By Name Persalinan

DATA IBU BERSALIN
PUSKESMAS BOJONEGORO
BULAN : JANUARI 2019
PUSKESMAS G.. P....A.. LABORATORIUM PPIA
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP GOL Hb Prot GDA Tawar Test Hasil SCOR
UK
DA gr% Urin
RT (+)/(-)
BANJAREJO
1 Dewi Lestari- 30 BANJAREJO 20-4-18 27-1-19 G2P1A0 A 12,7 - 76 + + - 2
Erfan E 7/1
2 Mulyati 28 Banjarejo 12-4-2018 19-1-2019 G3P1A1 A 11 - 90 + + - 6
Agus 6/1
3 Yatmiasih- 28 BANJAREJO 8-4-18 15-1-19 G1P0A0 O 11,5 - 72 + + - 6
Sartono 9/2
4 Teti A. 20 BANJAREJO 25-4-18 2-1-19 G1P0A0 B 11,8 - 92 + + - 2
Edi Fika 14/2

5 Diani Rahayu- 22 BANJAREJO 31-3-18 7-1-19 G1 P0AO A 11,4 - 100 + + - 2
Imam Mursidi 20/3

6 Melisa 18 Banjarejo 21/3 24-04-2018 1-2-2019 G1P0A0 O 11 - 73 + + - 6
Hasyim
CAMPUREJO
7 SITI RAHAYU 37 CAMPUREJO RT 11 29/3/18 6/1/19 G3P2A0 AB 12,5- 122 V V 18
ARI WIBOWO
8 CHOIRUNISA 26 CAMPUREJO RT 17 8/3/18 15/12/18 G2P1A0 O 11 - 80 V V 2

DIVA JEFRI
9 NUR KHOLIFAH 20 CAMPUREJO RT 26 1/4/18 8/1/19 G1P0A0 B 13,2 - 98 V V 6
DITA
10 MUSLIMAH 22 CAMPUREJO RT 26 16/4/18 23/1/19 G2P1A0 O 11 - 80 V V - 6
EDI S
11 NITIS SAHPENI 34TH CAMPUREJO RT 8 20/3/18 27/12/18 G2P1A0 O 11,2 - 80 V V - 2
AGUS
KADIPATEN
12 INDRI K 31 RT 3/1 4/20/2018 1/27/2019 GIIIPIIA1 A 12 - - √ - - 2
AIRLANGGA
13 YENI / DANNIS 28 RT 4/2 4/10/2018 1/17/2019 GIP0A0 A 12 - - V - - 2
KALIREJO
14 NURUL HIDAYAH / DIDIK PRASETYO B 25 th Kalirejo rt 10 / rw 02 23-3-2018 30-12-2018 G1 P0A0 11.5 2
15 SITI RAHAYU GINAWATI/ KHOIRUL ANWAR 24 th Desa Kalirejo rt 09 / rw 02 4/15/2018 1/22/2019 G2 P1A0 O 13 2
16 SITI NUR AISYAH / DARMAWAN 24 th Desa Kalirejo rt 12 / rw 02 5/26/2018 2/2/2019 G1 P0A0 O 11.5 2
KARANGPACAR
17 MARETHA INDAHSARI/ISWANTO 25 KR PACAR 7/1 3/5/2018 12/12/2018 G2P1A0 O 12 _ _ V V _ 6
18 VINA/SHOLIH 21 KEPATIHAN 10/04/2018 1/17/2019 G2P1A0 A 12 _ _ V V _ 10
19 DIAN RENI SUSANTI/HENDRA 23 KR PACAR 2/1 3/10/2018 12/17/2018 G1P0A0 O 11 _ _ V V _ 2
20 JUANITA NOVITASARI/ SYAIFUDDIN N 34 KR PACAR 15/3 15/3/2018 22/12/2019 G2P1A0 A 12 _ _ V V _ 2
21 MAMA/ LEON 34 KR PACAR 23/3 4/1/2018 1/8/2019 G3P1A0 O 12 _ _ V V _ 10
22 MERY/NICO 25 KR PACAR 17/3 4/20/2018 1/27/2019 G2P1A0 A 12 _ _ V V _ 2
23 NINING SUSANTI/ANTON/SUSANTO 30 KR PACAR 23/3 3/18/2018 12/25/2019 G3P2A0 AB 13 _ _ V V _ 6

KEPATIHAN
24 Ratna Asmarani 28 RT 2 /01 4/21/2018 1/28/2019 G2 P0 A1 6
Deny Fajarani 30
25 Suliyeni 24 RT 10 /02 4/8/2018 1/15/2019 G1 P0 A0 2
Ahmad Rosyid
26 Vinna Ressiani W 20 RT 12 /02 4/4/2018 1/11/2019 G1 P0 A0 2
Jemmi Apriadna
MOJOKAMPUNG
27 Rina Faridatus /Rahman Hakim 34 RT 04/01 09/04/2018 16/01/2019 G2P1A0 O 11.5 2
28 Siti R/Imam 35 RT 06/01 16/04/2018 23/01/2019 G3P2A0 B 12 6
29 Sania Rahayuning/Muntolib 34 RT 14/01 26/03/2018 02/01/2019 G2P1A0 B 11.8 2

30 Devi/ 30 RT 03/01 17/04/2018 24/01/2018 G2P1A0 O 12.2 2
31 Yuli Indra/Rian 28 RT 08/02 11/04/2018 18/01/2019 G2P1A0 O 12.4 2
32 Fika Suci/Ujang 34 RT 08/02 12/04/2018 19/01/2019 G2P1A0 O 12.4 2
33 Yunia/Erwin 31 RT 05/01 07/04/2018 14/01/2019 G2P1A0 B 11.8 2
MULYOAGUNG
34 sulis mahariyani 31 rt 13 4/16/2017 1/23/2018 g2p1a0 a 12 neg neg neg 2
teguh budi prasetyo
35 linda kristiana 28 rt 13 4/24/2018 1/31/2019 g2p1a0 o 11 neg neg v 2
anwarul
36 enggrit 24 rt 15 4/13/2017 1/21/2018 g1poao v 12.3 6
kartono
NGROWO
37 DIAN W/AHMAD ZUKARNI 24 RT 2 04/04/2018 01/11/2019 G1P0A0 AB 11.9 0 - V - - 2
38 IRMA AYU/ADAM SUKMORO 26 RT 3 29/03/2018 16/01/2019 G3P2A0 O 12 0 - V - - 2
39 LUSI KISWANDINI/YAYAK S 26 RT 19 29-3-18 12/06/2018 G1P0A0 B 12 0 - V - - 6
40 RIRIN W/ 38 RT 19 04/10/2018 17-1-19 G3P2A0 O 12.1 0 - V - - 6
41 YANTI/ SAIFUL ARIF 37 RT 9 21-3-18 28-12-2018 G2P1A0 B 12.4 - - V - - 10

SEMANDING
42 siti yuyun / 29 rt.05/rw01 04/03/2018 12/1/2019 G2P1A0 o 11 (-) (-) v (-) (-) 2
43 Tawiyati/Patmo 36 RT.1/RW.1 21/05/2018 28/02/2019 G2P1A0 B 11,7 (-) (-) V (-) (-) 10
SUKOREJO
DATA IBU BERSALIN
KESMAS BOJONEGORO
BULAN : JANUARI 2019
PENYAKIT RENCANA PENANGAN / PERSALINAN
FAKTOR RESIKO / BUFAS
PENYERTA TEMPAT KOLABORASI JENIS RISTI KET
TANGGAL TEMPAT PENOLONG ( KASUS )
KOMPLIKASI SAAT INI BERSALIN DOKTER / dr.Spesialis
BPM Dokter Puskesmas 25-1-19 BPM Normal Bidan taa by. Taa
Konsul DSOG
abortus BPM Dokter Puskesmas 15-1-19 BPM Normal Bidan taa by. Taa
Konsul DSOG
lila 23 cm BPM Dokter Puskesmas 10-1-19 BPM Normal Bidan taa by. Taa
Konsul DSOG
BPM Dokter Puskesmas 1-1-19 BPM Normal Bidan taa by. Taa
Konsul DSOG
BPM Dr. Puskesmas 1-1-19 BPM Normal Bidan taa by. Taa
Konsul DSOG
awal,usia,sinyal PE RS Dr. Puskesmas 19-1-19 RS Fatma Normal Bidan taa by. Taa
Konsul DSOG
USIA,RWYT SC,TNGGI BADAN<145 RS DR.PKM 24/12/18 RS SC SPOG
BPS DR.PKM 9/1/19 BPS N BIDAN

KEK BPS DR.PKM 2/1/19 RS N SPOG
JARAK ANAK <2TH RS DR.PKM 8/1/19 PD N BIDAN
RS DR.SPOG 27/12/18 RS N SPOG
- - BPS ANC RUTIN 25-Jan BPS SPT BIDAN -
2019
- - BPS ANCRUTIN 17-Jan BPS SPT BIDAN -
2019
PKM dr PKM 30-12-2018 RS FATMA VAKUM DOKTER IBU SEHAT

BAYI SEHAT
RS.IBNU SINAdr.PKM 22-1-2019 RS IBNU SINA SPONTAN DOKTER IBU SEHAT
dr.OBGYN BAYI SEHAT
PUSKESMAS Dr PKM 31-1-2019 RS FATMA SPONTAN DOKTER IBU SEHAT
Dr.OBGYN BAYI SEHAT

IMT >26 BPS DR SPOG 21/12/2018 RS N DR SPOG INDUKSI
RIWAYAT ABORTUS, KEK RS DR SPOG 15/1/2019 BPS N BIDAN

BPS BIDAN 10/1/2019 BPS N BIDAN
BPS BIDAN 13/1/2019 RS SC DR SPOG
RIWAYAT SC RS DR SPOG 9/1/2019 RS SC DR SPOG
BPS BIDAN 17/1/2019 BPS N BIDAN

SINYAL PE PKM DR SPOG 30/12/2018 BPS N BIDAN
Riwayat Abortus - RS Fatma DSOG 1/16/2019 BPS N Bdn - Bdn. Dwi
- BPS PKM 1/3/2019 BPM N Bdn - BPS Siti
- 1/1/2019 BPM N Bdn -
BPS Konsul rutin 12/01/2019 BPS Normal Bidan

BPS Kontrol rutin 22/01/2019 BPS Normal Bidan
bps 1/20/2019 BPS SPT BIDAN
RS 1/31/2019 RS SPT bidan
kek pk m 1/23/2019 RS SPT BIDAN
PD/BPS DOKTER PUSKESMAS 21-12-18 BPS NORMAL BIDAN
PE(TD 130/80) PD/BPS DOKTER PUSKESMAS 27-12-18 RS SC DOKTER PE
USIA 38 PD/BPS DOKTER PUSKESMAS 01/07/2019 BPS NORMAL BIDAN
JARAK ANAK>10TH BPS DOKTER PUSKESMAS 23-12-18 RS F NORMAL
BPS konsul rutin 18-01-2019 RS Fatma SPONTAN bidan bayi+ibu sehat
usia >35 thn RS KONSUL SPOG 20-01-2019 RSUD SC(PLSPREFIA) dokter bayi+ibu sehat
jarak anak > 10 thn
DAT
PUSKES
BULA
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP UK GOL Prot Tawar Test
Hb gr% GDA
RT DA Urin
BANJAREJO
1 Novitasari- 33 BANJAREJO 27-5-18 4-2-19 G3 P2AO
Khoirul 21/3
2 Wiji Astutik- 46 BANJAREJO 14-5-18 21-2-19 G3 P2AO
Sakiman 23/3
3 Masrurotin- 33 BANJAREJO 25-4-18 2-2-19 G2 P1AO B 12,5 - 83 + +
Irhamna 17/3
4 Ifa Wahyuni 34 Banjarejo 6-6-2018 13-3-2019 G2P1A0 O 11,5 - 77 + +
Abdu Syasik 1/1

CAMPUREJO
5 ETIK P 24 CAMPUREJO RT 32 8/5/18 15/2/19 G2P1A0 A 12,8 - 122 V V
MARDI
6 LUSIANA 34 CAMPUREJO RT32 5/6/18 12/3/19 G4P2A1 O 12 - 90 V V
AGUS M
7 PINGKAN UPAKARTI 30 CAMPUREJO RT 13 14/2/18 21/2/19 G2P1A0 A 11,3 - 80 V V
ARDY OKTAVIAN
8 RATNA DWI 26 CAMPUREJO RT 24 24/4/18 31/1/19 G1P0A0 AB 13,5 - 87 V V
RWIN GUTAWA
9 FENI APRILIA 28 CAMPUREJO RT 30 25/4/18 2/2/19 G3P1A1 O 11 - 80 V V
SANDY PRAMUDYA
KADIPATEN
10 RISKY 26 RT 15/1 5/8/2018 2/15/2019 GIIPIA0 O 12 - - √ -
DAVID 30 36-37
11 MAHESWARI 29 RT12/3 5/5/2018 2/12/2019 GIP0A0 AB 12 - - √ -
HARTANTO
KALIREJO
NIHIL
KARANGPACAR
12 NOVI/ LEO 31 KR PCAR 5/1 5/10/2018 2/17/2019 G2P1A0 A 11 _ _ V V
13 MUALIMATUL H. / DISTAN 22 KR PACAR 7/1 5/10/2018 2/17/2019 G1P0A0 AB 11 _ _ V V
14 LULUK LESTARI/ ARIS WA 26 3/1 5/16/2018 2/20/2019 G2P1A0 AB 12 _ _ V V
15 SRI MURTIN/LEONARDO 24 KR PACAR 2/2 4/30/2018 2/7/2019 G1P0A0 O 11 _ _ V V
16 IIN/BUDI 33 KR PACAR 12/2 10/5/218 2/17/2019 G2P1A0 A 12 _ _ V V
17 YANTI/ 38 KR PACAR 2/1 5/20/2018 2/27/2019 G3P2A0 O 12.2 _ _ V V
18 FIFI/ AGUS SETIAWAN 29 KR PACAR 19/3 5/15/2018 2/22/2019 G3P1A1 O 11.6 _ _ V V
19 TIRZA OCTAVIA P/ AGOES 25 KR PACAR 19/3 4/15/2018 1/22/2019 G1P0A0 A 11 _ _ V V

KEPATIHAN
20 Betty Putri W 30 RT 2 /01 5/9/2018 2/16/2019 G2 P1 A0
Irmansyah Abbas 30
21 Loeritha Shinta 27 RT 12 / 02 9/13/2018 6/20/2019 G3 P2 A0
Zakarias Agung
MOJOKAMPUNG
22 Ariek Yunita/Gaguk 32 rt 02/01 02/05/2018 09/02/2019 G3P2A0 O 11,8
23 Eva Agustinigtyas/Hegki P 24 RT 13/01 10/05/2018 17/02/2019 G1P0A0 O 11.6
24 Endah/Arifin 23 RT 10/02 10/05/2018 17/02/2019 G1P0A0 O 11.8
25 Sari Ambar/Wawan 24 RT 12/02 07/05/2018 14/02/2019 G1P0A0 B 11.8
26 Palupi Ratna/Aziz 25 RT 11/02 12/05/2018 19/02/2019 G1P0A0 O 12
27 Yemi/Faisal 32 RT 13/01 02/05/2018 09/02/2019 G2P1A0 O 12.2
28 Putri/ 32 rt 10/02 16/05/2018 23/02/2019 G2P1A0 B
29 Shintia/Agus 26 rt 8/2 22/04/2018 02/01/2019 G2P1A0
MULYOAGUNG
30 wati 30 rt 8 8/1/2018 5/8/2019 g3p2a1 o 11 neg neg v
sutomo
NGROWO
31 SELVIA YOLANDA 25 RT 10 16-4-18 23-1-19 G1P0A0 O 11.7 0 - V -

32 KIKI WIJAYANTI/DIDIK 31 RT 3 22-4-18 29-1-19 G2P1A0 A 11 0 - V -
33 ATIK PUSPITA /EKO F 21 RT3 14-4-18 21-1-19 G1P0A0 B 11.6 0 - V -
34 LUSIANA/ JUNIARTO 35 RT 3 27-4-18 02/04/2019 G3P2A0 O 12 0 - V -
35 IKA / JEFRI 35 RT 8 G4P3A0 B 11.2 - - V -
36 RIKA HARIATI/AGUS N 25 RT 20 7/6/2018 14-3-19 G2P1A0 B 11.3 - - V -
37 RUTHDIANA/NATANAEL 30 RT 14 G2P1A0 O 11 0 - V -
38 FITRI ANGGRAINI 26 RT12 04/05/2018 01/12/2019 G2P1A0 A 11.2 0 - V -

SEMANDING
NIHIL
SUKOREJO
39 WIWIK SURYANI 36 30/06 08-05-2018 15-02-2018 G2 P1 A0
FINO NUGROHO
40 DEFVI ANIKA S 21 30/06 04-06-2018 11-03-2019 GI P0 A0
M. RIFA'I 10-11 Mg
41 MARITA ANGGRIANA/ 22 11/03 29-04-2018 06-02-2019 GI P0 A0
ARISONA 36 Mg
42 MARDHIYAH D 30 16/04 20-05-2018 27-02-2019 G2 P1 A0
SUPRIO
43 DIAH TRI WARDANI 28 19/08 -05-2018 -02-2019 GIII P1 A1
ILLMUDIN SYAHRIZA 12 Mg
44 TRI NADIA NINGSIH/ 28 19/05 21-05-2018 30-02-2019 GIII P2 A0
ZAENUDIN 14-15
DATA IBU BERSALIN
BULAN : FEBRUARI 2019
PPIA PENYAKIT RENCANA PENANGAN / PERSALINAN
FAKTOR RESIKO /
Hasil SCOR PENYERTA TEMPAT KOLABORASI
TANGGAL TEMPAT
(+)/(-) KOMPLIKASI SAAT INI BERSALIN DOKTER / dr.Spesialis
10 riwayat SC RS Dr. Puskesmas 3/2/2019 RS FATMA
Konsul DSOG
10 usia, jarak anak 21 th RS Dr. Puskesmas 18-02-2019 BPS
Konsul DSOG
- 2 BPM Dr. Puskesmas 26-1-2019 RS
- 14 TB 142 cm, Gemelli, RS Dokter Puskesmas 8-2-19 RS FATMA
TD 140/100 Konsul DSOG
- 2 RS DR.PKM 6/2/2019 RS
18 RIWAYAT SC,GRANDE,PERNAH ABORTUS RS DR.PKM 21/2/19 RS
2 BPS DR.PKM 118/2/19 BPS

2 RS DR.PKM 2/2/19 RS
6 PERNH ABORTUS RS DR.PKM 19/2/19 RS
- 2 - - BPS ANC RUTIN 15-Feb BPS
2019
- 2 - - BPS ANC RUTIN 12-Feb BPS
2019
_ 2 BPS BIDAN 2/15/2019 BPS
_ 6 BIDAN DR SPOG 2/10/2019 BPS
_ 6 USIA> 35 TH BPS DR SPOG 2/20/2019 BPS

_ 6 RIWAYAT ABORTUS PKM DR SPOG 2/20/2018 RS
2 - - RS Fatma dr. Wafi OG 2/8/2019 BPM
- - BPM dr. Askan 2/20/2019 BPM
2 BPS Kontrol rutin 07/02/2019 BPS

2 BPS Kontrol rutin 04/02/2019 BPS
2 BPS Konsul Dokter 15/02/2019 BPS
2 BPS Konsul rutin 12/02/2019 BPS
2 BPS Konsul Dokter 20/02/2019 BPS
BPS Konsul Dokter 01/02/2019 BPS
2 pkm 2/18/2019 rsf
- 2 PD/BPS DOKTER PUSKESMAS 22-1-19 RS F

- 2 PD/BPS DOKTER PUSKESMAS 23-1-19 BPS
- 6 USIA 35 PD/BPS DOKTER PUSKESMAS 28-1-19 BPS
- 14 USIA35. JARAK ANAK 8 BLN, GRANDE BPS DOKTER PUSKESMAS 21-1-19 BPS
- 2 BPS DOKTER PUSKESMAS 19-2-19 BPS
14 - USIA>35 HT RS ANC RUTIN 10-02-2019 RS FATMA
- HT KONSUL PKM
- RWYT PE
2 - - RS ANC RUTIN 21-02-2019 RMH BIDAN
6 - KEK - RMH BIDAN ANC RUTIN 01-02-2019 RMH BIDAN

