JANUARI 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
S D/S
L P L P L P L P L P L P L P L P L

1 PARKIT .001 2 2 23 17 26 27 27 29 153 98.693 2 2 23 17 26 27 27 29 2

2 CAMAR .002 4 3 3 5 9 16 13 20 73 94.521 4 3 3 5 9 16 13 20 2
3 GELATIK A .003 2 5 15 9 33 22 39 40 165 100 2 5 15 9 33 22 39 40 2
4 GELATIK B .003 4 7 2 5 20 25 40 35 138 100 4 7 2 5 20 25 40 35 4
5 ELANG .004 2 3 7 5 16 16 44 26 119 100 2 3 7 5 16 16 44 26 2
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 1 1 0 2 4 6 10 19 43 100 1 1 0 2 4 6 10 19 1
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 0 2 2 3 8 2 18 24 59 100 0 2 2 3 8 2 18 24 0
11 KUTILANG .011 1 1 2 2 4 5 8 6 29 100 1 1 2 2 4 5 8 6 1
12 PANDA A .012 2 13 15 20 24 18 35 43 170 100 2 13 15 20 24 18 35 43 2
13 PANDA B .012 4 4 15 9 16 8 85 57 198 100 4 4 15 9 16 8 85 57 4
14 RUSA 013 8 7 18 15 32 30 48 44 202 100 8 7 18 15 32 30 48 44 5
15 MURAI .014 1 2 6 4 7 11 24 21 76 100 1 2 6 4 7 11 24 21 1
16 MERAK .015 3 1 4 4 7 10 40 30 99 100 3 1 4 4 7 10 40 30 2
17 KANCIL 016 3 4 2 1 12 8 12 24 66 100 3 4 2 1 12 8 12 24 2
18 KELINCI 017 6 4 9 7 28 8 46 45 153 100 6 4 9 7 28 8 46 45 6
19 CAMAR B .018 1 4 5 3 8 7 12 13 53 107.55 1 4 5 3 8 7 12 13 1
20 KANGURU A .019 9 11 7 3 26 17 64 64 201 100 9 11 7 3 26 17 64 64 9
21 KANGURU B .019 12 5 11 10 22 16 48 46 170 98.824 12 5 11 10 22 16 48 46 11
22 NURI 20 6 7 19 14 20 25 35 30 156 102.56 6 7 19 14 20 25 35 30 6
23 BANGAU .023 3 6 4 2 7 3 15 14 54 100 3 6 4 2 7 3 15 14 3
JUMLAH 79 93 177 148 344 303 724 694 2562 79 93 177 148 344 303 724 694 68

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

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

C. KIA I. KUNJUNGAN KIA

 C. KIA I. KUNJUNGAN KIA
BULAN = JANUARI
UMUR
NAMA ALAMAT UMUR KEHAMILA
BUMIL HAMIL
(Bln)
N0 SUAMI ISTRI (Thn) KE

POSYANDU RW RT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
C. KIA I. KUNJUNGAN KIA
BULAN = JANUARI
NAMA UMUR
ALAMAT UMUR KEHAMILA
N0 BUMIL HAMIL
KE (Bln)
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 JANUARI 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 2 2 23 17 26 27 27 29 2 2 23 17 26 27 27 29 2 2
2 CAMAR 4 3 3 5 9 16 13 20 4 3 3 5 9 16 13 20 2 3
3 GELATIK A 2 5 15 9 33 22 39 40 2 5 15 9 33 22 39 40 2 5
GELATIK B 4 7 2 5 20 25 40 35 4 7 2 5 20 25 40 35 4 7
4 ELANG 2 3 7 5 16 16 44 26 2 3 7 5 16 16 44 26 2 3
5 MERPATI 2 1 1 2 5 10 12 17 2 1 1 2 5 10 12 17 2 1
6 GARUDA 1 1 0 2 4 6 10 19 1 1 0 2 4 6 10 19 1 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 0 2 2 3 8 2 18 24 0 2 2 3 8 2 18 24 0 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 13 15 20 24 18 35 43 2 13 15 20 24 18 35 43 2 13
PANDA B 4 4 15 9 16 8 85 57 4 4 15 9 16 8 85 57 4 4
13 RUSA 8 7 18 15 32 30 48 44 8 7 18 15 32 30 48 44 5 7
14 MURAI 1 2 6 4 7 11 24 21 1 2 6 4 7 11 24 21 1 1
15 MERAK 3 1 4 4 7 10 40 30 3 1 4 4 7 10 40 30 2 1
16 KANCIL 3 4 2 1 12 8 12 24 3 4 2 1 12 8 12 24 2 4
17 KELINCI 6 4 9 7 28 8 46 45 6 4 9 7 28 8 46 45 6 4
18 CAMAR B 1 4 5 3 8 7 12 13 1 4 5 3 8 7 12 13 1 3
19 KANGURU A 9 11 7 3 26 17 64 64 9 11 7 3 26 17 64 64 9 9
KANGURU B 12 5 11 10 22 16 48 46 12 5 11 10 22 16 48 46 11 5
20 NURI 6 7 19 14 20 25 35 30 6 7 19 14 20 25 35 30 6 7
21 BANGAU 3 6 4 2 7 3 15 14 3 6 4 2 7 3 15 14 3 6
JUMLAH 79 93 177 148 344 303 724 694 79 93 177 148 344 303 724 694 68 83
LAPORAN BULANAN POSYANDU
KELURAHAN DEPOK KECAMATAN PANCORAN MAS DEPOK
BULAN JANUARI 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 1 0 1 2 3 2
2 CAMAR 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 3
3 GELATIK A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5
GELATIK B 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 7
4 ELANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3
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 1 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 0 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 13
PANDA B 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 4 4 4
13 RUSA 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 8 7
14 MURAI 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 2
15 MERAK 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 3 1
16 KANCIL 0 0 0 0 4 0 1 4 1 0 0 1 0 0 0 0 3 4
17 KELINCI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 4
18 CAMAR B 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 4
19 KANGURU A 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 9 11
KANGURU B 0 0 0 2 0 1 5 4 1 0 0 0 0 0 3 3 12 5
20 NURI 0 0 0 0 0 3 0 0 0 0 3 1 0 0 0 0 6 7
21 BANGAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 6
JUMLAH 0 0 0 2 4 4 6 8 8 4 5 4 1 0 4 9 79 93
JANUARI 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 0 0 1 0 0 1 0 0 1 0 0 0 0 1 0 0
2 CAMAR 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0
3 GELATIK A 0 0 0 1 0 0 2 0 0 0 0 1 0 0 2 0 0 1
GELATIK B 0 0 0 0 1 0 3 1 0 0 0 0 1 0 3 1 0 2
4 ELANG 0 0 1 2 1 0 0 0 0 0 1 2 1 0 1 0 1 2
5 MERPATI 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 1 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 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0
8 ANGSA 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0
9 KIJANG 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 1 0
11 KUTILANG 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0
12 PANDA A 0 0 1 2 1 2 0 0 0 0 1 2 1 2 0 0 1 2
PANDA B 0 0 1 0 1 0 2 1 0 0 1 0 1 0 2 1 1 0
13 RUSA 2 2 0 0 0 0 1 1 2 2 0 0 0 0 1 1 0 0
14 MURAI 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 0 0
15 MERAK 0 0 0 0 0 0 1 2 0 0 0 0 0 0 1 2 0 0
16 KANCIL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 KELINCI 2 0 0 1 1 0 2 1 2 0 1 1 1 0 1 2 0 1
18 CAMAR B 0 0 1 1 1 0 0 1 0 0 1 1 1 0 1 0 1 1
19 KANGURU A 0 0 2 1 0 1 0 2 0 0 2 1 0 1 2 0 2 1
 KANGURU B 2 2 5 1 3 0 1 1 2 2 5 1 3 0 1 1 5 1
20 NURI 2 0 3 3 1 0 0 0 2 0 3 3 3 0 0 2 3 3
21 BANGAU 0 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0
JUMLAH 10 5 17 12 13 7 16 15 11 5 19 12 14 7 19 15 17 14

