LAPORAN BULANAN GIZI

PEKON KUBULANGKA
BULAN SEPTEMBER
TAHUN 2021

NO LAPORAN Jumlah
dikumpul (januari - desember)
1 Jumlah Ibu Hamil Periksa Hb 0
2 Jumlah Ibu Hamil Anemia 0
3 Jumlah Ibu Hamil Periksa LiLA 12
4 Jumlah Ibu Hamil KEK 2
5 Jumlah Ibu hamil akhir TW 3 (KF4) 2
laki-laki 0
6 Jumlah Bayi baru lahir
Perempuan 0
laki-laki 0
7 Jumlah bayi BBLR
Perempuan 0
8 Jumlah bayi umur 6 bulan 0
9 Jumlah bayi ASI Eksklusif 0
10 Jumlah Balita Kurus 3
laki-laki 3
11 Jumlah Balita (bulan ini)
Perempuan 3
laki-laki 3
12 Jumlah Balita Ditimbang
Perempuan 3
13 Jumlah Balita punya KMS 114
14 Jumlah Balita Baru 0
15 Jumlah Balita tidak ditimbang bulan lalu 0
16 Jumlah balita naik berat badannya (N) 6
17 Jumlah balita tidak naik berat badannya 2 kali 0
18 Jumlah Ibu Nifas 0
19 Jumlah Kasus Balita Gizi buruk ditemukan bulan ini 0
FORMULIR PEMANTAUAN PROGRAM PEMBERIAN TTD REMAJA PUTRI DI SEKOLAH

Kelas :
Nama Sekolah : Triwulan :
Nama Puskesmas Pembina : Tahun :
Nama Kabupaten/Kota :

MARET JUNI SEPTEMBER DESEMBER

No. Nama Remaja Putri NIK 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M T M
1
2
3
4
5
6
7
8
9
10

Keterangan:
Isilah kolom T dan M dengan angka 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) Jika terima TTD dan angka nol (0) Jika tidak terima TTD
Kolom M diisi angka satu (1) Jika minum TTD dan angka nol (0) Jika tidak minum TTD
Kolom Jumlah minggu yang dilalui diisi dengan jumlah minggu yang dilalui remaja putri umur 12-18 tahun pada Triwulan tersebut
Dikumpul Tiap Bulan
Pekon :KUBULANGKA
Bulan SEPTEMBER
Tahun 2021

NO LAPORAN JUMLAH
1 Jumlah Bayi 6-11 bulan 20
2 Jumlah Balita 12-59 bulan 6
3 Jumlah bayi masih ASI Eksklusif umur 1 bulan 2
4 Jumlah bayi masih ASI Eksklusif umur 2 bulan 2
5 Jumlah bayi masih ASI Eksklusif umur 3 bulan 2
6 Jumlah bayi masih ASI Eksklusif umur 4 bulan 2
7 Jumlah bayi masih ASI Eksklusif umur 5 bulan 1
Gizi buruk 0
Gizi kurang 2
8 Status Gizi Indeks BB/U
Gizi baik 18
Gizi lebih 0
Sangat pendek 1
9 Status Gizi Indeks TB/U pendek 1
Normal
Sangat Kurus 1
kurus 1
10 Status Gizi Indeks BB/TB
normal 18
gemuk 0
Lampiran 3
FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi :LAMPUNG Nama Posyandu

Kabupaten/Kota :TANGGAMUS Bulan
Puskesmas/Kecamatan :PUTIH DOH Tahun
Desa/Kelurahan : KUBULANGKA

Jenis NIK (Nomor Induk

No Anak Ke Tanggal Lahir Kelamin No Kartu Keluarga Kependudukan)

(1) (2) (3) (4) (5) (6)

