LAPORAN RUTIN PWS KIA

KABUPATEN : KONAWE SELATAN

PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023
JUMLAH PELAYANAN KUNJUNGAN IBU HAMIL
K1 K6
K1 AKSES (K 1
NO NAMA DESA SASARAN SASARAN BUKU KIA MURNI + K1>12 K4
PENDUDUK K 1 MURNI K 1>12 MINGGU MINGGU K 6 O/ BIDAN K6 2X O/ DOKTER
BUMIL WUS

ABS % ABS % ABS % ABS % ABS % ABS %

TOTAL 11365 278 2928 6 5 1.71821 1 14.2857 6 2.06186 13 3.78 6 2.06 1 14.3
1 Awunio 277 11 123 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Lamotau 552 13 134 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Mataiwoi 613 14 155 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Andinete 740 15 158 0 0 0 0 0 0 0 2 0 0 0 0 0
5 Waworano 648 12 127 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Alosi 398 9 96 1 1 11.1111 0 0 1 11.1111 4 44.444 0 0 0 0
7 Langgowala 330 7 75 2 1 14.2857 1 14.2857 2 28.5714 1 14.285 1 14.3 1 14.3
8 Wawoosu 337 8 85 0 0 0 0 0 0 0 0 0 0 0 0
9 Sawah 552 14 149 1 1 6.66667 0 0 1 6.66667 0 0 0 0 0
10 Silea 248 14 145 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Puudongi 534 10 105 1 1 10 0 0 1 10 0 0 0 0 0 0
12 Mondoe Jaya 503 11 122 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Puupi 1091 26 278 1 1 3.57143 0 0 1 3.57143 1 3.571 0 0 0 0
14 Tiraosu 496 15 158 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Matandahi 249 6 62 0 0 0 0 0 0 0 1 16.666 0 0 0 0
16 Kolono 1030 29 319 0 0 0 0 0 0 0 0 0 1 3.13 0 0
17 Meletumbo 686 15 157 0 0 0 0 0 0 0 3 20 3 20 0 0
18 Roda 598 14 150 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Lamapu 589 12 127 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Ulusena Jaya 285 5 57 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Sarandua 399 9 94 0 0 0 0 0 0 0 0 0 0 0 0 0
22 UPT Roda 210 9 52 0 0 0 0 0 0 0 1 10 1 10 0 0

