BLUD UPT PUSKESMAS WERGU WETAN

BULAN : NOVEMBER 2018

Jumlah Sasaran Pra Lanjut Usila /Lanjut Usia di Wilayah Kelompok : 21 Kel
Jumlah Pra Lanjut Usila : Laki Laki 2,830 Perempuan 3,316 Lansia Resti Laki Laki : 510
Jumlah Lanjut Usia : Laki Laki 1,984 Perempuan 1,479 Lansia Resti Perempuan : 798
Jumlah Jumlah Umur Kegiatan Sehari 2 x / Kemandirian
Kunjungan 45-59 Tahun 60-69 Tahun > 70 Tahun A B C
No. NAMA NAMA L P L P L P L P L P L P
Baru Lama Abs
Urut DESA KELOMPOK B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Wergu CEMPAKA I 20 135 155 2 20 22 10 64 74 5 5 10 20 10 30 0 0 0 2 0 2 7 23 30 20 43 63 0 0 0 2 0 2 0 0 0 0 0 0
2 Wetan CEMPAKA II 20 126 146 2 17 19 10 74 84 2 2 4 20 10 30 0 0 0 1 0 1 4 17 21 20 47 67 0 0 0 1 0 1 0 0 0 0 0 0
3 CEMPAKA III 20 125 145 1 19 20 10 69 79 0 3 3 20 10 30 0 0 0 3 0 3 1 21 22 20 45 65 0 0 0 3 0 3 0 0 0 0 0 0
4 CEMPAKA IV 20 153 173 4 36 40 10 69 79 0 1 1 20 17 37 0 0 0 2 0 2 4 33 37 20 44 64 0 0 0 2 0 2 0 0 0 0 0 0
5 CEMPAKA V 20 137 157 0 23 23 10 79 89 3 2 5 20 12 32 0 0 0 5 0 5 3 25 28 20 43 63 0 0 0 5 0 5 0 0 0 0 0 0
6 Wergu MATAHARI I 20 124 144 2 17 19 10 74 84 0 2 2 20 10 30 0 0 0 3 0 3 2 17 19 20 45 65 0 0 0 3 0 3 0 0 0 0 0 0
7 Kulon MATAHARI II 20 157 177 6 36 42 10 82 92 0 3 3 20 14 34 0 0 0 2 0 2 6 33 39 20 48 68 0 0 0 2 0 2 0 0 0 0 0 0
8 Mlati L RAHAYU I 20 149 169 5 31 36 10 83 93 0 3 3 20 15 35 0 0 0 1 0 1 5 29 34 20 49 69 0 0 0 1 0 1 0 0 0 0 0 0
9 RAHAYU II 20 159 179 8 38 46 10 78 88 0 3 3 20 12 32 0 0 0 1 0 1 8 33 41 20 50 70 0 0 0 1 0 1 0 0 0 0 0 0
10 Mlati K MLATI INDAH 20 150 170 4 30 34 10 71 81 0 3 3 20 7 27 0 0 0 2 0 2 4 29 0 20 52 72 0 0 0 2 0 2 0 0 0 0 0 0
11 Panjunan ANGREK II 20 151 171 7 36 43 10 69 79 0 3 3 20 10 30 0 0 0 1 0 1 7 32 39 20 47 67 0 0 0 1 0 1 0 0 0 0 0 0
12 MELATI 20 134 154 4 26 30 10 78 88 3 2 5 20 6 26 0 0 0 1 0 1 7 24 31 20 44 64 0 0 0 1 0 1 0 0 0 0 0 0
13 Nganguk CEMPAKA I 20 124 144 1 18 19 10 78 88 0 2 2 20 10 30 0 0 0 2 0 2 1 29 30 20 46 66 0 0 0 2 0 2 0 0 0 0 0 0
14 CEMPAKA III 20 149 169 5 31 36 10 78 88 0 3 3 20 8 28 2 0 2 2 0 2 7 29 36 20 51 71 0 0 0 2 0 2 0 0 0 0 0 0
