MENGETAHUI
KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 03 Juni 2021
PELAKSANA
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KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 30 Juni 2021
PELAKSANA
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KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 30 Juli 2021
PELAKSANA
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KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 30 September 2021
PELAKSANA
MENGETAHUI
KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 30 September 2021
PELAKSANA
MENGETAHUI
KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 31 Agustus 2021
PELAKSANA
MENGETAHUI
KEPALA PUSKESMAS TALAGA JAYA Talaga Jaya, 31 Agustus 2021
PELAKSANA
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 8 0 0 8 2 6
2 BCG 12 0 0 12 2 10
3 POLIO 37 0 0 37 7 30
4 DPT/HB/HIB 23 0 0 23 12 11
5 Td 17 0 0 17 7 10
6 DT 16 0 0 16 0 16
8 MR 20 0 0 20 3 17
9 IPV 31 0 0 31 2 29
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
12 5 Ml 40 0 0 40 5 35
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 8 0 0 8 2 6
2 BCG 10 0 0 10 1 9
3 POLIO 30 0 0 30 7 23
4 DPT/HB/HIB 11 0 30 41 12 29
5 Td 10 0 30 40 6 34
6 DT 16 0 0 16 0 16
8 MR 14 0 20 34 3 31
9 IPV 29 0 0 29 3 26
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
12 5 Ml 35 0 0 35 5 30
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 6 0 0 6 2 4
2 BCG 9 0 20 29 3 26
3 POLIO 23 0 30 53 13 40
4 DPT/HB/HIB 29 0 40 69 17 52
5 Td 34 0 20 54 6 48
6 DT 16 0 0 16 0 16
8 MR 31 0 20 51 6 45
9 IPV 26 0 0 26 5 21
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 94 0 0 94 11 83
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 21 0 0 21 2 19
2 BCG 23 0 0 23 5 18
3 POLIO 40 0 0 40 10 30
4 DPT/HB/HIB 20 0 0 20 14 6
5 Td 12 0 0 12 5 7
6 DT 16 0 0 16 0 16
8 MR 26 0 0 26 5 21
9 IPV 19 0 0 19 2 17
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 83 0 0 83 12 71
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 19 0 0 19 3 16
2 BCG 18 0 0 18 5 13
3 POLIO 30 0 10 40 7 33
4 DPT/HB/HIB 6 0 0 6 6 0
5 Td 7 0 10 17 7 10
6 DT 16 0 0 16 0 16
8 MR 21 0 10 31 5 26
9 IPV 17 0 0 17 3 14
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 71 0 0 71 19 52
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
Dr. Tantri Luawo Fitrianti Ramli Ali, A.Md.Kep
Nip. 19740508 200901 2 002 Nip. 19880917 201001 2 001
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 16 0 0 16 5 11
2 BCG 13 0 0 13 4 9
3 POLIO 33 0 0 33 5 28
4 DPT/HB/HIB 0 0 0 0 0 0
5 Td 10 0 0 10 7 3
6 DT 16 0 0 16 0 16
8 MR 26 0 0 26 5 21
9 IPV 14 0 0 14 2 12
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 52 0 0 52 16 36
13 Safety Box
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
Dr. Tantri Luawo Fitrianti Ramli Ali, A.Md.Kep
Nip. 19740508 200901 2 002 Nip. 19880917 201001 2 001
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 11 0 0 11 2 9
2 BCG 9 0 0 9 4 5
3 POLIO 28 0 0 28 6 22
4 DPT/HB/HIB 0 0 20 20 8 12
5 Td 3 0 50 53 5 48
6 DT 16 0 0 16 0 16
8 MR 21 0 0 21 4 17
9 IPV 12 0 0 12 2 10
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 36 0 0 36 17 19
13 Safety Box
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 9 0 0 9 9 0
2 BCG 5 0 30 35 4 31
