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FORMULIR PENDATAN PUS TAHUNAN

Tahun : ……………………………….
Propinsi : ……………….……………… Kecamatan : ………………………………..
Kab/Kota : ………………………………. Desa : ………………………………..

Nama PUS PUS Gakin Anak


Kepesertaan BPJS
Metode
N0 Umur Istri Alamat NO HP Usia anak terakhir
Suami Istri Ya Tidak Jml Jarak kelahiran KB
Ya Tidak (tahun, bln)
Jumlah - - - - - - - - - - - -
PUS perempuan IMT PENYAKIT KRONIS

PUS 4T
Tempat yang dilakukan
Pelayanan skrining layak PENY

ANEMIA
JANTUNG DM GAGAL HIPERTENSI ASMA TB PARU CA GYNEKOL LEUKIMIA
hamil kurang Lebih GINJAL BRONKITIS OGY

KEK
(<22) (>28)
- - - - - - - - - - - - - - -
PUS ALKI
PENYAKIT KRONIS IMS/HIV-AIDS

ISK PENY KELAINAN OBESITAS GANGGUAN RADANG RADANG HEPATITIS GONDOK MIGRAIN LAIN- LAIN IMS GO SPILIS HIV / AIDS LAIN- LAIN
KULIT SARAF MENTAL TULANG OTAK (sebutkan) (sebutkan)
- - - - - - - - - - - - - - - -
REKAPITULASI PENDATAAN PUS TINGKAT PUSKESMAS
REK. P KOHORT KB/08

Tahun : 2023
Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Puskesmas : Lasem

PUS Dengan 4T PUS ALKI AKSEPTOR KB 4T


AKSEPTOR KB
PUS Dengan AKSEPTOR AKSEPTOR GAKIN DG
No NAMA DESA JUMLAH WUS PUS TOTAL PUS Gakin kepesertaan BPJS Abs % Abs % KB TOTAL KB GAKIN KEPESERTAAN Abs
BPJS

1 Karasgede 443 344 90 200 175 50.87209302 22 6.3953488 295 75 75 135


2 Jolotundo 896 594 382 475 75 12.62626263 10 1.6835017 509 378 378 72
3 Sendangcoyo 468 377 102 370 273 72.4137931 10 2.6525199 366 102 102 273
4 Ngargomulyo 89 60 50 50 5 8.333333333 5 8.3333333 50 35 35 5
5 Kajar 404 284 260 205 60 21.12676056 11 3.8732394 229 175 175 60
6 Selopuro 922 640 384 394 62 9.6875 20 3.125 749 165 165 120
7 Sumbergirang 1074 766 165 440 120 15.66579634 5 0.6527415 735 165 165 120
8 Karangturi 523 257 87 179 97 37.74319066 5 1.9455253 236 68 68 70
9 Babagan 584 377 80 290 160 62.25680934 8 3.1128405 357 65 95 120
10 Dorokandang 915 525 378 312 139 54.08560311 21 8.1712062 474 157 157 89
11 Gedongmulyo 862 633 545 392 40 15.56420233 21 8.1712062 606 45 45 40
12 Soditan 856 480 500 380 45 17.50972763 30 11.673152 502 63 63 40
13 Ngemplak 586 404 152 205 105 40.85603113 21 8.1712062 347 158 158 115
14 Sendangasri 751 583 396 475 44 7.547169811 10 1.7152659 465 266 156 44
15 Gowak 371 229 173 211 68 29.69432314 6 2.6200873 266 137 137 68
16 Sriombo 488 268 265 160 126 47.01492537 45 16.791045 222 135 135 99
17 Binangun 584 315 319 319 10 3.174603175 10 3.1746032 324 155 10
18 Bonang 525 307 250 285 138 44.95114007 37 12.052117 188 151 10 138
19 Tasiksono 154 148 103 76 17 11.48648649 13 8.7837838 111 103 103 17
20 Dasun 198 171 84 98 15 8.771929825 11 6.4327485 128 69 69 9

JUMLAH 11693 7,762 4765 5516 1774 22.8549343 321 4.1355321 7,159 2,512 2,446 1,644
AKSEPTOR KB 4T AKSEPTOR KB ALKI

% Abs %

77.14285714 22 100
96 8 80
100 10 100
100 5 100
100 11 100
193.5483871 20 100
100 5 100
72.16494845 5 100
75 8 100
64.02877698 14 66.666667
100 21 100
88.88888889 25 83.333333
109.5238095 21 100
100 10 100
100 6 100
78.57142857 45 100
100 10 100
100 37 100
100 13 100
60 11 100

92.67192785 307 95.638629


REGISTER KOHORT KB
K/KB/08

Tahun : 2023 Kecamatan : Lasem


Propinsi : Jawa Tengah Puskesmas : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : ………………………………..

Anemia/ Lila Tahun : ……………… Bulan ke : ……………………………………….


IMT IMT Pasca
No. Jml 23,5cm/ Peny.
No Nama Akseptor Alamat Umur Gakin 4T kurang lebih Persalina 1 2 3 4 5 6 7 8 9 10 11 12
Register Anak Kronis/ IMS
(<22) ( > 27) n
(ALKI)
A B C A B C A B C A B C A B C A B C A B C A B C A B C A B C A B C A B
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Formula Indikator Keterangan Pengisian Kolom A,B,C


