REKAPITULASI PENDATAAN PER DESA SASARAN BIAN

SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN
Provinsi Jawa Barat
Kabupaten Bogor
Puskesmas
Desa

Jumlah anak sasaran Imunisasi

Jumlah anak merupakan
Kejar
sasaran Imunisasi
No. NAMA POSYANDU
Tambahan
Campak Rubella
OPV IPV DPT-HB-Hib

1 NIRWANA 1 #REF! #REF! #NAME? #REF!

2 NIRWANA 2 30 30 1 29
3 NIRWANA 3 127 124 2 126
4 Nirwana 4 142 139 1 129
5 NIRWANA 5 67 67 1 59
6 NIRWANA 6 97 97 1 93
7 NIRWANA 7 58 57 1 55
8 NIRWANA 8 115 115 0 110
9 : 4 2 2 4
10 : 4 2 2 4
11 : 4 2 2 4
12 : 4 2 2 4
13 : 4 2 2 4
14 : 4 2 2 4
15 : 4 2 2 4
16 : 4 2 2 4
17 : 4 2 2 4
18 : 4 2 2 4
19 : 4 2 2 4
20 : 4 2 2 4
21 : 4 2 2 4
22 : 4 2 2 4
23 : 4 2 2 4
24 : 4 2 2 4
25 : 4 2 2 4
26 : 4 2 2 4
27 : 4 2 2 4
28 : 4 2 2 4
29 : 4 2 2 4
30 : 4 2 2 4
31 : 4 2 2 4
32 : 4 2 2 4
33 : 4 2 2 4
34 : 4 2 2 4
35 : 4 2 2 4
36 : 4 2 2 4
37 : 4 2 2 4
38 : 4 2 2 4
39 : 4 2 2 4
40 : 4 2 2 4
TOTAL #REF! #REF! ### #REF!
LAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN

Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran

Jumlah Anak untuk melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus
merupakan sasaran
imunisasi KEJAR
OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

#REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!

30 34 1 31 30 1 29 30
126 132 2 361 124 2 126 127
141 143 1 137 139 1 129 142
67 68 1 60 67 1 59 67
97 98 1 93 97 1 93 97
58 65 1 60 57 1 55 58
115 117 0 110 115 0 110 115
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
 4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
4 7 2 10 2 2 4 4
#REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
 Jumlah Diisi pada saat pelayanan imunisasi Kejar & Diisi pada saat pelayanan imunisasi Kejar
Sasaran anak CR bulan Agustus 2022 bulan September 2022
Suntikan sasaran (JIKA DIIMUNISASI, ISI TANGGAL (JIKA DIIMUNISASI, ISI TANGGAL
Bulan BIAN PELAYANAN) PELAYANAN)
Agustus (Agustus
) OPV IPV DPT-HB-Hib CR OPV IPV DPT-HB-Hib

#REF! #REF! 0 0 0 0 0 0 0
60 30 0 0 0 0 0 0 0
255 127 0 0 0 0 0 0 0
272 142 0 0 0 0 0 0 0
127 67 0 0 0 0 0 0 0
191 97 0 0 0 0 0 0 0
114 58 0 0 0 0 0 0 0
225 115 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
 10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
10 5 0 0 0 0 0 0 0
#REF! #REF! 0 0 0 0 0 0 0
nan imunisasi Kejar
mber 2022
SI, ISI TANGGAL
NAN)

CR

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
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 ABDUL MUFLIH L 5/23/2021 3201902305218364 

2 ABDUL MUFLIN L 5/23/2021 3201902305211320 
3 ABDUL MUPLIH L 5/23/2021 3201902305219505 
4 ABDUL MURON ALMUIS L 11/20/2017 3201272011170003 
5 ABDULLAH ALWI H L 7/13/2020 3201271307200003 
ABDULLAH ALWI
6 HUSAINI L 7/13/2020 3201271407200003 
AHMAD ARSYAD
7 IBRAHIM P 12/6/2017 3201270612170001 
8 AHMAD MAULANA P 9/12/2019 3201271209190002 
9 AMANDA SEPTIANI P 9/5/2018 3201274509180004 
10 ANJANI SYAKIRA P 1/27/2021 3201276701210001 
11 APRILIA P 4/22/2018 3201276204180003 
12 AYSILA HUSNA L 8/17/2018 3201275708180001 
13 AZAM LUTFI RAHMANI L 8/28/2018 3201272808180004 
14 AZMI MURHAFIID L 12/28/2018 3175102812180001 
15 AZZAM LUTFI RAHMANI P 8/28/2018 3201902808187917 
16 DEFFAN DWI SAPUTRA L 3/6/2020 3201275310403320 
17 ELEN SYAQIYYA P 11/24/2017 3201276411170001 
18 FAIZ ALFIANSYAH P 11/29/2019 3201272911190003 
19 FUTRI KAMELIA P 5/21/2021 3201906105213682 
20 HADIBAIJATUS SYAHRA P 3/31/2019 3201277103190004 
21 HANA LAUNA P 7/14/2020 3201275407200001 
22 HANNA LAUNA P 7/14/2020 320127540720001 
23 HILYAH RUMAISA P 6/24/2018 3201276406180003 
HILYAH RUMAISA AL
24 KHOIR P 6/24/2018 320127640618003 
25 LABIBA NAZIATUNISA L 3/29/2020 3201276903200006 
26 LAIBAH NAZIATUN NISA L 3/29/2020 3201276403200006 
27 LAURA RAMDANI L 5/21/2020 3201276105200006 
28 m balqis L 8/21/2018 3201902108180000 
29 M FATUR ROHMAN L 7/22/2018 3201902207180000 
30 M HANIF R L 5/18/2018 3201271805182000 
31 m rizki maulana L 7/13/2017 3201271307140002 
32 m taufiq L 10/28/2017 3201902810170000 
33 m varell L 8/3/2018 3201900308180000 
34 M ZAINUL MALIK L 9/11/2018 3201271109180003 
35 M. ABDUL RASYID L 8/23/2020 329122308200003 
36 M. AKMAR NADAFA L 3/16/2019 320127160319004 
37 M. AKMAR NADAFI L 3/16/2019 3201271603190005 
38 M. AKRAM NADAFA L 3/16/2019 3201901603197039 
39 M. ALFARIZI L 10/30/2018 3201273010180009 
40 M. ALWI AL FAUZAN L 12/20/2017 3201272012170007 
41 M. ARIFIN ILHAM L 4/15/2018 3201271564180005 
42 M. AZMI A L 11/14/2019 3201211411180001 
43 M. AZMI AR RIZQI L 2/15/2021 3201271502211003 
44 M. EL FATIH DUMIYATI L 9/22/2019 3201272209190003 
M. FARREL SEPTIAN
45 ARIZKI L 8/3/2018 321270309180001 
46 M. GIBRAN ATTARAZKA L 2/14/2021 3201271402210003 
47 M. GILANG RAFFSYA L 4/20/2018 3201272004180004 
48 M. HISYAM KHAMIL L 10/1/2020 3201270110200001 
49 M. KHAIDAR MUZAQIR L 5/25/2020 3201272505200003 
50 M. LUTFI ADAMI L 12/18/2018 3201271812180004 
51 M. REHAN ASOBARI L 2/17/2018 3201271702180218 
52 M. RIDWAN L 7/10/2017 3201271007170003 
53 M. RIDWAN L 7/10/2020 3201271007570003 
54 M. RIFKI ABDULLAH L 4/25/2020 3201272504200004 
55 M. ZAENAL MALIK L 9/11/2018 3202127110918000 
56 MALIK ALFIYANSYAH L 3/3/2020 3201270303200007 
57 MAULIA LAISYA SAFITRI P 6/29/2019 32127696190001 
58 MAULIYA LAISA S P 6/29/2019 3201276906190001 
59 MENDRU KHOIRUL PAJAR L 2/12/2020 3201271202200003 
60 MUHAMAD AL IKRAM L 4/3/2020 3201270304200004 
61 MUHAMAD AL KRAM L 4/3/2020 3201900304201117 
62 MUHAMAD AL PARIZI L 10/30/2018 320127310180009 
MUHAMAD ARFAN
63 MUTAQIN L 4/10/2018 3201272902210003 
64 MUHAMAD AZMI ALRIZKI L 2/15/2021 3201901502215035 
65 MUHAMAD FARHAN L 4/6/2018 3201900604183259 
66 MUHAMAD FARZAN L 10/28/2020 3201272810200001 
67 MUHAMAD FARZAN L 10/28/2020 3201902810203216 
68 MUHAMAD HAFIZ JUNDI L 8/12/2019 3201900303226784 
MUHAMAD HAIQAL
69 HAFIS L 8/6/2018 3201270608180002 
MUHAMAD HISAM
70 KHAMIL L 10/1/2020 320127011020001 
71 MUHAMAD HISNU MASIZ L 8/22/2020 3201902208208737 
72 MUHAMAD PARHAN L 4/6/2018 3201900604184818 
73 MUHAMAD RAFA L 6/2/2020 3201900206209870 
 MUHAMAD RAFFA
74 ALFAHRI L 6/2/2020 3201900206209253 
75 MUHAMAD YUSUF L 9/14/2019 3201274109190004 
MUHAMMAD FAHRI
76 YUSUF L 7/9/2020 3201270907200001 
MUHAMMAD HAFIZ
77 DJUNDI L 8/12/2019 3201271208190819 
MUHAMMAD KHAIDAR
78 MUZAKQIR L 5/25/2020 3210127250520000 
MUHAMMAD RAFA
79 HAKIMI L 2/24/2018 3201272502180003 
80 MUHAMMAD YUSUF L 9/14/2019 3201271409190004 
MUHMAD RAMA
81 RADIANSYAH L 5/18/2020 3201901805204354 
82 NABILA KHOIRUNNISA P 6/27/2019 3201276104910004 
83 NABILA KHOIRUNNISA P 10/29/2020 3201906910208715 
84 NATASHA P 2/28/2020 3201276802200005 
85 NAURA ARSYILA P 12/16/2019 3201252061900004 
86 NAYA HAFIDZA P 1/10/2019 3201274111019000 
87 NESYA SAPIRA P 8/26/2020 3201906608203383 
88 PUTRI KAMILA SAUDIAH P 5/21/2021 3201906105215884 
89 RAHAYU SALSABILA P 4/12/2018 3201905204182490 
90 RAYAN AGUSTIN P 1/2/2020 3201270201200004 
91 READIANSYAH L 2/6/2020 3201900602206378 
92 RENDI YANSAH L 2/6/2020 320127060270006 
93 REVITA AULIA P 12/2/2017 3201274212170005 
94 SABILA FAUZIAH P 9/11/2018 3201175109180003 
95 SAFIRA NURMAULIDIA P 10/3/2020 320127431020003 
SANUM AYUDIA
96 FADHEELA P 9/18/2018 3201275809180002 
SANUM AYUDIA
97 FADHEELA P 9/18/2018 3201272402180003 
98 SAVIRA NUR MAULIDA P 10/3/2020 3201274510200003 
99 SHAFANA AQILAH P 3/20/2020 3201276003200001 
100 SITI AIRIN RUKMANA P 8/28/2019 3201276808190001 
101 SITI ALIKA HUMAIRAH P 7/15/2019 3201275507190003 
102 SITI JULIANA PIRLI P 7/3/2018 3201274307180003 
103 SITI MUDSIFA NAZWA P 11/10/2020 3201275011200002 
104 SITI NAPISA PIRMANSAH P 11/26/2018 3201276611180006 
105 SITI NENG RARA P 9/26/2018 3201276609180001 
106 SITI SALMAH AL HOERIAH P 6/17/2019 3201275706190002 
107 SITI SALSA MAULIDINA P 11/24/2020 3201276411200002 
108 SITI SALWA P 6/16/2018 3201275606180001 
109 ZAHIRA MAULIDA P 11/29/2019 3201276911190003 
110 ZAHWA JULIA NISA P 7/1/2019 3201274107190002 
111 ZAIFA QIRANI P 8/5/2018 3201274508180002 
112 ZIANA LUSIANTI P 8/2/2019 3201274208190006 
113
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115
116
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160
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203
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289
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332
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375
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418
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461
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495
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497
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499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 1

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

SITI HENA SARAH Kp. Lw Larangan 0 1 1 3

SITI HENA SARAH Kp. Lw Larangan 0 1 1 3
HENA Kp. Lw Larangan 0 1 0 3
SUARSIH Kp. Lw Larangan 0 2 1 3
SANI Kp. Lw Larangan 0 2 1 4
SANIA Kp. Lw Larangan 0 1 3 1
YULI Kp. Lw Larangan 0 2 1 4
CICIH MINTARSIH Kp. Lw Larangan 0 2 1 3
IMAS Kp. Lw Larangan 0 2 1 3
DINY Kp. Lw Larangan 0 3 1 3
LENI Kp. Lw Larangan 0 3 1 3
SITI LATIFAH Kp. Lw Larangan 0 3 1 3
SARYUNAH Kp. Lw Larangan 0 3 1 3
UUT Kp. Lw Larangan 0 3 0 2
SAIYUNAH Kp. Lw Larangan 0 3 0 2
JUWA Kp. Lw Larangan 0 3 1 2
ANIS Kp. Lw Larangan 0 3 1 2
MITA Kp. Lw Larangan 0 3 1 2
IIS Kp. Lw Larangan 0 3 1 3
SARAH Kp. Lw Larangan 0 3 1 3
TRI Kp. Lw Larangan 0 3 1 3
TRI WAHYUNINGSIH Kp. Lw Larangan 0 3 1 3
HALIMAH Kp. Lw Larangan 0 3 1 3
HALIMAH Kp. Lw Larangan 0 3 1 3
LIA SARI Kp. Lw Larangan 0 3 1 3
LIA Kp. Lw Larangan 0 3 1 3
TITA Kp. Lw Larangan 0 3 1 3
YENI Kp. Lw Larangan 0 3 1 3
SITI NURHALIA Kp. Lw Larangan 0 3 1 3
WATI Kp. Lw Larangan 0 3 1 3
NURHAYATI Kp. Lw Larangan 0 3 1 3
JAKIYAH Kp. Lw Larangan 0 3 1 3
AHENI Kp. Lw Larangan 0 3 1 3
NENAH Kp. Lw Larangan 0 3 1 3
MASLIAH Kp. Lw Larangan 0 3 1 3
EKA Kp. Lw Larangan 0 3 1 3
EKA Kp. Lw Larangan 0 3 1 3
EKA Kp. Lw Larangan 0 3 1 3
ANAH Kp. Lw Larangan 0 3 1 3
SITI HAPSOH Kp. Lw Larangan 0 3 1 3
ALIS Kp. Lw Larangan 0 3 1 3
PIPIN
KAMALUDIN/ Kp. Lw Larangan 0 3 1 3
ST.JUBAEDAH Kp. Lw Larangan 0 3 1 3
NUNUNG Kp. Lw Larangan 0 3 1 3
AHENI Kp. Lw Larangan 0 3 1 3
ELIH Kp. Lw Larangan 0 3 1 3
ISMA Kp. Lw Larangan 0 3 1 3
SITI HAPSOH Kp. Lw Larangan 0 3 1 3
KIKI Kp. Lw Larangan 0 3 1 3
IAH Kp. Lw Larangan 0 3 1 3
KARTIKA Kp. Lw Larangan 0 3 1 3
RINI Kp. Lw Larangan 0 3 1 3
RINI Kp. Lw Larangan 0 3 1 3
ELINDA Kp. Lw Larangan 0 3 1 3
NENAH Kp. Lw Larangan 0 3 1 3
ERINA Kp. Lw Larangan 0 3 1 3
SITI HASMAH Kp. Lw Larangan 0 3 1 3
SITI HASMAH Kp. Lw Larangan 0 3 1 3
RAHMA Kp. Lw Larangan 0 3 1 3
WIDA Kp. Lw Larangan 0 3 1 3
WIDA Kp. Lw Larangan 0 3 1 3
ANAH NURHAYATI Kp. Lw Larangan 0 3 1 3
EPA Kp. Lw Larangan 0 3 1 3
SITI JUBAEDAH Kp. Lw Larangan 0 3 1 3
NYAI CICAH Kp. Lw Larangan 0 3 1 3
MITA Kp. Lw Larangan 0 3 1 3
KUSMITA SULASTARI Kp. Lw Larangan 0 3 1 3
SITI NURLELA Kp. Lw Larangan 0 3 1 3
NURLAELAH Kp. Lw Larangan 0 3 1 3
SITI HAPSOH Kp. Lw Larangan 0 3 1 3
MAESAROH Kp. Lw Larangan 0 3 1 3
CICAH Kp. Lw Larangan 0 3 1 3
SINDI Kp. Lw Larangan 0 3 1 3
SINDI AULIA Kp. Lw Larangan 0 3 1 3
IIS Kp. Lw Larangan 0 3 1 3
HALIMAH Kp. Lw Larangan 0 3 1 3
NURLELA Kp. Lw Larangan 0 3 1 3
EKI Kp. Lw Larangan 0 3 1 3
SITI MUNIARSIH Kp. Lw Larangan 0 3 1 3
IIS Kp. Lw Larangan 0 3 1 3
DIDAH Kp. Lw Larangan 0 3 1 3
RINA Kp. Lw Larangan 0 3 1 3
NENENG DIAH Kp. Lw Larangan 0 3 1 3
LIA Kp. Lw Larangan 0 3 1 3
ST. NURJANAH Kp. Lw Larangan 0 3 1 3
ROBIAH Kp. Lw Larangan 0 3 1 3
PIPAH Kp. Lw Larangan 0 3 1 3
NONI SRI HANDAYANI Kp. Lw Larangan 0 3 1 3
AJENG Kp. Lw Larangan 0 3 1 3
SANTI Kp. Lw Larangan 0 3 1 3
ROSITA Kp. Lw Larangan 0 3 1 3
ROSITA Kp. Lw Larangan 0 3 1 3
MIRA Kp. Lw Larangan 0 3 1 3
ROSITA Kp. Lw Larangan 0 3 1 3
SITI SAODAH Kp. Lw Larangan 0 3 1 3
PUTRI Kp. Lw Larangan 0 3 1 3
PUTRI RAHAYU Kp. Lw Larangan 0 3 1 3
SITI SAODAH Kp. Lw Larangan 0 3 1 3
IKOH Kp. Lw Larangan 0 3 1 3
AISAH Kp. Lw Larangan 0 3 1 3
SITI RAHMAH Kp. Lw Larangan 0 3 1 3
ONIH Kp. Lw Larangan 0 3 1 3
SITI JUFLAH Kp. Lw Larangan 0 3 1 3
YUni Kp. Lw Larangan 0 3 1 3
RINA Kp. Lw Larangan 0 3 1 3
SITI PARIDA Kp. Lw Larangan 0 3 1 3
NENG Kp. Lw Larangan 0 3 1 3
AISYAH Kp. Lw Larangan 0 3 1 3
SITI FARIDAH Kp. Lw Larangan 0 3 1 3
NURAENI Kp. Lw Larangan 0 3 1 3
MARIAM Kp. Lw Larangan 0 3 1 3
SITI HOLISOH Kp. Lw Larangan 0 3 1 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
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0
0
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0
0
0
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0
0
0
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0
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0
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0
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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
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0
0
0
0
0
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0
0
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0
0
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0
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0
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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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