MENGETAHUI KOLONO, 30 APRIL 2023

KEPALA PUSKESMAS KOLONO KOORDINATOR BIDAN

H.ABDUL SAMAD.SKM.,M.,Kes ATIK ROHAYATI, A.Md.Keb

NIP. 19690930 199102 1 O1 NIP.19721226 20050 1 002
 PELAYANAN KUNJUNGAN IBU HAMIL DENGAN 10 T
K6 TES LABORATORIUM
IBU IBU IBU HAMIL IBU IBU IBU IBU HAMIL IBU HAMIL
HAMIL HAMIL DI DIPERIKSA IBU HAMIL IBU HAMIL IBU IBU IBU HAMIL DI TATA DILAKUKAN
K 6 2X O/ DOKTER DI PERIKSA STATUS HAMIL DIPERIKSA HAMIL DI HAMIL
+ USG DIUKUR PERIKSA DIBERI PERIKSA HAMIL HAMIL LAKSANA TEMU
PERIKSA TD GIZI(UKUR TFU DJJ STATUS TT TTD GOL. PERIKSA PERIKSA DI PERIKSA KASUS WICARA
TB/BB (TENSI) LILA) HEPATITIS
ABS % DARAH HIV SIFILIS
1 0 76 76 5 67 71 4 18 0 0 0 0 15 59
0 0 0 0 0 0 0 0 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 4 0 4 4 0 0 0 0 0 0 0 0
0 0 14 14 0 12 12 0 0 0 0 0 0 2 14
0 0 5 5 0 5 5 1 0 0 0 0 0 0 5
0 0 8 8 1 9 8 0 5 0 0 0 0 4 9
0 0 4 4 2 4 3 1 3 0 0 0 0 1 4
0 0 1 1 0 1 1 0 0 0 0 0 0 1 1
0 0 2 2 1 3 2 1 1 0 0 0 0 0 3
0 0 4 4 0 4 4 0 1 0 0 0 0 2 4
0 0 3 3 0 3 3 0 0 0 0 0 0 0 3
1 0 8 8 0 0 8 0 0 0 0 0 0 3 8
0 0 5 5 1 4 4 0 2 0 0 0 0 2 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 1 1 1 1 0 0 0 0 0 0
0 0 3 3 0 3 3 0 1 0 0 0 0 0 0
0 0 5 5 0 5 4 0 3 0 0 0 0 0 0
0 0 3 3 0 3 3 0 0 0 0 0 0 0 3
0 0 3 3 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 2 2 0 2 2 0 0 0 0 0 0 0 0
0 0 1 1 0 1 1 0 1 0 0 0 0 0 0
 STATUS IBU HAMIL PEMERIKSAAN HB TRIMESTER 1 PEMERIKSAAN HB TRIMESTER 3
TT BUMIL PEMBERIAN TAB.FE NORMAL >12 mg/dl HB 8-11 mg/dl HB < 8 mg/dl NORMAL >12 mg/dl HB 8-11 mg/dl HB < 8 mg/dl
IBU
HAMIL
BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL BUMIL KEK(LILA
T1 T2 T3 T4 T5 T 2+ FE 1 FE 3 BARU LAMA BARU LAMA BARU LAMA BARU LAMA BARU LAMA BARU LAMA < 23,5
CM )

0 1 2 0 1 0 5 7 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 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 1 4 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 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 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 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
 PELAYANAN KOMPLIKASI MATERNAL IBU HAMIL DIVAKSINASI COVID 19DETEKSI RESTI IBU HAMIL RUJUKAN

IBU IBU HAMIL IBU HAMIL IBU IBU HAMIL IBU HAMIL IBU DETEKSI
IBU HAMIL HAMIL DENGAN DENGAN DETEKSI RESTI IBU HAMIL
GULA DENGAN HAMIL MENGALAMI PENYAKIT HAMIL VAKSIN VAKSIN VAKSIN 3 RESTI O/ O/ DENGAN 4T MATERNAL NEONATAL
MENGALA PROTEIN PREEKLAMS DENGAN GANGGUAN DENGAN 1 2 (BOSTER) TENAGA
MI URIN (+) DARAH > I/EKLAMSIA INFEKSI JANTUNG DIABETES COVID 19 KESEHATAN MASYARAKAT
PERDARAH 140 g/dl MELITUS
AN
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 1 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
 LAPORAN PNC

KABUPATEN : KONAWE SELATAN

PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023
JUMLAH PERSALINAN KUNJUNGAN NIS ( KF )
KOMPLIKASI
PERSALINAN O/ PERSALINAN O/ PERSALINAN O/ PEMBERIAN VIT
PERSALINAN MATERNAL
NO NAMA DESA SASARAN BULIN NAKES NAKES DI NON NON NAKES A PADA BUFAS KF 1 KF 2 KF 3 KF 4
O/NAKES DITANGANI ( PK )
DIFASYANKES FASYANKES (DUKUN)

