DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas Jejawi
Nama Bidan Koordinator: Saleha,AM.Keb

Nama Ibu Hamil & Nama Pekerjaan Pendidikan

NO Bulan Nama Bidan Alamat Usia Ibu Agama HPHT
Suami Ibu Ibu

1 Januari Ruslina, Am.keb Riska Hairani/Iwan Setiawan Air Itam 40 th MRT SLTA Islam 15/04/2022
2 Ida Royani, Am.keb Mega Purwati/A.Yani Air itam 28 th MRT SMA Islam 04/04/2022
3 Yuliana/Musri Air itam MRT SD Islam Islam 03/04/2022
4 Meisarani/ Pidin Air Itam 28 th MRT SMA islam 07/04/2022
5 Meri/Limin Air itam 18 th MRT SMP Islam 08/04/2022
6 Yati/Alatas Bubusan 34th MRT SD Islam 10/04/2022
7 Diana/ Edi samsul Air Itam 42 th MRT SMP islam 27/04/2022
8 Yuliana/Musri Air itam 27 th MRT SD Islam 03/05/2022
9 Indah sari/Musa Agung Air itam 23 th MRT SMA Islam 17/05/2022
10 Yeni Haryati/Andra Saputra Air Itam 20 th MRT SLTA Islam 22/05/2022
11 Sapira/Yamin Air itam 22 th SMK Islam Islam 25/06/2022
12 Gusnani/Efriza Air itam 29TH MRT SD Islam 15/07/2022
13 Sabrina/Sunardi Air itam 29TH MRT SMA Islam 13/09/2022
14 Silvia/Krisna Air itam 23th MRT SMA Islam 13/09/2022
15 Nilawati/ Azi Air itam 20 th MRT SD islam 12/12/2021
16 Vita Dwi/Dandi Air itam 21 th MRT SMK islam 12/02/2022
17 Suheni/Deska Air itam 26 th MRT SMA Islam 08/05/2022
BU HAMIL 2023

Tanda Obat yg
Riwayat
Siklus Haid Bahaya / dikonsumsi Imunisasi
TP G,P,A Kesehatan / No. HP Bumil NIK/ KK Jaminan Persalinan
(Hari) Penyulit (Termasuk TT
Penyakit
(jika ada) Jamu)

22/01/2023 28 hr G5P3A1 U.40 th Vitamin, Fe T5+ 085273398469 1602175211800001

11/01/2023 29 hr G2P1A0 085381371337 160217590494003 0001885630983
1/9/2023 28 hr G2P1A0 Vitamin,Fe T3 Tidak Ada 1602175212950006
14/01/2023 28 hr G1P0A0 082371164427 1602174107790071 00002862933254
15/01/2023 28 hr G1P0A0 Umur 18 th Vitamin, Fe 0003091693972
17/01/2023 28 hr G3P2A0 T4 1602175504840000
03/02/2023 28 hr G3P2A0 umur 42 th 082371164427 1602174107790071 00002862933254
10/02/2023 28 hr G2P1A0 Vitamin,Fe T5+ Tidak Ada 083155527480 1602175212950006
22/02/2023 28 hr G3P0A2 2kali AB Vitamin, Fe 083193260536 1602171802970003 0003091693972
29/02/2024 28 hr G2P0A1 lila 22 cm Vitamin, Fe T1 082175092485 1602172911210002
02/04/2023 28 hr G2P0A1 Vitamin,Fe Tidak Ada 083803625825 1610094501010001 0002855657845
22/04/2023 28hr G4P2A1 lila 19 cm T4
20/06/2023 28hr G2P1A0 T4
10/06/2023 28hr G1P0A0 T4
10/02/2023 28 hr G1P0A0 083802684399
10/02/2023 28 hr G1P0A0 Vitamin,Fe
15/02/2023 28 hr G2P1A0 Vitamin,Fe 083103087709 1602175611970001 0001507432342
 DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas : Jejawi
Nama Bidan Koordinator : Saleha,AM.Keb

Siklus
Nama Ibu Hamil & Pekerjaa Pendidik
NO Bulan Nama Bidan Alamat Usia Ibu Agama HPHT TP Haid
Nama Suami n Ibu an Ibu
(Hari)

