0

TAHUN 2021

Nama Puskesmas : LASEM

Bulan : JANUARI
JML KUNJUGAN BATUK DIARE

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Batuk bkn pneomonia

Diare Prsistn Berat

Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri
MTBS

1 Karasgede 1 1 100 - - 1 - - - - - -
2 Joltundo 1 1 100 - - 1 - - - - - -
3 Sdcoyo 1 1 100 - - 1 - - - - - -
4 Ngargomulyo - - - - - - - - - - - -
5 Kajar 3 3 100 - - 3 - - - - - -
6 Selopuro 6 6 100 - - 6 - - - - - -
7 Sumbergirang 1 1 100 - - 1 - - - - - -
8 Karangturi 1 1 100 - - 1 - - - - - -
9 Babagan 1 1 100 - - 1 - - - - - -
10 Dorokandang - - - - - - - - - - - -
11 Gedong mulyo 1 1 100 - - 1 - - - - - -
12 Soditan 1 1 100 - - 1 - - - - - -
13 Ngemplak 1 1 100 - - 1 - - - - - -
14 Sendang asri 2 2 100 - - 2 - - - - - -
15 Gowak 1 1 100 - - 1 - - - - - -
16 Sriombo 1 1 100 - - 1 - - - - - -
17 Binangun 1 1 100 - - 1 - - - - - -
 18 Bonang 2 2 100 - - 2 - - - - - -
19 Tasiksono 1 1 100 - - 1 - - - - - -
20 Dasun 1 1 100 - - 1 - - - - - -

Jumlah bln ini 27 27 100 - - 27 - - - - - -

Jumlah bln lalu
Komulatif 27 27 100 - - 27 - - - - - -
 DEMAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELI
Tinggi malaria Rendah Malaria
Malaria
Peny. Berat dg demam

Peny. Berat dg demam

Peny. Berat dg demam

Kom.pd mata &mulut

Dgn kompliksi berat
Demam mgk bukan

Demam mgkn bkn

Dmm bkn malaria
Dmm mgkn bkn

Mungkin DBD

Mastoideus
Campak
malaria

malaria

malaria

malaria

DBD

DBD
- - - - - - - - - - - - - - -
- - - - - - - 1 - - - - - 1 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - 3 - - - - - 3 -
- - - - - - - - - - - -- - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - 1 - - - - - 1 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - 5 - - - - - 5 -

- - - - - - - 5 - - - - - 5 -
MASALAH TELINGA STATUS GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Sangat Kurus dan/atau
Tdk ada inf.telinga
Inf.telinga kronis
Inf.Telinga akut

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
oedema

Normal

Anemi
Kurus

- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - - - - - - - - - - -
- - 3 - - 3 - - 3 - - -
- - 6 - - 6 - - 6 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - - - - - - - - - - -
- - 1 - - 1 - - 1 - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - -
- - 2 - - 2 - - 2 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -
- - 2 - - 2 - - 2 - - -
- - 1 - - 1 - - 1 - - -
- - 1 - - 1 - - 1 - - -

- - 27 - - 27 - - 27 - - -

- - 27 - - 27 - - 27 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : FEBRUARI
DEMAM/ DAERAH RES
JML KUNJUGAN BATUK DIARE
Tinggi malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 2 2 100 0 0 0 0 0 0 0 0 0 0 0 0
2 Joltundo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
3 Sdcoyo 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
6 Selopuro 6 6 100 0 0 6 0 0 0 0 0 0 0 0 0
7 Sumbergirang 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
9 Babagan 2 2 100 0 0 1 0 0 0 0 0 0 0 0 0
10 Dorokandang 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
13 Ngemplak - - 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
16 Sriombo 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang 7 7 100 0 0 7 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0

