APRIL 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 S D/S l p L P L P L P L
1 PARKIT .001 5 5 23 21 22 24 26 27 153 100 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 90.654 4 2 6 5 11 8 32 39 4
5 ELANG .004 6 8 2 6 10 11 49 27 119 100.84 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 1 2
7 GARUDA .006 0 1 1 2 5 6 10 18 43 100 0 1 1 2 5 6 10 1 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 33 103 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 99.412 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 86 186 172 344 294 717 724 72 86 186 172 344 294 717 691 70

B. SURVEILANS
BULAN = APRIL

ALAMAT LAHIR UMUR

NAMA (Bulan)
NO NAMA BALITA ORANG TUA
POSYANDU RW RT Tgl Bln Thn
1 M ASSAUQI DARWIN / ROHANA RUSA 13 3 22 10 2018 30
2 SYAWAL RAMADON /YANTI RUSA 13 6 6 6 2020 16
3 KENZO SAIPUL / ERNI RUSA 13 6 16 3 2019 23
4 AISYA SURYADI /AYU RUSA 13 5 17 4 2020 12
5 ANINDA AGUS / MILA RUSA 13 1 17 10 2019 18
6 ZULAIKA HENGKI / NOVI RUSA 13 7 13 1 2017 51
7 MARWAH DODO KANGURU B 19 4 25 7 2016 59
8 ALIZA DODY KANGURU B 19 4 20 10 2020 9
9 BANU TRI KANGURU B 19 7 10 10 2019 19
10 ALFARO RUDI KANGURU B 19 5 20 3 2018 40
11 M HANAN HANAFI KANGURU B 19 4

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

C. KIA I. KUNJUNGAN KIA

BULAN = APRIL
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 = APRIL
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 APRIL 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 5 5 23 21 22 24 26 27 5 5 23 21 22 24 26 27 5 5
2 CAMAR 0 1 2 9 17 11 17 25 0 1 2 9 17 11 17 25 0 1
3 GELATIK A 7 7 9 14 30 23 52 72 7 7 9 14 30 23 52 72 7 7
GELATIK B 4 2 6 5 11 8 32 39 4 2 6 5 11 8 32 39 4 2
4 ELANG 6 8 2 6 10 11 49 27 6 8 2 6 10 11 49 27 6 7
5 MERPATI 2 1 1 2 5 10 12 17 2 1 1 2 5 10 12 1 2 1
6 GARUDA 0 1 1 2 5 6 10 18 0 1 1 2 5 6 10 1 0 1
7 CENDRAWASIH 1 0 4 2 7 6 26 29 1 0 4 2 7 6 26 29 1 0
8 ANGSA 2 0 3 4 3 7 23 18 2 0 3 4 3 7 23 18 2 0
9 KIJANG 1 2 2 0 3 3 9 13 1 2 2 0 3 3 9 13 1 2
11 KUTILANG 1 1 2 2 4 5 8 6 1 1 2 2 4 5 8 6 1 1
12 PANDA A 2 9 17 22 24 18 35 43 2 9 17 22 24 18 35 43 2 9
PANDA B 2 2 13 10 23 12 63 46 2 2 13 10 23 12 63 46 2 2
13 RUSA 6 4 18 16 32 30 48 44 6 4 18 16 32 30 48 44 6 4
14 MURAI 1 6 6 4 7 11 21 21 1 6 6 4 7 11 21 21 1 6
15 MERAK 4 3 4 3 9 7 30 31 4 3 4 3 9 7 30 31 4 3
16 KANCIL 2 0 3 5 15 8 13 29 2 0 3 5 15 8 13 29 2 0
17 KELINCI 3 5 8 6 30 12 50 46 3 5 8 6 30 12 50 46 3 5
18 CAMAR B 1 5 5 3 7 11 19 18 1 5 5 3 7 11 19 18 1 5
19 KANGURU A 4 7 28 14 23 16 44 52 4 7 28 14 23 16 44 52 4 7
KANGURU B 9 5 9 5 23 21 57 65 9 5 9 5 23 21 57 65 9 5
20 NURI 7 8 15 13 26 29 60 26 7 8 15 13 26 29 60 26 7 8
21 BANGAU 2 4 5 4 8 5 13 12 2 4 5 4 8 5 13 12 2 4
JUMLAH 72 86 186 172 344 294 717 724 72 86 186 172 344 294 717 691 70 81
LAPORAN BULANAN POSYANDU
 KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN APRIL TAHUN 2021
NAMA O B
RW POSYANDU 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN
L P L P L P L P L P L P L P L P L P
1 2 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
1 PARKIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5
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 7
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 81
APRIL TAHUN 2021
D. IMUNISASI
JENIS IMUNISASI
NAMA
DPT POLIO HIPATITIS
RW POSYANDU BCG
I II III I II III IV I
L P L P L P L P L P L P L P L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 PARKIT 0 0 1 1 1 1 0 0 1 1 1 1 2 1 0 0 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 1 1 1 1 4 5 0 0 1 1 1 1 4 5 1 1
GELATIK B 0 0 2 0 1 0 2 1 0 0 2 0 1 0 2 1 2 0
4 ELANG 0 0 0 0 1 0 4 3 0 0 1 0 1 0 4 3 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 0 0 0 2 2 0 0 0 0 0 0
 PANDA B 0 0 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1 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 4 1 1 0 0 0 1 0 4 1 1 0 1 0
15 MERAK 0 1 0 1 1 0 1 0 0 1 0 1 1 1 1 0 0 1
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 KELINCI 0 0 1 1 0 1 1 0 0 0 1 1 0 1 1 0 1 1
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 1 0 1 1 1 1 1 1 1 0 1 0 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 1
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 1 1 12 9 13 5 18 16 2 2 12 9 13 7 18 16 10 7

