3 GELATIK A 11 14 72 11 14 72 130 140 42
GELATIK B 2 7 26 2 7 26 141 140 32
4 ELANG 11 14 27 11 14 27 107 116 35
5 MERPATI 0 3 18 0 3 18 20 30 5
6 GARUDA 1 2 12 1 2 12 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 1 1 13 30 37 20
12 PANDA A 10 13 77 10 13 77 20 32 10
PANDA B 6 5 45 6 5 45 75 100 15
13 RUSA 12 10 92 12 10 92 79 132 100
14 MURAI 2 7 28 2 7 28 125 125 75
15 MERAK 9 8 22 9 6 22 0 0 0
16 KANCIL 6 5 28 6 5 28 50 70 39
17 KELINCI 11 8 56 11 8 56 120 149 31
18 CAMAR B 7 6 24 7 6 26 20 21 20
19 KANGURU A 9 11 73 9 11 73 30 33 10
KANGURU B 5 18 50 5 18 54 120 157 30
20 NURI 13 15 67 13 15 67 50 50 38
21 BANGAU 0 5 21 0 5 21 28 21 9
JUMLAH 132 170 923 132 167 927 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN MEI 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 25 25 0 0 22 24 0 0 26 27 164 154 4
2 CAMAR .002 0 0 2 10 0 0 17 11 0 0 17 25 88 76 6
3 GELATIK A .003 0 0 16 21 0 0 30 23 0 0 52 72 185 180 11
4 GELATIK B .003 0 0 10 7 0 0 11 8 0 0 32 39 227 209 2
5 ELANG .004 0 0 8 14 0 0 10 11 0 0 49 27 135 120 11
6 MERPATI .005 0 0 3 3 0 0 5 10 0 0 12 17 78 66 0
7 GARUDA .006 0 0 1 3 0 0 5 6 0 0 10 18 72 62 1
 8 CENDRAWASIH .007 0 0 5 2 0 0 7 6 0 0 26 29 90 80 3
9 ANGSA .008 0 0 5 4 0 0 3 7 0 0 23 18 128 110 3
10 KIJANG .009 0 0 3 2 0 0 3 3 0 0 9 13 68 56 0
11 KUTILANG .011 0 0 3 3 0 0 4 5 0 0 8 6 58 46 1
12 PANDA A .012 0 0 19 31 0 0 24 18 0 0 35 43 158 150 10
13 PANDA B .012 0 0 15 12 0 0 23 12 0 0 63 46 125 116 6
14 RUSA .013 0 0 24 20 0 0 32 30 0 0 48 44 190 175 12
15 MURAI .014 0 0 7 10 0 0 7 11 0 0 21 21 84 80 2
16 MERAK .015 0 0 8 6 0 0 9 7 0 0 30 31 115 105 9
17 KANCIL .016 0 0 5 5 0 0 15 8 0 0 13 29 65 58 6
18 KELINCI .017 0 0 11 11 0 0 30 12 0 0 50 46 215 185 11
19 CAMAR B .018 0 0 6 8 0 0 7 11 0 0 19 18 115 101 7
20 KANGURU A .019 0 0 32 21 0 0 23 16 0 0 44 52 210 200 9
21 KANGURU B .019 0 0 18 10 0 0 23 21 0 0 57 65 275 140 5
22 NURI .020 0 0 22 21 0 0 26 29 0 0 60 26 188 178 13
23 BANGAU .023 0 0 7 8 0 0 8 5 0 0 13 12 55 49 0
JUMLAH 0 0 255 249 0 0 336 289 0 0 704 712 3088 2696 132
DATA HASIL KEGIATAN POSYANDU
BULAN MEI TAHUN 2021
format 7

NAMA
JUMLAH BAYI YANG DI IMUNISASI
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 0 0 1 1 1 1 2 1 0 0 1 1 1 1 2 1 2
2 CAMAR .002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
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 2 0 1 0 2 1 0 0 2 0 1 0 2 1 1
5 ELANG .004 0 0 1 0 4 3 1 0 0 0 1 0 4 3 1 0 0
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 0
 9 ANGSA .008 0 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 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 0 0 2 2 0 0 0 1 2 0 2 2 0 0 0 1 1
13 PANDA B .012 0 0 1 0 0 1 0 0 0 0 1 0 0 1 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 0 0 1 0 0 4 1 0 1 0 1
16 MERAK .015 0 1 1 0 1 0 1 2 0 1 1 0 1 0 1 2 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 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 1
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 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1
21 KANGURU B .019 0 0 1 1 1 0 1 1 0 0 1 0 1 1 1 0 0
22 NURI .020 0 0 1 1 1 0 1 3 0 0 1 1 1 0 1 3 1
23 BANGAU .023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 1 12 6 12 10 16 17 3 1 11 9 13 7 17 16 12
DATA HASIL KEGIATAN POSYANDU
BULAN MEI 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 POSYANDU RW K D L O O U T L JML JML BALITA
L U L P W D
HAMIL