1 Januari Erlin Suryani,AM.Keb Mita Lestari P.Kijang 33 Thn IRT SMA Islam 19/04/2022 24/01/2023 28 Hari
2 Jumiyana P.Kijang 35 Thn IRT SD Islam 08/05/2022 11/02/2023 28 Hari
3 Rotiwa P.Kijang 27 Thn IRT SD Islam 15/05/2022 19/02/2023 30 Hari
4 Fitri/Jeki P.Kijang 22 Thn IRT SD Islam 28/05/2022 04/03/2023 28 Hari
5 Latri/Hendriyadi P.Kijang 22 Thn IRT SD Islam 25/04/2022 28/03/2023 30 Hari
6 Rini P.Kijang 25 Thn IRT SMA Islam 09/08/2022 16-04-2023 28 Hari
7 Partia P.Kijang 38 Thn IRT SD Islam 07/12/2022 17-04-2023 30 Hari
8 Anisa/Ilyas P.Kijang 34 Thn IRT SD Islam 12/07/2022 19/04/2023 30 Hari
9 Dahlia/Sangkut P.Kijang 21 Thn IRT SMA Islam 19/01/2022 25/10/2023 28 Hari
10 Maryati P.Kijang 37 Thn IRT SLTA Islam 10/05/2022 07/12/2023 28 Hari
 Obat yg Riwayat
Tanda Bahaya /
dikonsumsi Imunisa Kesehat No. HP Bumil NIK/ KK Jaminan Persalinan
G,P,A Penyulit (jika
(Termasuk si TT an /
ada)
Jamu) Penyakit

G4P3A0 Vitamin,Fe TT4 085758546528 140502909890002

G3P2A0 Vitamin, Fe TT4 1602175208870003
G3P2A0 Vitamin, Fe TT4 085366752099 1602177009940003
G2P1A0 Vitamin, Fe TT3 083183007623 1602174101000013
G2P1A0 Vitamin,Fe TT3 082179493649 1606095509020004
G2P1A0 Vitamin, Fe TT3 082345611833
G5P4A0 H anak ke 5 U.38 th Vitamin, Fe TT5 082178925163 1602174601840002
G2P1A0 Vitamin, Fe TT5 08896638350 1602174508891001
G1P0A0 Vitamin, Fe TT2 088286681700
G3P2A0 Umur 37 th Vitamin, Fe TT4 085764027284 1602175511850003
 DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas : Jejawi
Nama Bidan Koordinator : Saleha,Am.Keb

Nama Ibu Hamil & Tanggal Pekerjaa Pendidik

NO Bulan Nama Bidan Alamat Usia Ibu Agama HPHT TP
Nama Suami Lahir n Ibu an Ibu

1 Januari Bariah,AM.Keb Yusman/mery P.bulan 17/02/1995 27 Th MRT SD Islam 15/03/2022 22/12/2022

2 Irmawati/Sabila P.bulan MRT SD Islam 01/O4/2022 08/01/2023
3 Rita/anna P.bulan 40 Th MRT SD Islam 20/05/2022 27/02/2023
4 Tasima/Sopar p.bulan 1992 30 th MRT SD Islam 08/07/2022 14/04/2023
5 leni/abadi P.Bulan 7/1/1988 34 th MRT SD Islam 15/07/2022 22/04/2023
6 Depi/Sulisno P.bulan 18/11/1993 29 th MRT SD Islam 27/07/2022 03/05/2023
7 Lena/Etet P.bulan 1994 28 th MRT SMP Islam 05/08/2022 12/05/2023
8 lilis/efendi p.bulan 9/10/1991 21 Th MRT S1 Islam 10/08/2022 18/05/2023
9 rita/rendi p.bulan 30 th MRT SD Islam 01/09/2022 08/06/2023
10 Ira/Sudar P.bulan 1993 29 th MRT SD Islam 02/02/2022 09/10/2023
Islam
 Obat yg
Tanda
dikonsu
Siklus Bahaya / Riwayat
msi Imunisa No. HP Bumil NIK/ KK Jaminan Persalinan
Haid G,P,A Penyulit Kesehatan /
(Termas si TT
(Hari) (jika Penyakit
uk
ada)
Jamu)
28 Hari G3P1A1 083849918511 1602174706850005
28Hari G2P1A0 TT2 T.A.K 160217670489001
28 Hari G3P1A1
28Hari G2P1A0 K.E.K TT2
28 Hari G3P1A1 vit.FE TT1 T.A.K 16021749 11790004
29 Hari G2P1A0 K.E.K TT2 081368012643 1602175105990001
28Hari G2P2A0 TT1 T.A.K 082373099560 1602175810940004
28 Hari G2P1A1 vit.FE TT1 T.A.K 088286897925 160217500 9920002 00003257 403737
28Hari G3P2A0 vit.FE TT1 T.A.K 082287518747 1602234202920002
28Hari G3P2A0 K.E.K TT1 T.A.K 1602175309930007
 DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas : Jejawi
Nama Bidan Koordinator : Saleha,AM.Keb