APRIL TAHUN 2021 G. KB J. VITAMIN A

ALAT KONTRASEPSI
JML SASARAN
RW NAMA IUD MOW MOP IMPLANT SUNTIK PIL KONDOM
POSYANDU JUMLAH PESERTA 6 - 11 BLN 12-59 BLN
P S P S P S P S P S P S P S L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 PARKIT 14 7 0 0 0 0 0 0 34 18 39 2 0 0 0 0 0 0
2 CAMAR 0 0 0 0 0 0 0 0 0 31 0 12 10 0 0 0 0 0
3 GELATIK A 23 11 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

APRIL 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 82 4 82 90 100 125 20
2 CAMAR 6 2 38 5 7 36 50 50 40
3 GELATIK A 14 15 72 14 15 72 130 140 42
GELATIK B 2 9 27 2 9 27 141 140 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 2 1 13 30 37 20
12 PANDA A 10 15 77 10 15 77 20 32 10
PANDA B 7 7 45 7 7 45 75 100 15
13 RUSA 12 12 94 12 12 94 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 26 7 6 26 20 21 20
19 KANGURU A 9 11 76 9 11 76 30 33 10
KANGURU B 5 18 54 5 18 54 120 157 30
20 NURI 13 18 70 13 18 70 50 50 38
21 BANGAU 0 6 21 0 6 21 28 21 9
JUMLAH 136 183 930 136 257 936 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN APRIL 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 26 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 5
3 GELATIK A .003 0 0 16 21 0 0 30 23 0 0 52 72 185 180 14
4 GELATIK B .003 0 0 10 7 0 0 11 8 0 0 32 29 227 209 2
5 ELANG .004 0 0 8 13 0 0 11 12 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 3 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 2
12 PANDA A .012 0 0 19 31 0 0 24 18 0 0 34 43 158 150 10
13 PANDA B .012 0 0 15 12 0 0 23 12 0 0 63 46 125 116 7
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 0 255 250 0 0 337 290 0 0 703 702 3088 2696 136
DATA HASIL KEGIATAN POSYANDU
BULAN APRIL 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 0 0 1 1 1 1 0 0 1 1 1 1 2 1 0 0 1
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 1 1 1 1 4 5 0 0 1 1 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 0 0 1 0 4 3 0 0 1 0 1 0 4 3 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 1
 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 0 0 0 2 2 0 0 0 0 1
13 PANDA B .012 0 0 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0
14 RUSA .013 0 0 0 1 1 0 3 2 0 0 0 1 1 0 3 2 2
15 MURAI .014 0 0 1 0 4 1 1 0 0 0 1 0 4 1 1 0 0
16 MERAK .015 0 1 0 1 1 0 1 0 0 1 0 1 1 1 1 0 1
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 1 1 0 1 1 0 0 0 1 1 0 1 1 0 0
19 CAMAR B .018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 KANGURU A .019 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1
21 KANGURU B .019 1 0 1 1 1 1 1 1 1 0 1 0 1 1 1 1 1
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 1 1 12 9 13 5 18 16 2 2 12 9 13 7 18 16 11
DATA HASIL KEGIATAN POSYANDU
BULAN APRIL 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 O O U L
POSYANDU RW K L U D L L
P
T JML JML BALITA
W
HAMIL

