Provinsi : KEPULAUAN BANGKA BELITUNG

Kab/Kota :
Tahun : 2020

No Kabupaten/Kota Kegiatan

Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)

a. Katarak: > 3/60
≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

I Provinsi h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka
h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
 d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):
Konjungtivitis
5 Bangka Tengah
5 Bangka Tengah h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):
konjungtivitis
6 Bangka Selatan h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

 ≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):
Konjungtivitis
Hordeulum
pterigium
Disorder of refraction and accomodation
Follow up examination after treatment for
conditioner other than neoplasm
Corpus Alineum
8 Pangkalpinang
8 Pangkalpinang Pendarahan Sub Konjungtiva
h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
pasca stoke
Konjungtivitis
Otalgia
Otitis media akut
Otitis eksterna
Infeksi Telinga
Suppurative and unspecified otitis media
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGS

Kode
0-7 hr 8-28 hr
ICD X
L P L P
butaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

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

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

0 0 0 0
0 0 0 1
0 0 0 0
0 0 0 0
0 0 0 0

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

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

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

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

0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0

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

0 0 0 0

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

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

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

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

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

0 0 0 0
0 0 0 0

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

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

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

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

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
PORAN
AN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th
L P L P L P L P L P L P L

0 0 0 0 0 0 0 0 0 0 1 0 4
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 1 3
0 0 0 0 3 2 5 15 8 16 6 22 3
0 0 0 0 0 0 0 0 0 0 2 1 2
0 0 0 0 0 0 4 3 8 7 4 6 2
0 0 0 0 0 1 0 0 1 1 1 4 1
0 0 0 0 0 0 0 0 0 1 3 16 7
0 0 0 0 1 0 0 0 1 3 2 2 1
0 0 0 0 0 1 0 0 0 0 1 2 3
0 0 0 2 1 0 0 0 1 0 7 3 4
0 0 0 0 0 0 0 0 0 0 0 0 0
2 3 6 3 6 8 7 6 4 2 10 10 5
0 0 0 0 1 0 1 1 1 0 1 2 0
0 0 0 0 1 0 0 1 0 3 3 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 1 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran
1 0 0 4 12 0 4 3 4 1 4 11 2
0 0 0 0 6 6 3 1 1 1 2 5 1
0 0 0 0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 2 0 0 0 2 1 2 0
Jenis Gangguan Penglihatan d
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 3
0 0 0 0 0 0 4 11 2 7 0 9 0
0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 4 3 8 7 4 5 2
0 0 0 0 0 0 0 0 1 1 1 4 1
0 0 0 0 0 0 0 0 0 1 3 14 4
0 0 0 0 1 0 0 0 1 3 2 2 1
0 0 0 0 0 1 0 0 0 0 1 0 3
0 0 0 2 1 0 0 0 1 0 7 3 4
0 0 0 0 0 0 0 0 0 0 0 0 0

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

Jenis Gangguan Pendengaran

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

Jenis Gangguan Penglihatan d

Jenis Gangguan Pendengaran

 Jenis Gangguan Penglihatan d

Jenis Gangguan Pendengaran

Jenis Gangguan Penglihatan d

0 0 0 0 0 0 0 0 0 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 4 6 2 6 1
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 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 5 3 4 6 5 4 1 1 4 6 3
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangguan Pendengaran

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

3 0 1 0 0 4 1 1 1 2 1 0 0
0 0 0 0 0 1 0 0 0 0 0 2 0
Jenis Gangguan Penglihatan d
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 1 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 1 0 2 2 2 2 3 1 6 4 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

Jenis Gangguan Pendengaran

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

Jenis Gangguan Penglihatan d

0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 1 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

Jenis Gangguan Pendengaran

0 0 0 0 4 0 2 0 2 0 2 5 2
0 0 0 0 4 1 2 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 2 1 0 0
Jenis Gangguan Penglihatan d
0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0

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

0 1 1 1 3 0 3 3 2 2 6 5 3
0 0 0 3 0 0 1 1 1 1 0 2 0
0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangguan Pendengaran

0 0 0 1 8 0 1 2 2 0 0 1 0
0 0 0 0 0 3 0 1 0 0 2 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 1 1 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 0 0 0
0 0 2 1 0 0 1 1 0 0 3 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 Jumlah Jumlah Jum
45-59 th >59 th kasus baru Kasus KET. 0-7 hr 8-28 hr
P L P L P Total Dirujuk L P L P

5 11 6 16 11 27 14 0 0 0 0
0 5 3 6 3 9 0 0 0 0 0
8 8 12 11 21 32 51 0 0 0 0
8 3 1 28 64 92 66 0 0 0 0
2 2 1 6 4 10 8 0 0 0 0
5 3 13 21 34 55 87 0 0 0 0
0 3 6 6 12 18 28 0 0 0 0
5 6 14 16 36 52 76 0 0 0 0
3 2 1 7 9 16 25 0 0 0 0
1 2 4 6 8 14 18 0 0 0 0
3 7 5 20 13 33 46 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
6 5 1 45 39 84 0 0 0 0 0
0 3 0 7 3 10 26 0 0 0 0
1 5 5 10 12 22 32 0 0 0 0
1 0 1 0 2 2 0 0 0 0 0
4 2 7 5 13 18 21 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
8 2 1 29 28 57 0 0 0 0 0
1 0 1 13 15 28 0 0 0 0 0
0 0 0 1 0 1 0 0 0 0 0
0 0 0 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 6 8 0 0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
2 3 3 4 5 9 14 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
8 8 11 11 20 31 51 0 0 0 0
1 2 1 8 29 37 66 0 0 0 0
1 2 1 4 2 6 8 0 0 0 0
5 3 13 21 33 54 87 0 0 0 0
0 3 6 6 11 17 28 0 0 0 0
 3 5 14 12 32 44 76 0 0 0 0
3 2 1 7 9 16 25 0 0 0 0
1 2 4 6 6 12 18 0 0 0 0
3 7 5 20 13 33 46 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0
0 0 0
0 3 0 7 3 10 26 0 0 0 0
1 5 4 10 11 21 32 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
4 2 4 5 8 13 21 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
0 3 1 3 1 4 0
0 0 0 0 0 0 0

