Lap Kia Ibu

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021
Bulan : Januari
Kunjungan Status Imunisasi
Riwayat Umur K1 Faktor
No Nama Ibu hamil Umur Alamat
kehamilan Kehamilan K1 K4 Murni Resti
TT1 TT2 TT3 TT4 TT5
Baru Lama Baru Lama
1
2
3
4
5
6
7
8
9
10
11
12
Total Err:522 Err:522 Err:522 Err:522 ### ### ### ### ### ###
Pelapor
NIP.
Bulan : Februari
No Nama Ibu hamil Umur Alamat K1 K4
kehamilan Kehamilan Murni TT1 TT2 TT3 TT4 TT5 Resti
Baru Lama Baru Lama
1
2
3
4
5
6
7
8
9
10
11
12
Pelapor
NIP.
Bulan : Maret
Baru Lama Baru Lama
1
2
3
4
5
6
7
8
9
10
11
12
Pelapor
NIP.
Bulan : April
Baru Lama Baru Lama
1 SURYANI 33 BTS G3P2A0H2 20 mg
2 DIANA 33 BTS G7P3A3H3 18 mg
3 TRI WAHYUNI 24 BTS G2P1A0H1 12 mg √
4
5
6
7
8
9
10
11
12
Pelapor
NIP.
Bulan : Mei
Baru Lama Baru Lama
1
2
3
4
5
6
7
8
9
10
11
12
Pelapor
NIP.
Bulan : Juni
Baru Lama Baru Lama
1 SURYANI 31 BATU SAWAR G4P3A0H2 24 MG
2 DIANA 33 BATU SAWAR G7P4A2H3 20 MG
3 REZA AYU L. 17 BATU SAWAR G1P0A0H0 16 MG √ √
4 TRI WAHYUNI 24 BATU SAWAR G2P1A0H1 15 MG
5 ROHANA 31 BATU SAWAR G2P1A0H1 10 MG √ √
6
7
8
9
10
11
12
Pelapor
NIP.
Bulan : Juli
Baru Lama Baru Lama
3 REZA AYU L. 17 BATU SAWAR G1P0A0H0 27 MG √
5 ROHANA 31 BATU SAWAR G2P1A0H1 14 MG √
6 SITI HAJAR 31 BATU SAWAR G1P0A0H0 19 MG √ √
7
8
9
10
11
12
Pelapor
NIP.

Bulan : Agustus
Baru Lama Baru Lama
3 REZA AYU L. 17 BATU SAWAR G1P0A0H0 31 MG
5 ROHANA 31 BATU SAWAR G2P1A0H1 18 MG
6 SITI HAJAR 31 BATU SAWAR G1P0A0H0 23 MG
7 DESI D. 22 BATU SAWAR G1P0A0H0 8 MG √ √
8 SUSILAWATI 27 BATU SAWAR G1P0A0H0 20 MG √ √
9
10
11
12
Pelapor
NIP.

Bulan : September
Baru Lama Baru Lama
3 ROHANA 31 BATU SAWAR G2P1A0H1 22 MG
5 DESI D. 22 BATU SAWAR G1P0A0H0 11 MG
6 SUSILAWATI 27 BATU SAWAR G1P0A0H0 24 MG
7
8
9
10
11
12
Pelapor
NIP.

Bulan : Oktober
Baru Lama Baru Lama
4 SANTI S. 34 BATU SAWAR G4P3A0H3 12 MG √ √ √
5
6
7
8
9
10
11
12
Pelapor
NIP.

Bulan : November
Baru Lama Baru Lama
1 TRIWAHYUNI 24 BATU SAWAR G2P1A0H1 34 MG √
2 SITI HAJAR 31 BATU SAWAR G1P0A0H0 35 MG √
4 SUSILAWATI 27 BATU SAWAR G1P0A0H0 32 MG √ √
5 ZULIATI 31 BATU SAWAR G2P1A0H1 8 MG √
6 LENI APRITA 28 BATU SAWAR G4P3A0H3 8 MG √
7
8
9
10
11
12
Pelapor
NIP.

Bulan : Desember
Baru Lama Baru Lama
2 ZULIATI 31 BATU SAWAR G2P1A0H1 12 MG
3 LENI APRITA 28 BATU SAWAR G4P3A0H3 12 MG
4
5
6
7
8
9
10
11
12
Pelapor
NIP.
LAPORAN IBU BERSALIN
BULAN : JANUARI
Tanggal Jenis kelamin Kunjungan Nifas Jenis Persalinan

No Nama ibu Bersalin Umur Alamat
Bersalin
L P KF 1 KF 2 KF 3 KF 4 Normal sc vakum forcef sungsang
Total
Pelapor
NIP.
BULAN : FEBRUARI
Bersalin L P KF 1 KF 2 KF 3 KF 4 Normal sc vakum forcef sungsang
Total
Pelapor
NIP.
BULAN : MARET
Total
Pelapor
NIP.
BULANAPRIL
1 NIHIL
Total
Pelapor
NIP.
BULANMEI
NIHIL
Total
Pelapor
NIP.
BULANJUN
: I
NIHIL
Total
Pelapor
NIP.

BULANJULI
1 Reza ayu lestari 18 tahun batu sawar 10.9.2021 √ √ √ √ √ √
2 suryani 33 tahun batu sawar 23.9.2021 √ √ √ √ √ √
Total
Pelapor
NIP.

BULAN : AGUSTUS
Total
Pelapor
NIP.

BULAN : SEPTEMBER
1 Reza ayu lestari 18 tahun batu sawar 10.9.2021 √ √ √ √ √ √
2 suryani 33 tahun batu sawar 23.9.2021 √ √ √ √ √ √
Total
Pelapor
NIP.