Bulan Nama Ibu Hamil & Usia Pekerjaa Pendidik

NO Nama Bidan Alamat Agama HPHT TP
Nama Suami Ibu n Ibu an Ibu

1 Januari Nova Pransiska,Amd.Keb Iis Dahlia Danau ceper 26 th IRT SD Islam 01/04/2022 07/01/2023
2 Baidah/Dar Danau ceper 30 th Guru S1 Islam 25/08/2022 02/06/2023
3 Nia/Amanan Danau ceper 29th IRT SD Islam 04/10/2022 11/07/2023
 Tanda
Obat yg
Siklus Bahaya / Riwayat
dikonsumsi Imunisa
Haid G,P,A Penyulit Kesehatan No. HP Bumil NIK/ KK Jaminan Persalinan
(Termasuk si TT
(Hari) (jika / Penyakit
Jamu)
ada)

29hari G2P1A0 tidak ada vitamin,Fe TT2 082379617789 1602174509950004 0002855530113

28 hari G2P1A0 vitamin,Fe TT2 083187482941 1610096611920003
29hari G2P1A0 vitamin, FE TT2 081274775848
 DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas : Jejawi
Nama Bidan Koordinator : Saleha,AM.Keb

Siklus
Nama Ibu Hamil & Usia Pekerjaa Pendidik
NO Bulan Nama Bidan Alamat Agama HPHT TP Haid G,P,A
Nama Suami Ibu n Ibu an Ibu
(Hari)