Jumlah bln ini 41 41 1,700 - - 37 - - - - - - - - -

Jumlah bln lalu 27 27 100 - - 27 - - - - - - - - -
Komulatif 68 68 1,800 - - 64 - - - - - - - - -
DEMAM/ DAERAH RESIKO Tanpa STATUS GIZI
CAMPAK DBD MASALAH TELINGA ANEMIA
Rendah Malaria Resiko (BB/TB)
Malaria
Peny. Berat dg demam

Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Tidak Anemia
Anemia Berat
Mastoideus
Campak

oedema

Normal
malaria

malaria

Anemi
Kurus
DBD

DBD
0 0 0 0 2 0 0 0 0 0 2 0 0 0 2 0 0 2 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 6 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 1 0 0 0 0 0 1 0 0 0 2 0 0 2 0 0 2
0 0 0 0 2 0 0 0 0 0 2 0 0 0 2 0 0 2 0 0 2
0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2
0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 1
0 0 0 0 3 0 0 0 0 0 3 0 0 0 3 0 0 3 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 7 0 0 0 0 0 7 0 0 0 7 0 0 7 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1

- - - - 17 - - - - - 17 - - - 41 - - 41 - - 41
- - - - 5 - - - - - 5 - - - 27 - - 27 - - 27
- - - - 22 - - - - - 22 - - - 68 - - 68 - - 68
 DIRUJUK
Puskesmas Rawat Inap

Rumah Sakit
Keluhan lain

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

- - -
- - -
- - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : MARET
JML KUNJUGAN BATUK DIARE

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Batuk bkn pneomonia

Diare Prsistn Berat

Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri
MTBS

1 Karasgede 2 2 100 0 0 2 0 0 0 0 0 0
2 Joltundo 2 2 100 0 0 2 0 0 0 0 0 0
3 Sdcoyo 2 2 100 0 0 2 0 0 0 0 0 0
4 Ngargomulyo 1 1 100 0 0 1 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 2 0 0 0 0 0 0
6 Selopuro 5 5 100 0 0 5 0 0 0 0 0 0
7 Sumbergirang 2 2 100 0 0 2 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0
9 Babagan 2 2 100 0 0 2 0 0 0 0 0 0
10 Dorokandang - - 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0
13 Ngemplak 1 1 100 0 0 0 0 0 1 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0
15 Gowak - - 0 0 0 0 0 0 0 0 0 0
16 Sriombo 1 1 100 0 0 1 0 0 0 0 0 0
17 Binangun 2 2 100 0 9 2 0 0 0 0 0 0
 18 Bonang 2 2 100 0 0 2 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0

Jumlah bln ini 32 32 100 - 9 32 - - 1 - - -

Jumlah bln lalu 68 68 100 - - 64 - - - - - -
Komulatif 100 100 100 - 9 96 - - 1 - - -
 DEMAM/ DAERAH RESIKO
Tinggi malaria
Peny. Berat dg demam
Demam mgk bukan
malaria
malaria
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Tanpa Resiko CAMPAK DBD MASALAH TELI
Rendah Malaria
Malaria
Peny. Berat dg demam
Peny. Berat dg demam
Kom.pd mata &mulut
Dgn kompliksi berat
Demam mgkn bkn
Dmm bkn malaria
Dmm mgkn bkn
Mungkin DBD
Mastoideus
Campak
malaria
malaria
DBD
DBD
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

- - - - - - - - - - - - - - -
- - - - - - - 22 - - - - - 22 -
- - - - - - - 22 - - - - - 22 -
MASALAH TELINGA STATUS GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Sangat Kurus dan/atau
Tdk ada inf.telinga
Inf.telinga kronis
Inf.Telinga akut

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
oedema

Normal

Anemi
Kurus

0 0 2 0 0 2 0 0 2 0 0 0
0 0 2 0 0 2 0 0 2 0 0 0
0 0 2 0 0 2 0 0 2 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 5 0 0 5 0 0 0
0 0 0 0 0 2 0 0 2 0 0 0
0 0 2 0 0 2 0 0 2 0 0 0
0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 0 2 0 0 0
0 0 0 0 0 2 0 0 0 0 0 0
0 0 1 0 0 1 0 0 1 0 0 0
0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 0 1 0 0 0
0 0 0 0 0 2 0 0 0 0 0 0
0 0 2 0 0 2 0 0 2 0 0 0
0 0 1 0 0 1 0 0 1 0 0 0
0 0 1 0 0 1 0 0 1 0 0 0