10 - BEKAS SC - RS ANC RUTIN 12-02-2019 RS FATMA
6 - RWYT AB - BPM ANC RUTIN 23-02-3019 RSA
6 - HT - HT RS ANC RUTIN 15-02-2019 RS FATMA

PERSALINAN
BUFAS RISTI
JENIS KET
PENOLONG ( KASUS )
SC Dokter taa by taa
normal Bidan taa by taa
normal Bidan taa By taa
SC Dokter Bumil post sc bblr,
bblr+asfiksia
SC SPOG
SC SPOG
N BIDAN
N SPOG
SC SPOG
SPT BIDAN -
SPT BIDAN -
N BIDAN
N BIDAN
N BIDAN
N BIDAN
N BIDAN
N BIDAN
N BIDAN
N BIDAN
N Bdn - BPM Dwi
N Bdn HPP Nur Fat
sisa Plas
Curret
Normal Bidan
Normal Bidan
Normal Bidan
Normal Bidan
Normal Bidan
NormalBidan
NormalBidan
NormalBidan
spt bidan
NORMAL DOKTER
NORMAL BIDAN
NORMAL BIDAN
NORMAL BIDAN
NORMAL BIDAN
NORMAL BIDAN
NORMAL BIDAN
NORMAL BIDAN
SC DSOG PE -
NORMAL BIDAN - -
NORMAL BIDAN - -
SC DSOG - -
NORMAL DSOG - -
SC DSOG PE -
DATA IBU BERSALIN
BULAN : MARET 2018
PUSKESMAS G.. P....A.. LABORATORIUM PPIA PENYAKIT RENCANA PENANGAN / PERSALINAN
FAKTOR RESIKO /
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP Tawar Test Hasil SCOR PENYERTA TEMPAT KOLABORASI
UK GOL Hb gr Prot
GDA TANGGAL
DA % Urin DOKTER /
RT (+)/(-) KOMPLIKASI SAAT INI BERSALIN dr.Spesialis
BANJAREJO
1 Nurjanah- 37 BANJAREJO 9-6-2017 16-3-2018 G4P3A0 A 12,8 - 88 + + - 14 usia, jarak anak, RS D0kter Puskesmas 16-3-18
Julianto 7/1 Grande Konsul DSOG
2 Any Safitri- 24 BANJAREJO 11-7-2017 18-4-2018 G2P1A0 B 12,2 - 86 + + - 2 BPSDOKTER PUSKESMAS 2-3-18
Sunarto 9/2
3 Juli Danita - 32 BANJAREJO 15-6-17 13-3-18 G2 P1A0 B 11,8 - 88 + + - 2 BPSDOKTER PUSKESMAS 22-3-18
Dudi Susilo 2-Nov
4 Reni Rengga- 25 BANJAREJO 10-6-17 17-3-18 G1P0AO - 6 KEK lila 23cm BPSDOKTER PUSKESMAS 15-3-18
Moh Yusuf 9/02
5 Fitri - 34 BANJAREJO 13-6-17 20-3-18 G2 P1AO B 11,6 - 94 + + - 6 jarak anak > 10 th PKM Dr. Puskesmas 17-3-18
Asmari 15/03 Konsul DSOG
CAMPUREJO
6 AJENG DIYAH 31CAMPUREJO RT 19 8/6/17 15/3/18 G3P2A0 O 11 - 80 V V 2 BPS DR.SPOG 5/3/18
M.SAIFUL
7 sri utami 40 campurejo 6 5/4/2017 2/11/2018 G3P2A0 O 11 _ 81 v v 6 umur >35 th RS dr.PKM 3/3/18
rusgianto
8 Anik supartiana 22 campurejo rt 31 22/6/17 29/3/18 G1P0A0 O 11,5 - V V 6 KEK PKM KONTROL RUTIN 23/3/18
adip m.
9 DWI RETNO N W 23CAMPUREJO RT 19 '28/5/17 5/3/18 G1P0A0 O 11,5 _ 80 V V 2 RS KONTROL RUTIN 28/2/18
ACHMAD SYAFIUL
10 TRIANI 24 CAMPUREJO RT 4 1/6/17 8/3/18 G2P1A0 B 11 - 80 V V 6 JARAK ANAK <2TH BPS DR.SPOG 3/3/18
TULUS
11 TITIK SIROTIN 27 CMPUREJO 29 10/6//17 3/17/2018 G2P1A0 AB 11,5 - 82 V V 6 KEK BPS DR.PKM 13/3/18
EKA DAVID S.
12 IKA AGUSTINA 37 CAMPUREJO RT 9LUPA 4/2017 AKHIR 1/2018 G2P1A0 O 11,5 _ 80 V V 6 UMUR>35TH RS DR.SPESIALIS 8/3/18
YUUDA TTP:2/3/18
13 ANITA PRATIWI 22CAMPUREJO RT 16 24/6/17 31/3/17 G2P1A0 B 6,9 - 98 V V 10 ANEMIA,JARAK ANAK<2TH RS DR.PKM 8/3/18
TULUS
KADIPATEN
14 ELY NUR AZIZAH 35 4/1 6/13/2017 3/20/2018 G4P3A1 O 12 - - √ - - 2 - - BPS ANC RUTIN 20-Mar
M ALI MUSTOFA 2018
15 ARUMIATININGSIH 42 RT 2/ RW 1 5/22/2017 29-2-2018 G3P2A0 AB 12 - - √ - - 6 USIA 42 TH - BPS ANC RUTIN 2-Mar
HARTONO 2018
KALIREJO
16 TARBIYAH/ KUSNADI 34Kalirejo rt 09/ rw 027/12/2017 4/19/2018 G2 P1A0 AB 12 10 Jarak anak 11 th RS Dr OBGYN
Riwayat abortus
17 SULIKAH/ MUGIK 28Kalirejo rt 11/ rw 0212/06/2017 19/03/2018 G2 P1 A0 O 11.2 2 BPS Dr PKM 3/12/2018
18 ASTUTIK/ EKO PRASETYO KALIREJO

28 RT 08/ RW 02
7/14/2017 4/21/2018 G2 P1A0 O 12.5 2 POLINDES Dr PKM 3/29/2018
19SULISTYOWATI / DIKA CAHYONO 23

KALIREJO
th RT 12 / RW 04/06/2017
02 11/03/2018 G1 P0A0 O 12 2 POLINDES
dr PKM,dr OBGYN 3/31/2018
PINDAHAN DARI TRUCUK
20 RINAWATI / SLAMET WIDODO 18

KALIREJO
th RT 14 / RW 22/07/2017
02 29/04/2018 G1 P0A0 O 11.2 6 USIA < 20 th POLINDES
dr PKM,dr OBGYN 3/31/2018
PINDAHAN DARI TUBAN
KARANGPACAR
21 YULI/ BUDI 30 KR PACAR 5/1 6/12/2017 3/19/2018 G2P1A0 O 12 _ _ V V _ 2 BPS BIDAN 3/17/2018
KR PCAR RT RIWAYAT ABORTUS,JARAK

22 UMMI KUSMITHA/SHOLIKIN 29 5/25/2017 3/2/2018 G5P2A2 A 12 _ _ V V _ 14 RS DR SPOG 3/6/2018
9/2 ANAK <2TH,GRANDE
23 DITA/MUHAMMAD 31KR PACAR RT 11/2 8/12/2017 5/19/2018 G1P0A0 O 11 _ _ V V _ 2 BPS DR SPOG 3/20/2018
24DESSY AGUSTINA/ GOZA NAFIZA 23 KR PACAR 21/3 13/6/2017 20/3/2018 G1P0A0 B 12 _ _ V V _ 2 BPS BIDAN 3/15/2018
KR PACAR
25 WINDANIA/ROFII 22 5/22/2017 29/2/2018 G1P0A0 O 11 _ _ V V _ 6 KEK PKM DR SPOG 3/1/2018
RT 15/3
KEPATIHAN
26 Tri Mardiningsih 34 RT1 /01 6/16/2017 3/23/2018 G4 P1 A2 O 11.6 ( -) 93 V V ( -) 10 Riw Abortus - RSA Dr. Ika 3/8/2018
Grande Multipara
Moh. Rifa'i
27 Niyan Selvi Mey 34 RT 12 / 02 7/27/2017 4/3/2018 G3 P2 A0 O 12 ( -) 89 V V (-) 2 - - BPS dr. Didik 08/03/18
Rohmad Ismail 31
MOJOKAMPUNG
RT. 13 RW.
28 Catur Widya / Wibowo 34 13/06/2017 20/03/2018 G2P1A0 O 11.8 - - - - - 2 - - BPS Kontrol rutin 12/03/2018
01
Adinta Maulida / Aang RT. 07 RW.
29 26 23/06/2017 30/03/2018 G1P0A0 O 12 - - - - - 2 - - BPS Kontrol rutin 23/03/2018
Samsudi 02
RT. 09 RW.
30 Kiki / Indra 24 11/06/2017 18/03/2018 G1P0A0 O 11.8 - - - - - 2 - - BPS Kontrol rutin 16/03/2018
02
MULYOAGUNG
31 ratna dewi 25 6/28/2017 4/3/2018 g2p1a0 11.2 neg v 2 pkm 3/19/2018

32 puji astuti 37 9/16/2017 6/24/2018 g3p2a0 neg v 6 umur > 35th pkm 3/15/2018
andi
33 aprilia siswati 31 6/14/2017 3/21/2018 g2p1a0 o 11 neg neg v 2 bps 3/19/2018
abu hoir
34 ida rosanti 20 6/10/2017 3/17/2018 g1p0a0 o 11 neg neg v 2 3/24/2018
NGROWO
35 UMBARWATI/ MUKAROM 25 RT2 08/06/2017 15/03/2018 G2P1A0 B 12.7 0 - V - - 2 PD/BPS
DOKTER PUSKESMAS
12/03/2018
36 UMBARWATI/ MUKAROM 25 RT2 08/06/2017 15/03/2018 G2P1A0 B 12.7 0 - V - - 2 PD/BPS

DOKTER PUSKESMAS
12/03/2018
37 SUNARTI/ YANTO 31 RT 5 5/20/2017 3/27/2018 G2P1A0 O 12 - - V - - 2 BPS 2/23/2018
38 HAIZATUS S/M. JUPRON 27 RT 8 26-6-17 3/4/2018 G2P1A0 B 11.3 - - V - - 2 BPS 2/23/2018
39 ALVENIA K/DEDIK EFENDI 24 RT 20 07/06/2017 14/03/2018 G1P0A0 B 13,4 - - V - - 2 BPS 3/11/2018
40 DELLA / ADI 27 RT 14 17-5-17 24-2-18 G1P0A0 A 12,2 - - V - - 2 PD/BPS

DOKTER PUSKESMAS2/21/2018
SEMANDING
41 Megowati / Lasaji 32 RT 05/01 25/07/2017 1/5/2018 G4P3A0 AB 11,5 - - V - - 6 - BPS Konsul SPOG 3/12/2018
42 Sri wahyuni /M.Muso 32 RT 05 25/06/2017 02/04/2018 G2P1A0 O 11.2 - - V V - 2 - - BPS 3/25/2018
SUKOREJO
43 LILIK PURWATI N/ 41 03/01 05-05-2017 12-03-2018 G2 P1 A0 10 - USIA >35 - RMH BIDAN ANC RUTIN 13-03-2018
M. EKSAN 12 MG - JRK ANAK>10
44 DESI WERDININGSIH 28 02/01 28-05-2017 05-03-2018 G2 P1 A0 2 - - RMH BIDAN ANC RUTIN 01-03-2018
AKHMAD KARIS
45 CYNTHIA ZELMY P 27 24/06 06-07-2017 13-04-2018 G2 P1 A0 2 - - RMH BIDAN ANC RUTIN 21-03-2018
NADIAR AJI
46 FAIZATUN NISA 24 26/06 27-05-2017 04-03-2017 G2 P1 A0 10 - KEK - RMH BIDAN ANC RUTIN 03-03-2018
ANDIK INDRIANTO 12 MG - JRK ANK<2TH
47 LENI NOVIANTI 34 33/08 06-06-2017 13-03-2018 G3 P0 A0 2 - - RMH BIDAN ANC RUTIN 08-03-2018
FIFID SURYO HS 12 MG
48 NIMAS GALUH RORO 22 32/08 12-06-2017 19-03-2018 G1 P0 A0 2 - - RMH BIDAN ANC RUTIN 19-03-2018
IVAN ARIF 6-8 MG
19 Kepala UPTD Puskesmas Bojonegoro
Dr. Bayu Linuwih

NIP. 19690214 201001 1 001
PERSALINAN
BUFAS
JENIS RISTI KET
PENOL ( KASUS )
TEMPAT ONG
BPM Normal Bidan Taa By taa
BPM Normal Bidan taa bayi taa
BPS N Bidan - ibu & by taa
BPS N BIDAN
RS N SPOG PE
RS N SPOG FASELATEN
MEMANJANG
BPS N BIDAN
BPS N BIDAN
PKM N NIDAN
RS N SPOG
RS N SPOG
BPS SPT BIDAN -
BPS SPT BIDAN -
RS FATMA SC DOKTER IBU SEHAT

BAYI ASFIKSIA
BPS SPONTANBIDAN IBU SEHAT

BAYI SEHAT
RSUD SPONTANBIDAN IBU SEHAT

BAYI SEHAT
POLINDES SPONTANBIDAN IBU SEHAT

BAYI SEHAT
RSUD SPONTANBIDAN IBU SEHAT

BAYI SEHAT
RS N DR SPOG
RS N DR SPOG
RS N DR SPOG
RS N DR SPOG INDUKSI
BPS N BIDAN
RSA N dr. Ika -

DSOG
RSU N Bdn Partus Anjar

Prematurus
BPS Normal Bidan
RS Normal
BPS Normal
RSF SPT BIDAN

RSU SPT BIDAN
BPS SPT BIDAN
BPS SPT Bidan
BPS NORMAL
BPS NORMAL
BPS NORMALBIDAN
BPS NORMALBIDAN
RS NORMAL
DOKTER
BPS NORMALBIDAN
BY + IBU
BPM SPONTANBIDAN - SEHAT
by+ibu
BPM SPONTANBIDAN sehat
PD N BIDAN - -
RMH BIDAN NORMALBIDAN - -
RS FATMA NORMALDSOG - -
RMH BIDAN NORMALBIDAN - -
RS NORMALDSOG - -
RSA NORMALDSOG - -
as Bojonegoro
PUSKESMAS G.. P....A.. LABORATORIUM
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP GOL Hb gr Prot

UK
DA % Urin
RT
BANJAREJO
1 Mei Wulan- 33 BANJAREJO 27-6-2017 4-4-2018 G4P0A0 O 10,8 -
Eko Budiono 6/1
2 Novitasari- 23 BANJAREJO 19-07-17 26-4-18 G1P0A0 B 11,6 -
Ahmad Zaki 1/1
3 Any Safitri- 24 BANJAREJO 11-7-2017 18-4-2018 G2P1A0 B 12,2 -
Sunarto 9/2
4 Lia - 26 BANJAREJO 21-7-17 28-4-18 G2 P1A0 A 12,7 -
Adi 14/02 ? USG
5 Sri Utami- 40 BANJAREJO 10-7-17 17-4-18 G1P0A0
Dwi Ahmad 19/3
6 Endang - 34 BANJAREJO 9-7-17 16-4-18 G3 P1 A1 O 11,4 -
Budianto 21/03
7 Kiki A - 24 BANJAREJO 28-6-17 ,5-4-17 G2 P1AO A 10'5 -
Fathur R 20/03
8 Ririn Atrianawati 32 Banjarejo 15-7-2017 22-4-18 G3P2A0 O 9,5 -
Ahmad Purnomo 22/2
CAMPUREJO
9 LILIK WASIATUL 25 CAMPUREJO RT6 1/6/17 8/3/18 G2P1A0 AB 11,4 -
AGUNG
10 LINA WULANDARI 23 CAMPUREJO11 6/21/2017 3/28/2018 G1P0A0 A 13,6 -
ARKHAM F.
11 ISA YUNITA 27 CAMPUREJO RT 16 23/6/17 30/3/18 G1P0A0 AB -
NOVAN
12 AYU NURUL 26 CAMPUREJO RT 8 1/7/2017 8/4/2018 G1P0A0 0 11 -
EDI
13 SRI ASIH 32 CAMPUREJO RT 6 17/6/17 24/3/18 G2P1A0 B 11,5 _
MUSLIH
KADIPATEN
14 YULIANA KRISTIAWATI 26 RT 7/2 17-72017 24-04-2018 G1P0A0 O 12 _
DIDIK PURWANTO
KALIREJO
15 MARINDA SRI R / DEDI IRAWAN 20 th KALIREJO RT 11/ R 23/07/2017 30/04/2018 G1 P0A0 O 11.5
16 DWI SULISTYOWATI / IRAWAN 25 th KALIREJO RT 08 / R 18/07/2017 25/04/2018 G2 P1A0 O 11.2
17 DEWI FITRIANI / HERU 25 th Kalirejo rt 03 / rw 0 12/07/2017 19/04/2018 G2 P1A0 O 12
KARANGPACAR
18 SATENI/MATNIN 24 KR PACAR RT 2/1 8/1/2017 5/8/2018 G1P0A0 O 11 _
19 ANGEL/DERY 28 KR PACAR RT 4/1 7/15/2017 4/22/2018 G1P0A0 A 12 _
20 SALOM/BRIAN 27 KR PACAR RT 3/1/ 7/20/2017 4/27/2018 G1P0A0 O 11.6 _
21 DYAH AYU/ ROHKIM 22 KR PACAR 1/1 7/12/2017 4/19/2018 G1P0A0 O 12 _
22 YULI DEVITA 27 KR PACAR 10/2 7/9/2017 4/16/2018 G2P1A0 O 11 _
23 SUTARSIH/KUSUMA HADI 38 KR PACAR RT19/03 7/8/2017 4/15/2017 G2P1A0 O 11 _
KEPATIHAN
NIHIL
MOJOKAMPUNG
24 Sri Wahyuni / Novan 26 RT. 01 RW. 01 24/07/2017 01/04/2018 G1P0A0 O 11.8 -
25 Latifah Yuni Nur / M. Ni'am 27 RT. 03 RW. 01 06/08/2017 12/04/2018 G1P0A0 O 11.8 -
26 Dwi Indah Febrianti / Yoyok Dwi 25 RT. 09 RW. 02 16/07/2017 23/04/2018 G1P0A0 O 12 -
27 Umi Aisyah / Tomi 30 RT. 08 RW. 02 /07/2017 /04/2018 G2P1A0 O 11.8 -
MULYOAGUNG
28 neti rt 2 8/12/2017 5/19/2018 g3p2a0 11 neg
edi purwanto
29 suntari 35 rt 17 7/21/2017 4/28/2018 g2p1a0 neg
abd salam
NGROWO
30 FYOLA NOVALISTA/ EKO P 23 RT2 19/06/2017 26/03/2018 G1P0A0 O 11.3 0
31 FIATA FIDINI/KHOIRUL A 28 RT19 28-6-17 30-3-18 G2P1A0 O 12,6 0
32 DEVI MAULANA/ AGUS G 30 RT 19 07/01/2017 04/08/2018 G3P2A0 0 11.6 0
33 NURUL HANDAYANI/TRISNO 32 RT 19 G3P1A1 O 13,3 0
34 SULISTYOWATI/AGUS P 34 RT 9 10/16/2017 7/23/2018 G3P2A0 B 12 -
35 SULIKAH/ WARSO EDI 34 RT16 226-7-17 05/03/2018 G4P2A1 O 11,5 -
36 RETNO/ADI EKO 33 RT 14 G3P2A0 O 12,5 -
37 LELI /ENDIK 29 RT 12 G2P1A0 O 11,7 -
SEMANDING
38 Endang/Aidin 23 RT 03 03/07/2017 10/04/2018 G1P0AO O 12 -
39 SiswiJarti/ Suprapto 26 RT 04 07/07/2017 14/04/2018 G1P0AO O 11.4 -
40 Arin / Roni 35 3 05/05/2017 12/02/2018 G3P2A0 O 12 -
SUKOREJO
41 SUMARSIH 24 03/01 13-07-2017 20-04-2018 G3 P1 A1
ROHMAD HUSIAN 4-6 MG
42 TYAS ADINDA SARI 23 01/01 06-07-2017 13-04-2018 G1 P1 A0
EKA FEBRIANSYAH
43 SHOFI NUR A 30 25/06 01-07-2017 08-04-2018 G1 P0 A0 O 11.5 (-)
TRI HADI
44 AYU MIRAWATI 25 36/07 07-07-2017 14-04-2018 G1 P0 A0
CHANDRA ADE 4-6 MG
45 ANINDYA RIZKY 28 27/07 -07-2017 -04-2018 G1 P0 A0
SEPTIAN
46 INDAH FATMAWATI 32 27/07 08-06-2017 15-03-2018 G2 P1 A0
ABDULLAH
47 NAFIA HARTIYANA 31 11/03 30-06-2017 07-04-2018 G3 P2 A0
MASDUKI 8-10 MG
48 DIAN ANISSA 27 12/04 16-07-2017 23-04-2018 G1 P0 A0
AGUS CATUR H
49 SUCI INDAH S 24 08/03 03-08-2017 10-05-2018 G1 P0 A0
HARIYANTO 12 MG
50 RULIN FAJAR IDA 35 10/03 -08-2017 -05-2018 G4 P3 A0
TEGUH HERI W 12 MG
51 MELISA HANDAYANI 28 16/04 15-07-2017 22-04-2018 G1 P0 A0

