LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : JANUARI 2022

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Asem Nonggal 34 37 71 52 64 116 5 14.706 5 13.514 10 14.08 9 17.31 9 14.06 18 15.52 2 3.846 0 0 2 1.724 0 0 0 0
3 Majangan 22 24 46 33 41 74 2 9.0909 1 4.1667 3 6.522 1 3.03 1 2.439 2 2.703 0 0 0 0 0 0 0 0
4 Kalangan Prao 49 54 103 75 93 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Asem Raja 57 63 120 87 108 195 1 1.7544 2 3.1746 3 2.5 1 1.149 1 0.926 2 1.026 0 0 0 0 0 0 0 0
6 Plakaran 63 70 133 97 120 217 0 0 11 15.714 11 8.271 0 0 13 10.83 13 5.991 0 0 0 0 0 0 0 0
7 Buker 150 167 317 231 286 517 2 1.3333 3 1.7964 5 1.577 1 0.433 2 0.699 3 0.58 0 0 0 0 0 0 0 0
8 Bancelok 114 127 241 175 217 392 3 2.6316 3 2.3622 6 2.49 2 1.143 2 0.922 4 1.02 0 0 0 0 0 0 0 0
9 Mlaka 103 115 218 159 196 355 2 1.9417 1 0.8696 3 1.376 1 0.629 1 0.51 2 0.563 0 0 0 0 0 0 0 0
10 Kotah 106 118 224 163 202 365 2 1.8868 2 1.6949 4 1.786 0 0 1 0.495 1 0.274 0 0 0 0 0 0 0 0
11 Jungkarang 92 103 195 142 176 318 3 3.2609 3 2.9126 6 3.077 2 1.408 2 1.136 4 1.258 0 0 0 0 0 0 0 0
12 Jrengik 89 102 191 137 169 306 4 4.4944 11 10.784 15 7.853 6 4.38 7 4.142 13 4.248 2 1.46 4 2.367 6 1.961 0 0 0 0
13 Taman 65 72 137 99 123 222 0 0 3 4.1667 3 2.19 1 1.01 0 0 1 0.45 1 1.01 0 0 1 0.45 0 0 0 0
14 Panyepen 59 67 126 96 115 211 9 15.254 15 22.388 24 19 4 4.167 1 0.87 5 2.37 0 0 0 0 0 0 0 0
JUMLAH ### ### ### ### ### ### 33 ### 60 Err:522 93 ### 28 ### 40 ### 68 ### 5 ### 4 ### 9 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : FEBRUARI 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 3 882% 7 ### 10 ### 3 577% 3 469% 6 517% 1 192% 4 625% 5 431% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 20 ### 8 ### 28 ### 3 909% 6 1463% 9 ### 1 303% 0 0% 1 135% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0 0% 5 926% 5 485% 1 133% 1 108% 2 119% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 1 175% 20 ### 21 ### 1 115% 6 556% 7 359% 0 0% 1 93% 1 51% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0 0% 6 857% 6 451% 1 103% 4 333% 5 230% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 3 200% 4 240% 7 221% 2 87% 3 105% 5 97% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 2 175% 15 ### 17 705% 2 114% 3 138% 5 128% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 1 97% 3 261% 4 183% 1 63% 2 102% 3 85% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 2 189% 3 254% 5 223% 1 61% 2 99% 3 82% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 3 326% 9 874% 12 615% 3 211% 5 284% 8 252% 0% 0% 0 0% 2 ### 5 ### 7 ###
12 Jrengik 89 102 191 137 169 306 7 787% 9 882% 16 838% 6 438% 7 414% 13 425% 3 219% 1 59% 4 131% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0 0% 3 417% 3 219% 0 0% 0 0% 0 0% 0% 0% 0 0% 3 ### 0 0.0% 3 ###
14 Panyepen 59 67 126 96 115 211 1 169% 4 597% 5 397% 1 104% 2 174% 3 142% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### 43 ### 96 ### 139 ### 25 ### 44 ### 69 ### 5 ### 6 ### 11 ### 5 ### 5 ### 10 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : MARET 2022

