Form Program Ibu 2021 PKM Daaz

LAPORAN KESEHATAN IBU PUSKESMAS DARUL AZHAR
Bulan : JANUARI 2021

Form
1 (ANC)
Penggunaan Buku KIA K1 Murni K1 Akses (K1 keseluruhan) K4 K6 ABORTUS

NO. DESA Sasaran 20%
Bumil Bumil BLN BLN BLN BLN JAN BLN JAN ABS BLN JAN
JAN ABS % JAN ABS % JAN ABS % ABS % % ABS %
LALU LALU LALU LALU LALU LALU
1 BERSUJUD 240 48 0 15 15 6.25 0 14 14 5.8333 0 15 15 6.3 0 13 13 5.417 0 0 0 0 0 1 1 0.4167

TUNGKARAN 212 42 0 17 17 7.5472 0 17 17 8.0 0 15 15 7.075 0 0 0 0 0 0 0 0
2 PANGERAN 8.0189 0 16 16
G.UNUNG 29 0 16 16 10.884 0 16 16 10.9 0 15 15 10.2 0 0 0 0 0 0 0 0
3 ANTASARI 147 10.884 0 16 16
4 GUNUNG BESAR 175 35 0 20 20 11.429 0 17 17 9.7143 0 20 20 11.4 0 16 16 9.143 0 0 0 0 0 1 1 0.5714
5 BATU AMPAR 34 7 0 4 4 11.765 0 3 3 8.8235 0 4 4 11.8 0 2 2 5.882 0 0 0 0 0 0 0 0
JUMLAH 808 162 0 72 72 8.9109 0 72 72 8.9109 0 72 72 8.9 0 61 61 7.55 0 0 0 0 0 2 2 0.2475
Mengetahui
Kepala Puskesmas Darul Azhar Pengelola Program Kesehatan Ibu
dr. Mardalena Nurmaliana, AM. Keb

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
Status Bumil Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS %
0 6 6 2.5 0 3 3 1.25 0 9 9 3.75 0 1 1 0.417 0 0 0 0 0 13 13 5.4167

0 3 3 0.9434 0 9 9
1.4151 0 2 2 0.9434 0 2 2 0.9434 0 3 3 1.415 0 2 2 4.2453
0 0 0 0.6803 0 12 12
0 0 4 4 2.7211 0 3 3 2.04082 0 4 4 2.721 0 1 1 8.1633
0 1 1 0.5714 0 3 3 1.7143 0 5 5 2.85714 0 3 3 1.714 0 3 3 1.7143 0 14 14 8
0 2 2 5.8824 0 1 1 2.9412 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2.9412
0 12 12 1.4851 0 13 13 1.6089 0 19 19 2.35149 0 11 11 1.361 0 0 0 0 0 49 49 6.0644
DETEKSI RISIKO RUJUKAN KASUS RISTI
FE1 FE3
NAKES MASYARAKAT MATERNAL
BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS %
LALU LALU LALU LALU LALU
0 15 15 6.25 0 13 13 5.4167 0 2 2 4.167 0 0 0 0 0 1 1 2.083
0 17 17 8.0189 0 15 15 7.0755 0 3 3 7.075 0 1 1 2.358 0 2 2 4.717
0 16 16 10.884 0 15 15 10.204 0 2 2 6.803 0 0 0 0 0 2 2 6.803

0 20 20 11.429 0 16 16 9.1429 0 8 8 22.86 0 2 2 5.714 0 8 8 22.86
0 4 4 11.765 0 2 2 5.8824 0 0 0 0 0 0 0 0 0 0 0 0
0 72 72 8.9109 0 61 61 7.5495 0 15 15 9.282 0 0 0 0 0 13 13 8.045
LAPORAN KESEHATAN IBU PUSKESMAS DARUL AZHAR
Bulan
Form : FEBRUARI 2021
1 (ANC)
Penggunaan Buku KIA K1 Murni K1 Akses K4 K6 ABORTUS
Bumil Bumil BLN BLN FEB BLN BLN FEB ABS BLN FEB ABS BLN FEB
FEB ABS % ABS % FEB ABS % % % ABS %
1 BERSUJUD 240 48 15 14 29 12.083 14 13 27 12.083 15 14 29 12.1 13 5 18 7.5 0 5 5 2.083 1 0 1 0.4167

TUNGKARAN 212 42 17 16 33 31 15.566 17 16 33 15.6 15 15 30 14.15 0 7 7 3.302 0 1 1 0.4717
2 PANGERAN 15.566 16 15
G.UNUNG 29 16 13 29 29 19.728 16 13 29 19.7 15 10 25 17.01 0 10 10 6.803 0 0 0 0
3 ANTASARI 147 19.728 16 13
4 GUNUNG BESAR 175 35 20 21 41 23.429 17 21 38 23.429 20 21 41 23.4 16 13 29 16.57 0 5 5 2.857 1 1 2 1.1429
5 BATU AMPAR 34 7 4 5 9 26.471 3 5 8 26.471 4 5 9 26.5 2 5 7 20.59 2 4 6 17.65 0 0 0 0
JUMLAH 808 162 72 69 141 17.45 72 69 133 17.45 72 69 141 17.5 61 48 109 13.49 0 31 31 3.837 2 2 4 0.495
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS %
6 2 8 3.3333 3 4 7 2.9167 9 3 12 5 1 2 3 1.25 0 0 0 0 13 9 22 9.1667

3 2 5 1.4151 9 14 23
2.3585 2 5 7 3.3019 2 6 8 3.77358 3 2 5 2.358 2 1 3 10.849
0 5 5 3.4014 12 15 27
3.4014 4 3 7 4.7619 3 5 8 5.44218 4 3 7 4.762 1 4 5 18.367
1 0 1 0.5714 3 1 4 2.2857 5 1 6 3.42857 3 1 4 2.286 3 4 7 4 14 7 21 12
2 0 2 5.8824 1 2 3 8.8235 0 2 2 5.88235 0 1 1 2.941 0 0 0 0 1 5 6 17.647
12 9 21 2.599 13 15 28 3.4653 19 17 36 4.45545 11 9 20 2.475 0 9 9 1.1139 49 50 99 12.252
FE1 FE3
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS %
15 14 29 12.083 13 5 18 7.5 2 3 5 10.42 0 0 0 0 1 1 2 4.167
17 16 33 15.566 15 15 30 14.151 3 4 7 16.51 1 1 2 4.717 2 1 3 7.075
16 13 29 19.728 15 10 25 17.007 2 2 4 13.61 0 0 0 0 2 2 4 13.61

20 21 41 23.429 16 13 29 16.571 8 4 12 34.29 2 0 2 5.714 8 5 13 37.14
4 5 9 26.471 2 5 7 20.588 0 1 1 14.71 0 0 0 0 0 1 1 14.71
72 69 141 17.45 61 48 109 13.49 15 14 29 17.95 0 1 1 0.619 13 10 23 14.23
LAPORAN KESH. IBU PUSKESMAS DARUL AZHAR
Bulan : MARET 2021

Form
1 (ANC)
Bumil Bumil BLN BLN MAR ABS BLN MAR BLN MAR ABS BLN MAR ABS BLN MAR ABS
MAR ABS % % ABS % % % %
1 BERSUJUD 240 48 29 9 38 15.833 27 9 36 15 29 9 38 15.8 18 12 30 12.5 5 12 17 7.083 1 1 2 0.8333

TUNGKARAN 212 42 33 16 49 21.226 33 16 49 23.1 30 14 44 20.75 7 6 13 6.132 1 1 2 0.9434
2 PANGERAN 23.113 31 14 45
G.UNUNG 29 29 20 49 33.333 29 20 49 33.3 25 19 44 29.93 10 17 27 18.37 0 0 0 0
3 ANTASARI 147 33.333 29 20 49
4 GUNUNG BESAR 175 35 41 8 49 28 38 6 44 25.143 41 8 49 28.0 29 10 39 22.29 5 6 11 6.286 2 1 3 1.7143
5 BATU AMPAR 34 7 9 3 12 35.294 8 3 11 32.353 9 3 12 35.3 7 3 10 29.41 6 2 8 23.53 0 0 0 0
JUMLAH 808 162 141 56 197 24.381 133 52 185 22.896 141 56 197 24.4 109 58 167 20.67 31 33 64 7.921 4 3 7 0.8663
Mengetahui 20
Kepala Puskesmas Darul Azhar 18 Bidan Koordinator
12
15
3
dr. Mardalena 67 Yayuk Trisnawati, AM. Keb
Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS %
8 1 9 0 7 2 9 3.75 12 3 15 6.25 3 0 3 1.25 0 1 1 0.4167 22 6 28 11.667

5 3 8 1.4151 23 11 34
0 7 6 13 6.1321 8 4 12 5.66038 5 1 6 2.83 3 0 3 16.038
5 5 10 6.1224 27 15 42
0 7 4 11 7.483 8 4 12 8.16327 7 3 10 6.803 5 4 9 28.571
1 1 2 0 4 3 7 4 6 1 7 4 4 1 5 2.857 7 0 7 4 21 5 26 14.857
2 0 2 0 3 0 3 8.8235 2 1 3 8.82353 1 0 1 2.941 0 0 0 0 6 1 7 20.588
21 10 31 0 28 15 43 5.3218 36 13 49 6.06436 20 5 25 3.094 9 5 14 1.7327 99 38 137 16.955
FE1 FE3
BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS %
29 9 38 15.833 18 12 30 12.5 5 0 5 10.42 0 0 0 0 2 0 2 4.167
33 16 49 23.113 30 14 44 20.755 7 2 9 21.23 2 0 2 4.717 3 2 5 11.79
29 20 49 33.333 25 19 44 29.932 4 0 4 13.61 0 0 0 0 4 0 4 13.61

38 8 46 26.286 29 10 39 22.286 12 2 14 40 2 0 2 5.714 13 2 15 42.86
8 3 11 32.353 7 3 10 29.412 1 0 1 14.71 0 0 0 0 1 0 1 14.71
137 56 193 23.886 109 58 167 20.668 29 4 33 20.42 1 0 1 0.619 23 4 27 16.71
10.42
25.94
13.61
45.71
14.71
21.04
Bulan : APRIL 2021
Form
1 (ANC)
Bumil Bumil BLN BLN APR BLN APR BLN APR ABS BLN APR ABS BLN APR ABS
APR ABS % ABS % ABS % % % %
1 BERSUJUD 240 48 38 24 62 25.833 36 23 59 24.583 38 24 62 25.8 30 13 43 17.92 17 8 25 10.42 2 0 2 0.8333

TUNGKARAN 212 42 49 15 64 28.302 49 15 64 30.2 44 16 60 28.3 13 10 23 10.85 2 0 2 0.9434
2 PANGERAN 30.189 45 15 60
G.UNUNG 29 49 12 61 41.497 49 12 61 41.5 44 12 56 38.1 27 5 32 21.77 0 1 1 0.6803
3 ANTASARI 147 41.497 49 12 61
4 GUNUNG BESAR 175 35 49 24 73 41.714 44 24 68 38.857 49 24 73 41.7 39 10 49 28 11 5 16 9.143 3 1 4 2.2857
5 BATU AMPAR 34 7 12 2 14 41.176 11 2 13 38.235 12 2 14 41.2 10 2 12 35.29 8 2 10 29.41 0 0 0 0
JUMLAH 808 162 197 77 274 33.911 185 76 261 32.302 197 77 274 33.9 167 53 220 27.23 64 30 94 11.63 7 2 9 1.1139
Mengetahui
Kepala Puskesmas Darul Azhar Pengelola Progam Kes. Ibu
dr. H. Muhammad Erhamsyah Nurmaliana, AM. Keb

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS %
9 2 11 4.5833 9 8 17 7.0833 15 5 20 8.33333 3 3 6 2.5 1 0 1 0.4167 28 16 44 18.333

8 5 13 2.3585 34 10 44
6.1321 13 4 17 8.0189 12 3 15 7.07547 6 1 7 3.302 3 2 5 20.755
10 1 11 8.1633 42 11 53
7.483 11 3 14 9.5238 12 3 15 10.2041 10 2 12 8.163 9 3 12 36.054
2 1 3 1.7143 7 7 14 8 7 4 11 6.28571 5 3 8 4.571 7 2 9 5.1429 26 16 42 24
2 1 3 8.8235 3 2 5 14.706 3 0 3 8.82353 1 0 1 2.941 0 0 0 0 7 2 9 26.471
31 10 41 5.0743 43 24 67 8.2921 49 15 64 7.92079 25 9 34 4.208 20 7 27 3.3416 137 55 192 23.762
FE1 FE3
BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS %
38 24 62 25.833 30 13 43 17.917 5 6 11 22.92 0 1 1 2.083 2 0 2 4.167
49 15 64 30.189 44 16 60 28.302 9 1 10 23.58 2 1 3 7.075 5 2 7 16.51
49 12 61 41.497 44 12 56 38.095 4 1 5 17.01 0 0 0 0 4 1 5 17.01

46 24 70 40 39 10 49 28 14 1 15 42.86 2 0 2 5.714 15 2 17 48.57
11 2 13 38.235 10 2 12 35.294 1 0 1 14.71 0 0 0 0 1 1 2 29.41
193 77 270 33.416 167 53 220 27.228 33 9 42 25.99 1 0 1 0.619 27 6 33 20.42
Bulan : MEI 2021
Form
1 (ANC)

NO. KABUPATEN/ Sasaran 20%
KOTA Bumil Bumil BLN BLN MEI BLN BLN MEI ABS BLN MEI ABS BLN MEI
MEI ABS % ABS % MEI ABS % % % ABS %
1 BERSUJUD 240 48 62 17 79 32.917 59 17 76 32.917 62 17 79 32.9 43 12 55 22.92 25 12 37 15.42 2 0 2 0.8333

TUNGKARAN 212 42 64 16 80 37.736 64 16 80 37.7 60 14 74 34.91 23 8 31 14.62 2 0 2 0.9434
2 PANGERAN 37.736 60 15 75
G.UNUNG 29 61 8 69 46.939 61 8 69 46.9 56 8 64 43.54 32 8 40 27.21 1 0 1 0.6803
3 ANTASARI 147 46.939 61 8 69
4 GUNUNG BESAR 175 35 73 24 97 55.429 68 18 86 55.429 73 24 97 55.4 49 17 66 37.71 16 8 24 13.71 4 0 4 2.2857
5 BATU AMPAR 34 7 14 2 16 47.059 13 2 15 47.059 14 2 16 47.1 12 1 13 38.24 10 2 12 35.29 0 1 1 2.9412
JUMLAH 808 162 274 67 341 42.203 261 67 328 42.203 274 67 341 42.2 220 52 272 33.66 94 38 132 16.34 9 0 9 1.1139
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS %
11 0 11 4.5833 17 2 19 7.9167 20 1 21 8.75 6 0 6 2.5 1 0 1 0.4167 44 3 47 19.583

13 3 16 2.3585 44 13 57
7.5472 17 8 25 11.792 15 3 18 8.49057 7 2 9 4.245 5 0 5 26.887
11 2 13 9.5238 53 8 61
8.8435 14 2 16 10.884 15 2 17 11.5646 12 2 14 9.524 12 2 14 41.497
3 4 7 4 14 1 15 8.5714 11 2 13 7.42857 8 3 11 6.286 9 0 9 5.1429 42 6 48 27.429
3 0 3 8.8235 5 2 7 20.588 3 0 3 8.82353 1 0 1 2.941 0 0 0 0 9 2 11 32.353
41 9 50 6.1881 67 15 82 10.149 64 8 72 8.91089 34 7 41 5.074 27 0 27 3.3416 192 32 224 27.723
FE1 FE3
BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS %
62 17 79 32.917 43 12 55 22.917 11 0 11 22.92 1 1 2 4.167 2 0 2 4.167
64 16 80 37.736 60 14 74 34.906 10 3 13 30.66 3 2 5 11.79 7 2 9 21.23
61 8 69 46.939 56 8 64 43.537 5 2 7 23.81 0 0 0 0 5 2 7 23.81

70 24 94 53.714 49 17 66 37.714 15 3 18 51.43 2 0 2 5.714 17 1 18 51.43
13 2 15 44.118 12 1 13 38.235 1 1 2 29.41 0 0 0 0 2 1 3 44.12
270 67 337 41.708 220 52 272 33.663 42 9 51 31.56 1 3 4 2.475 33 6 39 24.13
Bulan : JUNI 2020
Form 1 (ANC)
Penggunaan Buku KIA K1 Murni K1 Akses K4 ABORTUS
Sasaran 20%
NO. KABUPATEN/ KOTA Bumil Bumil BLN BLN BLN BLN BLN
LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS %
1 BERSUJUD
TUNGKARAN 240 48 79 79 32.917 79 79 32.917 79 79 32.9 55 55 22.92 2 2 4.1667
2 PANGERAN 212 42 80 80 37.736 80 80 37.736 80 80 37.7 74 74 34.91 2 2 4.717
3 G.ANTASARI 147 29 69 69 46.939 69 69 46.939 69 69 46.9 64 64 43.54 1 1 3.4014
4 GUNUNG BESAR 175 35 97 97 55.429 97 97 55.429 97 97 55.4 66 66 37.71 4 4 11.429
5 BATU AMPAR 34 7 16 16 47.059 16 16 47.059 16 16 47.1 13 13 38.24 0 0 0
JUMLAH 808 162 341 0 341 42.203 341 0 341 42.203 341 0 341 42.2 272 0 272 33.66 9 0 9 5.5693
Mengetahui
Kepala Puskesmas Darul Azhar Bidan Koordinator
dr. Mardalena Yayuk Trisnawati, AM. Keb

Nip. 19791127 200904 2 Nip. 19850911 200904 2
005 002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN BLN BLN BLN BLN BLN
LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 0 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 0 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 0 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 0 11 32.353
50 0 50 6.1881 82 0 82 10.149 72 0 72 8.91089 41 0 41 5.074 27 0 27 3.3416 224 0 224 27.723
FE1 FE3
BLN BLN BLN BLN BLN
LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS % LALU JUNI ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 7 7 23.81 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 2 2 5.714 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 4 0 4 2.475 39 0 39 24.13
Bulan : JULI 2020 AZHA
PKM : DARUL R
Form
1 (ANC)
Bumil Bumil BLN BLN JULI BLN JULI BLN JULI ABS BLN JULI ABS
JULI ABS % ABS % ABS % % %
1 BERSUJUD 240 48 79 79 32.917 79 0 79 32.917 79 79 32.9 55 55 22.92 2 2 4.1667

2 T. PANGERAN 212 42 80 80 37.736 80 0 80 37.736 80 80 37.7 74 74 34.91 2 2 4.717
3 G.ANTASARI 147 29 69 69 46.939 69 0 69 46.939 69 69 46.9 64 64 43.54 1 1 3.4014
4 GUNUNG BESAR 175 35 97 97 55.429 97 0 97 55.429 97 97 55.4 66 66 37.71 4 4 11.429
5 BATU AMPAR 34 7 16 16 47.059 16 0 16 47.059 16 16 47.1 13 13 38.24 0 0 0
JUMLAH 808 162 341 0 341 42.203 341 0 341 42.203 341 0 341 42.2 272 0 272 33.66 9 0 9 5.5693
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2
002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 0 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 0 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 0 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 0 11 32.353
50 0 50 6.1881 82 0 82 10.149 72 0 72 8.91089 41 0 41 5.074 27 0 27 3.3416 224 0 224 27.723
FE1 FE3
BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS %
79 79 32.917 55 55 22.917 11 11 4.583 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 6.132 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 7 7 4.762 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 10.29 2 2 5.714 18 18 51.43
15 15 44.118 13 13 38.235 2 2 5.882 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 6.312 4 0 4 2.475 39 0 39 24.13
Bulan : AGUSTUS 2020
Form
1 (ANC)
NO. KABUPATEN/ Sasaran 20%
KOTA Bumil Bumil BLN BLN AGT BLN AGT BLN AGT ABS BLN AGT ABS
AGT ABS % ABS % ABS % % %
1 BERSUJUD 240 48 79 79 32.917 79 79 32.917 79 79 32.9 55 55 22.92 2 2 0.8333

2 T. PANGERAN 212 42 80 80 37.736 80 80 37.736 80 80 37.7 74 74 34.91 2 2 0.9434
3 G.ANTASARI 147 29 69 69 46.939 69 69 46.939 69 69 46.9 64 64 43.54 1 1 0.6803
4 GUNUNG BESAR 175 35 97 97 55.429 97 97 55.429 97 97 55.4 66 66 37.71 4 4 2.2857
5 BATU AMPAR 34 7 16 16 47.059 16 16 47.059 16 16 47.1 13 13 38.24 0 0 0
JUMLAH 808 162 341 0 341 42.203 341 0 341 42.203 341 0 341 42.2 272 0 272 33.66 9 0 9 1.1139
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2
002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN AGT ABS % BLN AGT ABS % BLN AGT ABS % BLN AGT ABS % BLN AGT ABS % BLN AGT ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 11 32.353
50 0 50 6.1881 82 0 82 10.149 72 0 72 8.91089 41 0 41 5.074 27 0 27 3.3416 224 0 224 27.723
FE1 FE3
BLN AGT ABS % BLN AGT ABS % BLN AGT ABS % BLN AGT ABS % BLN AGT ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 7 7 23.81 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 2 2 5.714 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 4 0 4 2.475 39 0 39 24.13
Bulan : SEPTEMBER 2020
Form
1 (ANC)
Bumil Bumil BLN BLN BLN BLN SEP BLN SEP
SEP ABS % SEP ABS % SEP ABS % ABS % ABS %
1 BERSUJUD 240 48 79 79 32.917 79 79 32.917 79 52 0.0 55 55 22.92 2 2 0.8333

2 T. PANGERAN 212 42.4 80 80 37.736 80 80 37.736 80 18 0.0 74 74 34.91 2 2 0.9434
3 G.ANTASARI 147 29.4 69 69 46.939 69 69 46.939 69 16 0.0 64 64 43.54 1 1 0.6803
4 GUNUNG BESAR 175 35 97 97 55.429 97 97 55.429 97 13 0.0 66 66 37.71 4 4 2.2857
5 BATU AMPAR 34 6.8 16 16 47.059 16 16 47.059 16 3 0.0 13 13 38.24 0 0 0
JUMLAH 808 161.6 341 0 341 42.203 341 0 341 42.203 341 102 443 54.8 272 0 272 33.66 9 0 9 1.1139
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 11 32.353
50 0 50 6.1881 82 0 82 10.149 72 0 72 8.91089 41 0 41 5.074 27 0 29 3.5891 224 0 224 27.723
FE1 FE3
BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 7 7 23.81 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 2 0 0 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 9 0 9 5.569 39 0 64 39.6
Bulan : OKTOBER 2020
Form
1 (ANC)
Bumil Bumil BLN BLN OKT ABS BLN OKT BLN OKT ABS BLN OKT ABS
OKT ABS % % ABS % % %
1 BERSUJUD 240 48 79 79 32.917 79 0 0 0 0 0.0 55 55 22.92 2 2 0.8333