3 POLIO 22 0 30 52 11 41
4 DPT/HB/HIB 12 0 50 62 12 50
5 Td 48 43 20 68 5 20
6 DT 16 0 0 16 0 16
8 MR 17 0 30 47 11 36
9 IPV 10 0 20 30 4 26
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 36 0 0 36 17 19
13 Safety Box
1 2 3 4 5 6 7 8 9 10
A VAKSIN
1 HBO 0 0 0 0 0 0
2 BCG 0 0 0 0 0 0
3 POLIO 41 0 0 41 16 25
4 DPT/HB/HIB 50 0 0 50 24 26
5 Td 20 0 0 20 7 13
6 DT 16 0 0 16 0 16
8 MR 36 0 0 36 18 18
9 IPV 26 0 0 26 3 23
B ADS/SPUIT
10 0.5 Ml
b. Bumil dan 0 0 0 0 0 0
c. BIAS 0 0 0 0 0 0
11 0.05 Ml 19 0 0 19 5 14
13 Safety Box
D* Rasio Penyuntikan Yang Aman ADS 0,5 Ml
Mengetahui PELAKSANA
KEPALA PUSKESMAS TALAGA JAYA
NO DESA DPT/HB1 DPT/HB 2 DPT/HB3 POL I POL 2 POL 3 POL 4 CAMP DPT/HB LANJ CAMP
L P Total
L P L P L P L P L P L P L P L P L P L P
1 LUWOO 21 32 53 3 2
2 BULOTA 17 22 39 0 2
3 BUNGGALO 12 17 29 3 1
4 BUHU 14 19 33 3 2
5 HUTADAA 16 22 38 3 2
Total 80 112 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 9 0 0 0 0
Total kumulatif
NO DESA DPT/HB1 DPT/HB 2 DPT/HB3 POL I POL 2 POL 3 POL 4 CAMP DPT/HB LANJ CAMP
L P Total
L P L P L P L P L P L P L P L P L P L P
1 LUWOO 21 32 53 1 1
2 BULOTA 17 22 39
3 BUNGGALO 12 17 29 2 2 1
4 BUHU 14 19 33 1 1 1 1
5 HUTADAA 16 22 38
Total 80 112 192 0 0 3 0 0 1 0 0 0 0 2 1 0 1 1 2 0 0 0 0
Total kumulatif
NO DESA DPT/HB1 DPT/HB 2 DPT/HB3 POL I POL 2 POL 3 POL 4 CAMP DPT/HB LANJ CAMP
L P Total
L P L P L P L P L P L P L P L P L P L P
1 BULOTA 17 22 39 1 1 1 1
2 BUHU 14 19 33 1 1
3 HUTADAA 16 22 38 1 2 1 2
Total 47 112 110 0 0 1 1 3 0 0 0 0 0 0 1 3 0 0 0 0 0 0 0
Total kumulatif
NO DESA DPT/HB1 DPT/HB 2 DPT/HB3 POL I POL 2 POL 3 POL 4 CAMP DPT/HB LANJ CAMP
L P Total
L P L P L P L P L P L P L P L P L P L P
1 BULOTA 17 22 39 1 1 1
2 BUHU 14 19 33 1 1
3 HUTADAA 16 22 38 1 1 2
Total 47 112 110 0 0 0 0 1 1 0 0 0 0 0 0 1 1 4 1 0 0 0 0
Total kumulatif
MENGETAHUI
KEPALA PUSKESMAS TALAGA JAYA
8 MI Al-Magfirah 16 #REF! 13 13 12 7 19
178.26 #REF!
181.82 #REF!
161.11 #REF!
211.11 #REF!
153.85 #REF!
181.82 #REF!
188.89 #REF!
146.15 #REF!
175.86 #REF!
luwoo
bulan hb0 bcg dpt 1 dpt 2 dpt 3 pol 1 pol 2 pol 3 pol 4 ipv camp penta camp tt1 tt2
januari 2 1 0 1 2 3 1 1 1 2 0 1 2 3 1 1 1 2 0 2 2 5 1 3 0 0 4 4 46
feb 1 2 1 1 0 1 0 3 2 3 1 1 0 1 1 3 2 3 2 3 2 1 2 2 0 2 6 4 49
mar 3 0 0 0 1 1 0 1 1 2 0 0 1 1 0 1 0 2 0 1 4 7 1 0 1 2 3 6 40
apr 3 1 2 1 0 0 1 1 0 1 2 1 0 0 1 1 0 1 0 0 0 1 1 2 2 0 4 3 32
mei 4 0 2 2 1 0 0 0 0 2 2 2 1 0 0 0 0 2 0 2 1 4 0 0 0 0 5 4 51
juni 5 2 4 1 0 0 0 0 0 0 4 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 4 5 40
juli 73
agt 50
sep 37
okt 25
nov 0
des 0
total 18 6 9 6 4 5 2 6 4 10 9 6 4 5 3 6 3 10 2 9 9 19 5 7 3 5 26 26 227
24 15 9 8 14 15 9 9 13 11 28 12 8 36 34 245
55 44 27 16 15 25 27 16 16 24 20 51 22 15 36 34 388
bulota
bulan hb0 bcg dpt 1 dpt 2 dpt 3 pol 1 pol 2 pol 3 pol 4 ipv camp penta camp tt1 tt2
januari 2 3 0 4 3 0 1 1 0 2 0 4 3 0 2 1 0 2 0 1 1 2 2 0 0 0 10 5 49
feb 3 2 0 1 2 3 3 1 1 2 0 1 2 3 3 1 1 2 1 3 1 2 0 1 1 2 10 4 56
mar 3 2 0 0 1 3 3 4 3 4 0 0 1 3 3 4 3 4 3 4 3 2 0 0 0 1 2 4 60
apr 0 0 4 1 0 0 0 1 2 1 4 1 0 0 0 1 2 1 0 0 0 1 1 0 0 0 6 0 26
mei 5 7 1 2 3 2 1 1 1 1 1 2 3 2 1 1 1 1 1 1 5 5 1 1 1 0 5 12 68
juni 2 4 3 3 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 4 28
juli #REF!
