Form Laporan Lengkap PMB Churnia Amin Oktober, November, Desember 2021

LB3 MATERNAL (LB3KIA) TAHUN 2021
KAB/ KOTA : SIDOARJO

KECAMATAN : TANGGULANGIN
PUSKESMAS : TANGGULANGIN
BULAN : OKTOBER 2021
TRIBULAN : I (Satu)
Hb HB TM I HB TM 3 KEK Protein urin Gula Darah HIV Golongan darah Hbs Ag Sypilis
Jumlah Jumlah Anem Anem Anem
NO. DESA Bumil K1 Bumil K4 Diperik i Anem Diperi i Anem Diperi i Anem Diperi KE Diperi Positi Diperi GD Ditawa Diperi Diperik Diperik Posit Diperi
Posi
(pws kia) (pws kia) sa Hb (8- i ksa i ksa i ksa >140 (+) A B O AB tif
(8- (8- K ksa f (+) ksa ri ksa sa sa if (+) ksa
(<8) Hb (<8) Hb (<8) LiLA g/dl (+)
11) 11) 11)
1 2 1 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 Randegan 6 8 6 0 0 4 0 0 2 0 0 6 0 4 0 4 0 6 4 0 6 1 2 2 1 4 0 4 0
2 Kedensari 12 10 12 0 0 8 0 0 4 0 0 12 0 4 0 4 0 12 4 0 12 4 3 4 1 4 0 4 0
3 Kali sampurno 12 12 12 0 1 6 1 0 6 0 0 12 1 9 0 9 0 12 9 0 12 5 2 3 2 9 0 9 0
4 Ketapang 2 1 2 0 0 2 0 0 0 0 0 2 0 0 0 0 0 2 0 0 2 1 0 0 1 0 0 0 0
5 Kedung Bendo 0 0 0 0 0 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 Gempol Sari 5 4 5 0 0 5 0 0 0 0 0 5 0 6 0 6 0 5 6 0 5 1 1 2 1 6 0 6 0
7 Sentul 3 4 3 0 1 3 1 0 0 0 0 3 0 2 0 2 0 3 2 0 3 1 0 1 1 2 0 2 0
8 Penatar Sewu 10 5 10 0 0 8 0 0 2 0 0 10 0 5 0 5 0 10 5 0 10 3 1 2 4 5 0 5 0
9 Banjar Asri 4 4 4 0 0 4 0 0 0 0 0 4 0 2 0 2 0 4 2 0 4 1 1 1 1 2 0 2 0
10 Banjar Panji 3 0 3 0 0 3 0 0 0 0 0 3 0 1 0 1 0 3 1 0 3 1 1 0 1 1 0 1 0
11 Kedung Banteng 4 4 4 0 0 3 0 0 1 0 0 4 0 1 0 1 0 4 1 0 4 1 2 0 1 1 0 1 0
12 Kali Dawir 6 4 6 0 0 4 0 0 2 0 0 6 0 9 0 9 0 6 9 0 6 1 1 2 2 9 0 9 0
13 Putat 4 5 4 0 0 3 0 0 1 0 0 4 0 2 0 2 0 4 2 0 4 1 0 0 3 2 0 2 0
14 Ngaban 5 6 5 0 0 3 0 0 2 0 0 5 0 2 0 2 0 5 2 0 5 1 1 1 2 2 0 2 0
15 Kali Tengah 12 11 12 0 3 8 0 0 4 3 0 12 1 14 0 14 0 12 14 0 12 5 4 1 2 14 0 14 0
16 Kludan 6 6 6 0 1 4 1 0 2 0 0 6 0 4 0 4 0 6 4 0 6 0 3 2 1 4 0 4 0
17 Boro 6 5 6 0 1 4 0 0 2 1 0 6 1 3 0 3 0 6 3 0 6 4 1 1 0 3 0 3 0
18 Ketegan 7 6 7 0 0 4 0 0 3 0 0 7 1 2 0 2 0 7 2 0 7 1 2 2 2 2 0 2 0
19 Ganggang Panjang 8 7 8 0 0 5 0 0 3 0 0 8 0 5 0 5 0 8 5 0 8 2 2 2 2 5 0 5 0
20
TOTAL PUSK 115 102 115 0 7 81 3 0 34 4 0 115 4 75 0 75 0 115 75 0 115 34 27 26 28 75 0 75 0

BULAN : NOVEMBER 2021
TRIBULAN : I (Satu)
Posi
(<8) Hb (<8) Hb (<8) LiLA g/dl (+)
11) 11) 11)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 Randegan 3 5 3 1 0 2 0 0 1 1 0 3 0 3 0 3 0 3 6 0 3 1 1 0 1 6 0 6 0
2 Kedensari 9 9 9 0 0 9 0 0 0 0 0 9 1 9 0 9 0 9 8 0 9 2 3 3 1 8 0 8 0
3 Kali sampurno 11 12 11 1 0 10 0 0 1 1 0 11 0 11 0 11 0 11 10 0 11 2 3 4 2 10 0 10 0
4 Ketapang 0 0 0 1 0 0 0 0 1 1 0 0 1 0 0 0 0 0 3 0 0 0 0 0 0 3 0 3 0
5 Kedung Bendo 0 0 0 0 0 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 Gempol Sari 5 3 5 0 0 5 0 0 0 0 0 5 1 5 0 5 0 5 4 0 5 1 2 1 1 4 0 4 0
7 Sentul 6 3 6 1 0 6 0 0 0 0 0 6 0 6 0 6 0 6 3 0 6 2 0 2 2 3 0 3 0
8 Penatar Sewu 7 6 7 0 0 7 0 0 0 0 0 7 0 7 0 7 0 7 6 0 7 0 3 1 3 6 0 6 0
9 Banjar Asri 1 3 1 0 0 1 0 0 0 0 0 1 0 1 0 1 0 1 1 0 1 1 0 0 0 1 0 1 0
10 Banjar Panji 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
11 Kedung Banteng 2 4 2 1 0 3 1 0 0 0 0 2 1 2 0 2 0 2 2 0 2 1 0 1 0 2 0 2 0
12 Kali Dawir 4 3 4 2 0 2 0 0 0 1 0 4 0 4 0 4 0 4 4 0 4 1 2 0 1 4 0 4 0
13 Putat 4 1 4 0 0 1 0 0 0 0 0 4 0 4 0 4 0 4 2 0 4 1 1 1 1 2 0 2 0
14 Ngaban 3 4 3 0 0 3 0 0 0 0 0 3 1 3 0 3 0 3 3 0 3 1 1 0 1 3 0 3 0
15 Kali Tengah 16 13 16 0 0 10 0 0 6 0 0 16 0 16 0 16 0 16 16 0 16 5 5 1 5 16 0 16 0
16 Kludan 1 2 1 0 0 1 0 0 0 0 0 1 0 1 0 1 0 1 1 0 1 0 0 1 0 1 0 1 0
17 Boro 5 6 5 0 0 5 0 0 0 0 0 5 1 5 0 5 0 5 5 0 5 2 1 2 0 5 0 5 0
18 Ketegan 3 5 3 1 0 2 0 0 1 1 0 3 0 3 0 3 0 3 3 0 3 0 1 1 1 3 0 3 0
TOTAL KAB 86 86 86 9 0 71 1 0 12 6 0 86 6 86 0 86 0 86 83 0 86 22 26 19 19 83 0 83 0

BULAN : DESEMBER 2021
TRIBULAN : I (Satu)
NO. PUSKESMAS Bumil K1 Bumil K4 Diperik i Anem Diperi i Anem Diperi i Anem Diperi KE Diperi Positi Diperi GD Ditawa Diperi Diperik Diperik Posit Diperi
Posi
(<8) Hb (<8) Hb (<8) LiLA g/dl (+)
11) 11) 11)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 Randegan 6 5 6 1 0 6 1 0 0 0 0 6 0 6 0 6 0 6 3 0 6 1 2 2 1 6 0 6 0
2 Kedensari 10 11 10 1 0 10 1 0 0 0 0 10 1 10 0 10 0 10 9 0 10 2 3 3 2 10 0 10 0
3 Kali sampurno 8 8 8 0 0 8 0 0 0 0 0 8 0 8 0 8 0 8 5 0 8 2 2 3 1 8 0 8 0
4 Ketapang 4 3 4 0 0 4 0 0 0 0 0 4 0 4 0 4 0 4 1 0 4 1 1 1 1 4 0 4 0
5 Kedung Bendo 0 0 0 0 0 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 Gempol Sari 5 8 5 2 0 5 2 0 0 0 0 5 1 5 0 5 0 5 3 0 5 2 1 2 0 5 0 5 0
7 Sentul 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0
8 Penatar Sewu 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
9 Banjar Asri 8 0 8 1 0 8 1 0 0 0 0 8 0 8 0 8 0 8 4 0 8 2 2 3 1 8 0 8 0
10 Banjar Panji 2 0 2 0 0 2 0 0 0 0 0 2 0 2 0 2 0 2 2 0 2 1 1 0 0 2 0 2 0
11 Kedung Banteng 1 1 1 0 0 1 0 0 0 0 0 1 0 1 0 1 0 1 3 0 1 0 1 0 0 1 0 1 0
12 Kali Dawir 3 8 3 1 0 3 1 0 0 0 0 3 0 3 0 3 0 3 2 0 3 0 1 2 1 3 0 3 0
13 Putat 5 6 5 0 0 5 0 0 0 0 0 5 0 5 0 5 0 5 4 0 5 1 2 2 0 5 0 5 0
14 Ngaban 8 8 8 1 0 8 1 0 0 0 0 8 0 8 0 8 0 8 4 0 8 2 2 3 1 8 0 8 0
15 Kali Tengah 22 24 22 2 0 22 2 0 0 0 0 22 1 22 0 22 0 22 16 0 22 3 7 10 2 22 0 22 0
16 Kludan 8 8 8 0 0 8 0 0 0 0 0 8 0 8 0 8 0 8 4 0 8 1 2 3 2 8 0 8 0
17 Boro 4 8 4 1 0 4 1 0 0 0 0 4 0 4 0 4 0 4 6 0 4 2 2 0 0 4 0 4 0
18 Ketegan 8 8 8 0 0 8 0 0 0 0 0 8 0 8 0 8 0 8 1 0 8 0 4 4 0 8 0 8 0
20
TOTAL KAB 105 110 105 10 0 105 10 0 0 0 0 105 5 105 0 105 0 105 78 0 105 20 34 40 12 105 0 105 0

BULAN : OKTOBER-NOVEMBER-DESEMBER 2021
TRI BULAN : I (Satu)
Gula Darah
Hb HB TM I HB TM 3 KEK Protein urin HIV Golongan darah Hbs Ag Sypilis
(GD)
Posi
(<8) Hb (<8) Hb (<8) LiLA g/dl (+)
11) 11) 11)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 Randegan 15 2 0 12 1 0 3 3 0 15 0 #REF! 4 13 7 15 10 0 15 3 5 4 3 16 0 16 0
2 Kedensari 31 1 0 27 1 0 4 4 0 31 2 #REF! 4 23 13 31 22 0 31 8 9 10 4 22 0 22 0
3 Kali sampurno 31 1 1 24 1 0 7 7 0 31 1 #REF! 9 28 20 31 25 0 31 9 7 10 5 27 0 27 0
4 Ketapang 6 1 0 6 0 0 1 1 0 6 1 #REF! 0 4 0 6 1 0 6 2 1 1 2 7 0 7 0
5 Kedung Bendo 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 0
6 Gempol Sari 15 2 0 15 2 0 0 0 0 15 2 #REF! 6 16 11 15 14 0 15 4 4 5 2 15 0 15 0
7 Sentul 9 1 1 9 1 0 0 0 0 9 1 #REF! 2 8 8 9 14 0 9 3 0 3 3 5 0 5 0
8 Penatar Sewu 17 0 0 15 0 0 2 2 0 17 0 #REF! 5 12 12 17 15 0 17 3 4 3 7 11 0 11 0
9 Banjar Asri 13 1 0 13 1 0 0 0 0 13 0 #REF! 2 11 3 13 7 0 13 4 3 4 2 11 0 11 0
10 Banjar Panji 5 0 0 5 0 0 0 0 0 5 0 #REF! 1 3 1 5 3 0 5 2 2 0 1 3 0 3 0
11 Kedung Banteng 7 1 0 7 1 0 1 1 0 7 1 #REF! 1 4 3 7 6 0 7 2 3 1 1 4 0 4 0
12 Kali Dawir 13 3 0 9 1 0 2 3 0 13 0 #REF! 9 16 13 13 15 0 13 2 4 4 4 16 0 16 0
13 Putat 13 0 0 9 0 0 1 1 0 13 0 #REF! 2 11 6 13 10 0 13 3 3 3 4 9 0 9 0
14 Ngaban 16 1 0 14 1 0 2 2 0 16 1 #REF! 2 13 5 16 9 0 16 4 4 4 4 13 0 13 0
15 Kali Tengah 50 2 3 40 2 0 10 4 0 50 2 #REF! 14 52 30 50 46 0 50 13 16 12 9 52 0 52 0
16 Kludan 15 0 1 13 1 0 2 2 0 15 0 #REF! 4 13 5 15 9 0 15 1 5 6 3 13 0 13 0
17 Boro 15 1 1 13 1 0 2 2 0 15 2 #REF! 3 12 8 15 14 0 15 8 4 3 0 12 0 12 0
18 Ketegan 18 1 0 14 0 0 4 4 0 18 1 #REF! 2 13 5 18 6 0 18 1 7 7 3 13 0 13 0
19 Ganggang Panjang 17 1 0 12 0 0 5 4 0 17 1 #REF! 5 14 11 17 13 0 17 4 6 5 2 14 0 14 0
20
TOTAL PUSK 306 19 7 257 14 0 46 40 0 306 15 #REF! 75 266 161 306 239 0 306 76 87 85 59 263 0 263 0
DO/ Cara isi Diisi seluruh jumlah Diisi jumlah bumil Diisi jumlah bumil
Diisi sm dg di PWS bumil yg di periksa yg di periksa hb yg di periksa hb
hb tanpa melihat TM pada kunjungan 1 pada TM III (hsl bs
atau UK (K1) atau TM I cros cek dg K4)

TRIBULAN : III (TIGA)
KASUS MATERNAL YANG DITEMUKAN JENIS PERSALINAN

Hiper Abort PE/ Perdarahn Partus Infek HIV/ TB Mal Jant DM covi Kasus Lain - Normal SC Tindakan
Emesi us Ekla Keha Persa Nifa Lama si AIDS aria ung d Lain Drip VE/ Cure Plas
s mp milan linn s Total Ttl Persal
NO. DESA Kasus Forcp tage Man Persaln Dukun
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1 Randegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 3 0 0 0 0 3 0
2 Kedensari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 6 7 5 0 0 0 0 12 0
3 Kali sampurno 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 11 1 0 0 0 0 12 0
4 Ketapang 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 Kedung Bendo 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 Gempol Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 3 0
7 Sentul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 4 0 0 0 0 0 4 0
8 Penatar Sewu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 -1 3 0 0 0 0 2 0
9 Banjar Asri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0
10 Banjar Panji 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 2 0
11 Kedung Banteng 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 3 1 0 0 0 0 4 0
12 Kali Dawir 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1 0 0 0 0 4 0
13 Putat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 0 0 0 0 4 0
14 Ngaban 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 4 1 0 0 0 0 5 0
15 Kali Tengah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 12 0
16 Kludan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 3 0
17 Boro 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0
18 Ketegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 6 0
19 Ganggang Panjang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 3 1 0 0 0 0 4 0
20
TOTAL PUSK 0 0 1 0 0 0 0 0 0 0 0 0 0 0 24 25 66 19 0 0 0 0 85 0


Emesi us Ekla Keha Persa Nifa Lama si/ AIDS aria ung d Lain Drip VE/ Cure Plas
NO. DESA s mp milan linn s KPP Total Ttl Persal
Kasus Forcp tage Man Persaln Dukun
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1 Randegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1 0 0 0 0 4 0
2 Kedensari 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 10 1 0 0 0 0 11 0
3 Kali sampurno 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3 0 0 0 0 7 0
4 Ketapang 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 Kedung Bendo 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 Gempol Sari 0 0 0 0 0 0 0 1 0 0 0 0 0 0 Postdate 2 5 2 0 0 0 0 7 0
7 Sentul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0
8 Penatar Sewu 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 2 2 0 0 0 0 4 0
9 Banjar Asri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 3 2 0 0 0 0 5 0
10 Banjar Panji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
11 Kedung Banteng 0 0 0 0 0 0 0 2 0 0 0 0 0 0 HbsAg (+) 3 1 4 0 0 0 0 5 0
12 Kali Dawir 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 2 1 0 0 0 0 3 0
13 Putat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0
14 Ngaban 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 2 1 0 0 0 0 3 0
15 Kali Tengah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Postdate 1 11 7 0 0 0 0 18 0
16 Kludan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 6 0
Boro Plasenta 3
17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 previa 1 2 1 0 0 0 0 0
18 Ketegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0
19 Ganggang Panjang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 10 0
20
TOTAL PUSK 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 13 74 25 0 0 0 0 99 0


Emesi us Ekla Keha Persa Nifa Lama si/ AIDS aria ung d Lain Drip VE/ Cure Plas
NO. DESA s mp milan linn s kpp Total Ttl Persal
Kasus Forcp tage Man Persaln Dukun
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1 Randegan 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 Kedensari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 2 0 0 0 0 8 0
3 Kali sampurno 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 0 0 0 0 9 0
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0
5 Kedung Bendo 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 Gempol Sari 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 4 1 0 0 0 0 5 0
7 Sentul 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 3 6 2 0 0 0 0 8 0
8 Penatar Sewu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 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 Banjar Panji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 2 0
11 Kedung Banteng 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 2 1 0 0 0 0 3 0
12 Kali Dawir 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 (bblr) 3 6 2 0 0 0 0 8 0
13 Putat 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 3 0 0 0 0 0 3 0
14 Ngaban 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 3 8 2 0 0 0 0 10 0
15 Kali Tengah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 6 0 0 0 0 20 0
16 Kludan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
17 Boro 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 0 0 0 0 8 0
18 Ketegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 4 0 0 0 0 9 0
19 Ganggang Panjang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 (BBLR) 1 6 2 0 0 0 0 8 0
20
TOTAL PUSK 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 13 74 30 0 0 0 0 104 0



Hiper Abort PE/ Perdarahn Partus Infek HIV/ TB Mal Jant DM covi Kasus Lain - Total Normal SC Tindakan Ttl Persal
NO. DESA Emesi us Ekla Keha Persa Nifa Lama si AIDS aria ung d Lain Kasus Drip VE/ Cure Plas Persaln Dukun
s mp milan linn s Forcp tage Man
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1 Randegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 6 4 0 0 0 0 10 0
2 Kedensari 0 0 0 0 0 0 0 1 0 0 0 0 0 0 6 7 28 8 0 0 0 0 36 0
3 Kali sampurno 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 22 7 0 0 0 0 29 0
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0
5 Kedung Bendo 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 Gempol Sari 0 0 0 0 0 0 0 2 0 0 0 0 0 0 #VALUE! ### 12 3 0 0 0 0 15 0
7 Sentul 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 4 12 2 0 0 0 0 14 0
8 Penatar Sewu 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 5 4 5 0 0 0 0 9 0
9 Banjar Asri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 4 3 2 0 0 0 0 5 0
10 Banjar Panji 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 4 2 0 0 0 0 6 0
11 Kedung Banteng 0 0 0 0 0 0 0 3 0 0 0 0 0 0 #VALUE! ### 7 6 0 0 0 0 13 0
12 Kali Dawir 0 0 0 0 0 0 0 3 0 0 0 0 0 0 #VALUE! ### 12 4 0 0 0 0 16 0
13 Putat 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 3 12 2 0 0 0 0 14 0
14 Ngaban 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1 5 15 4 0 0 0 0 19 0
15 Kali Tengah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #VALUE! ### 37 13 0 0 0 0 50 0
16 Kludan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 10 0
17 Boro 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #VALUE! ### 11 5 0 0 0 0 16 0
18 Ketegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 4 0 0 0 0 20 0
19 Ganggang Panjang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #VALUE! ### 20 3 0 0 0 0 23 0
20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0
TOTAL PUSK 0 0 1 0 0 0 0 20 0 0 0 0 0 0 #VALUE! ### 233 74 0 0 0 0 307 0
DO/ Cara isi Diisi jml Isian di kolom jenis persalinan harap di cek dg hasil yang di
bumil yg sdh PWS
dinyatakan
sakit tsb :
jantung, DM
dan covid