2 T. PANGERAN 212 42.4 80 80 37.736 80 17 0 0 0 0.0 74 74 34.91 2 2 0.9434
3 G.ANTASARI 147 29.4 69 69 46.939 69 0 0 0 0 0.0 64 64 43.54 1 1 0.6803
4 GUNUNG BESAR 175 35 97 97 55.429 97 32 0 0 0 0.0 66 66 37.71 4 4 2.2857
5 BATU AMPAR 34 6.8 16 16 47.059 16 0 0 0 0 0.0 13 13 38.24 0 0 0
JUMLAH 808 161.6 341 0 341 42.203 341 0 341 42.203 443 0 443 54.8 272 0 272 33.66 9 0 9 1.1139
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 11 32.353
50 0 50 6.1881 82 0 82 10.149 72 0 72 8.91089 41 0 41 5.074 29 0 29 3.5891 224 0 224 27.723
FE1 FE3
BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 0 0 0 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 0 0 0 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 9 0 9 5.569 39 0 39 24.13
Bulan : NOVEMBER 2020
Form
1 (ANC)
Bumil Bumil BLN BLN NOV ABS BLN NOV BLN BLN NOV ABS
NOV ABS % % ABS % ABS % %
1 BERSUJUD 240 48 79 79 32.917 0 0 32.917 0 0 0.0 55 55 22.92 2 2 0.8333

2 T. PANGERAN 212 42 80 80 37.736 0 0 37.736 0 0 0.0 74 74 34.91 2 2 0.9434
3 G.ANTASARI 147 29 69 69 46.939 0 0 46.939 0 0 0.0 64 64 43.54 1 1 0.6803
4 GUNUNG BESAR 175 35 97 97 55.429 0 0 55.429 0 0 0.0 66 66 37.71 4 4 2.2857
5 BATU AMPAR 34 7 16 16 47.059 0 0 47.059 0 0 0.0 13 13 38.24 0 0 0
JUMLAH 808 162 341 0 341 42.203 341 0 341 42.203 443 0 443 54.8 272 0 272 33.66 9 0 9 1.1139
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 0 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 0 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 0 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 0 11 32.353
50 0 50 6.1881 82 0 82 10.149 47 0 47 5.81683 41 0 41 5.074 29 0 29 3.5891 224 0 224 27.723
FE1 FE3
BLN NOV ABS % BLN NOV OKT % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 0 0 0 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 0 0 0 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 9 0 9 5.569 39 0 39 24.13
Bulan : DESEMBER 2020
Form
1 (ANC)
Bumil Bumil BLN BLN DES BLN BLN DES ABS BLN DES
DES ABS % ABS % DES ABS % % ABS %
1 BERSUJUD 240 48 79 79 32.917 0 79 32.917 0 0 0.0 55 55 22.92 2 2 0.8333

2 T. PANGERAN 212 42 80 80 37.736 0 0 0 0 0 0.0 74 74 34.91 2 2 0.9434
3 G.ANTASARI 147 29 69 69 46.939 0 69 46.939 140 140 95.2 64 64 43.54 1 1 0.6803
4 GUNUNG BESAR 175 35 97 97 55.429 0 161 92 0 0 0.0 0 0 0 4 4 2.2857
5 BATU AMPAR 34 7 16 16 47.059 0 16 47.059 0 0 0.0 13 13 38.24 0 0 0
JUMLAH 808 162 341 0 341 42.203 341 0 341 42.203 443 0 443 54.8 272 0 272 33.66 9 0 9 1.1139
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
Status T Bumil
T1 T2 T3 T4 T5 T2+
BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS %
11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

16 16 7.5472 25 25 11.792 18 18 8.49057 9 9 4.245 5 5 2.3585 57 0 57 26.887
13 13 8.8435 16 16 10.884 17 17 11.5646 14 14 9.524 14 14 9.5238 61 0 61 41.497
7 7 4 15 15 8.5714 13 13 7.42857 11 11 6.286 9 9 5.1429 48 0 48 27.429
3 3 8.8235 7 7 20.588 3 3 8.82353 1 1 2.941 0 0 0 11 0 11 32.353
50 0 50 6.1881 82 0 82 10.149 0 0 72 8.91089 41 0 41 5.074 29 0 29 3.5891 224 0 224 27.723
FE1 FE3
BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS %
79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

80 80 37.736 74 74 34.906 13 13 30.66 5 5 11.79 9 9 21.23
69 69 46.939 64 64 43.537 0 0 0 0 0 0 7 7 23.81
94 94 53.714 66 66 37.714 18 18 51.43 0 0 0 18 18 51.43
15 15 44.118 13 13 38.235 2 2 29.41 0 0 0 3 3 44.12
337 0 337 41.708 272 0 272 33.663 51 0 51 31.56 9 0 9 5.569 39 0 39 24.13
PUSKESMAS: DARUL AZHAR
Bulan : JANUARI Tahun : 2021
Form (Persalinan Dan Nifas)
2
Persalinan Ditolong Nakes (PN)

PN DI FASYANKES
Sasaran 20% PN PUSTU, POSKESDES,
NO. DESA RS RS SWASTA, RSIB, KLINIK
Bulin Bulin POLINDES/PUSKESMAS
BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN LALU JAN ABS %
LALU LALU LALU
1 BERSUJUD 229 46 0 13 13 5.67686 0 2 2 0.87 0 10 10 4.37 0 1 1 0.44

2 T. PANGERAN 202 40 0 11 11 5.44554 0 3 3 1.49 0 8 8 3.96 0 0 0 0.00
3 G.UNUNG ANTASARI 140 28 0 15 15 10.7143 0 1 1 0.71 0 13 13 9.29 0 1 1 0.71
4 GUNUNG BESAR 167 33 0 17 17 10.1796 0 0 0 0.00 0 15 15 8.98 0 2 2 1.20
5 BATU AMPAR 33 7 0 1 1 3.0303 0 0 0 0.00 0 1 1 3.03 0 0 0 0.00
Jumlah 771 154 0 57 57 7.393 0 6 6 3.0728 0 47 47 6.10 0 4 4 2.349
inan Ditolong Nakes (PN)
Persalinan Ditolong Non Nakes Total Persalinan
PN DI NON FASYANKES
PN DI NON FASYANKES
total DI RUMAH DI PERJALANAN
total/abs %
pf BLN BLN BLN BLN BLN
JAN ABS % JAN ABS % JAN ABS % JAN ABS % JAN ABS %
13 13 5.68 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 13 13 5.68

11 11 5.45 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 11 11 5.45
15 15 10.71 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 15 15 10.71
17 17 10.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 17 17 10.18
1 1 3.03 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 1 1 3.03
57 57 7.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 57 7.39
Kunjungan Nifas (KF) PERIODE INPUT DATA
Komplikasi Maternal VIT A NIFAS
Ditangani (PK)
KF1 KF2 KF3 KF4
BUL
TAHUN
BLN JAN ABS BLN JAN BLN JAN BLN JAN BLN BLN JAN AN
% ABS % ABS % ABS % JAN ABS % ABS %
0 0 0 0.00 0 13 13 5.68 0 13 13 5.68 0 13 13 5.68 0 15 15 6.55 0 0.00 jan 2021

0 2 2 4.95 0 11 11 5.45 0 11 11 5.45 0 11 11 5.45 0 9 9 4.46 0 0.00 jan 2021
0 0 0 0.00 0 15 15 10.71 0 15 15 10.71 0 14 14 10.00 0 7 7 5.00 0 0.00 jan 2021
0 1 1 2.99 0 17 17 10.18 0 17 17 10.18 0 17 17 10.18 0 12 12 7.19 0 0.00 jan 2021
0 0 0 0.00 0 1 1 3.03 0 1 1 3.03 0 1 1 3.03 0 0 0 0.00 0 0.00 jan 2021
0 3 3 1.95 0 57 57 35.0466 0 57 57 7.39 0 56 56 7.26 0 43 43 5.58 0 0 0 0.00 jan 2021
PUSKESMAS: DARUL AZHAR
Bulan : FEBRUARI Tahun : 2021
Form 2 (Persalinan Dan Nifas)

PN DI FASYANKES
PN
Sasaran 20% RS RS SWASTA, RSIB, KLINIK PUSTU, POSKESDES, POLINDES
NO. DESA
Bulin Bulin
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN LALU FEB ABS %
LALU LALU LALU
46 13 6 19 8.29694 2 0 2 0.87 10 2 12 5.24 1 4 5 2.18

1 BERSUJUD 229
T.PANGERAN 40 11 16 27 13.3663 3 4 7 3.47 8 10 18 8.91 0 2 2 0.99

2 202
28 15 10 25 17.8571 1 0 1 0.71 13 9 22 15.71 1 1 2 1.43

3 G.UNUNG ANTASARI 140
33 17 11 28 16.7665 0 0 0 0.00 15 10 25 14.97 2 1 3 1.80

4 GUNUNG BESAR 167
7 1 5 6 18.1818 0 0 0 0.00 1 5 6 18.18 0 0 0 0.00

5 BATU AMPAR 33
771 154 57 48 105 13.6187 6 4 10 1.30 47 36 83 10.77 4 8 12 1.56
JUMLAH
PN DI NON FASYANKES Persalinan Ditolong Non Nakes Total Persalinan
PN DI NON FASYANKES
total DI RUMAH DI PERJALANAN
total/abs %
FEB ABS % FEB ABS % FEB ABS % FEB ABS % FEB ABS %
6 19 8.30 0 0 0.00 0.00 0.00 0 0.00 6 8.30

0 0 0 0 0 0 0 0 0 13 19
16 27 13.37 0 0 0.00 0.00 0.00 0 0.00 16 13.37

0 0 0 0 0 0 0 0 0 11 27
10 25 17.86 0 0 0.00 0.00 0.00 0 0.00 10 17.86

0 0 0 0 0 0 0 0 0 15 25
11 28 16.77 0 0 0.00 0.00 0.00 0 0.00 11 16.77
0 0 0 0 0 0 0 0 0 17 28
5 6 18.18 0 0 0.00 0.00 0.00 0 0.00 5 18.18
0 0 0 0 0 0 0 0 0 1 6
48 105 13.61868 0 0 0.00 0.00 0.00 0 0.00 48 13.62
0 0 0 0 0 0 0 0 0 57 105
Ditangani (PK) KF1 KF2 KF3 KF4
BUL
TAHUN
BLN FEB ABS BLN FEB BLN FEB BLN FEB BLN BLN FEB AN
% ABS % ABS % ABS % FEB ABS % ABS %
1 2.18 13 5 18 7.86 6 8.30 5 7.86 13 4 17 7.42 10 8.73 feb

0 1 13 19 13 18 10 20 2021
2 9.90 11 16 27 13.37 16 13.37 16 13.37 11 16 27 13.37 12 8.42 feb

2 4 11 27 11 27 5 17 2021
1 3.57 15 10 25 17.86 10 17.86 10 17.14 14 10 24 17.14 15 15.71 feb

0 1 15 25 14 24 7 22 2021
1 5.99 17 11 28 16.77 11 16.77 11 16.77 17 11 28 16.77 12 18.56 feb

1 2 17 28 17 28 19 31 2021
0 0.00 1 5 6 18.18 5 18.18 4 15.15 1 1 2 6.06 1 6.06 feb

0 0 1 6 1 5 1 2 2021
5.19 57 47 104 13.49 13.62 46 13.23 56 42 98 12.71 50 11.93 feb 2021

3 5 8 57 48 105 56 102 42 92
Bulan : MARET Tahun : 2020
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN LALU MAR ABS %
LALU LALU LALU
46 19 11 30 13.10 2 0 2 0.87 12 10 22 9.61 5 1 6 2.62

1 BERSUJUD 229
T.PANGERAN 40 27 13 40 19.80 7 1 8 3.96 18 11 29 14.36 2 1 3 1.49

2 202
28 25 17 42 30.00 1 4 5 3.57 22 12 34 24.29 2 1 3 2.14

3 G.UNUNG ANTASARI 140
33 28 12 40 23.95 0 1 1 0.60 25 11 36 21.56 3 0 3 1.80

4 GUNUNG BESAR 167
7 6 3 9 27.27 0 0 0 0.00 6 2 8 24.24 0 1 1 3.03

5 BATU AMPAR 33
771 154 105 56 161 20.88 10 6 16 2.08 83 46 129 16.73 12 4 16 2.08

Jumlah
PN DI NON FASYANKES
total % DI RUMAH DI PERJALANAN
total/abs
MAR ABS % MAR ABS % MAR ABS % MAR ABS % MAR ABS %
11 30 13.10 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 1 1 0.44 19 12 31 13.54
13 40 19.80 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 1 1 0.50 27 14 41 20.30
17 42 30.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 25 17 42 30.00
12 40 23.95 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 28 12 40 23.95
3 9 27.27 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 6 3 9 27.27
56 161 20.88 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 2 2 0.26 105 58 163 21.14

BUL
TAHUN
BLN MAR ABS BLN MAR ABS BLN MAR BLN MAR BLN BLN MAR ABS AN
% % ABS % ABS % MAR ABS % %
1 0 1 2.18 18 12 30 13.10 19 12 31 13.54 18 12 30 13.10 17 10 27 11.79 20 4 24 10.48 MAR

2021
4 2 6 14.85 27 14 41 20.30 27 13 40 19.80 27 13 40 19.80 27 14 41 20.30 17 14 31 15.35 MAR

2021
1 1 2 7.14 25 17 42 30.00 25 17 42 30.00 24 17 41 29.29 24 16 40 28.57 22 11 33 23.57 MAR

2021
2 1 3 8.98 28 12 40 23.95 28 12 40 23.95 28 12 40 23.95 28 12 40 23.95 31 9 40 23.95 MAR

2021
0 0 0 0.00 6 3 9 27.27 6 3 9 27.27 5 3 8 24.24 2 4 6 18.18 2 3 5 15.15 MAR

2021
8 4 12 7.78 104 58 162 21.01 105 57 162 21.01 102 57 159 20.62 98 56 154 19.97 92 41 133 17.25 MAR 2021
Bulan : APRIL Tahun : 2020
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN LALU APR ABS %
LALU LALU LALU
1 BERSUJUD 229 33 30 13 43 18.78 2 0 2 0.87 22 13 35 15.28 6 0 6 2.62

2 T.PANGERAN 202 40 40 15 55 27.23 8 1 9 4.46 29 14 43 21.29 3 0 3 1.49
3 G.UNUNG ANTASARI 140 28 42 12 54 38.57 5 1 6 4.29 34 11 45 32.14 3 0 3 2.14
4 GUNUNG BESAR 167 33 40 12 52 31.14 1 1 2 1.20 36 11 47 28.14 3 0 3 1.80
5 BATU AMPAR 33 7 9 3 12 36.36 0 0 0 0.00 8 3 11 33.33 1 0 1 3.03
Jumlah 771 142 161 55 216 28.02 16 3 19 2.46 129 52 181 23.48 16 0 16 2.08
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
PN DI NON FASYANKES
total/abs
APR ABS % APR ABS % APR ABS % APR ABS % APR ABS %
13 43 18.77729 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.44 31 13 44 19.21

15 55 27.22772 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.50 41 15 56 27.72
12 54 38.57143 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 42 12 54 38.57
12 52 31.13772 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 12 52 31.14
3 12 36.36364 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 9 3 12 36.36
55 216 28.01556 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 0.26 163 55 218 28.27
Kunjungan Nifas (KF)
1 0 1 2.99 30 13 43 18.78 31 13 44 19.21 30 13 43 18.78 27 14 41 17.90 24 15 39 17.03

6 2 8 19.80 41 15 56 27.72 40 15 55 27.23 40 14 54 26.73 41 12 53 26.24 31 12 43 21.29
2 2 4 14.29 42 12 54 38.57 42 12 54 38.57 41 12 53 37.86 40 12 52 37.14 33 15 48 34.29
3 2 5 14.97 40 12 52 31.14 40 12 52 31.14 40 12 52 31.14 40 12 52 31.14 40 12 52 31.14
0 1 1 15.15 9 3 12 36.36 9 3 12 36.36 8 3 11 33.33 6 3 9 27.27 5 3 8 24.24
12 7 19 2.46 162 55 217 28.15 162 55 217 28.15 159 54 213 27.63 154 53 207 26.85 133 57 190 24.64
Bulan : MEI Tahun : 2021
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN LALU MEI ABS %
LALU LALU LALU
1 BERSUJUD 229 33 43 10 53 23.14 2 0 2 0.87 35 10 45 19.65 6 0 6 2.62

2 T.PANGERAN 202 40 55 15 70 34.65 9 1 10 4.95 43 13 56 27.72 3 1 4 1.98
3 G.UNUNG ANTASARI 140 28 54 7 61 43.57 6 0 6 4.29 45 6 51 36.43 3 1 4 2.86
4 GUNUNG BESAR 167 33 52 11 63 37.72 2 1 3 1.80 47 10 57 34.13 3 0 3 1.80
5 BATU AMPAR 33 7 12 1 13 39.39 0 0 0 0.00 11 0 11 33.33 1 1 2 6.06
Jumlah 771 142 216 44 260 33.72 19 2 21 2.72 181 39 220 28.53 16 3 19 2.46
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
PN DI NON FASYANKES
total/abs
MEI ABS % MEI ABS % MEI ABS % MEI ABS % MEI ABS %
10 53 23.14 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.44 44 10 54 23.58

15 70 34.65 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.50 56 15 71 35.15
7 61 43.57 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 54 7 61 43.57
11 63 37.72 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 52 11 63 37.72
1 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 1 13 39.39
44 260 33.72 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 0.26 218 44 262 33.98
1 0 1 2.09 43 10 53 23.14 44 10 54 23.58 43 10 53 23.14 41 12.00 53 23.14 39 12 51 22.27

8 3 11 25.35 56 15 71 35.15 55 15 70 34.65 54 17 71 35.15 53 17 70 34.65 43 18 61 30.20
4 1 5 17.61 54 7 61 43.57 54 7 61 43.57 53 7 60 42.86 52 7.00 59 42.14 48 4 52 37.14
5 6 11 32.54 52 11 63 37.72 52 11 63 37.72 52 11 63 37.72 52 11.00 63 37.72 52 12 64 38.32
1 0 1 15.15 12 1 13 39.39 12 1 13 39.39 11 1 12 36.36 9 3.00 12 36.36 8 2 10 30.30
19 10 29 18.12 217 44 261 33.85 217 44 261 33.85 213 46 259 33.59 207 50.00 257 33.33 190 48 238 30.87
Bulan : JUNI Tahun : 2020
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN JUN ABS % BLN JUN ABS % BLN JUN ABS % BLN LALU JUN ABS %
LALU LALU LALU
1 BERSUJUD 239 48 53 53 22.18 2 2 0.84 45 45 18.83 6 0 6 2.51

2 T.PANGERAN 217 43 70 70 32.26 10 10 4.61 56 56 25.81 4 0 4 1.84
3 G.UNUNG ANTASARI 142 28 61 61 42.96 6 6 4.23 51 51 35.92 4 0 4 2.82
4 GUNUNG BESAR 169 34 63 63 37.28 3 3 1.78 57 57 33.73 3 0 3 1.78
5 BATU AMPAR 33 7 13 13 39.39 0 0 0.00 11 11 33.33 2 0 2 6.06
Jumlah 800 160 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 Nip. 19850911 200904 2 002
005
PN DI NON FASYANKES
total/abs
JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS %
0 53 22.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 1 0.42 54 0 54 22.59

0 70 32.26 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 1 0.46 71 0 71 32.72
0 61 42.96 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 61 0 61 42.96
0 63 37.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 63 0 63 37.28
0 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 13 0 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 0.25 262 0 262 32.75
Ditangani (PK) KF1 KF2 KF3
BLN JUN ABS % BLN JUN ABS % BLN JUN ABS % BLN JUN ABS % BLN JUN ABS %
1 1 2.09 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 25.35 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 17.61 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 32.54 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 15.15 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 18.12 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : JULI Tahun : 2019
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN LALU JULI ABS %
LALU LALU LALU
1 BERSUJUD 239 48 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 43 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G. ANTASARI 142 28 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 34 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 7 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 160 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
5.5272
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PN DI NON FASYANKES
total/abs
JULI ABS % JULI ABS % JULI ABS % JULI ABS % JULI ABS %
0 53 22.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.42 54 54 22.59

0 70 32.26 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.46 71 71 32.72
0 61 42.96 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 61 61 42.96
0 63 37.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 63 63 37.28
0 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 0.25 262 0 262 32.75
5.527211
1 1 2.09 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 25.35 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11 54.86065393899
5 5 17.61 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 32.54 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 15.15 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 18.12 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : AGUSTUS Tahun : 2020
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN AGUST ABS % BLN AGUST ABS % BLN AGUST ABS % BLN LALU AGUST ABS %
LALU LALU LALU
1 BERSUJUD 239 48 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 43 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G.UNUNG ANTASARI 142 28 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 34 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 7 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 160 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PN DI NON FASYANKES
total/abs
AGUST ABS % AGUST ABS % AGUST ABS % AGUST ABS % AGUST ABS %
0 53 22.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.42 54 54 22.59

0 70 32.26 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 1 0.46 71 71 32.72
0 61 42.96 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 61 61 42.96
0 63 37.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 63 63 37.28
0 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 0.25 262 0 262 32.75
BLN AGUS ABS % BLN AGU ABS % BLN AGU ABS % BLN AGU ABS % BLN AGUS ABS %
LALU T LALU ST LALU ST LALU ST LALU T
1 1 2.09 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 25.35 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 17.61 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 32.54 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 15.15 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 3.62 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : SEPTEMBER Tahun : 2020
PN DI FASYANKES
PN
Sasaran 20% RS RS SWASTA, RSIB, KLINIK PUSTU, POSKESDES, POLINDES,PKM
NO. DESA
Bulin Bulin
BLN SEPT ABS % BLN SEPT ABS % BLN SEPT ABS % BLN LALU SEPT ABS %
LALU LALU LALU
1 BERSUJUD 239 48 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 43 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G.UNUNG ANTASARI 142 28 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 34 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 7 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 160 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PN DI NON FASYANKES
total/abs
SEPT ABS % SEPT ABS % SEPT ABS % SEPT ABS % SEPT ABS %
0 53 22.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 0.00 54 0 54 22.59