1 Januari Sri Utari Amd.Keb Nurbaya/Helendri Jejawi 25 th IRT SD Islam 08/05/2022 04/12/2023 28 hr G2P1A0
2 Yunitasari/Andrayono Jejawi 24 th IRT SMP Islam 01/04/2022 08/01/2023 29 hr G2P1A0
3 Ranti/Andari Jejawi 22 th IRT SMA Islam 23/04/2022 30/01/2023 28 hr G2P1A0
4 Erika/Aminudin Jejawi 21 th IRT SMK Islam 25/03/2022 01/01/2023 28 hr G1P0A0
5 Erika/Akari Jejawi 20 th IRT Islam 04/10/2022 14/01/2023 28 hr G1A0P0
6 Yati Oktavia/ Sekuale Jejawi 42 th MRT SD Islam 21/04/2022 18/01/2023 28 hr G4P3A0
7 Mayang/Nopriyanto Jejawi 23 th IRT SMA Islam 04/12/2022 19/01/2023 30 hr G2P1A0
8 Karmila/Hardi Jejawi 27 th IRT SD Islam 15/04/2022 22-01-2023 28 hr G3P2A0
9 Wiwit/Mohromli Jejawi 30 th IRT SMA Islam 15/04/2022 22/01/2023 29 hr G2P1A0
10 Imelda/Kasmir Jejawi 24 th IRT SMP Islam 20/04/2022 27/01/2023 29 hr G1P0A0
11 Anggun lestari/Radius Jun Jejawi 24 th IRT SMA Islam 25/04/2022 01/02/2023 29 hr G1P0A0
12 Tri/Parmansyah Jejawi 21 th IRT SMA Islam 05/05/2022 02/02/2023 28 hr G1P0A0
13 Evi/Naimar Jejawi 29 th IRT SD Islam 12/05/2022 19/02/2023 28 hr G3P2A0
14 Ernawati/Matsari Jejawi 38 th IRT SD Islam 10/07/2022 17/04/2023 28 hr G3P2A0
15 Susilawati/Jepri Jejawi 30 th IRT D3 Islam 25/07/2022 04/03/2023 29 hr G3P2A1
16 Yenni/ Asmuni Jejawi 42 th MRT Islam 29/06/2022 08/04/2023 28 hr G4P3A0
17 Swarna/Abdul soib Jejawi 36 th IRT SMP Islam 10/07/2022 18/04/2023 28 hr G5P2A2
18 Andini/Anjas Jejawi 20 th IRT SMK Islam 26/07/2022 25/04/2023 28 hr G1P0A0
19 Lena/Irwansyah Jejawi 36 th MRT SMP Islam 07/08/2022 14/05/2023 28 hr G3P2A0
20 Yesi susanti /Jumantara Jejawi 31 th Guru Diploma IVIslam 21/08/2022 15/05/2023 29 hr G2P1A0
21 Ayulestari/Joniasmara Jejawi 29 th IRT SMA Islam 22/08/2022 16/05/2023 28 hr G3P2A0
22 Maryati/Ahmad Pausi Jejawi 35 th IRT SD Islam 04/09/2022 11/06/2023 28 hr G3P2A0
23 Ria/ Nasrullah Jejawi 27 th IRT SMA Islam 15/9/2022 22/06/2023 29 hr G3P3A0
24 Anita Agustina/Hikma P Jejawi 27 th IRT SMA Islam 20/07/2022 28/062023 28 hr G1P0A0
25 Diana /Dedi irwansah Jejawi 29 th Guru Diploma IVIslam 28/09/2022 30/06/2023 28 hr G2P1A0
26 Yuliani/Sarpani Jejawi 37 th IRT SD Islam 01/10/2022 08/07/2023 28 hr G4P3A0
27 Trisnawati/Redo EdwansyaJejawi 29 th IRT SMA Islam 08/10/2022 15/07/2023 28 hr G2P1A0
28 Ayu Ratnasari/Tolip Jejawi 32 th IRT SMA Islam 15/10/2022 20/07/2023 28 hr G2P1A0
29 Nurjana/Rohmat Jejawi 27 th IRT SMA Islam 15/11/2022 02/08/2023 29 hr G2P1A0
30 Dina/M.Saleh Jejawi 26 th IRT SMA Islam 10/10/2022 17/08/2023 28 hr G2P1A0
31 Novitasari/Yensen Jejawi 30 th IRT SMA Islam 27/11/2022 14/09/2023 29 hr G2P1A0
32 Dalisa/Aldi Jejawi 22 th IRT SMA Islam 01/08/2022 06/10/2023 28 hr G1P1A0
33 Yesi/Deniharyanto Jejawi 33 th IRT SMA Islam 04/12/2021 09/10/2023 29 hr G3P2A0
34 Rendi Antika/ Jejawi 22 th IRT SMA Islam 01/08/2022 06/10/2023 28 hr G1P1A0
35 Yulwani/Sarpani Jejawi 37 th IRT SD Islam 01/10/2022 08/07/2023 29 hr G4P3A0
 Obat yg
Tanda
dikonsum Riwayat
Bahaya / Imunisa No. HP Bumil NIK/ KK Jaminan Persalinan
si Kesehatan /
Penyulit si TT
(Termasu Penyakit
(jika ada)
k Jamu)
vitamin fe T3 081283908680 1602174909970002
vitamin fe T5 081271704528 1602085906980001
vitamin fe T3 1602080706970006
vitamin fe T3 083177734618 1602174110010002 0002178409026
vitamin fe 083824524820 1602085412020001 0002571984055
U.42 vitamin fe T5 00002178416518
vitamin fe T5 082215148362 1811014303990003
vitamin fe T5 081273125284 1602176102940003
vitamin fe T5 1602176408951001 00003129798914
vitamin fe T3 1602175007980008
vitamin fe T3 083172987031 1602174107950132
lila 23cm Vitamin fe T2 083164622657 1602175504000004
vitamin fe T5 085273251647 1602174703940005 0000990009448
U.38 th vitamin fe T5 0858962663586 1602085210760003
vitamin fe T5 083190094021 1602174505921001
U.42 vitamin fe 081239203604 1602176608600001
1602174107860065
lila 21 Vitamin fe T2 083800550938 1671025302030007 0000323793617
U.36 vitamin fe T5 082340113348 0002567678139
vitamin fe T3 085783638793 1602176712910001 0002317828487
Vitamin fe T5 087713444675 1602175408940001
1602174107870104
Vitamin, Fe TT 083163400996 1602174107950145
TT4 081373849610 1602176008960001 0003005348589
vitamin fe T3 085267963554 1602176705930001 0002443305971
U.37 TT5 083898303940 1602175307860003 0003175721897
Vitamin fe T3 085767037406 1602174203941001 0003089072024
vitamin fe T3 083169606641 1602175607900004
TT5 083809552890 160217410196008 0000307590434
TT5 083113016904 1602174107970092 0000307529403
082282305069 1602175611930001 0002473646613
U.18 vitamin fe T2 083840125556 1602174811000001
T5 089625020839 1671025011890020
vitamin fe T2 16021761021010001
U 37 th T5 083898303940 1602175307860003 0003175721897
 DATA PEMANTAUAN IBU HAMIL 202