M. ISMAIL 6-8 MG
52 LISTIANA 38 15/04 20-05-2017 27-02-2018 G3 P2 A0
WAHYU TRI W 35-36 Mg
53 NINIK SETYANI 29 34/08 25-06-2017 02-05-2018 G1 P0 A0
MUKHIBBUDIN
54 SASTRAWATI S 24 38/06 18-07-2017 25-04-2018 G1 P0 A0
M. ALIF ROMADHON
55 NORMA 28 17/08 11-08-2017 18-05-2018 G2 P1 A0
BUDI 16 MG
DATA IBU BERSALIN
BULAN : APRIL 2018
ORATORIUM PPIA PENYAKIT RENCANA PENANGAN / PERSAL
FAKTOR RESIKO /
Tawar Test Hasil SCOR PENYERTA TEMPAT KOLABORASI
GDA TANGGAL
98 + + - 10 Anemia,Grande PKM D0kter Puskesmas 6-4-18

Konsul DSOG
96 + + - 6 lila 21,3 BPM Dokter Puskesmas 24-4 -18
Konsul DSOG
86 + + - 2 BPS DOKTER PUSKESMAS 15-4-18
86 + + - 2 BPS DOKTER PUSKESMAS 25-4-18
14 usia, jarak anak 12 th' RS Dr. Puskesmas 13-4-18

TB 143 cm DSOG
97 + + - 10 jarak anak 1 th, PKM Dr. Puskesmas 17-4-18

riwayat abortus Konsul DSOG
106 + + - 14 riwayat abortus,anemia RS Dr. Puskesmas 8-4-18
jarak kehamilan < 2th Konsul DSOG
92 + + - 6 anemia BPM Dokter Puskesmas 20-4-18
80 V V 2 BPS DR.PKM 28/3/18
92 V V 2 BPS DR.PKM 3/4/2018
80 V V 10 KEK,PERNAH ABORTUS RS DR.PKM 7/4/2018
85 V V 2 RS SPOG 6/4/2018
80 V V 2 RS DR. SPESIALIS 26/3/18

_ V _ _ 2 _ BPS ANCRUTIN 20-4-
2018
6 Tinggi Badan 142 cm RSUD 4/26/2018
2 BPM 4/28/2018
10 LETSU RS 4/16/2018
_ V V _ 6 KEK BPS DR SPOG 2/24/2018

_ V V _ 2 RS DR SPOG 4/10/2018
_ V V _ 2 RS DR SPOG 4/14/2018
_ V V _ 2 BPS BIDAN 4/1/2018
_ V V _ 2 BPS BIDAN 4/2/2018
_ V V _ 6 USIA >35 THN PD DR SPOG 4/19/2018
- - - - 2 - - BPS Kontrol rutin 05/04/2018

neg v 14 umur > 35th HT RS 4/23/2018

jarak anak >10 th
neg v 2 4/25/2018
- V - - 2 PD/BPS DOKTER PUSKESMAS 31/03/2018

- V - - 18 R.SC,R.ABORTUS,HT PD/BPS DOKTER PUSKESMAS 17/04/2018
- V - - 2 BPS 4/2/2018
- V - - 10 R. ABORTUS, PD/BPS DOKTER PUSKESMAS 4/20/2018
- V V - 2 - - BPS 3/4/2018
- V V - 2 - - BPS 12/4/2018
- V V - 2 - - PKM - 28/4/2018
6 - RIWAYAT AB - RMH BIDAN ANC RUTIN 19-04-2018
2 - - RMH BIDAN ANC RUTIN 18-04-2018
(-) 2 - - RMH BIDAN ANC RUTIN 08-04-2018
2 - - BPS ANC RUTIN 14-04-2018
6 - JRK ANK>10 - RMH BIDAN ANC RUTIN 03-04-2018
6 - JRK ANK<2 TH - RMH BIDAN ANC RUTIN 18-04-2018
2 - - RS ANC RUTIN 27-04-2017
6 - KEK - RMH BIDAN ANC RUTIN 16-04-2018
22 - BEKAS SC - HT RS ANC RUTIN 05-04-2018

- HT KONSUL DSOG
- JRK ANK<2TH
10 - USIA>35 - BPM ANC RUTIN 30-03-2018

- JRK>2 Th
2 - - BPM ANC RUTIN 23-03-2018
19
Mengetahui
Kepala Puskesmas Bojonegoro
Dr. Bayu Linuwih

NIP. 19690214 201001 1 001
PERSALINAN
JENIS BUFAS RISTI KET

TEMPAT PENOLONG ( KASUS )
RSIS induksi dokter post date by asfiksia
RSUD Normal Bidan - Ibu taa

by asfiksia
BPS N BIDAN
BPS N BIDAN
RS N SPOG
RS N SPOG
BPS N
BPS SPT BIDAN -
RSUD SPONTAN BIDAN IBU SEHAT
BAYI ASFIKSIA
BPM SPONTAN BIDAN IBU SEHAT
BAYI SEHAT
RS FATMSC DOKTER IBU SEHAT

BAYI SEHAT
BPS N BIDAN
RS N DR SPOG
RS N DR SPOG
RS N DR SPOG
BPS N BIDAN
BPS N BIDAN
BPS Normal Bidan

BPS Normal Bidan
BPS Normal Bidan
BPS Normal Bidan
rs spt spog
bps spt bidan
RSUD INDUKSI BIDAN POST DATE

RS.F NORMAL BIDAN
RS.A SC DR
RS.F SC DR PEB
BPS BIDAN
RSUD NORMAL BIDAN PEB
BPS NURMAL BIDAN
BPS NORMAL BIDAN
BPM SPONTAN BIDAN - BY + IBU SEHAT

BPM SPONTAN BIDAN by+ibu sehat
PKM SPONTAN BIDAN BY + IBU SEHAT
RMH BI NORMAL BIDAN - -
RS FATMINDUKSI DSOG - -
RS FATMINDUKSI DSOG - -
PMB NORMAL BIDAN - -
RSU INDUKSI BIDAN - POSTDATE
RSU SC DSOG - -
RSU NORMAL BIDAN - -
RSU SC DSOG - PARTUS LAMA
PMB NORMAL BIDAN - -

RS FATMSC DSOG - -
PUSKESMAS G.. P....A..
DESA UK
NO NAMA IBU / SUAMI UMUR HPHT TTP
RT
BANJAREJO
1 Vika- 30 BANJAREJO 6-8-17 13-5-17 G2 P1AO
Luki 16/03
2 Ari Dwi R - 31 BANJAREJO 23-7-17 30-4-18 G2 P1AO
M. Arifin 18/03
3 Dwi Andini 18 BANJAREJO 15-8-18 22-5-18 G1P0A0
Vicky 20/3
4 Marina Suci- 25 BANJAREJO 26-7-17 3-5-18 G1P0A0
Tono 5/1
5 Rosta-Ahmad Toha 27 BANJAREJO 18-8-2017 15-5-2018 G2P1A0
1/1
CAMPUREJO
6 ANIZ ZULAIKAH 38 CAMPUREJO RT 422/7/17 29/4/18 G3P2A0
CUCUCK HARIANTO
7 FONITA 29 CAMPUREJO RT 126/8/17 3/6/18 G3P2A0

EKO IRAWAN
8 REZI 23 CAMPUREJO RT 316/8/17 23/5/18 G1P0A0

TRI AJI
9 FITRI NURDIANA 21 CAMPUREJO 24 8/8/17 15/5/18 G1P0A0

DIMAS 85806125151
10 WIDAYATI 32 CAMPUREJO RT 213/8/17 20/5/18 G2P1A0

SUGIANTO
11 NILA DWI R 22 CAMPUREJO RT 4/16/8/17 23/5/18 G1P0A0

NGATIMIN
12 SITI MAHMUDAH 33 CAMPUREJO RT 126/8/17 3/6/18 G2P1A0

JUMINTONO
13 SANIT YASA 27 CAMPUREJO RT 15

7/8/17' 14/5/18' G2P1A0
HENDRI ADI 812160234
KADIPATEN
14 ARI DWI SUSANTI 30 RT 12/RW 3 8/17/2017 5/24/2018 G2P1A0
DANANG
KALIREJO
15 NINIK / ALFAN 26 th KALIREJO RT 02 /13-9-2017 20-6-2018 G2 P1 A0
16 ANITA APRILIA SARI 26 th Kalirejo rt 04 / rw 0 20/07/2017 27/04/2018 G1 P0A0

Pindahan dari mulyoagung
17 IIN RETNO ZUHRO I 29 th Kalirejo rt 06 / rw 0 9/20/2017 6/27/2018 G2 P1A0
18 LASIANA/ IMAM ARIF 27 KALIREJO RT 03 / 8/7/2017 5/14/2018 G2 P1A1
19 MUNTIYAH / M.JON 22 th Kalirejo rt 09 / rw 0 01/09/2017 08/06/2018 G1 P0A0
KARANGPACAR
DINA
20 MAGFIROH/KHUSN
UL 39 KRPACAR RT14/2 6/23/2017 3/30/2018 G2P1A0
KR PACAR RT
21
FINA/SANDI 28 12/2 8/12/2017 5/19/2018 G2P1A0
22 RIKA AMBARWATI/
M.EFFENDI 38 KR PACAR 14/2 13/8/2017 20/5/2018 G1P0A0
23 ULIYA 32 KR PACAR 10/2 3/7/2017 4/14/2018 G4P3A0
DINA
KRPACAR RT
24 SEPTIANASARI/ARI 23 6/16/2017 3/23/2018 G1A0P0
23/3/
F SUBAGIO
KRPACAR RT
25 MELISA/STEVE
SITI 27 8/20/2017 5/27/2018 G1A0P0
16/3
MUAWANAH/MISBA
26 HUL H 21 KR PACAR 21/3 9/22/2017 6/29/2018 G1P0A0
KEPATIHAN
27 Elfira Hernaningtyas 27 Jl. Pangsud 22-8-17 29-5-18 G1 P0 A0
Gg. Telpon
Iwan Surya Aanggara RT 8 /02
28 Karmelia susilowati 20 RT 12 / 02 ? ? - 5 - 18 G1 P0 A0
?
MOJOKAMPUNG
29 Eka Diah N / 32 RT. 03 RW. 01 /07/2017 04/2018 G2P1A0
Ika Narti Hidayati /
30 26 RT. 13 RW. 01 /07/2017 04/2018 G1P1A0
Ali Sobirin
31 Martiah/M.Yahya 44 RT 13/01 ?{lupa} G3P2A0
Lilik Oktavia / M.
32 26 RT. 02 RW. 01 /08/2017 05/2018 G2P1A0
Efendi
33 Karmini / Solikin 32 RT.12 RW.02 06/09/2017 13/06/2018 G2P1A0
MULYOAGUNG
34 lika indartiana 2 8/10/2017 5/17/2018 g1p0a0
bayu
35 marlina 2 7/1/2017 4/8/2018 g2p1a0
guntur
36 yusnita 5 6/17/2017 9/10/2017 gip0a0
mustakim
37 tutik 30 rt 8 8/15/2017 5/22/2018 g2p1a0
suparno
38 jami"ah 2 7/10/2017 4/17/2018 g4p1a2
siman
39 nur fatimah s 27 rt 13 8/3/2017 5/10/2018 g1p0a0
nur ahmad
40 dewi lestari 26 rt 10 8/13/2017 5/20/2018 g2p1a0
NGROWO
41 LIDIA DESITA/AGUN 28 RT 8 10/10/2017 17/07/2018 G2P1AO
42 LUNGIT/ TAUFIK 39 RT 13 LUPA G6P5A0
43 YENI PURWATI 35 RT 14 20/07/2017 27/04/2018 G2P1A0
SEMANDING
44 Listina/slamet 32 RT 06 07/07/2017 14/04/2018 G2P1A0
45 Erni Dwi / Eko Widod 27 RT 04/01 1/7/2017 8/4/2018 G3P2A0
SUKOREJO
46 FEBRIANI NUR TRI 29 35/07 23-07-2017 30-04-2018 G2 P1 A0
DWI YAMERDI
47 WAHYU ADITYA P 17 29/07 06-11-2017 13-08-2018 G2 P1 A0

AGUM GUMELAR
48 IKA NANT NUR H 26 25/06 29-07-2017 06-05-2018 G1 P0 A0

ALI SHOBIRIN
49 YESI WIDAYANTI 37 12/04 22-08-2017 29-05-2018 G2 P1 A0

GUNARDI
50 WIWIN RAHAYU 27 08/03 -09-2017 -06-2018 G2 P1 A0

ABDUL HAKIM
51 NANIK WIDAYANTI 36 08/03 -08-2017 -05-2018 G7 P4 A2

NUR YASIN
52 SAWITRIANI 32 16/04 13-08-2017 20-05-2018 G4 P2 A1

YAHYA 19-20 Mg
53 INDAH KUMALA S 26 19/05 03-08-2017 10-05-2018 G1 P0 A0

BAGUS SUBAGYO
54 RIA SEPTIANI 27 18/08 04-08-2017 11-05-2018 G2 P1 A0

SYAFRUDIN A 6-8 MG
55 MUDRIKA 30 17/08 13-10-2017 20-07-2018 G2 P1 A0

AGUS NAVIUDIN
DATA IBU BERSALIN
BULAN : MEI 2018
LABORATORIUM PPIA
FAKTOR RESIKO /
Tawar Test Hasil
GOL Hb gr Prot SCOR
GDA
DA % Urin (+)/(-) KOMPLIKASI
O 10'5 - 88 + + - 6 anemia
A 9,8 - 96 + + - 10 jarak anak > 10 tahun,

anemia
B 10.8 - 92 + + - 10 usia < 20th, anemia
O 12,2 - 89 + + - 6 lila 23 cm
B 11,8 - 84 + + - 2
10,9 - V 18 UMUR>35,JARAK ANAK >10TH,ANEMIA RINGAN

15/2/18 TD NAIK 130/90
O 11,7 _ 81 V V 2
AB 12,4 - 124 V 2
B 10 - 108 V V 6 ANEMIA, KEK
A 11 - 94 V V 10 RIWAYAT SC
AB 11,5 - 82 V V 10 LILA 23,5 CM, TB 144CM
A 15 - 100 V V 10 RIWAYAT SC
O 11,2 - 82 V V 14 RIWAYAT SC,JARAK ANAK <2TH

AB 12 - - √ - - 2 -
B 12.5 2
A 13.2 2
AB 12.5 2
B 11.2 6 RIWAYAT ABORTUS
AB 12.5 2
10 PE (1-5-2018)
A 11 _ _ V V _ 6 USIA > 35
O 11.8 _ _ V V _ 2
O 11 _ _ V V _ 6 USIA > 35
O 11 _ _ V V _ 10 GRANDE MULTI, JARAK HAMIL <2TH
B 11.6 _ _ V V _ 2
O 12.2 _ _ V V _ 2
A 11 _ _ V V _ 2
B 13,2 (-) 104 v v (-) 2 -

10 PE (21-5-18)
2+ KEK
MBA
A 12 - - - - - 2 -
O 12 - - - - - 2
B 13.3 10 usia,riwayat PE
A 12 - - - - - 2 -
O 12.2 - - - - - 2
neg v 2
11 neg v 2
a 11.6 neg v 2
a 11 neg neg v 6 jarak anak 11th
neg v 10 grande multi, umur > 35
o 11 neg neg v 2
o 12 neg neg v 2
O 11 - - V - - 6 JARAK ANAK 11 BLN
O 9.9 - - V - - 18 USIA,GRANDE,
JARAK ANAK,HB
B 11,7 - - V - - 6 USIA
AB 11 - - V V - 6 -
O 11,7 - - V - - 2 -
6 JRK ANK<2 TH
10 - USIA < 20
- KEK
2 -
18 - USIA>35
- JRK ANK>10
- RWYT SC
14 - ASMA
- RWYT SC
14 - USIA>35
18 - GRANDE
- RWYT AB
- LET-SU
14 - RWYT AB
- GRANDE
- JRK<2 Th
2 -
2 -
2 -
PENYERTA TEMPAT KOLABORASI JENIS
PENOLO
TANGGAL TEMPAT
SAAT INI BERSALIN DOKTER / dr.Spesialis NG
BPS Dr. Puskesmas 15-5-2018 BPS Normal Bidan
RS Dr. Puskesmas 3-5-2018 BPS Normal Bidan
RS Dr. Puskesmas 23-5-18 RS Fatma Induksi Dokter

Konsul DSOG
PKM Dokter Puskesmas, kosul 3-5-18 BPM Normal Bidan
DSOG
BPM Dokter Puskesmas BPM Normal Bidan
H,ANEMIA RINGANRS DR.SPOG 28/4/18 BPS N BIDAN
RS DR.SESIALIS 15/5/18 BPS N BIDAN
BPS DR.PKM 9/5/2018 RS SC SPOG
BPS Dr. PKM 30/4/18 RS SC S[POG
RS DR.PKM 14/5/18 RS SC SPOG
RS Dr. PKM 23/5/18 rs sc spog
RS DR.PKM 15/5/18 rs sc spog
RS Dr.PKM 14/5/18 rs sc spog

- BPS ANC RUTIN 20-May BPS SPT BIDAN
2018
POLINDES dr PKM POLINDES

4/29/2018 SPONTANBIDAN
RS dr PKM 5/2/2018 RS FATMA SC DOKTER
PKM dr PKM 5/13/2018 PKM SPONTANBIDAN
POLINDES dr PKM 5/16/2018 POLINDES SPONTANBIDAN
RSUD 5/17/2018 RSUD SPONTANBIDAN
BPS DRSPOG 5/1/2018 BPS N BIDAN
RS DRSPOG 5/20/2018 BPS N BIDAN
BPS DR SPOG 5/18/2018 RS SC DR SPOG

IL <2TH RS DR SPOG 5/10/2018 RS N BIDAN
BPS DRSPOG 5/10/2015 RS N DR SOG
RS DRSPOG 5/28/2018 RS N DR SPOG
5/7/2018 RS N DR SOPOG
- BPM dr. Askan 5/22/2018 RSU N Bdn

PKM
- PKM 5/20/2018 PKM N Bdn

- BPS Kontrol rutin 06/05/2018 BPS Normal Bidan
RSU kontrol rutin 24/05/2018 RSUD Normal Bidan
Kontrol rutin /05/2018 RSUD Normal Dokter
rs 12-May rsf spt
bps 5/5/2018 bps spt
bps 4/30/2018 bps spt
polindes 5/18/2018 pkm spt
pkm 4/30/2018 pkm spt bidan
bps 5/2/2018 bps spt bidan
rs 5/23/2018 rs spt bidan
BPS 12/5/2018 BPS NORMAL BIDAN
PD/BPS DOKTER PUSKESMAS 15-5-18 RSUD NORMAL BIDAN
PD/BPS DOKTER PUSKESMAS 27-4-18 RSF SC DOKTER
- BPS Konsul Dr SPOG 6/5/2018 RSUD SPONTANBIDAN