% KB Baru = (Jml peserta KB Baru / jml PUS) x 100% Kolom A : Diisi dengan tanggal kunjungan
% Peserta KB Aktif (CPR) = (Jml peserta KB Aktif / Jml PUS) x 100% Kolom B : Diisi dengan Kode B = Peserta baru (Peserta baru hanya dihitung hanya satu kali),
% Kegagalan = (Jml Kasus kegglan KB / jml peserta KB aktif) x 100% L = peserta lama (Hanya dihitung satu kali, bulan berikutnya tidak dihitung lagi kecuali ada peserta lama yang baru datang
% Komplikasi = (Jml Kasus komplikasi / jml peserta KB Aktif) x 100% DO = jika klien drop out, GC = jika klien ganti cara, G = jika klien kontrasepsinya gagal, K = jika klien ada komplikasi
% DO = ( Jml kasus Drop out / jml peserta KB aktif ) x 100% ES = efek samping (untuk kejadian ES, K, DO, G hanya dihitung 1 kali dalam satu tahun kalender)
% Pasca Bersalin = (Jml ibu pasca bersalin ber KB / jml sasaran ibu bersalin) x 100% Kolom C : Diisi dengan metode kontrasepsi : Pil (P), Suntik (S), IUD,Implant (I), MOP,MOW
12
C
22
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : Januari / 2023 Puskesmas : Lasem


Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : Puskesmas Lasem

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
2 Jolotundo 594 4 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
3 Sendangcoyo 377 4 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
4 Ngargomulyo 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 9 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
8 Karangturi 257 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Babagan 377 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 8 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
13 Ngemplak 404 3 0 2 0 0 1 0 0 3 0 0 0 0 0 0 0 0
14 Sendangasri 583 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Binangun 315 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 2 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0
20 Dasun 171 3 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0

Jumlah 7,762 73 0 2 0 0 5 0 0 7 4 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 73 0 2 0 0 5 0 0 7 4 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 0 0 0 0 0 0 0 8 264 10 10 2 0 1 295 0 0 0 0
0 0 0 0 0 0 0 0 0 91 327 36 5 22 0 28 509 0 0 0 0
0 0 0 0 0 0 0 0 0 30 195 7 128 2 0 3 365 0 0 0 0
0 0 0 0 0 0 0 0 0 14 17 2 13 4 0 0 50 0 0 0 0
0 0 0 0 0 0 0 0 0 23 133 6 59 5 0 3 229 0 0 0 0
0 0 0 0 0 0 0 0 0 98 445 32 55 10 0 0 640 0 0 0 0
0 0 0 0 0 0 0 0 0 96 546 30 18 32 0 13 735 0 0 0 0
0 0 0 0 0 0 0 0 0 55 140 16 8 12 0 5 236 0 0 0 0
0 0 1 0 0 1 0 0 2 45 269 13 11 16 0 3 357 0 0 0 0
0 0 2 0 0 0 0 0 2 62 336 10 32 23 0 9 472 0 0 0 0
0 0 0 0 0 0 0 0 0 113 434 15 32 12 0 15 621 0 0 0 0
0 0 1 0 0 0 0 0 1 63 398 18 6 10 0 5 500 0 0 0 0
0 0 0 0 0 0 0 0 0 72 174 16 34 16 0 35 347 0 0 0 0
0 0 2 0 0 0 0 0 2 47 313 5 85 13 0 0 463 0 0 0 0
0 0 0 0 0 0 0 0 0 43 152 4 67 0 0 0 266 0 0 0 0
0 0 0 0 2 2 0 1 5 34 163 15 1 2 0 2 217 0 0 0 0
0 0 3 0 0 0 0 0 3 45 231 17 24 4 0 2 323 0 0 0 0
0 0 0 0 0 0 0 0 0 47 113 6 7 15 0 0 188 0 0 0 0
0 0 0 0 0 0 0 0 0 7 77 4 8 4 0 11 111 0 0 0 0
0 0 0 0 0 0 0 0 0 4 100 1 18 5 0 0 128 0 0 0 0

0 0 9 0 2 3 0 1 15 997 4827 263 621 209 0 135 7052 0 0 0 0


0 0 9 0 2 3 0 1 15 997 4827 263 621 209 0 135 7052 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 0 0 0 0 0 0 0 0 0 0 8 264 10 10 2 0 1 295
0 0 0 0 0 0 0 0 0 0 0 0 91 327 36 5 22 0 28 509
0 0 0 0 0 0 0 0 0 0 0 0 30 195 7 128 3 0 3 366
0 0 0 0 0 0 0 0 0 0 0 0 14 17 2 13 4 0 0 50
0 0 0 0 0 0 0 0 0 0 0 0 23 133 6 59 5 0 3 229
0 0 0 0 0 0 0 0 0 0 0 0 98 445 32 55 10 0 0 640
0 0 0 0 0 0 0 0 0 0 0 0 96 546 30 18 33 0 13 736
0 0 0 0 0 0 0 0 0 0 0 0 55 140 16 8 12 0 5 236
0 0 0 0 0 0 0 0 0 0 0 0 45 270 13 11 17 0 3 359
0 0 0 0 0 0 0 0 0 0 0 0 62 338 10 32 23 0 9 474
0 0 0 0 0 0 0 0 0 0 0 0 113 434 15 32 12 0 15 621
0 0 0 0 0 0 0 0 0 0 0 0 63 399 18 6 11 0 5 502
0 0 0 0 0 0 0 0 0 0 0 0 72 176 16 34 17 0 35 350
0 0 0 0 0 0 0 0 0 0 0 0 47 315 5 85 13 0 0 465
0 0 0 0 0 0 0 0 0 0 0 0 43 152 4 67 0 0 0 266
0 0 0 0 0 0 0 0 0 0 0 0 34 163 15 3 4 0 3 222
0 0 0 0 0 0 0 0 0 0 0 0 45 234 17 24 4 0 2 326
0 0 0 0 0 0 0 0 0 0 0 0 47 113 6 7 15 0 0 188
0 0 0 0 0 0 0 0 0 0 0 0 7 77 4 8 5 0 11 112
0 0 0 0 0 0 0 0 0 0 0 0 4 100 1 18 5 0 0 128

0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074


0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

75 135 0 0 22
378 72 0 0 10
595 273 0 0 10
6 5 0 0 5
150 60 0 0 11
320 120 0 0 20
165 120 0 0 5
116 70 0 0 5
80 120 0 0 8
157 89 0 0 21
545 40 0 0 21
500 40 0 0 30
259 89 0 0 21
266 44 0 0 10
2 68 0 0 6
135 99 0 0 45
121 10 0 0 10
151 138 0 0 37
103 17 0 0 13
69 9 0 0 11