14 1 1 0 0 1
14 1 1 0 0 1
14 1 1 1 0 1
56 1 1 0 1 1
24 1 1 0 0 1
24 1 0 0 1 1
55 1 1 0 0 1
34 1 1 0 1 1
46 1 1 0 1 1
18 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF!
51 1 1 0 1 1
47 1 1 0 1 1
47 1 1 1 1 1
43 1 1 1 1 1
47 1 1 0 1 1
28 1 1 0 1 1
56 1 1 0 1 1
32 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF!
14 1 1 0 0 1
#REF! #REF! #REF! #REF! #REF! #REF!
40 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF!
24 1 1 0 1 1
24 1 1 0 1 1
49 1 1 0 1 1
49 1 1 0 1 1
28 1 1 0 1 1
28 1 1 0 1 1
 26 1 1 0 1 1
47 1 1 0 1 1
48 1 1 0 1 1
50 1 1 0 1 1
60 0 0 0 0 0
#REF! #REF! #REF! #REF! #REF! #REF!
47 1 1 0 1 1
46 1 1 0 1 1
23 1 1 0 1 1
40 1 1 0 1 1
40 1 1 0 1 1
40 1 1 0 1 1
45 1 1 0 1 1
55 1 1 0 1 1
51 1 1 0 1 1
32 1 1 0 1 1
17 1 1 0 0 1
34 1 1 0 1 1
47 1 1 0 1 1
17 1 1 0 0 1
51 1 1 0 1 1
22 1 1 0 1 1
26 1 1 0 1 1
43 1 1 0 1 1
53 1 1 0 1 1
60 0 0 0 0 0
24 1 1 0 1 1
27 1 1 0 1 1
46 1 1 0 1 1
28 1 1 0 1 1
37 1 1 0 1 1
37 1 1 0 1 1
29 1 1 0 1 1
27 1 1 0 1 1
27 1 1 0 1 1
45 1 1 0 1 1
51 1 1 0 1 1
17 1 1 0 0 1
51 1 1 0 1 1
21 1 1 0 1 1
21 1 1 0 1 1
35 1 1 0 1 1
47 1 1 0 1 1
22 1 1 0 1 1
23 1 1 0 1 1
51 1 1 0 1 1
25 1 1 0 1 1
25 1 1 0 1 1
34 1 1 0 1 1
24 1 1 0 1 1
35 1 1 0 1 1
26 1 1 0 1 1
53 1 1 0 1 1
34 1 1 0 1 1
26 1 1 0 1 1
37 1 1 0 1 1
21 1 1 0 1 1
29 1 1 0 1 1
31 1 1 0 1 1
42 1 1 0 1 1
23 1 1 0 1 1
14 1 1 0 0 1
51 1 1 0 1 1
30 1 1 0 1 1
29 1 1 0 1 1
29 1 1 0 1 1
55 1 1 0 1 1
46 1 1 0 1 1
21 1 1 0 1 1
46 1 1 0 1 1
46 1 1 0 1 1
21 1 1 0 1 1
28 1 1 0 1 1
35 1 1 0 1 1
36 1 1 0 1 1
48 1 1 0 1 1
20 1 1 0 1 1
44 1 1 0 1 1
46 1 1 0 1 1
37 1 1 0 1 1
47 1 1 0 1 1
35 1 1 0 1 1
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

#REF! #REF! #REF! #REF! #REF!

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

3 0 0 1 0 0 1
3 0 0 1 0 0 1
3 1 0 1 1 0 1
2 0 1 1 0 1 1
2 0 0 1 0 0 1
0 0 3 0 0 1 1
2 0 0 1 0 0 1
2 0 1 1 0 1 1
2 0 1 1 0 1 1
1 0 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF! #REF!
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 1 2 1 1 1 1
1 1 2 1 1 1 1
1 0 2 1 0 1 1
1 0 2 1 0 1 1
1 0 2 1 0 1 1
1 0 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF! #REF!
1 0 0 1 0 0 1
#REF! #REF! #REF! #REF! #REF! #REF! #REF!
1 0 1 1 0 1 1
#REF! #REF! #REF! #REF! #REF! #REF! #REF!
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
 1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
#REF! #REF! #REF! #REF! #REF! #REF! #REF!
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
#REF! #REF! #REF! #REF! #REF! #REF! #REF!

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) #REF! #REF! #REF! #REF!
 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

1 1
1 1
2 1
2 1
1 1
2 1
1 1
2 1
2 1
2 1
#REF! #REF!
2 1
2 1
3 1
3 1
2 1
2 1
2 1
2 1
#REF! #REF!
1 1
#REF! #REF!
2 1
#REF! #REF!
2 1
2 1
2 1
2 1
2 1
2 1
 2 1
2 1
2 1
2 1
0 0
#REF! #REF!
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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
#REF! #REF! 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1
2 ABDUL
ADELIA ADE AL HAMDI
SAFANA L 12/7/2017 3201270712170004 
3 HAMDANI
ADREENA L 7/27/2020 3201276906200003 
4 ALTHAFUNNISA
AHMAD ZAMZAMI AN P 10/27/2019 3201276700190005 
5 NAHROWI L 11/1/2018 3201270111180003 
6 AISYATUL URWA P 12/12/2018 3201275212180003 
7 ALINA MUHTAR P 4/22/2019 3201276204190005 
8 ALIYA ZAHRA P 1/19/2019 3201275901190001 
9 ALMAIRA AZAHRA P 10/12/2017 3201275210170001 
10 arsyfa P 2/27/2018 3201276702198000 
11 ARSYILA ALFATUNISA
AVIDA MUMTAZA P 1/28/2021 3201246801210001 
12 TAFTAZANI L 9/18/2018 3201905809188563 
13 AYIDA
AZZAHRAMUMTAJAT
SITI L 9/18/2018 32012718918918 
14 UMAEROH P 6/19/2018 3201275906180001 
15 DELLA
DEVIN OKTAFIANI
RAYYAN P 10/10/2020 3201275010200001 
16 WICAKSONO L 10/18/2020 3201271810200005 
17 fatimatu
LIFIA NADHIFA P 4/26/2018 3201276604180003 
18 HERMAWAN L 4/3/2019 3201274304190004 
19 M HANIP RANADAN L 9/27/2019 3201272705190003 
20 M. IKBAL FAUZI L 9/26/2020 3201902609202741 
21 MUHAMAD AZKA L 5/14/2018 3201271405180003 
22 MUHAMAD
MUHAMAD HAIKAL
HOERUL L 7/1/2018 3201270107180001 
23 AZAM
MUHAMAD MULKI L 5/25/2021 3201902505215091 
24 SOLAHUDIN
MUHAMAD SYAIRIL L 10/11/2018 3201271110180006 
25 AZKA L 9/1/2020 3201270109200003 
26 NAUREEN
NOUREEN MIKAYILA
MIKAYLA P 7/19/2018 3201271977187718 
27 PUTRI P 7/19/2018 3201275907180005 
28 SAKILA P 1/29/2021 3201906901219473 
29 SHAQILA ALVIYANA
SITI FATIMAH P 1/30/2021 3201277001210004 
30 AHZAHRA P 9/8/2020 3201274809200002 
31 umar L 1/21/2019 3201272101190004 
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 2

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

1 0
IPAY Kp. Lw Larangan 0 3 1 3
SUSI Kp. Lw Larangan 0 2 0 3
ADE.S Kp. Lw Larangan 0 2 1 2
NURLELAH Kp. Lw Larangan 0 2 1 3
IIS Kp. Lw Larangan 0 2 1 2
TUTI Kp. Lw Larangan 0 3 1 3
ENI Kp. Lw Larangan 0 3 1 3
RANI NURAENI Kp. Lw Larangan 0 3 1 3
kosasih Kp. Lw Larangan 0 3 1 3
MELA Kp. Lw Larangan 0 3 1 3
SITI MARYAM Kp. Lw Larangan 0 3 1 3
Abdul wahab Kp. Lw Larangan 0 3 1 3
SUKAESIH Kp. Lw Larangan 0 3 1 3
HELMI Kp. Lw Larangan 0 3 1 3
KARTIKA Kp. Lw Larangan 0 3 1 3
ISNA Kp. Lw Larangan 0 3 1 3
NYAI.N Kp. Lw Larangan 0 3 1 3
Ejeh Kp. Lw Larangan 0 3 1 3
WATI Kp. Lw Larangan 0 3 1 3
PITRIA Kp. Lw Larangan 0 3 1 3
NURHASANAH Kp. Lw Larangan 0 3 1 3
NURAENI Kp. Lw Larangan 0 3 1 3
WATI Kp. Lw Larangan 0 3 1 3
ANISA NADYA.S Kp. Lw Larangan 0 3 1 3
LINA Kp. Lw Larangan 0 3 1 3
SInta.s Kp. Lw Larangan 0 3 1 3
RANI Kp. Lw Larangan 0 3 1 3
RANI NURAENI Kp. Lw Larangan 0 3 1 3
EVA Kp. Lw Larangan 0 3 1 3
SUSI Kp. Lw Larangan 0 3 1 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
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
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

1471 0 0 0 0 0
55 1 1 0 1 1
24 1 1 1 1 1
33 1 1 0 1 1
45 1 1 0 1 1
43 1 1 0 1 1
39 1 1 0 1 1
42 1 1 0 1 1
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53 1 1 0 1 1
18 1 1 0 1 1
46 1 1 0 1 1
46 1 1 0 1 1
49 1 1 0 1 1
21 1 1 0 1 1
21 1 1 0 1 1
51 1 1 0 1 1
39 1 1 0 1 1
34 1 1 0 1 1
22 1 1 0 1 1
50 1 1 0 1 1
49 1 1 0 1 1
14 1 1 0 0 1
45 1 1 0 1 1
23 1 1 0 1 1
48 1 1 0 1 1
48 1 1 0 1 1
18 1 1 0 1 1
18 1 1 0 1 1
22 1 1 0 1 1
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30 30 1 29 30

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
1 0 1 1 0 1 1
2 1 1 1 1 1 1
2 0 2 1 0 1 1
2 0 1 1 0 1 1
2 0 2 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 0 0 0 0 0 0
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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 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 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 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 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 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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 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
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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 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 0 0 0 0 0 0
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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
34 1 31 30 1 29 30

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 4 1 8 4

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
2 1
3 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 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
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
0 0
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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
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
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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
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
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
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
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
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
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
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
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
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
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
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
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
60 30 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 a.baehaqi
ABDUL HALIM AL L 4/13/2019 3201276403963412 
2 HAFIZ L 9/14/2020 32012714920920 
3 ABDUL JABAR A.S L 5/3/2018 3201270305180004 
4 ABDUL LATIF AL FATAH L 10/19/2017 3201271916170004 
5 abdul zabar L 5/3/2018 3201270305780004 
6 ADELIA ZAHRA ADILA P 10/21/2018 3201276110180003 
7 AHMAD BAEHAQI N L 4/13/2019 3201901304193198 
8 ahsan L 9/30/2017 3201273000917002 
9 AHSAN ABDUL HADI L 9/30/2017 3201273009170002 
10 AISHWA
AISHWA HASANATUL
HASANATUL.A P 4/25/2020 320127654200001 
11 A P 4/25/2020 3201276504200001 
12 alfa rizki L 12/4/2018 3201275308830009 
13 ANINDITA KEISHA H P 7/9/2018 3201276809900001 
14 ANISA NAZIA P 3/15/2021 3271015105880022 
15 ANISYA NAZIA AZHARI P 3/15/2021 3201275503210003 
16 BADRIAN L 7/29/2019 3201272907200720 
17 BADRINA AINAYYA P 7/29/2018 3201906907181166 
18 bilal L 11/13/2020 3201276111940009 
19 BILAL HAFIZ L 11/13/2019 3201901311197638 
20 CANTIKA SITI RAISYA P 5/27/2020 6705201400 
21 DIVANA P 11/20/2017 3201906011170000 
22 DIVANA AZAHRA P P 11/20/2017 3201276011170002 
23 diza L 12/15/2017 3201275522170004 
24 DIZHA P RISANATULA P 12/15/2017 3201275512170004 
25 eki
EKI MAULANA L 6/27/2019 3201272706190010 
26 RAMDAN L 6/27/2019 3201272706190001 
27 fajila L 9/8/2018 3201274809180005 
28 GHINA ULYA SARIFAH P 9/29/2020 3201276909200002 
29 ILARIO GULFAM Q L 5/19/2020 3201271905200002 
30 INTAN P 1/4/2019 3201274401219078 
31 jakiaturohaniah P 1/17/2020 3201271907850015 
32 jasmin P 7/15/2018 3201275712860006 
33 lutfi L 7/16/2019 3201271807190003 
34 M AHTAR L 6/21/2020 3201272106200620 
35 M ARKA RIZKI L 6/25/2017 3201272506170001 
36 M ARKANDA L 12/10/2018 3201271012181218 
37 M
M AZRIL
HASANALALRIZKI L 9/11/2019 3201901109194650 
38 BIANSYAH L 10/22/2019 3201272210190002 
39 M NADZRAN F L 2/2/2020 3201270202200001 
40 M RAFA SETIAWAN L 9/18/2020 3201275705960007 
41 M RAFASYA ADITIA L 1/21/2020 3201272101200120 
42 M. ABDUL MU\'AFIQ L 2/14/2020 3201271402200005 
43 M. FATIH L 5/8/2021 320127780521521 
44 M. NAZRIL M L 11/18/2020 3201271811200004 
45 M. RAFLI SAPUTRA L 12/1/2020 320127320120003 
46 M. RAZIQ AL MALIKI L 8/12/2020 3201271208200004 
47 M. ZEMMA BUDIARTO L 10/25/2020 3201902510209863 
48 M. ZIDAN MAULANA L 11/21/2019 3201272111190005 
49 M.ABDUL ROHMAN L 8/29/2018 3201276711860009 
50 M.ADHA L 9/10/2017 3201271009170003 
51 m.apriliansyah L 4/15/2019 3201276403961001 
52 m.azrial L 9/11/2019 3201276503920005 
53 M.BALQIS P 8/21/2018 3201274707900017 
54 M.DANIEL RAHMAN L 1/8/2018 3201270801180001 
55 M.FAIZ KANZI L 6/8/2020 3201270806200003 
56 M.FAUZI SAPUTRA L 11/23/2018 3201272311180002 
57 M.GIBRAN L 4/28/2019 3201276909860006 
58 M.HANIF RAMADHAN L 5/18/2018 3201271808180002 
59 m.muafik L 4/15/2020 3201276709890007 
60 M.NAUFAL
M.RAFASYARAIS L 7/8/2019 3201270807190004 
61 HERMAWAN L 5/16/2019 3201275605190001 
62 M.RAJIK L 8/12/2020 3201274306970007 
63 m.rifki L 1/30/2018 3201273001180001 
64 MIKAILA CANTIKA A P 9/1/2017 3201274109170001 
65 MUAMAR KADAFA L 4/28/2019 3201902804199320 
66 MUAMAR KADAFI L 4/28/2019 3201902804193726 
67 MUHAMAD
MUHAMAD L 2/28/2021 3201276207870002 
68 ADRIANSAH L 10/21/2017 3201272110170002 
69 MUHAMAD
MUHAMAD AKHTAR.
FAIZ F L 6/21/2020 3201272107200001 
70 RAMADHAN L 5/25/2018 3201272505180005 
71 MUHAMAD FATIH. A L 5/18/2021 3201271805210005 
72 MUHAMAD GIBRAN F L 1/31/2021 3201273101210001 
73 MUHAMAD LUTHFI. Z L 7/16/2019 3201901607199763 
74 MUHAMAD RAZIK L 3/7/2021 3201900703211565 
75 MUHAMAD RIFKY M. L 1/30/2018 3201903001185658 
76 MUHAMAD RIZKY L 3/7/2021 320127770321321 
77 MUHAMAD RUSLAN L 2/20/2021 320127700221221 
78 MUHAMAD
MUHAMMAD SAHDAN L 11/30/2020 3201273011200001 
79 ROSYDAN B L 5/24/2021 3201272405210003 
80 MYSHA BANAFSHA P 7/21/2019 3201906107194669 
81 nabila P 10/22/2017 3201276010173200 
82 NABILA PUTRI NAURA P 10/20/2017 3201906010175271 
83 NADHIRA KHAERUNISA P 3/13/2021 3201275203210006 
84 NADIRA HOERUNISA P 3/12/2021 3201276008910011 
85 nazran L 2/2/2020 3201275604840000 
86 NITA UMANAIROH P 7/6/2017 3201274607170005 
87 PAZILA P 9/8/2018 3201275208180003 
88 PUTRI ALULA JASMINE P 9/29/2017 3201276909170002 
89 PUTRI HUMAEROH P 8/22/2018 3201906208180001 
90 PUTRI KHUMAIROH L 8/12/2018 3201275208180002 
91 RABIL MUHAMAD M. L 1/22/2020 3201272901200005 
92 RADIT L 7/16/2018 3201274303930003 
93 RAFAEJA AROJA L 12/17/2018 3201901712183254 
94 rafaeza L 12/17/2018 3201276202170001 
95 RAFARDAN SULAEMAN L 10/26/2018 320127690180002 
96 RAFTA AL-RAHMAN L 12/3/2017 3201270312170003 
97 RAIHANA SALMA L 7/21/2017 3201276107190002 
98 RAIHANI P 7/26/2020 3201272311960005 
99 RAIHANI P 7/26/2020 3201276607200002 
100 RAIMA ATHIRA S P 2/20/2021 3201270202221221 
101 RAISYA KAILA P 4/29/2020 3201906904201691 
102 RAMZI JAUHARI BL L 4/13/2018 3201271304180002 
103 REZVAN AHYAN L 5/4/2018 3201274209820002 
104 REZVAN AHYAN.A L 5/4/2018 3201270505180004 
105 sadriana P 7/29/2018 3201275111880005 
106 SAFIA OKTAFIANA P 10/9/2019 3201275707030002 
107 SATRIA MANDALA P 9/25/2019 3201274807170002 
108 SELINA HAMRA U L 7/24/2020 3201272509190004 
109 SITI AGISNA P 1/27/2020 3201276407200003 
110 SITI AMALIA PUTRI P 4/15/2018 32012727120120 
111 SITI FATIMAH AZAHRA P 1/21/2019 3201275504180004 
112 SITI FAZILA MARWAH P 9/8/2018 3201906101194603 
113 SITI JULIANTI ARYANI P 7/26/2018 3201274809180003 
114 siti lubna P 7/9/2018 3201276607180005 
115 SITI NABILA T.R P 4/28/2020 3201274907118004 
116 SITI NAZMA ALAWIAH P 3/15/2019 3201276705200002 
117 SITI NUR AGISNI L 1/27/2020 3201275503190003 
118 SITI NUR ALIKA P 3/22/2020 320127920120120 
119 SITI NURAGISNI
ST ALIPA NUR P 1/27/2020 3201276203200001 
120 HASANAH P 1/8/2018 320127470900017 
121 st.fatimah P 1/21/2019 3201276707170005 
122 st.julianti P 7/26/2018 3201274801180009 
123 st.nazma P 3/15/2019 3201276101190008 
124 ST.ULFAH
SYAFA AQILA TRINAWATI P 5/8/2018 3201276607180002 
125 TAHAZANAH P 2/19/2019 3201274506720005 
126 SYAHBAN RADITYA H P 3/16/2018 3201276502840002 
127 SYARIFAH NAFISAH P 6/15/2018 3201271607190003 
128 SYIFA AQILA L 2/19/2019 3201271603180006 
129 USMAN P 6/28/2019 3201275508160001 
130 YASMIN HUSNIAH A P 7/15/2018 32012719219219 
131
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480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 3