Jumlah Bayi Jumlah Bayi di TOTAL KASUS

Lahir Hidup KASUS NEONATAL YANG DITEMUKAN
Prematur SHK
NO. DESA Trauma Lahir Asfiksia BBLR < 2500 gr Infeksi TN Kel Bawaan HK (+) COVID19 Lain-Lain
L P TTL
L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 2 1 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 0 0 0 0 0 0 0 0 0 0 0
2 Kedensari 7 5 12 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
3 Kali sampurno 6 6 12 6 6 12 1 0 1 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 1 0 1
4 Ketapang 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 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 Kedung Bendo 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 2 1 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 0 0 0 0 0 0 0 0 0 0 0
7 Sentul 2 2 4 2 2 4 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
8 Penatar Sewu 2 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
9 Banjar Asri 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 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 Banjar Panji 1 1 2 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
11 Kedung Banteng 2 2 4 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
12 Kali Dawir 2 2 4 2 2 4 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 1 1
13 Putat 2 2 4 2 2 4 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 1 0 1
14 Ngaban 3 2 5 3 2 5 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
15 Kali Tengah 7 5 12 7 5 12 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
16 Kludan 2 1 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 0 0 0 0 0 0 0 0 0 0 0
17 Boro 3 2 5 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
18 Ketegan 3 3 6 3 3 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
19 Ganggang Panjang 2 2 4 2 2 4 1 1 2 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 1 0 1
20
Puskesmas 48 37 85 48 37 85 4 4 8 0 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 3 1 4

Jumlah Bayi TOTAL KASUS

Lahir Hidup
Prematur
Jumlah Bayi di SHK KASUS NEONATAL YANG DITEMUKAN
NO. Puskesmas
L P TTL Trauma Lahir Asfiksia BBLR < 2500 gr Infeksi/KPP TN Kel Bawaan HK (+) COVID19 Lain-Lain
L P TTL L P TTL
L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 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
2 Kedensari 4 7 11 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 1
3 Kali sampurno 4 3 7 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 1 1 2 2 1 3
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 1 6 7 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 2 2 1 2 3
7 Sentul 1 1 2 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
8 Penatar Sewu 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 0
9 Banjar Asri 3 2 5 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 2 1 3
10 Banjar Panji 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
11 Kedung Banteng 2 3 5 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 1 0 1 1 1 2
12 Kali Dawir 1 2 3 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 1
13 Putat 4 1 5 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
14 Ngaban 2 1 3 0 0 0 0 1 1 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 1 0 1
15 Kali Tengah 8 10 18 0 0 0 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 1 3 4 2 4 6
16 Kludan 3 3 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
17 Boro 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
18 Ketegan 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
20
Puskesmas 43 56 99 0 0 0 1 3 4 0 0 0 0 0 0 0 0 0 6 5 11 0 0 0 0 0 0 0 0 0 0 0 0 3 6 9 9 11 20

Jumlah Bayi TOTAL KASUS

Lahir Hidup
Prematur
NO. Puskesmas
L P TTL Trauma Lahir Asfiksia BBLR < 2500 gr Infeksi TN Kel Bawaan HK (+) COVID19 Lain-Lain
L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Kedensari 3 5 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
3 Kali sampurno 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
4 Ketapang 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
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 5 0 5 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 1 0 1
7 Sentul 5 5 10 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 2 1 3
8 Penatar Sewu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Banjar Panji 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
11 Kedung Banteng 4 2 6 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 1
12 Kali Dawir 2 3 5 0 0 0 0 1 1 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 1 2 3
13 Putat 2 0 2 0 0 0 0 1 1 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 1 0 1
14 Ngaban 8 2 10 0 0 0 1 0 1 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 2 1 3
15 Kali Tengah 12 10 22 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
16 Kludan 6 1 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
17 Boro 5 0 5 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
18 Ketegan 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
20
Puskesmas 61 43 104 0 0 0 4 7 11 0 0 0 0 0 0 0 2 2 7 4 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 6 13

NO. Puskesmas Jumlah Bayi TOTAL KASUS

Lahir Hidup
Prematur
L P TTL Trauma Lahir Asfiksia BBLR < 2500 gr Infeksi TN Kel Bawaan HK (+) COVID19 Lain-Lain
L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 2 5 7 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
2 Kedensari 11 12 23 7 5 12 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 1
3 Kali sampurno 10 9 19 6 6 12 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 3 1 4
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 3 7 10 2 1 3 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 2 2 1 2 3
7 Sentul 3 3 6 2 2 4 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
8 Penatar Sewu 5 1 6 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
9 Banjar Asri 3 2 5 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 2 1 3
10 Banjar Panji 1 2 3 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
11 Kedung Banteng 4 5 9 2 2 4 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 1 0 1 1 1 2
12 Kali Dawir 3 4 7 2 2 4 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
13 Putat 6 3 9 2 2 4 1 0 1 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 1 0 1
14 Ngaban 5 3 8 3 2 5 0 2 2 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 1 0 1
15 Kali Tengah 15 15 30 7 5 12 1 2 3 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0 1 3 4 2 4 6
16 Kludan 5 4 9 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
17 Boro 4 4 8 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
18 Ketegan 6 5 11 3 3 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
20
Puskesmas 91 93 184 48 37 85 5 7 12 0 0 0 0 0 0 3 1 4 6 5 11 0 0 0 0 0 0 0 0 0 0 0 0 3 6 9 12 12 24
LAPORAN BAYI (LB3KIA) TAHUN 2021

BAYI
Jumlah Penyimpangan SDIDTK Jumlah yang
NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK 4x LKA tidak MME mungkin
Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi TDL gangguan TDD gangguan Dirujuk
normal ada gangguan
L P Ttl L P Ttl L P Ttl L P TTL L P TTL L P TTL L P TTL Lkemandirian
P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 38 37 75 32 28 60 28 24 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 0 0
2 Kedensari 63 62 125 56 55 111 50 47 97 0 0 0 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 Kali sampurno 67 66 133 61 57 118 49 47 96 0 0 0 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 Ketapang 13 13 26 9 8 17 8 7 15 0 0 0 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 Kedung Bendo - - 0 0 0 0 0 0 0 0 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 Gempol Sari 36 36 72 33 32 65 28 27 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
7 Sentul 30 29 59 22 26 48 18 22 40 0 0 0 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 Penatar Sewu 25 25 50 16 25 41 14 23 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 19 19 38 23 16 39 23 16 39 0 0 0 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 Banjar Panji 13 13 26 11 12 23 10 10 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 25 50 21 23 44 18 21 39 0 0 0 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 Kali Dawir 37 37 74 32 32 64 29 30 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
13 Putat 28 28 56 26 20 46 26 17 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 0
14 Ngaban 44 43 87 37 36 73 32 31 63 0 0 0 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 Kali Tengah 104 103 207 88 85 173 78 73 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 34 69 28 27 55 24 23 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
17 Boro 38 38 76 31 31 62 28 28 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 38 38 76 34 32 66 26 27 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 42 41 83 34 36 70 30 31 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 695 687 1382 594 581 1175 519 504 1023 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAYI
NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK 4x MME mungkin
LKA tidak normal Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi TDL gangguan TDD gangguan Dirujuk
ada gangguan
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 38 37 75 32 31 63 28 28 56 0 0 0 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 Kedensari 63 62 125 52 51 103 50 47 97 0 0 0 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 Kali sampurno 67 66 133 53 63 116 49 57 106 0 0 0 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 Ketapang 13 13 26 9 12 21 9 12 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
5 Kedung Bendo - - 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 36 36 72 29 32 61 28 32 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
7 Sentul 30 29 59 24 26 50 22 26 48 0 0 0 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 Penatar Sewu 25 25 50 18 25 43 16 25 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 19 19 38 23 16 39 23 16 39 0 0 0 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 Banjar Panji 13 13 26 11 12 23 11 12 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 25 50 21 23 44 21 23 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
12 Kali Dawir 37 37 74 33 33 66 32 32 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 28 28 56 26 20 46 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
14 Ngaban 44 43 87 39 39 78 37 36 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
15 Kali Tengah 104 103 207 94 92 186 88 85 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 34 69 29 28 57 28 27 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
17 Boro 38 38 76 31 31 62 31 31 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 38 38 76 34 32 66 34 32 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 695 687 1382 594 602 1196 567 577 1144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAYI
Jumlah Dilakukan Jumlah Penyimpangan SDIDTK Jumlah yang
NO. DESA SASARAN SDIDTK pertama MME mungkin
SDIDTK LKA tidak normal Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi TDL gangguan TDD gangguan Dirujuk
kemandirian ada gangguan
L P Ttl L P Ttl L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 38 37 75 35 35 70 32 31 63 0 0 0 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 Kedensari 63 62 125 60 56 116 52 51 103 0 0 0 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 Kali sampurno 67 66 133 59 63 122 53 63 116 0 0 0 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 Ketapang 13 13 26 11 12 23 9 12 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
5 Kedung Bendo - - 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 36 36 72 33 33 66 29 32 61 0 0 0 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 Sentul 30 29 59 27 29 56 24 26 50 0 0 0 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 Penatar Sewu 25 25 50 23 25 48 18 25 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 0
9 Banjar Asri 19 19 38 23 16 39 23 16 39 0 0 0 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 Banjar Panji 13 13 26 11 14 25 11 12 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 25 50 21 26 47 21 23 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
12 Kali Dawir 37 37 74 33 33 66 33 33 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 28 28 56 26 26 52 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
14 Ngaban 44 43 87 42 40 82 39 39 78 0 0 0 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 Kali Tengah 104 103 207 97 93 190 94 92 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 34 69 33 32 65 29 28 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 38 38 76 37 37 74 31 31 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 38 38 76 41 37 78 34 32 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 695 687 1382 658 651 1309 594 602 1196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

BULAN :OKTOBER-NOVEMBER-DESEMBER 2021
BAYI
Jumlah Penyimpangan SDIDTK
SASARAN SDIDTK pertama Dpt SDIDTK 4x Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi MME mungkin ada
LKA tidak normal kemandirian TDL gangguan TDD gangguan Jumlah yang
NO. DESA gangguan Dirujuk
L P Ttl L P Ttl L P Ttl L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kedensari 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali sampurno 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Ketapang 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kedung Bendo 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Gempol Sari 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Sentul 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Penatar Sewu 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Banjar Panji 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali Dawir 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali Tengah 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 ANAK BALITA (LB3KIA) TAHUN 2021

ANAK BALITA
NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK 2x LKA tidak Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi TDL gangguan TDD gangguan MME mungkin Dirujuk
normal ada gangguan
L P Ttl L P Ttl L P Ttl L P TTL L P TTL L P TTL L P TTL kemandirian
L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
1 Randegan 191 185 376 28 27 55 122 121 243 0 0 0 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 Kedensari 317 307 624 46 46 92 193 176 369 0 0 0 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 Kali sampurno 335 325 660 50 49 99 250 246 496 0 0 0 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 Ketapang 64 62 126 10 8 18 37 55 92 0 0 0 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 Kedung Bendo 0 0 0 0 0 0 0 - 0 0 0 0 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 Gempol Sari 183 177 360 27 26 53 98 85 183 0 0 0 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 Sentul 150 145 295 20 18 38 112 108 220 0 0 0 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 Penatar Sewu 128 124 252 16 21 37 96 91 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 95 92 187 14 20 34 89 91 180 0 0 0 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 Banjar Panji 64 64 128 8 5 13 44 46 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 126 122 248 19 21 40 100 74 174 0 0 0 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 Kali Dawir 188 182 370 26 26 52 111 109 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 141 137 278 19 20 39 80 88 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 227 220 447 29 28 57 127 140 267 0 0 0 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 Kali Tengah 522 506 1028 74 74 148 301 315 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 175 169 344 28 27 55 101 112 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 192 186 378 28 24 52 105 118 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 192 186 378 29 28 57 76 114 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 3499 3392 6891 504 499 1003 2161 2212 4373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ANAK BALITA
normal ada gangguan
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 191 185 376 129 129 258 126 125 251 0 0 0 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 Kedensari 317 307 624 214 194 408 199 184 383 0 0 0 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 Kali sampurno 335 325 660 277 266 543 262 256 518 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
4 Ketapang 64 62 126 38 56 94 38 56 94 0 0 0 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 Kedung Bendo - - 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 183 177 360 99 91 190 98 85 183 0 0 0 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 Sentul 150 145 295 112 108 220 112 108 220 0 0 0 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 Penatar Sewu 128 124 252 96 91 187 96 91 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 95 92 187 89 91 180 89 91 180 0 0 0 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 Banjar Panji 64 64 128 45 46 91 44 46 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 126 122 248 100 74 174 100 74 174 0 0 0 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 Kali Dawir 188 182 370 113 111 224 111 109 220 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
13 Putat 141 137 278 86 92 178 80 88 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 227 220 447 147 155 302 132 145 277 0 0 0 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 Kali Tengah 522 506 1028 334 345 679 311 327 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 175 169 344 113 121 234 105 116 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 192 186 378 115 125 240 108 121 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 192 186 378 92 123 215 84 119 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 3499 3392 6891 2329 2350 4679 2218 2269 4487 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

ANAK BALITA
normal ada gangguan
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 191 185 376 147 146 293 147 146 293 0 0 0 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 Kedensari 317 307 624 250 225 475 243 220 463 0 0 0 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 Kali sampurno 335 325 660 262 256 518 262 256 518 0 0 0 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 Ketapang 64 62 126 44 58 102 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
5 Kedung Bendo - - 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 183 177 360 146 138 284 138 130 268 0 0 0 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 Sentul 150 145 295 112 108 220 112 108 220 0 0 0 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 Penatar Sewu 128 124 252 96 91 187 96 91 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 95 92 187 89 91 180 89 91 180 0 0 0 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 Banjar Panji 64 64 128 49 53 102 49 51 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 126 122 248 113 102 215 108 102 210 0 0 0 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 Kali Dawir 188 182 370 141 132 273 141 132 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 141 137 278 116 103 219 116 103 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 227 220 447 177 185 362 162 175 337 0 0 0 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 Kali Tengah 522 506 1028 397 399 796 377 389 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 175 169 344 132 140 272 132 140 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 192 186 378 143 151 294 143 151 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 192 186 378 143 168 311 132 165 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 3499 3392 6891 2708 2701 5409 2640 2661 5301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ANAK BALITA
SASARAN SDIDTK pertama Dpt SDIDTK 2x LKA tidak Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi MME mungkin
NO. DESA normal kemandirian TDL gangguan TDD gangguan ada gangguan Jumlah yang
Dirujuk
L P Ttl L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
1 Randegan 573 555 1,128 #REF! #REF! 606 #REF! #REF! 787 0 0 0 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 Kedensari 951 921 1,872 #REF! #REF! 975 #REF! #REF! 1215 0 0 0 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 Kali sampurno 1,005 975 1,980 #REF! #REF! 1160 #REF! #REF! 1532 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
4 Ketapang 192 186 378 #REF! #REF! 214 #REF! #REF! 284 0 0 0 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 Kedung Bendo - - - #REF! #REF! 0 #REF! #REF! 0 0 0 0 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 Gempol Sari 549 531 1,080 #REF! #REF! 527 #REF! #REF! 634 0 0 0 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 Sentul 450 435 885 #REF! #REF! 478 #REF! #REF! 660 0 0 0 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 Penatar Sewu 384 372 756 #REF! #REF! 411 #REF! #REF! 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 285 276 561 #REF! #REF! 394 #REF! #REF! 540 0 0 0 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 Banjar Panji 192 192 384 #REF! #REF! 206 #REF! #REF! 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 378 366 744 #REF! #REF! 429 #REF! #REF! 558 0 0 0 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 Kali Dawir 564 546 1,110 #REF! #REF! 549 #REF! #REF! 713 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
13 Putat 423 411 834 #REF! #REF! 436 #REF! #REF! 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 681 660 1,341 #REF! #REF! 721 #REF! #REF! 881 0 0 0 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 Kali Tengah 1,566 1,518 3,084 #REF! #REF! 1623 #REF! #REF! 2020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 525 507 1,032 #REF! #REF! 561 #REF! #REF! 706 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 576 558 1,134 #REF! #REF! 586 #REF! #REF! 746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 576 558 1,134 #REF! #REF! 583 #REF! #REF! 690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 627 609 1,236 #REF! #REF! 632 #REF! #REF! 799 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 10497 10176 20673 #REF! #REF! 11091 #REF! #REF! 14161 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
LAPORAN APRAS (LB3KIA) TAHUN 2021

ANAK PRA SEKOLAH

NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK 2x LKA tidak Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi MME mungkin Jumlah yang
normal TDL gangguan TDD gangguan ada gangguan Dirujuk
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 38 36 74 0 63 #REF! 0 0 0 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 Kedensari 63 60 123 102 #REF! 0 0 0 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 Kali sampurno 67 64 131 109 #REF! 0 0 0 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 Ketapang 13 12 25 20 #REF! 0 0 0 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 Kedung Bendo 0 0 0 0 #REF! 0 0 0 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 Gempol Sari 37 35 72 61 #REF! 0 0 0 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 Sentul 30 29 59 50 #REF! 0 0 0 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 Penatar Sewu 26 24 50 44 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 19 18 37 34 #REF! 0 0 0 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 Banjar Panji 13 12 25 22 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 24 49 41 #REF! 0 0 0 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 Kali Dawir 38 36 74 62 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 28 27 55 46 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 44 44 88 74 #REF! 0 0 0 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 Kali Tengah 104 100 204 169 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 33 68 58 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 38 37 75 65 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 38 37 75 62 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 42 40 82 68 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 698 668 1366 0 0 1150 0 0 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


ANAK PRA SEKOLAH

NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK x LKA tidak Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi MME mungkin
TDL gangguan TDD gangguan Dirujuk
normal ada gangguan
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 0 0 0 0 0 0 0 0 0 0 0 0
2 Kedensari 0 0 0 0 0 0 0 0 0 0 0 0
3 Kali sampurno 0 0 0 0 0 0 0 0 0 0 0 0
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 0 0 0 0 0 0 0 0 0 0 0 0
7 Sentul 0 0 0 0 0 0 0 0 0 0 0 0
8 Penatar Sewu 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 0 0 0 0 0 0 0 0 0 0 0 0
10 Banjar Panji 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 0 0 0 0 0 0 0 0 0 0 0 0
12 Kali Dawir 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 0 0 0 0 0 0 0 0 0 0 0 0
15 Kali Tengah 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 0 0 0 0 0 0 0 0 0 0 0 0
20
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