4193 1618 0 0 321


4193 1618 0 0 321
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : Januari / 2023 Puskesmas : Lasem


Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : Puskesmas Lasem

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Jolotundo 594 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Sendangcoyo 377 4 0 0 0 0 0 0 0 0 1 25 0 0 0 0 1 25
4 Ngargomulyo 60 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
5 Kajar 284 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
8 Karangturi 257 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Babagan 377 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 8 0 0 0 0 0 0 0 0 1 12.5 0 0 0 0 1 12.5
13 Ngemplak 404 3 0 0 2 66.6666667 0 0 0 0 1 33.3333333 0 0 0 0 3 100
14 Sendangasri 583 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Binangun 315 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 2 0 0 0 0 0 0 0 0 1 50 0 0 0 0 1 50
20 Dasun 171 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 73 0 0 2 2.73972603 0 0 0 0 5 6.84931507 0 0 0 0 7 9.589041096


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 73 0 0 2 2.73972603 0 0 0 0 5 6.84931507 0 0 0 0 7 9.589041096

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 2 0.677966102 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.677966102 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.338983051 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.677966102 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 1.694915254 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 3 1.016949153 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 0 0 9 0 2 3 0 1 15 5.084745763 0 0
4 0 0 0 0 0 0 0 0 0 0 9 0 2 3 0 1 15 5.084745763 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 264 10 10 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 327 36 5 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 195 7 128 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 17 2 13 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 133 6 59 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 445 32 55 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 546 30 18 33
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 140 16 8 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 270 13 11 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 338 10 32 23
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 434 15 32 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 399 18 6 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 176 16 34 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 315 5 85 13
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 152 4 67 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 163 15 3 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 234 17 24 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 113 6 7 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 77 4 8 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 100 1 18 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 1 295 85.75581395 75 135 0 0 22


0 28 509 147.9651163 378 72 0 0 10
0 3 366 106.3953488 595 273 0 0 10
0 0 50 14.53488372 6 5 0 0 5
0 3 229 66.56976744 150 60 0 0 11
0 0 640 186.0465116 320 120 0 0 20
0 13 736 213.9534884 165 120 0 0 5
0 5 236 68.60465116 116 70 0 0 5
0 3 359 104.3604651 80 120 0 0 8
0 9 474 137.7906977 157 89 0 0 21
0 15 621 180.5232558 545 40 0 0 21
0 5 502 145.9302326 500 40 0 0 30
0 35 350 101.744186 259 89 0 0 21
0 0 465 135.1744186 266 44 0 0 10
0 0 266 77.3255814 2 68 0 0 6
0 3 222 64.53488372 135 99 0 0 45
0 2 326 94.76744186 121 10 0 0 10
0 0 188 54.65116279 151 138 0 0 37
0 11 112 32.55813953 103 17 0 0 13
0 0 128 37.20930233 69 9 0 0 11
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 136 7074 2056.395349 4193 1618 0 0 321


0 136 7074 2056.395349 4193 1618 0 0 321
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : Februari / 2023 Puskesmas : Lasem


Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : Puskesmas Lasem

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
2 Jolotundo 594 3 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0
3 Sendangcoyo 377 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 3 0 0 0 0 1 0 0 1 2 0 0 0 0 0 0 0
8 Karangturi 257 2 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0
9 Babagan 377 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Ngemplak 404 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Sendangasri 583 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 7 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0
17 Binangun 315 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Dasun 171 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah 7,762 35 0 0 2 0 3 0 0 5 2 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 35 0 0 2 0 3 0 0 5 2 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 0 0 0 0 0 0 0 8 264 10 10 2 0 1 295 0 0 0 0
0 0 0 0 0 0 0 0 0 91 327 36 5 22 0 28 509 0 0 0 0
0 0 0 0 0 0 0 0 0 30 195 7 128 3 0 3 366 0 0 0 0
0 0 0 0 0 0 0 0 0 14 17 2 13 4 0 0 50 0 0 0 0
0 0 0 0 0 0 0 0 0 23 133 6 59 5 0 3 229 0 0 0 0
0 0 0 0 0 0 0 0 0 98 445 32 55 10 0 0 640 0 0 0 0
0 0 0 0 0 0 0 0 0 96 546 30 18 33 0 13 736 0 0 0 0
0 0 0 0 0 0 0 0 0 55 140 16 8 12 0 5 236 0 0 0 0
0 0 1 0 0 0 0 0 1 45 270 13 11 17 0 3 359 0 0 0 0
0 0 0 0 1 0 0 0 1 62 338 10 32 23 0 9 474 0 0 0 0
0 0 0 0 0 0 0 0 0 113 434 15 32 12 0 15 621 0 0 0 0
0 0 1 0 0 0 0 0 1 63 399 18 6 11 0 5 502 0 0 0 0
0 0 0 0 0 0 0 0 0 72 176 16 34 17 0 35 350 0 0 0 0
0 0 1 0 2 0 0 0 3 47 315 5 85 13 0 0 465 0 0 0 0
0 0 0 0 0 0 0 0 0 43 152 4 67 0 0 0 266 0 0 0 0
0 0 0 0 0 0 0 0 0 34 163 15 3 4 0 3 222 0 0 0 0
0 0 2 0 0 0 0 0 2 45 234 17 24 4 0 2 326 0 0 0 0
0 0 0 0 0 0 0 0 0 47 113 6 7 15 0 0 188 0 0 0 0
0 0 0 0 0 0 0 0 0 7 77 4 8 5 0 11 112 0 0 0 0
0 0 1 0 0 0 0 0 1 4 100 1 18 5 0 0 128 0 0 0 0

