DATA PEMANTAUAN IBU HAMIL 2022

Puskesmas : Pematang Panggang IV

Nama Bidan Koordinator : ZURAIDAH,Am.Keb, SKM

Siklus Obat yg
Nama Ibu Hamil & Pekerjaa Pendidikan Tanda Bahaya / Imunisasi Riwayat Kesehatan / No. HP Bumil NIK/ KK Jaminan Persalinan
NO Bulan Nama Bidan Alamat Usia Ibu Agama HPHT TP Haid G,P,A dikonsumsi
Nama Suami n Ibu Ibu Penyulit (jika ada) TT Penyakit
(Hari) (Termasuk Jamu)
1 JANUARI INDAH PERMATASARI, Am.Keb VIBAITI/ SURYO SUMBU SARI DS. IV 28 IRT SMA ISLAM 5/3/2021 2/10/2022 28 HARI G2P1A0 - - TT2 - 085609292819 160221149150001
2 ERNA/ KRISDIANTO I 23 IRT S1 ISLAM 7/24/2021 31-04-2022 28 HARI G1P0A0 - - TT2 - 085709800844 1602215612980001
3 TUTI/ PONIRAN II 35 IRT SMP ISLAM 6/10/2021 3/17/2022 28 HARI G2P1A0 - - TT2 - 085709800844 1602211705860003
4 NOVA/ ILHAM II 19 IRT SMP ISLAM 4/29/2021 2/3/2022 28 HARI G1P0A0 - - TT2 - 081274762132 1602210706210003
5 MAY/ TEGUH I 19 IRT SMP ISLAM 8/15/2021 5/22/2022 28 HARI G1P0A0 - - - - 085769841337 1602210506110003
6 YESI/ AHMAD III 20 IRT SMA ISLAM 9/17/2021 6/24/2022 28 HARI G1P0A0 - - TT1 - 085769178493 1602214209000002
7 SEPTI/ AGUS VI 24 IRT SMA ISLAM 9/20/2021 6/27/2022 28 HARI G1P0A0 - - TT1 - 0895604397033 1810015309950002
8 YULIANA/ DANANG III 32 GURU S1 ISLAM 5/17/2021 2/14/2022 28 HARI G2P1A0 - - TT1 - 081273372211 1602214701890013
9 NOVI/ TONI III 26 IRT SMA ISLAM 8/4/2021 5/11/2022 28 HARI G2P1A0 - - TT2 - 085765338235 1602211106140001
10 IIS/ NANANG II 26 IRT SMA ISLAM 5/5/2021 2/12/2022 28 HARI G2P1A0 - - TT2 - 085809604098 1602225501880025
11 PURWANTI/ HARJITO VI 36 IRT SMP ISLAM 7/17/2021 4/24/2022 28 HARI G3P2A0 - - TT4 - 085789926277 1602214107850006
12 DWI H/ PUJI II 21 IRT SMP ISLAM 10/16/2021 7/23/2022 28 HARI G2P1A0 - - - - 082181491217 1602246802000001
13 PUPUT/ PARDI V 28 IRT SMP ISLAM 7/15/2021 4/22/2022 28 HARI G2P1A0 - - TT1 - 085767108990 1602214701800020
14 RAHMI/ AHMAD II 25 IRT SMA ISLAM 11/5/2021 8/12/2022 28 HARI G1P0A0 - - - - 081321812406 3204076006960002
15 SETIANINGSIH/ ADI II 24 IRT SMA ISLAM 11/5/2021 8/12/2022 28 HARI G1P0A0 - - - - 081315725045 1807075108970003

16 ANI ASIH/ ARIS S VI 31 IRT SMA ISLAM 10/25/2021 8/2/2022 28 HARI G3P2A0 - - - - 085793390820 1602214505910002
17 SITI J/ IRFAN VI 22 IRT SMA ISLAM 9/10/2021 6/17/2022 28 HARI G1P0A0 - - TT1 - 085841751540 1602214710000002
18 FEBRUARI INDAH PERMATASARI, Am.Keb DWI SITI R/ YUSUF III 23 IRT SMA ISLAM 12/25/2021 10/1/2022 28 HARI G1P0A0 - - - - 081279345188 1602215606300001
19 ISMIATI/ AGUS RIYONO V 31 IRT SD ISLAM 12/17/2021 9/24/2022 28 HARI G1P0A0 - - - - 085839807903 1602215312910003

MAYLINA/ TEGUH RAHAYU V 19 IRT SMP ISLAM 8/15/2021 5/22/2022 28 HARI G1P0A0 <20 TAHUN - TT1 - 085769841387 1602216205052002
20
DWI NOVIYANTI/ SIGIT
SUTEDI V 22 IRT SMK ISLAM 9/20/2021 6/27/2022 28 HARI G1P0A0 - - - - 08122938019 1602214107040005
21
22 TUTUT/ ROBIN II 32 IRT SMA ISLAM 10/8/2021 7/15/2022 28 HARI G2P1A0 - - TT1 - 085645715500 1602215611890002
23 MAYKE/ RIKI V 22 IRT SMA ISLAM 11/16/2021 8/23/2022 28 HARI G1P0A0 - - - - 085809612955 1601135405040009
24 MARET INDAH PERMATASARI, Am.Keb LISA/ YUDI III 22 IRT SMK ISLAM 17/12/2021 24/09/2022 28 HARI G1P0A0 - - TT1 - 081240892809 1602215202000003
25 YONA MELANI/ TRIADI V 18 IRT SMK ISLAM 08/11/2021 15/08/2022 28 HARI G1P0A0 <20 TAHUN - TT1 - 085769050504 1602215905030004
26 TUTUT/ KOMARUDIN II 33 IRT S1 ISLAM 08/10/2021 15/07/2022 28 HARI G3P2A0 - - TT1 - 085645715500 1602215611890002
27 HENITA/ RIKI IKANG V 25 IRT SMA ISLAM 03/02/2021 10/11/2022 28 HARI G2P1A0 - - - - 082384627364 -
28 RISKA. A/ HARIYANTO VI 19 IRT SMA ISLAM 30/12/2021 07/10/2022 28 HARI G1P0A0 <20 TAHUN - TT1 - 085832021638 1602216008410001
29 ROHANA/ HARYANTO II 29 IRT SMP ISLAM 23/09/2021 30/06/2022 28 HARI G2P1A0 - - TT1 - 081539835020 1602215308930003
30 APRIL INDAH PERMATASARI, Am.Keb KHUSNUL H/ MANSYUR A I 22 IRT SMP ISLAM 03/02/2022 10/11/2022 28 HARI G1P0A0 - - - - 081539835731 1602215708030001
31 IIS PUSTIKA. S/ ADI I 21 IRT SMP ISLAM 20/02/2022 27/11/2022 28 HARI G1P0A0 - - - - 085273400583
32 DWI FATMA SARI/ SUHADA III 30 IRT SMP ISLAM 30/11/2021 07/08/2022 28 HARI G2P1A0 - - I - 085767408813 1602214211900003
33 SUTIANI/ WINARKO IV 28 IRT DIII ISLAM 27/12/2021 04/10/2022 28 HARI G2P1A0 - - I - 082273300759 1602214701950010
34 MEI INDAH PERMATASARI, Am.Keb MIFTAKHUR/ IMAM S I 24 IRT SMA ISLAM 20/03/2022 27/12/2022 28 HARI G1P0A0 - - TT1 - 085727327876 1602225202000001
35 SUSANTI/ ARIF P II 28 IRT SLTP ISLAM 02/04/2022 09/01/2023 28 HARI G2P1A0 - - TT1 - 085789297288 1602215407950003
36 WARGIATI/ APRIYANTO IV 31 IRT S1 ISLAM 16/10/2021 23/07/2022 28 HARI G3P2A0 - - TT2 - 085841337857 1602216905910001
37 JUNI INDAH PERMATASARI, Am.Keb TUTUT NOVIANA D.P/EKO.W V 28 KARYAWAN DIII ISLAM 20/02/2022 27/11/2022 28 HARI G1P0A0 - - TT1 - 081379040874 1602215311940001
38 ANDRAYANI/ AHMAD KUSNI I 28 IRT SLTA ISLAM 08/02/2022 15/11/2022 28 HARI G2P1A0 - - TT1 - 085768060806 1602214405940004
39 RIRIN FAUZIAH/ YOYOK III 28 IRT SLTA ISLAM 06/03/2022 13/12/2022 28 HARI G1P0A0 - - TT1 - 082185745374 1602214103961001
40 JULI INDAH PERMATASARI, Am.Keb ANISATUL/ ANGOT DSN II 17 IRT SD ISLAM 19/03/2022 26/12/2022 28 HARI G1P0A0 <20 TAHUN - TT1 - 085809573432 1602216701050001
41 LULUS MIFA/ SUYATNO V 24 IRT DIII ISLAM 21/04/2022 28/12/2022 28 HARI G1P0A0 - - TT1 - 085745804618 1602244310970001
42 SITI FATIMAH/ ANDIKA V 25 IRT SMA ISLAM 01/05/2022 08/02/2023 28 HARI G1P0A0 - - - - 082228518849 1602216712980003
43 AGUSTUS INDAH PERMATASARI, Am.Keb DESI AYUNINGTYAS/ BARUDIDSN II 26 IRT SMP ISLAM 06/06/2022 13/03/2023 28 HARI G2P1A0 - - - - 081216684891 16022136512960009
44 FIRDA A/ SIGIT RESTU DSN VI 23 IRT SMA ISLAM 15/06/2022 22/03/2023 28 HARI G1P0A0 - - - - 085841042150 1602216505990004
45 SEPTEMBER INDAH PERMATASARI, Am.Keb MASKANATUL/ WISNO DSN VI 30 IRT SMP ISLAM 02/08/2022 09/05/2023 28 HARI G2P1A0 - - - - 1608095011920001
46 SRIANI/ AHMAD NUR DSN III 29 IRT SMA ISLAM 02/06/2022 09/03/2023 28 HARI G2P1A0 - - - - 081632259322 1602215106930001
47 WINARNI/ YUDI DSN III 22 IRT SMA ISLAM 13/07/2022 20/04/2023 28 HARI G1P0A0 - - - - 082285486166 1602215001020001
48 OKTOBER
 49
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60 JULI
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70 AGUSTUS
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80 SEPTEMBER
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90 OKTOBER
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100 NOVEMBER
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110 DESEMBER
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 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil &

NO Bulan Nama Bidan Alamat
Nama Suami

SITI KHODIJAH /
Siti Eta Martika Diana,S.Tr.keb RUSMANTO SUKA SARI
1 JANUARI
MARWATI / DERI WALUYO
2
3 PUJI LESTARI/ DEDI ISWANTO
KHUSNUL INDRIYAH/
4 FIRDAUS A.R
5 SITI KHOTIMAH/ RUSDI ARIANTO
6 PUJI RAHAYU/ BONANG ASMORO. S
7 LINDA MARYANA/ JOKO BUDI P
8 SUHARTI/ BUDI
9 ENI ROHAYATUN/ SUGIYANTO
10 RISMA SARI/ AHMAD RIYANTO
11 MILATUL KH/ HARIYANTO
12 GINI/JUWAHIR
YANA MARYANA/ A.
13 MUZDAID
FEBRUARI Siti Eta Martika Diana,S.Tr.keb -
14 MARET Siti Eta Martika Diana,S.Tr.keb PURWANTI/ ANGGIS GAS SUKA SARI
15 APRIL Siti Eta Martika Diana,S.Tr.keb -
16 MEI Siti Eta Martika Diana,S.Tr.keb -
17 JUNI Siti Eta Martika Diana,S.Tr.keb SUSI LESTARI/ ROHMAN SUKA SARI
18 LILIK SURYANI/ SOLIKHAN
19 MARYUNI/ REDHI. H
20 JULI Siti Eta Martika Diana,S.Tr.keb MARWIYAH/ AGUS UUN. SUKA SARI
21 SUSANTI/ MARYON
22 RUSTIANAH/ ROBI KURNIAWAN
23 PARMINI/ TUSIMIN
24 AGUSTUS Siti Eta Martika Diana,S.Tr.keb DEWI INDAH SUKA SARI
25 SRI LESTARI
26 SEPTEMBER Siti Eta Martika Diana,S.Tr.keb -
27 OKTOBER
28
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30
31
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33
34
35
36
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39
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41
42
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45
46
47
48
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 DATA PEMANTAUAN IBU HAMIL 2022