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

NYAI kp. Lemah Nendeut 0 1 1 2

uswatun h kp. Lemah Nendeut 0 0 0 0
USWATUN HASANAH kp. Lemah Nendeut 0 1 0 3
SALSA OKTAVIA kp. Lemah Nendeut 0 2 2 2
SUSI kp. Lemah Nendeut 0 1 3 4
U.DADANG / SITI HANFAH kp. Lemah Nendeut 0 1 3 1
MAMAY M kp. Lemah Nendeut 0 3 1 1
rohim kp. Lemah Nendeut 0 2 1 3
SULASTRI kp. Lemah Nendeut 0 3 1 1
AI kp. Lemah Nendeut 0 3 1 1
AI kp. Lemah Nendeut 0 3 1 1
IIN kp. Lemah Nendeut 0 3 1 1
ATI.N kp. Lemah Nendeut 0 3 1 1
LINDA S kp. Lemah Nendeut 0 3 1 1
LINDASARI kp. Lemah Nendeut 0 3 1 1
ida kp. Lemah Nendeut 0 3 1 1
IDA SOLIHAH kp. Lemah Nendeut 0 3 1 1
RIDA kp. Lemah Nendeut 0 3 1 1
RISMA kp. Lemah Nendeut 0 3 1 1
IKOH kp. Lemah Nendeut 0 3 1 1
IDA kp. Lemah Nendeut 0 3 1 1
IDA kp. Lemah Nendeut 0 3 1 1
WIWIT kp. Lemah Nendeut 0 3 1 1
TATI SUMIATI kp. Lemah Nendeut 0 3 1 1
RIFA kp. Lemah Nendeut 0 3 1 1
SITI LAELA. N kp. Lemah Nendeut 0 3 1 1
SUSI kp. Lemah Nendeut 0 3 1 1
YEYEH D kp. Lemah Nendeut 0 3 1 1
ALFINDA HERDAYANTI kp. Lemah Nendeut 0 3 1 1
LIA.Y kp. Lemah Nendeut 0 3 1 1
dede kp. Lemah Nendeut 0 3 1 1
ELAH kp. Lemah Nendeut 0 3 1 1
ESIH kp. Lemah Nendeut 0 3 1 1
EVI kp. Lemah Nendeut 0 3 1 1
CHA CHA kp. Lemah Nendeut 0 3 1 1
fitri kp. Lemah Nendeut 0 3 1 1
MAYASARI kp. Lemah Nendeut 0 3 1 1
ST LIAH KOMALIAH kp. Lemah Nendeut 0 3 1 1
SINARIAH kp. Lemah Nendeut 0 3 1 1
ipah s.l kp. Lemah Nendeut 0 3 1 1
FITRI kp. Lemah Nendeut 0 3 1 1
SITI SUNENGSIH kp. Lemah Nendeut 0 3 1 1
SITI HINDUN kp. Lemah Nendeut 0 3 1 1
NURHAYATI kp. Lemah Nendeut 0 3 1 1
ANISA kp. Lemah Nendeut 0 3 1 1
KIKI KOMALASARI kp. Lemah Nendeut 0 3 1 1
ERnawati kp. Lemah Nendeut 0 3 1 1
ILAH kp. Lemah Nendeut 0 3 1 1
IDA kp. Lemah Nendeut 0 3 1 1
DEDE kp. Lemah Nendeut 0 3 1 1
WATI kp. Lemah Nendeut 0 3 1 1
YAYAT kp. Lemah Nendeut 0 3 1 1
YENI
HJ kp. Lemah Nendeut 0 3 1 1
ROHIMATURROMDONA kp. Lemah Nendeut 0 3 1 1
PARMI kp. Lemah Nendeut 0 3 1 1
NENG ROSITA kp. Lemah Nendeut 0 3 1 1
SITI. A kp. Lemah Nendeut 0 3 1 1
MUBAROK / LISNAWATI.J kp. Lemah Nendeut 0 3 1 1
ISNA kp. Lemah Nendeut 0 3 1 1
SUMIATI kp. Lemah Nendeut 0 3 1 1
YULIA.N kp. Lemah Nendeut 0 3 1 1
HUSNA kp. Lemah Nendeut 0 3 1 1
EVA kp. Lemah Nendeut 0 3 1 1
SITI NURLELA kp. Lemah Nendeut 0 3 1 1
INDAH NOVIANTI kp. Lemah Nendeut 0 3 1 1
INDAH NOVIANTI kp. Lemah Nendeut 0 3 1 1
Roni siantori / siti holipah kp. Lemah Nendeut 0 3 1 1
NYAI SAIROH kp. Lemah Nendeut 0 3 1 1
LINA SUSANTI kp. Lemah Nendeut 0 3 1 1
TATI kp. Lemah Nendeut 0 3 1 1
HINDUN kp. Lemah Nendeut 0 3 1 1
DIAH kp. Lemah Nendeut 0 3 1 1
YENI ROSMANA kp. Lemah Nendeut 0 3 1 1
FILI ROSA kp. Lemah Nendeut 0 3 1 1
SITI SAADAH kp. Lemah Nendeut 0 3 1 1
PIRLIROSA kp. Lemah Nendeut 0 3 1 1
ST HOLIPAH
DADANG S / ST kp. Lemah Nendeut 0 3 1 1
NURASIAH kp. Lemah Nendeut 0 3 1 1
SITI YULIANI kp. Lemah Nendeut 0 3 1 1
SITI MARLINA kp. Lemah Nendeut 0 3 1 1
ENENG kp. Lemah Nendeut 0 3 1 1
NURLELAH.R kp. Lemah Nendeut 0 3 1 1
SUSILAWATI kp. Lemah Nendeut 0 3 1 1
SUSILAWATI kp. Lemah Nendeut 0 3 1 1
ILA kp. Lemah Nendeut 0 3 1 1
AI kp. Lemah Nendeut 0 3 1 1
Paris
ENDANGj.h / SITI kp. Lemah Nendeut 0 3 1 1
NURJANAH kp. Lemah Nendeut 0 3 1 1
REFITA kp. Lemah Nendeut 0 3 1 1
DEDEH kp. Lemah Nendeut 0 3 1 1
SITI NURKIAH kp. Lemah Nendeut 0 3 1 1
DINI kp. Lemah Nendeut 0 3 1 1
FILI ROSA kp. Lemah Nendeut 0 3 1 1
DINA
GIRI SULAIMAN / ELI kp. Lemah Nendeut 0 3 1 1
ERMAWATI kp. Lemah Nendeut 0 3 1 1
SITI MARLENI kp. Lemah Nendeut 0 3 1 1
NIAWATI kp. Lemah Nendeut 0 3 1 1
IIN kp. Lemah Nendeut 0 3 1 1
NIAWATI
GIRI SULAIMAN / ELI kp. Lemah Nendeut 0 3 1 1
ERMAWATI kp. Lemah Nendeut 0 3 1 1
Diana kp. Lemah Nendeut 0 3 1 1
RIPA kp. Lemah Nendeut 0 3 1 1
JUMER kp. Lemah Nendeut 0 3 1 1
LINA SUSANTI kp. Lemah Nendeut 0 3 1 1
DESI kp. Lemah Nendeut 0 3 1 1
SAFIRA kp. Lemah Nendeut 0 3 1 1
ACEP SUNANDI kp. Lemah Nendeut 0 3 1 1
NIA ADE.W kp. Lemah Nendeut 0 3 1 1
ULAN kp. Lemah Nendeut 0 3 1 1
SITI ROBIAH kp. Lemah Nendeut 0 3 1 1
ILAH kp. Lemah Nendeut 0 3 1 1
SURYATI kp. Lemah Nendeut 0 3 1 1
PIPIT FITRIA kp. Lemah Nendeut 0 3 1 1
ANI kp. Lemah Nendeut 0 3 1 1
ITA NITA kp. Lemah Nendeut 0 3 1 1
SITI SUHAEBAH kp. Lemah Nendeut 0 3 1 1
ULAN kp. Lemah Nendeut 0 3 1 1
NENG IMAS kp. Lemah Nendeut 0 3 1 1
ULAN kp. Lemah Nendeut 0 3 1 1
APUDIN / SITI
SAEPULOH SUHAEBAH
/ ST. kp. Lemah Nendeut 0 3 1 1
HASANAH kp. Lemah Nendeut 0 3 1 1
IIS kp. Lemah Nendeut 0 3 1 1
dede kp. Lemah Nendeut 0 3 1 1
AIDIN kp. Lemah Nendeut 0 3 1 1
AAT kp. Lemah Nendeut 0 3 1 1
MILA N kp. Lemah Nendeut 0 3 1 1
RAHMAILLAH kp. Lemah Nendeut 0 3 1 1
NURAMIAH kp. Lemah Nendeut 0 3 1 1
mila n kp. Lemah Nendeut 0 3 1 1
WINDA kp. Lemah Nendeut 0 3 1 1
0
0
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0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

39 1 1 0 1 1
22 1 1 1 1 1
50 1 1 1 1 1
57 1 0 0 1 1
50 1 0 0 0 0
45 1 0 0 1 1
39 1 1 0 1 1
58 1 1 0 1 1
58 1 1 0 1 1
27 1 1 0 1 1
27 1 1 0 1 1
43 1 1 0 1 1
48 1 1 0 1 1
16 1 1 0 1 1
16 1 1 0 1 1
36 1 1 0 1 1
48 1 1 0 1 1
20 1 1 0 1 1
32 1 1 0 1 1
26 1 1 0 1 1
56 1 1 0 1 1
56 1 1 0 1 1
55 1 1 0 1 1
55 1 1 0 1 1
37 1 1 0 1 1
37 1 1 0 1 1
46 1 1 0 1 1
22 1 1 0 1 1
26 1 1 0 1 1
42 1 1 0 1 1
30 1 1 0 1 1
48 1 1 0 1 1
36 1 1 0 1 1
25 1 1 0 1 1
61 0 0 0 0 0
43 1 1 0 1 1
34 1 1 0 1 1
33 1 1 0 1 1
29 1 1 0 1 1
22 1 1 0 1 1
30 1 1 0 1 1
29 1 1 0 1 1
14 1 1 0 1 1
20 1 1 0 1 1
20 1 1 0 1 1
23 1 1 0 1 1
21 1 1 0 1 1
32 1 1 0 1 1
47 1 1 0 1 1
58 1 1 0 1 1
39 1 1 0 1 1
34 1 1 0 1 1
47 1 1 0 1 1
54 1 1 0 1 1
25 1 1 0 1 1
44 1 1 0 1 1
39 1 1 0 1 1
50 1 1 0 1 1
27 1 1 0 1 1
36 1 1 0 1 1
38 1 1 0 1 1
23 1 1 0 1 1
54 1 1 0 1 1
59 1 1 0 1 1
39 1 1 0 1 1
39 1 1 0 1 1
17 1 1 0 1 1
57 1 1 0 1 1
25 1 1 0 1 1
50 1 1 0 1 1
14 1 1 0 1 1
18 1 1 0 1 1
36 1 1 0 1 1
16 1 1 0 1 1
54 1 1 0 1 1
16 1 1 0 1 1
17 1 1 0 1 1
20 1 1 0 1 1
14 1 1 0 1 1
36 1 1 0 1 1
57 1 1 0 1 1
57 1 1 0 1 1
16 1 1 0 1 1
16 1 1 0 1 1
29 1 1 0 1 1
60 0 0 0 0 0
46 1 1 0 1 1
58 1 1 0 1 1
47 1 1 0 1 1
47 1 1 0 1 1
30 1 1 0 1 1
48 1 1 0 1 1
43 1 1 0 1 1
43 1 1 0 1 1
45 1 1 0 1 1
55 1 1 0 1 1
60 0 0 0 0 0
24 1 1 0 1 1
24 1 1 0 1 1
17 1 1 0 1 1
27 1 1 0 1 1
51 1 1 0 1 1
50 1 1 0 1 1
50 1 1 0 1 1
48 1 1 0 1 1
33 1 1 0 1 1
34 1 1 0 1 1
24 1 1 0 1 1
30 1 1 0 1 1
51 1 1 0 1 1
42 1 1 0 1 1
46 1 1 0 1 1
48 1 1 0 1 1
48 1 1 0 1 1
27 1 1 0 1 1
40 1 1 0 1 1
30 1 1 0 1 1
28 1 1 0 1 1
30 1 1 0 1 1
54 1 1 0 1 1
42 1 1 0 1 1
48 1 1 0 1 1
40 1 1 0 1 1
50 1 1 0 1 1
41 1 1 0 1 1
52 1 1 0 1 1
49 1 1 0 1 1
41 1 1 0 1 1
37 1 1 0 1 1
48 1 1 0 1 1
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

127 124 2 126 126

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

3 0 2 1 0 1 1
4 1 4 1 1 1 1
3 1 1 1 1 1 1
0 0 2 0 0 1 1
0 0 0 0 0 0 1
0 0 3 0 0 1 1
1 0 3 1 0 1 1
2 0 1 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
0 0 0 0 0 0 0
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
0 0 0 0 0 0 0
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
0 0 0 0 0 0 0
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 2 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
1 0 3 1 0 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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
132 2 361 124 2 126 127

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 16 1 32 16

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

2 1
3 1
3 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 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 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 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 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 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 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 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 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 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 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 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 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 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
255 127 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi JAWA BARAT Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 ABIL L 1/20/2018 3201272001180004 