2 0 0 7 16 23 0 0 0 0 0
1 0 0 0 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
1 0 0 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
5 4 1 28 29 57 0
 0 0 0 0
0 0 1 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
1 0 0 4 6 10 0 0 0 0 0
1 0 1 2 7 9 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

1 0 0 7 8 15 0
0 0 0 0 3 3 0
ngguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

0 0 0 1 1 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 2 3 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
1 1 0 17 10 27 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
0 1 1 1 6 7 0 0 0 0 0
0 0 0 1 1 2 0 0 0 0 0
0 0 0 1 0 1 0 0 0 0 0
0 0 0 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
1 4 1 5 2 7 0 0 0 0 0
 0 4 0 5 0 5 0 0 0 0 0
0 0 1 0 1 1 0 0 0 0 0
2 1 0 3 6 9 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 0 2 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
ngguan Pendengaran dan Ketulian (H60-H95)
6 0 0 12 11 23 0 0 0 0 0
0 0 0 7 1 8 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 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 5 0 0 0 0 0
ngguan Penglihatan dan Kebutaan (H00-H59)
2 1 1 4 3 7 0 0 0 0 0
0 1 3 1 3 4 0 0 0 0 0
0 0 0 0
3 0 0 9 12 21 0 0 0 0 0
0 0 0 2 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 0 0
0 0 0 1 1 2 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
2 1 1 19 15 34 0 0 0 0 0
1 0 0 2 8 10 0 0 0 0 0
0 0 0 0 2 2 0
0 0 0 0 0 0 0
0 2 0 3 0 3 0
0 0 0 0 0 0 0
 0 0 0 0 0 0 0
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 1 0 2 2 0 0 0 0 0
0 0 3 0 5 5 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

ngguan Pendengaran dan Ketulian (H60-H95)

1 1 0 12 5 17 0 0 0 0 0
0 0 0 3 6 9 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
0 0 0 1 0 1 0
0 0 0 1 1 2 0 0 0 0 0
0 0 0 1 0 1 0
1 0 0 6 4 10 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
 Jumlah Kunjungan / Kunjungan Lama Menurut Golongan Umur
1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th
L P L P L P L P L P L P L

0 0 0 0 0 0 0 0 0 0 1 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 2 2 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 1 1 0 2 2 8 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

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

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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 1 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0

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

0 1 0 0 0 0 1 1 0 2 2 8 0

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

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

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

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

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

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

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

0 0 0 0 0 0 0 0 0 0 1 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 Jumlah Jumlah
45-59 th >59 th Kunjungan Kunjungan KET.
P L P L P Total Dirujuk

3 3 9 7 12 19 0
2 1 0 1 2 3 0
0 0 0 0 0 0 0
0 1 0 6 4 10 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 0 2 1 3 0
3 1 1 2 5 7 0
0 0 1 0 1 1 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 3 12 15 0
0 0 0 0 0 0 0
1 2 1 3 2 5 0
0 1 3 1 3 4 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0 1 1 5 6 0
1 0 0 7 1 8 0
1 0 0 5 2 7 0
0 0 0 0 1 1 0
0 0 0 0 0 0 0
0 0 0 5 1 6 0
0 0 0 0 0 0 0

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

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

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

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

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

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

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

0 0 0
0 0 0
0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1 1 0 2 1 3
3 1 1 2 5 7
0 0 1 0 1 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0
 0 0 0
1 0 0 0 1 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0

0 0 0 0 0 0
0 0 0 0 0 0
1 0 0 0 1 1
0 0 0 0 1 1
0 0 0 0 0 0
0 0 0

0 0 0

1 1 5 5 6 11
0 0 0 0 0 0
0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 12 15
0 0 0
0 0 0
0 1 1 1 1 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0

0 0 0 1 0 1
0 0 0 5 0 5
0 0 0 5 1 6
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 5 1 6
0 0 0

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

0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 2 4 2 6 8
2 1 0 1 2 3
0 0 0
0 1 0 6 4 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0
1 1 0 9 11 20
0 0 0 1 1 2
0 0 0
0 0 0

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

0 0 1 0 5 5
1 0 0 2 1 3
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0
0 0 0
0 0 0 1 0 1
0 0 0
0 1 0 1 0 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Provinsi :
Kab/Kota :
Tahun :

Jumlah Kasus Baru Menurut Golongan Umur

Kode
No Kabupaten/Kota Kegiatan 0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th
ICD X
L P L P L P L P L P L P L P L P L P

Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 4 6
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0
b. Kelainan Refraksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Miopi 0 0 0 0 0 0 0 0 9 12 2 9 3 9 12 22 7 8
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 9
- Presbiopia 0 0 0 0 0 0 0 0 1 0 1 2 5 10 5 16 7 13
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 6 1 5
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 3 14
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 2
e. Low Vision 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 2 0 4
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 4 1 0 0 3 1 4 18 8 7
g. Lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 2 2 2 5 2 1 17 12 10 7
I Provinsi h. Jumlah operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
i. Follow up pasca operasi katarak 0 0 0 1 0 0 0 0 0 0 0 0 0 0 5 1 1 3
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 1 3 8 4 5 2 4 1 0 5 2 6
b. Serumen 0 0 0 0 0 0 3 2 8 13 5 3 3 1 4 4 2 1
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan): 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 2 0
0 0 0 0 0 0 0 0 4 1 1 1 0 2 2 2 1 0
Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 2
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Kelainan Refraksi
- Miopi 0 0 0 0 0 0 0 0 0 0 0 1 2 2 7 8 1 4
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 7
- Presbiopia 0 0 0 0 0 0 0 0 1 0 1 2 5 10 5 16 6 13
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 6 1 4
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 12
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 2
e. Low Vision 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 4 1 0 0 3 1 4 18 8 7
g. Lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 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 1 1
2 Bangka h. Jumlah operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
i. Follow up pasca operasi katarak 0 0 0 1 0 0 0 0 0 0 0 0 0 0 4 1 1 3
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Serumen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangg
a. Katarak: > 3/60
≤3/60 1
b. Kelainan Refraksi
- Miopi 1 1
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision 1
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):
1
3 Belitung h. Jumlah operasi katarak
i. Follow up pasca operasi katarak 1
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 2 1 1
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