BULANOKTOBER
1 DIANA 33 TH BATU SAWAR 30.9.2021 √ √ √ √ √ √
Total
Pelapor
NIP.

BULAN : NOVEMBER
NIHIL
Total
Pelapor
NIP.

BULAN : DESEMBER
TRIWAHYUNI 24 BATU SAWAR 21.12.2021 √ √ √ √ √ √
SITI HAJAR 31 BATU SAWAR 8.12.2021 √ √
SUSILAWATI 27 BATU SAWAR √
Total
Pelapor
NIP.
LAPORAN PWS KIA (IBU)
PUSKESMAS RAKIT KULIM
TAHUN 2021
BULAN : JANUARI
Sasaran K1 K1 Murni K4 Deteksi Resiko Tinggi Persalinan oleh Nakes Persalinan Kunjungan Nifas Oleh Nakes FE Vit Vit
Hb Bumil Imunisasi TT
Kumulatif Kumulatif Kumulatif Oleh Nakes Oleh masyarakat Kumulatif Fasilts kes Non fasilts kes Dukun Bulan Lalu Bulan ini Kumulatif A K1
Injek BBl
No DESA Kumulatif Kumulatif <8 8-11 >11 TT TT TT TT TT Kumulatif Kumulatif Ter Tdk Absolut Persen(%) Bu
Buteki
Bln Bln Bln Bln Bln Bln Bln Bln
Bumil Bulin Bumil lalu ini Abs lalu ini Abs lalu ini Bln Bln Bln Bln lalu ini Bln Bln Bln Bln
% % Abs % Abs % Kf 1 Kf 2 Kf 3 Kf 4 Kf 1 Kf 2 Kf 3 Kf 4
lalu Ini lalu Ini lalu Ini lalu Ini
Resti gr gr gr 1 2 3 4 5 latih ter Fas
Abs % Abs % Abs % Abs % Kf 1 Kf 2 Kf 3 kf 4 Kf 1 Kf 2 Kf 3 kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,30 JANUARI 2021

Plt KEPALA UPTD PUSKESMAS RAKIT KULIM BIDAN KOORDINATOR PENGELOLA DATA
SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : FEBRUARI
Injek BBl
Buteki
% % Abs % Abs % Kf 1 Kf 2 Kf 3 Kf 4 Kf 1 Kf 2 Kf 3 kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,28 FEBRUARI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MARET
Injek BBl
Buteki
Abs % Abs % Abs % Abs % Kf 1 Kf 2 Kf 3 Kf 4 Kf 1 Kf 2 Kf 3 Kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,30 MARET 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : APRIL
Injek BBl
Buteki
Abs % Abs % Abs % Abs % Kf 1 Kf 2 Kf 3 kf 4 Kf 1 Kf 2 Kf 3 Kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 1 1 9.09 0 1 1 9.09 0 0 0 0 0 0 0 0 0 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
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 0 1 1 0.27 0 1 1 0.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 APRIL 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MEI
Injek BBl
Buteki
Abs % Abs % Abs % Abs % Kf 1 Kf 2 Kf 3 Kf 4 Kf 1 Kf 2 Kf 3 Kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 1 0 1 9.09 1 0 1 9.09 1 0 1 9.09 0 0 0 0 0 0 0 0 0 0 0 0 1 1 9.09 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 9.09 9.09 ### 9.09 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 1 0 1 0.27 1 0 1 0.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0.29 0.29 ### 0.29 1 1 1
Mengetahui PETONGGAN,30 MEI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : JUNI
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 1 1 9.09 2 2 18 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 9.09 9.09 9.09 9.09 0 0 0
3 BUKIT INDAH 31 30 6 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 1 1 2 0.55 1 2 3 0.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0.29 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 0.29 0.29 0.29 0.29 0 0 0
Mengetahui PETONGGAN,30 JUNI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : AGUSTUS
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 1 0 2 2 18 0 0 0 0 0 1 1 9.09 0 0 0 0 0 0 √ √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 0 √ ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 70 2 2 4 1.1 3 0 3 0.82 0 1 1 0.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0.29 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 0.29 0.29 0.29 0.29 0 0 0
Mengetahui PETONGGAN,30 JULI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN SEPTEMBER
Injek BBl
Buteki
Abs % Abs % Abs % Abs % Kf 1 Kf 2 Kf 3 Kf 4 Kf 1 Kf 2 Kf 3 kf 4
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 1 2 0 2 18 0 0 0 0 1 1 2 18 0 0 0 0 0 0 0 0 0 0 0 0 2 2 18 0 1 1 9.09 0 1 1 9.09 0 0 0 0 2 2 2 2 2 2 2 2 18 18 18 18.2 2 2 2
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 √ ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 70 4 0 4 1.1 3 0 3 0.01 1 3 4 1.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 3 0.86 0 1 1 0.29 0 1 1 0.29 0 0 1 1 1 1 2 2 2 2 3 3 3 3 0.86 0.86 0.86 0.86 2 2 2
Mengetahui PETONGGAN,30 AGUSTUS 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : SEPTEMBER
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 2 0 2 18 0 0 0 0 2 0 2 18 0 0 0 0 0 0 0 0 0 0 0 2 0 2 18 1 1 9.09 1 1 9.09 2 2 2 2 0 0 0 0 2 2 2 2 18 18 18 18.2 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 4 0 4 1.1 3 0 3 0.82 4 0 4 1.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0.86 1 0 1 0.29 1 0 1 0.29 0 0 3 3 3 3 0 0 0 0 3 3 3 3 0.86 0.86 0.86 0.86 0 0 0
Mengetahui PETONGGAN,30 SEPTEMBER 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : OKTOBER
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 2 1 3 27 0 0 0 0 2 0 2 18 0 0 0 0 0 0 1 0 0 0 0 2 1 3 27 1 1 9.09 1 1 2 18 2 2 2 2 1 1 1 1 3 3 3 3 27 27 27 27.3 1 1 1
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 0 √ ### ### 0 √ ### ### 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 4 1 5 1.37 3 0 3 0.82 4 0 4 1.1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 1 4 1.14 1 0 1 0.29 1 1 2 0.57 0 0 3 3 3 3 1 1 1 1 4 4 4 4 1.14 1.14 1.14 1.14 1 1 1
Mengetahui PETONGGAN,30 OKTOBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : NOVEMBER
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 0 2 2 0 1 2 3 27 0 2 2 18 0 0 0 0 0 0 1 0 0 0 0 1 0 1 9.09 1 1 9.09 2 2 18 1 1 1 1 ` 0 0 0 ### 1 1 1 ### 9.09 9.09 9.09 0 0 0
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 ### 0 ### ### ### 0 ### ### 0 √ ### ### 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 0 √ ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 ### √ ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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
Jumlah 365 350 71 5 2 7 1.92 3 2 5 1.37 4 2 6 1.64 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0.29 1 0 1 0.29 2 0 2 0.57 0 0 4 4 4 4 0 0 0 0 4 4 4 4 1.14 1.14 1.14 1.14 0 0 0
Mengetahui PETONGGAN,30 NOEMBER 2021