BPS kontrol rutin 10/5/2018 BPM SPONTANBIDAN
- RMH BIDAN ANC RUTIN 29-04-2018 RMH BIDANNORMAL BIDAN
- RS ANC RUTIN 11-05-2018 RSU NORMAL BIDAN
- RMH BIDAN ANC RUTIN 24-05-2018 RS FATMA NORMAL DSOG
- RS ANC RUTIN 16-05-2018 RS IBNU SI SC DSOG

ASMA RS ANC RUTIN 10-05-2018 RSUD NORMAL BIDAN
- RS ANC RUTIN 07-05-2018 RSUD SC DSOG
- RS ANC RUTIN 05-05-2018 RMH BIDANNORMAL BIDAN
- RMH BIDAN ANC RUTIN 14-05-2018 RMH BIDANNORMAL BIDAN
- RMH BIDAN ANV RUTIN 14-05-2018 RMH BIDANNORMAL BIDAN
- BPM ANC RUTIN 23-08-2018 RSA NORMAL DSOG

BUFAS RISTI
KET
( KASUS )
- Ibu taa
by taa
- Ibu taa
by taa
partus tak maju ibu taa
by asfiksia
Taa By taa
Taa By taa
KPD
pe
-
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
BAYI SEHAT
R SPOG PE
INDUKSI
FASE AKTIF
MEMAMNJAN
G
R SPOG
R SOPOG
PE
- Pd
IUFD
LETSU
> 10 TH
- -
- PREMATUR
- -
- -
- -
- -
- -
- -
- -
- -
PUSKESMAS G.. P....A.. L
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP

UK GOL DA
RT
BANJAREJO
1 Anita Wahyuni- 22 BANJAREJO 12-9-2017 19-6-2018 G1P0A0 B
Afif 6/1
2 Sulistiyarini - 38 BANJAREJO 3- 9-17 10- 6-18 G3 P2 A0 AB
Agus Harsono 3/1
3 Putri Devi- 25 Banjarejo 15-9-17 ,22-6-18 G2P1A0 A
Dedy 12/2
4 Maslikah - 28 BANJAREJO 21-8-17 28-5-18 G2 P1A0
Sujatmiko 14/02
5 Heni Nur - 32 BANJAREJO 6-9-176 13-6-18 G2 P1AO O
Zaenal 22/03
6 Istitoah- 25 BANJAREJO 20-9-17 27-6-18 G3P1A1 B
Riko 16/3
CAMPUREJO
7 EKA DEFI 20 CAMPUREJO 5 13/9/17 20/6/18 G1P0A0 B
SUGIHARTO
8 ANIK 26 CAMPUREJO RT 5 10/9/17 17/6/18 G2P1A0 O

SIFAUL
9 SITI IFADATUL 26 CAMPUREJO RT4 6/9/17 13/6/18 G1P0A0 B

EDI SUTRISNO
10 IRMAYANTI 20 CAMPUREJO RT 12 23/8/17 30/5/18 G1P0A0 0

M.NUR K.
11 KISWATI 35 CAMPUREJO RT 26 25/8/17 2/6/18 G7P5A1 B

N.ALIMAN
12 HELNA P 25 CAMPUREJO RT 7 10/9/17 17/6/18 G2P1A0 O

ILHAM
KADIPATEN
13 DWI LAILATUL 27 RT 2/1 9/13/2017 6/20/2018 GIIPIA0 A

PURNOMO
14 AMALIA / JEFRI 28 RT 7/2 9/14/2017 6/23/2018 GIP0A0 A

15 HAYATI / REZKY 24 RT 8/2 8/30/2017 6/8/2018 GIIPIA0 A
16 EVA ASIH 32 RT 9/2 9/8/2017 6/7/2018 GIP0A0 A

RAMA
17 LISA ULFAIDA 33 RT 12/3 8/29/2017 6/7/2018 GIIPIA0 AB

YUDI
18 FARIDA / ARI H 23 RT 11 / 3 8/27/2017 6/5/2018 GIIPIA0 AB
19 LIA / HAMBALI 33 RT 1/1 8/25/2017 6/2/2018 G3P1A1 AB
20 FARIDA 28 RT 3/1 9/15/2017 6/25/2018 GIP0A0 AB
21 NURANI / ANTON 35 RT 14/3 9/9/2017 6/18/2018 G3P2A0 AB
KALIREJO
22 DESI RESITA / NUR HUDA 23 th KALIREJO RT 04 / RW42975.00 04/05/2018 G1 P0 A0 A
23 NGATEMI / SUJIRAN 36 th Kalirejo rt 14 / rw 02 9/18/2017 6/25/2018 G2 P1 A0 A
24 MAYA / MAHMUD 29 th Kalirejo rt 02/ rw 01 10/28/2017 7/5/2018 G3 P1A1 O
25 SUCIATIK / SUKAMTO 28 th Kalirejo rt 10 / rw 02 05/09/2017 12/06/2018 G2 P1A0 O
26 PUTRI ANDRIYANI / SEPTI 17 th Kalirejo rt 13 / rw 02 ? ? G1 P0A0
KARANGPACAR
CITRA/AHMAD 30 KR PACAR RT 07/01 8/20/2017 5/27/2018 G2P1A0 A
27
PUTRI
28 MERDEKA/SUPRIYANTO 31 KRPACAR 9/1 9/20/2017 6/27/2018 G2P1A0 AB
RETA WIDYASTUTI/
29 M.ABDUL AZIS 23 KRPACAR 2/1 14/9/2017 21/6/2018 G1P0A0 O
30 FITRIA/EDI 33 RT 09/2 8/29/2017 6/6/2018 G3P1A0 O
31 ARIEK/ARIF 31 KRPACAR RT 11/2 7/29/2017 5/5/2018 G1P0A0 O

ERVINA KARANG PACAR
KUMALASARI/EKO 30 G4P3A0 A
RT20/03
32 WAHYUDI 9/12/2017 6/19/2018
33 YULIA/FAUZAN ANWAR 31 KRPACAR RT 22/3 9/10/2017 6/17/2018 G2P1A0 O
KEPATIHAN
34 Asih Saraswati 24 RT 10 / 02 8/26/2017 6/2/2018 G2 P1 A0
M Zaeni
MOJOKAMPUNG
31/05/2018
35 Meinita / Novan 31 RT. 04 RW. 01 ? G2P0A1 A
(USG)
36 Triana Agustin / Joko 36 RT. 01 RW. 01 /09/2017 /06/2018 G3P2A0 O

Prihatin
37 Shintia/Agus 26 RT 08/02 10/09/2017 17/06/2018 G1P0A0 O
38 Samini wahyu / Aji S. 35 RT.12 RW.02 01/09/2017 08/06/2018 G1P0A0 A
MULYOAGUNG
39 Arum dwi 2 8/20/2017 5/27/2018 g2p1a0 o
yudiono
40 pina
m dzikron 22 rt 9 8/24/2017 6/1/2018 g1p0a0 o
41 fitri k 26 9/7/2017 6/14/2018 g2p1a0 o
42 mahlumatul h 20 rt11 9/13/2017 6/20/2018 g1p0a0 o
tatag
43 holifatul 24 10 8/28/2017 6/5/2017 g1p0a0 12
rudi
44 wiwik 25 9/1/2017 6/8/2018 g2p1a0 11
chrisma
45 raya 27 rt 17 9/1/2017 6/8/2018 g2p1a0 o
lantik
46 sumarni 32 rt 17 9/20/2017 6/27/2018 g2p1a0 a
budi santoso
47 rostini 34 rt16 10/20/2017 7/27/2018 G4P2A1 o
suprapto
NGROWO
48 HEPPY AYU/SEPTIAN FEBY 17 RT 2 10/10/2017 17/07/2018 G1P0A0 B
49 SARI/EKO WAHYUDI 36 RT 12 G4P3A0 O
50 SUMIATUN/WARAS 38 RT 14 09/08/2017 15-6-18 G4P3A0 O
51 FITRIANI/ DEDI IRAWAN 28 RT 17 8/25/2017 6/4/2018 G2P1A0 O
SEMANDING
NIHIL
SUKOREJO
52 RAHMATINA 35 07/02 17-09-2017 24-06-2018 G2 P1 A0
ABDUL HANAN
53 KISWATI 34 03/01 20-09-2017 27-06-2018 G1 P1 A0

AHMAD SYAIFUL R.
54 IKA LAILATUS 29 03/01 22-09-2017 29-06-2018 G1 P0 A0
MUCHOIRUL HUDA
55 SUCI NURLAILI 26 03/01 28-09-2017 05-07-2018 G1 P0 A0 B

MANSYUR 6-7 Mg
56 ENDANG L 28 31/06 -08-2017 -05-2018 G4 P2 A1

SUKARDI
57 SITI IKA WAHYUNI 31 23/06 24-09-2017 01-07-2018 G2 P1 A0

YULI PURNOMO
58 MELISA KUMALASARI 25 29/07 03-09-2017 10-06-2018 G1 P0 A0

ADI SETIAWAN 20-21 Mg
59 DEWI INDRA SARI 26 08/03 25-08-2017 02-06-2018 G1 P0 A0

DATA IBU BERSALIN
BULAN : JUNI 2018
LABORATORIUM PPIA PENYAKIT
FAKTOR RESIKO /
Tawar Test Hasil SCOR PENYERTA
Hb gr% Prot Urin GDA
(+)/(-) KOMPLIKASI SAAT INI
11,1 - 94 + + - 6 lila 21,1
10,2 - 107 + + - 18 usia,jarak anak > 10 th

astma,anemia
11,6 - 92 + + - 6 Jarak anak < 2 th
11,2 - 86 + + - 2
13,9 - 70 + + - 10 Abortus, jarak anak
15,6 - 95 V V 2
6 PE,TGL 5/5 /2018
11,5 _ 80 V V 10 RIWAYAT SC
10,4 - 97 V V 6 ANEMIA
13 - 80 V V 2
11,3 - 81 V V 18 RIWAYAT ASMA,GRANDE MASMA

22 PE,5/5/18
12 - 82 V V 6 TB TULANG
12 - - √ - - 2 - -
12 - - V - - 2 - -
12 - - V - - 2 - -
12 - - V - - 2 - -
12 - - √ - - 2 - -
12 - - √ - - 2 - -
12 - - √ - - 2 - -
12 - - √ - - 2 - -
12 - - √ - - 2 - -
13.3 6 LILA 22 cm
13.8 V V 10 USIA TERLALU TUA, JARAK ANAK
10.3 - - V V - 6 Riwayat Abortus
11.2 2
12 _ _ V V _ 2
TB <145,JARAK ANAK
11 _ _ V V _ 14 <2TH,LILA 22,3
PENYAKIT PENYERTA (MIN
12 _ _ V V _ 6 12)
12 _ _ V V _ 10 RIWYAT MOLA
12 _ _ V V _ 2
12 _ _ V V _ 6 GRANDE
11.4 _ _ V V _ 2
2+ IMT -
12.5 - - - - - 6 Riwayat abortus -
12 - - - - - 6 Usia 36 th -
13.7 108 2
11.5 - - - - - 6 Primi tua -
12 neg v 6 rwyt retensio plasenta
11 neg v 6 kek,lila 19,5

12.2 neg neg v 2
11 neg neg v 2
10 GEMELI(20/3/2018)
11 neg v 2
11 neg v 2
11 neg v 2
12 neg neg v 2
12 neg v 10 perna abortus, hamil ke 4
12 0 - V - - 6 USIA
12,4 - - V - - 6 USIA
11,2 - - V - - 10 USIA,GRANDE
12,4 - - V - - 18 R. GEMELLY.R.PEB,LILA 23,TB 143
2 PE -
6 04-06-2018 -
6 - PRIMI TUA -
10 - PLAS PREVIA
2 - -
10 6 - HB<11 -
6 - RWYT AB -
2 - -
6 KEK -
2 - -
RENCANA PENANGAN / PERSALINAN
BUFAS
TEMPAT KOLABORASI JENIS RISTI
BERSALIN DOKTER / dr.Spesialis
PKM D0kter Puskesmas 22-6-18 BPM Normal Bidan Taa

Konsul DSOG
RS Dokter Puskesmas ,12-6-18 RSUD Normal Bidan taa
Konsul DSOG
RS Dokter Puskesmas 22-6-18 RS Fatma SC Dokter rwyt SC
Konsul DSOG
BPS DOKTER PUSKESMAS 1-6-18 BPM Normal Bidan taa
BPM Dr. Puskesmas 27-6-18 RSUD Induksi Bidan Partus ta

Konsul DSOG
RS Dr. Puskesmas 20-6-18 RS Fatma Normal Dokter -
BPS Dr.PKM 29/5/18 RS N SPOG
RS DR. PKM 4/6/2018 RS SC SPOG
BPS DR.PKM 26/5/18 RS N SPOG
BPS DR.PKM 8/6/2018 RS N SPOG
RS DR.PKM 31/5/18 RS N SPOG
BPS ANC RUTIN 19-Jun BPS SPT BIDAN -

2018
BPS ANCRUTIN 20-Jun BPS SPT BIDAN -

POLINDES dr PKM 6/2/2018 POLINDES SPONTAN BIDAN
PKM dr PKM 28-5-2018 RSUD SPONTAN BIDAN
PKM dr pkm 14-6-2018 POLINDES SPONTAN BIDAN
PKM dr PKM 14-6-2018 PKM SPONTAN BIDAN
12/6/2018 PKM SPONTAN BIDAN
PD DR SPOG 6/11/2018 PKM N BIDAN
RS DR SPOG 6/2/2018 RS N DR SPOG
BPS DR SPOG 6/5/2018 RS SC DR SPOG

RS DR SPOG 6/10/2018 RS N BIDAN
BPS DR SPOG 6/9/2018 RS N BIDAN
PD DRSPOG
6/18/2018 PKM N BIDAN
BPS DR SPOG 6/16/2018 PKM N BIDAN
BPS dr Didik 6/2/2018 RSIS N DSOG -

- Kontrol rutin 06/06/2018 RSUD Normal Dokter
RS 6/1/2018 rs spt bidan
bps 6/5/2018 rs spt bidan

rs 6/3/2017 rs sc spog
6/5/2018 bps spt bidan
bps 6/5/2018 bps spt bidan
rs 6/13/2017 pkm spt bidan
PD/BPS DOKTER PUSKESMAS 17-6-18 PKM NORMAL BIDAN
PD/BPS DOKTER PUSKESMAS 5/6/2018 RS F NORMAL DOKTER
PD/BPS DOKTER PUSKESMAS 30-5-2018 RS NORMAL DOKTER
RMH BIDAN ANC RUTIN 07-06-2018 RSU INDUKSI BIDAN -
RS ANC RUTIN 10-06-2018 RSU SC DCOG -

RMH BIDAN ANC RUTIN 20-05-2018 RS IBNUSINNORMAL DSOG -
RMH BIDAN ANC RUTIN 26-06-2018 RS BAYANGSC DSOG -
BPM ANC RUTIN 30-05-2018 RSU INDKSI BIDAN -
RMH BIDAN ANC RUTIN 31-05-2018 RS FATMA NORMAL DSOG -
RMH BIDAN ANC RUTIN 05-06-2018 RMH BIDA NORMAL BIDAN -
RMH BIDAN ANC RUTIN 03-06-2018 RSU INDUKSI BIDAN -

KET
By taa
by.taa
ibu,bayi taa
bayi taa
ibu & by taa
ibu taa
by taa
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BAYI SEHAT
IBU SEHAT
BY KELAINAN KONGENITAL
MATA MIN=10
Nur Fat
-
-
PREMATUR
PRTS TAK MAJU

DATA IBU BERSALIN
BULAN : JULI 2018
PUSKESMAS G.. P....A.. LABORATORIUM PPIA PENYAKIT
FAKTOR RESIKO /
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP Prot Tawar Test Hasil SCOR PENYERTA
UK GOL DA Hb gr% GDA
Urin
RT (+)/(-) KOMPLIKASI SAAT INI
BANJAREJO
1 Nuryani- 35 BANJAREJO 12-10-17 19-7-18 G3P2A0 B 10,8 - 88 + + - 18 usia,anemia,
Isman J 1/1 riwayat SC
2 Susi Setia-Eka S. 24 BANJAREJO 9- 10-17 16- 7-17 G1P0A0 O 11,6 - 99 + + - 2
1/1
3 Novia-Kamimtuhari 40 BANJAREJO USG G5P4A0 B 8,3 - + + - 14 usia, grande, anemia
1/1 11- 7-18
4 Ninik Hariyani- 40 BANJAREJO 3-10-17 10-7-18 G2P1A0 B 11,0 - 72 + + - 6 usia.
Nus Sukmana 9/2
5 Sholikatin- 25 BANJAREJO 6-10-18 13-7-19 G3P1A1 O 11,1'- 84 + + - 14 Abortus, Jarak anak
Eko 22/3 10,0 28-6-18 ,lila22,5 cm,anemia
6 Ratna Putri- 26 BANJAREJO 16-10-17 23-7-18 G2 P1AO A 12,1 - 70 + + - 2
Candra 16/3
7 Fia Era Nurwika D- 39 BANJAREJO ,28-9-17 5-7-18 G3P2 A0 A 11,2 - 6 usia
Didik Dwi R 21/3
CAMPUREJO
8 SRI NURHENIK 34 CAMPUREJO RT 4 14/10/17 21/7/18 G2P1A0 AB 11,2 - 92 V V 6 GEMELI
KHOIRUL HUDA
9 ida virgo wati 31 campurejo rt 3 28/10/17 4/8/18 G4P2A1 B 15 - 92 V V 14 RWYAT HT,RWYAT ABORTUS,GRANDE MULTI
DART0
10 PUSPITASARI 26 CAMPUREJO RT6 13/10/17 20/7/18 G3P1A1 O 11,5 - 80 V V 6 PERNAH ABORTUS

M.YUDI
11 FANNY 30 CAMPUREJO RT5 LUPA /10/17 AKHIR 7/18 G2P1A0 O 11,5 _ 80 V V 6 JARAK ANAK KURANGDARI 2TH
ERVAN D
12 NUR ISNAINI RAHMAWAT25 CAMPUREJO 19 27/9/17 4/7/18 G1P0A0 O 12 _ 80 V V 2

ADITYA
13 SISMAWATI 21 CAMPPUREJO RT 20 1/10/17 8/7/18 G2P1A0 11 - 86 V 10 KEK,JARAK ANAK <2TH
BUYUNG
14 JUWARIYAH 32 CAMPUREJO R 17 5/10/17 12/7/18 G2P1A0 O 11 - 80 V V 2

KOLIK
15 DIAH RETNO 21 CAMPUREJO RT 16 15/10/`17 22/7/18 G1P0A0 O 11,7 - 80 V V 6 KEK

FIAN ASHARUDIN
KADIPATEN
16 DWI WAHYUNI 27 RT 3 / RW 1 9/20/2017 6/27/2018 GIP0A0 AB 12 - - √ - - 2 - -
ANANG R 28
17 ALIYYA 24 RT 7/RW 2 10/16/2017 7/23/2017 GIP0A0 AB 12 - - V - - 2 -
DIDIK
KALIREJO
18 KAYATIN / TEGUH 39 th KALIREJO RT 08 / RW 09/13/2017 6/20/2018 G3 P2 A0 AB 12 6 UMUR > 35 th
19 SISKA / NUR CAHYO 22 th KALIREJO RT 14 / RW 009/10/2017 16/07/2018 G2 P1A0 O 11 2
20 ANA / HANDOKO 26 th Kalirejo rt 01 / rw 01 10/09/2017 17/06/2018 G2 P1A0 AB 11.5 2