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

1 PARKIT .001 4 4 4 172 0 41 0 0 0 7 52 0 76 77 76

2 CAMAR .002 6 5 5 43 10 12 0 0 0 0 31 0 36 46 36
3 GELATIK A .003 14 14 14 87 2 30 13 0 6 11 48 0 98 116 98
 4 GELATIK B .003 2 2 2 36 2 15 10 0 2 0 15 0 53 54 53
5 ELANG .004 11 11 11 41 5 8 1 0 0 0 33 0 67 52 67
6 MERPATI .005 0 0 0 21 9 11 0 0 0 28 38 0 20 30 20
7 GARUDA .006 1 1 1 14 15 3 0 0 0 11 9 0 16 27 16
8 CENDRAWASIH .007 3 3 3 19 51 11 3 0 1 11 35 0 38 37 38
9 ANGSA .008 3 3 3 19 0 18 2 0 1 0 25 0 31 29 31
10 KIJANG .009 0 0 0 11 5 5 7 0 0 0 19 0 15 18 15
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 92 0 10 4 0 0 0 90 0 78 92 78
13 PANDA B .012 7 7 7 52 1 16 0 1 2 3 35 0 101 70 101
14 RUSA .013 12 12 12 106 0 71 0 4 5 3 70 0 104 94 104
15 MURAI .014 2 2 2 35 6 6 3 3 2 0 30 0 35 42 35
16 MERAK .015 9 9 9 28 10 27 3 0 8 0 35 0 47 44 47
17 KANCIL .016 6 6 6 33 0 23 3 0 3 0 27 0 33 42 33
18 KELINCI .017 11 11 11 64 7 25 7 2 11 11 73 0 91 69 91
19 CAMAR B .018 7 7 7 32 0 10 0 0 0 0 30 0 32 37 32
20 KANGURU A .019 9 9 9 87 5 80 1 0 3 0 100 0 99 89 99
21 KANGURU B .019 5 5 5 72 8 10 10 0 5 0 50 0 98 96 98
22 NURI .020 13 13 13 88 8 10 10 0 5 0 50 0 108 76 108
23 BANGAU .023 0 0 0 27 0 19 0 0 0 2 18 0 28 25 28
JUMLAH 136 136 136 1193 0 152 473 79 10 54 95 919 0 1319 1276 1319
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : APRIL
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 72 86 72 86 70 81 0 0 0 0 0 0 72 81 1 BCG
6 - 11 Bulan 186 172 186 172 176 159 6 9 0 0 0 0 181 169 2 DPT 1
JUMLAH 258 258 258 258 246 240 6 9 0 0 0 0 253 250 3 DPT 2
12 - 24 Bulan 344 294 344 294 270 234 67 58 0 0 0 0 337 290 4 DPT 3
25 - 59 Bulan 717 724 717 691 545 530 161 171 0 0 0 0 703 702 5 POLIO 1
 JUMLAH 1061 1018 1061 985 815 764 228 229 0 0 0 0 1040 992 6 POLIO 2
TOTAL 1 + 2 1319 1276 1319 1243 1061 1004 234 238 0 0 0 0 1293 1242 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 = 1193 ( ...................)