NIP.19760210 200501 2 007 NIP.19880917 201102 2 001 NIP.19880917 201102 2 001

TAHUN 2021
BULAN : DESEMBER
Injek BBl
Buteki
latih
1 PETONGGAN 44 42 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 11 2 2 0 2 18 3 0 3 27 2 0 2 18 0 0 0 0 0 0 0 0 0 0 0 0 3 3 27 0 1 1 0.09 0 2 2 18 0 0 0 0 3 3 3 3 3 3 3 0 27 27 27 0 3 3 3
3 BUKIT INDAH 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 35 7 ### 0 ### ### ### 0 ### ### ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 57 12 ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 38 8 ### 0 ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 51 49 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 16 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
9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 7 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

Jumlah 365 350 71 7 0 7 1.92 5 0 5 1.37 6 0 6 1.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 4 1.14 1 1 2 0.01 2 2 4 1.14 0 0 4 4 4 4 3 3 3 3 7 7 7 4 2 2 2 1.14 3 3 3
Mengetahui PETONGGAN,30 DESEMBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
LAPORAN PELAKSANAAN PROGRAM PERENCANAAN PERSALINAN DAN PENCEGAHAN KOMPLIKASI (P4K)
TAHUN 2021
BULAN : JANUARI
JUMLAH IBU Jumlah Ibu JUMLAH BUMIL JUMLAH STIKER YG JUMLAH BUMIL
JML SASARAN HAMIL YANG JML STIKER JML STIKER Hamil yang (BERSTIKER) YG JML BUMIL YG TELAH DICABUT BERSTIKER YG
NO DESA
IBU HAMIL DIDATA YG DITERIMA YG DIPASANG di skreening DIKUNJUNGI BIDAN PUNYA BUKU KIA (telah bersalin) BERSALIN KE
Telapak Kaki (ANC) NAKES
1 PETONGGAN 44 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 JANUARI 2021

Plt KEPALA UPTD PUSKESMAS RAKIT KULIM BIDAN KOORDINATOR ENTRY DATA

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : FEBRUARI
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 28 FEBRUARI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MARET
NO DESA

1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 MARET 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : APRIL
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 4 4 4 4 4 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MEI
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 1 1
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 MEI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : JUNI
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 5 5 5 5 5 0 0
3 BUKIT INDAH 31 √ √ √ √ √ 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 √ √ √ √ √ 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 1 1 1 0 1 1 0 0
Mengetahui PETONGGAN, 30 JUNI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : JULI
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 √ √ √ √ √ 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 2 2 2 0 2 2 0 0
Mengetahui PETONGGAN, 30 JUNI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : AGUSTUS
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 2 2 2 2 2 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 √ √ √ √ √ 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 2 2 2 0 2 2 0 0
Mengetahui PETONGGAN, 30 JULI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : SEPTEMBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 8 8 8 8 8 2 2
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 √ √ √ √ √ 0 0
8 TL. GEDABU 17 √ √ √ √ √ 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 2 2
Mengetahui PETONGGAN, 30 AGUSTUS 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : SEPTEMBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 SEPTEMBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : OKTOBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 1 1 1 1 1 1 1
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 √ √ √ √ √ 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 1 1 1 0 1 1 0 0
Mengetahui PETONGGAN, 30 OKTOBER 2021

NIP.19760210 200501 2 007 NIP.19880917 201102 2 001 NIP.19880917 201102 2 001

TAHUN 2021
BULAN : NOVEMBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 2 2 2 2 2 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 √ √ √ √ √ 0 0
6 TL. PERIGI 40 √ √ √ √ √ 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 2 2 2 0 2 2 0 0
Mengetahui PETONGGAN, 30 NOVEMBER 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : OKTOBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 0 0 0 0 0 0 0
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19880917 201102 2 001 NIP.19880917 201102 2 001