S E S O A I A
BALITA YG MEMILIKI
A T U M N K I
N KMS
I
(S) (K)
L P L

1 PARKIT .001 4 4 4 100 0 41 0 0 0 7 52 0 76 149.3464 76

2 CAMAR .002 6 6 6 38 10 12 0 0 0 0 31 0 36 121 36
3 GELATIK A .003 11 11 11 86 2 30 13 0 6 11 48 0 98 144 98
 4 GELATIK B .003 2 2 2 33 2 15 10 0 2 0 15 0 53 115 53
5 ELANG .004 11 11 11 41 5 8 1 0 0 0 33 0 67 125 67
6 MERPATI .005 0 0 0 21 9 11 0 0 0 28 38 0 20 113 20
7 GARUDA .006 1 1 1 14 15 3 0 0 0 11 9 0 16 109 16
8 CENDRAWASIH .007 3 3 3 19 51 11 3 0 1 11 35 0 38 108 38
9 ANGSA .008 3 3 3 19 0 18 2 0 1 0 25 0 31 111 31
10 KIJANG .009 0 0 0 11 5 5 7 0 0 0 19 0 15 105 15
11 KUTILANG .011 1 1 1 14 8 12 2 0 0 8 6 0 15 108 15
12 PANDA A .012 10 10 10 90 0 10 4 0 0 0 90 0 78 149 78
13 PANDA B .012 6 6 6 50 1 16 0 1 2 3 35 0 101 124 101
14 RUSA .013 12 12 12 102 0 71 0 4 5 3 70 0 104 150 104
15 MURAI .014 2 2 2 35 6 6 3 3 2 0 30 0 35 121 35
16 MERAK .015 9 9 9 28 10 27 3 0 8 0 35 0 47 113 47
17 KANCIL .016 6 6 6 33 0 23 3 0 3 0 27 0 33 113 33
18 KELINCI .017 11 11 11 64 7 25 7 2 11 11 73 0 91 123 91
19 CAMAR B .018 7 7 7 32 0 10 0 0 0 0 30 0 32 119 32
20 KANGURU A .019 9 9 9 84 5 80 1 0 3 0 100 0 99 137 99
21 KANGURU B .019 5 5 5 72 8 10 10 0 5 0 50 0 98 131 98
22 NURI .020 13 13 13 82 8 10 10 0 5 0 50 0 108 150 108
23 BANGAU .023 0 0 0 26 0 19 0 0 0 2 18 0 28 113 28
JUMLAH 132 132 132 1094 0 152 473 79 10 54 95 919 0 1319 2851.346 1319
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : MEI
RW / Kelurahan : DEPOK Petugas yang membina :

A. SKDN D. IMUNISASI
UMUR S K N T O B D = N+T+O+B NO JENIS
BALITA
L P L P L P L P L P L P L P IMUNISASI
0 - 5 Bulan 72 86 72 86 70 81 0 0 0 0 0 0 72 85 1 BCG
6 - 11 Bulan 186 172 186 172 178 164 3 4 0 0 0 0 186 172 2 DPT 1
JUMLAH 258 258 258 258 248 245 3 4 0 0 0 0 258 257 3 DPT 2
12 - 24 Bulan 344 294 344 294 298 260 38 29 0 0 0 0 344 294 4 DPT 3
25 - 59 Bulan 717 2299.3464 717 724 648 667 56 45 0 0 0 0 717 724 5 POLIO 1
 JUMLAH 1061 2593.34641 1061 1018 946 927 94 74 0 0 0 0 1061 1018 6 POLIO 2
TOTAL 1 + 2 1319 2851.34641 1319 1276 1194 1172 97 78 0 0 0 0 1319 1275 7 POLIO 3

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

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 = 1094 ( ...................)