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 0 0 255 250 0 0 337 290 0 0 703 702 3088 2696 136 1193

2 APRIL 0 0 255 250 0 0 337 290 0 0 703 702 3088 2696 136 1193

3
4
5
6
7
8
9
10
11
12
J UM L A H 0 0 510 500 0 0 674 580 0 0 1406 1404 6176 5392 272 2386

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 N
P
P M M I N N
I B Y I O O U L
N0 BULAN K L U D L L
P W
T 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 JANUARI 136 136 136 1193 152 473 79 10 54 95 919 0 1319 1276 1319

2 APRIL 136 136 136 1193 152 473 79 10 54 95 919 0 1319 1276 1319

3
4
5
6
7
8
9
10

J UM L A H 0 272 272 2386 0 304 946 158 20 108 190 1838 0 2638 2552 2638

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

2 APRIL

10

11

12
JUMLAH 1 1 12 9 13 5 18 16 2 2 12 9 13 7 18 16 11
 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
5 23 21 19 20 20 20 0 0 0 0 3 4 6 7 0 0 0 0 0 0 0 0 0 0 0
1 2 9 14 10 14 23 0 0 0 0 3 1 3 2 0 0 0 0 0 0 0 0 0 0 0
7 10 13 28 21 49 62 0 0 0 0 2 4 6 9 0 0 0 0 0 0 0 0 0 0 0
2 6 5 10 7 20 20 0 0 0 0 1 1 12 9 0 0 0 0 0 0 0 0 0 0 0
7 2 5 9 10 35 21 0 0 0 1 2 2 14 6 0 0 0 0 0 0 0 0 0 0 0
1 1 1 5 5 10 16 0 0 0 1 0 5 2 1 0 0 0 0 0 0 0 0 0 0 0
1 1 2 4 5 8 14 0 0 0 0 1 1 2 4 0 0 0 0 0 0 0 0 0 0 0
0 4 2 5 5 21 20 0 0 0 0 2 1 5 9 0 0 0 0 0 0 0 0 0 0 0
0 3 4 3 6 18 14 0 0 0 0 0 1 5 4 0 0 0 0 0 0 0 0 0 0 0
2 2 1 3 3 7 9 0 0 0 0 0 0 2 4 0 0 0 0 0 0 0 0 0 0 0
1 2 2 3 4 7 5 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0
9 16 20 18 15 26 28 0 0 1 2 6 3 8 15 0 0 0 0 0 0 0 0 0 0 0
2 13 10 20 9 50 34 0 0 0 0 3 3 13 12 0 0 0 0 0 0 0 0 0 0 0
4 18 16 26 26 36 30 0 0 0 0 6 4 12 14 0 0 0 0 0 0 0 0 0 0 0
6 6 4 6 8 15 16 0 0 0 0 1 3 6 5 0 0 0 0 0 0 0 0 0 0 0
3 4 3 7 6 21 22 0 0 0 0 2 1 9 9 0 0 0 0 0 0 0 0 0 0 0
0 3 5 9 7 9 22 0 0 0 0 6 1 4 7 0 0 0 0 0 0 0 0 0 0 0
5 8 6 26 10 36 32 0 0 0 0 4 2 14 14 0 0 0 0 0 0 0 0 0 0 0
5 5 3 5 9 14 14 0 0 0 0 2 2 5 4 0 0 0 0 0 0 0 0 0 0 0
7 25 10 12 8 35 40 0 0 3 4 11 8 9 12 0 0 0 0 0 0 0 0 0 0 0
5 9 5 17 17 46 49 0 0 0 0 6 4 11 16 0 0 0 0 0 0 0 0 0 0 0
8 13 12 21 23 48 19 0 0 2 1 5 6 12 7 0 0 0 0 0 0 0 0 0 0 0
 4 5 4 6 4 11 11 0 0 0 0 2 1 2 1 0 0 0 0 0 0 0 0 0 0 0
81 176 159 270 234 545 530 0 0 6 9 67 58 161 171 0 0 0 0 0 0 0 0 0 0 0

