FORMAT PENCATATAN HASIL PELAYANAN

osyandu/Pos ayanan BIAN lainnya : SDN 003 MAWA', SDN 013 TULLU, SDN 012 BUTTU DEWATA
Desa/kelurahan : DESA TABANG BARAT
Tanggal : 27 MEI 2022

Jenis Kelamin
No. Nama Anak NIK ANAK Tgl lahir Umur Nama orang tua Alamat
(L/P)

a b c d e f g
1 MELKIAS ROMBE 7603101905110001 5/9/2011 11 L AMINNAH TABANG BARAT
2 JUBER SURIANG 7603101410110001 10/14/2011 10 L DINA DO LUNGA TABANG BARAT
3 LETHICHIA VIRGINIA 7603105711100003 11/17/2010 11 P SRI WAHYUNI MAWA
4 SEAN TRIONEL P.B 7603101206110001 6/12/2011 10 L YULIANA MESA BULAWAN MAWA
5 HENDRIK RINGGA 7603100312100001 12/3/2010 11 L BITTAN MAWA
6 ASCHA BUMBUNGAN 7603106204110001 4/22/2011 11 P OKTOVINA TABANG BARAT
7 JANNUAR PALULLUNGAN 7603101901110001 1/19/2011 11 L NORIATI PATOTTONG
8 JHONDRIS R.L 7603102306110001 6/23/2011 10 L NAOMI RATTE LANGI' MAWA
9 YONA TALLOK 3/30/2014 8 P TABANG BARAT
10 FRISKY D. 9/15/2014 7 L ADOLVINA MAWA
11 EDGAR SEPTIADI MARIO 7371120209140003 9/2/2014 7 L DIANA KOMBONG T. TABANG BARAT
12 DIRTO HOLIANUS LELE 7603102107150001 7/21/2015 6 L JENIATI KABIA' MAWA
13 SEPRIANUS AGSEL R. 7603102909140001 9/29/2014 7 L ARTIKA SELVIYANA MAWA
14 KRISTODER UNDAN 7603120710140001 10/7/2014 7 L IRMAYANTI TABANG BARAT
15 MARIANI LE'TO RARA' 7318315903150001 3/19/2015 7 P DORCE DO'SE TABANG BARAT
16 STEVANY KOMBONG LAMBA 7603104808140001 8/3/2014 7 P FEBRIANTI DUMA MAWA
17 JOICE ANGGREINY B. 7603106201150001 1/22/2015 7 P LINCE SALIMBO MAWA
18 MARCHELINUS RATTANG 7603100103140001 3/1/2014 8 L LINDA MAWA
19 DEO REWARD PABENO 7318131211130001 11/12/2013 8 L ADRYANTY BUNGALELE MAWA
20 AMELIA EVELIN 7603084605140002 5/6/2014 8 P AGUSTINA TASIK PASAU MAWA
21 ADELIA YOSEVIN 7603084605140001 5/6/2014 8 P AGUSTINA TASIK PASAU MAWA
22 ALDHES IRAWAN R.M 7603101006140001 6/10/2014 7 L IRAWATI KARUA MAWA
23 ARIFIN 7603101904130001 4/19/2013 9 L TABANG BARAT
24 JHUYNITA PUTRI 7603104406140002 6/4/2014 7 P KARTIKA TABANG BARAT
25 SUKARTIKO 7603102108130002 8/21/2013 8 L DORCE R. TABANG BARAT
26 JORDI BUTTU M. 7603101003120002 3/10/2012 10 L DORKAS YULIANA TABANG BARAT
27 YUADISTA S. LEMBANG 7603102308130001 6/23/2013 8 L SUA' LANGI' DEMMALEWA MAWA
28 CHRISTY PUTRI M.B 7603104405130001 5/4/2013 9 P RANGGA BULAWAN MAWA
29 GLADIES LEBOK KARUA 7603105805130001 5/18/2013 9 P DANIATI DATU LEBOK TABANG BARAT
30 PUTRIYANI LIKU TASIK 7603105501130001 1/15/2013 9 P LEVINA MAWA
31 TALAR TOLA'BI' 7603101709120001 9/17/2012 9 L ARMIN ARRANG MAWA
32 CELSY PANI R.B TABANG BARAT
33 MIRA TABANG BARAT
34 VALEN T.P 2/13/2012 10 L ROHAMA MAWA
35 KASIH MULIAH SOMBO B. 7603106303120001 3/23/2012 10 P DORCE R. MAWA
36 AHADBRITU VALENTINO 7603101202120002 2/12/2012 10 L NOVIANTI MAWA
37 MAWAR BANNE BUA' 7603105605110001 5/16/2011 11 P MELSINA DATU LUMILING GANTUNGAN
38 SASQHIA CHELIN 7603104909120001 9/9/2012 9 P JENIATI KABIA' MAWA