TAHUN 2021
BULAN : DESEMBER
NO DESA
1 PETONGGAN 44 0 0 0 0 0 0 0
2 BATU SAWAR 11 6 6 6 6 6 3 3
3 BUKIT INDAH 31 0 0 0 0 0 0 0
4 LUBUK SITARAK 37 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 60 0 0 0 0 0 0 0
6 TL. PERIGI 40 0 0 0 0 0 0 0
7 TL. SUKAMAJU 51 0 0 0 0 0 0 0
8 TL. GEDABU 17 0 0 0 0 0 0 0
9 TL. SEI PARIT 26 0 0 0 0 0 0 0
10 TL. SEI LIMAU 31 0 0 0 0 0 0 0
11 TL. SELANTAI 10 0 0 0 0 0 0 0
12 TL. SEI EKOK 7 0 0 0 0 0 0 0
Jumlah 365 0 0 0 0 0 0 3 3
Mengetahui PETONGGAN, 30 DESEMBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
0
0
REKAPITULASI KEGIATAN AUDIT MATERNAL & PERINATAL
TAHUN 2021
BULAN :
Jumlah Kematian Maternal Penanganan Ibu dengan Jumlah Kelahiran Cara Persalinan dalam kelahiran Hidup
IBU HAMIL Ibu Bersalin Ibu Nifas komplikasi* TEMPAT KEMATIAN Nakes dan Dengan Tindakan
No DESA
Perdarahan Infeksi Pre/Eklamsi Abortus Sbb Lain Perdarahan Infeksi Pre/Eklamsi Partus lama Sbb Lain Perdarahan Infeksi Sbb Lain Tingkat dasar Lanjutan Dukun
Normal Porcef Vacum Sungsang SC
Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jlh Mati Jml Mati Jlh Mati Jlh Mati Jlh mati Jml Mati jml Mati RUMAH PKM/POLINDES PERJALANAN RB/BPS RSIA/RSUD L P Jlh
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN :
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MARET
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : APRIL
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jenis kelamin0 ###
Jenis Persalinan0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 L P ### ### 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ### 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
buLAN mei
Jumlah Kematian Maternal Penanganan Ibu dengan
IBU HAMIL Ibu Bersalin Ibu Nifas komplikasi* TEMPAT KEMATIAN
No DESA
Perdarahan Infeksi Pre/Eklamsi Abortus Sbb Lain Perdarahan Infeksi Pre/Eklamsi Partus lama Sbb Lain Perdarahan Infeksi Sbb Lain Tingkat dasar Lanjutan
Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jlh Mati Jml Mati Jlh Mati Jlh Mati Jlh mati Jml Mati jml Mati RUMAH
PKM/POLINDES
PERJALANAN
1 PETONG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DUR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIG 0 0 0 0 0 0 0 0 0 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 TL. SUK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI P 0 0 0 0 0 0 0 0 0 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 TL. SEI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui
Plt KEPALA UPTD PUSKESMAS RAKIT KULIM BIDAN KOORDINATOR
SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : JUNI
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jenis kelamin0 ### ### 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 L P ### ### 0 0 0 0
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 ### ### 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 ### ### 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ### 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : AGUSTUS
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jenis kelamin0 ### ### 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 L P ### ### 0 0 0 0
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ### 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : SEPTEMBER
Jumlah Kematian Maternal
Penanganan Ibu dengan komplikasi*
IBU HAMIL Ibu Bersalin Ibu Nifas
No DESA
Perdarahan Infeksi Pre/Eklamsi Abortus Sbb Lain Perdarahan Infeksi Pre/Eklamsi Partus lama Sbb Lain Perdarahan Infeksi Sbb Lain Tingkat dasar Lanjutan
Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jml Mati Jlh Mati Jml Mati Jlh Mati Jlh Mati Jlh mati Jml Mati jml Mati
1 PETONGG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT IN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIG 0 0 0 0 0 0 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 TL. SUKA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI P 0 0 0 0 0 0 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 TL. SEI L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI E 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui
Plt KEPALA UPTD PUSKESMAS RAKIT KULIM BIDAN KOORDINATOR
SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : OKTOBER
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : NOVEMBER
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : DESEMBER
No DESA
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
Jumlah Kelahiran Cara Persalinan dalam kelahiran Hidup
TEMPAT KEMATIAN Nakes dan Dengan Tindakan
Dukun
RB/BPS RSIA/RSUD L P Jlh
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
PETONGGAN, 30 MARET 2021

PENGELOLA DATA
MISRIATI,Amd.Keb
NIP.19860323 201704 2 020
Jumlah Kelahiran Cara Persalinan dalam kelahiran Hidup
TEMPAT KEMATIAN Nakes dan Dengan Tindakan
Dukun
RUMAHPKM/POLINDES
PERJALANAN RB/BPS RSIA/RSUD L P Jlh
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
PETONGGAN, 30 MARET 2021

PENGELOLA DATA
MISRIATI,Amd.Keb
NIP.19860323 201704 2 020
FORMAT 1 (ANC)
2021
Jumlah Status T Bumil DETEKSI RISIKO RUJUKAN KASUS RISTI PERIODE INPUT DATA
Buku
No DESA Penduduk Bumil K1 K4 FE1 FE3
KIA T1 T2 T3 T4 T5 T2+ NAKES MASYARAKAT MATERNAL NEONATAL BULAN TAHUN
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 JAN 2021

2 BATU SAWAR 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEB 2021

2 BATU SAWAR 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,28 FEBRUARI 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MAR 2021

2 BATU SAWAR 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,30 MARET 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
APRIL
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 APR 2021

2 BATU SAWAR 505 4 4 3 1 0 1 0 0 0 0 3 1 1 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 1 1 1 0 0 1 0 0 0 0 1 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
MEI 2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MEI 2021

2 BATU SAWAR 426 3 3 3 0 0 0 0 0 0 0 3 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN,30 MEI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
JUNI 2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 JUNI 2021

2 BATU SAWAR 505 5 5 5 0 1 0 1 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 1,182 √ √ √ 0 √ 0 0 0 0 0 √ 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 √ √ √ 0 0 0 √ 0 0 0 √ 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 1 1 1 0 1 0 1 0 0 0 1 0 0 0 0 0
Mengetahui PETONGGAN,30 JUNI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
JULI 2021
Buku
KIA
T1 T2 T3 T4 T5 T2+ NAKES MASYARAKAT MATERNAL NEONATAL BULAN TAHUN
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 JULI 2021

