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FORMULIR PENCATATAN

PEMANTAUAN STATUS GIZI (PSG) BALITA


TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BULANG LINTANG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : MELATI I
07. TIPE DESA/KELURAHAN : PEDESAAN
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U B
M. ANANDA ABIZAR L 17 Februari 2018 2/14/2023 60 Buruk Sangat Pendek Sangat Kurus
2
KAMNUR HIDAYAT L 20 Maret 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
3
AHMAD LIZALUDIN L 21 Maret 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
4
M. ABIZAN L 22 April 2018 5/17/2023 60 Buruk Sangat Pendek Sangat Kurus
5
CAYLA SISKA A. P 05 April 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
6
RANIA AQILA P 15 April 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
7
ZAFRAN AFNAN L 23 April 2018 5/17/2023 60 15.5 T 106.0 Baik Normal Normal
8
R. EMBUN FATIMAH P 04 Mei 2018 5/17/2023 60 Buruk Sangat Pendek Sangat Kurus
9
ALIF ABDILLAH L 09 Juni 2018 5/17/2023 59 19.2 N 113.0 Baik Normal Normal
10
RIFALDI SAPUTRA L 25 Juni 2018 5/17/2023 58 Buruk Sangat Pendek Sangat Kurus
11
ZAHRATUL ZAHWA P 23 Agustus 2018 5/17/2023 56 15.9 T 104.0 Baik Normal Normal
12
ABIDAH SAKILA P 31 Agustus 2018 5/17/2023 56 15.9 T 100.0 Baik Normal Normal
13
NASIRUDIN L 03 Oktober 2018 5/17/2023 55 Buruk Sangat Pendek Sangat Kurus
14
M. AHDAN BAYANAKA L 05 Januari 2019 5/17/2023 52 14.3 N 100.0 Baik Normal Normal
15
BILION NAIRY B. L 17 Januari 2019 5/17/2023 52 21.5 N 107.0 Baik Normal Gemuk
16
ASIA FAIHA P 04 Juni 2019 5/17/2023 47 11.4 T 95.0 Kurang Normal Kurus
17
ANDINI MULYANI P 21 Mei 2019 5/17/2023 48 15.2 T 102.0 Baik Normal Normal
18
ILMA NUR FATIHAH P 19 Juli 2019 5/17/2023 46 Buruk Sangat Pendek Sangat Kurus
19
M. MAULANA L 08 September 2019 5/17/2023 44 Buruk Sangat Pendek Sangat Kurus
20
M. LUTHFI L 21 Agustus 2019 5/17/2023 45 12.1 N 96.0 Kurang Normal Kurus
21
ARIL SEPTIANSYAH L 05 September 2019 5/17/2023 44 13.6 T 94.0 Baik Normal Normal
22
RUDIANSYAH L 08 Agustus 2019 5/17/2023 45 Buruk Sangat Pendek Sangat Kurus
23
R. AHMAD RAFI L 14 Agustus 2019 5/17/2023 45 14.5 T 100.0 Baik Normal Normal
24
TAMARA AZKA G. P 13 November 2019 5/17/2023 42 Buruk Sangat Pendek Sangat Kurus
25
NURSYA KHALIF F. L 23 Desember 2019 5/17/2023 40 13.4 T 96.0 Baik Normal Normal
26
AL HABIB L 14 Januari 2020 5/17/2023 40 12.2 T 92.0 Baik Normal Normal
27
M. ADRIL L 22 Januari 2020 5/17/2023 39 Buruk Sangat Pendek Sangat Kurus
28
RISDA FEBY AMELIA P 21 Februari 2020 5/17/2023 38 12 N 92.0 Baik Normal Normal
29
DAFA ABYAN SYAKIR L 23 Maret 2020 5/17/2023 37 14.6 N 97.0 Baik Normal Normal
30
ZIDAH P 06 Juli 2020 5/17/2023 34 Buruk Sangat Pendek Sangat Kurus
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
31 U U B
NAUMI AULIA SABILA P 15 Agustus 2020 5/17/2023 33 11 T 90.0 Baik Normal Normal
32
ALBY DAVIE F. L 12 Agustus 2020 5/17/2023 33 Buruk Sangat Pendek Sangat Kurus
33
AZHAM LUKMAN Z. L 03 Juni 2020 5/17/2023 35 12.7 T 92.0 Baik Normal Normal
34
AINUR ADZRA P 27 November 2020 5/17/2023 29 10.3 T 86.0 Baik Normal Normal
35
ALESHA ZAHRA P 18 November 2020 5/17/2023 30 10.8 T 89.0 Baik Normal Normal
36
SALMA AIZA P 20 Oktober 2020 5/17/2023 30 13 T 91.0 Baik Normal Normal
37
M. RIALDI ALFIANSYAH L 10 Februari 2021 5/17/2023 27 11 N 88.0 Baik Normal Normal
38
HAZANAH P 31 Mei 2021 5/17/2023 23 9.2 T 80.0 Baik Normal Normal
39
M. FADRIANSYAH L 28 November 2021 5/17/2023 17 10.6 N 79.0 Baik Normal Normal
40
KARINA AHYANA P 08 November 2021 5/17/2023 18 8.4 N 75.0 Baik Normal Normal
41
PUTRI AISAH P 18 Mei 2021 5/17/2023 24 12.3 O 91.0 Baik Normal Normal
42
RAFASYA AL FARIQ L 16 Juli 2021 5/17/2023 22 13.1 N 85.0 Baik Normal Normal
43
SYILA NURAINI P 15 Juli 2021 5/17/2023 22 8.2 N 78.0 Kurang Pendek Kurus
44
DYA KIRANA PUTRI P 23 Oktober 2021 5/17/2023 18 Buruk Sangat Pendek Sangat Kurus
45
M. SADIQIN ARRASYID L 25 Januari 2022 5/17/2023 15 Buruk Sangat Pendek Sangat Kurus
46
M. BAHTIAR L 14 Januari 2022 5/17/2023 16 8.7 T 76.0 Baik Normal Normal
47
ILONA PERMATASARI P 19 Februari 2022 5/17/2023 14 7.3 T 71.0 Kurang Pendek Normal
48
ANJANI MUTIA P 28 Maret 2022 5/17/2023 13 8 T 71.0 Baik Normal Normal
49
ROMADAN ISWAN A. F L 05 April 2022 5/17/2023 13 Buruk Sangat Pendek Sangat Kurus
50
R. RIZKI FIRMANSYAH L 15 Juni 2022 5/17/2023 11 9.2 T 72.0 Baik Normal Normal
51
M. SAIFUL L 15 Mei 2022 5/17/2023 12 8.4 N 72.0 Baik Normal Normal
52
AZKA ARRAZI L 09 Juli 2022 5/17/2023 10 8.8 T 69.0 Baik Normal Normal
53
GALIPIN ALBIMAYU L 24 Juli 2022 5/17/2023 9 10 N 72.0 Baik Normal Normal
54
RAYYAN SAZWAN L 29 Juli 2022 5/17/2023 9 8 T 71.0 Baik Normal Normal
55
M. DZULFIKAR AL GADRI L 01 Agustus 2022 5/17/2023 9 7.7 T 68.0 Baik Normal Normal
56
AHMAD ARFAN GHIFARI L 18 Agustus 2022 5/17/2023 9 10 O 71.0 Baik Normal Normal
57
RISKI FEBIAN L 27 Agustus 2022 5/17/2023 8 10.1 O 71.0 Baik Normal Normal
58
MUHAMMAD AQIL L 11 Oktober 2022 5/17/2023 7 7.3 T 65.0 Baik Normal Normal
59
ARKA ARFARIZI L 11 November 2022 5/17/2023 6 6.7 T 65.0 Baik Normal Normal
60
M. BASIR L 04 Desember 2018 5/17/2023 53 12.6 T 94.0 Kurang Pendek Normal
61
NURUL KHAIRUNISA P 14 Desember 2022 5/17/2023 5 Buruk Sangat Pendek Sangat Kurus
62
AMELDA ZAHRA O. P 15 Oktober 2022 5/17/2023 7 Buruk Sangat Pendek Sangat Kurus
63
SITI RAHAYU P 13 Juni 2022 5/17/2023 11 Buruk Sangat Pendek Sangat Kurus
64
M. ARRAYAN A. L 18 Oktober 2022 5/17/2023 7 Buruk Sangat Pendek Sangat Kurus
65
ANINDIA ASSYIFA ZAHRA P 21 Desember 2022 5/17/2023 4 6.6 N 60.0 Baik Normal Normal
66
RIS NURAINI P 08 Mei 2021 5/17/2023 24 Buruk Sangat Pendek Sangat Kurus
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
67 U U B
UAIS ELHADIST S. P 27 Desember 2021 5/17/2023 16 Buruk Sangat Pendek Sangat Kurus
68
NUR PUTRI ASYIFA P 08 Januari 2023 5/17/2023 4 Buruk Sangat Pendek Sangat Kurus
69
AIRA NABILA TANISHA P 05 Januari 2023 5/17/2023 4 7.5 N 62.0 Baik Normal Normal
70
M. REYGANTARA L 24 Desember 2022 5/17/2023 4 6 N 62.0 Baik Normal Normal
71
KHALISA GANIA P 25 Februari 2023 5/17/2023 2 4.3 N 55.0 Baik Normal Normal
72
01 Agustus 2022 12/15/2022 4 ### ### ###
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
73 U U B
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
79 U U B
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###
81
05 November 2020 12/15/2021 13 ### ### ###
82
14 Januari 2021 12/15/2021 11 ### ### ###
83
18 Mei 2021 12/15/2021 7 ### ### ###
84
15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
U U
14 Agustus 2019 12/5/2019 3 ### ### ### B
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
03 Oktober 2018 12/10/2018 2 U
### ### U ### B
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BULANG LINTANG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : MELATI 2
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU B B STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR BB KET TB /
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U B
M. KHAIRUL AQIL AL AMIN L 03 Februari 2018 3/13/2023 61 Buruk Sangat Pendek Sangat Kurus
2
M. ALFIKI AFASI L 03 Februari 2018 2/14/2023 60 Buruk Sangat Pendek Sangat Kurus
3
RIFANA P 13 Maret 2018 4/15/2023 61 Buruk Sangat Pendek Sangat Kurus
4
ERHAN REZA PUTRA L 25 Juni 2018 5/17/2023 58 16 O 105.0 Baik Normal Normal
5
M. RAIHAN PRATAMA L 25 Juni 2018 5/17/2023 58 Buruk Sangat Pendek Sangat Kurus
6
DHAFIR AYDIN L 01 Juli 2018 5/17/2023 58 15.5 N 104.0 Baik Normal Normal
7
M. HAZIQ AL THAF L 19 Agustus 2018 5/17/2023 57 16.2 N 104.0 Baik Normal Normal
8
SARINA P 11 Juli 2018 5/17/2023 58 14.8 N 101.0 Baik Normal Normal
9
M. HAIKAL ALAMSYAH L 02 September 2018 5/17/2023 56 Buruk Sangat Pendek Sangat Kurus
10
M. LUTFI SANJAYA N. L 21 September 2018 5/17/2023 55 21.3 N 108.0 Baik Normal Gemuk
11
M. ZAFATAR L 21 September 2018 5/17/2023 55 Buruk Sangat Pendek Sangat Kurus
12
SUHAINA P 14 Oktober 2018 5/17/2023 55 14.2 T 103.0 Baik Normal Normal
13
M. AZKA RAFASYA L 08 Desember 2018 5/17/2023 53 15.2 O 98.0 Baik Normal Normal
14
NAYYRA FALISHA Y. P 11 Februari 2018 5/17/2023 63 Buruk Sangat Pendek Sangat Kurus
15
MILIEA PUTRI LIANA P 04 Februari 2019 5/17/2023 51 11.6 T 94.0 Kurang Pendek Normal
16
SITI HUMAIROH P 25 Februari 2019 5/17/2023 50 15.1 N 104.0 Baik Normal Normal
17
FADLAN ARKAN L 04 April 2019 5/17/2023 49 25 N 107.0 Lebih Normal Gemuk
18
AFIFAH SYAHIRA NAFISAH P 19 Mei 2019 5/17/2023 48 Buruk Sangat Pendek Sangat Kurus
19
FATIH NAUFAL RABANI L 10 Juni 2019 5/17/2023 47 17.8 N 96.0 Baik Normal Gemuk
20
FAIZA ULYA PUTRI P 05 Oktober 2019 5/17/2023 43 14.9 O 101.0 Baik Normal Normal
21
M. NARENDRA ZAFIR AKTAR L 05 September 2019 5/17/2023 44 19.8 O 103.0 Baik Normal Gemuk
22
ARVIANIKA KARNIA PUTRI S P 03 Oktober 2019 5/17/2023 43 12.9 N 96.0 Baik Normal Normal
23
M. DARUL IKHSAN L 11 September 2019 5/17/2023 44 12.6 T 96.0 Baik Normal Normal
24
M. AISYAR SYAFIK L 12 September 2019 5/17/2023 44 13.3 O 100.0 Baik Normal Normal
25
M. NAWFAL HAKIMI L 21 September 2019 5/17/2023 43 13 O 99.0 Baik Normal Normal
26
M. NUR ALFA L 14 Desember 2019 5/17/2023 41 12.5 O 92.0 Baik Normal Normal
27
KASMAN L 03 Februari 2020 5/17/2023 39 14.4 O 97.0 Baik Normal Normal
28
KENZIA PUTRI FIRMANSYAH P 26 April 2020 5/17/2023 36 16.9 T 100.0 Baik Normal Normal
29
M. RAFASYA YUSRIKA L 16 Agustus 2020 5/17/2023 33 Buruk Sangat Pendek Sangat Kurus
30
M. RAFAN DAIFULLAH L 23 Agustus 2020 5/17/2023 32 13.6 N 88.0 Baik Normal Normal
31
GIO GIFARA L 23 Agustus 2020 5/17/2023 32 10.1 T 86.0 Kurang Pendek Normal
32
SERLITA NAILA SALSABILA P 29 September 2020 5/17/2023 31 10.2 N 85.0 Baik Normal Normal
33
M. ARFAN L 25 November 2020 5/17/2023 29 14.7 N 90.0 Baik Normal Normal
34
M. YAFIQ ARGANI ARKAN L 20 Januari 2020 5/17/2023 39 13 N 91.0 Baik Normal Normal
35
R. ALFAN KHUZAIRI L 09 Februari 2021 5/17/2023 27 11.4 N 90.0 Baik Normal Normal
36
AFILA ZARA BATISHA P 03 Maret 2021 5/17/2023 26 9.6 T 81.0 Baik Normal Normal
37
FITRIA DELISA MECCA P 17 Maret 2021 5/17/2023 26 13.7 N 87.0 Baik Normal Normal
38
RARA HAIFA AR RAHIM P 24 Maret 2021 5/17/2023 25 10.1 T 83.0 Baik Normal Normal
39
HILYA NURUL AZKIA P 11 April 2021 5/17/2023 25 Buruk Sangat Pendek Sangat Kurus
40
M. ARYA SATYA L 27 April 2021 5/17/2023 24 12.5 N 88.0 Baik Normal Normal
41
M. IQRAM ATTIRMIZI L 10 Mei 2021 5/17/2023 24 10.7 T 82.0 Baik Normal Normal
42
M. NABIL AL FAHRI L 19 Juni 2021 5/17/2023 23 11.4 N 85.0 Baik Normal Normal
43
RABIATUL NUR FATIHAH P 26 Agustus 2021 5/17/2023 20 10.5 N 77.0 Baik Normal Normal
44
AZRA SAUFA P 18 Oktober 2021 5/17/2023 19 10.5 N 76.0 Baik Normal Normal
45
SABINA AZKIARA P 27 September 2021 5/17/2023 19 Buruk Sangat Pendek Sangat Kurus
46
ATQA MIRZA L 10 Oktober 2021 5/17/2023 19 14 O 84.0 Lebih Normal Gemuk
47
M. GIOVANO VANENDRA L 14 Desember 2021 5/17/2023 17 11.2 N 81.0 Baik Normal Normal
48
M. NAZRIL L 06 Oktober 2021 5/17/2023 19 9.2 N 78.0 Baik Normal Normal
49
NUR SHAKIRA NAHLA P 20 Maret 2022 5/17/2023 13 10.5 T 77.0 Baik Normal Normal
50
M. HAFIZ AL RASYID L 01 Juni 2022 5/17/2023 11 9 T 70.0 Baik Normal Normal
51
ZAFANA AULIA LUTFI P 08 Agustus 2022 5/17/2023 9 9 N 67.0 Baik Normal Normal
52
AHMAD FIKRI L 15 Agustus 2022 5/17/2023 9 Buruk Sangat Pendek Sangat Kurus
53
ZIFIA KANAYA A. P 21 September 2022 5/17/2023 7 7.8 N 67.0 Baik Normal Normal
54
PUTRI AFIA MISYARI P 07 Oktober 2022 5/17/2023 7 7.7 N 63.0 Baik Normal Normal
55
M. ARRAYAN APRIADI L 18 November 2022 5/17/2023 6 Buruk Sangat Pendek Sangat Kurus
56
LOVA AURELIA SHAQUIN P 30 November 2022 5/17/2023 5 9.2 N 68.0 Lebih Normal Normal
57
MUHAMMAD GAMA ATHADHL 14 Desember 2022 5/17/2023 5 6.9 N 64.0 Baik Normal Normal
58
REISA PUTRI ADILIA P 30 Desember 2022 5/17/2023 4 9.1 N 66.0 Lebih Normal Gemuk
59
AIMAN GAFFA FARHANSYAH L 10 Juli 2022 5/17/2023 10 Buruk Sangat Pendek Sangat Kurus
60
NURI AL MAIM P 17 Maret 2022 5/17/2023 14 Buruk Sangat Pendek Sangat Kurus
61
NUR AIRA NABILA TANSHA P 02 Februari 2023 5/17/2023 3 6.2 N 59.0 Baik Normal Normal
62
FAIQA ANINDIA P 03 Februari 2023 5/17/2023 3 5.7 N 58.0 Baik Normal Normal
63
BELVANIA RAMADANI P 08 April 2023 5/17/2023 1 4.4 B 52.0 Baik Normal Normal
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
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### ### ###
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1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 0 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 13 14.1 19.8 19.81
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 12.8 13.9 19.4 19.41
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 12.8 13.9 19.4 19.41
4 10 11.9 13.5 24.4 24.41 94.3 99 117.7 117.71 11.8 12.8 18.5 18.51
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71
4 7 11.9 13.5 22.9 22.91 93.9 98.3 116.1 116.11 13.7 14.9 21 21.01
4 7 11.9 13.5 22.9 22.91 93.9 98.3 116.1 116.11
4 7 11.6 13.2 23.5 23.51 93 97.6 115.9 115.91 12.3 13.3 19.2 19.21
4 5 11.7 13.3 22.4 22.41 93 97.4 114.9 114.91 11.6 12.5 17.3 17.31
5 3 0 0 0 0 95.2 99.9 118.9 118.91
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 10.4 11.3 16.2 16.21
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71 12.5 13.6 19.6 19.61
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 13.5 14.6 20.6 20.61
3 12 10.9 12.3 21.5 21.51 89.8 94.1 111.3 111.31
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11 11.2 12.1 16.7 16.71
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 11.8 12.8 18.5 18.51
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 12.6 13.6 19 19.01
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 10.8 11.7 16.8 16.81
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 11.2 12.1 16.7 16.71
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 12 12.9 18 18.01
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 11.8 12.7 17.6 17.61
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 10.5 11.3 15.6 15.61
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71 11.4 12.3 17 17.01
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 11.6 12.6 18.1 18.11
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 9.7 10.5 14.5 14.51
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 9.3 10 13.9 13.91
2 7 9 10.1 16.8 16.81 80.7 84.3 98.6 98.61 8.7 9.4 13.5 13.51
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91 10.1 10.9 15 15.01
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71 10.3 11.1 15.3 15.31
2 3 9 10.1 16.1 16.11 79.9 83.1 96.1 96.11 10.1 10.9 15 15.01
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8 8.7 12.4 12.41
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 9.1 9.9 14.1 14.11
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 8.3 9 12.9 12.91
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 9.7 10.5 14.5 14.51
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.5 9.2 12.8 12.81
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91 9.1 9.8 13.6 13.61
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71 7.4 8 11.5 11.51
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.2 7.8 11.2 11.21
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.9 9.6 13.3 13.31
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 8.4 9.1 12.6 12.61
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 7.9 8.6 12 12.01
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51 7.4 8 11.5 11.51
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 6.6 7.2 10 10.01
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 5.8 6.3 9.1 9.11
0 9 6.4 7.1 11 11.01 65.2 67.5 76.5 76.51
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.8 6.3 9.1 9.11
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.1 5.5 8 8.01
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 6 6.5 9.4 9.41
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 5.5 6 8.3 8.31
0 4 4.4 5 8.2 8.21 55.6 57.8 66.4 66.41 5.6 6.1 8.8 8.81
0 10 6.6 7.4 11.4 11.41 66.4 68.7 77.9 77.91
1 2 6.6 7.4 12.1 12.11 68.3 71 81.7 81.71
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 4.3 4.7 6.8 6.81
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 4.1 4.5 6.5 6.51
0 1 2.7 3.2 5.5 5.51 47.8 49.8 57.6 57.61 2.9 3.2 4.6 4.61
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : PULAU BULUH
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : RUMPUN BAMBU 1
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
MEALIN KARASIA P 13 Februari 2018 2/20/2023 60 Buruk Sangat Pendek Sangat Kurus
2
FEBRIANA P 26 Februari 2018 4/18/2023 61 Buruk Sangat Pendek Sangat Kurus
3
MAYYIDINA NAZIFA A. P 31 Maret 2018 5/22/2023 61 Buruk Sangat Pendek Sangat Kurus
4
NUR APRIANTI P 16 April 2018 5/22/2023 61 Buruk Sangat Pendek Sangat Kurus
5
FATIHAH SRI H. P 25 Mei 2018 5/22/2023 60 Buruk Sangat Pendek Sangat Kurus
6
FATIAN SARIQ L 07 Juni 2018 5/22/2023 59 Buruk Sangat Pendek Sangat Kurus
7
ANISSA ROHMANAH P 15 Agustus 2018 5/22/2023 57 15.5 T 101.0 Baik Normal Normal
8
SHEEZAN NADA R. P 01 September 2018 5/22/2023 56 Buruk Sangat Pendek Sangat Kurus
9
NUR FAJIRAH P 09 September 2018 5/22/2023 56 Buruk Sangat Pendek Sangat Kurus
10
M. PANJI L 06 Oktober 2018 5/22/2023 55 Buruk Sangat Pendek Sangat Kurus
11
DAFA AL FARID L 30 Oktober 2018 5/22/2023 54 Buruk Sangat Pendek Sangat Kurus
12
SALSABILA NUR S. P 10 November 2018 5/22/2023 54 17.9 O 103.0 Baik Normal Normal
13
MASKIA AMIRA P 18 November 2018 5/22/2023 54 Buruk Sangat Pendek Sangat Kurus
14
ANDI PALAKA L 12 Januari 2019 5/22/2023 52 15 T 99.0 Baik Normal Normal
15
RIZWANAH Q. P 19 Januari 2019 5/22/2023 52 Buruk Sangat Pendek Sangat Kurus
16
PUTRI UMAIROH P 09 Februari 2019 5/22/2023 51 Buruk Sangat Pendek Sangat Kurus
17
ANDRA L 23 Maret 2019 5/22/2023 50 Buruk Sangat Pendek Sangat Kurus
18
FAJRINA KANZA P 15 April 2019 5/22/2023 49 Buruk Sangat Pendek Sangat Kurus
19
M. GAZA L 13 Mei 2019 5/22/2023 48 Buruk Sangat Pendek Sangat Kurus
20
SULTAN MAHER L 26 Juni 2019 5/22/2023 47 Buruk Sangat Pendek Sangat Kurus
21
FELICIA DZAKIRA P 01 Juli 2019 5/22/2023 46 Buruk Sangat Pendek Sangat Kurus
22
BREDLY KHO L 05 Juli 2019 5/22/2023 46 Buruk Sangat Pendek Sangat Kurus
23
RAID FACHRUL L 10 September 2019 5/22/2023 44 Buruk Sangat Pendek Sangat Kurus
24
FATHAN DZIKRINA J. L 21 September 2019 5/22/2023 44 13.2 N 94.0 Baik Normal Normal
25
AMELIA PUTRI P 13 Oktober 2019 5/22/2023 43 11.5 O 88.0 Kurang Pendek Normal
26
M. SALMAN L 02 November 2019 5/22/2023 42 Buruk Sangat Pendek Sangat Kurus
27
ELLA CAHAYA PUTRI P 10 November 2019 5/22/2023 42 Buruk Sangat Pendek Sangat Kurus
28
AZANA NAFIZA P 06 Desember 2019 5/22/2023 41 Buruk Sangat Pendek Sangat Kurus
29
ADINDA AZANI P 09 Desember 2019 5/22/2023 41 Buruk Sangat Pendek Sangat Kurus
30
M. SYAFI'I L 14 Desember 2019 5/22/2023 41 12.5 N 92.0 Baik Normal Normal
31
DESWITA P 14 Desember 2019 5/22/2023 41 Buruk Sangat Pendek Sangat Kurus
32
AKBAR ZULKHAIRI L 27 Desember 2019 5/22/2023 40 10.8 T 88.0 Kurang Pendek Normal
33
ANNISA NUR SYAFA P 19 Januari 2020 5/22/2023 40 Buruk Sangat Pendek Sangat Kurus
34
M. ALFAHRI L 22 Januari 2021 5/22/2023 28 Buruk Sangat Pendek Sangat Kurus
35
NAILA JANNATI P 26 Januari 2020 5/22/2023 39 Buruk Sangat Pendek Sangat Kurus