ANAK PRA SEKOLAH

NO. DESA SASARAN SDIDTK pertama Dpt SDIDTK 2x LKA tidak Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi MME mungkin
TDL gangguan TDD gangguan Dirujuk
normal ada gangguan
1 2 3 4 5 6 7 8 9 10 11 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
1 Randegan 38 36 74 33 30 63 30 28 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
2 Kedensari 63 60 123 48 54 102 44 50 94 0 0 0 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 Kali sampurno 67 64 131 57 52 109 52 49 101 0 0 0 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 Ketapang 13 12 25 11 9 20 10 8 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
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 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 Gempol Sari 37 35 72 34 27 61 30 27 57 0 0 0 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 Sentul 30 29 59 26 24 50 24 20 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
8 Penatar Sewu 26 24 50 21 23 44 17 23 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 19 18 37 14 20 34 14 20 34 0 0 0 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 Banjar Panji 13 12 25 12 10 22 11 8 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 24 49 20 21 41 19 21 40 0 0 0 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 Kali Dawir 38 36 74 30 32 62 27 28 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
13 Putat 28 27 55 25 21 46 23 20 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 0
14 Ngaban 44 44 88 39 35 74 33 31 64 0 0 0 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 Kali Tengah 104 100 204 85 84 169 82 79 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 33 68 30 28 58 27 25 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 0 0
17 Boro 38 37 75 33 32 65 30 29 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
18 Ketegan 38 37 75 32 30 62 29 27 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 698 668 1366 585 565 1150 524 522 1046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ANAK PRA SEKOLAH
Motorik Kasar Motorik Halus Bicara Bahasa Sosialisasi Dirujuk
SASARAN SDIDTK pertama Dpt SDIDTK 2x MME mungkin
LKA tidak normal kemandirian TDL gangguan TDD gangguan ada gangguan
NO. DESA
L P Ttl L P Ttl L P Ttl L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL L P TTL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
1 Randegan 38 36 74 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kedensari 63 60 123 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali sampurno 67 64 131 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Ketapang 13 12 25 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kedung Bendo 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Gempol Sari 37 35 72 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Sentul 30 29 59 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Penatar Sewu 26 24 50 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Banjar Asri 19 18 37 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Banjar Panji 13 12 25 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Kedung Banteng 25 24 49 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali Dawir 38 36 74 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Putat 28 27 55 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Ngaban 44 44 88 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 Kali Tengah 104 100 204 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Kludan 35 33 68 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Boro 38 37 75 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ketegan 38 37 75 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ganggang Panjang 42 40 82 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20
Puskesmas 698 668 1366 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 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 PWS KIA (INDIKATOR KESEHATAN ANAK)
BULAN : OKTOBER
TAHUN : 2021
SASARAN LAHIR HIDUP RIIL KN 1
LAHIR MATI
15% Kelahiran PENCAPAIAN
NO DESA/ KELURAHAN Kelahiran Hidup KUMULATIF
Hidup(ByRisti) BULAN INI BULAN INI BULAN LALU BULAN INI
L P Total L P Total L P Total L P Total L P Total L P Total L % P % ABS %
1 Randegan 36 36 72 5 5 10.8 2 1 3 0 0 0 1 3 4 2 1 3 33 91.667 37 102.78 70 97.222
2 Kedensari 60 60 120 9 9 18 7 5 12 0 0 0 5 6 11 7 5 12 55 91.667 42 70 97 80.833
3 Kali sampurno 64 63 127 10 9 19.05 6 6 12 0 0 0 5 15 20 6 6 12 53 82.813 53 84.127 106 83.465
4 Ketapang 12 12 24 2 2 3.6 0 0 0 0 0 0 1 2 3 0 0 0 1 8.3333 5 41.667 6 25
5 Kedung Bendo - - 0 - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 35 35 70 5 5 10.5 2 1 3 0 0 0 4 6 10 2 1 3 25 71.429 28 80 53 75.714
7 Sentul 29 28 57 4 4 8.55 2 2 4 0 0 0 2 6 8 2 2 4 20 68.966 22 78.571 42 73.684
8 Penatar Sewu 24 24 48 4 4 7.2 2 0 2 0 0 0 1 4 5 2 0 2 22 91.667 24 100 46 95.833
9 Banjar Asri 18 18 36 3 3 5.4 0 0 0 0 0 0 0 1 1 0 0 0 15 83.333 18 100 33 91.667
10 Banjar Panji 12 12 24 2 2 3.6 1 1 2 0 0 0 2 4 6 1 1 2 9 75 14 116.67 23 95.833
11 Kedung Banteng 24 24 48 4 4 7.2 2 2 4 0 0 0 2 4 6 2 2 4 17 70.833 24 100 41 85.417
12 Kali Dawir 36 36 72 5 5 10.8 2 2 4 0 0 0 5 5 10 2 2 4 27 75 31 86.111 58 80.556
13 Putat 27 27 54 4 4 8.1 2 2 4 0 0 0 3 3 6 2 2 4 23 85.185 23 85.185 46 85.185
14 Ngaban 43 42 85 6 6 12.75 3 2 5 0 0 0 8 8 16 3 2 5 33 76.744 36 85.714 69 81.176
15 Kali Tengah 100 99 199 15 15 29.85 7 5 12 0 0 0 10 10 20 7 5 12 78 78 74 74.747 152 76.382
16 Kludan 33 33 66 5 5 9.9 2 1 3 0 0 0 2 4 6 2 1 3 31 93.939 28 84.848 59 89.394
17 Boro 37 36 73 6 5 10.95 3 2 5 0 0 0 3 6 9 3 2 5 22 59.459 36 100 58 79.452
18 Ketegan 37 36 73 6 5 10.95 3 3 6 0 0 0 4 5 9 3 3 6 25 67.568 31 86.111 56 76.712
19 Ganggang Panjang 40 40 80 6 6 12 2 2 4 0 0 0 3 3 6 1 2 3 33 82.5 26 65 59 73.75
20 - -
Total Puskesmas 667 661 1328 100.05 99.15 199.2 48 37 85 0 0 0 61 95 156 47 37 84 522 78.261 552 83.51 1074 80.873
UNIT LAIN WIL KAB
LUAR WIL PUSK.WIL.KAB/
TOTAL BULAN INI 667 661 1328 100.05 99.15 199.2 48 37 85 0 0 0 61 95 156 47 37 84 522 78.261 552 83.51 1074 80.873
LUAR WIL PUSK LUAR.WIL
BULAN : OKTOBER
TAHUN : 2021
KN 2 KN 3 (Lengkap)
SASARAN Kelahiran
PENCAPAIAN PENCAPAIAN
NO DESA/ KELURAHAN Hidup KUMULATIF KUMULATIF
BULAN LALU BULAN INI BULAN LALU BULAN INI
L P Total L P Total L P Total L % P % ABS % L P Total L P Total L % P % ABS %
1 Randegan 36 36 72 1 3 4 2 1 3 32 88.8888889 36 100 70 97.22222 1 3 4 2 1 3 32 88.88889 36 100 68 94.444444
2 Kedensari 60 60 120 5 6 11 7 5 12 56 93.3333333 42 70 97 80.83333 5 6 11 7 5 12 56 93.33333 42 70 98 81.666667
3 Kali sampurno 64 63 127 5 15 20 6 6 12 51 79.6875 55 87.301587 106 83.46457 5 15 20 6 6 12 51 79.6875 55 87.30159 106 83.464567
4 Ketapang 12 12 24 1 2 3 0 0 0 1 8.33333333 5 41.666667 6 25 1 2 3 0 0 0 1 8.333333 5 41.66667 6 25
5 Kedung Bendo - - 0 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 Gempol Sari 35 35 70 4 6 10 2 1 3 25 71.4285714 28 80 53 75.71429 4 6 10 2 1 3 25 71.42857 28 80 53 75.714286
7 Sentul 29 28 57 2 6 8 2 2 4 20 68.9655172 22 78.571429 42 73.68421 2 6 8 2 2 4 20 68.96552 22 78.57143 42 73.684211
8 Penatar Sewu 24 24 48 1 4 5 2 0 2 22 91.6666667 23 95.833333 46 95.83333 1 4 5 2 0 2 22 91.66667 23 95.83333 45 93.75
9 Banjar Asri 18 18 36 0 1 1 0 0 0 15 83.3333333 18 100 33 91.66667 0 1 1 0 0 0 15 83.33333 18 100 33 91.666667
10 Banjar Panji 12 12 24 2 4 6 1 1 2 9 75 13 108.33333 23 95.83333 2 4 6 1 1 2 9 75 13 108.3333 22 91.666667
11 Kedung Banteng 24 24 48 2 4 6 2 2 4 17 70.8333333 24 100 41 85.41667 2 4 6 2 2 4 17 70.83333 24 100 41 85.416667
12 Kali Dawir 36 36 72 5 5 10 2 2 4 27 75 32 88.888889 58 80.55556 5 5 10 2 2 4 27 75 32 88.88889 59 81.944444
13 Putat 27 27 54 3 3 6 2 2 4 24 88.8888889 22 81.481481 46 85.18519 3 3 6 2 2 4 24 88.88889 22 81.48148 46 85.185185
14 Ngaban 43 42 85 8 8 16 3 2 5 33 76.744186 36 85.714286 69 81.17647 8 8 16 3 2 5 33 76.74419 36 85.71429 69 81.176471
15 Kali Tengah 100 99 199 10 10 20 7 5 12 78 78 75 75.757576 152 76.38191 10 10 20 7 5 12 78 78 74 74.74747 152 76.38191
16 Kludan 33 33 66 2 4 6 2 1 3 31 93.9393939 28 84.848485 59 89.39394 2 4 6 2 1 3 31 93.93939 28 84.84848 59 89.393939
17 Boro 37 36 73 3 6 9 3 2 5 22 59.4594595 36 100 58 79.45205 3 6 9 3 2 5 22 59.45946 36 100 58 79.452055
18 Ketegan 37 36 73 4 5 9 3 3 6 25 67.5675676 31 86.111111 56 76.71233 4 5 9 3 3 6 25 67.56757 31 86.11111 56 76.712329
19 Ganggang Panjang 40 40 80 3 3 6 1 2 3 32 80 26 65 59 73.75 3 3 6 1 2 3 32 80 26 65 58 72.5
20
Total Puskesmas 667 661 1328 61 95 156 47 37 84 520 77.9610195 552 83.509834 1074 80.87349 61 95 156 47 37 84 520 77.96102 551 41.49096 1071 80.64759
UNIT LAIN WIL KAB
TOTAL BULAN INI 667 661 1328 61 95 156 47 37 84 520 77.9610195 552 83.509834 1074 80.87349 61 95 156 47 37 84 520 77.96102 551 41.49096 1071 80.64759
BULAN : OKTOBER
TAHUN : 2021
SASARAN Neo Komplikasi Kunjungan Bayi (Pr)
15% Kelahiran PENCAPAIAN PENCAPAIAN
NO DESA/ KELURAHAN BAYI KUMULATIF TOTAL KUMULATIF TOTAL
Hidup(ByRisti) BULAN LALU BULAN INI BULAN LALU BULAN INI
L P Total L P Total L P Total L P Total L % P % ABS % L P Total L P Total L % P % ABS %
3 Randegan 6 5 11 38 37 75 0 0 0 1 0 1 4 66.66667 2 40 6 54.545 4 3 7 0 4 4 28 73.684211 28 75.67568 56 74.66667
1 Kedensari 10 9 19 63 62 125 1 0 1 2 3 5 9 90 5 55.5556 14 73.684 12 8 20 0 0 0 50 79.365079 47 75.80645 97 77.6
1 Kali sampurno 12 7 19 67 66 133 2 1 3 1 0 1 8 66.66667 5 71.4286 13 68.421 5 4 9 0 10 10 49 73.134328 57 86.36364 106 79.69925
4 Ketapang - 1 1 13 13 26 0 0 0 1 2 3 1 #DIV/0! 2 200 3 300 3 3 6 1 5 6 9 69.230769 12 92.30769 21 80.76923
5 Kedung Bendo - - 0 - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0! 0 #DIV/0! 0 0
6 Gempol Sari 4 5 9 36 36 72 2 0 2 0 0 0 6 150 2 40 8 88.889 2 3 5 0 5 5 28 77.777778 32 88.88889 60 83.33333
7 Sentul 5 5 10 30 29 59 1 0 1 0 0 0 1 20 3 60 4 40 1 1 2 4 4 8 22 73.333333 26 89.65517 48 81.35593
8 Penatar Sewu 3 4 7 25 25 50 1 1 2 1 0 1 8 266.6667 4 100 12 171.43 0 0 0 2 2 4 16 64 25 100 41 82
9 Banjar Asri 2 3 5 19 19 38 2 0 2 0 0 0 3 150 3 100 6 120 8 0 8 0 0 0 23 121.05263 16 84.21053 39 102.6316
10 Banjar Panji 4 2 6 13 13 26 0 0 0 1 0 1 3 75 0 0 3 50 1 1 2 1 2 3 11 84.615385 12 92.30769 23 88.46154
11 Kedung Banteng 5 4 9 25 25 50 1 0 1 0 1 1 5 100 4 100 9 100 3 3 6 3 2 5 21 84 23 92 44 88
12 Kali Dawir 5 5 10 37 37 74 1 1 2 0 1 1 5 100 6 120 11 110 8 8 16 3 2 5 32 86.486486 32 86.48649 64 86.48649
13 Putat 4 5 9 28 28 56 0 0 0 2 0 2 8 200 3 60 11 122.22 9 0 9 0 3 3 26 92.857143 20 71.42857 46 82.14286
14 Ngaban 6 6 12 44 43 87 0 1 1 1 0 1 1 16.66667 2 33.3333 3 25 4 4 8 5 5 10 37 84.090909 36 83.72093 73 83.90805
15 Kali Tengah 15 16 31 104 103 207 0 0 0 0 0 0 8 53.33333 4 25 12 38.71 8 8 16 10 12 22 88 84.615385 85 82.52427 173 83.57488
16 Kludan 5 5 10 35 34 69 0 0 0 0 0 0 2 40 4 80 6 60 2 2 4 4 4 8 28 80 27 79.41176 55 79.71014
17 Boro 6 5 11 38 38 76 2 3 5 0 0 0 3 50 3 60 6 54.545 3 3 6 3 3 6 31 81.578947 31 81.57895 62 81.57895
18 Ketegan 5 6 11 38 38 76 1 1 2 0 0 0 2 40 3 50 5 45.455 3 3 6 8 5 13 34 89.473684 32 84.21053 66 86.84211
19 Ganggang Panjang 6 8 14 42 41 83 0 1 1 2 1 3 8 133.3333 3 37.5 11 78.571 4 4 8 4 5 9 34 80.952381 36 87.80488 70 84.33735
20
Total Puskesmas 103 101 204 695 687 1382 14 9 23 12 8 20 85 82.52427 58 57.4257 143 70.098 80 58 138 48 73 121 567 81.582734 577 83.98836 1144 82.77858
UNIT LAIN WIL KAB
TOTAL BULAN INI 103 101 204 695 687 1382 14 9 23 12 8 20 85 82.52427 58 57.4257 143 70.098 80 58 138 48 73 121 567 81.582734 577 83.98836 1144 82.77858
BULAN : NOVEMBER
TAHUN : 2021
LAHIR MATI
1 Randegan 36 36 72 5.4 5.4 10.8 0 4 4 0 0 0 2 1 3 0 4 5 33 91.667 41 113.89 74 102.78
2 Kedensari 60 60 120 9 9 18 4 7 11 0 0 0 7 5 12 4 7 12 59 98.333 49 81.667 108 90
3 Kali sampurno 64 63 127 9.6 9.45 19.05 4 3 7 0 0 0 6 6 12 4 3 12 57 89.063 56 88.889 113 88.976
4 Ketapang 12 12 24 1.8 1.8 3.6 0 0 0 0 0 0 0 0 0 0 0 0 1 8.3333 5 41.667 6 25
5 Kedung Bendo 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 Gempol Sari 35 35 70 5.25 5.25 10.5 1 6 7 0 0 0 2 1 3 1 6 10 26 74.286 34 97.143 60 85.714
7 Sentul 29 28 57 4.35 4.2 8.55 1 1 2 0 0 0 2 2 4 1 1 5 21 72.414 23 82.143 44 77.193
8 Penatar Sewu 24 24 48 3.6 3.6 7.2 3 1 4 0 0 0 2 0 2 3 1 4 25 104.17 25 104.17 50 104.17
9 Banjar Asri 18 18 36 2.7 2.7 5.4 3 2 5 0 0 0 0 0 0 3 2 3 18 100 20 111.11 38 105.56
10 Banjar Panji 12 12 24 1.8 1.8 3.6 0 1 1 0 0 0 1 1 2 0 1 1 9 75 15 125 24 100
11 Kedung Banteng 24 24 48 3.6 3.6 7.2 2 3 5 0 0 0 2 2 4 2 3 4 19 79.167 27 112.5 46 95.833
12 Kali Dawir 36 36 72 5.4 5.4 10.8 1 2 3 0 0 0 2 2 4 1 2 8 28 77.778 33 91.667 61 84.722
13 Putat 27 27 54 4.05 4.05 8.1 4 1 5 0 0 0 2 2 4 4 1 5 27 100 24 88.889 51 94.444
14 Ngaban 43 42 85 6.45 6.3 12.75 2 1 3 0 0 0 3 2 5 2 1 10 35 81.395 37 88.095 72 84.706
15 Kali Tengah 100 99 199 15 14.85 29.85 8 10 18 0 0 0 7 5 12 8 10 16 86 86 84 84.848 170 85.427
16 Kludan 33 33 66 4.95 4.95 9.9 3 3 6 0 0 0 2 1 3 3 3 5 34 103.03 31 93.939 65 98.485
17 Boro 37 36 73 5.55 5.4 10.95 1 2 3 0 0 0 3 2 5 1 2 8 23 62.162 38 105.56 61 83.562
18 Ketegan 37 36 73 5.55 5.4 10.95 3 2 5 0 0 0 3 3 6 3 2 8 28 75.676 33 91.667 61 83.562
19 Ganggang Panjang 40 40 80 6 6 12 3 7 10 0 0 0 1 2 3 3 7 6 36 90 33 82.5 69 86.25
20
Total Puskesmas 667 661 1328 100.05 99.15 199.2 43 56 99 0 0 0 47 37 84 43 56 122 565 84.708 608 91.982 1173 88.328
UNIT LAIN WIL KAB
TOTAL BULAN INI 667 661 1328 100.05 99.15 199.2 43 56 99 0 0 0 47 37 84 43 56 122 565 84.708 608 91.982 1173 88.328
BULAN : NOVEMBER
TAHUN : 2021
KN 2 KN 3 (Lengkap)
SASARAN Kelahiran
1 Randegan 36 36 72 2 1 3 0 4 4 32 88.8888889 40 111.11111 72 100 2 1 3 0 4 4 32 88.88889 40 111.1111 72 100
2 Kedensari 60 60 120 7 5 12 4 7 11 60 100 49 81.666667 109 90.83333 7 5 12 4 7 11 60 100 49 81.66667 109 90.833333
3 Kali sampurno 64 63 127 6 6 12 4 3 7 55 85.9375 58 92.063492 113 88.97638 6 6 12 4 3 7 55 85.9375 58 92.06349 113 88.976378
4 Ketapang 12 12 24 0 0 0 0 0 0 1 8.33333333 5 41.666667 6 25 0 0 0 0 0 0 1 8.333333 5 41.66667 6 25
5 Kedung Bendo 0 0 0 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 Gempol Sari 35 35 70 2 1 3 1 6 7 26 74.2857143 34 97.142857 60 85.71429 2 1 3 1 6 7 26 74.28571 34 97.14286 60 85.714286
7 Sentul 29 28 57 2 2 4 1 1 2 21 72.4137931 23 82.142857 44 77.19298 2 2 4 1 1 2 21 72.41379 23 82.14286 44 77.192982
8 Penatar Sewu 24 24 48 2 0 2 3 1 4 25 104.166667 24 100 49 102.0833 2 0 2 3 1 4 25 104.1667 24 100 49 102.08333
9 Banjar Asri 18 18 36 0 0 0 3 2 5 18 100 20 111.11111 38 105.5556 0 0 0 3 2 5 18 100 20 111.1111 38 105.55556
10 Banjar Panji 12 12 24 1 1 2 0 1 1 9 75 14 116.66667 23 95.83333 1 1 2 0 1 1 9 75 14 116.6667 23 95.833333
11 Kedung Banteng 24 24 48 2 2 4 2 3 5 19 79.1666667 27 112.5 46 95.83333 2 2 4 2 3 5 19 79.16667 27 112.5 46 95.833333
12 Kali Dawir 36 36 72 2 2 4 1 2 3 28 77.7777778 34 94.444444 62 86.11111 2 2 4 1 2 3 28 77.77778 34 94.44444 62 86.111111
13 Putat 27 27 54 2 2 4 4 1 5 28 103.703704 23 85.185185 51 94.44444 2 2 4 4 1 5 28 103.7037 23 85.18519 51 94.444444
14 Ngaban 43 42 85 3 2 5 2 1 3 35 81.3953488 37 88.095238 72 84.70588 3 2 5 2 1 3 35 81.39535 37 88.09524 72 84.705882
15 Kali Tengah 100 99 199 7 5 12 8 10 18 86 86 85 85.858586 171 85.92965 7 5 12 8 10 18 86 86 84 84.84848 170 85.427136
16 Kludan 33 33 66 2 1 3 3 3 6 34 103.030303 31 93.939394 65 98.48485 2 1 3 3 3 6 34 103.0303 31 93.93939 65 98.484848
17 Boro 37 36 73 3 2 5 1 2 3 23 62.1621622 38 105.55556 61 83.56164 3 2 5 1 2 3 23 62.16216 38 105.5556 61 83.561644
18 Ketegan 37 36 73 3 3 6 3 2 5 28 75.6756757 33 91.666667 61 83.56164 3 3 6 3 2 5 28 75.67568 33 91.66667 61 83.561644
19 Ganggang Panjang 40 40 80 1 2 3 3 7 10 35 87.5 33 82.5 68 85 1 2 3 3 7 10 35 87.5 33 82.5 68 85
20
Total Puskesmas 667 661 1328 47 37 84 43 56 99 563 1465.43753 608 1673.3165 1171 82 47 37 84 43 56 99 563 1465.438 607 1672.306 1170 82
UNIT LAIN WIL KAB
TOTAL BULAN INI 667 661 1328 47 37 84 43 56 99 563 71.51 608 1673.3165 1171 82 47 37 84 43 56 99 563 1465.438 607 1672.306 1170 82
BULAN : NOVEMBER
TAHUN : 2021
1 Randegan 6 5 11 38 37 75 1 0 1 0 0 0 4 66.66667 2 40 6 54.545 0 4 4 4 3 7 32 84.210526 31 83.78378 63 84
2 Kedensari 10 9 19 63 62 125 2 3 5 0 0 0 9 90 5 55.5556 14 73.684 0 0 0 2 4 6 52 82.539683 51 82.25806 103 82.4
3 Kali sampurno 12 7 19 67 66 133 1 0 1 1 0 1 9 75 5 71.4286 14 73.684 0 10 10 4 6 10 53 79.104478 63 95.45455 116 87.21805
4 Ketapang 0 1 1 13 13 26 1 2 3 0 0 0 1 0 2 200 3 300 1 5 6 0 0 0 9 69.230769 12 92.30769 21 80.76923
5 Kedung Bendo 0 0 0 0 0 0 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 Gempol Sari 4 5 9 36 36 72 0 0 0 1 2 3 7 175 4 80 11 122.22 0 5 5 1 0 1 29 80.555556 32 88.88889 61 84.72222
7 Sentul 5 5 10 30 29 59 0 0 0 0 0 0 1 20 3 60 4 40 4 4 8 2 0 2 24 80 26 89.65517 50 84.74576
8 Penatar Sewu 3 4 7 25 25 50 1 0 1 0 1 1 8 266.6667 5 125 13 185.71 2 2 4 2 0 2 18 72 25 100 43 86
9 Banjar Asri 2 3 5 19 19 38 0 0 0 2 1 3 5 250 4 133.333 9 180 0 0 0 0 0 0 23 121.05263 16 84.21053 39 102.6316
10 Banjar Panji 4 2 6 13 13 26 1 0 1 0 0 0 3 75 0 0 3 50 1 2 3 0 0 0 11 84.615385 12 92.30769 23 88.46154
11 Kedung Banteng 5 4 9 25 25 50 0 1 1 2 2 4 7 140 6 150 13 144.44 3 2 5 0 0 0 21 84 23 92 44 88