KARANGPACAR
21 MICHELE/DEDI 28 KR PACAR 5/1 10/10/2017 7/17/2018 G1P0A0 A 11.4 _ _ V V _ 2
22 NITA/JERY 29 KR PACAR 4/1 9/23/2017 6/30/2018 G1P0A0 O 12 _ _ V V _ 2
23 ARIK / 30 KRPACAR RT 11/2 9/15/2017 6/22/2018 G1P0A0 O 11 _ _ V V _ 2
24 ANA /BUDI 34 KRPACAR RT 20/3 9/15/2017 6/22/2018 G2P1A0 O 12 _ _ V V _ 6 JARAK ANAK >10 THN
25 KANTIKA/ - 22 KR PACAR 23/3 11/20/2017 8/27/2018 G2P1A0 O 12 _ _ V V _ 2
KEPATIHAN
26 Ny. Novi Ratna WP 34 RT 2/ 01 10/10/2017 7/17/2018 G3P2A0 10 Riw : P1 --> bayi asphexia
kmd meninggal
M Okta R P2 --> IUFD
Jarak < 2th
KEK
MOJOKAMPUNG
27 Dwi Erawati / Sumidi 37 RT. 13 RW. 01 15/10/2017 22/07/2018 G4P2A1 O 11.5 - - - - - 14 Usia, grande, riwayat abortus -
28 Indar Priwanci/Imam 36 RT 04/01 19/10/2017 22/07/2018 G2P1A0 B 12 6 usia
29 Lusi / Siswadi 38 RT.07 RW.02 /11/17 /8/2018 G3P2A0 O 11.8 - - - - - 6 Usia 38 tahun -
MULYOAGUNG
30 iis ambarwati 2 10/10/2017 7/17/2018 g2p0a1 6 perna abortus
31 lia agus 29 rt 6 10/20/2017 7/27/2018 g2p1a0 o 11 neg v 2

solikin
NGROWO
32 JUMINTEN/IMAM SUDA 45 RT 8 10/5/2017 Jul-18 G3P2A0 A 12,5 - - V - - 14 USIA,R.SC,
33 ENDRI DIANA NIYESI 38 RT 20 9/12/2017 6/19/2018 G4P3A0 O 12,6 - - V - - 10 USIA ,GRANDE
34 NINGRUM/ 31 RT 9 9/17/2017 6/24/2018 G2P1A0 O 11,5 - - V - - 2
35 EDE NINA/YUDA 17 RT 14 10/08/2017 17/05/2018 G1P0A0 A 12,2 - - V - - 6 USIA
SEMANDING
NIHIL
SUKOREJO
36 FRIDA OKTAVIANDRI 36 31/06 14-10-2017 21-07-2018 G2 P1 A0 10 - USI>35 -
HARSONO - JRK ANK>10
37 MEI LINA 23 37/06 ? ? G2 P1 A0 2 - -

ABDUL AZIS ± 12 Mg
38 IKFINA HIMMATI 29 09/03 05-10-2017 12-07-2018 G1 P0 A0 6 - PRIMI TUA -

MUHAYAD NAIM 10-12 Mg
39 ZAENAB 20 10/03 -09-2017 -06-2018 G2 P1 A0 10 - JRK ANK < 2 TH

TSALIS DUHA R 20 Mg - RWYT TRANSFUSI
40 SITI YUNIATI 27 20/05 22-09-2017 29-06-2018 G3 P2 A0 2 - -

ACH. PRASETYO 10-12 MG
41 CHOIRUN NISA 33 14/04 14-10-2017 21-07-2018 G3 P2 A0 2 - -

AGUS RIFAL S 20 Mg
42 SRI ANGGRAINI 29 34/08 10-10-2017 17-07-2018 G1 P0 A0 6 - LILA 23 CM -

SLAMET ARIFIN
43 UMI NUR FARADIKA 26 32/08 08-10-2017 15-07-2018 G1 P0 A0 2 - -

EDI SAPUTRO 19-20 Mg 6 - HB 9,3 gr%
RENCANA PENANGAN / PERSALINAN
BUFAS
TEMPAT KOLABORASI JENIS RISTI KET
BERSALIN DOKTER / dr.Spesialis
RS Dokter Puskesmas 11-7-18 RSUD SC dokter taa By taa

Konsul DSOG
BPM Dokter Puskesmas 14-7-18 BPM Normal Bidan Taa By taa
RS Dokter Puskesmas ,13-7-18 RS Fatma Normal Bidan taa by.taa

Konsul DSOG
RS Dokter Puskesmas 1-6-18 BPM Normal Bidan taa bayi taa
Konsul DSOG
BPM Dr. Puskesmas 17-7-2018 BPS Normal Bidan - Ibu taa
Konsul DSOG by taa
BPM Dr. Puskesmas 20-7-2018 BPS Normal Bidan - Ibu taa
by taa
RS Dr. Puskesmas 23-7-2018 BPS Normal Bidan - Ibu taa
Konsul DSOG by taa
RS DR.PKM 21/7/18 rs N SPOG
RS DR.PKM 23/7/18 RS SC SPOG
PKM DR.PKM 29/6/18 PKM N BIDAN
RS DR.SPESIALIS 26/6/18 RS N SPOG

BPS ANC RUTIN 7/2/2018 bps spt bidan
BPS ANCRUTIN 7/27/2018 bps spt bidan
POLINDEdr PKM 28-6-2018 RSUD SPONTANBIDAN IBU SEHAT

BAYI SEHAT
BPM dr PKM,dr OBGYN 23-7-2018 PUSKESMASPONTANBIDAN IBU SEHAT

BAYI SEHAT
BPM dr PKM 10/7/2018 BPM SPONTANBIDAN IBU SEHAT

BAYI SEHAT
RS DR SPOG 7/20/2018 RS N DR SPOG

RS DR SPOG 7/5/2018 BPS N BIDAN
BPS DR SPOG 7/10/2018 BPS N BIDAN
BPS DR SPOG 7/24/2018 BPS N BIDAN
BPS BIDAN 6/26/2018 RS N BIDAN
RS F Dr Askan 6/29/2018 RS F N dr. Jihan Post SC
RS Kontrol rutin 21/07/2018 BPS Normal Bidan

BPS kontrol rutin 23/07/2018 BPS Normal Bidan
- Kontrol rutin 26/07/2018 RSUD Normal Dokter
pkm 7/26/2018 rs spontan bidan
pkm 7/29/2018 bps spt bidan
RS 22-6-18 RS SC DOKTER
BPS 21-6-18 RS SC DOKTER
BPS 18-7-18 BPS NORMALBIDAN
PD/BPS DOKTER PUSKESMAS 22-6-18 RSA SC DOKTER

RMH BID ANC RUTIN 02-07-2018 RS FATMA INDUKSI DSOG - -
RMH BID ANC RUTIN 02-07-2018 RSU INDUKSI BIDAN - PE
RS ANC RUTIN 24-07-2018 RS FATMA INDUKSI DSOG - POSTDATE
RS ANC RUTIN 27-06-2018 BPM NORMALBIDAN - -
RMH BID ANC RUTIN 27-06-2018 BPM NORMALBIDAN - -
RMH BID ANC RUTIN 30-06-2018 BPM NORMALBIDAN
RMH BID ANC RUTIN 08-07-2018 RMH BIDANNORMALBIDAN -
RMH BID ANC RUTIN 16-07-2018 RS FARMA INDUKSI DSOG -

NO NAMA IBU / SUAMI UMUR DESA HPHT TTP GOL Hb gr Prot GDA Tawar Test Hasil
UK
DA % Urin
RT (+)/(-)
BANJAREJO
1 Risnawati- 32 BANJAREJO 10-11-17 17-8 -18 G3 P2A0
Debi 4/1
2 Santi- 21 BANJAREJO 23-10-18 30-7-18 G1P0A0 B 11'3 - + + -
Widodo 7/1
3 Frida Agustini- 42 BANJAREJO - 12-17 -9-18 G4 P3A0 A 11,5 - 89 + + -
Kusdi 1/1
4 Aprilia W- 27 BANJAREJO 14-11-2017 21-8-2018 G3P1A1 O 12,3 - 100 + + -
M Zazuli 13/2
5 Sri Isnaini- 39 BANJAREJO 16-11-17 23-8-18 G2P1A0 B 12,8 - 69 + + -
Supoyo 11/2
6 Dwi Utami-Supandi 39 BANJAREJO 26-10-17 2-8-18 G4P3A0 B 9,8 - 67 + + -
11/2
7 Ayu Febriani- 19 BANJAREJO 14-12-17 21-9-18 G1P0A0 AB 10,3 - 81 + + -
Alif Khosyiin 9/2
8 Nurul Ekawati- 28 BANJAREJO 20-10-17 27-7-18 G4P3A0 B 11,5 - 80 + + -
Sadoro 20/3
9 Nila Gede- 28 BANJAREJO 31-10-17 5-8-18 G2 P1AO B 12,3 - 98 + + -
Bayu K 17/3
10 Mita Aprilia- 19 BANJAREJO 20-11-17 27-8-18 G1P0A0 A 10.0 - 90 + + -
Doni Listiawan 21/3
CAMPUREJO
11 DHIKA KARISMA 31 CAMPUREJO RT1931/10/17 7/8/18 G3P2AO O 11,5 _ 80 V V
MORDHEI L
12 NOVI PUSPITA 30 CAMPUREJO RT 2LUPA 12/17 USG 3/9/18 G3P2A0 O 12 - 89 V V

DONI S 85233728334
13 IMRO'ATUL MAGHFIROH 14 CAMPUREJO RT 125/11/17 2/9/18 G2P1A0 O 11,5 - 85 V V

ABDUL AZIZ
KADIPATEN
14 SITI NUR A 32 RT 3/RW 1 11/20/2017 8/27/2018 G2P1A0 A 12 - - √ - -
ARDIAN K
15 CITRA WIJAYANTI 28 RT 2/1 11/12/2017 8/19/2018 G1P0A0 O 12 - - √ - -
ABDI
16 MIA / KIKI 32 RT 3/ 1 11/20/2017 8/27/2018 G3P2A1 AB 12 - - √ - -

35
17 INNAYAH 25 RT 8 / 2 12/11/2017 19-8-2018 G2P1A0 AB 12 - - V - -
AFFANDY 27
18 DINDA 29 RT 13 RW 3 3/2/2018 12/8/2018 G1P0A0 AB 12 - - √ - -
ADAM
19 AMY 25 RT 9/3 22-11-2017 29-8-2018 G2P1A0 AB 12 - - √ - -
RUSLAN 27
KALIREJO
20 IRIANI / ABDUL JALIL 37 thKalirejo rt 01 / rw 0104/11/2017 11/08/2018 G3 P2A0 0 11.2 - - V V -
KARANGPACAR
ANGEL/TONI O 12 _ _ V V _
21 28 KRPACAR 4/1 11/6/2017 8/13/2018 G1P0A0
22 YOANITA AVILIONI/RENDY 25 KR PACAR 4/1 13/11/2017 20/8/2018 GIP0A0 AB 12.2 _ _ V V _
O 12 _ _ V V _
23 IDA MUSTIKA R/ SLAMET PURWANTO 29 KRPACAR 10/2 15/10/2017 22/7/2018 G2P1A0
24 LUCIA AGUSTINA/ JOHAN 33 KRPACAR 20/3 10/10/2017 17/7/2018 G4P3A0 O 12 _ _ V V _
25 LUKI DIAN/HARI SUCIPTO 40 KR PACAR 23/3 10/25/2017 8/2/2018 G5P4A0 O 12 _ _ V V _
26 MITHA APRILIA/ DANI LISTIAWATI 19 KR PACAR 20/3 10/20/2017 7/27/2018 G1P0A0 O 11 _ _ V V _
27 ENDANG LISWATI/ SUYITNO 31 KR PACAR 13/3 15/11/2017 8/22/2018 G2P1A0 AB 11,2 _ _ V V _
28 SILVIA/REINHART 23 KR PACAR 16/3 11/7/2017 8/14/2018 G1P0A0 O 11 _ _ V V _
KEPATIHAN
29 Widarti 33 Rt 3 / 01 ?- 11- 17 ? - 8 -18 G6 P2 A3 B 12.5 (-) 90 v v (-)
Teddy
MOJOKAMPUNG
30 Eli P / 38 RT. 04 RW. 01 01/12/2017 08/09/2018 G4P3A0 A 11.8 - - - - -
31 Susyanti/Yitno 34 RT. 05 RW.01 15/11/2017 22/08/2018 G2P1A0 O 11.7 - - - - -

32 Ninik/zaenal 33 RT.10 RW.02 03/11/2017 10/08/2018 G1P0A0 O - - - - - -
MULYOAGUNG
33 marita 23 rt 6 g1p0a0 12 neg v
rayyan
34 Anita rahmawati rt 2 11/17/2017 8/24/2018 g1p0a0 a 12 neg neg v neg
pungki wahyu
35 nur alfiah 30 rt 12 11/2/2017 8/9/2018 g3p2a0 a 11 neg v
agus
NGROWO
36 SRIATI/ M. IKHSAN 40 RT 3 G3P2A0 B 11.8 0 - V - -
SEMANDING
37 Suaidah / Suyanto 33 RT 05/01 12/11/2017 9/8/2018 G3P2A0 O 11.2 - - V - -
SUKOREJO
38 MARIYANTI 34 05/01 05-11-2017 12-08-2018 G2 P1 A0
LUTHFI S
39 LASTRI 31 05/01 05-11-2017 12-08-2018 G2 P1 A0

HENDRIK IRWANSYAH 7-8
40 YENI ULFADHILA 29 03/01 20-11-2017 27-08-2018 G3 P2 A0

ARY UDIYANTO 28 MG
41 SUCI RAHAYU 27 23/06 19-11-2017 26-08-2018 G1 P0 A0

DARMOYO 6-7 MG
42 PUJI LESTARI 34 29/07 06-11-2017 13-08-2018 G2 P1 A0

PURNOMO SIDIQ
43 PUTRI FEBRIAN SARI 24 35/07 25-10-2017 02-08-2018 G1 P0 A0

ERWIN TRI G 8-10 Mg
44 DEWI RATNA A 31 37/06 -12-2017 -09-2018 G2 P1 A0

KHOIRUL ANAM
45 AULIA FITRI N 22 25/06 -11-2017 -08-2018 G1 P0 A0

SAIFUL FAHMI 6 MG
46 NAILUL HIDAYAH 23 09/03 23-10-2017 30-07-2018 G1 P0 A0

ACH. SYAIFUL A. 8-10 MG
47 LINA AYU R 26 09/03 03-10-2017 10-07-2018 G2 P0 A1

RIBA'AN 34-35 MG
48 ANIS IRAWATI 37 22/05 03-12-2017 10-09-2019 G3 P2 A0

EKO HARIYONO 9-10 Mg
49 GITA PERMATA 25 20/05 15-11-2017 22-08-2018 G1 P0 A0

BAGUS SETYAWAN 20 MG
50 DESI RETNO D 31 19/05 25-10-2017 02-08-2018 G2 P1 A0

M. RIDWAN 5-6 MG
51 UMROTUL ANIK N 19 17/08 20-10-2017 27-07-2018 G2 P0 A1

AHM CHOIRUL A
DATA IBU BERSALIN
BULAN : AGUSTUS 2018
FAKTOR RESIKO /
SCOR PENYERTA TEMPAT KOLABORASI JENIS
TANGGAL TEMPAT PENOLONG
KOMPLIKASI SAAT INI BERSALIN DOKTER / dr.Spesialis
2 BPS Dokter Puskesmas 15-8-18 BPM Normal Bidan
2 BPM Dokter Puskesmas 2-8-2018 BPM Normal Bidan

Konsul DSOG
10 usia, terlalu sering, BPM Dokter Puskesmas ,2-8-2018 RS Fatma Normal Bidan
Konsul DSOG
10 ABORTUS,JARAK ANAK PKM DOKTER PUSKESMAS ,20-8-18 PKM Normal Bidan
10 usia,jarak anak RS Dokter Puskesmas 21-8-2018 PKM Normal Bidan

Konsul DSOG
14 RS Dokter Puskesmas 5-8-2018 RSUD induksi dokter
grande, usia, anemia
Konsul DSOG
6 usia RS Dokter Puskesmas 21-8-2018 RSUD induksi dokter
Konsul DSOG
6 jumlah anak BPM Dokter Puskesmas 26-7-18 RS Fatma Induksi Dokter
2- BPS Dr. Puskesmas 3-8-2018 BPS Normal Bidan

Konsul DSOG
10 usia, anemia RS Dr. Puskesmas 21-8-18 PKM Normal Bidan
Konsul DSOG
2 RS DR.SPESIALIS 26/7/18 BPS N BIDAN
2 BPS DR.PKM 22/8/18 BPS N BIDAN
2 BPS DR.PKM 18/8/18 rs sc spog
2 - - BPS ANC RUTIN 25-Aug BPS SPT BIDAN
2018
2 - - BPS ANC RUTIN 19-Aug BPS SPT BIDAN
2018
6 PERNAH GAGAL KEHAMILAN - BPS ANC RUTIN 27-8 BPS SPT BIDAN
2018
2 - - BPS ANCRUTIN 17-8 BPS SPT BIDAN
2018
2 - - BPS ANC RUTIN 8-Dec BPS SPT BIDAN
2018
2 - - BPS ANC RUTIN 25-8 BPS SPT BIDAN
2018
6 Usia > 35 th PKM dr PKM 8/12/2018 RSUD SPONTAN BIDAN
2
BPS DR SPOG 8/10/2018 RS N DR SPOG
6 ASMA BPS DR SPOG 8/20/2018 RS N DR SPOG
2
BPS DR SPOG 8/5/2018 RS N BIDAN
6 GRANDE MULTI RS DR SPOG 8/1/2018 RS N DR SPOG
10 USIA > 35TH, GRANDE MULTI RS DR SPOG 8/1/2018 RS N DR SPOG
6 USIA <20 TH PKM DR SPOG 8/3/2018 BPS N BIDAN
6 LILA <23,5 BPS DR SPOG 8/20/2018 BPS N BIDAN
2 BPS BIDAN 8/14/2018 RS N DR SPOG
14 grande (-) PKM dr PKM 8/18/2018 RSU N Bdn

riw abortus
riw IUFD
10 Usia 36 th, jarak anak 10 tahun - BPS Kontrol rutin 03/08/2018 BPS Normal Bidan
2 BPS Kontrol rutin 19/08/2018 BPS Normal Bidan

2 BPS Kontrol rutin 08/08/2018 BPS Normal Bidan
2 bps 8/11/2018 pkm spt bidan
2 pkm 8/4/2018 rsis spt spog
6 jarak kehamilan < 2th bps 8/10/2018 bps spt bidan
6 USIA PD/BPS DOKTER PUSKESMAS 24-7-18 RS NORMAL DOKTER
2 - - BPS kontrol rutin 8/29/2018 PKM SPONTAN BIDAN

2 - - RMH BIDAN ANC RUTIN 06-08-2018 BPM NORMAL BIDAN
10 - JRK ANK>10 HT RS ANC RUTIN 16-08-2018 RS FATMA SC DSOG

- HT
2 - - BPM ANC RUTIN 29-08-2018 RS NORMAL DSOG
6 - TB<145 Cm - RS ANC RUTIN 07-08-2018 RS FATMA SC DSOG
2 - - RMH BIDAN ANC RUTIN 13-08-2018 RMH BIDAN NORMAL BIDAN
2 - - RMH BIDAN ANC RUTIN 16-08-2018 RS MUNA INDUKSI DSOG

6 POSTDATE
6 - JRN ANK>10 - RMH BIDAN ANC RUTIN 28-08-2018 RS FATMA SC -

14 - PE
- PLAS PREVIA
6 - LILA 21 - RMH BIDAN ANC RUTIN 20-08-2018 RMH BIDAN NORMAL -
2 - - RMH BIDAN ANC RUTIN 14-08-2018 RMH BIDAN NORMAL BIDAN
6 - RWYT AB - BPM ANC RUTIN 28-07-2018 RS FATMA NORMAL DSOG
6 - USIA>35 - RS ANC RUTIN 25-08-2018 RSU INDUKSI BIDAN

10 PE (JUNI) KONSUL RS
2 - - RMH BIDAN ANC RUTIN 21-08-2018 BPM NORMAL BIDAN

6 PE RS KONSUL DSOG
2 - - RMH BIDAN ANC RUTIN -03-08-2018 RMH BIDAN NORMAL BIDAN
10 - USIA<20 - RMH BIDAN ANC RUTIN 02-08-2018 RS FATMA INDUKSI DSOG

