FORMAT 1 - Isian Master Posyandu

Tahun : 2022
Kab/Kot:
Provinsi:
Kecamat: IV Jurai
RUKUN WARGA

TERINTEGRASI
POSYANDU

POSYANDU PROGRAM JUMLAH KADER

KD DESA

STRATA
NOMOR
KD KEC

PENANGGUNG POSYANDU
NAMA ALAMAT PENANGGUNG KETUA PETUGAS MEDIS DAN BIDAN KETERAN
JAWAB SEKRETARIS

Lain-lain
POSYANDU POSYANDU JAWAB UMUM PELAKSANA KB PARAMEDIS DESA GAN

PAUD
OPERASIONAL

BKB
TIDAK
AKTIF
AKTIF
* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 1 4 Nenas I Pasar Salido Ripha Andria Dian Febrian Rina Novianti 1 1 0 5 0 0 1 1
2 4 Nenas II Pasar Salido Ripha Andria Melani Oktarida Dona Putri 0 0 0 5 0 0 1
3 4 Teratai I Koto Salido Vivi Wahyuni Sri Mulyeni Mardiatin 0 0 0 5 0 0 1
4 4 Teratai II Koto Salido Vivi Wahyuni Desmiyenti Kiki Ulandari 5 0 0 1
5 4 Kenanga I Laban Watrimarni Desvawanti Sri Yuhartati 0 0 0 5 0 0 1
6 4 Kenanga II Laban Shinta Trisia Syafnayenti Afri Helmayori 0 0 0 5 0 0 1
7 4 Kenanga III Laban Watrimarni Tasnidar Sulastri 1 1 0 5 0 0 1
8 4 Anggur I Kp.Luar Nori Yulianingsih Yuni Darni Yeni Suryani 0 0 0 5 0 0 1
9 4 Anggur II Kp.Luar Nori Yulianingsih Susi madrita Dia Yolanda 0 0 0 5 0 0 1
10 4 Anggur III Kp.Luar Nori Yulianingsih Desi gawat ripai Del eki 1 1 0 5 0 0 1
11 4 Raflesia I Balai Lamo Wirabetha Yuliska Rini Zulfarina Afnidarwati 0 0 0 5 0 0 1
12 4 Raflesia II Balai Lamo Wirabetha Yuliska Dalisaweni Nova yenti 0 0 0 5 0 0 1
13 4 Nusa Indah I Sianik Nini Kusniati Neng Payasni Beby Olivia 0 0 0 5 0 0 1
14 4 Nusa Indah II Kampung baru Desy Indah Natalia Rini Oktavia Mawaddaturahma 0 0 0 5 0 0 1
15 4 Nusa Indah III Sago Mecy Fimilia Sari Ermawati Lusi 0 0 0 5 0 0 1 1
16 4 Nusa Indah IV Sago Mecy Fimilia Sari Yara melvita nurul atika 0 0 0 5 0 0 1 1
17 4 Rose I Bg.Pasang I Asriyanti Ali Mawarti Fitria 0 0 0 5 0 0 1
18 4 Rose II Bg.Pasang I Asriyanti Ermayenti Mildayani 1 1 0 5 0 0 1
19 4 Mawar I Bg.Pasang II Riana Yorianas Maineri Yenti Tuti Wahyu Lestari 1 1 0 5 0 0 1 1
20 4 Mawar II Bg.Pasang III Rahmika Zandi Nurmayenti Lisa Isugiarti 0 0 0 5 0 0 1
21 4 Mawar III Bg.Pasang III Rahmika Zandi Yurniati Desmayenti 0 0 0 5 0 0 1
22 4 Melati I Tambang Maria Devi Vera Angraini Refnida 1 1 0 5 0 0 1
