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    Format Pencatatan Dan Pelaporan Hepatitis B

    Diunggah oleh

    Gianti wulandari

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai XLSX, PDF, TXT atau baca online dari Scribd
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    dari 316

    DATA DASAR 2022

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    No. Desa/Kelurahan Jumlah Penduduk


    1 SAMBIROTO 16873
    2 SENDANGGUWO 23650
    3 TANDANG 26399
    4 SENDANGMULYO 41849
    5 JANGLI 8446
    6 MANGUNHARJO 12235
    7 KEDUNGMUNDU 14082
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18

    19 Luar Wilayah
    JUMLAH 143534
    No Tanggal Lapor NIK Nama

    1 2 3 4
    1 8/6/2022 3374062207960002 DITHO TANJUNG PRAKOSO, SDR
    2 8/13/2022 3329162105960002 ALDIANA, SDR
    3 8/13/2022 3372042602940003 RUDY FEBRIANTO, SDR
    4 8/18/2022 3374104408000003 OVIT ROSITA NINGRUM, NN.
    5 8/18/2022 3313172308890003 YASIR RAJIYO
    6 8/20/2022 3374060907930004 LIAN,ANTONIUS BUDI HARYONO,SDR
    7 8/20/2022 3374030608920002 BUDI PURWANTORO
    8 8/22/2022 3320040901960002 DENDY ANDREA ANTARES
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    36
    37
    38
    39
    40
    41
    42
    43
    44
    45
    46
    47
    48
    49
    50
    51
    52
    53
    54
    55
    56
    57
    58
    59
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    36
    37
    38
    39
    40
    41
    42
    43
    44
    45
    46
    47
    48
    49
    50
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    36
    37
    38
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25
    26
    27
    28
    29
    30
    31
    32
    33
    34
    35
    36
    37
    38
    39
    40
    41
    42
    3
    44
    45
    46
    47
    48
    49
    50
    51
    52
    53
    Data pasien

    Jenis Kelamin Tanggal lahir Usia Pendidikan Pekerjaan Status Pernikahan

    5 6 7 8 9 10
    L 7/22/1996 26 SMA/Sederajat Swasta Belum Kawin
    L 5/21/1996 26 SMA/Sederajat Swasta Belum Kawin
    L 2/26/1994 28 Akademi/Perguruan TiSwasta Belum Kawin
    P 8/4/2000 22 SMA/Sederajat Swasta Belum Kawin
    L 8/23/1989 33 Akademi/Perguruan TiSwasta Belum Kawin
    L 7/9/1993 29 Akademi/Perguruan TiSwasta Belum Kawin
    L 8/6/1992 30 SMA/Sederajat Swasta Belum Kawin
    L 1/9/1996 26 Akademi/Perguruan TiSwasta Belum Kawin
    No Telp Alamat Domisili Kelurahan Domisili

    11 12 14
    081390489489 JL.KESATRIAN H.60/12 JATINGALEH CANDISARI RT/RW : 0 Luar Wilayah
    085786987766 JL. LOBAK RT 03/05 TANDANG
    085786394325 SUMUR BOTO JL. TANJUNG SARI 1 NO. 72 // SOROGENEN,Luar Wilayah
    GAYAMSARI SELATAN RT/RW : 6/3 SENDANGGUWO
    POLAN RT/RW : 01/05 Luar Wilayah
    089513269197 ARYA MUKTI RAYA 5/1 RT/RW : 01/03 Luar Wilayah
    08812455135 SIDO LUHUR X RT/RW : 08/05 Luar Wilayah
    GAYAMSARI RT/RW : 02/03 SENDANGGUWO
    GEJALA

    Status Pasien DAFTAR KE / IK Demam Jaundice Mual

    15 16 17 18 19
    Kontak Erat
    Kontak Erat
    Kontak Erat
    Konfirmasi
    Kontak Erat
    Kontak Erat
    Kontak Erat
    Kontak Erat
    GEJALA

    Kencing Berwarna
    Muntah Sering Lemas Perut Terasa Sebah Feses Pucat
    Gelap Seperti the

