LAPORAN KONSULTASI BULANAN PROGRAM IMUNISASI

RUMAH SAKIT EFARINA PEMATANGSIANTAR

RUMAH SAKIT : Efarina Etaham Siantar

BULAN : Desember
KELURAHAN : Bane
KECAMATAN : Siantar Martoba

A. PEMAKAIAN VAKSIN
HEPATITIS B
Pemakaian Vaksin di Rumah Sakit Bulan Ini

Indek Pemakaian Vaksin (IP) 79

B. PEMANTAUAN VAKSIN
KEADAAN VAKSIN HEPATITIS B

Sisa Akhir Bulan Lalu 36

Diterima Bulan Ini 100

Dibagikan Bulan Ini 79

Sisa Akhir Bulan Ini 21 + 36 = 57

Dibutuhkan Bulan Depan 50

C. PEMANTAUAN SAFETY BOX

SAFETY BOX
KEADAAN SAFETY BOX
2,5 ML

Sisa Akhir Bulan Lalu

Diterima Bulan Ini

Dibagikan Bulan Ini

Sisa Akhir Bulan Ini

Dibutuhkan Bulan Depan

 PEMATANGSIANTAR,

DIKETAHUI :
KEPALA RUANGAN PENANGGUNGJAWAB LAPORAN IM

( Fitriwanti..s ) (
RAM IMUNISASI
GSIANTAR

HEPATITIS B

HEPATITIS B

SAFETY BOX

5 ML
ATANGSIANTAR, 2022

ANGGUNGJAWAB LAPORAN IMUNISASI

)
 LAPORAN HASIL IMUNISASI BAYI TAHUN 2022
( HEPATITIS.B )
RUMAH SAKIT RS.EFARINA
BULAN DESEMBER
TAHUN 2022
1
NO Nama Bayi Laki/ Wnt Tanggal Lahir Bayi Nama Orang tua NIK Alamat Lengkap ( RW/RT ) Kelurahan
HB0 ( < 24 jam )