15 CEMPAKA IV 20 148 168 6 31 37 10 77 87 0 3 3 20 9 29 0 0 0 1 0 1 5 6 11 20 50 70 0 0 0 1 0 1 0 0 0 0 0 0
16 RW 2 20 143 163 4 30 34 10 80 90 0 1 1 20 10 30 0 0 0 1 0 1 4 27 31 20 48 68 0 0 0 1 0 1 0 0 0 0 0 0
17 Demaan BLIMBING 20 147 167 6 34 40 10 71 81 0 1 1 20 11 31 0 0 0 1 0 1 6 29 35 20 47 67 0 0 0 1 0 1 0 0 0 0 0 0
18 ANGGUR 20 159 179 2 33 35 10 80 90 6 3 9 20 11 31 0 0 0 1 0 1 6 8 14 20 48 68 0 0 0 1 0 1 0 0 0 0 0 0
19 APOKAT 20 129 149 0 17 17 10 81 91 3 2 5 20 10 30 0 0 0 1 0 1 3 29 32 20 49 69 0 0 0 1 0 1 0 0 0 0 0 0
20 DELIMA 20 160 180 5 36 41 10 83 93 3 3 6 20 12 32 0 0 0 1 0 1 8 34 42 20 50 70 0 0 0 1 0 1 0 0 0 0 0 0
21 Kramat RW I 20 154 174 3 29 32 15 89 104 0 2 2 20 16 36 0 0 0 1 0 1 3 28 31 20 50 70 0 0 0 1 0 1 0 0 0 0 0 0
22 RW II 20 160 180 8 39 47 15 97 112 0 2 2 20 12 32 0 0 0 1 0 1 8 33 41 20 47 67 0 0 0 1 0 1 0 0 0 0 0 0
23 RW III 20 164 184 4 29 33 15 1843 1858 0 3 3 20 8 28 0 0 0 2 0 2 4 28 0 20 49 69 0 0 0 2 0 2 0 0 0 0 0 0
24 RW IV 40 181 221 7 37 44 15 0 15 0 1 1 40 11 51 0 0 0 1 0 1 7 31 38 40 49 89 0 0 0 1 0 1 0 0 0 0 0 0
JUMLAH 500 3518 4018 96 693 789 260 3547 3807 25 58 83 500 261 761 2 0 2 39 0 39 120 627 682 500 1141 1641 0 0 0 39 0 39 0 0 0 0 0 0
BLUD UPT PUSKESMAS WERGU WETAN
BULAN : NOVEMBER 2018
Jumlah Sasaran Pra Lanjut Usila /Lanjut Usia di Wilayah Kel : 21 Kel
Jumlah Pra Lanjut U: Laki Laki 2,830 Perempuan 3,316 Lansia Resti Laki Laki : 510
Jumlah Lanjut Usia: Laki Laki 1,948 Perempuan 1,479 Lansia Resti Perempuan : 798
JUMLAH USILA DENGAN KELAINAN
Gangguan Mental Emosional IMT TEKANAN DARAH ANEMI
LEBIH KURANG TINGGI RENDAH SEDANG BERAT DM
L P L P L P L P L P L P
B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs
19 20 21 22 23 24 25 26 27 28 29 30
0 0 0 0 0 0 3 8 11 8 0 8 1 5 6 8 0 8 10 13 23 20 75 95 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 2 5 7 3 0 3 0 2 2 8 0 8 12 12 24 20 90 110 0 0 0 0 0 0 0 0 0 2 0 2
0 0 0 0 0 0 0 3 3 3 0 3 1 3 4 9 0 9 13 17 30 20 79 99 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 1 14 15 4 0 4 0 5 5 8 0 8 10 17 27 20 76 96 0 0 0 0 0 0 0 0 0 5 0 5