0 70 32.26 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 0 0.00 71 0 71 32.72
0 61 42.96 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 61 0 61 42.96
0 63 37.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 63 0 63 37.28
0 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 13 0 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 0 0.00 262 0 262 32.75
BLN SEPT ABS % BLN SEPT ABS % BLN SEP ABS % BLN SEP ABS % BLN SEPT ABS %
LALU LALU LALU T LALU T LALU
1 1 2.09 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 25.35 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 17.61 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 32.54 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 15.15 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 18.12 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : OKTOBER Tahun : 2020
PN DI FASYANKES
PN
NO. PUSKESMAS
Bulin Bulin
BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN LALU OKT ABS %
LALU LALU LALU
1 BERSUJUD 239 48 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 43 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G.UNUNG ANTASARI 142 28 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 34 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 7 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 160 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PN DI NON FASYANKES
total/abs
OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS %
0 53 22.18 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 54 54 22.59

0 70 32.26 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 71 71 32.72
0 61 42.96 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 61 61 42.96
0 63 37.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 63 63 37.28
0 13 39.39 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0.00 13 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 262 0 262 32.75
BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS % BLN OKT ABS %
1 1 2.09 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 25.35 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 17.61 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 32.54 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 15.15 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 18.12 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : NOVEMBER Tahun : 2020
PN DI FASYANKES
PN
NO. DESA
Bulin Bulin
BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN LALU NOV ABS %
LALU LALU LALU
1 BERSUJUD 239 52 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 47 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G.UNUNG ANTASARI 142 30 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 33 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 8 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 170 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PN DI NON FASYANKES
total/abs
NOV ABS % NOV ABS % NOV ABS % NOV ABS % NOV ABS %
0 53 22.18 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00 54 8 62 25.94

0 70 32.26 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00 71 0 71 32.72
0 61 42.96 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00 61 0 61 42.96
0 63 37.28 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00 63 0 63 37.28
0 13 39.39 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 0 13 39.39
0 260 32.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 262 8 270 33.75
BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
1 1 1.92 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 23.40 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 16.67 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 33.33 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 12.50 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 3.62 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
Bulan : DESEMBER Tahun : 2020
PN DI FASYANKES
PN
NO. DESA
Bulin Bulin
BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN LALU DES ABS %
LALU LALU LALU
1 BERSUJUD 239 52 53 53 22.18 2 2 0.84 45 45 18.83 6 6 2.51

2 T.PANGERAN 217 47 70 70 32.26 10 10 4.61 56 56 25.81 4 4 1.84
3 G.UNUNG ANTASARI 142 30 61 61 42.96 6 6 4.23 51 51 35.92 4 4 2.82
4 GUNUNG BESAR 169 33 63 63 37.28 3 3 1.78 57 57 33.73 3 3 1.78
5 BATU AMPAR 33 8 13 13 39.39 0 0 0.00 11 11 33.33 2 2 6.06
Jumlah 800 170 260 0 260 32.50 21 0 21 2.63 220 0 220 27.50 19 0 19 2.38
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
PN DI NON FASYANKES
total/abs
DES ABS % DES ABS % DES ABS % DES ABS % DES ABS %
0 53 22.17573 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 62 62 25.94

0 70 32.25806 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 71 71 32.72
0 61 42.95775 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 61 61 42.96
0 63 37.27811 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 63 63 37.28
0 13 39.39394 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 13 39.39
0 260 32.5 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 270 0 270 33.75
1 1 1.92 53 53 22.18 54 54 22.59 53 53 22.18 51 51 21.34

11 11 23.40 71 71 32.72 70 70 32.26 71 71 32.72 61 61 28.11
5 5 16.67 61 61 42.96 0 0 0.00 60 60 42.25 52 52 36.62
11 11 33.33 63 63 37.28 63 63 37.28 63 63 37.28 64 64 37.87
1 1 12.50 13 13 39.39 13 13 39.39 12 12 36.36 10 10 30.30
29 0 29 17.06 261 0 261 32.63 200 0 200 25.00 259 0 259 32.38 238 0 238 29.75
PUSKESMAS : DARUL AZHAR
Bulan : JANUARI Tahun : 2021
Form 3 (Sumber Daya)
JUMLAH DESA JUMLAH PUSKESMAS Rumah Sakit
Jml Jml Jml

Jml Jml Rumah Jml PKM Perawatan PKM RS Pemerintah RS Swasta
Tunggu PKM PKM Jml
NO. DESA Jml Jml Desa Total PKM Dengan Jml Melaks PKM Melaks
JMLH DESA Posyan Poskesd Melaksa Kelahiran
PKM Memilik Ruang PKM Kelas Mampu Supervi
du es nakan i Dokter Bersali PKRT Ibu PP-KtP si
P4K Umum Fasilitat
JML MAMPU n Hamil
if Jml RSU Jml Jml RSU Jml
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 4 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 10 5 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
umah Sakit Jml Fasyankes Mampu Pelayanan KB Dokter Umum Dokter Spesialis Bidan Dukun Beranak PERIODE INPUT
Sesuai Standar (DU) DATA
Jml RS Jml Jml Jml BDD Jml

Jml RS MEMILI RSU Poskes Jml Jml Jml DU Jml Jml SpA SpAn Jml Jml Bidan Jml BDD Punya Jml Dukun
Mampu KI Pemeri PKM Pustu des Total Total di PKM SpOG (Anak) (Aneste Total Bidan di Di Desa Tinggal Bidan Dukun Bermitr BULAN TAHUN
PONEK PPT/PK ntah DU (Obgin) si) Bidan PKM (BDD) di Desa Kit a
T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 1 0 1 2 0 0 0 0 0 0 0 3 1 1 3 3 Januari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 0 1 0 0 Januari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 1 0 0 Januari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 1 1 1 Januari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 1 0 0 Januari 2021
0 0 0 1 0 5 6 0 4 0 0 0 24 12 16 3 5 4 4 Januari 2021
Bulan : FEBRUARI Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 10 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 1 1 3 3 Februari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 6 0 0 0 0 Februari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 5 1 0 0 0 Februari 2021
0 0 0 0 1 1 1 0 0 0 0 0 0 0 4 0 0 1 1 Februari 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 0 0 0 Februari 2021
0 0 1 1 1 4 4 4 4 0 0 0 34 12 22 5 1 4 4 Februari 2021
Bulan : MARET Tahun : 2021
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0
JUMLAH 5 10 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 1 3 3 maret 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 maret 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 5 1 0 0 0 maret 2021
0 0 0 0 0 1 1 0 0 0 0 0 5 0 5 1 0 2 0 maret 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 0 0 0 maret 2021
0 0 1 1 1 4 4 4 4 0 0 0 24 11 19 6 1 4 4 maret 2021
Bulan : APRIL Tahun : 2021
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 1 3 3 April 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 April 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 1 0 0 0 April 2021
0 0 0 0 1 1 1 0 0 0 0 0 0 0 2 0 0 1 1 April 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 0 0 0 April 2021
0 0 1 1 1 4 4 4 4 0 0 0 24 11 13 5 1 4 4 April 2021
Bulan : MEI Tahun : 2021
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 1 3 3 MEI 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 MEI 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 1 0 0 0 MEI 2021
0 0 0 0 1 1 1 0 0 0 0 0 0 0 2 0 0 1 1 MEI 2021
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 0 0 0 MEI 2021
0 0 1 1 1 4 4 4 4 0 0 0 24 11 13 5 1 4 4 MEI 2021
Bulan : JUNI Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 1 3 3 Juni 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Juni 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 0 0 0 Juni 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 Juni 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 0 Juni 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 14 6 1 4 4 Juni 2020
Bulan : JULI Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 1 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 1 3 3 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 0 0 0 Juli 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 0 Juli 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 14 6 1 4 4 Juli 2020
Bulan : AGUSTUS Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 1 3 3 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 0 0 0 Juli 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 Juli 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 n Juli 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 14 6 1 4 4 Juli 2020
Bulan : SEPTEMBER Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 9 4 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 3 1 3 3 Sept 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Sept 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 0 0 0 Sept 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 4 0 0 1 1 Sept 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 n Sept 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 15 6 1 4 4 Sept 2020
Bulan : OKTOBER Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 10 4 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 3 1 3 3 okt 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 okt 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 1 0 0 0 okt 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 okt 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 n okt 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 15 6 1 4 4 okt 2020
Bulan : NOVEMBER Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 10 4 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 3 1 3 3 Nov 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Nov 2020
0 0 0 0 0 1 1 0 0 0 0 0 5 0 5 1 0 0 0 Nov 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 Nov 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 n Nov 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 17 6 1 4 4 Nov 2020
Bulan : DESEMBER Tahun : 2020
Jml Jml Jml

Tunggu PKM PKM Jml
P4K Umum Fasilitat
JML MAMPU n Hamil
PONED RSIA RSIA
34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
1 BERSUJUD 1 3 1 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0
2 T.PANGERAN 1 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
3 GUNUNG ANTASARI 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
4 GUNUNG BESAR 1 2 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
5 BATU AMPAR 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0
JUMLAH 5 10 4 5 0 1 4 0 0 1 0 5 0 1 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

T
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72
0 0 0 0 0 1 1 0 0 0 0 0 0 0 4 3 1 3 3 Des 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 3 0 0 0 0 Des 2020
0 0 0 0 0 1 1 0 0 0 0 0 5 0 5 1 0 0 0 Des 2020
0 0 0 0 1 1 1 0 0 0 0 0 0 0 3 0 0 1 1 Des 2020
0 0 0 0 0 1 1 0 0 0 0 0 0 0 2 2 0 0 n Des 2020
0 0 1 1 1 4 4 4 4 0 0 0 24 11 17 6 1 4 4 Des 2020
Bulan :JANUARI 2021
Form
4 (Kematian)
SEBAB KEMATIAN IBU

JUMLAH KEMATIAN IBU HIPERTENSI DLM INFEKSI Gangguan darah ( ITP, LAIN2 (malaria,
KEHAMILAN ( HT, (abortus,sepsis,sepsis Thalesemia, GGN METABOLIK (DM, meningitis, emboli
NO. DESA PERDRH JANTUNG,DLL)
Preeklamsia, eklamsi) puerperalis) Leukimia,dsb) ketuban, TB,HIV,dll)
BLN BLN BLN BLN BLN BLN BLN
LALU JAN ABS LALU JAN ABS LALU JAN ABS LALU JAN ABS LALU JAN ABS LALU JAN ABS LALU JAN ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERIODE INPUT
JML BAYI LAHIR HIDUP DATA PENOLONG
Melaksanakan
JML BAYI LAHIR MATI IUFD AMP
Laki Peremp Laki Perem Laki Peremp
laki uan laki puan laki uan obgyn dokter bidan DK Keluarga
BULAN TAHUN
BLN
BLN LALU JAN ABS BLN LALU JAN ABS LALU JAN ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
0 0 6 7 6 7 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
0 0 5 6 5 6 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
0 0 6 9 6 9 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
0 0 8 9 8 9 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
0 0 1 0 1 0 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
0 0 26 31 26 31 0 0 0 0 0 0 0 0 Januari 2021 0 0 0 0 0 0 0 0 0 0
TEMPAT MENINGGAL MASA MENINGGAL
RS PKM Klinik / BPM Rumah diperjalanan HAMIL BERSALIN NIFAS
INI ABS INI ABS INI ABS INI ABS INI ABS INI ABS INI ABS INI ABS
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PKM DARUL AZHAR
Bulan :FEBRUARI 2020
Form
4 (Kematian)
SEBAB KEMATIAN IBU

JUMLAH KEMATIAN IBU HIPERTENSI DLM INFEKSI Gangguan darah ( ITP, GGN METABOLIK (DM, LAIN2 (malaria,
PERDRH KEHAMILAN ( HT, (abortus,sepsis,sepsis Thalesemia, JANTUNG,DLL) meningitis, emboli
NO. DESA Preeklamsia, eklamsi) puerperalis) Leukimia,dsb) ketuban, TB,HIV,dll)
LALU PEB ABS LALU PEB ABS LALU PEB ABS LALU PEB ABS LALU PEB ABS LALU PEB ABS LALU PEB ABS
1 BERSUJUD 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PERIODE INPUT
Melaksanakan
Laki Peremp Laki Perem Laki Peremp JML BAYI LAHIR MATI IUFD AMP
BULAN TAHUN
BLN
BLN LALU FEB ABS BLN LALU PEB ABS LALU PEB ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
6 7 3 3 9 10 0 0 0 0 0 0 februari 2021 0 1 0 1 0 0 0
5 6 9 7 14 13 0 0 0 0 0 0 februari 2021 0 0 0 0 0
6 9 2 8 8 17 0 0 0 0 0 0 februari 2021 0 0 0 0 0
8 9 5 6 13 15 0 0 0 0 0 0 februari 2021 0 0 0 0 0
1 0 2 3 3 3 0 0 0 0 0 0 februari 2021 0 0 0 0 0
26 31 21 27 47 58 0 0 0 0 0 0 februari 2021 0 0 0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PKM DARUL AZHAR
Bulan :MARET 2021
Form
4 (Kematian)
SEBAB KEMATIAN IBU
PERDRH KEHAMILAN ( HT, (abortus,sepsis,sepsis Thalesemia, Leukimia,dsb) JANTUNG,DLL) meningitis, emboli
NO. PUSKESMAS Preeklamsia, eklamsi) puerperalis) ketuban, TB,HIV,dll)
LALU MAR ABS LALU MAR ABS LALU MAR ABS LALU MAR ABS LALU MAR ABS LALU MAR ABS LALU MAR ABS
1 BERSUJUD 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU MARET ABS BLN LALU MAR ABS LALU MAR ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
9 10 4 7 13 17 0 0 0 0 1 1 Maret 2021 0 1 1 0 0
14 13 7 7 21 20 0 0 0 0 0 0 Maret 2021 0 0 0 0 0
8 17 8 9 16 26 0 0 0 0 0 0 ya Maret 2021 0 0 0 0 0
13 15 5 7 18 22 0 1 1 0 0 0 ya Maret 2021 0 0 0 0 0
3 3 0 3 3 6 0 0 0 0 0 0 Maret 2021 0 0 0 0 0
47 58 24 33 71 91 0 1 1 0 1 1 Maret 2021 0 0 0 1 0 1 0 0 0 0
1 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
Bulan : Apr-21
Form
4 (Kematian)
JUMLAH SEBAB HIPERT LAIN2
NO. PUSKESMAS KEMATI KEMATI ENSI Ganggu (malari
AN IBU AN IBU DLM INFEKSI an GGN a,
KEHAMI (abortu darah METAB meningi
PERDR LAN s,sepsis, ( ITP, OLIK tis,
H ( HT, sepsis Thalese (DM, emboli
Preekla puerper mia, JANTUN ketuban
BLN BLN msia,
BLN alis)
BLN Leukimi
BLN G,DLL)
BLN BLN,
LALU APR ABS LALU APR ABS eklamsi
LALU APR ABS LALU APR ABS a,dsb)
LALU APR ABS LALU APR ABS TB,HIV,
LALU APR ABS
) dll)
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5
JUML BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
AH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
JML
BAYI PERIODE INPUT
LAHIR DATA
PENOLONG
HIDUP Melaksanakan
JML BAYI LAHIR MATI IUFD AMP
Laki Peremp Laki Perem Laki Peremp Keluarg
laki uan laki puan laki uan obgyn dokter bidan DK
a
BULAN TAHUN
BLN
BLN LALU APR ABS BLN LALU APR ABS LALU APR ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
13 17 4 9 17 26 0 0 0 1 0 1 April 2021 0 0 0 1 0 1 0 0 0 0
21 20 11 4 32 24 0 0 0 0 0 0 April 2021 0 0 0 0 0 0 0 0 0 0
16 26 9 3 25 29 0 0 0 0 0 0 April 2021 0 0 0 0 0 0 0 0 0 0
18 22 6 6 24 28 1 0 1 0 0 0 April 2021 0 0 0 0 0 0 0 0 0 0
3 6 1 2 4 8 0 0 0 0 0 0 April 2021 0 0 0 0 0 0 0 0 0 0
71 91 31 24 102 115 1 0 1 1 0 1 April 2021 0 0 0 1 0 1 0 0 0 0
Klinik / diperjal
RS PKM Rumah HAMIL BERSALIN NIFAS
BPM anan
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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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
Bulan : May-21
Form
4 (Kematian)
SEBAB KEMATIAN IBU
LALU MEI ABS LALU MEI ABS LALU MEI ABS LALU MEI ABS LALU MEI ABS LALU MEI ABS LALU MEI ABS
1 BERSUJUD 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 1 1 2 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1
.

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU MEI ABS BLN LALU APR ABS LALU APR ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
17 26 2 8 19 34 0 0 1 1 Mei 2021 0 0 0 1 0 1 0 0 0 0
32 24 11 5 43 29 0 0 0 0 0 0 0 0 Mei 2021 0 0 0 0 0 0 0 0 0 0
25 29 4 3 29 32 0 0 0 0 Mei 2021 0 0 0 0 0 0 0 0 0 0
24 28 5 6 29 34 1 0 1 0 0 0 Mei 2021 0 0 0 0 0 0 0 0 0 0
4 8 0 1 4 9 0 0 0 0 0 0 0 0 Mei 2021 0 0 0 0 0 0 0 0 0 0
102 115 22 23 124 138 1 0 1 1 0 1 Mei 2021 0 0 0 1 0 1 0 0 0 0
TP :
gemelli 1
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 0 0
0 0 0 0 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 1 0 0
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 2 0 0 0 0 0 0 0 0 0 0 1 1 0 1
Bulan : Jun-20
Form
4 (Kematian)
SEBAB KEMATIAN IBU
NO. PUSKESMAS Preeklamsia, eklamsi) puerperalis) Leukimia,dsb) ketuban, TB,HIV,dll)
LALU JUNI ABS LALU JUNI ABS LALU JUNI ABS LALU JUNI ABS LALU JUNI ABS LALU JUNI ABS LALU JUNI ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU JUNI ABS BLN LALU JUNI ABS LALU JUNI ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
Juni 2020 0 0 0 0 0 0 0 0 0 0
Juni 2020 0 0 0 0 0 0 0 0 0 0
Juni 2020 0 0 0 0 0 0 0 0 0 0
Juni 2020 0 0 0 0 0 0 0 0 0 0
Juni 2020 0 0 0 0 0 0 0 0 0 0
Juni 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
JULI 2020
SEBAB KEMATIAN IBU

LALU JULI ABS LALU JULI ABS LALU JULI ABS LALU JULI ABS LALU JULI ABS LALU JULI ABS LALU JULI ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU JULI ABS BLN LALU JUNI ABS LALU JUNI ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
Juli 2020 0 0 0 0 0
Juli 2020 0 0 0 0 0
Juli 2020 0 0 0 0 0
Juli 2020 0 0 0 0 0
Juli 2020 0 0 0 0 0
Juli 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
AGUSTUS 2020
SEBAB KEMATIAN IBU

NO. PUSKESMAS Preeklamsia, eklamsi) puerperalis) Leukimia,dsb) ketuban, TB,HIV,dll)
LALU AGT ABS LALU AGT ABS LALU AGT ABS LALU AGT ABS LALU AGT ABS LALU AGT ABS LALU AGT ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU AGT ABS BLN LALU AGT ABS LALU AGT ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
0 Agt 2020 0 0 0 0 0
0 Agt 2020 0 0 0 0 0
0 Agt 2020 0 0 0 0 0
0 Agt 2020 0 0 0 0 0
0 0 Agt 2020 0 0 0 0 0
0 Agt 2020 0 0 0 0 0 0 0 0 0 0
0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
SEPTEMBER 2020
SEBAB KEMATIAN IBU

LALU SEP ABS LALU SEP ABS LALU SEP ABS LALU SEP ABS LALU SEP ABS LALU SEP ABS LALU SEP ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU SEPT ABS BLN LALU AGT ABS LALU AGT ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
Sept 2020 0 0 0 0 0
Sept 2020 0 0 0 0 0
Sept 2020 0 0 0 0 0
Sept 2020 0 0 0 0 0
Sept 2020 0 0 0 0 0
Sept 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
OKTOBER 2020
SEBAB KEMATIAN IBU

LALU OKT ABS LALU OKT ABS LALU OKT ABS LALU OKT ABS LALU OKT ABS LALU OKT ABS LALU OKT ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU OKT ABS BLN LALU OKT ABS LALU OKT ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
OKT 2020 0 0 0 0 0
OKT 2020 0 0 0 0 0
OKT 2020 0 0 0 0 0
OKT 2020 0 0 0 0 0
OKT 2020 0 0 0 0 0
OKT 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
NOVEMBER 2020
SEBAB KEMATIAN IBU

LALU NOV ABS LALU NOV ABS LALU NOV ABS LALU NOV ABS LALU NOV ABS LALU NOV ABS LALU NOV ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU NOV ABS BLN LALU NOV ABS LALU NOV ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
NOV 2020 0 0 0 0 1 1
NOV 2020 0 0 0 0 0
NOV 2020 0 0 0 0 0
NOV 2020 0 0 0 0 0
NOV 2020 0 0 0 0 0
NOV 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 1 1 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORM : KEMATIAN
PKM DARUL AZHAR
DESEMBER 2020
SEBAB KEMATIAN IBU

