Kunjungan/kasus lama (kunjungan ke puskesmas lebih dari 1 kali)

Jumlah Kunjungan Menurut Golongan Umur Jumlah Jumlah

Kode
NO 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 Kunjungan Kunjungan 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

I 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 1 0 1 0 2 2 2
≤3/60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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
- Miopi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Hipermetropia 0 0 0 0 0 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 0 0 0 0 0
- Astigmatisme 0 0 0 0 0 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 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 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 0 0 0 0 0
f.
e.Retinopati of prematurity (ROP)
Lain-lain (sebutkan):-Dry Eyes 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 0 0 0 0 0 0 0 0 2 2 0 1 0 0 2 3 5
-OMA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. 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
f. Follow up pasca 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
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
< 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
< 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
II Jenis Gangguan Pendengaran dan Ketulian (H60-H95)
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 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 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 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 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 0 0 0 0 0
f. lain-lain (sebutkan): OMP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui: Ukui, April 2023

Kepala Puskesmas Pengelola program

ROSDIANA,SKM NURSADILA,AMK
(NIP.197501112006042007
 LAPORAN IND

Puskesmas : PUSKESMAS PANGKALAN KERINCI

Bulan : januari
Tahun : 2023

Kasus baru (kunjungan pertama kali ke puskesmas)

Kode
NO KEGIATAN 0-7 hr 8-28 hr 1-11 bn
ICD X
L P L P L

I Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)

a. Katarak: > 3/60 0 0 0 0 0
≤3/60 0 0 0 0 0
b. Kelainan Refraksi 0 0 0 0 0
- Miopi 0 0 0 0 0
- Hipermetropia 0 0 0 0 0
- Presbiopia 0 0 0 0 0
- Astigmatisme 0 0 0 0 0
c. Glaukoma 0 0 0 0 0
d. Retinopati Diabetikum 0 0 0 0 0
e. Low Vision 0 0 0 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0
e. Lain-lain (sebutkan):-Konjungtivitis 0 0 0 0 1

e. Jumlah operasi katarak 0 0 0 0 0

f. Follow up pasca operasi katarak 0 0 0 0 0
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0
< 6/60 0 0 0 0 0
II Jenis Gangguan Pendengaran dan Ketulian (H60-H95)

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

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

Kunjungan/kasus lama (kunjungan ke puskesmas lebih dari 1 kali)

Kode
NO KEGIATAN 0-7 hr 8-28 hr 1-11 bn
ICD X
L P L P L

I Jenis Gangguan Penglihatan dan Kebutaan (H00-H59)

a. Katarak: > 3/60 0 0 0 0 0
≤3/60 0 0 0 0 0
b. Kelainan Refraksi 0 0 0 0 0
- Miopi 0 0 0 0 0
- Hipermetropia 0 0 0 0 0
- Presbiopia 0 0 0 0 0
- Astigmatisme 0 0 0 0 0
c. Glaukoma 0 0 0 0 0
d. Retinopati Diabetikum 0 0 0 0 0
e. Low Vision 0 0 0 0 0
f. Retinopati of prematurity (ROP) 0 0 0 0 0
e. Lain-lain (sebutkan):-Dry Eyes
0 0 0 0 0
-Konjungtivitis 0 0 0 0 1
 -OMA 0 0 0 0 0
e. Jumlah operasi katarak 0 0 0 0 0
f. Follow up pasca operasi katarak 0 0 0 0 0
Tajam penglihatan: 6/12 - 6/18 0 0 0 0 0
< 6/18 - 6/60 0 0 0 0 0
< 6/60

II Jenis Gangguan Pendengaran dan Ketulian (H60-H95)

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

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

Mengetahui:
Kepala Puskesmas

KRISTINA SRI PURWATI,S.Sos

(NIP.19690317198811200)
 LAPORAN INDRA JANUARI Tahun 2023

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 >59 th
P L 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 1 0 0 0 1 0 1 0 5 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 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 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

Jumlah Kunjungan Menurut Golongan Umur

1-11 bn 1-4 th 5-9 th 10-14 th 15-19 tn 20-44 th 45-59 th >59 th
P L 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 1 0 0 0 1 0 1 0 5 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 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 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 1 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

Pangkalan Kerinci, Desember 2022

Pengelola program

NARTI JELITA,S.Tr.Keb
(Nip.198206272017052002)
 Jumlah Jumlah
kasus baru Kasus KET.
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
10 2 12 -

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

Jumlah Jumlah
Kunjungan Kunjungan KET.
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 10 10 -
 1 0 1 -
0 0 0
0 1 1
0 0 0 -
0 0 0

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

Kerinci, Desember 2022

JELITA,S.Tr.Keb
8206272017052002)