1 BY NURI LK KAMIS1/12/22 NURI NURAINI 1272036301710004 BAGADUN KANOPAN 1/12/22 <24 JAM

2 BY ISRA LK SENIN 5/12/22 ISRA NUR HUSNAH 1208286311980001 JL KENANGAN HUTA I PURBASARI 5/12/22 <24 JAM

3 BY KARMINI LK SENIN 5/12/22 KARMINI MANIK 1272066110870002 JL PISANG KIPAS BLOK X1 BAN SORMA 5/12/22 <24 JAM

4 BY SUHELPI PR SENIN 5/12/22 SUHELPI 120802700698000001 HUTA V PULO SARANA BAHAL BATU 5/12/22 <24 JAM

5 BY DINDA PR SENIN 5/12/22 DINDA DELLA LIMBONG 1208165307950001 JL DIPONEGORO GG KOPRAL TELADAN 5/12/22 <24 JAM

6 BY ANISA LK SENIN 5/12/22 ANISA KRISTI SARAGIH 1208297009920001 KP PITARA DEPOK 5/12/22 <24 JAM

7 BY LASMA PR SELASA 6/12/22 LASMA NAFTALIA .SPHTR 1207234506950010 JL KARYA UJUNG HELVETIA 6/12/22 <24 JAM

8 BY PESTARIA PR SELASA 6/12/22 PESTARIA NAIBORHU 1212126210930001 JL SERI WANGI NAGAHUTA 6/12/22 <24 JAM

9 BY H.WIDIA LK SELASA 6/12/22 HOTMAUHUR WIDIA SPYG 1208014141670005 JL KEMIRI RAYA NO 2 NUSA HARAPAN 6/12/22 <24 JAM

10 BY BERLIANA PR SELASA 6/12/22 BERLIANA SIHOMBING 1218057003980002 HAPOLTAKAN SONDI RAYA 6/12/22 <24 JAM

11 BY RANI PR RABU 7/12/22 RANI JUITA SIDABALOK 1208216710910003 DOLOG HULUAN DOLOG HULUAN 7/12/22 <24 JAM

12 BY WARNITA PR RABU 7/12/22 WARNITA HASIBUAN 1208226609870001 JL SINGOSARI BANJAR 7/12/22 <24 JAM

13 BY VINNI LK RABU 7/12/22 VINNI RIAN SARAGIH 1272024966920001 JL SERAH BAWANG BANTAN 7/12/22 <24 JAM

14 BY ASTRI PR KAMIS 8/12/22 ASTRI GUSTIANTI 1208216710910003 DUSUN TAPIAN NAULI JUHAR 8/12/22 <24 JAM

15 BY PUSPITA LK JUMAT 9/12/22 PUSPITA RATNA DEWI 120922710981001 JL KAUMAN HUTA I KARANG SARI 9/12/22 <24 JAM

16 BY RINA LK SABTU 10/12/22 RINA SARTIKA LUBIS 1276016801870001 KARANG ANOM PANEI TONGAH 10/12/22 <24 JAM

17 BY YENI LK SENIN 12/12/22 YENI FRISDA PAKPAHAN 1272060911020002 HUTA I DOLOK MARAJA DOLOK MARAJA 12/12/22 <24 JAM

18 BY TRIA PR MINGGU11/12/22 TRIA AYU NINGSIH 127206560990004 JL TANJUNG PINGGIR TANJUNG PINGGIR 11/12/22 <24 JAM

19 BY RISKI LK SENIN 12/12/22 RISKI SARI PRADINI 1272026304920002 JL SERAM ATAS BANTAN 12/12/22 <24 JAM

20 BY DELI PR SENIN 12/12/22 DELI MARIATI SITORUS 1272206101890006 HUTA II BANUA BALIJU 12/12/22 <24 JAM

21 BY SUSI PR SENIN 12/12/22 SUSI FEBRINA 1208025902900004 HUTA III SILAU MALELA SILAU MALELA 12/12/22 <24 JAM

22 BY SIPONNIYEM LK SENIN 12/12/22 SIPONNIYEM 1208176911890001 LK II AMAN SARI SERBELAWAN 12/12/22 <24 JAM

23 BY INDRIYANI PR SELASA 13/12/22 INDRIYANI TAMPUBOLON 1272034201930001 JL TELKOM LEIDONG TANJUNG LEIDONG 13/12/22 <24 JAM

24 BY MEGA LK SELASA 13/12/22 MEGA MAWAR SIHOMBING 1102065102950003 BAGADUN BANGUN RAKYSAT 13/12/22 <24 JAM

25 BY PUTRI LK SELASA 13/12/22 PUTRI WINDA NOVIANTI 1208116609880002 HUTA I MARGOSONO MEKAR MULIA 13/12/22 <24 JAM

26 BY VERA PR RABU 14 /12/22 VERA NURLINA SIAHAAN 1272084512860001 JL D 1 PANJAITAN NAGAHUTA 14/12/22 <24 JAM

27 BY NURMIATI LK RABU 14 /12/22 NURMIATI ROSA SIMARMT 1272035202890002 JL GAHARU BLOK NO 26 KAHAEAN 14/12/22 <24 JAM

28 BY NURLIANA PR RABU 14 /12/22 NURLIANA NASUTION 1208114612950003 HUTA 1 SINAR REJO BAH SIKAT 14/12/22 <24 JAM

29 BY YANTI LK RABU 14 /12/22 YANTI 1208035504820003 SIMP INPRES HUTA III KARANG REJO 14/12/22 <24 JAM

30 BY ANGGI PR KAMIS15 /12/22 ANGGI ANGGREANI 1208165301990002 SIBAGANDING SIBAGANDING 15/12/22 <24 JAM

31 BY RINI LK KAMIS 15/12/22 RINI AGUS PERTIWI 1272026908950001 JL R SIHOMBING LORONG BAJA PONDOK SAYUR 15/12/22 <24 JAM
 32 BY RIKA LK JUMAT 16/12/22 RIKA RAMAHDANI 1208034503920001 JL PURWO HUTA IV KARANG SARI 16/12/22 <24 JAM