Siklus
Pekerjaa Pendidikan
Usia Ibu Agama HPHT TP Haid G,P,A
n Ibu Ibu
(Hari)

25 IRT SMA ISLAM 11/12/2020 09/17/2021 28 hari G2P1A0

25 IRT SMA ISLAM 01/20/2021 10/27/2021 28 hari G2P1A0

23 IRT SMA ISLAM 8/26/2021 6/2/2022 28 HARI G1P0A0

39 PNS S1 ISLAM 7/2/2021 4/9/2022 28 HARI G7P5A1

23 IRT SMP ISLAM 9/11/2021 6/18/2022 28 HARI G2P1A0

25 IRT S1 ISLAM 7/23/2021 4/29/2022 28 HARI G1P0A0
37 IRT SMP ISLAM 9/20/2021 6/27/2022 28 HARI G4P3A0
39 IRT SMA ISLAM 9/13/2021 6/20/2022 28 HARI G3P1A1
31 IRT SMP ISLAM 9/27/2021 7/6/2022 28 HARI G2P1A0
22 IRT SD ISLAM 11/9/2021 8/16/2022 28 HARI G2P1A0
34 GURU S1 ISLAM 10/25/2021 8/1/2022 28 HARI G3P2A0
33 IRT SD ISLAM 11/9/2021 8/16/2022 28 HARI G2P1A0

32 IRT SMA ISLAM 11/29/2021 9/9/2022 28 HARI G3P2A0

21 IRT SMP ISLAM 18/02/2022 25/11/2022 28 HARI G1P0A0

21 IRT SMP ISLAM 19/03/2022 26/12/2022 28 HARI G1P0A0

28 IRT SD ISLAM 28/04/2022 06/02/2023 28 HARI G2P1A0
20 IRT SD ISLAM 23/04/2022 30/01/2023 28 HARI G1P0A0
37 IRT SD ISLAM 28/04/2022 02/02/2023 28 HARI G3P2A0
33 IRT SD ISLAM 28/04/2022 02/02/2023 28 HARI G3P2A0
20 IRT SD ISLAM 25/02/2022 02/12/2022 28 HARI G1P0A0
36 IRT SD ISLAM 28 HARI G3P1A0
19 IRT SMA ISLAM 19/06/2022 26/03/2023 28 HARI G1P0A0
39 IRT SD ISLAM 20/04/2022 25/01/2023 28 HARI G4P1A2
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan /
dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)

- - - -

- - - -

- - TT1 -

> 35 TAHUN & PARITAS >3 FE, B6 TT1 -

- - TT1 -
- - TT1 -
>35 TAHUN & PARITAS >3 FE,KALK TT1 -
>35 TAHUN FE TT2 -
- FE, B6 TT1 -
- FE, B6 TT1 -
- FE, B6 TT1 -
- FE, B6 TT1 -

- FE, B6 TT1 -

- B6, FE TT1 -

- - TT1 -
- - TT1 -
- - TT1 -
>35 TAHUN B6, FE TT1 -
- B6, FE TT1 -
- B6, FE TT1 -
>35 TAHUN B6, FE TT1 -
<20 TAHUN - TT1 -
>35 TAHUN, PARITAS >3 - TT1 -
 No. HP Bumil NIK/ KK Jaminan Persalinan

082372056435' 1602225703020002' KIS

82281216861 1602214709940000 jampersal

085834853089 1602214903980004

081392746661 1602216905820001

085609363900 1602215804980005
081334889133 1602214601960002
081229858173 1602216210840001
081368957151 1601309820001
085839210559 1602215806900001
085758310814 1602210707990001 jampersal
085640407252 3326155305880021 jampersal
085215015517 3323195803890001 jampersal

081326889871 1602215208900004 jampersal

081373421191 1602214710030002 jampersal

082338819252 1602215509010001
085788981855 1602216904940001
085609343423 1602214102020004
081368957153 1602214701840012 jampersal
082269454676 1602216910880001 jampersal
085267865010 1610095710020002 jampersal
082371931881 1602216108600003 jampersal
081540050988 1602216604030001
085709800802 1602212505820001
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil &

NO Bulan Nama Bidan
Nama Suami

1 JANUARI NI GEDE INTAN,S.Tr.Keb ESTI / KENANG

2 SISKA / SURYO
3 NIA/ ADI
4 HESTI / NURSAFAAT
5 LINAWATI/ M. AJIS
6 ANI/ HARYONO
7 SITI HIDAYAH/ALI
8 SUMIYATI/ SUTIK
9 NURHAYATI/RANDI
10 PONISA/ANTO
11 ALMUTAQIAH/ ALEX
12 SUWARNI/SUWARDI
13 EKA WAHYUNI/ FERI
14 FEBRUARI NI GEDE INTAN,S.Tr.Keb AYU/ AGUS
15 HERLINA/ BESUS
16 MARET NI GEDE INTAN,S.Tr.Keb WULAN/ WASRUDIN
17 APRIL NI GEDE INTAN,S.Tr.Keb ARISTIANI/ TRIONO
18 RISMA/ MIFA
19 MEI NI GEDE INTAN,S.Tr.Keb KHUSNUL/KRIS
20 NILA/ MUKAROM
21 TRIA/ SUHENDRI
22 RAFI/ YAYAN
23 JUNI NI GEDE INTAN,S.Tr.Keb MUNARTI/SUKARMAN
24 PUTRI/ALISNO
25 JULI NI GEDE INTAN,S.Tr.Keb -
26 AGUSTUS NI GEDE INTAN,S.Tr.Keb SULIS/ BAYU
27 SUSILAWATI/SAKIM
28 WULANDARI/ DIDI
29 SEPTEMBER NI GEDE INTAN,S.Tr.Keb LILIS/ MUKTI
30 SUTRIANI/ JOKO
31 SITI/ SLAMET
32 SUMIYATI/ NUR.H
33 SUCI/ SUSANTO
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 DATA PEMANTAUAN IBU HAMIL 2022

ang Panggang IV
AIDAH, Am.Keb,SKM

Siklus
Usia Pekerjaa Pendidikan
Alamat Agama HPHT TP Haid
Ibu n Ibu Ibu
(Hari)
CIPTA SARI 30 IRT SMP ISLAM 25/5/2021 2/2/2022 28 HARI
20 IRT SD ISLAM 4/28/2021 1/5/2022 28 HARI
23 IRT SD ISLAM 3/13/2021 12/20/2022 28 HARI
22 IRT SMA ISLAM 6/5/2021 3/12/2022 28 HARI
20 IRT SMK ISLAM 7/30/2021 4/7/2022 28 HARI
36 GURU S1 ISLAM 4/24/2021 1/31/2022 28 HARI
30 IRT SD ISLAM 5/17/2021 2/24/2022 28 HARI
40 IRT SMP ISLAM 8/10/2021 5/17/2022 28 HARI
31 IRT SMP ISLAM 9/8/2021 6/15/2022 28 HARI
28 IRT SMA ISLAM 9/17/2021 6/24/2022 28 HARI
20 IRT SMP ISLAM 11/8/2021 8/15/2022 28 HARI
36 IRT SD ISLAM 8/10/2021 5/17/2022 28 HARI
26 IRT SMP ISLAM 11/7/2021 8/14/2022 28 HARI
24 IRT SMK ISLAM 10/16/2021 7/23/2022 28 HARI
28 BIDAN D3 ISLAM 12/21/2021 9/28/2022 28 HARI
CIPTA SARI BLOK A 26 GURU D3 ISLAM 20/01/2022 27/10/2022 28 HARI
38 IRT D1 ISLAM 08/02/2022 15/11/2022 28 HARI
21 IRT SMA ISLAM 05/03/2022 12/12/2022 28 HARI
BLOK C 32 IRT - ISLAM 13/03/2022 20/12/2022 28 HARI
BLOK A 37 IRT SMA ISLAM 24/03/2022 31/12/2022 28 HARI
BLOK B 22 IRT SMP ISLAM 10/01/2022 17/10/2022 28 HARI
PKK 24 IRT SMA ISLAM 15/02/2022 22/11/2022 28 HARI
A 39 IRT SMP KRISTEN 20/04/2022 27/01/2023 28 HARI
C 31 IRT SMP ISLAM 29/12/2022 05/09/2022 28 HARI

C 24 IRT S1 ISLAM 06/02/2022 13/11/2022 28 HARI

D 30 IRT SD ISLAM 20/01/2022 27/10/2022 28 HARI
B 20 IRT SMA ISLAM 18/05/2022 25/02/2023 28 HARI
D 31 IRT SMA ISLAM 10/02/2022 17/11/2022 28 HARI
C 31 IRT SMA ISLAM 28/07/2022 04/04/2023 28 HARI
A 37 IRT SD ISLAM 13/05/2022 20/02/2023 28 HARI
C 39 IRT SD ISLAM 16/06/2022 23/03/2023 28 HARI
PKK 16 IRT SMP ISLAM 20/07/2022 27/04/2023 28 HARI
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan /
G,P,A dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)
G12P1A0 - KALK, FE TT2 TV ODGJ
G1POAO - KALK, FE TT2 -
G1POAO - KALK, FE TT2 -
G1POAO - KALK, FE TT2 -
G1P0A0 - KALK, FE TT2 -
G2P1A0 FR. UMUR KALK, FE TT2 -
G3P2A0 KALK, FE TT2 -
G4P3A0 >35 TAHUN & PARITAS >3 KALK, FE TT2 HT, DM
G2P1A0 - KALK, FE TT2 -
G2P1A0 - KALK, FE TT2 -
G1P0A0 KALK, FE TT1 -
G3P2A0 KALK, FE TT1 -
G2P1A0 KALK, FE TT1 -
G1P0A0 - KALK, B12 TT1 -
G2P1A0 - KALK, B12 TT1 -
G2P1A0 - FE TT3 -
G4P3A0 UMUR >35, PARITAS >3 FE, VITAMIN TT1 -
G1P0A0 - FE, VITAMIN TT1 -
G2P1A0 - FE, VITAMIN TT3 -
G2P1A0 - FE, VITAMIN TT3 -
G2P1A0 - FE, VITAMIN TT3 -
G2P1A0 - FE, VITAMIN TT3 -
G1P1A1 >35 TAHUN, RIW.AB VITAMIN, KALK TT3 -
G3P2A0 - VITAMIN, KALK TT3 HIPERTENSI

G1P0A0 - VITAMIN, FE TT1 -

G4P3A0 PARITAS >3 VITAMIN, FE TT1 -
G1P0A0 KEK VITAMIN, FE TT1 -
G3P2A0 KEK (22,5) VITAMIN, KALK √ -
G3P1A1 - VITAMIN, KALK √ RIW. AB
G7P2A4 UMUR >35, PARITAS >3 VITAMIN, KALK √ RIW. AB
G5P2A2 UMUR >35, PARITAS >3 VITAMIN, KALK √ RIW. AB
G1P0A0 UMUR <20 TAHUN VITAMIN, KALK √ -
 No. HP Bumil NIK/ KK Jaminan Persalinan