36
ZALINE ZAKAISHA P 01 Februari 2020 5/22/2023 39 Buruk Sangat Pendek Sangat Kurus
37
QATRUN NADA P 09 Februari 2020 5/22/2023 39 Buruk Sangat Pendek Sangat Kurus
38
DATI RAFI YANDI L 11 Februari 2020 5/22/2023 39 Buruk Sangat Pendek Sangat Kurus
39
ALETA PASARIBU P 09 Maret 2020 5/22/2023 38 Buruk Sangat Pendek Sangat Kurus
40
ATHAR ZENDY G. L 27 Maret 2020 5/22/2023 37 Buruk Sangat Pendek Sangat Kurus
41
RAFIKA FAZIRA P 25 Mei 2020 5/22/2023 36 Buruk Sangat Pendek Sangat Kurus
42
NURUL ALFANI P 19 Juni 2020 5/22/2023 35 Buruk Sangat Pendek Sangat Kurus
43
RAFI AQI MAULANA L 07 Juli 2020 5/22/2023 34 Buruk Sangat Pendek Sangat Kurus
44
NADA INAYA P 12 Juli 2020 5/22/2023 34 Buruk Sangat Pendek Sangat Kurus
45
AFIFAH HILYA P 12 Juli 2020 5/22/2023 34 10.2 O 84.0 Kurang Pendek Normal
46
ALIESYA YULISNAINI P 17 Juli 2020 5/22/2023 34 Buruk Sangat Pendek Sangat Kurus
47
NADHIRA ASHADYA P 22 Juli 2020 5/22/2023 34 Buruk Sangat Pendek Sangat Kurus
48
M. HAFIDZ L 26 Agustus 2020 5/22/2023 32 12.2 N 87.0 Baik Normal Normal
49
ALYA HAFIZAH R. P 30 Agustus 2020 5/22/2023 32 10.7 O 86.0 Baik Normal Normal
50
SELSY NATASYA P 02 September 2020 5/22/2023 32 Buruk Sangat Pendek Sangat Kurus
51
M. RAFQY S. L 10 September 2020 5/22/2023 32 9.9 O 86.0 Kurang Pendek Kurus
52
M. RAIKAL S. L 18 September 2020 5/22/2023 32 14.5 O 92.0 Baik Normal Normal
53
M. ZAFRAN N. L 19 September 2020 5/22/2023 32 10.8 O 86.0 Kurang Pendek Normal
54
M. ANTANA L 08 November 2020 5/22/2023 30 Buruk Sangat Pendek Sangat Kurus
55
RAZIEF AQIL L 02 Desember 2020 5/22/2023 29 Buruk Sangat Pendek Sangat Kurus
56
M. BARA F. L 22 Desember 2020 5/22/2023 29 Buruk Sangat Pendek Sangat Kurus
57
M. DZIKRI K. L 28 Januari 2021 5/22/2023 27 12.2 O 84.0 Baik Normal Normal
58
ANDIN KARISMA P 01 Februari 2021 5/22/2023 27 Buruk Sangat Pendek Sangat Kurus
59
FEBRI KIRANA P 07 Februari 2021 5/22/2023 27 9.2 O 82.0 Kurang Normal Normal
60
MIKAELA A. P 18 Februari 2021 5/22/2023 27 9.2 T 79.0 Kurang Pendek Normal
61
FELIX TAN L 28 Februari 2021 5/22/2023 26 Buruk Sangat Pendek Sangat Kurus
62
M. ISMULYADI L 26 Maret 2021 5/22/2023 25 11.6 O 86.0 Baik Normal Normal
63
HANIN CAHAYA P 31 Maret 2021 5/22/2023 25 Buruk Sangat Pendek Sangat Kurus
64
FIRZA ROSMALIZA P 21 April 2021 5/22/2023 25 9.5 O 81.0 Baik Normal Normal
65
M. ARKA L 05 Mei 2021 5/22/2023 24 Buruk Sangat Pendek Sangat Kurus
66
ROMADHONI L 07 Mei 2021 5/22/2023 24 10.3 T 82.0 Baik Normal Normal
67
M. ALMAHDI L 08 Mei 2021 5/22/2023 24 Buruk Sangat Pendek Sangat Kurus
68
CLARISA P 25 Mei 2021 5/22/2023 24 10.9 N 85.0 Baik Normal Normal
69
ASKA RADIM L 21 Juni 2021 5/22/2023 23 13.7 N 86.0 Baik Normal Normal
70
RASYID L 22 Juni 2021 5/22/2023 23 13 N 87.0 Baik Normal Normal
71
RASYID FARIQ L 06 Juli 2021 5/22/2023 22 Buruk Sangat Pendek Sangat Kurus
72
GIO SYAHIR L 26 Juli 2021 5/22/2023 22 10.6 T 81.0 Baik Normal Normal
73
M. ARSYAH L 09 Agustus 2021 5/22/2023 21 Buruk Sangat Pendek Sangat Kurus
74
RAFAIZAH P 10 September 2021 5/22/2023 20 Buruk Sangat Pendek Sangat Kurus
75
ALMERA L 12 September 2021 5/22/2023 20 Buruk Sangat Pendek Sangat Kurus
76
AHMAD JRIAN P 20 September 2021 5/22/2023 20 Buruk Sangat Pendek Sangat Kurus
77
RIFANA AQISAH P 12 Oktober 2021 5/22/2023 19 Buruk Sangat Pendek Sangat Kurus
78
RANU PRATAMA L 15 November 2021 5/22/2023 18 Buruk Sangat Pendek Sangat Kurus
79
AAN ZULFIKAR L 10 Desember 2021 5/22/2023 17 9.7 T Baik
77.0 Baik Normal
Normal Normal
Normal
80
ADELALARD FIN H. L 28 Januari 2022 5/22/2023 15 Buruk Sangat Pendek Sangat Kurus
81
AFIFA ZHAVIRA P 09 April 2022 5/22/2023 13 8.1 O Baik
74.0 Baik Normal
Normal Normal
Normal
82
M. ATHA HAFIDZ L 28 Januari 2022 5/22/2023 15 Buruk Sangat Pendek Sangat Kurus
83
M. SYAIFULLAH L 30 Mei 2022 5/22/2023 11 Buruk Sangat Pendek Sangat Kurus
84
ALYSHA ANJANI P 07 Juni 2022 5/22/2023 11 Buruk Sangat Pendek Sangat Kurus
85
ASILA FITRI P. S. P 21 Juni 2022 5/22/2023 11 Buruk Sangat Pendek Sangat Kurus
86
SITI SALEHA P 20 September 2022 5/22/2023 8 Buruk Sangat Pendek Sangat Kurus
87
FARZAN L 27 September 2022 5/22/2023 7 8.4 N Baik
69.0 Baik Normal
Normal Normal
Normal
88
PUTRI OKTAVIANI P 08 Oktober 2022 5/22/2023 7 Buruk Sangat Pendek Sangat Kurus
89
M. AZRUL L 23 Oktober 2022 5/22/2023 7 Buruk Sangat Pendek Sangat Kurus
90
AKIFAH HASNA K. P 31 Oktober 2022 5/22/2023 6 5.9 O Baik
63.0 Baik Normal
Normal Normal
Normal
91
AZRIEL RAFIF A. L 09 November 2022 5/22/2023 6 8.2 T Baik
64.0 Baik Normal
Normal Normal
Normal
92
SYAFANA AMORA L 21 November 2022 5/22/2023 6 7.4 T Baik
64.0 Baik Normal
Normal Normal
Normal
93
ANZALIA CARISSA P 19 Desember 2022 5/22/2023 5 5.7 T Baik
60.0 Baik Normal
Normal Normal
Normal
94
DANEENTA P 23 Januari 2023 5/22/2023 3 6.1 T Baik
61.0 Baik Normal
Normal Normal
Normal
95
BARA HARSAVI L 10 Januari 2023 5/22/2023 4 8.2 N Baik
67.0 Baik Normal
Normal Normal
Normal
96
M. ALFATIH L 05 September 2020 5/22/2023 32 Buruk Sangat Pendek Sangat Kurus
97
VIRDAN BAYHAQIE L 29 Januari 2020 5/22/2023 39 Buruk Sangat Pendek Sangat Kurus
98
ASWINDA SINATRIA P 28 Desember 2020 5/22/2023 28 Buruk Sangat Pendek Sangat Kurus
99
SITI KAYESA ASMAF P 09 Januari 2023 5/22/2023 4 6.2 N Baik
63.0 Baik Normal
Normal Normal
Normal
100
M. HAZIQ MIFTAH L 23 Februari 2023 5/22/2023 2 4.5 B Baik
55.0 Baik Normal
Normal Normal
Normal
101
AIDAN L 08 Februari 2023 5/22/2023 3 5.2 T Baik
58.0 Baik Normal
Normal Normal
Normal
102 08 Mei 2018 12/10/2018 7 ### ### ###
103 05 April 2018 12/10/2018 8 ### ### ###
104 23 April 2018 12/10/2018 7 ### ### ###
105 04 Mei 2018 12/10/2018 7 ### ### ###
106 07 Juni 2018 12/10/2018 6 ### ### ###
107 09 Juni 2018 12/10/2018 6 ### ### ###
108 24 Desember 2017 12/10/2018 11 ### ### ###
109 08 Maret 2017 12/10/2018 21 ### ### ###
110 25 Juni 2018 12/10/2018 5 ### ### ###
111 23 Agustus 2018 12/10/2018 3 ### ### ###
112 31 Agustus 2018 12/10/2018 3 ### ### ###
113 20 Maret 2018 12/10/2018 8 ### ### ###
114 03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
116 22 April 2018 12/10/2018 7 ### ### ###
117 05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 95.2 99.9 118.9 118.91
5 1 0 0 0 0 95.2 99.9 118.9 118.91
5 1 0 0 0 0 95.2 99.9 118.9 118.91
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 12 0 0 0 0 95.2 99.9 118.9 118.91
4 11 12.3 14 23.9 23.91 95.6 100.2 118.6 118.61
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 11.8 12.8 18.5 18.51
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51
4 7 11.9 13.5 22.9 22.91 93.9 98.3 116.1 116.11
4 6 11.8 13.4 22.7 22.71 93.4 97.8 115.5 115.51
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21 12.3 13.3 19.2 19.21
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 11.8 12.7 17.6 17.61
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31
4 2 11.4 12.9 21.7 21.71 91.6 95.9 113 113.01
4 1 11 12.4 21.8 21.81 90.3 94.6 112 112.01
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 10.8 11.7 16.1 16.11
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 9.3 10.1 14.4 14.41
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 10.5 11.3 15.6 15.61
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 9.7 10.5 14.5 14.51
3 4 10.1 11.3 19.2 19.21 85.8 89.8 105.7 105.71
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21
2 12 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91
2 10 9.8 11 17.8 17.81 83.9 87.5 102 102.01
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11 8.5 9.2 13.2 13.21
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 9.5 10.2 14.2 14.21
2 8 9.1 10.3 17.1 17.11 81.3 84.9 99.4 99.41 8.9 9.7 13.8 13.81
2 8 9.1 10.3 17.1 17.11 81.3 84.9 99.4 99.41
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 9.3 10 13.9 13.91
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 10.5 11.3 15.6 15.61
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 9.3 10 13.9 13.91
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91
2 3 9 10.1 16.1 16.11 79.9 83.1 96.1 96.11 8.9 9.6 13.3 13.31
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 8.1 8.8 12.6 12.61
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 7.7 8.3 11.9 11.91
2 2 8.9 10 15.8 15.81 79.3 82.5 95.2 95.21
2 1 8.8 9.8 15.5 15.51 78.6 81.7 94.2 94.21 9.3 10 13.9 13.91
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 8 8.7 12.4 12.41
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.5 9.2 12.8 12.81
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91
1 12 8.1 9 14.8 14.81 76.7 80 92.9 92.91 8.7 9.4 13.5 13.51
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91 9.3 10 13.9 13.91
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91 9.5 10.2 14.2 14.21
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 8.4 9.1 12.6 12.61
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61
1 6 7.8 8.8 13.7 13.71 74.2 76.9 87.7 87.71
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 7.8 8.4 11.7 11.71
1 3 7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21
1 1
6.4 7.2 11.8 11.81 67.3 70 80.5 80.51 6.9 7.5 10.8 10.81
1 3
7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21
0 11
6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21
0 11
6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81
0 8
5.6 6.3 10.2 10.21 61.7 64 73.5 73.51
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51 6.5 7 9.7 9.71
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31 5.1 5.5 8 8.01
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.5 6 8.3 8.31
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.5 6 8.3 8.31
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 4.5 4.9 7.1 7.11
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 4.7 5.1 7.4 7.41
0 4 4.9 5.6 8.7 8.71 57.6 59.7 68 68.01 6.1 6.6 9.2 9.21
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71
2 4 8.6 9.7 16 16.01 78.8 82.2 96 96.01
0 4 4.4 5 8.2 8.21 55.6 57.8 66.4 66.41 5.1 5.5 8 8.01
0 2 3.8 4.3 7.1 7.11 52.4 54.4 62.4 62.41 3.6 3.8 5.4 5.41
0 3 4.4 5 8 8.01 55.3 57.3 65.5 65.51 4.3 4.6 6.4 6.41
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BULANG LINTANG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : RUMPUN BAMBU 2
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
ABDULLAH ANWAR L 14 Februari 2018 3/20/2023 61 Buruk Sangat Pendek Sangat Kurus
2
NURHASANAH P 02 Mei 2018 5/22/2023 60 Buruk Sangat Pendek Sangat Kurus
3
MARVINO ABRAHAM L 29 Maret 2018 5/22/2023 61 Buruk Sangat Pendek Sangat Kurus
4
AHMAD AL FATIH L 22 April 2018 5/22/2023 61 Buruk Sangat Pendek Sangat Kurus
5
REVAN DWI SAPUTRA L 19 Agustus 2018 5/22/2023 57 17.8 O 106.0 Baik Normal Normal
6
MARVIN ARRAHIM L 13 Juli 2018 5/22/2023 58 16 O 106.0 Baik Normal Normal
7
ANANDA MAISARAH P 24 Agustus 2018 5/22/2023 57 13.4 N 101.0 Kurang Normal Normal
8
NAURA RANIA E. P 25 Agustus 2018 5/22/2023 57 23 T 106.0 Baik Normal Gemuk
9
ASIFA OKTAVIANI P 24 Oktober 2018 5/22/2023 55 14 O 98.0 Baik Normal Normal
10
EZLINA MAUZARA P 16 November 2018 5/22/2023 54 18.2 N 107.0 Baik Normal Normal
11
HELPINA WELAN I. P 03 Maret 2019 5/22/2023 50 17.5 O 110.0 Baik Normal Normal
12
APRILIA NUR L. P 20 April 2019 5/22/2023 49 Buruk Sangat Pendek Sangat Kurus
13
KAREL SAUQI A. L 09 Mei 2019 5/22/2023 48 16.2 N 98.0 Baik Normal Normal
14
FAEZA R. L 24 Mei 2019 5/22/2023 48 Buruk Sangat Pendek Sangat Kurus
15
DILLA SAFITRI P 05 Juni 2019 5/22/2023 47 10.4 O 89.0 Buruk Sangat Pendek Normal
16
M. IKROM L 05 Juli 2019 5/22/2023 46 15.7 T 95.0 Baik Normal Normal
17
AYLA KHALILUNA S. P 22 Juli 2019 5/22/2023 46 18.6 N 104.0 Baik Normal Normal
18
SINTIA ANJELIKA P. P 16 September 2019 5/22/2023 44 11.4 T 96.0 Kurang Normal Kurus
19
M. NAUFAL S. L 16 November 2019 5/22/2023 42 13.2 O 92.0 Baik Normal Normal
20
M. RAFISQI K. A. L 30 November 2019 5/22/2023 41 13.6 O 93.0 Baik Normal Normal
21
NADIM ALFATUL I. L 05 Desember 2019 5/22/2023 41 13.5 N 93.0 Baik Normal Normal
22
ALETHA MAMIDANGGI P 09 Maret 2020 5/22/2023 38 16 T 100.0 Baik Normal Normal
23
NASYAFA AQIRA W. P 15 Maret 2020 5/22/2023 38 14 T 92.0 Baik Normal Normal
24
ARKHA RAMADHAN L 20 April 2020 5/22/2023 37 13.3 N 91.0 Baik Normal Normal
25
NAJWA ARUMIATI P 04 April 2020 5/22/2023 37 13 N 89.0 Baik Normal Normal
26
ZAIRAH NURAHMADANI P 28 April 2020 5/22/2023 36 12.5 N 89.0 Baik Normal Normal
27
AZIVA RAMADANI P 08 Mei 2020 5/22/2023 36 14.6 O 92.0 Baik Normal Normal
28
ALIKA FEBRIYANA P. P 05 Februari 2020 5/22/2023 39 10.3 O 86.0 Kurang Pendek Normal
29
AUDIYA HUMAIRAH P 20 Juni 2020 5/22/2023 35 10.2 O 85.8 Kurang Pendek Normal
30
HANIF AL GHIFARI L 07 Juli 2020 5/22/2023 34 13.4 T 92.8 Baik Normal Normal
31
AZRIL ARFANDI G. L 03 Maret 2020 5/22/2023 38 14.6 O 97.0 Baik Normal Normal
32
MUDZAKIR L 03 Agustus 2020 5/22/2023 33 11.9 O 90.0 Baik Normal Normal
33
M. ARDIANSYAH L 07 Agustus 2020 5/22/2023 33 13 N 88.0 Baik Normal Normal
34
ASILLA DARMAWATI P 13 Agustus 2020 5/22/2023 33 16.5 N 93.0 Baik Normal Gemuk
35
NADINE NADARA N. P 08 September 2020 5/22/2023 32 11.9 O 85.0 Baik Normal Normal
36
M. ASRAF AL HAFIZ L 19 September 2020 5/22/2023 32 Buruk Sangat Pendek Sangat Kurus
37
RAHMAT SYAFARUDIN L 29 September 2020 5/22/2023 31 13.5 O 91.0 Baik Normal Normal
38
ANDINDIA LASHIRA P 08 November 2020 5/22/2023 30 11.2 O 84.0 Baik Normal Normal
39
M. NAUFAL L 14 November 2020 5/22/2023 30 10.3 N 86.0 Lebih Normal Gemuk
40
HADI MAULANA L 20 November 2020 5/22/2023 30 9.8 N 82.0 Kurang Pendek Normal
41
M. RAKA SUBARI L 05 November 2020 5/22/2023 30 10 O 82.0 Kurang Pendek Normal
42
RASQYA NURAZILA P 02 Januari 2021 5/22/2023 28 12 O 83.0 Baik Normal Normal
43
ANDINDITA AZZA S. P 05 Januari 2021 5/22/2023 28 12.3 N 84.0 Baik Normal Normal
44
M. ZIKRI L 05 Maret 2021 5/22/2023 26 10.2 N 83.0 Baik Normal Normal
45
ASYELLA NORAH S. P 06 Maret 2021 5/22/2023 26 12.4 N 89.0 Baik Normal Normal
46
M.. FADIL L 15 April 2018 5/22/2023 61 Buruk Sangat Pendek Sangat Kurus
47
M. RANDI SYAHRI L 22 April 2021 5/22/2023 25 13 O 87.0 Baik Normal Normal
48
ANDINI SALSABILA P 14 Juni 2021 5/22/2023 23 Buruk Sangat Pendek Sangat Kurus
49
PUTRI ANJANI A. P 21 Juli 2021 5/22/2023 22 8.7 N 76.4 Kurang Pendek Normal
50
ELVARD HARDIYATA L 22 Juli 2021 5/22/2023 22 Buruk Sangat Pendek Sangat Kurus
51
AZELI HAZIQ L 03 Juli 2018 5/22/2023 58 16.3 O 105.5 Baik Normal Normal
52
MAURA NELOFA P 30 Agustus 2021 5/22/2023 20 9 N 78.0 Baik Normal Normal
53
SANDIRA OKTAVIA P 11 Oktober 2021 5/22/2023 19 7.9 O 71.6 Kurang Sangat Pendek Normal
54
ALIYA KHAILA A. P 12 Oktober 2021 5/22/2023 19 10.1 N 77.0 Baik Normal Normal
55
DILAN ZIKRI L 09 Januari 2022 5/22/2023 16 9.2 N 76.0 Baik Normal Normal
56
NOVELA FEBIANTI P 30 November 2021 5/22/2023 17 8.5 O 75.0 Baik Normal Normal
57
DAFI M. IKRAM L 18 Desember 2021 5/22/2023 17 8.5 O 74.4 Kurang Pendek Normal
58
AZLILA NUR AIZA P 12 Juni 2022 5/22/2023 11 8.1 O 68.0 Baik Normal Normal
59
RANIA AISYAH PUTRI P 27 Februari 2022 5/22/2023 14 9.5 N 72.0 Baik Normal Normal
60
FAIZAN AZRIL M. L 12 Maret 2022 5/22/2023 14 10.1 O 75.0 Baik Normal Normal
61
SHANUM QIANDRA A. P 26 April 2022 5/22/2023 12 6.6 T 67.0 Kurang Pendek Normal
62
MAHESA ASNI A. P 21 Juni 2022 5/22/2023 11 7.3 N 68.0 Baik Normal Normal
63
ALMAIRA SHANUM A. P 04 Juli 2022 5/22/2023 10 8.9 N 69.0 Baik Normal Normal
64
M. AKIP SHARI L 11 Juli 2022 5/22/2023 10 9 O 70.0 Baik Normal Normal
65
AZUINAR UMAIRAH P 03 September 2022 5/22/2023 8 6.7 N 65.0 Baik Normal Normal
66
YURA AKHIRIANA P. P 18 September 2022 5/22/2023 8 8.2 N 69.0 Baik Normal Normal
67
RAJA APUL GERALD P. L 20 September 2022 5/22/2023 8 9.5 O 74.0 Baik Normal Normal
68
SHAZELYA AZZAHRA P 24 September 2022 5/22/2023 8 8 O 65.0 Baik Normal Normal
69
STARLA ARTHA A. P 09 September 2022 5/22/2023 8 9.4 N 67.0 Baik Normal Gemuk
70
ANDIANA FARANISA P 31 Agustus 2022 5/22/2023 8 7.3 T 65.0 Baik Normal Normal
71
NURUL HUSNA P 20 Oktober 2022 5/22/2023 7 7.5 T 64.0 Baik Normal Normal
72
M. AFIF ABRAHAM L 22 Oktober 2022 5/22/2023 7 8.8 N 65.0 Baik Normal Gemuk
73
MIYKAYLA P 11 Juni 2018 5/22/2023 59 15.2 N 100.0 Baik Normal Normal
74
PUTRI ELIRA P 22 Desember 2021 5/22/2023 17 Buruk Sangat Pendek Sangat Kurus
75
M. YUSUF PUTRAWATUN L 24 Februari 2022 5/22/2023 14 8.3 N Baik
75.0 Baik Normal
Normal Normal
Normal
76
FARA AISYA P 28 Februari 2023 5/22/2023 2 5.3 N Baik
55.0 Baik Normal
Normal Normal
Normal
77
ADINDA HUMAIRA P 24 Desember 2022 5/22/2023 4 5.7 N Baik
60.0 Baik Normal
Normal Normal
Normal
78
NAJWA NURHASANAH P 16 Februari 2023 5/22/2023 3 4.9 B Baik
57.0 Baik Normal
Normal Normal
Normal
79
RASIEZA MALAIKA ARSYILA P 18 Maret 2023 5/22/2023 2 5.1 B Baik
57.0 Baik Normal
Normal Normal
Normal
80
AIRUMI ALHAFIQ L 25 Maret 2023 5/22/2023 1 4.1 B Baik
52.0 Baik Normal
Normal Normal
Normal
81
M. AL HADI L 03 April 2023 5/22/2023 1 3.5 B Baik
52.0 Baik Normal
Normal Normal
Normal
82
14 Januari 2021 12/15/2021 11 ### ### ###
83
18 Mei 2021 12/15/2021 7 ### ### ###
84
15 Mei 2021 12/15/2021 7 ### ### ###
85
31 Mei 2021 12/15/2021 6 ### ### ###
86
16 Juli 2021 12/15/2021 5 ### ### ###
87
08 November 2021 12/15/2021 1 ### ### ###
88
05 September 2019 12/5/2019 3 ### ### ###
89
04 Juni 2019 12/5/2019 6 ### ### ###
90
18 April 2015 12/5/2019 55 ### ### ###
91
30 Oktober 2015 12/5/2019 49 ### ### ###
92
19 Juli 2019 12/5/2019 4 ### ### ###
93
21 Agustus 2019 12/5/2019 3 ### ### ###
94
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 0 0 0 0 0 95.2 99.9 118.9 118.91
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 13.3 14.4 20.2 20.21
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 13.3 14.4 20.2 20.21
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 11.8 12.8 18.5 18.51
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 13 14.1 20.5 20.51
4 7 11.6 13.2 23.5 23.51 93 97.6 115.9 115.91 11.2 12.2 17.5 17.51
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21 13.2 14.4 20.9 20.91
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71 14 15.3 22.3 22.31
4 1 11 12.4 21.8 21.81 90.3 94.6 112 112.01
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 11.6 12.5 17.3 17.31
3 12 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71 9.5 10.3 14.7 14.71
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 11 11.9 16.4 16.41
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01 12.5 13.6 19.6 19.61
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61 10.8 11.7 16.8 16.81
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81 10.5 11.3 15.6 15.61
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 10.7 11.5 15.8 15.81
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 10.7 11.5 15.8 15.81
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 11.6 12.6 18.1 18.11
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 10.1 10.9 15.6 15.61
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21 10.3 11.1 15.3 15.31
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 9.5 10.3 14.7 14.71
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 9.5 10.3 14.7 14.71
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 10.1 10.9 15.6 15.61
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01 8.9 9.7 13.8 13.81
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 8.8 9.5 13.6 13.61