1 2 2/26/2016 P .180609806120004 .1806096602160002
2 2 1/1/2017 L .1806091205110122 .1806090101170003
3 2 9/10/2019 L .1806091105110302 .1806091009170001
4 2 4/14/2018 P .1806092708150002 .1806095404180002
5 2 12/19/2018 P .1806091205110141 .1806095912180001
6 3 9/20/2018 L .1806091105110095 .1806092009180001
7 2 6/25/2017 P .180609120210009 .1806096506170002
8 2 6/29/2017 P .1806091205110112 .1806096906170002
9 1 7/29/2017 L .1806091307170001 .1806092907170001
10 1 4/8/2017 L .1806091506120001 .1806091004170001
11 2 12/7/2017 L .1806091205110138 .1806090712180001
12 2 12/29/2018 P .1806092705130001 .1806096912180001
13 2 3/13/2019 P .1806093005130001 .1806091901190001
14 1 11/5/2017 L .1806090204085029 .1806090511170001
15 2 8/27/2018 P .1806091105110246 .1806096708180001
16 2 6/2/2018 L .1806091301110163 .1806095010880009
17 6 3/2/2019 L .1806091205110121 .180609020319031
18 2 4/4/2017 P .1806091910160007 .1806094404170001
19 3 1/9/2019 P .1806091205110116 .1806091205750002
20 1 3/21/2017 L .1806090505170001 .1806092103170001
21 2 5/21/2018 P .1806092805130002 .1806096105180001
22 2 6/25/2018 L .1806092711130011 .1806092506170001
23 1 11/20/2016 L .1806090204085029 .1806092011150001
24 4 11/12/2016 L .1806091911120002 .1806091211160002
25 2 10/18/2018 P .1806090204084984 .18006095810180002
26 1 12/7/2018 P .
27 1 5/2/2017 L .1806282103170005 .1806280205170001
28 2 8/18/2018 P .1806092207130005 .1806095708180002
29 2 2/19/2018 P .1806172005140005 .1806174902180000
30 3 1/9/2017 P .1806094901170001
31 3 12/25/2018 L .1806092305170000 .1806092512180002
32 1 3/8/2016 P .1806090904150004 .1806094803160001
33 1 7/17/2018 L .180609240220001 .1806091707180002
34 3 5/15/2016 L .180609407130004 .1806096302150001
35 2 2/23/2015 P .180609407130004 .1806091505160001
36 2 8/28/2018 L .1806170504190000 .1806172808180001
37 1 6/2/2016 P .1806092107170004 .1806094206160002
38 2 2/11/2018 L .1806091206110073 .1806091102180001
39 2 1/25/2018 P .1806091709180002 .1806096501180001
40 4 11/24/2017 P .1806091407170001 .1806096411170001
41 1 .02/09/2018 P .1806092504190005 .1806094209180001
42 1 11/18/2018 P .1806090204084984 .1806095811180001
43 2 5/6/2018 L .1806091105110248 .1806090605180001
44 2 03-19-2014 L .1806091105110108 .1806090309140001
45 3 11/4/2017 L .1806091205110025 .1806090411170001
46 1 2/26/2019 L .
47 2 5/5/2018 L .180609030940001 .1806090505180001
48 2 8/9/2017 P .1806091105110110 .1806094908170001
49 2 10/10/2018 L .1806091205110101 .1806091010180002
50 1 9/14/2017 P .1806090901180002 .1806096301180002
51 2 12/17/2016 P .1806172008100009 .1806175711160001
52 2 2/26/2016 L .1806090410130001 .1806092602160002
53 2 5/5/2016 L .180609110511106 .1806090505160002
54 2 2/11/2019 P .1806091711170005 .1806095102190002
55 2 12/8/2018 L .1806091205110176 .1806090812180001
56 1 1/23/2018 P .1806090407130013 .1806096301180002
57 1 11/4/2017 P .1806092107170003 .1806094411170001
58 1 11/22/2018 L .180601107180004 .180602211180002
59 1 8/17/2019 P .180609300410001 .1806095708190001
60 3 9/7/2019 P .1806091105110157 .1806094709190001
61 1 11/16/2019 P .1806090911180001 .1806095611190002
62 3 6/9/2019 P .1806091105110329 .1806094906190001
63 2 7/27/2019 L .1806091202100007 .180609270719000
64 2 10/25/2019 L .1806091205110082 .1806092501190001
65 1 3/25/2016 L .180609045160001 .1806092503160001
66 3 6/26/2019 P .1806091105110324 .1806096606190001
68 2 4/11/2017 L .1806091105110066 .1806091104170001
69 2 9/8/2018 L .1806090102160001 .1806090809180003
70 3 10/25/2019 P .1806090204085007 .18060960510190001
71 2 8/13/2018 L .1806090910120001 .1806091208180003
72 2 3/29/2019 P .1806091610180002 .1806096903190001
73 2 6/27/2019 L .1806090806120003 .1806091505190001
74 2 5/15/2019 L .180600809120003 .1806091505190001
75 1 1/6/2020 L .1806092504190003 .1806090601200001
76 1 6/8/2019 P .1806091105110335 .1806095806190001
77 3 9/6/2019 L .1806091912140007 .1806090609190001
78 1 10/8/2018 P .1806091204180001 .1806094810180001
79 1 2/6/2018 P .
80 2 1/11/2020 L .1806091105110331 .1806091101200001
81 1 4/13/2016 L .1806092411170001 .1806091304160001
82 3 1/16/2018 L .1806091105110311 .1806091601180002
83 1 1/13/2020 L .180609300910001 .1806091301200001
84 2 5/28/2019 P .1806091205110017 .1806096805190001
85 1 9/13/2019 L .1806090401190003 .1806091309190002
87 1 12/20/2017 L .1806091302170003 .1806092012170001
88 4 8/12/2017 P .1806091105110140 .1806095108170001
90 2 5/19/2019 P .1806091406120001 .1806095905190001
91 3 1/4/2020 p .1806092705130006 .1806094301200001
92 3 8/29/2019 L .1806091205110206 .1806092908190001
93 3 12/27/2019 L .1806092402200002 .1806091812190001
94 1 11/13/2017 L .1806091204180005 .1806091311170002
1 4/28/2017 P .1806092402200003 .1806096804170001
96 2 2/26/2017 L .180617200810002 .1806172602170001
97 1 11/13/2019 P .1906092207190001 .1806095311190001
98 1 5/8/2019 L .1806091610180004 .1806090805190001
99 4 4/17/2019 P .3319090312080023 .3319095704190006
100 1 7/23/2019 P .1806091812190002 .1806096307190003
101 1 11/11/2015 L .1806090202160003 .180609111150001
102 1 4/2/2016 L .1806042907150001 .1806040204160001
103 1 6/21/2019 L .1806042907150001 .1806042106190001
104 1 11/3/2018 L
105 2 .05/03/20 l .1806090709160004 .1806094503200001
106 2 .04/01/20 p .1806091105110143 .180609440200001
107 2 ,24/03/2020 p .1806091311180004 .1806096403200002
108 2 .8/04/20 p .1806092904150001 .1806090804200001
19 3 .7/04/20 p .1806091205110029 .1806095604200001
110 2 .21/04/20 p .1806091205110087 .1806096104200001
111 3 .22/04/2020 p .18060913011110681 .180609620420001
112 2 .02/04/20 l .1806091302150004 .1806090204200001
113 2 .07/05/20 p .1806091205110151 .1806094605200001
114 1 .12/05/20 p .1806090609190002 .1806095205200001
115 3 .14/5/20 p .180609060990002 .180609145200002
116 2 .14.06/20 p .1806090901180002 .1806095406200001
117 2 .03/07/20 l .1806091711170004 .1806090207200001
118 2 .23/07/17 L .1806091711170001 .1806092307170001
119 1 .11/7/17 P .1806090704700001 .180609571170002
120 2 .10/4/17 P .1806091105110219 .1806095004170001
121 2 .12/7/17 P .1806091205110252 .1806095207170001
122 3 .16/8/16 P .1806091105110214 .1806094608160001
123 2 .13/7/16 L .1806091309120001 .1806091307160001
124 2 .22/1/17 P .18060913011101 .1806096201170001
125 1 .10./4/17 P .1806090709160006 .1806095604170001
126 3 .9/5/16 P .1806090204084877 .1806094905160001
127 2 .27/10/16 L .1806092203110018 .1806092710160001
128 2 .16/7/18 P .180-6093008120005 .1806095607180001
129 1 .28/5/20 L .1806091001200001 .1806092805200003
130 2 .14/9/16 L .1806091409140001
131 2 .3/2/18 P .1806091105110126 .1806094302180001
132 1 ,23/6/17 P .1806091302170004 .1806092906170001
133 1 P
134 3 .09/12/2016 L .1806091105110092 .1806090912150001
135 1 9/27/2020 P
136 2 4/24/2021 P 1806091205110071 1806096403210001
137 1 2/1/2021 P 1806092501210004 1806094102210001
138 3 10/2/2020 L 1806090204084954 1806090402200001
139 3 4/22/2021 L
140 1 11/12/2020 P 1806091712190002 1806095211200001
141 2 1/24/2021 P
142 1 1/12/2021 L 1806091404210002 1806090205210003
143 2 2/18/2021 L 1806090202160003 1806091802210001
144 2 4/2/2020 L .1806091302150004 .1806090204200001
145 2 5/22/2020 P .1806090512130026 .18060962052OOOO1
146 2 2/4/2021 L 1806091506120002 1806090402210001
147 2 10/4/2020 L .1806092206150005 .18060904102200001
148 3 4/23/2021 L 1806092305170001 1806092304210001
149 1 4/2/2021 L 1806091404210002 1806090205210003
150 1 5/4/2021 P
151 1 4/28/2021 P 1806091407210005 1806096804210002
152 1 4/23/2021 l 1806090401190002 1806092306210002
153 3 6/3/2021 L 1806092302210001 1806090306210002
152 1 6/27/2021 L
153 1 7/4/2021 P 1806093004190002 1806094407210001
154 3 7/9/2021 L 1806091105110004 1806090907210001
155 3 8/11/2021 P .18060928100190004 1806095108210001
156 2 8/22/2021 L
157 2 8/31/2021 L 1806091205110077 1806093108210001
158 1 10/10/2021 L
159 3 11/2/2021 P 1806091901100028 1806094211210001
160 3 12/7/2021 L
161 2 12/11/2021 L
162 2 12/27/2021 L
163 2 12/30/2021 L
164 2 2/6/2022 P
165 3 2/23/2022 p
 :ANYELIR
: FEBRUARI
:2022