LALU DES ABS LALU DES ABS LALU DES ABS LALU DES ABS LALU DES ABS LALU DES ABS LALU DES ABS
1 BERSUJUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 T.PANGERAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 G. ANTASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 G.BESAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 BATU AMPAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
PERIODE INPUT
Melaksanakan
BULAN TAHUN
BLN
BLN LALU DES ABS BLN LALU DES ABS LALU DES ABS Ya Tidak INI ABS INI ABS INI ABS INI ABS INI ABS
DES 2020 0 0 0 0 0
DES 2020 0 0 0 0 0
DES 2020 0 0 0 0 0
DES 2020 0 0 0 0 0
DES 2020 0 0 0 0 0
DES 2020 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Laporan Rekapitulasi ANC Terpadu (PKM DARUL AZHAR)
Bulan : JANUARI Tahun 2020
Form 5 (ANC Terpadu)
HB
90%
NO. DESA SASARAN Jumlah Diperiksa Hb Anemia Ringan (10-10,9) Anemia sedang (7-9,9) Anemia berat (<7)
BUMIL
BUMIL Bidan
(PPIA)
BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS %
LALU LALU LALU LALU
1 BERSUJUD 240 3 216 0 13 13 5.4167 0 1 1 0.4167 0 0 0 0 0 0 0 0,00
2 T.PANGERAN
GUNUNG 212 3 191 0 8 8 3.7736 0 1 1 0.4717 0 0 0 0 0 0 0 0,00
3 ANTASARI 147 2 132 0 16 16 10.884 0 2 2 1.3605 0 0 0 0 0 0 0 0,00
4 GUNUNG BESAR 175 2 158 0 5 5 2.8571 0 0 0 0 0 0 0 0 0 0 0 0,00
5 BATU AMPAR 34 3 31 0 4 4 11.765 0 1 1 2.9412 0 0 0 0 0 0 0 0,00
JUMLAH 808 13 727 0 46 46 5.6931 0 5 5 0.6188 0 0 0 0 0 0 0 0
KEK Protein urin Gula Darah (GD)
Jumlah Anemia Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa Positif (+) Diperiksa GD >140 g/dl
ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS
1 0.41667 0 15 15 6.25 0 2 2 0.833 0 0 0 0,00 0 0 0 0,00 0 0 0 0,00 0 0 0
1 0.4717 0 17 17 8.01887 0 3 3 1.415 0 1 1 0,00 0 0 0 0,00 0 0 0 0,00 0 0 0
2 1.36054 0 16 16 10.8844 0 0 0 0 0 0 0 0,00 0 0 0 0,00 0 0 0 0,00 0 0 0
0 0 0 20 20 11.4286 0 5 5 2.857 0 0 0 0,00 0 0 0 0,00 0 0 0 0,00 0 0 0
1 2.94118 0 4 4 11.7647 0 0 0 0 0 1 1 0,00 0 0 0 0,00 0 1 1 0,00 0 0 0
5 0.61881 0 72 72 8.91089 0 10 10 1.238 0 2 2 0 0 0 0 0 0 1 1 0 0 0 0
la Darah (GD)
GD >140 g/dl Ibu Hamil Datang dengan Ibu Hamil ditawarkan Tes HIV Ibu Hamil dites HIV Ibu Hamil Hasil Tes HIV (+) JUMLAH Bumil HIV (+)
HIV(+)
% BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS %
0,00 0 0 0 0.00 0 15 15 6.94 0 8 8 3.70 0 0 0 0.00 0 0 0 0.00
0,00 0 0 0 0.00 0 17 17 8.91 0 3 3 1.57 0 0 0 0.00 0 0 0 0.00
0,00 0 0 0 0.00 0 16 16 12.09 0 1 1 0.76 0 0 0 0.00 0 0 0 0.00
0,00 0 0 0 0.00 0 20 20 12.70 0 2 2 1.27 0 0 0 0.00 0 0 0 0.00
0,00 0 0 0 0.00 0 4 4 13.07 0 3 3 9.80 0 0 0 0.00 0 0 0 0.00
0 0 0 0 0 0 72 72 9.90 0 17 17 2.34 0 0 0 0 0 0 0 0
Pencegahan Penularan HIV, SIFILIS, HEPATITIS B dari Ibu ke Anak (PPIA)
Ibu Hamil HIV(+)
Ibu Hamil Mendapat ART Persalinan Perabdominam Ibu Hamil Dites Sifilis Ibu Hamil Sifilis (+) Ibu Hamil Sifilis diobati
Persalinan Pervaginam
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 8 8 3.70 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 3 3 1.57 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 1 1 0.76 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 2 2 1.27 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 3 3 9.80 0 0 0 0.00 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 17 17 2.34 0 0 0 0 0 0 0 0
Integrasi Program
Pencegahan Malaria Dalam Kehamilan (PMD
Ibu Hamil Sifilis Dirujuk Ibu Hamil dites Hep B Ibu Hamil Hep. B (+) Ibu Hamil Hep.B (+) dirujuk Ibu Hamil mendapatkan Ibu Hamil Diperiksa
kelambu Mikroskopis/RDT
0 0 0 0.00 0 8 8 3.70 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 3 3 1.57 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 1 1 0.76 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 2 2 1.27 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 3 3 9.80 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0 0 17 17 2.34 0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0.00
Pencegahan Malaria Dalam Kehamilan (PMDK) TB dalam Kehamilan
Ibu Hamil Malaria (+) Ibu Hamil mendapatkan Ibu Hamil diperiksa Dahak Ibu Hamil Hasil Dahak TB(+) Obat**
Kina/ ACT
BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS % BLN JAN ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kecacingan dalam Kehamilan Pencegahan IMS dalam Kehamilan
Ibu Hamil diperiksa Ibu Hamil Hasil Tes Ibu Hamil diobati Ibu Hamil diperiksa IMS Ibu Hamil Hasil Tes IMS (+) Ibu Hamil diobati
Ankylostoma Ankylostoma (+)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 8 8 3.33 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 3 3 1.42 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 1 1 0.68 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 2 2 1.14 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 3 3 8.82 0 0 0 0.00 0 0 0 0.00
0 0 0 0 0 0 0 0 0 0 0 0 0 17 17 2.10 0 0 0 0 0 0 0 0
KELAS IBU HAMIL
Jumlah suami/keluarga bidan yg
Desa yang melaksanakan Jumlah Kelas Ibu Jumlah Ibu Hamil yang
yang mengikuti kelas ibu melaksanakan kls
kelas ibu hamil Hamil yang terbentuk mengikuti kelas ibu hamil
hamil bumil
BLN JAN ABS % BLN JAN ABS BLN JAN ABS % BLN JAN ABS % JAN ABS %
LALU LALU LALU LALU
0 0 0 0.00 0 0 0 0 0 0.00 0.00 0 0 0 0.00 0 0 0
0 0 0 0.00 0 0 0 0 0 0.00 0.00 0 0 0 0.00 0 0 0
0 0 0 0.00 0 0 0 0 0 0.00 0.00 0 0 0 0.00 0 0 0
0 0 0 0.00 0 0 0 0 0 0.00 0.00 0 0 0 0.00 0 0 0
0 0 0 0.00 0 0 0 0 0 0.00 0.00 0 0 0 0.00 0 0 0
0 0 0 0.00 0 0 0 0 0 0 0 0 0 0 0.00 0 0 0
Laporan Rekapitulasi ANC Terpadu (PKM DARUL AZHAR)
Bulan : FEBRUARI Tahun 2021
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS %
LALU LALU LALU LALU
1 BERSUJUD 240 3 216 13 9 22 9.17 1 1 2 0.83 0 0 0 0 0 0 0 0,00
2 T.PANGERAN 212 3 191 8 8 16 7.55 1 0 1 0.47 0 2 2 0.9434 0 0 0 0,00
3 GUNUNG ANTASARI 147 2 132 16 13 29 19.73 2 0 2 1.36 0 0 0 0 0 0 0 0,00
4 GUNUNG BESAR 175 2 158 5 10 15 8.57 0 1 1 0.57 0 1 1 0.5714 0 0 0 0,00
5 BATU AMPAR 34 3 31 4 5 9 26.47 1 2 3 8.82 0 0 0 0 0 0 0 0,00
JUMLAH 808 13 727 46 45 91 11.262 5 4 9 1.1139 0 3 3 0.3713 0 0 0 0,00
ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS
2 0.83 15 14 29 12.0833 2 1 3 1.25 0 1 1 0.4167 0 1 1 0,00 0 2 2 0.83 0 1 1
3 1.42 17 16 33 15.566 3 0 3 1.415 1 1 2 0,00 0 1 1 0,00 0 0 0 0.00 0 0 0
2 1.36 16 13 29 19.7279 0 0 0 0 0 0 0 0,00 0 0 0 0,00 0 0 0 0.00 0 0 0
2 1.14 20 21 41 23.4286 5 0 5 2.857 0 0 0 0,00 0 0 0 0,00 0 12 12 6.86 0 0 0
2 5.88 4 5 9 26.4706 0 0 0 0 1 2 3 0,00 0 1 1 0,00 1 3 4 11.76 0 0 0
11 1.36139 72 69 141 17.4505 10 1 11 1.361 2 4 6 0 0 3 3 0 0 17 17 2.10 0 1 1
la Darah (GD)
HIV(+)
% BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS %
0.42 0 0 0 0.00 15 14 29 13.43 8 17 25 11.57 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 17 16 33 17.30 3 10 13 6.81 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 16 13 29 21.92 1 11 12 9.07 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 20 21 41 26.03 2 10 12 7.62 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 4 5 9 29.41 3 3 6 19.61 0 0 0 0.00 0 0 0 0.00
0.12 0 0 0 0.00 72 69 141 19.39 17 51 68 9.35 0 0 0 0.00 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 8 17 25 11.57 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 3 10 13 6.81 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 11 12 9.07 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 10 12 7.62 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 3 3 6 19.61 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 51 68 9.35 0 0 0 0.00 0 0 0 0.00
Integrasi Program
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN 0 ABS % BLN FEB ABS %
0 0 0 0.00 8 17 25 11.57 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 3 10 13 6.81 0 1 1 0.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 1 11 12 9.07 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 2 10 12 7.62 0 1 1 0.63 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 3 3 6 19.61 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 17 51 68 9.35 0 2 2 0.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS % BLN FEB ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 8 17 25 11.57 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 3 10 13 6.81 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 1 11 12 9.07 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 10 12 7.62 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 3 3 6 19.61 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 51 68 9.35 0 0 0 0.00 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN FEB ABS % BLN FEB ABS BLN FEB ABS % BLN FEB ABS % FEB ABS %
LALU LALU LALU LALU
0 1 1 0.42 0 1 1 0 7 7 2.92 0 1 1 0.42 1 1 0.4167
0 1 1 0.47 0 1 1 0 10 10 4.72 0 2 2 0.94 1 1 0.4717
0 1 1 0.68 0 1 1 0 10 10 6.80 0 0 0 0.00 1 1 0.6803
0 1 1 0.57 0 1 1 0 12 12 6.86 0 0 0 0.00 1 1 0.5714
0 1 1 2.94 0 1 1 0 8 8 23.53 0 3 3 8.82 1 1 2.9412
0 0 5 0.62 0 5 5 0 47 47 5.82 0 6 6 0.74 5 5 0.6188
Bulan : MARET Tahun 2021
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS %
LALU LALU LALU LALU
1 BERSUJUD 240 3 216 22 8 30 12.50 2 1 3 1.25 0 1 1 0.42 0 0 0 0.00
2 T.PANGERAN
GUNUNG 212 3 191 16 10 26 12.26 1 0 1 0.47 2 0 2 0.94 0 0 0 0.00
3 ANTASARI 147 2 132 29 20 49 33.33 2 0 2 1.36 0 0 0 0.00 0 0 0 0.00
4 GUNUNG BESAR 175 2 158 15 12 27 15.43 1 3 4 2.29 1 2 3 1.71 0 0 0 0.00
5 BATU AMPAR 34 3 31 9 3 12 35.29 3 1 4 11.76 0 0 0 0.00 0 0 0 0.00
JUMLAH 808 13 727 91 53 144 17.82 9 5 14 1.73 3 3 6 0.74 0 0 0 0.00
ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS
4 1.67 29 9 38 15.83 3 0 3 1.25 1 0 1 0.42 1 0 1 0.42 2 13 15 6.25 1 1 2
3 1.42 33 16 49 23.11 3 2 5 2.36 2 0 2 0.94 1 0 1 0.47 0 0 0 0.00 0 0 0
2 1.36 29 20 49 33.33 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0
7 4.00 41 8 49 28.00 5 1 6 3.43 0 0 0 0.00 0 0 0 0.00 12 1 13 7.43 0 0 0
4 11.76 9 3 12 35.29 0 0 0 0.00 3 2 5 14.71 1 1 2 5.88 4 0 4 11.76 0 0 0
20 2.48 141 56 197 24.38 11 3 14 1.73 6 2 8 0.99 3 1 4 0.50 18 14 32 3.96 1 1 2
la Darah (GD)
Ibu Hamil Datang dengan

GD >140 g/dl Ibu Hamil ditawarkan Tes HIV Ibu Hamil dites HIV Ibu Hamil Hasil Tes HIV (+) JUMLAH Bumil HIV (+)
HIV(+)
% BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS %
0.83 0 0 0 0.00 29 9 38 17.59 25 8 33 15.28 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 33 16 49 25.68 13 22 35 18.34 0 1 1 0.52 0 0 0 0.00
0.00 0 0 0 0.00 29 20 49 37.04 12 5 17 12.85 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 41 8 49 31.11 12 14 26 16.51 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 9 3 12 39.22 6 3 9 29.41 0 0 0 0.00 0 0 0 0.00
0.25 0 0 0 0.00 141 56 197 27.09 68 52 120 16.50 0 1 1 0.14 0 0 0 0.00
catt : hasil tes HIV di RS ( intermediet)
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 25 8 33 15.28 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 22 35 18.34 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 5 17 12.85 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 14 26 16.51 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 6 3 9 29.41 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 68 52 120 16.50 0 0 0 0.00 0 0 0 0.00
Integrasi Program
0 0 0 0.00 25 8 33 15.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 13 22 35 18.34 1 0 1 0.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 5 17 12.85 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 14 26 16.51 1 0 1 0.63 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 6 3 9 29.41 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 68 52 120 16.50 2 0 2 0.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Ibu Hamil mendapatkan
Ibu Hamil Malaria (+) Ibu Hamil diperiksa Dahak Ibu Hamil Hasil Dahak TB(+) Obat**
Kina/ ACT
BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS % BLN MAR ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Ibu Hamil diperiksa Ibu Hamil Hasil Tes
Ibu Hamil diobati Ibu Hamil diperiksa IMS Ibu Hamil Hasil Tes IMS (+) Ibu Hamil diobati
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 25 8 33 13.75 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 13 22 35 16.51 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 5 17 11.56 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 14 26 14.86 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 6 3 9 26.47 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 68 52 120 14.85 0 0 0 0.00 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN MAR ABS % BLN MAR ABS BLN MAR ABS % BLN MAR ABS % MAR ABS %
LALU LALU LALU LALU
1 0 1 0.42 1 0 1 7 9 16 6.667 1 2 3 1.25 0 1 0.4167
1 0 1 0.47 1 0 1 10 7 17 8.019 2 1 3 1.415 0 1 0.4717
1 0 1 0.68 1 0 1 10 10 20 13.61 0 2 2 1.361 0 1 0.6803
1 0 1 0.57 1 0 1 12 13 25 14.29 0 0 0 0 0 1 0.5714
1 0 1 2.94 1 0 1 8 10 18 52.94 3 3 6 17.65 0 1 2.9412
5 0 5 0.62 5 0 5 47 49 96 11.88 6 8 14 1.733 0 5 0.6188
Bulan : APRIL Tahun 2019
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS %
LALU LALU LALU LALU
1 BERSUJUD 240 3 216 30 3 33 13.75 3 0 3 1.25 1 0 1 0.42 0 0 0 0.00
2 T.PANGERAN
GUNUNG 212 3 191 26 12 38 17.92 1 3 4 1.89 2 0 2 0.94 0 0 0 0.00
3 ANTASARI 147 2 132 49 12 61 41.50 2 0 2 1.36 0 0 0 0.00 0 0 0 0.00
4 GUNUNG BESAR 175 2 158 27 24 51 29.14 4 4 8 4.57 3 1 4 2.29 0 0 0 0.00
5 BATU AMPAR 34 3 31 12 2 14 41.18 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 808 13 727 144 53 197 24.38 14 7 21 2.60 7 1 8 0.99 0 0 0 0.00
Mengetahui
Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031

ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS
4 1.67 38 24 62 25.83 3 6 9 3.75 1 1 2 0.83 1 1 2 0.83 15 11 26 10.83 2 0 2
6 2.83 49 15 64 30.19 5 0 5 2.36 2 0 2 0.94 1 0 1 0.47 0 0 0 0.00 0 0 0
2 1.36 49 12 61 41.50 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0
12 6.86 49 24 73 41.71 6 1 7 4.00 0 0 0 0.00 0 0 0 0.00 13 1 14 8.00 0 0 0
5 14.71 12 2 14 41.18 0 0 0 0.00 5 0 5 14.71 2 0 2 5.88 4 1 5 14.71 0 0 0
29 3.59 197 77 274 33.91 14 7 21 2.60 8 1 9 1.11 4 1 5 0.62 32 13 45 5.57 2 0 2
la Darah (GD)
HIV(+)
% BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS %
0.83 0 0 0 0.00 38 24 62 28.70 33 0 33 15.28 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 49 15 64 33.54 35 1 36 18.87 1 0 1 0.52 0 0 0 0.00
0.00 0 0 0 0.00 49 12 61 46.11 17 0 17 12.85 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 49 24 73 46.35 26 3 29 18.41 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 12 2 14 45.75 9 2 11 35.95 0 0 0 0.00 0 0 0 0.00
0.25 0 0 0 0.00 197 77 274 37.68 120 6 126 17.33 1 0 1 0.14 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 33 0 33 15.28 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 35 1 36 18.87 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 0 17 12.85 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 26 3 29 18.41 0 1 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 9 2 11 35.95 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 120 6 126 17.33 0 1 1 0.14 0 0 0 0.00
Integrasi Program
0 0 0 0.00 33 0 33 15.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 35 1 36 18.87 1 0 1 0.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 17 0 17 12.85 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 1 1 0.63 26 3 29 18.41 1 0 1 0.63 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 9 2 11 35.95 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 1 1 0.14 120 6 126 17.33 2 0 2 0.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS % BLN APR ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 33 0 33 13.75 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 35 1 36 16.98 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 0 17 11.56 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 26 3 29 16.57 0 1 1 0.57 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 9 2 11 32.35 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 120 6 126 15.59 0 1 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN APR ABS % BLN APR ABS BLN APR ABS % BLN APR ABS % APR ABS %
LALU LALU LALU LALU
1 0 1 0.42 1 0 1 16 0 16 6.667 3 0 3 1.25 0 1 0.4167
1 0 1 0.47 1 0 1 17 0 17 8.019 3 0 3 1.415 0 1 0.4717
1 0 1 0.68 1 0 1 20 0 20 13.61 2 0 2 1.361 0 1 0.6803
1 0 1 0.57 1 0 2 25 0 25 14.29 0 0 0 0 0 1 0.5714
1 0 1 2.94 1 0 1 18 0 18 52.94 6 0 6 17.65 0 1 2.94
5 0 5 0.62 5 0 5 96 20 116 14.36 14 0 14 1.733 0 5 0.6188
Bulan : MEI Tahun 2021
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS %
LALU LALU LALU LALU
1 BERSUJUD 240 3 216 33 13 46 19.17 3 1 4 1.67 1 1 2 0.83 0 0 0 0.00
2 T.PANGERAN 212 3 191 38 10 48 22.64 4 0 4 1.89 2 1 3 1.42 0 0 0 0.00
3 G.ANTASARI 147 2 132 61 8 69 46.94 2 0 2 1.36 0 2 2 1.36 0 0 0 0.00
4 GUNUNG BESAR 175 2 158 51 10 61 34.86 8 3 11 6.29 4 2 6 3.43 0 0 0 0.00
5 BATU AMPAR 34 3 31 14 2 16 47.06 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 808 13 727 197 43 240 29.70 21 4 25 3.09 8 0 14 1.73 0 0 0 0.00
Mengetahui

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS
6 2.50 62 17 79 32.92 9 0 0 0.00 2 0 2 0.83 2 0 2 0.83 26 2 28 11.67 2 0 2
7 3.30 64 16 80 37.74 5 3 8 3.77 2 2 4 1.89 1 1 2 0.94 0 0 0 0.00 0 0 0
4 2.72 61 8 69 46.94 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 10 10 6.80 0 0 0
17 9.71 73 24 97 55.43 7 2 9 5.14 0 0 0 0.00 0 0 0 0.00 14 1 15 8.57 0 0 0
5 14.71 14 2 16 47.06 0 0 0 0.00 5 2 7 20.59 2 0 2 5.88 5 2 7 20.59 0 0 0
39 4.83 274 67 341 42.20 21 5 17 2.10 9 0 13 1.61 5 0 6 0.74 45 0 60 7.43 2 0 2
la Darah (GD)

HIV(+)
% BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS %
0.83 0 0 0 0.00 62 17 79 36.57 33 10 43 19.91 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 64 16 80 41.93 36 4 40 20.96 1 0 1 0.52 0 0 0 0.00
0.00 0 0 0 0.00 61 8 69 52.15 17 5 22 16.63 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 73 24 97 61.59 29 1 30 19.05 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 14 2 16 52.29 11 1 12 39.22 0 0 0 0.00 0 0 0 0.00
0.25 0 0 0 0.00 274 67 341 46.89 126 21 147 20.21 1 0 1 0.14 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 33 10 43 19.91 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 36 4 40 20.96 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 5 22 16.63 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 29 1 30 19.05 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 11 1 12 39.22 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 126 21 147 20.21 1 0 1 0.14 0 0 0 0.00
Integrasi Program
0 0 0 0.00 33 10 43 19.91 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 36 4 40 20.96 1 0 1 0.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 17 5 22 16.63 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 29 1 30 19.05 1 0 1 0.63 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 11 1 12 39.22 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.14 126 21 147 20.21 2 0 2 0.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS % BLN MEI ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 33 10 43 17.92 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 36 4 40 18.87 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 17 5 22 14.97 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 29 1 30 17.14 1 0 1 0.57 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 11 1 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 126 21 147 18.19 1 0 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN MEI ABS % BLN MEI ABS BLN MEI ABS % BLN MEI ABS % MEI ABS %
LALU LALU LALU LALU
1 0 1 0.42 1 0 1 16 0 16 6.667 3 0 3 1.25 0 1 0.4167
1 0 1 0.47 1 0 1 17 0 17 8.019 3 0 3 1.415 0 1 0.4717
1 0 1 0.68 1 0 1 20 0 20 13.61 2 0 2 1.361 0 1 0.6803
1 0 1 0.57 1 0 1 25 0 25 14.29 0 0 0 0 0 1 0.5714
1 0 1 2.94 1 0 1 18 0 18 52.94 6 0 6 17.65 0 1 2.9412
5 0 5 0.62 5 0 5 116 4 120 14.85 14 0 14 1.733 0 5 0.6188
Bulan : JUNI Tahun 2020
HB
90%
SASARAN Jumlah
NO. DESA
BUMIL Bidan BUMIL Diperiksa Hb Anemia Ringan (10-10,9) Anemia sedang (7-9,9) Anemia berat (<7)
(PPIA)
BLN BLN BLN BLN
JUN ABS % JUN ABS % JUN ABS % JUN ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 46 46 18.40 4 4 1.60 2 2 0.80 0 0 0 0.00
2 T.PANGERAN 228 3 205 48 48 21.05 4 4 1.75 3 3 1.32 0 0 0 0.00
3 G. ANTASARI 148 2 133 69 69 46.62 2 2 1.35 2 2 1.35 0 0 0 0.00
4 GUNUNG BESAR 177 2 159 61 61 34.46 11 11 6.21 6 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 16 16 47.06 4 4 11.76 1 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 240 0 240 28.67 25 0 25 2.99 14 0 14 1.67 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002

ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS
6 2.40 79 79 31.60 0 0 0.00 2 0 2 0.89 2 0 2 0.80 28 0 28 11.20 2 0.8333 2.8333
7 3.07 80 80 35.09 8 8 3.51 4 0 4 1.95 2 0 2 0.88 0 0 0 0.00 0 0 0
4 2.70 69 69 46.62 0 0 0.00 0 0 0 0.00 0 0 0 0.00 10 0 10 6.76 0 0 0
17 9.60 97 97 54.80 9 9 5.08 0 0 0 0.00 0 0 0 0.00 15 0 15 8.47 0 0 0
5 14.71 16 16 47.06 0 0 0.00 7 0 7 22.88 2 0 2 5.88 7 0 7 20.59 0 0 0
39 4.66 341 0 341 40.74 17 0 17 2.03 13 0 13 42.48 6 0 6 0.72 60 0 60 7.17 2 0.8333 2.8333
ula Darah (GD)
GD >140 g/dl Ibu Hamil Datang dengan HIV(+) Ibu Hamil ditawarkan Tes HIV Ibu Hamil dites HIV Ibu Hamil Hasil Tes HIV (+) JUMLAH Bumil HIV (+)
BLN BLN BLN BLN BLN

% JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS %
1.13 0 0 0 0.00 79 79 35.11 43 43 19.11 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 80 80 38.99 40 40 19.49 1 0.5241 1.5241 0.74 0 0 0 0.00
0.00 0 0 0 0.00 69 69 51.80 22 22 16.52 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 97 97 60.89 30 30 18.83 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 16 16 52.29 12 12 39.22 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 341 0 341 45.27 147 0 147 19.51 1 0.5241 1.5241 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
Ibu Hamil Mendapat ART Ibu Hamil Dites Sifilis Ibu Hamil Sifilis (+) Ibu Hamil Sifilis diobati
Persalinan Pervaginam Persalinan Perabdominam (SC)
JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 43 19.11 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 40 19.49 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 22 16.52 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 30 18.83 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 12 39.22 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 0 147 19.51 1 0 1 0.13 0 0 0 0.00
Integrasi Program
Pencegahan Malaria Dalam Kehamilan (PMDK)
Ibu Hamil Diperiksa
Ibu Hamil Sifilis Dirujuk Ibu Hamil dites Hep B Ibu Hamil Hep. B (+) Ibu Hamil Hep.B (+) dirujuk Ibu Hamil mendapatkan kelambu Mikroskopis/RDT
0 0 0 0.00 43 43 19.11 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 40 40 19.49 1 0 1 0.49 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 22 22 16.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 30 30 18.83 1 1 2 1.26 0 1 1 0.63 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 12 39.22 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.13 147 0 147 19.51 2 1 3 0.40 0 1 1 0.13 0 0 0 0.00 0 0 0 0.00
Ibu Hamil mendapatkan Kina/
Ibu Hamil Malaria (+) ACT Ibu Hamil diperiksa Dahak Ibu Hamil Hasil Dahak TB(+) Obat**
BLN BLN BLN BLN BLN

JUN ABS % JUN ABS % JUN ABS % JUN ABS % JUN ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Ibu Hamil Hasil Tes Ankylostoma
Ibu Hamil diperiksa Ankylostoma (+) Ibu Hamil diobati Ibu Hamil diperiksa IMS Ibu Hamil Hasil Tes IMS (+) Ibu Hamil diobati

0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 43 17.20 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 40 17.54 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 22 14.86 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 30 16.95 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 0 147 17.56 1 0 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
Desa yang melaksanakan kelas Jumlah Kelas Ibu Hamil Jumlah Ibu Hamil yang Jumlah suami/keluarga yang bidan yg melaksanakan
ibu hamil yang terbentuk mengikuti kelas ibu hamil mengikuti kelas ibu hamil kls bumil
BLN BLN BLN BLN

JUN ABS % JUN ABS JUN ABS % JUN ABS % JUN ABS %
LALU LALU LALU LALU
1 0 1 0.40 1 0 2 16 0 16 6.4 3 0 3 1.2 0 0 0
1 0 1 0.44 1 0 2 17 0 17 7.456 3 0 3 1.316 0 0 0
1 0 1 0.68 1 0 2 20 0 20 13.51 2 0 2 1.351 0 0 0
1 0 1 0.56 1 0 2 25 0 25 14.12 0 0 0 0 0 0 0
1 0 1 2.94 1 0 2 18 0 18 52.94 6 0 6 17.65 0 0 0
5 0 5 0.60 5 0 10 120 0 120 14.34 14 0 14 1.673 0 0 0
Bulan : JULI Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 46 46 18.40 4 4 1.60 2 2 0.80 0 0 0 0.00
2 T.PANGERAN 228 3 205 48 48 21.05 38 38 16.67 3 3 1.32 0 0 0 0.00
3 G. ANTASARI 148 2 133 69 69 46.62 2 2 1.35 2 2 1.35 0 0 0 0.00
4 GUNUNG BESAR 177 2 159 61 61 34.46 11 11 6.21 6 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 16 16 47.06 4 4 11.76 1 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 240 240 28.67 59 59 7.05 14 14 1.67 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS
6 2.40 79 79 31.60 0 0 0.00 2 0 2 0.80 2 0 2 0.80 28 0 28 11.20 2.83333 0 2.83333
41 17.98 80 80 35.09 8 8 3.51 4 0 4 1.75 2 0 2 0.88 0 0 0 0.00 0 0 0
4 2.70 69 69 46.62 0 0 0.00 0 0 0 0.00 0 0 0 0.00 10 0 10 6.76 0 0 0
17 9.60 97 97 54.80 9 9 5.08 0 0 0 0.00 0 0 0 0.00 15 0 15 8.47 0 0 0
5 14.71 16 16 47.06 0 0 0.00 7 0 7 20.59 2 0 2 5.88 7 0 7 20.59 0 0 0
73 8.72 341 341 40.74 17 17 2.03 13 13 1.55 6 6 0.72 60 0 60 7.17 2.83333 0 2.83333
la Darah (GD)
HIV(+)
% BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS % BLN JULI ABS %
1.13 0 0 0 0.00 79 29 108 48.00 43 10 53 23.56 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 80 37 117 57.02 40 17 57 27.78 1.52411 0 1.52411 0.74 0 0 0 0.00
0.00 0 0 0 0.00 69 15 84 63.06 22 8 30 22.52 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 97 9 106 66.54 30 9 39 24.48 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 16 6 22 71.90 12 6 18 58.82 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 341 437 58.01 147 197 26.15 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 43 19.11 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 40 19.49 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 22 16.52 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 30 18.83 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 12 39.22 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 147 19.51 1 0 1 0.13 0 0 0 0.00
Integrasi Program
0 0 0 0.00 43 43 19.11 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 40 40 19.49 1 1 0.49 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 22 22 16.52 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 30 30 18.83 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 12 39.22 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.13 147 0 147 19.51 1 0 1 0.13 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 43 17.20 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 40 17.54 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 22 14.86 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 30 16.95 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 0 147 17.56 1 0 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN JULI ABS % BLN JULI ABS BLN JULI ABS % BLN JULI ABS % JULI ABS %
LALU LALU LALU LALU
1 0 1 0.40 1 0 1 16 0 16 6.4 3 0 3 1.2 0 1 0.4
1 0 1 0.44 1 0 1 17 0 17 7.456 3 0 3 1.316 0 1 0.4386
1 0 1 0.68 1 0 1 20 10 30 20.27 2 0 2 1.351 0 1 0.6757
1 0 1 0.56 1 0 1 25 10 35 19.77 0 0 0 0 0 1 0.565
1 0 1 2.94 1 0 1 18 3 21 61.76 6 0 6 17.65 0 1 2.9412
5 0 5 0.60 5 0 5 120 23 143 17.08 14 0 14 1.673 0 5 0.5974
Bulan : AGUSTUS Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 46 46 18.40 4 4 1.60 2 2 0.80 0 0 0 0.00
2 T.PANGERAN 228 3 205 48 48 21.05 38 38 16.67 3 3 1.32 0 0 0 0.00
3 G. ANTASARI 148 2 133 69 69 46.62 2 2 1.35 2 2 1.35 0 0 0 0.00
4 GUNUNG BESAR 177 2 159 61 61 34.46 11 11 6.21 6 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 16 16 47.06 4 4 11.76 1 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 240 0 240 28.67 59 0 59 7.05 14 0 14 1.67 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS
6 2.40 79 79 31.60 0 0 0.00 2 0 2 0.80 2 0 2 0.80 28 0 28 11.20 2.83333 0 2.83333
41 17.98 80 80 35.09 8 8 3.51 4 0 4 1.75 2 0 2 0.88 0 0 0 0.00 0 0 0
4 2.70 69 69 46.62 0 0 0.00 0 0 0 0.00 0 0 0 0.00 10 0 10 6.76 0 0 0
17 9.60 97 97 54.80 9 9 5.08 0 0 0 0.00 0 0 0 0.00 15 0 15 8.47 0 0 0
5 14.71 16 16 47.06 0 0 0.00 7 0 7 20.59 2 0 2 5.88 7 0 7 20.59 0 0 0
73 8.72 341 0 341 40.74 17 0 17 2.03 13 0 13 1.55 6 0 6 0.72 60 0 60 7.17 2.83333 0 2.83333
la Darah (GD)
HIV(+)
% BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS %
1.13 0 0 0 0.00 108 21 129 57.33 53 8 61 27.11 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 117 28 145 70.66 57 3 60 29.24 1.52411 0 1.52411 0.74 0 0 0 0.00
0.00 0 0 0 0.00 84 12 96 72.07 30 3 33 24.77 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 106 17 123 77.21 39 7 46 28.88 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 22 5 27 88.24 18 0 18 58.82 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 437 83 520 69.03 197 21 218 28.94 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 8 51 22.67 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 3 43 20.96 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 3 25 18.77 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 7 37 23.23 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 0 12 39.22 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 21 168 22.30 1 0 1 0.13 0 0 0 0.00
Integrasi Program
0 0 0 0.00 43 43 19.11 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 40 40 19.49 1 0 1 0.49 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 22 26 19.52 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 30 30 18.83 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 12 39.22 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.13 147 0 151 20.05 1 0 1 0.13 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS % BLN AGUS ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 43 17.20 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 40 17.54 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 22 14.86 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 30 16.95 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 0 147 17.56 1 0 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN AGUS ABS % BLN AGUS ABS BLN AGUS ABS % BLN AGUS ABS % AGUS ABS %
LALU LALU LALU LALU
1 0 1 0.40 1 0 1 16 0 16 6.4 3 0 3 1.2 0 1 0.4
1 0 1 0.44 1 0 1 17 0 17 7.456 3 0 3 1.316 0 1 0.4386
1 0 1 0.68 1 0 1 30 0 30 20.27 2 0 2 1.351 0 1 0.6757
1 0 1 0.56 1 0 1 35 0 35 19.77 0 0 0 0 0 1 0.565
1 0 1 2.94 1 0 1 21 0 21 61.76 6 0 6 17.65 0 1 2.9412
5 0 5 0.60 5 0 5 143 143 17.08 14 0 14 1.673 0 5 0.5974
Bulan : SEPTEMBER Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 46 22 68 27.20 4 3 7 2.80 2 0 2 0.80 0 0 0 0.00
2 T.PANGERAN 228 3 205 48 8 56 24.56 38 2 40 17.54 3 0 3 1.32 0 0 0 0.00
3 G. ANTASARI 148 2 133 69 6 75 50.68 2 4 6 4.05 2 1 3 2.03 0 0 0 0.00
4 GUNUNG BESAR 177 4 159 61 4 65 36.72 11 0 11 6.21 6 0 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 16 5 21 61.76 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 240 45 285 34.05 59 9 68 8.12 14 1 15 1.79 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS
9 3.60 79 0 79 31.60 0 3 3 1.20 2 2 4 1.60 2 2 4 1.60 28 0 28 11.20 2.83333 0 2.83333
43 18.86 80 0 80 35.09 8 2 10 4.39 4 0 4 1.75 2 0 2 0.88 0 0 0 0.00 0 0 0
9 6.08 69 0 69 46.62 0 0 0 0.00 0 1 1 0.68 0 1 1 0.68 10 0 10 6.76 0 0 0
17 9.60 97 0 97 54.80 9 1 10 5.65 0 17 17 9.60 0 2 2 1.13 15 0 15 8.47 0 0 0
5 14.71 16 0 16 47.06 0 0 0 0.00 7 4 11 32.35 2 0 2 5.88 7 4 11 32.35 0 0 0
83 9.92 341 0 341 40.74 17 6 23 2.75 13 24 37 4.42 6 5 11 1.31 60 4 64 7.65 2.83333 0 2.83333
la Darah (GD)

HIV(+)
% BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS %
1.13 0 0 0 0.00 129 52 181 80.44 61 10 71 31.56 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 145 18 163 79.43 60 5 65 31.68 1.52411 0 1.52411 0.74 0 0 0 0.00
0.00 0 0 0 0.00 96 7 103 77.33 33 3 36 27.03 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 123 13 136 85.37 46 4 50 31.39 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 27 3 30 98.04 18 0 18 58.82 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 520 93 613 81.38 218 22 240 28.67 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 51 10 61 24.40 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 5 48 21.05 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 25 3 28 18.92 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 37 4 41 23.16 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 0 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 168 22 190 22.70 1 0 1 0.13 0 0 0 0.00
Integrasi Program
0 0 0 0.00 43 10 53 23.56 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 40 5 45 21.93 1 0 1 0.49 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 26 3 29 21.77 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 30 4 34 21.34 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 0 12 39.22 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.13 151 22 173 20.67 1 0 1 0.13 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
Kina/ ACT
BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS % BLN SEP ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 43 10 53 21.20 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 40 5 45 19.74 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 22 3 25 16.89 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 30 4 34 19.21 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 0 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 147 22 169 20.19 1 0 1 0.12 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN SEP ABS % BLN SEP ABS BLN SEP ABS % BLN SEP ABS % SEP ABS %
LALU LALU LALU LALU
1 0 1 0.40 1 0 1 16 0 16 6.4 3 0 3 1.2 0 1 0.4
1 0 1 0.44 1 0 1 17 0 17 7.456 3 0 3 1.316 0 1 0.4386
1 0 1 0.68 1 0 1 30 0 30 20.27 2 0 2 1.351 0 1 0.6757
1 0 1 0.56 1 0 1 35 0 35 19.77 0 0 0 0 0 1 0.565
1 0 1 2.94 1 0 1 21 0 21 61.76 6 0 6 17.65 0 1 2.9412
5 0 5 0.60 5 0 5 143 0 143 17.08 14 0 14 1.673 0 5 0.5974
Bulan : OKTOBER Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN BLN BLN BLN
OKT ABS % OKT ABS % OKT ABS % OKT ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 4 225 68 40 108 43.20 7 2 9 3.60 2 0 2 0.80 0 0 0 0.00
2 T.PANGERAN 28 3 205.2 56 15 71 253.57 40 3 43 153.57 3 0 3 10.71 0 0 0 0.00
3 G. ANTASARI 148 3 133.2 75 19 94 63.51 6 3 9 6.08 3 0 3 2.03 0 0 0 0.00
4 GUNUNG BESAR 177 3 159.3 65 0 65 36.72 11 0 11 6.21 6 0 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 2 30.6 21 2 23 67.65 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 837 13 753.3 285 76 361 43.13 68 8 76 9.08 15 0 15 1.79 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002

ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS
11 4.40 79 26 105 42.00 3 1 4 1.60 4 0 4 1.60 4 0 4 1.60 28 0 28 11.20 2.83333 0 2.83333
46 164.29 80 28 108 385.71 10 3 13 46.43 4 0 4 14.29 2 0 2 7.14 0 0 0 0.00 0 0 0
12 8.11 69 13 82 55.41 0 1 1 0.68 1 0 1 0.68 1 0 1 0.68 10 0 10 6.76 0 0 0
17 9.60 97 32 129 72.88 10 0 10 5.65 17 0 17 9.60 2 0 2 1.13 15 0 15 8.47 0 0 0
5 14.71 16 3 19 55.88 0 1 1 2.94 11 1 12 35.29 2 0 2 5.88 11 1 12 35.29 0 0 0
91 10.87 341 102 443 52.93 23 6 29 3.46 37 1 38 4.54 11 0 11 1.31 64 1 65 7.77 2.83333 0 2.83333
la Darah (GD)
HIV(+)
BLN BLN BLN BLN BLN
% OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS %
1.13 0 0 0 0.00 181 26 207 92.00 71 9 80 35.56 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 163 17 180 87.72 65 5 70 34.11 1.52411 0 1.52411 0.74 0 0 0 0.00
0.00 0 0 0 0.00 103 10 113 84.83 36 10 46 34.53 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 136 32 168 105.46 50 5 55 34.53 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 30 3 33 107.84 18 0 18 58.82 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 613 88 701 93.06 240 29 269 35.71 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 61 9 70 31.11 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 48 5 53 25.83 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 28 10 38 28.53 0 1 1 0.75 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 41 5 46 28.88 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 0 12 39.22 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 190 29 219 29.07 1 1 2 0.27 0 0 0 0.00
Integrasi Program
0 0 0 0.00 53 9 62 27.56 0 1 1 0.44 0 1 1 0.44 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 45 5 50 24.37 1 0 1 0.49 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 1 1 0.75 29 10 39 29.28 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 34 5 39 24.48 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 0 12 39.22 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 5.88
1 1 2 0.27 173 29 202 26.82 1 1 2 0.27 0 1 1 0.13 0 0 0 0.00 2 0 2 0.24
Kina/ ACT
BLN BLN BLN BLN BLN
OKT ABS % OKT ABS % OKT ABS % OKT ABS % OKT ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 53 9 62 24.80 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 45 5 50 178.57 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 25 10 35 23.65 1 0 1 0.68 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 34 5 39 22.03 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 0 12 35.29 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 169 29 198 23.66 2 0 2 0.24 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN BLN BLN BLN
OKT ABS % OKT ABS OKT ABS % OKT ABS % OKT ABS %
LALU LALU LALU LALU
1 1 2 0.80 1 1 2 16 7 23 9.2 3 1 4 0 1 2 0.8
1 1 2 7.14 1 1 2 17 3 20 71.43 3 0 3 0 1 2 7.1429
1 1 2 1.35 1 1 2 30 10 40 27.03 2 0 2 1.351 1 2 1.3514
1 1 2 1.13 1 1 2 35 8 43 24.29 0 1 1 0.565 1 2 1.1299
1 1 2 5.88 1 1 2 21 4 25 73.53 9 1 10 29.41 1 2 5.8824
5 5 10 1.19 5 5 10 143 32 175 20.91 14 3 17 2.031 5 10 1.1947
Bulan : NOVEMBER Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 108 25 133 53.20 9 3 12 4.80 2 0 2 0.80 0 0 0 0.00
2 T.PANGERAN
GUNUNG 28 3 25 71 14 85 303.57 43 3 46 164.29 3 0 3 10.71 0 0 0 0.00
3 ANTASARI 148 2 133 94 20 114 77.03 9 0 9 6.08 3 0 3 2.03 0 0 0 0.00
4 GUNUNG BESAR 177 2 159 65 0 65 36.72 11 0 11 6.21 6 0 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 23 4 27 79.41 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 361 63 424 50.66 76 6 82 9.80 15 0 15 1.79 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS
14 5.60 105 13 118 47.20 4 6 10 4.00 4 0 4 1.60 4 0 4 1.60 28 0 28 11.20 2.83333 0 2.83333
49 175.00 108 9 117 417.86 13 2 15 53.57 4 0 4 14.29 2 0 2 7.14 0 0 0 0.00 0 0 0
12 8.11 82 14 96 64.86 1 0 1 0.68 1 0 1 0.68 1 0 1 0.68 10 0 10 6.76 0 0 0
17 9.60 129 12 141 79.66 10 0 10 5.65 17 0 17 9.60 2 0 2 1.13 15 0 15 8.47 0 0 0
5 14.71 19 1 20 58.82 1 0 1 2.94 8 2 10 29.41 2 0 2 5.88 12 2 14 41.18 0 0 0
97 11.59 443 49 492 58.78 29 8 37 4.42 34 2 36 4.30 11 0 11 1.31 65 2 67 8.00 2.83333 0 2.83333
la Darah (GD)
HIV(+)
% BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
1.13 0 0 0 0.00 207 13 220 97.78 80 23 103 45.78 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 180 9 189 750.00 70 9 79 313.49 1.52411 0 1.52411 6.05 0 0 0 0.00
0.00 0 0 0 0.00 113 30 143 107.36 46 20 66 49.55 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 168 16 184 115.51 55 16 71 44.57 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 33 1 34 111.11 18 2 20 65.36 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 701 69 770 102.22 269 70 339 45.00 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 70 23 93 41.33 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 53 9 62 246.03 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 38 20 58 43.54 1 0 1 0.75 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 46 16 62 38.92 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 2 14 45.75 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 219 70 289 38.36 2 0 2 0.27 0 0 0 0.00
Integrasi Program
0 0 0 0.00 62 23 85 37.78 1 0 1 0.44 1 0 1 0.44 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 50 9 59 234.13 1 0 1 3.97 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
1 0 1 0.75 39 21 60 45.05 0 1 1 0.75 0 1 1 0.75 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 39 16 55 34.53 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 12 2 14 45.75 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 5.88
2 0 2 0.27 202 71 273 36.24 2 1 3 0.40 1 1 2 0.27 0 0 0 0.00 2 0 2 0.24
Kina/ ACT
BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS % BLN NOV ABS %
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 62 23 85 34.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 50 9 59 210.71 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 35 21 56 37.84 1 0 1 0.68 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 39 16 55 31.07 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 12 2 14 41.18 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 198 71 269 32.14 2 0 2 0.24 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN NOV ABS % BLN NOV ABS BLN NOV ABS % BLN NOV ABS % NOV ABS %
LALU LALU LALU LALU
2 0 2 0.80 2 0 2 23 0 23 9.2 4 0 4 1.6 0 2 0.8
2 0 2 7.14 2 0 2 20 0 20 71.43 3 0 3 10.71 0 2 7.1429
2 0 2 1.35 2 0 2 40 0 40 27.03 2 0 2 1.351 0 2 1.3514
2 0 2 1.13 2 0 2 43 0 43 24.29 1 0 1 0.565 0 2 1.1299
2 0 2 5.88 2 0 2 25 0 25 73.53 10 0 10 29.41 0 2 5.8824
10 0 10 1.19 10 0 10 175 0 175 20.91 17 0 17 2.031 0 10 1.1947
Bulan : DESEMBER Tahun 2020
HB
90%
BUMIL
BUMIL Bidan
(PPIA)
BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS %
LALU LALU LALU LALU
1 BERSUJUD 250 3 225 133 10 143 57.20 12 0 12 4.80 2 2 4 1.60 0 0 0 0.00
2 T.PANGERAN 28 3 25 85 14 99 353.57 46 0 46 164.29 3 1 4 14.29 0 0 0 0.00
3 G. ANTASARI 148 2 133 114 12 126 85.14 9 1 10 6.76 3 1 4 2.70 0 0 0 0.00
4 GUNUNG BESAR 177 2 159 65 3 68 38.42 11 1 12 6.78 6 0 6 3.39 0 0 0 0.00
5 BATU AMPAR 34 3 31 27 1 28 82.35 4 0 4 11.76 1 0 1 2.94 0 0 0 0.00
JUMLAH 837 13 753 424 40 464 55.44 82 2 84 10.04 15 4 19 2.27 0 0 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS
16 6.40 118 8 126 50.40 10 0 10 4.00 4 0 4 1.60 4 0 4 1.60 28 0 28 11.20 2.83333 0 2.83333
50 178.57 117 3 120 428.57 15 3 18 64.29 4 0 4 14.29 2 0 2 7.14 0 0 0 0.00 0 0 0
14 9.46 140 5 145 97.97 1 0 1 0.68 1 0 1 0.68 1 0 1 0.68 10 0 10 6.76 0 0 0
18 10.17 141 1 142 80.23 10 0 10 5.65 17 0 17 9.60 2 0 2 1.13 15 0 15 8.47 0 0 0
5 14.71 20 1 21 61.76 1 0 1 2.94 10 1 11 32.35 2 0 2 5.88 14 1 15 44.12 0 0 0
103 12.31 536 18 554 66.19 37 3 40 4.78 36 0 37 4.42 11 0 11 1.31 67 1 68 8.12 2.83333 0 2.83333
la Darah (GD)

