.

PUSKESMAS : Puskesmas PEKAN HERAN

KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : JULI 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 3 6 0 0 2 3 0 0 2 2 0 0 4 5

2. Redang 1 0 104 115 24 25 12 17 0 1 0 2 0 0 0 1 0 0 0 0 0 0 0 1

3. Danau Baru 1 0 2 0 3 6 1 2 0 3 0 0 0 0 1 2 0 3
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 1 1
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 0 2 3 0 1 0 1 0 0 0 0 0 1 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 2 6 4 8 0 2 4 4 0 2 1 2 0 6 5 6
91 81 16 13 5 4
7. Pematang Reba 1 0 4 7 4 4 0 1 0 0 0 0 0 1 0 1 0 1
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 0 5 5 0 0 0 4 0 0 1 2 0 4 1 2
580 525 24 36 6 12
9. Tanah Datar 1 0 6 15 5 20 4 7 6 6 0 10 3 10 4 17 9 16
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 7 24 0 0 0 3 0 0 0 1 0 0 0 4
88 84 28 25 16 8
11. Kota Lama 1 0 0 0 4 6 0 0 0 3 0 0 0 0 0 0 0 3
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 3 2 5 0 1 1 0 0 2 0 0 0 3 1 0
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 1 0 9 7 0 0 2 0 0 0 0 0 0 0 2 0

14. Barangan 1 0 31 25 6 6 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

15. Tani Makmur 1 0 158 136 57 40 28 22 0 1 0 3 2 0 2 0 0 0 0 1 2 0 2 1

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 0 2 0 0 2 0 0 0 0 0 0 0 2 0

17. Danau Tiga 1 0 241 252 14 16 16 4 2 3 1 2 0 5 0 2 0 0 0 0 0 5 0 2

18. Air Jernih 1 0 67 62 17 17 7 7 1 2 0 5 1 0 0 1 0 0 0 0 1 0 0 2

JUMLAH 18 0 4019 3760 998 926 385 348 19 38 49 110 8 19 20 32 0 14 7 19 8 39 27 48

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
18 0 0 0 0 0 4 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 2 0 3 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0

3 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 1 0 2 3 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

35 0 0 0 0 1 4 0 0 2 3 1 1 0 0 0 0 0 0 0 0 0 0 0 0

21 0 0 0 0 0 4 0 3 2 3 1 2 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

92 0 0 0 0 0 1 0 2 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

35 0 0 0 0 5 4 0 2 2 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0

13 0 0 0 4 0 4 0 1 1 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0

14 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

19 0 0 0 0 0 2 0 3 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0

2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

9 0 0 0 0 2 0 0 0 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

15 0 0 0 0 2 5 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 0 0 0 0 2 3 0 0 4 0 0 0 0 0 0 0 0 1 3 6 0 0 0 0

335 0 0 0 4 12 39 0 20 25 21 7 12 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 18 0 0 10 0 18 0 0 0

0 0 0 0 0 0 0 0 4 0 0 3 0 4 0 0 0

0 0 0 0 0 0 0 0 17 0 3 6 0 17 0 0 0

0 0 0 0 0 0 0 0 3 0 2 8 0 3 0 0 0

0 0 0 0 0 0 0 0 7 0 2 5 0 7 0 0 0

0 0 0 0 0 0 0 0 35 0 15 9 0 35 0 0 0

0 0 0 0 0 0 0 0 21 0 9 8 0 21 0 0 0

0 0 0 0 0 0 0 0 17 0 4 6 0 17 0 0 0

0 0 0 0 0 0 0 0 92 0 17 20 0 92 0 0 0

0 0 0 0 0 0 0 0 35 0 15 10 0 35 0 0 0

0 0 0 0 0 0 0 0 13 0 6 5 0 13 0 0 0

0 0 0 0 0 0 0 0 14 0 3 6 0 14 0 0 0

0 0 0 0 0 0 0 0 19 0 1 10 0 19 0 0 0

0 0 0 0 0 0 0 0 2 0 2 0 0 2 0 0 0

0 0 0 0 0 0 0 0 9 0 4 1 0 9 0 0 0

0 0 0 0 0 0 0 0 4 0 0 4 0 4 0 0 0

0 0 0 0 0 0 0 0 15 0 6 3 0 15 0 0 0

0 0 0 0 0 0 0 0 10 0 0 5 0 10 0 0 0

0 0 0 0 0 0 0 0 335 0 89 119 0 335 0 0 0

 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : AGUSTUS 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 0 8 0 0 0 3 0 0 0 4 0 3 0 4