- - 18 - - 31 - - 27 - - -
- - 68 - - 68 - - 68 - - -
- - 86 - - 99 - - 95 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : APRIL
DEMAM/ DAERAH RESIKO
JML KUNJUGAN BATUK DIARE Tanpa Resiko
Tinggi malaria Rendah Malaria
Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat

Dmm bkn malaria

Pneomonia berat/
Prosentase ( % )
NO DESA

Dmm mgkn bkn

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria

malaria

malaria
MTBS

1 Karasgede 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Joltundo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 2 2 100 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Babagan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0
12 Soditan 3 3 100 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0
13 Ngemplak - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0
16 Sriombo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0
17 Binangun 3 3 100 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0
18 Bonang 2 2 100 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0
19 Tasiksono - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 32 32 100 - - 32 - - - - - - - - 16 - - - - -

Jumlah bln lalu 135 135 100 - 9 116 - - 9 - - - - - - - - - - 40
Komulatif 167 167 100 - 9 148 - - 9 - - - - - 16 - - - - 40
 CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Sangat Kurus dan/atau
Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn

Inf.telinga kronis
Inf.Telinga akut
Mungkin DBD

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Mastoideus
Campak

oedema

Normal

Anemi
Kurus
DBD

0 0 0 0 0 DBD 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 0 0 0
0 0 0 0 0 2 0 0 0 2 0 0 2 0 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0

- - - - - 2 - - - 23 - - 32 - - 26 - - -
- - - - - 40 - - - 101 - - 118 - - 114 - - -
- - - - - 42 - - - 124 - - 150 - - 140 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : MEI
DEMAM/ DAERAH RESI
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
2 Joltundo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
6 Selopuro 4 4 100 0 0 4 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
13 Ngemplak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
16 Sriombo 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang 5 5 60 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 32 32 100 - - 27 - - - - - - - - - -

Jumlah bln lalu 135 135 100 - 9 116 - - 9 - - - - - - -
Komulatif 167 167 100 - 9 143 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 2 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 2 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 3 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 5 0 0 0 0 0 5 0 0 0 5 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 1 0 0

- - - 6 - - - - - 6 - - - 32 - -
- - - 40 - - - - - 40 - - - 101 - -
- - - 46 - - - - - 46 - - - 133 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
2 0 0 2 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
4 0 0 4 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
3 0 0 3 0 0 0
0 0 0 0 0 0 0
5 0 0 5 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0

32 - - 32 - - -
118 - - 114 - - -
150 - - 146 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : JUNI
DEMAM/ DAERAH RESI
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
5 Kajar 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
6 Selopuro 5 5 100 0 0 5 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 28 28 100 - - 28 - - - - - - - - - -

Jumlah bln lalu 167 167 100 - 9 143 - - 9 - - - - - - -
Komulatif 195 195 100 - 9 171 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
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 1 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1 0 0

- - - - - - - - - - - - - 28 - -
- - - 46 - - - - - 46 - - - 133 - -
- - - 46 - - - - - 46 - - - 161 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
5 0 0 5 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
3 0 0 3 0 0 0
0 0 0 0 0 0 0
3 0 0 3 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0

28 - - 28 - - -
150 - - 146 - - -
178 - - 174 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : JULI
DEMAM/ DAERAH RESI
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 3 3 100 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 4 4 100 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
16 Sriombo 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 28 28 100 - - 18 - - - - - - - - - -

Jumlah bln lalu 195 195 100 - 9 171 - - 9 - - - - - - -
Komulatif 223 223 100 - 9 189 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 0 0 0 3 0 0 0 3 0 0
0 0 0 4 0 0 0 0 0 4 0 0 0 4 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 2 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 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 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 0 0 0 3 0 0 0 3 0 0
0 0 0 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 1 0 0