Kepemilikan
Berat Badan Buku IMD 1=YA, No Tlp/ HP
Nama Anak (BB) Lahir KIA/KMS 2=Tidak Nama Ayah NIK Ayah Ayah
1=YA,
2=Tidak
(7) (8) (9) (10) (11) (12) (13)
ANJANI HILYA ALIFA 3kg 1 1 WAHIRIN .1806090507840006
TEGAR ARDIANSAH 4kg 1 1 kajat .1806090504750005
M. ROGHIB AL MUZAQI 2,8kg 1 1 ansori .1806091801860001
AFRINA DELISA 3kg 1 1 ahmad wahyudi .1809051607850006
muslifah KHUMAIROH 2,8kg 1 1 jasman .1806091005700003
M.MUAMAR FADLI 3,5 kg 1 1 sutar .1806090703760002
NURI SAFITRI 2,8 kg 1 1 salimin .1806091807830002 .082213146485
AZKIA FATIHATUL A 3 kg 1 1 sodikin .1806091212870002
DAVIN ADEKSA P 3,5 kg 1 1 deni setiawan .1801232510910001
MUHAMMAD ZIKRI M 2,8kg 1 2 ujang .1806091905850000
ABDILLAH FAISOL MUFID 3kg 1 1 kamsir .1806090606860002
AISAH NUHA ZAHIRA 3kg 1 2 solihin .1806091908870002
ZULFA MALIKA 2,8 kg 1 1 jarwo .1806281211810003
ADITIA SAPUTRA 3kg 1 2 komarudin .1806094905510001
ADIFA NAZAHA SAKIRA 3,5kg 1 1 nahrudin .1806090808790005
ADNAN RAMADAN .Z 4kg 1 1 supri yadi .1806092703770002
M. LABIB MUAFIK 3kg 1 1 jahidin .1806091408730002
KHOIRUNNISA P. 3,5kg 1 1 darmadi .1806090811810002
ADELIA VARANISA AZNI 3kg 1 1 kirno .1806091205750002
M. REHAN 3,5kg 1 1 dulrohman .1806093005900001
VITA SUCI RAMADAN 2,8kg 1 1 wasrip .1806091806820002
GILANG RAMA ADITIA 2,8kg 1 1 edi ivana .1806091304920002
RADISKA 3,2kg 1 2 nanang .1806096406970001
MIFTAHUL USMAN 4 kg 1 1 muhaini usman .1806090804770003
SHAKIRA ROUDATUL J 3,3kg 1 1 dayat .1806091211870003
GISELA 3,2kg 1 1 jumanto
AJI AKBAR 1,7kg 1 2 nazarudin .1806090301940001
AMIRA ULFA 3kg 1 1 darto .180601412870003
ZAHRA SALSABILA 4kg 1 1 defri .1806170605850003
RAISAH ALMAHIRA 2,8kg 1 1 sahroni .1806090205810003
FARHAN AFDIANSYAH 3,5kg 1 1 efendi .1806090611920003
AVIKA MARFA S 2,8kg 1 2 teguh .1806090608850003
JUNA JZAWI SETIAWAN 3kg 1 2 nurhasim .1806051806960003
M. AL HABSI 3kg 1 2 rosyid .1806092006890003
FEBI MAULIDA 2,8kg 1 2 rosyid .1806092006890003
KEVIN AL VINO 2,8kg 1 2 samsul arifin .1809051109880009
MEGA RAFELA DEVIANI 3kg 1 2 rudiyono .1809050201910010
M. RAFA AL FIKRI 3kg 1 1 dasrito .1806092106850002
ADIBA ASYAQILA 3kg 1 1 nurhamid .1810011808900002
DELA NOVITA PUTRI 3kg 1 2 dawi .1806170610770001
NAURA PUTRI UTAMI 3,4kg 1 1 nurohman .1806092503910001 .082306626426
IBNATUL ADIBA 3kg 1 1 suratno .1806090104910002
FAHRI HAYUMAULANA 3,2kg 1 1 turmudi .1806090605180001
M.ALFIAN HABIBI 4kg 1 2 kusyanto .1806092906790001
M.ATHA ALFARIZI 4kg 1 1 karsito .1806092309820001
M. FARID AL FAKIH 3kg 1 1 dedi .1806095402020001
ZAINI FATHUROHMAN 3,5kg 1 1 muhadis .1806091701880001
QONITATUS SANIA 3kg 1 2 aminudin .1806091207850006
RAFA MAULANA FIKRI 3,2kg 1 1 soleh .1806090206850002
ZIVANA FIORENZA 3,5kg 1 1 hanita .1806091206860004
MELITA ANGGRAINI 2,8kg 1 2 wantoro .1806170912770001
FAKHIR M. MUMTAZ 4kg 1 2 ismanto .1806091807910001
FAIZ 3,5kg 1 2 sarno .1806091908860001
AFIFAH EKA FITRI YANI 2,8kg 1 1 komarudin .1806092707790006
KEVIN MAULANA 2,8kg 1 1 asminto .1806090107870071
MYESHA QAILA A. 3kg 1 1 bambang .1806090102840002
IKA ISABELA 2,8kg 1 2 edi .1806092312900001
FIQRI ADITIA ZAYDAN 3KG 1 TRIYONO .1806282105850002
REYNA INDRIYANI 2,8KG 1 2 RAMIN .1806090910910005
OLIVIA TRI ANJANI 3KG 1 1 PARNO .1806090910910005
TALITA KHOIRUN NI'MAH 2.4 1 1 MUSLIMIN .1806090303880004