JANUARI TAHUN 2021 G. KB J. VITAMIN A

ALAT KONTRASEPSI
JML SASARAN
RW NAMA IUD MOW MOP IMPLANT SUNTIK PIL KONDOM
POSYANDU 6 - 11 BLN 12-59 BLN
JUMLAH PESERTA
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 23 17 53 56
2 CAMAR 3 2 1 0 0 0 2 0 1 31 0 12 10 0 2 4 15 14
3 GELATIK A 23 11 2 4 0 0 9 4 34 14 15 15 1 1 15 9 72 62
GELATIK B 3 0 2 0 0 0 10 0 15 0 15 0 2 0 2 5 60 60
4 ELANG 4 0 0 0 0 0 1 0 30 3 1 7 0 5 7 5 60 42
5 MERPATI 2 28 0 0 0 0 0 0 3 35 0 11 0 9 2 1 17 27
6 GARUDA 0 7 1 0 0 0 0 2 0 5 0 2 0 3 0 2 14 25
7 CENDRAWASIH 8 11 0 1 0 0 1 2 20 15 3 8 23 28 4 2 33 35
8 ANGSA 3 0 1 0 0 0 2 0 25 0 18 0 0 0 0 2 26 25
9 KIJANG 0 2 0 0 0 0 4 3 15 4 2 3 0 5 2 3 26 26
11 KUTILANG 0 8 0 0 0 0 2 0 6 0 0 12 0 8 2 2 12 11
12 PANDA A 5 0 0 0 0 0 4 0 90 0 0 10 0 0 15 20 59 61
PANDA B 0 2 0 2 0 0 0 4 1 21 0 1 0 0 15 9 69 49
13 RUSA 3 2 3 3 0 0 1 1 55 30 40 26 0 0 18 15 80 74
14 MURAI 5 0 3 0 0 0 3 0 25 0 30 0 2 0 6 4 24 21
15 MERAK 5 0 0 0 0 0 3 0 0 25 0 25 10 0 4 4 40 30
16 KANCIL 3 0 3 0 0 0 3 0 27 0 23 0 0 0 2 1 12 24
17 KELINCI 0 11 0 11 0 2 0 7 42 31 0 25 0 7 9 7 46 45
18 CAMAR B 2 0 0 0 0 0 0 0 30 0 0 10 0 0 5 3 20 20
 19 KANGURU A 10 0 3 0 0 0 1 0 20 80 5 75 5 0 7 3 90 81
KANGURU B 10 0 5 0 0 0 10 0 50 0 10 0 8 0 11 10 48 46
20 NURI 10 0 5 0 0 0 10 0 50 0 10 0 8 0 19 14 55 55
21 BANGAU 1 2 0 0 0 0 0 0 3 15 0 19 0 0 4 2 22 12
JUMLAH 114 93 29 21 0 2 66 23 576 327 211 263 69 66 174 144 953 901