ABS % ABS % ABS % ABS % ABS % ABS % ABS % ABS % ABS % ABS %
TOTAL 278 30 11.407 30 11.407 0 0 0 0 4 1.52 30 10.072 30 10.072 30 10.072 30 10.07 30 10.072
1 Awunio 11 2 18.182 2 18.18 0 0 0 0 1 41.67 2 18.182 2 18.182 2 18.182 2 18.18 2 18.182
2 Lamotau 13 2 25 2 25 0 0 0 0 1 38.46 2 25 2 25 2 25 2 25 2 25
3 Mataiwoi 14 2 14.286 2 14.29 0 0 0 0 0 - 2 14.286 2 14.286 2 14.286 2 14.29 2 14.286
4 Andinete 15 4 28.571 4 28.57 0 0 0 0 2 66.67 4 28.571 4 28.571 4 28.571 4 28.57 4 28.571
5 Waworano 12 1 8.3333 1 8.333 0 0 0 0 0 - 1 8.3333 1 8.3333 1 8.3333 1 8.333 1 8.3333
6 Alosi 9 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
7 Langgowala 7 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
8 Wawoosu 8 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
9 Sawah 14 1 8.333 1 8.333 0 0 0 0 0 - 1 8.3333 1 8.3333 1 8.3333 1 8.333 1 8.3333
10 Silea 14 2 15.38 2 15.38 0 0 0 0 0 - 2 15.385 2 15.385 2 15.385 2 15.38 2 15.385
11 Puudongi 10 1 10 1 10 0 0 0 0 0 - 1 10 1 10 1 10 1 10 1 10
12 Mondoe Jaya 11 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
13 Puupi 26 3 0 3 0 0 0 0 0 0 - 3 0 3 0 3 0 3 0 3 0
14 Tiraosu 15 3 21.43 3 21.43 0 0 0 0 0 - 3 21.429 3 21.429 3 21.429 3 21.43 3 21.429
15 Matandahi 6 0 50 0 50 0 0 0 0 0 - 0 50 0 50 0 50 0 50 0 50
16 Kolono 29 3 11.54 3 11.54 0 0 0 0 0 - 3 11.538 3 11.538 3 11.538 3 11.54 3 11.538
17 Meletumbo 15 1 7.143 1 7.143 0 0 0 0 0 - 1 7.1429 1 7.1429 1 7.1429 1 7.143 1 7.1429
18 Roda 14 1 7.143 1 7.143 0 0 0 0 0 - 1 7.1429 1 7.1429 1 7.1429 1 7.143 1 7.1429
19 Lamapu 12 2 16.67 2 16.67 0 0 0 0 0 - 2 16.667 2 16.667 2 16.667 2 16.67 2 16.667
20 Ulusena Jaya 5 1 20 1 20 0 0 0 0 0 - 1 20 1 20 1 20 1 20 1 20
21 Sarandua 9 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
22 UPT Roda 9 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 0 0 0 0
 FORMAT NEONATAL
KABUPATEN : KONAWE SELATAN
PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023

JUMLAH PERAWATAN
PELAYANAN NEONATAL ESENSIAL SAAT LAHIR 0 - 6 JAM NEONATAL ESENSIAL SAAT PELAYANAN NEONATAL SET
LAHIR 0 - 6 JAM
JUMLAH SASARAN JUMLAH
NO NAMA DESA KELAHIRAN HIDUP SASARAN BAYI
PERAWATAN NEONATAL 30 - 90 PERAWATAN NEONATAL 90 MENJAGA BAYI TETAP
PERAWATAN NEONATAL 0 -30 DETIK MENIT MENIT - 6 JAM HANGAT
L P TOTAL
L P TOTAL L P TOTAL L P TOTAL L P TOTAL
TOTAL 263 263 13 17 30 13 17 30 13 17 30 13 17 30 13 17 30

1 Awunio 11 11 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2

2 Lamotau 12 12 2 1 3 2 1 3 2 1 3 2 1 3 2 1 3

3 Mataiwoi 14 14 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2

4 Andinete 14 14 1 3 4 1 3 4 1 3 4 1 3 4 1 3 4

5 Waworano 12 12 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1

6 Alosi 8 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Langgowala 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Wawoosu 8 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Sawah 12 12 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1

10 Silea 13 13 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2

11 Puudongi 10 10 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1

12 Mondoe Jaya 11 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Puupi 25 25 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3

14 Tiraosu 14 14 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3

15 Matandahi 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 Kolono 26 26 0 3 3 0 3 3 0 3 3 0 3 3 0 3 3

17 Meletumbo 14 14 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1

18 Roda 14 14 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1

19 Lamapu 12 12 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2

20 Ulusena Jaya 5 5 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1

21 Sarandua 8 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

22 UPT Roda 8 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 JUMLAH BAYI 0 - 28 HARI ( 0-6
JUMLAH BAYI ( 6 JAM -28 HARI) JAM + 6-28 HARI ) YANG
PELAYANAN NEONATAL SETELAH LAHIR 6 - 28 HARI YANG MENDAPATKAN PELAYANAN CAKUPAN KUNJUNGAN NEONATAL
NEONATAL ESENSIAL MENDAPAT PELAYANAN
NEONATAL ESENSIAL