HIV(+)
% BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS % BLN DES ABS %
1.13 0 0 0 0.00 220 8 228 101.33 103 19 122 54.22 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 189 14 203 90.22 79 14 93 41.33 1.52411 0 1.52411 6.05 0 0 0 0.00
0.00 0 0 0 0.00 143 12 155 116.37 66 6 72 54.05 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 184 2 186 116.76 71 2 73 45.83 0 0 0 0.00 0 0 0 0.00
0.00 0 0 0 0.00 30 1 31 101.31 20 1 21 68.63 0 0 0 0.00 0 0 0 0.00
0.34 0 0 0 0.00 766 37 803 106.60 339 42 381 50.58 1.52411 0 1.52411 0.20 0 0 0 0.00
Ibu Hamil HIV(+)
(SC)
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 93 19 112 49.78 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 62 14 76 301.59 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 58 6 64 48.05 1 0 1 0.75 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 62 2 64 40.18 1 0 1 0.63 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 14 1 15 49.02 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 289 42 331 43.94 2 0 2 0.27 0 0 0 0.00
Integrasi Program
0 0 0 0.00 85 0 85 37.78 1 0 1 0.44 1 0 1 0.44 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 59 0 59 26.22 1 0 1 3.97 2 0 2 7.94 0 0 0 0.00 0 0 0 0.00
1 0 1 0.75 60 0 60 26.67 1 0 1 0.75 1 0 1 0.75 0 0 0 0.00 0 0 0 0.00
1 0 1 0.63 55 2 57 35.78 0 0 0 0.00 1 0 1 0.63 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 14 0 14 45.75 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 2 0 2 5.88
2 0 2 0.27 273 0 275 36.51 3 0 3 0.40 5 0 5 0.66 0 0 0 0.00 2 0 2 0.24
Kina/ ACT
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 85 19 104 41.60 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 59 14 73 260.71 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 56 6 62 41.89 1 0 1 0.68 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 55 2 57 32.20 1 0 1 0.56 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 14 1 15 44.12 0 0 0 0.00 0 0 0 0.00
0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 269 42 311 37.16 2 0 2 0.24 0 0 0 0.00
KELAS IBU HAMIL
hamil bumil
BLN DES ABS % BLN DES ABS BLN DES ABS % BLN DES ABS % DES ABS %
LALU LALU LALU LALU
2 0 2 0.80 2 0 2 23 0 23 9.2 4 0 4 1.6 0 2 0.8
2 0 2 7.14 2 0 2 20 0 20 71.43 3 0 3 10.71 0 2 7.1429
2 0 2 1.35 2 0 2 40 0 40 27.03 2 0 2 1.351 0 2 1.3514
2 0 2 1.13 2 0 2 43 0 43 24.29 1 0 1 0.565 0 2 1.1299
2 0 2 5.88 2 0 2 25 0 25 73.53 10 0 10 29.41 0 2 5.8824
10 0 10 1.19 10 0 10 175 0 175 20.91 17 0 17 2.031 0 10 1.1947
ANC 10 T
BLN: JANUARI 2020 2019
Timbang Badan dan Tinggi

Badan Ukur TD Nilai Status Gizi (lila)
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU JAN ABS % LALU JAN ABS % LALU JAN ABS %
1 BERSUJUD 240 0 15 15 6.25 0 15 15 6.25 0 15 15 6.25
2 T.PANGERAN 212 0 17 17 8.02 0 17 17 8.02 0 17 17 8.02
3 G.ANTASARI 147 0 16 16 10.88 0 16 16 10.88 0 16 16 10.88
4 GUNUNG BESAR 175 0 20 20 11.43 0 20 20 11.43 0 20 20 11.43
5 BATU AMPAR 34 0 4 4 11.76 0 4 4 11.76 0 4 4 11.76
JUMLAH 808### 0 72 72 8.91 0 72 72 8.91 0 72 72 8.91
Ukur TFU Presentasi janin dan DJJ Skrining TT Pemberian TTD
BLN BLN BLN BLN

LALU JAN ABS % LALU JAN ABS % LALU JAN ABS % LALU JAN ABS %
0 13 13 5.42 0 13 13 5.42 0 15 15 6.25 0 13 13 5.42
0 15 15 7.08 0 15 15 7.08 0 17 17 8.02 0 15 15 7.08
0 15 15 10.20 0 15 15 10.20 0 16 16 10.88 0 15 15 10.20
0 16 16 9.14 0 16 16 9.14 0 20 20 11.43 0 16 16 9.14
0 2 2 5.88 0 2 2 5.88 0 4 4 11.76 0 2 2 5.88
0 61 61 7.55 0 61 61 7.55 0 72 72 8.91 0 61 61 7.55
Tes Lab
HB Gol. Darah Protein urin HIV
BLN BLN BLN BLN
0 13 13 5.42 0 13 13 5.42 0 0 0 0.00 0 8 8 3.33
0 8 8 3.77 0 12 12 5.66 0 1 1 0.47 0 3 3 1.42
0 16 16 10.88 0 16 16 10.88 0 0 0 0.00 0 1 1 0.68
0 5 5 2.86 0 1 1 0.57 0 0 0 0.00 0 2 2 1.14
0 4 4 11.76 0 4 4 11.76 0 1 1 2.94 0 3 3 8.82
0 46 46 5.69 0 46 46 5.69 0 2 2 3.4129 0 17 17 2.10
Tatalaksana Kasus Temu wicara/konseling
Sifilis Hep. B
BLN BLN BLN BLN
0 8 8 3.33 0 8 8 3.33 0 2 2 0.83 0 15 15 6.25
0 3 3 1.42 0 3 3 1.42 0 2 2 0.94 0 17 17 8.02
0 1 1 0.68 0 1 1 0.68 0 0 0 0.00 0 16 16 10.88
0 2 2 1.14 0 2 2 1.14 0 8 8 4.57 0 20 20 11.43
0 3 3 8.82 0 3 3 8.82 0 0 0 0.00 0 4 4 11.76
0 17 17 2.10 0 17 17 2.10 0 12 12 1.49 0 72 72 8.91
ANC 10 T
BLN: FEBRUARI 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU Feb ABS % LALU Feb ABS % LALU Feb ABS %
1 BERSUJUD 240 15 14 29 12.08 15 14 29 12.08 15 14 29 12.08

2 T.PANGERAN 212 17 16 33 15.57 17 16 33 15.57 17 16 33 15.57
3 G.ANTASARI 147 16 13 29 19.73 16 13 29 19.73 16 13 29 19.73
4 GUNUNG BESAR 175 20 21 41 23.43 20 21 41 23.43 20 21 41 23.43
5 BATU AMPAR 34 4 5 9 26.47 4 5 9 26.47 4 5 9 26.47
JUMLAH 808 72 69 141 17.45 72 69 141 17.45 72 69 141 17.45
BLN BLN BLN BLN

LALU Feb ABS % LALU Feb ABS % LALU Feb ABS % LALU Feb ABS %
13 5 18 7.50 13 5 18 7.50 15 14 29 12.08 13 5 18 7.50
15 15 30 14.15 15 15 30 14.15 17 16 33 15.57 15 15 30 14.15
15 10 25 17.01 15 10 25 17.01 16 13 29 19.73 15 10 25 17.01
16 13 29 16.57 16 13 29 16.57 20 21 41 23.43 16 13 29 16.57
2 5 7 20.59 2 5 7 20.59 4 5 9 26.47 2 5 7 20.59
61 48 109 13.49 61 48 109 13.49 72 69 141 17.45 61 48 109 13.49
Tes Lab
BLN BLN BLN BLN
13 9 22 9.17 13 5 18 7.50 0 1 0 0.00 8 17 25 11.57

8 8 16 7.55 12 10 22 10.38 1 1 2 0.94 3 10 13 6.81
16 13 29 19.73 16 13 29 19.73 0 0 0 0.00 1 11 12 9.07
5 10 15 8.57 1 21 22 12.57 0 0 0 0.00 2 10 12 7.62
4 5 9 26.47 4 5 9 26.47 1 2 3 8.82 3 3 6 19.61
46 45 91 11.26 46 54 100 12.38 0 0 0 0.00 3.4 51 54.4 9.35
Sifilis Hep. B
BLN BLN BLN BLN
8 17 25 11.57 8 17 25 11.57 2 2 4 1.67 15 14 29 12.08
3 10 13 6.81 3 10 13 6.81 2 2 4 1.89 17 16 33 15.57
1 11 12 9.07 1 11 12 9.07 0 0 0 0.00 16 13 29 19.73
2 10 12 7.62 2 10 12 7.62 8 4 12 6.86 20 21 41 23.43
3 3 6 19.61 3 3 6 19.61 0 1 1 2.94 4 5 9 26.47
17 51 68 9.35 17 51 68 9.35 12 9 21 2.60 72 69 141 17.45
ANC 10 T
BLN: MARET 2021
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU MAR ABS % LALU MAR ABS % LALU MAR ABS %
1 BERSUJUD 240 29 9 38 15.83 29 9 38 15.83 29 9 38 15.83

2 T.PANGERAN 212 33 16 49 23.11 33 16 49 23.11 33 16 49 23.11
3 G.ANTASARI 147 29 20 49 33.33 29 20 49 33.33 29 20 49 33.33
4 GUNUNG BESAR 175 41 8 49 28.00 41 8 49 28.00 41 8 49 28.00
5 BATU AMPAR 34 9 3 12 35.29 9 3 12 35.29 9 3 12 35.29
JUMLAH 808 141 56 197 24.38 141 56 197 24.38 141 56 197 24.38
BLN BLN BLN BLN

LALU MAR ABS % LALU MAR ABS % LALU MAR ABS % LALU MAR ABS %
18 12 30 12.50 18 12 30 12.50 29 9 38 15.83 18 12 30 12.50
30 14 44 20.75 30 14 44 20.75 33 16 49 23.11 30 14 44 20.75
25 19 44 29.93 25 19 44 29.93 29 20 49 33.33 25 19 44 29.93
29 10 39 22.29 29 10 39 22.29 41 8 49 28.00 29 10 39 22.29
7 3 10 29.41 7 3 10 29.41 9 3 12 35.29 7 3 10 29.41
109 58 167 20.67 109 58 167 20.67 141 56 197 24.38 109 58 167 20.67
Tes Lab
BLN BLN BLN BLN
22 8 30 12.50 18 12 30 12.50 0 0 0 0.00 25 8 33 13.75
16 10 26 12.26 22 7 29 13.68 2 0 2 0.94 13 22 35 16.51
29 20 49 33.33 29 20 49 33.33 0 0 0 0.00 12 5 17 11.56
15 12 27 15.43 22 1 23 13.14 0 0 0 0.00 12 14 26 14.86
9 3 12 35.29 9 3 12 35.29 3 2 5 14.71 6 3 9 26.47
91 53 144 17.82 100 43 143 17.70 0 2 2 0.25 54.4 52 106.4 13.17
Sifilis Hep. B
BLN BLN BLN BLN
25 8 33 13.75 25 8 33 13.75 4 1 5 2.08 29 9 38 15.83
13 22 35 16.51 13 22 35 16.51 4 2 6 2.83 33 16 49 23.11
12 5 17 11.56 12 5 17 11.56 0 0 0 0.00 29 20 49 33.33
12 14 26 14.86 12 14 26 14.86 12 1 13 7.43 41 8 49 28.00
6 3 9 26.47 6 3 9 26.47 1 1 2 5.88 9 3 12 35.29
68 52 120 14.85 68 52 120 14.85 21 5 26 3.22 141 56 197 24.38
ANC 10 T
BLN: APRIL 2021
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU APR ABS % LALU APR ABS % LALU APR ABS %
1 BERSUJUD 240 38 24 62 25.83 38 24 62 25.83 38 24 62 25.83

2 T.PANGERAN 212 49 15 64 30.19 49 15 64 30.19 49 15 64 30.19
3 G.ANTASARI 147 49 12 61 41.50 49 12 61 41.50 49 12 61 41.50
4 GUNUNG BESAR 175 49 24 73 41.71 49 24 73 41.71 49 24 73 41.71
5 BATU AMPAR 34 12 2 14 41.18 12 2 14 41.18 12 2 14 41.18
JUMLAH 808 197 77 274 33.91 197 77 274 33.91 197 77 274 33.91
Mengetahui
Kepala Puskesmas Darul Pengelola Progam Kes. Ibu
Azhar

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
BLN BLN BLN BLN

LALU APR ABS % LALU APR ABS % LALU APR ABS % LALU APR ABS %
30 13 43 17.92 30 13 43 17.92 38 24 62 25.83 30 13 43 17.92
44 16 60 28.30 44 16 60 28.30 49 15 64 30.19 44 16 60 28.30
44 12 56 38.10 44 12 56 38.10 49 12 61 41.50 44 12 56 38.10
39 10 49 28.00 39 10 49 28.00 49 24 73 41.71 39 10 49 28.00
10 2 12 35.29 10 2 12 35.29 12 2 14 41.18 10 2 12 35.29
167 53 220 27.23 167 53 220 27.23 197 77 274 33.91 167 53 220 27.23
001 2 031
Tes Lab
BLN BLN BLN BLN
30 3 33 13.75 30 8 38 15.83 0 1 1 0.42 33 0 33 13.75
26 12 38 17.92 29 10 39 18.40 2 0 2 0.94 35 1 36 16.98
49 12 61 41.50 49 12 61 41.50 0 0 0 0.00 17 0 17 11.56
27 24 51 29.14 23 3 26 14.86 0 0 0 0.00 26 3 29 16.57
12 2 14 41.18 12 2 14 41.18 5 0 5 14.71 9 2 11 32.35
144 53 197 24.38 143 35 178 22.03 7 1 8 0.99 120 6 126 15.59
Sifilis Hep. B
BLN BLN BLN BLN
33 0 33 13.75 33 0 33 13.75 5 0 5 2.08 38 24 62 25.83
35 1 36 16.98 35 1 36 16.98 6 2 8 3.77 49 15 64 30.19
17 0 17 11.56 17 0 17 11.56 0 0 0 0.00 49 12 61 41.50
26 3 29 16.57 26 2 28 16.00 13 2 15 8.57 49 24 73 41.71
9 2 11 32.35 9 2 11 32.35 2 1 3 8.82 12 2 14 41.18
120 6 126 15.59 120 6 126 15.59 26 5 31 3.84 197 77 274 33.91
ANC 10 T
BLN: MEI 2021
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU MEI ABS % LALU MEI ABS % LALU MEI ABS %
1 BERSUJUD 240 62 17 79 32.92 62 17 79 32.92 62 17 79 32.92

2 T.PANGERAN 212 64 16 80 37.74 64 16 80 37.74 64 16 80 37.74
3 G.ANTASARI 147 61 8 69 46.94 61 8 69 46.94 61 8 69 46.94
4 GUNUNG BESAR 175 73 24 97 55.43 73 24 97 55.43 73 24 97 55.43
5 BATU AMPAR 34 14 2 16 47.06 14 2 16 47.06 14 2 16 47.06
JUMLAH 808 274 67 341 42.20 274 67 341 42.20 274 67 341 42.20
Mengetahui
Kepala Puskesmas Darul
Azhar Pengelola Progam Kes. Ibu

Nip. 19700111 200312 1 004 Nip. 19850716 201001 2 031
BLN BLN BLN BLN

LALU MEI ABS % LALU MEI ABS % LALU MEI ABS % LALU MEI ABS %
43 12 55 22.92 43 12 55 22.92 62 17 79 32.92 43 12 55 22.92
60 14 74 34.91 60 14 74 34.91 64 16 80 37.74 60 14 74 34.91
56 8 64 43.54 56 8 64 43.54 61 8 69 46.94 56 8 64 43.54
49 17 66 37.71 49 17 66 37.71 73 24 97 55.43 49 17 66 37.71
12 1 13 38.24 12 1 13 38.24 14 2 16 47.06 12 1 13 38.24
220 52 272 33.66 220 52 272 33.66 274 67 341 42.20 220 52 272 33.66
001 2 031
Tes Lab
BLN BLN BLN BLN
33 13 46 19.17 38 13 51 21.25 2 0 2 0.83 33 10 43 17.92
38 10 48 22.64 39 11 50 23.58 2 2 4 1.89 36 4 40 18.87
61 8 69 46.94 61 8 69 46.94 0 0 0 0.00 17 5 22 14.97
51 1 52 29.71 26 2 28 16.00 0 0 0 0.00 29 1 30 17.14
14 2 16 47.06 14 2 16 47.06 5 2 7 20.59 11 1 12 35.29
197 43 240 29.70 178 43 214 26.49 8 0 13 1.61 126 21 147 20.21
Sifilis Hep. B
BLN BLN BLN BLN
33 10 43 17.92 33 10 43 17.92 5 0 5 2.08 62 17 79 32.92
36 4 40 18.87 36 4 40 18.87 8 3 11 5.19 64 16 80 37.74
17 5 22 14.97 17 5 22 14.97 0 0 0 0.00 61 8 69 46.94
29 1 30 17.14 29 1 30 17.14 15 1 16 9.14 73 24 97 55.43
11 1 12 35.29 11 1 12 35.29 3 1 4 11.76 14 2 16 47.06
126 21 147 18.19 126 21 147 18.19 31 5 36 4.46 274 67 341 42.20
ANC 10 T j
u
BLN: JUNI 2020 m
l
a Timbang Badan dan Tinggi Ukur TD Nilai Status Gizi (lila)
Sasaran h Badan
NO. DESA Bumil
b BLN JUN ABS %
BLN
JUN ABS %
BLN
JUN ABS %
uLALU LALU LALU
1 BERSUJUD 240 m 79 0 79 32.92 79 0 79 32.92 79 0 79 32.92
i
2 T.PANGERAN 212 l 80 0 80 37.74 80 0 80 37.74 80 0 80 37.74
3 G.ANTASARI 147 69 0 69 46.94 69 0 69 46.94 69 0 69 46.94
4 GUNUNG BESAR 175 97 10 107 61.14 97 10 107 61.14 97 10 107 61.14
5 BATU AMPAR 34 16 0 16 47.06 16 0 16 47.06 16 0 16 47.06
JUMLAH 808 341 0 351 43.44 341 0 341 42.20 341 0 341 42.20
Mengetahui
Azhar Bidan Koordinator
dr. Mardalena Yayuk Trisnawati, AM.Keb

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU JUN ABS % LALU JUN ABS % LALU JUN ABS % LALU JUN ABS %
55 0 55 22.92 55 0 55 22.92 79 0 79 32.92 55 0 55 22.92
74 0 74 34.91 74 0 74 34.91 80 0 80 37.74 74 0 74 34.91
64 0 64 43.54 64 0 64 43.54 69 0 69 46.94 64 0 64 43.54
66 0 66 37.71 66 0 66 37.71 97 10 107 61.14 66 0 66 37.71
13 0 13 38.24 13 0 13 38.24 16 0 16 47.06 13 0 13 38.24
272 0 272 33.66 272 0 272 33.66 341 0 351 43.44 272 0 272 33.66
Tes Lab
BLN BLN BLN BLN
46 0 46 19.17 51 0 51 21.25 2 0 2 0.83 43 0 43 19.11
48 0 48 22.64 49 0 49 23.11 4 0 4 1.89 40 0 40 19.49
69 0 69 46.94 34 2 36 24.49 0 0 0 0.00 22 0 22 16.52
38 0 38 21.71 28 1 29 16.57 0 0 0 0.00 30 0 30 18.83
16 0 16 47.06 9 4 13 38.24 7 0 7 20.59 12 0 12 39.22
240 0 240 29.70 171 0 171 21.16 13 0 13 1.61 147 0 147 19.51
Sifilis Hep. B
BLN BLN BLN BLN
43 0 43 19.11 5 0 5 2.22 5 0 5 10.42 79 0 79 32.92
40 0 40 19.49 3 0 3 1.46 11 0 11 25.94 61 26 87 41.04
22 0 22 16.52 12 0 12 9.01 0 0 0 0.00 69 0 69 46.94
30 0 30 18.83 2 0 2 1.26 16 1 17 48.57 97 10 107 61.14
12 0 12 39.22 10 0 10 32.68 4 0 4 58.82 16 0 16 47.06
147 0 147 19.51 32 0 32 4.25 36 1 37 22.90 322 0 358 44.31
ANC 10 T
BLN: JULI 2020

Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU JULI ABS % LALU JULI ABS % LALU JULI ABS %
1 BERSUJUD 240 79 29 108 45.00 79 29 108 45.00 79 29 108 45.00

2 T.PANGERAN 212 80 37 117 55.19 80 37 117 55.19 80 37 117 55.19
3 G.ANTASARI 147 69 15 84 57.14 69 15 84 57.14 69 15 84 57.14
4 GUNUNG BESAR 175 107 28 135 77.14 107 28 135 77.14 107 28 135 77.14
5 BATU AMPAR 34 16 5 21 61.76 16 5 21 61.76 16 5 21 61.76
JUMLAH 808 351 114 465 57.55 341 114 455 56.31 341 114 455 56.31
Mengetahui