Jenis Gangg
a. Katarak: > 3/60
≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Kelainan Refraksi
- Miopi 0 0 0 0 0 0 0 0 8 11 3 7 1 3 2 7 1 1
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
- Presbiopia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Low Vision 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Lain-lain (sebutkan):
Konjungtivitis 0 0 0 0 0 0 1 0 1 0 1 1 1 0 4 4 0 1
5 Bangka Tengah h. Jumlah operasi katarak
i. Follow up pasca operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 1 0 4 2 0 0 0 0 0 4 0 2
b. Serumen 0 0 0 0 0 0 1 0 6 7 4 2 1 0 1 0 1 0
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan):
0 0 0 0 0 0 0 1 0 2 0 0 2 1 2 0 0 1
0 0 0 0 0 0 0 0 3 1 0 0 0 1 2 2 1 0
Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Kelainan Refraksi
- Miopi 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Presbiopia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Low Vision 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Lain-lain (sebutkan):
konjungtivitis 0 0 0 0 0 0 0 1 1 1 1 2 0 1 8 2 4 3
6 Bangka Selatan h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0
b. Serumen 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2 0 1
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan): 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 2 0

Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
b. Kelainan Refraksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 - Miopi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 1 1
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Presbiopia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Low Vision 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 1 0 2 1 0 5 4 4 2
7 Belitung Timur h. Jumlah operasi katarak
i. Follow up pasca operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 0 2 0 1 1 1 0 0 0 0 2 3
b. Serumen 0 0 0 0 0 0 1 0 0 0 0 0 1 0 3 2 0 0
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0
Jenis Gangg
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
b. Kelainan Refraksi
- Miopi 0 0 0 0 0 0 0 0 0 0 -1 0 0 4 1 6 3 1
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
- Presbiopia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Low Vision 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Lain-lain (sebutkan):
Konjungtivitis 0 0 0 0 0 0 1 1 1 0 0 -1 1 0 3 6 1 2
Hordeulum 0 0 0 0 0 0 0 0 2 0 1 0 3 0 0 1 0 0
pterigium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
Disorder of refraction and accomodation 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Follow up examination after treatment for
conditioner other than neoplasm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
Corpus Alineum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
Dry eyes 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1
8 Pangkalpinang keratis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pendarahan Sub Konjungtiva 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
h. Jumlah operasi katarak
i. Follow up pasca operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jenis Gangg
a. Otitis Media Supuratif Kronik (OMSK/Congek) 0 0 0 0 0 0 0 1 2 0 2 0 4 0 0 0 0 1
b. Serumen 0 0 0 0 0 0 1 2 2 5 1 1 1 0 0 0 1 0
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. lain-lain (sebutkan):
pasca stoke 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Konjungtivitis 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0
Otalgia 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
Otitis media akut 0 0 0 0 0 0 0 0 0 1 1 1 0 1 3 1 0 3
Otitis eksterna 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Infeksi Telinga 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
Suppurative and unspecified otitis media 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 Jumlah Jumlah Jumlah Kunjungan / Kasus Lama Menurut Golongan Umur Jumlah
>59 th kasus baru Kasus KET. 0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th >59 th Kunjungan
L P L P Total Dirujuk L P L P L P L P L P L P L P L P L P L P L P

Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)

13 15 17 23 40 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 3 8 10 12 13
4 4 7 4 11 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 1 2
1 2 1 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
2 3 35 63 98 47 0 0 0 0 0 0 0 0 0 0 2 2 2 2 1 0 0 0 1 0 6 4
3 1 7 10 17 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 12 26 53 79 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 10 6 21 27 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 12 11 28 39 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1
2 3 4 8 12 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 3 7 10 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 16 28 43 71 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 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 6 37 35 72 23 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 5 0 0 0 0 2 7
0 0 0 0 0 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 6 8 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 2 2 2 5
3 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 1 3
2 2 5 2 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 1 20 22 42 0 0 0 0 0 0 1 1 1 1 2 1 0 2 0 0 2 0 1 0 0 5 7
1 5 26 29 55 32 0 0 0 0 0 0 0 3 1 0 2 0 1 3 1 1 2 2 0 0 7 9
0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 2 0 0 0 0 0 4 1
0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
0 1 5 4 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 2 0 0 1 4
0 0 8 6 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 4 4 7 11 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 10 18 28 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 3 7 10 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 12 25 53 78 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 10 6 20 26 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 12 4 25 29 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 3 4 8 12 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 6 7 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 16 28 43 71 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 3 2 6 8 14 0 0
0 0 0 0 0 0 0 0
0 3 5 8 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 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 2 5 2 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 0 1 1 1 5 1 5 1
1 0 1 1 0 0
0 0 0 0 0 0
0 2 2 1 1 0 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2 2 0 2 2 1 1 0
0 0 0 0 0 0
1 0 1 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1 1 1 2 1 0 0
0 0 0 0 0 0
1 0 1 0 3 1 0 4
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 1 4 0 1 1 1 1 1 1 3 3
0 0 0 0 1 1 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 4 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0 0 0
0 0 0 16 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 4 2 6 8 0 0
1 0 1 0 1 0 0
0 0 0 0 0 0
2 0 17 29 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 8 6 14 2 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 5 8 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 15 9 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0
0 0 4 5 9 0
0 0 6 4 10 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 1 1 5 5 6
0 0 0 0 0 0 0 0 0 0 0 0 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 1 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
1 0 15 10 25 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 5 0 0 0 0 2 7
0 0 0 0 0 0
0 0 0 0 0 0
2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 1 1 4 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
0 4 0 9 9 0 0 0 0 0 0 0 0 1 0 0 0 0 0 3 0 1 0 0 0 0 0 5
0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 2 0 0 0 0 0 4 1
0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
0 1 5 4 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 2 0 0 1 4
0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
5 3 6 4 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 3 1 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 1 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 3 2 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 4 1 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 11 12 23 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
1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 3 7 10 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 2 1
0 1 5 3 8 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 2 4 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
4 3 5 5 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 4 2 6
1 3 2 3 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 1 2
0 0 0 0 0 0
0 0 3 11 14 0 0 0 0 0 0 0 0 0 0 0 2 2 2 1 1 0 0 0 1 0 6 3
2 1 4 2 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
2 1 9 9 18 0 0 0 0 0 0 0 0 0 3 2 0 3 0 3 5 2 5 1 1 1 14 12
0 0 6 1 7 0 0 0
1 0 3 0 3 0 0 0
0 0 0 0 0 0 0 0