39 DATU 7603104910100001 10/9/2010 11 P DO' MADAN MAWA
40 SERLIANTI TASIK 7603104708120001 8/7/2012 9 P FEBRIANTI DUMA MAWA
41 KRISNA MULYA RAPA 7603100311110001 11/3/2011 10 L IDA ROS MAWA
42 ILHAM MANGNGALA 7603101105110001 5/11/2011 11 L ABIDA TABANG BARAT
43 REZA HARLINO RAYA 7603102311110001 11/23/2011 10 L HERLINA LEBOK PATOTTONG
44 REYSTI YUNI 7603106103120001 3/21/2012 10 P LIKU PATOTTONG
45 SEPRIANTO YAFET S. 7603102708120001 8/27/2012 9 L MARLINA TINDO TABANG BARAT
46 ENJEL JUNITA PAILIN 7603107006120001 6/30/2012 9 P HERLINA MAWA
47 MARGARETA PINDAN 7603104107120001 7/1/2012 9 P TIPPIN MAWA
48 GILBERT 7603100707110001 7/7/2011 10 L MARLINA MAWA
49 NOVITA SOMBO RARA' 7603104111110002 11/1/2011 10 P AGUSTINA KUMBA MAWA
50 OLMAN SAPUTRA 7603100110110001 10/1/2011 10 L MARYATI MA'DIKA MAWA
51 CLARA SIRUMBA 7603104107110002 7/1/2011 10 P LEVINA PINDAN TULLU
52 CLAURA LEBOK 7603104107110001 7/1/2011 10 P LEVINA PINDAN TULLU
53 WANDARISKA MASUA 7603105107100001 7/11/2010 11 P KARTIKA TABANG BARAT
54 JUNIATI LEBOK KARUA 7603106906100001 6/29/2010 11 P MAYUNG TABANG BARAT
55 LENIN BUNTU BAMBA 7603101907110001 7/19/2011 10 L LINCE SALIMBO MAWA
56 AXEL L TABANG BARAT
57 TIARA TABANG BARAT
58 TITIN TABANG BARAT
59 MARSELIANI B. 7603107103150001 3/31/2015 7 P ESTERLINA K. POKKO
60 MARSELYANTO T. 7603101003150001 3/10/2015 7 L LOLOK REA
61 KRISTIAN P.B L TABANG BARAT
62 PUTRA D. 7603102911130001 11/29/2013 8 L JUSNITA TABANG BARAT
63 IMANUEL D. 7603101608130001 8/16/2013 8 L DORCE TABANG BARAT
64 ALDANI TAMBO 7603100801140001 8/16/2013 8 L DAMARIA D.K POKKO
65 ARDIANUS P.B 7603100505130001 5/5/2013 8 L LIMBONG T. TABANG BARAT
66 CHRISJHON R.L 7603100911120001 11/9/2012 9 L SRIWARNI MAWA
67 LEBRI 7603103105120001 5/31/2012 10 L SARCE M POKKO
68 SOMBO 7603106811120001 11/28/2012 9 P TALIMBONG TABANG BARAT
69 GRACIA A.M 7603106101130001 1/21/2013 9 P MARLINA M.B POKKO
70 AKNES S.B 7603105710110001 10/17/2011 10 P SISILIA A.M TABANG BARAT
71 SELVI 7603105309110001 9/13/2011 10 P LANGI POKKO
72 NOVITALIATI 7603105111100001 11/11/2010 11 P SILOMBA REA
73 ARSIATI 7603106111100001 11/21/2010 11 P DINA POKKO
74 RASYUNI PUTRI 7603105106150001 6/11/2015 6 P LETO TABANG BARAT
75 RIVALDIANUS T. 7603102510140001 10/25/2014 7 L MALA POKKO
76 AL HAYYU REGAR 7603105905150001 5/19/2015 7 L ATIK TABANG BARAT
77 LESTY 7603105103140001 3/11/2014 8 P HERLINA POKKO
78 PUTRIANI BUDA 7603105008130001 8/10/2013 8 P SILOMBA REA
79 AYUNITA 7603105409140001 9/14/2014 7 P MA'NA REA
80 IMANUEL PASAU 7603040707130001 7/7/2013 7 L ESTER BIRING MAMASA
81 JUNAEDI 7603080806130001 6/8/2013 7 L LIA RAGGA L. POKKO
82 NELSON P. LANGI 7603102609130002 9/26/2013 7 L RIPKA TASIK P. POKKO
83 GERNAL D. KARUA 7318310608120001 8/6/2012 9 L NAOMI LIKU A. BUTTU DEWATA
84 MIKHAEL PASA'BUAN 7603101805120001 5/18/2012 10 L RIPKA TASIK P. POKKO
85 WIDELA SARI L. 7603106612120001 10/26/2012 9 P MARLINA SADE REA