12 Kali Dawir 5 5 10 37 37 74 0 1 1 1 0 1 6 120 6 120 12 120 3 2 5 1 1 2 33 89.189189 33 89.18919 66 89.18919
13 Putat 4 5 9 28 28 56 2 0 2 2 0 2 10 250 3 60 13 144.44 0 3 3 0 0 0 26 92.857143 20 71.42857 46 82.14286
14 Ngaban 6 6 12 44 43 87 1 0 1 0 0 0 1 16.66667 2 33.3333 3 25 5 5 10 2 3 5 39 88.636364 39 90.69767 78 89.65517
15 Kali Tengah 15 16 31 104 103 207 0 0 0 2 3 5 10 66.66667 7 43.75 17 54.839 10 12 22 6 7 13 94 90.384615 92 89.32039 186 89.85507
16 Kludan 5 5 10 35 34 69 0 0 0 0 0 0 2 40 4 80 6 60 4 4 8 1 1 2 29 82.857143 28 82.35294 57 82.6087
17 Boro 6 5 11 38 38 76 0 0 0 0 0 0 3 50 3 60 6 54.545 3 3 6 0 0 0 31 81.578947 31 81.57895 62 81.57895
18 Ketegan 5 6 11 38 38 76 0 0 0 0 0 0 2 40 3 50 5 45.455 8 5 13 0 0 0 34 89.473684 32 84.21053 66 86.84211
19 Ganggang Panjang 6 8 14 42 41 83 2 1 0 0 0 0 8 133.3333 3 37.5 11 78.571 4 5 9 2 0 2 36 85.714286 36 87.80488 72 86.74699
20
Total Puskesmas 103 101 204 695 687 1382 12 8 17 11 9 20 96 93.20388 67 66.3366 163 79.902 48 73 121 27 25 52 594 85.467626 602 87.62737 1196 86.54124
UNIT LAIN WIL KAB
TOTAL BULAN INI 103 101 204 695 687 1382 12 8 17 11 9 20 96 93.20388 67 66.3366 163 79.902 48 73 121 27 25 52 594 85.467626 602 87.62737 1196 86.54124
BULAN : DESEMBER
TAHUN : 2021
LAHIR MATI
1 Randegan 36 36 72 5.4 5.4 10.8 0 0 0 0 0 0 0 4 4 0 0 0 33 91.667 41 113.89 74 102.78
2 Kedensari 60 60 120 9 9 18 3 5 8 0 0 0 4 7 11 3 5 8 62 103.33 54 90 116 96.667
3 Kali sampurno 64 63 127 9.6 9.45 19.05 3 6 9 0 0 0 4 3 7 3 6 9 60 93.75 62 98.413 122 96.063
4 Ketapang 12 12 24 1.8 1.8 3.6 0 3 3 0 0 0 0 0 0 0 3 3 1 8.3333 8 66.667 9 37.5
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 35 35 70 5.25 5.25 10.5 5 0 5 0 0 0 1 6 7 5 0 5 31 88.571 34 97.143 65 92.857
7 Sentul 29 28 57 4.35 4.2 8.55 5 5 10 0 0 0 1 1 2 5 5 10 26 89.655 28 100 54 94.737
8 Penatar Sewu 24 24 48 3.6 3.6 7.2 0 0 0 0 0 0 3 1 4 0 0 0 25 104.17 25 104.17 50 104.17
9 Banjar Asri 18 18 36 2.7 2.7 5.4 0 0 0 0 0 0 3 2 5 0 0 0 18 100 20 111.11 38 105.56
10 Banjar Panji 12 12 24 1.8 1.8 3.6 0 0 0 0 0 0 0 1 1 0 0 0 9 75 15 125 24 100
11 Kedung Banteng 24 24 48 3.6 3.6 7.2 4 2 6 0 0 0 2 3 5 4 2 6 23 95.833 29 120.83 52 108.33
12 Kali Dawir 36 36 72 5.4 5.4 10.8 2 3 5 0 0 0 1 2 3 2 3 5 30 83.333 36 100 66 91.667
13 Putat 27 27 54 4.05 4.05 8.1 2 0 2 0 0 0 4 1 5 2 0 2 29 107.41 24 88.889 53 98.148
14 Ngaban 43 42 85 6.45 6.3 12.75 8 2 10 0 0 0 2 1 3 8 2 10 43 100 39 92.857 82 96.471
15 Kali Tengah 100 99 199 15 14.85 29.85 12 10 22 0 0 0 8 10 18 12 10 22 98 98 94 94.949 192 96.482
16 Kludan 33 33 66 4.95 4.95 9.9 6 1 7 0 0 0 3 3 6 6 1 7 40 121.21 32 96.97 72 109.09
17 Boro 37 36 73 5.55 5.4 10.95 5 0 5 0 0 0 1 2 3 5 0 5 28 75.676 38 105.56 66 90.411
18 Ketegan 37 36 73 5.55 5.4 10.95 5 2 7 0 0 0 3 2 5 5 2 7 33 89.189 35 97.222 68 93.151
19 Ganggang Panjang 40 40 80 6 6 12 1 4 5 0 0 0 3 7 10 1 4 5 37 92.5 37 92.5 74 92.5
20
Total Puskesmas 667 661 1328 100.05 99.15 199.2 61 43 104 0 0 0 43 56 99 61 43 104 626 1617.6 651 1796.2 1277 1706.6
UNIT LAIN WIL KAB
TOTAL BULAN INI 667 661 1328 100.05 99.15 199.2 61 43 104 0 0 0 43 56 99 61 43 104 626 1617.6 651 1796.2 1277 1706.6
BULAN : DESEMBER
TAHUN : 2021
KN 2 KN 3 (Lengkap)
SASARAN Kelahiran
1 Randegan 36 36 72 0 4 4 0 0 0 32 88.8888889 40 111.11111 72 100 0 4 4 0 0 0 32 88.88889 40 111.1111 72 100
2 Kedensari 60 60 120 4 7 11 3 5 8 63 105 54 90 117 97.5 4 7 11 3 5 8 63 105 54 90 117 97.5
3 Kali sampurno 64 63 127 4 3 7 3 6 9 58 90.625 64 101.5873 122 96.06299 4 3 7 3 6 9 58 90.625 64 101.5873 122 96.062992
4 Ketapang 12 12 24 0 0 0 0 3 3 1 8.33333333 8 66.666667 9 37.5 0 0 0 0 3 3 1 8.333333 8 66.66667 9 37.5
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0! 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 35 35 70 1 6 7 5 0 5 31 88.5714286 34 97.142857 65 92.85714 1 6 7 5 0 5 31 88.57143 34 97.14286 65 92.857143
7 Sentul 29 28 57 1 1 2 5 5 10 26 89.6551724 28 100 54 94.73684 1 1 2 5 5 10 26 89.65517 28 100 54 94.736842
8 Penatar Sewu 24 24 48 3 1 4 0 0 0 25 104.166667 24 100 49 102.0833 3 1 4 0 0 0 25 104.1667 24 100 49 102.08333
9 Banjar Asri 18 18 36 3 2 5 0 0 0 18 100 20 111.11111 38 105.5556 3 2 5 0 0 0 18 100 20 111.1111 38 105.55556
10 Banjar Panji 12 12 24 0 1 1 0 0 0 9 75 14 116.66667 23 95.83333 0 1 1 0 0 0 9 75 14 116.6667 23 95.833333
11 Kedung Banteng 24 24 48 2 3 5 4 2 6 23 95.8333333 29 120.83333 52 108.3333 2 3 5 4 2 6 23 95.83333 29 120.8333 52 108.33333
12 Kali Dawir 36 36 72 1 2 3 2 3 5 30 83.3333333 37 102.77778 67 93.05556 1 2 3 2 3 5 30 83.33333 37 102.7778 67 93.055556
13 Putat 27 27 54 4 1 5 2 0 2 30 111.111111 23 85.185185 53 98.14815 4 1 5 2 0 2 30 111.1111 23 85.18519 53 98.148148
14 Ngaban 43 42 85 2 1 3 8 2 10 43 100 39 92.857143 82 96.47059 2 1 3 8 2 10 43 100 39 92.85714 82 96.470588
15 Kali Tengah 100 99 199 8 10 18 12 10 22 98 98 95 95.959596 193 96.98492 8 10 18 12 10 22 98 98 94 94.94949 192 96.482412
16 Kludan 33 33 66 3 3 6 6 1 7 40 121.212121 32 96.969697 72 109.0909 3 3 6 6 1 7 40 121.2121 32 96.9697 72 109.09091
17 Boro 37 36 73 1 2 3 5 0 5 28 75.6756757 38 105.55556 66 90.41096 1 2 3 5 3 5 28 75.67568 41 113.8889 69 94.520548
18 Ketegan 37 36 73 3 2 5 5 2 7 33 89.1891892 35 97.222222 68 93.15068 3 2 5 5 2 7 33 89.18919 35 97.22222 68 93.150685
19 Ganggang Panjang 40 40 80 3 7 10 2 4 6 37 92.5 37 92.5 74 92.5 3 7 10 2 4 5 37 92.5 37 92.5 74 92.5
20
Total Puskesmas 667 661 1328 43 56 99 62 43 105 625 93.7031484 651 98.487141 1276 96.08434 43 56 99 62 46 104 625 93.70315 653 49.17169 1278 96.23494
UNIT LAIN WIL KAB
TOTAL BULAN INI 667 661 1328 43 56 99 62 43 105 625 93.7031484 651 98.487141 1276 96.08434 43 56 99 62 46 104 625 93.70315 653 49.17169 1278 96.23494
BULAN : DESEMBER
TAHUN : 2021
1 Randegan 6 5 11 38 37 75 0 0 0 0 0 0 4 66.66667 2 40 6 54.545 4 3 7 3 4 7 35 92.105263 35 94.59459 70 93.33333
2 Kedensari 10 9 19 63 62 125 0 0 0 0 0 0 9 90 5 55.5556 14 73.684 2 4 6 8 5 13 60 95.238095 56 90.32258 116 92.8
3 Kali sampurno 12 7 19 67 66 133 1 0 1 0 0 0 9 75 5 71.4286 14 73.684 4 6 10 6 0 6 59 88.059701 63 95.45455 122 91.72932
4 Ketapang 0 1 1 13 13 26 0 0 0 0 0 0 1 0 2 200 3 300 0 0 0 2 0 2 11 84.615385 12 92.30769 23 88.46154
5 Kedung Bendo 0 0 0 0 0 0 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 Gempol Sari 4 5 9 36 36 72 1 2 3 1 0 1 8 200 4 80 12 133.33 1 0 1 4 1 5 33 91.666667 33 91.66667 66 91.66667
7 Sentul 5 5 10 30 29 59 0 0 0 2 1 3 3 60 4 80 7 70 2 0 2 3 3 6 27 90 29 100 56 94.91525
8 Penatar Sewu 3 4 7 25 25 50 0 1 1 0 0 0 8 266.6667 5 125 13 185.71 2 0 2 5 0 5 23 92 25 100 48 96
9 Banjar Asri 2 3 5 19 19 38 2 1 3 0 0 0 5 250 4 133.333 9 180 0 0 0 0 0 0 23 121.05263 16 84.21053 39 102.6316
10 Banjar Panji 4 2 6 13 13 26 0 0 0 0 0 0 3 75 0 0 3 50 0 0 0 0 2 2 11 84.615385 14 107.6923 25 96.15385
11 Kedung Banteng 5 4 9 25 25 50 2 2 4 0 1 1 7 140 7 175 14 155.56 0 0 0 0 3 3 21 84 26 104 47 94
12 Kali Dawir 5 5 10 37 37 74 1 0 1 1 2 3 7 140 8 160 15 150 1 1 2 0 0 0 33 89.189189 33 89.18919 66 89.18919
13 Putat 4 5 9 28 28 56 2 0 2 1 0 1 11 275 3 60 14 155.56 0 0 0 0 6 0 26 92.857143 26 92.85714 52 92.85714
14 Ngaban 6 6 12 44 43 87 0 0 0 2 1 3 3 50 3 50 6 50 2 3 5 3 1 4 42 95.454545 40 93.02326 82 94.25287
15 Kali Tengah 15 16 31 104 103 207 2 3 5 0 0 0 10 66.66667 7 43.75 17 54.839 6 7 13 3 1 4 97 93.269231 93 90.29126 190 91.78744
16 Kludan 5 5 10 35 34 69 0 0 0 0 0 0 2 40 4 80 6 60 1 1 2 4 4 8 33 94.285714 32 94.11765 65 94.2029
17 Boro 6 5 11 38 38 76 0 0 0 0 0 0 3 50 3 60 6 54.545 0 0 0 6 6 12 37 97.368421 37 97.36842 74 97.36842
18 Ketegan 5 6 11 38 38 76 0 0 0 0 0 0 2 40 3 50 5 45.455 0 0 0 7 5 12 41 107.89474 37 97.36842 78 102.6316
19 Ganggang Panjang 6 8 14 42 41 83 0 0 0 0 1 1 8 133.3333 4 50 12 85.714 2 0 2 10 8 18 46 109.52381 44 107.3171 90 108.4337
20
Total Puskesmas 103 101 204 695 687 1382 11 9 20 7 6 13 103 100 73 72.2772 176 86.275 27 25 52 64 49 107 658 94.676259 651 94.75983 1309 94.7178
UNIT LAIN WIL KAB
TOTAL BULAN INI 103 101 204 695 687 1382 11 9 20 7 6 13 103 100 73 72.2772 176 86.275 27 25 52 64 49 107 658 94.676259 651 94.75983 1309 94.7178
RAN PWS KIA (INDIKATOR KESEHATAN IBU)
BULAN/TAHUN : OKTOBER
KX KEBIDANAN YG
SASARAN K1 K4 K6 DRT MASYARAKAT DRT OLEH NAKES
DITANGANI
NO DESA BUMIL BULIN PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL
BLN BLN
BUMIL RISTI / BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN
JML % JML % JML % LAL JML % JML % LAL JML %
20% BUFAS LALU INI LALU INI LALU INI INI LALU INI INI
U U
1 Randegan 80 16 76 6 6 66 83 6 8 63 79 6 8 63 78.75 1 0 16 20 2 0 22 27.5 1 0 18 112.5
2 Kedensari 132 26 126 12 12 107 81 12 10 103 78 12 10 102 77.2727 1 2 11 8.333333 1 4 18 13.636 1 0 25 94.697
3 Kali sampurno 140 28 134 15 12 114 81 15 12 109 78 15 12 109 77.8571 1 0 5 3.571429 1 0 12 8.5714 2 0 19 67.8571
4 Ketapang 27 5 26 5 2 20 74 5 1 19 70 5 1 21 77.7778 0 0 0 0 0 0 0 0 0 0 0 0
5 Kedung Bendo - 0 - 0 0 0 - 0 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 76 15 73 10 5 62 82 10 4 59 78 10 4 57 75 1 0 7 9.210526 2 0 14 18.421 1 1 9 59.2105
7 Sentul 63 13 60 8 3 52 83 8 4 57 90 8 4 54 85.7143 0 0 3 4.761905 0 1 8 12.698 0 3 5 39.6825
8 Penatar Sewu 54 11 51 2 10 48 89 2 5 45 83 2 5 43 79.6296 1 0 3 5.555556 1 2 12 22.222 1 0 14 129.63
9 Banjar Asri 40 8 38 1 4 27 68 1 4 36 90 1 4 29 72.5 2 0 4 10 0 1 4 10 2 0 7 87.5
10 Banjar Panji 27 5 26 1 3 23 85 1 0 24 89 1 0 23 85.1852 0 0 2 7.407407 0 1 3 11.111 0 0 3 55.5556
11 Kedung Banteng 53 11 50 7 4 46 87 7 4 45 85 7 4 44 83.0189 1 0 3 5.660377 2 2 10 18.868 1 1 12 113.208
12 Kali Dawir 79 16 75 10 6 67 85 10 4 64 81 10 4 63 79.7468 0 1 4 5.063291 0 2 14 17.722 3 2 15 94.9367
13 Putat 59 12 56 5 4 47 80 5 5 50 85 5 5 46 77.9661 0 0 5 8.474576 0 2 16 27.119 0 1 10 84.7458
14 Ngaban 94 19 90 10 5 76 81 10 6 74 79 10 6 73 77.6596 0 1 3 3.191489 0 1 4 4.2553 1 3 3 15.9574
15 Kali Tengah 218 44 208 20 12 164 75 20 11 160 73 20 11 162 74.3119 1 1 18 8.256881 0 0 21 9.633 1 0 19 43.578
16 Kludan 73 15 70 8 6 61 84 8 6 58 79 8 6 55 75.3425 1 1 12 16.43836 1 2 10 13.699 0 2 8 54.7945
17 Boro 80 16 76 6 6 65 81 6 5 60 75 6 5 57 71.25 1 0 4 5 1 0 8 10 3 0 9 56.25
18 Ketegan 80 16 77 6 7 64 80 6 6 61 76 6 6 61 76.25 1 0 4 5 1 0 5 6.25 0 0 4 25
19 Ganggang Panjang 87 17 83 12 8 73 84 12 7 72 83 12 7 70 80.4598 1 0 4 4.597701 1 2 9 10.345 1 1 10 57.4713
20
Total Puskesmas 1462 292 1395 144 115 1182 81 144 102 1159 79.27 144 102 1132 77.43 13 6 108 7.39 13 20 190 13.00 18 14 190 64.98
Unit Lain Wil Kab
Rumah Sakit
Luar Wil Pusk.Wil.Kab
Total Bulan Ini 1462 292.4 1395 144 115 1182 80.8482 144 102 1159 79.275 144 102 1132 77.4282 13 6 108 7.387141 13 20 190 13 18 14 190 64.9795
Luar Wil Pusk Luar.Wi
Jml PN Di Polindes
LAPORAN PWS KIA (INDIKATOR KESEHATAN IBU)
BULAN/TAHUN OKTOBER
PN DI FASILITAS PERKIRAAN PERSALINAN BLN
SASARANPERSALINAN OLEH NAKES
KESEHATAN Nifas/ KF 1 Nifas/ KF 2 Nifas/ KF 3 Nifas/ KF 4 INI (HPL)
DESA/
NO BULIN PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL
KELURAHAN
/ BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN
BUFAS LALU INI JML % JML % JML % JML % JML % JML % JML %
LALU INI LALU INI LALU INI LALU INI LALU INI LALU INI
1 Randegan 76 4 3 71 93.42 4 3 71 93.42 4 3 71 93.42 4 3 71 93.42 4 3 71 93.42 4 3 66 86.84 5 3 59 63.15
2 Kedensari 126 12 12 98 77.78 12 12 98 77.78 12 12 98 77.78 12 12 98 77.78 12 12 98 77.78 12 12 94 74.60 0 12 88 113.14
3 Kali sampurno 134 20 12 106 79.10 20 12 106 79.10 20 12 106 79.10 20 12 106 79.10 20 12 106 79.10 20 12 103 76.87 0 12 97 122.62
4 Ketapang 26 3 0 6 23.08 3 0 6 23.08 3 0 6 23.08 3 0 6 23.08 3 0 6 23.08 3 0 6 23.08 2 0 3 13.00
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ### 0 0 0 #DIV/0!
6 Gempol Sari 73 10 3 53 72.60 10 3 53 72.60 10 3 53 72.60 10 3 53 72.60 10 3 53 72.60 10 3 53 72.60 5 3 47 64.74
7 Sentul 60 8 4 42 70.00 8 4 42 70.00 8 4 42 70.00 8 4 42 70.00 8 4 42 70.00 8 4 40 66.67 6 4 34 48.57
8 Penatar Sewu 51 5 2 45 88.24 5 2 45 88.24 5 2 45 88.24 5 2 45 88.24 5 2 45 88.24 5 2 46 90.20 4 2 38 43.07
9 Banjar Asri 38 1 0 35 92.11 1 0 35 92.11 1 0 35 92.11 1 0 35 92.11 1 0 35 92.11 1 0 31 81.58 5 0 21 22.80
10 Banjar Panji 26 6 2 22 84.62 6 2 22 84.62 6 2 22 84.62 6 2 22 84.62 6 2 22 84.62 6 2 19 73.08 2 2 13 15.36
11 Kedung Banteng 50 6 4 41 82.00 6 4 41 82.00 6 4 41 82.00 6 4 41 82.00 6 4 41 82.00 6 4 42 84.00 4 4 36 43.90
12 Kali Dawir 75 10 4 58 77.33 10 4 58 77.33 10 4 58 77.33 10 4 58 77.33 10 4 58 77.33 10 4 57 76.00 6 4 51 65.95
13 Putat 56 6 4 46 82.14 6 4 46 82.14 6 4 46 82.14 6 4 46 82.14 6 4 46 82.14 6 4 48 85.71 6 4 41 49.91
14 Ngaban 90 16 5 69 76.67 16 5 69 76.67 16 5 69 76.67 16 5 69 76.67 16 5 69 76.67 16 5 68 75.56 9 5 62 80.87
15 Kali Tengah 208 20 12 150 72.12 20 12 150 72.12 20 12 150 72.12 20 12 150 72.12 20 12 150 72.12 20 12 151 72.60 1 12 147 203.84
16 Kludan 70 6 3 59 84.29 6 3 59 84.29 6 3 59 84.29 6 3 59 84.29 6 3 59 84.29 6 3 64 91.43 6 3 54 64.07
17 Boro 76 9 5 58 76.32 9 5 58 76.32 9 5 58 76.32 9 5 58 76.32 9 5 58 76.32 9 5 57 75.00 5 5 51 66.83
18 Ketegan 77 9 6 56 72.73 9 6 56 72.73 9 6 56 72.73 9 6 56 72.73 9 6 56 72.73 9 6 52 67.53 7 6 46 63.25
19 Ganggang Panjang 83 6 4 60 72.29 6 4 60 72.29 6 4 60 72.29 6 4 60 72.29 6 4 60 72.29 6 4 64 77.11 5 4 56 77.47
20
Total Puskesmas 1395 157 85 1075 77.06 157 85 1075 77.06 157 85 1075 77.06 157 85 1075 77.06 157 85 1075 77.06 157 85 1061 76.06 78 85 944 1225.004651
Unit Lain Wil Kab
Rumah Sakit
Total Bulan Ini 1395 157 85 1075 77.0609 157 85 1075 77.061 157 85 1075 77.061 157 85 1075 77.061 157 85 1075 77.061 157 85 1061 76.0573 78 85 944 1225.004651
Jml PN Di Polindes
BULAN/TAHUN : NOVEMBER 2021
KX KEBIDANAN YG
DITANGANI
BUMIL BULIN PENC KUMUL PENC KUMUL PENC KUMUL BLNPENC KUMUL PENC KUMUL BLNPENC KUMUL
NO DESA
BUMIL RISTI / BLN BLN BLN BLN BLN BLN LAL BLN BLN BLN LAL BLN
JML % JML % JML % JML % JML % JML %
20% BUFAS LALU INI LALU INI LALU INI U INI LALU INI U INI
1 Randegan 80 16 76 6 3 69 86.25 8 5 68 85.00 8 5 68 85.00 0 0 16 20.00 0 0 22 27.50 0 1 19 118.75
2 Kedensari 132 26 126 12 9 116 87.88 10 9 112 84.85 10 9 111 84.09 2 0 11 8.33 4 1 19 14.39 0 1 26 98.48
3 Kali sampurno 140 28 134 12 11 125 89.29 12 12 121 86.43 12 12 121 86.43 0 0 5 3.57 0 0 12 8.57 0 4 23 82.14
4 Ketapang 27 5 26 2 0 20 74.07 1 0 19 70.37 1 0 21 77.78 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
5 Kedung Bendo - 0 - 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 Gempol Sari 76 15 73 5 5 67 88.16 4 3 62 81.58 4 3 60 78.95 0 0 7 9.21 0 0 14 18.42 1 4 13 85.53
7 Sentul 63 13 60 3 6 58 92.06 4 3 60 95.24 4 3 57 90.48 0 0 3 4.76 1 0 8 12.70 3 0 5 39.68
8 Penatar Sewu 54 11 51 10 7 55 101.85 5 6 51 94.44 5 6 49 90.74 0 0 3 5.56 2 1 13 24.07 0 1 15 138.89
9 Banjar Asri 40 8 38 4 1 28 70.00 4 3 39 97.50 4 3 32 80.00 0 0 4 10.00 1 0 4 10.00 0 1 8 100.00
10 Banjar Panji 27 5 26 3 0 23 85.19 0 2 26 96.30 0 2 25 92.59 0 0 2 7.41 1 0 3 11.11 0 0 3 55.56
11 Kedung Banteng 53 11 50 4 2 48 90.57 4 4 49 92.45 4 4 48 90.57 0 0 3 5.66 2 1 11 20.75 1 3 15 141.51
12 Kali Dawir 79 16 75 6 4 71 89.87 4 3 67 84.81 4 3 66 83.54 1 1 5 6.33 2 0 14 17.72 2 0 15 94.94
13 Putat 59 12 56 4 4 51 86.44 5 1 51 86.44 5 1 47 79.66 0 0 5 8.47 2 0 16 27.12 1 0 10 84.75
14 Ngaban 94 19 90 5 3 79 84.04 6 4 78 82.98 6 4 77 81.91 1 0 3 3.19 1 0 4 4.26 3 1 4 21.28
15 Kali Tengah 218 44 208 12 16 180 82.57 11 13 173 79.36 11 13 175 80.28 1 0 18 8.26 0 3 24 11.01 0 4 23 52.75
16 Kludan 73 15 70 6 1 62 84.93 6 2 60 82.19 6 2 57 78.08 1 1 13 17.81 2 0 10 13.70 2 0 8 54.79
17 Boro 80 16 76 6 5 70 87.50 5 6 66 82.50 5 6 63 78.75 0 0 4 5.00 0 0 8 10.00 0 1 10 62.50
18 Ketegan 80 16 77 7 3 67 83.75 6 5 66 82.50 6 5 66 82.50 0 0 4 5.00 0 0 5 6.25 0 0 4 25.00
19 Ganggang Panjang 87 17 83 8 6 79 90.80 7 5 77 88.51 7 5 75 86.21 0 0 4 4.60 2 0 9 10.34 1 0 10 57.47
20 -
-
Total Puskesmas 1462 292.4 1395 115 86 1268 86.73 102 86 1245 85.16 102 86 1218 83.31 6 2 110 7.52 20 6 196 13.41 14 21 211 72.16
Unit Lain Wil Kab
Rumah Sakit
Total Bulan Ini 1462 292.4 1395 115 86 1268 86.7305 102 86 1245 85.1573 102 86 1218 83.3105 6 2 110 7.52394 20 6 196 13.406 14 21 211 72.1614
Jml PN Di Polindes
BULAN/TAHUN : NOVEMBER 2021
SASARANPERSALINAN OLEH NAKES
KESEHATAN Nifas/ KF 1 Nifas/ KF 2 Nifas/ KF 3 Nifas/ KF 4 INI (HPL)
DESA/ PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL
NO BULIN
KELURAHAN
/ BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN
1 Randegan 76 3 4 75 98.68 3 4 75 98.68 3 4 75 98.68 3 4 75 98.68 3 4 75 98.68 3 4 70 92.11 3 4 63 63.84
2 Kedensari 126 12 11 109 86.51 12 11 109 86.51 12 11 109 86.51 12 11 109 86.51 12 11 109 86.51 12 11 105 83.33 12 11 99 114.44
3 Kali sampurno 134 12 7 113 84.33 12 7 113 84.33 12 7 113 84.33 12 7 113 84.33 12 7 113 84.33 12 7 110 82.09 12 7 104 123.33
4 Ketapang 26 0 0 6 23.08 0 0 6 23.08 0 0 6 23.08 0 0 6 23.08 0 0 6 23.08 0 0 6 23.08 0 0 3 13.00
5 Kedung Bendo 0 0 0 0 0 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 Gempol Sari 73 3 7 60 82.19 3 7 60 82.19 3 7 60 82.19 3 7 60 82.19 3 7 60 82.19 3 7 60 82.19 3 7 54 65.70
7 Sentul 60 4 2 44 73.33 4 2 44 73.33 4 2 44 73.33 4 2 44 73.33 4 2 44 73.33 4 2 42 70.00 4 2 36 49.09
8 Penatar Sewu 51 2 4 49 96.08 2 4 49 96.08 2 4 49 96.08 2 4 49 96.08 2 4 49 96.08 2 4 50 98.04 2 4 42 43.71