2. Redang 1 0 104 115 24 25 12 17 0 1 0 1 0 0 0 2 0 2 0 0 0 2 0 2

3. Danau Baru 1 0 0 2 0 3 0 0 0 1 0 0 0 0 0 0 0 1
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 3 3 0 1 0 0 1 0 0 0 1 1 0 0
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 0 3 3 0 0 0 1 0 0 0 0 0 0 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 2 1 4 6 2 2 4 4 0 1 1 2 2 3 4 7
91 81 16 13 5 4
7. Pematang Reba 1 0 2 2 4 4 0 0 0 0 0 0 0 0 0 0 0 0
684 658 407 382 94 73
8. Talang Jerinjing 1 0 1 2 3 4 0 0 2 2 0 0 0 2 0 0 2 4
580 525 24 36 6 12
9. Tanah Datar 1 0 3 3 16 20 2 5 3 4 0 1 3 1 2 6 6 6
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 6 6 0 0 3 2 0 0 0 1 0 0 3 3
88 84 28 25 16 8
11. Kota Lama 1 0 3 4 11 11 1 1 2 0 0 2 0 3 1 1 2 5
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 4 2 3 0 2 2 2 0 0 0 2 0 2 2 4
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 1 3 5 0 0 0 0 0 0 0 0 0 0 0 0

14. Barangan 1 0 31 25 6 6 0 3 2 2 0 2 0 1 1 0 1 0 0 0 1 1 1 0

15. Tani Makmur 1 0 158 136 57 40 28 22 2 2 0 6 2 0 2 2 0 1 0 0 2 1 2 4

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 0 2 0 1 2 2 0 0 0 2 0 1 2 4

17. Danau Tiga 1 0 241 252 14 16 16 4 0 2 0 1 0 2 0 1 0 1 0 2 0 3 2 1

18. Air Jernih 1 0 67 62 17 17 7 7 0 2 1 2 0 0 0 1 0 0 0 1 0 0 0 2

JUMLAH 18 0 4019 3760 998 926 385 348 15 28 56 90 7 15 21 27 2 8 4 20 9 24 26 48

Mengetahui 293
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANTI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
15 0 0 0 0 4 6 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 3 0 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 2 0 3 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 0 0 0 1 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 1 0 2 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

29 0 0 0 0 1 4 0 0 3 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 0 4 0 3 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

16 0 0 0 0 0 0 0 1 1 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

61 0 0 0 0 5 1 0 2 7 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0

18 1 0 0 0 0 4 0 2 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0

37 0 0 0 4 0 4 0 0 2 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 1 2 0 1 3 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 2 0 3 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

17 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 2 3 0 0 1 0 0 2 0 0 0 0 0 1 3 6 0 0 0 0

292 1 0 0 4 15 36 0 19 25 28 0 26 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 15 0 0 5 0 15 0 0 0