agt #REF!
sep #REF!
okt
nov
des 0
total 15 18 8 11 9 8 8 8 7 10 8 11 9 8 9 8 7 10 5 9 10 12 4 2 3 3 38 29 287
33 19 17 16 17 19 17 17 17 14 22 6 6 40 39 299
40 83 48 43 40 43 48 43 43 43 35 55 15 15 40 39 629
bunggalo
bulan hb0 bcg dpt 1 dpt 2 dpt 3 pol 1 pol 2 pol 3 pol 4 ipv camp penta camp tt1 tt2
januari 1 2 0 3 3 1 1 0 2 2 0 3 3 1 1 0 2 2 2 2 0 0 0 0 0 1 6 2 40
feb 1 1 1 0 0 1 2 0 1 0 1 0 0 1 2 0 1 0 1 0 0 2 0 1 1 0 7 3 27
mar 4 2 2 2 2 1 3 0 4 1 2 2 2 1 3 0 4 1 4 1 3 4 0 1 0 1 6 4 60
apr 2 2 1 0 0 2 1 0 0 1 1 0 0 2 1 0 0 1 0 1 0 1 0 0 0 0 3 4 23
mei 4 1 1 4 1 0 0 2 0 1 1 4 1 0 0 2 0 1 0 1 5 3 0 0 0 0 2 2 36
juni 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 8
juli #REF!
agt #REF!
sep 0
okt
nov 0
des 0
total 12 8 6 9 6 5 7 2 7 5 6 9 6 5 7 2 7 5 8 6 8 10 0 2 1 2 24 19 194
20 15 11 9 12 15 11 9 12 14 18 2 3 32 26 209
30 67 50 37 30 40 50 37 30 40 47 60 7 10 32 26 561
buhu
bulan hb0 bcg dpt 1 dpt 2 dpt 3 pol 1 pol 2 pol 3 pol 4 ipv camp penta camp tt1 tt2
januari 2 1 1 2 1 1 0 0 1 1 1 2 1 1 0 0 1 1 0 1 1 0 2 1 0 1 5 4 32
feb 0 3 1 0 1 1 2 3 0 0 1 0 1 1 2 3 0 0 0 0 2 0 0 3 1 2 4 0 31
mar 0 1 1 5 2 0 0 1 3 4 1 5 2 1 0 1 3 5 3 5 5 2 0 1 0 0 4 4 59
apr 0 1 0 0 1 4 2 2 0 0 0 0 1 4 2 2 0 0 0 0 0 2 1 0 0 1 3 2 28
mei 2 2 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 3 1 0 0 0 0 1 5 18
juni 3 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 6 5 19
juli #REF!