0 0 6 0 3 0 0 0 9 997 4838 263 623 217 0 136 7074 0 0 0 0


0 0 6 0 3 0 0 0 9 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 0 0 0 0 0 0 0 0 0 0 8 264 10 10 3 0 1 296
0 0 0 0 0 0 0 0 0 0 0 0 91 327 36 5 23 0 28 510
0 0 0 0 0 0 0 0 0 0 0 0 30 195 7 128 3 0 3 366
0 0 0 0 0 0 0 0 0 0 0 0 14 17 2 13 4 0 0 50
0 0 0 0 0 0 0 0 0 0 0 0 23 133 6 59 5 0 3 229
0 0 0 0 0 0 0 0 0 0 0 0 98 445 32 55 10 0 0 640
0 0 0 0 0 0 0 0 0 0 0 0 96 546 30 18 34 0 13 737
0 0 0 0 0 0 0 0 0 0 0 0 55 140 17 8 12 0 5 237
0 0 0 0 0 0 0 0 0 0 0 0 45 271 13 11 17 0 3 360
0 0 0 0 0 0 0 0 0 0 0 0 62 338 10 33 23 0 9 475
0 0 0 0 0 0 0 0 0 0 0 0 113 434 15 32 12 0 15 621
0 0 0 0 0 0 0 0 0 0 0 0 63 400 18 6 11 0 5 503
0 0 0 0 0 0 0 0 0 0 0 0 72 176 16 34 17 0 35 350
0 0 0 0 0 0 0 0 0 0 0 0 47 316 5 87 13 0 0 468
0 0 0 0 0 0 0 0 0 0 0 0 43 152 4 67 0 0 0 266
0 0 0 0 0 0 0 0 0 0 0 0 34 163 16 3 4 0 3 223
0 0 0 0 0 0 0 0 0 0 0 0 45 236 17 24 4 0 2 328
0 0 0 0 0 0 0 0 0 0 0 0 47 113 6 7 15 0 0 188
0 0 0 0 0 0 0 0 0 0 0 0 7 77 4 8 5 0 11 112
0 0 0 0 0 0 0 0 0 0 0 0 4 101 1 18 5 0 0 129

0 0 0 0 0 0 0 0 0 0 0 0 997 4844 265 626 220 0 136 7088


0 0 0 0 0 0 0 0 0 0 0 0 997 4844 265 626 220 0 136 7088
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

75 135 0 0 22
378 72 0 0 10
595 273 0 0 10
6 5 0 0 5
150 60 0 0 11
320 120 0 0 20
165 120 0 0 5
116 70 0 0 5
80 120 0 0 8
157 89 0 0 21
545 40 0 0 21
500 40 0 0 30
259 89 0 0 21
266 44 0 0 10
2 68 0 0 6
135 99 0 0 45
121 10 0 0 10
151 138 0 0 37
103 17 0 0 13
69 9 0 0 11

4193 1618 0 0 321


4193 1618 0 0 321
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : Februari / 2023 Puskesmas : Lasem


Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : Puskesmas Lasem

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.507614213 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.507614213 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.338409475 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.846023689 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.846023689 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.846023689 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.169204738 0 0

6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 4.060913706 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 4.060913706 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 528 20 20 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 654 72 10 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 390 14 256 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 34 4 26 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 266 12 118 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 890 64 110 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 1092 60 36 67
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 280 33 16 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 541 26 22 34
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 676 20 65 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 868 30 64 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 799 36 12 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 352 32 68 34
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 631 10 172 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 304 8 134 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 326 31 6 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 470 34 48 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 226 12 14 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 154 8 16 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 201 2 36 10

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1994 9682 528 1249 437


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1994 9682 528 1249 437
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 2 591 171.8023256 150 270 0 0 44


0 56 1019 296.2209302 756 144 0 0 20
0 6 732 212.7906977 1190 546 0 0 20
0 0 100 29.06976744 12 10 0 0 10
0 6 458 133.1395349 300 120 0 0 22
0 0 1280 372.0930233 640 240 0 0 40
0 26 1473 428.1976744 330 240 0 0 10
0 10 473 137.5 232 140 0 0 10
0 6 719 209.0116279 160 240 0 0 16
0 18 949 275.872093 314 178 0 0 42
0 30 1242 361.0465116 1090 80 0 0 42
0 10 1005 292.1511628 1000 80 0 0 60
0 70 700 203.4883721 518 178 0 0 42
0 0 933 271.2209302 532 88 0 0 20
0 0 532 154.6511628 4 136 0 0 12
0 6 445 129.3604651 270 198 0 0 90
0 4 654 190.1162791 242 20 0 0 20
0 0 376 109.3023256 302 276 0 0 74
0 22 224 65.11627907 206 34 0 0 26
0 0 257 74.70930233 138 18 0 0 22

0 272 14162 4116.860465 8386 3236 0 0 642


0 272 14162 4116.860465 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : Februari / 2023 Puskesmas : Lasem


Propinsi : Jawa Tengah Kecamatan : Lasem
Kab/Kota : Rembang Nama fasilitas Pelayanan KB : Puskesmas Lasem

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.338600451 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.338600451 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.225733634 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.564334086 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.564334086 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.564334086 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.112866817 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 2.708803612 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 2.708803612 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 792 30 30 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 981 108 15 67
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 585 21 384 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 51 6 39 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 399 18 177 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 1335 96 165 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 1638 90 54 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 420 49 24 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 811 39 33 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 1014 30 97 69
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 1302 45 96 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 1198 54 18 33
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 528 48 102 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 946 15 257 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 456 12 201 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 489 46 9 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 704 51 72 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 339 18 21 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 231 12 24 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 301 3 54 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2991 14520 791 1872 654


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2991 14520 791 1872 654
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 3 886 257.5581395 150 270 0 0 44