MUR BGM 2T GAKIN/

lan) BB
L P (Kg)
L 8.8
L 6.9
L 9.3
P 6.5
P 7.3
P 12.8
P 10.5
P 5.3
L 10.3
L 10
TB NON
(Cm) GAKIN
L B L B
76 V V
67 V V
82 V V
V VV
76.5 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
23 21 19 20 20 20 0 0 0 0 L 4 6 7
2 9 14 10 14 23 0 0 0 0 3 1 3 2
10 13 28 21 49 62 0 0 0 0 2 4 6 9
6 5 10 7 20 20 0 0 0 0 1 1 12 9
2 5 9 10 35 21 0 0 0 1 2 2 14 6
1 1 5 5 10 16 0 0 0 1 0 5 2 1
1 2 4 5 8 14 0 0 0 0 1 1 2 4
4 2 5 5 21 20 0 0 0 0 2 1 5 9
3 4 3 6 18 14 0 0 0 0 0 1 5 4
2 1 3 3 7 9 0 0 0 0 0 0 2 4
2 2 3 4 7 5 0 0 0 0 1 1 1 1
16 20 18 15 26 28 0 0 1 2 6 3 8 15
13 10 20 9 50 34 0 0 0 0 3 3 13 12
18 16 26 26 36 30 0 0 0 0 6 4 12 14
6 4 6 8 15 16 0 0 0 0 1 3 6 5
4 3 7 6 21 22 0 0 0 0 2 1 9 9
3 5 9 7 9 22 0 0 0 0 6 1 4 7
8 6 26 10 36 32 0 0 0 0 4 2 14 14
5 3 5 9 14 14 0 0 0 0 2 2 5 4
25 10 12 8 35 40 0 0 3 4 11 8 9 12
9 5 17 17 46 49 0 0 0 0 6 4 11 16
13 12 21 23 48 19 0 0 2 1 5 6 12 7
5 4 6 4 11 11 0 0 0 0 2 1 2 1
176 159 270 234 545 530 0 0 6 9 67 58 161 171
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
23 21 22 24 26 27 10 0 0 0 0 0
2 9 17 11 17 25 10 0 0 0 0 0
9 14 30 23 52 72 10 0 0 0 0 0
6 5 11 8 32 29 12 0 0 0 0 0
2 6 11 12 49 27 15 0 0 0 0 0
1 2 5 10 12 17 10 0 0 0 0 0
1 2 5 6 10 18 15 0 0 0 0 0
4 2 7 6 26 29 11 0 0 0 1 0
3 4 3 7 23 18 6 0 0 0 0 0
2 1 3 3 9 13 6 0 0 0 0 0
2 2 4 5 8 6 6 0 0 0 0 0
17 22 24 18 34 43 10 0 0 0 1 0
13 10 23 12 63 46 10 0 0 0 1 0
18 16 32 30 48 44 10 0 0 0 3 0
6 4 7 11 21 21 10 0 0 0 0 0
4 3 9 7 30 31 8 0 0 0 2 0
3 5 15 8 13 29 10 0 0 0 0 0
8 6 30 12 50 46 10 0 0 0 1 0
5 3 7 11 19 18 10 0 0 0 4 0
28 14 23 16 44 52 10 0 0 0 1 0
9 5 23 21 57 65 10 0 0 0 1 0
15 13 26 29 60 26 10 0 0 0 4 0
5 4 8 5 13 12 6 0 0 2 0
181 169 337 290 703 702 225 0 0 2 19 -
 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 1 2 0 1 0 2 0 0 0 0
0 0 0 0 1 0 0 1 0 5 0 0 0 0
1 1 4 5 1 2 0 0 0 5 0 1 1 2
1 0 2 1 1 1 0 0 0 1 0 0 0 1
1 0 4 3 0 0 0 0 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 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 0 0 0 4 0 1 0 0
 1 0 0 0 0 1 0 0 0 5 0 0 0 0
1 0 3 2 2 0 0 3 0 9 0 1 0 1
4 1 1 0 0 1 0 0 0 1 1 0 0 1
1 0 1 0 1 0 0 1 0 4 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 1 0 0 1 0 0 0 3 0 0 0 0
0 0 0 0 0 0 0 0 0 7 0 0 0 0
0 0 0 1 1 1 0 0 0 4 1 0 1 0
1 1 1 1 1 1 0 0 0 3 1 0 1 0
1 0 1 3 0 0 0 2 0 3 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 5 18 16 11 11 0 8 0 63 4 3 5 5