- RIWAYAT AB
BUFAS RISTI ( KASUS ) KET
Taa taa
Taa By taa
taa by.taa
taa
taa bayi taa
post date by taa
kala I memanjang MBA

by. Asfiksia
ketuban pecah ibu taa
dini by.taa
- Ibu taa
by taa
- Ibu taa
by taa
- -
- -
-
-
IBU SEHAT
BAYI SEHAT
- MOW
HPP
BY + IBU SEHAT
- -
PE -
- -
- -
- -
- POSTDATE
PE -
- -
- -
- -
PE -
- -
- -
- -
PUSKESMAS G.. P....A.. LABOR
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP UK GOL Hb gr%

DA
RT
BANJAREJO
1 Sutik - 29 BANJAREJO 2-12-17 9-9-18 G2P1A0 A 12.2
Catur 6/1
2 Rika Haruma- 34 BANJAREJO 8-12-17 15-9-18 G2P1A0 O 10,6
Hendra 5/1
3 Siti Nur K-Joko 25 BANJAREJO 5-12-17 17-9-18 G2P0A1 O 13,5
11/2
4 Susi Lestari- 38 BANJAREJO 23-11-18 30-8-18 G2P1A0 O 13.5
Puji H 14/02
5 Intan Caesar- 31 BANJAREJO 15-12-17 22-9-18 G2P1A0 B 13.2
Eko 12/2
6 Sri Utami-Mungin 26 BANJAREJO 18-9-18 G2PIA0 A 10,5
22/3
7 Ayu Elok- 22 BANJAREJO 27-12-17 3-9-18 G1P0A0 O 13
Andra P 20/3
8 Erik Erna- 21 BANJAREJO 29-12-17 6-10-18 G1P0A0 B 11,2
Dedi 20/3
CAMPUREJO
9 SITI NUR ELISA 18 CAMPUREJO RT 17 7/12/2017 14/9/18 G1P0A0 O 12
M.HERU
10 SUNARTI 37 CAMPUREJO RT 12 1012/17 17/9/18 G3P2A0 A 11

M.WAHIB
11 ENI NURWITA 37 CAMPUREJO RT 9 13/12/17 20/9/18 G3P2A0 AB 13,1

A.MUSAFAK
12 SITI LISTIROKAH 35 CAMPUREJO RT 22 12/12/17 19/9/18 G3P2A0 B 12,7

AGUSTUS
13 WINARSIH 37 CAMPUREJO RT 26 15/11/17 22/8/18 G4P3A0 B 9,9

WIJI
14 SULASTRI 34 CAMPUREJO RT 6 1/12/2017 8/9/2018 G3P1A0 B 12,1

EKO,
15 YESSI 32 CAMPUREJO RT 27 3/12/2017 10/9/2018 G1P0A0 B 12,4-

AGUS SETIYAWAN 82245227071
KADIPATEN
16 RAGIL APRILIANTI 27 RT 8/2 12/15/2017 9/17/2018 GIP0A0 O 12
INDRA NUR R
17 WIWIN 30 RT7/2 3/2/2018 12/9/2018 GIIPIA0 A 12
RICHO 10-12 MG
18 INDAH DWI R 28 RT 11/3 12/22/2017 9/29/2018 GIIPIA0 O 12
M MALIK
19 SILA 27 RT 13 RW 3 2/2/2018 11/9/2018 G1P0A0 AB 12
SUSENO
20 MIA / KIKI 32 RT 3/ 1 11/20/2017 8/27/2018 G3P2A1 AB 12
35
KALIREJO
21 DEWI PURWANTI / M.FAUZI 27 th KALIREJO RT 10 / RW05/12/2017 12/09/2018 G2 P1A0
22 SRIANI / BANDIS TRI W 26 th KALIREJO RT 12/ RW 21/11/2017 28/08/2018 G2 P1A0 AB 11.3
23 KURUN ININ ANIL C / AGUS W 21 th KALIREJO RT 08 / RW15/12/2017 22/09/2018 G1 P0A0 O 13.3
24 RINI / IMAM BAHAUDIN 22 th Kalirejo rt 06 / rw 01 12/3/2017 9/10/2018 G1 P0A0
25 JULITA / ARIF SUGIANTO 27 th KALIREJO RT 14/ RW 10/12/2017 17/09/2018 G3 P2A0 O 12
26 ENY / ANDIK 24 th Kalirejo rt 04 / rw 01 17/09/2017 24/06/2018 G2 P1A0
27 WARSIYAH / SAIM 39 th Kalirejo rt 11 / rw 02 12/8/2017 9/15/2018 G3 P2A0
KARANGPACAR
28 NUNUNG KUSMIATI/SURAJI 41 KRPACAR 1/1 22/11/2017 29/8/2018 G4P2A1 O 11.4
29 MONIKA /DAREL 27 KR PACAR 4/1 12/10/2017 9/17/2018 GIP0A0 O 11.8
30 GRACE/ KELVIN 28 KR PACAR 5/1 11/20/2017 8/27/2018 G1P0A0 O 11
31 SHINTA / DONI NOFAYANTO 28 KR PACAR 8/2 8/12/2017 15/9/2018 G2P1A0 B 11,4
32 MARTIANINGRUM/ KHOIRIL BAZAR 32 KR PACAR 21/ 3 11/5/2017 8/12/2018 G2P1A0 O 11
33 SUHARIK/ERIK 25 KR PACAR 20/3 12/15/2017 9/22/2018 G1P0A0 O 12
34 ERISKA DWI C/ALFIN NASFIN 23 KR PACAR 20/3 11/24/2017 8/31/2018 G1P0A0 B 11
KEPATIHAN
35 Nurul Puji A 37 RT 11 / 02 1/25/2018 1/2/2019 G2 P0 A1 O 11.8
Soni taufik
MOJOKAMPUNG
36 Ayik / Erfan 31 RT. 03 RW. 01 02/12/2017 09/09/2018 G2P1A0 O 11.5
37 Endar Riani/Agus 26 RT 05/01 12/11/2017 19/08/2018 G3P2A0 O 12
MULYOAGUNG
38 dwi kurniawati 30 4 12/7/2017 9/14/2018 g3p2a0 a 11
meyfi
39 yusana 34 2
arif 12/20/2017 9/27/2018 g2p1a0 a 12
40 esa novita 25 rt7 12/14/2017 9/21/2018 g1p0a0 A 12

yuda prawira
41 kusmiatun 40 rt 6 11/27/2017 9/4/2018 g2p1aa0 b 11
catur h
42 aan anis rt2 11/15/2017 8/22/2018 g2p1a0 a 9
handry
43 julia arrahmaaati 28 rt 13 1/1/2018 10/8/2018 g1p0a0 a 12
hoirul fatikin
NIHIL
NGROWO
44 ANIS S/GUNAWAN 28 RT 19 03/01/2018 10/10/2018 G1P0A0 O 12
45 RANI TERA SUSTARI/NUR K 33 RT 5 12/14/2017 9/21/2018 G1P0A0 O 11,3
46 ELLY/ 36 RT9 G3P2A0 O 11.5

SEMANDING
NIHIL
SUKOREJO
47 IKA DIANA SARI 40 02/01 -12-2018 -09-2018 G4 P3 A0
M. KHAMIM
48 MELINDA R. 34 06/02 ? 24-09-2018 G2 P1 A0

SAMSUL ARIFIN USG 29-30 mg
49 ERNI SUMARNI 22 31/06 04-01-2018 11-10-2018 G3 P2 A0

AGUS SUPRIYADI
50 SRI RAHAYU 25 36/07 10-12-2017 17-09-2018 G2 P1 A0

AHMAD ANSHORI
51 IKA AGUSTINA 31 12/02 01-01-2018 08-10-2018 G3 P2 A0

TOMI WIJAYA KTP LMGAN 20 MG
52 RISWARA WIDYA N 38 11/01 28-11-2017 05-09-2018 GIV P3 A0

AGUS TRIATNO 38 Mg
53 NOVI SUHARIYANTI 32 20/05 03-12-2017 12-09-2018 G2 P1 A0

MARSUDI 8-10 Mg
54 MEI LESTARI 26 21/06 06-12-2017 13-09-2018 G2 P1 A0

MUGI RAHARJO 5-6 Mg
55 PUTRI YUNITA DESI 28 19/05 05-12-2017 12-09-2018 G3 P2 A0 O

AHM. MUJIBURROHMAD 11-12 Mg
56 PUJI ASTUTIK 39 39/08 -11-2017 -08-2018 G3 P2 A0

KUKUH JATI Y 8 Mg
DATA IBU BERSALIN
BULAN : SEPTEMBER 2018
RATORIUM PPIA PENYAKIT RENCANA
FAKTOR RESIKO /
Tawar Test Hasil SCOR PENYERTA TEMPAT
Prot GDA
Urin
(+)/(-) KOMPLIKASI SAAT INI BERSALIN
- 101 + + - 2 BPM
- 89 + + - 14 jrk anak 11 th,asma, RS

anemia
- 97 + + - 6 abortus BPM
- 97 + + - 10 usia > 35, jrk anak RS

> 10 th
- 96 + + - 2 BPM
- 72 + + - 2 BPM
- 96 + + - 2 - BPS
- 102 + + - 2 BPM
- V 6 UMUR<20TH RS
- 113 V 14 UMUR>35TH,RIWAYAT SC RS
- 82 V V 14 UMUR>35TH,PE,JRK ANK>10TH RS
- 94 V V - 18 LETSU, HT, USIA 35TH RS
- 92 V V - 14 USIA>35TH,GRANDE MULTI,ANEEMIA RS
- 64 V V 10 PERNAH ABORTUS,JARAK ANAK<2TH RS
129 V V 2 RS
- - V - - 2 - BPS
- - V - - 2 - - BPS
- - √ - - 2 - - BPS
- - √ - - 2 - - BPS
- - √ - - 6 PERNAH GAGAL KEHAMILAN - BPS
10 TINGGI BADAN 144 cm,LILA 20 cm RSUD
2 PKM
2 POLINDES
2 POLINDES
2 POLINDES
2 BPS
14 USIA > 35 th,TD 150/90 mmhg,Riwayat RSUD

manual Placenta
USIA 35 TH, JARAK >10 TH, ABORTUS,
_ _ V V _ 14 FASE LATEN MEMANJANG RS
_ _ V V _ 2 FASE LATEN MEMANJANG BPS
_ _ V V _ 2 BPS
_ _ V V _ 6 PENYULIT KEHAMILAN BPS
_ _ V V _ 6 IMT >26 PKM
_ _ V V _ 2 BPS
_ _ V V _ 6 LILA<23,5 CM PKM
(-) 245 v v (-) 22 usia, riw abortus HT Rsu

jarak >10 th DM
DM, HT
- - - - - 2 - - BPS
2 BPS
neg v 2 RS
tensi tdak stabil(naik,turun) waktu

neg v 6 RS
sebelum hamil
neg v 2 pkm
neg v 6 umur > 35 th bps
neg neg v neg 6 anemia pkm
neg neg v neg 2 bps
0 - V - - 6 PENY. PENYERTA TBC +SKOR PD/BPS
- - V - - 2 BPS
- - V - - 10 USIA 36,HT BPS

14 - USIA 40 HT RS
-GRANDE
- HT
10 - BKS SC - RS
2 - - RMH BIDAN
2 - - RMH BIDAN
2 - - DSOG
14 - GRANDE - RS
- USIA>35
2 - - RMH BIDAN
2 - - RMH BIDAN
2 - - RMH BIDAN
18 - RWYT SC - RS
- USIA>35
- JRK>2 Th
PENANGAN / PERSALINAN
KOLABORASI JENIS BUFAS RISTI ( KASUS KET
TANGGAL TEMPAT PENOLONG )
DOKTER / dr.Spesialis
Dokter Puskesmas 15-9-18 BPM Normal Bidan Taa By taa

Konsul DSOG
Dokter Puskesmas ,3-9-18 RS Graha SC DSOG bufas SC bayi dg kel.
Konsul DSOG Medika o/k rhesus + jantung bawaan
Dokter Puskesmas 15-9-18 BPM Normal Bidan taa bayi taa
Konsul DSOG
Dokter Puskesmas 3-9-18 RSUD Induksi Bidan partus tak maju
Konsul DSOG
Dokter Puskesmas 20-9-18 BPS Normal Bidan taa by taa
Dr. Puskesmas 17/9/18 bps Normal Bidan
Dr. Puskesmas 4/9/2018 BPS Normal Bidan

Konsul DSOG
Dr. Puskesmas 10-9-18 RS Fatma SC Dokter PE ibu taa
Konsul DSOG by taa
DR.PKM 15/9/18 RS N SPOG
KONTROL RUTIN 20/9/18 RS SC SPOG
DR.PKM 7/9/2018 RS SC SPOG
DR.PKM 29/8/18 rs n spog
DR.PKM 29/8/18 RS SC SPOG

ANCRUTIN 17-9 BPS SPT BIDAN -
2018
ANCRUTIN 9-Dec BPS SPT BIDAN -
2018
ANC RUTIN 25-9 BPS SPT BIDAN -
2018
ANC RUTIN 9-Nov BPS SPT BIDAN -
2018
2018
dr PKM,dr OBGYN PUSKESMAS SPONTAN BIDAN IBU SEHAT

BAYI SEHAT
dr OBGYN 9/6/2018 RS IBNU SINA SPONTAN BIDAN IBU SEHAT

BAYI SEHAT
dr PKM 9/10/2018 RS FATMA SPONTAN BIDAN IBU SEHAT

BAYI SEHAT
Dr.PKM 9/18/2018 RS IBNU SINA SPONTAN DOKTER IBU SEHAT

Dr.OBGYN BAYI SEHAT
dr.PKM 9/22/2018 POLINDES SPONTAN BIDAN IBU SEHAT

dr.OBGYN BAYI SEHAT
dr.PKM 8/24/2018 BPM SPONTAN IBU SEHAT

BAYI SEHAT
dr PKM 9/28/2018 RSUD SOSODOROSPONTAN BIDAN IBU SEHAT

dr.OBGYN BAYI SEHAT
DR SPOG 1-Sep RS N BIDAN
BIDAN 9/18/2018 BPS N BIDAN
BIDAN 8/30/2018 BPS N BIDAN
DR SPOG 9/14/2018 BPS N BIDAN
DR SPOG 8/15/2018 RS N BIDAN
BIDAN 9/20/2018 RS N BIDAN
DR SPOG 9/1/2018 RS N DR SPOG
Dr Obgyn rsu 9/22/2018 RSU SC DSOG PE

Dr PD rsu
Kontrol rutin 14/09/2018 BPS Normal Bidan

Kontrol rutin 01/09/2018 bps normal bidan
9/20/2018 rsa spt spog
9/28/2018 rsf spt bidan

bps 9/20/2018
DOKTER PUSKESMAS 18-9-18 RS SC DR P. MACET
16-9-18 BPS BIDAN
DOKTER PUSKESMAS 10/9/2018 RS NORMAL DOKTER PE

ANC RUTIN 28-09-2018 RS FATMA INDUKSI DSOG RISTI PE
KONSUL DSOG
ANC RUTIN 06-09-2018 RS FATMA SC DSOG -
ANC RUTIN 27-09-2018 RMH BIDAN NORMAL BIDAN - -
ANC RUTIN 26-09-2018 RS IBNU SINA NORMAL DSOG - -
ANC RUTIN 31-08-2018 RSU INDUKSI BIDAN PE PE
ANC RUTIN 09-09-2018 RS IBNU SINA NORMAL DSOG - -
ANC RUTIN 09-09-2018 RS IBNU SINA INDUKSI DSOG - -
ANC RUTIN 05-09-2018 RS IBNU SINA SC DSOG - -

PUSKESMAS G.. P....A..
NO NAMA IBU / SUAMI UMUR DESA HPHT TTP

UK
RT
BANJAREJO
1 Dariyatun- 38 BANJAREJO G3P2A0
Agusman 6/1
2 Wahyuni 36 BANJAREJO 17-1-18 24-10-18 G3P2A0
Imam 6/1
3 Kismiatun- 40 BANJAREJO 1- 1-18 8- 10-18 G4P3A1
Anim Subagiyo 6/1
4 Titik Ekavianti- 23 BANJAREJO 19-1-18 26-10-18 G1P0A0
Deni Krintanto 6/1
5 Siti Nur Khasanah- 33 BANJAREJO 27-12-17 4-10-18 G4P3A0
Arif Afianto 11/2
6 Darmini 37 BANJAREJO 15-1-18 22-10-18 G3P2A0
Supriyadi 14/2
7 Siti Umaroh - 38 BANJAREJO USG 29-10-18 G2 P1AO
Sulistri S 21/3
8 Vinandra Eka- 21 BANJAREJO 3-1-18 10- 10-18 G1P0A0
Franki 1/1
9 Lutfiani - 20 BANJAREJO 23-12-17 30-9-18 G1P0A0
Friandita 9/2
CAMPUREJO
10 DEWI ARISTA 32 CAMPUREJO 15/1/18 22/10/18 G1P0A0
SEPTIAN YUDA
11 DENI OKTAVIA 26 CAMPUREJO RT 6 28/12/17 3/10/18 G2P0A0

DANI
12 ITA DIAKH K 30 CAMPUREJO RT 11 LUPA JANUAROKTOBER 18G3P2A0

SAMSUL
13 SETYO WINARYANI 39 CAMPUREJO RT 24 22/1/18 29/10/18 G2P1A0

SUTRISNO
14 TUTIK R 31 CAMPUREJO RT 12 9/1/18 16/10/18 G1P0A0

TOTOK
15 DWI RETNO 33 CAMPUREJO RT 8 21/12/17 28/9/18 G3P2A0

AGUNG
KADIPATEN
16 UTAMI YULIATI 33 TH RT 3 RW 1 1/17/2018 10/14/2018 G2P1A0
TAMA
17 RINA UMI N 39 TH RT 8 RW 2 3/4/2017 10/1/2018 G4P3A0
A.SATRIA UTAMA
18 CITRA YUNIATI 27 RT 5/RW 2 1/19/2018 10/26/2018 G1P0A0
EKY YANUAR
19 DESY ANDINI 33 RT 10/3 1/10/2018 10/17/2018 GIIIPIIA1
ERY 18MG
KALIREJO
20 LIMAH / PURWANTO 28 th Kalirejo rt 04 / rw 01 1/12/2018 10/19/2018 G2 P1A0
21 MONICA / HADI 23 th Kalirejo rt 04 / rw 01 08/01/2018 15/10/2018 G1 P0A0

pindahan dari Tuban
KARANGPACAR
22 TUTIK SETYOWATI/ IWAN WAHYUONO 34 KR PACAR 7/1 1/11/2018 10/18/2018 G2P1A0
23 RISTIA CAHAYA/ RIZKY ADITIA 25 KR PACAR 12/2 1/20/2018 10/27/2018 G3P1A1
24 FARIDA NUR A/ ARIS RAGIL 24 KR PACAR 20/3 1/13/2018 10/20/2018 G1P0A0
25 UUT MEGAWATI/ MUHAMMAD 35 KR PACAR 20/4 11/20/2017 8/27/2018 G2P1A0
26 ARUM INDAH R/ SUKRIAWAN 32 KR PACAR 22/3 1/10/2018 12/17/2018 G2P1A0
KEPATIHAN
Endah Putri 21 RT 1 /01 7/20/2018 4/27/2019 G2 P1 A0
27
Kariyono 53
28 Suksmaya Susila 25 RT 1 / 01 1/10/2018 11/17/2018 G2 P0 A1