23 4 Melati II Tambang Maria Devi Saprina Yola Riri Subara 1 1 0 5 0 0 1
24 4 Melati III Tambang Maria Devi Desmawati Nengsih 1 1 0 5 0 0 1
25 4 Bougenvile I S.S.B mezy Chintia Dewi Febrianti Puspita Sari Melan Putri 1 1 0 5 0 0 1 1
26 4 Bougenvile II S.S.B mezy Chintia Dewi Yohana Meli Fitri 0 0 0 5 0 0 1 1
27 4 Bougenvile III Koto Rawang Vini Azian Darwanti Sri Suharti 1 1 0 5 0 0 1
28 4 Bougenvile IV Sei.Salak Silvy Rista Meisara Fitnaimat NovitDirna Wati 1 1 0 5 0 0 1
29 4 Asoka I Jln.Darwis Laura Susandra Kirdawati Rosnida Thalib 0 0 0 5 0 0 1
30 4 Asoka II Pn.utara Sri Sumersi Trimurti Elni Sukaisih 0 0 0 5 0 0 1
31 4 Asoka III Jln.Darwis Laura Susandra Murni Yusrita 0 0 0 5 0 0 1
32 4 Asoka IV Pn.Utara Sri Sumersi Nurhayati Arlentika 0 0 0 5 0 0 1
33 4 Asoka V Pn.Utara Sri Sumersi Asni Widya Astuti 0 0 0 5 0 0 1
34 4 Anggrek Sei.Nipah Novita Roya Azmi Rostina Rici Asmar 0 0 0 5 0 0 1
35 4 Dahlia I Pn.Selatan Titik Nur Ismaillia Netty wijaya Hartati 0 0 0 5 0 0 1
36 4 Dahlia II Pn.Selatan Masyitah Yesry seppitri Sepriani 1 1 0 5 0 0 1
37 4 Dahlia III Pn.Selatan Masyitah Roza Umami Sylvia Herlin 0 0 0 5 0 0 1
38 4 Kamboja I Pn.Timur Astika Chandra Irmawati sari rahayu 0 0 0 5 0 0 1
39 4 Kamboja II Pn.Timur Astika Chandra Nurhayati kiki Gusriza 0 0 0 5 0 0 1
39
 40 4 Kamboja III Perumnas yora Adhayani Desmawati Wiwi Meisack 0 0 0 5 0 0 1
41 4 Kamboja IV Perumnas yora Adhayani Liza Rafnur Yeni Evia 1 1 0 5 0 0 1
2 1 4 Anggrek I Kp. Alai Nasrul Citra Resmi Yola Handayani Desrimari 0 0 0 5 0 1 1 1 0
2 4 Anggrek II Kp. S. liek Nasrul Citra Resmi Satria Liza Marnis 0 0 0 5 0 1 1 1 0
3 4 Anggrek III Kp. L. Tinggi Nasrul Citra Resmi Masyunis Nurlaili 0 0 0 5 0 1 1 1 0
4 4 Anggrek IV Kp. Alai Nasrul Citra Resmi Silvia Dewita Revi Nufrianti 0 0 0 5 0 1 1 1 0
5 4 Bunga Tanjung Kp. Batu Kunik Syafriyil Widya Narta Refrimar Yeni Fitri 0 0 0 5 0 1 1 1 0
6 4 Raflesia Kp. Batu Kunik Syafriyil Widya Narta Osparida Wempi Permata 0 0 0 5 0 1 1 1 0
7 4 Mawar I Taratak Tangah Deweel Cilivefra Resi Putri Merdianti Tari Ayu Aneka 1 1 0 5 0 2 1 1 0
8 4 Mawar II Bukik Parik Deweel Cilivefra Resi Putri Yusdianil Dona e Farita 0 0 0 5 0 1 1 1 0