85709428906 1602214701910010' jampersal

081340388393 1602244511010001 JAMPERSAL
085838733159 1602215807960003 JAMPERSAL
081532571695 16022261129990002 JAMPERSAL
085768062942 1602215301010004 JAMPERSAL
081278095452 1602214505840002 JAMPERSAL
08578383276740 1608066810910001 BPJS
082281786394 1602216912600004 JAMPERSAL
081532943573 1807115604900002 JAMPERSAL
085841218273 1602214701940041 JAMPERSAL
085267013193 160215702020001 JAMPERSAL
085380666566 1602215212860004 JAMPERSAL
085809522271 3302165505980002 JAMPERSAL
081377972594 1602214302990002 JAMPERSAL
081367772091 1671035807930005 JAMPERSAL
081367103853 1602215501960004 JAMPERSAL
085609104045 1602214112830001 BPJS
085609549354 1602225212000001 JAMPERSAL
085789145827 1602215804840002 JAMPERSAL
082272545275 1602214701830026 JAMPERSAL
081268781294 1602206509050001 JAMPERSAL
085769755795 1602226105980004 JAMPERSAL
085788006777 1602215002800003 jampersal
085609185769 1602214605911001 KIS

085282960919 1602236808982001 jampersal

085783334305 1602225209920004 jampersal
082182877423 1602134209000005 jampersal
085788819541 1602216107910001 jampersal
081367280258 1602214201910002 BPJS
083158337745 1602215505851001 jampersal
jampersal
jampersal
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil & Nama

NO Bulan Nama Bidan Alamat
Suami

1 JANUARI YELIS FIRA,AM.Keb SRI L/ ALAMSAH

SUMBER BARU
2 SUPRIATIN/HERI ADE
3 NURAPRILIA/ SAUD P
4 SITI. J/ AGUS
5 SITI. H/ ANNUR
6 KASDIYANTI/EKO. N
7 AISYAH/MULYADI
8 FATMASARI/ALAMSAH
9 MARINI/SAUD
10 MARTANTI/WALUYA
11 SITI FATIMAH/ ANDIKA EGY
12 NILA S/ HAIRUL S
13 SARINGGAH/ DWI S
14 NURUL/ HENDRA
15 NUR ARLEA/ SAUP P
16 HENI R/ SUDARYANTO
17 ANI FITNANI/ SUHERMANTO

PUTRI SINTAWATI/ IRWAN

18
SUSIYANTI/ NUR ASHARI
19
WINDARI SEPTIANA/ YUSUF
20 EFENDI
21 PUSPITASARI/ NURHUDA
22 WINDARAMAWATI/ GITO
23 FEBRUARI YELIS FIRA,AM.Keb NINING/ YAYAN
24 NURUL/ HENDRO
25 LEVI/ FIRMAN
26 MARET YELIS FIRA,AM.Keb CLARISA/ M.MALIK KEM
27 RISMA/ JOSI C1 DUSUN II
28 ALFIAH/ SUDIRMAN C1 DUSUN I
29 APRIL YELIS FIRA,AM.Keb NOVI YANI/ KIRMAN SUMBER BARU
30 RENI N/ IMAM
31 ISNATI/ GIAT
32 MEI YELIS FIRA,AM.Keb HARIYANTI/ PENDI III
33 CHOIRUNISA/ DIRGA B PKS
34 RIRIN F/ WARDIANTO IV
35 JUNI YELIS FIRA,AM.Keb SUNDARTI/ KARIM VII
36 RENI L/ SUWAJI III
37 ROSITA/ VII
38 PUTRI S/ IWAN I
39 HIFA/ AGUS VV
40 JULI YELIS FIRA,AM.Keb IKA. K VII
41 IQILI. S VII
42 ANI R/ HERMAN VII
43 SITI F/ANDIKA VII
44 EVI M./IMAM VII
45 AGUSTUS YELIS FIRA,AM.Keb MUNA/ KEM
46 IKA KURNIA ERVIANA/ KEM
47 LISNAQUL ERVIANI/ KEM
48 LAILY SURYANI/ KEM
49 SEPTEMBER YELIS FIRA,AM.Keb SITI F/ SAMSUL DSN VII
50 FATIMAH/ ANDIKA DSN VII
51 MUNAWAROH/ AMED DSN VII
52 NOVIYANI/ ALI DSN VII
53 OKTOBER
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
 DATA PEMANTAUAN IBU HAMIL 2022

Keb,SKM

Siklus
Pekerjaan
Usia Ibu Pendidikan Ibu Agama HPHT TP Haid G,P,A
Ibu
(Hari)

38 IRT SD ISLAM 5/4/2021 11/02/2022 28 hari G4P2A1

34 IRT SMP ISLAM 7/21/2021 28/04/2022 28 hari G2P1A0
25 IRT S1 ISLAM 5/30/2021 06/03/2022 28 hari G1P0A0
31 IRT SMP ISLAM 7/1/2021 08/04/2022 28 hari G3P2A0
25 IRT SMP ISLAM 7/15/2021 22/04/2022 28 hari G2P1A0
22 IRT SMK ISLAM 4/21/2021 28/01/2022 28 hari G1P0A0
21 IRT SD ISLAM 6/4/2021 11/03/2022 28 hari G1P0A0
26 IRT SMK ISLAM 5/12/2021 19/02/2022 28 hari G2P1A0
24 IRT SMK ISLAM 7/8/2021 15/04/2022 28 hari G2P1A0
25 IRT SH ISLAM 8/14/2021 21/05/2022 28 hari G1P0A0
26 IRT SMP ISLAM 10/9/2021 16/07/2022 28 hari G2P1A0
24 IRT SMK ISLAM 9/23/2021 6/30/2022 28 hari G2P1A0
30 IRT SD ISLAM 4/7/2021 1/11/2022 28 hari G3P2A0
28 KARYAWAN SMK ISLAM 9/17/2021 6/22/2022 28 hari G2P1A0
25 IRT S1 ISLAM 5/30/2021 3/6/2022 28 hari G1P0A0
27 IRT SMP ISLAM 10/5/2021 7/12/2022 28 hari G2P1A0
29 IRT SMA ISLAM 9/6/2021 6/22/2022 28 hari G2P1A0

18 IRT SMP ISLAM 10/7/2021 7/14/2022 28 hari G1P0A0

38 IRT SMP ISLAM 3/27/2021 1/4/2022 28 hari G3P2A0

20 IRT SMP ISLAM 9/29/2021 7/6/2022 28 hari G1P0A0

18 IRT SMA ISLAM 9/28/2021 7/5/2022 28 hari G2P1A0

30 IRT SMP ISLAM 9/10/2021 6/17/2022 28 hari G2P1A0
27 IRT SMP ISLAM 11/18/2021 8/25/2022 28 hari G2P1A0
28 KARYAWAN SMK ISLAM 9/17/2021 6/24/2022 28 hari G2P1A0
26 IRT SMA ISLAM 11/4/2021 8/11/2022 28 hari G3P2A0
21 IRT SMK ISLAM 15/01/2022 22/10/2022 28 hari G1P0A0
19 IRT SMK ISLAM 15/12/2021 22/09/2022 28 hari G1P0A0
29 IRT SMK ISLAM 13/12/2021 20/09/2022 28 hari G2P1A0
27 IRT SMA ISLAM 05/12/2021 12/09/2022 28 hari G2P1A0
28 IRT SD ISLAM 25/10/2021 02/08/2022 28 hari G3P2A0
32 IRT SMP ISLAM 20/12/2021 27/09/2022 28 hari G2P1A0
27 IRT SMA ISLAM 29/01/2022 06/11/2022 28 hari G2P1A0
23 IRT D1 ISLAM 18/12/2021 25/09/2022 28 hari G1P0A0
35 IRT SMA ISLAM 27/12/2021 04/10/2022 28 hari G3P2A0
22 IRT SMP ISLAM 10/03/2022 17/12/2022 28 hari G1P0A0
24 IRT SMU ISLAM 12/04/2022 19/01/2023 28 hari G2P1A0
39 IRT SMA ISLAM 14/04/2022 21/01/2023 28 hari G3P2A0
18 IRT SMA ISLAM 03/05/2022 10/02/2023 28 hari G1P0A0
22 IRT SMA ISLAM 08/04/2022 15/01/2023 28 hari G1P0A0
32 IRT SMP ISLAM 11/05/2022 18/03/2023 28 hari G3P2A0
27 IRT DIII ISLAM 14/05/2022 21/03/2023 28 hari G2P1A0
26 IRT SMA ISLAM 03/02/2022 10/12/2022 28 hari G2P1A0
30 IRT SMA ISLAM 04/03/2022 11/01/2023 28 hari G2P1A0
29 IRT SD ISLAM 08/04/2022 15/01/2023 28 hari G2P1A0
20 IRT SD ISLAM 10/03/2022 17/11/2022 28 hari G2P1A0
32 IRT SMP ISLAM 13/04/2022 20/01/2023 28 hari G3P2A0
29 IRT S1 ISLAM 05/05/2022 12/02/2023 28 hari G2P1A0
27 IRT DIII ISLAM 08/04/2022 15/01/2023 28 hari G1P0A0
27 IRT SMP ISLAM 20/08/2022 27/05/2023 28 hari G1P0A0
28 IRT SD ISLAM 25/07/2022 02/04/2023 28 hari G1P0A0
28 IRT SD ISLAM 14/06/2022 21/03/2023 28 hari G1P0A0
19 IRT DII ISLAM 13/04/2022 20/01/2023 28 hari G2P1A0
Tanda Bahaya / Penyulit Obat yg dikonsumsi Riwayat Kesehatan / No. HP Bumil
Imunisasi TT
(jika ada) (Termasuk Jamu) Penyakit

>35 TAHUN & PARITAS >3 - TT - 081312067973

- - TT - 085273276849
- - TT - 081360233613
- - TT - 085386815202
- - TT - 082375776937
- - TT - 085368700451
- - TT - 085221668606
- - TT RIW. SC 087736630177
- - TT - 081277617871
- - TT - 08218587115
- - TT - 082382859106
- - TT - 085268584689
- - TT - 082315040149
- - TT - 081374557313
- - TT - 081360233613
- - TT - 085364661067
- - TT - 085369204269

UMUR <20 TAHUN - TT - 082397934926

>35 TAHUN - TT - -

- - TT - 085840333181

KEK, <20 TAHUN - TT - 082378894414

- - TT RIW. SC 081274991895
- - TT1 - 085268174830
- - TT1 - 081374557317
- - TT1 - 080269760077
- - TT3 - 081272428559
<20 TAHUN - - - 085758063967
- - - - 085268779736
- - 2020 - 085357803052
- - 2015 - 085295182732
- - 2008 - 082319107531
- - 2015 - 081282581774
- - - - 082278719067
- - 2017 - 082269775796
- - - - 082278086229
- - 2012 - 082277456888
>35 TAHUN - 2011 - 082348717892
<20 TAHUN - - - 08217885708
- - - - 082172181450
- - 2007 - 081278773322
- - 2008 - 08527871632
- - 2013 - 082132420712
- - 2014 - 083143390160
- - 2012 - 085360617161
- - - - 082286226625
- - - - 082280955046
- - - - 085380248249
- - - - 082174312109
- - - - 082269260077
- - - - 081368883237
- - - - 085367204265
<20 TAHUN - - - 082269260077
 NIK/ KK Jaminan Persalinan

3270057105830007 BPJS
1602215010960024
160221140720001
1602214807900004
1602211641097002
1602214109490003
1602216005900001
1602211605170004
16022127110002
1602211010080001
160220406880003
1602217434980001
1602210809880002
1602210418910004
1275045506960001
1602213714510002
1802151010890003

1602210908840001

1602211819910001

160221840110002
1602218177210001
1602214702950001 BPJS
1602216802930024 BPJS
160221207960002 BPJS
1602215908010001 BPJS
 16022153070002 JAMPERSAL
1602215206930001 JAMPERSAL
1802154107950004 BPJS
1602214703430002 JAMPERSAL
1602212710900002 JAMPERSAL
1602215702540002 BPJS
1602216807990003 BPJS
1671104202870006 JAMPERSAL
1802045604000007 BPJS
1602214707810002 JAMPERSAL
160221780610004 JAMPERSAL
16022134703020001 JAMPERSAL
1602215008040001 JAMPERSAL
1671006107900007 BPJS
16002204502950001 BPJS
1602217284010001 BPJS
1802206004950004 BPJS
1602210704200001 BPJS
1602217180920002 BPJS
1602214151920003 BPJS
160221143040001 BPJS
1602216101980002 BPJS
1602212004950002 BPJS
1602201408010002 BPJS
1602211604000002 BPJS
1602214755300002 BPJS
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil &

NO Bulan Nama Bidan Alamat Usia Ibu
Nama Suami

CONT 1 JANUARI NOVA SUHARTINI,Am.Keb MARTIKA / NGADIMIN MULYA JAYA 26

2 YENI/ NANO 36
3 INTAN N/ YEYEN ANDI S 20
4 RITA HAMIDAN/ BAGUS 26
5 DESI H/ EKO SUSANTO 25
6 DESTIA I/ NURHADI 20
7 TRI WULANDARI/ IMAM. S 27
8 PARYATI/IWAN 35
9 RENA/MARHAN 31
10 SITI UMAIROH/INDRA 21
11 EVI/SUPENO 31
12 CATUR/WINARNO 33
13 APRIYANTI/ ISWANTO 31
14 NOVI/M. ROBY 25
15 SRI WAHYUNI/ SUKARMAN 30

SRI MURNIATI/ SUPRIYANTO 37

16
17 LILI/ TRI S 23
18 NINGSIH/ DIAN 31
19 SITI M/ SUPRIYONO 39
20 FEBRUARI NOVA SUHARTINI,Am.Keb RUSMIYATI/ ANGAR C2 34
21 NURFATIMAH/ BAMBANG C2 30
22 MARET NOVA SUHARTINI,Am.Keb SUGIYATMI/ SUPRIYADI C2/ F 28
23 SITI HASANAH/ SOLIHIN C2/ G 32
24 KHOIRUNISA/ A. FENDI C2/ C 27
25 APRIL NOVA SUHARTINI,Am.Keb -
26 MEI NOVA SUHARTINI,Am.Keb SUHARTATI/ TRIONO C2/ O 42
27 ADE SEVARINA/ ZAINI C2/ F 43
28 IKA RATNAWATI/ILHAM C2/ F 22
29 MELIS H/BENI C2/ D 30
30 DIAN/ PORTO UTOMO C2/ A 22
31 JUNI NOVA SUHARTINI,Am.Keb ELI USWATUN/ FIRMANSYAH C2/C 17
32 CARISAH/ SAHYONO C2/A 41
33 ERMAWATI/ WAHYU A. C2/6 25
34 JULI NOVA SUHARTINI,Am.Keb -
35 AGUSTUS NOVA SUHARTINI,Am.Keb SITI AMINAH/ A. RAHMAN DSN 1 37
36 SEPTEMBER NOVA SUHARTINI,Am.Keb YULI DIAN/ KRISNANTO DSN 2 21
37 OKTOBER
38
39
40
41
42
43
44
45
46
47
48
49
50
 DATA PEMANTAUAN IBU HAMIL 2022

Siklus
Pekerjaa Pendidikan
Agama HPHT TP Haid G,P,A
n Ibu Ibu
(Hari)
IRT SMP Islam 00-6-2021 00-3-2022 28 hari G4P3A0
IRT SMP KRISTEN 6/17/2021 3/24/2022 28 hari G5P2A2
IRT SMP ISLAM 7/10/2021 4/17/2022 28 hari G1P0A0
IRT SMA ISLAM /06/2021 /3/2022 28 hari G2P1A0
IRT SMP ISLAM 7/24/2021 5/1/2022 28 hari G2P1A0
IRT SMA ISLAM 7/10/2021 4/17/2022 28 hari G1P0A0
IRT SD ISLAM 8/10/2021 5/17/2022 28 hari G1P0A0
IRT SMP ISLAM 7/14/2021 4/21/2022 28 hari G3P2A0
IRT SMP ISLAM 7/27/2021 5/4/2022 28 hari G3P2A0
IRT SMA ISLAM 10/3/2021 7/10/2022 28 hari G1P0A0
IRT SMP ISLAM 8/6/2021 5/13/2022 28 hari G2P1A0
IRT SMA ISLAM 8/17/2021 5/24/2022 28 hari G2P1A0
IRT SMP ISLAM 9/26/2021 7/3/2022 28 hari G2P1A0
IRT SMA ISLAM 11/9/2021 8/16/2022 28 hari G2P1A0
IRT SMP ISLAM 8/1/2021 6/8/2022 28 hari G3P2A0

IRT SMP ISLAM 8/1/2021 5/8/2022 28 hari G3P2A0

IRT SMP ISLAM 11/25/2021 9/2/2022 28 hari G3P2A0

IRT SMP ISLAM 10/26/2021 8/3/2022 28 hari G3P2A0
IRT SMP ISLAM 6/10/2021 3/13/2022 28 hari G2P1A0
IRT SMP ISLAM 11/13/2021 8/20/2022 28 hari G3P2A0
IRT SMP ISLAM 10/14/2021 7/21/2022 28 hari G2P1A0
IRT SMP ISLAM 05/08/2021 12/05/2022 28 hari G2P1A0
IRT SMP ISLAM 10/02/2021 17/11/2022 28 hari G3P2A0
IRT SMA ISLAM 21/12/2021 28/09/2022 28 hari G2P1A0

IRT SMP ISLAM 06/01/2022 13/10/2022 28 hari G3P2A0

PNS S1 ISLAM 05/03/2022 12/12/2022 28 hari G3P2A0
IRT SD ISLAM 02/04/2022 09/11/2022 28 hari G1P0A0
 IRT SMP ISLAM 26/03/2022 03/11/2022 28 hari G3P1A1
IRT SMA ISLAM 09/03/2022 16/12/2022 28 hari G1P0A0
IRT SMP ISLAM 13/01/2022 20/10/2022 28 hari G1P0A0
IRT SD ISLAM 20/02/2022 27/11/2022 28 hari G4P3A0
IRT SMA ISLAM 07/03/2022 14/12/2022 28 hari G1P0A0

GURU S1 Islam 21/05/2022 28/02/2023 28 hari G3P2A0

IRT SMA ISLAM 14/05/2022 21/02/2023 28 hari G1P0A0
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan / No. HP Bumil
dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)
PARITAS >3 _ TT4 _ -
>35 TAHUN & PARITAS >3 - TT4 - 081272294348
- - TT4 - 082372494194
- - TT4 - 081377561225
- - TT4 - 085788986033
- - TT4 - 085769570049
- - TT4 - 085838236902
- - TT4 -
- - TT5 - 085788181058
- - TT1 - 082278629522
- - TT4 - 085896138147
- - TT4 - 082226831887
- - TT4 - 085841546495
- - TT4 - 081776623377
- - TT4 - 085809210754

>35 TAHUN - TT4 - -

- - TT4 - 081339047396
- - TT4 - 082316344589
>35 TAHUN - TT5 - -
- - TT4 - -
- - TT4 - 085377758521
- - TT5 - 082178740860
- - TT4 - 085367265136
- - TT4 - 082374516155

>35 TAHUN - TT1 - 081368275633

>35 TAHUN - TT1 - 081368685168
- - TT1 - 082279978518
 - - TT1 - 082310650454
- - TT2 - 082322658488
<20 TAHUN - TT4 - 082281588556
>35 TAHUN, PARITAS >3 - TT4 - 085367704184
- - TT4 - 085866017159

>35 TAHUN - TT4 - 085266683674

- - TT1 - 085767117032
 NIK/ KK Jaminan Persalinan

1602216407840001' Jampersal
1602216910860002 jampersal
1602154104010002 jampersal
1602215808940002 jampersal
1602217012960002 jampersal
1602134112010003 jampersal
jampersal
1602215710860003 jampersal
1602214606910004 jampersal
1602135105000002 jampersal
1602216207920003 jampersal
1602214610870002 jampersal
1602217004890001 jampersal
1602215111969003 jampersal
1602214705900002 jampersal

jampersal
1602214906840002
1602216601010001 jampersal
1602216310900004 jampersal
1602214502830001 jampersal
1602214303860002 jampersal
1602217105910002 jampersal
1602215206880008 jampersal
1602215606900005 jampersal
1812025705940001 jampersal

1602215108850004
1607211604790002 BPJS
1602044411950004
 1602225501900028
1602216510010005
1602044107040058
1602215211810001
1602207005960001

160221709850004
1602205806010001
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil &

NO Bulan Nama Bidan Alamat
Nama Suami

1 JANUARI RUSMITA,Am.Keb TRISNAYANTI/ SEPRIYANTO DABUK MAKMUR

2 LILIK/ SUMANTO
3 IIS LESTARI/ A. SAHRONI
4 INTAN/ RURI
5 RUSMI/ ULUDIN
6 MILA/ RIO
7 SINTA/ SUKARI
8 NOVEL/ REVI
9 UCI WULANDARI/ NUROHMAN
10 WARDIANA/ HENDRO
11 NENENG/ ADI P
12 SUHENI/ JAUHARI
13 RANTI/YADI
14 YANTI/ RONO H
15 SOIMAH/ EDI SASTRO
16 MARLINA/ HERI
17 AMBARWATI/ RUDI
18 MILA DWI LESTARI/ WAHYUDI
19 RATIH/ NURFAIS
20 FEBRUARI RUSMITA,Am.Keb LIA/ ISKANDAR DABUK MAKMUR
21 LISTIANI/IQBAL
22 RINA WATI/ DARUL H
23 MARET RUSMITA,Am.Keb DWI AYU/ ARKAN DABUK MAKMUR
24 HASANAH/ EKO SUSILO
25 SULATIN/ YUNAWIRAWAN
26 WARPIAH/ MARIYUN
27 APRIL RUSMITA,Am.Keb NURHAINI/ ASEP DABUK MAKMUR
28 YULI SARTIKA/ WAHYUDI
29 TUTI AGUSTINA/ MISWANDI
30 MEI RUSMITA,Am.Keb IMAS / RUSMIN DUSUN I
31 EVI YULIANA / MUHTARUDIN DUSUN I
32 REKA / SUPRI DUSUN II
33 NURAINI / ASEP DM
34 DEWI/ HENDRI DSN II
35 JUNI RUSMITA,Am.Keb WARKESI/MIANTO DABUK MAKMUR
36 DARMI/ ANTON DABUK MAKMUR
37 PUTRI/ BASTIAN DSN II
38 HARTATI/ HENDRA DABUK MAKMUR
39 JULI RUSMITA,Am.Keb TIA OKTAVIANI/DEDEN DSN II
40 TIARA SAPUTRI/ AGUS DSN II
41 SITI KHOTIJAH/ DANIEL
42 MARATUS/ ANDRI
43 EVA/ SAYANG SUWITO DSN II
44 AGUSTUS RUSMITA,Am.Keb DESI/ AHMAD DSN II
45 RIKA CAHYATI/ ALDI DSN II
46 SANTI/ ARIS DSN II
47 SEPTEMBER RUSMITA,Am.Keb AGUSTINA/ FEBRI DSN I
48 ICA CACA/ YOGA DSN 2
49 OKTOBER
50
 DATA PEMANTAUAN IBU HAMIL 2021