0 0 0 0 0 0 0 5 5 3 0 3 0 5 5 10 3 13 10 18 28 20 87 107 0 0 0 0 0 0 0 0 0 4 0 4
0 0 0 0 0 0 0 2 2 0 0 0 2 2 4 6 0 6 10 13 23 20 87 107 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 2 2 4 5 0 5 2 2 4 9 0 9 10 31 41 20 90 110 0 0 0 0 0 0 0 0 0 6 0 6
0 0 0 0 0 0 0 5 5 5 0 5 0 4 4 11 0 11 12 25 37 20 118 138 0 0 0 0 0 0 0 0 0 4 0 4
0 0 0 0 0 0 1 3 4 6 0 6 2 5 7 10 0 10 10 30 40 20 119 139 0 0 0 0 0 0 0 0 0 5 0 5
0 0 0 0 0 0 4 5 9 2 0 2 0 5 5 8 2 10 12 23 35 20 100 120 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 3 5 8 5 0 5 2 5 7 14 0 14 10 24 34 20 97 117 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 3 4 7 6 2 8 2 8 10 11 0 11 12 14 26 20 137 157 0 0 0 0 0 0 0 0 0 4 0 4
0 0 0 0 0 0 0 9 9 3 2 5 0 5 5 10 0 10 10 16 26 20 115 135 0 0 0 0 0 0 0 0 0 2 0 2
0 0 0 0 0 0 3 4 7 3 2 5 4 4 8 9 0 9 12 5 17 20 112 132 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 2 5 7 4 2 6 2 5 7 9 0 9 13 20 33 20 115 135 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 4 5 9 4 0 4 4 5 9 8 0 8 10 20 30 20 129 149 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 3 5 8 4 0 4 4 5 9 9 0 9 10 24 34 20 107 127 0 0 0 0 0 0 0 0 0 4 0 4
0 0 0 0 0 0 3 2 5 3 0 3 3 4 7 9 0 9 12 8 20 20 126 146 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 3 5 8 3 0 3 0 5 5 8 1 9 12 22 34 20 126 146 0 0 0 0 0 0 0 0 0 2 0 2
0 0 0 0 0 0 3 5 8 4 2 6 3 9 12 9 0 9 12 22 34 20 122 142 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 0 4 4 3 0 3 0 4 4 9 0 9 12 23 35 20 136 156 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 4 5 9 4 0 4 0 5 5 10 0 10 10 27 37 20 147 167 0 0 0 0 0 0 0 0 0 5 0 5
0 0 0 0 0 0 2 4 6 4 0 4 2 4 6 9 0 9 10 24 34 20 2555 2575 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 2 11 13 3 0 3 0 5 5 16 0 16 10 20 30 40 0 40 0 0 0 0 0 0 0 0 0 3 0 3
0 0 0 0 0 0 48 125 173 92 10 102 34 111 145 227 6 233 264 468 732 500 4945 5445 0 0 0 0 0 0 0 0 0 82 0 82
 : 21 Kel
1,804 Perempuan 2,526 Lansia Resti Laki Laki : 159
854 Perempuan 1,233 Lansia Resti Perempuan : 263
LANSIA DENGAN KELAINAN PENGOBATAN
Jumlah Kasus Konseling