PEMERIKSAAN DENGAN PERAWATAN METODE PEMANTAUAN

MTBM PEMBERIAN ASI KANGGURU PERTUMBUHAN KN 1 KN 3 ( LENGKAP )
L P TOTAL L P TOTAL
L P TOTAL L P TOTAL L P TOTAL L P TOTAL L P ABS % L P ABS %
13 17 30 13 17 30 13 17 30 13 17 30 13 17 30 13 17 30 13 17 30 11.03 13 17 30 11.03

1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 18.18 1 1 2 18.18

2 1 3 2 1 3 2 1 3 2 1 3 2 1 3 2 1 3 2 1 3 25.00 2 1 3 25.00

2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 14.29 2 0 2 14.29

1 3 4 1 3 4 1 3 4 1 3 4 1 3 4 1 3 4 1 3 4 28.57 1 3 4 28.57

0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 8.33 0 1 1 8.33

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 8.33 0 1 1 8.33

1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 1 1 2 15.38 1 1 2 15.38

0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 10.00 0 1 1 10.00

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 12.00 1 2 3 12.00

1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 21.43 1 2 3 21.43

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

0 3 3 0 3 3 0 3 3 0 3 3 0 3 3 0 3 3 0 3 3 11.54 0 3 3 11.54

1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 7.14 1 0 1 7.14

1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 7.14 1 0 1 7.14

2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 2 0 2 16.67 2 0 2 16.67

0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0 1 1 0.00 0 1 1 0.00

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0 0.00

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0.00 0 0 0
0.00
 JUMLAH LAHIR HIDUP JUMLAH LAHIR MATI PELAYANAN KESEHATAN BAYI KOMPLIKAS PADA NEONATUS

< 2500 > 2500 < 2500 > 2500 ASFIKSIA INFEKSI TETANUS NEONATORUM
L P ABS %
L P ABS % L P ABS % L P ABS % L P ABS % L P ABS L P ABS L P ABS
2 1 3 7.604 11 16 27 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 1 1 2 18.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 0 1 55.56 1 1 2 16.67 0 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 14.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 0 1 47.62 0 3 3 21.43 0 0 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 8.33 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 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0.00 0 0 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 8.33 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 1 1 2 15.38 0 0 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 10.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0.00 0 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 21.43 0 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 50.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 1 1 25.64 0 2 2 7.69 0 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 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 1 0 1 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 2 0 2 16.67 0 0 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 20.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0
0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 CAKUPAN PENANGGANAN NEONATAL
JUMLAH KOMPLIKASI
SASARAN
NEONATAL
KOMPLIKASI=
15% KELAHIRAN
COMFIR COVID 19 DAN HIDUP
KELAINAN KONGGENITAL SUSPEK L P ABS %
L P ABS L P ABS
0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0
 LAPORAN BALITA
PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023

BALITA(0-59 BULAN) YG PUNYA BUKU

PELAYANAN KESEHATAN BALITA
KIA
SASARAN BALITA
NO NAMA DESA
USIA 0-59 BULAN
LAMA ( SUDAH PERNAH
BARU TERCATAT PADA BULAN L P TOTAL
SEBELUMNYA)