agt 0
sep 0
okt 0
nov 0
des 0
total 7 10 4 7 5 6 4 6 4 5 4 7 5 7 4 6 4 6 3 8 12 5 3 5 2 5 23 20 187
17 11 11 10 9 11 12 10 10 11 17 8 7 29 38 211
35 49 31 31 29 26 31 34 29 29 31 49 23 20 29 38 478
hutadaa
bulan hb0 bcg dpt 1 dpt 2 dpt 3 pol 1 pol 2 pol 3 pol 4 ipv camp penta camp tt1 tt2
januari 4 3 2 3 1 1 1 4 0 0 3 2 1 1 1 4 0 0 0 0 0 0 1 1 1 4 4 9 51
feb 0 1 1 3 2 1 0 0 0 4 1 3 2 1 0 0 0 4 0 2 2 2 2 3 0 0 2 4 40
mar 4 2 1 0 1 6 2 4 1 4 1 0 1 6 2 4 1 4 2 4 3 2 1 1 1 2 8 5 73
apr 1 1 2 1 2 3 1 4 4 1 2 1 2 3 1 4 4 1 2 1 0 2 0 0 0 0 3 4 50
mei 2 4 4 2 0 0 0 0 0 0 4 2 0 0 0 0 0 0 0 1 4 3 0 0 2 0 6 3 37
juni 2 2 2 2 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 1 0 3 0 0 1 1 4 3 25
juli 0
agt 0
sep 0
okt 0
nov 0
des 0
total 13 13 12 11 6 11 4 12 5 9 13 10 6 11 4 12 5 9 4 9 9 12 4 5 5 7 27 28 276
26 23 17 16 14 23 17 16 14 13 21 9 12 37 37 295
40 65 58 43 40 35 58 43 40 35 33 53 23 30 37 37 627
50 53 56 42 41 53 52 40 41 42
41 42 42 42 42 42 41 43 42 43
32 32 33 31 30 32 33 31 30 33
35 35 35 41 44 35 35 41 44 41
43 44 40 41 43 44 40 41 43 51
201 206 206 197 200 206 201 196 200 210
42 18 20
51 22 17
44 14 9
45 10 7
62 27 18
244 91 71
0 0 0
DAFTAR NAMA BALITA YANG DI WISUDA
DAN TANGGAL PEMBERIAN IMUNISASI PER-ANTIGEN
PUSKESMAS TALAGA JAYA
VAKSINASI
NAMA TANGGAL BCG / DPT-HB 1 / DPT-HB 2 / DPT-HB 3 / DPT HB-Hib CAMP
NO NAMA IBU JK
HB0 IPV CAMP
POL 1 POL 2 POL 3 POL 4 BOOSTER BOOSTER
BALITA LAHIR
1 ABI ARFAN ABDULAH 27/9/17 SULASTRI DJIUWA L 27/9/17 14/11/17 14/12/17 13/1/18 14/2/18 14/3/18 11/6/2018 15/12/18
2 SAFRUDIN SUNATI 24/6/17 WARI DALI L 24/6/17 14/8/17 14/9/17 14/10/17 14/11/17 14/12/17 16/4/18 14/1/19
3 MEIMUN LAGAMANI 6/5/2017 NOVITA PAU P 9/5/2017 14/7/17 14/8/17 14/9/17 14/10/17 13/1/18 14/2/18
4 FATMA MARJUN 20/1/17 RULIYANTI HAJI P 21/1/17 14/3/17 13/4/17 14/6/17 14/7/17 14/7/17 14/11/17 14/7/18 15/12/18
5 ILYAS AKUBA 14/5/17 NURLANI MUKU L 15/5/17 14/7/17 14/8/17 14/10/17 14/11/17 14/11/17 14/2/18 15/12/18
6 NAURA APRILIA HANDOK 29/4/17 NOVA HASANIA P 29/4/17 14/6/17 14/7/17 14/8/17 14/9/17 14/9/17 14/2/18
7 MOH ALIF PRADITYA NUS 20/9/17 HALIMA LAMALANI L 20/9/17 14/11/17 14/12/17 13/1/18 14/2/18 14/3/18 11/6/2018 20/4/19
8 MIRNA BADARU 3/3/2016 HASANIA BILOLOA P 3/3/2016 14/4/16 14/5/16 14/6/16 15/7/16 15/8/16 14/12/16 14/9/17 14/3/18
9 MOH RIFALDI KAZE 1/5/2017 NURMALA SULEMAN L 2/5/2017 14/6/17 14/7/17 14/8/17 14/9/17 14/10/17 14/2/18 15/12/18
LAPORAN BULAN IMUNISASI ANAK SEKOLAH (BIAS) DT DAN Td
WILAYAH PUSKESMAS TALAGA JAYA
SD MI Total SD MI Total % KLS. I KLS. II KLS. V ABS % ABS % ABS % DIPAKAI IP DIPAKAI IP DIPAKAI DIPAKAI DIPAKAI
TOTAL 7 1 8 7 1 8 100 231 197 239 125 54.11 105 53.30 134 56.07 16 7.81 30 7.96 364 0 5
32
42
28
76
239
6.375