0 84 1528 444.1860465 756 144 0 0 20
0 9 1098 319.1860465 1190 546 0 0 20
0 0 150 43.60465116 12 10 0 0 10
0 9 687 199.7093023 300 120 0 0 22
0 0 1920 558.1395349 640 240 0 0 40
0 39 2209 642.1511628 330 240 0 0 10
0 15 709 206.1046512 232 140 0 0 10
0 9 1078 313.372093 160 240 0 0 16
0 27 1423 413.6627907 314 178 0 0 42
0 45 1863 541.5697674 1090 80 0 0 42
0 15 1507 438.0813953 1000 80 0 0 60
0 105 1050 305.2325581 518 178 0 0 42
0 0 1398 406.3953488 532 88 0 0 20
0 0 798 231.9767442 4 136 0 0 12
0 9 667 193.8953488 270 198 0 0 90
0 6 980 284.8837209 242 20 0 0 20
0 0 564 163.9534884 302 276 0 0 74
0 33 336 97.6744186 206 34 0 0 26
0 0 385 111.9186047 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 408 21236 6173.255814 8386 3236 0 0 642


0 408 21236 6173.255814 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.254022015 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.254022015 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.16934801 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.423370025 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.423370025 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.423370025 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.084674005 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 2.032176122 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 2.032176122 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 1056 40 40 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 1308 144 20 89
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 780 28 512 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 68 8 52 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 532 24 236 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 1780 128 220 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 2184 120 72 133
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 560 65 32 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 1081 52 44 68
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 1352 40 129 92
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 1736 60 128 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 1597 72 24 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 704 64 136 68
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 1261 20 342 52
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 608 16 268 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 652 61 12 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 938 68 96 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 452 24 28 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 308 16 32 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 401 4 72 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3988 19358 1054 2495 871


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3988 19358 1054 2495 871
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 4 1181 343.3139535 150 270 0 0 44


0 112 2037 592.1511628 756 144 0 0 20
0 12 1464 425.5813953 1190 546 0 0 20
0 0 200 58.13953488 12 10 0 0 10
0 12 916 266.2790698 300 120 0 0 22
0 0 2560 744.1860465 640 240 0 0 40
0 52 2945 856.1046512 330 240 0 0 10
0 20 945 274.7093023 232 140 0 0 10
0 12 1437 417.7325581 160 240 0 0 16
0 36 1897 551.4534884 314 178 0 0 42
0 60 2484 722.0930233 1090 80 0 0 42
0 20 2009 584.0116279 1000 80 0 0 60
0 140 1400 406.9767442 518 178 0 0 42
0 0 1863 541.5697674 532 88 0 0 20
0 0 1064 309.3023256 4 136 0 0 12
0 12 889 258.4302326 270 198 0 0 90
0 8 1306 379.6511628 242 20 0 0 20
0 0 752 218.6046512 302 276 0 0 74
0 44 448 130.2325581 206 34 0 0 26
0 0 513 149.127907 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 544 28310 8229.651163 8386 3236 0 0 642


0 544 28310 8229.651163 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.203252033 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.203252033 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.135501355 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.338753388 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.338753388 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.338753388 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.067750678 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.62601626 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.62601626 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 1320 50 50 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 1635 180 25 111
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 975 35 640 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 85 10 65 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 665 30 295 25
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 2225 160 275 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480 2730 150 90 166
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 700 81 40 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 1351 65 55 85
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 1690 50 161 115
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565 2170 75 160 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 1996 90 30 55
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 880 80 170 85
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 1576 25 427 65
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 760 20 335 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 815 76 15 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 1172 85 120 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 565 30 35 75
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 385 20 40 25
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 501 5 90 25
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4985 24196 1317 3118 1088


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4985 24196 1317 3118 1088
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 5 1476 429.0697674 150 270 0 0 44


0 140 2546 740.1162791 756 144 0 0 20
0 15 1830 531.9767442 1190 546 0 0 20
0 0 250 72.6744186 12 10 0 0 10
0 15 1145 332.8488372 300 120 0 0 22
0 0 3200 930.2325581 640 240 0 0 40
0 65 3681 1070.05814 330 240 0 0 10
0 25 1181 343.3139535 232 140 0 0 10
0 15 1796 522.0930233 160 240 0 0 16
0 45 2371 689.244186 314 178 0 0 42
0 75 3105 902.6162791 1090 80 0 0 42
0 25 2511 729.9418605 1000 80 0 0 60
0 175 1750 508.7209302 518 178 0 0 42
0 0 2328 676.744186 532 88 0 0 20
0 0 1330 386.627907 4 136 0 0 12
0 15 1111 322.9651163 270 198 0 0 90
0 10 1632 474.4186047 242 20 0 0 20
0 0 940 273.255814 302 276 0 0 74
0 55 560 162.7906977 206 34 0 0 26
0 0 641 186.3372093 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 680 35384 10286.04651 8386 3236 0 0 642


0 680 35384 10286.04651 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.169395822 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.169395822 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.112930548 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.282326369 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.282326369 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.282326369 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.056465274 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.355166573 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.355166573 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 1584 60 60 13
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 1962 216 30 133
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 1170 42 768 18
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 102 12 78 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 798 36 354 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 2670 192 330 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 3276 180 108 199
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 840 97 48 72
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 1621 78 66 102
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372 2028 60 193 138
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 2604 90 192 72
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 2395 108 36 66
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 1056 96 204 102
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 1891 30 512 78
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 912 24 402 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 978 91 18 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 1406 102 144 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 678 36 42 90
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 462 24 48 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 601 6 108 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5982 29034 1580 3741 1305


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5982 29034 1580 3741 1305
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 6 1771 514.8255814 150 270 0 0 44