AQILA NAZMA HAFIS 3KG 1 1 KAMSIN .1806091108750002
BILAL PRIMA KUSUMA 2,8KG 1 1 RISTONO .1806091510820003
M. WISNU ALFARIZ 3,5KG 1 1 MUTOHARUN .1806090612850003
NAUFAL AKAR 3,5 KG 1 1 WAHIDIN .1806092301840001
SITI MASITOH ANJANI 3KG 1 1 ALIMUDIN .180609160680003
ALFIAN FITO PRASTIO 3KG 1 1 RISDIANTO .1806092304890002
ATHALA NAZIB ZH 2,8KG 1 1 karsito .1809051007820008
JINGGA MUTIARA JASMINE 3KG 1 1 ALENDRA .1806090705780005
HASBI AL KAHFI 3kg 1 1 ismanto .1806091401880002
LAILUN NI'MATUL AFIA 3KG 1 1 SUPRIYONO .1806092403920003
M.MAULANA ISHAQ 3KG 1 1 SAMSUL .1806091207860005
ABIDZAR ADI WISTARA 3KG 1 1 SUHERMAN .1806091207860005
ADNAN ZAFRAN ARRAFIQ 3,5KG 1 1 BUDI .1806151102920006
ARTIKA MUFIDATUL ISMI 3KG 1 1 TARYO .180609071270001
M. ASKAR ANNALA 3KG 1 1 SOYIB .1806091305840001
AZKIA AILA VARISHA 3KG 1 1 ANDIKA .180609130791000
NADIA OKTAVIA 3KG 1 1 MUSLIM
M. ADNANUL MUAFI 3,3KG 1 1 ZAINUDIN .1806091712870003
SYAHDANKHOIRUL FAIZ 3 KG 1 1 TAUFIQ .180609260520001
M. FAISAL ALBAIHAQI 2,8KG 1 1 suratno .1806090707710003
HILMI SYAFIQ FIRDAUS 2,5KG 1 1 MUHLISIN
NAILA HAFIATUN NISA 2,8KG 1 1 JAMALI .1806091604860002
NARENDRA KUSUMA H 3,3KG 1 1 OGI .1809052310930002
AHWAL AHNAL SAUQI 3KG 1 1 SUSILO .1806092405930002
SUPRIYANA 1,5KG 1 1 SANTRISNO .1806090203690005
SITI KHODIJAH 2.8KG 1 1 ROJIDIN .1806090709830002
AJMALA SYARIFAKUL H 3KG 1 1 SATIM .1806091077700043
AKRAM ZAIDAN H 2,8KG 1 1 NURSALIM .1806091801770001
AHMAD AL FAROKH 2,9KG 1 1 HENDRIYANTO ..1871131011920003
DZAKI AL MAIN JAMIL 3KG 1 1 ALI MANSUR .1806092408950003
AQILA ALISYA APRILIA 4KG 1 1 HAIDIR ALI .1809051411940005
M. AFDAL 3KG 1 1 ASMIN .1806171306850000
QIYANA NAFIZARI 3KG 1 1 IWAN .1806091708960003
RAFKA KHOTIBUL UMAMA 2,8KH 1 1 MUSTAKIM .1806090810960006
KHOMSATUN MUFADILAH 3KG 1 1 KAMSIN .3319090912700002
JULIA SAFITRI 3,2KG 1 1 JUPRIYANTO .1806092011980003
GIBRAN RAMA ADITYA 2,8KG 1 1 WAKUN .1806091406860001
M.FATHIR AL GHIFAHRI 3,4KG 1 1 ANWAR M .1806020404880006
M.ABIZAR ALBIYANSYAH 3,9KG 1 1 ANWAR M .1806020404880006
M.LUTFI ALFARII 3 KG 1 1 SOLEH
nur aimal rzqiyah 3kg 1 1 slamet .1806092707930003
azalea naurena 2,8kg 1 1 amyono .1806090610860004
salma sakinatun naza 3kg 1 1 heri .1806053007880002
gina afia najuha 3kg 1 1 hari .1806090505840010
devi aqiatun nafisa 2,8kg 1 1 tohirin .1806091707830009
calista apriyanti 3kg 1 1 sartono .1806091005860002
nur naili kamilah 2,9kg 1 1 m.munir .1806093006800004
alqa rifaldi r 3kg 1 1 trisno .1806090501910001
khumairoh rahmadianti 2,6kg 1 1 kartono .1806090608850002
rafifatul mulya h 3kg 1 1 basuki .1806090310960002
bilal asrafi sodik 3kg 1 1 sodik
khansa vahima w 3kg 1 1 hanita .1806091206860004
m.angga saputra 3kg 1 1 suparman .1806090506910005
M. ANGGI PRATAMA 3KG 1 1 suparman .1806090506910005
RERE OLIVIA 2,8KG 1 1 alimiadi .1806090106920001
ZALVA HUMAERA R 3kg 1 1 rohman .1806091604850003
RANIA AYU SAPUTRI 2,8kg 1 1 mistam .1806092501940002
NABILA QUROTA 4kg 1 1 tasno .1806091007810002
TENGKU ARSYA 3,5kg 1 1 sugirin .1806091305770002
HANUM ADIBATUL 3,3kg 1 1 risyono .1806091111840005
SOFIYATURROHMAH 3kg 1 1 suyitno .1806280905920001
SALSABILA IZATUN 3kg 1 1 amir .1806091705800001
M RAYIS SYAFIQ 3kg 1 1 andiyoko .180609090380003
ALDA VANIA RISMA 2,8kg 1 1 kasimun .1806090303830006
PRADIPTA ARKAN 3,5kg 1 1 adiyas .1806132711950003
A MAULANA FAID 3kg 1 1 mugiono .1806091306820001