2 ABIZAR AL-GHIFARI L 12/26/2018 3201272612180004 
3 ADNAN KIRAN L 7/14/2017 3201901407171779 
4 ALIT L 4/4/2018 3201270404180003 
5 ANDRA PRATOMO L 12/18/2019 3201271802190003 
6 ARFAN L 7/10/2020 320127610720720 
7 ARSILA HUSNA P 10/9/2019 320127910191019 
8 AULIA DENIA PUTRI P 7/23/2018 3201276307180002 
AYRA AZKAYR A.
9 MAHDOR P 4/7/2020 3201274704190001 
10 DEA PUSPITA SARI P 2/24/2018 3201276402180001 
11 DINI JULIANA P 7/14/2019 3201275407190004 
12 DWI ANDIKA ASSIDIQ L 7/25/2018 3201276507180003 
FARIZA ATAYA SHANUM.
13 M P 10/17/2017 3201271711070005 
14 FUZNA M.A P 8/7/2019 3201274708190002 
GADIS RAHMA
15 WIJAYANTI P 11/8/2020 3201274811200000 
16 HALWA EVAZZAHRO P 7/27/2019 3201272712200002 
17 HUSNI RAMDANI L 5/17/2020 3201271705200005 
IFTIAH HAIFATU
18 IRWANSYAH P 8/1/2020 3201904108207302 
19 INTAN MIRATUSSANI P 4/17/2020 3201272207160005 
20 KA INAYAH P 8/6/2020 3201270608200820 
21 KAILA PUTRI P 6/19/2019 3201275906190001 
22 kamila P 8/30/2017 3201277408178945 
23 KAMILA TSIMNI P 8/30/2017 3201277008170004 
24 KHALISA NUR SAFEEA P 11/15/2019 3201275511190001 
25 KINAN P 11/9/2019 3201274911190005 
26 KIRANA PUTRI P 10/28/2018 3201276801180002 
27 LIA SUSANTI P 12/22/2020 3201276212180003 
28 M AKMAR NADIF R L 4/24/2019 32012724419419 
29 M ALFATIH MAKINUL.U L 6/29/2020 3201271007200004 
M GIBRAN SAMSUL
30 BAHRI L 7/1/2020 3201273105200002 
31 M HAFIZ ALFAZRI L 9/7/2017 3201900709170000 
32 M IBRAHIM L 4/13/2020 3201271304200001 
33 M IDRIS PRATAMA L 3/30/2020 3201273003200002 
34 M REVAN A L 7/11/2020 3201271107200005 
35 M RIZKY L 6/7/2020 3201240706200003 
36 M RIZKY ARDIANSYAH L 8/23/2018 3201276308180004 
37 M SAHDAN L 3/13/2020 320127313320320 
38 M YUSUF AL-FARIZQI L 12/27/2020 3201275308180001 
39 M ZIKRA AWALUDIN L 6/21/2018 3201272106180008 
40 M. AL-KUSAERI L 3/27/2019 3201272703190001 
41 M. ALVIANSAH L 12/23/2019 3201276707180005 
42 M. AQMAR NAHDIP. R L 4/24/2019 3201272405190005 
M. AQROM
43 HIDAYATULLOH L 4/25/2019 3201272504190002 
44 M. AZHAR GINJANJI L 1/2/2020 3201270201200005 
45 M. DAFFA MAULANA L 4/8/2019 3201270804190006 
46 M. FADLAN AL-HAFIZ L 12/13/2019 3201901312192469 
47 M. FADLI RABANI L 3/30/2018 3201273003190004 
48 M. FATIR RIZAL L 3/21/2018 3201272906170003 
49 M. KHAIRAN ARAHIM L 12/14/2019 3201271412190001 
50 M. KHAIRAN ARAHIM L 12/14/2019 3201901412194476 
M. NAZRIL ZAFLAN
51 ZAKARIYA L 8/20/2018 3201272008180003 
52 M. RAIYAN RAMADHAN L 5/9/2019 3201270905190007 
53 M. RAPI DARMAWAN L 3/16/2019 3201271603190002 
54 M. REFAN AL-FARIZKY L 7/11/2020 3201270802910002 
55 M. RENDY AL-FARIZKY L 6/17/2020 3201901706209227 
56 m. rizky L 9/23/2018 3201272309184520 
M. SYAHDAN
57 MUNANDAR L 3/13/2020 3201271303200002 
58 M. SYAHLAN MAULANA L 10/2/2018 3201900210181419 
59 m.faturahman L 7/22/2018 3201272207180003 
60 M.HABIBI AR-RAHMAN L 3/20/2019 3201272003190003 
61 M.HAFIDZ ALFAZRI L 9/7/2017 3201270709173341 
62 M.NAHDAN SAJILI L 10/29/2017 3201272910172312 
63 MALIK L 8/28/2019 3201272808190819 
64 MELISA OKTAVA PUTRI P 10/26/2019 3201276610190001 
65 MOCH RIDHO RHAMA. N L 6/14/2017 3201271406170006 
66 MUHAMAD ADITIYA L 4/21/2020 3201272104200004 
MUHAMAD ARFAN
67 SALIM L 3/21/2020 3201272710320004 
MUHAMAD BILAL AL
68 FAHRI L 3/16/2021 3201270603210001 
69 MUHAMAD DALFA L 2/8/2021 3201900802214655 
70 MUHAMAD DALFI L 2/8/2021 3201900802214903 
71 MUHAMAD FADILAH L 4/26/2020 3201272604200004 
72 MUHAMAD FASNIDALIL L 4/27/2021 3201902704218291 
MUHAMAD FATHUR
73 ROHMAN L 7/22/2018 3201273207180003 
74 MUHAMAD FAZRI L 12/5/2019 3201270512200003 
MUHAMAD FIKRA
75 AWALUDIN L 6/21/2018 3201272106080001 
76 MUHAMAD NIZAR L 1/29/2020 3201272901200006 
77 MUHAMAD SARDAN L 12/18/2019 3201901812196332 
NADINE AULIA
78 MASYIDA.P P 2/26/2019 3201276602190003 
NADIRA LAIBA
79 RUDIAWAN P 12/4/2019 3201904412199094 
80 NAURA TALITA HASNA P 1/13/2019 3201275301190004 
81 NAYA P 2/12/2018 320127122218218 
82 NAYAKA PUTRI ASHEKA P 4/3/2020 3201274304200006 
83 NOVAL L 3/2/2021 3201900203216835 
84 NOVITA WULANDARI P 4/2/2018 3201270204180001 
85 NOVITA WULANDARI P 4/2/2018 3201274204180004 
86 NURI P 7/31/2020 32012731720720 
87 PAIZ SAHREZA L 6/8/2019 3201270806190002 
88 PARID FIRDAUS L 9/20/2018 3201272009180002 
89 pranaja L 8/30/2018 3201273008180003 
90 PUTRI NATASYA P 12/1/2020 3201274112200002 
91 RAFA L 1/7/2021 32012777121121 
92 RAFASYA JANUAR. S L 1/7/2021 3201270701210004 
93 RAJITA KULTUM NADA P 8/13/2017 3201275308170006 
94 RAMA L 6/11/2018 32012711618618 
95 RATU KEYSA P 10/8/2020 3201904810209986 
96 RAZKA YUSA AYASI L 12/29/2019 3201272912190001 
97 RIZKI MAULANA L 1/7/2018 3201270701180005 
98 RIZKYA P 4/15/2020 3201271504200420 
99 RIZQIASAH QUEENA L 4/15/2020 3201901504209816 
100 S. ANASYA UFAIRAH P 7/10/2020 320127500720008 
101 safira P 11/2/2017 3201274211170001 
102 SAHIDA P 12/13/2020 3201273312201220 
103 SAHILA P 8/13/2018 3201271388188818 
104 SAHLAN L 10/2/2018 3201279210181018 
105 SALMAN AL-FARIZI L 12/21/2020 3201272112200002 
106 SEVIA PUTRI KHODIJAH P 9/12/2018 3201275209180002 
SHANUM ZAIDA
107 NURRAMADANI P 5/18/2020 3201275805200004 
SISILIA HUMAIRA
108 FADILAH P 2/14/2019 3201275402190004 
109 SITI AFIFAH KHAIRIYAH P 12/22/2020 3201276212200001 
110 SITI AFIFATUL HASNA P 2/9/2018 3201274902180007 
111 SITI ALIA D P 11/11/2018 3201279111180005 
112 SITI ALIYA D P 11/11/2018 3201275111180005 
113 SITI AMELISA P 4/18/2020 320127680420420 
114 SITI ASIAH JAMILAH P 4/18/2018 3201275804190006 
115 SITI ASIYAH J P 4/18/2019 32012758190006 
116 SITI FATIMAH TUZ ZAHRO P 2/23/2021 3201276302210003 
117 SITI KAMILA AMELIA P 12/28/2018 3201276812180004 
118 SITI KAMILIA RAHMA P 9/2/2018 3201904209188293 
119 SITI KHODIJAH P 2/2/2020 3201904202208763 
SITI LATIFATUL
120 LUTHFIYAH P 3/8/2021 3201274803210004 
121 SITI MUNAWAROH P 4/15/2018 3201275006180002 
122 SITI NABILA ZAHRA P 10/7/2019 3201274710190002 
123 siti nhanalifa P 11/20/2017 3201276011170001 
124 SITI NUR KALISTA P 12/20/2018 3201276012180004 
125 SITI NURAZIZAH P 6/29/2018 3201276906180002 
126 SITI NURHALIZA P 3/10/2021 3201272503190009 
127 SITI NURHANIFAH P 3/1/2021 3201274103210004 
128 SITI SALIS S P 9/5/2017 32012755917917 
129 SITI SALISAJINA P 9/5/2017 3201904509173116 
130 SITI SALSABILA AZAHRA P 12/2/2019 3201274212190002 
SITI SHOFA SALWATUN.
131 N P 12/24/2018 3201276412180004 
132 SITI SIFA P 7/27/2018 3201276707180001 
133 SITI VANIA MAHARANI P 5/29/2021 3201276905210002 
134 SRI NURSILVA P 9/17/2018 3201275709180004 
135 ST.NAISILA P 5/28/2018 3201276805180002 
136 suci P 6/18/2017 3201275886110001 
137 SYAHILA ARVIANI P 8/13/2018 3201275704200002 
SYAKILA MALIFAH
138 ABIDAN P 8/19/2019 3201275908190004 
139 tiara P 3/19/2019 3201275903180003 
140 USMAN ABDUROHMAN L 2/20/2021 3201902002217601 
141 USWATUN HASANAH P 2/6/2020 3201276602200220 
142 YESIKA PUTRIYAH P 8/25/2017 3201276508170004 
143 ZAHROTUS YASMIN A P 7/2/2020 3201275207200720 
144 ZAKIA RIZATUN NISA P 9/5/2018 3201274509180005 
145 ZEIN MALIK L 4/7/2021 3201270704210002 
146
147
148
149
150
151
152
153
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155
156
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158
159
160
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449

450
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461
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498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
Nirwana 4

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Ridwan / ebah kp. Pasir Kuda 0 3 1 3

IAN / YULI kp. Pasir Kuda 0 0 0 0
HERMAWAN kp. Pasir Kuda 0 1 0 3
Tini kp. Pasir Kuda 0 2 2 2
SARNO / JUBAEDAH kp. Pasir Kuda 0 1 3 4
Ika / salim kp. Pasir Kuda 0 1 3 1
YANI / PUPUT kp. Pasir Kuda 0 3 1 1
DEVI WULANDARI kp. Pasir Kuda 0 2 1 3
IMRON / IYA kp. Pasir Kuda 0 3 1 3
IHAT kp. Pasir Kuda 0 3 1 3
DEDE JUBAEDAH kp. Pasir Kuda 0 3 1 3
DEWI / IYAN kp. Pasir Kuda 0 3 1 3
MUSTOFA kp. Pasir Kuda 0 3 1 3
H.ABDUL kp. Pasir Kuda 0 3 1 3
ROHMAT WIJAYA kp. Pasir Kuda 0 3 1 3
SITI KHODIJAH kp. Pasir Kuda 0 3 1 3
Atikah kp. Pasir Kuda 0 3 1 3
M.RIDWAN / AGUSTIANA kp. Pasir Kuda 0 3 1 3
IPAH HAPIPAH kp. Pasir Kuda 0 3 1 3
OMAN S / IDA PARIDA kp. Pasir Kuda 0 3 1 3
ARIFIN kp. Pasir Kuda 0 3 1 3
santobi kp. Pasir Kuda 0 3 1 3
SANTOBI0SITI RUBAEDAH kp. Pasir Kuda 0 3 1 3
KHOLIK / SITI NURAENI kp. Pasir Kuda 0 3 1 3
APOENDI kp. Pasir Kuda 0 3 1 3
MOCH HASAN E kp. Pasir Kuda 0 3 1 3
KOMAR / AIDA kp. Pasir Kuda 0 3 1 3
Abdul rohman kp. Pasir Kuda 0 3 1 3
SAMSU E / ANIH kp. Pasir Kuda 0 3 1 3
MISBAH / DIANI kp. Pasir Kuda 0 3 1 3
HERI RUYANIC-SITI
NURHAENI kp. Pasir Kuda 0 3 1 3
LATIF / ELIH.N kp. Pasir Kuda 0 3 1 3
HUDRI / ST SADIAH kp. Pasir Kuda 0 3 1 3
Opik / nurma kp. Pasir Kuda 0 3 1 3
Saepuloh kp. Pasir Kuda 0 3 1 3
RUDI HARYANTO kp. Pasir Kuda 0 3 1 3
Aris / yanti kp. Pasir Kuda 0 3 1 3
RAHMAT kp. Pasir Kuda 0 3 1 3
KOSASIH-SUHAEBAH kp. Pasir Kuda 0 3 1 3
KUSMIAH kp. Pasir Kuda 0 3 1 3
NURHAYATI kp. Pasir Kuda 0 3 1 3
ABDUL ROHMAN kp. Pasir Kuda 0 3 1 3
UES kp. Pasir Kuda 0 3 1 3
RAHMAT HIDAYAT kp. Pasir Kuda 0 3 1 3
WANDI / DEDE.M kp. Pasir Kuda 0 3 1 3
WULAN kp. Pasir Kuda 0 3 1 3
NANI kp. Pasir Kuda 0 3 1 3
PIPIH kp. Pasir Kuda 0 3 1 3
SELFIANA.F kp. Pasir Kuda 0 3 1 3
SELFIANA.F kp. Pasir Kuda 0 3 1 3
KIKI / SITRIANI kp. Pasir Kuda 0 3 1 3
MISBAHUDIN kp. Pasir Kuda 0 3 1 3
MIA TRI.U kp. Pasir Kuda 0 3 1 3
NAurma.y kp. Pasir Kuda 0 3 1 3
DEDE YANI kp. Pasir Kuda 0 3 1 3
rudi kp. Pasir Kuda 0 3 1 3
YANTI kp. Pasir Kuda 0 3 1 3
ANI NURAENI kp. Pasir Kuda 0 3 1 3
suryadi kp. Pasir Kuda 0 3 1 3
M.AYUB / SOLIHAH kp. Pasir Kuda 0 3 1 3
HERIYANTO kp. Pasir Kuda 0 3 1 3
MISBAHUDIN kp. Pasir Kuda 0 3 1 3
Nurdin / ipah kp. Pasir Kuda 0 3 1 3
RIANTO / ENENG kp. Pasir Kuda 0 3 1 3
HOERUDIN / NURHAYATI kp. Pasir Kuda 0 3 1 3
ENAP NAFISAH kp. Pasir Kuda 0 3 1 3
HAerman kp. Pasir Kuda 0 3 1 3
Ade kul kul kp. Pasir Kuda 0 3 1 3
SUPRIADI kp. Pasir Kuda 0 3 1 3
DINI AYU.J kp. Pasir Kuda 0 3 1 3
HENDRA / SUSI.H kp. Pasir Kuda 0 3 1 3
WAHYUDIN kp. Pasir Kuda 0 3 1 3
SURYADI kp. Pasir Kuda 0 3 1 3
SAFEI kp. Pasir Kuda 0 3 1 3
KOSASIH kp. Pasir Kuda 0 3 1 3
SUHANAH kp. Pasir Kuda 0 3 1 3
SITI SAADAH kp. Pasir Kuda 0 3 1 3
ABDUL / MELINDA kp. Pasir Kuda 0 3 1 3
SHIFA CHAERUNISA kp. Pasir Kuda 0 3 1 3
USMAN kp. Pasir Kuda 0 3 1 3
Lili kp. Pasir Kuda 0 3 1 3
IWAN / ENI kp. Pasir Kuda 0 3 1 3
SITI JULAEHA kp. Pasir Kuda 0 3 1 3
herman kp. Pasir Kuda 0 3 1 3
HERMAN kp. Pasir Kuda 0 3 1 3
Hamdan kp. Pasir Kuda 0 3 1 3
WIDIA ASTUTI kp. Pasir Kuda 0 3 1 3
IYUS kp. Pasir Kuda 0 3 1 3
tamamudin kp. Pasir Kuda 0 3 1 3
SOdikin kp. Pasir Kuda 0 3 1 3
Aray / eros kp. Pasir Kuda 0 3 1 3
ROSITA kp. Pasir Kuda 0 3 1 3
ST.SARAH kp. Pasir Kuda 0 3 1 3
Maman / mita kp. Pasir Kuda 0 3 1 3
FANI OKTAVIANI kp. Pasir Kuda 0 3 1 3
ENDANG / MARLI kp. Pasir Kuda 0 3 1 3
YAYAH kp. Pasir Kuda 0 3 1 3
Usman / aisah kp. Pasir Kuda 0 3 1 3
WATI MARLINA kp. Pasir Kuda 0 3 1 3
M APIPUDIN / SITI
MASRIFAH kp. Pasir Kuda 0 3 1 3
gunawan kp. Pasir Kuda 0 3 1 3
Acep / lani kp. Pasir Kuda 0 3 1 3
Haryo kp. Pasir Kuda 0 3 1 3
Apur / ani kp. Pasir Kuda 0 3 1 3
IDA PARIDA kp. Pasir Kuda 0 3 1 3
NOVA SETIAWAN kp. Pasir Kuda 0 3 1 3
CECEP W / LENI N kp. Pasir Kuda 0 3 1 3
PADILAH / SISKA kp. Pasir Kuda 0 3 1 3
KHAR / IDA kp. Pasir Kuda 0 3 1 3
UMAR MAULANA-SITI AISAH kp. Pasir Kuda 0 3 1 3
DONI RAMDONI kp. Pasir Kuda 0 3 1 3
Dani ramdani kp. Pasir Kuda 0 3 1 3
OBAN / LINA.M kp. Pasir Kuda 0 3 1 3
DEDE SURYANA kp. Pasir Kuda 0 3 1 3
Dede / irma kp. Pasir Kuda 0 3 1 3
LUPIAH ALAWIAH kp. Pasir Kuda 0 3 1 3
DAE / UNAH kp. Pasir Kuda 0 3 1 3
IRAWATI kp. Pasir Kuda 0 3 1 3
AGUS/MUTIA kp. Pasir Kuda 0 3 1 3
SITI AISAH kp. Pasir Kuda 0 3 1 3
WARSUD kp. Pasir Kuda 0 3 1 3
TUTI NURHAYATI kp. Pasir Kuda 0 3 1 3
saepuloh kp. Pasir Kuda 0 3 1 3
DEDE kp. Pasir Kuda 0 3 1 3
SAiti euis.m kp. Pasir Kuda 0 3 1 3
SITI NENG.A kp. Pasir Kuda 0 3 1 3
UJANG SULAEMAN kp. Pasir Kuda 0 3 1 3
Abdulloh / nyai s kp. Pasir Kuda 0 3 1 3
ABDULLAH kp. Pasir Kuda 0 3 1 3
ILAH kp. Pasir Kuda 0 3 1 3
M. ZEN SOLAHUDIN kp. Pasir Kuda 0 3 1 3
TUDI DWI.Y kp. Pasir Kuda 0 3 1 3
NENTI kp. Pasir Kuda 0 3 1 3
SAPRUDIN kp. Pasir Kuda 0 3 1 3
AIM / SURAINAH kp. Pasir Kuda 0 3 1 3
oman kp. Pasir Kuda 0 3 1 3
IRMA SURYANI kp. Pasir Kuda 0 3 1 3
MANTA kp. Pasir Kuda 0 3 1 3
suhada kp. Pasir Kuda 0 3 1 3
MAMAN ABDUROHMAN kp. Pasir Kuda 0 3 1 3
Misbahudin / siti aisah kp. Pasir Kuda 0 3 1 3
ISOP SOFARIAH kp. Pasir Kuda 0 3 1 3
Dendi / teti f kp. Pasir Kuda 0 3 1 3
ELIH kp. Pasir Kuda 0 3 1 3
RIDWAN / EBAH kp. Pasir Kuda 0 3 1 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
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
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
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
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
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
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0
0
0
0
0
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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
0
0
0
0
0
0
0
0
0
0
0
0
0