0 0 0 0 0 0 0 0 6 0 3 3 0 6 0 0 0

0 0 0 0 0 0 0 0 6 0 3 3 0 6 0 0 0

0 0 0 0 0 0 0 0 8 0 0 8 0 8 0 0 0

0 0 0 0 0 0 0 0 7 0 2 5 0 7 0 0 0

0 0 0 0 0 0 0 0 29 0 5 9 0 29 0 0 0

0 0 0 0 0 0 0 0 12 0 0 3 0 12 0 0 0

0 0 0 0 0 0 0 0 16 0 4 6 0 16 0 0 0

0 0 0 0 0 0 0 0 61 0 9 20 0 61 0 0 0

0 0 0 0 0 0 0 0 18 0 15 10 0 18 0 0 0

0 0 0 0 0 0 0 0 37 0 6 5 0 37 0 0 0

0 0 0 0 0 0 0 0 17 0 4 6 0 17 0 0 0

0 0 0 0 0 0 0 0 9 0 1 3 0 9 0 0 0

0 0 0 0 0 0 0 0 9 0 2 7 0 9 0 0 0

0 0 0 0 0 0 0 0 17 0 4 5 0 17 0 0 0

0 0 0 0 0 0 0 0 9 0 0 4 0 9 0 0 0

0 0 0 0 0 0 0 0 9 0 1 4 0 9 0 0 0

0 0 0 0 0 0 0 0 7 0 0 5 0 7 0 0 0

0 0 0 0 0 0 0 0 292 0 59 111 0 292 0 0 0

 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : JANUARI 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 4 4 0 0 0 4 0 0 0 3 0 0 0 7

2. Redang 1 0 104 115 24 25 12 17 0 1 0 1 0 0 0 2 0 0 0 0 0 0 0 2

3. Danau Baru 1 0 0 5 1 2 0 0 0 0 0 0 0 0 0 0 0 0
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 4 0 2 0 0 0 2 0 0 0 0 0 0 0 2
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 1 0 3 0 1 0 3 0 0 0 0 0 1 0 3
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 5 5 5 5 0 7 0 16 0 2 0 2 0 9 0 18
91 81 16 13 5 4
7. Pematang Reba 1 0 1 0 2 0 0 0 0 0 0 0 0 1 0 0 0 1
684 658 407 382 94 73
8. Talang Jerinjing 1 0 1 1 4 7 0 0 0 4 0 0 0 3 0 0 0 7
580 525 24 36 6 12
9. Tanah Datar 1 0 5 5 3 6 0 7 0 12 0 7 0 8 0 14 0 20
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 4 20 0 0 0 4 0 0 0 1 0 0 0 5
88 84 28 25 16 8
11. Kota Lama 1 0 0 4 0 3 0 8 0 3 0 0 0 0 0 8 0 3
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 2 0 4 0 1 0 3 0 0 0 0 0 1 0 3
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 0 0 0 0 3 0 7 0 3 0 0 0 6 0 7

14. Barangan 1 0 31 25 6 6 0 3 0 0 0 3 0 3 0 0 0 0 0 0 0 3 0 0

15. Tani Makmur 1 0 158 136 57 40 28 22 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 0 4 0 0 0 5 0 0 0 1 0 0 0 6

17. Danau Tiga 1 0 241 252 14 16 16 4 0 0 0 9 0 0 0 4 0 0 0 3 0 0 0 7

18. Air Jernih 1 0 67 62 17 17 7 7 0 3 0 4 0 2 0 0 0 1 0 1 0 3 0 1

JUMLAH 18 0 4019 3760 998 926 385 348 12 32 23 81 0 32 0 69 0 13 0 23 0 45 0 92

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
15 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 3 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 2 0 3 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 1 0 2 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0

47 0 0 0 0 1 4 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 4 0 3 4 0 3 2 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 5 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0

53 0 0 0 0 0 1 0 2 1 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0

29 0 0 0 0 0 4 0 2 4 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0

18 0 0 0 4 0 4 0 0 4 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

10 0 0 0 0 0 2 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

13 0 0 0 3 0 2 0 3 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

10 0 0 0 2 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0

16 0 0 0 0 3 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

11 0 0 0 1 2 3 0 0 0 0 3 0 0 0 0 0 0 1 3 6 0 0 0 0

285 0 0 0 11 11 30 0 19 26 11 21 7 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 15 0 2 7 0 15 0 0 0