9 Banjar Asri 38 0 5 40 105.26 0 5 40 105.26 0 5 40 105.26 0 5 40 105.26 0 5 40 105.26 0 5 36 94.74 0 5 26 24.70
10 Banjar Panji 26 2 1 23 88.46 2 1 23 88.46 2 1 23 88.46 2 1 23 88.46 2 1 23 88.46 2 1 20 76.92 2 1 14 15.83
11 Kedung Banteng 50 4 5 46 92.00 4 5 46 92.00 4 5 46 92.00 4 5 46 92.00 4 5 46 92.00 4 5 47 94.00 4 5 41 44.57
12 Kali Dawir 75 4 3 61 81.33 4 3 61 81.33 4 3 61 81.33 4 3 61 81.33 4 3 61 81.33 4 3 60 80.00 4 3 54 66.39
13 Putat 56 4 5 51 91.07 4 5 51 91.07 4 5 51 91.07 4 5 51 91.07 4 5 51 91.07 4 5 53 94.64 4 5 46 50.51
14 Ngaban 90 5 3 72 80.00 5 3 72 80.00 5 3 72 80.00 5 3 72 80.00 5 3 72 80.00 5 3 71 78.89 5 3 65 81.25
15 Kali Tengah 208 12 18 168 80.77 12 18 168 80.77 12 18 168 80.77 12 18 168 80.77 12 18 168 80.77 12 18 169 81.25 12 18 165 204.29
16 Kludan 70 3 6 65 92.86 3 6 65 92.86 3 6 65 92.86 3 6 65 92.86 3 6 65 92.86 3 6 70 100.00 3 6 60 64.62
17 Boro 76 5 3 61 80.26 5 3 61 80.26 5 3 61 80.26 5 3 61 80.26 5 3 61 80.26 5 3 60 78.95 5 3 54 67.28
18 Ketegan 77 6 5 61 79.22 6 5 61 79.22 6 5 61 79.22 6 5 61 79.22 6 5 61 79.22 6 5 57 74.03 6 5 51 64.38
19 Ganggang Panjang 83 4 10 70 84.34 4 10 70 84.34 4 10 70 84.34 4 10 70 84.34 4 10 70 84.34 4 10 74 89.16 4 10 66 78.26
20
Total Puskesmas 1395 85 99 1174 84.16 85 99 1174 84.16 85 99 1174 84.16 85 99 1174 84.16 85 99 1174 84.16 85 99 1160 83.15 85 99 1043 74.77
Unit Lain Wil Kab
Rumah Sakit
Total Bulan Ini 1395 85 99 1174 84.1577 85 99 1174 84.158 85 99 1174 84.158 85 99 1174 84.158 85 99 1174 84.158 85 99 1160 83.1541 85 99 1043 74.76702509
Jml PN Di Polindes
BULAN/TAHUN : DESEMBER 2021
KX KEBIDANAN YG
DITANGANI
BUMIL BULIN PENC KUMUL PENC KUMUL PENC KUMUL PENC
BLN KUMUL PENC KUMUL BLNPENC KUMUL
NO DESA
BUMIL RISTI / BLN BLN BLN BLN BLN BLN LAL BLN BLN BLN LAL BLN JML
JML % JML % JML % JML % JML % %
20% BUFAS LALU INI LALU INI LALU INI U INI LALU INI U INI
1 Randegan 80 16 76 3 6 75 93.75 5 5 73 91.25 5 5 73 91.25 0 16 20.00 0 2 24 30.00 1 3 22 137.50
2 Kedensari 132 26 126 9 10 126 95.45 9 11 123 93.18 9 11 122 92.42 0 2 13 9.85 1 3 22 16.67 1 3 29 109.85
3 Kali sampurno 140 28 134 11 8 133 95.00 12 8 129 92.14 12 8 129 92.14 0 0 5 3.57 0 0 12 8.57 4 2 25 89.29
4 Ketapang 27 5 26 0 4 24 88.89 0 3 22 81.48 0 3 24 88.89 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
5 Kedung Bendo - - - 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
6 Gempol Sari 76 15 73 5 5 72 94.74 3 8 70 92.11 3 8 68 89.47 0 0 7 9.21 0 2 16 21.05 4 2 15 98.68
7 Sentul 63 13 60 6 0 58 92.06 3 0 60 95.24 3 0 57 90.48 0 3 6 9.52 0 1 9 14.29 0 1 6 47.62
8 Penatar Sewu 54 11 51 7 0 55 101.85 6 0 51 94.44 6 0 49 90.74 0 0 3 5.56 1 0 13 24.07 1 2 17 157.41
9 Banjar Asri 40 8 38 1 8 36 90.00 3 0 39 97.50 3 0 32 80.00 0 2 6 15.00 0 1 5 12.50 1 1 9 112.50
10 Banjar Panji 27 5 26 0 2 25 92.59 2 0 26 96.30 2 0 25 92.59 0 0 2 7.41 0 0 3 11.11 0 0 3 55.56
11 Kedung Banteng 53 11 50 2 1 49 92.45 4 1 50 94.34 4 1 49 92.45 0 0 3 5.66 1 0 11 20.75 3 3 18 169.81
12 Kali Dawir 79 16 75 4 3 74 93.67 3 8 75 94.94 3 8 74 93.67 1 0 5 6.33 0 1 15 18.99 0 3 18 113.92
13 Putat 59 12 56 4 5 56 94.92 1 6 57 96.61 1 6 53 89.83 0 1 6 10.17 0 3 19 32.20 0 2 12 101.69
14 Ngaban 94 19 90 3 8 87 92.55 4 8 86 91.49 4 8 85 90.43 0 0 3 3.19 0 0 4 4.26 1 0 4 21.28
15 Kali Tengah 218 44 208 16 22 202 92.66 13 24 197 90.37 13 24 199 91.28 0 1 19 8.72 3 0 24 11.01 4 0 23 52.75
16 Kludan 73 15 70 1 8 70 95.89 2 8 68 93.15 2 8 65 89.04 1 1 14 19.18 0 0 10 13.70 0 0 8 54.79
17 Boro 80 16 76 5 4 74 92.50 6 8 74 92.50 6 8 71 88.75 0 0 4 5.00 0 0 8 10.00 1 0 10 62.50
18 Ketegan 80 16 77 3 8 75 93.75 5 8 74 92.50 5 8 74 92.50 0 0 4 5.00 0 1 6 7.50 0 0 4 25.00
19 Ganggang Panjang 87 17 83 6 3 82 94.25 5 4 81 93.10 5 4 79 90.80 0 0 4 4.60 0 1 10 11.49 0 2 12 68.97
20
Total Puskesmas 1462 292.4 1395 86 105 1373 93.91 86 110 1355 92.68 86 110 1328 90.83 2 10 120 8.21 6 15 211 14.43 21 24 235 80.37
Unit Lain Wil Kab
Rumah Sakit
Total Bulan Ini 1462 292.4 1395 86 105 1373 93.9124 86 110 1355 92.6813 86 110 1328 90.8345 2 10 120 8.207934 6 15 211 14.432 21 24 235 80.3694
Jml PN Di Polindes
BULAN/TAHUN : DESEMBER 2021
SASARANPERSALINAN OLEH NAKES Nifas/ KF 1 Nifas/ KF 2 Nifas/ KF 3 Nifas/ KF 4
KESEHATAN INI (HPL)
DESA/ BULIN PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL PENC KUMUL
NO
KELURAHAN / BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN BLN
1 Randegan 76 4 0 75 98.68 4 0 75 98.68 4 0 75 98.68 4 0 75 98.68 4 26 75 98.68 4 0 70 92.11 4 0 63 63.84
2 Kedensari 126 11 8 117 92.86 11 8 117 92.86 11 8 117 92.86 11 8 117 92.86 11 50 117 92.86 11 8 113 89.68 11 9 108 116.31
3 Kali sampurno 134 7 9 122 91.04 7 9 122 91.04 7 9 122 91.04 7 9 122 91.04 7 75 122 91.04 7 9 119 88.81 7 10 114 125.21
4 Ketapang 26 0 2 8 30.77 0 2 8 30.77 0 2 8 30.77 0 2 8 30.77 0 56 8 30.77 0 2 8 30.77 0 2 5 16.25
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 73 7 5 65 89.04 7 5 65 89.04 7 5 65 89.04 7 5 65 89.04 7 208 65 89.04 7 5 65 89.04 7 5 59 66.26
7 Sentul 60 2 8 52 86.67 2 8 52 86.67 2 8 52 86.67 2 8 52 86.67 2 70 52 86.67 2 8 50 83.33 2 8 44 50.77
8 Penatar Sewu 51 4 0 49 96.08 4 0 49 96.08 4 0 49 96.08 4 0 49 96.08 4 76 49 96.08 4 0 50 98.04 4 0 42 43.71
9 Banjar Asri 38 5 0 40 105.26 5 0 40 105.26 5 0 40 105.26 5 0 40 105.26 5 77 40 105.26 5 0 36 94.74 5 0 26 24.70
10 Banjar Panji 26 1 2 25 96.15 1 2 25 96.15 1 2 25 96.15 1 2 25 96.15 1 83 25 96.15 1 2 22 84.62 1 2 16 16.64
11 Kedung Banteng 50 5 3 49 98.00 5 3 49 98.00 5 3 49 98.00 5 3 49 98.00 5 - 49 98.00 5 3 50 100.00 5 3 44 44.90
12 Kali Dawir 75 3 8 69 92.00 3 8 69 92.00 3 8 69 92.00 3 8 69 92.00 3 - 69 92.00 3 8 68 90.67 3 8 62 67.39
13 Putat 56 5 3 54 96.43 5 3 54 96.43 5 3 54 96.43 5 3 54 96.43 5 1,395 54 96.43 5 3 56 100.00 5 4 50 51.85
14 Ngaban 90 3 10 82 91.11 3 10 82 91.11 3 10 82 91.11 3 10 82 91.11 3 - 82 91.11 3 10 81 90.00 3 11 76 83.41
15 Kali Tengah 208 18 20 188 90.38 18 20 188 90.38 18 20 188 90.38 18 20 188 90.38 18 - 188 90.38 18 20 189 90.87 18 21 186 205.79
16 Kludan 70 6 1 66 94.29 6 1 66 94.29 6 1 66 94.29 6 1 66 94.29 6 - 66 94.29 6 1 71 101.43 6 1 61 64.70
17 Boro 76 3 8 69 90.79 3 8 69 90.79 3 8 69 90.79 3 8 69 90.79 3 1,395 69 90.79 3 8 68 89.47 3 8 62 68.29
18 Ketegan 77 5 9 70 90.91 5 9 70 90.91 5 9 70 90.91 5 9 70 90.91 5 - 70 90.91 5 9 66 85.71 5 10 61 67.10
19 Ganggang Panjang 83 10 8 78 93.98 10 8 78 93.98 10 8 78 93.98 10 8 78 93.98 10 - 78 93.98 10 8 82 98.80 10 8 74 78.74
20
Total Puskesmas 1395 99 104 1278 91.61 99 104 1278 91.61 99 104 1278 91.61 99 104 1278 91.61 99 3601 1278 91.61 99 104 1264 90.61 99 110 1153 1258.556338
Unit Lain Wil Kab
Rumah Sakit
Total Bulan Ini 1395 99 104 1278 91.6129 99 104 1278 91.613 99 104 1278 91.613 99 104 1278 91.613 99 3601 1278 91.613 99 104 1264 90.6093 99 110 1153 1258.556338
Jml PN Di Polindes
BULAN : OKTOBER
TAHUN : 2021
SASARAN PELAYANAN KESEHATAN BALITA
PENCAPAIAN
NO DESA/ KELURAHAN Balita (0-4) Anak Balita (1-4) KUMULATIF TOTAL
BULAN LALU BULAN INI
L P Total L P Total L P Total L P Total L % P % ABS %
1 Randegan 191 185 376 153 147 300 2 0 2 4 4 8 126 65.96859 125 67.56757 251 83.66667
2 Kedensari 317 307 624 254 245 499 12 13 25 6 8 14 199 62.77603 184 59.93485 383 76.75351
3 Kali sampurno 335 325 660 269 259 528 120 130 250 12 10 22 262 78.20896 256 78.76923 518 98.10606
4 Ketapang 64 62 126 51 49 100 4 3 7 1 1 2 38 59.375 56 90.32258 94 74.60317
5 Kedung Bendo - - 0 0 0 0 0 0 0 0 0 0 0 #DIV/0! 0 #DIV/0! 0 0
6 Gempol Sari 183 177 360 147 141 288 0 0 0 0 0 0 98 53.55191 85 48.0226 183 63.54167
7 Sentul 150 145 295 120 116 236 0 0 0 0 0 0 112 74.66667 108 74.48276 220 93.22034
8 Penatar Sewu 128 124 252 103 99 202 0 0 0 0 0 0 96 75 91 73.3871 187 92.57426
9 Banjar Asri 95 92 187 76 73 149 0 0 0 0 0 0 89 93.68421 91 98.91304 180 120.8054
10 Banjar Panji 64 64 128 52 50 102 0 0 0 0 0 0 44 68.75 46 71.875 90 88.23529
11 Kedung Banteng 126 122 248 101 97 198 0 0 0 0 0 0 100 79.36508 74 60.65574 174 87.87879
12 Kali Dawir 188 182 370 151 146 297 0 0 0 0 0 0 111 59.04255 109 59.89011 220 74.07407
13 Putat 141 137 278 113 109 222 0 0 0 0 0 0 80 56.73759 88 64.23358 168 75.67568
14 Ngaban 227 220 447 179 177 356 5 5 10 5 5 10 132 58.14978 145 65.90909 277 77.80899
15 Kali Tengah 522 506 1028 419 404 823 90 90 180 10 12 22 311 59.57854 327 64.62451 638 77.52126
16 Kludan 175 169 344 140 135 275 5 5 10 4 4 8 105 60 116 68.63905 221 80.36364
17 Boro 192 186 378 154 148 302 4 5 9 3 3 6 108 56.25 121 65.05376 229 75.82781
18 Ketegan 192 186 378 154 148 302 0 0 0 8 5 13 84 43.75 119 63.97849 203 67.21854
19 Ganggang Panjang 209 203 412 168 162 330 5 0 5 4 5 9 123 58.85167 128 63.05419 251 76.06061
20
Total Puskesmas 3,499 3,392 6,891 2,804 2,705 5,509 247 251 498 57 57 114 2,218 79.10 2,269 83.88 4,487 81.45
UNIT LAIN WIL KAB
LUAR WIL PUSK.WIL.KAB/KOT
TOTAL BULAN INI 3,499 3,392 6,891 2,804 2,705 5,509 247 251 498 57 57 114 2,218 79 2,269 84 4,487 81
LUAR WIL PUSK LUAR.WIL.KAB
DINAS : TANGGULANGIN
BULAN : OKTOBER
TAHUN : 2021
PELY. APRAS
Sasaran Anak Prasekolah PENCAPAIAN
NO DESA / KELURAHAN {5 th} KUMULATIF TOTAL
L P Total L P Total L P Total L % P % ABS %
1 Randegan 38 36 74 3 6 9 2 2 4 25 65.78947 25 69.44444 50 67.56757
2 Kedensari 63 60 123 4 10 14 3 5 8 43 68.25397 42 70 85 69.10569
3 Kali sampurno 67 64 131 6 6 12 4 4 8 46 68.65672 45 70.3125 91 69.46565
4 Ketapang 13 12 25 4 2 6 0 0 0 10 76.92308 8 66.66667 18 72
5 Kedung Bendo - - 0 0 0 0 0 0 0 0 #DIV/0! 0 #DIV/0! 0 0
6 Gempol Sari 37 35 72 3 3 6 2 2 4 24 64.86486 23 65.71429 47 65.27778
7 Sentul 30 29 59 4 3 7 0 0 0 20 66.66667 18 62.06897 38 64.40678
8 Penatar Sewu 26 24 50 0 0 0 2 2 4 16 61.53846 21 87.5 37 74
9 Banjar Asri 19 18 37 0 0 0 0 0 0 14 73.68421 20 111.1111 34 91.89189
10 Banjar Panji 13 12 25 0 0 0 3 0 0 11 84.61538 8 66.66667 19 76
11 Kedung Banteng 25 24 49 4 8 12 0 0 0 19 76 21 87.5 40 81.63265
12 Kali Dawir 38 36 74 6 6 12 0 0 0 26 68.42105 26 72.22222 52 70.27027
13 Putat 28 27 55 2 5 7 0 0 0 19 67.85714 20 74.07407 39 70.90909
14 Ngaban 44 44 88 6 4 10 0 0 0 29 65.90909 28 63.63636 57 64.77273
15 Kali Tengah 104 100 204 12 15 27 12 14 26 74 71.15385 74 74 148 72.54902
16 Kludan 35 33 68 7 7 14 0 0 0 26 78 25 75.75758 51 75
17 Boro 38 37 75 6 5 11 0 0 0 28 73.68421 24 64.86486 52 69.33333
18 Ketegan 38 37 75 6 6 12 0 0 0 27 71.05263 26 70.27027 53 70.66667
19 Ganggang Panjang 42 40 82 10 6 16 0 0 0 31 73.80952 29 72.5 60 73.17073
20
Total Puskesmas 698 668 1366 83 92 175 28 29 54 488 69.91404 483 48 971 71.08346
UNIT LAIN WIL KAB
TOTAL BULAN INI 698 668 1366 83 92 175 28 29 54 488 69.91404 483 48 971 71.08346
BULAN : NOVEMBER
TAHUN : 2021
PENCAPAIAN
1 Randegan 191 185 376 153 147 300 4 4 8 21 21 42 147 76.96335 146 78.91892 293 98
2 Kedensari 317 307 624 254 245 499 6 8 14 44 36 80 243 76.65615 220 71.66124 463 93
3 Kali sampurno 335 325 660 269 259 528 12 10 22 0 0 0 262 78.20896 256 78.76923 518 98
4 Ketapang 64 62 126 51 49 100 1 1 2 4 0 4 42 65.625 56 90.32258 98 98
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 183 177 360 147 141 288 0 0 0 40 45 85 138 75.40984 130 73.44633 268 93
7 Sentul 150 145 295 120 116 236 0 0 0 0 0 0 112 74.66667 108 74.48276 220 93
8 Penatar Sewu 128 124 252 103 99 202 0 0 0 0 0 0 96 75 91 73.3871 187 93
9 Banjar Asri 95 92 187 76 73 149 0 0 0 0 0 0 89 93.68421 91 98.91304 180 121
10 Banjar Panji 64 64 128 52 50 102 0 0 0 5 5 10 49 76.5625 51 79.6875 100 98
11 Kedung Banteng 126 122 248 101 97 198 0 0 0 8 28 36 108 85.71429 102 83.60656 210 106
12 Kali Dawir 188 182 370 151 146 297 0 0 0 30 23 53 141 75 132 72.52747 273 92
13 Putat 141 137 278 113 109 222 0 0 0 36 15 51 116 82.2695 103 75.18248 219 99
14 Ngaban 227 220 447 179 177 356 5 5 10 30 30 60 162 71.36564 175 79.54545 337 95
15 Kali Tengah 522 506 1028 419 404 823 10 12 22 66 62 128 377 72.22222 389 76.87747 766 93
16 Kludan 175 169 344 140 135 275 4 4 8 27 24 51 132 75.42857 140 82.84024 272 99
17 Boro 192 186 378 154 148 302 3 3 6 35 30 65 143 74.47917 151 81.1828 294 97
18 Ketegan 192 186 378 154 148 302 8 5 13 48 46 94 132 68.75 165 88.70968 297 98
19 Ganggang Panjang 209 203 412 168 162 330 4 5 9 28 27 55 151 72.2488 155 76.35468 306 93
20
Total Puskesmas 3499 3392 6891 2804 2705 5509 57 57 114 422 392 814 2640 76.45 2661 79.98 5301 538878.19
UNIT LAIN WIL KAB
TOTAL BULAN INI 3499 3392 6891 2804 2705 5509 57 57 114 422 392 814 2640 76.45 2661 79.98 5301 538878.19
BULAN : NOVEMBER
TAHUN : 2021
PELY. APRAS
1 Randegan 38 36 74 2 2 4 5 3 8 30 78.94737 28 77.77778 58 78.37838
2 Kedensari 63 60 123 3 5 8 1 8 9 44 69.84127 50 83.33333 94 76.42276
3 Kali sampurno 67 64 131 4 4 8 6 4 10 52 77.61194 49 76.5625 101 77.09924
4 Ketapang 13 12 25 0 0 0 0 0 0 10 76.92308 8 66.66667 18 72
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 37 35 72 2 2 4 6 4 10 30 81.08108 27 77.14286 57 79.16667
7 Sentul 30 29 59 0 0 0 4 2 6 24 80 20 68.96552 44 74.57627
8 Penatar Sewu 26 24 50 2 2 4 1 2 3 17 65.38462 23 95.83333 40 80
9 Banjar Asri 19 18 37 0 0 0 0 0 0 14 73.68421 20 111.1111 34 91.89189
10 Banjar Panji 13 12 25 3 0 3 0 0 0 11 84.61538 8 66.66667 19 76
11 Kedung Banteng 25 24 49 0 0 0 0 0 0 19 76 21 87.5 40 81.63265
12 Kali Dawir 38 36 74 0 0 0 1 2 3 27 71.05263 28 77.77778 55 74.32432
13 Putat 28 27 55 0 0 0 4 0 4 23 82.14286 20 74.07407 43 78.18182
14 Ngaban 44 44 88 0 0 0 4 3 7 33 75 31 70.45455 64 72.72727
15 Kali Tengah 104 100 204 12 14 26 8 5 13 82 78.84615 79 79 161 78.92157
16 Kludan 35 33 68 0 0 0 1 0 1 27 77.14286 25 75.75758 52 76.47059
17 Boro 38 37 75 0 0 0 2 5 7 30 78.94737 29 78.37838 59 78.66667
18 Ketegan 38 37 75 0 0 0 2 1 3 29 76.31579 27 72.97297 56 74.66667
20
Total Puskesmas 698 668 1366 28 29 57 47 39 86 535 76.64756 522 48 1057 77.37921
UNIT LAIN WIL KAB
TOTAL BULAN INI 698 668 1366 28 29 57 47 39 86 535 76.64756 522 48 1057 77.37921
BULAN : DESEMBER
TAHUN : 2021
PENCAPAIAN
1 Randegan 191 185 376 153 147 300 21 21 42 0 0 0 147 76.96335 146 78.91892 293 97.66667
2 Kedensari 317 307 624 254 245 499 44 36 80 7 5 12 250 78.86435 225 73.2899 475 95.19038
3 Kali sampurno 335 325 660 269 259 528 0 0 0 0 0 0 262 78.20896 256 78.76923 518 98.10606
4 Ketapang 64 62 126 51 49 100 4 0 4 2 2 4 44 68.75 58 93.54839 102 80.95238
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 183 177 360 147 141 288 40 45 85 8 8 16 146 79.78142 138 77.9661 284 98.61111
7 Sentul 150 145 295 120 116 236 0 0 0 0 0 0 112 74.66667 108 74.48276 220 93.22034
8 Penatar Sewu 128 124 252 103 99 202 0 0 0 0 0 0 96 75 91 73.3871 187 92.57426
9 Banjar Asri 95 92 187 76 73 149 0 0 0 0 0 0 89 93.68421 91 98.91304 180 120.8054
10 Banjar Panji 64 64 128 52 50 102 5 5 10 0 2 2 49 76.5625 53 82.8125 102 100
11 Kedung Banteng 126 122 248 101 97 198 8 28 36 5 0 5 113 89.68254 102 83.60656 215 108.5859
12 Kali Dawir 188 182 370 151 146 297 30 23 53 0 0 0 141 75 132 72.52747 273 91.91919
13 Putat 141 137 278 113 109 222 36 15 51 0 0 0 116 82.2695 103 75.18248 219 98.64865
14 Ngaban 227 220 447 179 177 356 30 30 60 15 10 25 177 77.97357 185 84.09091 362 101.6854
15 Kali Tengah 522 506 1028 419 404 823 66 62 128 20 10 30 397 76.05364 399 78.85375 796 96.71932
16 Kludan 175 169 344 140 135 275 27 24 51 0 0 0 132 75.42857 140 82.84024 272 98.90909
17 Boro 192 186 378 154 148 302 35 30 65 0 0 0 143 74.47917 151 81.1828 294 97.35099
18 Ketegan 192 186 378 154 148 302 48 46 94 11 3 14 143 74.47917 168 90.32258 311 102.9801
19 Ganggang Panjang 209 203 412 168 162 330 28 27 55 0 0 0 151 72.2488 155 76.35468 306 92.72727
20 2708 2701
Total Puskesmas 3499 3392 6891 2804 2705 5509 422 392 814 68 40 108 2708 96.57632 2701 99.85213 5409 98.18479
UNIT LAIN WIL KAB
TOTAL BULAN INI 3499 3392 6891 2804 2705 5509 422 392 814 68 40 108 2708 96.57632 2701 99.85213 5409 98.18479
BULAN : DESEMBER
TAHUN : 2021
PELY. APRAS
1 Randegan 38 36 74 5 3 8 3 2 5 33 86.84211 30 83.33333 63 85.13514
2 Kedensari 63 60 123 1 8 9 4 4 8 48 76.19048 54 90 102 82.92683
3 Kali sampurno 67 64 131 6 4 10 5 3 8 57 85.07463 52 81.25 109 83.20611
4 Ketapang 13 12 25 0 0 0 1 1 2 11 84.61538 9 75 20 80
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0! 0 0
6 Gempol Sari 37 35 72 6 4 10 4 0 4 34 91.89189 27 77.14286 61 84.72222
7 Sentul 30 29 59 4 2 6 2 4 6 26 86.66667 24 82.75862 50 84.74576
8 Penatar Sewu 26 24 50 1 2 3 4 0 0 21 80.76923 23 95.83333 44 88
9 Banjar Asri 19 18 37 0 0 0 0 0 0 14 73.68421 20 111.1111 34 91.89189
10 Banjar Panji 13 12 25 0 0 0 1 2 3 12 92.30769 10 83.33333 22 88
11 Kedung Banteng 25 24 49 0 0 0 1 0 1 20 80 21 87.5 41 83.67347
12 Kali Dawir 38 36 74 1 2 3 3 4 12 30 78.94737 32 88.88889 62 83.78378
13 Putat 28 27 55 4 0 4 2 1 3 25 89.28571 21 77.77778 46 83.63636
14 Ngaban 44 44 88 4 3 7 6 4 10 39 88.63636 35 79.54545 74 84.09091
15 Kali Tengah 104 100 204 8 5 13 3 5 8 85 81.73077 84 84 169 82.84314
16 Kludan 35 33 68 1 0 0 3 3 6 30 85.71429 28 84.84848 58 85.29412
17 Boro 38 37 75 2 5 7 3 3 6 33 86.84211 32 86.48649 65 86.66667
18 Ketegan 38 37 75 2 1 3 3 3 6 32 84.21053 30 81.08108 62 82.66667
Total Puskesmas 698 668 1366 47 39 85 50 43 94 585 83.81089 565 48 1150 84.18741
UNIT LAIN WIL KAB
TOTAL BULAN INI 698 668 1366 47 39 85 50 43 94 585 83.81089 565 48 1150 84.18741
LB3 MTBS