9 4 Melati I Pr. Gadang Suhardi Rahmi Dwi. P Nurhaini Rika Murni 0 0 0 5 0 0 1 1 0
10 4 Melati II Bukit Siayah Suhardi Rahmi Dwi. P Hendika Yeni Indra Beni 0 0 0 5 0 0 1 1 0
Kamp. Ampang
Dahlia 1 Sufri Ali Andaro,SH Meci Sri Yuliasni Evita Endriyanti 1 1 0 5 0 1 1 1 0
11 4 Tareh
12 4 Dahlia 2 Kamp. Tanah Bato Sufri Ali Andaro,SH Meci Sri Yuliasni Ermayulinda Melvita 0 0 0 5 0 1 1 1 0
13 4 Dahlia 3 Kamp. Barangan Sufri Ali Andaro,SH Meci Sri Yuliasni Nurmayanti Ermaita 0 0 0 5 0 1 1 1 0
14 4 Dahlia 4 Kamp. Barangan Sufri Ali Andaro,SH Meci Sri Yuliasni Winda Wilis Res Suryani 0 0 0 5 0 1 1 1 0
15 4 Asoka 1 KP. PASAR SYAHRIAL. R Hartina YUNIATRI WIDIANTI 0 0 0 5 0 1 1 1 0
16 4 Asoka 2 KP. AMPUAN SYAHRIAL. R Hartina ROSNIANTI FATMAWATI 1 1 0 5 0 1 1 1 0
17 4 Asoka 3 KP. RIMBO LAWEH SYAHRIAL. R Hartina NURBAYA ARGOGO 0 0 0 5 0 1 1 1 0
Kamp.Gunung
Kenanga 1 Doni Iskandar Yuli Tri Wahyuni Pasrina Helma Putri 0 0 0 5 0 1 1 1 0
18 4 Bungkuk
Kamp.Gunung
Kenanga 2 Doni Iskandar Yuli Tri Wahyuni Netri Zalni Indrawati 1 1 0 5 0 1 1 1 0
19 4 Bungkuk
Kamp.Gunung
Kenanga 3 Doni Iskandar Yuli Tri Wahyuni Riza Fiddayati Siti Jelita 0 0 0 5 0 1 1 1 0
20 4 Bungkuk
21 4 Matahari 1 Kp.Bukik Kaciak Syahrial Febrina Livia Roliza Lili Elfia Sisri Nofita Yanti 0 0 0 5 0 2 1 1 0
Kp.Ambacang
Matahari 2 Syahrial Febrina Livia Roliza Sisri Handayani Yori Afriyeni 0 0 0 5 0 1 1 1 0
22 4 Badak
23 4 bougenvile Koto Ranggo Syatrial Silvia Novriati Yanti Gaslina 0 0 0 5 0 1 1 1 0
24 4 Kamboja 1 kamp. Balai SinayanSabandi Neci Yulia Putri Nurmi Watna wati 1 1 0 5 0 3 1 1 0
25 4 Kamboja 2 Kamp. Jua Banyak Sabandi Neci Yulia Putri Irdawati Itmawati 0 0 0 5 0 3 1 1 0
26 4 Cempaka 1 Kp. Koto Sepri Putra Srina Rahayu Elvita Keni Suryani 0 0 0 5 0 2 1 1 0
27 4 Cempaka 2 Kp. Rumah Gadang Sepri Putra Srina Rahayu Musda Yetrri Lidia Novi 0 0 0 5 0 1 1 1 0
28 4 Cempaka 3 Kp. Sungai Gayo Sepri Putra Srina Rahayu Yulia DEvi Cindi Andika 0 0 0 5 0 1 1 1 0
29 4 Teratai 1 SEI. SARIAK EDI AMANTO Vivi Weldia Yanti YASMALINDA RECI 0 0 0 5 0 1 1 1 0
30 4 Teratai 2 KASAI EDI AMANTO Vivi Weldia Yanti RAHMA DRIKA ELMAWARNI 0 0 0 5 0 1 1 1 0
jumlah 18 18 0 355 0 35 36 71 0