Penyuluhan
Jantung YA TIDAK

Di Rujuk
Di Obati
P L P L P L P
B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs Baru Lama Selesai
42 43 44 45 46 47 48 49 50 51 52 53 54
0 0 0 0 0 0 0 0 0 7 23 30 20 93 113 0 0 0 0 0 0 62 1 V
0 0 0 0 0 0 0 0 0 4 17 21 20 94 114 0 0 0 0 0 0 51 1 V
0 0 0 0 0 0 0 0 0 1 21 22 20 93 113 0 0 0 0 0 0 56 1 V
0 0 0 0 0 0 0 0 0 4 33 37 20 106 126 0 0 0 0 0 0 82 1 V
0 0 0 0 0 0 0 0 0 3 25 28 20 99 119 0 0 0 0 0 0 68 1 V
0 0 0 0 0 0 0 0 0 2 17 19 20 98 118 0 0 0 0 0 0 55 1 V
0 0 0 0 0 0 0 0 0 6 33 39 20 108 128 0 0 0 0 0 0 82 1 V
0 0 0 0 0 0 0 0 0 5 29 34 20 105 125 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 8 33 41 20 108 128 0 0 0 0 0 0 82 1 V
0 0 0 0 0 0 0 0 0 4 29 33 20 107 127 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 7 32 39 20 104 124 0 0 0 0 0 0 78 1 V
0 0 0 0 0 0 0 0 0 7 24 31 20 93 113 0 0 0 0 0 0 62 1 V
0 0 0 0 0 0 0 0 0 1 29 30 20 94 114 0 0 0 0 0 0 62 1 V
0 0 0 0 0 0 0 0 0 7 29 36 20 93 113 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 5 6 11 20 107 127 0 0 0 0 0 0 49 1 V
0 0 0 0 0 0 0 0 0 4 27 31 20 102 122 0 0 0 0 0 0 69 1 V
0 0 0 0 0 0 0 0 0 6 29 35 20 102 122 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 6 8 14 20 111 131 0 0 0 0 0 0 54 1 V
0 0 0 0 0 0 0 0 0 3 29 32 20 99 119 0 0 0 0 0 0 62 1 V
0 0 0 0 0 0 0 0 0 6 34 40 20 125 145 0 0 0 0 0 0 102 1 V
0 0 0 0 0 0 0 0 0 3 28 31 20 110 130 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 8 33 41 20 104 124 0 0 0 0 0 0 82 1 V
0 0 0 0 0 0 0 0 0 4 28 32 20 115 135 0 0 0 0 0 0 72 1 V
0 0 0 0 0 0 0 0 0 7 31 38 40 128 168 0 0 0 0 0 0 9 1 V
0 0 0 0 0 0 0 0 0 118 627 745 500 2498 2998 0 0 0 0 0 0 1599 24 0 0 0 24
Mengetahui
Kepala BLUD UPT Puskesmas KUDUS ,
Wergu Wetan Pengelola Program Kesehatan Lansia

DODY HERBOWO LAKSONO , Skep SRI WAHYUNI Amk

NIP 19631205 198803 1 010 NIP 19790805 199903 2 002
 PENDATAAN LANSIA TAHUN 2017

SASARAN USIA
NO DESA 45 - 59 THN 60 - 69 THN > 70 THN RESTI
L P L P L P
1 WERGU WETAN 273 389 197 177 93 72
2 WERGU KULON 314 381 166 235 110 111
3 MLATI LOR 356 450 120 170 69 86
4 MLATI KIDUL 211 321 70 178 26 31
5 PANJUNAN 200 244 120 153 99 77
6 KRAMAT 78 144 51 65 72 134
7 NGANGUK 159 181 35 42 100 126
8 DEMAAN 353 472 163 233 35 55

JUMLAH 1,944 2,582 922 1,253 604 692

Mengetahui
Kepala BLUD UPT Puskesmas
Wergu Wetan

DODY HERBOWO LAKSONO , Skep

NIP 19631205 198803 1 010
 PENDATAAN LANSIA TAHUN 2016

SASARAN USIA
NO DESA 45 - 59 THN 60 - 69 THN > 70 THN RESTI
L P L P L P
1 WERGU WETAN 256 318 180 228 83 62
2 WERGU KULON 222 280 238 316 100 101
3 MLATI LOR 342 472 114 128 59 76
4 MLATI KIDUL 143 271 208 218 16 21
5 PANJUNAN 87 163 213 214 89 67
6 KRAMAT 68 134 117 176 62 124
7 NGANGUK 53 51 121 152 90 116
8 DEMAAN 379 514 117 176 25 45