JANUARI TAHUN 2021

F. KPPASI E. LANSIA
NO NAMA JML SASARAN JML YG HADIR JUMLAH SASARAN
POSYANDU BUSUI BUSUI UMUR
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 13 6 91 13 6 91 100 125 20
2 CAMAR 3 6 34 3 6 34 50 50 40
3 GELATIK A 9 7 75 9 7 75 130 140 42
GELATIK B 6 11 52 6 11 52 141 140 32
4 ELANG 10 5 44 10 5 44 107 116 35
5 MERPATI 0 3 18 0 3 18 20 30 5
6 GARUDA 0 2 39 0 2 39 26 26 29
7 CENDRAWASIH 3 1 19 3 1 19 130 125 68
8 ANGSA 6 7 17 6 7 17 125 143 42
9 KIJANG 2 2 15 2 2 12 88 101 75
11 KUTILANG 2 2 13 2 2 13 30 37 20
12 PANDA A 13 17 73 13 17 73 20 32 10
PANDA B 6 10 46 6 10 46 75 100 15
13 RUSA 10 19 91 10 19 91 79 132 100
14 MURAI 6 3 28 6 3 28 125 125 75
15 MERAK 9 4 25 9 4 25 0 0 0
16 KANCIL 1 8 22 1 8 22 50 70 39
17 KELINCI 5 10 26 5 10 26 120 149 31
 18 CAMAR B 9 8 23 9 8 23 20 21 20
19 KANGURU A 11 26 47 11 26 47 30 33 10
KANGURU B 9 19 57 9 19 57 120 157 30
20 NURI 10 14 76 10 14 76 50 50 38
21 BANGAU 1 8 16 1 8 16 28 21 9
JUMLAH 144 198 947 144 198 944 1664 1923 785
JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU
JUMLAH BAYI LAHIR / MENINGGAL
BULAN JANUARI 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 19 1 0 25 26 1 2 26 27 164 154 13
2 CAMAR .002 2 0 4 7 0 0 9 14 0 0 13 20 88 76 3
3 GELATIK A .003 0 0 17 14 0 0 33 22 0 0 39 40 185 180 9
4 GELATIK B .003 0 0 6 12 0 0 20 25 0 0 40 35 227 209 6
5 ELANG .004 0 0 9 8 0 0 16 16 0 0 44 26 135 120 10
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 4 6 0 0 10 19 72 62 0
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 6
10 KIJANG .009 0 0 2 5 0 0 8 2 0 0 18 24 68 56 2
11 KUTILANG .011 0 0 3 3 0 0 4 5 0 0 8 6 58 46 2
12 PANDA A .012 0 0 17 33 0 0 24 18 0 0 35 43 158 150 13
13 PANDA B .012 2 2 17 11 0 0 16 8 0 4 85 53 125 116 6
14 RUSA .013 3 0 23 22 0 0 32 30 0 0 48 44 190 175 10
15 MURAI .014 0 1 7 5 0 0 7 11 0 0 24 21 84 80 6
16 MERAK .015 1 0 6 5 0 0 7 10 0 0 40 30 115 105 9
 17 KANCIL .016 1 1 4 4 0 0 12 8 0 0 12 24 65 58 1
18 KELINCI .017 0 0 15 11 0 0 28 8 0 0 46 45 215 185 5
19 CAMAR B .018 0 1 6 6 0 0 8 11 0 0 12 13 115 101 9
20 KANGURU A .019 0 2 16 12 0 0 26 17 0 0 64 64 210 200 11
21 KANGURU B .019 1 0 21 15 0 0 22 15 3 3 45 43 275 140 9
22 NURI .020 3 1 25 21 0 0 20 25 0 0 35 30 188 178 10
23 BANGAU .023 0 0 7 8 0 0 7 3 0 0 15 14 55 49 1
JUMLAH 13 8 244 225 1 0 336 300 4 9 705 671 3088 2696 144
DATA HASIL KEGIATAN POSYANDU
BULAN JANUARI TAHUN 2021
format 7

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

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

1 PARKIT .001 13 13 13 97 0 41 0 0 0 7 52 0 78 75 78
2 CAMAR .002 3 3 3 40 10 12 2 0 1 2 32 0 29 44 29
3 GELATIK A .003 9 9 9 82 2 30 13 0 6 11 48 0 89 76 89
4 GELATIK B .003 6 6 6 63 2 15 10 0 2 0 15 0 66 72 66
5 ELANG .004 10 10 10 49 5 8 1 0 0 0 33 0 69 50 69
6 MERPATI .005 0 0 0 21 9 11 0 0 0 28 38 0 20 30 20
7 GARUDA .006 0 0 0 41 3 2 2 0 1 7 5 0 15 28 15
8 CENDRAWASIH .007 3 3 3 20 51 11 3 0 1 11 35 0 38 37 38
9 ANGSA .008 6 6 6 24 0 18 2 0 1 0 25 0 31 29 31
10 KIJANG .009 2 2 2 14 5 5 7 0 0 2 19 0 28 31 28
11 KUTILANG .011 2 2 2 15 8 12 2 0 0 8 6 0 15 14 15
12 PANDA A .012 13 13 13 90 0 10 4 0 0 0 90 0 76 94 76
13 PANDA B .012 6 6 6 56 0 1 4 0 2 2 22 0 120 78 120
 14 RUSA .013 10 10 10 110 0 66 2 0 6 2 85 0 106 96 106
15 MURAI .014 6 6 6 31 2 30 3 0 3 0 25 0 38 38 38
16 MERAK .015 9 9 9 29 10 25 3 0 0 0 25 0 54 45 54
17 KANCIL .016 1 1 1 30 0 23 3 0 3 0 27 0 29 37 29
18 KELINCI .017 5 5 5 36 7 25 7 2 11 11 73 0 89 64 89
19 CAMAR B .018 9 9 9 31 0 10 0 0 0 0 30 0 26 27 26
20 KANGURU A .019 11 11 11 73 5 80 1 0 3 0 100 0 106 95 106
21 KANGURU B .019 9 9 9 76 8 10 10 0 5 0 50 0 93 77 93
22 NURI .020 10 10 10 90 8 10 10 0 5 0 50 0 80 76 80
23 BANGAU .023 1 1 1 24 0 19 0 0 0 2 18 0 29 25 29
JUMLAH 144 144 144 1142 0 135 474 89 2 50 93 903 0 1324 1238 1324
LAPORAN BULANAN POSYANDU
Nama posyandu : PKK KELURAHAN DEPOK Tanggal penimbangan : JANUARI
RW / Kelurahan : DEPOK Petugas yang membina :