33 BY LIANI LK JUMAT 16/12/22 LIANI SIMARMATA 120866702910001 DOLOG HULUAN DOLOK HULUAN 16/12/22 <24 JAM

34 BY WIDARI PR SABTU 17/12/22 WIDARI 1208036210950001 HUTA II HUBUAN BOSAR GALUGIR 17/12/22 <24 JAM

35 BY SARMA LK SABTU 17/12/22 SARMA ULINA SILALAHI 1208105909930001 SAIT BUTTU SARIBU SAIT BUTTU SARIBU 17/12/22 <24 JAM
36 BY LIRAHAYU LK SABTU 17/12/22 LIRAHAYU SIREGAR 1208176902960001 HUTA II TANJUNG HATARAN TANJUNG HATARAN 17/12/22 <24 JAM
37 BY SITI PR SABTU 17/12/22 SITI NURHAIRANI 1271055307880001 JL PRINGGAN BAGELAN UJUNG PADANG HILIR 17/12/22 <24 JAM
38 BY YULINA LK JUMAT 23/12/22 YULINA SIREGAR 1209096412940002 JL JAWA NO 34 BANTAN 23/12/22 <24 JAM
39 BY ANGGUN PR SENIN 19/12/22 ANGGUN WINARTI 1208024109920005 JL AMAL HUTA II SENIO 19/12/22 <24 JAM
40 BY ULFA LK SENIN 19/12/22 ULFA DWI SARTIKA 1208017006970001 JL BESAR SIANTAR SERIBU DOLOK 19/12/22 <24 JAM
41 BY HERPINA PR SENIN 19/12/22 HERPINA NASUTION 1272064141089001 JL TAMBUN TIMUR TAMBUN NABOLON 19/12/22 <24 JAM