2 10 9.8 11 17.8 17.81 83.9 87.5 102 102.01 10.6 11.4 15.7 15.71
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 11.4 12.3 17 17.01
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21 10.1 10.9 15 15.01
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21 9.7 10.5 14.5 14.51
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 10.2 11.1 15.9 15.91
2 8 9.1 10.3 17.1 17.11 81.3 84.9 99.4 99.41 8.7 9.4 13.5 13.51
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41
2 7 9.5 10.7 17.1 17.11 82.3 85.7 99.6 99.61 10.3 11.1 15.3 15.31
2 6 8.9 10 16.5 16.51 80.1 83.6 97.7 97.71 8.5 9.2 13.2 13.21
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71 9.3 10 13.9 13.91
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71 8.5 9.2 12.8 12.81
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71 8.5 9.2 12.8 12.81
2 4 8.6 9.7 16 16.01 78.8 82.2 96 96.01 8.3 9 12.9 12.91
2 4 8.6 9.7 16 16.01 78.8 82.2 96 96.01 8.5 9.2 13.2 13.21
2 2 8.9 10 15.8 15.81 79.3 82.5 95.2 95.21 8.7 9.4 13.1 13.11
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 9.5 10.3 14.7 14.71
5 1 0 0 0 0 96.1 100.7 119.2 119.21
2 1 8.8 9.8 15.5 15.51 78.6 81.7 94.2 94.21 9.5 10.2 14.2 14.21
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91
1 10 7.8 8.7 14.3 14.31 75.2 78.4 90.8 90.81 7.2 7.8 11.2 11.21
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 13.2 14.2 20 20.01
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71 7.5 8.2 11.7 11.71
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 6.5 7.1 10.2 10.21
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.4 8 11.5 11.51
1 4 7.5 8.4 13.1 13.11 72.5 75 85.4 85.41 7.6 8.3 11.5 11.51
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41 7.1 7.7 11 11.01
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 7.3 7.9 11 11.01
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81 6 6.5 9.4 9.41
1 2 6.6 7.4 12.1 12.11 68.3 71 81.7 81.71 6.6 7.2 10.3 10.31
1 2 7.2 8.1 12.6 12.61 70.6 73.1 83 83.01 7.5 8.1 11.3 11.31
1 0 6.3 7 11.5 11.51 66.3 68.9 79.2 79.21 5.8 6.3 9.1 9.11
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81 6 6.5 9.4 9.41
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6.1 6.7 9.6 9.61
0 10 6.6 7.4 11.4 11.41 66.4 68.7 77.9 77.91 6.6 7.2 10 10.01
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.5 5.9 8.6 8.61
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6.1 6.7 9.6 9.61
0 8 6.2 6.9 10.7 10.71 64 66.2 75 75.01 7.3 7.9 11 11.01
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.5 5.9 8.6 8.61
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.8 6.3 9.1 9.11
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.5 5.9 8.6 8.61
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.3 5.7 8.3 8.31
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51 5.7 6.2 8.6 8.61
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31 11.6 12.6 18.1 18.11
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41
1 2 7.2 8.1 12.6 12.61 70.6 73.1 83 83.01 7.5 8.1 11.3 11.31
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 3.5 3.8 5.5 5.51
0 4 4.4 5 8.2 8.21 55.6 57.8 66.4 66.41 4.5 4.9 7.1 7.11
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 3.9 4.3 6.1 6.11
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 3.9 4.3 6.1 6.11
0 1 2.9 3.4 5.8 5.81 48.9 50.8 58.6 58.61 2.9 3.2 4.5 4.51
0 1
2.9 3.4 5.8 5.81 48.9 50.8 58.6 58.61 2.9 3.2 4.5 4.51
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BULANG LINTANG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : ASOKA
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
U U T
#REF! B
M. RAFATAR L 02 Februari 2018 2/16/2023 60 Buruk Sangat Pendek Sangat Kurus
2
SADAM MESI L 04 April 2018 5/11/2023 61 Buruk Sangat Pendek Sangat Kurus
3
SRI SAPIRA SAFITRI P 16 Juni 2018 5/11/2023 59 Buruk Sangat Pendek Sangat Kurus
4
REVALINA P 02 Juli 2018 5/11/2023 58 Buruk Sangat Pendek Sangat Kurus
5
RAFIDA NOVELIA P 04 November 2020 5/11/2023 30 11.7 T 95.0 Baik Normal Normal
6
M. AMAR L 16 Juli 2018 5/11/2023 58 24.4 T 108.0 Lebih Normal Gemuk
7
NURI NUR HIDAYAH P 23 Agustus 2018 5/11/2023 56 Buruk Sangat Pendek Sangat Kurus
8
ANJANI P 18 Juli 2018 5/11/2023 57 16.3 T 100.0 Baik Normal Normal
9
M. ABABIL L 16 Oktober 2018 5/11/2023 54 Buruk Sangat Pendek Sangat Kurus
10
KHAIRA NUR HAFIZA P 05 November 2018 5/11/2023 54 Buruk Sangat Pendek Sangat Kurus
11
HANIS QALISYA A. P 26 Desember 2018 5/11/2023 52 Buruk Sangat Pendek Sangat Kurus
12
HILYA HAFIZA SALSABILA P 04 April 2018 5/11/2023 61 Buruk Sangat Pendek Sangat Kurus
13
SAQIL BILAL M. L 04 Agustus 2020 5/11/2023 33 Buruk Sangat Pendek Sangat Kurus
14
M. REZA SAPUTRA L 18 Maret 2019 5/11/2023 49 14.5 N 105.0 Baik Normal Normal
15
ARIANA PUTRI P 06 Januari 2019 5/11/2023 52 Buruk Sangat Pendek Sangat Kurus
16
JIHAN FAHIRA P 05 Mei 2019 5/11/2023 48 Buruk Sangat Pendek Sangat Kurus
17
NUR DARISA P 08 Januari 2019 5/11/2023 52 Buruk Sangat Pendek Sangat Kurus
18
RAMA ALIANSYAH L 05 September 2019 5/11/2023 44 12.7 T 98.0 Baik Normal Normal
19
MISANA SYAFIRA P 02 Oktober 2019 5/11/2023 43 13.6 T 98.0 Baik Normal Normal
20
REVAN SAPUTRA L 16 September 2019 5/11/2023 43 15.1 T 102.0 Baik Normal Normal
21
M. HARIS ALFAHRI L 03 September 2019 5/11/2023 44 Buruk Sangat Pendek Sangat Kurus
22
AHMAD AKBAR L 23 September 2019 5/11/2023 43 17.3 N 101.0 Baik Normal Normal
23
AHMAD IKBAL L 23 September 2019 5/11/2023 43 21 N 102.0 Lebih Normal Gemuk
24
ICA ATARI P 12 Oktober 2019 5/11/2023 43 10.8 T 91.0 Kurang Pendek Normal
25
HUMAIRA KESSA P 12 Oktober 2019 5/11/2023 43 14.5 T 99.0 Baik Normal Normal
26
ISKANDAR ZULKARNAIN L 04 Januari 2020 5/11/2023 40 Buruk Sangat Pendek Sangat Kurus
27
RAFLI L 03 Januari 2020 5/11/2023 40 13 N 96.0 Baik Normal Normal
28
PINI AZIRA P 15 Februari 2020 5/11/2023 38 21.1 O 94.0 Lebih Normal Gemuk
29
M. DARWIS L 08 April 2020 5/11/2023 37 11.2 N 89.0 Kurang Pendek Normal
30
M. SAKIR L 14 April 2020 5/11/2023 36 13.1 N 93.0 Baik Normal Normal
31
M. FIGO L 29 Juli 2020 5/11/2023 33 12 N 89.0 Baik Normal Normal
32
M. SOBRI L 10 September 2021 5/11/2023 20 10.1 O 83.0 Baik Normal Normal
33
NADA SALWA P 12 September 2020 5/11/2023 32 13 O 88.0 Baik Normal Normal
34
HILYA NAJIHA P 01 Oktober 2020 5/11/2023 31 10.2 O 85.0 Baik Normal Normal
35
M. GIBRAN L 18 Oktober 2020 5/11/2023 30 11.1 T 86.0 Baik Normal Normal
36
ARIFIN L 15 Februari 2021 5/11/2023 26 Buruk Sangat Pendek Sangat Kurus
37
LINDA P 22 Maret 2021 5/11/2023 25 8.5 N 79.0 Kurang Pendek Normal
38
HANIA KASIH P 24 April 2021 5/11/2023 24 8.2 T 77.0 Kurang Pendek Normal
39
M. KHALIF UZAIR L 27 April 2021 5/11/2023 24 11.5 T 82.0 Baik Normal Normal
40
IHZA TAHIRA AZIS P 16 Februari 2021 5/11/2023 26 11.8 O 82.0 Baik Normal Normal
41
REFA NAURA P 07 Februari 2022 5/11/2023 15 7.2 N 74.0 Kurang Normal Kurus
42
ZACKY ARDIANSYAH L 31 Mei 2022 5/11/2023 11 Buruk Sangat Pendek Sangat Kurus
43
M. KHAIRIL L 27 Juli 2022 5/11/2023 9 10.5 T 75.0 Baik Normal Normal
44
PUTRI IMPIAN P 10 Oktober 2022 5/11/2023 7 5.5 N 63.0 Kurang Normal Kurus
45
M. FAREL PRAYOGA L 03 Desember 2022 5/11/2023 5 7.7 O 68.0 Baik Normal Normal
46
AHMAD RANDI PRATAMA L 24 November 2022 5/11/2023 5 5.5 N 63.0 Kurang Normal Kurus
47
DEVAN ZHIAN L 22 Desember 2022 5/11/2023 4 7.7 N 65.0 Baik Normal Normal
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31
4 10 11.9 13.5 24.4 24.41 94.3 99 117.7 117.71
2 6 8.9 10 16.5 16.51 80.1 83.6 97.7 97.71 10.6 11.5 16.5 16.51
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 13.7 14.9 21 21.01
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 11.6 12.6 18.1 18.11
4 6 11.8 13.4 22.7 22.71 93.4 97.8 115.5 115.51
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01
5 1 0 0 0 0 95.2 99.9 118.9 118.91
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 13 14.1 19.8 19.81
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01
4 0 10.9 12.3 21.5 21.51 89.8 94.1 111.3 111.31
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 11.6 12.5 17.3 17.31
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 11.2 12.2 17.5 17.51
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 12.4 13.4 18.7 18.71
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 12.2 13.2 18.3 18.31
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 12.4 13.4 18.7 18.71
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 9.9 10.7 15.3 15.31
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 11.4 12.4 17.8 17.81
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 11.2 12.1 16.7 16.71
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 10.4 11.3 16.2 16.21
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21 9.9 10.7 14.7 14.71
3 0 10 11.3 18.3 18.31 85 88.7 103.5 103.51 10.7 11.5 15.8 15.81
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21 9.9 10.7 14.7 14.71
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.7 9.4 13.1 13.11
2 8 9.1 10.3 17.1 17.11 81.3 84.9 99.4 99.41 9.3 10.1 14.4 14.41
2 7 9 10.1 16.8 16.81 80.7 84.3 98.6 98.61 8.7 9.4 13.5 13.51
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71 9.3 10 13.9 13.91
2 2 8.9 10 15.8 15.81 79.3 82.5 95.2 95.21
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 7.7 8.3 11.9 11.91
2 0 8.1 9 14.8 14.81 76.7 80 92.9 92.91 7.4 8 11.5 11.51
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.5 9.2 12.8 12.81
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8.1 8.8 12.6 12.61
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01 6.9 7.5 10.8 10.81
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21
0 9 6.4 7.1 11 11.01 65.2 67.5 76.5 76.51 7.5 8.1 11.3 11.31
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.1 5.5 8 8.01
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 6.3 6.8 9.4 9.41
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 5.3 5.8 8 8.01
0 4 4.9 5.6 8.7 8.71 57.6 59.7 68 68.01 5.7 6.2 8.6 8.61
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : TEMOYONG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : MAWAR 1
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B
/
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
CHELSIA NAURA ARZIANA P 18 Januari 2018 2/12/2023 60 Buruk Sangat Pendek Sangat Kurus
2
FINO ADINATA L 20 Februari 2018 4/12/2023 61 Buruk Sangat Pendek Sangat Kurus
3
MAHADI L 15 Maret 2018 5/12/2023 61 Buruk Sangat Pendek Sangat Kurus
4
YULIANI ASTUTI P 04 Mei 2018 5/12/2023 60 Buruk Sangat Pendek Sangat Kurus
5
RAMADANI L 18 Juli 2018 5/12/2023 57 28.2 N 116.0 Lebih Normal Gemuk
6
MIRZA HAKIM L 01 Agustus 2018 5/12/2023 57 15.9 T 105.0 Baik Normal Normal
7
ASIFA SAFITRI P 27 Oktober 2018 5/12/2023 54 18.7 N 103.0 Baik Normal Normal
8
RAISYA MAULIDA P 07 Desember 2018 5/12/2023 53 13.4 T 100.0 Baik Normal Normal
9
SUSI LINA AZAHRA P 21 Maret 2019 5/12/2023 49 13.9 N 100.0 Baik Normal Normal
10
ARIYANI P 21 Juni 2019 5/12/2023 46 13.9 N 100.0 Baik Normal Normal
11
M. FAKHRUL ZIDNI L 26 Juni 2019 5/12/2023 46 11.4 T 93.0 Kurang Pendek Kurus
12
M. FARIS L 26 Juni 2019 5/12/2023 46 15 N 99.0 Baik Normal Normal
13
M. DAFFA BATISTA L 27 Juni 2019 5/12/2023 46 23 T 105.0 Lebih Normal Gemuk
14
ANISA SAFITRI P 10 Juli 2019 5/12/2023 46 12.5 N 99.0 Baik Normal Normal
15
TRI ANISA P 19 September 2019 5/12/2023 43 12.9 N 100.0 Baik Normal Normal
16
BIMA SYAKLI L 08 Oktober 2019 5/12/2023 43 13 N 93.0 Baik Normal Normal
17
SAHIDI L 24 Februari 2020 5/12/2023 38 12.2 O 90.0 Baik Normal Normal
18
M. KELVIN AIDIL ILHAM L 10 Mei 2020 5/12/2023 36 13 T 90.0 Baik Normal Normal
19
M. GIBRAN ATTAQY L 30 Mei 2020 5/12/2023 35 13.4 N 96.0 Baik Normal Normal
20
ZAYA AZAHRA PUTRI P 22 Juli 2020 5/12/2023 33 13.7 T 100.0 Baik Normal Normal
21
SYAHADAT L 23 Juli 2020 5/12/2023 33 12.5 T 90.0 Baik Normal Normal
22
FATHAN ZUHAIRY L 31 Juli 2020 5/12/2023 33 11.8 T 90.0 Baik Normal Normal
23
HERMANSYAH L 26 September 2020 5/12/2023 31 18 N 92.0 Lebih Normal Gemuk
24
M. SATRIA L 29 September 2020 5/12/2023 31 16.4 T 91.0 Baik Normal Gemuk
25
ARUMI RIZASHA IBRAHIM P 03 November 2020 5/12/2023 30 13.5 N 91.0 Baik Normal Normal
26
AISHWA NAYLA P 04 Desember 2020 5/12/2023 29 12 N 86.0 Baik Normal Normal
27
MASKEN L 06 Februari 2021 5/12/2023 27 11 T 84.0 Baik Normal Normal
28
TATI RANA P 26 Februari 2021 5/12/2023 26 10.8 T 88.0 Baik Normal Normal
29
BASTIAN FAUDILA L 01 Juli 2021 5/12/2023 22 9.5 T 81.0 Baik Normal Normal
30
NAURA DAFIYA P 07 Agustus 2021 5/12/2023 21 8 T 75.0 Kurang Pendek Normal
31
M. AINOR ROFIQ L 25 Agustus 2021 5/12/2023 20 21 N 85.0 Lebih Normal Gemuk
32
M. RIFQI USMAN L 19 September 2021 5/12/2023 19 11.9 N 84.0 Baik Normal Normal
33
RAZAN ALFANDI L 17 Oktober 2021 5/12/2023 18 10.7 N 77.0 Baik Normal Normal
34
NUR SAFIKA P 30 Oktober 2021 5/12/2023 18 9.4 N 75.0 Baik Normal Normal
35
ALINA NUR ZAHARA P 01 Desember 2021 5/12/2023 17 8.3 N 75.0 Baik Normal Normal
36
UMAR L 04 Januari 2022 5/12/2023 16 10.9 N 77.0 Baik Normal Normal
37
RUMAISHA P 09 Februari 2022 5/12/2023 15 8.2 N 77.0 Baik Normal Normal
38
M. FARHAN L 02 Agustus 2022 5/12/2023 9 9.3 N 68.0 Baik Normal Normal
39
ANANDA AHMAD MIRZAN L 29 Agustus 2022 5/12/2023 8 8.9 N 68.0 Baik Normal Normal
40
OKTA FAREL L 17 Oktober 2022 5/12/2023 6 7.3 N 64.0 Baik Normal Normal
41
ALVIAN SYAHPUTRA L 19 Oktober 2022 5/12/2023 6 7.9 N 65.0 Baik Normal Normal
42
AYSYAH AZAHRA P 23 November 2022 5/12/2023 5 7 N 60.0 Baik Normal Normal
43
ALFIANA P 28 November 2022 5/12/2023 5 7.4 N 64.0 Baik Normal Normal
44
M. ZAFRAN AL AQSHA L 12 Desember 2022 5/12/2023 5 6.2 N 62.0 Baik Normal Normal
45
MECCA ALDAREA P 07 Desember 2022 5/12/2023 5 7.7 N 63.0 Baik Normal Normal
46
DEFINA AZKIA ZAHRA P 21 Maret 2023 5/12/2023 1 4.9 B 55.0 Baik Normal Normal
47
HERLINA SAFITRI P 11 Maret 2023 5/12/2023 2 4.5 B 55.0 Baik Normal Normal
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 95.2 99.9 118.9 118.91
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 0 0 0 0 0 95.2 99.9 118.9 118.91
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 14.2 15.4 21.9 21.91
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 13 14.1 19.8 19.81
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21 12.3 13.3 19.2 19.21
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 11.6 12.6 18.1 18.11
4 1 11 12.4 21.8 21.81 90.3 94.6 112 112.01 11.6 12.6 18.1 18.11
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01 11.6 12.6 18.1 18.11
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 10.7 11.5 15.8 15.81
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 11.8 12.7 17.6 17.61
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 13 14.1 19.8 19.81
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01 11.4 12.4 17.8 17.81
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 11.6 12.6 18.1 18.11
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 10.7 11.5 15.8 15.81
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 10.1 10.9 15 15.01
3 0 10 11.3 18.3 18.31 85 88.7 103.5 103.51 10.1 10.9 15 15.01
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71 11.2 12.1 16.7 16.71
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 11.6 12.6 18.1 18.11
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21 10.1 10.9 15 15.01
2 9 9.7 10.9 17.6 17.61 83.4 86.9 101.2 101.21 10.1 10.9 15 15.01
2 7 9.5 10.7 17.1 17.11 82.3 85.7 99.6 99.61 10.5 11.3 15.6 15.61
2 7 9.5 10.7 17.1 17.11 82.3 85.7 99.6 99.61 10.3 11.1 15.3 15.31
2 6 8.9 10 16.5 16.51 80.1 83.6 97.7 97.71 9.9 10.7 15.3 15.31
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 8.9 9.7 13.8 13.81
2 3 9 10.1 16.1 16.11 79.9 83.1 96.1 96.11 8.9 9.6 13.3 13.31
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 9.3 10.1 14.4 14.41
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 8.4 9.1 12.6 12.61
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 7.1 7.7 11 11.01
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 9.1 9.8 13.6 13.61
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.9 9.6 13.3 13.31
1 6 7.8 8.8 13.7 13.71 74.2 76.9 87.7 87.71 7.8 8.4 11.7 11.71
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 7.1 7.7 11 11.01
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41 7.1 7.7 11 11.01
1 4 7.5 8.4 13.1 13.11 72.5 75 85.4 85.41 7.8 8.4 11.7 11.71
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01 7.4 8 11.5 11.51
0 9 6.4 7.1 11 11.01 65.2 67.5 76.5 76.51 6.3 6.8 9.4 9.41
0 8 6.2 6.9 10.7 10.71 64 66.2 75 75.01 6.3 6.8 9.4 9.41
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.5 6 8.3 8.31
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.7 6.2 8.6 8.61
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 4.5 4.9 7.1 7.11
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 5.3 5.7 8.3 8.31
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 5.1 5.6 7.7 7.71
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 5.1 5.5 8 8.01
0 1 2.7 3.2 5.5 5.51 47.8 49.8 57.6 57.61 3.5 3.8 5.5 5.51
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 3.5 3.8 5.5 5.51
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : TEMOYONG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : MAWAR 2
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B
/
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 106.0 U U
B
SINTA P 19 Mei 2018 5/19/2023 60 16.4 O Baik Normal Normal
2
SALSABILA P 05 Maret 2018 4/12/2023 61 Buruk Sangat Pendek Sangat Kurus
3
RIA AMELIA P 27 Mei 2018 5/19/2023 59 Buruk Sangat Pendek Sangat Kurus
4
NISA P 14 Februari 2018 4/12/2023 61 Buruk Sangat Pendek Sangat Kurus
5
ANISA P 14 Juni 2019 5/19/2023 47 Buruk Sangat Pendek Sangat Kurus
6
AGRA L 04 Mei 2019 5/19/2023 48 18.8 T 102.0 Baik Normal Gemuk
7
AKMAL L 04 November 2019 5/19/2023 42 13.9 N 94.0 Baik Normal Normal
8
DYLAN L 19 September 2019 5/19/2023 44 14.6 N 97.0 Baik Normal Normal
9
FITRIANTI P 29 Oktober 2019 5/19/2023 42 Buruk Sangat Pendek Sangat Kurus
10
M. FIKRI L 23 Juli 2019 5/19/2023 46 15.2 N 100.0 Baik Normal Normal
11
SHELIA P 07 Februari 2020 5/19/2023 39 13.1 N 90.0 Baik Normal Normal
12
SISKAMELIA P 01 Agustus 2020 5/19/2023 33 15 O 91.0 Baik Normal Normal
13
RUSDI L 18 Mei 2020 5/19/2023 36 14 O 95.0 Baik Normal Normal
14
BASIL L 17 Maret 2020 5/19/2023 38 13.8 N 96.0 Baik Normal Normal
15
AFNAN L 01 Maret 2018 5/19/2023 62 Buruk Sangat Pendek Sangat Kurus
16
ANIS QALISA P 11 November 2021 5/19/2023 18 11.7 O 79.0 Baik Normal Normal
17
AKILA P 23 Juni 2021 5/19/2023 23 10.9 T 83.0 Baik Normal Normal
18
NAURA P 03 Juli 2021 5/19/2023 22 8 N 76.0 Kurang Pendek Normal
19
AIYSAH P 27 April 2021 5/19/2023 24 9.3 T 81.0 Baik Normal Normal
20
SOFIANA P 27 Mei 2022 5/19/2023 11 9.7 N 71.0 Baik Normal Normal
21
ZEAN ARJUNA L 30 Oktober 2022 5/19/2023 6 7.3 N 65.0 Baik Normal Normal
22
AHMAT ATAR L 30 Maret 2022 5/19/2023 13 9.2 N 74.0 Baik Normal Normal
23
JORJINA P 06 Agustus 2022 5/19/2023 9 6.9 T 68.0 Baik Normal Normal
24
RADIT ADITIYA L 14 November 2022 5/19/2023 6 7 O 65.0 Baik Normal Normal
25
AL FATIH L 23 September 2022 5/19/2023 7 Buruk Sangat Pendek Sangat Kurus
26
NAJLA P 04 November 2022 5/19/2023 6 7.1 N 64.0 Baik Normal Normal
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###