A. SKDN D. IMUNISASI
S K N T O B D = N+T+O+B NO JENIS
UMUR L P L P L P L P L P L P L P IMUNISASI
BALITA
0 - 5 Bulan 79 93 79 93 68 83 0 0 0 0 8 4 79 93 1 BCG
6 - 11 Bulan 177 148 177 148 160 131 8 9 0 2 5 4 177 148 2 DPT 1
JUMLAH 256 241 256 241 228 214 8 9 0 2 13 8 256 241 3 DPT 2
12 - 24 Bulan 344 303 344 303 275 252 57 44 4 4 1 0 344 303 4 DPT 3
25 - 59 Bulan 724 694 724 694 578 549 121 114 6 8 4 9 724 694 5 POLIO 1
JUMLAH 1068 997 1068 997 853 801 178 158 10 12 5 9 1068 997 6 POLIO 2
TOTAL 1 + 2 1324 1238 1324 1238 1081 1015 186 167 10 14 18 17 1324 1238 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 114 93 DIARE YANG 1 K1 0 - 5 bulan
2 MOW 29 21 L P DIBERIKAN 2 K4 6 bulan
3 MOP 0 2 3 N2 pada
4 IMPLANT 66 23 4 LINAKES bulan ini
JUMLAH 209 139
 5 SUNTIK 576 327
6 PIL 211 263
7 KONDOM 69 66
JUMLAH 856 656
TOTAL 1065 795 Mengetahui
Pembina Wilayah Posyandu
Hal yang perlu dilaporkan :
PUS = 2696
WUS = 3088
BUSUI = 1142 ( ...................)

JUMLAH PENGUNJUNG / JUMLAH PETUGAS POSYANDU

JUMLAH BAYI LAHIR / MENINGGAL
TAHUN 2021

JUMLAH PENGUNJUNG
BALITA IBU
N0 BULAN 0 - 11 BULAN 12 - 24 BULAN 25 - 60 BULAN WUS

HAMIL

BUSUI
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 9 705 671 3088 2696 144 1142

2 JANUARI
3
4
5
6
7
8
9
10
11
12
J UM L A H 13 8 244 225 1 0 336 300 4 9 705 671 3088 2696 144 1142

DATA HASIL KEGIATAN POSYANDU

TAHUN 2021

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

S E S O A D I A
A T U M N K I KMS
I N (S) (K)
L P L
1 JANUARI 144 144 144 1142 135 474 89 2 50 93 903 0 1324 1238 1324
2 JANUARI
3
4
5
6
7
8
9
10

J UM L A H 0 144 144 1142 0 135 474 89 2 50 93 903 0 1324 1238 1324

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 18 12 13 6 18 15 6

2 JANUARI

10

11

12
JUMLAH 10 5 16 12 12 6 15 15 10 5 18 12 13 6 18 15 6
 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

2 20 16 23 25 22 24 0 0 2 1 2 1 4 3 0 0 0 0 0 0 0 0 0 0 0
3 2 4 7 11 13 18 0 0 0 0 2 3 0 2 0 0 0 0 0 0 0 0 2 0 0
5 13 8 27 18 31 27 0 0 2 1 6 4 8 13 0 0 0 0 0 0 0 0 0 0 0
7 2 5 19 23 37 33 0 0 0 0 1 2 3 2 0 0 0 0 0 0 0 0 0 0 0
3 7 5 14 13 36 20 0 0 0 0 2 3 8 6 0 0 0 0 0 0 0 0 0 0 0
1 1 1 4 8 9 13 0 0 0 1 1 2 3 4 0 0 0 0 0 0 0 0 0 0 0
1 0 2 4 4 8 14 0 0 0 0 0 2 2 5 0 0 0 0 0 0 0 0 0 0 0
0 4 2 5 4 21 23 0 0 0 0 2 2 5 6 0 0 0 0 0 0 0 0 0 0 0
0 3 4 3 7 20 10 0 0 0 0 0 0 3 8 0 0 0 0 0 0 0 0 0 0 0
2 2 3 5 2 14 21 0 0 0 0 3 0 4 3 0 0 0 0 0 0 0 0 0 0 0
1 2 2 3 3 5 4 0 0 0 0 1 2 3 2 0 0 0 0 0 0 0 0 0 0 0
13 15 20 15 13 20 35 0 0 0 0 9 5 15 8 0 0 0 0 0 0 0 0 0 0 0
4 13 7 14 7 63 43 0 0 0 0 2 1 22 10 0 0 0 0 0 0 0 0 0 0 2
7 18 15 31 29 46 43 0 0 0 0 1 1 2 1 0 0 0 0 0 0 0 0 3 0 0
1 6 4 5 10 18 15 0 0 0 0 2 1 6 6 0 0 0 0 0 0 0 0 0 1 0
1 4 4 4 8 30 19 0 0 0 0 3 2 10 11 0 0 0 0 0 0 0 0 1 0 0
4 2 0 4 6 6 15 0 0 0 0 4 2 5 5 0 0 0 0 4 0 1 4 1 0 0
4 9 7 18 5 38 35 0 0 0 0 10 3 8 10 0 0 0 0 0 0 0 0 0 0 0
3 5 1 7 9 11 11 0 0 0 2 1 2 1 2 0 0 0 0 0 0 0 0 0 1 0
9 5 2 25 15 61 62 0 0 2 1 1 2 3 2 0 0 0 0 0 0 0 0 0 2 0
5 8 5 20 12 37 36 0 0 2 3 2 2 3 3 0 0 0 2 0 1 5 4 1 0 0
7 19 14 18 20 32 28 0 0 0 0 2 2 3 2 0 0 0 0 0 3 0 0 0 0 3
6 4 2 5 2 11 12 0 0 0 0 2 1 4 2 0 0 0 0 0 0 0 0 0 0 0
83 160 131 275 252 578 549 0 0 8 9 57 44 121 114 0 0 0 2 4 4 6 8 8 4 5

MUR BGM 2T GAKIN/

ulan) BB TB NON
(Kg) (Cm) GAKIN
MUR GAKIN/
ulan) BB TB NON
L P (Kg) (Cm) GAKIN
L B L B
V V
V V
V V
V VV
V V
V V
V V
V V
V V
V V
V V
V V
V V
 UMUR
KEHAMILAN GAKIN/ JUMLAH KUNJUNGAN
(Bln) NON
GAKIN UNRAIAN
K1 K4 N2 LINAKES