0 168 3055 888.0813953 756 144 0 0 20
0 18 2196 638.372093 1190 546 0 0 20
0 0 300 87.20930233 12 10 0 0 10
0 18 1374 399.4186047 300 120 0 0 22
0 0 3840 1116.27907 640 240 0 0 40
0 78 4417 1284.011628 330 240 0 0 10
0 30 1417 411.9186047 232 140 0 0 10
0 18 2155 626.4534884 160 240 0 0 16
0 54 2845 827.0348837 314 178 0 0 42
0 90 3726 1083.139535 1090 80 0 0 42
0 30 3013 875.872093 1000 80 0 0 60
0 210 2100 610.4651163 518 178 0 0 42
0 0 2793 811.9186047 532 88 0 0 20
0 0 1596 463.9534884 4 136 0 0 12
0 18 1333 387.5 270 198 0 0 90
0 12 1958 569.1860465 242 20 0 0 20
0 0 1128 327.9069767 302 276 0 0 74
0 66 672 195.3488372 206 34 0 0 26
0 0 769 223.5465116 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 816 42458 12342.44186 8386 3236 0 0 642


0 816 42458 12342.44186 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.145208132 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.145208132 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.096805421 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.242013553 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.242013553 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.242013553 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.048402711 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.161665053 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.161665053 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 1848 70 70 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 2289 252 35 155
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 1365 49 896 21
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 119 14 91 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 931 42 413 35
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686 3115 224 385 70
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 3822 210 126 232
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 980 113 56 84
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 1891 91 77 119
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434 2366 70 225 161
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791 3038 105 224 84
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 2794 126 42 77
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504 1232 112 238 119
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 2206 35 597 91
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 1064 28 469 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 1141 106 21 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 1640 119 168 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 791 42 49 105
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 539 28 56 35
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 701 7 126 35
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6979 33872 1843 4364 1522


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6979 33872 1843 4364 1522
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 7 2066 600.5813953 150 270 0 0 44


0 196 3564 1036.046512 756 144 0 0 20
0 21 2562 744.7674419 1190 546 0 0 20
0 0 350 101.744186 12 10 0 0 10
0 21 1603 465.9883721 300 120 0 0 22
0 0 4480 1302.325581 640 240 0 0 40
0 91 5153 1497.965116 330 240 0 0 10
0 35 1653 480.5232558 232 140 0 0 10
0 21 2514 730.8139535 160 240 0 0 16
0 63 3319 964.8255814 314 178 0 0 42
0 105 4347 1263.662791 1090 80 0 0 42
0 35 3515 1021.802326 1000 80 0 0 60
0 245 2450 712.2093023 518 178 0 0 42
0 0 3258 947.0930233 532 88 0 0 20
0 0 1862 541.2790698 4 136 0 0 12
0 21 1555 452.0348837 270 198 0 0 90
0 14 2284 663.9534884 242 20 0 0 20
0 0 1316 382.5581395 302 276 0 0 74
0 77 784 227.9069767 206 34 0 0 26
0 0 897 260.755814 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 952 49532 14398.83721 8386 3236 0 0 642


0 952 49532 14398.83721 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.127064803 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.127064803 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.084709869 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.211774672 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.211774672 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.211774672 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.042354934 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.016518424 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 1.016518424 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 2112 80 80 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728 2616 288 40 177
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 1560 56 1024 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 136 16 104 32
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 1064 48 472 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 3560 256 440 80
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768 4368 240 144 265
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440 1120 129 64 96
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 2161 104 88 136
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 2704 80 257 184
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 904 3472 120 256 96
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504 3193 144 48 88
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 1408 128 272 136
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 2521 40 682 104
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 1216 32 536 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 1304 121 24 32
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 1874 136 192 32
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 904 48 56 120
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 616 32 64 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 801 8 144 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7976 38710 2106 4987 1739


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7976 38710 2106 4987 1739
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 8 2361 686.3372093 150 270 0 0 44


0 224 4073 1184.011628 756 144 0 0 20
0 24 2928 851.1627907 1190 546 0 0 20
0 0 400 116.2790698 12 10 0 0 10
0 24 1832 532.5581395 300 120 0 0 22
0 0 5120 1488.372093 640 240 0 0 40
0 104 5889 1711.918605 330 240 0 0 10
0 40 1889 549.127907 232 140 0 0 10
0 24 2873 835.1744186 160 240 0 0 16
0 72 3793 1102.616279 314 178 0 0 42
0 120 4968 1444.186047 1090 80 0 0 42
0 40 4017 1167.732558 1000 80 0 0 60
0 280 2800 813.9534884 518 178 0 0 42
0 0 3723 1082.267442 532 88 0 0 20
0 0 2128 618.6046512 4 136 0 0 12
0 24 1777 516.5697674 270 198 0 0 90
0 16 2610 758.7209302 242 20 0 0 20
0 0 1504 437.2093023 302 276 0 0 74
0 88 896 260.4651163 206 34 0 0 26
0 0 1025 297.9651163 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 1088 56606 16455.23256 8386 3236 0 0 642


0 1088 56606 16455.23256 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.112951807 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.112951807 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.075301205 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.188253012 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.188253012 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.188253012 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.037650602 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.903614458 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.903614458 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 2376 90 90 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 819 2943 324 45 199
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 1755 63 1152 27
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 153 18 117 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 1197 54 531 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 882 4005 288 495 90
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864 4914 270 162 298
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 1260 145 72 108
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 2431 117 99 153
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558 3042 90 289 207
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1017 3906 135 288 108
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 3592 162 54 99
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648 1584 144 306 153
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 2836 45 767 117
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 1368 36 603 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 1467 136 27 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 2108 153 216 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 1017 54 63 135
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 693 36 72 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 901 9 162 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8973 43548 2369 5610 1956


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8973 43548 2369 5610 1956
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 9 2656 772.0930233 150 270 0 0 44