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
7
8
9
10
11
12
J UM L A H 36 39 1237 1196 4 3 1671 1464 6 0 3525 3485 15440 13480 677 5667

DATA HASIL KEGIATAN POSYANDU

TAHUN 2021

D F JML
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 N O P M U A
I N P M M I N N
B Y
N0 BULAN K L U D
I
L L O O U T L JML JML BALITA
P W D

HAMIL
S E S O A I A BALITA YG MEMILIKI
A T U M N K I
N KMS
I
(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 2851.35 1319
6
7
8
9
10

J UM L A H 0 677 677 5667 0 720 2367 413 34 213 467 4562 0 5451 6743.35 6640

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

10

11

12
JUMLAH 37 26 68 53 65 41 67 71 40 27 49 47 68 41 72 72 63
 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
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
4 23 20 22 23 26 26 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0
1 2 9 16 11 17 25 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
7 9 14 29 22 50 72 0 0 0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0
2 6 5 10 7 30 38 0 0 0 0 1 1 2 1 0 0 0 0 0 0 0 0 0 0
8 2 6 9 10 48 26 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0
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
1 1 2 4 5 10 16 0 0 0 0 1 1 0 2 0 0 0 0 0 0 0 0 0 0
0 4 2 6 6 25 27 0 0 0 0 1 0 1 2 0 0 0 0 0 0 0 0 0 0
0 3 4 3 7 20 17 0 0 0 0 0 0 3 1 0 0 0 0 0 0 0 0 0 0
2 2 0 2 3 9 12 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0
1 2 2 3 4 6 6 0 0 0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0
9 15 21 22 16 34 40 0 0 2 1 2 2 1 3 0 0 0 0 0 0 0 0 0 0
2 13 10 20 10 60 40 0 0 0 0 3 2 3 6 0 0 0 0 0 0 0 0 0 0
4 18 16 30 30 40 37 0 0 0 0 2 0 8 7 0 0 0 0 0 0 0 0 0 0
6 6 4 7 11 21 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 4 3 8 5 25 30 0 0 0 0 1 2 5 1 0 0 0 0 0 0 0 0 0 0
0 3 5 13 6 10 27 0 0 0 0 2 2 3 2 0 0 0 0 0 0 0 0 0 0
5 8 6 20 10 47 45 0 0 0 0 10 2 3 1 0 0 0 0 0 0 0 0 0 0
5 5 3 7 10 16 18 0 0 0 0 0 1 3 0 0 0 0 0 0 0 0 0 0 0
7 28 14 20 10 40 49 0 0 0 0 3 6 4 3 0 0 0 0 0 0 0 0 0 0
5 9 5 21 19 52 58 0 0 0 0 2 2 5 7 0 0 0 0 0 0 0 0 0 0
8 14 11 21 25 50 20 0 0 1 2 5 4 10 6 0 0 0 0 0 0 0 0 0 0
 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
81 178 164 298 260 648 667 0 0 3 4 38 29 56 45 0 0 0 0 0 0 0 0 0 0

