FORMAT PENCATATAN DAN PELAPORAN KESEHATAN LANJUT USIA DI UPTD.

PUSKESMAS JEUNIEB
PUSKESMAS : JEUNIEB
KABUPATEN : BIREUEN
BULAN : JULI
TAHUN : 2023

Sasaran Lansia Kunjungan Lansia Kegiatan sehari-hari Jumlah Lansia dengan Kelainan Pengobatan

Konseling
Jml Lansia dgn
Jumlah 45-59 60-69 > 70 45-59 60-69 > 70 Kemandirian IMT Tek. Darah
Jumlah kelainan Jumlah Panti Jumlah
Jumlah posyandu Kolesterol As. Urat Ggn Ggn Pemberdayaan
No Nama Desa Panti Ggn ME Hb Kurang DM Ggn ginjal Ggn kognitif Lain-lain penyuluhan Wredha Kunjungan Ket.
Posyandu aktif yang tinggi tinggi Penglihatan pendengaran Lansia
Wredha dibina Rumah
dilaksanakan L P L P L P L K T R Diobati Dirujuk

L P L P L P A B C B L S

B L B L B L B L B L B L 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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

1 ALUE LAMSABA 1 1 0 12 14 1 10 2 2 0 1 0 6 0 1 0 2 0 0 0 2 12 0 0 0 0 0 0 0 0 1 2 1 3 0 0 0 1 0 0 0 0 0 0 0 1 1 2 1 1 0 0 0 0 0 0 0 0 12 1 12 0 0

2 ALUE SEUTUI 1 1 0 21 18 14 12 2 7 0 6 0 11 0 1 0 0 0 1 0 4 21 2 0 0 0 0 0 0 0 2 3 2 7 0 0 0 0 1 1 2 1 0 0 0 1 1 6 1 3 0 0 0 0 0 0 0 0 23 1 21 0 0

3 BLANG LANCANG 1 1 0 55 58 37 55 15 20 0 2 0 2 0 1 0 8 0 1 0 8 22 0 0 0 0 0 0 0 0 1 4 1 3 0 0 2 3 1 1 0 3 0 0 0 0 1 6 0 1 0 0 0 0 0 0 0 0 22 1 22 0 0

4 BLANG ME BARAT 1 1 0 73 72 36 35 13 19 0 1 0 4 0 2 0 14 0 2 0 4 27 0 0 0 0 0 0 0 0 1 4 2 5 0 0 0 3 1 4 2 4 0 0 2 4 1 3 0 2 0 0 0 0 0 0 0 0 27 1 27 0 0

5 BLANG ME TIMU 1 1 0 68 79 29 38 8 11 0 2 0 5 0 1 0 3 0 2 0 3 16 0 0 0 0 0 0 0 0 0 3 0 2 0 0 1 7 1 1 0 1 0 0 0 0 1 2 1 3 0 0 0 0 0 0 0 0 16 1 16 0 0

6 BLANG NEUBOK 1 1 0 20 21 27 26 4 7 0 1 0 4 0 3 0 8 0 0 0 3 19 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 1 1 1 0 0 0 1 2 6 1 2 0 0 0 0 0 0 0 0 19 1 19 0 0

7 BLANG POROH 1 1 0 50 53 26 42 5 9 0 1 0 4 0 2 0 6 0 2 0 4 17 2 1 0 0 0 0 0 0 2 2 2 3 0 0 0 0 2 2 0 0 0 0 1 1 1 1 1 2 0 0 0 0 0 0 0 0 17 1 17 0 0

8 COT GEULUMPANG BAROH 1 1 0 43 34 30 45 7 15 0 4 0 5 0 2 2 9 0 0 1 2 25 0 0 0 0 0 0 0 0 2 3 0 4 0 0 0 1 0 2 0 4 0 0 0 0 1 4 0 2 0 0 0 0 0 0 0 0 25 1 25 0 0