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

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 0 0 5 5 0 1 5 5 1 0
0 0 0 0 0 0 0 1 0 1 0 1 0 1
0 0 0 0 0 0 7 7 0 0 7 7 0 0
0 0 0 0 0 0 4 2 1 0 4 2 1 0
0 0 0 0 0 0 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 2 1 2 2 2 1
0 0 0 0 1 2 6 4 1 1 6 4 1 1
0 0 0 0 0 0 1 6 0 0 1 6 0 0
0 0 0 0 1 2 4 3 1 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 5 4 7 0 5
0 0 0 0 0 0 9 5 4 0 9 5 4 0
0 0 0 0 2 4 7 8 1 2 7 8 1 2
0 0 0 0 0 0 2 4 0 1 2 4 0 1
0 0 0 0 7 14 72 86 13 15 72 86 14 14

SIA
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
172 - 10 0 0 0 0 1 1 0 0
43 - 10 0 0 0 0 0 0 0 0
87 - 10 0 0 0 0 0 0 0 0
36 - 12 0 0 0 0 0 0 0 0
41 - 15 0 0 0 0 0 0 0 0
21 0 10 0 0 0 0 0 0 0 0
14 - 15 0 0 0 0 0 0 0 0
 19 - 11 0 0 0 1 0 0 0 0
19 - 6 0 0 0 0 0 0 0 0
11 - 6 0 0 0 0 0 0 0 0
14 - 6 0 0 0 0 0 0 0 0
92 - 10 0 0 0 1 0 0 0 0
52 - 10 0 0 0 1 0 0 0 0
106 - 10 0 0 0 3 0 0 0 0
35 - 10 0 0 0 0 0 0 0 0
28 - 8 0 0 0 2 0 0 0 0
33 - 10 0 0 0 0 0 0 0 0
64 - 10 0 0 0 1 0 0 0 0
32 - 10 0 0 0 4 0 0 0 0
87 - 10 0 0 0 1 0 0 0 0
72 - 10 0 0 0 1 0 0 0 0
88 - 10 0 0 0 4 0 0 0 0
27 - 6 0 0 2 0 0 0 0
1193 - 225 0 0 2 19 1 1 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
2 1 1 1 1 4 5 0 1 1 2
1 2 0 1 0 2 1 0 0 0 1
0 0 0 1 0 4 3 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 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 0 0 0 1 0 0
1 1 0 1 0 0 0 0 0 0 0
0 0 1 1 0 3 2 0 1 0 1
1 1 0 4 1 1 0 1 0 0 1
0 0 1 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 1 1 0 1 1 0 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 1 1 1 1 1 1 1 0 1 0
0 1 1 1 0 1 3 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0
11 10 7 13 5 18 16 4 3 5 5

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 77 67 66 0 0 76 77 1 2
46 36 46 30 43 0 0 36 46 1 5
116 98 116 94 103 0 0 98 116 0 5
 54 53 44 40 34 0 0 53 44 0 1
52 68 52 52 43 0 0 68 52 0 4
14 20 30 18 23 0 0 20 30 0 0
10 16 27 13 22 0 0 16 27 0 0
37 38 37 31 27 0 0 38 37 0 3
29 31 29 26 24 0 0 31 29 0 0
18 15 19 13 15 0 0 15 19 0 0
14 15 14 13 12 0 0 15 14 0 0
92 77 92 62 72 0 0 77 92 0 4
70 101 70 85 55 0 0 101 70 0 5
94 104 94 86 76 0 0 104 94 3 9
42 35 42 28 34 0 0 35 42 0 1
44 47 44 36 34 0 0 47 44 1 4
42 33 42 23 34 0 0 33 42 0 0
69 91 69 73 53 0 0 91 69 0 3
37 32 37 25 31 0 0 32 37 0 7
89 99 89 76 65 0 0 99 89 0 4
96 98 96 81 76 0 0 98 96 0 3
76 108 76 89 62 0 0 108 76 2 3
25 28 25 24 23 0 0 28 25 0 0
1243 1319 1267 1085 1027 0 0 1319 1267 8 63