UMUR JUMLAH KUNJUNGAN

KEHAMILAN GAKIN/
(Bln) NON UNRAIAN
GAKIN
K1 K4 N2 LINAKES
021

N T
6 - 12 BLN 12-24 BLN 25-59 BLN 0 - 5 BLN 6 - 11 BLN 12-24 BLN 25-59 BLN
L P L P L P L P L P L P L P
 21 22 23 24 25 26 27 28 29 30 31 32 33 34
20 16 23 25 22 24 0 0 2 1 L 1 4 3
2 4 7 11 13 18 0 0 0 0 2 3 0 2
13 8 27 18 31 27 0 0 2 1 6 4 8 13
2 5 19 23 37 33 0 0 0 0 1 2 3 2
7 5 14 13 36 20 0 0 0 0 2 3 8 6
1 1 4 8 9 13 0 0 0 1 1 2 3 4
0 2 4 4 8 14 0 0 0 0 0 2 2 5
4 2 5 4 21 23 0 0 0 0 2 2 5 6
3 4 3 7 20 10 0 0 0 0 0 0 3 8
2 3 5 2 14 21 0 0 0 0 3 0 4 3
2 2 3 3 5 4 0 0 0 0 1 2 3 2
15 20 15 13 20 35 0 0 0 0 9 5 15 8
13 7 14 7 63 43 0 0 0 0 2 1 22 10
18 15 31 29 46 43 0 0 0 0 1 1 2 1
6 4 5 10 18 15 0 0 0 0 2 1 6 6
4 4 4 8 30 19 0 0 0 0 3 2 10 11
2 0 4 6 6 15 0 0 0 0 4 2 5 5
9 7 18 5 38 35 0 0 0 0 10 3 8 10
5 1 7 9 11 11 0 0 0 2 1 2 1 2
5 2 25 15 61 62 0 0 2 1 1 2 3 2
8 5 20 12 37 36 0 0 2 3 2 2 3 3
19 14 18 20 32 28 0 0 0 0 2 2 3 2
4 2 5 2 11 12 0 0 0 0 2 1 4 2
160 131 275 252 578 549 0 0 8 9 57 44 121 114

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
22 17 26 26 27 29 10 0 0 0 0 0
2 4 9 14 13 20 10 0 0 0 4 0
15 9 33 22 39 40 10 0 0 0 5 0
2 5 20 25 40 35 12 0 0 0 4 0
7 5 16 16 44 26 15 0 0 0 4 0
1 2 5 10 12 17 10 0 0 0 3 0
0 2 4 6 10 19 15 0 1 0 6 0
4 2 7 6 26 29 11 0 0 0 5 0
3 4 3 7 23 18 6 0 0 0 2 0
2 3 8 2 18 24 6 0 0 0 0 0
2 2 4 5 8 6 6 0 0 0 2 0
15 20 24 18 35 43 10 0 0 0 5 0
15 9 16 8 85 57 10 0 0 0 5 0
18 15 32 30 48 44 10 0 0 0 5 0
6 4 7 11 24 21 10 0 0 0 5 0
4 4 7 10 40 30 8 0 0 0 2 0
2 1 12 8 12 24 10 0 0 0 4 0
9 7 28 8 46 45 10 0 0 0 5 0
5 3 8 11 12 13 10 0 0 0 4 0
7 3 26 17 64 64 10 0 0 0 5 0
10 10 22 15 48 46 10 0 0 0 5 0
22 15 20 25 35 30 10 0 0 0 4 0
4 2 7 3 15 14 8 0 0 2 3 0
177 148 344 303 724 694 227 0 1 2 87 -
 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
0 0 0 1 0 0 0 0 0 8 0 0 0 0
0 0 0 0 0 1 0 0 0 2 0 0 0 0
0 0 1 0 0 1 0 2 0 9 0 1 0 1
1 0 3 1 0 2 0 2 0 1 0 0 0 1
1 0 0 0 0 1 0 0 0 4 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 1 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 3 0 0 0 0
0 0 1 1 0 0 0 2 0 2 0 0 0 0
0 1 0 0 0 0 0 0 0 1 0 0 0 0
0 0 0 1 0 0 0 0 0 2 0 0 0 0
1 2 0 0 0 0 0 4 0 4 1 0 1 0
1 0 2 1 0 1 0 4 0 4 0 0 0 0
0 0 1 1 1 1 0 1 0 8 1 0 1 0
1 1 1 1 1 1 0 1 0 4 1 0 0 1
0 0 2 1 0 1 0 3 0 4 0 0 0 0
0 0 0 0 0 2 0 0 0 0 0 0 0 0
1 0 1 2 1 0 0 0 0 3 0 1 0 1
1 0 0 1 0 0 0 2 0 3 0 0 0 0
0 1 0 2 1 1 0 2 0 7 0 2 0 2
 3 0 1 1 1 1 0 2 0 6 0 0 0 0
1 0 0 0 1 0 0 2 0 5 1 0 1 0
1 1 1 0 0 1 0 0 0 0 0 0 0 0
12 6 15 14 6 14 0 27 0 80 5 5 3 6

VITAMIN A K. ASI EKSLUSIF

BUFAS JML SASARAN MASIH LULUS ASI
JML YG DIBERI VIT A ASI

MENDPT VIT.A
0 - 5 BLN 6 Bln pd 6 Bln pd

SASARAN
AKSLUSIF
Bln ini 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
23 17 53 56 1 2 2 2 2 0 2 2 2 0
2 4 15 14 1 2 4 3 2 4 1 1 2 4
15 9 72 62 2 4 2 5 2 2 2 5 2 2
2 5 60 60 0 0 4 7 0 0 4 7 0 0
7 5 60 42 0 0 2 3 0 0 2 3 0 0
2 1 17 27 0 0 2 1 0 0 2 1 0 0
0 2 14 25 0 0 1 1 0 0 0 1 0 0
4 2 33 35 0 0 1 0 0 0 1 0 0 0
0 2 26 25 0 0 2 0 0 0 2 0 0 0
2 3 26 26 0 0 0 2 0 0 0 2 0 0
2 2 12 11 0 0 1 1 0 0 1 1 0 0
15 20 59 61 2 4 2 13 2 2 2 13 2 2
15 9 69 49 0 0 4 4 1 1 4 4 1 1
18 15 80 74 4 8 8 7 4 0 8 7 4 0
6 4 24 21 0 0 1 2 0 0 1 2 0 0
4 4 40 30 0 0 3 1 0 0 3 1 0 0
2 1 12 24 0 0 3 4 0 1 4 3 0 1
9 7 46 45 2 4 6 4 0 0 6 4 0 0
5 3 20 20 0 0 1 4 0 0 1 4 0 0
 7 3 90 81 0 0 9 11 3 3 9 11 3 3
11 10 48 46 1 2 12 5 2 0 12 5 2 0
19 14 55 55 2 4 6 7 2 0 6 8 2 0
4 2 22 12 1 2 3 6 0 0 3 6 0 0
174 144 953 901 16 32 79 93 20 13 76 91 20 13