2 2 2 5 7 0
0 0 2 0 2 0
0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 8 2 10 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 2
0 0 6 8 14 0 0 0 0 0 0 0 0 2 0 0 2 0 1 0 0 0 2 1 0 0 5 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
0 0 1 0 1 0 0 0
0 0 4 7 11 0 0 0 0 0 0 0 0 3 0 0 1 0 0 0 0 0 0 0 1 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 0 0
0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
 Jumlah Jumlah
Kunjungan Kunjungan KET.
Total Dirujuk

25 6
3 0
0 0
10 0
0 0
0 0
0 0
2 0
0 0
0 0
0 0
0 0
9 0
0 0
7 2
4 0
0 0
0 0
0 0

12 2
16 0
5 0
3 0
1 0
5 0
0 0

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

0
0
0
0
0
0
0

6 6
0
0
1
0
0
0
1
0
0
0
0
0
0
4 2
0
0
0
0

6 2
1
0
0
0
0
0

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

0
0
0
0
0
0
0

0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0

0
0
0
3
0
0

11
0
0
0
0
0
0
0
0
0
0
0
9
0
0
2
0
0
0

1
5
5
0
1
5
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

8
3
0
9
0
0
0
0
0
0
0
0
26
0
0
0

0
0
3
2
0
0
0

2
8
0
0
0
0
0
1
0
5
0
0
0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
 c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
konjungtivitis 0
3 Belitung Hordeulum 0
h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
 d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan):
Konjungtivitas 0
5 Bangka Tengah
5 Bangka Tengah h. Jumlah operasi katarak
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan):
0
0

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan):
konjungtivitis 0
6 Bangka Selatan h. Jumlah operasi katarak
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

 ≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 1 0 2 2 10
0 0 0 0 0 0 0 1 0 0 0 0 2
0 0 0 0 0 0 0 0 0 2 3 0 5
0 0 0 0 0 0 0 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 2 3 2 4 3 2 1 3
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 1 1 3 4 4 1 4 3 0 0
0 0 0 0 0 0 0 0 3 2 0 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 2 4 6 2 4 4 1 1

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

0 0 0 0 0 0 0 0 1 0 1 2 9
0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 2 3 0 5
0 0 0 0 0 0 0 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

0 0 0 0 0 2 4 4 1 3 3 0 0
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 4 4 1 4 3 0 1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 1 1 4 0 2 1 7 8 7 0
0 0 2 3 1 1 3 4 7 11 0
0 0 0 0 0 0 0 0 0 0 0
26 11 6 5 1 14 36 43 79 99 0
5 14 24 1 4 1 34 18 52 69 0
1 6 4 23 23 20 30 57 87 142 0
0 3 3 2 0 1 3 7 10 17 0
2 2 12 5 10 12 24 19 43 57 0
1 0 0 4 2 0 3 4 7 11 0
0 1 0 0 1 0 1 1 2 1 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
9 12 5 8 2 2 25 35 60 0 0
0 0 0 0 0 0 0 0 0 0 0
5 1 1 2 1 0 8 4 12 16 0
0 0 0 1 6 2 6 3 9 12 0
0 0 1 0 0 0 2 0 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
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 2 0 1 0 0 15 12 27 2 0
0 0 0 0 0 0 4 4 8 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 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 6 0 0 1 1 17 19 36 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 1 1 2 0 0 1 3 4 7 0
0 0 2 3 1 1 3 4 7 11 0
0 0 0 0
26 4 6 3 1 14 35 32 67 99 0
5 14 24 1 4 1 33 18 51 69 0
1 5 4 23 23 20 30 56 86 142 0
0 3 3 2 0 1 3 7 10 17 0
2 1 11 4 10 12 23 17 40 57 0
1 0 0 4 2 0 3 4 7 11 0
0 0 0 0 1 0 1 0 1 1 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
5 1 1 2 1 0 8 4 12 16 0
0 0 0 1 6 2 6 3 9 12 0
0 0 1 0 0 0 2 0 2 2 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 0 0 1 1 2 0 0
0 0 0 0 0 0 2 0 2 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 2 0 1 0 0 0 4 4 1 0
0 0 0 0 0 0 3 0 3 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 2 0 2 0 4 4 0
0 0 0 0 0 0 0 0 0 0

0 6 0 2 0 0 0 8 8 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 11 0 4 1 2 10 23 33 0
 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
2 0 0 0 0 0 5 0 5 0 0
0 0 0 0 0 0 0 3 3 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
0 4 0 0 0 0 3 6 9 0
2 6 0 0 1 1 6 10 16 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
0 1 0 0 0 0 1 3 4 0 0
0 0 0 0 0 0 1 0 1 0 0
0 1 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 1 1 0 0 1 2 3 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
5 1 5 3 1 0 14 11 25 0 0
0 0 0 0
0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 0 0 0 0 0 10 8 18 0 0
0 0 0 0 0 0 1 1 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
1 0 0 0 0 0 11 9 20 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 2 0 0 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
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 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

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

-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

-H59)

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

-H59)

-H95)

-H59)

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

-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

0 0 0 1 1 0 0 1 0 0 0 0 1

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

-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
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 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

-H59)
-H95)

-H59)
-H95)
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 1 0 4 1 6 1 7 4
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
5 6 1 0 0 0 9 9 18 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

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

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

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

0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 1
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0

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

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

0 0 0
0 0 0
0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 1 1
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0
 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0