PELAYANAN BALITA SAKIT OKTOBER PELAYANAN BALITA SAKIT NOVEMBER PELAYANAN BALITA SAKIT DESEMBER
NO DESA JUMLAH BALITA SAKIT DI MTBS JUMLAH BALITA SAKIT DI MTBS JUMLAH BALITA SAKIT DI MTBS
L P L+ P L P L+ P L P L+ P L P L+ P L P L+ P L P L+ P
1 Randegan 3 3 6 3 3 6 3 3 6 3 3 6 3 3 6 3 3 6
2 Kedensari 6 6 12 6 6 12 5 5 10 5 5 10 5 5 10 5 5 10
3 Kali sampurno 8 5 13 8 5 13 6 8 14 6 8 14 6 8 14 6 8 14
4 Ketapang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kedung Bendo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 4 5 9 4 5 9 3 4 7 3 4 7 3 4 7 3 4 7
7 Sentul 3 4 7 3 4 7 3 4 7 3 4 7 3 4 7 3 4 7
8 Penatar Sewu 4 5 9 4 5 9 3 3 6 3 3 6 3 3 6 3 3 6
9 Banjar Asri 3 6 9 3 6 9 3 5 8 3 5 8 3 5 8 3 5 8
10 Banjar Panji 3 2 5 3 2 5 2 3 5 2 3 5 2 3 5 2 3 5
11 Kedung Banteng 4 5 9 4 5 9 5 6 11 5 6 11 5 6 11 5 6 11
12 Kali Dawir 6 4 10 6 4 10 8 6 14 8 6 14 8 6 14 8 6 14
13 Putat 8 4 12 8 4 12 6 8 14 6 8 14 6 8 14 6 8 14
14 Ngaban 5 6 11 5 6 11 7 5 12 7 5 12 7 5 12 7 5 12
15 Kali Tengah 6 8 14 6 8 14 6 5 11 6 5 11 6 5 11 6 5 11
16 Kludan 1 1 2 1 1 2 3 4 7 3 4 7 3 4 7 3 4 7
17 Boro 0 2 2 0 2 2 5 1 6 5 1 6 5 1 6 5 1 6
18 Ketegan 0 1 1 0 1 1 6 4 10 6 4 10 6 4 10 6 4 10
19 Ganggang Panjang 0 0 0 0 0 0 8 4 12 8 4 12 8 4 12 8 4 12
20
TOTAL PUSK 64 67 131 64 67 131 82 78 160 82 78 160 82 78 160 82 78 160