0 252 4582 1331.976744 756 144 0 0 20
0 27 3294 957.5581395 1190 546 0 0 20
0 0 450 130.8139535 12 10 0 0 10
0 27 2061 599.127907 300 120 0 0 22
0 0 5760 1674.418605 640 240 0 0 40
0 117 6625 1925.872093 330 240 0 0 10
0 45 2125 617.7325581 232 140 0 0 10
0 27 3232 939.5348837 160 240 0 0 16
0 81 4267 1240.406977 314 178 0 0 42
0 135 5589 1624.709302 1090 80 0 0 42
0 45 4519 1313.662791 1000 80 0 0 60
0 315 3150 915.6976744 518 178 0 0 42
0 0 4188 1217.44186 532 88 0 0 20
0 0 2394 695.9302326 4 136 0 0 12
0 27 1999 581.1046512 270 198 0 0 90
0 18 2936 853.4883721 242 20 0 0 20
0 0 1692 491.8604651 302 276 0 0 74
0 99 1008 293.0232558 206 34 0 0 26
0 0 1153 335.1744186 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 1224 63680 18511.62791 8386 3236 0 0 642


0 1224 63680 18511.62791 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.101660454 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.101660454 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.067773636 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.16943409 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.16943409 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.16943409 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.033886818 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.813283633 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.813283633 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 2640 100 100 21


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910 3270 360 50 221
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 1950 70 1280 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 170 20 130 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 1330 60 590 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 980 4450 320 550 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960 5460 300 180 331
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 1400 161 80 120
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 2701 130 110 170
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 3380 100 321 230
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130 4340 150 320 120
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630 3991 180 60 110
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720 1760 160 340 170
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 3151 50 852 130
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 1520 40 670 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 1630 151 30 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 2342 170 240 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 1130 60 70 150
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 770 40 80 50
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 1001 10 180 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9970 48386 2632 6233 2173


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9970 48386 2632 6233 2173
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 10 2951 857.8488372 150 270 0 0 44


0 280 5091 1479.94186 756 144 0 0 20
0 30 3660 1063.953488 1190 546 0 0 20
0 0 500 145.3488372 12 10 0 0 10
0 30 2290 665.6976744 300 120 0 0 22
0 0 6400 1860.465116 640 240 0 0 40
0 130 7361 2139.825581 330 240 0 0 10
0 50 2361 686.3372093 232 140 0 0 10
0 30 3591 1043.895349 160 240 0 0 16
0 90 4741 1378.197674 314 178 0 0 42
0 150 6210 1805.232558 1090 80 0 0 42
0 50 5021 1459.593023 1000 80 0 0 60
0 350 3500 1017.44186 518 178 0 0 42
0 0 4653 1352.616279 532 88 0 0 20
0 0 2660 773.255814 4 136 0 0 12
0 30 2221 645.6395349 270 198 0 0 90
0 20 3262 948.255814 242 20 0 0 20
0 0 1880 546.5116279 302 276 0 0 74
0 110 1120 325.5813953 206 34 0 0 26
0 0 1281 372.3837209 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 1360 70754 20568.02326 8386 3236 0 0 642


0 1360 70754 20568.02326 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.092421442 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.092421442 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.061614295 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.154035736 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.154035736 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.154035736 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.030807147 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.739371534 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.739371534 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 2904 110 110 23


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1001 3597 396 55 243
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 2145 77 1408 33
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 187 22 143 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 1463 66 649 55
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1078 4895 352 605 110
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 6006 330 198 364
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 1540 177 88 132
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 2971 143 121 187
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 682 3718 110 353 253
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243 4774 165 352 132
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693 4390 198 66 121
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792 1936 176 374 187
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 3466 55 937 143
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 1672 44 737 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 1793 166 33 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495 2576 187 264 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 1243 66 77 165
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 847 44 88 55
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 1101 11 198 55
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10967 53224 2895 6856 2390


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10967 53224 2895 6856 2390
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 11 3246 943.6046512 150 270 0 0 44


0 308 5600 1627.906977 756 144 0 0 20
0 33 4026 1170.348837 1190 546 0 0 20
0 0 550 159.8837209 12 10 0 0 10
0 33 2519 732.2674419 300 120 0 0 22
0 0 7040 2046.511628 640 240 0 0 40
0 143 8097 2353.77907 330 240 0 0 10
0 55 2597 754.9418605 232 140 0 0 10
0 33 3950 1148.255814 160 240 0 0 16
0 99 5215 1515.988372 314 178 0 0 42
0 165 6831 1985.755814 1090 80 0 0 42
0 55 5523 1605.523256 1000 80 0 0 60
0 385 3850 1119.186047 518 178 0 0 42
0 0 5118 1487.790698 532 88 0 0 20
0 0 2926 850.5813953 4 136 0 0 12
0 33 2443 710.1744186 270 198 0 0 90
0 22 3588 1043.023256 242 20 0 0 20
0 0 2068 601.1627907 302 276 0 0 74
0 121 1232 358.1395349 206 34 0 0 26
0 0 1409 409.5930233 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 1496 77828 22624.4186 8386 3236 0 0 642


0 1496 77828 22624.4186 8386 3236 0 0 642
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin Baru Pasca Keguguran


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom
Keguguran

1 Karasgede 344 0
2 Jolotundo 594 0
3 Sendangcoyo 377 0
4 Ngargomulyo 60 0
5 Kajar 284 0
6 Selopuro 640 0
7 Sumbergirang 766 0
8 Karangturi 257 0
9 Babagan 377 0
10 Dorokandang 525 0
11 Gedongmulyo 633 0
12 Soditan 480 0
13 Ngemplak 404 0
14 Sendangasri 583 0
15 Gowak 229 0
16 Sriombo 268 0
17 Binangun 315 0
18 Bonang 307 0
19 Tasiksono 148 0
20 Dasun 171 0
21 0 0 0
22 0 0 0
23 0 0 0
Jumlah 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Lain Lama Kegagalan

TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074 0 0 0 0
Kegagalan DO Aktif

MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL Pil Suntik IUD Implant MOW MOP Kondom TOTAL