Desa 1565 20 644 22 14 36

1 Awunio 37 2 23 1 0 1
2 Lamotau 40 0 19 1 1 2
3 Mataiwoi 51 1 25 0 0 0
4 Andinete 87 6 28 3 2 5
5 Waworano 90 0 39 1 1 2
6 Alosi 51 0 23 1 0 1
7 Langgowala 36 0 31 0 0 0
8 Wawoosu 45 0 39 0 2 2
9 Sawah 62 1 36 0 1 1
10 Silea 57 0 30 1 0 1
11 Puudongi 388 1 23 0 1 1
12 Mondoe Jaya 40 1 25 1 1 2
2 Puupi 115 3 17 2 3 5
14 Tiraosu 50 3 46 1 1 2
15 Matandahi 40 0 39 2 0 2
16 Kolono 85 0 32 1 1 2
17 Meletumbo 84 1 42 1 0 1
18 Roda 48 0 42 1 0 1
19 Lamapu 69 0 26 1 0 1
20 Ulusena Jaya 41 1 16 1 0 1
21 Sarandua 24 0 29 2 0 2
22 UPT Roda 25 0 14 1 0 1
 ANC TERPADU
KABUPATEN : SULAWESI TENGGARA
PUSKESMAS : KONAWE SELATAN
BULAN : APRIL
TAHUN : 2023
PENCEGAHAN PENULARAN HIV DARI IBU KE ANAK ( PPIA ) PENCEGAHAN MALARIA DALAM KEHAMILAN
IBU HAMIL HIV (+)
IBU HAMIL IBU HAMIL IBU HAMIL DGN IBU HAMIL IBU HAMIL IBU HAMIL IBU HAMIL
NO NAMA DESA IBU HAMIL DI IBU HAMIL MENDAPAT DIPERIKSA MENDAPAT
DATANG DITAWARKAN TES HIV HASIL TES HIV MENDAPAT ARV PERSALINAN KAN MIKROSKOP MALARIA KAN
DENGAN HIV(+) TES HIV (+) PERSALINAN PERABDOMIN (+)
PERVAGINAAM KELAMBU IS/RDT KINA/ACT
AM (SC)

TOTAL 0 0 0 0 0 0 0 0 0 0 0

1 Awunio 0 0 0 0 0 0 0 0 0 0 0
2 Lamotau 0 0 0 0 0 0 0 0 0 0 0
3 Mataiwoi 0 0 0 0 0 0 0 0 0 0 0
4 Andinete 0 0 0 0 0 0 0 0 0 0 0
5 Waworano 0 0 0 0 0 0 0 0 0 0 0
6 Alosi 0 0 0 0 0 0 0 0 0 0 0
7 Langgowala 0 0 0 0 0 0 0 0 0 0 0
8 Wawoosu 0 0 0 0 0 0 0 0 0 0 0
9 Sawah 0 0 0 0 0 0 0 0 0 0 0
10 Silea 0 0 0 0 0 0 0 0 0 0 0
11 Puudongi 0 0 0 0 0 0 0 0 0 0 0
12 Mondoe Jaya 0 0 0 0 0 0 0 0 0 0 0
13 Puupi 0 0 0 0 0 0 0 0 0 0 0
14 Tiraosu 0 0 0 0 0 0 0 0 0 0 0
15 Matandahi 0 0 0 0 0 0 0 0 0 0 0
16 Kolono 0 0 0 0 0 0 0 0 0 0 0
17 Meletumbo 0 0 0 0 0 0 0 0 0 0 0
18 Roda 0 0 0 0 0 0 0 0 0 0 0
19 Lamapu 0 0 0 0 0 0 0 0 0 0 0
20 Ulusena Jaya 0 0 0 0 0 0 0 0 0 0 0
21 Sarandua 0 0 0 0 0 0 0 0 0 0 0
22 UPT Roda 0 0 0 0 0 0 0 0 0 0 0
 TB DALAM KEHAMILAN KECACINGAN DALAM KEHAMILAN PENCEGAHAN IMS DALAM KEHAMILAN PENCEGAHAN HEPATITIS B DALAM KEHAMILAN

IBU HAMIL IBU HAMIL IBU IBU HAMIL BAYI YANG

IBU HAMIL DENGAN IBU HAMIL IBU HAMIL DENGAN HAMIL IBU HAMIL IBU HAMIL IBU HAMIL IBU HAMIL DENGAN IBU HAMIL MENDAPAT
MENDAPAT DIPERIKSA DENGAN YANG
DIPERIKSA HASIL KAN OBAT ANGKYLOST HASIL TES YANG DIPERIKSA HASIL TES YANG DI DIPERIKSA HASIL YANG KAN
DAHAK DAHAK TB ANGKYLOST DIBERI IMS OBATI HEPATITIS B DIOBATI VAKSIN
(+) TB OMA OMA (+) OBAT IMS (+) HEPATITIS B (+) HBig