UR BGM 2T GAKIN/
an) BB TB NON
(Kg) (Cm) GAKIN
L P
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/
NON JUMLAH KUNJUNGAN
(Bln)
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
23 20 22 23 26 26 0 0 0 1 L 1 0 1
2 9 16 11 17 25 0 0 0 0 1 0 0 0
9 14 29 22 50 72 0 0 0 0 1 1 2 0
6 5 10 7 30 38 0 0 0 0 1 1 2 1
2 6 9 10 48 26 0 0 0 0 1 1 1 1
1 2 5 10 12 17 0 0 0 0 0 0 0 0
1 2 4 5 10 16 0 0 0 0 1 1 0 2
4 2 6 6 25 27 0 0 0 0 1 0 1 2
3 4 3 7 20 17 0 0 0 0 0 0 3 1
2 0 2 3 9 12 0 0 0 0 1 0 0 1
2 2 3 4 6 6 0 0 0 0 1 1 2 0
15 21 22 16 34 40 0 0 2 1 2 2 1 3
13 10 20 10 60 40 0 0 0 0 3 2 3 6
18 16 30 30 40 37 0 0 0 0 2 0 8 7
6 4 7 11 21 21 0 0 0 0 0 0 0 0
4 3 8 5 25 30 0 0 0 0 1 2 5 1
3 5 13 6 10 27 0 0 0 0 2 2 3 2
8 6 20 10 47 45 0 0 0 0 10 2 3 1
5 3 7 10 16 18 0 0 0 0 0 1 3 0
28 14 20 10 40 49 0 0 0 0 3 6 4 3
9 5 21 19 52 58 0 0 0 0 2 2 5 7
14 11 21 25 50 20 0 0 1 2 5 4 10 6
5 4 8 5 13 12 0 0 0 0 0 0 0 0
178 164 298 260 648 667 0 0 3 4 38 29 56 45
HUN 2021
D PETUGAS YG HADIR
6 - 12 BLN D PKK PLKB MEDIS KETERANGAN
12-24 BLN 25-59 BLN
L P L P L P L P L P
53 54 55 56 57 58 436 59 60 61 62 63 64
23 21 22 24 26 27 149 10 0 0 0 0 0
2 9 17 11 17 25 82 10 0 0 0 2 0
9 14 30 23 52 72 214 10 0 0 0 2 0
6 5 11 8 32 39 107 10 0 0 0 2 0
2 6 10 11 49 27 119 10 0 0 0 2 0
1 2 5 10 12 17 50 6 0 0 0 2 0
1 2 5 6 10 18 43 10 0 1 0 2 0
4 2 7 6 26 29 75 11 0 0 0 5 0
3 4 3 7 23 18 60 6 0 0 0 2 0
2 0 3 3 9 13 33 6 0 0 0 0 0
2 2 4 5 8 6 29 6 0 0 0 2 0
17 22 24 18 35 43 170 10 0 0 0 2 0
13 10 23 12 63 46 171 10 0 0 0 3 0
18 16 32 30 48 44 198 10 0 0 0 3 0
6 4 7 11 21 21 77 10 0 0 0 3 0
4 3 9 7 30 31 91 8 0 0 0 2 0
3 5 15 8 13 29 75 10 0 0 0 4 0
8 6 30 12 50 46 160 10 0 0 0 3 0
5 3 7 11 19 18 69 10 0 0 0 4 0
28 14 23 16 44 52 188 10 0 0 0 3 0
9 5 23 21 57 65 194 10 0 0 0 3 0
15 13 26 29 60 26 184 10 0 0 0 2 0
5 4 8 5 13 12 53 6 0 0 2 0
186 172 344 294 717 724 209 0 1 2 53 -
 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 1 0 0 2 2 0 2 0 1 0 0 0 0
0 0 0 0 1 0 0 1 0 5 0 0 0 0
1 1 5 4 1 1 0 2 0 3 0 1 1 0
1 0 2 1 1 0 0 1 0 0 0 0 0 1
4 3 1 0 0 1 0 2 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 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 1 0 0 0 3 0 1 0 0
 1 0 0 1 1 1 0 1 0 6 0 0 0 0
1 0 3 2 1 0 0 2 0 6 0 1 0 1
1 0 1 0 1 1 0 0 0 1 1 0 0 1
1 0 2 1 0 1 0 2 0 6 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 1 1 0 3 0 4 0 0 0 0
0 0 0 0 0 0 0 0 0 5 0 0 0 0
0 0 0 1 1 1 0 2 0 5 1 0 1 0
1 1 1 1 0 1 0 1 0 4 1 0 1 0
1 0 1 3 1 1 0 2 0 4 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 6 16 16 12 12 0 21 0 59 4 3 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