Puskesmas : JEJAWI
Nama Bidan Koordinator : SALEHA, AM.Keb

Nama Ibu Hamil & Nama Penddka

NO Bulan Nama Bidan Alamat Usia Ibu Pekerjaan Ibu Agama HPHT
Suami n Ibu
1 Januari 2023 Anna Riantika,AM.Keb Dina Sapriana/Rensa Bubusan 25th MRT SMA Islam 04/05/2022
2 Eni Sagita/Iis Marzuki Bubusan 24th MRT SMK Islam 18/05/2022
3 Putri Ayu/Heriyadi Bubusan 18th MRT SD Islam 04/05/2022
4 Nais paramitha/Naidi Bubusan 27th MRT SMP Islam 25/09/2022
5 Dwi Anggraini/Rudiansyah Bubusan 34th Guru Honorer S1 islam 08/05/2022
6 Nur Anita/kausar Bubusan 39th MRT SD islam 19/06/2022
7 Rana/Agus Bubusan 28th MRT SD Islam 26/10/2022
8 Desi Hartati/Udin Bubusan 37th MRT SD Islam 25/07/2022
9 Reci/Bambang Bubusan 33th MRT SD islam 6/24/2022
10 Anita Agustina/Hikmah pujiadi Bubusan 26th MRT SMA Islam 27/06/2022
11 Sulastri/Bastomi Bubusan 36th MRT SMA Islam 05/08/2022
12 Herlina Agustina/Yonsutra Bubusan 18th MRT SMP Islam 15/08/2022
13 Minarti/Rahmat Hidayat Bubusan 23th MRT SMA Islam 15/08/2022
14 Misbahul Jannah/M.Sani Bubusan 23th MRT SMA Islam 15/08/2022
15 Dian Sundari/Helmi Siswanto Bubusan 27th MRT SMA Islam 19/08/2022
16 Suryani/Marwan Bubusan 28th MRT SD Islam 17/09/2022
17 Rati/Heriyanto Bubusan 25th MRT SMK Islam 26/10/2022
18 Rindi/Kamandanu Bubusan 22th MRT SMP Islam 08/10/2022
19 Damayanti/Yudiansyah Bubusan 22th MRT SMP Islam 11/07/2022
BU HAMIL 2023