86 ENJELI TASIK M. 7603106510120003 10/25/2012 9 P KRISDAYANTIN A. POKKO
87 JUIDEDI TANGNGAYA 7603103007110001 7/30/2011 10 L MARLINA SADE POKKO
88 ANTI 7603105211100001 11/20/2010 11 P SARCE M. POKKO
89 NOVRIANTI M. 7603106811110001 11/28/2011 10 P MARIANA S. POKKO
90 APRIL SAMBO K. L DAUN TULLU
91 ELWIN ERIKA 7603106303050001 3/23/2015 7 P DATU TULLU
92 PENI MARSYA BANSELE 7371145402150001 2/14/2015 7 P DIANA KRISTIN TULLU
93 JEFLIYANTO SYAPUTRA 7318311210140001 10/12/2014 8 L LINDAWATI SADIPE
94 APNEL S. 7603102607130001 7/26/2013 8 L ATI AMBULUNG SADIPE
95 ALVIN MALLOGA 7603102306140001 6/23/2014 7 L LIKU RARA SADIPE
96 BILSON BLIATON 7603102608130001 8/26/2013 8 L BANNE K SADIPE
97 ESTER EPPO 7603104603140001 3/6/2014 8 P DO'SE SADIPE
98 HIZKIA AGUNG PANCA 7603102308140001 7/1/2014 7 L HERLINA SADIPE
99 JANNUAR B. 7603102901140001 1/29/2014 8 L LIMBONG TASIK RA'DA
100 ULIA LA'BI 7603106908140001 8/29/2014 7 P SAMMIN TULLU
101 RISNAWATI RANGGA 7603104202140001 2/2/2014 8 P BULAWAN M. TULLU
102 SARATU 7603104401140001 1/4/2014 8 P MASIRI TULLU
103 MATTHEW TOLABI 7603100504140001 4/5/2014 8 L TIARA PUTRI TULLU
104 ARJUN TANDI P. 9 L TULLU
105 DAFBRIEL BONGGA 7603080206130001 6/2/2013 8 L BA'YAN TULLU
106 MYCHEL MANGNGAPI 7603100805130001 5/8/2013 9 L YULINDRA TULLU
107 ROBI 7603100105120001 5/1/2012 10 L MASIRI TULLU
108 VALEN RANDI 9 L TULLU
109 ATMI BUNGAN LEBOK 7603106608130001 6/26/2013 8 P ARSELINA DAUN RARA SADIPE
110 CHELSIA LEBOK 7603106803130001 3/28/2013 9 P TINAKKA TULLU
111 FITRA LIMBONG RARA 7603106602130001 2/26/2013 9 P ANITA LE'TO RARA TULLU
112 ALVRIANUS ALLO M. 7603101206120001 4/12/2012 10 L MARIA RATTE TULLU
113 DANYEL DUA L. 7603100804120001 4/8/2012 10 L RITAWATI RENDEN TULLU
114 OKTOVIANUS LUNGAN 7603102610120001 10/26/2012 9 L MARTHA LOLA TULLU
115 AGUSTINA SEBO 7603104206130001 8/11/2012 9 P SARCE KOMBONG SADIPE
116 JANAWATI DATU 7603105901120001 1/19/2012 10 P BAWAN TULLU
 117 JESIKA BATTI M. 7603105708120001 8/17/2012 9 P MARUMBA TULLU
118 FELISYA 7603104601130001 1/6/2013 9 P KRISTINA KAIDA TABANG BARAT
119 PEDLY MAKESSA 7603105006120001 6/10/2012 9 P LIKU RARA' SADIPE
120 WULAN LEBOK B. 7603105407110001 7/14/2012 9 P SUKU TULLU
121 JANUAR SEWE 7603101101110001 1/11/2011 11 L BUNGIN TULLU
122 DIANA KRISTIN B. 7371144908110002 8/9/2011 10 P YUSTUS TULLU
123 GRESLIN AMELIA FAOT 7371124305110006 5/3/2011 11 P MELDA TABANG BARAT
124 HERMANTO 7603100706100001 6/7/2010 11 L MOGEN TULLU
125 PIKA BIMBAN 7603104105100001 6/24/2010 11 P SARCE KOMBONG SADIPE
Jumlah vaksin (vial) dan logistik yang digunakan
Pelarut Campak
Jenis logistik OPV IPV DPT-HB-HIB CAMPAK RUBELA Rubela
Jumlah 13 13
Catatan
* Tuliskan alasan jika anak tidak bisa diimunisasi dan rencana jadwal pemberian imunisasi susulan pada kolom keterangan
PELAYANAN
Nama petugas :
Puskesmas : TABANG
Kabupaten : MAMASA