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
97 - 10 0 0 0 0 1 0 0 0
40 - 10 0 0 0 4 0 1 0 0
82 - 10 0 0 0 5 1 1 0 0
63 - 12 0 0 0 4 0 0 0 0
49 - 15 0 0 0 4 0 0 0 0
21 0 10 0 0 0 3 0 0 0 0
41 - 15 0 1 0 6 0 0 0 0
20 - 11 0 0 0 5 0 0 0 0
24 - 6 0 0 0 2 0 0 0 0
14 - 6 0 0 0 0 0 0 0 0
15 - 6 0 0 0 2 0 0 0 0
90 - 10 0 0 0 5 1 1 0 0
56 - 10 0 0 0 5 0 0 0 0
110 - 10 0 0 0 5 2 2 0 0
31 - 10 0 0 0 5 0 0 0 0
29 - 8 0 0 0 2 0 0 0 0
 30 - 10 0 0 0 4 0 0 0 0
36 - 10 0 0 0 5 2 0 0 0
31 - 10 0 0 0 4 0 0 0 0
73 - 10 0 0 0 5 0 0 0 0
76 - 10 0 0 0 5 1 0 0 0
90 - 10 0 0 0 4 0 2 0 0
24 - 8 0 0 2 3 1 0 0 0
1142 - 227 0 1 2 87 9 7 0 0

021
BALITA YANG
MENDERITA DIARE
HEPATITIS B Mendapat
I II III ORALIT
CAMPAK P L P L P L P JUMLAH
L P L P
0 0 0 0 0 0 1 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0
1 0 1 0 0 1 0 0 1 0 1
2 0 2 1 0 3 1 0 0 0 1
1 1 2 1 0 0 0 0 0 0 0
0 1 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 1 1 0 0 0 0
0 1 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 0
0 1 2 1 2 0 0 1 0 1 0
1 1 0 1 0 2 1 0 0 0 0
1 0 0 0 0 1 1 1 0 1 0
1 0 0 1 1 1 1 1 0 0 1
1 0 0 0 0 2 1 0 0 0 0
 2 0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 1 2 0 1 0 1
0 1 1 1 0 0 1 0 0 0 0
1 2 1 0 1 0 2 0 2 0 2
1 5 1 3 0 1 1 0 0 0 0
0 3 3 1 0 0 0 1 0 1 0
1 1 0 1 1 1 0 0 0 0 0
13 16 14 11 5 14 14 5 5 3 6

IMUNISASI
PENIMBANGAN BALITA 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

75 77 74 67 67 76 73 77 74 0 8
44 28 41 24 36 17 18 28 41 0 2
76 89 76 73 58 87 71 89 76 2 9
72 66 72 62 68 62 65 66 72 2 1
50 69 50 59 41 67 47 69 50 0 4
30 20 30 16 23 19 28 20 30 0 0
28 15 28 13 21 14 27 15 28 0 0
37 38 37 31 29 37 37 38 37 0 3
29 31 29 28 21 26 27 31 29 2 2
31 28 31 21 28 28 29 28 31 0 1
14 15 14 11 10 14 13 15 14 0 2
94 76 94 52 81 74 81 76 94 4 4
78 120 78 94 61 84 58 120 78 4 4
 96 106 96 100 94 98 89 106 96 1 8
38 38 38 30 30 30 25 38 38 1 4
45 54 45 40 32 44 34 54 45 3 4
37 29 37 14 25 14 25 29 37 0 0
64 89 64 71 51 55 52 89 64 0 3
27 26 31 24 24 25 23 26 31 2 3
95 106 95 100 88 97 84 106 95 2 7
77 92 76 76 58 59 56 92 76 2 6
76 83 77 75 69 74 69 83 77 2 5
25 29 25 23 22 26 14 29 25 0 0
1238 1324 1238 1104 1037 1127 1045 1324 1238 27 80

PLKB = ORANG MEDIS = 87 ORANG

PKK = 227 ORANG

E. LANSIA
JUMLAH NO JENIS JUMLAH JUMLAH JUMLAH
L P IMUNISASI L P UMUR SASARAN YANG HADIR
10 5 8 POLIO 4 19 15 L P L P
17 12 9 HEPATITIS 1 17 14 45-60 Tahun 1664 1923 198 441
13 7 10 HEPATITIS 2 12 6 60-69 Tahun 785 805 90 217
16 15 11 HEPATITIS 3 15 14 > 70 Tahun 256 399 16 115
11 5 12 CAMPAK 6 14
19 12 13 TT I 0 27 F. KPPASI
14 7 14 TT 2 0 80 PESERTA JML
SASARAN YG HADIR
I EKSLUSIF BUMIL 144 144
SASARAN MASIH ASI E BUSUI 0-6 BLN 198 198
L P L P BUSUI 7-24 BLN 939 939
79 93 76 91
SASARAN LULUS ASI E J. VITAMIN
L P L P SASARAN Jml.VIT A yg
20 13 20 13 UMUR diberikan
L P L P
 6 - 11 bulan 174 144 174 144
12 - 59 bulan 953 901 953 901
Bufas - 16 - 32

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

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

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 9 7 0 0
 0 227 0 0 2 87 9 7 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 1127 1045 1324 1238 27 80