JUMLAH 1,550 2,203 1,308 1,608 524 612

Mengetahui
Kepala UPT Puskesmas
Wergu Wetan

Dody Herbowo Laksono,Skep

NIP 19631205 198803 1 010
 PENDATAAN LANSIA TAHUN 2019

SASARAN USIA
NO DESA 45 - 59 THN 60 - 69 THN > 70 THN RESTI
L P L P L P
1 WERGU WETAN 448 565 173 222 40 76
2 WERGU KULON 375 437 165 179 21 26
3 MLATI LOR 163 166 232 277 133 125
4 MLATI KIDUL 415 495 202 202 73 98
5 PANJUNAN 328 414 154 167 136 170
6 KRAMAT 240 245 85 100 40 45
7 NGANGUK 222 304 112 136 51 90
8 DEMAAN 470 480 118 121 48 53

JUMLAH 2,661 3,106 1,241 1,404 542 683

Mengetahui
Kepala BLUD UPT Puskesmas
Wergu Wetan

DODY HERBOWO LAKSONO , Skep

NIP 19631205 198803 1 010
 RENCANA KEGIATAN SENAM DAN EDUKASI
UPT PUSKESMAS WERGU WETAN KUDUS

NO TANGGAL KEGIATAN KETERANGAN

1 8 Januari 2016
2 12 Februari 2016
3 11 Maret 2016
4 8 April 2016
5 13 Mei 2016
6 10 Juni 2016 Libur Puasa
7 15 Juli 2016
8 12 Agustus 2016
9 9 September 2016
10 14 Oktober 2016
11 11 November 2016
12 9 Desember 2016

Mengetahui
An.Kepala UPT Puskesmas
Wergu Wetan

……………………………….
LAMPIRAN 6 FORMAT LAPORAN KEGIATAN PELAYANAN KESEHATAN PEDULI REMAJA ( PKPR ) PUSKESMAS WERGU WETAN

BULAN : APRIL
TAHUN : 2016
KAB : KUDUS

DATA DASAR
DATA SASARAN KARAKTERISTIK SUMBER DAYA MANUSIA
NO NAMA DESA 10-14 15-18 10-14 15-18 PUSKESMAS NAKES TERLATIH NAKES BLM TERLATIH FASILATOR JMLH KONSELOR SEBAYA
TAHUN TAHUN TAHUN TAHUN JML PUSKESMAS PKPR PKPR PKPR TERLATIH PKPR DIDALAM SEKOLAH DILUAR SEKOLAH
LAKI LAKI PEREMPUAN PKPR LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 PANJUNAN 401 425 189 142 0 0 0 0 0 1 2 13 37 13 37 0 0
2 DEMAAN 683 180 1114 1492 0 0 0 0 0 1 2 15 135 15 135 0 0
3 NGANGUK 388 99 372 146 0 0 0 0 0 1 2 33 67 33 67 0 0
4 KRAMAT 262 391 274 855 0 0 0 0 0 1 2 24 26 24 26 0 0
5 MLATI KIDUL 561 229 554 143 0 0 0 0 0 1 2 75 75 75 75 0 0
6 MLATI LOR 208 73 213 5 0 0 0 0 0 1 2 50 50 50 50 0 0
7 WERGU WETAN 112 0 101 0 0 0 0 0 0 1 2 43 7 43 7 0 0
8 WERGU KULON 271 119 301 143 0 0 0 0 0 1 2 0 0 0 0 0 0
 CAKUPAN PELAYANAN KESEHATAN REMAJA
REMAJA REMAJA
YANG YANG REMAJA YANG ANEMIA REMAJA YANG TERKENA IMS REMAJA YANG TERKENA ISR REMAJA DENGAN HIV REMAJA DENGAN AIDS
HAMIL BERSALIN
10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN
< 20 TAHUN <20 TAHUN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 CAKUPAN PELAYANAN KESEHATAN REMAJA
REMAJA YANG MEMAKAI NAPZA
REMAJA YANG MEROKOK REMAJA YANG MEMAKAI ALKOHOL SELAIN MEROKOK DAN ALKOHOL REMAJA YANG MENDAPAT YANKES DI PUSK REMAJA YANG DIRUJUK