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

0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
 LAPORAN KEMATIAN IBU
KABUPATEN : KONAWE SELATAN
PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023

SEBAB KEMATIAN IBU

JUMLAH GGN SISTEM

NO. NAMA DESA HIPERTENSI PEREDARAN GGN
KEMATIAN IBU PARTUS
PERDARAHAN DLM INFEKSI ABORTUS DARAH METABOLIK COVID 19
LAMA
KEHAMILAN (JANTUNG, (DM, DLL)
STROKE, DLL)
TOTAL - - - - - - - - -
1 Awunio 0 0 0 0 0 0 0 0 0
2 Lamotau 0 0 0 0 0 0 0 0 0
3 Mataiwoi 0 0 0 0 0 0 0 0 0
4 Andinete 0 0 0 0 0 0 0 0 0
5 Waworano 0 0 0 0 0 0 0 0 0
6 Alosi 0 0 0 0 0 0 0 0 0
7 Langgowala 0 0 0 0 0 0 0 0 0
8 Wawoosu 0 0 0 0 0 0 0 0 0
9 Sawah 0 0 0 0 0 0 0 0 0
10 Silea 0 0 0 0 0 0 0 0 0
11 Puudongi 0 0 0 0 0 0 0 0 0
12 Mondoe Jaya 0 0 0 0 0 0 0 0 0
13 Puupi 0 0 0 0 0 0 0 0 0
14 Tiraosu 0 0 0 0 0 0 0 0 0
15 Matandahi 0 0 0 0 0 0 0 0 0
16 Kolono 0 0 0 0 0 0 0 0 0
17 Meletumbo 0 0 0 0 0 0 0 0 0
18 Roda 0 0 0 0 0 0 0 0 0
19 Lamapu 0 0 0 0 0 0 0 0 0
20 Ulusena Jaya 0 0 0 0 0 0 0 0 0
21 Sarandua 0 0 0 0 0 0 0 0 0
22 UPT Roda 0 0 0 0 0 0 0 0 0
 DATA KEMATIAN
SAAT KEJADIAN (ISI 1 ATAU 0)
LAIN2
NAMA UMUR AGAMA ALAMAT PENYEBAB
HAMIL BERSALIN NIFAS
KET ( DI ISI NAMA
JUMLAH
PENYEBAB)

- - - - - - - - -
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
 DATA KEMATIAN
TEMPAT ( ISI 1 ATAU 0) PENOLONG( ISI 1 ATAU 0)
TENAGA KRSEHATAN NON TENAGA KESEHATAN
RUMAH WAKTU TANGGAL
RUMAH PUSKESMAS PERJALANAN
SAKIT
BIDAN PERAWAT DOKTER DUKUN KELUARGA

- - - - - - - - - - -
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
KABUPATEN : KONAWE SELATAN LAPORAN KEMATIAN NEO
PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023
Bayi (0-11 bln)
Kematian Neonatal
SEBAB KEMATIAN 0-6 HARI
NO NAMA PUSKESMAS ∑ Kematian 0-6 hari
Lain-lain
Tetanus Kelainan
BBLR Asfiksia Sepsis IKTERUS KET ( ISI NAMA
L P ∑ Absolut Neonaturum Bawaan JUMLAH
PENYEBAB