Imunisasi Kejar
(Ya = 1, Tidak=0) Ket** (bila anak
mendapatkan dosis
Campak
kedua/keetiga/keempat
Rubela
No.Hp NIK OPV/Penta saat BIAN,
(Ya=1,
maka tetap dicatat namun
Tidak=0)
OPV IPV DPT-HB-Hib tidak dimasukkan sebagai
cakupan BIAN)

h i j k l m n
7603107112750002 1
7603104807810001 1
7603106009920001 1
7603104707670001 1
7603106912840003 1
7603035909870001 1
7603105611850002 1
7603105206880001 1
1
7603104104800002 1
7371124401880004 1
7603105108810001 1
7603104612890001 1
7603126911950001 1
7318314107830038 1
7603104602860001 1
7603106506790001 1
7603104101950001 1
7604045809870007 1
7603084208900001 1
7603084208900001 1
7603104710950001 1
1
7603106707830004 1
7603106008750001 1
7603104707800002 1
7603104608920002 1
7603104405130001 1
7603105705930002 1
7603106507930001 1
7603104505820001 1
1
1
7603106408800001 1
7603108008750001 1
7603104811770001 1
7603105812800001 1
7603105108810001 1
7603107012740001 1
7603104602860001 1
7603106311790002 1
7603106312740001 1
7603104609900001 1
7603104210820001 1
7603106303880002 1
7603106510960001 1
7603104412780001 1
7603105003870001 1
7603104107920018 1
7603106903760001 1
7603105612860001 1
7603105612860001 1
7603106707830004 1
7603107112700006 1
7603106606790001 1
1
1
1
7603104508940001 1
7603104705970002 1
1
7603104803930001 1
7603104712920001 1
7603105712850001 1
7603106008880001 1
7603105110880002 1
1
7603106908830001 1
7603105807910001 1
7603106008850001 1
7603104806640001 1
7603104906930001 1
7603104506800001 1
7603107112770002 1
7603104201950001 1
1
7603105612940001 1
7603104906930001 1
7603104904890001 1
7603045003810001 1
7603084408910001 1
7603104106890001 1
1
7603104106890001 1
7603105912880001 1
7603106002810002 1
7603105912880001 1
1
7603105507800001 1
1
1
7371144908110002 1
7603106110970001 1
7603107112890001 1
7603104107910010 1
7603046701870001 1
7603105003800001 1
7603107112810005 1
7603105012790001 1
7603104910520001 1
7603104112840002 1
7603104107680015 1
7603106905080002 1
1
7603084802890002 1
7603015505930001 1
7603104107680015 1
1
7603106305960001 1
7603107007890002 1
7318287010920001 1
1
1
1
7603104502880003 1
7603104107790008 1
 7603106508590001 1
7603104505860003 1
7603104107910019 1
1
7603104505790001 1
7371111908850005 1
7371116403920012 1
1
7603104502880003 1
ang digunakan

Dropper ADS 0,5 ML ADS 5 ML Safety Box Pen Marker

125 13 2 1
 FORMAT REKAPITULASI HASIL PELAYANAN BULAN IMUNISASI ANAK NASIONAL
Desa/kelurahan :
Puskesmas :
Isilah pada kolom yang berwarna