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 2 ### 1 ### 3 ### 0 ### 2 ### 2 ### 0 ### 1 ### 1 ### ### ### 0 ###
2 Asem Nonggal 1 ### 7 ### 8 ### 2 ### 6 ### 8 ### 1 ### 4 ### 5 ### ### ### 0 ###
3 Majangan 16 ### 12 ### 28 ### 11 ### 7 ### 18 ### ### ### 0 ### ### ### 0 ###
4 Kalangan Prao 0 ### 6 ### 6 ### 0 ### 4 ### 4 ### 0 ### 1 ### 1 ### ### ### 0 ###
5 Asem Raja 1 ### 24 ### 25 ### 2 ### 9 ### 11 ### 0 ### 1 ### 1 ### ### ### 0 ###
6 Plakaran 0 ### 11 ### 11 ### 3 ### 12 ### 15 ### 0 ### 3 ### 3 ### ### ### 0 ###
7 Buker 2 ### 3 ### 5 ### 3 ### 2 ### 5 ### 1 ### 1 ### 2 ### ### ### 0 ###
8 Bancelok 4 ### 3 ### 7 ### 2 ### 1 ### 3 ### 1 ### 1 ### 2 ### ### ### 0 ###
9 Mlaka 103 115 218 159 196 355 3 291% 2 174% 5 229% 2 126% 2 102% 4 113% 1 63% 1 51% 2 56% 0.0% 0.0% 0 0.0%
10 Kotah 3 ### 3 ### 6 ### 3 ### 3 ### 6 ### 1 ### 1 ### 2 ### ### ### 0 ###
11 Jungkarang 4 ### 9 ### 13 ### 2 ### 6 ### 8 ### ### ### 0 ### ### ### 0 ###
12 Jrengik 7 ### 15 ### 22 ### 5 ### 7 ### 12 ### 2 ### 1 ### 3 ### ### ### 0 ###
13 Taman 3 ### 6 ### 9 ### 0 ### 2 ### 2 ### 0 ### 1 ### 1 ### ### ### 0 ###
14 Panyepen 4 ### 5 ### 9 ### 5 ### 2 ### 7 ### 1 ### 1 ### 2 ### ### ### 0 ###
JUMLAH ### ### ### ### ### ### 50 ### 107 ### 157 ### 40 ### 65 ### 105 ### 8 ### 17 ### 25 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : APRIL 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : MEI 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : JUNI 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : JULI 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : AGUSTUS 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : SEPTEMBER 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : OKTOBER 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : NOVEMBER 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010
LAPORAN PROGRAM PELAYANAN KESEHATAN LANJUT USIA

PROVINSI : JAWA TIMUR

KABUPATEN : SAMPANG
PUSKESMAS : JRENGIK
BULAN/TAHUN : DESEMBER 2021

SASARAN JUMLAH LANSIA YANG DILAYANI

Jumlah
Jumlah Lansia Jumlah Lansia Risti Pra Lansia Lansia Lansia Risti Lansia (≥ 60 tahun) yang diskrining
Pra Lansia
( ≥ 60 tahun) (≥ 70 tahun) (45-59 tahun) (≥ 60 tahun) (≥ 70 tahun) kesehatan sesuai standar
(45-59 tahun)
NO. NAMA DESA

L P T L P T L P T L P T
L P T L P T L P T
Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. %

1 Margantoko 37 41 78 57 71 128 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%

2 Asem Nonggal 34 37 71 52 64 116 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
3 Majangan 22 24 46 33 41 74 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
4 Kalangan Prao 49 54 103 75 93 168 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
5 Asem Raja 57 63 120 87 108 195 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
6 Plakaran 63 70 133 97 120 217 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
7 Buker 150 167 317 231 286 517 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
8 Bancelok 114 127 241 175 217 392 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
9 Mlaka 103 115 218 159 196 355 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
10 Kotah 106 118 224 163 202 365 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
11 Jungkarang 92 103 195 142 176 318 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
12 Jrengik 89 102 191 137 169 306 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
13 Taman 65 72 137 99 123 222 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
14 Panyepen 59 67 126 96 115 211 0% 0% 0 0% 0% 0% 0 0% 0% 0% 0 0% 0.0% 0.0% 0 0.0%
JUMLAH ### ### ### ### ### ### ### ### 0 ### ### ### 0 ### ### ### 0 ### ### ### 0 ###
 SARANA

Tingkat Kemandirian B (Ketergantungan Tingkat Kemandirian C (Ketergantungan Puskesmas Jumlah

Tingkat Kemandirian A (Mandiri) Jumlah Lansia yang diberdayakan Jumlah Posyandu Lansia / Posbindu Puskesmas
ringan/sedang) Berat/Total) yang Puskesmas
dengan
Jumlah Melaksanaka yang
Posyandu
Panti n Long Term Melaksanaka
Total Werdha Lansia Aktif
Care n Home Care
L P T L P T L P T L P T Pratama Madya Purnama Mandiri yg dibina

Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. % Abs. Abs. Abs. Abs. Abs. Abs. % Abs. % Abs. %

Sampang, 3 April 2021

PENANGGUNG JAWAB

NORMA DWI HARDIANI, Amd. Kep

NIP. 19850307 201101 2 010