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU JULI ABS % LALU JULI ABS % LALU JULI ABS % LALU JULI ABS %
55 29 84 35.00 55 29 84 35.00 79 29 108 45.00 55 29 84 35.00

74 27 101 47.64 74 27 101 47.64 80 37 117 55.19 74 27 101 47.64
64 18 82 55.78 64 18 82 55.78 69 15 84 57.14 64 18 82 55.78
66 33 99 56.57 66 33 99 56.57 107 28 135 77.14 66 33 99 56.57
13 4 17 50.00 13 4 17 50.00 16 5 21 61.76 13 4 17 50.00
272 111 383 47.40 272 111 383 47.40 351 114 465 57.55 272 111 383 47.40
Tes Lab
BLN BLN BLN BLN
46 10 56 23.33 51 10 61 25.42 2 0 2 0.83 43 10 53 22.08

48 55 103 48.58 49 55 104 49.06 4 0 4 1.89 40 17 57 26.89
69 8 77 52.38 36 9 45 30.61 0 0 0 0.00 22 8 30 20.41
38 4 42 24.00 29 6 35 20.00 0 0 0 0.00 30 9 39 22.29
16 6 22 64.71 13 5 18 52.94 7 0 7 20.59 12 6 18 52.94
240 83 300 37.13 171 85 256 31.68 13 0 13 1.61 147 50 197 24.38
Sifilis Hep. B
BLN BLN BLN BLN
43 10 53 22.08 5 10 15 6.25 5 0 5 2.08 79 29 108 45.00

40 17 57 26.89 3 18 21 9.91 11 2 13 6.13 87 37 124 58.49
22 8 30 20.41 12 8 20 13.61 0 0 0 0.00 69 15 84 57.14
30 9 39 22.29 2 9 11 6.29 17 0 17 9.71 107 28 135 77.14
12 5 17 50.00 10 5 15 44.12 4 1 5 14.71 16 5 21 61.76
147 49 196 24.26 32 50 82 10.15 37 0 37 4.58 358 114 472 58.42
ANC 10 T
BLN: AGUSTUS 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU AGU ABS % LALU AGU ABS % LALU AGU ABS %
1 BERSUJUD 240 108 0 108 45.00 108 0 108 45.00 108 0 108 45.00
2 T.PANGERAN 212 117 28 145 68.40 117 28 145 68.40 117 28 145 68.40
3 G.ANTASARI 147 84 0 84 57.14 84 0 84 57.14 84 0 84 57.14
4 GUNUNG BESAR 175 135 0 135 77.14 135 0 135 77.14 135 0 135 77.14
5 BATU AMPAR 34 21 0 21 61.76 21 0 21 61.76 21 0 21 61.76
JUMLAH 808 465 0 465 57.55 465 0 465 57.55 465 0 465 57.55
Mengetahui

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU AGU ABS % LALU AGU ABS % LALU AGU ABS % LALU AGU ABS %
84 0 84 35.00 84 0 84 35.00 108 0 108 45.00 84 0 84 35.00
101 0 101 47.64 101 0 101 47.64 117 25 145 68.40 101 0 101 47.64
82 0 82 55.78 82 0 82 55.78 84 0 84 57.14 82 0 82 55.78
99 7 106 60.57 99 7 106 60.57 135 0 135 77.14 99 7 106 60.57
17 0 17 50.00 17 0 17 50.00 21 0 21 61.76 17 0 17 50.00
383 0 383 47.40 383 0 383 47.40 465 0 465 57.55 383 0 383 47.40
Tes Lab
BLN BLN BLN BLN
56 0 56 23.33 61 0 61 25.42 2 0 2 0.83 61 8 69 28.75
103 0 103 48.58 104 20 124 58.49 4 0 4 1.89 60 3 63 29.72
77 0 77 52.38 45 9 54 36.73 0 0 0 0.00 53 3 56 38.10
42 0 42 24.00 35 16 51 29.14 0 0 0 0.00 46 7 53 30.29
22 0 22 64.71 18 5 23 67.65 7 0 7 20.59 18 0 18 52.94
300 0 300 37.13 256 0 256 31.68 13 0 13 1.61 218 21 239 29.58
Sifilis Hep. B
BLN BLN BLN BLN
53 8 61 25.42 15 0 15 6.25 5 0 5 2.08 108 0 108 45.00
57 3 60 28.30 21 0 21 9.91 13 0 13 6.13 117 28 145 68.40
30 3 33 22.45 20 3 23 15.65 0 0 0 0.00 84 0 84 57.14
39 7 46 26.29 11 0 11 6.29 17 0 17 9.71 135 0 135 77.14
17 0 17 50.00 15 0 15 44.12 5 0 5 14.71 21 0 21 61.76
196 21 217 26.86 82 0 82 10.15 37 0 37 4.58 465 0 465 57.55
ANC 10 T
BLN: SEPTEMBER 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU SEP ABS % LALU SEP ABS % LALU SEP ABS %
1 BERSUJUD 240 108 0 108 45.00 108 0 108 45.00 108 0 108 45.00
2 T.PANGERAN 212 145 0 145 68.40 145 0 145 68.40 145 0 145 68.40
3 G.ANTASARI 147 84 0 84 57.14 84 0 84 57.14 84 0 84 57.14
4 GUNUNG BESAR 175 135 0 135 77.14 135 0 135 77.14 135 0 135 77.14
5 BATU AMPAR 34 21 0 21 61.76 21 0 21 61.76 21 0 21 61.76
JUMLAH 808 465 0 465 57.55 465 0 465 57.55 465 0 465 57.55
Mengetahui

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU SEP ABS % LALU SEP ABS % LALU SEP ABS % LALU SEP ABS %
84 0 84 35.00 84 0 84 35.00 108 0 108 45.00 84 0 84 35.00
101 0 101 47.64 101 0 101 47.64 145 0 145 68.40 101 0 101 47.64
82 0 82 55.78 82 0 82 55.78 84 0 84 57.14 82 0 82 55.78
106 0 106 60.57 106 0 106 60.57 135 0 135 77.14 106 0 106 60.57
17 0 17 50.00 17 0 17 50.00 21 0 21 61.76 17 0 17 50.00
383 0 383 47.40 383 0 383 47.40 465 0 465 57.55 383 0 383 47.40
Tes Lab
BLN BLN BLN BLN
56 22 78 32.50 61 21 82 34.17 2 2 4 1.67 61 10 71 29.58
103 8 111 52.36 124 8 132 62.26 4 0 4 1.89 60 5 65 30.66
77 6 83 56.46 54 4 58 39.46 0 1 1 0.68 33 3 36 24.49
42 4 46 26.29 51 4 55 31.43 0 17 17 9.71 46 4 50 28.57
22 5 27 79.41 23 3 26 76.47 7 4 11 32.35 18 0 18 52.94
300 45 345 42.70 256 45 301 37.25 13 24 37 4.58 218 22 240 29.70
Sifilis Hep. B
BLN BLN BLN BLN
51 10 61 25.42 43 10 53 22.08 5 2 7 2.92 108 0 108 45.00
43 5 48 22.64 40 5 45 21.23 5 0 5 2.36 145 0 145 68.40
25 3 28 19.05 26 3 29 19.73 22 1 23 15.65 84 0 84 57.14
37 4 41 23.43 30 4 34 19.43 13 0 13 7.43 135 0 135 77.14
12 0 12 35.29 12 0 12 35.29 12 0 12 35.29 21 0 21 61.76
168 22 190 23.51 151 22 173 21.41 57 3 60 7.43 465 0 465 57.55
ANC 10 T
BLN: OKTOBER 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU OKT ABS % LALU OKT ABS % LALU OKT ABS %
1 BERSUJUD 240 108 26 134 55.83 108 26 134 55.83 108 26 134 55.83
2 T.PANGERAN 212 145 28 173 81.60 145 28 173 81.60 145 28 173 81.60
3 G.ANTASARI 147 84 13 97 65.99 84 13 97 65.99 84 13 97 65.99
4 GUNUNG BESAR 175 135 34 169 96.57 135 34 169 96.57 135 34 169 96.57
5 BATU AMPAR 34 21 3 24 70.59 21 3 24 70.59 21 3 24 70.59
JUMLAH 808 465 104 569 70.42 465 104 569 70.42 465 104 569 70.42
Mengetahui

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU OKT ABS % LALU OKT ABS % LALU OKT ABS % LALU OKT ABS %
84 40 124 51.67 84 40 124 51.67 108 26 134 55.83 84 40 124 51.67
101 15 116 54.72 101 15 116 54.72 145 28 173 81.60 101 15 116 54.72
82 15 97 65.99 82 15 97 65.99 84 13 97 65.99 82 15 97 65.99
106 29 135 77.14 106 29 135 77.14 135 34 169 96.57 106 29 135 77.14
17 2 19 55.88 17 2 19 55.88 21 3 24 70.59 17 2 19 55.88
383 101 484 59.90 383 101 484 59.90 465 104 569 70.42 383 101 484 59.90
Tes Lab
BLN BLN BLN BLN
78 40 118 49.17 82 40 122 50.83 4 0 4 1.67 71 9 80 33.33
111 15 126 59.43 132 15 147 69.34 4 0 4 1.89 65 5 70 33.02
83 19 102 69.39 58 13 71 48.30 1 0 1 0.68 36 10 46 31.29
46 0 46 26.29 55 2 57 32.57 17 0 17 9.71 50 5 55 31.43
27 1 28 82.35 26 3 29 85.29 11 1 12 35.29 18 0 18 52.94
345 76 421 52.10 301 76 377 46.66 37 1 38 4.70 240 29 269 33.29
Sifilis Hep. B
BLN BLN BLN BLN
61 9 70 29.17 53 9 62 25.83 7 1 8 3.33 108 26 134 55.83
48 5 53 25.00 45 5 50 23.58 23 2 25 11.79 145 28 173 81.60
28 10 38 25.85 29 10 39 26.53 22 1 23 15.65 84 13 97 65.99
41 5 46 26.29 34 5 39 22.29 13 1 14 8.00 135 34 169 96.57
12 0 12 35.29 12 0 12 35.29 12 0 12 35.29 21 3 24 70.59
190 29 219 27.10 173 29 202 25.00 77 5 82 10.15 465 104 569 70.42
ANC 10 T
BLN: NOVEMBER 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU NOV ABS % LALU NOV ABS % LALU NOV ABS %
1 BERSUJUD 240 134 0 134 55.83 134 0 134 55.83 134 0 134 55.83
2 T.PANGERAN 212 173 9 182 85.85 173 9 182 85.85 173 9 182 85.85
3 G.ANTASARI 147 97 0 97 65.99 97 0 97 65.99 97 0 97 65.99
4 GUNUNG BESAR 175 169 15 184 105.14 169 15 184 105.14 169 15 184 105.14
5 BATU AMPAR 34 24 0 24 70.59 24 0 24 70.59 24 0 24 70.59
JUMLAH 808 569 0 569 70.42 569 0 569 70.42 569 0 569 70.42
Mengetahui

Nip. 19791127 200904 2
005 Nip. 19850911 200904 2 002
BLN BLN BLN BLN

LALU NOV ABS % LALU NOV ABS % LALU NOV ABS % LALU NOV ABS %
124 0 124 51.67 124 0 124 51.67 134 0 134 55.83 124 0 124 51.67
116 0 116 54.72 116 0 116 54.72 173 9 182 85.85 116 0 116 54.72
97 0 97 65.99 97 0 97 65.99 97 0 97 65.99 97 0 97 65.99
135 0 135 77.14 135 0 135 77.14 169 15 184 105.14 135 0 135 77.14
19 0 19 55.88 19 0 19 55.88 24 0 24 70.59 19 0 19 55.88
484 0 484 59.90 484 0 484 59.90 569 0 569 70.42 484 0 484 59.90
Tes Lab
BLN BLN BLN BLN
118 25 143 59.58 122 8 130 54.17 4 0 4 1.67 80 23 103 42.92
126 14 140 66.04 147 14 161 75.94 4 0 4 1.89 70 9 79 37.26
102 20 122 82.99 71 35 106 72.11 1 0 1 0.68 46 20 66 44.90
46 0 46 26.29 57 2 59 33.71 17 0 17 9.71 55 16 71 40.57
28 4 32 94.12 29 1 30 88.24 8 2 10 29.41 18 2 20 58.82
421 63 484 59.90 377 63 440 54.46 34 2 36 4.46 269 70 339 41.96
Sifilis Hep. B
BLN BLN BLN BLN
70 23 93 38.75 62 23 85 35.42 8 0 8 3.33 134 0 134 55.83
53 9 62 29.25 50 9 59 27.83 25 2 27 12.74 173 0 173 81.60
38 20 58 39.46 39 21 60 40.82 23 1 24 16.33 97 0 97 65.99
46 16 62 35.43 39 16 55 31.43 14 0 14 8.00 169 15 184 105.14
12 2 14 41.18 12 2 14 41.18 12 0 12 35.29 24 0 24 70.59
219 70 289 35.77 202 71 273 33.79 82 0 82 10.15 569 0 569 70.42
ANC 10 T
BLN: DESEMBER 2020
Sasaran
NO. DESA Bumil
BLN BLN BLN
LALU DES ABS % LALU DES ABS % LALU DES ABS %
1 BERSUJUD 240 134 0 134 55.83 134 0 134 55.83 134 0 134 55.83
2 T.PANGERAN 212 182 0 182 85.85 182 0 182 85.85 182 0 182 85.85
3 G.ANTASARI 147 97 0 97 65.99 97 0 97 65.99 97 0 97 65.99
4 GUNUNG BESAR 175 184 0 184 105.14 184 0 184 105.14 184 0 184 105.14
5 BATU AMPAR 34 24 0 24 70.59 24 0 24 70.59 24 0 24 70.59
JUMLAH 808 569 0 569 70.42 569 0 569 70.42 569 0 569 70.42
Mengetahui
Azhar Pengelola Program Kesehatan Ibu

Nip. 19791127 200904 2
005 Nip. 19850716 201001 2 031
BLN BLN BLN BLN

LALU DES ABS % LALU DES ABS % LALU DES ABS % LALU DES ABS %
124 0 124 51.67 124 0 124 51.67 134 0 134 55.83 124 0 124 51.67
116 0 116 54.72 116 0 116 54.72 182 0 182 85.85 116 0 116 54.72
97 0 97 65.99 97 0 97 65.99 97 0 97 65.99 97 0 97 65.99
135 0 135 77.14 135 0 135 77.14 184 0 184 105.14 135 0 135 77.14
19 0 19 55.88 19 0 19 55.88 24 0 24 70.59 19 0 19 55.88
484 0 484 59.90 484 0 484 59.90 569 0 569 70.42 484 0 484 59.90
esehatan Ibu
001 2 031
Tes Lab
BLN BLN BLN BLN
143 10 153 63.75 130 26 156 65.00 4 0 4 1.67 103 19 122 50.83
140 14 154 72.64 161 14 175 82.55 4 0 4 1.89 79 14 93 43.87
122 12 134 91.16 106 10 116 78.91 1 0 1 0.68 66 6 72 48.98
46 3 49 28.00 59 1 60 34.29 17 0 17 9.71 71 2 73 41.71
32 2 34 100.00 30 1 31 91.18 10 1 11 32.35 20 1 21 61.76
484 40 524 64.85 440 40 480 59.41 36 1 37 4.58 339 42 381 47.15
Sifilis Hep. B
BLN BLN BLN BLN
93 19 112 46.67 85 0 85 35.42 8 0 8 3.33 134 0 134 55.83
62 14 76 35.85 59 0 59 27.83 27 2 29 13.68 173 0 173 81.60
58 6 64 43.54 60 0 60 40.82 24 1 25 17.01 97 0 97 65.99
62 2 64 36.57 55 2 57 32.57 14 0 14 8.00 184 0 184 105.14
14 1 15 44.12 14 0 14 41.18 12 0 12 35.29 24 0 24 70.59
289 42 331 40.97 273 0 273 33.79 82 0 82 10.15 569 0 569 70.42
DATA TRIPLE ELIMINASI (HIV, SIFILIS DAN HEPATITIS B)
PUSKESMAS DARUL AZHAR
JANUARI 2021
Bumil Bumil Hasil Jumlah

Bumil ditawarkan Bumil di
NO DESA Jumlah K1 datang Abs % Abs % Abs % Tes Positif Abs % Bumil Positif Abs %
tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 15 0 0.00 15 6.9 8 3.70 0 0 0 0

2 T.PANGERAN 31 0 0.00 17 8.9 3 1.57 0 0 0 0
3 G.ANTASARI 29 0 0.00 16 12.1 1 0.76 0 0 0 0
4 G.BESAR 38 0 0.00 20 12.7 2 1.27 0 0 0 0
5 BATU AMPAR 8 0 0.00 4 13.1 3 9.80 0 0 0 0
JUMLAH 121 0 0.00 72 9.9 17 2.34 0 0 0 0
Jumlah
Jumlah Jumlah Jumlah Bumil HIV Bayi yang
jumlah Bayi
Bumil HIV Bumil HIV melahirkan Jumlah Bayi diberikan jumlah Bayi Jumlah Jumlah
mendapatkan
masuk Abs % baru Abs % lahir dari kotrimoks di tes HIV Balita tes Bayi/balita
ARV
perawatan memulai ibu HIV azol (EID/PCR) Serologis positif
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
FEBRUARI 2021

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 29 0 0.00 29 13.43 25 11.57 0 0.00 0 0.00

2 T.PANGERAN 33 0 0.00 33 17.30 13 6.81 0 0.00 0 0.00
3 G.ANTASARI 29 0 0.00 29 21.92 12 9.07 0 0.00 0 0.00
4 G.BESAR 41 0 0.00 41 26.03 12 7.62 0 0.00 0 0.00
5 BATU AMPAR 9 0 0.00 9 29.41 6 19.61 0 0.00 0 0.00
JUMLAH 141 0 0.00 141 19.39 68 9.35 0 0.00 0 0.00
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
MARET 2021

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 38 0 0.00 38 17.59 33 15.28 0 0.00 0 0.00

2 T.PANGERAN 49 0 0.00 49 25.68 35 18.34 1 0.52 0 0.00
3 G.ANTASARI 49 0 0.00 49 37.04 17 12.85 0 0.00 0 0.00
4 G.BESAR 49 0 0.00 49 31.11 26 16.51 0 0.00 0 0.00
5 BATU AMPAR 12 0 0.00 12 39.22 9 29.41 0 0.00 0 0.00
JUMLAH 197 0 0.00 197 27.09 120 16.50 1 0.14 0 0.00
catt : hasil tes HIV di RS ( intermediet)
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
et)
Apr-21

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 12 0 0.00 9 17.59 8 15.28 0 0.00 0 0.00

2 T.PANGERAN 17 0 0.00 16 25.68 22 18.34 1 0.52 0 0.00
3 G.ANTASARI 10 0 0.00 20 37.04 5 12.85 0 0.00 0 0.00
4 G.BESAR 9 0 0.00 8 31.11 14 16.51 0 0.00 0 0.00
5 BATU AMPAR 2 0 0.00 3 39.22 3 29.41 0 0.00 0 0.00
JUMLAH 50 0 0.00 56 27.09 6 16.50 0 0.14 0 0.00
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
APRIL 2021

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 62 0 0.00 62 28.70 33 15.28 0 0.00 0 0.00

2 T.PANGERAN 64 0 0.00 64 33.54 36 18.87 1 0.52 0 0.00
3 G.ANTASARI 61 0 0.00 61 46.11 17 12.85 0 0.00 0 0.00
4 G.BESAR 73 0 0.00 73 46.35 29 18.41 0 0.00 0 0.00
5 BATU AMPAR 14 0 0.00 14 45.75 11 35.95 0 0.00 0 0.00
JUMLAH 274 0 0.00 274 37.68 126 17.33 1 0.14 0 0.00
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
MEI 2021

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 79 36.57 43 19.91 0 0.00 0 0.00

2 T.PANGERAN 80 0 0.00 80 41.93 40 20.96 1 0.52 0 0.00
3 G.ANTASARI 69 0 0.00 69 52.15 22 16.63 0 0.00 0 0.00
4 G.BESAR 97 0 0.00 97 61.59 30 19.05 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 16 52.29 12 39.22 0 0.00 0 0.00
JUMLAH 341 0 0.00 341 46.89 147 20.21 1 0.14 0 0.00
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
DATA TRIPLE ELIMINASI (HIV)
JUNI 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 79 35.11 43 19.11 0 0.00 0 0.00

2 T.PANGERAN 80 0 0.00 80 38.99 40 19.49 0.524109 0.74 0 0.00
3 G.ANTASARI 69 0 0.00 69 51.80 22 16.52 0 0.00 0 0.00
4 G.BESAR 97 0 0.00 97 60.89 30 18.83 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 16 52.29 12 39.22 0 0.00 0 0.00
JUMLAH 341 0 0.00 341 45.27 147 19.51 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 Nip. 19850911 200904 2 002
005
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
JULI 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 108 48.00 53 23.56 0 0.00 0 0.00

2 T.PANGERAN 80 0 0.00 117 57.02 57 27.78 0 0.74 0 0.00
3 G.ANTASARI 69 0 0.00 84 63.06 30 22.52 0 0.00 0 0.00
4 G.BESAR 97 0 0.00 106 66.54 39 24.48 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 22 71.90 18 58.82 0 0.00 0 0.00
JUMLAH 341 0 0.00 437 58.01 197 26.15 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
AGUSTUS 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 129 70.66 61 27.11 0 0.74 0 0.00

2 T.PANGERAN 80 0 0.00 145 72.07 60 29.24 0 0.00 0 0.00
3 G.ANTASARI 69 0 0.00 96 77.21 33 24.77 0 0.00 0 0.00
4 G.BESAR 97 0 0.00 123 88.24 46 28.88 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 27 69.03 18 58.82 0 0.20 0 0.00
JUMLAH 341 0 0.00 520 69.03 218 28.94 0 0.00 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Jumlah
jumlah Bayi
mendapatkan
ARV
profilaksis
HIV ARV Profilaksi
SC pervaginam s
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
SEPTEMBER 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 181 80.44 71 31.56 0 0.00 0 0.00

2 T.PANGERAN 80 0 0.00 163 79.43 65 31.68 0 0.74 0 0.00
3 G.ANTASARI 69 0 0.00 103 77.33 36 27.03 0 0.00 0 0.00
4 G.BESAR 97 0 0.00 136 85.37 50 31.39 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 30 98.04 18 58.82 0 0.00 0 0.00
JUMLAH 341 0 0.00 613 81.38 240 28.67 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Jumlah
jumlah Bayi
mendapatkan
SC pervaginam ibu HIV ARV
perawatan memulai azol (EID/PCR) Serologis positif
profilaksis
HIV ARV Profilaksi
0 0 0 0 0 0 0 0 0s 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
OKTOBER 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 0 0 0.00 207 92.00 80 35.56 0 0.00 0 0.00