Sasaran dan Cakupan Imunisasi Kejar Sasaran dan cakupan imunisasi campak rubela

Usia 12 - 59 bulan Usia 9-59 bulan Usia 5 - <7 thn Usia 7-<12 thn Usia 12 -<15 thn
(bagi 5 Prov.)
NO Posyandu/Pos layanan
BIAN lainnya OPV IPV DPT-HB-Hib Campak Rubella Campak Rubela Campak Rubela Campak Rubela
Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah Jumlah
Jumlah sasaran % % % % % %
diimunisasi sasaran diimunisasi sasaran diimunisasi sasaran diimunisasi sasaran diimunisasi sasaran diimunisasi sasaran diimunisasi

a b c d e f g h i j k l m n o p q r s t u v
200 50 25.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Total 200 50 25.0% 0.0% 0.0% 0.0% 0.0% 0.0%
 Periode
Nama petugas

Usia 12 -<15 thn

(bagi 5 Prov.)
Campak Rubela Total Sasaran Campak Total dimunisasi Campak Total
Rubella Rubella Cakupan
%

w x = l+o+r / l+o+r+u y = m+p+s / m+p+s+v

0.0% 200 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0 0.0%
0.0% 0 0.0%
Nama Provinsi :

Nama Kabupaten :
Nama Puskesmas :

Isilah Kolom yang berwarna!

OPV IPV
Posyandu/Pos Imunisasi
No. lainnya
Jumlah diimunisasi Jumlah Vial Indeks Pemakaian Jumlah diimunisasi
digunakan Vaksin

a b c d e f
100 10 10 30
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
TOTAL 100 10 10 30

Catatan :
IP = Jumlah yang diimunisasi/jumlah vial vaksin yang digunakan
 FORMAT REKAPITULASI LOGISTIK PUSKESMAS

h Kolom yang berwarna!

IPV DPT-HB-Hib Campak Rubela

Jumlah Vial Indeks Jumlah Jumlah Vial

Pemakaian IP Jumlah diimunisasi Jumlah Vial IP
digunakan Vaksin diimunisasi digunakan

g h i j k l m n
10 3 50 40 1.25 #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
10 3 50 40 1.25 0 0 #DIV/0!
 Jumlah Logistik yang digunakan

Pelarut Dropper ADS 0,5 ML ADS 5 ML Safety Box Pen Marker

o p q r s t
4 5 4 5 7 3

4 5 4 5 7 3
 FORMAT REKAPITULASI LOGISTIK KABUPATEN
Nama Provinsi :

Nama Kabupaten/Kota:

Isilah Kolom yang berwarna!

OPV IPV DPT-HB-Hib
No. Nama Puskesmas
Jumlah Jumlah Vial Indeks Pemakaian Jumlah diimunisasi Jumlah Vial Indeks Jumlah Jumlah Vial
diimunisasi digunakan Vaksin digunakan Pemakaian diimunisasi digunakan
Vaksin

a b c d e f g h i j
100 10 10 30 10 3 50 40
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
TOTAL 100 10 10 30 10 3 50 40

Catatan :
IP = Jumlah yang diimunisasi/jumlah vial vaksin yang digunakan
REKAPITULASI LOGISTIK KABUPATEN

T-HB-Hib Campak Rubela Jumlah Logistik yang digunakan

IP Jumlah diimunisasi Jumlah Vial IP Pelarut Dropper ADS 0,5 ML ADS 5 ML Safety Box Pen Marker

k l m n o p q r s t
1.25 #DIV/0! 4 5 4 5 7 3
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
1.25 0 0 #DIV/0! 4 5 4 5 7 3
 FORMAT REKAPITULASI LOGISTIK PROV
Nama Provinsi :

Isilah Kolom yang berwarna!

OPV IPV DPT-HB-Hib
No. Kabupaten/Kota
Indeks
Jumlah Vial Indeks Pemakaian Jumlah Vial Jumlah Jumlah Vial
Jumlah diimunisasi Jumlah diimunisasi Pemakaian
digunakan Vaksin digunakan diimunisasi digunakan
Vaksin

a b c d e f g h i j
100 10 10 30 10 3 50 40
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
TOTAL 100 10 10 30 10 3 50 40

Catatan :
IP = Jumlah yang diimunisasi/jumlah vial vaksin yang digunakan
APITULASI LOGISTIK PROVINSI

T-HB-Hib Campak Rubela Jumlah Logistik yang digunakan

IP Jumlah diimunisasi Jumlah Vial IP Pelarut Dropper ADS 0,5 ML ADS 5 ML Safety Box Pen Marker

k l m n o p q r s t
1.25 #DIV/0! 4 5 4 5 7 3
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
1.25 0 0 #DIV/0! 4 5 4 5 7 3