15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 95.2 99.9 118.9 118.91 13 14.1 20.5 20.51
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31
5 1 0 0 0 0 95.2 99.9 118.9 118.91
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 12.4 13.4 18.7 18.71
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81 10.8 11.7 16.1 16.11
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 11.4 12.3 17 17.01
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 12 12.9 18 18.01
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01 9.7 10.5 15 15.01
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 9.9 10.7 15.3 15.31
3 0 10 11.3 18.3 18.31 85 88.7 103.5 103.51 11 11.9 16.4 16.41
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 11.2 12.1 16.7 16.71
5 2 0 0 0 0 96.1 100.7 119.2 119.21
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 7.7 8.3 11.9 11.91
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91 8.3 9 12.9 12.91
1 10 7.8 8.7 14.3 14.31 75.2 78.4 90.8 90.81 7.2 7.8 11.2 11.21
2 0 8.1 9 14.8 14.81 76.7 80 92.9 92.91 8 8.7 12.4 12.41
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81 6.5 7 10.1 10.11
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.7 6.2 8.6 8.61
1 1 7.1 7.9 12.3 12.31 69.6 72.1 81.8 81.81 7.3 7.9 11 11.01
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 6 6.5 9.4 9.41
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.7 6.2 8.6 8.61
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31 5.3 5.7 8.3 8.31
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BATU LEGONG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : TUNAS KENCANA
07. TIPE DESA/KELURAHAN : PEDESAAN
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B
/
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 95.0 U U
B
CINTA AZZATUN N. P 23 Juni 2018 5/19/2023 59 12.6 N Kurang Pendek Normal
2
TARI REGINA P 06 Desember 2018 5/19/2023 53 15.7 N 102.0 Baik Normal Normal
3
M. IRSAD L 20 September 2018 5/19/2023 56 16.4 N 101.0 Baik Normal Normal
4
HASANAH P 06 Maret 2019 5/19/2023 50 Buruk Sangat Pendek Sangat Kurus
5
IKRAM ZAYDAN H. L 13 Juli 2020 5/19/2023 34 12 N 95.0 Baik Normal Normal
6
AZZAHARA ALFATUN P 07 Juni 2020 5/19/2023 35 10.1 N 85.0 Kurang Pendek Normal
7
AYUDIAN RAHMADANI P 16 Juli 2020 5/19/2023 34 12.8 N 87.0 Baik Normal Normal
8
ARIN KARNIKA N. P 25 Desember 2021 5/19/2023 16 10.1 N 76.0 Baik Normal Normal
9
AQILA AZZAHRA AD. P 16 Juni 2021 5/19/2023 23 9.6 N 80.0 Baik Normal Normal
10
M. RIALDI ROMADON L 12 April 2021 5/19/2023 25 10 N 85.0 Baik Normal Normal
11
ADELIA KHALISA P. P 26 Juli 2021 5/19/2023 21 9.6 N 78.0 Baik Normal Normal
12
AMELDA ZAHRA OK. P 15 Oktober 2022 5/19/2023 7 7.1 N 67.0 Baik Normal Normal
13
NURUL KHAIRUNISA P 14 Desember 2022 5/19/2023 5 6.5 N 61.0 Baik Normal Normal
14
SITI RAHAYU P 13 Juni 2022 5/19/2023 11 Buruk Sangat Pendek Sangat Kurus
15
M. ATRIANSYAH L 26 September 2022 5/19/2023 7 6.9 N 66.0 Baik Normal Normal
16
MAYZURA P 09 Desember 2019 5/19/2023 41 Buruk Sangat Pendek Sangat Kurus
17
APRILIYANI P 08 April 2021 5/19/2023 25 Buruk Sangat Pendek Sangat Kurus
18
DAFIKA ANDRIYANI P 12 Januari 2019 5/19/2023 52 18 N 108.0 Baik Normal Normal
19
AMAYRA NURSAKILA P 29 Agustus 2021 5/19/2023 20 Buruk Sangat Pendek Sangat Kurus
20
AMAR DARMAWAN L 02 Mei 2019 5/19/2023 48 13.4 N 95.0 Baik Normal Normal
21
FA'AR RUDIN L 30 Juli 2021 5/19/2023 21 Buruk Sangat Pendek Sangat Kurus
22
M. ANUGRAH YASIN L 07 Juli 2021 5/19/2023 22 12 N 90.0 Baik Normal Normal
23
CAHAYAFATIHA YASMIN P 12 September 2021 5/19/2023 20 12 N 84.0 Baik Normal Normal
24
AFIF ALFARENDRA SAPUTRA L 03 Maret 2023 5/19/2023 2 5.5 N 60.0 Baik Normal Normal
25
SURYATUN HASANA P 06 Maret 2019 5/19/2023 50 Buruk Sangat Pendek Sangat Kurus
26
M. FAKHRI AKBAR L 18 April 2023 5/19/2023 1 4.5 B 52.0 Baik Normal Normal
27
NAURA NUR AQILA P 14 April 2023 5/19/2023 1 6 B 55.0 Lebih Normal Gemuk
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31 10.6 11.5 16.5 16.51
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 12 13.1 18.9 18.91
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71 12.2 13.2 18.3 18.31
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71
2 10 9.8 11 17.8 17.81 83.9 87.5 102 102.01 11 11.9 16.4 16.41
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 8.7 9.4 13.5 13.51
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11 9.1 9.9 14.1 14.11
1 4 6.9 7.7 12.6 12.61 70.2 73 84.2 84.21 7.2 7.8 11.2 11.21
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91 7.8 8.5 12.1 12.11
2 1 8.8 9.8 15.5 15.51 78.6 81.7 94.2 94.21 9.1 9.8 13.6 13.61
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 7.5 8.2 11.7 11.71
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.8 6.3 9.1 9.11
0 5 4.8 5.4 8.8 8.81 57.4 59.6 68.5 68.51 4.7 5.1 7.4 7.41
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51 5.9 6.4 8.9 8.91
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01 13.5 14.7 21.3 21.31
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 11 11.9 16.4 16.41
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 10.1 10.9 15 15.01
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71 8.5 9.2 13.2 13.21
0 2 3.8 4.3 7.1 7.11 52.4 54.4 62.4 62.41 4.7 5.1 7.1 7.11
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71
0 1 2.9 3.4 5.8 5.81 48.9 50.8 58.6 58.61 2.9 3.2 4.5 4.51
0 1 2.7 3.2 5.5 5.51 47.8 49.8 57.6 57.61 3.5 3.8 5.5 5.51
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BATU LEGONG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : TUNAS BARU
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
AULIA P 24 Februari 2018 3/21/2023 60 Buruk Sangat Pendek Sangat Kurus
2
RAIMAN L 13 Maret 2018 3/21/2023 60 Buruk Sangat Pendek Sangat Kurus
3
OLIVIA SLAFINA P 17 Juli 2018 5/20/2023 58 17 T 102.0 Baik Normal Normal
4
M. PARID L 23 Juli 2018 5/20/2023 58 14.4 T 100.0 Baik Normal Normal
5
FAHMI L 04 Agustus 2018 5/20/2023 57 11.9 T 94.0 Buruk Sangat Pendek Normal
6
NANDA P 28 Agustus 2018 5/20/2023 56 12.4 T 94.0 Kurang Pendek Normal
7
NADIA P 16 September 2018 5/20/2023 56 14.3 T 105.0 Baik Normal Normal
8
MARSEL L 25 September 2018 5/20/2023 55 18.3 O 104.0 Baik Normal Normal
9
INDAH RIANA L 09 Oktober 2018 5/20/2023 55 15.8 N 104.0 Baik Normal Normal
10
PIKRIANSYAH L 10 November 2018 5/20/2023 54 15 T 102.0 Baik Normal Normal
11
IRMA P 08 Desember 2018 5/20/2023 53 12.4 T 94.0 Kurang Pendek Normal
12
M. FAUZAN P 21 Januari 2019 5/20/2023 52 13.5 N 97.0 Baik Normal Normal
13
FEBRI TRI A. L 05 Maret 2019 5/20/2023 50 13.2 T 97.0 Baik Normal Normal
14
WAHYUDA L 26 Maret 2019 5/20/2023 49 27 N 106.0 Lebih Normal Gemuk
15
AL FATIHA L 21 Agustus 2019 5/20/2023 45 12.4 T 97.0 Kurang Normal Normal
16
RENATA SEPTIAN P 06 September 2019 5/20/2023 44 Buruk Sangat Pendek Sangat Kurus
17
ARNI NAZIRA P 02 Desember 2019 5/20/2023 41 13.1 T 99.0 Baik Normal Normal
18
M. ALPAN P 20 Januari 2020 5/20/2023 40 14.7 T 93.0 Baik Normal Normal
19
ARA L 28 Januari 2020 5/20/2023 39 12.4 T 91.0 Baik Normal Normal
20
M. AL KABIR L 04 Februari 2020 5/20/2023 39 11.7 T 91.0 Baik Normal Normal
21
RASIPA P 05 April 2020 5/20/2023 37 11.3 N 89.0 Baik Normal Normal
22
YOLA NOVALINDA P 18 April 2020 5/20/2023 37 12.4 N 92.0 Baik Normal Normal
23
SOFI P 05 Mei 2020 5/20/2023 36 Buruk Sangat Pendek Sangat Kurus
24
M. ALVIZI L 13 Mei 2020 5/20/2023 36 10.2 T 86.0 Kurang Pendek Normal
25
M. FARHAN L 08 Juni 2020 5/20/2023 35 Buruk Sangat Pendek Sangat Kurus
26
NATASYA BILLA A. P 22 Juni 2020 5/20/2023 35 12.7 N 89.0 Baik Normal Normal
27
FARHANA SOFIA P 26 Juni 2020 5/20/2023 34 Buruk Sangat Pendek Sangat Kurus
28
NAISYA P 27 Februari 2021 5/20/2023 26 11.3 T 82.0 Baik Normal Normal
29
HASIFA HUMAIROH P 17 Maret 2021 5/20/2023 26 9.9 O 81.0 Baik Normal Normal
30
ADIFA APRILIA P 12 April 2021 5/20/2023 25 Buruk Sangat Pendek Sangat Kurus
31
SAFIRA AULIA P 25 Mei 2021 5/20/2023 24 12.2 O 85.0 Baik Normal Normal
32
ARIQAH AZZAHRA P 02 Juni 2021 5/20/2023 23 Buruk Sangat Pendek Sangat Kurus
33
TUAH KAWALAN L 30 September 2021 5/20/2023 19 9.9 N 79.0 Baik Normal Normal
34
IRZAN L 17 Oktober 2021 5/20/2023 19 9.5 N 80.0 Baik Normal Normal
35
NATASYA AULIA P 28 Oktober 2021 5/20/2023 18 10.4 N 81.0 Baik Normal Normal
36
ELIF KAYLA R. P 03 Maret 2022 5/20/2023 14 9.4 N 76.0 Baik Normal Normal
37
M. ALWI L 24 April 2022 5/20/2023 12 8.5 N 74.0 Baik Normal Normal
38
SAFINA YUMIKA A. P 02 Juli 2022 5/20/2023 10 6.2 N 68.0 Kurang Normal Kurus
39
CITRA AYUNDA P. P 11 September 2022 5/20/2023 8 7.8 N 72.0 Baik Normal Normal
40
REFINA AULIA P 21 Oktober 2022 5/20/2023 7 7.7 N 70.0 Baik Normal Normal
41
ELSA MARSELA P 11 November 2022 5/20/2023 6 Buruk Sangat Pendek Sangat Kurus
42
DINDA ANDRIYANI P 02 Februari 2023 5/20/2023 3 6.1 N 60.0 Baik Normal Normal
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 95.2 99.9 118.9 118.91
5 0 0 0 0 0 96.1 100.7 119.2 119.21
4 10 11.9 13.5 24.4 24.41 94.3 99 117.7 117.71 12 13.1 18.9 18.91
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 12 12.9 18 18.01
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 10.8 11.7 16.1 16.11
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 10.4 11.3 16.2 16.21
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 12.7 13.8 20 20.01
4 7 11.9 13.5 22.9 22.91 93.9 98.3 116.1 116.11 12.8 13.9 19.4 19.41
4 7 11.9 13.5 22.9 22.91 93.9 98.3 116.1 116.11 12.8 13.9 19.4 19.41
4 6 11.8 13.4 22.7 22.71 93.4 97.8 115.5 115.51 12.4 13.4 18.7 18.71
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 10.4 11.3 16.2 16.21
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01 11 12 17.1 17.11
4 2 11.4 12.9 21.7 21.71 91.6 95.9 113 113.01 11.4 12.3 17 17.01
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 13.3 14.4 20.2 20.21
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81 11.4 12.3 17 17.01
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41 11.4 12.4 17.8 17.81
3 4 10.1 11.3 19.2 19.21 85.8 89.8 105.7 105.71 10.2 11.1 15.9 15.91
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71 10.3 11.1 15.3 15.31
3 3 10.3 11.6 19 19.01 86.5 90.3 105.7 105.71 10.3 11.1 15.3 15.31
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 9.5 10.3 14.7 14.71
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 10.1 10.9 15.6 15.61
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71
3 0 10 11.3 18.3 18.31 85 88.7 103.5 103.51 9.3 10 13.9 13.91
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 9.5 10.3 14.7 14.71
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8.1 8.8 12.6 12.61
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8 8.7 12.4 12.41
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11
1 12 8.1 9 14.8 14.81 76.7 80 92.9 92.91 8.7 9.4 13.5 13.51
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.1 8.7 12.2 12.21
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.2 8.9 12.4 12.41
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 8 8.7 12.4 12.41
1 2 6.6 7.4 12.1 12.11 68.3 71 81.7 81.71 7.2 7.8 11.2 11.21
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7.3 7.9 11 11.01
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6 6.5 9.4 9.41
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6.6 7.2 10.3 10.31
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 6.3 6.9 9.9 9.91
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 4.5 4.9 7.1 7.11
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : BATU LEGONG
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : TUNAS KARYA
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
U U T
#REF! B
RISKI FEBRIANSYAH L 02 Mei 2018 5/12/2023 60 Buruk Sangat Pendek Sangat Kurus
2
SIFAUL HAKIM L 03 Juli 2018 5/12/2023 58 15.1 T 104.0 Baik Normal Normal
3
ELVIA LUTFI P 09 September 2018 5/12/2023 56 15.6 N 104.0 Baik Normal Normal
4
INSA NAJIHA FAYANA P 16 November 2018 5/12/2023 53 13.8 T 102.0 Baik Normal Normal
5
M. RIDHO L 06 Januari 2019 5/12/2023 52 13.3 T 97.0 Baik Normal Normal
6
DALPI ANANDA PUTRA L 19 Juli 2019 5/12/2023 45 Buruk Sangat Pendek Sangat Kurus
7
BAYU PURNAMA L 14 Oktober 2019 5/12/2023 43 Buruk Sangat Pendek Sangat Kurus
8
SAFAZIRA AGUSTIANTI P 29 Agustus 2019 5/12/2023 44 13.6 N 97.0 Baik Normal Normal
9
FARIDA AMELIANA P 11 Oktober 2019 5/12/2023 43 10.6 T 90.0 Kurang Pendek Normal
10
M. ALDO SAPUTRA L 16 November 2019 5/12/2023 41 17.7 T 96.0 Baik Normal Gemuk
11
NASMIATUN LATISYA P 06 September 2019 5/12/2023 44 Buruk Sangat Pendek Sangat Kurus
12
KENZO L 26 November 2019 5/12/2023 41 Buruk Sangat Pendek Sangat Kurus
13
FIRDAN L 03 Juni 2020 5/12/2023 35 Buruk Sangat Pendek Sangat Kurus
14
AWRI GAVA FAEZA L 13 Juni 2020 5/12/2023 35 Buruk Sangat Pendek Sangat Kurus
15
ANGGUN NUR QAIDAH P 28 Juni 2020 5/12/2023 34 13.7 N 92.0 Baik Normal Normal
16
ANGGIA P 08 Oktober 2020 5/12/2023 31 12.9 N 87.0 Baik Normal Normal
17
SAHWAN ALGI FAHRI P 30 November 2020 5/12/2023 29 14.6 N 93.0 Baik Normal Normal
18
OKA GERHANA PUTRA L 09 Mei 2021 5/12/2023 24 9.7 T 81.0 Kurang Pendek Normal
19
AZNUR FAIZ L 28 Mei 2021 5/12/2023 23 10.1 T 83.0 Baik Normal Normal
20
M. ALFA RIZKI ABDUL H. L 28 Agustus 2020 5/12/2023 32 Buruk Sangat Pendek Sangat Kurus
21
ELISA YUNI P 13 Juni 2021 5/12/2023 23 Buruk Sangat Pendek Sangat Kurus
22
ABDULLAH SAHID L 17 Juli 2021 5/12/2023 21 12.4 T 83.0 Baik Normal Normal
23
M. ZULFI KURNIADI L 17 Juli 2021 5/12/2023 21 Buruk Sangat Pendek Sangat Kurus
24
M. SYAHRIL HANIF L 24 September 2021 5/12/2023 19 10.7 N 83.0 Baik Normal Normal
25
AINA ANHAFIA P 09 November 2021 5/12/2023 18 9.3 T 76.0 Baik Normal Normal
26
M. ARFAN ELMIANSYAH L 17 Januari 2022 5/12/2023 15 8.8 N 75.0 Baik Normal Normal
27
M. SYAKIR L 31 Oktober 2020 5/12/2023 30 Buruk Sangat Pendek Sangat Kurus
28
M. SUTRA ASSAUQI L 07 Mei 2022 5/12/2023 12 Buruk Sangat Pendek Sangat Kurus
29
M. AZRI OMAER L 09 Mei 2022 5/12/2023 12 9.1 T 76.0 Baik Normal Normal
30
ATTAR SAHMAN L 26 Juni 2022 5/12/2023 10 8.9 T 75.0 Baik Normal Normal
31
M. ARHAN PRATAMA L 31 Oktober 2022 5/12/2023 6 8 N 68.0 Baik Normal Normal
32
M. ALVIN L 09 November 2022 5/12/2023 6 8.7 N 71.0 Baik Normal Normal
33
HESTI P 06 Oktober 2022 5/12/2023 7 Buruk Sangat Pendek Sangat Kurus
34
SEPTIANTI P 06 September 2018 5/12/2023 56 15.3 T 104.0 Baik Normal Normal
35
M. ARHAN L 20 April 2022 5/12/2023 12 Buruk Sangat Pendek Sangat Kurus
36
RENDI RASYA ALZIKRI L 21 Januari 2023 5/12/2023 3 6.6 N 65.0 Baik Normal Normal
37
M. ZAINUL ARIFIN L 02 Maret 2023 5/12/2023 2 5.9 N 60.0 Baik Normal Normal
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 96.1 100.7 119.2 119.21
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01 12.8 13.9 19.4 19.41
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 12.5 13.6 19.6 19.61
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 12 13.1 18.9 18.91
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 11.4 12.3 17 17.01
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61 11 12 17.1 17.11
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 9.7 10.5 15 15.01
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 11.2 12.1 16.7 16.71
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11 10.1 10.9 15.6 15.61
2 7 9 10.1 16.8 16.81 80.7 84.3 98.6 98.61 9.1 9.9 14.1 14.11
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 10.2 11.1 15.9 15.91
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.4 9.1 12.6 12.61
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91 8.7 9.4 13.1 13.11
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91 8.7 9.4 13.1 13.11
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.7 9.4 13.1 13.11
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 7.2 7.8 11.2 11.21
1 3 7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21 7.5 8.1 11.3 11.31
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7.6 8.3 11.5 11.51
0 10 6.6 7.4 11.4 11.41 66.4 68.7 77.9 77.91 7.5 8.1 11.3 11.31
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 6.3 6.8 9.4 9.41
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 6.8 7.4 10.2 10.21
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 12.5 13.6 19.6 19.61
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51
0 3 4.4 5 8 8.01 55.3 57.3 65.5 65.51 5.7 6.2 8.6 8.61
0 2 3.8 4.3 7.1 7.11 52.4 54.4 62.4 62.41 4.7 5.1 7.1 7.11
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : PANTAI GELAM
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : AGLONEMA
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 103.0 U U
B
AURELIA P. P 26 Juli 2018 5/13/2023 57 15.8 N Baik Normal Normal
2
AL JIAD L 23 Maret 2018 5/13/2023 61 Buruk Sangat Pendek Sangat Kurus
3
TAZMAL AHMAD L 26 Maret 2018 5/13/2023 61 Buruk Sangat Pendek Sangat Kurus
4
FAZIL AHMAD L 11 April 2018 5/13/2023 61 Buruk Sangat Pendek Sangat Kurus
5
M. SYAH PUTRA L 02 Juli 2018 5/13/2023 58 Buruk Sangat Pendek Sangat Kurus
6
SILVALI P 10 Juni 2018 5/13/2023 59 Buruk Sangat Pendek Sangat Kurus
7
NOLA FAHIRA P 17 Agustus 2018 5/13/2023 57 Buruk Sangat Pendek Sangat Kurus
8
M. FIRDAUS L 26 Agustus 2018 5/13/2023 56 15.5 T 103.0 Baik Normal Normal
9
NARESH MAHFUD L 08 September 2018 5/13/2023 56 20.8 T 115.0 Baik Normal Normal
10
SAKIRA AMEERA P 16 Oktober 2018 5/13/2023 55 16.4 O 108.0 Baik Normal Normal
11
ZAFRAN L 26 November 2018 5/13/2023 53 14.4 T 102.0 Baik Normal Normal
12
EMELIA IZORA P 29 Desember 2018 5/13/2023 52 17.6 T 111.0 Baik Normal Normal
13
M. FATIH L 01 Januari 2019 5/13/2023 52 14.5 T 100.0 Baik Normal Normal
14
KHARISYAH P 17 Februari 2019 5/13/2023 50 14.8 T 101.0 Baik Normal Normal
15
NUR AL FARISKA P 02 Maret 2019 5/13/2023 50 Buruk Sangat Pendek Sangat Kurus
16
DEVANO L 18 Maret 2019 5/13/2023 49 12.7 T 97.0 Kurang Normal Normal
17
M. SAPARAS L 25 Maret 2019 5/13/2023 49 13.4 T 98.0 Baik Normal Normal
18
KHAIRUL NIZAM L 19 Mei 2019 5/13/2023 48 Buruk Sangat Pendek Sangat Kurus
19
FAIZA TUNISA P 23 Mei 2019 5/13/2023 47 Buruk Sangat Pendek Sangat Kurus
20
ROBIANSYAH L 26 Mei 2019 5/13/2023 47 12.6 T 99.0 Kurang Normal Kurus
21
NUZULIANA F. P 15 Juni 2019 5/13/2023 47 13.1 O 94.0 Baik Normal Normal
22
HANISYAH AUDITYA FITRI P 04 Juni 2020 5/13/2023 35 14 O 93.0 Baik Normal Normal
23
AYU WANZIRA P 27 Juni 2019 5/13/2023 46 20.5 N 104.0 Baik Normal Gemuk
24
AL FAJRI L 04 Juli 2019 5/13/2023 46 14.1 O 103.0 Baik Normal Normal
25
AGUS SAPUTRA L 02 Agustus 2019 5/13/2023 45 16.4 N 105.0 Baik Normal Normal
26
M. SALMAN L 13 September 2019 5/13/2023 44 16.9 N 100.0 Baik Normal Normal
27
HAFIA AINA P 25 September 2019 5/13/2023 43 13.4 T 100.0 Baik Normal Normal
28
ANNISAH P 10 Oktober 2019 5/13/2023 43 Buruk Sangat Pendek Sangat Kurus
29
HAMDAN L 21 November 2019 5/13/2023 41 12.4 T 93.0 Baik Normal Normal
30
SAFIRA P 30 November 2019 5/13/2023 41 15.4 O 98.0 Baik Normal Normal
31
ARKA L 12 Januari 2020 5/13/2023 40 12.9 O 92.0 Baik Normal Normal
32
AISI KASARA P 15 Januari 2020 5/13/2023 39 13.5 N 98.0 Baik Normal Normal
33
NURASISKA P 26 Januari 2020 5/13/2023 39 14.6 O 98.0 Baik Normal Normal
34
VIONA P 02 Februari 2020 5/13/2023 39 15.9 N 95.0 Baik Normal Normal
35
ZAYYID L 01 April 2020 5/13/2023 37 Buruk Sangat Pendek Sangat Kurus
36
AQIS P 08 Mei 2020 5/13/2023 36 10.9 O 88.0 Baik Normal Normal
37
ARESHA P 13 Juni 2020 5/13/2023 35 12.2 T 93.0 Baik Normal Normal
38
ASKIA P 19 Juni 2020 5/13/2023 34 13.4 T 92.0 Baik Normal Normal
39
SITI NUR AIZA P 14 Juli 2020 5/13/2023 34 13.4 N 88.0 Baik Normal Normal
40
NUR AZRIN P 29 Juli 2020 5/13/2023 33 10.9 T 86.0 Baik Normal Normal
41
HANA NAYLA P 30 November 2020 5/13/2023 29 12.3 N 84.0 Baik Normal Normal
42
ZURIN P 17 Oktober 2020 5/13/2023 30 10.6 T 86.0 Baik Normal Normal
43
PUTRI INDRIANI P 01 Maret 2021 5/13/2023 26 9.5 T 82.0 Baik Normal Normal
44
ZULFA ADIRA P 04 Maret 2021 5/13/2023 26 11.9 N 87.0 Baik Normal Normal
45
ELENA FAHIRA P 29 Maret 2021 5/13/2023 25 11.3 O 83.0 Baik Normal Normal
46
HUSNA P 09 April 2021 5/13/2023 25 13.2 O 88.0 Baik Normal Normal
47
KARISMA P 22 April 2021 5/13/2023 24 9.5 O 81.0 Baik Normal Normal
48
LAURA SIFAZIA P 16 Juni 2021 5/13/2023 23 11.5 N 80.0 Baik Normal Normal
49
NUR ALISYA P 22 Juli 2021 5/13/2023 21 9.8 T 78.0 Baik Normal Normal
50
RITA NUR ALENA P 03 Agustus 2021 5/13/2023 21 10.3 T 81.0 Baik Normal Normal
51
AL MUZAMIL L 07 Agustus 2021 5/13/2023 21 9.2 O 79.0 Kurang Pendek Normal
52
AYDAN L 10 Agustus 2021 5/13/2023 21 Buruk Sangat Pendek Sangat Kurus
53
RAHAYU P 22 Agustus 2021 5/13/2023 20 8.8 T 77.0 Baik Normal Normal
54
M. MUZAHIR L 04 September 2021 5/13/2023 20 9.1 N 76.0 Kurang Pendek Normal
55
AURA MEDINA P 11 September 2021 5/13/2023 20 Buruk Sangat Pendek Sangat Kurus
56
MUHAMMAD ASSAFAR L 14 September 2021 5/13/2023 20 Buruk Sangat Pendek Sangat Kurus
57
ARFAN ZIKRY L 05 Oktober 2021 5/13/2023 19 Buruk Sangat Pendek Sangat Kurus
58
FAIZAN HAZIQ L 10 Oktober 2021 5/13/2023 19 11.3 N 78.0 Baik Normal Normal
59
FAID HAZIQ L 12 Oktober 2021 5/13/2023 19 12.2 N 84.0 Baik Normal Normal
60
M. ADNAN L 02 Desember 2021 5/13/2023 17 8.4 O 76.0 Kurang Pendek Normal
61
NAGITA SLAVINA P 03 Desember 2021 5/13/2023 17 10.1 O 79.0 Baik Normal Normal
62
WA ODE KAIRA P 15 Desember 2021 5/13/2023 16 Buruk Sangat Pendek Sangat Kurus
63
LILI NUR LIANA P 18 Februari 2022 5/13/2023 14 8.4 N 75.0 Baik Normal Normal
64
RADITYA L 09 Maret 2022 5/13/2023 14 8.4 O 74.0 Baik Normal Normal
65
ZAYYAN L 30 Maret 2022 5/13/2023 13 7.9 O 72.0 Kurang Pendek Normal
66
JIANZA R. L 04 April 2022 5/13/2023 13 9.2 N 73.0 Baik Normal Normal
67
M. HANIF L 24 Mei 2022 5/13/2023 11 7.7 N 70.0 Baik Normal Normal
68
AQILA P 25 Mei 2022 5/13/2023 11 7.3 N 68.0 Baik Normal Normal
69