39
39
 FORMAT 2 - Isian Data Umum Posyandu
Tahun : 2022
Kab/Kota : 01
Provinsi : 13
JUMLAH PETUGAS JML IBU
JUMLAH PENGUNJUNG JUMLAH BAYI IBU HAMIL
HADIR NIFAS YANG
ISI 1 BILA ADA DATA

BULAN PENDATAAN
IBU JML MENDAPAT
NO POSYANDU

KEMAT
JML JML
IAN JML JML
KD DESA
KD KEC

MEDI Pengun- JML JML Ibu Kematia JML

BALITA IBU KADE Pengun- Kematia
RW

BAYI 0- BALITA S DAN jung Kepala Melahir- n Ibu Kematia KETERANGAN

12-23 MENIN HAMIL, R PKK PLKB/ jung n Ibu
11 24-59 WUS MENYU LAHIR PARA VITAM KEK ANEMIA Perem- Keluarga kan Melahir- n Nifas
BULAN PUS HAMIL GGAL MELAH POSY PKB Fe Laki-laki Hamil
BULAN BULAN SUI MEDI IN puan kan
(BADUTA) IRKAN ANDU
S
NIFAS

* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1 01 01 01 1 3 7 11 0 21 0 3 0 0 0 1 1 0 0 0 0 0 21 150 0 0 0 0
2 3 4 8 0 15 0 3 0 0 0 0 0 1 0 0 0 0 0 15 161 0 0 0 0
3 4 6 14 2 22 4 10 1 0 0 0 1 1 1 1 0 0 5 35 127 0 0 0 0
4 4 2 16 1 28 1 4 1 0 0 0 1 1 1 1 0 0 0 28 101 1 0 0 0
5 12 15 34 21 61 4 12 0 0 0 0 0 1 0 0 2 0 0 61 216 0 0 0 0
6 17 21 42 10 80 11 7 2 0 0 0 0 1 2 0 1 3 10 80 80 2 0 0 0
7 4 3 14 6 21 4 7 1 0 0 0 0 1 1 1 0 0 1 21 117 1 0 0 0
8 17 12 45 8 70 5 29 2 0 0 0 1 1 2 0 0 1 4 70 293 2 0 0 0
9 6 8 20 5 32 2 14 0 0 0 0 0 1 0 0 0 0 3 32 110 0 0 0 0
10 4 4 14 2 20 0 8 0 0 0 0 0 3 0 0 0 0 2 20 52 0 0 0 0
11 5 4 24 20 25 3 5 0 0 0 0 0 1 0 0 0 0 8 37 0 0 0 0
12 11 10 22 24 31 4 8 0 0 0 0 0 1 0 0 1 0 5 30 0 0 0 0
13 8 15 58 8 40 12 12 0 0 0 0 0 1 0 0 1 1 8 40 40 0 0 0 0
14 14 11 48 6 35 10 8 2 0 0 0 0 1 2 2 1 1 8 33 41 2 0 0 0
15 15 18 36 19 65 8 18 0 0 0 0 0 1 0 0 0 1 9 43 245 0 0 0 0
16 16 16 33 13 58 6 15 1 0 0 0 0 1 1 1 0 1 8 39 239 1 0 0 0
17 13 11 28 11 67 6 24 1 0 0 0 0 1 1 1 1 0 6 67 250 1 0 0 0
18 15 10 38 11 63 3 25 0 0 0 1 0 1 0 0 1 0 2 53 290 0 0 0 0
19 18 9 33 10 56 4 25 2 0 0 1 0 1 2 2 0 1 10 66 298 2 0 0 0
20 6 17 27 30 9 1 16 0 0 0 0 0 1 0 0 0 0 2 24 130 0 0 0 0
21 11 17 27 9 27 14 18 0 0 0 0 0 1 0 0 1 1 5 35 180 0 0 0 0
22 12 21 29 8 50 2 22 2 0 0 0 0 1 2 2 0 0 3 50 236 2 0 0 0
23 12 17 29 5 58 2 20 1 0 0 0 0 1 1 1 0 0 6 58 121 1 0 0 0
24 8 9 27 7 44 2 16 5 0 0 0 0 1 5 5 0 0 4 44 213 5 0 0 0
25 19 20 41 28 62 9 39 2 0 0 0 0 1 2 2 0 0 10 63 368 2 0 0 0
26 14 11 42 14 67 6 25 1 0 0 0 0 1 1 1 0 0 8 67 262 1 0 0 0
27 11 18 34 45 36 10 14 2 0 0 0 0 1 2 2 0 0 0 60 215 2 0 0 0
28 10 1 21 35 33 4 2 2 0 0 2 1 1 2 2 0 0 3 33 124 2 0 0 0
29 9 10 25 5 30 3 10 0 0 0 1 0 1 0 0 0 0 8 30 110 0 0 0 0
30 6 12 19 42 9 1 26 2 0 0 0 1 1 2 2 0 5 24 147 2 0 0 0