0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

54 1 1 0 1 1
43 1 1 1 1 1
60 0 0 0 0 0
51 1 0 0 1 1
31 1 0 0 0 0
24 1 0 0 1 1
33 1 1 0 1 1
48 1 1 0 1 1
27 1 1 0 1 1
53 1 1 0 1 1
36 1 1 0 1 1
48 1 1 0 1 1
57 1 1 0 1 1
35 1 1 0 1 1
20 1 1 0 1 1
36 1 1 0 1 1
26 1 1 0 1 1
24 1 1 0 1 1
27 1 1 0 1 1
23 1 1 0 1 1
37 1 1 0 1 1
59 1 1 0 1 1
59 1 1 0 1 1
32 1 1 0 1 1
32 1 1 0 1 1
45 1 1 0 1 1
19 1 1 0 1 1
39 1 1 0 1 1
25 1 1 0 1 1
25 1 1 0 1 1
58 1 1 0 1 1
27 1 1 0 1 1
28 1 1 0 1 1
24 1 1 0 1 1
25 1 1 0 1 1
47 1 1 0 1 1
28 1 1 0 1 1
19 1 1 0 1 1
49 1 1 0 1 1
40 1 1 0 1 1
31 1 1 0 1 1
39 1 1 0 1 1
39 1 1 0 1 1
30 1 1 0 1 1
39 1 1 0 1 1
31 1 1 0 1 1
52 1 1 0 1 1
52 1 1 0 1 1
31 1 1 0 1 1
31 1 1 0 1 1
47 1 1 0 1 1
38 1 1 0 1 1
40 1 1 0 1 1
24 1 1 0 1 1
25 1 1 0 1 1
46 1 1 0 1 1
28 1 1 0 1 1
45 1 1 0 1 1
48 1 1 0 1 1
40 1 1 0 1 1
58 1 1 0 1 1
57 1 1 0 1 1
35 1 1 0 1 1
33 1 1 0 1 1
61 0 0 0 0 0
27 1 1 0 1 1
28 1 1 0 1 1
16 1 1 0 0 1
17 1 1 0 0 1
17 1 1 0 0 1
27 1 1 0 1 1
15 1 1 0 0 1
48 1 1 0 1 1
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49 1 1 0 1 1
30 1 1 0 1 1
31 1 1 0 1 1
41 1 1 0 1 1
31 1 1 0 1 1
42 1 1 0 1 1
53 1 1 0 1 1
27 1 1 0 1 1
16 1 1 0 0 1
51 1 1 0 1 1
51 1 1 0 1 1
24 1 1 0 1 1
37 1 1 0 1 1
46 1 1 0 1 1
47 1 1 0 1 1
20 1 1 0 1 1
18 1 1 0 1 1
18 1 1 0 1 1
59 1 1 0 1 1
49 1 1 0 1 1
21 1 1 0 1 1
31 1 1 0 1 1
54 1 1 0 1 1
27 1 1 0 1 1
27 1 1 0 1 1
24 1 1 0 1 1
56 1 1 0 1 1
19 1 1 0 1 1
47 1 1 0 1 1
45 1 1 0 1 1
19 1 1 0 1 1
46 1 1 0 1 1
26 1 1 0 1 1
41 1 1 0 1 1
19 1 1 0 1 1
53 1 1 0 1 1
44 1 1 0 1 1
44 1 1 0 1 1
27 1 1 0 1 1
51 1 1 0 1 1
39 1 1 0 1 1
17 1 1 0 0 1
43 1 1 0 1 1
46 1 1 0 1 1
29 1 1 0 1 1
16 1 1 0 0 1
51 1 1 0 1 1
33 1 1 0 1 1
56 1 1 0 1 1
43 1 1 0 1 1
49 1 1 0 1 1
16 1 1 0 0 1
17 1 1 0 0 1
58 1 1 0 1 1
58 1 1 0 1 1
31 1 1 0 1 1
43 1 1 0 1 1
48 1 1 0 1 1
14 1 1 0 0 1
46 1 1 0 1 1
50 1 1 0 1 1
61 0 0 0 0 0
47 1 1 0 1 1
35 1 1 0 1 1
40 1 1 0 1 1
17 1 1 0 0 1
29 1 1 0 1 1
59 1 1 0 1 1
24 1 1 0 1 1
46 1 1 0 1 1
15 1 1 0 0 1
1471 0 0 0 0 0
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142 139 1 129 141

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

1 0 1 1 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 2 0 0 1 1
0 0 0 0 0 0 1
0 0 3 0 0 1 1
1 0 3 1 0 1 1
2 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 0 1 0 0 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
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1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 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 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 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 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 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
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 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 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 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 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 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 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
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 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
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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
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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 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 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 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 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 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
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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 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 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
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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 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 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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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
143 1 137 139 1 129 142

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 18 1 33 18

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

2 1
3 1
0 0
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
1 1
1 1
1 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
1 1
1 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
0 0
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
1 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 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 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 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 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 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 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 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 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 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 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 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 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 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
272 142 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten Bogor Posyandu
Puskesmas Ciderum
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 ABDUL MALIK L 10/10/2020 3201275010201020 

2 ABDUL MUGIT L 4/12/2019 3201271204190419 
3 ABDUL MUQIT L 4/12/2019 3201271204190006 
4 AGISNA NURUL AINI P 5/28/2021 3201906805211795 
5 AKILA L 8/8/2019 3201900808192115 
6 ALIKA P 10/28/2017 3201272810171017 
7 ALIKA MAULIDIA PUTRI P 9/29/2017 3201276909170001 
8 ALMIRA AZKADINA P 10/4/2019 3201274410191019 
9 ALMIRA AZKADINA P 10/4/2019 3201274410190002 
10 ANDINI P 9/5/2019 3201274509190001 
11 ARSYILA PUTRI P 11/12/2017 3201275211170003 
12 ATTA HAFIZ L 8/30/2019 3201273008190003 
13 AULIA P 10/27/2019 3201276710190003 
14 AZQIA P 1/20/2018 320127020118118 
15 BAHAR L 2/5/2018 320127107880003 
16 BELA SAFITRI P 5/31/2021 3201277105200001 
17 DARA P 12/21/2017 3201276112170004 
18 DESVITA P 12/7/2017 3201274712170002 
19 ENGGAR AULIA P 6/16/2017 3201275606170617 
20 FAHIMA P 1/25/2018 3201276501180001 
21 FAHRANI RAMDANTI P 5/7/2019 3201274705190003 
22 FATHAN L 2/23/2018 3201272302180007 
23 GUMASYA P 9/21/2018 3201271091080004 
24 GUMAYSA P 9/21/2018 3201276109180918 
25 HAIKAL HAFIZ L 8/10/2019 3201271008190005 
26 M FARDAN L 9/15/2020 32012715920920 
27 M HIQAM L 11/11/2017 3201271111170004 
28 M RAIHAN L 3/31/2019 3201273103190319 
29 M SIHAB L 1/17/2019 3201271701190002 
30 M TOPAN RIFA\'I L 1/1/2018 3201271710180004 
31 M. AZWAR L 1/3/2021 3201270301210001 
32 M. FADLAN L 6/6/2021 3201900606216262 
33 M. FATIH L 3/15/2019 3201271503190002 
34 M. HAEKAL KAHFI L 8/10/2019 3201271008100819 
35 M. HIKAM ASKANDAR L 11/11/2017 3201275111170004 
36 M. LATIF L 4/26/2020 3201272604200003 
37 M. NIRZA ARDIANSYAH L 3/24/2021 3201272403210002 
38 M. RAFA L 1/29/2021 3201902901219363 
39 M. RAIHAN L 3/31/2018 3201273103180006 
40 M. RAMDAN L 5/17/2018 3201271705180005 
41 M. REZA L 5/28/2019 3201272806190003 
42 M. RUJIB L 1/1/2018 3201270101180118 
43 M. RUZIB L 1/1/2018 3201900101185381 
44 M. TEDIYANSYAH L 5/8/2021 3201900905212256 
45 M. YUSUP JANUAR L 1/30/2021 3201903001211750 
46 M. ZIDAN L 6/20/2017 3201902006176747 
47 MAHIR L 8/29/2019 3201272908190819 
48 MALIKA ISMAYANTI P 10/14/2018 3201275410180001 
49 NADIA P 3/10/2021 3201905003218260 
50 NAUFAL L 7/8/2019 3201270807190001 
51 NISA SAKILA P 10/2/2020 3201278210201020 
52 NISA SYAKILA P 10/2/2020 3201274210200001 
53 NURANISAH PUTRI P 3/21/2019 3201276103190002 
54 NURHASAH P 10/14/2018 3201905410182856 
NURHASANAH
55 WIDIYANTI P 4/12/2018 3201275204190005 
56 NURUL AINI P 5/28/2021 3201906805214106 
57 PUPUT P 10/14/2018 3201275364180003 
58 PUPUT ANDINI P 4/13/2019 3201275304180003 
59 RAFFASYA L 8/3/2020 3201275308200820 
60 RAHMAH L 12/21/2020 3201902112206294 
61 RAKA L 8/26/2018 3201272608180002 
62 RIZKIA SAQILA P 11/21/2018 320127111180005 
63 SAFIAH P 10/5/2017 3201274510170005 
64 SALSABILA P 1/16/2018 3271025601180002 
65 SAQILA P 11/21/2018 3201276111180005 
ST. MUGNIATU
66 SALAMAH P 11/30/2020 3201907011209485 
67 ST. SILMA DEWI P 12/1/2019 3201274112190001 
68 TIARA P 3/10/2021 3201275003210006 
69 ZAINAH P 6/21/2020 3173046104200009 
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 5

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Iwan / empur kp. Ciherang Satim 0 2 0 2

MUHARAM/ PIPAH kp. Ciherang Satim 0 3 1 3
MUHAROM / PIPAH kp. Ciherang Satim 0 3 1 3
HILAL / ELIH kp. Ciherang Satim 0 3 1 3
yana/sema kp. Ciherang Satim 0 3 1 3
Sudedi / jijah kp. Ciherang Satim 0 3 1 3
DEDE SEDEVI kp. Ciherang Satim 0 3 1 3
USMAN NIA kp. Ciherang Satim 0 3 1 3
M. USMAN/NIA kp. Ciherang Satim 0 3 1 3
Irpan / ica kp. Ciherang Satim 0 3 1 3
ANDRI / JULAEHA kp. Ciherang Satim 0 3 1 3
HASANUDIN/HOLIPAH kp. Ciherang Satim 0 3 1 3
RUSLIH / DAHLIA kp. Ciherang Satim 0 3 1 3
Entis / wita kp. Ciherang Satim 0 3 1 3
Aim / ayu kp. Ciherang Satim 0 3 1 3
HUDRI/ESA kp. Ciherang Satim 0 3 1 3
Asep / titin kp. Ciherang Satim 0 3 1 3
Emul / tuti kp. Ciherang Satim 0 3 1 3
KOHARUDIN/ST. KULSUM kp. Ciherang Satim 0 3 1 3
Umar / fatimah kp. Ciherang Satim 0 3 1 3
UPAH / DEDE kp. Ciherang Satim 0 3 1 3
JUBAEDI/HERLIN kp. Ciherang Satim 0 3 1 3
ZAENAL / AISAH kp. Ciherang Satim 0 3 1 3
zainal/ ai kp. Ciherang Satim 0 3 1 3
MISBAH / AISAPILOH kp. Ciherang Satim 0 3 1 3
Feri / midah kp. Ciherang Satim 0 3 1 3
H hendra / titin kp. Ciherang Satim 0 3 1 3
SAEPULLAH/YATI kp. Ciherang Satim 0 3 1 3
MAMI / ESIH kp. Ciherang Satim 0 3 1 3
ENCU / ROSI kp. Ciherang Satim 0 3 1 3
TULUS kp. Ciherang Satim 0 3 1 3
jubaedi/herlin kp. Ciherang Satim 0 3 1 3
jenal/hani kp. Ciherang Satim 0 3 1 3
MISBAH/AI SAFIROH kp. Ciherang Satim 0 3 1 3
TITIN kp. Ciherang Satim 0 3 1 3
A. BUSYAIRI/S.MAYA kp. Ciherang Satim 0 3 1 3
FITRIANENGSIH kp. Ciherang Satim 0 3 1 3
KOHAR/KULSUM kp. Ciherang Satim 0 3 1 3
ASEP S / YATI kp. Ciherang Satim 0 3 1 3
M. NASIR/S. HABIBAH kp. Ciherang Satim 0 3 1 3
M. RIZAL/LIA kp. Ciherang Satim 0 3 1 3
HUDRI/ESA kp. Ciherang Satim 0 3 1 3
HUDRI / ESA kp. Ciherang Satim 0 3 1 3
SAMSUDIN/ROSITA kp. Ciherang Satim 0 3 1 3
KHOIRUDIN / ST.KULSUM kp. Ciherang Satim 0 3 1 3
SULAEMAN / NYAI.M kp. Ciherang Satim 0 3 1 3
PAHRUDIN/NENENG kp. Ciherang Satim 0 3 1 3
LUKMAN kp. Ciherang Satim 0 3 1 3
m. rizal/lia kp. Ciherang Satim 0 3 1 3
Hasan / siti kp. Ciherang Satim 0 3 1 3
Handi kp. Ciherang Satim 0 3 1 3
SUHANDI / KOBTIAH kp. Ciherang Satim 0 3 1 3
M. PIRMAN kp. Ciherang Satim 0 3 1 3
SUWIRA/MARYANTI kp. Ciherang Satim 0 3 1 3
WIRA / YATI kp. Ciherang Satim 0 3 1 3
hilal/elih kp. Ciherang Satim 0 3 1 3
Enjen / wulan kp. Ciherang Satim 0 3 1 3
ENJEN kp. Ciherang Satim 0 3 1 3
Jenal / lia kp. Ciherang Satim 0 3 1 3
SUPARLAN kp. Ciherang Satim 0 3 1 3
Irpan / ica kp. Ciherang Satim 0 3 1 3
HERMAN kp. Ciherang Satim 0 3 1 3
Dadan / ai kp. Ciherang Satim 0 3 1 3
agus/mesa kp. Ciherang Satim 0 3 1 3
Wira / yati kp. Ciherang Satim 0 3 1 3
NUMAN/AISAH kp. Ciherang Satim 0 3 1 3
UJANG DEDI/AAP kp. Ciherang Satim 0 3 1 3
SUDIRMAN/MIA kp. Ciherang Satim 0 3 1 3
suhendi/rosdayanti kp. Ciherang Satim 0 3 1 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
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
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
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
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
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
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0
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0
0
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0
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0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

21 1 1 1 1 1
39 1 1 0 1 1
39 1 1 0 1 1
14 1 1 0 0 1
35 1 1 0 1 1
57 1 1 0 1 1
58 1 1 0 1 1
33 1 1 0 1 1
33 1 1 0 1 1
34 1 1 0 1 1
56 1 1 0 1 1
35 1 1 0 1 1
33 1 1 0 1 1
54 1 1 0 1 1
53 1 1 0 1 1
14 1 1 0 0 1
55 1 1 0 1 1
55 1 1 0 1 1
61 0 0 0 0 0
54 1 1 0 1 1
38 1 1 0 1 1
53 1 1 0 1 1
46 1 1 0 1 1
46 1 1 0 1 1
35 1 1 0 1 1
22 1 1 0 1 1
56 1 1 0 1 1
40 1 1 0 1 1
42 1 1 0 1 1
55 1 1 0 1 1
18 1 1 0 1 1
13 1 1 0 0 1
40 1 1 0 1 1
35 1 1 0 1 1
56 1 1 0 1 1
27 1 1 0 1 1
16 1 1 0 0 1
18 1 1 0 1 1
52 1 1 0 1 1
50 1 1 0 1 1
38 1 1 0 1 1
55 1 1 0 1 1
55 1 1 0 1 1
14 1 1 0 0 1
18 1 1 0 1 1
61 0 0 0 0 0
35 1 1 0 1 1
45 1 1 0 1 1
16 1 1 0 0 1
36 1 1 0 1 1
21 1 1 0 1 1
21 1 1 0 1 1
40 1 1 0 1 1
45 1 1 0 1 1
51 1 1 0 1 1
14 1 1 0 0 1
45 1 1 0 1 1
39 1 1 0 1 1
23 1 1 0 1 1
19 1 1 0 1 1
47 1 1 0 1 1
44 1 1 0 1 1
57 1 1 0 1 1
54 1 1 0 1 1
44 1 1 0 1 1
20 1 1 0 1 1
32 1 1 0 1 1
16 1 1 0 0 1
25 1 1 0 1 1
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67 67 1 59 67

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

2 1 2 1 1 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 0 0 0 0
0 0 0 0 0 0 0
68 1 60 67 1 59 67

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 9 1 15 9

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

3 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
0 0
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
127 67 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 ABIZAR L 9/7/2017 320170709170002 