42 BY ELISA LK SENIN 19/12/22 ELISA ANANDA KARANG REJO KARANG REJO 19/12/22 <24 JAM

43 BY ELVINAWATI LK SELASA 20/12/22 ELVINAWATI LINGGA 2171126310910003 PERJALANGAN PERJALANGAN 20/12/22 <24 JAM

44 BY NURMIAN LK SELASA 20/12/22 NURMIAN HUTAURUK 1202035008840001 JL KESATRIA NO 23 MERDEKA 20/12/22 <24 JAM

45 BY ASRIUL PR RABU 21/12/22 ASRIUL CHORIJA 12085111070001 HUTA VI PONDOK GALUGUR TANGGA BAYU 21/12/22 <24 JAM

46 BY IDARIANI PR RABU 21/12/22 IDARIANI 1272015004890002 PERUM PUMA YUDHA KABIL 21/12/22 <24 JAM
47 BY INTAN LK RABU 21/12/22 INTAN SOPIANI 120817550192001 HUTA BAN TOBU BAN TOBU 21/12/22 <24 JAM
48 BY RAYANTIKA PR RABU 21/12/22 RAYANTIKA 1208015407930002 HUTA III UJUNG NO 4 KARANG BANGUN 21/12/22 <24 JAM
49 BY NILA PR RABU 21/12/22 NILA YUSNIKA NAINGGOL 12081165005920006 NAHORHOP PANANGGANAN 27/12/22 <24 JAM
50 BY RATI PR KAMIS 22/12/22 RATIH PURWANINGSIH 1208224164950001 HUTA IV SWEMBAYU NAGA SOPPA 22/12/22 <24 JAM
51 BY ELIDAWATI PR KAMIS 22/12/22 ELIDAWATI SIMARMATA 12082071018890001 DESA BANGUN PANE BANGUN PANE 22/12/22 <24 JAM
52 BY SULASTRI PR KAMIS 22/12/22 SULASTRI 1208174404920005 LK VII KAMPUNG LALANG SERBELAWAN 22/12/22 <24 JAM
53 BY NUR INTAN PR KAMIS 22/12/22 NUR INTAN 1208176907020002 HUTA III PURWOSARI DOLOK TANJUNG 22/12/22 <24 JAM
54 BY NURSA"ADAH PR JUMAT 23/12/22 NURSA'ADAH 1218054311940002 JL KAPTEN WAN RAHMAD TANJUNG BERINGIN 23/12/22 <24 JAM
55 BY DEVI PR SABTU 24/12/22 DEVI MAYANG SARI 1208116012930007 KOMPLEKS RS BALIMBING BALIMBING 24/12/22 <24 JAM
56 BY MURNIAWATI PR MINGGU25/12/22 MURNIAWATI SEMBIRING 1207224607930001 BUAH BOLON MEREK RAYA 25/12/22 <24 JAM
57 BY INTAN PR MINGGU25/12/22 INTAN SYAHRANI 1272014707970009 JL PATTIMURA UJUNG TOMUAN 25/12/22 <24 JAM
58 BY SARI LK MINGGU25/12/22 SARI SITANGGANG 1219036401920001 TANJUNG KUBAN TANJUNG KUBAN 25/12/22 <24 JAM
59 BY DINDA LK MINGGU25/12/22 DINDA SARI 1208035303020001 JL MASJID PANDAPOTAN KARANG SARI 25/12/22 <24 JAM
60 BY NOVIA LK SELASA 27/12/22 NOVIA JULIANA TARIGAN 1208124907940003 HUTA SAMPE MAULI JAWA TONGAH 27/12/22 <24 JAM
61 BY SELLI PR SELASA 27/12/22 SELLI SINAGA 1206054112030002 DOLOK SARIBU DOLOK SARIBU 27/12/22 <24 JAM
62 BY SAPRINA LK SELASA 27/12/22 SAPRINA BATUBARA 1203215009900001 JL PDT W. SARAGIH BANE 27/12/22 <24 JAM
63 BY NENG ENJI PR SELASA 27/12/22 NENG ENJI NURSANAH 1208285206930001 JL SUBUR LK VIII SINAKSAK 27/12/22 <24 JAM
64 BY NOVRIANA PR SELASA 27/12/22 NOVRIANA RITONGA JL CEMPAKA ATAS RAMBUNG MERAH 27/12/22 <24 JAM
65 BY DEBY LK SELASA 27/12/22 DEBY MARIA PURBA 1270074607030001 SINAMAN II P.SIDAMANIK 27/12/22 <24 JAM
66 BY MIA LK RABU 28/12/22 MIA AGUSTINA PAKPAHAN 1208204508950003 SIPINTUANGIN PARIKSABUNGAN 28/12/22 <24 JAM
67 BY JURAIDAH PR RABU 28/12/22 JURAIDAH 1208034107940007 HUTA III RABUHIT RABUHIT 28/12/22 <24 JAM
68 BY WIDYA LK RABU 28/12/22 WIDYA PUSPITA SARI 1271204908850002 JL CEMARA ASRAMA YON PULO BRAYAN 28/12/22 <24 JAM
69 BY CHANDRA LK KAMIS 29/12/22 CHANDRA PURNAMA PURBA 1208176203920001 HUTA 1 NAGERI DOLOK KATARAN 29/12/22 <24 JAM
70 BY ELLYS PR KAMIS 29/12/22 ELLYS S. SIMANJUNTAK 1208136702890001 JL TAMBUSAI GG HOP KAMPUNG MELAYU 29/12/22 <24 JAM
71 BY ORDELIANI LK KAMIS 29/12/22 ORDELIANI PURBA 1208194501950003 KAV BUKIT SEROJA SUNGAI PELENGGUT 29/12/22 <24 JAM
72 BY LELY LK KAMIS 29/12/22 LELY MAHENI STMRG 120804550990003 AEK NAULI PANEI TONGAH 29/12/22 <24 JAM
73 BY RISMA PR JUMAT 30/12/22 RISMA MANDAYANI 1208194501860001 HUTA JAMBI MARIAH JAMBI 30/12/22 <24 JAM
74 BY MARDIANA LK JUMAT 30/12/22 MARDIANA 1206044605830001 HUTA 1 SAH KUDA SAH KUDA BAYU 30/12/22 <24 JAM
75 BY YAYUK LK SABTU 31/12/22 YAYUK NURHAYATI. SPYG 1208015607940004 JL VITAERA YUDA SETIA NEGARA 31/12/22 <24 JAM
76 BY LUSI PR SABTU 31/12/22 LUSI ELISABET .MRPG 140609170990002 TANJUNG MEDAN TAMBUSAI UTARA 31/12/22 <24 JAM
77 BY SITI PR SABTU 31/12/22 SITI JMILAH 520316541090002 DUSUN VIII SUKA MAKMUR 31/12/22 <24 JAM
78 BY LAMHOT PR SABTU 31/12/22 LAMHOT DOLOK SARIBU 120816540480003 GIRSANG I GIRSANG 31/12/22 <24 JAM
79 BY SUMIATI PR SABTU 31/12/22 SUMIATI SITUMORANG 1208046803940003 PARBATUAN BANGUN RAKYAT 31/12/22 <24 JAM