10-14 THN 15-18 THN 10-14 THN 15-18 THN 10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN10-14 THN15-18 THN
LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN LAKI LAKI PEREMPUAN
42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61
0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 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 3 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 2 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

Mengetahui
Kepala UPT Puskesmas KUDUS , Mei 2016
Wergu Wetan Penanggung Jawab Program PKPR

DODY HERBOWO LAKSONO , Skep Dwi Erlina

NIP 19631205 198803 1 010 NIP 19670403 198803 2 009
KEGIATAN PROLANIS TAHUN 2016
BLUD UPT PUSKESMAS WERGU WETAN

NO BULAN JUMLAH UKET

BLUD UPT PUSKESMAS WERGU WETAN
BULAN : APRIL 2019
Jumlah Sasaran Pra Lanjut Usila /Lanjut Usia di Wilayah Kelompok : 21 Kel
Jumlah Pra Lanjut Usila : Laki Laki Perempuan Lansia Resti Laki Laki :
Jumlah Lanjut Usia : Laki Laki Perempuan Lansia Resti Perempuan :
Jumlah Jumlah Umur Kegiatan Sehari 2 x / Kemandirian
Kunjungan 45-59 Tahun 60-69 Tahun > 70 Tahun A B C
No. NAMA NAMA L P L P L P L P L P L P
Baru Lama Abs
Urut DESA KELOMPOK B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Wergu CEMPAKA I 10 73 83 2 4 6 5 32 37 0 0 0 5 35 40 0 0 0 0 0 0 2 4 6 10 67 77 0 0 0 0 0 0 0 0 0 0 0 0
2 Wetan CEMPAKA II 10 55 65 0 4 4 5 36 41 0 0 0 5 15 20 0 0 0 0 0 0 0 4 4 10 50 60 0 0 0 0 0 0 0 0 0 0 0 0
3 CEMPAKA III 10 50 60 2 2 4 5 32 37 0 0 0 5 14 19 0 0 0 0 0 0 2 2 4 10 46 56 0 0 0 0 0 0 0 0 0 0 0 0
4 CEMPAKA IV 10 65 75 2 4 6 5 31 36 0 0 0 5 28 33 0 0 0 0 0 0 2 4 6 10 59 69 0 0 0 0 0 0 0 0 0 0 0 0
5 CEMPAKA V 10 50 60 2 4 6 5 27 32 0 0 0 5 17 22 0 0 0 0 0 0 2 4 6 10 44 54 0 0 0 0 0 0 0 0 0 0 0 0
6 Wergu MATAHARI I 10 48 58 2 5 7 5 26 31 0 0 0 5 17 22 0 0 0 0 0 0 2 5 7 10 43 53 0 0 0 0 0 0 0 0 0 0 0 0
7 Kulon MATAHARI II 10 48 58 0 5 5 5 30 35 0 0 0 5 13 18 0 0 0 0 0 0 0 5 5 10 43 53 0 0 0 0 0 0 0 0 0 0 0 0
8 Mlati L RAHAYU I 10 72 82 2 4 6 5 26 31 0 0 0 5 40 45 0 0 0 0 0 0 2 4 6 10 66 76 0 0 0 0 0 0 0 0 0 0 0 0
9 RAHAYU II 10 40 50 2 2 4 5 22 27 0 0 0 5 14 19 0 0 0 0 0 0 2 2 4 10 36 46 0 0 0 0 0 0 0 0 0 0 0 0
10 Mlati K MLATI INDAH 10 70 80 2 2 4 5 31 36 0 0 0 5 38 43 0 0 0 0 0 0 2 2 4 10 66 76 0 0 0 0 0 0 0 0 0 0 0 0
11 Panjunan ANGREK II 10 55 65 2 5 7 5 30 35 0 0 0 5 18 23 0 0 0 0 0 0 2 5 7 10 48 58 0 0 0 0 0 0 0 0 0 0 0 0
12 MELATI 10 50 60 2 5 7 5 25 30 0 0 0 5 18 23 0 0 0 0 0 0 2 5 7 10 48 58 0 0 0 0 0 0 0 0 0 0 0 0
13 Nganguk CEMPAKA I 10 60 70 0 2 2 5 32 37 0 0 0 5 26 31 0 0 0 0 0 0 0 2 2 10 58 68 0 0 0 0 0 0 0 0 0 0 0 0
14 CEMPAKA III 10 55 65 2 2 4 5 26 31 0 0 0 5 25 30 0 0 0 0 0 0 2 2 4 10 51 61 0 0 0 0 0 0 0 0 0 0 0 0
15 CEMPAKA IV 10 50 60 2 5 7 5 20 25 0 0 0 5 23 28 0 0 0 0 0 0 2 5 7 10 53 63 0 0 0 0 0 0 0 0 0 0 0 0
16 RW 2 10 50 60 2 4 6 5 20 25 0 0 0 5 24 29 0 0 0 0 0 0 2 4 6 10 44 54 0 0 0 0 0 0 0 0 0 0 0 0
17 Demaan BLIMBING 10 57 67 2 2 4 5 26 31 0 0 0 5 27 32 0 0 0 0 0 0 2 2 4 10 53 63 0 0 0 0 0 0 0 0 0 0 0 0