 0 1238 1324 1238 1104 1037 1127 1045 1324 1238 27 80

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 14 11 5 14 14 5 5 3 6

13 16 14 11 5 14 14 5 5 3 6
 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

0 1 0 1 2 2 2 22 17 26 26 27 29 151 10 0 0 0 0 - 0 0 0 0 1 0 0 1 0
0 0 0 0 0 4 3 2 4 9 14 13 20 69 10 0 0 0 40 0 1 0 0 0 0 0 1 0
0 0 0 0 0 2 5 15 9 33 22 39 40 165 10 0 0 0 50 0 0 0 1 0 0 2 0 0
0 0 0 0 4 7 2 5 20 25 40 35 138 12 0 0 0 40 0 0 0 0 1 0 3 1 0
0 0 0 0 0 2 3 7 5 16 16 44 26 119 15 0 0 0 40 0 0 1 2 1 0 0 0 0
0 0 0 0 0 2 1 1 2 5 10 12 17 50 10 0 0 0 30 0 0 1 0 0 1 0 0 0
0 0 0 0 0 1 1 0 2 4 6 10 19 43 15 0 1 0 60 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 0 0 0 0 1 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 1 1 0
0 0 0 0 0 0 2 2 3 8 2 18 24 59 6 0 0 0 00 0 0 1 0 0 1 0 0 0
0 0 0 0 0 1 1 2 2 4 5 8 6 29 6 0 0 0 20 1 0 0 0 0 0 0 1 1
0 0 0 0 0 2 13 15 20 24 18 35 43 170 10 0 0 0 50 0 0 1 2 1 2 0 0 0
2 0 0 0 4 4 4 15 9 16 8 85 57 198 10 0 0 0 50 0 0 1 0 1 0 2 1 0
0 0 0 0 0 8 7 18 15 32 30 48 44 202 10 0 0 0 50 2 2 0 0 0 0 1 1 2
0 0 0 0 0 1 2 6 4 7 11 24 21 76 10 0 0 0 50 1 0 0 0 1 1 1 1 1
0 0 0 0 0 3 1 4 4 7 10 40 30 99 8 0 0 0 20 0 0 0 0 0 0 1 2 0
1 0 0 0 0 3 4 2 1 12 8 12 24 66 10 0 0 0 40 0 0 0 0 0 0 0 0 0
0 0 0 0 0 6 4 9 7 28 8 46 45 153 10 0 0 0 50 2 0 0 1 1 0 2 1 2
0 0 0 0 0 1 4 5 3 8 11 12 13 57 10 0 0 0 40 0 0 1 1 1 0 0 1 0
0 0 0 0 0 9 11 7 3 26 17 64 64 201 10 0 0 0 50 0 0 2 1 0 1 0 2 0
0 0 0 3 3 12 5 10 10 22 15 48 46 168 10 0 0 0 50 2 2 5 1 3 0 1 1 2
1 0 0 0 0 6 7 22 15 20 25 35 30 160 10 0 0 0 40 2 0 3 3 1 0 0 0 2
0 0 0 0 0 3 6 4 2 7 3 15 14 54 8 0 0 2 30 0 0 1 0 1 1 1 0 1
4 1 0 4 9 79 93 177 148 344 303 724 694 2562 227 0 1 2 87 - 10 5 17 12 13 7 16 15 11
 H.P. DIARE G. KB

POLIO HIPATITIS CAMPAK TT JUMLAH

YG DAPAT IUD MOW MOP IMPLANT
ALAT KONTRASEPSI
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 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 8 0 0 0 0 14 7 0 0 0 0 0
1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 2 0 0 0 0 3 2 1 0 0 0 2
0 0 1 0 0 2 0 0 1 0 0 1 0 0 1 0 2 0 9 0 1 0 1 23 11 2 4 0 0 9
0 0 0 1 0 3 1 0 2 1 0 3 1 0 2 0 2 0 1 0 0 0 1 3 0 2 0 0 0 10
0 1 2 1 0 1 0 1 2 1 0 0 0 0 1 0 0 0 4 0 0 0 0 4 0 0 0 0 0 1
0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 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 0 7 1 0 0 0 0
0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 3 0 0 0 0 8 11 0 1 0 0 1
0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 2 0 2 0 0 0 0 3 0 1 0 0 0 2
0 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 2 0 0 0 0 4
0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 2 0 0 0 0 0 8 0 0 0 0 2
0 1 2 1 2 0 0 1 2 1 2 0 0 0 0 0 4 0 4 1 0 1 0 5 0 0 0 0 0 4
0 1 0 1 0 2 1 1 0 1 0 2 1 0 1 0 4 0 4 0 0 0 0 0 2 0 2 0 0 0
2 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 1 0 8 1 0 1 0 3 2 3 3 0 0 1
0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 4 1 0 0 1 5 0 3 0 0 0 3
0 0 0 0 0 1 2 0 0 0 0 2 1 0 1 0 3 0 4 0 0 0 0 5 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 3 0 3 0 0 0 3
0 1 1 1 0 1 2 0 1 1 0 1 2 1 0 0 0 0 3 0 1 0 1 0 11 0 11 0 2 0
0 1 1 1 0 1 0 1 1 1 0 0 1 0 0 0 2 0 3 0 0 0 0 2 0 0 0 0 0 0
0 2 1 0 1 2 0 2 1 0 1 0 2 1 1 0 2 0 7 0 2 0 2 10 0 3 0 0 0 1
2 5 1 3 0 1 1 5 1 3 0 1 1 1 1 0 2 0 6 0 0 0 0 10 0 5 0 0 0 10
0 3 3 3 0 0 2 3 3 1 0 0 0 1 0 0 2 0 5 1 0 1 0 10 0 5 0 0 0 10
0 1 0 1 1 1 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0
5 19 12 14 7 19 15 17 14 12 6 15 14 6 14 0 27 0 80 5 5 3 6 114 93 29 21 0 2 66
 J. VITAMIN A K. ASI EKSLUSIF F. KPPASI