2 BATU SAWAR 505 6 6 1 1 √ √ 0 0 0 0 0 1 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 √ √ √ 0 0 √ 0 0 0 0 √ 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 2 2 2 1 0 0 0 0 0 0 2 1 0 0 0 0
Mengetahui PETONGGAN,30 JULI 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
AGUSTUS 2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AGUST 2021

2 BATU SAWAR 426 8 8 8 1 1 1 0 0 0 0 6 1 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 √ √ √ 0 0 √ 0 0 0 0 √ 0 0 0 0 0
8 TL. GEDABU 626 √ √ √ 0 √ 0 0 0 0 0 √ 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 3 0 0 0 0 0 0 0 3 0 0 0 0
Mengetahui PETONGGAN, 30 AGUSTUS 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
Sep-21
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SEPT 2021

2 BATU SAWAR 426 6 6 6 1 0 0 0 0 0 0 6 1 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 SEPTEMBER 2021

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
OKTOBER 2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OKT 2021

2 BATU SAWAR 426 6 6 1 0 1 0 0 0 0 0 1 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 √ √ √ 0 √ 0 0 0 0 0 √ 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
Nov-21
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOV 2021

2 BATU SAWAR 426 2 2 2 2 1 0 0 0 0 0 2 2 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 √ √ 0 0 0 0 0 0 √ 0 0 0 0
5 TL. DURIAN CACAR 2,261 √ √ √ 0 0 0 0 0 0 0 √ 0 0 0 0 0
6 TL. PERIGI 1,509 √ √ √ 0 0 0 0 0 0 0 √ 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 2 2 2 2 1 0 0 0 0 0 2 2 0 0 0 0
Mengetahui PETONGGAN, 30 NOVEMBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 1 (ANC)
DESEMBER 2021
Buku
1 PETONGGAN 1,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DES 2021

2 BATU SAWAR 426 6 6 6 0 0 0 0 0 0 0 6 0 0 0 0 0
3 BUKIT INDAH 1,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 1,408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 2,261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 1,509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 1,179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 22,778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui PETONGGAN, 30 DESEMBER 2021


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
Form 2 (Persalinan Dan Nifas)
Puskesmas Rakit Kulim
Bulan : Januari Tahun : 2021
Persalinan Ditolong Nakes (PN) Komplikasi Kunjungan Nifas (KF) PERIODE INPUT DATA
Persalinan
Maternal
No DESA BULIN PN DI PN DI NON Ditolong Non VIT A NIFAS
PN Ditangani KF1 KF2 KF3 KF4 BULAN TAHUN
FASYANKES FASYANKES Nakes
(PK)
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 JAN 2021

2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0

Plt KEPALA UPTD PUSKESMAS BIDAN KOORDINATOR ENTRY DATA

NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020
Bulan : Februari Tahun : 2021
Persalinan Ditolong Nakes (PN) Komplikasi Kunjungan Nifas (KF) PERIODE INPUT DATA
Persalinan
Maternal
No DESA BULIN PN DI PN DI NON Ditolong Non VIT A NIFAS
PN Ditangani KF1 KF2 KF3 KF4 BULAN TAHUN
FASYANKES FASYANKES Nakes
(PK)
1 PETONGGAN FEB 2021

2 BATU SAWAR
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020
Bulan : Tahun : 2021
Komplikasi
Persalinan Persalinan
Maternal
No DESA BULIN Ditolong Ditolong Non VIT A NIFAS
Kunjungan Nifas (KF) PERIODE INPUT DATA
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
PN KF1 KF2 KF3 KF4 BULAN TAHUN
FASYANKES FASYANKES
1 PETONGGAN 2021
2 BATU SAWAR
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan : APRIL Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN 2021
2 BATU SAWAR N I H I L
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah

NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan : MEI Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
2 BATU SAWAR NIHIL JUNI 2021
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020
Bulan : JULI Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan : AGUSTUS Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah

NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan : SEPTEMBER Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
2 BATU SAWAR 1 1 2 1 1 1 1 OKT 2021
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan OKTOBER Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
2 BATU SAWAR 1 1 2 1 1 1 1 OKT 2021
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan NOVEMBER Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
2 BATU SAWAR
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020

Bulan DESEMBER Tahun : 2021
Komplikasi
Maternal
Ditangani
Nakes (PN) Nakes
(PK)
PN DI PN DI NON
FASYANKES FASYANKES
1 PETONGGAN
2 BATU SAWAR 3 1 2 4 3 3 3 3 DES 2021
3 BUKIT INDAH
4 LUBUK SITARAK
5 TL. DURIAN CACAR
6 TL. PERIGI
7 TL. SUKAMAJU
8 TL. GEDABU
9 TL. SEI PARIT
10 TL. SEI LIMAU
11 TL. SELANTAI
12 TL. SEI EKOK
Jumlah


NIP.19760210 200501 2 007 NIP.19880323 201704 2 020 NIP.19880323 201704 2 020
Form 4 (Kematian)
Bulan : JANUARI Tahun : 2021
SEBAB KEMATIAN IBU
JML BAYI JML KEMATIAN PERI - JML BAYI LAHIR JML

JUMLAH LAHIR HIDUP NEONATAL MATI KAB/KOTA
NO DESA GGN SISTEM
KEMATIAN IBU HIPERTENSI GGN MELAKSANAK
PEREDARAN AN AMP
PERDARAHAN DLM INFEKSI METABOLIK LAIN2
DARAH (JANTUNG,
KEHAMILAN (DM, DLL)
STROKE, DLL)
L P L P L P
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 BATU SAWAR NIHIL 0 0 0 0 0 0 0 0 0 0 0 0 0
7 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MENGETAHUI