    20 21 22 23 24

    IYA IYA TIDAK


    FAK

    Pernah Transfusi Pernah Transplantasi


    Pernah Operasi Pernah Cuci Darah
    Darah Organ

    25 26 27 28
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    FAKTOR RISIKO

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg
    Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B
    WPS/Waria/LSL

    29 30 31 32
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Ya Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Tidak Tidak Tidak Tidak
    Pernah
    Pernah Serumah dg
    Punya Tato Saat ini WBP Imunisasi Hepatitis B Hepatitis C
    Pasien Hepatitis C
    Hepatitis B

    33 34 35 36 37
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Positif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    Tidak Tidak Tidak Tidak Negatif Negatif
    RIWAYAT TES DAN PENGOBATAN

    Sedang/Pernah Sedang/Pernah
    Sedang/ Pernah
    Pengobatan Pengobatan Pernah Tes HIV Status HIV
    Pengobatan HIV
    Hepatitis B Hepatitis C

    38 38 39 40 41
    Tidak Tidak Ya Non Reaktif Tidak
    Tidak Tidak Ya Non Reaktif Tidak
    Tidak Tidak Ya Reaktif Ya
    Tidak Tidak Tidak Non Reaktif Tidak
    Tidak Tidak Ya Non Reaktif Tidak
    Tidak Tidak Ya Non Reaktif Tidak
    Tidak Tidak Ya Non Reaktif Tidak
    Tidak Tidak Ya Non Reaktif Tidak
    Pemeriksaan Fisik
    Sedang
    Diagnosa Klinis Lab HBsAg Diagnosa Akhir
    Pengobatan TB Ikretik Pembesaran Hati

    42 43 44 45 46 47
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Positif Positif Positif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tidak Negatif Negatif Negatif Negatif Negatif
    Tanggal Mulai Lama Pengobatan
    Dirujuk Nama Faskes Rujukan Statu Sirosis
    Terapi (Mingggu)

    48 49 52 53 54
    Tidak Non Sirosis
    Tidak Non Sirosis
    Tidak Non Sirosis
    Ya RS ROEMANI Non Sirosis
    Tidak Non Sirosis
    Tidak Non Sirosis
    Tidak Non Sirosis
    Tidak Non Sirosis
    PEMANTAUAN PENGOBATAN