- - - 14 - - - - - 14 - - - 28 - -
- - - 46 - - - - - 46 - - - 161 - -
- - - 60 - - - - - 60 - - - 189 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0
0 0 0 0 0 0 0
3 0 0 3 0 0 0
4 0 0 4 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
0 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
2 0 0 2 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
3 0 0 3 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0

27 - - 28 - - -
178 - - 174 - - -
205 - - 202 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : AGUSTUS
DEMAM/ DAERAH RESI
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
6 Selopuro 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
16 Sriombo - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Binangun 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
 18 Bonang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 21 21 100 - - 21 - - - - - - - - - -

Jumlah bln lalu 223 223 100 - 9 189 - - 9 - - - - - - -
Komulatif 244 244 100 - 9 210 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
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 1 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 2 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 3 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0

- - - - - - - - - - - - - 21 - -
- - - 60 - - - - - 60 - - - 189 - -
- - - 60 - - - - - 60 - - - 210 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
3 0 0 3 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0

21 - - 21 - - -
205 - - 200 - - -
226 - - 221 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : SEPTEMBER
DEMAM/ DAERAH RESI
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
6 Selopuro 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
16 Sriombo 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
17 Binangun 3 3 100 0 0 3 0 0 0 0 0 0 0 0 0 0
 18 Bonang 2 2 100 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 25 25 100 - - 22 - - - - - - - - - -

Jumlah bln lalu 244 244 100 - 9 210 - - 9 - - - - - - -
Komulatif 269 269 100 - 9 232 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
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 1 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 2 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 1 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0
0 0 0 2 0 0 0 0 0 2 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0

- - - 2 - - - - - 3 - - - 25 - -
- - - 60 - - - - - 60 - - - 210 - -
- - - 62 - - - - - 63 - - - 235 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
3 0 0 3 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
3 0 0 3 0 0 0
3 0 0 3 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0

25 - - 25 - - -
226 - - 221 - - -
251 - - 246 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : OKTOBER
DEMAM/ DAERAH RES
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
6 Selopuro 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
16 Sriombo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
17 Binangun - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 20 20 100 - - 20 - - - - - - - - - -

Jumlah bln lalu 269 269 100 - 9 232 - - 9 - - - - - - -
Komulatif 289 289 100 - 9 252 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
0 0 0 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 2 0 0 0 0 0 2 0 0 0 2 0 0
0 0 0 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 1 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 2 0 0 0 0 0 2 0 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0
0 0 0 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 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0

- - - 11 - - - - - 11 - - - 20 - -
- - - 62 - - - - - 63 - - - 235 - -
- - - 73 - - - - - 74 - - - 255 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0

20 - - 20 - - -
251 - - 246 - - -
271 - - 266 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : NOVEMBER
DEMAM/ DAERAH RE
JML KUNJUGAN BATUK DIARE
Tinggi malaria
BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
3 Sdcoyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - - 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
6 Selopuro 6 6 100 0 0 6 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
9 Babagan 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - - 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
12 Soditan 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0
13 Ngemplak - - - 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri - - - 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak - - 100 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang - - - 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0

Jumlah bln ini 20 20 100 - - 18 - - - - - - - - -

Jumlah bln lalu 289 289 100 - 9 252 - - 9 - - - - - -
Komulatif 309 309 100 - 9 270 - - 9 - - - - - -
DEMAM/ DAERAH RESIKO Tanpa
Rendah Malaria Resiko
Malaria
Peny. Berat dg demam
Dmm mgkn bkn
malaria
malaria
0 0
0 0
0 0
0 0
0 0
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 GIZI
CAMPAK DBD MASALAH TELINGA ANEMIA
(BB/TB)
Peny. Berat dg demam
Sangat Kurus dan/atau
Kom.pd mata &mulut
Dgn kompliksi berat
Tdk ada inf.telinga
Demam mgkn bkn
Dmm bkn malaria
Inf.telinga kronis
Inf.Telinga akut
Mungkin DBD
Anemia Berat
Mastoideus
Campak
oedema
Normal
Kurus
DBD
DBD
0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 6 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0
0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0
0 0 0 0 0 0 0 0 2 0 0 0 2 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 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 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0