Bln ini Bln ini

0 - 5 BLN AKSLUSIF
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 5 5 0 0 5 5 0 0
0 0 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 0 0 0 7 7 0 0 7 7 0 0
0 0 0 0 2 4 4 2 1 1 4 2 1 1
0 0 0 0 1 2 6 8 0 0 6 8 0 0
0 0 0 0 0 0 2 1 0 0 2 1 0 0
0 0 0 0 0 0 0 1 1 0 0 1 1 0
0 0 0 0 0 0 1 0 0 0 1 0 0 0
0 0 0 0 0 0 2 0 0 0 2 0 0 0
0 0 0 0 0 0 1 2 0 0 1 2 0 0
0 0 0 0 0 0 1 1 0 0 1 1 0 0
 0 0 0 0 0 0 2 9 1 1 2 9 1 1
0 0 0 0 1 2 2 2 0 0 2 2 0 0
0 0 0 0 0 0 6 4 0 0 6 4 0 0
0 0 0 0 0 0 1 6 0 0 1 6 0 0
0 0 0 0 0 0 4 3 0 0 4 3 1 0
0 0 0 0 0 0 2 0 1 2 2 0 1 2
0 0 0 0 2 4 3 5 0 0 3 5 0 0
0 0 0 0 0 0 1 5 0 0 1 5 0 0
0 0 0 0 0 0 4 7 0 0 4 7 0 0
0 0 0 0 0 0 9 5 0 0 9 5 0 0
0 0 0 0 0 0 7 8 0 0 7 8 0 0
0 0 0 0 0 0 2 4 0 0 2 4 0 0
0 0 0 0 8 16 72 86 4 4 72 86 5 4
IA
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
100 - 10 0 0 0 0 0 0 0 0
38 - 10 0 0 0 2 0 0 0 0
86 - 10 0 0 0 2 0 0 0 0
33 - 10 0 0 0 2 0 0 0 0
41 - 10 0 0 0 2 0 0 0 0
21 0 6 0 0 0 2 0 0 0 0
14 - 10 0 1 0 2 0 0 0 0
 19 - 11 0 0 0 5 0 0 0 0
19 - 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
90 - 10 0 0 0 2 0 0 0 0
50 - 10 0 0 0 3 0 0 0 0
102 - 10 0 0 0 3 0 0 0 0
35 - 10 0 0 0 3 0 0 0 0
28 - 8 0 0 0 2 0 0 0 0
33 - 10 0 0 0 4 0 0 0 0
64 - 10 0 0 0 3 0 0 0 0
32 - 10 0 0 0 4 0 0 0 0
84 - 10 0 0 0 3 0 0 0 0
72 - 10 0 0 0 3 0 0 0 0
82 - 10 0 0 0 2 0 0 0 0
26 - 6 0 0 2 0 0 0 0
1094 - 209 0 1 2 53 0 0 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
2 1 1 1 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 1 5 4 0 1 1 0
0 2 0 1 0 2 1 0 0 0 1
1 0 0 4 3 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 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
1 2 2 0 0 0 1 0 1 0 0
1 0 0 1 0 0 1 0 0 0 0
0 0 1 1 0 3 2 0 1 0 1
1 0 4 1 0 1 0 1 0 0 1
1 0 1 1 0 2 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 0 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 1 1 0 1 0
1 0 0 1 1 1 1 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
12 7 10 14 6 16 16 4 3 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

77 76 76 76 73 0 0 76 76 2 1
46 36 46 35 46 0 0 36 46 1 5
116 98 116 95 115 0 0 98 116 2 3
 54 53 54 50 52 0 0 53 54 1 0
52 67 52 65 50 0 0 67 52 2 4
30 20 30 20 30 0 0 20 30 0 0
27 16 27 15 24 0 0 16 27 0 0
37 38 37 36 35 0 0 38 37 0 2
29 31 29 28 28 0 0 31 29 0 0
18 15 18 14 17 0 0 15 18 0 0
14 15 14 12 13 0 0 15 14 0 0
92 78 92 73 86 0 0 78 92 0 3
70 101 70 95 62 0 0 101 70 1 6
94 104 94 94 87 0 0 104 94 2 6
42 35 42 35 42 0 0 35 42 0 1
44 47 44 41 41 0 0 47 44 2 6
42 33 42 28 38 0 0 33 42 0 0
69 91 69 78 66 0 0 91 69 3 4
37 32 37 29 36 0 0 32 37 0 5
89 99 89 92 80 0 0 99 89 2 5
96 98 96 91 87 0 0 98 96 1 4
76 108 76 92 64 0 0 108 76 2 4
25 28 25 28 25 0 0 28 25 0 0
1276 1319 1275 1222 1197 0 0 1319 1275 21 59

PLKB = ORANG MEDIS = 53 ORANG

PKK = 209 ORANG

E. LANSIA
JUMLAH NO JENIS JUMLAH JUMLAH JUMLAH
L P IMUNISASI L P UMUR SASARAN YANG HADIR
0 1 8 POLIO 4 17 16 L P L P
12 6 9 HEPATITIS 1 7 10 45-60 Tahun 1664 1923 198 441
12 10 10 HEPATITIS 2 14 6 60-69 Tahun 785 805 90 217
16 17 11 HEPATITIS 3 16 16 > 70 Tahun 256 399 16 115
3 1 12 CAMPAK 12 12
 11 9 13 TT I 0 21 F. KPPASI
13 7 14 TT 2 0 59 PESERTA JML
SASARAN YG HADIR
I EKSLUSIF BUMIL 132 132
SASARAN MASIH ASI E BUSUI 0-6 BLN 170 167
L P L P BUSUI 7-24 BLN 988 988
72 86 72 86
SASARAN LULUS ASI E J. VITAMIN
L P L P SASARAN Jml.VIT A yg
4 4 5 4 UMUR diberikan
L P L P
6 - 11 bulan 0 0 0 0
12 - 59 bulan 0 0 0 0
Bufas - 8- 16