LB3 MTBS

PELAYANAN BALITA SAKIT TRI BULAN I

NO PUSKESMAS JUMLAH BALITA SAKIT DI MTBS CAKUPAN MTBS
L P L+ P L P L+ P L P L+P
1 Randegan 9 9 18 9 9 18 100.00 100.00 100.00

2 Kedensari 16 16 32 16 16 32 100.00 100.00 100.00
3 Kali sampurno 20 21 41 20 21 41 100.00 100.00 100.00
4 Ketapang 0 0 0 0 0 0 #DIV/0! #DIV/0! #DIV/0!
5 Kedung Bendo 0 0 0 0 0 0 #DIV/0! #DIV/0! #DIV/0!
6 Gempol Sari 10 13 23 10 13 23 100.00 100.00 100.00
7 Sentul 9 12 21 9 12 21 100.00 100.00 100.00
8 Penatar Sewu 10 11 21 10 11 21 100.00 100.00 100.00
9 Banjar Asri 9 16 25 9 16 25 100.00 100.00 100.00
10 Banjar Panji 7 8 15 7 8 15 100.00 100.00 100.00
11 Kedung Banteng 14 17 31 14 17 31 100.00 100.00 100.00
12 Kali Dawir 22 16 38 22 16 38 100.00 100.00 100.00
13 Putat 20 20 40 20 20 40 100.00 100.00 100.00
14 Ngaban 19 16 35 19 16 35 100.00 100.00 100.00
15 Kali Tengah 18 18 36 18 18 36 100.00 100.00 100.00
16 Kludan 7 9 16 7 9 16 100.00 100.00 100.00
17 Boro 10 4 14 10 4 14 100.00 100.00 100.00
18 Ketegan 12 9 21 12 9 21 100.00 100.00 100.00
19 Ganggang Panjang 16 8 24 16 8 24 100.00 100.00 100.00
20
TOTAL KAB 228 223 451 228 223 451 100.00 100.00 100.00
LB3 MTBM

PELAYANAN BALITA SAKIT OKTOBER PELAYANAN BALITA SAKIT NOVEMBER PELAYANAN BALITA SAKIT DESEMBER
NO DESA JUMLAH BALITA SAKIT DI MTBM JUMLAH BALITA SAKIT DI MTBM JUMLAH BALITA SAKIT DI MTBM
L P L+ P L P L+ P L P L+ P L P L+ P L P L+ P L P L+ P
1 Randegan 2 1 3 2 1 3 0 4 4 0 4 4 2 1 3 0 4 4
2 Kedensari 7 5 12 7 5 12 4 7 11 4 7 11 7 5 12 4 7 11
3 Kali sampurno 6 6 12 6 6 12 4 3 7 4 3 7 6 6 12 4 3 7
4 Ketapang - 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kedung Bendo - 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Gempol Sari 2 1 3 2 1 3 1 6 7 1 6 7 2 1 3 1 6 7
7 Sentul 2 2 4 2 2 4 1 1 2 1 1 2 2 2 4 1 1 2
8 Penatar Sewu 2 0 2 2 0 2 3 1 4 3 1 4 2 0 2 3 1 4
9 Banjar Asri - 0 0 - 0 0 3 2 5 3 2 5 0 0 0 3 2 5
10 Banjar Panji 1 1 2 1 1 2 0 1 1 0 1 1 1 1 2 0 1 1
11 Kedung Banteng 2 2 4 2 2 4 2 3 5 2 3 5 2 2 4 2 3 5
12 Kali Dawir 2 2 4 2 2 4 1 2 3 1 2 3 2 2 4 1 2 3
13 Putat 2 2 4 2 2 4 4 1 5 4 1 5 2 2 4 4 1 5
14 Ngaban 3 2 5 3 2 5 2 1 3 2 1 3 3 2 5 2 1 3
15 Kali Tengah 7 5 12 7 5 12 8 10 18 8 10 18 7 5 12 8 10 18
16 Kludan 2 1 3 2 1 3 3 3 6 3 3 6 2 1 3 3 3 6
17 Boro 3 2 5 3 2 5 1 2 3 1 2 3 3 2 5 1 2 3
18 Ketegan 3 3 6 3 3 6 3 2 5 3 2 5 3 3 6 3 2 5
19 Ganggang Panjang 1 2 3 1 2 3 3 7 10 3 7 10 1 2 3 3 7 10
20
TOTAL PUSK 47 37 84 47 37 84 43 56 99 43 56 99 47 37 84 43 56 99
LB3 MTBM

PELAYANAN BALITA SAKIT TRI BULAN III

NO PUSKESMAS JUMLAH BALITA SAKIT DI MTBM CAKUPAN MTBM
L P L+ P L P L+ P L P L+P
1 Randegan 4 6 10 2 9 11 50.00 150.00 110.00

2 Kedensari 18 17 35 15 19 34 83.33 111.76 97.14
3 Kali sampurno 16 15 31 14 12 26 87.50 80.00 83.87
4 Ketapang 0 0 0 0 0 0 #DIV/0! #DIV/0! #DIV/0!
5 Kedung Bendo 0 0 0 0 0 0 #DIV/0! #DIV/0! #DIV/0!
6 Gempol Sari 5 8 13 4 13 17 80.00 162.50 130.77
7 Sentul 5 5 10 4 4 8 80.00 80.00 80.00
8 Penatar Sewu 7 1 8 8 2 10 114.29 200.00 125.00
9 Banjar Asri 3 2 5 6 4 10 200.00 200.00 200.00
10 Banjar Panji 2 3 5 1 3 4 50.00 100.00 80.00
11 Kedung Banteng 6 7 13 6 8 14 100.00 114.29 107.69
12 Kali Dawir 5 6 11 4 6 10 80.00 100.00 90.91
13 Putat 8 5 13 10 4 14 125.00 80.00 107.69
14 Ngaban 8 5 13 7 4 11 87.50 80.00 84.62
15 Kali Tengah 22 20 42 23 25 48 104.55 125.00 114.29
16 Kludan 7 5 12 8 7 15 114.29 140.00 125.00
17 Boro 7 6 13 5 6 11 71.43 100.00 84.62
18 Ketegan 9 8 17 9 7 16 100.00 87.50 94.12
19 Ganggang Panjang 5 11 16 7 16 23 140.00 145.45 143.75
20
TOTAL KAB 137 130 267 133 149 282 97.08 114.62 105.62
LAPORAN KASUS BBLR
JENIS NAMA TMP JENIS PERSALINAN PENYEBAB BBLR KEL
NO NAMA TGL LAHIR BB (gr) ALAMAT Persalinan KONGENITAL UK
L P BAPAK IBU spt SC tind BAYI IBU
1 By.Ny.Lisilmik 16-Oct-21 1600 √ Tn. Agus Ny.Lisilmik Ganggangpanjang 4/1 RSUD √ 28mgg
2 By Ny. Dewi 28-Sep-21 2200 √ Tn. Sofiyan Ny. Dewi Kalidawir 9/4 RSUD √ 35mgg
3 By.Ny.Fatin 16-Oct-21 2430 √ Tn.Ahmad Ny.Fatin Putat 8/2 RSI √ 37 mgg
4 By.Ny.Siti Masruroh 1-Oct-21 2400 √ TnAngga Ny.Siti Kalisampurno 13/4 RSUD √ 40 mgg
5
6
7
8
9
10
11
12
13
14
15
16
17
18
mengetahui Sidoarjo,
Kepala Puskesmas Pengelola KIA
( ) ( )
LAPORAN KASUS BBLR
1 NIHIL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
( ) ( )
LAPORAN KASUS BBLR
BULAN : DESEMBER
1 By. Ny Lasmi 30-Nov-21 1600 gr v Tn. Agus Ny. Lasmi Ganggang Panjang 4/1 RS v IUGR 37 mgg
2 By. Ny Iis Murodah 5-Dec-21 2300 gr v Tn Misbahul Ny Iis Muroda Kali Dawir 7/2 RSS v IUGR 38 mgg
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
( ) ( )
DATA IUFD TH 2021
KABUPATEN SIDOARJO
BULAN : OKTOBER
Orang Tua GENDER Tmp Lahir Penolong KETERANGAN

N0 NAMA TGL Lahir ALAMAT
Bpk Ibu L P (sebutkan nama) Sebab BB Kondisi Bayi
1 By.Ny.Hanum Tn.Nurul Huda Ny.Hanum √ Sep-21 DKT Dokter Kalidawir 6/2
2
3
4
5
6
7
8
9
10
Keterangan : diisi dgn BB dan kelainan bawaan yg ada
Mengetahui Sidoarjo, 25 Oktober 2021
Kepala Puskesmas................... Pengelola KIA

DATA IUFD TH 2021
KABUPATEN SIDOARJO

1 NIHIL
2
3
4
5
6
7
8
9
10
Mengetahui Sidoarjo, 25 November 2021

DATA IUFD TH 2021
KABUPATEN SIDOARJO
BULAN : DESEMBER

1 NIHIL
2
3
4
5
6
7
8
9
10
Mengetahui Sidoarjo, 2021

DATA GEMELLI TH 2021
KABUPATEN SIDOARJO
Orang Tua GENDER KETERANGAN

Bpk Ibu L P BB Pencetus Lahir TMp Partus
1 NIHIL
2
3
4
5
6
7
8
9
10
Keterangan : bisa diisi dgn BB dan kelainan bawaan yg ada

Kepala Puskesmas ........................... Pengelola KIA
KABUPATEN SIDOARJO

1 NIHIL
2
3
4
5
6
7
8
9
10

KABUPATEN SIDOARJO

1 NIHIL
2
3
4
5
6
7
8
9
10

LAPORAN KASUS RISIKO TINGGI DAN KOMPLIKASI PADA NEONATUS
BULAN / TAHUN : OKTOBER 2021
NAMA ORANG TUA Tanggal Gender Alamat Umur FAKTOR RISIKO & KOMPLIKASINYA
lahir Trauma BBLR sebutkan Asfiksi Infeksi TN Kel Lain - lain
NO NAMA BAYI Lahir BB, sebab) (sebutkan Kongenit (sebutkan)
Bapak Ibu
(sebutkan) sebab) al
(sebutkan
1 By Ny Uswatun Tn Tri Ny Uswatun 10/9/2021 I Kedensari 3/1 23th KPP )
2 By Ny Ika Tn Bahrul Ny Ika 10/13/2021 I Kedensari 21/6 24th KPP Letsu
3 By Ny Eka Tn Erwin Ny Eka 10/20/2021 III Kedensari 3/1 34th KPP
4 By Ny Indah Tn Mudakkir Ny Indah 10/3/2021 II Kedungbanteng 6/3 29th KPP
5 By Ny Siti Tn Agus Ny Siti 9/7/2021 I Randegan 1/1 22th KPP
6 By Ny Sandra Tn Wildan Ny Sandra 9/8/2021 II Randegan 9/2 25th KPP
7 By Ny .Maulidevi Tn.Galang Ny.Maulidevi 10/14/2021 I Randegan 3/1 27 th KPP
8 By.Ny.Lisilmik Tn.Agus Ny.Lisilmik 10/16/2021 II Ganggangpanjang 4/1 35 th 1600
9 By.Ny.Nastiti Tn.Alfin Ny.Nastiti 10/16/2021 II Ganggangpanjang 14/4 24 th BSC
10 By.Ny.Ria Tn.Imron Ny.Ria II Penatarsewu 8/2 27 th BSC
11 By.Ny.Indri Tn.Aris Ny.Indri I Penatarsewu 2/1 24 th Postdate
12 By.Ny.Yuniarti Tn.Ari Ny.Yuniarti 10/12/2021 II Ngaban 8/2 31 th BSC
13 By.Ny.Siti Tn.Angga Ny.Siti 10/1/2021 I Kalisampurno 13/4 24 th 2400
14 By.Ny.Hanum Tn.Nurul Ny.Hanum 9/25/2021 II Kalidawir 6/2 24 th IUFD
15 By.Ny.Yeni Tn.Maksum Ny.Yeni 10/8/2021 I Putat 4/1 23 th HBSAG (+) SC
16 By.Ny.Fifin Tn.Zainun Ny.Fifin 10/13/2021 IV Banjar ari 9/3 39 th Letsu
17 By.Ny.Fatin Tn.Anton Ny.Fatin 10/16/2021 I Putat 8/2 23 th 2430 KPP
18 By.Ny.Hikmatul Tn.Lukman Ny.Hikmatul 10/19/2021 II Kedungbanteng 4/1 26 th KPP
19 By.Ny.Nur Amanah Tn.Agus Ny.Nur Amanah 10/21/2021 II Banjarpanji 3/1 39 th Postdate + PE
20 By.Ny.Dewi Tn.Sofyan Ny.Dewi 9/28/2021 IV Kalisawir9/4 33 th 2200 BSC
BULAN / TAHUN : NOVEMBER 2021
NAMA ORANG TUA Tanggal lahir Gender Alamat Umur Ibu FAKTOR RISIKO & KOMPLIKASINYA
Trauma BBLR sebutkan Asfiksi Infeksi TN Kel Lain - lain
NO NAMA BAYI Lahir BB, sebab) (sebutkan Kongenita (sebutkan)
Bapak Ibu
(sebutkan) sebab) l
(sebutkan)
1 By. Ny. Dita Nur M Tn. Eko Priyo Ny. Dita Nur M 11/11/2021 L Kali Sampurno 9/3 25 th Prematur
2. By. Ny. Yayuk Tn. Arifin Ny. Yayuk 10/27/2021 P Gempol Sari 7/2 25 th Postdate
3 By. Ny. Emi Tn Diki Ny. Emi 28/20/2021 L Banjar Asri 11/3 27 th KPP
4 By. Ny. Sumiati Tn Slamet Ny. Sumiati 11/2/2021 L Banjar Asri 11/3 38 th KPP
5 By. Ny. Ainun Tn Ikhsan Ny. Ainun 11/2/2021 P Kali Tengah 3/15 37 th Postdate
6 By. Ny. Dyah Tn Ayyuf Ny. Dyah 11/4/2021 L Nganban 8/3 28 th KPP
7. By. Ny. Maurin Tn. Faktur Ny. Maurin 11/9/2021 L Kedung Banteng 6/3 26 th KPP
8 By. Ny. Vivi Tn Zaelani Ny. Vivi 11/10/2021 L Gempol Sari 7/2 23 th KPP
9 By. Ny. Ratna Tn.Sudarto Ny. Ratna 11/10/2021 P Kedung Banteng 8/4 30 th KPP
10 By. Ny. Rida Tn Zaelani Ny. Rida 11/10/2021 L Kedung Banteng 5/2 28 th Bsc + HbsAg
(+)
11 By. Ny. Itaul Tn Adeng Ny. Itaul 11/17/2021 P Kedung Banteng 2/1 28 th KPP
12 By. Ny. Mifba'ati Tn Sukan Ny. Mifba'ati 11/19/2021 P Banjar Asri 4/3 42 th KPP
13 By. Ny. Bela Dian Tn. Junaedi Ny. Bela Dian 11/20/2021 P Penatar Sewu 6/2 21 th KPP
14 By. Ny. Finda Tn. Ny. Finda 11/22/2021 P Gempol Sari 9/2 27 th Postdate
15 By. Ny. Novika sari Tn. Fakthur R Ny. Novika sari 07/10.2021 P Kali Tengah 4/2 24 th HbsAg (+)
16 By. Ny. Ainun Tn. Ikhsan Ny. Ainun 11/3/2021 L Kali Tengah 3/15 38 th KPP
17 By. Ny. Mindarwati Tn. Hendra Ny. Mindarwati 11/13/2021 L Kali Tengah 5/4 34 th Postdate
18 By. Ny. Ummu Safina Tn. M. Sandi Ny. Ummu S 11/13/2021 P Kali Tengah 8/6 26 th KPP
19 By.Ny.Dwi Sulis TN.M..Fadil Ny.Dwi Sulis 11/16/2921 L Kedensari 4/2 24 KPP
20 By.Ny.wiwin Tn.Sudarto Ny.Wiwin 11/23/2021 P Kalidawir 6/2 41 KPP
BULAN / TAHUN : DESEMBER 2021
NAMA ORANG TUA Tanggal Gender Alamat Umur FAKTOR RISIKO & KOMPLIKASINYA
lahir Trauma BBLR sebutkan Asfiksi Infeksi/ TN Kel Lain - lain
Lahir BB, sebab) (sebutkan KPP Kongenit (sebutkan)
NO NAMA BAYI (sebutkan) sebab) al
Bapak Ibu
(sebutkan
)
1 By. Ny Lasmi Tn. Agus Ny. Lasmi 30-Nov-21 p Ganggang Panjang 4/1 28 v ( 1600 gr)
2 By. Ny Iis Murodah Tn Misbahul Ny Iis Murodah 5-Dec-21 p Kali Dawir 7/2 25 v (2300 gr)
3 By. Ny Fitra Tn. Saiful Ny. Fitra 12/10/2021 P Sentul 11/3 22 v
4 By. Ny Novia Tn Andre Ny. Novia 11/26/2021 L Putat 4/1 21 v
5 By. Ny Nurul Tn Ainur Ny. Nurul 11/30/2021 P Kedung Banteng 5/2 30 th v
6 By. Ny Fatimatus Tn. Mahmudi Ny. Fatimatus 12/3/2021 P Kali Dawir 3/1 23 th v
7 By. Ny Siti Nur Tn. Luqman Ny. Siti Nur 12/6/2021 L Sentul 9/3 23 th Anansephalus
8 By. Ny Reni Tn Candra Ny. Reni 12/18/2021 L Gempol Sari 9/2 21 th v
9 By. Ny Tina Tn. Mulyadi Ny. Tina 12/19/2021 L Kali Dawir 29 th v
10 By. Ny Masruro Tn Wahyu H Ny. Masruroh 12/22/2021 L Sentul 4/1 32 th v
11 By. Ny Imaniar Tn Budi Ny. Imaniar 11/29/2021 L Ngaban 13/5 26 th v
12 By. Ny Agustina Tn Budi Ny. Agustina 27.11.2021 L Ngaban 4/1 28 th v
13 By. Ny Devi Tn. Prawira Ny. Devi 12/18/2021 P Ngaban 2/2 27 th Postdate
21
22
23
YA
Jenis
persalinan
SC
SC
SC
SC
SC
SC
SC
SPT B
SC
SC
SC
SC
SC
SPT B
HBSAG (+) SC
SC
SC
SC
SC
SC
YA
Jenis
persalinan
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
SC
YA
Jenis
persalinan
SPT B
SPT B
SC
SC
SC
SC
SPT B
SC
SC
SPT B
SPT B
sc
SPT B
LAPORAN KASUS RISIKO TINGGI DAN KOMPLIKASI PADA IBU HAMIL, BERSALIN DAN NIFAS
BULAN / TAHUN : OKTOBER
FAKTOR RISIKO/ KOMPLIKASI YANG ADA