31 8 8 20 10 8 4 8 0 0 0 0 0 1 0 0 0 0 8 30 120 0 0 0 0
32 9 17 21 9 27 3 27 2 0 0 0 0 1 2 2 0 0 12 35 218 2 0 0 0
33 11 15 23 43 16 12 21 2 0 0 0 0 1 3 3 0 0 27 42 214 3 0 0 0
34 7 6 30 4 43 4 11 1 0 0 0 0 1 1 1 0 0 2 43 149 1 0 0 0
35 17 15 48 10 5 6 24 3 0 0 0 0 1 1 1 1 1 5 61 312 3 0 0 0
36 7 16 26 6 41 5 16 2 0 0 0 1 1 2 2 1 0 19 31 47 2 0 0 0
37 8 13 18 3 32 3 14 0 0 0 0 0 1 0 0 0 0 13 26 39 0 0 0 0
38 6 8 27 41 10 1 14 1 0 0 0 0 1 1 1 0 0 23 28 38 1 0 0 0
39 10 17 25 52 12 5 27 8 0 0 0 0 1 7 7 0 0 39 25 41 8 0 0 0
40 10 12 41 6 63 3 11 0 0 0 1 0 1 0 0 0 0 1 63 189 0 0 0 0
41 20 17 54 2 57 6 14 3 0 0 1 0 1 3 3 1 0 4 54 210 3 0 0 0
2 1 8 10 13 60 56 4 4 1 0 0 8 1 1 1 0 0 0 0 0 43 4 0 0 0
2 10 5 21 45 38 4 7 2 0 0 8 1 1 1 0 0 0 0 0 0 2 0 0 0
 3 8 5 13 61 40 3 2 0 0 0 6 1 1 0 0 0 0 0 0 0 0 0 0 0
4 2 1 9 32 21 1 3 0 0 0 5 1 1 0 0 0 0 0 0 19 0 0 0 0
5 6 7 18 78 40 3 5 1 0 0 5 1 1 1 1 0 0 16 15 98 1 0 0 0
6 5 5 25 85 58 3 6 2 0 0 5 2 1 2 2 0 0 19 16 97 2 0 0 0
7 8 21 14 106 64 95 7 0 0 0 1 2 1 0 0 0 0 0 0 0 0 0 0 0
8 7 23 15 121 69 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0
9 8 3 19 29 70 2 4 0 0 0 5 0 1 0 0 0 0 1 29 0 0 0 0 0
10 8 7 33 48 65 5 4 2 0 0 5 0 1 1 2 2 1 0 48 0 2 0 0 0
11 3 3 11 17 17 0 6 0 0 0 5 1 1 0 0 0 0 0 0 0 0 0 0 0
12 12 12 9 32 32 0 24 2 1 0 5 2 1 2 2 0 0 0 32 32 2 0 0 0
13 1 1 14 16 16 1 2 0 0 0 5 1 1 0 0 0 0 0 16 16 0 0 0 0
14 4 7 8 19 19 2 0 0 0 0 5 0 1 0 0 0 0 0 19 19 0 0 0 0
15 12 10 21 50 45 0 0 0 0 5 1 1 1 0 0 0 0 23 20 40 0 0 0 0
16 7 5 25 45 30 4 2 2 0 0 5 1 1 2 2 16 21 31 2 0 0 0
17 8 1 22 29 20 3 1 1 0 0 5 1 1 1 1 0 0 16 15 28 1 0 0 0
18 6 6 22 34 34 2 12 1 0 0 0 1 1 1 1 0 0 0 0 34 1 0 0 0
19 5 4 13 22 22 4 9 0 0 0 5 1 1 0 0 0 0 0 0 22 0 0 0 0
20 5 8 14 27 27 1 13 0 0 0 5 1 1 0 0 0 0 0 0 27 0 0 0 0
21 7 3 11 30 27 4 7 2 0 0 5 1 1 2 2 0 0 0 0 0 2 0 0 0
22 10 6 24 50 41 1 6 1 0 0 5 1 1 1 1 0 0 0 0 0 1 0 0 0
23 5 1 6 45 25 4 1 4 1 1 5 1 1 2 2 1 1 1 1 1 1 1 1 1
24 7 8 20 106 76 7 0 0 0 0 0 3 1 0 0 0 0 0 35 32 0 0 0 0
25 4 8 24 45 26 4 0 0 0 0 1 3 1 0 0 1 0 0 36 33 0 0 0 0
26 5 3 13 20 18 2 8 1 0 0 5 2 1 1 1 0 0 0 20 18 1 0 0 0
27 8 4 14 25 23 3 12 1 0 0 5 1 1 1 1 0 0 0 25 23 1 0 0 0
28 6 6 18 28 27 1 12 0 0 0 5 1 1 0 0 0 0 0 28 27 0 0 0 0
29 3 6 9 38 25 0 0 0 0 0 0 0 1 0 0 0 0 9 9 0 0 0 0 0
30 5 11 17 55 40 3 0 1 0 0 0 0 1 0 0 0 0 17 16 0 1 0 0 0
jumlah 420 483 1192 591 1549 193 632 52 0 0 7 7 43 50 46 12 11 296 1717 6493 52 0 0 0
 FORMAT 4 - Isian Data Sarana Posyandu
Tahun 2022
Kab/Kota
Provinsi
TEMPAT PELAYANAN TIMBANGAN