Siklus
Pekerjaa Pendidikan
Usia Ibu Agama HPHT TP Haid G,P,A
n Ibu Ibu
(Hari)
23 IRT SMP ISLAM 11/21/2021 9/28/2022 28 HARI G2P1A0
30 IRT SD ISLAM 6/11/2021 3/18/2022 28 HARI G2P1A0
30 IRT SD ISLAM 7/28/2021 5/5/2022 28 HARI G3P2A0
20 IRT SMK ISLAM 5/24/2021 31-02-2022 28 HARI G1P0A0
32 IRT SD ISLAM 9/26/2021 7/2/2022 28 HARI G3P2A0
20 IRT SMP ISLAM 7/20/2021 4/27/2022 28 HARI G2P1A0
26 IRT SMA ISLAM 9/17/2021 6/24/2022 28 HARI G1P0A0
23 IRT SMP ISLAM 4/25/2021 1/28/2022 28 HARI G1P0A0
25 IRT SMA ISLAM 4/10/2021 1/17/2022 28 HARI G2P1A0
33 IRT SMA ISLAM 6/22/2021 3/29/2022 28 HARI G2P1A0
20 IRT SMP ISLAM 7/25/2021 31-04-2022 28 HARI G2P1A0
37 IRT SD ISLAM 6/27/2021 4/3/2022 28 HARI G3P2A0
25 IRT SD ISLAM 8/3/2021 5/10/2022 28 HARI G3P2A0
22 IRT SMP ISLAM 8/20/2021 5/27/2022 28 HARI G3P2A0
22 IRT SMP ISLAM 11/2/2021 9/9/2022 28 HARI G2P1A0
22 IRT SD ISLAM 6/12/2021 3/17/2022 28 HARI G2P1A0
32 IRT SD ISLAM 11/15/2021 8/22/2022 28 HARI G2P1A0
17 IRT SD ISLAM 9/1/2021 6/8/2022 28 HARI G1P0A0
23 IRT SMP ISLAM 6/28/2021 4/4/2022 28 HARI G2P1A0
25 IRT SD ISLAM 9/10/2021 6/17/2022 28 HARI G3P2A0
24 IRT SMP ISLAM 12/23/2021 9/30/2022 28 HARI G3P1A1
29 IRT SMP ISLAM 12/30/2021 10/10/2022 28 HARI G2P1A0
19 IRT SMA ISLAM 27/10/2021 03/07/2022 28 HARI G1P0A0
26 IRT SD ISLAM 25/12/2021 31/09/2022 28 HARI G2P1A0
26 IRT SMP ISLAM 19/01/2022 26/10/2022 28 HARI G2P1A0
34 IRT SD ISLAM 13/12/2021 20/09/2022 28 HARI G2P1A0
19 IRT SD ISLAM 23/02/2022 30/11/2022 28 HARI G1P0A0
23 IRT SMP ISLAM 22/02/2022 29/11/2022 28 HARI G1P0A0
23 IRT SMA ISLAM 05/03/2022 12/12/2022 28 HARI G1P0A0
30 IRT SMA ISLAM 02/03/2022 09/12/2022 28 HARI G3P1A1
18 IRT SMP ISLAM 25/03/2022 31/12/2022 28 HARI G1P0A0
27 IRT SD ISLAM 10/01/2022 17/10/2022 28 HARI G3P2A0
19 IRT SD ISLAM 23/02/2022 30/11/2022 28 HARI G1P0A0
18 IRT SMP ISLAM 10/04/2022 17/01/2023 28 HARI G2P0A1
40 IRT SD ISLAM 10/03/2022 17/12/2022 28 HARI G4P3A0
32 IRT SMP ISLAM 02/04/2022 09/01/2023 28 HARI G2P1A0
18 IRT SD ISLAM 28/02/2022 07/11/2022 28 HARI G1P0A0
25 IRT SD ISLAM 05/03/2022 12/12/2022 28 HARI G2P1A0
21 IRT SMA ISLAM 07/05/2022 14/02/2023 28 HARI G1P0A0
19 IRT MTS ISLAM 07/06/2022 14/03/2023 28 HARI G1P0A0
18 IRT SMP ISLAM 25/02/2022 02/12/2022 28 HARI G1P0A0
21 IRT SMA ISLAM 12/06/2022 19/03/2023 28 HARI G1P0A0
26 IRT SMP ISLAM 10/12/2021 17/07/2022 28 HARI G4P2A1
20 IRT SD ISLAM 01/05/2022 08/02/2023 28 HARI G2P1A0
20 IRT SMK ISLAM 28/06/2022 05/03/2023 28 HARI G1P0A0
23 IRT SD ISLAM 27/05/2022 04/02/2023 28 HARI G2P1A0
20 IRT SMP KRISTEN 09/07/2022 16/04/2023 28 HARI G1P0A0
16 IRT SMP ISLAM 26/06/2022 03/03/2023 28 HARI G1P0A0
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan / No. HP Bumil
dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)
- - TT1 - 085269224926
- - - - 082176155937
- - TT2 - 082328535502
- - - - 082315345919
- - - - 085383860366
- - - - 082377490516
- - TT2 - 085366050503
- - - - 085841926695
- - - - 085215001781
- - - - 085369905329
- - - - 085383571667
>35 TAHUN - - - 08579783486
- - - - 081274003718
- - - - 082328535502
- - TT2 - 081368692367
- - - - 082282412363
- - TT2 - 085357790912
<20 TAHUN - TT2 - -
- - - - 081273350835
- - TT2 - 085366732766
- - TT2 - 082121199253
- - TT2 - -
<20 TAHUN - TT2 - 085268916058
- - TT2 - 085372663383
- - TT2 - 085383441649
- - TT2 -
- - TT1 - 08535742417
- - TT1 - 085314683939
 - - TT1 - 085283104518
- - TT1 - 085352256401
<20 TAHUN - TT1 - 081250643498
- - TT1 -
<20 TAHUN - TT1 - 085357424217
<20 TAHUN - TT1 -
>35 TAHUN, PARITAS >3 - - - 085267641760
- - TT1 - 081367205941
<20 TAHUN - TT1 - 085379888709
- - - - 081377554534
- - 082278699004
<20 TAHUN - -
<20 TAHUN - - 081377768109
- - -
- - -
- - TT1 - 085769180683
- - TT1 - 081379966510
- - TT1 - 085378363582
- - - -
<20 TAHUN - - - 081379962085
 NIK/ KK Jaminan Persalinan

1602214209980005
1602216807910001
1601295205910004
1602214811010001
1602216011900004
1602215902010001
1602216302000003
1602215211980002
1602214103960002
1602214711880004
1602214105030002
1803234706850001
1602216408940001
-
1602216907990001
1602221110180014
1602136408890007
-
1602216511980001
1602214308930001
1602215609980002
-
1602216909020004
1602134212950002
1602215404940001
1602216304880001
160221471020002
1602215808990003
1602216002910001

16022147110200002

1802164412820001
1802075005860018
1602214209060005

1602215904030002

1608154502010001

1602216912020003
1602134806040001
1602215408990001
160225808030002
1602214912070001
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil &

NO Bulan Nama Bidan Alamat
Nama Suami

1 JANUARI Hj.Herlianah,SST ROMLAH/ SAMSUL KEMANG INDAH

2 SRI HARTATI/ SLAMET
3 FITRI/ DWI. P

4 INDAH MAITA/ HARIYANTO

5 SUPAMI/ SUGITO
6 TUTUT W./ FRENGKI
7 ENDANG/ MARINO
8 PUJI L/ WIDODO
9 MAGDALENA/ SUPRIADI
10 SEPTI K./ DEDI P
11 EVA T/ GUNAWAN
12 KM. AYU/ KM. YASE
13 NITA A./ TUKIMAN
14 AMILA/ SUGENG
15 APREKA/ YANDI
16 NOVITA/ BOWO
17 ULUL Q/ ANDRI P.
18 EKA A/ RAHMAD
19 ELISWATI/ NUGROHO

RINA WATI/ DONI MUSAFAK KEMANG INDAH

20 FEBRUARI Hj.Herlianah,SST
21 MARET Hj.Herlianah,SST RENI RATNA SARI/ HERIANSYAH KEMANG INDAH
22 APRIL Hj.Herlianah,SST DIAN SAFITRI/ WAHYU KI/ B
23 YULI AGUSTINA/ AWALUDIN KI/ D
24 JARIYATI/ KURNIAWAN KI/ C
25 MEI Hj.Herlianah,SST AYU SRI WULAN/ FENDA KI/B
26 LILI NURJANAH/ KADEK SUTAKE KI/A
27 SEPTIANA/ KUSWANDI KI/D
28 JUNI Hj.Herlianah,SST MEY SAFITRI/ AGUS SETIAWAN KI/A
29 TRI NURJANAH/FREDI DWI YAN KI/B
30 RISA INDRASWARI/ EDI SETIAW KI/D
31 JULI Hj.Herlianah,SST SITI SOLEKAH/ PONIDI KI/B
32 ERNI YUNITA/ DIMAS BAGUS P KI/B
33 SYARIATUN/ SLAMET SUDIONO KI/B
34 SUMARNI/ SUBROTO KI/B
35 AGUSTUS Hj.Herlianah,SST SARI DEWI/ KETUT SANTOSO KI/C
36 LELA/ EDI PURNAMA KI/C
37 USMAINIERNAWATI/ ARJUN KI/B
38 RAHAYU SOLEKHAH/ M. UMAR SKI/A
39 SEPTEMBER Hj.Herlianah,SST SITI ROMLAH/AGUS SANTOSA KI/B
40 ASIH TRIANTI/ ERIK SANTOSO KI/C
41 PUJI ASTUTI/ HENGKI KUNTARA KI/B
42 SITI SOLEKAH/HADI RISWANTO KI/A
43 RARA SEPTIANA/ ZAINAL MUST KI/A
44 YULITA/ SATIMAN KI/C
45 NURUL SINTIYA D/ HERIN PUR KI/D
46 EVI NIRMALA SARI/ MUHRIM KI/B
47 OKTOBER
48
49
50
 DATA PEMANTAUAN IBU HAMIL 2022

.Keb,SKM

Siklus
Usia Pekerjaa Pendidikan
Agama HPHT TP Haid G,P,A
Ibu n Ibu Ibu
(Hari)
33 IRT SMP ISLAM 10/10/2021 7/17/2022 28 HARI G4P3A0
26 IRT SD ISLAM 6/28/2021 4/5/2022 28 HARI G2P1A0
24 IRT SMP ISLAM 5/15/2021 2/22/2022 28 HARI G1P0A0
25 IRT D3 ISLAM 6/10/2021 3/17/2022 28 HARI G2P0A1
34 IRT SMP ISLAM 8/20/2021 5/27/2022 28 HARI G2P1A0
23 IRT SMA ISLAM 6/12/2021 3/19/2022 28 HARI G1P0A0
26 IRT SMP ISLAM 7/20/2021 4/27/2022 28 HARI G2P1A0
29 IRT SMP ISLAM 9/5/2021 6/12/2022 28 HARI G2P1A0
25 IRT SMA ISLAM 5/14/2021 2/21/2022 28 HARI G2P1A0
23 IRT SMP ISLAM 4/7/2021 1/14/2022 28 HARI G2P1A0
25 IRT SMP ISLAM 6/25/2021 4/2/2022 28 HARI G3P2A0
24 IRT SMA HINDU 5/12/2021 2/19/2022 28 HARI G1P0A0
43 IRT SD ISLAM 8/28/2021 6/5/2022 28 HARI G3P2A0
34 IRT SMP ISLAM 10/6/2021 7/13/2022 28 HARI G5P4A0
26 IRT SMA ISLAM 7/9/2021 4/16/2022 28 HARI G2P1A0
34 IRT D3 ISLAM 9/12/2021 6/19/2022 28 HARI G2P1A0
28 GURU S1 ISLAM 8/18/2021 5/25/2022 28 HARI G4P3A0
29 IRT SMA ISLAM 6/27/2021 4/4/2022 28 HARI G2P1A0
40 IRT SMA ISLAM 7/1/2021 4/8/2022 28 HARI G7P3A3