    Bulan 1 Bulan 2 Bulan 3 Bulan 4 Bulan 5 Bulan 6


    Tanggal Hail Akhir Hasil Akhir
    Terapi Lengkap
    Pengobatan Pengobatan

    55 56 57
    Sembuh
    Sembuh
    Sembuh
    Tidak Sembuh
    Sembuh
    Sembuh
    Sembuh
    Sembuh
    bln lapor
    8
    8
    8
    8
    8
    8
    8
    8
    1
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    1
    1
    1
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    1
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    1
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    id_kelurahkode_kd kelurahan
    1 KD01 Pandansari
    2 KD02 Bangunharjo
    3 KD03 Kauman
    4 KD04 Purwodinatan
    5 KD05 Pindrikan Lor
    6 KD06 Kranggan
    7 KD07 Kembangsari
    8 KD08 Pindrikan Kidul
    9 KD09 Sekayu
    10 KD10 Miroto
    11 KD11 Brumbungan
    12 KD12 Jagalan
    13 KD13 Gabahan
    14 KD14 Karangkidul
    15 KD15 Pekunden
    16 KD16 Bandarharjo
    17 KD17 Tanjungmas
    18 KD18 Kuningan
    19 KD19 Dadapsari
    20 KD20 Bulu Lor
    21 KD21 Panggung Kidul
    22 KD22 Purwosari
    23 KD23 Plombokan
    24 KD24 Panggung Lor
    25 KD25 Karangtempel
    26 KD26 Karangturi
    27 KD27 Rejosari
    28 KD28 Sarirejo
    29 KD29 Bugangan
    30 KD30 Kebonagung
    31 KD31 Mlatiharjo
    32 KD32 Rejomulyo
    33 KD33 Kemijen
    34 KD34 Mlatibaru
    35 KD35 Barusari
    36 KD36 Bulustalan
    37 KD37 Pleburan
    38 KD38 Wonodri
    39 KD39 Mugassari
    40 KD40 Randusari
    41 KD41 Lamper Tengah
    42 KD42 Lamper Kidul
    43 KD43 Lamper Lor
    44 KD44 Peterongan
    45 KD45 Karangayu
    46 KD46 Salamanmloyo
    47 KD47 Cabean
    48 KD48 Bojongsalaman
    49 KD49 Kalibanteng Kulon
    50 KD50 Kalibanteng Kidul
    51 KD51 Tambakharjo
    52 KD52 Gisikdrono
    53 KD53 Manyaran
    54 KD54 Krapyak
    55 KD55 Kembangarum
    56 KD56 Krobokan
    57 KD57 Tawangmas
    58 KD58 Tawangsari
    59 KD59 NgemplakSimongan
    60 KD60 Bongsari
    61 KD61 Gayamsari
    62 KD62 Siwalan
    63 KD63 Tambakrejo
    64 KD64 Kaligawe
    65 KD65 Sawah Besar
    66 KD66 Sambirejo
    67 KD67 Pandean Lamper
    68 KD68 Karanganyar Gunung
    69 KD69 Jomblang
    70 KD70 Jatingaleh
    71 KD71 Wonotingal
    72 KD72 Candi
    73 KD73 Kaliwiru
    74 KD74 Tegalsari
    75 KD75 Sampangan
    76 KD76 Bendan Ngisor
    77 KD77 Bendan Duwur
    78 KD78 Gajahmungkur
    79 KD79 Lempongsari
    80 KD80 Petompon
    81 KD81 Bendungan
    82 KD82 Karangrejo
    83 KD83 Genuksari
    84 KD84 Banjardowo
    85 KD85 Trimulyo
    86 KD86 Muktiharjo Lor
    87 KD87 Terboyo Kulon
    88 KD88 Terboyo Wetan
    89 KD89 Gebangsari
    90 KD90 Bangetayu Kulon
    91 KD91 Bangetayu Wetan
    92 KD92 Sembungharjo
    93 KD93 Penggaron Lor
    94 KD94 Kudu
    95 KD95 Karangroto
    96 KD96 Tlogosari Kulon
    97 KD97 Gemah
    98 KD98 Kalicari
    99 KD99 Muktiharjo Kidul
    100 KD100 Tlogosari Wetan
    101 KD101 Tlogomulyo
    102 KD102 Palebon
    103 KD103 Pedurungan Tengah
    104 KD104 Pedurungan Lor
    105 KD105 Plamongansari
    106 KD106 Pedurungan Kidul
    107 KD107 Penggaron Kidul
    108 KD108 Kedungmundu
    109 KD109 Tandang
    110 KD110 Jangli
    111 KD111 Sendangguwo
    112 KD112 Sendangmulyo
    113 KD113 Sambiroto
    114 KD114 Mangunharjo (Tembalang)
    115 KD115 Rowosari
    116 KD116 Meteseh
    117 KD117 Kramas
    118 KD118 Tembalang
    119 KD119 Bulusan
    120 KD120 Ngesrep
    121 KD121 Sumurboto
    122 KD122 Tinjomoyo
    123 KD123 Padangsari
    124 KD124 Pedalangan
    125 KD125 Jabungan
    126 KD126 Srondol Kulon
    127 KD127 Srondol Wetan
    128 KD128 Banyumanik
    129 KD129 Pudakpayung
    130 KD130 Gedawang
    131 KD131 Gunungpati
    132 KD132 Plalangan
    133 KD133 Pakintelan
    134 KD134 Nongkosawit
    135 KD135 Cepoko
    136 KD136 Jatirejo
    137 KD137 Sumurejo
    138 KD138 Mangunsari
    139 KD139 Pongangan
    140 KD140 Kandri
    141 KD141 Sadeng
    142 KD142 Sekaran
    143 KD143 Sukorejo
    144 KD144 Kalisegoro
    145 KD145 Patemon
    146 KD146 Ngijo
    147 KD147 Mijen
    148 KD148 Ngadirgo
    149 KD149 Kedungpane
    150 KD150 Cangkiran
    151 KD151 Tambangan
    152 KD152 Jatisari
    153 KD153 Wonolopo
    154 KD154 Wonoplumbon
    155 KD155 Pesantren
    156 KD156 Jatibarang
    157 KD157 Karangmalang
    158 KD158 Bubakan
    159 KD159 Polaman
    160 KD160 Purwosari (Mijen)
    161 KD161 Tambakaji
    162 KD162 Wonosari
    163 KD163 Purwoyoso
    164 KD164 Kalipancur
    165 KD165 Ngaliyan
    166 KD166 Bambankerep
    167 KD167 Wates
    168 KD168 Bringin
    169 kd169 Gondoriyo
    170 kd170 Podorejo
    171 KD171 Mangkang Kulon
    172 KD172 Mangkang Wetan
    173 KD173 Mangunharjo
    174 KD174 Tugurejo
    175 KD175 Jrakah
    176 KD176 Karanganyar
    177 KD177 Randugarut
    178 Luar Kota
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    1/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    1/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    2/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    2/28/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    3/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    3/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    4/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    4/30/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    5/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    5/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    6/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    6/30/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    7/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    7/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 1 1 0 0 1
    3 TANDANG 0 0 1 0 0 0 1
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 2 1 0 0 2
    19 Luar Wilayah 0 0 5 0 0 0 5
    Total 0 0 7 1 0 0 7