9 COT GEULUMPANG TUNONG 1 1 0 31 35 23 25 4 5 0 5 2 11 1 5 1 7 0 1 0 4 36 0 0 0 0 0 0 0 0 3 9 1 10 0 0 1 5 0 8 4 4 0 0 0 0 1 3 1 2 0 0 0 0 0 0 0 0 36 1 36 0

10 DARUL AMAN 1 1 0 35 34 19 38 7 10 0 0 0 5 0 2 0 7 0 1 0 2 13 3 1 0 0 0 0 0 0 1 4 0 4 0 0 0 3 0 1 0 2 0 0 0 1 1 4 0 1 0 0 0 0 0 0 0 0 17 1 13 0 4

11 DAYAH BAROE 1 1 0 80 100 42 55 11 17 0 2 3 27 0 5 0 13 0 2 0 6 56 2 0 0 0 0 0 0 0 2 12 2 7 0 0 0 0 0 4 2 13 0 0 1 1 0 8 0 3 0 0 0 0 0 0 0 0 58 1 56 0 0

12 DAYAH BLANG RALEE 1 1 0 60 68 42 42 5 8 0 1 0 3 0 2 0 7 0 1 0 3 15 2 0 0 0 0 0 0 0 2 4 0 3 0 0 0 0 0 3 0 2 0 0 0 0 1 3 0 2 0 0 0 0 0 0 0 0 17 1 15 0 0

13 JANGGOT SEUNGKO 1 1 0 65 102 50 60 19 28 0 3 0 6 0 5 0 9 0 4 0 7 34 0 0 0 0 0 0 0 0 2 4 2 5 0 0 0 0 2 4 3 5 0 0 0 0 2 6 0 2 0 0 0 0 0 0 0 0 34 1 34 0 0

14 JEUMPA SIKUREUENG 1 1 0 30 27 30 28 8 12 0 1 0 2 0 1 0 5 0 1 0 6 16 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 16 1 16 0 0

15 KEUDE JEUNIEB 1 1 0 28 29 19 16 6 7 0 4 0 7 0 3 0 1 0 2 0 0 16 1 0 0 0 0 0 0 0 0 2 1 1 0 0 0 0 2 3 1 2 0 0 0 0 1 3 0 0 0 0 0 0 0 0 0 0 17 1 16 0 0

16 LAMPOH OE 1 1 0 48 47 28 27 10 15 0 2 0 4 0 2 0 6 0 2 0 5 21 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 2 1 3 0 0 0 0 2 3 1 2 0 0 0 0 0 0 0 0 21 1 21 0 0

17 LANCANG 1 1 0 74 47 22 22 10 15 0 0 0 5 0 1 0 6 0 2 0 2 16 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 1 0 0 0 0 0 0 1 3 1 1 0 0 0 0 0 0 0 0 16 1 16 0 0

18 LHEU BARAT 1 1 0 35 38 20 30 7 9 0 4 0 12 0 6 0 5 0 1 0 4 32 0 0 0 0 0 0 0 0 1 2 4 8 0 0 0 0 3 2 0 2 0 0 0 0 2 6 1 1 0 0 0 0 0 0 0 0 32 1 32 0 0

19. LHEU SIMPANG 1 1 0 76 105 56 50 23 25 0 2 0 10 1 2 2 12 0 2 1 8 38 2 0 0 0 0 0 0 0 2 6 1 3 0 0 0 6 0 0 1 7 0 0 1 1 2 6 1 2 0 0 0 0 0 0 0 0 40 1 38 0 0

20. LHOK KULAM 1 1 0 74 85 34 47 8 9 0 4 0 12 0 2 0 12 0 2 0 4 29 3 1 0 0 0 0 0 0 0 2 2 10 0 0 1 6 0 0 1 4 0 0 1 0 2 5 1 2 0 0 0 0 0 0 0 0 33 1 29 0 4