ARSITA MUTIARA KASIH 3kg 1 1 tiyun .1806091408840002
M FATRA NUGRAHA 3,5kg 1 1 kariman .1806091204890004
MUFTIA ILMA 3kg 1 1 agus salim .1806091804930002
M ALFAN HALIM 4kg 1 1 dasijo .1806091611750002
SEPTIANA LESTARI 3kg 1 1 nasuri .1806096202080001
WINDA SARI 3 1 1 sarto 1806090506830003
VALERI CANTIKA K 2.8 1 1 samsul 1806090110930001
M. VAREL AL-FARIZ 3 1 1 budi 1806090803820001
M.ALAN AL-FAHRI 3.3 1 1 SARTOYO
AMELIA SALEHA 3 1 1 ROHMAT 1806091812890001
CAHAYA SULISTIYA 2.8 1 1 ALIMI
ERLANGGA LEO AL-FATH 3.3 1 1 EKO 18060920109600021
M.DEVIN AZ ZIKRI 3 1 1 WAKUN 1806091406860001
ALKA RIFALDI RAMADAN 3.3 1 1 SUTRISNO .1806090501910001
MUDRIKATUL KHOIRIAH 2.8 1 1 FERI .1806090510890002
M. ZIYAD AL-GHIFARI 4 1 1 SUPRIHNO 1806091703840004
SYARIF HIDAYATULLAH 3.4 1 1 RAKIMAN .1806091503870003
RIDWAN MAULANA HERMAN 2.8 1 1 HERMAN 180609065850002
YUFA ZAINI FARDAN 3.3 1 1 HENDRIK 1806090207790001
SAFIRA NESYA FADILAH 2.8 1 1 MUFID
ADIFA 3 1 1 IMAM 1806092803970002
ADI SAPUTRA 2.8 1 1 AMSORI 1806170410890001
ALIF ANDIKA 2.8 1 1 SODIKUN 1806090705970002
RAFASYA HAFIS ARZANKA 3.4 1 1 AULIYA
CAHAYA MUKAROMAH 2.7 1 1 ARDI 18090527109660003
M.AKHTAR ALFARIZI 2.9 1 1 JAPAR 1806090508790002
KHALISA AIZA AZ-ZAHRA 2.9 1 1 ISMANTO 180905180490001
M. ABDUL AZKA 2.6 1 1 AMIN
ASHAUQI KENZI ALFARIZI 3.5 1 1 WAHARIMAN 1806092010880002
ELVANO SETYA PRATAMA 3 1 1 EKO
NAFISA AYU ZAFIRA 2.9 1 1 SODRI 1806091008830001
M. AL FATIH 3 1 1 SALIMIN
NAUVAN AFDAL 2.8 1 1 WWAHIDIN
M.HADYAN SHAKIL 2.8 1 1 MAKMUN
MUHAMMAD USNI 2.8 1 1 ROHIDIN
arisha azzahra 2.8 1 1 surijal
1 1 risyono
 Panjang ASI EksklusifF1=YA, 2=Tida
Tgl Badan/ Cara Ukur
Alamat RT RW Pengukuran BB (kg) Tinggi 1=Telentan
umur 0 bln umur 1 bln
Badan (cm) g 2=Berdiri
(14) (15) (16) (17) (18) (19) (20) (21) (22)
karang tengah 5 5 20-Jun-21 2 1 1
kubulangka 2 2 20-Jun-21 20 11 2 1 1
pengandaran 6 6 20-Jun-21 15 101 2 1 1
kubulangka 3 3 20-Jun-21 16 95 1 1 1
kubulangka 2 2 20-Jun-21 14 85 1 2 2
kubulangka 2 2 20-Jun-21 18 91 1 1 1
kubulangka 2 2 20-Jun-21 19 90 2 1 1
kubulangka 1 1 20-Jun-21 14 92 2 1 1
kubulangka 2 2 20-Jun-21 15 100 2 1 1
karang tengah 5 5 20-Jun-21 2 2 2
kubulangka 2 2 20-Jun-21 14 89 1 1 1
pengandaran 7 7 20-Jun-21 13 90 1 1 1
karang tengah 5 5 20-Jun-21 13 101 2 1 1
karang tengah 5 5 20-Jun-21 15 102 1 1 1
kubulangka 2 2 20-Jun-21 13 90 2 1 1
kubulangka 2 2 20-Jun-21 12.6 98 1 1 1
kubulangka 1 1 20-Jun-21 14 100 1 1 1
kubulangka 1 1 20-Jun-21 15 99 2 1 1
kubulangka 2 2 20-Jun-21 11 89 2 1 1
pengandaran 7 7 20-Jun-21 15 103 2 1 1
pengandaran 7 7 20-Jun-21 12 89 1 1 1
kubulangka 4 4 20-Jun-21 14 104 2 1 1
kubulangka 2 20-Jun-21 2 1 1
kubulangka 4 4 20-Jun-21 15 100 2 1 1
pengandaran 7 7 20-Jun-21 13 91 1 1 1
kubulangka 3 3 20-Jun-21 1 1 1
pengandaran 6 6 20-Jun-21 15 102 2 2 2
pengandaran 7 7 20-Jun-21 14 94 2 1 1
kubulangka 3 3 20-Jun-21 1 1 1
kubulangka 4 4 20-Jun-21 14 100 2 1 1
pengandaran 7 7 20-Jun-21 12 90 1 2 2
kubulangka 2 2 20-Jun-21 15 104 2 2 2
kubulangka 2 2 20-Jun-21 14 92 2 1 1
kubulangka 1 1 20-Jun-21 13 105 2 1 2
kubulangka 1 1 20-Jun-21 2 1 1
kubulangka 3 3 20-Jun-21 1 1 1
kubulangka 3 3 20-Jun-21 2 1 1
pengandaran 6 6 20-Jun-21 11.5 98 1 1 1
pengandaran 6 6 20-Jun-21 12 91 2 1 1
kubulangka 4 4 20-Jun-21 13.5 96 2 1 1
pengandaran 6 6 20-Jun-21 12 89 1 2 2