TOTAL 0 0 0 0 0 0 0 0 0 0
1 Awunio 0 0 0 0 0 0 0 0 0 0
1 Lamotau 0 0 0 0 0 0 0 0 0 0
3 Mataiwoi 0 0 0 0 0 0 0 0 0 0
4 Andinete 0 0 0 0 0 0 0 0 0 0
5 Waworano 0 0 0 0 0 0 0 0 0 0
6 Alosi 0 0 0 0 0 0 0 0 0 0
7 Langgowala 0 0 0 0 0 0 0 0 0 0
8 Wawoosu 0 0 0 0 0 0 0 0 0 0
9 Sawah 0 0 0 0 0 0 0 0 0 0
10 Silea 0 0 0 0 0 0 0 0 0 0
11 Puudongi 0 0 0 0 0 0 0 0 0 0
12 Mondoe Jaya 0 0 0 0 0 0 0 0 0 0
13 Puupi 0 0 0 0 0 0 0 0 0 0
14 Tiraosu 0 0 0 0 0 0 0 0 0 0
15 Matandahi 0 0 0 0 0 0 0 0 0 0
16 Kolono 0 0 0 0 0 0 0 0 0 0
17 Meletumbo 0 0 0 0 0 0 0 0 0 0
18 Roda 0 0 0 0 0 0 0 0 0 0
19 Lamapu 0 0 0 0 0 0 0 0 0 0
20 Ulusena Jaya 0 0 0 0 0 0 0 0 0 0
21 Sarandua 0 0 0 0 0 0 0 0 0 0
22 UPT Roda 0 0 0 0 0 0 0 0 0 0
 Bayi (0-11 bln)
Kematian Neonatal
∑ Kematian post neonatal (29 hr - 11
Sebab Kematian 7-28 Neonatal
∑ Kematian 7-28 hari bln)
Lain-lain
Jumlah Kematian Tetanus Kelainan
BBLR Asfiksia Sepsis IKTERUS
L P ∑ Absolut Neonatal Neonaturum Bawaan JUMLAH KET ( ISI NAMA PENYEBAB 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
 KEMATIAN POST NEONATAL
Sebab Kematian post neonatal ∑ Kematian Bayi (0-11 bln) (neonatal
Kematian post neonatal (29 hr - 11 + post neonatal)
bln)
Lain - lain
Kelainan
Kelainan KET ( ISI NAMA
Pneumonia Diare Saluran Tetanus Malaria
∑ Absolut Saraf JUMLAH PENYEBAB L P ∑ Absolut
Cerna
KEMATIAN
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
KABUPATEN : KONAWE SELATAN
PUSKESMAS : KOLONO
BULAN : APRIL
TAHUN : 2023
Anak Balita (12 - 59 bln)
∑ Kematian Anak Balita (12- Sebab Kematian Anak Balita
59 bulan) Demam Lain lain
NAMA DESA NAMA IBU
ISPA DIARE Malaria Campak Berdarah Difteri KET ( ISI
L P TOTAL JUMLAH ALAMAT /AYAH
Dengue PENYEBAB)
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0
1 Awunio 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Lamotau 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Mataiwoi 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Andinete 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Waworano 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Alosi 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Langgowala 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Wawoosu 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Sawah 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Silea 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Puudongi 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Mondoe Jaya 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Puupi 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Tiraosu 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Matandahi 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kolono 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Meletumbo 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Roda 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Lamapu 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Ulusena Jaya 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Sarandua 0 0 0 0 0 0 0 0 0 0 0 0 0
22 UPT Roda 0 0 0 0 0 0 0 0 0 0 0 0 0
 ∑ Kematian Anak (7-18 th)
DATA KEMATIAN ANAK BALITA
PEMERIKSAAN TEMPAT KEMATIAN ( ISI ANGKA 1 ATAU 0)
TANGGAL TANGGAL PUSTU/POLINDES/ L
JAM KELAHIRAN UMUR KEMATIAN RUMAH JALAN RUMAH SAKIT P TOTAL
KELAHIRAN KEMATIAN PUSKESMAS
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
 Sebab Kematian Anak 7 -18 th

Lain-lain
Kecelakaan Akibat Penyakit Penyakit
NAPZA HIV/ AIDS Bunuh Diri
transportasi kehamilan menular Tidak Menular KET (ISI
JUMLAH ALAMAT
PENYEBAB)
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
 DATA KEMATIAN ANAK BALITA
PEMERIKSAAN TEMPAT KEMATIAN ( ISI ANGKA 1 ATAU 0)
NAMA IBU /AYAH TANGGAL TANGGAL PUSTU/POLINDES/
JAM KELAHIRAN UMUR KEMATIAN RUMAH JALAN RUMAH SAKIT
KELAHIRAN KEMATIAN PUSKESMAS
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0