ZULIKA P 12 Agustus 2022 5/13/2023 9 8 O 71.0 Baik Normal Normal
70
RAHMA FADILA P 24 Agustus 2022 5/13/2023 8 8.1 T 68.0 Baik Normal Normal
71
SAIDATUL NADIRA P 11 September 2022 5/13/2023 8 5.9 T 64.0 Kurang Pendek Normal
72
AZQA RANDIKA PUTRA L 03 Februari 2023 5/13/2023 3 5.7 B 58.0 Baik Normal Normal
73
FAIZ ZIKRI L 16 Maret 2023 5/13/2023 1 4.2 B 52.0 Baik Normal Normal
74
CHAREL DINATA L 11 November 2022 5/13/2023 6 5.7 T Buruk
59.0 Buruk SangatPendek
Sangat Pendek Normal
Normal
75
SOFIA NUR FATIHA P 08 Februari 2023 5/13/2023 3 6.1 T Baik
57.0 Baik Normal
Normal Normal
Normal
76
15 Mei 2022 3/13/2023 10 ### ### ###
77
11 Oktober 2022 3/13/2023 5 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###
81
05 November 2020 12/15/2021 13 ### ### ###
82
14 Januari 2021 12/15/2021 11 ### ### ###
83
18 Mei 2021 12/15/2021 7 ### ### ###
84
15 Mei 2021 12/15/2021 7 ### ### ###
85
31 Mei 2021 12/15/2021 6 ### ### ###
86
16 Juli 2021 12/15/2021 5 ### ### ###
87
08 November 2021 12/15/2021 1 ### ### ###
88
05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 12.3 13.3 19.2 19.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 96.1 100.7 119.2 119.21
4 10 12.2 13.8 23.7 23.71 95.2 99.7 118 118.01
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71 12.6 13.6 19 19.01
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71 14.2 15.4 21.9 21.91
4 7 11.6 13.2 23.5 23.51 93 97.6 115.9 115.91 13.5 14.7 21.3 21.31
4 5 11.7 13.3 22.4 22.41 93 97.4 114.9 114.91 12.4 13.4 18.7 18.71
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01 14 15.3 22.3 22.31
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 12 12.9 18 18.01
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71 11.8 12.8 18.5 18.51
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 11.4 12.3 17 17.01
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 11.6 12.5 17.3 17.31
3 12 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11 11.8 12.7 17.6 17.61
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71 10.4 11.3 16.2 16.21
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 10.2 11.1 15.9 15.91
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01 12.5 13.6 19.6 19.61
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 12.6 13.6 19 19.01
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81 13 14.1 19.8 19.81
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 12 12.9 18 18.01
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 11.6 12.6 18.1 18.11
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11 10.7 11.5 15.8 15.81
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41 11.2 12.2 17.5 17.51
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 10.5 11.3 15.6 15.61
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01 11.2 12.2 17.5 17.51
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01 11.2 12.2 17.5 17.51
3 3 9.9 11.2 19 19.01 85.3 89.2 105 105.01 10.6 11.5 16.5 16.51
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 9.3 10.1 14.4 14.41
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 10.2 11.1 15.9 15.91
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11 10.1 10.9 15.6 15.61
2 10 9.4 10.5 17.6 17.61 82.5 86.2 101.1 101.11 9.3 10.1 14.4 14.41
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 8.9 9.7 13.8 13.81
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 8.5 9.2 13.2 13.21
2 6 8.9 10 16.5 16.51 80.1 83.6 97.7 97.71 8.9 9.7 13.8 13.81
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8.1 8.8 12.6 12.61
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 9.1 9.9 14.1 14.11
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 8.3 9 12.9 12.91
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 9.3 10.1 14.4 14.41
2 0 8.1 9 14.8 14.81 76.7 80 92.9 92.91 8 8.7 12.4 12.41
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91 7.8 8.5 12.1 12.11
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 7.5 8.2 11.7 11.71
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 8 8.7 12.4 12.41
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91 8.1 8.7 12.2 12.21
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71 7.4 8 11.5 11.51
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 7.6 8.3 11.5 11.51
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 7.9 8.6 12 12.01
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 8.9 9.6 13.3 13.31
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 7.6 8.3 11.5 11.51
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41 7.7 8.3 11.9 11.91
1 4 6.9 7.7 12.6 12.61 70.2 73 84.2 84.21
1 2 6.6 7.4 12.1 12.11 68.3 71 81.7 81.71 7.1 7.7 11 11.01
1 2 7.2 8.1 12.6 12.61 70.6 73.1 83 83.01 7.3 7.9 11 11.01
1 1 7.1 7.9 12.3 12.31 69.6 72.1 81.8 81.81 7 7.6 10.5 10.51
1 1 7.1 7.9 12.3 12.31 69.6 72.1 81.8 81.81 7.2 7.7 10.8 10.81
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 6.6 7.2 10 10.01
0 11 6.1 6.9 11.2 11.21 65.2 67.7 77.8 77.81 6 6.5 9.4 9.41
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 6.5 7 10.1 10.11
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6 6.5 9.4 9.41
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.3 5.7 8.3 8.31
0 3 4.4 5 8 8.01 55.3 57.3 65.5 65.51 4.3 4.6 6.4 6.41
0 1 2.9 3.4 5.8 5.81 48.9 50.8 58.6 58.61 2.9 3.2 4.5 4.51
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 4.5 4.8 6.8 6.81
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 3.9 4.3 6.1 6.11
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 5 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : PANTAI GELAM
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : SEROJA
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 101.0 U U
B
ARZANI HERLAN L 16 Desember 2018 5/10/2023 52 16 T Baik Normal Normal
2
AKRAM ZAIDAN L 07 Juni 2019 5/10/2023 47 12.3 O 91.0 Kurang Pendek Normal
3
PUTRI SALSABILA P 13 Agustus 2019 5/10/2023 45 13.6 N 100.0 Baik Normal Normal
4
ARYA PERMANA L 29 Januari 2019 5/10/2023 51 19.7 N 107.0 Baik Normal Normal
5
ASIFA MULYANI P 29 September 2019 5/10/2023 43 Buruk Sangat Pendek Sangat Kurus
6
WAFIR MUBARAK L 16 Juni 2019 5/10/2023 46 15.9 N 101.0 Baik Normal Normal
7
MUHAMMAD RAIHAN L 22 Desember 2019 5/10/2023 40 14.6 N 95.0 Baik Normal Normal
8
MUHAMMAD NAZLI L 11 November 2019 5/10/2023 42 18.6 O 103.0 Baik Normal Normal
9
DEWI SRI JELITA P 08 Desember 2019 5/10/2023 41 Buruk Sangat Pendek Sangat Kurus
10
SELFIA AL FATONAH P 12 Desember 2019 5/10/2023 41 12.4 N 92.0 Baik Normal Normal
11
HILMAN MAULANA L 02 Februari 2019 5/10/2023 51 14.2 T 97.0 Baik Normal Normal
12
MUHAMMAD HAIKAL L 16 Mei 2020 5/10/2023 35 11.1 N 87.0 Kurang Pendek Normal
13
AYUDIYA AZHARA P 04 Agustus 2020 5/10/2023 33 9.6 T 82.0 Kurang Pendek Normal
14
ARUMI NAZIHA P 16 Oktober 2020 5/10/2023 30 Buruk Sangat Pendek Sangat Kurus
15
RAYYAN ASNITA P 28 Juli 2021 5/10/2023 21 9.3 N 78.0 Baik Normal Normal
16
ARYAN ARISKY SYAWAL L 05 Mei 2022 5/10/2023 12 8 N 72.0 Baik Normal Normal
17
ARHAN ARISKY SYAWAL L 05 Mei 2022 5/10/2023 12 7.8 N 73.0 Baik Normal Normal
18
SAUQY FIRDAUS L 26 Mei 2022 5/10/2023 11 7.7 T 71.0 Baik Normal Normal
19
HABIR BARAK L 31 Agustus 2022 5/10/2023 8 9.3 N 75.0 Baik Normal Normal
20
M. AZRIY L 26 Desember 2022 5/10/2023 4 5.7 N 60.0 Baik Normal Normal
21
05 September 2019 12/15/2022 39 ### ### ###
22
08 Agustus 2019 12/15/2022 40 ### ### ###
23
14 Agustus 2019 12/15/2022 40 ### ### ###
24
13 November 2019 12/15/2022 37 ### ### ###
25
23 Desember 2019 12/15/2022 35 ### ### ###
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 12.2 13.2 18.3 18.31
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11 10.3 11.1 15.3 15.31
3 9 10.6 12 20.7 20.71 88.4 92.5 109.3 109.31 11.6 12.6 18.1 18.11
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 13.5 14.6 20.6 20.61
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91
3 10 11 12.5 20.7 20.71 89.8 94 110.4 110.41 12.2 13.2 18.3 18.31
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 11 11.9 16.4 16.41
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81 12.6 13.6 19 19.01
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41 10.1 10.9 15.6 15.61
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 11.4 12.3 17 17.01
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71 9.5 10.2 14.2 14.21
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 8.1 8.8 12.6 12.61
2 6 8.9 10 16.5 16.51 80.1 83.6 97.7 97.71
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 7.5 8.2 11.7 11.71
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7 7.6 10.5 10.51
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7.2 7.7 10.8 10.81
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 6.8 7.4 10.2 10.21
0 8 6.2 6.9 10.7 10.71 64 66.2 75 75.01 7.5 8.1 11.3 11.31
0 4 4.9 5.6 8.7 8.71 57.6 59.7 68 68.01 4.7 5.1 7.1 7.11
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : ANGGREK 1
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 106.0 U U
B
RANIA RIVANA P 17 April 2018 5/12/2023 60 16 T Baik Normal Normal
2
NUR KAYLA MYANDRA P 02 Mei 2018 5/12/2023 60 14.5 N 100.0 Baik Normal Normal
3
MAULIDA ANNIKMAH P 19 November 2018 5/12/2023 53 20 N 108.0 Baik Normal Normal
4
JULIANTO L 21 Juli 2018 5/12/2023 57 16.3 T 105.0 Baik Normal Normal
5
HASNA NABILA P 12 Desember 2018 5/12/2023 53 14.8 T 99.0 Baik Normal Normal
6
LINDU AJI L 01 Februari 2019 5/12/2023 51 15.6 T 100.0 Baik Normal Normal
7
ALEESYA RIZKY A. P 24 Januari 2019 5/12/2023 51 17.3 T 108.0 Baik Normal Normal
8
RAYYAN KHAIRIL A. L 28 Januari 2019 5/12/2023 51 13.2 N 97.0 Baik Normal Normal
9
NANO RIZKY P. L 01 Maret 2019 5/12/2023 50 12.2 T 95.0 Kurang Pendek Normal
10
ARYANI ZAHIRA P 03 Februari 2019 5/12/2023 51 14.9 T 98.0 Baik Normal Normal
11
ANJELI MAHOTRA P 05 Maret 2019 5/12/2023 50 11.8 O 92.0 Kurang Pendek Normal
12
AN NUR SANAS P 14 April 2019 5/12/2023 48 15 N 100.0 Baik Normal Normal
13
M. WIRA RAMDHAN L 08 Mei 2019 5/12/2023 48 13.6 0 98.0 Baik Normal Normal
14
DEVI RATNA SARI P 26 Mei 2019 5/12/2023 47 12 T 90.0 Kurang Pendek Normal
15
RAUDAH ADELIA P 14 Juni 2019 5/12/2023 47 12.8 T 95.0 Baik Normal Normal
16
NAWALIA HUSNA P 27 Juli 2019 5/12/2023 45 12.8 O 93.0 Baik Normal Normal
17
ANGGINI P 12 Agustus 2019 5/12/2023 45 11.6 N 93.0 Kurang Normal Normal
18
KHAIRA HAFITU JANNAH P 18 Agustus 2019 5/12/2023 44 11.5 N 92.0 Kurang Pendek Normal
19
ANDRA MAHENDRA L 05 Januari 2019 5/12/2023 52 14.3 N 97.0 Baik Normal Normal
20
KHAIRUL ARMAN L 05 Oktober 2019 5/12/2023 43 15.7 T 106.0 Baik Normal Normal
21
FATIR RAHMAN L 14 Oktober 2019 5/12/2023 43 21.7 N 108.0 Lebih Normal Gemuk
22
NURISMAYATI P 15 Oktober 2019 5/12/2023 43 12.2 N 93.0 Baik Normal Normal
23
HAIDA ZAHIRA TUSSALAMAH P 25 Oktober 2019 5/12/2023 42 12.2 N 95.0 Baik Normal Normal
24
NURASYIFA P 25 Oktober 2019 5/12/2023 42 14.8 N 93.0 Baik Normal Normal
25
PUTRA ARYA L 01 November 2019 5/12/2023 42 13.1 O 95.0 Baik Normal Normal
26
HANA P 26 Desember 2019 5/12/2023 40 11.5 N 94.0 Baik Normal Normal
27
M. FAIZ L 30 Desember 2019 5/12/2023 40 11.6 T 94.0 Kurang Normal Kurus
28
ANGGUN RAHMANIA P 29 Februari 2020 5/12/2023 38 11.8 T 91.0 Baik Normal Normal
29
NUR KHALIFAH P 13 Maret 2020 5/12/2023 38 11.8 N 91.0 Baik Normal Normal
30
M. ADAM RIZKY L 17 Maret 2020 5/12/2023 37 13.5 N 90.0 Baik Normal Normal
31
ROHAN MAHOTRA L 22 Juni 2020 5/12/2023 34 12.7 T 88.0 Baik Normal Normal
32
HILYA ARISHA H. P 12 September 2020 5/12/2023 32 14.8 N 88.0 Baik Normal Gemuk
33
M. ABYANSYAH L 02 Oktober 2020 5/12/2023 31 10.2 T 83.0 Kurang Pendek Normal
34
TANTRA L 08 November 2020 5/12/2023 30 11.8 T 88.0 Baik Normal Normal
35
RAHIM LEHAT L 09 Desember 2020 5/12/2023 29 13.2 O 85.0 Baik Normal Normal
36
M. ARYAN ALFATAR L 19 Desember 2020 5/12/2023 28 13.2 T 90.0 Baik Normal Normal
37
AROHI MAHOTRA P 28 Februari 2020 5/12/2023 38 13.1 N 90.0 Baik Normal Normal
38
ADINDA ZULAIKA P 13 Januari 2021 5/12/2023 27 12 N 91.0 Baik Normal Normal
39
SELIYANI P 29 Januari 2021 5/12/2023 27 9.1 T 82.0 Kurang Normal Normal
40
NAILA P 24 Januari 2021 5/12/2023 27 10 N 82.0 Baik Normal Normal
41
NAIFA P 24 Januari 2021 5/12/2023 27 10.4 N 82.0 Baik Normal Normal
42
NINO RIZKY P. L 08 Juni 2021 5/12/2023 23 10.3 T 82.0 Baik Normal Normal
43
DEYA SAFITRI P 08 Juni 2021 5/12/2023 23 10.2 T 80.0 Baik Normal Normal
44
M. FARHAN L 01 Juli 2021 5/12/2023 22 11.4 T 86.0 Baik Normal Normal
45
M. ILHAM L 21 Juli 2021 5/12/2023 21 13 N 87.0 Baik Normal Normal
46
NURAISYAH P 21 Juli 2021 5/12/2023 21 11.2 N 81.0 Baik Normal Normal
47
NOVRY AULIAN P. L 22 Juli 2021 5/12/2023 21 9.9 T 81.0 Baik Normal Normal
48
HENDRA L 31 Agustus 2021 5/12/2023 20 11 T 80.0 Baik Normal Normal
49
AZKIYA OKTAVIA P 09 Oktober 2021 5/12/2023 19 8.5 T 76.0 Baik Normal Normal
50
SYAFIQAH SYAHLA P 04 Desember 2021 5/12/2023 17 11.2 N 79.0 Baik Normal Normal
51
NALA ALMIRA S. P 09 Januari 2022 5/12/2023 16 9.3 T 75.0 Baik Normal Normal
52
GALIH WICAKSONO L 26 Januari 2022 5/12/2023 15 8.8 T 78.0 Baik Normal Normal
53
JENNAIRA JASMINE P 24 Maret 2022 5/12/2023 13 10 N 75.0 Baik Normal Normal
54
PUTRI RAMDHANI P 24 April 2022 5/12/2023 12 8.7 N 74.0 Baik Normal Normal
55
KHAIRUL FATHAN L 05 Juni 2022 5/12/2023 11 10.6 N 74.0 Baik Normal Normal
56
INSAN NUR TAQWA L 26 Juli 2022 5/12/2023 9 8 N 70.0 Baik Normal Normal
57
KHAYLA NADIFA HUMAIRA P 11 Juli 2022 5/12/2023 10 7.1 T 67.0 Baik Normal Normal
58
SHANUM UMAIZA HANNAH P 16 Juli 2022 5/12/2023 10 8.6 N 72.0 Baik Normal Normal
59
SULAIKA P 22 Agustus 2022 5/12/2023 8 6.5 T 66.0 Baik Normal Normal
60
M. ASKAR NOAH L 25 Oktober 2022 5/12/2023 6 7.3 T 68.0 Baik Normal Normal
61
M. OKTAVIAN A. L 12 Oktober 2022 5/12/2023 7 9.3 T 67.0 Baik Normal Gemuk
62
RIKAR SANI L 29 Oktober 2022 5/12/2023 6 7.8 N 65.0 Baik Normal Normal
63
SRI ARDILA P 14 Oktober 2022 5/12/2023 7 7 N 64.0 Baik Normal Normal
64
ARSHAKA ELVANDIA A. L 05 Januari 2023 5/12/2023 4 7.2 N 62.0 Baik Normal Normal
65
ADRIAN AKBAR L 12 Agustus 2021 5/12/2023 21 10.3 N 80.0 Baik Normal Normal
66
DANENA TISHA ANAYA P 04 Februari 2023 5/12/2023 3 5 T 56.0 Baik Normal Normal
67
MARSEL JULIANTA V. L 28 Maret 2020 5/12/2023 37 14.4 N 90.0 Baik Normal Normal
68
FEBBY HUMAIRA P 16 Februari 2023 5/12/2023 2 5.8 N 58.0 Baik Normal Normal
69
FAHIRA AYLA TSABITA P 21 Februari 2023 5/12/2023 2 6 N 58.0 Baik Normal Normal
70
STEFANO PUTRA A. L 14 Juni 2019 5/12/2023 47 11.5 O 92.0 Kurang Pendek Normal
71
STEFANI CARLA R. P 14 Juni 2019 5/12/2023 47 11.8 O 95.0 Kurang Normal Normal
72
M. FIKRAM L 14 Maret 2023 5/12/2023 1 4.2 B 56.0 Baik Normal Normal
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###
81
05 November 2020 12/15/2021 13 ### ### ###
82
14 Januari 2021 12/15/2021 11 ### ### ###
83
18 Mei 2021 12/15/2021 7 ### ### ###
84
15 Mei 2021 12/15/2021 7 ### ### ###
85
31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 95.2 99.9 118.9 118.91 13 14.1 20.5 20.51
5 0 0 0 0 0 95.2 99.9 118.9 118.91 11.6 12.6 18.1 18.11
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 13.5 14.7 21.3 21.31
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 13 14.1 19.8 19.81
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 11.4 12.4 17.8 17.81
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 12 12.9 18 18.01
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 13.5 14.7 21.3 21.31
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 11.4 12.3 17 17.01
4 2 11.4 12.9 21.7 21.71 91.6 95.9 113 113.01 11 11.9 16.4 16.41
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 11.2 12.2 17.5 17.51
4 2 11.1 12.6 22.1 22.11 90.7 95.1 112.7 112.71 10.1 10.9 15.6 15.61
4 0 10.9 12.3 21.5 21.51 89.8 94.1 111.3 111.31 11.6 12.6 18.1 18.11
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 11.6 12.5 17.3 17.31
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71 9.7 10.5 15 15.01
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71 10.6 11.5 16.5 16.51
3 9 10.6 12 20.7 20.71 88.4 92.5 109.3 109.31 10.2 11.1 15.9 15.91
3 9 10.6 12 20.7 20.71 88.4 92.5 109.3 109.31 10.2 11.1 15.9 15.91
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61 10.1 10.9 15.6 15.61
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 11.4 12.3 17 17.01
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 13.3 14.4 20.2 20.21
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 13.7 14.9 21 21.01
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 10.2 11.1 15.9 15.91
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21 10.6 11.5 16.5 16.51
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21 10.2 11.1 15.9 15.91
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81 11 11.9 16.4 16.41
3 4 10.1 11.3 19.2 19.21 85.8 89.8 105.7 105.71 10.4 11.3 16.2 16.21
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 10.8 11.7 16.1 16.11
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 9.9 10.7 15.3 15.31
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 9.9 10.7 15.3 15.31
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21 10.1 10.9 15 15.01
2 10 9.8 11 17.8 17.81 83.9 87.5 102 102.01 9.7 10.5 14.5 14.51
2 8 9.1 10.3 17.1 17.11 81.3 84.9 99.4 99.41 9.3 10.1 14.4 14.41
2 7 9.5 10.7 17.1 17.11 82.3 85.7 99.6 99.61 8.7 9.4 13.1 13.11
2 6 9.4 10.5 16.9 16.91 81.7 85.1 98.7 98.71 9.7 10.5 14.5 14.51
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91 9.1 9.8 13.6 13.61
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01 10.1 10.9 15 15.01
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 9.7 10.5 15 15.01
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 9.9 10.7 15.3 15.31
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 8.1 8.8 12.6 12.61
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 8.1 8.8 12.6 12.61
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 8.1 8.8 12.6 12.61
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91 8.5 9.2 12.8 12.81
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91 7.8 8.5 12.1 12.11
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 9.3 10 13.9 13.91
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91 9.5 10.2 14.2 14.21
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 8 8.7 12.4 12.41
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91 8.4 9.1 12.6 12.61
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.2 8.9 12.4 12.41
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.2 7.8 11.2 11.21
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41 7.7 8.3 11.9 11.91
1 4 6.9 7.7 12.6 12.61 70.2 73 84.2 84.21 7.1 7.7 11 11.01
1 3 7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21 7.9 8.6 12 12.01
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51 7.1 7.7 11 11.01
1 0 6.3 7 11.5 11.51 66.3 68.9 79.2 79.21 6.9 7.5 10.8 10.81
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 7.3 7.9 11 11.01
0 9 6.4 7.1 11 11.01 65.2 67.5 76.5 76.51 6.6 7.2 10 10.01
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 5.8 6.3 9.1 9.11
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6.6 7.2 10.3 10.31
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.6 6.1 8.8 8.81
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 6.3 6.8 9.4 9.41
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51 6.1 6.6 9.2 9.21
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 5.7 6.2 8.6 8.61
0 7 5.3 6 9.8 9.81 60.3 62.7 71.9 71.91 5.3 5.7 8.3 8.31
0 4 4.9 5.6 8.7 8.71 57.6 59.7 68 68.01 5.1 5.6 7.7 7.71
1 9 8.2 9.2 14.5 14.51 76.5 79.4 90.9 90.91 8.2 8.9 12.4 12.41
0 3 4 4.5 7.5 7.51 53.5 55.6 64 64.01 3.7 4 5.8 5.81
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21 10.1 10.9 15 15.01
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 4.1 4.5 6.5 6.51
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 4.1 4.5 6.5 6.51
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11 10.5 11.3 15.6 15.61
3 11 10.8 12.2 21.2 21.21 89.3 93.6 110.7 110.71 10.6 11.5 16.5 16.51
0 1 2.9 3.4 5.8 5.81 48.9 50.8 58.6 58.61 3.8 4.1 5.8 5.81
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : ANGGREK 2
07. TIPE DESA/KELURAHAN : PEDESAAN
B T B
STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR UMU BB KET TB B B
/
R / BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
U U T
#REF! B
MUHAMMAD RAFFA L 30 Agustus 2018 5/17/2023 56 Buruk Sangat Pendek Sangat Kurus
2
MUHAMMAD ALIF L 13 Februari 2018 3/16/2023 61 Buruk Sangat Pendek Sangat Kurus
3
MUHAMMAD ZAYYAN L 07 Desember 2018 5/17/2023 53 Buruk Sangat Pendek Sangat Kurus
4
KIARA P 08 April 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
5
EREEN FAZIRA P 12 Juli 2018 5/17/2023 58 Buruk Sangat Pendek Sangat Kurus
6
CARISA NUR ASYKIN P 19 September 2018 5/17/2023 56 12.4 T 95.0 Kurang Pendek Normal
7
MUHAMAD GIBRAN L 28 Januari 2019 5/17/2023 51 14.2 T 99.0 Baik Normal Normal
8
NAJWA P 11 Februari 2019 5/17/2023 51 Buruk Sangat Pendek Sangat Kurus
9
KARISMA ARINI P 29 Januari 2019 5/17/2023 51 17 T 109.0 Baik Normal Normal
10
WIDI IBRAHIM L 02 November 2019 5/17/2023 42 Buruk Sangat Pendek Sangat Kurus
11
JULIANA NINGSIH P 27 Juli 2020 5/17/2023 33 13 T 95.0 Baik Normal Normal
12
RINA RIANA P 27 Mei 2020 5/17/2023 35 11 T 89.0 Baik Normal Normal
13
LINDA MARISA BELA P 04 Maret 2021 5/17/2023 26 10.3 T 81.0 Baik Normal Normal
14
MUHAMAD AZKA L 23 Agustus 2021 5/17/2023 20 11 T 83.0 Baik Normal Normal
15
MUHAMAD AQSA L 23 Agustus 2021 5/17/2023 20 11 T 83.0 Baik Normal Normal
16
MUHAMAD KHALID ALFARIQ L 17 Juli 2021 5/17/2023 22 Buruk Sangat Pendek Sangat Kurus
17
MUHAMAD MALIKI KHAIRAN L 30 Desember 2021 5/17/2023 16 Buruk Sangat Pendek Sangat Kurus
18
ARSYFA ZUNAIRAH NASUTIO P 10 Desember 2021 5/17/2023 17 Buruk Sangat Pendek Sangat Kurus
19