23 IRT SMP ISLAM 11/30/2021 10/7/2022 28 HARI G2P1A0

27 IRT D3 ISLAM 05/01/2022 12/10/2022 28 HARI G1P0A0

30 GURU S1 ISLAM 05/02/2022 12/11/2022 28 HARI G2P1A0
27 IRT SMP ISLAM 08/02/2022 15/11/2022 28 HARI G2P1A0
29 IRT SMP ISLAM 06/02/2022 13/11/2022 28 HARI G2P1A0
26 IRT SMP ISLAM 26/02/2022 03/12/2022 28 HARI G2P1A0
34 IRT S1 HINDU 04/03/2022 11/12/2022 28 HARI G6P2A3
30 IRT SMP ISLAM 27/02/2022 04/12/2022 28 HARI G3P1A1
26 IRT SMA ISLAM 27/02/2022 04/12/2022 28 HARI G2P1A0
18 IRT SMA ISLAM 07/03/2022 14/12/2022 28 HARI G1P0A0
29 IRT SMA ISLAM 28/12/2021 05/10/2022 28 HARI G4P3A0
35 IRT SMP ISLAM 05/04/2022 12/01/2023 28 HARI G3P2A0
19 IRT SMA ISLAM 03/04/2022 10/01/2023 28 HARI G1P0A0
33 IRT SMP ISLAM 07/04/2022 14/01/2023 28 HARI G3P2A0
35 IRT SMP ISLAM 09/01/2022 16/10/2022 28 HARI G3P2A0
32 IRT SMA HINDU 10/06/2022 17/03/2023 28 HARI G2P1A0
26 IRT SMP ISLAM 01/07/2022 08/04/2023 28 HARI G2P1A0
21 IRT SMK ISLAM 11/04/2022 18/01/2023 28 HARI G1P0A0
25 IRT SMA ISLAM 03/07/2022 10/04/2023 28 HARI G2P1A0
30 IRT SMP ISLAM 23/06/2022 30/03/2023 28 HARI G4P2A1
28 IRT SMP ISLAM 20/06/2022 27/03/2023 28 HARI G2P1A0
31 IRT SMP ISLAM 15/05/2022 22/02/2023 28 HARI G4P3A0
38 IRT SMK ISLAM 23/04/2022 30/01/2023 28 HARI G3P2A0
22 IRT SMA ISLAM 20/06/2022 27/03/2023 28 HARI G2P1A0
19 IRT SMA ISLAM 25/02/2022 02/12/2022 28 HARI G1P0A0
30 IRT DIII ISLAM 24/06/2022 01/04/2023 28 HARI G2P1A0
22 IRT SMA ISLAM 15/06/2022 22/03/2023 28 HARI G1P0A0
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan / No. HP Bumil
dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)
PARITAS >3 - TT2 - 085381242672
- - TT2 - 085709691739
- - TT2 - 085768260344
- - TT2 - 087747118032
- - TT2 - 085709296299
- - TT1 - 089894800358
- - TT2 - 087763985627
- - TT2 - 085783336796
LT. LINTANG - TT2 - 085669310797
- - TT2 - 085769063252
LILA 22CM - TT2 - 085788437072
LILA 23CM - TT2 - 082387429562
>35 TAHUN - TT2 - 085709524785
PARITAS >3 - TT2 - 082320630945
LILA 20CM - TT2 - 085783206349
- - TT2 - 081272084165
BB 103 - TT2 - 085764560118
- - TT1 - 083178425880
>35 TAHUN & PARITAS >3 - TT2 - 081532040551

- - TT1 - 085879105402

- - TT1 - 082176827429
- - T2 - 081532376418
LILA 23CM - T1 - 085838380522
- - T1 - 085809617075
LILA 23CM - TT2 - 081375689156
PARITAS >3 - TT2 - 082281268816
- - TT2 - 087776490057
- - T1 - 081274736906
<20 TAHUN - T1 - 085709034065
PARITAS>3 - T1 - 085279296491
- - T1 - 085783581602
 <20 TAHUN - T1 - 081266868418
LILA 23 CM - T1 - 082181775023
- - T1 -
- - T1 - 085788376960
- - T1 - 082372189312
LILA 19 CM - T1 - 082249168282
- - T1 - 085838188621
LILA 22CM - T1 - 085809962611
LILA 21 CM - T1 - 085314681400
- - T1 - 087880209980
- - T1 - 085216943184
LILA 22CM - T2 - 085267134923
LILA 19 CM, UMUR <20 TAHUN - T2 - 082283233927
- - T1 - 082135682879
- - T1 - 085384815257
 NIK/ KK Jaminan Persalinan

1602214205880003 JAMPERSAL
1602214403960004 JAMPERSAL
1602225509980002 JAMPERSAL
1602215211980001 JAMPERSAL
1602215008880002 BPJS
- JAMPERSAL
1602215111960005 JAMPERSAL
1602214601930002 BPJS
1602204605980001 JAMPERSAL
1602214909980004 BPJS
1801085807970003 JAMPERSAL
1802285312980001 JAMPERSAL
1602214105800004 BPJS
1602216002850001 BPJS
1602224504960004 JAMPERSAL
1608084907930001 JAMPERSAL
3518126004880002 BPJS
1602215504930005 JAMPERSAL
1602214509820002 JAMPERSAL

1602214204020002 JAMPERSAL

1805066604940004 JAMPERSAL
1671015504920006 BPJS
1602216907950001 BPJS
1602215701930003 BPJS
1901035212964001 BPJS
1602214401880002 JAMPERSAL
1602214904920001 BPJS
1602214705960003 BPJS
1602214404040002 JAMPERSAL
1602215905570003 JAMPERSAL
1602214710870002 JAMPERSAL
 1602216509030001 JAMPERSAL
1602216212880001 JAMPERSAL
1602215007870001 BPJS
1602217004900005 JAMPERSAL
1602214104960002 JAMPERSAL
1602216503010004 JAMPERSAL
1602216603970001 JAMPERSAL
1602214510910002 JAMPERSAL
1811056710950002 JAMPERSAL
1602217009910001 BPJS
1602216507840001 JAMPERSAL
1602215808020001 BPJS
1602215104030001 JAMPERSAL
127112403920002 JAMPERSAL
1602135510010001 JAMPERSAL
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

Nama Ibu Hamil & Nama

NO Bulan Nama Bidan Alamat
Suami

1 JANUARI HABIBAH,Am.Keb,SKM EKA /ZAENURI MATARAM JAYA

2 ROBINGAN/ WARDOYO
3 SITI DARIYAH/HABIB
4 WY. BUDRIANI/ WY. SUPARMAN
5 FITRIANI/JOKO
6 EKA/SARJONO
7 SITI. M/ RISMAN
8 DEVI/ AGUS
9 ROHAYATI/IWAN
10 NYOMAN ERLANDA/
11 ASLAMIAH/HERY
12 WY. SUWADRI/KD. SUDERKE
13 LAILATUL FITRIANI/TAUFIK FERIANTO
14 TRI MERIANA/ HERIYANTO
15 RINI/ SUGIANTO
16 SITI MAHMUDAH/ SUWARDI
17 SITI KOMARIAH/ SUPRAYETNO
18 LULUK FADHILAH/IMAM MUSTANGIN
19 NI MD HERTINA/ KT PASTIKE
20 ATNA AGUSTINA/ RUDIYANTO
21 MARIA VELINA/EDI SUSANTO
22 YULIYANTI/FEBRI SISWANTO
23 KOMANG SUJIATI/ MADE WIDANE
24 LIYA SRI L/ARI RAMADAN
25 SRI MURYANI/ FATKHU ROHMAN
26 NUR MIFTAKHUL/ ARIF PERMADI
27 PUJI ASTUTI/FENDI NURSALIM
28 FITRIANI/ NURSALIM
29 PAMUJI MURTI/ JUMIYO
30 ERNI HASANAH/ DAY ROGI
31 VERAWATI/IMAM
32 SITI YANTI/ ARIA WITANTO
33 KOMANG DIANA/ KOMANG MIRE
34 KOMANG SULASTRI/KADEK EDI
35 TUTIK HASANAH/ AHMADI
36 TOHAROH/ GIRI SUSILO
37 WAHYUNINGSIH/ TRIMO

NI NY KARINA/ MD EDI PURNAMA

38
39 HARTINI/ AHMADI
40 SUPRAPTI/ AKMALUDIN
41 FEBRUARI HABIBAH,Am.Keb,SKM NI LUH SASEH/ MATARAM JAYA
42 SITI MISWATI/ SARIPUDIN
43 SUNTARI/ AGUS
44 YULIA/
45 MIMI/ RIZAL
46 SUNDARI/ PURNOMO
47 MARET HABIBAH,Am.Keb,SKM ISTIYAH/ MUJIONO MATARAM JAYA
48 KETUT SRI RAHAYU/WAYAN EKE
49 KADEK SANDAT/ KADEK SUMANTRE
50 SEPTI NUR FADILAH/ YUSUF TUKIRAH
51 NI MADE HERLINA/ KETUT PASTIKE
52 SITI KHORIA/ DODY
53 NYOMAN PUSPASARI/ KOMANG BANG
54 KURNIYATI/ IWAN SUTRISNO
55 APRIL HABIBAH,Am.Keb,SKM TRI UMMU/ SUWARNO MATARAM JAYA/ D4
56 JARNIATI/ ERWANTO DSN 1
57 RINI/ SWARDI DSN 5
58 SITI NGAFIFAH/ FAUZUL ULUM DSN 4
59 KOMANG DESI/ GEDE GUNAWAN DSN 3
60 NILUH DEWI/ NYOMAN DADI DSN 3
61 SRI MULYANI/ JIYANTO DSN 5
62 LISTRI WAHYUNI/ MARDIYANTO DSN 1
63 MEI HABIBAH,Am.Keb,SKM BINTI KOFIFAH/ DIAN DSN 5
64 SITI SAMSUL M/ AGUS S DSN 1
65 WY. ARYANI/ WY. PUTRAYASA DSN 3
66 KT. AYU YANI/ GD. PUJE ASTUTI DSN 3
67 MD. BUDRIANI/ KT. KICEN DSN 3
68 SUSI YULIANA/ HERMAN DSN IV
69 AYU PUTRI/ RIKI JULIANTO DSN 2
70 AYU SARIAH/ DSN 6
71 JUNI HABIBAH,Am.Keb,SKM FITRIANI/ AGUS DSN 1
72 ENI RUSITA/ SAIFUL DSN 5
73 WAYAN SURYANI/ WAYAN SUTIKNO DSN 3
74 MIAYASIH/ DSN 4
75 JULI HABIBAH,Am.Keb,SKM FITRIYANI/ SUSENO DSN 2
76 KHOIRUNNIKMAH/ EDI BASUKI DSN 4
77 SRI HANDAYANI/ DARMAWAN DSN 4
78 AGUSTUS HABIBAH,Am.Keb,SKM INGE ARDIANA/ KOBAR BIMANTORO DSN 3
79 NURJANAH/ GODEM DSN 2
80 WAYAN RIKA/ WAYAN BUDAYASA DSN 6
 81 FIRDA/ ALEX DSN 4
82 SEPTEMBER HABIBAH,Am.Keb,SKM KOMANG YAKNI/ KOMANG SUDARTEDSN 3
83 MADE SUWARI/ KETUT PASTIKE DSN 3
84 ENDANG WAHYUNI/ SUGENG DSN 4
85 KADEK MURNIASIH/ WAYAN TOMI A DSN 3
86 KADEK DEWI/ YUDI DSN 3
87 SUPREHATEN/ DARMAWAN DSN 5
88 OKTOBER
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
 DATA PEMANTAUAN IBU HAMIL 2022