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

0 1113 0 3 10 330 26 26 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

0 6289 6591 6321 5538 5302 1176 1153 6591 6321 114 347
 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

70 62 185 65 36 69 70 22 19 22 24
 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 D L P L P L P L P L P L P L
0 0 0 0 0 0 5 4 23 21 22 24 26 27 152 10 0 0 0 0 - 0 0 1 1 1 1 2 1 0
0 0 0 0 0 0 0 1 2 9 17 11 17 25 82 10 0 0 0 20 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 7 7 9 14 30 23 52 72 214 10 0 0 0 20 0 0 0 0 1 1 4 5 0
0 0 0 0 0 0 4 2 6 5 11 8 32 39 107 10 0 0 0 20 0 0 2 0 1 0 2 1 0
0 0 0 0 0 0 6 8 2 6 10 11 49 27 119 10 0 0 0 20 0 0 1 0 4 3 1 0 0
0 0 0 0 0 0 2 1 1 2 5 10 12 17 50 6 0 0 0 20 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 20 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0 4 2 7 6 26 29 75 11 0 0 0 50 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 2 9 17 22 24 18 35 43 170 10 0 0 0 20 0 0 2 2 0 0 0 1 2
0 0 0 0 0 0 2 2 13 10 23 12 63 46 171 10 0 0 0 30 0 0 1 0 0 1 0 0 0
0 0 0 0 0 0 6 4 18 16 32 30 48 44 198 10 0 0 0 30 0 0 0 1 1 0 3 2 0
0 0 0 0 0 0 1 6 6 4 7 11 21 21 77 10 0 0 0 30 0 0 1 0 0 4 0 0 1
0 0 0 0 0 0 4 3 4 3 9 7 30 31 91 8 0 0 0 20 0 1 1 0 1 0 1 2 0
0 0 0 0 0 0 2 0 3 5 15 8 13 29 75 10 0 0 0 40 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 3 5 8 6 30 12 50 46 160 10 0 0 0 30 0 0 0 0 1 0 1 0 0
0 0 0 0 0 0 1 5 5 3 7 11 19 18 69 10 0 0 0 40 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 4 7 28 14 23 16 44 52 188 10 0 0 0 30 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 9 5 9 5 23 21 57 65 194 10 0 0 0 30 0 0 1 1 1 0 1 1 0
0 0 0 0 0 0 7 8 15 13 26 29 60 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 72 85 186 172 344 294 717 724 209 0 1 2 53 - 0 1 12 6 12 10 16 17 3
 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 1 1 1 1 0 0 2 2 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 5 4 1 1 0 2 0 3 0 1 1 0 23 11 2 4 0 0 9
0 2 0 1 0 2 1 2 0 1 0 2 1 1 0 0 1 0 0 0 0 0 1 3 0 2 0 0 0 10
0 1 0 4 3 1 0 0 0 4 3 1 0 0 1 0 2 0 4 0 0 0 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 0 0 0 0 0 2 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 1 2 2 0 0 0 1 1 1 0 0 0 3 0 1 0 0 5 0 0 0 0 0 4
0 1 0 0 1 0 0 0 0 1 0 0 1 1 1 0 1 0 6 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 6 0 1 0 1 5 3 3 2 2 2 0
0 0 4 1 0 1 0 0 4 1 0 1 0 1 1 0 0 0 1 1 0 0 1 3 0 2 0 3 0 3
1 1 0 1 0 1 2 0 1 1 0 2 1 0 1 0 2 0 6 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 0 0 1 0 1 0 0 0 1 0 0 1 1 1 0 3 0 4 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 5 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 5 1 0 1 0 10 0 3 0 0 0 1
0 1 0 1 1 1 0 0 0 1 1 1 1 0 1 0 1 0 4 1 0 1 0 10 0 5 0 0 0 10