Kustiningrum Srinayan Lr 3
M Rizky Prasetya
29 Sri Mukti Handayani 37 RT 4 /01 12/24/2017 10/1/2018 G3 P2 A0
Kusnan
30 Nurfia Rishardanty 24 RT 6 /01 10/16/2017 6/2/2018 G2 P0 A1
Teguh Cipto
MOJOKAMPUNG
31 Gita Indah/Yoka Agung 26 RT 05/01 01/01/2018 08/10/2018 G2P1A0
32 Intan 38 RT 04/01 /01/2018 /10/2018 G1P0A0
33 Yunia/Solihin 24 RT 03/01 11/01/2018 18/10/2018 G1P0A0
34 Kristina/Dwi M 25 RT 02/01 24/12/2017 01/10/2018 G2P1A0
35 Maulidia/Heru 24 RT 07/02 05/01/2018 12/10/2018 G1P0A0
MULYOAGUNG
36 hikmah 36 3--1-18 10/10/2018 g3p2a0
yuda
37 anik ruswati 35 2/5/2018 11/12/2018 g4p2a1
toni
38 devi 25 rt 4 12/2/2017 9/9/2018 g1p0a0
yanuar
39 mujiati 30 rt 16 12/19/2017 9/26/2018 g2p1a0
m sholeh
NGROWO
40 WIWIN W/ YEES IMANUEL 35 RT 3 13/02/2018 20/11/2018 G2P1A0
41 NURIL OKTAVIANI/ARIF S 32 RT 1 27-1-18 11/04/2018 G3 P2A0
42 FITRI RAHAYATI 33 RT 4 26/12/2017 03/10/2018 G3P2A0
43 SISKA DAMAYANTI 20 RT 20 17-Dec 18-Oct G1P0A0
44 NOVI S/BAYU ADITIA 27 RT12 Dec-17 Oct-18 G2P1A0
45 SUSI LUNGDAYANI/ EDI S 32 RT 16 27/12/2017 04/10/2018 G2P1A0
SEMANDING
NIHIL
SUKOREJO
46 HETTY FIKA L 22 31/06 06-01-2018 13-10-2018 G1 P0 A0
LUKMAN WAHYU S
47 LENNIDYA MARRISA 26 35/07 04-01-2018 11-10-2018 G2 P1 A0

ARI DWI BUDI 12 MG
48 SITI KHOSIDAH 32 16/04 05-01-2018 12-10-2018 G1 P0 A0

HERU PUJIANTO 5 Mg
49 BINTI NUR ARINI 31 14/04 10-01-2018 17-10-2019 G2 P1 A0

HERI PURWANTO 6-7 Mg
50 AGUSTIN Z 35 21/05 12-12-2017 19-09-2018 G3 P2 A0

HARIYADI
51 RATNA MEIDIAWATI 32 34/08 12-01-2018 19-10-2018 GIII P2 A0

B. MAHENDRA 28 Mg
52 ZULIAN FIRDA S 22 17/08 03-01-2018 10-10-2018 GII P1 A0

AGUS SETYA B 37-38 mg
DATA IBU BERSALIN
BULAN : OKTOBER 2018
LABORATORIUM PPIA PENYAKIT RENCANA
FAKTOR RESIKO /
Tawar Test Hasil SCOR PENYERTA TEMPAT
GOL DA Hb gr% Prot Urin GDA
(+)/(-) KOMPLIKASI SAAT INI BERSALIN
104 10 Kelainan BPM

Usia, Penyakit Penyerta( ht) Saraf Mata
B 12,7 - 78 + + - 10 jrk anak >10 th, usia RS
B 12,9 - 94 + + - 22 Usia, rwy DM, abortus RS

jrk anak,grande
B 12.1 - 87 + + - 2 BPM
B 12,8 - 92 + + - 10 grande,jarak anak RS

< 2 tahun
B 12,3 - 80 + + - 6 usia PKM
O 13,7 - 94 + + - 18 usia, Jarak Anak, Riw.SC RS
O 10,4 - 95 + + - 6 lila 23 cm, anema PKM
A 11,6 - 92 + + - 6 KEK,lila 23 cm BPM
B 11,8 - 180 V V 2 RS
O 11,9 - 72 V V 2 BPS
O 10,2 - 80 V V 6 KEK,ANEMIA BPS
12 12 - 64 V V 10 USIA>35TH,jarak anak>35 RS
O 11 110 V 6 KEK RS
B 8 - 88 V V - 6 ANEMIA RS
A 12 - - √ - - 2 - - BPS
AB 12 - - V - - 2 - BPS
O 12 - - V - - 6 KEK LILA 21 CM - BPS
AB 12 - - √ - - 2 - - BPS
2 BPM
2 BPM
B 11.2 _ _ V V _ 6 RIWAYAT PE BPS

O 10.2 _ _ V V _ 10 ABORTUS, ANEMIA RS
O 11 _ _ V V _ 2 BPS
O 12 _ _ V V _ 6 USIA >35 TH PKM
O 11.2 _ _ V V _ 2 RS
14 Riwayat SC - RSU
sinyal PE
6 Riw abortus - Rs Fatma
6 usia > 35 - BPS
o 11.8 (-) 110 v v (-) 6 riw abortus (-) RSA
B 11.8 6 Jarak anak < 2 tahun BPS

Usia 36 th, jarak anak 10
B 12.8 10 BPS
tahun
O 11.8 2 BPS
A 11.8 2 BPS
O 11.6 2 BPS
o 11 neg neg v 2 bps
o 12 neg neg v 6 perna abortus rs
a 12 neg v 2 bps
o 12 neg v 2 bps
O 11.2 0 - V - - 6 USIA PD/BPS

O 11.3 0 - V - - 2 PD/BPS
A 12 - - V - - 6 R. PREMATUR, JARAK ANAK 6 BLN BPS
O 11 - - V - - 10 B20, PE BPS
O 11.4 - - V - - 2 PD/BPS
A 12 - - V - - 2 PD/BPS
2 - - RMH BIDAN
6 - LILA 21,5 - RMH BIDAN
6 NIKAH 9 TH - RS
10 LET-SU
2 - - RMH BIDAN
2 - - RMH BIDAN
6 JRK ANK<2 TH - BPM
14 - RWYT SC - RMH BIDAN

- ANEMI
PENANGAN / PERSALINAN
KOLABORASI JENIS BUFAS RISTI ( KASUS ) KET

TANGGAL TEMPAT PENOLONG
DOKTER / dr.Spesialis
Dokter Puskesmas ,24-10-18 BPM Normal Bidan Kontraksi Dini Bayi BBLR
pe,sisa placenta
Dokter Puskesmas 25-10-18 BPM Normal Bidan TAA TAA
Konsul DSOG
Dokter Puskesmas 10-10-2018 RSIS induksi Bidan KPD by.asfiksia
Konsul DSOG
Dokter Puskesmas 24-10-18 BPM Normal Bidan Taa By taa
Konsul DSOG
Dokter Puskesmas 8-10-18 BPM Normal Bidan taa by taa
Konsul DSOG
Konsul DSOG
Dr. Puskesmas 16-10-18 RSUD SC DOKTER PE by taa
Konsul DSOG
Dokter Puskesmas 10-10-18 BPM Normal Bidan TAA TAA
DR.PKM 9/10/18 BPS N BIDAN
DR.PKM 16/10/18 PKM N BIDAN
DR.PKM 9/10/18 RS N SPOG PE
DR.SPOG 13/10/14 RS N SPOG PE
2018
ANCRUTIN 1-Oct BPS SPT BIDAN -
2018
ANCRUTIN 25-10 BPS SPT BIDAN -
2018
2018
dr OBGYN 10/10/2018 RSUD SPONTAN BIDAN IBU SEHAT

BAYI SEHAT
dr OBGYN 13-9-2018 BPM SPONTAN BIDAN IBU SEHAT
BAYI SEHAT

BIDAN 10/9/2018 RS SC DR SPOG
DR SPOG 9/27/2108 RS N BIDAN MENINGGAL
DR SPOG PPI
Abortus dr. JihaN

DSOG 10/1/2018
RS F komplet
dr. Askan 10/28/2018 RSU N Bdn -
dr. Askan 9/11/2018 BPM N Bdn -
dr. LA Siregar 10/7/2018 RSA N dr. Artur -
kontrol rutin 08/10/2018 Bps Normal Bidan

Kontrol rutin 17/10/2018 Bps Normal Bidan
Konsul rutin 16/10/2018 Bps Normal Bidan
Kontrol rutin 10/02/2018 Bps normal bidan
kontrol rutin 08/12/2018 Bps Normal Bidan
9/16/2018 rs spt bidan
DOKTER PUSKESM 10/11/2018 RS M NORMAL BIDAN PE

DOKTER PUSKESM21-9-18 BPS NORMAL BIDAN
7/10/2018 RS F NORMAL DOKTER
DOKTER PUSKESM 1/10/2018 RSUD SC DOKTER B 20/ PE
DOKTER PUSKESM25-9-18 RS SC DOKTER P. MACET
DOKTER PUSKESM 4/10/2018 BPS NORMAL BIDAN
ANC RUTIN 10-10-2018 RMH BIDANNORMAL BIDAN - -
ANC RUTIN 17-10-2018 RMH BIDANNORMAL - - -
ANC RUTIN 05-10-2018 RS FATMA SC DSOG - LET-SU
ANC RUTIN 11-10-2018 RS FATMA NORMAL DSOG - -
ANC RUTIN 02-10-2018 RS FATMA SC DSOG - -

DESA
NO NAMA IBU / SUAMI UMUR HPHT TTP UK Hb gr Prot GDA
GOL DA % Urin
RT
BANJAREJO
1 Jumilah-Yana Gilang 23 BANJAREJO 1- 2-18 8- 11-18 G1P0A0 B 11,1 - 95
5/1
2 Yasinta- 28 BANJAREJO 1-2-18 8-11-18 G2P1A0 A 11,5 - 99
Moh Zaenul 6/1
3 Juniana- 24 BANJAREJO 20-2-18 27-11-18 G2P1A0 B 12,5 - 78
SulisaFanto 1/1
4 Samiati 33 BANJAREJO 23-2-18 30-11-18 G3P2A0
Yudi Setiawan 3/1
5 Eni Puji L - 28 BANJAREJO 25-1-18 2-11-18 G2 P1AO A 11'6 - 96
Budi Utomo 19/3
6 Vita Dewi- 33 BANJAREJO 19-2-18 26-11-18 G2 P1AO B 10.8 - 92
Wiji 20/3
7 Yulia Sapta 23 BANJAREJO 22-2-18 29-11-18 G2 P1AO A 11,8 - 88
Nazia Hasan 15/3
CAMPUREJO
8 NUR INDANA 32 CAMPUREJO RT 19 3/2/2018 13/11/18 G1P0A0 O 11,5 - 80
FRENDY
9 SATIRA SISKA 18 CAMPUREJO RT 27 11/2/18 18/11/18 G1P0A0 B 11,7 - 64

NANANG 82216749280
10 WIWIN 38 CAMPUREJO RT 18 20/2/18 17/11/18 G4P3A0 O 11 -

SAIFUDIN
11 DESY N.F 28 CAMPUREJO RT 16 17/2/18 24/11/18 G1P0A0 A 13,7 - 105

NASHAN 82234021059
12 WINARTI 34 CAMPUREJO RT 23 17/3/18 22/12/18 G3P2A0 B 11,0 - 59

HARIYADI
KADIPATEN
13 DWI RATNA H 36 RT 8/ RW 2 2/12/2018 11/19/2018 G2P1A0 O 12 - -
AGUS BASUKI
14 LISTYOWATI 28 RT12/3 2/15/2018 11/22/2018 GIP0A0 O 12 - -

AGUNG 12MG
15 AMINATUN NASHIFAH 31 RT 15/1 2/18/2018 11/25/2018 GIIPIA0 A 12 - -

M YUSUP
KALIREJO
NIHIL
KARANGPACAR
16 DEVI ANITA SARI/SUPARMAN 31 KR PACAR 2/1 2/28/2018 12/7/2018 G2P0A1 O 11 _ _
17 STELA/ LONI 27 KR PACAR 5/1 2/10/2018 11/17/2018 GIP0A1 O 12 _ _
18 JENI/ STEVEN 32 KR PACAR 4/1 2/15/2018 11/22/2018 G2P1A0 O 11 _ _
19 ANA W ELLA 34 KR PACAR 14/2 2/13/2017 11/20/2018 G2P1A0 AB 12 _ _
20 DESY/ ROFIK 25 KR PACAR 2/2 Feb-18 Nov-18 G1P0A0 O 12 _ _
KEPATIHAN
21 Mega Kurnia 35 RT 11/ 02 2/4/2018 11/11/2018 G3 P2 A0 B
Dwi Astuti
22 Ega Ayunia 19 RT 2/28/2018 12/5/2018 G1 P0 A0
Sugeng Wibowo
23 Regita Manggarsari 28 RT 12 /02 12/28/2017 10/5/2018 G3 P2 A0
Anton Subagio
MOJOKAMPUNG
24 Sulastri/ 26 RT 02/01 /02/2018 /11/2018 G2P1A0 B 12
25 Erina Ardian/Nyapingi 40 RT 03/01 26/02/2018 05/11/2018 G2P1A0 O 9.8
26 Regina abdy/ 23 RT 13/01 24/03/2018 01/01/2019 G1P0A0 B 11.9
27 Astia Widianingrum/Bayu 22 RT 12/02 /01/2018 /10/2018 G1P0A0 O 12
Pratama
28 Mega Kurnia /Hudan 35 RT 08/02 04/02/2018 11/11/2018 G3P2A0 O 12
MULYOAGUNG
29 hoirun nasai 23 RT 15 3/23/2018 12/30/2018 g1p0a0 b 11 neg
30 ririn wahyuni 21 17 2/13/2018 11/21/2018 g1p0a0

wahrul
NGROWO
31 ELLI MUYASAROH/SUNARDI 30 RT 10 28/01/2018 04/11/2018 G2P1A0 O 12 0 -
32 VIDIA OKTAVIA/BURHANUDIN 24 RT 2 27/01/2018 03/11/2018 G2P1A0 B 12.5 0 -
33 ARUM SEKAR AYU/ M. RUDI 27 RT4 LUPA G3P2A0 O 11.2 - -

SEMANDING
34 Susiana R./Suyoto 28 RT.6/RW.1 25-2-2018 11/02/2018 G2P1A0 B 11,7 (-) (-)
35 Sri Ayu/Sukardayat 20 RT.6/RW.1 18-02-2018 25-11-2018 G1P0A0 O 11,5 (-) (-)

SUKOREJO
36 NISA'UL M 21 01/01 04-01-2018 11-10-2018 G2 P1 A0 B
EMAN FAREL USG BLN 11
37 SISKAWANTI 26 31/06 26-01-2018 03-10-2018 G1 P0 A0

JOKO PURNOMO
38 IDA YULIANTI 39 25/06 -03-2018 -12-2018 G4 P2 A1

ZAENAL ARIFIN 7-8 MG
39 YUNITA K/ 27 29/07 -03-2018 -12-2018 GII P1 A0

SUCIPTO 24 mg
40 ELLY NANDAR DWI S 27 28/07 -02-2018 -11-2018 G2 P1 A0

AHMAD SYAFI'I 11-12 MG
41 IFA DZULKHORIYAH 31 10/03 01-02-2018 08-11-2018 G2 P0 A1

SUPRIYO 6 Mg
42 NISFUN NIKMATUL 23 15/04 01-02-2018 08-11-2018 G1 P0 A0

FREDY SAPTA 5 Mg
43 IRENA ROMADHONA 24 21/05 11-02-2018 18-11-2018 G1 P0 A0

SYAHRUL QIROM 11-12 MG
44 UMI KULSUM 25 18/08 01-02-2018 18-11-2018 G2 P1 A0

SUHATNO 6 Mg
45 IRMA ROSITA 33 33/08 15-02-2018 22-11-2018 G2 P1 A0

PUGUH SUGIHARTO 6-7 Mg
46 ARI PUJI RAHAYU 27 33/08 14-02-2018 21-11-2018 G2 P0 A1

SAFRIDO A 6 Mg
47 JENI EGALIA 29 18/08 ? 20-11-2018 G3 P2 A0

LULUK YULIANTO (USG)
48 PUTRI RIZKIYAH 20 33/08 27-02-2018 04-12-2018 G2 P1 A0

SONI PRASETYO 21-22 mg
DATA IBU BERSALIN
BULAN : NOPEMBER 2018
PPIA PENYAKIT RENCANA PENANGAN /
FAKTOR RESIKO /
Tawar Test Hasil PENYERTA TEMPAT KOLABORASI
SCOR
+ + - 2 BPM Dokter Puskesmas
+ + - 2 BPM Dokter Puskesmas

Konsul DSOG
+ + - 2 sinyal PE BPM Dokter Puskesmas
(Imt 35,5) Konsul DSOG
14 Letsu, KEK RS Dokter Puskesmas
Konsul DSOG
+ + - 10 spooting/ perdarahan RS Dr. Puskesmas
Konsul DSOG
+ + - 10 jarak anak > 10 th, RS Dr. Puskesmas
anemia Konsul DSOG
+ + - 2 BPM Dr. Puskesmas
Konsul DSOG
V V 10 KEK,RIWAYAT ASMA RS DR.PKM
V V 10 USIA<20TH,KEK RS DR.PKM
V 10 UMUR>35TH, GRANDE MULTI RS DR.PKM
V V 2 BPS DR.PKM
V V 2 BPS DR.PKM
V - - 6 USIA 36 TH - BPS ANCRUTIN
√ - - 2 - - BPS ANC RUTIN
√ - - 2 - - BPS ANC RUTIN

V V _ 6 RIWAYAT ABORTUS BPS DR SPOG
V V _ 2 BPS DR SPOG PRKTEK SWASTA
V V _ 2 BPS DR SPOG PRKTEK SWASTA
V V _ 6 JARAK HAMIL >2TH BPS DR SPOG
V V _ 2 BPS BIDAN
10 usia - BPS dr. Didik

jarak anak
sinyal PE
2 - - RS A dr. Ika
2 - - RS F dr. Askan
2 BPS Konsul rutin
14 usia,jarak anak,anemia BPS Kontrol rutin
2 BPS Konsul rutin
2 BPS Kontrol rutin
10 Usia 35 th,jarak ank RS Kontrol rutin
v 2 bps
v 2 bps
V - - 2 PD/BPS DOKTER PUSKESMAS
V - - 2 PD/BPS DOKTER PUSKESMAS
V - - 6 LILA 19.5 BPS DOKTER PUSKESMAS
V (-) (-) 6 anak pertama BPS KONSUL SPOG
V (-) (-) 6 Lila < 23 cm BPS KONSUL SPOG
18 - LILA 22,5 - RS ANC RUTIN

- BEKAS SC
- JRK<2 TH
2 - - RMH BIDAN ANC RUTIN

6 - PE
18 -HT - RS ANC RUTIN

-JRK ANK>10
-USIA>35
-RWYT AB
2 - - BPM ANC RUTIN
2 - - RS ANC RUTIN
6 - RWYT AB - BIDAN ANC RUTIN
2 - - RS ANC RUTIN
6 - PE
10 - RWYT SC - RS ANC RUTIN

6 - RWYT AB - RMH BIDAN ANC RUTIN
2 - - BPM ANC RUTIN
10 - JRK ANK<2 TH - BPM ANC RUTIN

- KEK
PERSALINAN
JENIS BUFAS RISTI
KET
10-111-2018 BPM Normal Bidan taa by.taa
25-11-2018 RSUD Normal Dokter taa by. Asfiksia
10-11-18 RS Fatma Induksi Dokter post date ibu taa

by. Taa
20-11-2018 BPS Normal Bidan - Ibu taa
by taa
22-11-2018 BPS Normal Bidan - Ibu taa
by taa
17/11/18 RS N SPOG
7/11/18 RS N SPOG
17/11/18 BPS N BIDAN
22/11/18 BPS
9/11/18 RS N SPOG
19-11 BPS SPT BIDAN -

2018

2018

2018
11/26/2018 RS N DR SPOG INDUKSI
11/9/2018 RS N DR SPOG
11/10/2018 RS N DR SPOG
11/22/2018 RS B SC Dr. Post SC BPS Ita
11/20/2018 RSA N dr -
10/29/2018 RS B N DSOG -
13/11/2018 BPS Normal Bidan
03/11/2018 BPS Normal bidan
24/11/2018 RS SC Dokter
29/10/2018 BPS Normal Bidan
23/11/2018 RS SC Dokter
11/12/2018 RS SPT BIDAN
14-11-18 BPM N0RMAL BIDAN
11/02/2018 BPM N0RMAL BIDAN
27-10-18 BPM NORMAL BIDAN
2/11/2018 RS SPONTAN BIDAN Bayi + Ibu Sehat
30/11/2018 RS SPONTAN BIDAN Bayi + Ibu Sehat
05-11-2018 RS FATMA SC DSOG -
13-11-2018 RSU INDUKSI BIDAN - -
25-11-2018 RSU SC DSOG - -
15-10-2018 BPM NORMAL BIDAN - -
18-11-2018 BPM NORMAL BIDAN - -
14-11-2018 RS FATMA SC DSOG CPD
04-11-2018 RMH BIDAN NORMAL BIDAN - -
17-11-2018 RSA INDUKSI DSOG - -
22-11-2018 RSU SC DSOG - -