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORM 4 DATA KEMATIAN IBU HAMIL, BERSALIN DAN NIFAS KABUPATEN INDRAGIRI HULU
BULAN : JANUARI TAHUN : 2021

A. JUMLAH DAN PENYEBAB KEMATIAN IBU
SEBAB KEMATIAN IBU
GGN
JUMLAH METABOLIK
NO. PUSKESMAS KEMATIAN HIPERTENSI GGN SISTEM
(DM, COVID LAIN
IBU PERDARAHAN DLM INFEKSI PEREDARAN
JANTUNG, 19 2
KEHAMILAN DARAH
STROKE,
DLL)
1 Kuala Cinaku
2 Sipayung
3 Kambesko
4 Pekan Heran
5 Pangkalan Kasai
6 Batang Gansal
7 Kilan
8 Lubuk Kandis
9 Lirik
10 Air Molek
11 Sei Lala
12 Sungai Parit
13 Kulim Jaya
14 Polak Pisang
15 Kota Medan
16 Rakit Kulim
17 Kota Baru
18 Peranap
19 Batang Peranap
20 Sencano Jaya
TOTAL
B. FASE, TEMPAT DAN USIA KEMATIAN IBU
K
Fase kematian ibu tempat kematian ibu
JUMLAH KEMATIAN IBU HAMIL JUMLAH KEMATIAN IBU BERSALI
JUMLAH
NO. KABUPATEN/KOTA KEMATIAN
IBU PKM/P < 20 20-34 ≥35 JUML 20-34
Hamil Bersalin Nifas RS RUMAH RB/KLINI OLIND PERJA < 20 tahun
K ES/PU LANAN tahun tahun tahun AH tahun
STU
1 Kuala Cinaku
2 Sipayung
3 Kambesko
4 Pekan Heran
5 Pangkalan Kasai
6 Batang Gansal
7 Kilan
8 Lubuk Kandis
9 Lirik
10 Air Molek
11 Sei Lala
12 Sungai Parit
13 Kulim Jaya
14 Polak Pisang
15 Kota Medan
16 Rakit Kulim
17 Kota Baru
18 Peranap
19 Batang Peranap
20 Sencano Jaya
TOTAL
KEMATIAN IBU
H KEMATIAN IBU BERSALIN JUMLAH KEMATIAN IBU NIFAS JUMLAH KEMATIAN IBU
20-34 20-34
≥35 tahun JUMLAH < 20 tahun ≥35 tahun JUMLAH < 20 tahun ≥35 tahun JUMLAH
tahun tahun
FORMAT 5
BULAN : JANUARI
KABUPATEN INDRAGIRI HULU
Integrasi Program Pelaksanaan kelas ibu hamil
Gula Darah PERIODE INPUT
Hb KEK Protein urin
Jumlah bidan yang melakukan kelas ibu

Jumlah Ibu Hamil yang mengikuti kelas
Jumlah Kelas Ibu Hamil yang terbentuk
Jumlah suami/keluarga yang mengikuti

(GD) Pencegahan Malaria Dalam Kehamilan Pencegahan Hepatitis B dalam DATA
Puskesmas yang melaksanakan kelas

Pencegahan Penularan HIV dari Ibu ke Anak (PPIA) TB dalam Kehamilan Kecacingan dalam Kehamilan Pencegahan IMS dalam Kehamilan
(PMDK) Kehamilan
Ibu Hamil diperiksa Hepatitis B

Ibu Hamil ditawarkan Tes HIV
Ibu Hamil HIV(+)
Ibu Hamil Hasil Tes Hep B (+)

Ibu Hamil mendapatkan Kina/
Ibu Hamil Hasil Dahak TB(+)

Ibu Hamil Hasil Tes HIV (+)
Ibu Hamil Hasil Tes IMS (+)

Ibu Hamil diperiksa Dahak
Ibu Hamil Mendapat ART
Ibu Hamil Datang dengan
Ibu Hamil diperiksa IMS

Ibu Hamil mendapatkan
KEK (LiLA < 23,5 cm)
kelas ibu hamil

Ibu Hamil Malaria (+)
Persalinan Perabdominam
Ibu Hamil Diperiksa

Ibu Hamil dites HIV
Ibu Hamil Hasil Tes

Ibu Hamil diperiksa
Mikroskopis/RDT
Persalinan Pervaginam
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati
ibu hamil
ibu hamil
Ankylostoma (+)
NO. DESA
Diperiksa LiLA
GD >140 g/dl
hamil
Diperiksa Hb
Ankylostoma
(8-11 mg/dl)
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
ACT
BLN TH
(SC)
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 JAN 2021
2 BATU SAWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 12 0 0 13
MENGETAHUI PETONGGAN, 30 JANUARI 2021

Plt. KEPALA UPTD PUSKESMAS RAKIT KULIM BIDAN KOORDINATOR ENTRY DATA

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :MEI
Gula Darah Integrasi Program Pelaksanaan kelas ibu hamil PERIODE INPUT
Hb KEK Protein urin Pencegahan Malaria Dalam Kehamilan Pencegahan Hepatitis B dalam
(GD) Pencegahan Penularan HIV dari Ibu ke Anak (PPIA) TB dalam Kehamilan Kecacingan dalam Kehamilan Pencegahan IMS dalam Kehamilan DATA
Puskesmas yang melaksanakan
Jumlah bidan yang melakukan

Jumlah Kelas Ibu Hamil yang
(PMDK) Kehamilan
Jumlah suami/keluarga yang

mengikuti kelas ibu hamil
Jumlah Ibu Hamil yang
Ibu Hamil Hasil Tes Hep B
Ibu Hamil HIV(+)