0 0 0 0 0 0 0 0 4 0 2 2 0 4 0 0 0

0 0 0 0 0 0 0 0 8 0 0 8 0 8 0 0 0

0 0 0 0 0 0 0 0 8 0 2 5 0 8 0 0 0

0 0 0 0 0 0 0 0 8 0 0 8 0 8 0 0 0

0 0 0 0 0 0 0 0 47 0 7 8 0 47 0 0 0

0 0 0 0 0 0 0 0 4 0 4 0 0 4 0 0 0

0 0 0 0 0 0 0 0 20 0 5 4 0 20 0 0 0

0 0 0 0 0 0 0 0 53 0 7 8 0 53 0 0 0

0 0 0 0 0 0 0 0 29 0 3 6 0 29 0 0 0

0 0 0 0 0 0 0 0 18 0 4 5 0 18 0 0 0

0 0 0 0 0 0 0 0 10 0 5 2 0 10 0 0 0

0 0 0 0 0 0 0 0 13 0 1 6 0 13 0 0 0

0 0 0 0 0 0 0 0 6 0 3 0 0 6 0 0 0

0 0 0 0 0 0 0 0 5 0 2 0 0 5 0 0 0

0 0 0 0 0 0 0 0 10 0 5 0 0 10 0 0 0

0 0 0 0 0 0 0 0 16 0 7 0 0 16 0 0 0

0 0 0 0 0 0 0 0 11 0 3 0 0 11 0 0 0

0 0 0 0 0 0 0 0 285 0 62 69 0 285 0 0 0
 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : FEBRUARI 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 0 11 0 0 2 2 0 0 1 1 0 0 3 3

2. Redang 1 0 104 115 24 25 12 17 1 0 1 1 0 1 0 1 0 1 0 1 0 2 0 1

3. Danau Baru 1 0 0 0 0 2 0 2 0 0 0 0 0 2 0 2 0 2
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 0 2 0 0 0 2 0 1 0 1 0 0 0 2
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 0 7 0 8 0 3 0 2 0 1 0 2 0 4 0 2
91 81 16 13 5 4
7. Pematang Reba 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 1
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 1 5 5 0 0 0 3 0 0 0 2 0 0 0 5
580 525 24 36 6 12
9. Tanah Datar 1 0 0 4 0 36 0 7 8 0 5 0 15 0 5 7 8 15
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 0 31 0 0 3 0 0 0 1 0 0 0 4 0
88 84 28 25 16 8
11. Kota Lama 1 0 0 3 0 3 0 1 0 0 0 0 0 0 0 1 0 0
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 2 0 5 0 1 1 0 0 0 0 0 0 1 1 0
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 0 0 15 0 0 2 0 0 0 0 0 0 2 0 0

14. Barangan 1 0 31 25 6 6 0 3 0 0 0 3 0 3 0 0 0 0 0 0 0 3 0 0

15. Tani Makmur 1 0 158 136 57 40 28 22 0 1 0 3 0 1 1 0 0 0 0 0 1 0 1 0

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 0 6 0 0 5 0 0 0 1 0 0 1 0 5

17. Danau Tiga 1 0 241 252 14 16 16 4 0 1 0 8 0 1 5 0 0 0 3 0 0 4 5 0

18. Air Jernih 1 0 67 62 17 17 7 7 1 1 0 1 0 3 1 0 1 0 1 0 0 4 1 0

JUMLAH 18 0 4019 3760 998 926 385 348 2 21 6 141 0 23 28 11 7 3 22 10 7 31 23 37

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANTI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
17 0 0 0 0 0 0 0 0 0 5 1 0 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 3 0 2 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 2 0 3 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 0 0 0 0 0 1 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 0 0 0 0 1 4 0 0 5 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0

3 0 0 0 0 0 4 0 3 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

16 0 0 0 0 0 0 0 1 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

75 0 0 0 0 0 1 0 2 5 7 0 3 0 0 0 0 0 0 0 0 0 0 0 0

35 0 0 0 0 0 4 0 2 3 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 4 0 4 0 0 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 2 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 2 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

6 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

18 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 2 3 0 0 3 2 0 1 0 0 0 0 0 1 3 6 0 0 0 0

274 0 0 0 4 3 30 0 19 26 30 2 18 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 17 0 0 0 0 17 0 0 0