kubulangka 4 4 20-Jun-21 13 87 1 2 2
kubulangka 2 2 20-Jun-21 14 92 1 1 1
kubulangka 4 4 20-Jun-21 2 1 1
karang tengah 5 5 20-Jun-21 15 105 1 1 1
karang tengah 5 5 20-Jun-21 12.5 85 1 2 2
kubulangka 4 4 20-Jun-21 11.5 89 1 1 1
kubulangka 1 1 20-Jun-21 15.4 101 2 1 1
kubulangka 4 4 20-Jun-21 13.5 90 1 1 1
kubulangka 3 3 20-Jun-21 14 99 2 1 1
kubulangka 3 3 20-Jun-21 2 1 1
kubulangka 1 1 20-Jun-21 2 1 1
kubulangka 1 1 20-Jun-21 2 1 1
kubulangka 3 3 20-Jun-21 10 93 2 1 2
kubulangka 3 3 20-Jun-21 11.6 93 1 1 1
kubulangka 4 4 20-Jun-21 12 97 1 1 1
kubulangka 3 3 20-Jun-21 12.5 92 2 1 1
pengandaran 7 7 20-Jun-21 12.2 91 1 1 2
pengandaran 7 7 20-Jun-21 9 83 1 1 2
kubulangka 2 2 20-Jun-21 10.3 79 1 1 1
karang tengah 5 5 20-Jun-21 10.3 78 1 2 2
pengandaran 7 7 20-Jun-21 9.3 85 1 1 1
kubulangka 3 3 20-Jun-21 10.2 85 1 1 1
pengandaran 6 6 20-Jun-21 11.3 86 1 2 2
pengandaran 6 6 20-Jun-21 16.3 104 2 1 1
pengandaran 6 6 20-Jun-21 10.5 84 1 1 1
kubulangka 2 2 20-Jun-21 15 104 2 1 1
pengandaran 6 6 20-Jun-21 12 92 2 1 1
kubulangka 4 4 20-Jun-21 9.3 83 1 1 1
pengandaran 6 6 20-Jun-21 12.3 84 1 1 2
kubulangka 3 3 20-Jun-21 11.5 89 2 1 1
karang tengah 5 5 20-Jun-21 11.3 90 1 1 1
pengandaran 7 7 20-Jun-21 11 85 1 1 2
pengandaran 7 7 20-Jun-21 10.3 85 1 2 2
karang tengah 5 5 20-Jun-21 10 83 1 1 1
karang tengah 5 5 20-Jun-21 10.2 84 1 1 1
kubulangka 2 2 20-Jun-21 13 95 2 2 2
pengandaran 6 6 20-Jun-21 13.5 103 2 2 2
pengandaran 7 7 20-Jun-21 11 83 1 1 1
pengandaran 6 6 20-Jun-21 13 100 2 1 2
pengandaran 7 7 20-Jun-21 11.7 100 2 1 1
kubulangka 2 2 20-Jun-21 10.7 81 1 2 2
kubulangka 1 1 20-Jun-21 10.2 86 1 2 2
kubulangka 2 2 20-Jun-21 11.2 89 1 2 2
kubulangka 3 3 20-Jun-21 14 101 2 1 2
kubulangka 5 5 20-Jun-21 14.5 107 2 2 2
kubulangka 5 5 20-Jun-21 10.4 93 1 1 1
pengandaran 7 7 20-Jun-21 8 81 1 2 2
kubulangka 4 4 20-Jun-21 12.5 88 1 1 1
kubulangka 1 1 20-Jun-21 13 97 1 2 2
kubulangka 4 4 20-Jun-21 14.1 103 2 1 2
kubulangka 1 1 20-Jun-21 15.2 109 2 2 2
kubulangka 2 2 20-Jun-21 14.2 98 2 2 2
kubulangka 3 3 20-Jun-21 10 78 2 1 2
kubulangka 4 4 20-Jun-21 12.5 92 1 2 2
kubulangka 2 2 20-Jun-21 14.2 95 1 1 1
WAYLUNIK 3 3 20-Jun-21 13.5 91 1 1 1
kubulangka 4 4 20-Jun-21 2 1 2
kubulangka 2 2 20-Jun-21 20.2 120 2 2 2
kubulangka 2 2 20-Jun-21 11.5 91 1 1 1
kubulangka 3 3 20-Jun-21 2 2 2
pengandaran 7 7 20-Jun-21 10.1 84 1 2 2
kubulangka 4 4 20-Jun-21 10 79 1 1 2
pengandaran 7 7 20-Jun-21 11 72 1 2 2
kubulangka 1 1 20-Jun-21 10 77 1 1 1
pengandaran 1 1 20-Jun-21 10 78 1 1 1
WAYLUNIK 1 1 20-Jun-21 11 74 1 1 1
kubulangka 1 1 20-Jun-21 10 80 1 1 1
kubulangka 1 1 20-Jun-21 12.8 82 1 1 1
kubulangka 1 1 20-Jun-21 8 70 1 1 1
kubulangka 1 1 20-Jun-21 9 77 1 1 1
kubulangka 1 1 20-Jun-21 8 72 1 1 1
kubulangka 1 1 20-Jun-21 9 73 1 1 1
kubulangka 1 1 20-Jun-21 9.6 71 1 1 1
kubulangka 3 3 20-Jun-21 14 101 1 1 1
kubulangka 3 3 20-Jun-21 13.5 100 1 1 1
kubulangka 4 4 20-Jun-21 14 99 1 1 1
kubulangka 3 3 20-Jun-21 13.5 105 1 1 1
pengandaran 6 6 20-Jun-21 16 107 1 1 1
kubulangka 1 1 20-Jun-21 15 105 1 1 1
kubulangka 3 3 20-Jun-21 16 106 1 1 1
kubulangka 3 3 20-Jun-21 15 100 1 1 1
kubulangka 3 3 20-Jun-21 15 104 1 1 1
karang tengah 6 6 20-Jun-21 16 112 1 1 1
pengandaran 7 7 20-Jun-21 17 103 1 1 1
kubulangka 1 1 20-Jun-21 10 72 1 1 1
pengandaran 7 7 20-Jun-21 16 104 1 1 1
kubulangka 4 4 20-Jun-21 14 90 1 1 1