Ibu Hamil ditawarkan Tes
Ibu Hamil Hasil Tes HIV
Ibu Hamil Hasil Tes IMS


Ibu Hamil Hasil Dahak

Ibu Hamil Diperiksa
Ibu Hamil dites HIV
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
(+)
(+)
BLN TH
1 PETONGGAN 0 8-11 <8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 JAN 2021

2 BATU SAWAR 0 gr gr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :JUNI

(PMDK) Kehamilan

Ibu Hamil HIV(+)





Ibu Hamil dites HIV
Ibu Hamil Diperiksa
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
BLN TH
(+)
(+)
1 PETONGGAN 0 gr gr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 JAN 2021
2 BATU SAWAR 0 0 0 5 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 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 5 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 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN : APRIL

(PMDK) Kehamilan

Ibu Hamil HIV(+)




Ibu Hamil dites HIV
Ibu Hamil Diperiksa
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Anemia
Anemia
Obat**
TB(+)
Persalinan
HIV
(+)
BLN TH
(+)
(+)
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 JAN 2021
2 BATU SAWAR 0 0 0 4 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 4 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 12 0 0 13

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :JULI

(PMDK) Kehamilan

Ibu Hamil HIV(+)




Ibu Hamil Diperiksa
Ibu Hamil dites HIV
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
(+)
(+)
BLN TH
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 JAN 2021

2 BATU SAWAR 0 0 0 6 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 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 6 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 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :AGUSTUS
(GD) DATA
Jumlah Ibu Hamil yang mengikuti

Pencegahan Penularan HIV dari Ibu ke Anak (PPIA) TB dalam Kehamilan Kecacingan dalam Kehamilan Pencegahan IMS dalam Kehamilan

(PMDK) Kehamilan


Ibu Hamil Hasil Dahak TB(+)
Ibu Hamil diperiksa Hepatitis

Ibu Hamil Hasil Tes HIV (+)
Ibu Hamil Hasil Tes IMS (+)

Ibu Hamil HIV(+)




Ibu Hamil Diperiksa
Ibu Hamil dites HIV
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
terbentuk
GD >140 g/dl
Perabdominam (SC)
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
HIV
Persalinan
(+)
BLN TH
B
1 PETONGGAN 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 1 1 0 0 1 JAN 2021
2 BATU SAWAR √ 0 0 8 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 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK √ 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 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 1 1 0 0 1
Jumlah 0 0 0 10 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 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :SEPTEMBER

(PMDK) Kehamilan

Ibu Hamil HIV(+)





Ibu Hamil dites HIV
Ibu Hamil Diperiksa
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
BLN TH
(+)
(+)
1 PETONGGAN 0 gr gr 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 2021
2 BATU SAWAR 0 0 0 6 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU √ 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 8 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :OKTOBER

(PMDK) Kehamilan

Ibu Hamil HIV(+)




Ibu Hamil Diperiksa
Ibu Hamil dites HIV
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
(+)
(+)
BLN TH
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 2021
2 BATU SAWAR 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU √ 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT √ 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :NOVEMBER

(PMDK) Kehamilan

Ibu Hamil HIV(+)




Ibu Hamil dites HIV
Ibu Hamil Diperiksa
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Anemia
Anemia
Obat**
TB(+)
Persalinan
HIV
(+)
BLN TH
(+)
(+)
1 PETONGGAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 2021
2 BATU SAWAR 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 1 0 0 1
3 BUKIT INDAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
Jumlah 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
FORMAT 5
BULAN :DESEMBER

(PMDK) Kehamilan

Ibu Hamil HIV(+)




Ibu Hamil Diperiksa
Ibu Hamil dites HIV
Ibu Hamil Hasil Tes
kelas ibu hamil
kelas ibu hamil

Ibu Hamil diperiksa
Ibu Hamil diperiksa

Mikroskopis/RDT
Ibu Hamil diobati
Ibu Hamil diobati
Ibu Hamil diobati

Ankylostoma (+)
Diperiksa LiLA
Perabdominam (SC)
terbentuk
GD >140 g/dl
Diperiksa Hb
NO. DESA
Ankylostoma
(8-11 mg/dl)
Hepatitis B
Kina/ ACT
(<8 mg/dl)
Positif (+)
Diperiksa
Diperiksa
kelambu
HIV(+)
Obat**
Anemia
Anemia
TB(+)
Persalinan
HIV
(+)
(+)
(+)
BLN TH
1 PETONGGAN 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 1 1 0 0 1 2021
2 BATU SAWAR 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 1 0 0 1
3 BUKIT INDAH √ 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
4 LUBUK SITARAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
5 TL. DURIAN CACAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
6 TL. PERIGI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 TL. SUKAMAJU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8 TL. GEDABU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
9 TL. SEI PARIT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
10 TL. SEI LIMAU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
11 TL. SELANTAI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
12 TL. SEI EKOK 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 1 1 0 0 1
Jumlah 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 12 12 0 0 13