SASARAN

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

VIT. A
AH PESERTA JML SASARAN
6 - 11 BLN 12 - 59 BLN 6JML
- 11YG
BLNDIBERI
12VIT.
- 59 ABLN 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 23 17 53 56 23 17 53 56 1 2 2 2 2 0 2 2 2 0 13 6
0 1 31 0 12 10 0 2 4 15 14 2 4 15 14 1 2 4 3 2 4 1 1 2 4 3 6
4 34 14 15 15 1 1 15 9 72 62 15 9 72 62 2 4 2 5 2 2 2 5 2 2 9 7
0 15 0 15 0 2 0 2 5 60 60 2 5 60 60 0 0 4 7 0 0 4 7 0 0 6 11
0 30 3 1 7 0 5 7 5 60 42 7 5 60 42 0 0 2 3 0 0 2 3 0 0 10 5
0 3 35 0 11 0 9 2 1 17 27 2 1 17 27 0 0 2 1 0 0 2 1 0 0 0 3
2 0 5 0 2 0 3 0 2 14 25 0 2 14 25 0 0 1 1 0 0 0 1 0 0 0 2
2 20 15 3 8 23 28 4 2 33 35 4 2 33 35 0 0 1 0 0 0 1 0 0 0 3 1
0 25 0 18 0 0 0 0 2 26 25 0 2 26 25 0 0 2 0 0 0 2 0 0 0 6 7
3 15 4 2 3 0 5 2 3 26 26 2 3 26 26 0 0 0 2 0 0 0 2 0 0 2 2
0 6 0 0 12 0 8 2 2 12 11 2 2 12 11 1 1 0 0 1 1 0 0 2 2
0 90 0 0 10 0 0 15 20 59 61 15 20 59 61 2 4 2 13 2 2 2 13 2 2 13 17
4 1 21 0 1 0 0 15 9 69 49 15 9 69 49 0 0 4 4 1 1 4 4 1 1 6 10
1 55 30 40 26 0 0 18 15 80 74 18 15 80 74 4 8 8 7 4 0 8 7 4 0 10 19
0 25 0 30 0 2 0 6 4 24 21 6 4 24 21 0 0 1 2 0 0 1 2 0 0 6 3
0 0 25 0 25 10 0 4 4 40 30 4 4 40 30 0 0 3 1 0 0 3 1 0 0 9 4
0 27 0 23 0 0 0 2 1 12 24 2 1 12 24 0 0 3 4 0 1 4 3 0 1 1 8
7 42 31 0 25 0 7 9 7 46 45 9 7 46 45 2 4 6 4 0 0 6 4 0 0 5 10
0 30 0 0 10 0 0 5 3 20 20 5 3 20 20 0 0 1 4 0 0 1 4 0 0 9 8
0 20 80 5 75 5 0 7 3 90 81 7 3 90 81 0 0 9 11 3 3 9 11 3 3 11 26
0 50 0 10 0 8 0 11 10 48 46 11 10 48 46 1 2 12 5 2 0 12 5 2 0 9 19
0 50 0 10 0 8 0 19 14 55 55 19 14 55 55 2 4 6 7 2 0 6 8 2 0 10 14
0 3 15 0 19 0 0 4 2 22 12 4 2 22 12 1 2 3 6 0 0 3 6 0 0 1 8
23 576 327 211 263 69 66 174 144 953 901 174 144 953 901 16 32 79 93 20 13 76 91 20 13 144 198
PASI E. LANSIA

BUSUI BU- BUSUI JUMLAH SASARAN JML YG HADIR KETERANGAN WUS PUS
UMUR UMUR 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

91 13 6 91 100 125 20 22 13 10 45 35 7 4 2 2- - - 164 154 1 0 0 0

34 3 6 34 50 50 40 48 10 30 20 25 5 5 0 0- 88 76 0 1 0 0
75 9 7 75 130 140 42 50 15 12 25 50 6 10 4 7- 185 180 1 1 0 0
52 6 11 52 141 140 32 39 14 10 0 0 0 0 0 0- 227 209 0 0 0 0
44 10 5 44 107 116 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
39 0 2 39 26 26 29 13 13 21 2 3 3 3 2 5- 72 62 0 0 0 0
19 3 1 19 130 125 68 57 21 28 0 0 0 0 0 0- 90 80 0 0 0 0
17 6 7 17 125 143 42 45 19 21 0 0 0 0 0 0- 128 110 0 0 0 0
15 2 2 12 88 101 75 89 55 68 0 0 0 0 0 0- 68 56 0 0 0 0
13 2 2 13 30 37 20 22 1 12 20 25 18 20 0 6- 58 46 0 0 0 0
73 13 17 73 20 32 10 20 5 4 5 20 2 5 2 5- 158 150 1 1 0 0
46 6 10 46 75 100 15 20 1 10 11 20 6 15 1 10 - 125 116 0 0 0 0
91 10 19 91 79 132 100 75 35 42 10 48 18 31 1 22 - 190 175 2 2 0 0
28 6 3 28 125 125 75 75 1 55 2 87 1 55 0 30 - 84 80 0 0 0 0
25 9 4 25 0 0 0 0 0 0 0 0 0 0 0 0 115 105 0 0 0 0
22 1 8 22 50 70 39 38 3 5 4 27 1 10 0 3- 65 58 0 0 0 0
26 5 10 26 120 149 31 35 4 6 0 0 0 0 0 0- 215 185 2 0 0 0
23 9 8 23 20 21 20 23 13 10 2 8 0 1 0 5- 115 101 0 0 0 0
47 11 26 47 30 33 10 12 2 5 10 33 4 6 1 2- 210 200 0 0 0 0
57 9 19 57 120 157 30 30 5 8 5 10 3 10 0 2- 275 140 1 0 0 0
76 10 14 76 50 50 38 37 10 20 10 20 10 15 3 7- 188 178 0 2 0 0
16 1 8 16 28 21 9 8 3 2 0 0 0 0 0 0 55 49 1 0 0 0
947 144 198 944 1664 1923 785 805 256 399 198 441 90 217 16 115 - 3088 2696 9 7 0 0