POSYANDU
ADA DATA

BUKU BUKU ALAT

ISI 1 BILA

KD DESA

NOMOR
WARGA
KD KEC

RUKUN
ALAT
KESEHATAN FORMULIR BLANKO CATATAN PERAGA
PERMAINA LAINNYA KETERANGAN
GEDUNG IBU DAN SIP SKDN KEUANGA PENYULUH
MENUMPANG SEWA BAYI BALITA IBU N EDUKASI
SENDIRI ANAK N AN

* 1 2 3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 16
1 1 0 1 0 0 1 1 1 1 0 1 0 1 0
2 0 1 0 0 1 1 1 1 0 1 0 0 0
3 0 1 0 1 1 0 36 1 0 1 0 0 0
4 0 1 0 0 1 0 24 1 0 1 0 0 0
5 0 1 0 0 1 0 21 1 0 1 0 0 0
6 0 1 0 1 1 1 83 1 0 1 0 0 0
7 0 1 0 0 1 0 21 1 0 1 0 0 0
8 0 1 0 1 1 1 81 1 0 1 0 0
9 0 1 0 1 1 1 43 1 0 1 0 0 0
10 1 0 0 1 1 1 23 1 0 1 0 0 0
11 0 1 0 1 1 1 33 1 0 1 0 0 0
12 0 1 0 0 1 1 43 1 0 1 0 0 0
13 0 1 0 1 1 1 110 1 0 1 0 0 0
14 0 1 0 1 1 1 73 1 0 1 0 0 0
15 1 0 0 1 0 1 68 1 0 1 0 0 0
16 0 1 0 1 1 1 62 1 0 1 0 0 0
17 0 1 0 1 1 1 68 1 0 1 0 0 0
18 0 1 0 1 1 1 68 1 1 1 1 0 1
19 0 1 0 1 1 1 54 1 1 1 1 0 1
20 0 1 0 1 0 0 35 1 1 1 1 0 1
21 0 1 0 1 0 0 64 1 1 1 1 0 1
22 0 1 0 1 1 1 62 1 0 1 0 0 0
23 0 1 0 1 1 1 49 1 0 1 0 0 0
24 0 1 0 1 1 1 42 1 0 1 0 0 0
25 0 1 0 1 1 1 80 1 0 1 0 0 0
26 0 1 0 1 1 1 67 1 0 1 0 0 0
27 1 0 0 1 1 1 81 1 0 1 0 0 0
28 0 1 0 1 1 0 32 1 0 1 0 0 0
29 0 1 0 1 1 1 46 1 0 1 0 0 0
30 0 1 0 1 1 1 48 1 0 1 0 0 0
31 0 1 0 1 1 0 46 1 0 1 0 0 0
32 0 1 0 1 1 0 58 1 0 1 0 0 0
33 0 1 0 1 1 0 110 1 0 1 0 0 0
34 0 1 0 1 1 0 48 1 0 1 0 0 0
35 0 1 0 1 1 1 82 1 0 1 0 0 0
36 0 1 0 0 1 1 76 1 0 1 0 0 0
37 0 1 0 0 1 1 56 1 0 1 0 0 0
38 0 1 0 0 1 0 76 1 0 1 0 0 0
39 0 1 0 0 1 0 76 1 0 1 0 0 0
 40 0 1 0 1 1 0 63 1 0 1 0 0 0
41 0 1 0 1 1 1 91 1 0 1 0 0 0
2 1 1 0 0 0 0 1 31 1 1 1 1 0 0
2 1 0 0 0 0 1 36 1 1 1 1 0 0