kubulangka 3 3 20-Jun-21 14 96 1 1 1
kubulangka 3 3 20-Jun-21 17 111 1 1 1
karang tengah 5 5 20-Jun-21 18.3 109 1 1 1
kubulangka 5 5 20-Jun-21 9 73 1 1 1
pengandaran 7 7 20-Jun-21 8 71 1 1 1
karang tengah 5 5 20-Jun-21 10 82 1 1 1
pengandaran 6 6 20-Jun-21 9 63 2 2 2
Karang tengah 5 5 20-Jun-21 8 61 1 2 2
pengandaran 6 6 20-Jun-21 10 68 1
kubulangka 3 3 20-Jun-21 8 63 1
kubulangka 2 2 20-Jun-21 9 66 2 2 2
kubulangka 4 4 20-Jun-21 8 65 2 2 2
kubulangka 3 3 20-Jun-21 13 83 1 1 1
kubulangka 3 3 20-Jun-21 10 75 1 1 1
pengandaran 6 6 20-Jun-21 11 68 1 2
kubulangka 2 2 20-Jun-21 10.5 73 2 2 2
pengandaran
kubulangka
kubulangka
KUBULANGKA
kubulangka
kubulangka
kubulangka
kubulangka
karang tengah
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
kubulangka
ASI EksklusifF1=YA, 2=Tidak Vitamin A Vitamin A
Februari Agustus
1=YA 1=YA KET
umur 2 bln umur 3 bln umur 4 bln umur 5 bln
2=Tidak 2=Tidak
(23) (24) (25) (26) (27) (28) (29)
2 2 2 2 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
2 2 2 2 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
1 2 2 2 1 normal
1 2 2 2 1 NORMAL
2 2 2 2 1
1 2 2 2 1 NORMAL
1 2 2 1 1 NORMAL
1 1 2 2 1 NORMAL
1 1 1 2 1 NORMAL
2 2 2 2 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 2 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 normal
2 2 2 2 1 NORMAL
1 1 1 2 1 NORMAL
1 2 2 2 1 normal
2 2 2 2 1
1 1 2 2 1 normal
1 1 1 1 1 normal
1 1 1 1 1
2 2 2 2 1 normal
1 2 2 2 1 NORMAL
1 1 1 2 1
1 1 1 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
1 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
1 2 2 2 1
1 1 1 2 1
1 1 2 2 1 NORMAL
1 1 1 2 1 normal
1 2 2 1 1 NORMAL
1 2 2 1 1 normal
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
1 1 1 1 1 normal
2 2 2 2 1
2 2 2 2 1 normal
2 2 2 2 1 pendek
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
1 1 2 2 1
1 1 1 1 1 NORMAL
1 1 1 1 1 NORMAL
2 2 2 2 1 normal
1 1 1 1 1 normal
1 1 1 1 1 normal
1 2 2 2 1 normal
2 2 2 2 1 normal
2 2 2 2 1 NORMAL(kurus)
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 normal
1 1 1 1 1 NORMAL
2 2 2 2 1 normal
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
1 1 1 1 1 NORMAL
2 2 2 2 1 normal
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
1 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 normal
2 2 2 2 1 normal
1 1 1 2 1 NORMAL
2 2 2 2 1 PENDEK
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 normal
1 1 2 2 1 normal
2 2 2 2 1 NORMAL
1 1 1 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 NORMAL
2 2 2 2 1 normal
2 2 2 2 1 NORMAL
2 2 2 2 1 PENDEK
2 2 2 2 1 normal
1 2 2 2 1 NORMAL
1 2 2 2 1 NORMAL
2 2 2 2 1
2 2 2 2 1 TINGGI
1 1 1 1 1 NORMAL
2 2 2 2
2 2 2 2 NORMAL
2 2 2 2 2 NORMAL
2 2 2 2 2 NORMAL
1 1 1 1 2 NORMAL
1 1 1 1 2 NORMAL
1 1 1 2 NORMAL
1 2 2 2 2 NORMAL
1 2 2 2 2 TINGGI
1 1 1 1 2 PENDEK/ SANGAT KURUS
1 1 1 1 2 NORMAL
1 1 1 1 2 NORMAL
1 1 1 1 2 NORMAL
1 1 1 1 2 NORMAL
1 2 1 2 2 PENDEK
1 1 1 2 2 NORMAL
1 2 1 2 2 NORMAL
2 1 1 2 2 normal
1 2 2 2 2 NORMAL ( KURUS)
2 1 2 2 NORMAL
1 2 2 2 2 NORMAL
2 1 2 2 2 NORMAL
1 2 2 2 2 NORMAL
2 1 2 2 2 NORMAL
1 1 2 2 2 NORMAL
2 1 2 2 2 NORMAL
1 1 2 2 2 NORMAL
2 2 2 2 2 NORMAL
1 1 2 2 2 NORMAL
2 1 2 2 2 NORMAL
1 1 2 2 2 NORMAL
2 2 2 2 2 TINGGI
NORMAL
NORMAL
2 NORMAL
2 NORMAL
NORMAL
NORMAL
NORMAL
NORMAL
1 NORMAL
2 2 2 2 2 NOORMAL
NORMAL
2 2 2 2 NORMAL
ORAN KEGIATAN POSYANDU