PLKB = ORANG MEDIS = 19 ORANG

PKK = 225 ORANG

E. LANSIA
JUMLAH NO JENIS JUMLAH JUMLAH JUMLAH
L P IMUNISASI L P UMUR SASARAN YANG HADIR
1 1 8 POLIO 4 18 16 L P L P
12 9 9 HEPATITIS 1 10 7 45-60 Tahun 1664 1923 198 441
13 5 10 HEPATITIS 2 13 5 60-69 Tahun 785 805 90 217
18 16 11 HEPATITIS 3 18 16 > 70 Tahun 256 399 16 115
2 2 12 CAMPAK 11 11
 12 9 13 TT I 0 8 F. KPPASI
13 7 14 TT 2 0 63 PESERTA JML
SASARAN YG HADIR
I EKSLUSIF BUMIL 136 136
SASARAN MASIH ASI E BUSUI 0-6 BLN 183 257
L P L P BUSUI 7-24 BLN 968 968
72 86 72 86
SASARAN LULUS ASI E J. VITAMIN
L P L P SASARAN Jml.VIT A yg
13 15 14 14 UMUR diberikan
L P L P
6 - 11 bulan 0 0 0 0
12 - 59 bulan 0 0 0 0
Bufas - 7- 14

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

- 225 0 0 2 19 1 1 0 0

- 225 0 0 2 19 1 1 0 0

0 450 0 0 4 38 2 2 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

1243 1319 1267 1085 1027 0 0 1319 1267 8 63

1243 1319 1267 1085 1027 0 0 1319 1267 8 63

0 2486 2638 2534 2170 2054 0 0 2638 2534 16 126

 BALITA YANG
MENDERITA DIARE
CAMPAK HEPATITIS B JUMLAH Mendapat
I II III ORALIT
P L P L P L P L P L P

11 10 7 13 5 18 16 4 3 5 5

11 10 7 13 5 18 16 4 3 5 5
 0 0
D. IMUNISASI

B D PETUGAS YANG HADIR BCG DPT

6 - 12 BLN 12 - 24 BLN 25 - 59 BLN 0 - 5 BLN 6 - 12 BLN 12 - 24 BLN 25 - 59 BLN PKK PLKB MEDIS KETERANGAN I II III I
P L P L P L P L P L P L P L P L P L P L P L P L P L P
0 0 0 0 0 5 5 23 21 22 24 26 27 153 10 0 0 0 00 - 0 0 1 1 1 1 0 0 1 1
0 0 0 0 0 1 2 9 17 11 17 25 82 10 0 0 0 00 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 00 0 0 1 1 1 1 4 5 0 0
0 0 0 0 0 4 2 6 5 11 8 32 29 97 12 0 0 0 00 0 0 2 0 1 0 2 1 0 0
0 0 0 0 0 6 7 2 6 11 12 49 27 120 15 0 0 0 00 0 0 0 0 1 0 4 3 0 0
0 0 0 0 0 2 1 1 2 5 10 12 17 50 10 0 0 0 00 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 2 5 6 10 18 43 15 0 0 0 00 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 10 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 00 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 2 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 00 0 0 0 0 0 0 0 0 0 0
0 0 0 2 9 17 22 24 18 34 43 169 10 0 0 0 10 0 0 2 2 0 0 0 0 0 0
0 0 0 0 0 2 2 13 10 23 12 63 46 171 10 0 0 0 10 0 0 1 0 1 0 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 00 0 0 1 0 4 1 1 0 0 0
0 0 0 0 0 4 3 4 3 9 7 30 31 91 8 0 0 0 20 0 1 0 1 1 0 1 0 0 1
0 0 0 0 0 2 0 3 5 15 8 13 29 75 10 0 0 0 00 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 10 0 0 1 1 0 1 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 10 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 10 1 0 1 1 1 1 1 1 1 0
0 0 0 0 0 7 8 15 13 26 29 60 26 184 10 0 0 0 40 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 81 181 169 337 290 703 702 225 0 0 2 19 - 1 1 12 9 13 5 18 16 2 2
 H.P. DIARE G. KB
ALAT KONTRASEPSI
POLIO HIPATITIS CAMPAK TT JUMLAH
YG DAPAT IUD MOW MOP IMPLANT
ORALIT
II III IV I II III I II JUMLAH PESERTA
L P L P L P L P L P L P L P L P L P L P L P P S P S P S P S
1 1 2 1 0 0 1 1 1 1 0 0 1 2 0 1 0 2 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
1 1 1 1 4 5 1 1 1 1 4 5 1 2 0 0 0 5 0 1 1 2 23 11 2 4 0 0 9 4
2 0 1 0 2 1 2 0 1 0 2 1 1 1 0 0 0 1 0 0 0 1 3 0 2 0 0 0 10 0
1 0 1 0 4 3 0 0 1 0 4 3 0 0 0 0 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
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 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 2 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 4 0 1 0 0 5 0 0 0 0 0 4 0
0 1 0 1 0 0 1 0 1 0 0 0 0 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 2 0 0 3 0 9 0 1 0 1 5 3 3 2 2 2 0 0
1 0 4 1 1 0 1 0 4 1 1 0 0 1 0 0 0 1 1 0 0 1 3 0 2 0 3 0 3 0
0 1 1 1 1 0 0 1 1 0 1 0 1 0 0 1 0 4 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 0 1 1 0 1 1 0 1 1 0 0 1 0 0 0 3 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
0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 4 1 0 1 0 10 0 3 0 0 0 1 0
1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 0 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 0 0 2 0 3 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
12 9 13 7 18 16 10 7 13 5 18 16 11 11 0 8 0 63 4 3 5 5 118 95 28 26 6 4 63 16
 J. VITAMIN A K. ASI EKSLUSIF F. KPPASI
EPSI