3 1 0 0 0 0 1 23 1 1 1 1 0 0
4 1 0 0 0 0 1 12 1 1 1 1 0 0
5 0 0 0 0 1 1 31 1 1 1 1 0 0
6 0 0 0 0 0 0 35 1 1 1 1 0 0
7 0 0 0 0 1 1 29 1 1 1 1 0 0
8 0 0 0 0 1 1 43 1 1 1 1 1 0
9 1 0 0 1 1 1 45 1 1 1 1 0 0
10 1 0 0 1 1 1 48 1 1 1 1 0 0
11 0 1 0 0 1 1 17 1 1 1 1 0 0
12 0 1 0 0 1 1 32 1 1 1 1 0 0
13 0 1 0 0 1 1 16 1 1 1 1 0 0
14 0 1 0 0 1 1 19 1 1 1 1 0 0
15 0 1 0 1 1 1 43 1 1 1 1 0 0
16 0 1 0 1 1 1 37 1 1 1 1 0 0
17 0 1 0 1 1 1 31 1 1 1 1 0 0
18 0 1 0 1 1 1 28 1 1 1 1 0 0
19 0 1 0 1 1 1 17 1 1 1 1 0 0
20 0 1 0 1 1 1 22 1 1 1 1 0 0
21 0 1 0 1 1 0 21 1 1 1 1 0 0
22 0 1 0 1 1 1 40 1 1 1 1 0 0
23 0 1 0 0 1 0 36 1 1 1 1 0 0
24 0 1 0 1 1 1 36 1 1 1 1 0 0
25 0 1 0 1 1 1 32 1 1 1 1 0 0
26 0 1 0 0 1 1 21 1 1 1 1 0 0
27 0 1 0 0 1 1 26 1 1 1 1 0 0
28 0 1 0 0 1 1 30 1 1 1 1 0 0
29 1 0 0 0 1 1 23 1 1 1 1 0 0
30 1 0 0 0 1 1 32 1 1 1 1 0 0
Jumlah 11 56 0 43 63 54 3193 71 34 71 34 2 4 0
 FORMAT 3 - Isian Data Kegiatan Posyandu
Tahun : 2022
Kab/Kota :
Provinsi :

JUMLAH PESERTA BALITA

KB YANG YANG
IBU HAMIL MENDAPAT PENIMBANGAN BALITA (JUMLAH) JUMLAH BALITA JUMLAH BALITA YANG DIIMUNISASI MENDERI

JUMLAH BALITA YANG KURANG GIZI

JUMLAH BALITA DAPAT IMUNISASI
JUMLAH BAYI YG MENERIMA KMS
PELAYANAN TA
ULANG DIARE

SOSIALISASI PENYULUHAN

JUMLAH KEMATIAN BALITA

JUMLAH YANG MENYUSUI

LAYANAN KESEHATAN
YANG DI BAWAH GARIS MERAH (BGM)
JML BALITA SASARAN POSYANDU (S)
ISI 1 BILA ADA DATA

BULAN PENDATAAN

JML YANG MEMERIKSAKAN DIRI

NO POSYANDU

JUMLAH BALITA DAPAT ORALIT

YANG
DPT-HB POLIO HEPATITIS TT

JUMLAH BGM PEREMPUAN

DAPAT Fe
KD DESA
KD KEC

YANG DAPAT VITAMIN A

JUMLAH BGM LAKI-LAKI
YANG PUNYA KMS (K)