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
REKAPITULASI SKRINING / DETEKSI DINI IBU RESIKO TINGGI
DINAS KESEHATAN KABUPATEN INDRAGIRI HULU
TAHUN 2021
BULAN : JANUARI
FAKTOR RESIKO YANG DIJUMPAI
No DESA JUMLAH BUMIL Jumlah bumil tanpa Jumlah bumil dengan Masalah / Faktor resiko Bumil Tribulan Masalah / Faktor resiko Bumil Tribulan KET
faktor resti yang dijumpai faktor resiko I II III.1 III.2 I II III.1 III.2
1 PETONGGAN 0 0 0 1 Terlalu muda hamil ≤ 16 th 11 Penyakit pada ibu hamil :
2 BATU SAWAR 0 3 1(5) 2 a. Terlalu lambat hamil 1, kawin ≥ 4 th a. kurang darah
3 BUKIT INDAH 0 0 0 b. Terlalu tua, hamil 1 ≥ 35 th b. Malaria
4 LUBUK SITARAK 0 0 0 3 Terlalu cepat hamil lagi ( < 2 th ) c. TBC paru
5 TL. DURIAN CACAR 0 0 0 4 Terlalu lama hamil lagi ( ≥ 10 th ) d. Payah jantung
6 TL. PERIGI 0 0 0 5 Terlalu banyak anak, 4 / lebih e. Kencing manis ( Diabetes )
7 TL. SUKAMAJU 0 0 0 6 Terlalu tua, umur ≥ 35 th f. Penyakit menular seksual ( PMS )
8 TL. GEDABU 0 0 0 7 Terlalu pendek, ≤ 145 cm 12 Bengkak pada muka / tungkai
9 TL. SEI PARIT 0 0 0 8 Pernah gagal kehamilan dan tekanan darah tinggi
10 TL. SEI LIMAU 0 0 0 9 Pernah melahirkan dengan : 13 Hamil kembar 2 atau lebih
11 TL. SELANTAI 0 0 0 a. Tarikan tang / vakum 14 Hamil kembar air (hidramnion)
12 TL. SEI EKOK 0 0 0 b. Uri dirogoh 15 Bayi mati dalam kandungan
c. Diberi infus / transfusi 16 Kehamilan lebih bulan
10 Pernah operasi caesar 17 Letak sungsang
18 Letak lintang
19 Perdarahan dalam kehamilan ini
20 Preeklamsi berat / Kejang-kejang
JUMLAH 0 3 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : MEI
2 BATU SAWAR 3 3 0 2 a. Terlalu lambat hamil 1, kawin ≥ 4 th a. kurang darah
4 LUBUK SITARAK Bln ini 0 0 3 Terlalu cepat hamil lagi ( < 2 th ) c. TBC paru
5 TL. DURIAN CACAR 0 0 Bln Ini 4 Terlalu lama hamil lagi ( ≥ 10 th ) d. Payah jantung
18 Letak lintang
JUMLAH 3 3 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : JUNI
2 BATU SAWAR 6 5 1(5) 2 a. Terlalu lambat hamil 1, kawin ≥ 4 th a. kurang darah
9 TL. SEI PARIT Bln ini 0 0 8 Pernah gagal kehamilan dan tekanan darah tinggi
10 TL. SEI LIMAU 0 0 Bln Ini 9 Pernah melahirkan dengan : 13 Hamil kembar 2 atau lebih
18 Letak lintang
JUMLAH 6 5 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

TAHUN 2021
BULAN : Juli
18 Letak lintang
JUMLAH 6 5 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : AGUSTUS
18 Letak lintang
JUMLAH 8 7 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : SEPTEMBER
18 Letak lintang
JUMLAH 6 6 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : OKTOBER
18 Letak lintang
JUMLAH 7 6 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : NOVEMBER
1 PETONGGAN √ 0 0 1 Terlalu muda hamil ≤ 16 th 11 Penyakit pada ibu hamil :
18 Letak lintang
JUMLAH 8 6 0 0 0 0 0 0 0 0

NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020
TAHUN 2021
BULAN : DESEMBER
7 TL. SUKAMAJU √ 0 0 6 Terlalu tua, umur ≥ 35 th f. Penyakit menular seksual ( PMS )
8 TL. GEDABU √ 0 0 7 Terlalu pendek, ≤ 145 cm 12 Bengkak pada muka / tungkai
18 Letak lintang
JUMLAH 6 6 0 0 0 0 0 0 0 0


NIP.19760210 200501 2 007 NIP.19860323 201704 2 020 NIP.19860323 201704 2 020

Lap Kia Ibu

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Lap Kia Ibu

Diunggah oleh

Hak Cipta:

Format Tersedia

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

LAPORAN KUNJUNGAN IBU HAMIL TAHUN 2021

Tanggal Jenis kelamin Kunjungan Nifas Jenis Persalinan

LAPORAN IBU BERSALIN

LAPORAN IBU BERSALIN

LAPORAN IBU BERSALIN

LAPORAN IBU BERSALIN

LAPORAN IBU BERSALIN

LAPORAN IBU BERSALIN

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui PETONGGAN,30 JANUARI 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui PETONGGAN,28 FEBRUARI 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Jumlah 365 350 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui PETONGGAN,30 MARET 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

2 BATU SAWAR 11 11 2 0 1 1 9.09 0 1 1 9.09 0 0 0 0 0 0 0 0 0 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

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Jumlah 365 350 71 0 1 1 0.27 0 1 1 0.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui PETONGGAN, 30 APRIL 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Mengetahui PETONGGAN,30 MEI 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

2 BATU SAWAR 11 11 2 0 1 1 9.09 2 2 18 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 9.09 9.09 9.09 9.09 0 0 0

5 TL. DURIAN CACAR 60 57 12 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Mengetahui PETONGGAN,30 JUNI 2021

SRI LINDAWATI, S.sos. M.Kes MISRIATI,Amd.Keb MISRIATI,Amd.Keb

LAPORAN PWS KIA (IBU)

2 BATU SAWAR 11 11 1 0 2 2 18 0 0 0 0 0 1 1 9.09 0 0 0 0 0 0 √ √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1

5 TL. DURIAN CACAR 60 57 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 TL. PERIGI 40 38 8 0 √ ### ### 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 √ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 TL. SEI PARIT 26 25 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 TL. SEI LIMAU 31 30 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 TL. SEI EKOK 7 7 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

Mengetahui PETONGGAN,30 JULI 2021