Nama Puskesmas :
Nama Kabupaten : Lombok Tengah
TW I
Jumlah
No Nama Sekolah Jumlah Mendapat Jumlah Minum Keterangan
Siswi/Rematri
1-6 Tablet 7-11 Tablet ≥ 12 Tablet 1-6 Tablet 7-11 Tablet ≥ 12 Tablet
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0
7 0 0 0 0 0 0
8 0 0 0 0 0 0
9 0 0 0 0 0 0
10 0 0 0 0 0 0
Jumlah - 60 90 0 0 0
( Nama…………………………) ( Nama…………………………)
NIP. NIP.
LAPORAN CAKUPAN PEMBERIAN TTD PADA REMAJA PUTRI
KABUPATEN LOMBOK TENGAH TRIWULAN I TAHUN 2022
Nama Puskesmas :
TW I
1-6 Tablet 7-11 Tablet ≥ 12 Tablet 1-6 Tablet 7-11 Tablet ≥ 12 Tablet
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0
7 0 0 0 0 0 0
8 0 0 0 0 0 0
9 0 0 0 0 0 0
10 0 0 0 0 0 0
11 0 0 0 0 0 0
12 0 0 0 0 0 0
Jumlah - - - 0 0 0
Nama Puskesmas :
TW I
1-6 Tablet 7-11 Tablet ≥ 12 Tablet 1-6 Tablet 7-11 Tablet ≥ 12 Tablet
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0
7 0 0 0 0 0 0
8 0 0 0 0 0 0
9 0 0 0 0 0 0
10 0 0 0 0 0 0
11 0 0 0 0 0 0
12 0 0 0 0 0 0
Jumlah - - - 0 0 0
Nama Puskesmas :
TW I
1-6 Tablet 7-11 Tablet ≥ 12 Tablet 1-6 Tablet 7-11 Tablet ≥ 12 Tablet
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0
7 0 0 0 0 0 0
8 0 0 0 0 0 0
9 0 0 0 0 0 0
10 0 0 0 0 0 0
11 0 0 0 0 0 0
12 0 0 0 0 0 0
Jumlah - - - 0 0 0