- - - - 2 - - - - - 5 - - - 20 - - 20 -
- - - - 73 - - - - - 74 - - - 255 - - 271 -
- - - - 75 - - - - - 79 - - - 275 - - 291 -
ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia

Rumah Sakit
Keluhan lain
Anemi

0 1 0 0 0
0 1 0 0 0
0 1 0 0 0
0 0 0 0 0
0 1 0 0 0
0 6 0 0 0
0 1 0 0 0
0 2 0 0 0
0 1 0 0 0
0 0 0 0 0
0 1 0 0 0
0 2 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 1 0 0 0
0 1 0 0 0

- 20 - - -
- 266 - - -
- 286 - - -
LAPORAN PELAKSANAAN MTBS UMUR 2 BULAN - 5 TAHUN
TAHUN 2020

Nama Puskesmas : LASEM

Bulan : DESEMBER
DEMAM/ DAERAH RES
JML KUNJUGAN BATUK DIARE
Tinggi malaria Rendah Malaria

BALITA (2BL - 5 TH)

Diare Tanpa Dehidrasi

Peny. Berat dg demam

Peny. Berat dg demam

Batuk bkn pneomonia

Demam mgk bukan

Diare Prsistn Berat
Peny. sangat berat
Pneomonia berat/
Prosentase ( % )
NO DESA

Dehidrasi berat

Diare Persisten
ringan/sedang
Pneomonia

Dehidrasi

Desentri

malaria

malaria
MTBS

1 Karasgede - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Joltundo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
3 Sdcoyo - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
6 Selopuro 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
8 Karangturi 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
9 Babagan - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedong mulyo 1 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
13 Ngemplak - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendang asri 2 2 100 0 0 2 0 0 0 0 0 0 0 0 0 0
15 Gowak - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
17 Binangun - - 0 0 0 0 0 0 0 0 0 0 0 0 0
 18 Bonang 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0
19 Tasiksono - - - 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Dasun 1 1 100 0 0 1 0 0 0 0 0 0 0 0 0 0

Jumlah bln ini 13 13 100 - - 12 - - - - - - - - - -

Jumlah bln lalu 309 309 100 - 9 270 - - 9 - - - - - - -
Komulatif 322 322 100 - 9 282 - - 9 - - - - - - -
MAM/ DAERAH RESIKO
Tanpa Resiko CAMPAK DBD MASALAH TELINGA STATUS GIZI (BB/TB)
Rendah Malaria
Malaria
Peny. Berat dg demam

Sangat Kurus dan/atau

Kom.pd mata &mulut
Dgn kompliksi berat

Tdk ada inf.telinga

Demam mgkn bkn
Dmm bkn malaria

Inf.telinga kronis
Dmm mgkn bkn

Inf.Telinga akut
Mungkin DBD

Mastoideus
Campak

oedema
malaria

malaria

Kurus
DBD

DBD
0 0 0 0 0 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 0 0 0 0 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 1 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 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 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 1 0 0

- - - - - - - - - 2 - - - 13 - -
- - - 75 - - - - - 79 - - - 275 - -
- - - 75 - - - - - 81 - - - 288 - -
US GIZI (BB/TB) ANEMIA DIRUJUK

Puskesmas Rawat Inap

Tidak Anemia
Anemia Berat

Rumah Sakit
Keluhan lain
Normal

Anemi

0 0 0 0 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
2 0 0 2 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0
0 0 0 0 0 0 0
1 0 0 1 0 0 0

13 - - 13 - - -
291 - - 286 - - -
304 - - 299 - - -