0 0 1 0 0 0 1 0 1
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0

0 0 0

1 0 1 0 1 0 3 0 3
0 0 0 0 0 0 0 0 0
0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 5 1 0 0 0 6 7 13
0 0 0

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

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

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

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

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

-H95)

-H59)
-H95)

-H59)

-H95)
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

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

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

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

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

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

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

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

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

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

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

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

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

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

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

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 3 2 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 10 9 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 5 6 8 6 3 6 4 4
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 1 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 3 1 1 6 3 2 1 4
0 0 0 0 0 0 0 0 0 0 0 0 0
 10 9

1 3 4 2 1 4 2

1
1

1
 1 3 2 2 1

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

1 3 1 1 6 2 2 1 4
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 3 1 1 2 4 3 7 0 0
0 0 2 0 0 0 2 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 6 5 11 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 2 1 0 0 2 1 3 0 0
1 0 0 0 0 0 1 0 1 0 0
0 1 0 0 1 0 1 1 2 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 9 19 0 0
0 0 0 0 0 0 0 0 0 0 0
9 19 6 11 6 4 42 56 98 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 0 2 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 3 0 1 1 1 3 7 10 0 0
2 1 0 0 0 0 2 3 5 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
5 9 3 1 0 1 17 24 41 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 1 2 1 3 0
1 1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
10 9 19 0
0 0 0 0
6 9 2 5 3 1 19 24 43 0
0 0 0 0
0 0 0 0
0 0 0 0
2 2 0 2 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 2 1 1 1 3 4 7 0
2 2 1 3 0
0 0 0 0
0 0 0 0
0 0 0 0
1 2 0 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 1 1 1 2 2 4 0
1 1 0 1 0
0 0 0 0
1 1 6 5 11 0
0 0 0 0
2 1 2 1 3 0
1 1 0 1 0
1 1 1 1 2 0
0 0 0 0
0 0 0 0
0 0 0 0
3 10 4 6 3 3 23 32 55 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
 1 0 3 3 0
1 0 2 2 0
0 0 0 0
0 0 0 0
0 0 0 0
5 9 2 1 1 15 24 39 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

-H95)

-H59)
-H95)

-H59)

-H95)
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

0 0 2 1 0 4 2 5 7 0
0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 2 0 2 0
0 0 1 0 0 0 1 0 1 0
0 0 0 1 1 2 1 3 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 2 0 2 0 4 0 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
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 2 0 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

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

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

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

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

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 7 7 9 8 6 5 6 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 1 0 2 2 1 2 0 3
0 0 0 0 0 0 0 0 0 2 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 2 4 1 0 0 2 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
1 2 3 5 3 6 3 2 1

1 2 2 2 1

1
 1

2 5 4 4 5 2 4 1
 1 2
2 2

3 2 4 1 1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 4 0 2 2 6 2 8 0 0
0 0 1 0 0 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 3 0 1 0 0 0 5 5 0 0
0 1 0 1 0 0 0 2 2 0 0
1 0 0 0 0 0 1 0 1 0 0
0 1 0 0 0 0 0 1 1 0 0
0 0 0 1 1 0 1 1 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
15 25 5 2 2 3 50 55 105 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 0 0 0 0 0 5 7 12 0 0
6 0 1 0 0 0 11 0 11 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 1 0 0 0 7 7 14 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
3 3 0 3 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 0 1 1 0
0 0 0 0
0 0 0 0
0 0 0 0
12 6 1 1 1 29 18 47 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 4 5 9 0
2 1 3 0 3 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 2 2 3 2 5 0
1 1 0 1 0
0 0 0 0
3 1 0 5 5 0
1 1 0 2 2 0
1 1 0 1 0
1 0 1 1 0
1 1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
3 19 4 1 1 3 21 37 58 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
 1 2 3 0
4 8 0 8 0
0 0 0 0
0 0 0 0
0 0 0 0
1 6 6 12 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 2 4 1 2 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
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 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 2 4 2 1

-H95)

1 2
2 1

-H59)
-H95)

-H59)

-H95)
1 1
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 1 0 1 0 3 0 3 0
0 0 0 1 0 2 0 3 3 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 0 1 1 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 1 3 1 3 4 0
0 0 0 0 0 0 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 4 2 1 0 0 12 10 22 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 2 0
0 0 0 0 0 1 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

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

1 1 1 3 0 3
1 1 0 2 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1 1 0 1
0 0 0
0 0 0
0 0 0
1 4 2 1 10 9 19
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
0 0 0
0 0 0

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

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

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

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

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 3 1 1 0 3 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 1 0 0
0 0 0 1 1 5 4 13 4 2 5 3 13
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

1 1
1 1 1 5 2 2 6

1 1

1
 3 1 1 3

5 3 8 2 2 5 1 7
1 1 3 1 1 2 1
1 4

2 3 1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 2 0 1 2 3 2 5 0 0
1 1 1 1 0 0 2 2 4 0 0
0 1 0 0 0 0 1 2 3 0 0
2 5 3 3 1 0 13 9 22 0 0
0 0 0 1 0 0 0 1 1 0 0
1 1 0 2 0 2 1 5 6 0 0
0 1 0 0 0 0 0 1 1 0 0
0 2 0 2 0 0 0 4 4 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 1 2 0 0
21 23 9 9 3 3 57 62 119 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 6 0 1 0 2 5 14 19 0 0
2 2 0 1 2 1 5 10 15 0 0
2 1 0 0 0 0 2 1 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
1 1 3 0 0 0 6 6 12 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 2 2 2 4 0
0 0 0 0
1 1 2 3 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 0 2 2 0
0 0 0 0
0 0 0 0
1 1 2 0
14 8 4 2 26 20 46 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
1 2 2 1 4 4 8 0
2 1 2 1 3 0
0 0 0 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 1 0 1 0
1 1 1 1 2 2 4 0
0 0 0 0
2 5 3 3 1 13 9 22 0
1 0 1 1 0
1 1 2 2 1 5 6 0
1 0 1 1 0
2 0 2 2 0
0 0 0 0
0 0 0 0
0 0 0 0
7 15 5 7 3 3 31 42 73 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
 6 1 2 5 14 19 0
1 1 1 6 7 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 2 5 5 10 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 2 4 1 2 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 2
0 0 0 0 0 0 0 0 0 0 0 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 1 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 2 4 2 1