PEKON : KUBULANGKA
POSYAN: ANYELIR
BULAN : SEPTEMBER 2021
JUMLAH
NO. KEGIATAN L P
1. Jumlah Bayi Ditimbang 10 10
2. Jumlah Bayi Naik 10 10
Timbang
3. Jumlah Bayi BGM 1
4. Jumlah Bayi Gizi Lebih

JUMLAH
NO. KEGIATAN L P
1. Jumlah Anbal Ditimbang 3 3
2. Jumlah Anbal Naik 3 3
Timbang
3. Jumlah Anbal BGM
4. Jumlah Anbal Gizi Lebih

JUMLAH
NO. KEGIATAN L P
1. Jumlah Bumil Ukur 12
LILA
2. Jumlah Bumil LILA 2
<23,5
3. Jumlah Bumil dapet Fe 1 10

4. Jumlah Bumil dapet Fe 3 6

5. Jumlah Bumil Yod (6

Bln)

JUMLAH
NO. KEGIATAN L P
1. Jumlah Bufas dapat Fe 2
2. Jumlah Bufas dapat Vit 2
A
3. Jumlah Bufas dapat Yod

NAMA ORTU UMUR (Bln)

NAMA BAYI/BALITA
NO. BGM/BGK
 KHUMAROH Kartono/saeni 12 bln
1. RAHMADIANTI (BGM)
2.
3.
4.
5.

NO. KEGIATAN JUMLAH

1.
2.
KETERANGAN

KETERANGAN

KETERANGAN

KETERANGAN

BB/TB
 8kg/66cm

KETERANGAN

Kubulangka, 25 AGUSTUS 2021

petugas posyandu

Dianti oktasari,Amd.keb
NRPTT.19891010.2.008