0 0 0 0 0 0 0 0 7 0 0 3 0 7 0 0 0

0 0 0 0 0 0 0 0 6 0 0 2 0 6 0 0 0

0 0 0 0 0 0 0 0 6 0 0 0 0 6 0 0 0

0 0 0 0 0 0 0 0 2 0 0 1 0 2 0 0 0

0 0 0 0 0 0 0 0 23 0 1 4 0 23 0 0 0

0 0 0 0 0 0 0 0 3 0 0 4 0 3 0 0 0

0 0 0 0 0 0 0 0 16 0 0 0 0 16 0 0 0

0 0 0 0 0 0 0 0 75 0 0 1 0 75 0 0 0

0 0 0 0 0 0 0 0 35 0 0 4 0 35 0 0 0

0 0 0 0 0 0 0 0 7 0 0 4 0 7 0 0 0

0 0 0 0 0 0 0 0 9 0 0 2 0 9 0 0 0

0 0 0 0 0 0 0 0 17 0 0 2 0 17 0 0 0

0 0 0 0 0 0 0 0 6 0 0 0 0 6 0 0 0

0 0 0 0 0 0 0 0 6 0 0 0 0 6 0 0 0

0 0 0 0 0 0 0 0 12 0 0 0 0 12 0 0 0

0 0 0 0 0 0 0 0 18 0 0 0 0 18 0 0 0

0 0 0 0 0 0 0 0 9 0 2 3 0 9 0 0 0

0 0 0 0 0 0 0 0 274 0 3 30 0 274 0 0 0
 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : MARET 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 4 4 0 0 2 2 0 0 2 2 0 0 4 4

2. Redang 1 0 104 115 24 25 12 17 0 0 0 3 0 0 0 0 0 2 0 0 0 2 0 2

3. Danau Baru 1 0 0 2 2 0 0 2 0 1 0 0 0 0 0 2 0 2
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 0 4 2 0 0 2 0 0 0 0 2 0 2 0
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 0 0 2 0 1 0 1 0 0 0 0 0 1 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 0 3 0 7 0 2 3 3 0 1 0 1 0 3 3 4
91 81 16 13 5 4
7. Pematang Reba 1 0 0 2 0 0 0 0 0 1 0 0 0 0 0 0 0 1
684 658 407 382 94 73
8. Talang Jerinjing 1 0 2 2 4 10 0 0 0 3 0 1 0 2 0 1 0 5
580 525 24 36 6 12
9. Tanah Datar 1 0 0 2 5 56 0 0 7 7 0 0 4 4 0 0 11 11
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 6 6 0 0 3 2 0 0 0 1 0 0 3 3
88 84 28 25 16 8
11. Kota Lama 1 0 2 2 0 0 0 3 2 2 0 6 0 0 0 3 2 2
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 0 0 0 0 3 0 3 0 0 0 3 0 3 0 6
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 0 8 10 0 0 2 0 0 0 0 0 0 0 2 0

14. Barangan 1 0 31 25 6 6 0 3 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0

15. Tani Makmur 1 0 158 136 57 40 28 22 0 2 4 0 0 0 0 2 0 1 0 1 0 1 0 3

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 3 3 0 0 2 3 0 0 0 1 0 0 2 4

17. Danau Tiga 1 0 241 252 14 16 16 4 0 2 0 7 1 0 2 2 0 0 0 4 1 0 2 2

18. Air Jernih 1 0 67 62 17 17 7 7 0 1 0 5 0 1 0 0 0 2 0 3 0 1 0 5

JUMLAH 18 0 4019 3760 998 926 385 348 4 19 36 120 3 12 23 34 0 13 6 22 3 17 31 55

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANTI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
16 0 0 0 0 0 5 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 0 3 0 2 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 2 0 3 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 2 0 0 0 2 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 1 0 2 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 1 4 0 0 5 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0

3 0 0 0 0 0 4 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0

24 0 0 0 0 4 3 0 1 4 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0

85 0 0 0 0 6 6 0 5 8 6 0 1 0 0 0 0 0 0 0 0 0 0 0 0

18 0 0 0 0 0 4 0 2 2 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 4 0 4 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 2 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 4 2 0 3 5 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 1 0 0 0 0 0 0

10 0 0 0 0 3 0 0 0 1 4 0 2 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

18 0 0 0 0 0 0 0 0 3 4 1 0 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 2 3 0 0 4 3 0 0 0 0 0 0 0 1 3 6 0 0 0 0

292 0 0 0 0 22 43 0 26 45 39 6 18 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 16 0 3 6 0 16 0 0 0