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 2
    3 TANDANG 0 1
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 3
    19 Luar Wilayah 0 5
    Total 0 8
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    1 0 1 1 0 0 1 1 0 0
    0 0 0 1 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 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 0 1 2 0 0 1 2 0 0
    0 0 0 5 0 0 0 5 0 0
    1 0 1 7 0 0 1 7 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    1 1 0 0 1 1 0 0 0 0
    0 1 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 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 2 0 0 1 2 0 0 0 0
    0 5 0 0 0 5 0 0 0 0
    1 7 0 0 1 7 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    0 1 1 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 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 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 1 0 0 0 0 0 0 0
    0 5 0 0 0 0 0 0 0 0
    0 7 1 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P L
    0 0 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 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 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 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 1 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P L
    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 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 0 1 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    1 0 1 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 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 0 0 0 0
    0 0 0 0 0 1 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L P
    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 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    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 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 1 0 0
    Jangan di hapus

    8/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    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 0 0 0
    1 0 0 0
    ngan di hapus

    8/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    9/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    9/30/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    10/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    10/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    11/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    11/30/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 0 0 0 0 0
    3 TANDANG 0 0 0 0 0 0 0
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 0 0 0 0 0
    19 Luar Wilayah 0 0 0 0 0 0 0
    Total 0 0 0 0 0 0 0

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 0
    3 TANDANG 0 0
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 0
    19 Luar Wilayah 0 0
    Total 0 0
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L 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 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    Jangan di hapus

    12/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    ngan di hapus

    12/31/2022
    LAPORAN R

    Nama Faskes : PUSKESMAS KEDUNGMUNDU


    Tahun Lapor : 2022

    Rekap Hasil Pemerikaan

    Pemeriksaan Fisik
    Ikterik Pembesaran Hati

    No KELURAHAN
    Pos Neg Pos Neg

    L P L P L P L
    Positif Positif Negatif Negatif Positif Positif Negatif
    L P L P L P L
    1 SAMBIROTO 0 0 0 0 0 0 0
    2 SENDANGGUWO 0 0 1 1 0 0 1
    3 TANDANG 0 0 1 0 0 0 1
    4 SENDANGMULYO 0 0 0 0 0 0 0
    5 JANGLI 0 0 0 0 0 0 0
    6 MANGUNHARJO 0 0 0 0 0 0 0
    7 KEDUNGMUNDU 0 0 0 0 0 0 0
    8 0 0 0 0 0 0 0 0
    9 0 0 0 0 0 0 0 0
    10 0 0 0 0 0 0 0 0
    11 0 0 0 0 0 0 0 0
    12 0 0 0 0 0 0 0 0
    13 0 0 0 0 0 0 0 0
    14 0 0 0 0 0 0 0 0
    15 0 0 0 0 0 0 0 0
    16 0 0 0 0 0 0 0 0
    17 0 0 0 0 0 0 0 0
    18 0 0 0 0 0 0 0 0
    Jumlah Dalam Wilayah 0 0 2 1 0 0 2
    19 Luar Wilayah 0 0 5 0 0 0 5
    Total 0 0 7 1 0 0 7