Siklus
Pekerjaa Pendidikan
Usia Ibu Agama HPHT TP Haid G,P,A
n Ibu Ibu
(Hari)
23 IRT SMP ISLAM 3/15/2021 12/20/2021 28 hari G2P1A0
27 IRT SMP ISLAM 4/25/2021 1/30/2022 28 hari G3P2A0
19 IRT SMP ISLAM 7/28/2021 5/4/2022 28 hari G1P0A0
33 IRT SD HINDU 5/20/2021 2/24/2022 28 hari G3P2A0
40 IRT SD ISLAM 6/19/2021 3/26/2022 28 hari G3P2A0
32 IRT SD ISLAM 6/24/2021 4/1/2022 28 hari G2P1A0
21 IRT SMP ISLAM 5/2/2021 2/9/2022 28 hari G1P0A0
21 IRT SMK ISLAM 7/14/2021 4/21/2022 28 hari G1P0A0
34 IRT SMP HINDU 5/8/2021 5/15/2022 28 hari G3P2A0
19 IRT SMK ISLAM 5/1/2021 2/8/2022 28 hari G1P0A0
21 IRT SD HINDU 7/18/2021 4/25/2022 28 hari G1P0A0
30 IRT SMP ISLAM 5/28/2021 3/5/2022 28 hari G3P2A0
22 IRT MTS ISLAM 8/28/2021 6/4/2022 28 hari G1P0A0
18 IRT SD ISLAM 6/6/2021 3/13/2022 28 hari G1P0A0
32 IRT SD ISLAM 6/29/2021 4/5/2022 28 hari G1P0A0
27 IRT SMP ISLAM 6/14/2021 3/21/2022 28 hari G2P1A0
37 IRT SMP ISLAM 7/3/2021 4/9/2022 28 hari G2P1A0
34 IRT SD ISLAM 8/22/2021 5/29/2022 28 hari G3P2A0
36 IRT SMP HINDU 7/25/2021 5/1/2022 28 hari G3P2A0
19 IRT SMA ISLAM 8/15/2021 5/22/2022 28 hari G1P0A0
31 IRT SMA KATOLIK 8/25/2021 6/1/2022 28 hari G2P1A0
27 IRT SLTP ISLAM 9/15/2021 6/22/2022 28 hari G2P1A0
28 IRT BIDAN HINDU 6/28/2021 4/4/2022 28 hari G2P1A1
21 IRT SD ISLAM 6/4/2021 3/11/2022 28 hari G1P0A0
18 IRT SD ISLAM 5/23/2021 4/1/2022 28 hari G1P0A0
24 GURU SMA ISLAM 9/1/2021 6/8/2022 28 hari G1P0A0
19 IRT SLTA ISLAM 9/29/2021 7/6/2022 28 hari G1P0A0
31 IRT SD ISLAM 3/15/2021 12/22/2022 28 hari G3P2A0
22 IRT SD ISLAM 5/10/2021 2/17/2022 28 hari G2P1A1
17 IRT SD ISLAM 7/31/2021 5/1/2022 28 hari G1P0A0
30 IRT SLTP ISLAM 9/6/2021 6/13/2022 28 hari G3P2A0
30 IRT SD ISLAM 8/30/2021 6/6/2022 28 hari G2P1A1
35 KUD SMA HINDU 8/10/2021 5/17/2022 28 hari G3P2A0
24 IRT PERAWAT HINDU 7/2/2021 4/8/2022 28 hari G2P1A1
40 IRT SD ISLAM 10/20/2021 7/27/2022 28 hari G3P2A0
30 IRT SD ISLAM 10/10/2021 7/17/2022 28 hari G2P1A0
34 IRT SMA ISLAM 11/13/2021 8/20/2022 28 hari G3P2A0

29 IRT SD HINDU 8/3/2021 5/9/2022 28 hari G3P2A0

39 IRT SMP ISLAM 10/15/2021 7/22/2022 28 hari G5P4A0

39 IRT SMP ISLAM 9/5/2021 6/12/2022 28 hari G3P2A0
23 IRT SD HINDU 28 hari G2P1A0
30 IRT SD ISLAM 11/20/2021 8/27/2022 28 hari G2P1A0
32 IRT SD ISLAM 8/20/2021 5/27/2022 28 hari G2P1A0
20 IRT SD ISLAM 12/1/2021 9/8/2022 28 hari G1P0A0
20 IRT SD ISLAM 12/14/2021 9/20/2022 28 hari G1P0A0
32 IRT SD ISLAM 12/4/2021 9/11/2022 28 hari G3P2A0
36 IRT SD ISLAM 25/09/2021 02/07/2022 28 hari G3P2A0
29 IRT S1 HINDU 07/10/2021 14/07/2022 28 hari G3P2A0
29 IRT SMP HINDU 20/10/2021 27/07/2022 28 hari G3P2A0
19 IRT SD ISLAM 05/09/2021 12/06/2022 28 hari G1P0A0
36 IRT SMP HINDU 18/07/2021 25/04/2022 28 hari G3P2A0
24 IRT SMP ISLAM 13/10/2021 20/07/2022 28 hari G2P1A0
30 IRT SMP HINDU 05/11/2021 12/08/2022 28 hari G3P2A0
31 IRT SD ISLAM 12/10/2021 19/07/2022 28 hari G2P1A0
17 IRT SD ISLAM 25/08/2021 30/05/2022 28 hari G1P0A0
32 IRT SMA ISLAM 10/11/2021 18/07/2022 28 hari G2P1A0
32 IRT SD ISLAM 10/11/2021 18/07/2022 28 hari G2P1A0
19 IRT SMA ISLAM 27/01/2022 03/11/2022 28 hari G1P0A0
25 IRT SMA HINDU 17/11/2021 24/08/2022 28 hari G2P1A0
27 IRT SMP HINDU 27/07/2021 04/05/2022 28 hari G3P2A0
21 IRT SMA ISLAM 27/12/2021 04/10/2022 28 hari G1P0A0
18 IRT SMP ISLAM 05/12/2021 12/09/2022 28 hari G2P1A0
28 IRT SD ISLAM 12/12/2021 19/09/2022 28 hari G2P1A0
25 IRT SLTP ISLAM 05/09/2021 12/06/2022 28 hari G1P0A0
27 IRT SD HINDU 12/01/2022 19/10/2022 28 hari G4P3A0
22 IRT SLTP HINDU 15/02/2022 22/11/2022 28 hari G2P1A0
28 IRT SD HINDU 13/01/2022 20/10/2022 28 hari G3P2A0
28 IRT SMA ISLAM 20/01/2022 27/10/2022 28 hari G3P2A0
25 IRT SLTA ISLAM 17/11/2021 24/08/2022 28 hari G2P1A0
28 IRT SLTA ISLAM 29/10/2021 06/08/2022 28 hari G2P1A0
30 IRT SD ISLAM 23/03/2022 30/12/2022 28 hari G2P1A0
35 IRT SD KATOLIK 22/03/2022 29/12/2022 28 hari G3P2A0
20 IRT SD HINDU 19/04/2022 26/01/2023 28 hari G1P0A0
30 IRT SD ISLAM 12/04/2022 21/01/2023 28 hari G2P1A0
26 IRT SD ISLAM 16/05/2022 23/02/2023 28 hari G2P1A0
31 IRT SMA ISLAM 05/04/2022 12/01/2023 28 hari G3P2A0
26 IRT SD ISLAM 08/04/2022 15/01/2023 28 hari G2P1A0
22 IRT SMA ISLAM 08/02/2022 15/11/2022 28 hari G1P0A0
25 IRT SLTP ISLAM 03/07/2022 10/04/2023 28 hari G2P1A0
25 IRT SMA HINDU 07/05/2022 14/02/2023 28 hari G2P1A0
22 IRT SD ISLAM 10/05/2022 17/02/2023 28 hari G2P1A0
35 IRT TIDAK TAMAT HINDU 25/04/2022 01/01/2023 28 hari G3P2A0
35 IRT SD HINDU 18/06/2022 25/03/2023 28 hari G3P2A0
32 IRT SMA ISLAM 20/07/2022 27/04/2023 28 hari G4P2A1
27 IRT SMP HINDU 15/06/2022 22/03/2023 28 hari G2P1A0
20 IRT SMK HINDU 14/04/2022 21/01/2023 28 hari G1P0A0
34 IRT SLTP ISLAM 04/05/2022 11/02/2023 28 hari G3P2A0
 Obat yg
Tanda Bahaya / Imunisasi Riwayat Kesehatan / No. HP Bumil
dikonsumsi
Penyulit (jika ada) TT Penyakit
(Termasuk Jamu)
- B12, KALK - - 0858387336
- B12, KALK - - 085269928974
<20 TAHUN FE - - 085768061020
- B12, KALK - - 088276534476
>35 TAHUN B12, KALK - - 087896013362
- B12, KALK - SC 08570964679
- FE - - 087899683176
- FE - - 085788367160
- B6, KALK - SC 082278716088
<20 TAHUN FE - - 081274866232
- FE - - 085769179562
- FE - - 087812350048
- FE - - 085764634732
<20 TAHUN FE - - 082269442453
- B12, KALK - - 081919209561
- B12, KALK - - 083185962997
>35 TAHUN B12, KALK - - 082289387133
- B12, KALK - - 085709392156
>35 TAHUN B12, KALK - - 085709005298
<20 TAHUN FE - - 082182808865
- B12, KALK - SC 085838229053
- B12, KALK - - 081996897269
- B12, KALK - - 085205502757
- FE - - 081271322463
<20 TAHUN FE GEMELI - 081392275607
- FE - - 085601123387
<20 TAHUN FE - - 082374191628
- FE - - 082311622409
- FE - - 085709837803
<20 TAHUN FE - - 085789078912
- B6, KALK - SC 081213549986
- B6, KALK - - 087811818473
 - B6, KALK - - 085669259634
- FE - - 085381430752
>35 TAHUN B6 TT2 - 082179575978
- B6 TT2 - -
- B6 TT2 - 08560988849

- B6 TT2 - 085809214138

>35 TAHUN & PARITAS >3 B6 TT2 - 081919209561

>35 TAHUN B6 TT2 - 081929066772
- KALK TT2 - 0877930210906
- FE TT2 - 085926438925
- FE TT2 - 087891788770
- B6 TT2 - 083176132220
- B6 TT2 - 082178908926
BBLR KALK TT2 - 085783296029
>35 TAHUN FE TT1 - 082279658383
- FE TT1 - 081367697966
- B6 TT1 - 081939985832
<20 TAHUN B6 TT1 - 087769075005
>35 TAHUN KALK TT1 - 085709005298
- FE TT1 - 088272454008
- FE TT1 - 08526224921
- B6 TT1 - 085369777967
<20 TAHUN - T1 - 087838312690
- - T1 - 082269347947
- - T1 - 085609135310
<20 TAHUN - T1 - 082338365460
- - T1 - 081368020271
- - T1 -
- - T1 - 081539835079
<20 TAHUN - T1 - 085788639413
- - T1 - 085839211854
- - T2 - 081994265693
- - T1 - 087869468508
- - T1 - 087796695387
KEK - T1 -
- - T1 - 081279923715
- - T1 - 085769389040
- - T1 - 082278719114
KEK - T1 - 081379198409
KEK - T1 - 081278822887
KEK - T1 - 083171246169
- - T1 HIPERTENSI 087708229216
- - T1 RIW. SC 085379888382
- - T1 - 085766856079
- - T1 - 087893396739
KEK - T1 - 081367284083
- - T1 - 085609489228
- - T1 - 085758324598
 - - T1 - 087867551515
- - T2 - 081373063148
- - T1 - 081278828381
- - T1 RIW. AB, RIW. GEMELI 082182462825
KEK - T1 - 087819615213
- - T1 - 085769049206
- - T1 - 087897372933
 NIK/ KK Jaminan Persalinan

1602216904990002' Jampersal
160221601194000 Jampersal
1602041802020002 Jampersal
1602214301880002 Jampersal
1602215101810001 Jampersal
1602215803890001 Jampersal
1602215703000001 Jampersal
1602215404020004 Jampersal
1602216004870003 Jampersal
1608126510020003 Jampersal
1608154710010001 Jampersal
160221472900002 Jampersal
1608106312990004 Jampersal
1602214312030004
1602216009860005
1602224705940002
1602214101840008
1602215005860003
1602215007840002 BPJS
1602217008020002
1602214210900001
1602215810940003
1602215503930001
160219500900003
1602215108030004 BPJS
1602215904970002
1608044103030004
1602216210850003
160211106990001
1602216101040001
1608125004910001
1602215908900007
1602216004861001
1605026101970001
1602214603820002 BPJS
1602216309920001
1602214107880010

1602216512930002

1602216509830001
1602214105830001
1602215907000002
1602216311910002
1602215810880001
1602216907070001
1608124501010002
1602216808860001
1602216403861001
1607094101920001
1602216104920003
181008510902005
1602215007840002
1602215007980004
181104500992006
1602215490001
1602224101050001
1602216411900001
1602215305900002
1602214111030002
1602214505970005
1602216909940001
1602046810010001
1602215505920001
1602214503910003
1602214601940001
1602215303920001
1608094711000005
1602216101900001
1602214203920003
1602215303990002
1602216206900001
1606124906950002
1602215701850001
1602225408020002