JURIANA P 12 Februari 2022 5/17/2023 15 7.2 T 70.0 Kurang Pendek Normal
20
SALWA SAPUTRI P 28 Januari 2022 5/17/2023 15 10.6 T 74.0 Baik Normal Normal
21
RODEARDO L 22 April 2022 5/17/2023 12 8.8 T 72.0 Baik Normal Normal
22
RANGGA L 09 Februari 2022 5/17/2023 15 Buruk Sangat Pendek Sangat Kurus
23
FAUZIAH P 01 Maret 2022 5/17/2023 14 Buruk Sangat Pendek Sangat Kurus
24
MUHAMAD AFAN AL FATIH L 27 Februari 2022 5/17/2023 14 9.2 O 74.0 Baik Normal Normal
25
AISYAH NUR AQILA P 24 Februari 2020 5/17/2023 38 11 O 86.0 Kurang Pendek Normal
26
RAMDANI L 30 April 2022 5/17/2023 12 9.5 T 72.0 Baik Normal Normal
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71
5 1 0 0 0 0 96.1 100.7 119.2 119.21
4 5 11.7 13.3 22.4 22.41 93 97.4 114.9 114.91
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 10 11.9 13.5 24.4 24.41 94.3 99 117.7 117.71
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 10.6 11.5 16.5 16.51
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 11.8 12.7 17.6 17.61
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 13.7 15 21.8 21.81
3 6 10.6 12 19.7 19.71 88 91.9 107.8 107.81
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31 10.6 11.5 16.5 16.51
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 9.5 10.3 14.7 14.71
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11 8 8.7 12.4 12.41
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.7 9.4 13.1 13.11
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.7 9.4 13.1 13.11
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91
1 4 7.5 8.4 13.1 13.11 72.5 75 85.4 85.41
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01 6.3 6.9 9.9 9.91
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01 6.9 7.5 10.8 10.81
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7 7.6 10.5 10.51
1 3 7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21
1 2 6.6 7.4 12.1 12.11 68.3 71 81.7 81.71
1 2 7.2 8.1 12.6 12.61 70.6 73.1 83 83.01 7.3 7.9 11 11.01
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 8.9 9.7 13.8 13.81
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7 7.6 10.5 10.51
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : ANGGREK 3
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
RADITA L 17 Januari 2018 2/15/2023 61 Buruk Sangat Pendek Sangat Kurus
2
CAMELIA P 26 Agustus 2018 5/15/2023 56 18 N 110.0 Baik Normal Normal
3
EL CAIRA P 23 April 2018 5/15/2023 60 Buruk Sangat Pendek Sangat Kurus
4
KURNIAWAN L 12 September 2018 5/15/2023 56 16.7 T 106.0 Baik Normal Normal
5
AL QALIF L 19 April 2019 5/15/2023 48 15.1 N 100.0 Baik Normal Normal
6
NAULI TERESIA P 24 Oktober 2019 5/15/2023 42 15.1 N 103.0 Baik Normal Normal
7
M. DAFFI L 22 April 2020 5/15/2023 36 14.7 N 96.0 Baik Normal Normal
8
SAHLAN L 04 Juli 2021 5/15/2023 22 9.8 N 81.0 Baik Normal Normal
9
NAYLA P 16 Juli 2021 5/15/2023 22 11 N 79.0 Baik Normal Normal
10
25 Juni 2018 12/15/2022 53 ### ### ###
11
23 Agustus 2018 12/15/2022 51 ### ### ###
12
31 Agustus 2018 12/15/2022 51 ### ### ###
13
03 Oktober 2018 12/15/2022 50 ### ### ###
14
05 Januari 2019 12/15/2022 47 ### ### ###
15
17 Januari 2019 12/15/2022 47 ### ### ###
16
04 Juni 2019 12/15/2022 42 ### ### ###
17
21 Mei 2019 12/15/2022 42 ### ### ###
18
19 Juli 2019 12/15/2022 41 ### ### ###
19
08 September 2019 12/15/2022 39 ### ### ###
20
21 Agustus 2019 12/15/2022 39 ### ### ###
21
05 September 2019 12/15/2022 39 ### ### ###
22
08 Agustus 2019 12/15/2022 40 ### ### ###
23
14 Agustus 2019 12/15/2022 40 ### ### ###
24
13 November 2019 12/15/2022 37 ### ### ###
25
23 Desember 2019 12/15/2022 35 ### ### ###
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 1 0 0 0 0 96.1 100.7 119.2 119.21
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51 14 15.3 22.3 22.31
5 0 0 0 0 0 95.2 99.9 118.9 118.91
4 8 12 13.6 23.2 23.21 94.3 98.8 116.7 116.71 13.3 14.4 20.2 20.21
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 12 12.9 18 18.01
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21 12.3 13.3 19.2 19.21
3 0 10 11.3 18.3 18.31 85 88.7 103.5 103.51 11.2 12.1 16.7 16.71
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 8.4 9.1 12.6 12.61
1 10 7.8 8.7 14.3 14.31 75.2 78.4 90.8 90.81 7.7 8.3 11.9 11.91
4 5 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 2 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 5 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5 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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : TERATAI
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
MUHAMMAD RIZIQ L 30 April 2018 5/17/2023 60 Buruk Sangat Pendek Sangat Kurus
2
NURIN ATIKA BELA P 11 April 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
3
DIKA ADITIA L 25 Mei 2018 5/17/2023 59 Buruk Sangat Pendek Sangat Kurus
4
MUSTIKA PUTRI P 20 Juli 2019 5/17/2023 46 15.3 O 101.0 Baik Normal Normal
5
KHAIRA ARSILA P 04 Oktober 2019 5/17/2023 43 Buruk Sangat Pendek Sangat Kurus
6
MIKAILA ELINA AZZAHRA P 10 September 2019 5/17/2023 44 Buruk Sangat Pendek Sangat Kurus
7
DELISA SAKIRA P. P 05 November 2019 5/17/2023 42 Buruk Sangat Pendek Sangat Kurus
8
MENTARI P 20 November 2019 5/17/2023 41 10.4 N 89.0 Kurang Pendek Normal
9
MUHAMMAD RIZKI L 22 November 2019 5/17/2023 41 Buruk Sangat Pendek Sangat Kurus
10
M. HANIF ARIQIN L 25 April 2019 5/17/2023 48 12.9 N 95.0 Baik Normal Normal
11
WAHYU L 26 Mei 2019 5/17/2023 47 15.5 O 97.0 Baik Normal Normal
12
ASRAF ZAKWAN L 08 Maret 2020 5/17/2023 38 13.7 O 94.0 Baik Normal Normal
13
NURAYA P 20 Juni 2020 5/17/2023 35 13 T 88.0 Baik Normal Normal
14
MALIKA ILYANA NZ. P 14 Desember 2020 5/17/2023 29 13 T 90.0 Baik Normal Normal
15
MUHAMAD ABIZAR L 30 November 2020 5/17/2023 29 10.4 O 82.0 Kurang Pendek Normal
16
AISYAH HUMAIRA P 02 April 2020 5/17/2023 37 11.9 N 89.0 Baik Normal Normal
17
VIONA AMELIA LESTARY P 08 November 2021 5/17/2023 18 8.5 O 75.0 Baik Normal Normal
18
ASYABIYYA NATASA P 15 Desember 2021 5/17/2023 17 9.7 N 77.0 Baik Normal Normal
19
MUTIARA NURASIFA P 21 Januari 2021 5/17/2023 27 15 O 88.0 Baik Normal Gemuk
20
ALFATAN ALFAHRIZI L 12 Januari 2021 5/17/2023 28 11.7 O 88.0 Baik Normal Normal
21
ALYA HUMAIRAH PUSPITA S. P 14 Maret 2021 5/17/2023 26 Buruk Sangat Pendek Sangat Kurus
22
ADINDA AZ ZAHRA P 11 April 2021 5/17/2023 25 Buruk Sangat Pendek Sangat Kurus
23
DIANA KALIFA PUTRI P 30 Maret 2021 5/17/2023 25 10.2 O 81.0 Baik Normal Normal
24
AZZAHRA SHAQUEENA H. P 23 September 2021 5/17/2023 19 11 N 80.0 Baik Normal Normal
25
ARUMI NUR FAIZZAH EMI P 26 Maret 2022 5/17/2023 13 Buruk Sangat Pendek Sangat Kurus
26
KEYSA AISHWA NAHLA P 26 Juni 2022 5/17/2023 10 7.1 T 69.0 Baik Normal Normal
27
ALFA RISKHA ASMA KHAISA P 03 September 2022 5/17/2023 8 Buruk Sangat Pendek Sangat Kurus
28
HASELA ZAHARA P 02 April 2022 5/17/2023 13 Buruk Sangat Pendek Sangat Kurus
29
M. AFFAN AL FATIH L 02 Oktober 2021 5/17/2023 19 Buruk Sangat Pendek Sangat Kurus
30
MAULIYA NUR FAZIRA P 23 Oktober 2018 5/17/2023 54 Buruk Sangat Pendek Sangat Kurus
31
ALIFIA RAHMAWATI FAZILA P 01 Februari 2022 5/17/2023 15 9 T 73.0 Baik Normal Normal
32
RAFASYA QIYASIRAWAN L 25 April 2019 5/17/2023 48 12.1 T 94.0 Kurang Pendek Normal
33
M. ZAFRAN L 02 September 2022 5/17/2023 8 6.7 T 65.0 Kurang Pendek Normal
34
NILA AYANA FATIHAH P 16 November 2022 5/17/2023 6 Buruk Sangat Pendek Sangat Kurus
35
HANNY SAKILA RAHMA P 02 September 2018 5/17/2023 56 Buruk Sangat Pendek Sangat Kurus
36
IFRA MIKAILA P 28 April 2018 5/17/2023 60 Buruk Sangat Pendek Sangat Kurus
37
M. RISKI ABDILA L 03 Mei 2021 5/17/2023 24 10 T 82.0 Baik Normal Normal
38
RIAN ADRIANSYAH L 25 November 2022 5/17/2023 5 7.9 N 63.0 Baik Normal Normal
39
SAKILA PUTRI L. P 14 Desember 2018 5/17/2023 53 10 O 91.0 Buruk Sangat Pendek Kurus
40
AL FARISKY NURRAHMAN L 22 April 2019 5/17/2023 48 13 T 96.0 Baik Normal Normal
41
AL FARISKA ASMA P 03 September 2022 5/17/2023 8 7 T 65.0 Baik Normal Normal
42
PUTRY DHUHA NUR ASYIFA P 23 Februari 2023 5/17/2023 2 4.1 B 54.0 Baik Normal Normal
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 96.1 100.7 119.2 119.21
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 11 12.3 14 23.9 23.91 95.6 100.2 118.6 118.61
3 10 10.7 12.1 20.9 20.91 88.9 93.1 110 110.01 11.8 12.8 18.5 18.51
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91
3 8 10.5 11.8 20.4 20.41 87.9 92 108.6 108.61
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21
3 5 10.2 11.5 19.5 19.51 86.3 90.4 106.4 106.41 9.5 10.3 14.7 14.71
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 11 11.9 16.4 16.41
3 11 11.1 12.6 20.9 20.91 90.3 94.4 111.1 111.11 11.4 12.3 17 17.01
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 10.8 11.7 16.1 16.11
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 9.3 10.1 14.4 14.41
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 9.7 10.5 15 15.01
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91 8.5 9.2 12.8 12.81
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 9.5 10.3 14.7 14.71
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 7.1 7.7 11 11.01
1 5 7 7.9 12.9 12.91 71.1 74 85.4 85.41 7.4 8 11.5 11.51
2 3 8.5 9.5 15.7 15.71 78.1 81.5 95 95.01 9.3 10.1 14.4 14.41
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01 9.7 10.5 14.5 14.51
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 8 8.7 12.4 12.41
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.8 8.5 12.1 12.11
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6.1 6.7 9.6 9.61
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01 6.8 7.4 10.6 10.61
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 10.8 11.7 16.1 16.11
0 8 6.2 6.9 10.7 10.71 64 66.2 75 75.01 5.7 6.2 8.6 8.61
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51
5 0 0 0 0 0 95.2 99.9 118.9 118.91
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.5 9.2 12.8 12.81
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 5.3 5.8 8 8.01
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 9.9 10.7 15.3 15.31
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 11.2 12.1 16.7 16.71
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 5.5 5.9 8.6 8.61
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11 3.3 3.6 5.2 5.21
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : PERMATA HATI
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
KHAIRUL CHANDRA L 06 November 2018 5/16/2023 54 Buruk Sangat Pendek Sangat Kurus
2
SARAH AULIA P 18 November 2018 5/16/2023 54 13.3 N 100.0 Baik Normal Normal
3
ADITYA SYAH PUTRA L 26 Desember 2018 5/16/2023 52 Buruk Sangat Pendek Sangat Kurus
4
AHMAD JOHARI L 30 Juli 2019 5/16/2023 45 15.1 N 100.0 Baik Normal Normal
5
KABIR AHMAT L 01 Agustus 2019 5/16/2023 45 Buruk Sangat Pendek Sangat Kurus
6
SALSA BILA P 06 Agustus 2019 5/16/2023 45 Buruk Sangat Pendek Sangat Kurus
7
NADIA FAZIRA P 24 Februari 2020 5/16/2023 38 Buruk Sangat Pendek Sangat Kurus
8
M. ARIFIN L 11 Maret 2020 5/16/2023 38 12 N 95.0 Baik Normal Normal
9
SITI PATIMAH ZAHRA P 26 Maret 2020 5/16/2023 37 13.2 N 98.0 Baik Normal Normal
10
AL HAFIZ L 19 Mei 2020 5/16/2023 36 12.5 N 94.0 Baik Normal Normal
11
FITRI YANI SABILA P 11 Juni 2020 5/16/2023 35 10.8 N 90.0 Baik Normal Normal
12
DIO ALFAMZI L 18 Juni 2020 5/16/2023 35 15.2 N 96.0 Baik Normal Normal
13
AMANDA SAPUTRI P 27 Desember 2020 5/16/2023 28 12.2 N 92.0 Baik Normal Normal
14
SAHRI RAMADAN L 03 Mei 2021 5/16/2023 24 9.5 T 82.0 Kurang Normal Normal
15
ADAWIYAH P 20 Juli 2021 5/16/2023 22 10 N 86.0 Baik Normal Normal
16
KHALIA PERMATA P 22 Agustus 2021 5/16/2023 20 Buruk Sangat Pendek Sangat Kurus
17
MAULANA ZUBEL L 24 Agustus 2021 5/16/2023 20 9.6 N 80.0 Baik Normal Normal
18
MUHAMMAD RAIZAN L 21 November 2021 5/16/2023 17 Buruk Sangat Pendek Sangat Kurus
19
TAKISHA ZOYA P 04 Oktober 2021 5/16/2023 19 Buruk Sangat Pendek Sangat Kurus
20
M. KASIMSYAH F. L 29 Januari 2022 5/16/2023 15 9.2 N 80.0 Baik Normal Normal
21
HASELA ZAHRA P 02 April 2022 5/16/2023 13 Buruk Sangat Pendek Sangat Kurus
22
ADIT L 09 Maret 2022 5/16/2023 14 11.3 N 78.0 Baik Normal Normal
23
ARUMI P 11 September 2022 5/16/2023 8 8 N 70.0 Baik Normal Normal
24
BAHER NUR HUDA L 26 September 2022 5/16/2023 7 7.6 N 67.0 Baik Normal Normal
25
FAIKSON L 11 September 2021 5/16/2023 20 16.3 O 88.0 Lebih Normal Gemuk
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 6 11.8 13.4 22.7 22.71 93.4 97.8 115.5 115.51
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21 11.6 12.6 18.1 18.11
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81 12 12.9 18 18.01
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81
3 9 10.6 12 20.7 20.71 88.4 92.5 109.3 109.31
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 11 11.9 16.4 16.41
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 11.2 12.2 17.5 17.51
2 12 10 11.3 18.3 18.31 85 88.7 103.5 103.51 10.8 11.7 16.1 16.11
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 9.7 10.5 15 15.01
2 11 9.9 11.2 18.1 18.11 84.4 88.1 102.7 102.71 11.2 12.1 16.7 16.71
2 4 8.6 9.7 16 16.01 78.8 82.2 96 96.01 10.1 10.9 15.6 15.61
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.5 9.2 12.8 12.81
1 10 7.8 8.7 14.3 14.31 75.2 78.4 90.8 90.81 8.9 9.7 13.8 13.81
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.2 8.9 12.4 12.41
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61
1 3 7.4 8.3 12.8 12.81 71.6 74.1 84.2 84.21 8.2 8.9 12.4 12.41
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51
1 2 7.2 8.1 12.6 12.61 70.6 73.1 83 83.01 7.9 8.6 12 12.01
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6.3 6.9 9.9 9.91
0 7 5.9 6.7 10.3 10.31 62.7 64.8 73.5 73.51 6.1 6.6 9.2 9.21
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 9.7 10.5 14.5 14.51
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : SEDAP MALAM
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 98.0 U U
B
MUHAMMAD AL FATIH L 23 Juli 2018 5/16/2023 57 13.7 N Kurang Pendek Normal
2
KHAIRI RANDA AFRIZAN L 24 April 2018 5/16/2023 60 13.7 T 100.0 Kurang Pendek Normal
3
KHANZA NOR AZKIA P 23 September 2018 5/16/2023 55 15.6 T 104.0 Baik Normal Normal
4
MUHAMMAD AQIL ARRAYAN L 13 September 2019 5/16/2023 44 11.9 T 90.0 Kurang Pendek Normal
5
MUHAMMAD HAFIZ L 01 Januari 2021 5/16/2023 28 9.7 T 82.0 Kurang Pendek Normal
6
M. UZAIR AL FAHRI L 04 Maret 2020 5/16/2023 38 13.3 N 95.0 Baik Normal Normal
7
INDAH SARI P 31 Oktober 2021 5/16/2023 18 6.8 T 72.0 Buruk Sangat Pendek Kurus
8
HAFID HADORI L 09 September 2021 5/16/2023 20 12.4 N 82.0 Baik Normal Normal
9
ALFIN WILYAN L 15 November 2021 5/16/2023 18 8.3 N 75.0 Kurang Pendek Normal
10
NURUL FATEHA P 18 Mei 2022 5/16/2023 12 7.6 T 70.0 Baik Normal Normal
11
AHMAD FARHAN AZIQ L 06 Juni 2022 5/16/2023 11 9.2 T 71.0 Baik Normal Normal
12
MUHAMMAD PADIL AL MUML 28 Januari 2023 5/16/2023 3 5.7 T 60.0 Baik Normal Normal
13
03 Oktober 2018 12/15/2022 50 ### ### ###
14
05 Januari 2019 12/15/2022 47 ### ### ###
15
17 Januari 2019 12/15/2022 47 ### ### ###
16
04 Juni 2019 12/15/2022 42 ### ### ###
17
21 Mei 2019 12/15/2022 42 ### ### ###
18
19 Juli 2019 12/15/2022 41 ### ### ###
19
08 September 2019 12/15/2022 39 ### ### ###
20
21 Agustus 2019 12/15/2022 39 ### ### ###
21
05 September 2019 12/15/2022 39 ### ### ###
22
08 Agustus 2019 12/15/2022 40 ### ### ###
23
14 Agustus 2019 12/15/2022 40 ### ### ###
24
13 November 2019 12/15/2022 37 ### ### ###
25
23 Desember 2019 12/15/2022 35 ### ### ###
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 9 12.1 13.7 23.4 23.41 94.7 99.3 117.4 117.41 11.6 12.5 17.3 17.31
5 0 0 0 0 0 96.1 100.7 119.2 119.21 12 12.9 18 18.01
4 7 11.6 13.2 23.5 23.51 93 97.6 115.9 115.91 12.5 13.6 19.6 19.61
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 10.1 10.9 15 15.01
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01 8.5 9.2 12.8 12.81
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01 11 11.9 16.4 16.41
1 6 7.2 8.1 13.2 13.21 72 74.9 86.5 86.51 6.6 7.2 10.3 10.31
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.5 9.2 12.8 12.81
1 6 7.8 8.8 13.7 13.71 74.2 76.9 87.7 87.71 7.5 8.1 11.3 11.31
0 12 6.3 7 11.5 11.51 66.3 68.9 79.2 79.21 6.3 6.9 9.9 9.91
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 6.8 7.4 10.2 10.21
0 3 4.4 5 8 8.01 55.3 57.3 65.5 65.51 4.7 5.1 7.1 7.11
4 2 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 5 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : JENAWI
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
KEN ACHILES PRADIPTA L 22 Maret 2018 2/17/2023 59 Buruk Sangat Pendek Sangat Kurus
2
SAFIRA LOVITA AZKA S. P 27 Maret 2018 5/17/2023 61 Buruk Sangat Pendek Sangat Kurus
3
ANINDITA KEISHA ZAHRA P 19 Mei 2018 5/17/2023 60 14.5 T 104.0 Baik Normal Normal
4
ASHILA RAHMADANI P 21 Mei 2018 5/17/2023 60 16.7 O 100.0 Baik Normal Normal
5
SYAFIRA WIDY SENA P 27 Mei 2018 5/17/2023 59 18.3 T 109.0 Baik Normal Normal
6
DITA HERTIANAH P 18 Juli 2018 5/17/2023 58 Buruk Sangat Pendek Sangat Kurus
7
KAYLILA ORLIN P 29 Juli 2018 5/17/2023 57 17.9 N 107.0 Baik Normal Normal
8
DIKHA RADITYA W. L 21 Desember 2019 5/17/2023 40 Buruk Sangat Pendek Sangat Kurus
9
SHAQUEENA KHANZA P 23 Oktober 2018 5/17/2023 54 18.5 T 106.0 Baik Normal Normal
10
SANDYA GARWITA A. P 21 November 2018 5/17/2023 53 Buruk Sangat Pendek Sangat Kurus
11
ALZEIN NAJMA P 22 November 2018 5/17/2023 53 12.8 T 100.0 Kurang Normal Normal
12
AISYAH NAURA PUTRI P 23 Desember 2018 5/17/2023 52 20.4 N 107.0 Baik Normal Normal
13
YUNA AUDIA P 01 Februari 2019 5/17/2023 51 15 N 97.0 Baik Normal Normal
14
SA'ID SULTAN L 17 Januari 2019 5/17/2023 52 16.6 T 100.0 Baik Normal Normal
15
SABRIYA ALMAHYRA ACHMA P 29 Januari 2019 5/17/2023 51 12.7 T 96.0 Kurang Normal Normal
16
MUHAMMAD L 03 Januari 2019 5/17/2023 52 16.7 N 100.0 Baik Normal Normal
17
MOH. ADRIAN W. S. L 20 Maret 2019 5/17/2023 49 Buruk Sangat Pendek Sangat Kurus
18
M. SYAFAR L 10 Mei 2019 5/17/2023 48 12 O 92.0 Kurang Pendek Normal
19
DEVIA INGGRID P 17 November 2019 5/17/2023 42 12.7 N 93.0 Baik Normal Normal
20
RAZQA ALBIRUNI L 12 Oktober 2019 5/17/2023 43 12.5 O 93.0 Baik Normal Normal
21
KENZO XAVIER L 20 Desember 2019 5/17/2023 40 14.1 N 96.0 Baik Normal Normal
22
RAQUEENSHA KEINARRA P 20 Februari 2020 5/17/2023 38 16.6 T 98.0 Baik Normal Normal
23
TYARA SHAFIRA RAMADHAN P 27 April 2020 5/17/2023 36 17 O 96.0 Baik Normal Gemuk
24
SALSA KURNIASIH P 19 Juni 2020 5/17/2023 35 13.6 N 92.0 Baik Normal Normal
25
LAKSITA ZAHRA T. P 09 April 2020 5/17/2023 37 18.5 N 100.0 Lebih Normal Gemuk
26
JAGAT SATRIA L 16 September 2020 5/17/2023 32 17.7 N 97.0 Lebih Normal Gemuk
27
KHAULA NUR P 26 November 2020 5/17/2023 29 9.4 T 84.0 Kurang Normal Normal
28
M. ARRAFI JUNAIDI L 22 Desember 2020 5/17/2023 28 12.1 N 86.0 Baik Normal Normal
29
M. ZAYN AL FATIH L 23 Desember 2020 5/17/2023 28 Buruk Sangat Pendek Sangat Kurus
30
MUHAMAD DZIKRI AL FARIZQL 01 Desember 2021 5/17/2023 17 Buruk Sangat Pendek Sangat Kurus
31
ZEAN ALFARIZZY CANDRA L 25 Februari 2021 5/17/2023 26 Buruk Sangat Pendek Sangat Kurus
32
DESENDRIA RAEFAL L 03 Desember 2021 5/17/2023 17 Buruk Sangat Pendek Sangat Kurus
33
NIKEISHA ARDIANI P 04 Maret 2021 5/17/2023 26 Buruk Sangat Pendek Sangat Kurus
34
ARANSANG PINAYUNG L 25 Juni 2020 5/17/2023 34 Buruk Sangat Pendek Sangat Kurus
35
M. JALAMANGKARA L 06 September 2021 5/17/2023 20 10.4 T 81.0 Baik Normal Normal
36
ARSYLA PRISCANARA R. P 25 November 2020 5/17/2023 29 12.4 N 85.0 Baik Normal Normal
37
M. ATHARASKA RAFIZQI L 07 Mei 2021 5/17/2023 24 11.7 T 83.0 Baik Normal Normal
38
ALGIS RAFFASYA L 08 April 2021 5/17/2023 25 13 O 83.0 Baik Normal Normal
39
MARIA JOVANKA P 08 Juni 2021 5/17/2023 23 11.2 T 81.0 Baik Normal Normal
40
MADEENA NIJI P. P 18 Agustus 2021 5/17/2023 21 Buruk Sangat Pendek Sangat Kurus
41
KARTIKA AVICENNA P 09 Agustus 2021 5/17/2023 21 11.2 T 82.0 Baik Normal Normal
42
FELISHA NAYRA PRAWESTI P 19 Oktober 2021 5/17/2023 19 10.1 T 77.0 Baik Normal Normal
43
ARSENIO CALIEFA GURNIAW L 15 Desember 2021 5/17/2023 17 9.5 O 78.0 Baik Normal Normal
44
MEISYA AZZAHRA ALKASTOL P 19 Januari 2022 5/17/2023 15 Buruk Sangat Pendek Sangat Kurus
45
ABQARI EMIER BAGAWANTA L 02 April 2022 5/17/2023 13 9.5 O 78.0 Baik Normal Normal
46
NAZLA HARUNI NURFI P 04 September 2022 5/17/2023 8 7.5 O 69.0 Baik Normal Normal
47
SHEZA ARISHA A. P 14 April 2022 5/17/2023 13 8.1 T 72.0 Baik Normal Normal
48
BANAFASHA NATHIFA MEHR P 16 Januari 2022 5/17/2023 16 Buruk Sangat Pendek Sangat Kurus
49
NAYLA SHAKI A. P 08 Agustus 2022 5/17/2023 9 7.6 T 70.0 Baik Normal Normal
50
ARRASYA K. LUBIS L 20 Oktober 2022 5/17/2023 6 9 O 71.0 Baik Normal Normal
51
PARSHA CLENIA L 09 November 2022 5/17/2023 6 7 T 68.0 Baik Normal Normal
52
IRSHAQUEEN KHALEEFAH H. P 26 Desember 2022 5/17/2023 4 7.6 N 65.0 Baik Normal Normal
53
M. AMRAN R. L 08 Maret 2020 5/17/2023 38 Buruk Sangat Pendek Sangat Kurus
54
KEYLA NOVIANTY P 14 November 2022 5/17/2023 6 6.7 T 65.0 Baik Normal Normal
55
BANAFASHA PRITA R. P 02 November 2022 5/17/2023 6 8.9 T 67.0 Baik Normal Normal
56
M. AL FAHRI L 05 Juli 2021 5/17/2023 22 11.1 T 81.0 Baik Normal Normal
57
TIARA ANINDITA SUHENDAR P 18 Agustus 2022 5/17/2023 9 Buruk Sangat Pendek Sangat Kurus
58
ATIKA TSABITA P 11 Juli 2022 5/17/2023 10 8.9 N 70.0 Baik Normal Normal
59
ALTAN GHIFARI L 15 Februari 2019 5/17/2023 51 16.4 N 100.0 Baik Normal Normal
60
SATRIA BUHMI YUDHA L 22 April 2019 5/17/2023 48 18 N 109.0 Baik Normal Normal
61
VELENCIA PUTRI INFANTRI P 06 April 2022 5/17/2023 13 9.8 N 74.0 Baik Normal Normal
62
GENEVA SHALOM A. P 18 Agustus 2022 5/17/2023 9 8 N 73.0 Baik Normal Normal
63
ALVAN WIRA SAMUDRA L 30 November 2022 5/17/2023 5 8.1 T 69.0 Baik Normal Normal
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###