    Rekap Hasil Investigasi Kasus Berdasarkan Tanggal Lapor Pasien Positif Hepatitis

    Melakukan pengobatan
    No KELURAHAN
    No KELURAHAN
    Sudah Belum

    1 SAMBIROTO 0 0
    2 SENDANGGUWO 0 2
    3 TANDANG 0 1
    4 SENDANGMULYO 0 0
    5 JANGLI 0 0
    6 MANGUNHARJO 0 0
    7 KEDUNGMUNDU 0 0
    8 0 0 0
    9 0 0 0
    10 0 0 0
    11 0 0 0
    12 0 0 0
    13 0 0 0
    14 0 0 0
    15 0 0 0
    16 0 0 0
    17 0 0 0
    18 0 0 0
    Jumlah Dalam Wilayah 0 3
    19 Luar Wilayah 0 5
    Total 0 8
    LAPORAN REKAP JUMLAH HASIL PEMERIKSAAN DAN INVESTIGASI KASUS

    Diagnosa Klinis Jumlah Hasil Tes Lab HBsAg Diagnosa


    aran Hati

    Neg Pos Neg Pos Neg Pos

    P L P L P L P L P L
    Negatif Positif Positif Negatif Negatif Positif Positif Negatif Negatif Positif
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    1 0 1 1 0 0 1 1 0 0
    0 0 0 1 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 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 0 1 2 0 0 1 2 0 0
    0 0 0 5 0 0 0 5 0 0
    1 0 1 7 0 0 1 7 0 0
    KASUS

    Diagnosa Akhir
    Jumlah
    Jumlah Kematian
    JUMLAH DIRUJUK Kesembuhan Bulan
    Bulan ini
    Pos Neg ini Kawin

    P L P L P L P L P L
    Positif Negatif Negatif Kawin
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    1 1 0 0 1 1 0 0 0 0
    0 1 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 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 2 0 0 1 2 0 0 0 0
    0 5 0 0 0 5 0 0 0 0
    1 7 0 0 1 7 0 0 0 0
    Status Menikah

    Kawin Belum Kawin Cerai Hidup Cerai Mati Demam Jaundice

    P L P L P L P L P L
    Kawin Belum KawinBelum KawinCerai Hidup Cerai Hidup Cerai Mati Cerai Mati
    P L P L P L P L P L
    0 0 0 0 0 0 0 0 0 0
    0 1 1 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 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 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 1 0 0 0 0 0 0 0
    0 5 0 0 0 0 0 0 0 0
    0 7 1 0 0 0 0 0 0 0
    Gejala

    Kencing Berwarna
    Jaundice Mual Muntah Sering Lemas Perut Terasa Sebah
    Gelap Seperti the

    P L P L P L P L P L

    P L P L P L P L P L
    0 0 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 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 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 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 1 0
    Kencing Berwarna Pernah Transfusi Pernah Transplantasi
    Feses Pucat Pernah Operasi Pernah Cuci Darah
    Gelap Seperti the Darah Organ

    P L P L P L P L P L

    P L P L P L P L P L
    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 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 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 0 1 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    1 0 1 0 0 0 0 0 0 0
    Faktor Risiko

    Pernah Berhubungan
    Pernah Pakai Pernah serumah dg Pernah Serumah dg
    Pernah Cuci Darah Nakes Seks dg
    Narkoba Suntik Pasien Hepatitis B Pasien Hepatitis C
    WPS/Waria/LSL
    P L P L P L P L P L

    P L P L P L P L P 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
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0
    0 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 0 0 0 0
    0 0 0 0 0 1 0 0 0 0
    Riwayat Penyakit

    Pernah Serumah dg
    Punya Tato Saat ini WBP Hepatitis B Hepatitis C
    Pasien Hepatitis C

    P L P L P L P L P

    P L P L P L P L P
    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 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0
    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 0 0
    0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 1 0 0
    Jangan di hapus

    1/1/2022
    Riwayat Penyakit

    HIV TB

    L P L P

    L P L 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 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    0 0 0 0
    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 0 0 0
    1 0 0 0
    ngan di hapus

    12/31/2022

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