21. LUENG TEUNGOH 1 1 0 72 92 21 62 21 27 0 0 0 9 0 0 0 7 0 0 0 1 16 1 0 0 0 0 0 0 0 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 17 1 16 0 0

22. MATANG BANGKA 1 1 0 48 49 32 33 9 14 0 1 0 5 0 0 0 3 0 1 0 3 13 0 0 0 0 0 0 0 0 1 4 1 2 0 0 0 5 0 2 0 0 0 0 0 0 1 2 1 3 0 0 0 0 0 0 0 0 13 1 13 0 0

23. MATANG NIBONG 1 1 0 62 53 26 50 19 25 0 0 0 6 0 2 0 4 0 1 0 5 19 0 0 0 0 0 0 0 0 2 5 0 2 0 0 0 0 1 6 0 0 0 0 0 0 1 4 0 1 0 0 0 0 0 0 0 0 19 1 19 0 0

24. MATANG TEUNGOH 1 1 0 40 44 25 42 6 9 0 1 0 12 0 1 0 6 0 0 0 2 22 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 5 0 0 0 1 0 6 0 2 0 0 0 0 0 0 0 0 22 1 22 0 0

25. MEUNASAH ALUE 1 0 0 63 71 36 57 10 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26. MEUNASAH BLANG 1 1 0 62 57 35 33 10 17 0 0 0 5 0 0 0 4 0 1 0 4 14 0 0 0 0 0 0 0 0 1 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 0 0 0 0 0 0 0 0 0 14 1 14 0 0

27. MEUNASAH DAYAH 1 1 0 55 67 40 52 15 17 0 2 0 10 0 2 0 18 0 2 0 4 36 3 2 0 0 0 0 0 0 1 8 1 5 0 0 0 5 0 0 1 7 0 0 0 0 1 8 0 2 0 0 0 0 0 0 0 0 41 1 36 0 4

28. MEUNASAH KEUTAPANG 1 1 0 55 52 28 42 8 18 0 1 0 14 0 1 0 9 0 2 0 9 36 0 0 0 0 0 0 0 0 1 7 0 5 0 0 0 0 0 2 1 6 0 0 0 1 1 4 0 1 0 0 0 0 0 0 0 0 36 1 36 0 0

29 MEUNASAH KOTA 1 1 0 28 42 25 18 6 8 0 1 0 2 0 0 0 0 1 0 0 0 14 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 7 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 14 1 14 0 0

30 MEUNASAH KUPULA 1 1 0 55 55 41 44 20 18 0 2 0 16 0 2 0 4 0 1 0 5 30 0 0 0 0 0 0 0 0 1 6 1 2 0 0 1 2 0 1 1 2 0 0 0 1 1 6 1 2 0 0 0 0 0 0 0 0 30 1 30 0 0

31 MEUNASAH LUENG 1 1 0 53 59 30 47 14 19 0 1 0 4 0 2 0 6 0 2 0 4 17 2 1 0 0 0 0 0 0 2 2 2 3 0 0 0 0 2 2 0 0 0 0 1 1 1 1 1 2 0 0 0 0 0 0 0 0 17 1 17 0 0

32 MEUNASAH TAMBO 1 1 0 65 64 42 44 12 17 0 1 0 7 0 2 0 19 0 1 0 5 35 0 0 0 0 0 0 0 0 1 5 1 6 0 0 0 0 0 3 0 0 0 0 0 0 1 8 1 2 0 0 0 0 0 0 0 0 35 1 35 0 0

33 MEUNASAH TUNONG LUENG 1 1 0 55 67 40 42 12 20 0 2 0 1 0 1 0 2 0 2 0 4 3 8 1 0 0 0 0 0 0 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 3 1 1 0 0 0 0 0 0 0 0 12 1 3 0 12