16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
115 08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 11 12.3 14 23.9 23.91 95.6 100.2 118.6 118.61
5 1 0 0 0 0 95.2 99.9 118.9 118.91
4 12 0 0 0 0 95.2 99.9 118.9 118.91 12.5 13.6 19.6 19.61
4 12 0 0 0 0 95.2 99.9 118.9 118.91 11.6 12.6 18.1 18.11
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31 13.7 15 21.8 21.81
4 10 11.9 13.5 24.4 24.41 94.3 99 117.7 117.71
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 13.2 14.4 20.9 20.91
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41
4 6 11.5 13 23.2 23.21 92.6 97.1 115.2 115.21 13 14.1 20.5 20.51
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61
4 5 11.4 12.9 22.9 22.91 92.1 96.6 114.6 114.61 11.6 12.6 18.1 18.11
4 4 11.3 12.8 22.6 22.61 91.7 96.1 114 114.01 13.2 14.4 20.9 20.91
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 11 12 17.1 17.11
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 12 12.9 18 18.01
4 3 11.2 12.7 22.4 22.41 91.2 95.6 113.3 113.31 10.8 11.7 16.8 16.81
4 4 11.6 13.2 22.2 22.21 92.5 96.9 114.2 114.21 12 12.9 18 18.01
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 10.5 11.3 15.6 15.61
3 6 10.3 11.6 19.8 19.81 86.8 90.9 107.2 107.21 10.2 11.1 15.9 15.91
3 7 10.7 12.1 20 20.01 88.4 92.4 108.5 108.51 10.7 11.5 15.8 15.81
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41 11.2 12.1 16.7 16.71
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21 11.2 12.2 17.5 17.51
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 10.8 11.7 16.8 16.81
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 10.1 10.9 15.6 15.61
3 1 9.7 10.9 18.4 18.41 84.2 88 103.4 103.41 11.6 12.6 18.1 18.11
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41 11.4 12.3 17 17.01
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 8.5 9.2 13.2 13.21
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01 9.3 10 13.9 13.91
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51
2 2 8.9 10 15.8 15.81 79.3 82.5 95.2 95.21
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51
2 2 8.4 9.4 15.4 15.41 77.5 80.8 94.1 94.11
2 10 9.8 11 17.8 17.81 83.9 87.5 102 102.01
1 8 8.1 9.1 14.2 14.21 75.8 78.6 89.8 89.81 8.4 9.1 12.6 12.61
2 5 8.8 9.8 16.2 16.21 79.5 82.9 96.9 96.91 8.7 9.4 13.5 13.51
2 0 8.6 9.7 15.3 15.31 78.7 81.7 93.9 93.91 8.7 9.4 13.1 13.11
2 1 8.8 9.8 15.5 15.51 78.6 81.7 94.2 94.21 8.7 9.4 13.1 13.11
1 11 7.9 8.9 14.6 14.61 76 79.2 91.9 91.91 8 8.7 12.4 12.41
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81
1 9 7.6 8.6 14 14.01 74.5 77.5 89.8 89.81 8.1 8.8 12.6 12.61
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.4 8 11.5 11.51
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 7.9 8.6 12 12.01
1 3 6.7 7.6 12.4 12.41 69.3 72 83 83.01
1 1 7.1 7.9 12.3 12.31 69.6 72.1 81.8 81.81 7.9 8.6 12 12.01
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6.1 6.7 9.6 9.61
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51 6.6 7.2 10.3 10.31
1 4 6.9 7.7 12.6 12.61 70.2 73 84.2 84.21
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 6.3 6.9 9.9 9.91
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 6.8 7.4 10.2 10.21
0 6 5.7 6.4 9.8 9.81 61.2 63.3 71.9 71.91 6.3 6.8 9.4 9.41
0 4 4.4 5 8.2 8.21 55.6 57.8 66.4 66.41 5.5 5.9 8.6 8.61
3 2 10.2 11.5 18.8 18.81 86 89.9 105 105.01
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31 5.5 5.9 8.6 8.61
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31 5.8 6.3 9.1 9.11
1 10 8.4 9.4 14.7 14.71 77.2 80.2 91.9 91.91 8.4 9.1 12.6 12.61
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6.3 6.9 9.9 9.91
4 3 11.5 13.1 21.9 21.91 92.1 96.4 113.6 113.61 12 12.9 18 18.01
4 0 11.2 12.7 21.2 21.21 90.7 94.9 111.7 111.71 14 15.1 21.4 21.41
1 1 6.4 7.2 11.8 11.81 67.3 70 80.5 80.51 6.9 7.5 10.8 10.81
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 6.8 7.4 10.6 10.61
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 6.5 7 9.7 9.71
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : CEMPAKA
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
ARUMI P 30 Agustus 2018 5/10/2023 56 Buruk Sangat Pendek Sangat Kurus
2
ZAHFRAN L 20 Maret 2019 5/10/2023 49 16.4 T 109.0 Baik Normal Normal
3
NUHA P 30 September 2019 5/10/2023 43 Buruk Sangat Pendek Sangat Kurus
4
NAIRA P 10 Juni 2020 5/10/2023 35 11.8 N 95.0 Baik Normal Normal
5
ALISHA P 20 Juni 2022 5/10/2023 10 8.5 T 70.0 Baik Normal Normal
6
ARRUBY L 29 Juni 2022 5/10/2023 10 9.8 N 76.0 Baik Normal Normal
7
AMEENA P 06 Agustus 2022 5/10/2023 9 9 T 69.0 Baik Normal Normal
8
NUMA P 01 September 2022 5/10/2023 8 Buruk Sangat Pendek Sangat Kurus
9
IQLIMA P 05 September 2022 5/10/2023 8 9.4 N 68.0 Baik Normal Normal
10
25 Juni 2018 12/15/2022 53 ### ### ###
11
23 Agustus 2018 12/15/2022 51 ### ### ###
12
31 Agustus 2018 12/15/2022 51 ### ### ###
13
03 Oktober 2018 12/15/2022 50 ### ### ###
14
05 Januari 2019 12/15/2022 47 ### ### ###
15
17 Januari 2019 12/15/2022 47 ### ### ###
16
04 Juni 2019 12/15/2022 42 ### ### ###
17
21 Mei 2019 12/15/2022 42 ### ### ###
18
19 Juli 2019 12/15/2022 41 ### ### ###
19
08 September 2019 12/15/2022 39 ### ### ###
20
21 Agustus 2019 12/15/2022 39 ### ### ###
21
05 September 2019 12/15/2022 39 ### ### ###
22
08 Agustus 2019 12/15/2022 40 ### ### ###
23
14 Agustus 2019 12/15/2022 40 ### ### ###
24
13 November 2019 12/15/2022 37 ### ### ###
25
23 Desember 2019 12/15/2022 35 ### ### ###
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 8 11.7 13.3 23.8 23.81 93.4 98.1 116.5 116.51
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41 14 15.1 21.4 21.41
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91
2 11 9.5 10.7 17.9 17.91 83.1 86.8 101.9 101.91 10.6 11.5 16.5 16.51
0 10 5.9 6.7 10.9 10.91 64.1 66.5 76.4 76.41 6.3 6.9 9.9 9.91
0 10 6.6 7.4 11.4 11.41 66.4 68.7 77.9 77.91 7.6 8.3 11.5 11.51
0 9 5.8 6.5 10.5 10.51 62.9 65.3 75 75.01 6.1 6.7 9.6 9.61
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51
0 8 5.6 6.3 10.2 10.21 61.7 64 73.5 73.51 6 6.5 9.4 9.41
4 5 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 2 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 5 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : SETOKOK MADANI
07. TIPE DESA/KELURAHAN : PEDESAAN
B T B
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B /
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! 110.0 U U B
MYA QALESYA P 20 Mei 2018 5/12/2023 59 15.6 T Baik Normal Normal
2
JUWITA P 06 Agustus 2018 5/12/2023 57 15.8 N 99.0 Baik Normal Normal
3
ABDUL SOMAT AL FATIH L 08 November 2018 5/12/2023 54 13.7 N 99.0 Baik Normal Normal
4
ALIFA SUHAILA P 20 Maret 2019 5/12/2023 49 Buruk Sangat Pendek Sangat Kurus
5
ANANDA HAFIS L 27 Maret 2019 5/12/2023 49 Buruk Sangat Pendek Sangat Kurus
6
SYAHIRA HAYATUL H. P 14 Mei 2019 5/12/2023 48 12.3 O 93.0 Kurang Pendek Normal
7
MARVEL L 21 Juli 2019 5/12/2023 45 Buruk Sangat Pendek Sangat Kurus
8
SYAFIQ REIFALDI L 09 Agustus 2019 5/12/2023 45 Buruk Sangat Pendek Sangat Kurus
9
GUSTI AGUNG PERMANA L 19 Agustus 2019 5/12/2023 44 13.9 O 95.0 Baik Normal Normal
10
NAZLA ZULAIKHA P 17 September 2019 5/12/2023 43 22.5 N 105.0 Lebih Normal Gemuk
11
M. AL FATIH L 19 November 2019 5/12/2023 41 Buruk Sangat Pendek Sangat Kurus
12
ALBI SUHAIMI L 07 Januari 2020 5/12/2023 40 Buruk Sangat Pendek Sangat Kurus
13
AKILA PUTRI AFIRA P 11 Maret 2020 5/12/2023 38 Buruk Sangat Pendek Sangat Kurus
14
MARCEL JULIANTA FIRGI L 28 Maret 2020 5/12/2023 37 Buruk Sangat Pendek Sangat Kurus
15
MUHAMAD RIDHO AL FANDI L 16 Mei 2020 5/12/2023 36 Buruk Sangat Pendek Sangat Kurus
16
NUR HAZILA P 10 Mei 2020 5/12/2023 36 10.5 T 90.0 Kurang Normal Kurus
17
ALEXA NATHANIA IMERI ZEG P 14 Agustus 2020 5/12/2023 33 Buruk Sangat Pendek Sangat Kurus
18
MUHAMMAD SYUHADA RIZKIL 14 September 2020 5/12/2023 32 Buruk Sangat Pendek Sangat Kurus
19
WAHID FARAZ FATHONY L 06 Januari 2021 5/12/2023 28 13.3 T 90.0 Baik Normal Normal
20
MAUDI FADILA P 21 Maret 2021 5/12/2023 25 17.1 N 92.0 Lebih Normal Gemuk
21
AISYAH MUTIARA ANDINI P 22 April 2021 5/12/2023 24 10.5 T 81.0 Baik Normal Normal
22
MUHAMAD HAZIQ L 05 Juni 2021 5/12/2023 23 Buruk Sangat Pendek Sangat Kurus
23
RAHMA ISMAWATI P 12 September 2021 5/12/2023 20 10.6 N 80.0 Baik Normal Normal
24
KHUMAIR WILAN SAPUTRA L 15 September 2021 5/12/2023 19 6.4 O 64.0 Buruk Sangat Pendek Normal
25
NAILA P 27 September 2021 5/12/2023 19 9.5 N 78.0 Baik Normal Normal
26
MUHAMMAD AHDA SABLIA L 20 Oktober 2021 5/12/2023 18 Buruk Sangat Pendek Sangat Kurus
27
ZIKRAN ZAKIR AL ZAIN L 24 November 2021 5/12/2023 17 10.6 O 78.0 Baik Normal Normal
28
MUHAMMAD SYAHADAT L 25 Desember 2021 5/12/2023 16 8.7 T 76.0 Baik Normal Normal
29
MUHAMAD NAKULA IRWANS L 11 Januari 2022 5/12/2023 16 Buruk Sangat Pendek Sangat Kurus
30
REIFANSYAH L 03 Juni 2022 5/12/2023 11 8.1 N 70.0 Baik Normal Normal
31
M. GAFI ABDILAH L 28 Juni 2022 5/12/2023 10 9 N 69.0 Baik Normal Normal
32
FATHIN NURUL ASIFA P 21 Oktober 2022 5/12/2023 6 Buruk Sangat Pendek Sangat Kurus
33
MUHAMMAD HAIKAL NOVRI L 18 November 2022 5/12/2023 5 7.3 N 62.0 Baik Normal Normal
34
M. GAZI HARUN A. A. L 05 Juni 2022 5/12/2023 11 Buruk Sangat Pendek Sangat Kurus
35
FAHIRA NAYLA TSABITA P 21 Februari 2023 5/12/2023 2 Buruk Sangat Pendek Sangat Kurus
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
4 11 12 13.6 24.6 24.61 94.7 99.5 118.3 118.31 14 15.3 22.3 22.31
4 9 11.8 13.4 24.1 24.11 93.9 98.5 117.1 117.11 11.4 12.4 17.8 17.81
4 6 11.8 13.4 22.7 22.71 93.4 97.8 115.5 115.51 11.8 12.7 17.6 17.61
4 1 11 12.4 21.8 21.81 90.3 94.6 112 112.01
4 1 11.3 12.8 21.4 21.41 91.2 95.4 112.4 112.41
3 12 10.9 12.3 21.5 21.51 89.8 94.1 111.3 111.31 10.2 11.1 15.9 15.91
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81
3 9 10.9 12.4 20.5 20.51 89.4 93.5 109.8 109.81
3 8 10.8 12.2 20.2 20.21 88.9 93 109.1 109.11 11 11.9 16.4 16.41
3 7 10.4 11.7 20.1 20.11 87.4 91.5 107.9 107.91 12.7 13.8 20 20.01
3 5 10.5 11.9 19.5 19.51 87.5 91.4 107.1 107.11
3 4 10.4 11.8 19.3 19.31 87 90.9 106.4 106.41
3 2 9.8 11.1 18.7 18.71 84.7 88.6 104.2 104.21
3 1 10.1 11.4 18.6 18.61 85.5 89.2 104.2 104.21
2 12 10 11.3 18.3 18.31 85 88.7 103.5 103.51
3 0 9.6 10.8 18.1 18.11 83.6 87.4 102.7 102.71 9.7 10.5 15 15.01
2 9 9.3 10.4 17.3 17.31 81.9 85.6 100.3 100.31
2 8 9.6 10.8 17.4 17.41 82.8 86.4 100.4 100.41
2 4 9.1 10.2 16.3 16.31 80.5 83.8 97 97.01 10.1 10.9 15 15.01
2 1 8.2 9.2 15.1 15.11 76.8 80 93.1 93.11 10.1 10.9 15.6 15.61
2 0 8.1 9 14.8 14.81 76.7 80 92.9 92.91 8 8.7 12.4 12.41
1 11 8.5 9.5 15 15.01 78 81 92.9 92.91
1 8 7.5 8.4 13.7 13.71 73.7 76.7 88.7 88.71 7.8 8.5 12.1 12.11
1 7 8 8.9 13.9 13.91 75 77.7 88.8 88.81 5.5 6 8.3 8.31
1 7 7.3 8.2 13.5 13.51 72.8 75.8 87.6 87.61 7.5 8.2 11.7 11.71
1 6 7.8 8.8 13.7 13.71 74.2 76.9 87.7 87.71
1 5 7.7 8.6 13.4 13.41 73.3 76 86.5 86.51 7.9 8.6 12 12.01
1 4 7.5 8.4 13.1 13.11 72.5 75 85.4 85.41 7.6 8.3 11.5 11.51
1 4 7.5 8.4 13.1 13.11 72.5 75 85.4 85.41
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21 6.6 7.2 10 10.01
0 10 6.6 7.4 11.4 11.41 66.4 68.7 77.9 77.91 6.5 7 9.7 9.71
0 6 5.1 5.7 9.3 9.31 58.9 61.2 70.3 70.31
0 5 5.3 6 9.3 9.31 59.6 61.7 70.1 70.11 5.1 5.6 7.7 7.71
0 11 6.8 7.6 11.7 11.71 67.6 69.9 79.2 79.21
0 2 3.4 3.9 6.6 6.61 51 53 61.1 61.11
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMULIR PENCATATAN
PEMANTAUAN STATUS GIZI (PSG) BALITA
TAHUN : 2023