18 ANGGUR 10 50 60 0 2 2 5 25 30 0 0 0 5 23 28 0 0 0 0 0 0 0 2 2 10 48 58 0 0 0 0 0 0 0 0 0 0 0 0
19 APOKAT 10 50 60 0 4 4 5 21 26 0 0 0 5 25 30 0 0 0 0 0 0 0 4 4 10 46 56 0 0 0 0 0 0 0 0 0 0 0 0
20 DELIMA 10 45 55 2 5 7 5 20 25 0 0 0 5 18 23 0 0 0 0 0 0 2 5 7 10 38 48 0 0 0 0 0 0 0 0 0 0 0 0
21 Kramat RW I 10 50 60 2 4 6 5 23 28 0 0 0 5 21 26 0 0 0 0 0 0 2 4 6 10 44 54 0 0 0 0 0 0 0 0 0 0 0 0
22 RW II 10 48 58 2 2 4 5 22 27 0 0 0 5 22 27 0 0 0 0 0 0 2 2 4 10 44 54 0 0 0 0 0 0 0 0 0 0 0 0
23 RW III 10 45 55 2 4 6 5 25 30 0 0 0 5 14 19 0 0 0 0 0 0 2 4 6 10 39 49 0 0 0 0 0 0 0 0 0 0 0 0
24 RW IV 10 46 56 2 2 4 5 20 25 0 0 0 5 24 29 0 0 0 0 0 0 2 2 4 10 44 54 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 240 1282 1522 38 84 122 120 628 748 0 0 0 120 539 659 0 0 0 0 0 0 38 84 122 240 1178 1418 0 0 0 0 0 0 0 0 0 0 0 0
BLUD UPT PUSKESMAS WERGU WETAN
BULAN : APRIL 2019
Jumlah Sasaran Pra Lanjut Usila /Lanjut Usia di Wilayah Kel : 21 Kel
Jumlah Pra Lanjut U: Laki Laki Perempuan Lansia Resti Laki Laki :
Jumlah Lanjut Usia: Laki Laki Perempuan Lansia Resti Perempuan :
JUMLAH USILA DENGAN KELAINAN
Gangguan Mental Emosional IMT TEKANAN DARAH ANEMI
LEBIH KURANG TINGGI RENDAH SEDANG BERAT DM
L P L P L P L P L P L P
B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs
19 20 21 22 23 24 25 26 27 28 29 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 65 75 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 10 48 58 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 44 54 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 57 67 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 42 52 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 10 41 51 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5 10 41 51 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 64 74 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 34 44 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 64 74 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 10 46 56 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 10 46 56 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 10 56 66 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 49 59 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 10 51 61 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 42 52 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 51 61 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 10 46 56 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 10 44 54 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 10 36 46 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 42 52 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 42 52 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 6 10 37 47 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 10 42 52 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 84 122 240 1130 1370 0 0 0 0 0 0 0 0 0 0 48 48
 : 21 Kel
Perempuan Lansia Resti Laki Laki :
Perempuan Lansia Resti Perempuan :
LANSIA DENGAN KELAINAN PENGOBATAN
Jumlah Kasus Konseling