Siklus Haid Tanda Bahaya / Penyulit Obat yg dikonsumsi Imunisa Riwayat Kesehatan / No. HP Bumil
TP G,P,A
(Hari) (jika ada) (Termasuk Jamu) si TT Penyakit
11/02/2023 28hr G2P1A0 - T4 082186300171
25/02/2023 28hr G2P0A1 JK k-1&k-2 1 bulan T4 085809258208
11/02/2023 28 hr G1P0A0 Umur 17.th, lila 19,5 CM T4
06/02/2023 28hr G2P1A0 - T4 085789872795
3/15/2023 28 hr G5P4A0 JK 11-bulan T4 082175436868
26/03/2023 28hr G3P2A0 U.39th T5 083176502428
07/03/2023 28hr G1P0A0 - T4
02/04/2023 28hr G3P2A0 U.37th T5 083190690071
4/2/2023 28hr G2P1A0 T5 082376776201
04/04/2023 28hr G1P0A0 - T4 081373849610
12/05/2023 28hr G4P3A0 Umur 36.th T5 088274167790
20/05/2023 28hr G1P1A0 U. 18 th/ngeplek T4 083179321920
22/05/2023 28hr G2P1A0 083841143304
22/05/2023 28hr G3P2A0 JK2 bln T5 088975703579
26/05/2023 28hr G2P1A0 - T4 087867001500
24/06/2023 28hr G3P2A0 - T5
03/07/2023 28hr G3P2A0 Lila 22,5cm T3 -
15/07/2023 28hr G1P0A0
14/08/2023 28hr G1P0A0 Lila 22cm T4 087744741614
 NIK/ KK Jaminan Persalinan

- -
1602176112980002 2862936281

1602176405920001
1602172710170001 0000025274496
16021768112830002

16021760018600001 0000308038691
1602176812900001 0003302171987
1602176008960001 0003005348589
1602175110860001 0002567682999
1602174808040002 0002567673893

16021750610950002
0000307466324

- -
16021761020100001
1602084201030002
 DATA PEMANTAUAN IBU HAMIL 2023

Puskesmas : Jejawi
Nama Bidan Koordinator : Saleha,Am.Keb

Nama Ibu Hamil & Usia Pekerjaa Pendidik

NO Bulan Nama Bidan Alamat Agama HPHT TP
Nama Suami Ibu n Ibu an Ibu

1 Januari 2023 Ratna Juita,AM.Keb Rusna/Samsuri Krg Agung 42th IRT SMP Islam 17/05/2022 24/02/2023
2 Kusmaladewi/Nurimin Krg Agung 36th IRT SD Islam 20/05/2022 27/02/2023
3 Rasi Handayani/Anton Krg Agung 30TH IRT SMA Islam 06/07/2022 13/04/2023
4 Marleni/Yabani Krg Agung 37th IRT SMP Islam 13/07/2022 20/04/2023
5 Mike Ardila/Zulkarnain Krg Agung 35th IRT D3 Islam 20/07/2022 27/04/2023
6 Renta/M.Feri Krg Agung 22th IRT SMP Islam 10/08/2022 17/05/2023
7 Maimunah/Haryadi Krg Agung 25th IRT SMA Islam 15/08/2022 22/05/2023
8 Sartika/Usman Krg Agung 36th IRT SD Islam 18/08/2022 25/05/2023
 Obat yg
Tanda
dikonsu Riwayat
Siklus Bahaya /
msi Imunisa Kesehat No. HP Bumil NIK/ KK Jaminan Persalinan
Haid G,P,A Penyulit
(Termas si TT an /
(Hari) (jika
uk Penyakit
ada)
Jamu)
42th
30 hari G5P4A0 U.36th Vitamin TT3 T.A.K 081273026052 1671024503850010 0002787789947
28 hari G2P1A0 Vitamin TT3 T.A.K 085273334110 1602175402920006 0000307970447
28 hari G4P3A0 U.37th Vitamin T5 T.A.K 1602175006850005
30 hari G2P1A0 Vitamin TT3 T.A.K 082307493453 1671016010870006 0001447695527
30 hari G3P2A1 Vitamin TT5 T.A.K 082186603533
28 hari G1P0A0 Vitamin TT2 T.A.K 085367234335
30 hari G4P2A1 U.36th Vitamin TT5 T.A.K 082180125528 1602176803870001 00003088670002