0 1 1 1 0 1 3 1 1 1 0 1 3 1 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
1 11 9 13 7 17 16 7 10 14 6 16 16 12 12 0 21 0 59 4 3 4 3 118 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
LAH 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 2 4 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 0 0 1 0 0 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 11 14
0 15 0 15 0 2 0 0 0 0 0 0 0 0 0 2 4 4 2 1 1 4 2 1 1 2 7
0 30 3 1 7 0 5 0 0 0 0 0 0 0 0 1 2 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 2 1 0 0 2 1 0 0 0 3
0 3 6 3 0 15 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 2
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 2 9 1 1 2 9 1 1 10 13
0 17 18 9 7 1 0 0 0 0 0 0 0 0 0 1 2 2 2 0 0 2 2 0 0 6 5
0 32 38 45 26 0 0 0 0 0 0 0 0 0 0 0 0 6 4 0 0 6 4 0 0 12 10
0 30 0 6 0 6 0 0 0 0 0 0 0 0 0 0 0 1 6 0 0 1 6 0 0 2 7
0 35 0 27 0 10 0 0 0 0 0 0 0 0 0 0 0 4 3 0 0 4 3 1 0 9 8
0 27 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 2 2 0 1 2 6 5
7 42 31 0 25 0 7 0 0 0 0 0 0 0 0 2 4 3 5 0 0 3 5 0 0 11 8
0 30 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 0 1 5 0 0 7 6
0 20 80 5 75 5 0 0 0 0 0 0 0 0 0 0 0 4 7 0 0 4 7 0 0 9 11
0 50 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 9 5 0 0 9 5 0 0 5 18
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 5
16 611 308 231 242 89 63 0 0 0 0 0 0 0 0 8 16 72 86 4 4 72 86 5 4 132 170
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 0 0 0 0
38 6 2 36 50 50 40 48 10 30 20 25 5 5 0 0- 88 76 0 0 0 0
72 11 14 72 130 140 42 50 15 12 25 50 6 10 4 7- 185 180 0 0 0 0
26 2 7 26 141 140 32 39 14 10 0 0 0 0 0 0- 227 209 0 0 0 0
27 11 14 27 107 116 35 39 10 15 25 30 6 20 0 4- 135 120 0 0 0 0
18 0 3 18 20 30 5 8 3 5 2 0 0 7 0 5- 78 66 0 0 0 0
12 1 2 12 26 26 29 13 13 21 2 3 3 3 2 5- 72 62 0 0 0 0
19 3 0 19 130 125 68 57 21 28 0 0 0 0 0 0- 90 80 0 0 0 0
17 3 2 17 125 143 42 45 19 21 0 0 0 0 0 0- 128 110 0 0 0 0
8 0 3 8 88 101 75 89 55 68 0 0 0 0 0 0- 68 56 0 0 0 0
13 1 1 13 30 37 20 22 1 12 20 25 18 20 0 6- 58 46 0 0 0 0
77 10 13 77 20 32 10 20 5 4 5 20 2 5 2 5- 158 150 0 0 0 0
45 6 5 45 75 100 15 20 1 10 11 20 6 15 1 10 - 125 116 0 0 0 0
92 12 10 92 79 132 100 75 35 42 10 48 18 31 1 22 - 190 175 0 0 0 0
28 2 7 28 125 125 75 75 1 55 2 87 1 55 0 30 - 84 80 0 0 0 0
22 9 6 22 0 0 0 0 0 0 0 0 0 0 0 0 115 105 0 0 0 0
28 6 5 28 50 70 39 38 3 5 4 27 1 10 0 3- 65 58 0 0 0 0
56 11 8 56 120 149 31 35 4 6 0 0 0 0 0 0- 215 185 0 0 0 0
24 7 6 26 20 21 20 23 13 10 2 8 0 1 0 5- 115 101 0 0 0 0
73 9 11 73 30 33 10 12 2 5 10 33 4 6 1 2- 210 200 0 0 0 0
50 5 18 54 120 157 30 30 5 8 5 10 3 10 0 2- 275 140 0 0 0 0
67 13 15 67 50 50 38 37 10 20 10 20 10 15 3 7- 188 178 0 0 0 0
21 0 5 21 28 21 9 8 3 2 0 0 0 0 0 0 55 49 0 0 0 0
923 132 167 927 1664 1923 785 805 256 399 198 441 90 217 16 115 - 3088 2696 0 0 0 0