2 T.PANGERAN 0 0 0.00 180 87.72 70 34.11 0 0.74 0 0.00
3 G.ANTASARI 0 0 0.00 113 84.83 46 34.53 0 0.00 0 0.00
4 G.BESAR 0 0 0.00 168 105.46 55 34.53 0 0.00 0 0.00
5 BATU AMPAR 0 0 0.00 33 107.84 18 58.82 0 0.00 0 0.00
JUMLAH 341 0 0.00 701 93.06 269 35.71 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Jumlah
jumlah Bayi
mendapatkan
profilaksis
HIV ARV Profilaksi
0 0 0 0 0 0 0 0 0s 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
NOVEMBER

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 0 0 0.00 220 97.78 103 45.78 0 0.00 0 0.00

2 T.PANGERAN 0 0 0.00 189 750.00 79 34.11 0 0.74 0 0.00
3 G.ANTASARI 0 0 0.00 143 107.36 66 34.53 0 0.00 0 0.00
4 G.BESAR 0 0 0.00 184 115.51 71 34.53 0 0.00 0 0.00
5 BATU AMPAR 0 0 0.00 34 111.11 20 65.36 0 0.00 0 0.00
JUMLAH 341 0 0.00 770 93.06 339 45.00 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
Bumil HIV Bumil HIV melahirkan Jumlah Bayi jumlah Bayi diberikan jumlah Bayi Jumlah Jumlah
mendapatkan
SC pervaginam ibu HIV ARV (EID/PCR) Serologis positif
perawatan memulai azol
profilaksis
HIV ARV Profilaksi
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
DESEMBER 2020

tes HIV tes HIV
dengan HIV HIV HIV
1 BERSUJUD 79 0 0.00 228 101.33 122 54.22 0 0.00 0 0.00

2 T.PANGERAN 0 0 0.00 203 90.22 93 41.33 0 6.05 0 0.00
3 GUNUNG ANTASARI 69 0 0.00 155 116.37 72 54.05 0 0.00 0 0.00
4 GUNUNG BESAR 161 0 0.00 186 116.76 73 45.83 0 0.00 0 0.00
5 BATU AMPAR 16 0 0.00 31 101.31 21 68.63 0 0.00 0 0.00
JUMLAH 341 0 0.00 803 106.60 381 50.58 0 0.20 0 0.00
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
Jumlah
jumlah Bayi
mendapatkan
profilaksis
HIV ARV Profilaksi
0 0 0 0 0 0 0 0 0s 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
Januari
Jumlah Bayi lahir dari

jumlah Bumil Tes Jumlah Bumil Jumlah Bumil Sifilis Jumlah Bayi lahir
No DESA Jumlah Bumil K1 Abs % Abs % Abs % ibu Sifilis yang
Sifilis Sifilis positif diterapi dari ibu Sifilis
mendapatkan terapi
1
2
3
4
5
6
7
8
9
10
11
12
13
JANUARI 2021
Jumlah Bayi
Jumlah jumlah Bumil Jumlah Bumil Jumlah Bumil Jumlah Bayi lahir dari ibu
No DESA Bumil K1 Tes Sifilis Abs % Sifilis positif Abs % Sifilis diterapi Abs % lahir dari ibu Sifilis yang
Sifilis mendapatkan
terapi
1 BERSUJUD 14 8 3.70 0 0 0 0 0 0
2 T.PANGERAN 16 3 1.57 0 0 0 0 0 0
3 G.ANTASARI 16 1 0.76 0 0 0 0 0 0
4 G.BESAR 17 2 1.27 0 0 0 0 0 0
5 BATU AMPAR 3 3 9.80 0 0 0 0 0 0
JUMLAH 72 17 2.34 0 0 0 0 0 0
FEBRUARI 2021
Jumlah Bayi
Sifilis mendapatkan
terapi
1 BERSUJUD 29 25 11.57 0 0 0 0 0 0
2 T.PANGERAN 33 13 6.81 0 0 0 0 0 0
3 G.ANTASARI 29 12 9.07 0 0 0 0 0 0
4 G.BESAR 41 12 7.62 0 0 0 0 0 0
5 BATU AMPAR 9 6 19.61 0 0 0 0 0 0
JUMLAH 141 68 9.35 0 0 0 0 0 0
MARET 2021
Jumlah Bayi lahir dari ibu
Jumlah jumlah Bumil Jumlah Bumil Jumlah Bumil lahir dari ibu Sifilis yang
No DESA Bumil K1 Tes Sifilis Abs % Sifilis positif Abs % Sifilis diterapi Abs %
Sifilis mendapatkan
1 BERSUJUD 38 33 15.28 0 0.00 0 0 0 0
2 T.PANGERAN 49 35 18.34 0 0.00 0 0 0 0
3 G.ANTASARI 49 17 12.85 0 0.00 0 0 0 0
4 G.BESAR 49 26 16.51 0 0.00 0 0 0 0
5 BATU AMPAR 12 9 29.41 0 0.00 0 0 0 0
JUMLAH 197 120 16.50 0 0.00 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
APRIL 2021
Sifilis mendapatkan
6 BERSUJUD 79 33 15.28 0 0.00 0 0 0 0
7 T.PANGERAN 80 36 18.87 0 0.00 0 0 0 0
8 G.ANTASARI 69 17 12.85 0 0.00 0 0 0 0
9 G.BESAR 97 29 18.41 1 0.63 0 0 0 0
10 BATU AMPAR 16 11 35.95 0 0.00 0 0 0 0
JUMLAH 341 126 17.33 1 0.14 0 0 0 0
MEI 2021
Sifilis mendapatkan
6 BERSUJUD 79 43 19.91 0 0.00 0 0 0 0
7 T.PANGERAN 80 40 20.96 0 0.00 0 0 0 0
8 G.ANTASARI 69 22 16.63 0 0.00 0 0 0 0
9 G.BESAR 97 30 19.05 1 0.63 0 0 0 0
10 BATU AMPAR 16 12 39.22 0 0.00 0 0 0 0
JUMLAH 341 147 20.21 1 0.14 0 0 0 0
DATA TRIPLE ELIMINASI (SIFILIS)
JUNI 2020
Sifilis mendapatkan
1 BERSUJUD #REF! 43 19.11 0 0.00 0 0 0 0
2 T.PANGERAN #REF! 40 19.49 0 0.00 0 0 0 0
3 G.ANTASARI #REF! 22 16.52 0 0.00 0 0 0 0
4 G.BESAR #REF! 30 18.83 0 0.00 0 0 0 0
5 BATU AMPAR #REF! 12 39.22 0 0.00 0 0 0 0
JUMLAH #REF! 147 19.51 0 0.00 0 0 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
JULI 2020
Sifilis mendapatkan
1 BERSUJUD #REF! 43 19.11 0 0.00 0 0.00 0 0
2 T.PANGERAN #REF! 40 19.49 0 0.00 0 0.00 0 0
3 G.ANTASARI #REF! 22 16.52 0 0.00 0 0.00 0 0
4 G.BESAR #REF! 30 18.83 1 0.63 1 0.63 0 0
5 BATU AMPAR #REF! 12 39.22 0 0.00 0 0.00 0 0
JUMLAH #REF! 147 19.51 1 0.13 1 0.13 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
AGUSTUS 2020
Sifilis mendapatkan
1 BERSUJUD 79 61 25.42 0 0.00 0 0.00 0 0
2 T.PANGERAN 80 60 28.30 0 0.00 0 0.00 0 0
3 G.ANTASARI 69 33 22.45 0 0.00 0 0.00 0 0
4 G.BESAR 97 46 26.29 1 0.63 1 1.00 0 0
5 BATU AMPAR 16 17 50.00 0 0.00 0 0.00 0 0
JUMLAH 341 217 26.86 1 0.13 1 1.00 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
SEPTEMBER 2019
Sifilis mendapatkan
1 BERSUJUD 79 61 25.42 0 0.00 0 0.00 0 0
2 T.PANGERAN 80 48 22.64 0 0.00 0 0.00 0 0
3 G.ANTASARI 69 28 19.05 0 0.00 0 0.00 0 0
4 G.BESAR 97 41 23.43 1 0.63 1 0.63 0 0
5 BATU AMPAR 16 12 35.29 0 0.00 0 0.00 0 0
JUMLAH 341 190 23.51 1 0.13 1 0.13 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
OKTOBER 2020
Sifilis mendapatkan
1 BERSUJUD 0 70 31.11 0 0.00 0 0.00 0 0
2 T.PANGERAN 0 53 25.83 0 0.00 0 0.00 0 0
3 G.ANTASARI 0 38 28.53 1 0.75 1 0.75 0 0
4 G.BESAR 0 46 28.88 1 0.63 1 0.63 0 0
5 BATU AMPAR 0 12 39.22 0 0.00 0 0.00 0 0
JUMLAH 341 219 29.07 2 0.27 2 0.27 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
NOVEMBER 2019
Sifilis mendapatkan
1 BERSUJUD 0 93 41.33 0 0.00 0 0.00 0 0
2 T.PANGERAN 0 62 246.03 0 0.00 0 0.00 0 0
3 G.ANTASARI 0 88 43.54 1 0.75 1 0.75 0 0
4 G.BESAR 0 71 38.92 1 0.63 1 0.63 0 0
5 BATU AMPAR 0 15 45.75 0 0.00 0 0.00 0 0
JUMLAH 341 329 38.36 2 0.27 2 0.27 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 002
DESEMBER 2020
Sifilis mendapatkan
1 BERSUJUD 79 112 46.67 0 0.00 0 0.00 0 0
2 T.PANGERAN 0 76 35.85 0 0.00 0 0.00 0 0
3 G.ANTASARI 69 64 43.54 1 0.68 0 0.00 0 0
4 G.BESAR 161 64 36.57 1 0.56 0 0.00 0 0
5 BATU AMPAR 16 15 44.12 0 0.00 0 0.00 0 0
JUMLAH 341 331 40.97 2 0.24 0 0.00 0 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031
Januari
jumlah Bayi Jumlah Bayi

Jumlah Bumil Jumlah Bumil
Jumlah Bumil jumlah Bumil Jumlah Bayi lahir mendapatkan yang lahir dari
No DESA Abs % Hepatitis B Abs % Hepatitis B Abs %
K1 Tes Hepatitis B dari ibu hep B imunisasi Hb0 < ibu Hep B
positif dirujuk
24 jam diberikan HbIg
1
2
3
4
5
6
7
8
9
10
11
12
13
JANUARI 2021

positif dirujuk
1 BERSUJUD 14 8 3.70 0 0 0 0 0 13 0
2 T.PANGERAN 16 3 1.57 0 0 0 0 0 11 0
3 G.ANTASARI 16 1 0.76 0 0 0 0 0 15 0
4 G.BESAR 17 2 1.27 0 0 0 0 0 17 0
5 BATU AMPAR 3 3 9.80 0 0 0 0 0 1 0
PUSKESMAS 72 17 2.34 0 0 0 0 0 57 0
10
Februari FEBRUARI 2021

positif dirujuk
1 BERSUJUD 29 25 11.57 0 0 0 0 0 18 0
2 T.PANGERAN 33 13 6.81 1 0.52 0 0.00 0 27 0
3 G.ANTASARI 29 12 9.07 0 0 0 0 0 25 0
4 G.BESAR 41 12 7.62 1 0.63 0 0.00 0 28 0
5 BATU AMPAR 9 6 19.61 0 0 0 0 0 6 0
PUSKESMAS 141 68 9.35 2 0.28 0 0.00 0 105 0
10
MARET 2021

positif dirujuk
1 BERSUJUD 38 8 15.28 0 0.00 0 0.00 0 11 0

2 T.PANGERAN 49 22 18.34 1 0.52 0 0.00 0 13 0
3 G.ANTASARI 49 5 12.85 0 0.00 0 0.00 0 16 0
4 G.BESAR 49 14 16.51 1 0.63 0 0.00 0 12 0
5 BATU AMPAR 12 3 29.41 0 0.00 0 0.00 0 3 0
PUSKESMAS 197 52 16.50 2 0.28 0 0.00 0 55 0
Mengetahui

Nip. 19791127 200904 2 00 Nip. 19850911 200904 2 005
APRIL 2021

jumlah Bumil Jumlah Bumil Jumlah Bumil
Jumlah Bumil Jumlah Bayi lahir mendapatkan yang lahir dari
No DESA Tes Hepatitis Abs % Hepatitis B Abs % Hepatitis B Abs %
K1 dari ibu hep B imunisasi Hb0 ibu Hep B
B positif dirujuk
< 24 jam diberikan HbIg
1 BERSUJUD 79 33 15.28 0 0.00 0 0.00 0 13 0

2 T.PANGERAN 80 36 18.87 0 0.52 0 0.00 1 16 1
3 G. ANTASARI 69 17 12.85 0 0.00 0 0.00 1 12 1
4 G.BESAR 97 29 18.41 0 0.63 0 0.00 0 12 0
5 BATU AMPAR 16 11 35.95 0 0.00 0 0.00 0 3 0
PUSKESMAS 341 126 17.33 0 0.28 0 0.00 2 56 2
MEI 2021

positif dirujuk
1 BERSUJUD 79 43 19.91 0 0.00 0 0.00 0 55 0

2 T.PANGERAN 80 40 20.96 1 0.52 0 0.00 1 67 1
3 G.ANTASARI 69 22 16.63 0 0.00 0 0.00 1 68 1
4 G.BESAR 97 30 19.05 1 0.63 0 0.00 0 69 0
5 BATU AMPAR 16 12 39.22 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 147 20.21 2 0.28 0 0.00 2 273 2
DATA TRIPLE ELIMINASI (HEPATITIS B)
JUNI 2020

positif dirujuk
1 BERSUJUD #REF! 43 19.11 0 0.00 0 0.00 0 53 0

2 T.PANGERAN #REF! 40 19.49 0 0.00 0 0.00 0 70 0
3 G.ANTASARI #REF! 22 16.52 0 0.00 0 0.00 0 61 0
4 G.BESAR #REF! 30 18.83 1 1.26 1 0.63 0 63 0
5 BATU AMPAR #REF! 12 39.22 0 0.00 0 0.00 0 13 0
PUSKESMAS #REF! 147 19.51 1 0.49 0 0.00 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
JULI 2020

positif dirujuk
1 BERSUJUD #REF! 43 19.11 0 0.00 0 0.00 0 53 0

2 T.PANGERAN #REF! 40 19.49 1 0.49 2 0.00 0 70 0
3 G.ANTASARI #REF! 22 16.52 0 0.00 0 0.00 0 61 0
4 G.BESAR #REF! 30 18.83 0 0.00 0 0.00 0 63 0
5 BATU AMPAR #REF! 12 39.22 0 0.00 0 0.00 0 13 0
PUSKESMAS #REF! 147 19.51 1 0.13 0 0.00 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
AGUSTUS 2020

positif dirujuk
1 BERSUJUD 79 53 19.11 0 0.00 0 0.00 0 53 0

2 T.PANGERAN 80 40 19.49 1 0.49 0 0.00 0 70 0
3 G.ANTASARI 69 26 19.52 0 0.00 0 0.00 0 61 0
4 G.BESAR 97 30 18.83 0 0.00 0 0.00 0 63 1
5 BATU AMPAR 16 12 39.22 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 151 20.05 1 0.13 0 0.00 0 260 1
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
SEPTEMBER 2020

positif dirujuk
1 BERSUJUD 79 53 22.08 0 0.00 0 0.00 0 53 0

2 T.PANGERAN 80 45 21.23 0 0.49 0 0.00 0 70 0
3 G.ANTASARI 69 29 19.73 0 0.00 0 0.00 0 61 0
4 G.BESAR 97 34 19.43 0 0.00 0 0.00 0 63 0
5 BATU AMPAR 16 12 35.29 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 173 21.41 0 0.13 0 0.00 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
OKTOBER 2020

positif dirujuk
1 BERSUJUD 0 62 27.56 1 0.44 1 0.44 0 53 0

2 T.PANGERAN 0 50 24.37 1 0.49 1 0.49 0 70 0
3 G.ANTASARI 0 39 29.28 0 0.00 0 0.00 0 61 0
4 G.BESAR 0 39 24.48 0 0.00 0 0.00 0 63 0
5 BATU AMPAR 0 12 39.22 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 202 26.82 2 0.27 2 0.27 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
NOVEMBER 2020

positif dirujuk
1 BERSUJUD 0 85 37.78 1 0.44 1 0.44 0 53 0

2 T.PANGERAN 0 59 234.13 1 3.97 1 3.97 0 70 0
3 G.ANTASARI 0 60 45.05 1 0.75 1 0.75 0 61 0
4 G.BESAR 0 55 34.53 0 0.00 0 0.00 0 63 0
5 BATU AMPAR 0 14 45.75 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 273 36.24 3 0.40 3 0.40 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850911 200904 2 005
DESEMBER 2020

positif dirujuk
1 BERSUJUD 79 85 35.42 1 0.44 1 0.44 0 53 0

2 T.PANGERAN 0 59 27.83 1 3.97 1 3.97 0 70 0
3 G.ANTASARI 69 60 40.82 1 0.75 1 0.75 0 61 0
4 G.BESAR 161 57 32.57 0 0.00 0 0.00 0 63 0
5 BATU AMPAR 16 14 41.18 0 0.00 0 0.00 0 13 0
PUSKESMAS 341 273 33.79 3 0.40 3 0.40 0 260 0
Mengetahui

Nip. 19791127 200904 2 005 Nip. 19850716 201001 2 031

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LAPORAN KESEHATAN IBU PUSKESMAS DARUL AZHAR

Bulan : JANUARI 2021

Penggunaan Buku KIA K1 Murni K1 Akses (K1 keseluruhan) K4 K6 ABORTUS

1 BERSUJUD 240 48 0 15 15 6.25 0 14 14 5.8333 0 15 15 6.3 0 13 13 5.417 0 0 0 0 0 1 1 0.4167

dr. Mardalena Nurmaliana, AM. Keb

0 6 6 2.5 0 3 3 1.25 0 9 9 3.75 0 1 1 0.417 0 0 0 0 0 13 13 5.4167

0 15 15 6.25 0 13 13 5.4167 0 2 2 4.167 0 0 0 0 0 1 1 2.083

0 17 17 8.0189 0 15 15 7.0755 0 3 3 7.075 0 1 1 2.358 0 2 2 4.717

0 16 16 10.884 0 15 15 10.204 0 2 2 6.803 0 0 0 0 0 2 2 6.803

1 BERSUJUD 240 48 15 14 29 12.083 14 13 27 12.083 15 14 29 12.1 13 5 18 7.5 0 5 5 2.083 1 0 1 0.4167

dr. Mardalena Nurmaliana, AM. Keb

6 2 8 3.3333 3 4 7 2.9167 9 3 12 5 1 2 3 1.25 0 0 0 0 13 9 22 9.1667

15 14 29 12.083 13 5 18 7.5 2 3 5 10.42 0 0 0 0 1 1 2 4.167

17 16 33 15.566 15 15 30 14.151 3 4 7 16.51 1 1 2 4.717 2 1 3 7.075

16 13 29 19.728 15 10 25 17.007 2 2 4 13.61 0 0 0 0 2 2 4 13.61

Bulan : MARET 2021

1 BERSUJUD 240 48 29 9 38 15.833 27 9 36 15 29 9 38 15.8 18 12 30 12.5 5 12 17 7.083 1 1 2 0.8333

8 1 9 0 7 2 9 3.75 12 3 15 6.25 3 0 3 1.25 0 1 1 0.4167 22 6 28 11.667

29 9 38 15.833 18 12 30 12.5 5 0 5 10.42 0 0 0 0 2 0 2 4.167

33 16 49 23.113 30 14 44 20.755 7 2 9 21.23 2 0 2 4.717 3 2 5 11.79

29 20 49 33.333 25 19 44 29.932 4 0 4 13.61 0 0 0 0 4 0 4 13.61

1 BERSUJUD 240 48 38 24 62 25.833 36 23 59 24.583 38 24 62 25.8 30 13 43 17.92 17 8 25 10.42 2 0 2 0.8333

dr. H. Muhammad Erhamsyah Nurmaliana, AM. Keb

9 2 11 4.5833 9 8 17 7.0833 15 5 20 8.33333 3 3 6 2.5 1 0 1 0.4167 28 16 44 18.333

38 24 62 25.833 30 13 43 17.917 5 6 11 22.92 0 1 1 2.083 2 0 2 4.167

49 15 64 30.189 44 16 60 28.302 9 1 10 23.58 2 1 3 7.075 5 2 7 16.51

49 12 61 41.497 44 12 56 38.095 4 1 5 17.01 0 0 0 0 4 1 5 17.01

Penggunaan Buku KIA K1 Murni K1 Akses K4 K6 ABORTUS

1 BERSUJUD 240 48 62 17 79 32.917 59 17 76 32.917 62 17 79 32.9 43 12 55 22.92 25 12 37 15.42 2 0 2 0.8333

dr. H. Muhammad Erhamsyah Nurmaliana, AM. Keb

11 0 11 4.5833 17 2 19 7.9167 20 1 21 8.75 6 0 6 2.5 1 0 1 0.4167 44 3 47 19.583

62 17 79 32.917 43 12 55 22.917 11 0 11 22.92 1 1 2 4.167 2 0 2 4.167

64 16 80 37.736 60 14 74 34.906 10 3 13 30.66 3 2 5 11.79 7 2 9 21.23

61 8 69 46.939 56 8 64 43.537 5 2 7 23.81 0 0 0 0 5 2 7 23.81

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 79 0 79 32.917 79 79 32.9 55 55 22.92 2 2 4.1667

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

79 79 32.917 55 55 22.917 11 11 4.583 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 79 79 32.917 79 79 32.9 55 55 22.92 2 2 0.8333

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 79 79 32.917 79 52 0.0 55 55 22.92 2 2 0.8333

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 79 0 0 0 0 0.0 55 55 22.92 2 2 0.8333

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 0 0 32.917 0 0 0.0 55 55 22.92 2 2 0.8333

dr. Mardalena Yayuk Trisnawati, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

1 BERSUJUD 240 48 79 79 32.917 0 79 32.917 0 0 0.0 55 55 22.92 2 2 0.8333

dr. Mardalena Nurmaliana, AM. Keb

11 11 4.5833 19 19 7.9167 21 21 8.75 6 6 2.5 1 1 0.4167 47 0 47 19.583

79 79 32.917 55 55 22.917 11 11 22.92 2 2 4.167 2 2 4.167

Persalinan Ditolong Nakes (PN)

1 BERSUJUD 229 46 0 13 13 5.67686 0 2 2 0.87 0 10 10 4.37 0 1 1 0.44