2 ADELIA PUTRI P 2/20/2018 3201278202180218 
3 AIRA NABILA T P 8/28/2020 3201272888208820 
4 AISYAH FARHANA P 6/4/2020 320127440620002 
5 AIZA AZZAHRA P 8/20/2020 3201276008200003 
6 AKMAL L 11/23/2019 3201273311191119 
7 ALI L 12/13/2019 3201271312191219 
8 ALICIA PUTRI JAVI P 9/2/2017 3201270209170004 
9 ALIZA ZAHRATUL. R P 1/18/2019 3201275801190001 
10 AMIRA RAHMA P 11/10/2020 3201276011201120 
11 APRILLIANTI SUKARYA P 4/4/2018 3201904404181600 
12 aqila P 2/18/2018 3201275811168706 
13 AQILA AMELIA SARI P 2/18/2018 3201905802187132 
14 ARSYILA KHOERIAH P 7/21/2019 3201276107190074 
15 arsyla khoiriyah P 7/21/2019 3201721071900074 
16 ASYHAB DAFFA A P 9/14/2020 3201271409200001 
17 ASYIHAB DAFFA. A L 9/14/2020 3201271409200003 
18 atika P 4/16/2019 3201276203160001 
19 AZRIELL CHAIRIL. S L 12/11/2019 3201271112190002 
20 CANTIKA P 1/30/2021 32012730121121 
21 DERIL FALIH. K L 9/17/2019 3201271709190001 
22 deva P 7/11/2018 3201274312160004 
23 DEVANA PUTRI. A P 3/9/2019 3201274903190003 
24 FAJRI L 7/11/2018 3201271107180007 
25 HUMAERA P 6/13/2019 3201275306190087 
26 INARA PUTRI A P 11/1/2020 3201279111201120 
27 INTAN MAUILIDA P 11/30/2017 3201277011170002 
28 JAHRO RODIYAH P 1/1/2021 3201270502120008 
29 julpikar L 9/7/2017 3201271908160003 
30 KAIRA. S P 2/9/2019 3201274902190007 
31 KHALISA SYAFA. F P 4/5/2021 3201904504217246 
32 KHANZA AZZAHRA P 7/16/2018 3201271607187718 
33 KHOERUNNISA P 4/26/2019 3201276604190003 
34 lutfi P 9/7/2017 3201271111150004 
35 M ABDUL AJID L 5/29/2020 3201272905200520 
36 M AKBAR L 7/14/2020 3201271477207720 
37 M AZKA PRATAMA L 8/16/2017 3201271608170006 
38 M GIBRAN SIHAB L 7/19/2020 3201271977207720 
39 M HAQQI L 6/15/2020 3201271506200005 
40 M MAULANA MALIK L 7/29/2017 3201270907170004 
41 M NOPAL AL.P L 1/15/2020 320127271200002 
42 M
M.RAZKA
ABBAS L 3/8/2020 320127080320004 
43 HIDAYATULLAH L 2/16/2021 3201271602210006 
44 M. AL FATIH L 10/10/2017 3201271010179098 
45 M. ARFAN AL.MIYAS L 12/30/2019 3201277012190002 
46 M. AZKA AL-GHIFARI L 12/4/2018 3201277412191219 
47 M. DAFFIN AQUILA L 12/4/2017 3201270412170002 
48 M. FATHAN DZIKRAN L 7/13/2019 3201251307196745 
49 M. HANIF AL MALIK L 12/12/2018 3201271212180002 
50 M. NOVAL A L 1/15/2020 3201901501205365 
51 M. NUR ZAGAD L 4/6/2019 3201270604190004 
52 M.AZKA MAULANA L 3/12/2018 3201271203180001 
53 M.AZKA MUDZAKIR L 8/3/2018 3201270308180001 
54 M.BAHAR JAELANI L 12/28/2017 3201272812170003 
55 M.BAIHAQI KHAIZAN L 8/25/2020 32012725820820 
56 m.fadil saputra L 1/7/2018 3201270711800003 
57 m.fathan L 9/17/2019 3201271307196745 
58 M.FAUZAN.
M.GUNTUR ALIR L 6/23/2017 3201272306170002 
59 DANIAL L 5/17/2018 3201271705180002 
60 M.LATIFUL HABIR L 6/29/2018 320127290680005 
61 M.MUJIBATURIZKAH L 7/20/2018 3201272002180000 
62 m.saiyid P 12/29/2019 3201272912190078 
63 M.SIRAJ L 8/12/2018 3201271218189901 
64 MARWAH P 9/22/2020 32012722920920 
65 MOH. DZUL FADLI L 3/23/2019 3201272303190007 
66 MOH. FADIL.S L 1/7/2018 3201270701180003 
67 MOH. SYUHABUDIN L 12/13/2017 3201271312170004 
68 MUHAMAD AHLAN L 7/17/2019 3201271707190001 
69 muhamad faiz L 6/25/2019 3201272506191201 
70 MUHAMAD RAFA L 12/22/2018 3201272212180004 
71 MUHAMAD RIFKI L 2/21/2019 3201272104190001 
72 MUHAMAD SYAFKA L 9/26/2019 3201272609190001 
73 MUTIA AZZAHRA P 6/19/2017 3201275906170002 
74 NADIRA NUR M P 10/23/2018 3201276310180002 
75 NAYYA FATHI. Y P 10/20/2018 3201276010180001 
NAZLA HABIBATU
76 NISHA P 11/9/2018 3201270911180000 
77 neng yusriah P 1/26/2018 3201276601180004 
78 NUR AFIA MELANI P 7/23/2019 3201276307190001 
79 NURPAIJAH P 10/26/2020 3201272610201020 
80 NURUL TAPRIJIYYAH P 2/23/2018 3201276302180001 
81 PELANGI P 4/4/2020 320127740420420 
82 PUTRI AGUSTIN P 8/24/2018 3201276408180001 
83 PUTRI SAKIRA P 3/9/2021 3201274903210002 
84 RAFFAN AKHARI. F L 9/9/2020 3201270905200002 
85 RANIA P 7/13/2019 3201276208190087 
86 RANIA NUR AULIA P 7/6/2017 3201274607170003 
87 RAYIANSYAH L 6/15/2019 3201271506190006 
88 SALWA ALIYA R P 6/17/2020 3201271706200002 
89 SAPA P 9/22/2020 320137022920920 
SHABIRRA ADZKIA
90 LATISHA P 6/5/2021 320127350621621 
91 SHANUM P 11/13/2019 320127331191119 
92 siti agisna P 1/14/2018 3201275401180002 
93 SITI HUSNAENI P 8/2/2017 3201274208179900 
94 SITI KHOERUNNISA P 5/6/2020 3201275605200520 
95 SITI ZULPA P 8/13/2017 3201275308160004 
96 SRI SILLA HARYANTO P 6/12/2019 3201274302190002 
97 st.maulida P 11/22/2017 3201276211170003 
SYAFIRA NURUL
98 HUSNA P 8/12/2020 3201275208200001 
99 TSURAYA. F P 11/11/2018 3201905111184558 
100 ZENIA ASSYIFA MECCA P 1/1/2020 3201274101200007 
101 ZULFIKAR L 6/15/2018 3201275506180618 
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 6

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

LINA kp. Ciherang Satim 0 2 1 3

titin kp. Ciherang Satim 0 3 0 3
NURJANAH kp. Ciherang Satim 0 3 1 3
DEDEN S kp. Ciherang Satim 0 3 1 3
dewi.w kp. Ciherang Satim 0 3 1 3
ira kp. Ciherang Satim 0 3 1 3
iin kp. Ciherang Satim 0 3 1 3
JAJAT/DEVI kp. Ciherang Satim 0 3 1 3
TIA kp. Ciherang Satim 0 3 1 3
LUMAN / IIS kp. Ciherang Satim 0 3 1 3
SANTI kp. Ciherang Satim 0 3 1 3
parid kp. Ciherang Satim 0 3 1 3
PARIDUDIN / MAYA SARI kp. Ciherang Satim 0 3 1 3
KHODIJAH kp. Ciherang Satim 0 3 1 3
asep kp. Ciherang Satim 0 3 1 3
Asep / diana kp. Ciherang Satim 0 3 1 3
DIANA AGUSTINA kp. Ciherang Satim 0 3 1 3
hendar kp. Ciherang Satim 0 3 1 3
ALI / ANI kp. Ciherang Satim 0 3 1 3
DEDE.S / FITRI OKTARA kp. Ciherang Satim 0 3 1 3
DENI/ FITRI kp. Ciherang Satim 0 3 1 3
ibnu/linda kp. Ciherang Satim 0 3 1 3
BARYATI kp. Ciherang Satim 0 3 1 3
HERMAN/EUIS
DARUTTAHSIN / NURUL kp. Ciherang Satim 0 3 1 3
ULFAH kp. Ciherang Satim 0 3 1 3
SOPARUDIN / INEU kp. Ciherang Satim 0 3 1 3
SUGANDI / ITA ROSITA kp. Ciherang Satim 0 3 1 3
M. MUSLIH / EUIS kp. Ciherang Satim 0 3 1 3
saepul kp. Ciherang Satim 0 3 1 3
JUNAEDI / NURHAYATI kp. Ciherang Satim 0 3 1 3
DEDE HASANAH kp. Ciherang Satim 0 3 1 3
LUKMAN / NANAH kp. Ciherang Satim 0 3 1 3
KHORUDIN / TINI kp. Ciherang Satim 0 3 1 3
dumyati/iis kp. Ciherang Satim 0 3 1 3
SURYADI / EHA kp. Ciherang Satim 0 3 1 3
DEDE F / SITI.F kp. Ciherang Satim 0 3 1 3
ADBULLOH / MARYANAH kp. Ciherang Satim 0 3 1 3
IMAN / YULIA kp. Ciherang Satim 0 3 1 3
RAHMAT / IMAS kp. Ciherang Satim 0 3 1 3
RUBI / IRA kp. Ciherang Satim 0 3 1 3
Acep / nurjanah kp. Ciherang Satim 0 3 1 3
DEDE.R / IIS.S kp. Ciherang Satim 0 3 1 3
Leni aryani kp. Ciherang Satim 0 3 1 3
WILDAN / KHOERUNNISA kp. Ciherang Satim 0 3 1 3
ROBI / NENENG kp. Ciherang Satim 0 3 1 3
TRISNA / ERNAWATI kp. Ciherang Satim 0 3 1 3
SOBUR / SRI HANDAYANI kp. Ciherang Satim 0 3 1 3
IWAN / NENDEN kp. Ciherang Satim 0 3 1 3
ADE / IKAY kp. Ciherang Satim 0 3 1 3
NURJANAH kp. Ciherang Satim 0 3 1 3
NADIA WULANDARI kp. Ciherang Satim 0 3 1 3
AHMAD/PURNAMA kp. Ciherang Satim 0 3 1 3
HENDI / SITI TARWIYAH kp. Ciherang Satim 0 3 1 3
ADI / ULFAH kp. Ciherang Satim 0 3 1 3
Heriyanto / rani kp. Ciherang Satim 0 3 1 3
jumyadi/lia kp. Ciherang Satim 0 3 1 3
iwan/nendeun kp. Ciherang Satim 0 3 1 3
KOMARUDIN/RIKA kp. Ciherang Satim 0 3 1 3
USEP/LINDA kp. Ciherang Satim 0 3 1 3
MUHAMAD / JUJU kp. Ciherang Satim 0 3 1 3
IWAR/SITI NURSIMAH kp. Ciherang Satim 0 3 1 3
asep kp. Ciherang Satim 0 3 1 3
WAWANG/TIAH
DARUTTAHSIN / NURUL kp. Ciherang Satim 0 3 1 3
ULFAH kp. Ciherang Satim 0 3 1 3
PONO/TINI kp. Ciherang Satim 0 3 1 3
AJUM/LIA kp. Ciherang Satim 0 3 1 3
MARLINA kp. Ciherang Satim 0 3 1 3
AHMAD kp. Ciherang Satim 0 3 1 3
cepu/nenah kp. Ciherang Satim 0 3 1 3
KOHAR/NENAH kp. Ciherang Satim 0 3 1 3
SOLIHIN / AISAH kp. Ciherang Satim 0 3 1 3
BAITUL FAJAR / ZAHRA kp. Ciherang Satim 0 3 1 3
HENDRA/NENG kp. Ciherang Satim 0 3 1 3
IBNU / LINDA kp. Ciherang Satim 0 3 1 3
RADYANSYAH kp. Ciherang Satim 0 3 1 3
MAJID / MINTARSIH kp. Ciherang Satim 0 3 1 3
didah kp. Ciherang Satim 0 3 1 3
HERDI / ENUY kp. Ciherang Satim 0 3 1 3
HOLIK / NYAI.S kp. Ciherang Satim 0 3 1 3
SAEPULOH kp. Ciherang Satim 0 3 1 3
IWAN / ATUN kp. Ciherang Satim 0 3 1 3
KHODIJAH kp. Ciherang Satim 0 3 1 3
RAHMAT / ISUM kp. Ciherang Satim 0 3 1 3
JAMILAH kp. Ciherang Satim 0 3 1 3
FIRMAN/EMA kp. Ciherang Satim 0 3 1 3
ASEP/DIANA kp. Ciherang Satim 0 3 1 3
RUBI / IRA kp. Ciherang Satim 0 3 1 3
DANI / PITRI / NURUL
DARUTTAHSIN kp. Ciherang Satim 0 3 1 3
ULFAH kp. Ciherang Satim 0 3 1 3
DEDEN / HOLIPAH kp. Ciherang Satim 0 3 1 3
MAMAN / DEA kp. Ciherang Satim 0 3 1 3
ihwanudin kp. Ciherang Satim 0 3 1 3
CECEP / IPAH kp. Ciherang Satim 0 3 1 3
DEDI / YENI kp. Ciherang Satim 0 3 1 3
Pe'ih / eni kp. Ciherang Satim 0 3 1 3
SOBUR/IJAH kp. Ciherang Satim 0 3 1 3
surya kp. Ciherang Satim 0 3 1 3
NURAENI kp. Ciherang Satim 0 3 1 3
CUCU RUSMIATI kp. Ciherang Satim 0 3 1 3
ADE / SITI KHODIJAH kp. Ciherang Satim 0 3 1 3
PERI / SUSI kp. Ciherang Satim 0 3 1 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
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
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
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
0
0
0
0
0
0
0
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0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
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0
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0
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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
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

58 1 1 0 1 1
53 1 1 1 1 1
23 1 1 0 1 1
25 1 1 0 1 1
23 1 1 0 1 1
32 1 1 0 1 1
31 1 1 0 1 1
58 1 1 0 1 1
42 1 1 0 1 1
20 1 1 0 1 1
51 1 1 0 1 1
53 1 1 0 1 1
53 1 1 0 1 1
36 1 1 0 1 1
36 1 1 0 1 1
22 1 1 0 1 1
22 1 1 0 1 1
39 1 1 0 1 1
31 1 1 0 1 1
18 1 1 0 1 1
34 1 1 0 1 1
48 1 1 0 1 1
40 1 1 0 1 1
48 1 1 0 1 1
37 1 1 0 1 1
21 1 1 0 1 1
56 1 1 0 1 1
19 1 1 0 1 1
58 1 1 0 1 1
41 1 1 0 1 1
15 1 1 0 0 1
48 1 1 0 1 1
39 1 1 0 1 1
58 1 1 0 1 1
26 1 1 0 1 1
24 1 1 0 1 1
59 1 1 0 1 1
24 1 1 0 1 1
25 1 1 0 1 1
60 0 0 0 0 0
30 1 1 0 1 1
28 1 1 0 1 1
17 1 1 0 0 1
57 1 1 0 1 1
31 1 1 0 1 1
43 1 1 0 1 1
55 1 1 0 1 1
36 1 1 0 1 1
43 1 1 0 1 1
30 1 1 0 1 1
39 1 1 0 1 1
52 1 1 0 1 1
47 1 1 0 1 1
55 1 1 0 1 1
23 1 1 0 1 1
54 1 1 0 1 1
34 1 1 0 1 1
61 0 0 0 0 0
50 1 1 0 1 1
49 1 1 0 1 1
48 1 1 0 1 1
31 1 1 0 1 1
47 1 1 0 1 1
22 1 1 0 1 1
40 1 1 0 1 1
54 1 1 0 1 1
55 1 1 0 1 1
36 1 1 0 1 1
37 1 1 0 1 1
43 1 1 0 1 1
41 1 1 0 1 1
34 1 1 0 1 1
61 0 0 0 0 0
45 1 1 0 1 1
45 1 1 0 1 1
44 1 1 0 1 1
54 1 1 0 1 1
36 1 1 0 1 1
21 1 1 0 1 1
53 1 1 0 1 1
27 1 1 0 1 1
47 1 1 0 1 1
16 1 1 0 0 1
22 1 1 0 1 1
36 1 1 0 1 1
60 0 0 0 0 0
37 1 1 0 1 1
25 1 1 0 1 1
22 1 1 0 1 1
13 1 1 0 0 1
32 1 1 0 1 1
54 1 1 0 1 1
59 1 1 0 1 1
26 1 1 0 1 1
59 1 1 0 1 1
37 1 1 0 1 1
56 1 1 0 1 1
23 1 1 0 1 1
44 1 1 0 1 1
31 1 1 0 1 1
49 1 1 0 1 1
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

97 97 1 93 97

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

2 0 1 1 0 1 1
1 1 1 1 1 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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
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0 0 0 0 0 0 0
98 1 93 97 1 93 97

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 13 1 24 13

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

2 1
3 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
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2 1
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2 1
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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
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0 0
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0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
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0 0
0 0
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0 0
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0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
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0 0
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0 0
0 0
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0 0
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0 0
0 0
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0 0
0 0
0 0
0 0
0 0
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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
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191 97 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 AHTAR L 12/31/2020 3201903112209316 