1602044302960001
1602135405910005
1602216306960001
1807026101010011
1602215505930008
1802054910930005
160221670990001
1812084203870002
1602216105870004
1602215010930003
1602044403951101
1602215203030002
1602215602960011
 Puskesmas : Pematang Panggang IV
Nama Bidan Koordinator : ZURAIDAH, Am.Keb,SKM

NO Bulan Nama Bidan Nama Ibu Hamil & Nama Suami Alamat

1 JANUARI DEWI LUSANTRI,Am.Keb INDAH/ SOFYAN BALIAN MAKMUR

2 SULIYAH/AHMAD SUYONO
3 WINDI/ WIWIN
4 LISMIARTI/ KHABIB
5 ANI/ QOYUM
6 SUSI/ SUTRISNO
7 NURAINI/ IWAN SUHERMAN
8 AJENG/ HAMID
9 NY. PURNAMASARI/ KADEK
10 ANI/ EDI
11 LUH SAWITRI/ KADEK
12 LISIAMI/ ANDI
13 TRI SEPTI/ HENDRO
14 SURATMI/ NY. SUDIONO
15 ULFA/ NAUFAL
16 TUTI/ DENI
17 EVA/ RUSTANDI
18 DWI/ JOHAN
19 ANGGI/ AHMAD NAWAMI
20 ISTIQOMAH/ JOKO
21 LINDA/ ARIF
22 MUSTIKA/ SULAIMAN
23 KHUSNUL/ SAIFUL

PUTU SIDARWATI/ WY. SULITRA

24
25 LUTHFI/ MUNIB
26 FEBRUARI DEWI LUSANTRI,Am.Keb ARSYVINA/MARCORIUS BALIAN MAKMUR
27 ANISA ULFA/ABABIL
28 SITI FATIMAH/ DEDI
29 SUTIANI/ SUTIAJI
30 AISYAH/ AHMADI
31 YULIATI/ SUPRIYADI
32 MARET DEWI LUSANTRI,Am.Keb MUJAYANA/ NASIP BALIAN MAKMUR
33 MADE MURTI/ WAYAN BUDE
34 APRIL DEWI LUSANTRI,Am.Keb LIA/RO'UD BALIAN MAKMUR
35 WULAN/DEDI
36 WY. TINI/ WY. ARDI
37 MEI DEWI LUSANTRI,Am.Keb KHUSNUL/ WASIS BALIAN MAKMUR
38 NI LUH/ PUTU
39 MELI/ M ILHAM
40 JUNI DEWI LUSANTRI,Am.Keb HARMI/ HERU BALIAN MAKMUR
41 JULI DEWI LUSANTRI,Am.Keb SRI LESTARI/ WAWAN BALIAN MAKMUR
42 YENI/ ARIS
43 ERLINA/ ADI
44 AL ANIS/ HERI
45 NURUL/ TRI
46 AGUSTUS DEWI LUSANTRI,Am.Keb KD. SRIYANI/NENGAH BALIAN MAKMUR
47 AINUN/ IKHWAN
48 UMI/ M. HASAN
49 RINA/ PITOYO
50 UMI DUROTU/ SUGENG
51 SEPTEMBER DEWI LUSANTRI,Am.Keb MAHDULAH/YASIR BALIAN MAKMUR
52 META/ ARIS
53 OKTOBER
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
 DATA PEMANTAUAN IBU HAMIL 2022

Siklus
Pekerjaan
Usia Ibu Pendidikan Ibu Agama HPHT TP Haid G,P,A
Ibu
(Hari)

22 IRT SMP ISLAM 10/7/2021 7/14/2022 28 HARI G2P1A0

33 IRT SMP ISLAM 11/15/2021 8/22/2022 28 HARI G3P2A0
26 IRT SMA ISLAM 11/12/2021 8/19/2022 28 HARI G1P0A0
31 IRT SMP ISLAM 9/10/2021 6/17/2022 28 HARI G3P2A0
26 IRT SMA ISLAM 11/10/2021 8/17/2022 28 HARI G2P1A0
22 IRT SMA ISLAM 9/1/2021 6/8/2022 28 HARI G2P1A0
32 IRT SMA ISLAM 8/25/2021 5/2/2022 28 HARI G3P1A1
24 IRT SMA ISLAM 5/30/2021 2/7/2022 28 HARI G1P0A0
22 IRT SMA HINDU 7/17/2021 4/24/2022 28 HARI G2P1A0
40 IRT SMA ISLAM 5/14/2021 2/21/2022 28 HARI G3P2A0
20 IRT SMA HINDU 7/3/2021 4/10/2022 28 HARI G2P1A0
32 IRT SMA ISLAM 5/17/2021 2/24/2022 28 HARI G2P1A0
30 IRT SMP ISLAM 7/1/2021 4/8/2022 28 HARI G4P3A0
34 IRT SMP HINDU 6/1/2021 3/8/2022 28 HARI G3P2A0
20 IRT SMP ISLAM 6/2/2021 3/9/2022 28 HARI G1P0A0
36 IRT SMA ISLAM 9/9/2021 6/16/2022 28 HARI G3P2A0
28 IRT SMA ISLAM 9/28/2021 6/6/2022 28 HARI G2P1A0
21 IRT SMA ISLAM 9/10/2021 6/17/2022 28 HARI G1P0A0
16 IRT SD ISLAM 8/6/2021 5/13/2022 28 HARI G1P0A0
25 IRT SMA ISLAM 8/20/2021 5/27/2022 28 HARI G2P1A0
30 IRT D3 ISLAM 2/17/2021 1/23/2022 28 HARI G5P3A1
27 IRT SMP ISLAM 6/27/2021 3/3/2022 28 HARI G3P2A0
20 IRT SMA ISLAM 7/17/2021 4/24/2022 28 HARI G1P0A0

21 IRT SD HINDU 12/19/2021 9/26/2022 28 HARI G1P0A0

39 IRT D1 ISLAM 7/17/2021 4/24/2022 28 HARI G5P4A0

22 IRT SLTA ISLAM 7/1/2021 4/8/2022 28 HARI G1P0A0
22 IRT SMK ISLAM 12/23/2021 9/2/2022 28 HARI G1P0A0
33 IRT SD ISLAM 9/20/2021 6/27/2022 28 HARI G2P1A0
37 IRT SD ISLAM 12/15/2021 9/22/2022 28 HARI G3P2A0
38 IRT SD ISLAM 10/1/2021 7/8/2022 28 HARI G5P4A0
31 IRT SLTP ISLAM 10/18/2021 7/25/2022 28 HARI G3P2A0
38 IRT SD ISLAM 07/01/2022 14/10/2022 28 HARI G3P2A0
25 IRT SD HINDU 10/07/2021 17/04/2022 28 HARI G2P1A0
21 IRT SMP ISLAM 29/01/2022 05/10/2022 28 HARI G1P0A0
34 GURU S1 ISLAM 01/01/2022 08/10/2022 28 HARI G3P2A0
23 IRT SMA HINDU 07/03/2022 14/12/2022 28 HARI G1P0A0
21 IRT SMP ISLAM 28/03/2022 04/11/2022 28 HARI G1P0A0
23 IRT SMA HINDU 21/03/2022 28/12/2022 28 HARI G1P0A0
20 IRT SD ISLAM 03/04/2022 10/01/2023 28 HARI G1P0A0
28 IRT SMA ISLAM 11/03/2022 18/12/2022 28 HARI G2P1A0
29 IRT SMP ISLAM 27/02/2022 05/11/2022 28 HARI G3P2A0
26 IRT SMA ISLAM 22/05/2022 29/02/2023 28 HARI G1P0A0
36 IRT SD ISLAM 08/02/2022 05/11/2022 28 HARI G3P2A0
36 IRT SMA ISLAM 25/04/2022 02/01/2023 28 HARI G5P3A1
27 IRT SMP ISLAM 29/04/2022 06/01/2023 28 HARI G2P1A0
23 IRT SD HINDU 08/05/2022 15/02/2023 28 HARI G1P0A0
41 IRT SLTP ISLAM 07/05/2022 14/02/2023 28 HARI G5P4A0
20 IRT SD ISLAM 16/06/2022 23/03/2023 28 HARI G1P0A0
39 IRT SLTP ISLAM 31/05/2022 07/03/2023 28 HARI G3P2A0
21 HONOR S1 ISLAM 10/06/2022 17/03/2023 28 HARI G1P0A0
26 IRT SMA ISLAM 27/07/2022 05/04/2023 28 HARI G2P1A0
32 IRT SMA ISLAM 17/07/2022 24/04/2023 28 HARI G2P1A0
Tanda Bahaya / Penyulit (jika Obat yg dikonsumsi Riwayat Kesehatan /
Imunisasi TT
ada) (Termasuk Jamu) Penyakit

- FE, AFOLAT TT2 -

- FE - -
- FE TT1 -
- FE - HIPERTENSI
- DMP, FE - -
- FE TT2 -
- FE - -
- FE - -
- FE - -
UMUR >35 TAHUN FE - -
- FE - -
- FE - -
PARITAS >3 FE - -
- FE - -
- FE - -
- FE - -
- FE - -
- FE, KALK - -
UMUR <20 TAHUN FE, KALK - -
- FE, KALK - -
PARITAS >3 FE, KALK - RIW. SC
- FE, KALK TT5 -
- FE TT1 -

- DMP, FE - -

UMUR >35 TAHUN & PARITAS >3 FE TT5 -

- FE, KALK - -
- FE, KALK - -
- FE, KALK - -
>35 TAHUN FE, KALK - -
UMUR >35 TAHUN & PARITAS >3 FE, KALK - -
- FE, KALK - -
 UMUR >35 TAHUN - LENGKAP -
- - TT3 -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- FE TT2 -
FE, KALK LENGKAP -
FE, KALK LENGKAP -
>35 TAHUN FE, KALK LENGKAP -
UMUR >35 TAHUN & PARITAS >3 FE, KALK LENGKAP -
- FE, KALK TT2 -
- - - -
UMUR >35 TAHUN, PARITAS >3 FE,KALK LENGKAP -
- - TT1 -
UMUR >35 TAHUN FE - -
- AFOLAT TT1 -
- FE,AFOLAT TT1 -
- FE,AFOLAT TT1 -
No. HP Bumil NIK/ KK Jaminan Persalinan

081367609501 1602215603990001 JAMPERSAL

082372981202 1602215108890001 JAMPERSAL
085894084085 1802036907950001 JAMPERSAL
085783727832 1602216202900003 JAMPERSAL
085366703519 1602215603990001
081213549969 -
085709956991 3202404105890002
085788703426 1802194608980041
082182717017 1602216110990003
089621255728 1802064708810001
085838719195 1602213010170004
085788537643 1602044110920002
- 1602216209910002
085788384741 1602212701120081
082278362937 1602214606010001
082373487865 1602215309860001
085764120360 1607216401570002
085838718275 1602212909040002
082278061984 1610165208050002
085838715087 1602214708960001
082306322565 -
081367609501 1606086010910004
085709743132 1602214307010001

085669865561 1603144908010007

085764118630 1602214604830002
085658315574 160221660610005
085709187084 1807124803000001
085669694088 1602215003880001
085832908151 1807204507850015
081532547715 1602215507780003
085319584914 1602214608910003
085769948434 16102215112830002
085669865561 1602214107880001
081278986081 1602214807800002
085658927231 1602214101880009
081353358218 1602216007990002
085609889100 1602135101950003 BPJS
082278941547 1602214107990033 JAMPERSAL
082289416691 1602045003020002 JAMPERSAL
085769050238 3313166905940001
082373487865 1602214112930001
085831248215 1802276008970001
085894084085 1602215608860001
085609487528 1602214605860001
082371008059 1602216611950001
082388761807 1602216402980002
085764953804 1602216606830006
085767078465 1602214309020004
085649372104 1602214309840002
085367803432 1602217008000001
092177195975 1602215403960003
082176564129 1608124109890006