-H95)

1 2
2 1

1 1 1 1

-H59)
-H95)

-H59)

-H95)
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 1 0 2 2 4 2 6 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 2 2 2 4 0
0 0 0 0 0 1 0 1 1 0
1 0 0 1 0 0 1 1 2 0
0 1 0 0 0 0 0 1 1 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 2 0 0 0 3 1 4 0
2 6 4 1 1 1 14 13 27 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 2 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

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

1 1 1 3 0 3
0 0 0
0 0 0
0 0 0
0 0 0
1 0 1 1
0 0 0
1 1 0 1
0 0 0
0 0 0
1 1 2 3 1 4
2 5 4 1 13 10 23
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
1 1 0 1
0 0 0

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

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

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

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

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 1 0 0
0 0 0 1 1 0 1 5 2 0 0 2 6
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 1 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 1 1

1 1
1 1 1 5 2 2 6

1 1

1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 2 0 0 2 2 2 4 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 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 1 1 2 0 0
14 8 4 2 0 0 26 20 46 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 2 0 0 2 1 4 4 8 0 0
2 1 0 0 0 0 2 1 3 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 1 2 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 2 2 2 4 0
0 0 0 0
1 1 2 3 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 0 2 2 0
0 0 0 0
0 0 0 0
1 1 2 0
14 8 4 2 26 20 46 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 2 2 1 4 4 8 0
2 1 2 1 3 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 2 3 0 2 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 2
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 1 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 2 3 2 1

-H95)

1 2
1 1

1 1 1 1

-H59)
-H95)

-H59)

-H95)
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 1 0 1 0 3 0 3 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 2 0 0 0 3 1 4 0
2 4 4 1 0 0 12 9 21 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 2 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

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

1 1 1 3 0 3
0 0 0
0 0 0
0 0 0
0 0 0
1 0 1 1
0 0 0
1 1 0 1
0 0 0
0 0 0
1 1 2 3 1 4
2 4 4 1 12 9 21
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
1 1 0 1
0 0 0

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

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

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

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 0 0 1 1 0
0 0 0 0 0 0 0 0 1 0 0 1 2
0 0 0 0 0 0 0 0 0 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 1 1 11 13 15 10 6 7 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

1 1 1 4 4 1 2

1 1
1 3

1
 1 1 2

1 1 10 9 11 10 6 6 8
 1 3 3 1
1 2 1 1

3 2 2 3 1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 2 12 4 6 14 19 20 39 0 0
2 1 6 9 6 8 14 18 32 0 0
1 1 0 0 3 2 7 4 11 0 0
3 2 3 2 0 0 7 7 14 0 0
1 0 1 1 2 0 4 2 6 0 0
0 0 0 0 0 4 0 4 4 0 0
0 0 0 1 0 0 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
12 15 2 8 4 7 51 73 124 0 1
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0 0
0 0 0 0 1 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 1 0 3 0 0 7 10 17 0 0
3 0 0 0 0 0 7 5 12 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 2 1 0 1 8 9 17 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 5 2 3 8 9 10 19 0
2 1 6 9 6 8 14 18 32 0
1 1 4 2 6 0
0 0 0 0
0 1 1 0
0 0 0 0
1 0 1 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6 9 1 12 18 30 0 1
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 2 4 3 7 0
0 4 4 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 7 2 3 6 10 10 20 0
0 0 0 0
3 2 3 2 5 0
3 2 3 2 7 7 14 0
1 1 1 2 4 1 5 0
4 0 4 4 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6 6 2 7 4 7 39 55 94 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
 1 1 3 7 10 0
3 7 1 8 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 1 7 8 15 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 4 5 0 4 1 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 3 1 4 0 0 1 2
0 0 0 0 0 0 0 10 11 3 0 1 5
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 5 1 6 1 3 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 2 5 2 1 1

-H95)
1 2 1 2
10 11 1 1 2
1 1

1 1 2 1 3

-H59)
-H95)

-H59)

2 2 2

-H95)
3 2
2 3

5 4 5
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 5 3 4 1 10 4 14 0
0 0 0 2 0 4 0 6 6 0
0 0 0 0 0 0 0 0 0 0
1 0 1 0 0 0 2 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 3 2 2 2 5 7 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
5 11 4 4 0 0 20 24 44 0
0 0 0 0 0 0 0 0 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 1 2 3 5 8 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0

1 0 1 0 0 0 4 9 13 0
0 1 1 0 0 0 15 17 32 0
2 0 0 0 0 0 3 1 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 3 0 1 0 0 9 18 27 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

1 3 1 2 6 1 7
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1 1 0 1
0 0 0
0 0 0
0 0 0
3 8 3 1 15 14 29
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
1 1 0 1
0 0 0

1 3 4 7
12 13 25
2 3 1 4
0 0 0
0 0 0
1 1 1 4 7 11
0 0 0

0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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 2 2 1 4 3 7
2 4 0 6 6
0 0 0
1 1 2 0 2
0 0 0
3 2 2 2 5 7
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 3 1 3 5 10 15
0 0 0
0 0 0
0 0 0
2 3 1 2 4 6
0 0 0
0 0 0
0 0 0
 1 1 5 6
1 1 3 4 7
0 0 0
0 0 0
0 0 0
2 5 11 16
0 0 0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 2 1 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 2 8 1 1 6 5 3 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

2 2 1

2 2 8 1 1 6 5 3 5
1 1 3 4 1
1 1 1

1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 0 1 1 7 5 10 6 16 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
4 3 1 1 0 0 9 5 14 0 0
0 0 0 0 0 0 0 0 0 0 0
0 1 0 3 0 0 0 4 4 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
1 4 0 6 1 0 16 29 45 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 4 0 0 0 0 4 10 14 0 0
0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 1 2 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 1 1 7 5 10 6 16 0
0 0 0 0
0 0 0 0
4 3 1 1 9 5 14 0
0 0 0 0
1 3 0 4 4 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 4 6 1 16 29 45 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
4 4 10 14 0
1 2 3 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 2 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 1 1
0 0 0 0 0 0 0 0 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 1 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