2 ALEA P 9/2/2020 3201295800980006 
3 AMELIA P 7/30/2019 3201275007190719 
4 ARFI RAFASYA P L 4/20/2021 3201272004210004 
5 ARSYA PUTRA R L 5/6/2019 3201270605190002 
6 ASTRYA FIONA P 10/3/2017 3201274310170002 
7 DAMAR L 4/10/2020 3201271004200004 
8 DEA P 5/21/2021 3201906105213142 
9 DIANA SAIRA P 6/22/2020 3201906206202999 
10 GHIFARI L 8/15/2018 3201901508184814 
11 GRAFINA MAULIDINA P 12/14/2017 3201275412170004 
12 KAILA AZZAHRA P 4/28/2018 3201276804180001 
13 KAMILA P 7/19/2020 3201905907205646 
14 KAYLA P P 4/4/2019 3201274404190002 
15 M ATANG KURNIA L 2/8/2018 3201270802180002 
16 M FAHMI L 11/16/2017 3201271611171117 
17 M GHAFA AL JUANDA L 12/17/2019 3201271712190004 
18 M RAFA AZKA S L 7/5/2017 3201276507170717 
19 M. ALANG KURNIA L 2/8/2018 3200127080218000 
20 M. AZLAN S L 12/28/2020 3201902812202151 
21 M. FAIS L 1/17/2021 3201901701214861 
22 M. MALIK SALIM L 3/4/2021 3201900403215636 
23 M. MAULANA I L 8/27/2018 3201272708180006 
24 M. RAZKA P L 11/20/2020 3201271011200001 
25 M. REHAN FIRDAUS L 12/14/2019 3201271412190003 
26 M. SYAFIK L 12/28/2020 3201272812200001 
27 M. THARIQ JAMEEL L 3/22/2018 3201902203184064 
28 M.PAIS L 1/7/2021 3201900701216576 
29 M.TOPAN A.R L 1/17/2018 3201901701183374 
30 MALIK L 2/13/2019 3201271302190219 
31 MUHAMAD FAISAL L 1/21/2019 3201902101196361 
32 MUHAMAD
MUHAMMAD FAIZUL A. L 3/26/2020 3201272603200320 
33 AGASTYA
MUHAMMAD M AL L 8/8/2017 32012688817817 
34 ZAIDAN
MUHAMMAD L 7/13/2017 3201271307170009 
35 MARWAN L 8/31/2018 32012731818818 
36 MUHAMMAD SAM L 8/5/2020 3201275410940008 
37 MUSA L 8/28/2017 3201272808170001 
38 NADIRA NUR F P 12/17/2017 3201275712170001 
39 NAJMI L 7/24/2019 3201902407199652 
40 NINDIA P 7/20/2020 3201906007208669 
41 NUR ALFIAH HASNA P 7/16/2018 3201275607180005 
42 NURFITRI Z P 6/16/2018 3201275606180002 
43 OKTAVIANI
PIQIH MAJAM.P P 10/18/2019 3202085810190003 
44 YATUSALIMAH P 1/19/2020 3201275901200120 
45 PUTRI ZELITA P 7/23/2017 3201276307170004 
46 RATU ARSYILA P P 8/19/2017 3201275908170002 
47 RAYSA SALMA AZIZAH P 12/2/2018 3201274212180002 
48 RENDI L 5/5/2019 3201900505195723 
49 RIEKI SAFIAN A L 4/5/2019 3201270503190002 
50 ROSITA AQUINA P 7/21/2017 3201906107172969 
51 SAFIKA LALEGIT P 9/5/2019 3201274212060002 
52 SITI FATMAWATI P 9/26/2018 3201276609180002 
53 SITI NAIRA IBNATI P 8/1/2020 3201274108200003 
54 SITI NURIYATUL P 2/16/2020 3201275602200005 
55 SITI RAHMA P 9/21/2020 3201276008870005 
56 SITI RANIA ASYAHLA P 5/28/2020 3201276805200001 
57 SITI RESTIA PUTRI P 10/9/2019 3201274910190001 
58 SITI RIDA.A P 10/1/2020 3201275110020002 
59 SYABINA F P 10/9/2019 3201274910190002 
60 SYAHIRA NURUL H P 11/8/2019 3201274811190005 
61 SYAVIKA KARTINA L P 9/5/2018 3201274509180006 
62 TIARA.A P 10/24/2020 3201906410203600 
63
64
65
66
67
68
69
70
71
72
73
74
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160
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439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 7

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

nurdin/erna KP. PASIR TENGAH 0 1 1 0

BELA/RONI KP. PASIR TENGAH 0 2 1 2
WAWAN/POPOT KP. PASIR TENGAH 0 1 0 3
MITUN/HENI KP. PASIR TENGAH 0 2 2 2
asep ridwan/ ervina KP. PASIR TENGAH 0 2 1 4
indra KP. PASIR TENGAH 0 2 1 2
DADAN / SAROH KP. PASIR TENGAH 0 3 1 3
nurhasanah KP. PASIR TENGAH 0 2 1 3
SUPENDI/NUR KP. PASIR TENGAH 0 3 1 3
vanessa sri j KP. PASIR TENGAH 0 3 1 3
Dina KP. PASIR TENGAH 0 3 1 3
AEP SAEPUDIN KP. PASIR TENGAH 0 3 1 3
fauzan/halimah KP. PASIR TENGAH 0 3 1 3
kusnaedi KP. PASIR TENGAH 0 3 1 3
Asep kurniawan KP. PASIR TENGAH 0 3 1 3
Bubun b KP. PASIR TENGAH 0 3 1 3
ANDRI JUANDA KP. PASIR TENGAH 0 3 1 3
Aceng s KP. PASIR TENGAH 0 3 1 3
ASEP/NIRA KP. PASIR TENGAH 0 3 1 3
idrus suhendi KP. PASIR TENGAH 0 3 1 3
agus/yati KP. PASIR TENGAH 0 3 1 3
AGUS/HENI KP. PASIR TENGAH 0 3 1 3
ade KP. PASIR TENGAH 0 3 1 3
ujang/cucu KP. PASIR TENGAH 0 3 1 3
SIBRU MALISI KP. PASIR TENGAH 0 3 1 3
samsul/yanti KP. PASIR TENGAH 0 3 1 3
indrawan awaludin KP. PASIR TENGAH 0 3 1 3
AGus/yati KP. PASIR TENGAH 0 3 1 3
SAMSUDIN / ROSITA KP. PASIR TENGAH 0 3 1 3
ADIP/ TRIYULIANI KP. PASIR TENGAH 0 3 1 3
hendra/febi KP. PASIR TENGAH 0 3 1 3
OYOK/EVA KP. PASIR TENGAH 0 3 1 3
Acep suryadi KP. PASIR TENGAH 0 3 1 3
Acep sopian KP. PASIR TENGAH 0 3 1 3
Nurdin KP. PASIR TENGAH 0 3 1 3
Asep kurniawan KP. PASIR TENGAH 0 3 1 3
dadan KP. PASIR TENGAH 0 3 1 3
Ujang nurdin KP. PASIR TENGAH 0 3 1 3
rosita KP. PASIR TENGAH 0 3 1 3
NURDIN KP. PASIR TENGAH 0 3 1 3
AAB/LIMARASARI KP. PASIR TENGAH 0 3 1 3
DEDE/IMAS KP. PASIR TENGAH 0 3 1 3
ALDI FAHRI KP. PASIR TENGAH 0 3 1 3
MASRUKHIN/YAYAH KP. PASIR TENGAH 0 3 1 3
Ipah latifah KP. PASIR TENGAH 0 3 1 3
Yani andriani KP. PASIR TENGAH 0 3 1 3
MANAP/MAESAROH KP. PASIR TENGAH 0 3 1 3
DENDI / IMAS KP. PASIR TENGAH 0 3 1 3
ASEP/DENTI KP. PASIR TENGAH 0 3 1 3
siska KP. PASIR TENGAH 0 3 1 3
Deni lalegit KP. PASIR TENGAH 0 3 1 3
HERIYANTO/ROBI KP. PASIR TENGAH 0 3 1 3
AHYADI / SULASTRI KP. PASIR TENGAH 0 3 1 3
YUDI SETIAWAN KP. PASIR TENGAH 0 3 1 3
MISBAH/INA KP. PASIR TENGAH 0 3 1 3
samsudin KP. PASIR TENGAH 0 3 1 3
UJANG/SUSILAWATI KP. PASIR TENGAH 0 3 1 3
DODO/YANTI KP. PASIR TENGAH 0 3 1 3
AAN/ FAUZIAH KP. PASIR TENGAH 0 3 1 3
Resti / husen KP. PASIR TENGAH 0 3 1 3
DENI LALEGIT KP. PASIR TENGAH 0 3 1 3
SAEPUL/ROSIDAH KP. PASIR TENGAH 0 3 1 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
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
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
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
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
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
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
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
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
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

19 1 1 0 1 1
22 1 1 0 1 1
36 1 1 1 1 1
15 1 0 0 1 1
38 1 1 0 0 1
57 1 1 0 1 1
27 1 1 0 1 1
14 1 1 0 0 1
25 1 1 0 1 1
47 1 1 0 1 1
55 1 1 0 1 1
51 1 1 0 1 1
24 1 1 0 1 1
39 1 1 0 1 1
53 1 1 0 1 1
56 1 1 0 1 1
31 1 1 0 1 1
60 0 0 0 0 0
53 1 1 0 1 1
19 1 1 0 1 1
18 1 1 0 1 1
16 1 1 0 0 1
47 1 1 0 1 1
20 1 1 0 1 1
31 1 1 0 1 1
19 1 1 0 1 1
52 1 1 0 1 1
18 1 1 0 1 1
54 1 1 0 1 1
41 1 1 0 1 1
42 1 1 0 1 1
28 1 1 0 1 1
59 1 1 0 1 1
60 0 0 0 0 0
47 1 1 0 1 1
23 1 1 0 1 1
59 1 1 0 1 1
55 1 1 0 1 1
36 1 1 0 1 1
24 1 1 0 1 1
48 1 1 0 1 1
49 1 1 0 1 1
33 1 1 0 1 1
30 1 1 0 1 1
60 0 0 0 0 0
59 1 1 0 1 1
43 1 1 0 1 1
38 1 1 0 1 1
39 1 1 0 1 1
60 0 0 0 0 0
34 1 1 0 1 1
46 1 1 0 1 1
24 1 1 0 1 1
29 1 1 0 1 1
22 1 1 0 1 1
26 1 1 0 1 1
33 1 1 0 1 1
22 1 1 0 1 1
33 1 1 0 1 1
32 1 1 0 1 1
46 1 1 0 1 1
21 1 1 0 1 1
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

58 57 1 55 58

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

3 0 4 1 0 1 1
2 0 2 1 0 1 1
3 1 1 1 1 1 1
0 0 1 0 0 1 1
2 0 0 1 0 0 1
2 0 2 1 0 1 1
1 0 1 1 0 1 1
2 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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
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0 0 0 0 0 0 0
65 1 60 57 1 55 58

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 8 1 14 8

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

2 1
2 1
3 1
2 1
1 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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0 0
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0 0
0 0
0 0
0 0
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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
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0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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0 0
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0 0
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0 0
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0 0
0 0
0 0
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0 0
0 0
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0 0
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0 0
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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
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
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
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
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
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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
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
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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
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
114 58 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten BOGOR Posyandu
Puskesmas CIDERUM
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 ABDUL AZIZ L 6/6/2021 3201900606211073 

2 ABDUL MUNIT L 11/16/2020 3201901611204817 
3 AHMAD AZIN L 3/13/2021 3201901303218843 
4 AHMAD AZZAM. N L 12/27/2017 3201902712175647 
5 AHMAD BAGIR. A L 10/15/2020 3201271510200004 
6 AHMAD JUMADI L 12/15/2017 3201271512170002 
7 AHMAD RODIYUDIN L 2/7/2019 3201270702190001 
8 AHMAD ZARRUQ. A L 11/24/2019 3201272411190001 
9 AL HASNAN EYZZAS.A L 12/6/2020 3201270612200004 
10 ALMEERA SYAFITUN. N P 9/20/2018 3201276009180004 
11 ALNI NURPNIYAH P 7/31/2020 3201907107201053 
12 ALPIANSAH L 5/25/2019 3201272505190003 
13 ALWIE L 3/20/2018 3201272003180002 
14 AMARA NAVISHA. M P 4/28/2019 3201276804190001 
15 ANANDA ASKA H L 12/16/2018 3201275612180001 
16 AQILA NATALIA P 1/8/2018 3201274801180004 
17 AQILLA NOVARIZA PUTRI P 11/19/2019 3201275911190005 
18 ARFA FIRMANSYAH L 8/31/2017 3201273108170002 
19 ARVINO NAZRIL R L 6/11/2018 3201275106180004 
ASHIFA SAIDATUNA
20 FATIMAH P 5/8/2020 3201274805200005 
21 DEVITA MAULIDA. S P 12/22/2018 320127601190005 
22 FATIMAH P 2/2/2018 3201904202181466 
23 FAUZI RAHARDIAN. P L 6/16/2017 3201270606170006 
24 GAPI L 4/16/2019 3201271604190419 
25 HADI L 12/16/2019 3201271612191219 
26 HAMIDAN SANIYYAH P 12/24/2018 320127412180002 
27 HUMAIRA ASIFA. N P 5/1/2021 3201904105214706 
28 ISNAYAH P 1/21/2021 3201906101212729 
29 KINAN NURSABILA P 6/25/2019 3201276506190002 
30 M. ALDIANSYAH L 3/10/2020 3201271003200005 
31 M. AMMAR FIRDAUS L 6/2/2019 3201270208190004 
32 M. ARIANSYAH L 6/6/2021 3201900606218031 
33 M. BIMA SAPUTRA L 1/14/2021 3201271401210004 
34 M. FATIH HURROJIK L 7/20/2018 3201902007184054 
35 M. IRZA IRLIANSYAH L 5/4/2018 3201270405180004 
36 M. JAFAR SHODIQ L 3/16/2021 3201901603213446 
37 M. PAUJAN SYAFRI L 9/29/2017 3201272109190004 
38 M. RAFA SYAPUTRA L 8/12/2018 3201271208180005 
39 M. SALMA MUBAROK L 3/20/2018 3201902003182120 
40 M. ZAKIR MAULIDI L 10/29/2020 3201902910208809 
41 M. ZILDAN ALFIANSYAH L 12/12/2019 3201271212190005 
42 MADTEO AL HAIDAR L 11/21/2019 3201272111190003 
43 MUHAMAD AGUS S L 8/6/2018 3201270608180004 
44 MUHAMAD AL FAZRI L 12/17/2018 3201271712180002 
45 MUHAMAD AL-HASBI L 3/27/2021 3201902703217952 
46 MUHAMAD ALBAKTI. R L 5/16/2018 3201271605180003 
47 MUHAMAD AZAM. A L 3/25/2018 3201272503180001 
48 MUHAMAD BASIR L 2/20/2018 3201272002180003 
49 MUHAMAD GIBRAN. F L 4/10/2019 3201901004191476 
50 MUHAMAD HAPIJUL L 5/23/2019 3201902305195756 
51 MUHAMAD KENLI. F L 2/16/2019 3201271602190003 
52 MUHAMAD MIZWAR L 12/7/2017 3210270712170005 
53 MUHAMAD NAUVAL L 11/24/2020 320127241120003 
54 MUHAMAD PAHMI L 7/26/2018 3201902607181904 
55 MUHAMAD PAHMIF L 7/10/2019 3201271007190006 
56 MUHAMAD PAISAL L 5/23/2018 3201272305180002 
57 MUHAMAD PAJRI L 6/11/2019 3201271106190003 
58 MUHAMAD RAFA ISMAIL L 12/21/2019 3201272112190003 
59 MUHAMAD RAMADHAN L 4/26/2020 3201272604200002 
60 MUHAMAD RASID. A L 12/22/2019 3201272212190003 
61 MUHAMAD RIVAI L 9/27/2017 3201902709174050 
62 MUHAMAD RIZKI L 8/1/2017 3201272708180005 
63 MUHAMAD RIZZKI. H L 6/17/2019 3201271706190002 
64 MUHAMAD SYAPUTRA L 12/16/2018 3201271612180008 
65 MUHAMAD WILDAN. S L 10/25/2017 320127251017000 
66 MUHAMAD YAHYA. R L 5/24/2019 3201272405190006 
67 NABILA NUR AZAHRA P 3/27/2019 3201906703197534 
68 NADIA AGUSTIN P 8/9/2017 3201274908170005 
69 NADIRA JASMIN P 7/23/2019 3201276307190006 
NADZVIELA SHAVA
70 QINANTI P 12/22/2017 3201276212170005 
71 NAFISA AULIA Z P 8/19/2018 3201275908180003 
72 NAGITA P 10/1/2018 3201274110180001 
73 NAILA P 3/20/2020 320127220320320 
74 NAISA ZAHRA P 11/23/2018 3201276311180001 
75 NAJWA KAIRANI P 11/24/2020 3201906411202790 
76 NASYA APRILIA P 8/5/2018 3201274504180002 
NAYLA AZKADINA AL
77 FATUNISA P 3/20/2020 3201276003200002 
78 NAYRA RAMADANI P 6/15/2017 3201275506170001 
79 NAZRIL AZHARI L 6/5/2019 3201270506190003 
80 NUR KHALISA P 11/2/2018 3201274211180001 
81 NURALPIA P 5/1/2019 3201274105190004 
82 PAHMI ARDIANSYAH L 2/21/2019 3201272102190003 
83 PATIMAH P 3/13/2018 3201274303180318 
84 PAUJI L 6/16/2018 3201271606180618 
85 PUTRA L 12/16/2018 3201271612181218 
86 RAISYHA NURUL. M P 6/12/2017 3201275206170005 
87 RAMA L 7/10/2018 3201271007180718 
88 REPAN L 11/9/2018 3201270911160001 
89 RESTU ANANDA L 2/25/2018 3201272502180001 
90 RESYA MURSYAFARIDA P 12/29/2017 3201276912170006 
91 RIJWAN L 8/7/2018 3201270708160002 
92 RISHA QAIREEN ANSAR P 2/20/2018 3201906002187662 
93 SAFIRA MADINAH P 9/29/2018 3201276909180003 
94 SALMA ASSEGGAF P 12/28/2018 3201276812180003 
95 SALMAN L 7/31/2020 3201273177207720 
96 SALWA JULIANTI P 7/1/2020 3201278109200920 
97 SEPTI M P 9/16/2019 3201277609160916 
98 SHAKFA OKTAV P 10/17/2017 3201275710170003 
99 SIRIN NUR ASYIFA P 12/12/2018 3201275212180005 
100 SITI AISYAH P 3/8/2019 3201274803190003 
101 SITI ANDINI P 3/2/2019 3201274203190004 
102 SITI AYU NUR ADINDA P 10/5/2017 3201904510174488 
103 SITI AZKIANA P 3/21/2018 3201276103180004 
104 SITI HILYATUL A P 7/17/2019 3201275507190007 
105 SITI INDIYANI P 3/2/2019 3201274203190003 
106 SITI JULPA MAULIDA P 10/29/2020 3201906910203478 
107 SITI KAILA KARTIKA.P P 1/6/2021 3201904601215064 
108 SITI MARSITOH P 10/29/2018 3201276910180003 
109 SITI MASITOH P 9/28/2019 3201906809193278 
110 SITI MAULIDAH P 11/4/2020 3201904411209558 
111 SITI NADIA.P P 10/26/2019 3201906610192934 
112 SITI NAURA P 12/9/2018 3201274902180002 
113 SITI NURAENI P 11/23/2018 3201276311181118 
114 SITI NURSAKINAH P 12/31/2019 3201277012190006 
115 SITI SYADIAH P 4/2/2020 3201274204200001 
116 SOPIA P 12/12/2018 3201275212181218 
117 SYARIFAH FATIMATUH. Z P 6/5/2021 3201274506210002 
118 TIARA APRILIANI P 4/26/2019 3201276604190004 
119 ZAKIRA P 1/26/2019 3201276601190003 
120
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500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
PANCAWATI
NIRWANA 8