01. PROPINSI : KEPULAUAN RIAU


02. KABUPATEN/KOTA : KOTA BATAM
03. KECAMATAN : BULANG
04. NAMA DESA/KELURAHAN : SETOKOK
05. JUMLAH BALITA DITIMBANG :
06. NAMA KLASTER : BUNGA MAWAR
07. TIPE DESA/KELURAHAN : PEDESAAN
B
B T
UMU STATUS GIZIB
NO NAMA BALITA JK TGL LAHIR TGL UKUR R BB KET TB B B
/
/ BB/ U / TB/ U BB/ TB
1 2 3 4 5 6 7 8 9 ### 10 11 12
T
#REF! U U
B
WALDIYONO L 29 Januari 2018 2/15/2023 60 Buruk Sangat Pendek Sangat Kurus
2
M. RIEZIQ L 30 November 2020 5/15/2023 29 10 N 85.0 Kurang Normal Normal
3
RAFISKI JAYA L 07 Mei 2022 5/15/2023 12 12.8 T 75.0 Lebih Normal Gemuk
4
REZA JAYA PRATAMA L 08 September 2022 5/15/2023 8 9.1 N 75.0 Baik Normal Normal
5
EL FARAS SABRI L 01 Maret 2023 5/15/2023 2 6.2 N 62.0 Baik Normal Normal
6
15 April 2018 12/7/2022 55 ### ### ###
7
23 April 2018 12/7/2022 55 ### ### ###
8
04 Mei 2018 12/7/2022 55 ### ### ###
9
09 Juni 2018 12/7/2022 54 ### ### ###
10
25 Juni 2018 12/15/2022 53 ### ### ###
11
23 Agustus 2018 12/15/2022 51 ### ### ###
12
31 Agustus 2018 12/15/2022 51 ### ### ###
13
03 Oktober 2018 12/15/2022 50 ### ### ###
14
05 Januari 2019 12/15/2022 47 ### ### ###
15
17 Januari 2019 12/15/2022 47 ### ### ###
16
04 Juni 2019 12/15/2022 42 ### ### ###
17
21 Mei 2019 12/15/2022 42 ### ### ###
18
19 Juli 2019 12/15/2022 41 ### ### ###
19
08 September 2019 12/15/2022 39 ### ### ###
20
21 Agustus 2019 12/15/2022 39 ### ### ###
21
05 September 2019 12/15/2022 39 ### ### ###
22
08 Agustus 2019 12/15/2022 40 ### ### ###
23
14 Agustus 2019 12/15/2022 40 ### ### ###
24
13 November 2019 12/15/2022 37 ### ### ###
25
23 Desember 2019 12/15/2022 35 ### ### ###
26
14 Januari 2020 12/15/2022 35 ### ### ###
27
22 Januari 2020 12/15/2022 34 ### ### ###
28
21 Februari 2020 12/15/2022 33 ### ### ###
29
23 Maret 2020 12/15/2022 32 ### ### ###
30
06 Juli 2020 12/15/2022 29 ### ### ###
31
15 Agustus 2020 12/15/2022 28 ### ### ###
32
12 Agustus 2020 12/15/2022 28 ### ### ###
33
03 Juni 2020 12/15/2022 30 ### ### ###
34
27 November 2020 12/15/2022 24 ### ### ###
35
18 November 2020 12/15/2022 24 ### ### ###
36
20 Oktober 2020 12/15/2022 25 ### ### ###
37
10 Februari 2021 12/15/2022 22 ### ### ###
38
31 Mei 2021 12/15/2022 18 ### ### ###
39
28 November 2021 12/15/2022 12 ### ### ###
40
08 November 2021 12/15/2022 13 ### ### ###
41
18 Mei 2021 12/15/2022 19 ### ### ###
42
16 Juli 2021 12/15/2022 17 ### ### ###
43
15 Juli 2021 12/15/2022 17 ### ### ###
44
23 Oktober 2021 12/15/2022 13 ### ### ###
45
25 Januari 2022 12/15/2022 10 ### ### ###
46
14 Januari 2022 12/15/2022 11 ### ### ###
47
19 Februari 2022 12/15/2022 9 ### ### ###
48
28 Maret 2022 12/15/2022 8 ### ### ###
49
05 April 2022 12/15/2022 8 ### ### ###
50
15 Juni 2022 12/15/2022 6 ### ### ###
51
15 Mei 2022 12/15/2022 7 ### ### ###
52
09 Juli 2022 12/15/2022 5 ### ### ###
53
24 Juli 2022 12/15/2022 4 ### ### ###
54
29 Juli 2022 12/15/2022 4 ### ### ###
55
01 Agustus 2022 12/15/2022 4 ### ### ###
56
18 Agustus 2022 12/15/2022 3 ### ### ###
57
27 Agustus 2022 12/15/2022 3 ### ### ###
58
11 Oktober 2022 12/15/2022 2 ### ### ###
59
11 November 2022 12/15/2022 1 ### ### ###
60
28 November 2021 12/15/2022 12 ### ### ###
61
27 Desember 2021 12/15/2022 11 ### ### ###
62
23 Oktober 2021 12/15/2022 13 ### ### ###
63
14 Januari 2022 12/15/2022 11 ### ### ###
64
25 Januari 2022 12/15/2022 10 ### ### ###
65
28 Maret 2022 12/15/2022 8 ### ### ###
66
19 Februari 2022 12/15/2022 9 ### ### ###
67
27 Februari 2022 12/15/2022 9 ### ### ###
68
15 Juni 2022 12/15/2022 6 ### ### ###
69
05 April 2022 12/15/2022 8 ### ### ###
70
15 Juli 2021 12/15/2022 17 ### ### ###
71
09 Juli 2022 12/15/2022 5 ### ### ###
72
01 Agustus 2022 12/15/2022 4 ### ### ###
73
29 Juli 2022 12/15/2022 4 ### ### ###
74
24 Juli 2022 12/15/2022 4 ### ### ###
75
18 Agustus 2022 12/15/2022 3 ### ### ###
76
15 Mei 2022 12/15/2022 7 ### ### ###
77
11 Oktober 2022 12/15/2022 2 ### ### ###
78
03 Desember 2020 12/15/2021 12 ### ### ###
79
10 November 2020 12/15/2021 13 ### ### ###
80
05 September 2020 12/15/2021 15 ### ### ###

05 November 2020 12/15/2021 13 ### ### ###

14 Januari 2021 12/15/2021 11 ### ### ###

18 Mei 2021 12/15/2021 7 ### ### ###

15 Mei 2021 12/15/2021 7 ### ### ###

31 Mei 2021 12/15/2021 6 ### ### ###

16 Juli 2021 12/15/2021 5 ### ### ###

08 November 2021 12/15/2021 1 ### ### ###


05 September 2019 12/5/2019 3 ### ### ###
04 Juni 2019 12/5/2019 6 ### ### ###
18 April 2015 12/5/2019 55 ### ### ###
30 Oktober 2015 12/5/2019 49 ### ### ###
19 Juli 2019 12/5/2019 4 ### ### ###
21 Agustus 2019 12/5/2019 3 ### ### ###
08 September 2019 12/5/2019 2 ### ### ###
14 Agustus 2019 12/5/2019 3 ### ### ###
07 September 2019 12/5/2019 2 ### ### ###
30 September 2019 12/5/2019 2 ### ### ###
02 Agustus 2019 12/5/2019 4 ### ### ###
13 November 2019 12/5/2019 0 ### ### ###
22 April 2018 12/5/2019 19 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
08 Mei 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
23 April 2018 12/10/2018 7 ### ### ###
04 Mei 2018 12/10/2018 7 ### ### ###
07 Juni 2018 12/10/2018 6 ### ### ###
09 Juni 2018 12/10/2018 6 ### ### ###
24 Desember 2017 12/10/2018 11 ### ### ###
08 Maret 2017 12/10/2018 21 ### ### ###
25 Juni 2018 12/10/2018 5 ### ### ###
23 Agustus 2018 12/10/2018 3 ### ### ###
31 Agustus 2018 12/10/2018 3 ### ### ###
20 Maret 2018 12/10/2018 8 ### ### ###
03 Oktober 2018 12/10/2018 2 ### ### ###
08 Februari 2015 12/10/2018 46 ### ### ###
22 April 2018 12/10/2018 7 ### ### ###
05 April 2018 12/10/2018 8 ### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
### ### ###
1 2 3 4 5 6
BB/ U TB/ U BB/ TB
BRK BK KR LB SP P N T SK K N G
5 0 0 0 0 0 96.1 100.7 119.2 119.21
2 5 9.2 10.4 16.6 16.61 81.1 84.5 97.9 97.91 9.1 9.8 13.6 13.61
1 0 6.9 7.7 12 12.01 68.6 71 80.5 80.51 7.5 8.1 11.3 11.31
0 8 6.2 6.9 10.7 10.71 64 66.2 75 75.01 7.5 8.1 11.3 11.31
0 2 3.8 4.3 7.1 7.11 52.4 54.4 62.4 62.41 5.1 5.6 7.7 7.71
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 6 0 0 0 0 0 0 0 0 0 0 0 0
4 5 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 3 0 0 0 0 0 0 0 0 0 0 0 0
4 2 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 11 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 6 0 0 0 0 0 0 0 0 0 0 0 0
3 5 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 3 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 4 0 0 0 0 0 0 0 0 0 0 0 0
3 1 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 11 0 0 0 0 0 0 0 0 0 0 0 0
2 10 0 0 0 0 0 0 0 0 0 0 0 0
2 9 0 0 0 0 0 0 0 0 0 0 0 0
2 8 0 0 0 0 0 0 0 0 0 0 0 0
2 5 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 4 0 0 0 0 0 0 0 0 0 0 0 0
2 6 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
2 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0 0 0 0 0
1 10 0 0 0 0 0 0 0 0 0 0 0 0
1 6 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
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 1 0 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
1 5 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 7 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
1 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 0 0 0 0 0 0
1 3 0 0 0 0 0 0 0 0 0 0 0 0
1 1
0 0 0 0 0 0 0 0 0 0 0 0
0 11
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 7
0 0 0 0 0 0 0 0 0 0 0 0
0 6
0 0 0 0 0 0 0 0 0 0 0 0
0 5
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 3 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
4 7 0 0 0 0 0 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 3 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 3 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 2 0 0 0 0 0 0 0 0 0 0 0 0
0 4 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 6 0 0 0 0 0 0 0 0 0 0 0 0
0 11 0 0 0 0 0 0 0 0 0 0 0 0
1 9 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 3 0 0 0 0 0 0 0 0 0 0 0 0
0 8 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
3 10 0 0 0 0 0 0 0 0 0 0 0 0
0 7 0 0 0 0 0 0 0 0 0 0 0 0
0 8 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
REKAP HASIL PEMANTAUAN STATUS GIZI BALITA

Puskesmas : Bulang Kota Batam


Tahun : 2016

JML BALITA STATUS GIZI


NO KELURAHAN BB/U TB/U
DITIMBANG
Buruk Kurang Baik Lebih Sgt Pendek Pendek
L P L P L P L P L P L P L P

1 Bulang Lintang 79 68 1 0 12 4 60 62 6 2 1 0 8 5

2 Pulau Buluh 106 103 2 3 12 11 88 85 4 4 1 3 11 3

3 Temoyong 46 68 0 2 4 5 41 59 1 2 0 0 2 6

4 Batu Legong 46 50 4 2 8 5 34 42 0 1 3 2 5 1

5 Pantai Gelam 45 42 0 0 3 4 42 37 0 1 0 0 2 3

6 Setokok 148 169 5 9 15 12 125 144 3 4 4 3 10 7


Jumlah
470 500 12 16 54 41 390 429 14 14 9 8 38 25
Total
970 28 95 819 28 17 63
US GIZI BALITA

TATUS GIZI
BB/TB
Normal Sgt Kurus Kurus Normal Gemuk
L P L P L P L P L P

70 63 0 0 6 1 62 64 11 3

94 97 1 1 7 6 91 89 7 7

44 62 0 0 0 2 42 64 4 2

38 47 1 0 6 1 37 48 2 1

43 39 0 0 1 1 44 39 0 2

134 159 0 0 7 8 137 157 4 4

423 467 2 1 27 19 413 461 28 19

890 3 46 874 47

Yang Membuat Laporan


Pemegang Program Gizi

Siti Rodliyah
NIP. 19751015 200903 2 001
F III GIZI

D N T O B BGM

NO POSYANDU
A B C A B C A B C A B C A B C A B C

L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P

10

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