SASARAN

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

VIT. A
ESERTA 12 - 59 BLN 6 -JML YG DIBERI
11 BLN 12 -VIT. A
59 BLN 6 Bln pd 0 - 5 Bln Bln ini MIL 0-6 7 - 24 MIL
Bln ini
P S P S P S L P L P L P L P L P L P L P L P Bln Bln
34 18 39 2 0 0 0 0 0 0 0 0 0 0 0 0 5 5 0 1 5 5 1 0 4 10 82
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 38
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 15 72
15 0 15 0 2 0 0 0 0 0 0 0 0 0 0 0 4 2 1 0 4 2 1 0 2 9 27
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 27
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 18
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 12
20 15 3 8 23 28 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 3 0 19
25 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 3 2 17
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 8
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 13
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 15 77
17 18 9 7 1 0 0 0 0 0 0 0 0 0 1 2 2 2 2 1 2 2 2 1 7 7 45
32 38 45 26 0 0 0 0 0 0 0 0 0 0 1 2 6 4 1 1 6 4 1 1 12 12 94
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 28
35 0 27 0 10 0 0 0 0 0 0 0 0 0 1 2 4 3 1 0 4 3 1 0 9 8 22
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 28
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 56
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 26
20 80 5 75 5 0 0 0 0 0 0 0 0 0 0 0 4 7 0 5 4 7 0 5 9 11 76
50 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 9 5 4 0 9 5 4 0 5 18 54
50 0 10 0 8 0 0 0 0 0 0 0 0 0 2 4 7 8 1 2 7 8 1 2 13 18 70
 3 15 0 19 0 0 0 0 0 0 0 0 0 0 0 0 2 4 0 1 2 4 0 1 0 6 21
611 308 231 242 89 63 0 0 0 0 0 0 0 0 7 14 72 86 13 15 72 86 14 14 136 183 930
 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
4 82 90 100 125 20 22 13 10 45 35 7 4 2 2- - - 164 154 1 1 0 0
5 7 36 50 50 40 48 10 30 20 25 5 5 0 0- 88 76 0 0 0 0
14 15 72 130 140 42 50 15 12 25 50 6 10 4 7- 185 180 0 0 0 0
2 9 27 141 140 32 39 14 10 0 0 0 0 0 0- 227 209 0 0 0 0
11 14 27 107 116 35 39 10 15 25 30 6 20 0 4- 135 120 0 0 0 0
0 3 18 20 30 5 8 3 5 2 0 0 7 0 5- 78 66 0 0 0 0
1 2 12 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
3 2 17 125 143 42 45 19 21 0 0 0 0 0 0- 128 110 0 0 0 0
0 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 15 77 20 32 10 20 5 4 5 20 2 5 2 5- 158 150 0 0 0 0
7 7 45 75 100 15 20 1 10 11 20 6 15 1 10 - 125 116 0 0 0 0
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