0 0 8 264 10 10 2 0 1 295
0 0 91 327 36 5 22 0 28 509
0 0 30 195 7 128 3 0 3 366
0 0 14 17 2 13 4 0 0 50
0 0 23 133 6 59 5 0 3 229
0 0 98 445 32 55 10 0 0 640
0 0 96 546 30 18 33 0 13 736
0 0 55 140 16 8 12 0 5 236
0 0 45 270 13 11 17 0 3 359
0 0 62 338 10 32 23 0 9 474
0 0 113 434 15 32 12 0 15 621
0 0 63 399 18 6 11 0 5 502
0 0 72 176 16 34 17 0 35 350
0 0 47 315 5 85 13 0 0 465
0 0 43 152 4 67 0 0 0 266
0 0 34 163 15 3 4 0 3 222
0 0 45 234 17 24 4 0 2 326
0 0 47 113 6 7 15 0 0 188
0 0 7 77 4 8 5 0 11 112
0 0 4 100 1 18 5 0 0 128
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
0 0 0 0 0 0 0 0 0 0 0 0 997 4838 263 623 217 0 136 7074
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

PUS ALKI (Anemia/ Lila


AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
IMS)

0 0 0 0 0
0 0 0 0 0
REKAPITULASI KOHORT KB
REK. KOHORT KB/08

Bulan/Tahun : ……………………………….. Puskesmas : ………………………………..


Propinsi : ……………………………….. Kecamatan : ………………………………..
Kab/Kota : ……………………………….. Nama fasilitas Pelayanan KB : ………………………………..

Baru Pasca Salin


Jumlah Ibu
No DESA/PUSKESMAS JUMLAH PUS Bersalin
Pil % Suntik % IUD % Implant % MOW % MOP % Kondom % TOTAL %

1 Karasgede 344 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333


2 Jolotundo 594 7 0 0 0 0 0 0 0 0 1 14.2857143 0 0 0 0 1 14.28571429
3 Sendangcoyo 377 6 0 0 0 0 0 0 0 0 1 16.6666667 0 0 0 0 1 16.66666667
4 Ngargomulyo 60 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Kajar 284 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Selopuro 640 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Sumbergirang 766 12 0 0 0 0 0 0 0 0 2 16.6666667 0 0 0 0 2 16.66666667
8 Karangturi 257 4 0 0 0 0 1 25 0 0 0 0 0 0 0 0 1 25
9 Babagan 377 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Dorokandang 525 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Gedongmulyo 633 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Soditan 480 9 0 0 0 0 0 0 0 0 1 11.1111111 0 0 0 0 1 11.11111111
13 Ngemplak 404 4 0 0 2 50 0 0 0 0 1 25 0 0 0 0 3 75
14 Sendangasri 583 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Gowak 229 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Sriombo 268 10 0 0 0 0 1 10 0 0 0 0 0 0 0 0 1 10
17 Binangun 315 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Bonang 307 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Tasiksono 148 3 0 0 0 0 0 0 0 0 1 33.3333333 0 0 0 0 1 33.33333333
20 Dasun 171 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
22 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
23 0 0 0 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -

Jumlah 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111


Komuatif s/d bulan lalu
Komulatif s/d bulan ini 7,762 108 0 0 2 1.85185185 2 1.851852 0 0 8 7.40740741 0 0 0 0 12 11.11111111

AKTIF* = (Baru+lama)-(Kegagalan+DO)
Baru Pasca Keguguran Baru Lain

Jumlah Ibu
Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik
Keguguran

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 3 0.08472183 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 3 0.08472183 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0.05648122 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 5 0.14120305 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 1 5 0.14120305 0 0
0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 0.14120305 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0.02824061 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.67777464 0 0
6 0 0 0 0 0 0 0 0 0 0 15 0 5 3 0 1 24 0.67777464 0 0
Kegagalan DO Aktif

IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW MOP Kondom TOTAL % Pil Suntik IUD Implant MOW

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 3168 120 120 25


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1092 3924 432 60 265
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 2340 84 1536 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 204 24 156 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 1596 72 708 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176 5340 384 660 120
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1152 6552 360 216 397
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 660 1680 193 96 144
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 3241 156 132 204
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744 4056 120 385 276
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1356 5208 180 384 144
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756 4789 216 72 132
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864 2112 192 408 204
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 3781 60 1022 156
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 1824 48 804 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408 1956 181 36 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 2810 204 288 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 1356 72 84 180
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 924 48 96 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 1201 12 216 60
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11964 58062 3158 7479 2607


0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11964 58062 3158 7479 2607
Total PUS Gakin : ………………………………..
Total PUS 4T : ………………………………..
Total PUS ALKI : ………………………………..

Aktif
PUS ALKI (Anemia/ Lila
AKTIF* Gakin AKTIF* 4T Efek Samping Komplikasi 23,5cm/ Peny. Kronis/
MOP Kondom TOTAL % IMS)

0 12 3541 1029.360465 150 270 0 0 44


0 336 6109 1775.872093 756 144 0 0 20
0 36 4392 1276.744186 1190 546 0 0 20
0 0 600 174.4186047 12 10 0 0 10
0 36 2748 798.8372093 300 120 0 0 22
0 0 7680 2232.55814 640 240 0 0 40
0 156 8833 2567.732558 330 240 0 0 10
0 60 2833 823.5465116 232 140 0 0 10
0 36 4309 1252.616279 160 240 0 0 16
0 108 5689 1653.77907 314 178 0 0 42
0 180 7452 2166.27907 1090 80 0 0 42
0 60 6025 1751.453488 1000 80 0 0 60
0 420 4200 1220.930233 518 178 0 0 42
0 0 5583 1622.965116 532 88 0 0 20
0 0 3192 927.9069767 4 136 0 0 12
0 36 2665 774.7093023 270 198 0 0 90
0 24 3914 1137.790698 242 20 0 0 20
0 0 2256 655.8139535 302 276 0 0 74
0 132 1344 390.6976744 206 34 0 0 26
0 0 1537 446.8023256 138 18 0 0 22
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

0 1632 84902 24680.81395 8386 3236 0 0 642


0 1632 84902 24680.81395 8386 3236 0 0 642

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