-H95)

-H59)
-H95)

-H59)

1 1 1
1

2 1 4

-H95)
1
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

0 0 0 2 5 6 5 8 13 0
0 0 0 0 1 1 1 1 2 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 1 0 4 2 6 0
0 1 1 0 0 0 1 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 0 0 0 0 0
0 0 0 0 0 0 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 1 1 1 3 6 12 18 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

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

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

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

0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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 5 6 5 8 13
1 1 1 1 2
0 0 0
1 1 1 4 2 6
1 1 1 2 3
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 3 1 1 1 3 6 12 18
0 0 0
0 0 0
0 0 0
1 0 1 1
0 0 0
0 0 0
0 0 0
 1 1 0 1
2 1 3 1 4
0 0 0
0 0 0
0 0 0
1 1 0 1
0 0 0
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 1 1 0 2 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 5 3 1 14 3 6 6
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

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

1 2 2 1 2

1 1 2 1 1 2

1
 1 1 1 5

1 3 1 1 13 3 4 6
 1 1 1 1
1 1 3 2 1

2 1 1 1 1
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 0 4 3 3 6 8 9 17 0 0
1 0 4 4 6 5 11 9 20 0 0
0 0 0 0 0 0 0 0 0 0 0
5 3 1 2 3 2 14 13 27 0 0
0 1 0 0 0 1 0 2 2 0 0
0 0 0 0 2 1 2 1 3 0 0
0 0 0 0 0 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
8 14 5 7 3 4 40 41 81 0 1
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 0 1 0 0
0 0 1 0 0 3 1 3 4 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
4 0 1 0 0 0 14 3 17 0 0
0 0 0 1 0 0 4 5 9 0 0
0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 6 5 11 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 2 1 2 4 5 5 10 0
1 4 4 6 5 11 9 20 0
0 0 0 0
1 1 5 0 5 0
0 0 0 0
0 0 0 0
1 0 1 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 10 1 2 1 1 9 16 25 0 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 3 1 3 4 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 1 10 2 12 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 2 1 2 3 4 7 0
0 0 0 0
0 0 0 0
4 3 1 2 2 2 9 13 22 0
1 1 0 2 2 0
2 1 2 1 3 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6 4 4 5 2 3 31 25 56 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 1 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 4 1 5 0
1 4 5 9 0
0 0 0 0
0 0 0 0
0 0 0 0
2 1 5 4 9 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2 0 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 2 8 2 2 5 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 1 2 0 0 1 2
0 0 0 0 0 1 2 12 12 3 0 2 2
0 0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 2 1 3 0 0
0 0 0 0 0 0 2 0 0 1 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 2 5 2 1 1

-H95)
1 2 1 2
10 11 1 1 2
1 1

1 1 2 1 3

-H59)
-H95)

-H59)

2 2 1

3 2 4 3

-H95)
1 2 2 1 2 1

2 1
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

1 0 3 3 4 3 8 6 14 0
0 0 0 2 1 0 1 2 3 0
0 0 0 0 0 0 0 0 0 0
1 1 0 0 1 0 6 2 8 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
7 10 5 2 1 1 25 27 52 0
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 1 2 1 3 0
0 0 0 0 1 2 1 2 3 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0

1 0 0 0 0 0 3 4 7 0
0 0 2 1 0 0 20 17 37 0
2 0 0 0 0 0 3 1 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 0 1 0 0 4 7 11 0
0 0 0 0 0 0 1 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 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

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

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

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

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

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

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

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

1 3 1 2 6 1 7
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1 1 0 1
0 0 0
0 0 0
0 0 0
3 8 3 1 15 14 29
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
1 1 0 1
0 0 0

1 3 4 7
12 13 25
2 3 1 4
0 0 0
0 0 0
1 1 1 4 7 11
0 0 0

0 0 0
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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 2 3 2 5 7
2 1 1 2 3
0 0 0
1 1 1 6 2 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
4 2 2 1 1 1 10 13 23
0 0 0
0 0 0
2 1 2 1 3
1 0 1 1
0 0 0
0 0 0
0 0 0
 0 0 0
2 1 8 4 12
0 0 0
0 0 0
0 0 0
0 0 0
1 2 3
 KEGIATA

Provinsi :
Kab/Kota :
Tahun :

Kode
No Kabupaten/Kota Kegiatan 0-7 hr
ICD X
L

a. Katarak: > 3/60 0

≤3/60 0
b. Kelainan Refraksi 0
- Miopi 0
- Hipermetropia 0
- Presbiopia 0
- Astigmatisme 0
c. Glaukoma 0
d. Retinopati Diabetikum 0
e. Low Vision 0
f. Retinopati of prematurity (ROP) 0
g. Lain-lain (sebutkan): 0
0
I Provinsi h. Jumlah operasi katarak 0
i. Follow up pasca operasi katarak 0
Tajam penglihatan: 6/12 - 6/18 0
< 6/18 - 6/60 0
< 6/60 0
0

a. Otitis Media Supuratif Kronik (OMSK/Congek) 0

b. Serumen 0
c. Presbikusis 0
d. Tuli akibat Bising (NIHL) 0
e. Tuli Konginital (tuli sejak lahir) 0
f. lain-lain (sebutkan): 0
0

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
 c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

2 Bangka h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

3 Belitung h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
 e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

4 Bangka Barat h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

5 Bangka Tengah h. Jumlah operasi katarak

5 Bangka Tengah
i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

6 Bangka Selatan h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
 - Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

7 Belitung Timur h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60

a. Otitis Media Supuratif Kronik (OMSK/Congek)

b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):

a. Katarak: > 3/60

≤3/60
b. Kelainan Refraksi
- Miopi
- Hipermetropia
- Presbiopia
- Astigmatisme
c. Glaukoma
d. Retinopati Diabetikum
e. Low Vision
f. Retinopati of prematurity (ROP)
g. Lain-lain (sebutkan):