0 0 0 0 0 0 0 0 5 0 0 5 0 5 0 0 0

0 0 0 0 0 0 0 0 7 0 2 3 0 7 0 0 0

0 0 0 0 0 0 0 0 8 0 4 4 0 8 0 0 0

0 0 0 0 0 0 0 0 4 0 3 1 0 4 0 0 0

0 0 0 0 0 0 0 0 20 0 5 9 0 20 0 0 0

0 0 0 0 0 0 0 0 3 0 0 3 0 3 0 0 0

0 0 0 0 0 0 0 0 24 0 8 12 0 24 0 0 0

0 0 0 0 0 0 0 0 85 0 5 12 0 85 0 0 0

0 0 0 0 0 0 0 0 18 0 7 5 0 18 0 0 0

0 0 0 0 0 0 0 0 17 0 8 6 0 17 0 0 0

0 0 0 0 0 0 0 0 9 0 2 6 0 9 0 0 0

0 0 0 0 0 0 0 0 20 0 5 8 0 20 0 0 0

0 0 0 0 0 0 0 0 4 0 0 4 0 4 0 0 0

0 0 0 0 0 0 0 0 10 0 5 5 0 10 0 0 0

0 0 0 0 0 0 0 0 12 0 4 8 0 12 0 0 0

0 0 0 0 0 0 0 0 18 0 7 5 0 18 0 0 0

0 0 0 0 0 0 0 0 12 0 5 3 0 12 0 0 0

0 0 0 0 0 0 0 0 292 0 73 105 0 292 0 0 0

 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : MEI 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 0 11 0 0 2 2 0 0 1 1 0 0 3 3

2. Redang 1 0 104 115 24 25 12 17 1 0 1 1 0 1 0 1 0 1 0 1 0 2 0 1

3. Danau Baru 1 0 0 0 0 1 1 2 0 0 0 0 0 0 1 2 0 0
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 1 1 0 1 2 2 0 0 0 0 0 1 2 2
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 1 0 2 0 1 0 1 0 0 0 0 0 1 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 0 3 2 3 0 1 0 5 0 1 0 1 0 2 0 6
91 81 16 13 5 4
7. Pematang Reba 1 0 7 10 3 16 1 2 2 0 0 1 0 2 1 3 2 2
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 3 0 12 1 1 2 3 0 0 2 2 1 1 4 5
580 525 24 36 6 12
9. Tanah Datar 1 0 5 10 7 10 3 8 10 11 0 3 0 3 3 11 10 1
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 10 19 0 0 1 3 0 0 0 0 0 0 1 3
88 84 28 25 16 8
11. Kota Lama 1 0 2 2 2 3 0 1 0 2 0 0 0 0 0 1 0 2
239 149 88 83 37 45
12. Bukit Petaling 1 0 1 2 2 3 0 1 0 5 0 1 0 2 0 2 0 7
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 0 0 0 0 2 4 4 0 0 0 2 0 2 4 6

14. Barangan 1 0 31 25 6 6 0 3 0 0 0 0 0 0 0 0 0 1 0 3 0 1 0 3

15. Tani Makmur 1 0 158 136 57 40 28 22 0 1 2 5 0 2 1 2 1 0 0 0 1 0 0 0

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 2 2 0 0 0 1 0 0 0 0 0 0 0 0

17. Danau Tiga 1 0 241 252 14 16 16 4 0 1 3 4 0 1 1 2 0 1 1 1 0 1 1 1

18. Air Jernih 1 0 67 62 17 17 7 7 0 0 2 2 0 0 0 0 0 1 0 1 0 1 0 1

JUMLAH 18 0 4019 3760 998 926 385 348 16 33 37 95 6 24 25 44 1 10 4 19 7 31 27 44

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
17 0 0 0 0 0 3 2 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 2 0 0 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 1 0 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 0 1 0 2 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 0 0 0 0 3 4 0 0 5 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 0 0 0 0 4 4 0 3 3 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

26 0 0 0 0 3 0 0 1 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0

70 0 0 0 0 4 1 0 2 6 8 0 1 0 0 0 0 0 0 0 0 0 0 0 0

32 1 0 0 0 0 4 0 2 1 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 0 4 0 0 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 2 0 1 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 0 2 0 3 1 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0