YANG DITIMBANG (D)

JML YANG DAPAT Fe
RW

HEPATITIS 0-7 HARI

KMS YANG KELUAR
KETERANGAN

YANG DAPAT PMT

JUMLAH BALITA
YANG NAIK
KONDOM

CAMPAK
JUMLAH

SUNTIK

BCG
PIL
1 2

IV
III

III

III
II

II

II

II
I

I
* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48
1 1 2 0 0 3 0 0 0 29 29 21 19 2 0 2 0 1 0 0 0 0 1 1 0 0 1 1 0 0 0 1 0 0 0 0 0 1 0 0 2 0 0
2 2 0 0 3 0 0 0 25 25 15 7 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0
3 4 4 4 10 0 0 0 36 36 26 26 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0
4 1 1 1 4 0 0 0 24 24 20 20 2 1 1 0 0 0 0 0 1 3 0 0 0 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
5 3 3 3 17 0 0 0 42 42 35 31 1 1 1 0 0 0 0 0 5 1 0 1 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0
6 11 11 11 7 0 0 0 83 83 80 51 1 1 0 0 0 0 0 5 2 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0
7 4 4 1 7 0 0 0 21 21 21 15 2 1 1 0 0 0 0 0 1 1 1 0 0 1 0 0 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0
8 3 3 3 29 0 0 0 81 81 74 70 1 1 0 0 1 0 0 2 2 1 2 2 0 1 2 2 0 3 2 2 0 1 1 0 0 0 0 0 0 0 0
9 0 0 0 14 0 0 0 43 43 34 30 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0
10 0 0 0 8 0 0 0 23 23 22 22 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
11 4 4 2 1 0 0 0 33 33 33 17 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0
12 6 6 4 1 0 0 0 43 43 42 27 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0
13 15 12 12 12 0 0 0 110 110 81 53 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 3 2 0 0 0 0 0 0 0 0
14 10 10 10 0 0 0 73 73 54 38 1 1 0 0 1 0 0 0 2 1 2 1 2 1 2 1 2 2 2 1 2 3 2 0 0 0 0 0 0 0 0
15 8 5 5 22 0 0 0 68 68 60 55 2 1 1 0 0 0 0 0 0 0 1 1 2 0 1 1 2 2 1 1 2 1 1 0 0 0 0 0 0 0 0
16 13 6 5 21 0 0 0 62 62 55 52 1 1 0 0 0 0 0 0 1 1 0 2 1 1 0 2 1 2 0 2 1 1 1 0 0 0 0 0 0 0 0
17 6 6 6 24 0 0 0 68 68 52 49 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0
18 5 5 5 25 0 0 0 68 68 53 50 1 1 0 0 0 0 0 0 0 0 5 2 3 0 5 2 3 3 5 2 3 1 1 0 0 0 0 0 0 0 0
19 4 4 4 25 0 0 0 54 54 48 36 2 2 0 0 0 0 0 0 2 1 1 2 1 1 1 2 1 0 1 2 1 0 0 0 0 0 0 0 0 0 0
20 3 1 1 10 0 0 0 35 35 35 35 2 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0
21 14 4 4 18 0 0 0 64 64 50 46 1 1 0 0 0 0 0 0 0 3 1 2 0 3 1 0 0 1 1 2 0 2 0 0 0 0 0 0 0 0 0
22 4 4 4 30 0 0 0 62 62 50 47 0 0 0 0 0 0 0 0 2 0 0 3 3 0 0 3 3 2 0 3 3 0 0 0 0 0 0 0 0 0 0
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