8 Pangkalpinang h. Jumlah operasi katarak

i. Follow up pasca operasi katarak
Tajam penglihatan: 6/12 - 6/18
< 6/18 - 6/60
< 6/60
a. Otitis Media Supuratif Kronik (OMSK/Congek)
b. Serumen
c. Presbikusis
d. Tuli akibat Bising (NIHL)
e. Tuli Konginital (tuli sejak lahir)
f. lain-lain (sebutkan):
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Jumlah Kasus Baru Menurut Golongan Umur

0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P

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

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

1 1 1 2 1

1 1 1

1 2 1

1
 1 2 3

2 1 3 1 1 2 4
1 2 1

3 1 1 2 2
Umur Jumlah Jumlah
20-44 th 45-59 th >59 th kasus baru Kasus KET. 0-7 hr
L P L P L P L P Total Dirujuk L
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 0 2 3 2 6 5 9 14 0 0
0 0 3 2 4 3 7 5 12 0 0
1 0 1 0 1 0 6 0 6 0 0
0 0 0 0 0 0 0 0 0 0 0
0 9 2 2 1 2 4 18 22 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0 1 0 0
0 0 0 1 0 0 0 1 1 0 0
0 0 0 0 0 1 0 1 1 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
7 8 5 7 0 0 19 28 47 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 2 0 1 0 0 2 4 6 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
3 0 1 0 0 0 6 2 8 0 0
0 1 0 1 0 0 2 4 6 0 0
0 0 0 0 0 0 0 1 1 0 0
1 0 0 0 0 0 1 0 1 0 0
0 0 0 0 0 0 0 0 0 0 0
1 3 1 0 1 2 9 9 18 0 0
0 0 0 0 0 0 0 0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
1 2 1 2 3 5 4 9 0
3 2 4 3 7 5 12 0
1 1 5 0 5 0
0 0 0 0
0 0 0 0
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 4 4 3 13 16 0
0 0 0 0
0 0 0 0
0 0 0 0
1 2 2 4 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
2 1 5 2 7 0
0 0 0 0
0 1 1 0
1 1 0 1 0
0 0 0 0
1 1 1 2 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
2 3 0 5 5 0
0 0 0 0
1 1 0 1 0
0 0 0 0
9 2 2 1 2 4 18 22 0
0 0 0 0
1 0 1 0
1 0 1 1 0
1 0 1 1 0
0 0 0 0
0 0 0 0
5 4 5 3 16 15 31 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 0 2 2 0
0 0 0 0
0 0 0 0
0 0 0 0
Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
1 1 0 1 0
1 1 2 4 6 0
0 0 0 0
0 0 0 0
0 0 0 0
3 1 1 2 8 8 16 0
0 0 0 0
 Jumlah Kunjungan Menurut Golongan Umur
0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn
P L P L P L P L P L P L P
-H59)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 1 1 1 1 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H95)
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 0 0 0 0 3 0
0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 1 1 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
-H59)
-H95)

-H59)

-H95)
-H59)

-H95)

-H59)
-H95)

-H59)

1 1 1

-H95)

1 3
1

-H59)
-H95)

-H59)

1 1 1

-H95)
1 1
mur Jumlah Jumlah
20-44 th 45-59 th >59 th Kunjungan Kunjungan KET.
L P L P L P L P Total Dirujuk

0 0 4 2 4 6 8 8 16 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0
0 2 0 0 1 0 1 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 0 0 0 0 0
8 0 2 2 1 2 15 6 21 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 1 1 2 0
0 0 0 0 0 1 0 1 1 0
0 0 1 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 0

1 0 0 0 0 0 1 0 1 0
1 0 0 0 0 0 5 0 5 0
2 0 0 0 0 0 3 0 3 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 0 4 0 0 0 7 2 9 0
0 0 0 0 0 0 0 0 0 0

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

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

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

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

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

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

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

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

4 2 3 5 7 7 14
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
4 6 1 7
0 0 0
0 0 0
0 0 0
1 1 1 1 2
0 0 0
1 1 0 1
0 0 0

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

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

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

1 1 1 1 2
0 0 0
1 0 1 1
0 0 0
0 0 0
1 1 0 1
0 0 0
2 1 1 2 3
0 0 0
0 0 0
0 0 0
4 2 2 1 2 9 5 14
0 0 0
0 0 0
0 0 0
0 0 0
1 0 1 1
0 0 0
0 0 0
 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 3 1 4
0 0 0
 LAPORAN
KEGIATAN PROGRAM GANGGUAN INDERA DAN FUNGSIONAL (GIFU)

Kab/Kota :
Puskesmas :
Bulan :

Jumlah Kasus Baru Menurut Golongan Umur Jumlah Jumlah

Kode
No Puskesmas Kegiatan 0-7 hr 8-28 hr 1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th >59 th kasus baru Kasus KET.
ICD X
L P L P L P L P L P L P L P L P L P L P L P Total Dirujuk
Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)
a. Katarak: > 3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 #REF!
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 #REF!
b. Kelainan Refraksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
- Miopi 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 2 2 #REF!
- Hipermetropia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
- Presbiopia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
- Astigmatisme 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
c. Glaukoma 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 2 #REF!
d. Retinopati Diabetikum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
e. Low Vision 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 #REF!
f. Retinopati of prematurity (ROP) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
g. Lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 2 2 4 #REF!
h. Jumlah operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
i. Follow up pasca operasi katarak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 #REF!
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
< 6/18 - 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
< 6/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
0 0 0 #REF!

Jenis Gangguan Pendengaran dan Ketulian (H60-H95)

a. Otitis Media Supuratif Kronik
(OMSK/Congek) 0 0 0 0 0 1 0 0 2 0 1 1 0 0 0 2 0 1 0 0 3 5 8 #REF!
b. Serumen 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 3 0 3 #REF!
c. Presbikusis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
d. Tuli akibat Bising (NIHL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
e. Tuli Konginital (tuli sejak lahir) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
f. lain-lain (sebutkan): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #REF!
0 0 0 #REF!