19-11-2018 RS MUNA VACUM DSOG - -
06-11-2018 RS MUNA SC DSOG - -

NO NAMA IBU / SUAMI UMUR DESA HPHT TTP Prot

UK GOL DA Hb gr% Urin GDA
RT
BANJAREJO
1 Zuni Purwatiningsih 21 BANJAREJO 14-3-18 21-12-18 G1P0A0 O 10,9 - 80
Faruq 6/1
2 Siti Khofiyah- 30 BANJAREJO 13-3-18 20-12-18 G2P1A0 O 13,3 - 74
Imam Syafaat 5/1
3 Siti Musyarofah- 25 BANJAREJO 26-3-18 2-12-18 G2P0A1 A 12,4 - 81
Aan Galih P 14/2
4 Anggun- 21 BANJAREJO 12-3-18 19-12-18 G1P0A0 O 11,6 - 84
Mecco 15/2
5 Erika Dwi- 28 BANJAREJO 8-3-18 15-12-19 G3P2A0 B 11,8 - 92
Muh Muton 12/2
6 Selly Yuni 29 BANJAREJO 29-3-18 7-12-18 G3P2AO O 10,9 - 57
Eko P. 20/3
7 Tutik- 38 BANJAREJO 3-4-18 10-1-19 G3 P2AO o 12,6 - 85
Jupri 21/3
8 Khoirotun Nisa'- 26 BANJAREJO 8-3-18 15-12-18 G3 P1A1 B 9,9 - 84
Yuda BagusA 15/3
9 Anik Tri W- 33 BANJAREJO 1-3-18 8-12-18 G3 P1A1 O 15,4 - 227
Joko S 16/3
10 Mariyana-Misbakhul 22 BANJAREJO 9-3-18 16-12-18 G1P0A0 A 13,6 - 92
20/3
11 Diah Eka - 26 BANJAREJO 6-3-18 13-12-18 G1P0A0 B 13.5 -
Zaenudin 7/1
CAMPUREJO
12 SHEVIC 24 CAMPUREJO RT 25 18/6/18 25/3/19 G1P0A0 O 10,2 - 74
CONDRO
13 WIDYA ARISANTI 37 CAMPUREJ RT 22 20/3/18 27/12/18 G3P2A0 O 11,2 - 80
ASIF
14 UMI KULSUM 32 CAMPUREJO RT 26 15/2/18 22/11/18 G3P2A0 B 10 - 91
SUNTIONO
15 ENGGAR 28 CAMPUREJO 13 28/2/18 5/12/18 G2P1A0 B 10,6 - 96
CAHYO FAJAR
16 ELSA PUTRI 27 CAMPUREJO RT 20 2/3/2018 9/12/2018 G2P1A0 O 11,5 -
CHUSNUL ABIDIN 85233573170
17 DINDA AYU 29 CAMPUREJO RT 20 15/3/18 22/12/18 G2P1A0 B 11,2 - 96
MIFTAKHUL 82234731235
18 DIYAH WAHYU 25 CAMPUREJO R 28 16/3/18 23/12/18 G1P0A0 A 7,2 - 79
ABDUL ROHMN
KADIPATEN
LINDA 24 RT 4/2 3/12/2018 12/19/2018 GIP0A0 A 12 - -
19
ARIFIN 6-8 MG
RIZA 30 RT 12/3 3/12/2018 12/19/2018 GIIPIA0 AB 12 - -
20
DERMAWAN
KALIREJO
21 SURIRIN / TONI 34 th Kalirejo rt 12 / rw 02 27-2-2018 6-6-12-2018 G2 P1A0 11.5 - -
22 SRI IDAYATI / RATMIN 44 th Kalirejo rt 07 / rw 01 ? ? G4 P3A0 - -
23 ITA AGUSTINA / AHMAD 32 th Kalirejo rt 05 / rw 01 23-4-2018 30-12-2018 G2 P1A0 AB 11.9 - -

KARANGPACAR
24 RICE/ADE 28 KR PACAR 5/1 3/2/2018 12/9/2018 G1P0A0 O 12 _ _
25 DANISE/RONI 27 KR PACAR 4/1 2/20/2018 11/27/2018 G1P0A0 O 11 _ _
26 ARTHA/BAYU 29 KR PACAR 1/1 3/10/2018 12/17/2018 G2P1A0 O 11.5 _ _

_ _
27 DEWI SULISTYOWATI/ AHMAD 33 KR PACAR 23/2 3/3/2018 12/10/2018 G2P1A0 O 12
_ _
28 NETTY/ARIS 32 KR PACAR 20/3 3/11/2018 12/18/2018 G1P0A0 O 11
_ _
29 VINCY/ VICTOR 30 KR PACAR 16/3 3/10/2018 12/17/2018 G1P0A0 O 12
_ _
30 RATNA WULANSARI/ RAGIL SEP 26 KR PACAR 23/3 10/3/2018 17/12/2018 G1P0A0 O 11
_ _
31 FITRIANI/HENRI SC 26 KR PACAR 15/3 3/16/2018 12/23/2018 G1P0A0 O 12
KEPATIHAN
Ajeng Nur Suli 25 RumDin 2/20/2018 11/27/2018 G1 P0 A0 _ _
32
Setyo Rini LP
M Akhfar Zakhiri
MOJOKAMPUNG
33 Parwati/Agus 39 RT 02/01 10/03/2018 17/012/2018 G5P2A0 B 13 _ _
34 Fahmilia/Dirab 25 RT 05/01 07/03/2018 14/12/2019 G2P1A0 A 11 _ _
35 Indah/ 30 RT 08/02 2/18/2018 11/25/2018 G2P1A0 B 11.8 _ _
36 Siska Kusuma W/Ali 33 RT 08/02 16/03/2018 23/12/2018 G2P1A0 B 11.8 _ _
MULYOAGUNG
37 kotimah 38 rt 11 g3p2a1 0 12 neg neg
didik h
NGROWO
38 SITI KHOLIFAH/ FAJAR A 20 RT 16 G2P0A1 A 11.2 - -
SEMANDING
NIHIL
SUKOREJO
39 HIMMATUL U/ 25 03/01 15-02-2018 22-11-2018 GI P0 A0 - -
BAGUS DYMAS DS 32-33
40 ELIMATUL K 32 02/01 27-02-2018 06-12-2018 G4 P2 A1 A - -
KHUSNUL NUR H
41 FIKA 23 04/02 20-05-2018 07-02-2019 GI P0 A0 B 13,5 - -
ADI SUSANTO 30-31
42 SITI ULIFAH 34 30/06 -02-2018 -11-2018 G4 P3 A0 - -
ABDUL MUKRON
43 AYU RETNO F 20 26/06 23-03-2018 30-12-2018 G1 P0 A0 - -
PINKY ADITYA 7-8 MG
44 WINARTI 42 29/07 28-03-2018 05-12-2018 G3 P2 A0 - -
BAMBANG 16 mg
45 ULIL FITROTIN 29 25/06 20-03-2018 27-12-2018 GII P1 A0 - -
MARSONO 16 Mg
46 DINI TIARA 27 37/06 01-03-2018 08-12-2018 G2 P1 A0 - -
RUDIYANTO 6-7 MG
47 REZANIA 35 28/07 -02-2018 -11-2018 G4 P3 A0 - -
SETYO ADHI 11-12 MG
48 DEWI ASMIYAH 26 08/03 08-03-2018 15-12-2018 G1 P0 A0 - -
PUGUH DWI U 9-10 MG
49 NURUL HANIFA/ 33 20/05 13-04-2018 20-01-2019 GIII P1 A1 - -
AGUNG WIBOWO 32 Mg
50 VIVI MARDIANA 29 21/05 15-03-2018 22-12-2018 G1 P0 A0 - -
KHOLID MAWARTI
DATA IBU BERSALIN
BULAN : DESEMBER 2018
PPIA PENYAKIT RENCANA PENANGAN /
FAKTOR RESIKO /
Tawar Test Hasil SCOR PENYERTA TEMPAT KOLABORASI
TANGGAL
Dokter Puskesmas
+ + - 2 BPM 8-12-18
Dokter Puskesmas
+ + - 2 sinyal PE RS 18-12-18
MAP 96,6 Konsul DSOG

Dokter Puskesmas
+ + - 2 BPM 5-12-18
Konsul DSOG
Dokter Puskesmas
+ + - 2 BPM 14-12-18
Konsul DSOG
Dokter Puskesmas
+ + - 2 BPM 17-12-18
sinyal PE Konsul DSOG
+ + - 18 riwayat SC, jarak anak 1,5 th RS Dr. Puskesmas 17-12-18
anemia Konsul DSOG
+ + - 6 usia RS Dr. Puskesmas 22-12-18
Konsul DSOG
+ + - 10 anemia,riwayat Abortus RS Dr. Puskesmas 17-12-18
Konsul DSOG
+ + - 10 rwyt abortus DM RS Dr. Puskesmas 4-12-18
Konsul DSOG/S.Pd
+ + - 2 BPM Dr. Puskesmas 19-12-18

Dokter Puskesmas
+ + - 2 BPM 10-12-18
Konsul DSOG
V V - 14 GEMELI,HIDRANION,ANEMIA RS DR.PKM 13/12/18
V V 6 USIA>35TH RS DR.SPOG 24/12/18
V V 6 ANEMIA,OBESITAS RS DR.PKM 7/12/18
V V 6 ANEMIA RS DR.PKM 19/12/18
V 10 RIWAYAT SC RS SPOG 11/12/18
V V 2 RS DR.PKM 23/12/18
V V 6 ANEMIA KEK RS DR.PKM 13/12/18
V - - 2 - - BPS ANCRUTIN 19-12
2018
√ - - 2 - - BPS ANC RUTIN 12-Oct
2018
√ - - 6 Jarak anak >10 th PUSKESMAS dr.PKM 4/12/2018
√ - - 14 USIA 44 th,JARAK ANAK,GRANDE RSUD 19-12-2018
√ - - 6 KEK PUSKESMAS dr.PKM

25-12-2018
V V _ 2 BPS BIDAN 12/6/2018
V V _ 2 BPS BIDAN 12/1/2018

BPS BIDAN
V V _ 2 12/10/2018
V V _
6 JARAK ANAK >10 TH PKM DR SPOG 12/11/2018
V V _
2 BPS BIDAN 12/4/2018
V V _
2 BPS BIDAN 12/15/2018
V V _
2 BPS BIDAN 12/14/2018
V V _
2 BPS BIDAN 12/19/2018
V V _ 2 RS Fatma Dr. Askan

- - 11/30/2018
V V _ 18 usia 39,rwyt abortus RSU Kontrol rutin 15/12/2018
V V _ 2 Asma BPS Kontrol rutin 11/12/2019
V V _ 2 BPS Kontrol rutin 01/12/2018
V V _ 2 BPS Konsul rutin 22/12/2018
v neg 10 usi >35 kel tiroid rs 12/21/2018
pembesaran kelenjar tiroid
V - - 10 ABORTUS,HBSAG POSITIF PD/BPS DOKTER PUSKESMAS 21-11-18

√ - - 2 - - BPM ANC RUTIN 28-12-2018
√ - - 6 RWYT AB - PMB ANC RUTIN 27-11-2018
√ - - 6 - PE - RS ANC RUTIN 25-12-2018
√ - - 6 - GRANDE - PMB ANC RUTIN 30-11-2018
10 - HB 8,2gr%
√ - - 2 - - RMH BIDAN ANC RUTIN 25-12-2018
√ - - 10 - USIA>35 - RS ANC RUTIN 22-12-2018
- JRK ANK>10
√ - - 6 - GRANDE - RS ANC RUTIN 01-12-2018
√ - - 10 - RWYT AB - RS ANC RUTIN 25-11-2018
- PE KONSUL DSOG

PERSALINAN
BUFAS
JENIS RISTI KET
TEMPAT PENOLONG ( KASUS )
BPM Normal Bidan taa by.taa
BPM Normal Bidan TAA TAA
BPM Normal Bidan taa by taa
BPM Normal Bidan taa by taa
BPM Normal Bidan taa
RS Fatma SC DOKTER rwyt sc Ibu taa
by taa
RSUD induksi Bidan let su + K ibu & by taa
by asfiksia
BPS Normal Bidan - Ibu taa
by taa
by taa
by taa
RS N SPOG
RS SC SPOG
RS N SPOG
RS N SPOG
RS SC SPOG
BPS N BIDAN
RS N SPOG
BPS SPT BIDAN -

BPS SPT BIDAN -
RS FATMA SPONTAN DOKTER IBU SEHAT
BAYI SEHAT
RSUD SPONTAN BIDAN

IBU SEHAT
BAYI SEHAT
POLINDES SPONTAN BIDAN IBU SEHAT
BAYI SEHAT
RS N BIDAN
BPS N BIDAN
RS SC DR SPOG INDUKSI
RS N BIDAN
RS N BIDAN
RS N BIDAN
BPM N Bdn - B. Anjar
BPS Normal Bidan
BPS normal bidan
BPS Normal Dokter
BPS Normal Bidan
rs bidan$
spt
RSUD NORMAL BIDAN

RMH BIDAN NORMAL BIDAN - -
RS FATMA NORMAL DSOG - -
RSU NORMAL BIDAN - PREMATUR
BBLR
RS IBNUSINA NORMAL DSOG - -

RS FATMA NORMAL DSOG - -
RMH BIDAN NORMAL BIDAN - LET-SU
RSA INDUKSI DSOG - -
BPM NORMAL BIDAN - -
RSA SC DSOG POST PE PREMATUR
BBLR
BPM NORMAL BIDAN - -

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DATA IBU BERSALIN

1 Dewi Lestari- 30 BANJAREJO 20-4-18 27-1-19 G2P1A0 A 12,7 - 76 + + - 2

Edi Fika 14/2

Imam Mursidi 20/3

7 SITI RAHAYU 37 CAMPUREJO RT 11 29/3/18 6/1/19 G3P2A0 AB 12,5- 122 V V 18

8 CHOIRUNISA 26 CAMPUREJO RT 17 8/3/18 15/12/18 G2P1A0 O 11 - 80 V V 2

9 NUR KHOLIFAH 20 CAMPUREJO RT 26 1/4/18 8/1/19 G1P0A0 B 13,2 - 98 V V 6

10 MUSLIMAH 22 CAMPUREJO RT 26 16/4/18 23/1/19 G2P1A0 O 11 - 80 V V - 6

11 NITIS SAHPENI 34TH CAMPUREJO RT 8 20/3/18 27/12/18 G2P1A0 O 11,2 - 80 V V - 2

12 INDRI K 31 RT 3/1 4/20/2018 1/27/2019 GIIIPIIA1 A 12 - - √ - - 2

13 YENI / DANNIS 28 RT 4/2 4/10/2018 1/17/2019 GIP0A0 A 12 - - V - - 2

14 NURUL HIDAYAH / DIDIK PRASETYO B 25 th Kalirejo rt 10 / rw 02 23-3-2018 30-12-2018 G1 P0A0 11.5 2

17 MARETHA INDAHSARI/ISWANTO 25 KR PACAR 7/1 3/5/2018 12/12/2018 G2P1A0 O 12 _ _ V V _ 6

18 VINA/SHOLIH 21 KEPATIHAN 10/04/2018 1/17/2019 G2P1A0 A 12 _ _ V V _ 10

19 DIAN RENI SUSANTI/HENDRA 23 KR PACAR 2/1 3/10/2018 12/17/2018 G1P0A0 O 11 _ _ V V _ 2

20 JUANITA NOVITASARI/ SYAIFUDDIN N 34 KR PACAR 15/3 15/3/2018 22/12/2019 G2P1A0 A 12 _ _ V V _ 2

21 MAMA/ LEON 34 KR PACAR 23/3 4/1/2018 1/8/2019 G3P1A0 O 12 _ _ V V _ 10

22 MERY/NICO 25 KR PACAR 17/3 4/20/2018 1/27/2019 G2P1A0 A 12 _ _ V V _ 2

23 NINING SUSANTI/ANTON/SUSANTO 30 KR PACAR 23/3 3/18/2018 12/25/2019 G3P2A0 AB 13 _ _ V V _ 6

24 Ratna Asmarani 28 RT 2 /01 4/21/2018 1/28/2019 G2 P0 A1 6

25 Suliyeni 24 RT 10 /02 4/8/2018 1/15/2019 G1 P0 A0 2

26 Vinna Ressiani W 20 RT 12 /02 4/4/2018 1/11/2019 G1 P0 A0 2

27 Rina Faridatus /Rahman Hakim 34 RT 04/01 09/04/2018 16/01/2019 G2P1A0 O 11.5 2

28 Siti R/Imam 35 RT 06/01 16/04/2018 23/01/2019 G3P2A0 B 12 6

29 Sania Rahayuning/Muntolib 34 RT 14/01 26/03/2018 02/01/2019 G2P1A0 B 11.8 2

31 Yuli Indra/Rian 28 RT 08/02 11/04/2018 18/01/2019 G2P1A0 O 12.4 2

32 Fika Suci/Ujang 34 RT 08/02 12/04/2018 19/01/2019 G2P1A0 O 12.4 2

33 Yunia/Erwin 31 RT 05/01 07/04/2018 14/01/2019 G2P1A0 B 11.8 2

34 sulis mahariyani 31 rt 13 4/16/2017 1/23/2018 g2p1a0 a 12 neg neg neg 2

teguh budi prasetyo

35 linda kristiana 28 rt 13 4/24/2018 1/31/2019 g2p1a0 o 11 neg neg v 2

36 enggrit 24 rt 15 4/13/2017 1/21/2018 g1poao v 12.3 6

37 DIAN W/AHMAD ZUKARNI 24 RT 2 04/04/2018 01/11/2019 G1P0A0 AB 11.9 0 - V - - 2

38 IRMA AYU/ADAM SUKMORO 26 RT 3 29/03/2018 16/01/2019 G3P2A0 O 12 0 - V - - 2

39 LUSI KISWANDINI/YAYAK S 26 RT 19 29-3-18 12/06/2018 G1P0A0 B 12 0 - V - - 6

40 RIRIN W/ 38 RT 19 04/10/2018 17-1-19 G3P2A0 O 12.1 0 - V - - 6

41 YANTI/ SAIFUL ARIF 37 RT 9 21-3-18 28-12-2018 G2P1A0 B 12.4 - - V - - 10

USIA,RWYT SC,TNGGI BADAN<145 RS DR.PKM 24/12/18 RS SC SPOG

BPS DR.PKM 9/1/19 BPS N BIDAN

JARAK ANAK <2TH RS DR.PKM 8/1/19 PD N BIDAN

RS DR.SPOG 27/12/18 RS N SPOG

- - BPS ANC RUTIN 25-Jan BPS SPT BIDAN -

- - BPS ANCRUTIN 17-Jan BPS SPT BIDAN -

PKM dr PKM 30-12-2018 RS FATMA VAKUM DOKTER IBU SEHAT

RS.IBNU SINAdr.PKM 22-1-2019 RS IBNU SINA SPONTAN DOKTER IBU SEHAT

dr.OBGYN BAYI SEHAT

PUSKESMAS Dr PKM 31-1-2019 RS FATMA SPONTAN DOKTER IBU SEHAT

Dr.OBGYN BAYI SEHAT

RIWAYAT ABORTUS, KEK RS DR SPOG 15/1/2019 BPS N BIDAN

BPS BIDAN 13/1/2019 RS SC DR SPOG

RIWAYAT SC RS DR SPOG 9/1/2019 RS SC DR SPOG

BPS BIDAN 17/1/2019 BPS N BIDAN

Riwayat Abortus - RS Fatma DSOG 1/16/2019 BPS N Bdn - Bdn. Dwi

- BPS PKM 1/3/2019 BPM N Bdn - BPS Siti

- 1/1/2019 BPM N Bdn -

BPS Konsul rutin 12/01/2019 BPS Normal Bidan

BPS Konsul rutin 23/01/2019 BPS Normal Bidan

BPS Konsul rutin 04/01/2019 BPS Normal Bidan

BPS Konsul rutin 16/01/2019 BPS Normal Bidan

BPS Kontrol rutin 18/01/2019 BPS Normal Bidan

BPS Kontrol rutin 10/01/2019 BPS Normal Bidan

bps 1/20/2019 BPS SPT BIDAN