KEHAMILAN BERSALIN NIFAS
NO Nama Ibu/ Suami Alamat Umur
Post Post Kel Tl Psrt Fetal Partus
Gravida UK Jarak Ab Lab TB TFU APB KPP Peny (sebutkan) Gemeli Prematur Infeksi Perdarahan KPP HPP
Tindakan Date letak numbung distres lama
1 Ny.Hanum/Tn.Nurul Huda Kalidawir 6/2 24 th II 19 mgg IUFD
2
Ny.Putri/Tn.Ilyas Sentul 2/1 21 th II 4 mgg Amenorhe+Hiperfiasia
3 Ny.Yeni/Tn.M,Maksum Putat 4/1 23 th I 37 mgg HBSAG(+)
4 Ny.Ika/Tn.Bahrul Kedensari 21/6 25 th II 37 mgg Letsu
5 Ny.Hikmatul/Tn.Lukman Kedungbanteng 4/1
26 th II 38 mgg √
6 Ny. NurAmanah/Tn.Agus Banjar Panji 3/1 39 th II 40mgg Usia ibu √
Penatarsewu1/1 √
7 Ny. Indri/ Tn Aris 24th I 39mgg
8 Ny. Dewi/Tn Sofiyan Kalidawir 9/4 33th IV 35mgg BSC
9 Ny.Siti/Tn.Alimin Putat 6/2 34 th V 39 mgg Grademulti
10 Ny.Ida/Tn.Umar Kalidawir 11/4 25 th II 30 mgg <2 th
11 Ny.Aisyah/Tn.Bagus Penatarsewu 8/2 37 th III 7 mgg √ Usia ibu
12 Ny.Ida/Tn.Arif Sentul 1/1 26 th III 18 mgg <2 th
13 Ny.Yanita/Tn.Eka Penatarsewu 1/1 27 th III 29 mgg √
14 Ny.Yuniarli/Tn.Ari Ngaban 8/2 31 th II 39 mgg BSC
15 Ny.Ria/Tn.Imron Penatarsewu 8/2 27 th II 39 mgg BSC
16 Ny.Indri/Tn.Aris Penatarsewu 2/1 24 th I 40 mgg √
17 Ny.Siti Nur/Tn.Agus Randegan 1/1 22 th I 38 mgg √ √
18 Ny.Sandra/Tn.Wildan Randegan 9/2 25 th II 39 mgg √
19 Ny.Maulidevi/Tn.Galang Randegan 3/1 27 th I 38 mgg √
20 Ny.Lisilmik/Tn.Agus Gagangpanjang 4/2 35 th II 28 mgg 1600
21 Ny.Nastiti/Tn.Alfin Gagangpanjang 14/4 24 th II 39 mgg BSC
22 Ny.Maurin/Tn.Bima Kedungbanteng 6/3 38 th II 35 mgg Usia ibu
23 Ny.Sufiana/Tn.Maisnul Kedungbanteng 2/1 38 th I 8 mgg Usia ibu
24 Ny.Azizatut/Tn.Arif Kedensari 5/2 27 th III 12 mgg √
25 Ny.Khanifa/Tnm.Mustajib Kedensari 22/6 40 th IV 16 mgg Usia ibu
26 Ny.Masiah/Tn.Bagus Kedensari 11/4 25 th II 9 mgg <2 th Multipara
27 Ny.Dianti/Tn.Hermanto Kedensari 3/1 33 th IV 6 mgg Multipara
28 Hanim/Tn.Hari Mlagi 11/5 36 th III 11 mgg Usia ibu
29 Ny.Luluk/Tn.Edi Kludan 5/2 41 th III 31 mgg Usia ibu
30 Ny.Fita/Tn.Didi Dwi K Kludan 2/3 36 th III 32 mgg Usia ibu
31 Ny.Elly/Tn.Miskiran Kludan 2/3 39 th II 8 mgg Usia ibu
32 Ny.Sri Suryani/Tn.Syaifudri Kedensari 22/6 37 th V 41mgg Usia ibu + grademulti
33 Ny.Tety/Tn.Arip Kedensari 11/4 34 th I 40 mgg √
34 Ny.Uswatun/Tn.Tri Kedensari 3/1 23 th I 38 mgg √ √
35 Ny.Eka/Tn.Erwin Kedensari 3/1 34 th III 39 mgg √
36 Ny.Indah/Tn.M.Muddakir Kedungbanteng 6/3 29 th II 37 mgg √
37
38
39
40
BULAN / TAHUN : NOVEMBER

1 Ny. Sumiati/ Tn Slamet Banjar Asri 11/3 38 th IV 39 √
2 Ny. Ainun/ Tn Ikhsan Kali Tengah 3/15 37 th I 40 √
3 Ny. Dyah/ Tn Ayyuf Nganban 8/3 28 th II 37 √
4 Ny. Maurin/ Tn. Faktur Kedung Banteng 6/3 26 th III 40
√
5 Ny. Vivi/ Tn Zaelani Gempol Sari 7/2 23 th I 41 √

6 Ny. Ratna/Tn.Sudarto Kedung Banteng 8/4 30 th II 39
√
7 Ny. Rida/Tn Zaelani Kedung Banteng 5/2 28 th 2 40
8 Ny. Sri Rahayu/ Tn. Husman Boro 2/1 32 tn III 38
9 Ny. Dwi/Tn Fadil Kedensari 4/2 24 th I 38 √

10 Ny. Itaul/ Tn Adeng Kedung Banteng 2/1 28 th 3 39
√
11 Ny. Mifba'ati/ Tn Sukan Banjar Asri 4/3 42 th IV 38 √

12 Ny. Bela Dian/Tn. Junaedi Penatar Sewu 6/2 21 th I 38 √
13 Ny. Khirotul Aini/ Tn. Arifin Penatar Sewu 10/2 27 th 2 38 √
14 Ny. Wiwin/Tn Suyatno Kali Dawir 6/2 41 th III 38 √
15 Ny. Finda Gempol Sari 9/2 27 th II 41-42 √
16 Ny. Mindarwati/Tn. Hendra Kali tengah 5/4 34 th III 40 √
17 Ny. Ummu/Tn. Sandi Kali Tengah 8/6 26 th I 39 √
18 Ny. Emi/Tn Diki Banjar Asri 11/3 27 th I 39 √
19 Ny. Yeni Putat 4/1 24 th I 38 √
20 Ny. Fatin/Tn. Anton Putat 8/2 23 th I 38 √
21 Ny. Yayuk/ Tn. Arifin Gempol Sari 7/2 25 th II √
22 Ny. Ma'rifatul/Tn. Majidah Gempol Sari 5/2 22 th I
23 Ny. Yuliana/Tn. Denal Perumtas 2 29 th I
24 Ny. Miftachul/Yn. Hari Kali Sampurno 1/1 32 th II 40 √
25 Ny. Dita/Tn. Eko Kali Sampurno 9/3 25 th II 40 √
26
27
28
29
30
31
32
33
34
35
LAPORAN KASUS RISIKO TINGGI DAN KOMPLIKASI PADA IBU HAMIL, BERSALIN DAN NIFAS
BULAN / TAHUN : DESEMBER

1 Ny. Fitra/Tn. Saiful Sentul 11/3 22 v
2 Ny. Novia/Tn Andre Putat 4/1 21 v
3 Ny. Nurul/Tn Ainur Kedung Banteng 5/2 30 th v
4 Ny. Fatimatus/Tn. Mahmudi Kali Dawir 3/1 23 th v
5 Ny. Siti Nur/Tn. Luqman Sentul 9/3 23 th Anansephalus
6 Ny. Reni/Tn Candra Gempol Sari 9/2 21 th v
7 Ny. Tina/Tn. Mulyadi Kali Dawir 29 th v
8 Ny. Masruroh/Tn Wahyu H Sentul 4/1 32 th v
9 Ny. Imaniar/Tn Budi Ngaban 13/5 26 th v
10 Ny. Agustina/Tn Budi Ngaban 4/1 28 th v
11 Ny. Devi/Tn. Prawira Ngaban 2/2 27 th v
12 Ny. Resy/ Tn Deri Kali Tengah 1/6 28 th 1 40 mg v
13 Ny. Herma/ Tn Ali Kali Tengah 6/2 35 th 3 39 gg v
14 Ny. Siti M/ Tn. Firdaus Ganggang Panjang 16/428 th 3 40 mgg v
NIFAS
Peny
Infeksi
(sebutkan)
NIFAS
Peny
Infeksi
(sebutkan)
HbsAg (+)
Plasenta
previa
CPD
NIFAS
Peny
Infeksi
(sebutkan)
LAPORAN PWS BAYI
BULAN : OKTOBER
TAHUN : 2021
SASARAN KN 1 KN 2 KN 3 (Lengkap) Neo Komplikasi Kunjungan Bayi
PWS pr LAHIR MATI (Pr)
NO DESA/ KELURAHAN
Kelahiran Hidup BAYI PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN
L P L P L P L P L P L P L P L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Randegan - -
2 Kedensari - -
3 Kali sampurno - -
4 Ketapang - -
5 Kedung Bendo - -
6 Gempol Sari - -
7 Sentul - -
8 Penatar Sewu - -
9 Banjar Asri - -
10 Banjar Panji - -
11 Kedung Banteng - -
12 Kali Dawir - -
13 Putat - -
14 Ngaban - -
15 Kali Tengah - -
16 Kludan - -
17 Boro - -
18 Ketegan - -
19 Ganggang Panjang - -
20
Total Puskesmas - - - - - - - - - - - - - - - - - -
UNIT LAIN WIL KAB - - - -
LUAR WIL PUSK.WIL.KA - - - -
TOTAL BULAN INI - - - - - - - - 0 0 - - - - 0 0 - -
LUAR WIL PUSK LUAR.W
LAPORAN PWS BAYI
BULAN : NOVEMBER
TAHUN : 2021
Kunjungan Bayi
SASARAN KN 1 KN 2 KN 3 (Lengkap) Neo Komplikasi (Pr)
PWS pr LAHIR MATI
NO DESA/ KELURAHAN Kelahiran Hidup BAYI PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Randegan - -
2 Kedensari - -
3 Kali sampurno - -
4 Ketapang - -
5 Kedung Bendo - -
6 Gempol Sari - -
7 Sentul - -
8 Penatar Sewu - -
9 Banjar Asri - -
10 Banjar Panji - -
12 Kali Dawir - -
13 Putat - -
14 Ngaban - -
15 Kali Tengah - -
16 Kludan - -
17 Boro - -
18 Ketegan - -
20
Total Puskesmas - - - - - - - - - - - - - - - - - -
TOTAL BULAN INI - - - - - - - - 0 0 - - - - 0 0 - -
LAPORAN PWS BAYI
BULAN : DESEMBER
TAHUN : 2021
Kunjungan Bayi
SASARAN KN 1 KN 2 KN 3 (Lengkap) Neo Komplikasi (Pr)
PWS pr LAHIR MATI
NO DESA/ KELURAHAN Kelahiran Hidup BAYI PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN PENCAPAIAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Randegan - -
2 Kedensari - -
3 Kali sampurno - -
4 Ketapang - -
5 Kedung Bendo - -
6 Gempol Sari - -
7 Sentul - -
8 Penatar Sewu - -
9 Banjar Asri - -
10 Banjar Panji - -
12 Kali Dawir - -
13 Putat - -
14 Ngaban - -
15 Kali Tengah - -
16 Kludan - -
17 Boro - -
18 Ketegan - -
20
Total Puskesmas - - - - - - - - - - - - - - - - - -
TOTAL BULAN INI - - - - - - - - 0 0 - - - - 0 0 - -
CATATAN TAMBAHAN
DATA BY NAME IBU HAMIL DENGAN RHESUS NEGATIF
RHESUS GOLDA
NO NAMA SUAMI ALAMAT UMUR GRAV
A
1 NIHIL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Ket
Bila rhesus negatif ditulis (-)
CATATAN TAMBAHAN
DATA BY NAME IBU HAMIL DENGAN RHESUS NEGATIF
RHESUS GOLDA
NO NAMA SUAMI ALAMAT UMUR GRAV
A
1 NIHIL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
RHESUS GOLDA
B AB O
RHESUS GOLDA
B AB O
LAPORAN PENDAMPINGAN RESIKO TINGGI IBU HAMIL
BULAN OKTOBER 2021
Nama Usia Desa/ K/U Renc. Hidup/

No Nama Bumil Gravida UK Alamat Skor/ Jenis Resti
Kader Bumil Kelurahan Bumil Melahirkan Mati
1 Ny. Zakiyatus III 42 mgg Kalitengah 6/2 Kalitengah Skor Awal :2 Baik Bidan
33 th BSC :8
Jarak Ank <2th :4
2 Ny. Nadia IV 36 mgg Kalitengah 2/3 Kalitengah Skor Awal :2 Baik Bidan
37 th
Usia :4
3 Ny. Anita K III 36 mgg P. Eksekutif N/1 Kalitengah Skor Awal : 2 Baik Bidan
34 th
Jarak Ank<2th : 4
4 Ny. Farida II 30 mgg Kalitengah 6/2 Kalitengah Skor Awal : 2 Baik Bidan
Usia : 4
38 th
BSC : 8
Jarak Ank >10th : 4
5 Ny. Haninah I 29 mgg PTA FF no 30 6/6 Kaitengah Skor Awal : 2 Baik Bidan
31 th
Hamil ke-1 >4th : 4
6 Ny. Ferdita II 27 mgg Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan
24 th 1/1 Jarak Anak>10th : 4
7 Ny. Arin III 30 mgg Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan
30 th 1/1 BSC : 8
8 Ny.Dwi II 30 mgg Kalitengah 4/4 Kalitengah : 2 Baik Bidan
Skor Awal Abortus
30 th : 4
9 Ny.Erika II 26 mgg Perum.Executif Kalitengah Skor Awal Jarak : 2 Baik Bidan
18 th B-24 2/10 Anak <2 th : 4
10 Ny.Ayu II 32 mgg TA OO-8 2/6 Kalitengah Skor Awal : 2 Baik Bidan
24 th Jarak Anak <2th : 4
11 Ny.Lailatul II 18 mgg Kalitengah 2C Kalitengah : 2 Baik Bidan
Skor Awal Abortus
32 th : 4
12 Ny.Ety II 29 mgg Kalitengah 3/2 Kalitengah Skor Awal : 2 Baik Bidan
29 th BSC : 8
13 Ny.Susiatin II 18 mgg GAK 2D-1 3/8 Kalitengah Skor Awal : 2 Baik Bidan
32 th
BSC : 8
14 Ny Hijayud II 13 mgg Kali Tengah 3/2 Kalitengah Skor Awal : 2 Baik Bidan
23 th
Abortus : 4
15 Ny. Eveline 18 th II 40 mgg PKT Aj-31 Kali Tengah Skor Awal : 2 Baik Bidan Partus
Jarak Anak <2th : 4
16 Ny. Fitria 39 th II 17 mgg TA Q-20 Kali Tengah Skor Awal Usia : 2 Baik Bidan
Ibu : 4
BSC : 8
Sidoarjo, 25 Oktober 2021
Churnia Amin Suryani, SST

NIP. 196810101991022001
BULAN NOVEMBER 2021

1 Ny. Nadia IV 40 mgg Kalitengah 2/3 Kalitengah Skor Awal :2 Baik Bidan Partus
37 th
Usia :4
2 Ny. Anita K 34 th III 40 mgg P. Eksekutif N/1 Kalitengah Skor Awal : 2 Baik Bidan Partus
Jarak Ank<2th : 4
3 Ny. Farida II 34 mgg Kalitengah 6/2 Kalitengah Skor Awal : 2 Baik Bidan
Usia : 4
38 th
BSC : 8
Jarak Ank >10th : 4
31 th
Hamil ke-1 >4th : 4
5 Ny. Ferdita II 31 mgg Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan
24 th
Jarak Anak>10th : 4
6 Ny. Arin III 34 mgg 1/1
Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan
30 th 1/1 BSC : 8
7 Ny.Dwi II 34 mgg Kalitengah 4/4 Kalitengah : 2 Baik Bidan
Skor Awal Abortus
30 th : 4
18 th B-24 2/10 Anak <2 th : 4
9 Ny.Ayu II 34 mgg TA OO-8 2/6 Kalitengah Skor Awal : 2 Baik Bidan
Skor Awal Abortus
32 th : 4
29 th BSC : 8
32 th
BSC : 8
23 th
Abortus : 4
14 Ny. Fitria 39 th II 21 mgg TA Q-20 Kalitengah Skor Awal Usia : 2 Baik Bidan
Ibu : 4
BSC : 8
15 Ny.Sriana 42 th IV 12 mgg PKT 2/9 Kalitengah Skor awal 2 Baik Bidan
Usia ibu : 4
Multi 4
16 Ny.Heni 29 th II 8 mgg PKT 1/9 Kalitengah Skor awal 2
:
Jarak anak 4
17 Ny.Siti M 37 II 6 mgg Kalitengah 6/6 Kalitengah Skor awal 2 Baik Bidan
Usia ibu : 4
BSC 8
Sidoarjo, 25 November 2021

NIP. 19681010 199102 2 001
BULAN DESEMBER 2021

1. Ny.Karin II 6 mgg GAK K-15 Kalitengah Skor Awal 2 Baik RS
22 th :
BSC
8
2. Ny.Intan 26 th IV 38 mgg TA TT Kalitengah Skor awal :
2 Baik Bidan Partus
Abortus 6
3 Ny. Farida II 38 mgg Kalitengah 6/2 Kalitengah Skor Awal : 2 Baik Bidan Partus
Usia : 4
38 th
BSC : 8
Jarak Ank >10th : 4
31 th
Hamil ke-1 >4th : 4
5 Ny. Ferdita 24 th II 35 mgg Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan
1/1 Jarak Anak>10th : 4
6 Ny. Arin III 38 mgg Kalitengah utara Kalitengah Skor Awal : 2 Baik Bidan Partus
30 th
1/1 BSC : 8
7 Ny.Dwi II 38 mgg Kalitengah 4/4 Kalitengah : 2 Baik Bidan Partus
Skor Awal Abortus
30 th : 4
18 th B-24 2/10 Anak <2 th : 4
9 Ny.Ayu II 38 mgg TA OO-8 2/6 Kalitengah Skor Awal : 2 Baik Bidan Partus
Skor Awal Abortus
32 th : 4
29 th BSC : 8
32 th
BSC : 8
23 th
Abortus : 4
14 Ny. Fitria 39 th II 25 mgg TA Q-20 Kalitengah Skor Awal Usia : 2 Baik Bidan
Ibu : 4
BSC : 8
15 Ny.Sriana 42 th IV 16 mgg PKT 2/9 Kalitengah Skor awal 2 Baik Bidan
Usia ibu : 4
Multi 4
16 Ny.Heni 29 th II 12 mgg PKT 1/9 Kalitengah Skor awal 2
:
Jarak anak 4
17 Ny.Siti M 37 II 10 mgg Kalitengah 6/6 Kalitengah Skor awal 2 Baik Bidan
Usia ibu : 4
BSC 8
Sidoarjo, 20 Desember 2021

NIP. 19681010 199102 2 001

Form Laporan Lengkap PMB Churnia Amin Oktober, November, Desember 2021

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LB3 MATERNAL (LB3KIA) TAHUN 2021

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KASUS MATERNAL YANG DITEMUKAN JENIS PERSALINAN

KAB/ KOTA : SIDOARJO

KASUS MATERNAL YANG DITEMUKAN JENIS PERSALINAN

KAB/ KOTA : SIDOARJO

KASUS MATERNAL YANG DITEMUKAN JENIS PERSALINAN

TOTAL PUSK 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 13 74 30 0 0 0 0 104 0

KAB/ KOTA : SIDOARJO

KASUS MATERNAL YANG DITEMUKAN JENIS PERSALINAN

KAB/ KOTA : SIDOARJO

Jumlah Bayi Jumlah Bayi di TOTAL KASUS

KAB/ KOTA : SIDOARJO

Jumlah Bayi TOTAL KASUS

KAB/ KOTA : SIDOARJO

Jumlah Bayi TOTAL KASUS

KAB/ KOTA : SIDOARJO

NO. Puskesmas Jumlah Bayi TOTAL KASUS

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

Puskesmas 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

ANAK PRA SEKOLAH

Puskesmas 698 668 1366 0 0 1150 0 0 #REF! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

KAB/ KOTA : SIDOARJO

ANAK PRA SEKOLAH

KAB/ KOTA : SIDOARJO

ANAK PRA SEKOLAH

LAPORAN APRAS (LB3KIA) TAHUN 2021

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

TOTAL PUSK 64 67 131 64 67 131 82 78 160 82 78 160 82 78 160 82 78 160

KAB/ KOTA : SIDOARJO

PELAYANAN BALITA SAKIT TRI BULAN I

1 Randegan 9 9 18 9 9 18 100.00 100.00 100.00

KAB/ KOTA : SIDOARJO

KAB/ KOTA : SIDOARJO

PELAYANAN BALITA SAKIT TRI BULAN III

1 Randegan 4 6 10 2 9 11 50.00 150.00 110.00

Orang Tua GENDER Tmp Lahir Penolong KETERANGAN

Keterangan : diisi dgn BB dan kelainan bawaan yg ada

Mengetahui Sidoarjo, 25 Oktober 2021

Kepala Puskesmas................... Pengelola KIA

Orang Tua GENDER Tmp Lahir Penolong KETERANGAN

Keterangan : diisi dgn BB dan kelainan bawaan yg ada

Mengetahui Sidoarjo, 25 November 2021

Kepala Puskesmas................... Pengelola KIA

Orang Tua GENDER Tmp Lahir Penolong KETERANGAN

Keterangan : diisi dgn BB dan kelainan bawaan yg ada

Mengetahui Sidoarjo, 2021

Orang Tua GENDER KETERANGAN

Keterangan : bisa diisi dgn BB dan kelainan bawaan yg ada

Mengetahui Sidoarjo, 2021

Orang Tua GENDER KETERANGAN