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

EYEN KP. PASIR TENGAH 0 2 1 2

NInin nariah KP. PASIR TENGAH 0 3 1 3
TITI KP. PASIR TENGAH 0 2 1 2
ELIM KP. PASIR TENGAH 0 3 1 3
YUni KP. PASIR TENGAH 0 3 1 3
SITI NURJANAH KP. PASIR TENGAH 0 3 1 3
SITI HOLISOH KP. PASIR TENGAH 0 3 1 3
SITI KURNIAWATI KP. PASIR TENGAH 0 3 1 3
LILIS ATIKAH KP. PASIR TENGAH 0 3 1 3
LILIS ATIKAH KP. PASIR TENGAH 0 3 1 3
AISYAH KP. PASIR TENGAH 0 3 1 3
SAEPULOH/ICOH KP. PASIR TENGAH 0 3 1 3
HABIB/IPAH KP. PASIR TENGAH 0 3 1 3
SITI NURAEMI KP. PASIR TENGAH 0 3 1 3
AYAT/UTI SUMIATI KP. PASIR TENGAH 0 3 1 3
M.KUSNAEDI/ELSA LESTARI KP. PASIR TENGAH 0 3 1 3
WINNA FEBRI.Y.W KP. PASIR TENGAH 0 3 1 3
TARI SUTARI KP. PASIR TENGAH 0 3 1 3
NASRULLAH/HARIYANI KP. PASIR TENGAH 0 3 1 3
MEROH KP. PASIR TENGAH 0 3 1 3
NIna maryati KP. PASIR TENGAH 0 3 1 3
ROSIDAH KP. PASIR TENGAH 0 3 1 3
SITI NURHASANAH KP. PASIR TENGAH 0 3 1 3
YADI/HERNI KP. PASIR TENGAH 0 3 1 3
DEDE/HALIMAH KP. PASIR TENGAH 0 3 1 3
SITI JULAEHA KP. PASIR TENGAH 0 3 1 3
NIta sumiati KP. PASIR TENGAH 0 3 1 3
DEDE NURJANAH KP. PASIR TENGAH 0 3 1 3
WAHYU/KHOERUNNISA KP. PASIR TENGAH 0 3 1 3
AI SUTINI KP. PASIR TENGAH 0 3 1 3
SITI NURHALIMAH KP. PASIR TENGAH 0 3 1 3
SITI NUR YANTI KP. PASIR TENGAH 0 3 1 3
IKU / HENI KP. PASIR TENGAH 0 3 1 3
YUliana KP. PASIR TENGAH 0 3 1 3
YUlianti KP. PASIR TENGAH 0 3 1 3
INtan permata sari KP. PASIR TENGAH 0 3 1 3
SITI NURLELAH KP. PASIR TENGAH 0 3 1 3
RAUJAN/TITIN KP. PASIR TENGAH 0 3 1 3
TUTI ASTUTI KP. PASIR TENGAH 0 3 1 3
IRMA ROHIMAH KP. PASIR TENGAH 0 3 1 3
SAiti nurhasanah KP. PASIR TENGAH 0 3 1 3
YUYUN KP. PASIR TENGAH 0 3 1 3
SAEPULOH/ICOH KP. PASIR TENGAH 0 3 1 3
JUJUN/YANTI KP. PASIR TENGAH 0 3 1 3
IPI RATNASARI KP. PASIR TENGAH 0 3 1 3
MUMUH / IDOH KP. PASIR TENGAH 0 3 1 3
M. RAHMANIA/SITI HOLISOH KP. PASIR TENGAH 0 3 1 3
SULAEMAN/SITI SOPIAH KP. PASIR TENGAH 0 3 1 3
SITI SELPIA KP. PASIR TENGAH 0 3 1 3
ELIS MURIAH KP. PASIR TENGAH 0 3 1 3
UPAH / TITIN KP. PASIR TENGAH 0 3 1 3
RISKA KP. PASIR TENGAH 0 3 1 3
YAYAH KP. PASIR TENGAH 0 3 1 3
NAWIYAH KP. PASIR TENGAH 0 3 1 3
NENAH KP. PASIR TENGAH 0 3 1 3
AJUT/FITRIAWATI KP. PASIR TENGAH 0 3 1 3
SITI AISYAH KP. PASIR TENGAH 0 3 1 3
NIA ROBIATI KP. PASIR TENGAH 0 3 1 3
ENAH KP. PASIR TENGAH 0 3 1 3
ROHYATI KP. PASIR TENGAH 0 3 1 3
UUM KP. PASIR TENGAH 0 3 1 3
NANI KP. PASIR TENGAH 0 3 1 3
UJAN/AROH KP. PASIR TENGAH 0 3 1 3
SITI SUTINAH KP. PASIR TENGAH 0 3 1 3
YENI KP. PASIR TENGAH 0 3 1 3
AI YULIANI KP. PASIR TENGAH 0 3 1 3
N. SITI MAESAROH KP. PASIR TENGAH 0 3 1 3
KHAIRUDIN/ESIN.Y KP. PASIR TENGAH 0 3 1 3
SITI NURJANAH KP. PASIR TENGAH 0 3 1 3
WINNA FEBRI.Y.W KP. PASIR TENGAH 0 3 1 3
ASEP SUHANDA/ANISA KP. PASIR TENGAH 0 3 1 3
AAS/AISYAH KP. PASIR TENGAH 0 3 1 3
Pepen / hana KP. PASIR TENGAH 0 3 1 3
YANI HANDAYANI KP. PASIR TENGAH 0 3 1 3
HOLISOH KP. PASIR TENGAH 0 3 1 3
NUNUNG/ADE KP. PASIR TENGAH 0 3 1 3
HANA KP. PASIR TENGAH 0 3 1 3
NURSIH KP. PASIR TENGAH 0 3 1 3
IWAN HANAPI/TINI KP. PASIR TENGAH 0 3 1 3
SITI MARPUAH KP. PASIR TENGAH 0 3 1 3
DIAN / ASIH KP. PASIR TENGAH 0 3 1 3
ELAH KP. PASIR TENGAH 0 3 1 3
AYUB/ROSIDAH KP. PASIR TENGAH 0 3 1 3
HENDI/NUR KP. PASIR TENGAH 0 3 1 3
TAJUDIN/UTIN KP. PASIR TENGAH 0 3 1 3
NUNU/IRNA KP. PASIR TENGAH 0 3 1 3
BULUK/ROSIDAH KP. PASIR TENGAH 0 3 1 3
YADI/HERNI KP. PASIR TENGAH 0 3 1 3
ISTIKHAROH KP. PASIR TENGAH 0 3 1 3
ENENG RIANTI KP. PASIR TENGAH 0 3 1 3
Jajat / leni KP. PASIR TENGAH 0 3 1 3
NENG RIANTI KP. PASIR TENGAH 0 3 1 3
AJWAR / SITI MASITOH KP. PASIR TENGAH 0 3 1 3
SITI FATIMAH KP. PASIR TENGAH 0 3 1 3
Gojali / tuti KP. PASIR TENGAH 0 3 1 3
UCI / NANI KP. PASIR TENGAH 0 3 1 3
Goni / via KP. PASIR TENGAH 0 3 1 3
NENENG.R KP. PASIR TENGAH 0 3 1 3
BADRUDIN/RUKHIYATUN KP. PASIR TENGAH 0 3 1 3
ETI MARWATI KP. PASIR TENGAH 0 3 1 3
LINA KP. PASIR TENGAH 0 3 1 3
EUIS KP. PASIR TENGAH 0 3 1 3
NURAENI KP. PASIR TENGAH 0 3 1 3
HAMBALI / SITI HOLIDAH KP. PASIR TENGAH 0 3 1 3
LINA KP. PASIR TENGAH 0 3 1 3
IRMA ROHIMAH KP. PASIR TENGAH 0 3 1 3
YENI KP. PASIR TENGAH 0 3 1 3
NURHAYATI KP. PASIR TENGAH 0 3 1 3
ENI KP. PASIR TENGAH 0 3 1 3
WAWAN WIDA.S KP. PASIR TENGAH 0 3 1 3
SITI JULAEHA KP. PASIR TENGAH 0 3 1 3
EMA RUSNIAWATI KP. PASIR TENGAH 0 3 1 3
SULAEMAN/SITI SOPIAH KP. PASIR TENGAH 0 3 1 3
ELAH KP. PASIR TENGAH 0 3 1 3
SITI AISYAH KP. PASIR TENGAH 0 3 1 3
JAMAL/YEYEN KP. PASIR TENGAH 0 3 1 3
IPAH ZAENAB KP. PASIR TENGAH 0 3 1 3
DADANG/YUYUN KP. PASIR TENGAH 0 3 1 3
RIDWAN/RINI KP. PASIR TENGAH 0 3 1 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
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
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
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
0
0
0
0
0
0
0
0
0
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0
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0
0
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0
0
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0
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0
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0
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0
0
0
0
0
0
0
0
0
0
0
0
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0
0
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0
0
0
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0
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0
0
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0
0
0
0
0
0
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0
0
0
0
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0
0
0
0
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0
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0
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0
0
0
0
0
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0
0
0
0
0
0
0
0
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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
0
0
0
0
0

0
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

13 1 1 0 1 1
20 1 1 0 1 1
16 1 1 0 1 1
55 1 1 0 1 1
21 1 1 0 1 1
55 1 1 0 1 1
41 1 1 0 1 1
32 1 1 0 1 1
19 1 1 0 1 1
46 1 1 0 1 1
24 1 1 0 1 1
38 1 1 0 1 1
52 1 1 0 1 1
39 1 1 0 1 1
43 1 1 0 1 1
54 1 1 0 1 1
32 1 1 0 1 1
59 1 1 0 1 1
49 1 1 0 1 1
26 1 1 0 1 1
43 1 1 0 1 1
53 1 1 0 1 1
61 0 0 0 0 0
39 1 1 0 1 1
31 1 1 0 1 1
43 1 1 0 1 1
15 1 1 0 0 1
18 1 1 0 1 1
37 1 1 0 1 1
28 1 1 0 1 1
37 1 1 0 1 1
13 1 1 0 0 1
18 1 1 0 1 1
48 1 1 0 1 1
50 1 1 0 1 1
16 1 1 0 0 1
58 1 1 0 1 1
47 1 1 0 1 1
52 1 1 0 1 1
21 1 1 0 1 1
31 1 1 0 1 1
32 1 1 0 1 1
47 1 1 0 1 1
43 1 1 0 1 1
16 1 1 0 0 1
50 1 1 0 1 1
52 1 1 0 1 1
53 1 1 0 1 1
39 1 1 0 1 1
38 1 1 0 1 1
41 1 1 0 1 1
55 1 1 0 1 1
20 1 1 0 1 1
48 1 1 0 1 1
36 1 1 0 1 1
50 1 1 0 1 1
37 1 1 0 1 1
31 1 1 0 1 1
27 1 1 0 1 1
31 1 1 0 1 1
58 1 1 0 1 1
60 0 0 0 0 0
37 1 1 0 1 1
43 1 1 0 1 1
57 1 1 0 1 1
38 1 1 0 1 1
40 1 1 0 1 1
59 1 1 0 1 1
36 1 1 0 1 1
55 1 1 0 1 1
47 1 1 0 1 1
46 1 1 0 1 1
28 1 1 0 1 1
44 1 1 0 1 1
20 1 1 0 1 1
47 1 1 0 1 1
28 1 1 0 1 1
61 0 0 0 0 0
37 1 1 0 1 1
44 1 1 0 1 1
39 1 1 0 1 1
41 1 1 0 1 1
52 1 1 0 1 1
49 1 1 0 1 1
43 1 1 0 1 1
61 0 0 0 0 0
48 1 1 0 1 1
44 1 1 0 1 1
53 1 1 0 1 1
55 1 1 0 1 1
47 1 1 0 1 1
53 1 1 0 1 1
46 1 1 0 1 1
43 1 1 0 1 1
24 1 1 0 1 1
25 1 1 0 1 1
34 1 1 0 1 1
57 1 1 0 1 1
43 1 1 0 1 1
40 1 1 0 1 1
40 1 1 0 1 1
57 1 1 0 1 1
52 1 1 0 1 1
36 1 1 0 1 1
40 1 1 0 1 1
21 1 1 0 1 1
18 1 1 0 1 1
45 1 1 0 1 1
34 1 1 0 1 1
20 1 1 0 1 1
33 1 1 0 1 1
43 1 1 0 1 1
44 1 1 0 1 1
31 1 1 0 1 1
27 1 1 0 1 1
43 1 1 0 1 1
13 1 1 0 0 1
39 1 1 0 1 1
42 1 1 0 1 1
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

115 115 0 110 115

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

2 0 1 1 0 1 1
1 0 1 1 0 1 1
2 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
1 0 0 1 0 0 1
1 0 1 1 0 1 1
1 0 1 1 0 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
117 0 110 115 0 110 115

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 15 0 28 15

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
0 0
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
1 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
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2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
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2 1
2 1
2 1
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2 1
2 1
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2 1
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2 1
2 1
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2 1
2 1
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2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
2 1
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2 1
2 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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
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0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
0 0
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0 0
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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
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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
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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0 0
0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
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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
0 0
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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
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
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
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
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
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
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
225 115 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
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unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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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 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 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 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 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 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 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
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 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 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 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
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0

1471 0 0 0 0 0
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1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
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1 1
1 1
2 1
3 1
0 0
0 0
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10 5 0 0 0
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CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
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0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
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74
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160
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177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0

1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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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
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
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
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
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
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
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
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
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
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
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
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
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
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
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1 1
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10 5 0 0 0
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CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
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454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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3 1 1 1 1 1 1
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0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
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1 1
1 1
2 1
3 1
0 0
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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
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
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
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
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
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
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0 0
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0 0
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0 0
0 0
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10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0

1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
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203
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246
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272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
& CR bulan Agustus Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
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3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
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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
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
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
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
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
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
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
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
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
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
10 5 0 0 0
0 0 0
& CR bulan Agustus Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
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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 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 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 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
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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 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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3 1 1 1 1 1 1
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0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
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1 1
1 1
2 1
3 1
0 0
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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
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
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
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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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 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 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 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 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
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 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
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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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 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
0 0
0 0
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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
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
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
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
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
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
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
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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
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0 0
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0 0
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0 0
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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
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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
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
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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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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
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
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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
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
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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
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14
15
16
17
18
19
20
21
22
23
24
25
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27
28
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30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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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
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
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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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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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 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 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 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 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 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 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
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 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 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
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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 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 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 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 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 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 0 0 0 0
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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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
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354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
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1471 0 0 0 0 0

1471 0 0 0 0 0
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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
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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
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
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
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
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
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
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
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
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Intan Bogor 1 1 1 0
0 0 0 0
1 0 3
1 2 2 2
1 3 4
1 3 1

2 1 3
2
unisasi tambahan Campak Rubela sejak Januari 2022

PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

64 0 0 0 0 0
8 0 0 0 0 0
19 1 1 1 1 1
19 0 0 0 1 1
19 1 0 0 0 0
19 1 0 0 1 1
19 1 1 1 1 1
8 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

0 0 0 0 0 0 0
0 0 0 0 0 0 0
3 1 1 1 1 1 1
0 0 2 0 0 1 0
0 0 0 0 0 0 1
0 0 3 0 0 1 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 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 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 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 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 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 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
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 0 0 0 0 0 0
7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0 0
0 0
0 0
0 0
10 5 0 0 0
0 0 0
CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022
Provinsi : Desa/Kelurahan
Kabupaten : kkkk Posyandu
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK

1 Aning P 10 Maret 2017 0

2 Aneka 21 November 2021
3 "23 dec 2020" 23 Desember 2020
4 "23-12-2020 23 Desember 2020
5 "23/12/2020. 23 Desember 2020
6 "2020/12/23 23 Desember 2020
7 "2020-12-23 23 Desember 2020
8 02 November 2021
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449

450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: Setia (Contoh)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

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PT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
n ORI Campak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

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4 2 2 4 4

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR

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7 2 10 2 2 4 4

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 1

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus 2022
Sasaran Apakah anak (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Suntikan Bulan sasaran BIAN
Agustus (Agustus)
OPV IPV DPT-HB-Hib

0 0
0 0
3 1
1 1
1 1
2 1
3 1
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10 5 0 0 0
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CR bulan Agustus 2022 Diisi pada saat pelayanan imunisasi Kejar & bulan September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib CR

0 0 0 0 0
0 0 0 0 0