Penyuluhan
Jantung YA TIDAK

Di Rujuk
Di Obati
P L P L P L P
B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs B L Abs Baru Lama Selesai
42 43 44 45 46 47 48 49 50 51 52 53 54
0 0 0 0 0 0 0 0 0 2 4 6 10 69 79 0 0 0 0 0 0 20 1 10 25 48 v
0 0 0 0 0 0 0 0 0 0 4 4 10 53 63 0 0 0 0 0 0 20 1 10 10 35 v
0 0 0 0 0 0 0 0 0 2 2 4 10 46 56 0 0 0 0 0 0 22 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 4 6 10 61 71 0 0 0 0 0 0 22 1 10 10 45 v
0 0 0 0 0 0 0 0 0 2 4 6 10 46 56 0 0 0 0 0 0 22 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 5 7 10 46 56 0 0 0 0 0 0 20 1 10 8 30 v
0 0 0 0 0 0 0 0 0 0 5 5 10 46 56 0 0 0 0 0 0 20 1 10 8 30 v
0 0 0 0 0 0 0 0 0 2 4 6 10 68 78 0 0 0 0 0 0 25 1 10 12 50 v
0 0 0 0 0 0 0 0 0 2 2 4 10 36 46 0 0 0 0 0 0 25 1 10 10 20 v
0 0 0 0 0 0 0 0 0 2 2 4 10 66 76 0 0 0 0 0 0 20 1 10 10 20 v
0 0 0 0 0 0 0 0 0 2 5 7 10 51 61 0 0 0 0 0 0 22 1 10 10 35 v
0 0 0 0 0 0 0 0 0 2 5 7 10 46 56 0 0 0 0 0 0 22 1 10 10 30 v
0 0 0 0 0 0 0 0 0 0 2 2 10 58 68 0 0 0 0 0 0 25 1 10 10 40 v
0 0 0 0 0 0 0 0 0 2 2 4 10 51 61 0 0 0 0 0 0 22 1 10 10 35 v
0 0 0 0 0 0 0 0 0 2 5 7 10 46 56 0 0 0 0 0 0 20 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 4 6 10 46 56 0 0 0 0 0 0 20 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 2 4 10 53 63 0 0 0 0 0 0 20 1 10 12 35 v
0 0 0 0 0 0 0 0 0 0 2 2 10 48 58 0 0 0 0 0 0 20 1 10 10 30 v
0 0 0 0 0 0 0 0 0 0 4 4 10 48 58 0 0 0 0 0 0 20 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 5 7 10 41 51 0 0 0 0 0 0 22 1 10 10 25 v
0 0 0 0 0 0 0 0 0 2 4 6 10 46 56 0 0 0 0 0 0 22 1 10 10 30 v
0 0 0 0 0 0 0 0 0 2 2 4 10 44 54 0 0 0 0 0 0 20 1 10 8 30 v
0 0 0 0 0 0 0 0 0 2 4 6 10 41 51 0 0 0 0 0 0 22 1 10 10 25 v
0 0 0 0 0 0 0 0 0 2 2 4 10 41 51 0 0 0 0 0 0 20 1 10 8 20 v
0 0 0 0 0 0 0 0 0 38 84 122 240 1197 1437 0 0 0 0 0 0 513 24 240 251 763 24
Mengetahui
Kepala BLUD UPT Puskesmas KUDUS ,
Wergu Wetan Pengelola Program Kesehatan Lansia

DODY HERBOWO LAKSONO , Skep SRI WAHYUNI Amk

NIP 19631205 198803 1 010 NIP 19790805 199903 2 002