34 PAYA BILI 1 0 0 22 23 13 18 4 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

35 PULO RANGKILEH 1 1 0 45 57 29 47 11 18 0 2 0 8 0 2 0 14 0 2 0 12 37 2 0 0 0 0 0 0 0 2 8 1 3 0 0 0 7 0 2 0 0 0 0 0 0 2 6 1 2 0 0 0 0 0 0 0 0 39 1 37 0 0

36 SAMPO AJAD 1 1 0 60 140 28 43 12 19 0 2 0 8 0 2 0 8 0 3 0 7 26 4 0 0 0 0 0 0 0 1 6 1 3 0 0 0 0 0 2 0 1 0 0 0 2 1 3 0 2 0 0 0 0 0 0 0 0 30 1 26 0 4

37 TANJONG BUNGONG 1 1 0 65 87 59 67 24 23 0 2 0 21 0 3 0 12 0 2 0 3 40 2 1 0 0 0 0 0 0 2 6 2 4 0 0 1 6 0 6 2 4 0 0 1 1 1 4 1 2 0 0 0 0 0 0 0 0 43 1 40 0 0

38 TEUPIN KUPULA 1 1 0 50 52 30 32 6 12 0 1 0 6 0 1 0 7 0 1 0 4 20 0 0 0 0 0 0 0 0 1 6 0 4 0 0 0 0 0 3 0 1 0 0 0 0 1 6 0 2 0 0 0 0 0 0 0 0 20 1 20 0 0

39 TUFAH 1 1 0 45 64 24 35 9 13 0 1 0 3 0 4 0 4 0 1 0 3 11 3 1 0 0 0 0 0 0 2 3 2 4 0 0 0 1 0 1 0 1 0 0 1 1 0 2 0 0 0 0 0 0 0 0 0 0 15 1 11 0 0

40 ULEE BLANG 1 1 0 45 53 30 40 12 13 0 0 0 13 0 1 0 5 0 1 0 5 25 0 0 0 0 0 0 0 0 0 9 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0

41 ULEE GAJAH 1 1 0 40 31 30 32 9 10 0 3 2 6 0 1 0 8 0 2 1 4 28 0 0 0 0 0 0 0 0 3 5 0 3 0 0 0 4 1 1 0 0 0 0 0 0 2 2 1 1 0 0 0 0 0 0 0 0 28 1 28 0

42 ULEE RABO 1 1 0 65 74 30 47 8 14 0 2 0 14 0 2 0 8 0 1 0 7 30 4 0 0 0 0 0 0 0 1 5 2 9 0 0 0 0 2 6 0 4 0 0 0 2 3 1 0 1 0 0 0 0 0 0 0 0 34 1 30 0 0

43 UTEUN PUPALEH 1 1 0 20 22 32 22 6 10 0 3 0 7 0 2 0 2 0 2 0 3 19 0 0 0 0 0 0 0 0 0 2 2 8 0 0 2 2 0 2 0 2 0 0 0 0 2 1 1 1 0 0 0 0 0 0 0 0 19 1 19 0 0

44 KUNJUNGAN PUSKESMAS 0 0 0 5 51 12 146 3 53 6 97 27 2 43 3 415 28 0 0 0 0 0 0 0 11 16 7 13 0 0 8 12 13 31 7 32 0 0 0 0 6 18 3 7 0 0 0 0 415 28 0 0 443 1 415 0 0

JUMLAH 43 41 0 2148 2441 1311 1652 437 616 0 74 7 322 2 80 5 290 1 57 3 175 972 74 9 0 0 0 0 0 0 46 189 45 190 0 0 17 86 32 111 31 123 0 0 9 22 52 179 23 71 0 0 0 0 415 0 0 0 1464 40 1362 0 28

Mengetahui Jeunieb, 02 Agustus 2023

 Kepala UPTD Puskesmas Jeunieb Petugas Manula UPTD Puskesmas Jeunieb

dr.Zubaidah 1. safwani, A.Md.Kep ( )

Penata TK.I NIP. 19800205 201408 2 003
NIP.19810321 201003 2 001