14 0 0 0 0 2 0 2 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 0 3 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

15 0 0 0 0 2 3 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 0 0 0 0 2 3 0 0 0 1 0 0 0 0 0 0 0 1 3 6 0 0 0 0

313 1 0 0 0 20 39 5 18 31 38 0 8 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 17 0 2 8 0 17 0 0 0

0 0 0 0 0 0 0 0 7 0 1 5 0 7 0 0 0

0 0 0 0 0 0 0 0 4 0 0 2 0 4 0 0 0

0 0 0 0 0 0 0 0 7 0 0 3 0 7 0 0 0

0 0 0 0 0 0 0 0 5 0 1 2 0 5 0 0 0

0 0 0 0 0 0 0 0 16 0 0 2 0 16 0 0 0

0 0 0 0 0 0 0 0 44 0 2 5 0 44 0 0 0

0 0 0 0 0 0 0 0 26 0 3 6 0 26 0 0 0

0 0 0 0 0 0 0 0 70 0 2 2 0 70 0 0 0

0 0 0 0 0 0 0 0 32 0 3 2 0 32 0 0 0

0 0 0 0 0 0 0 0 12 0 2 1 0 12 0 0 0

0 0 0 0 0 0 0 0 17 0 3 2 0 17 0 0 0

0 0 0 0 0 0 0 0 12 0 1 1 0 12 0 0 0

0 0 0 0 0 0 0 0 4 0 2 0 0 4 0 0 0

0 0 0 0 0 0 0 0 14 0 0 3 0 14 0 0 0

0 0 0 0 0 0 0 0 5 0 2 0 0 5 0 0 0

0 0 0 0 0 0 0 0 15 0 2 1 0 15 0 0 0

0 0 0 0 0 0 0 0 6 0 2 1 0 6 0 0 0

0 0 0 0 0 0 0 0 313 0 28 46 0 313 0 0 0
 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : APRIL 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 3 4 0 0 0 5 0 0 0 4 0 0 0 9

2. Redang 1 0 104 115 24 25 12 17 0 0 0 3 0 0 0 1 0 0 0 0 0 0 0 1

3. Danau Baru 1 0 0 2 0 0 0 4 0 0 0 2 0 0 0 6 0 0
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 0 2 2 0 0 0 3 0 1 0 0 0 1 0 3
68 62 19 24 12 13
5. Rantau Bakung 1 0 1 0 0 5 0 1 0 2 0 0 0 0 0 1 0 2
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 0 7 0 12 0 2 0 2 0 1 0 1 0 3 0 1
91 81 16 13 5 4
7. Pematang Reba 1 0 2 0 4 0 0 0 0 3 0 0 0 1 0 0 0 4
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 2 0 15 0 0 0 3 0 0 2 2 0 0 2 5
580 525 24 36 6 12
9. Tanah Datar 1 0 0 25 0 15 0 5 0 36 0 5 0 7 0 10 0 36
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 0 11 0 0 0 5 0 0 0 1 0 0 0 6
88 84 28 25 16 8
11. Kota Lama 1 0 0 3 6 3 0 2 3 2 0 0 0 0 0 2 3 2
239 149 88 83 37 45
12. Bukit Petaling 1 0 0 2 2 5 0 1 0 2 0 0 0 1 0 1 0 3
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 0 6 10 0 0 0 0 0 0 0 0 0 0 0 0

14. Barangan 1 0 31 25 6 6 0 3 0 1 0 3 0 2 0 1 0 0 0 1 0 2 0 1

15. Tani Makmur 1 0 158 136 57 40 28 22 0 1 0 2 0 1 3 6 0 0 0 0 0 1 3 6

16. Sungai Baung 1 0 141 127 38 29 18 14 0 2 4 4 0 1 2 3 0 0 2 2 0 1 4 5

17. Danau Tiga 1 0 241 252 14 16 16 4 0 2 4 4 0 1 0 5 0 0 0 4 0 1 0 9

18. Air Jernih 1 0 67 62 17 17 7 7 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 2

JUMLAH 18 0 4019 3760 998 926 385 348 3 47 31 98 0 21 8 80 0 10 4 25 30 12 95

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
16 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 3 0 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 2 0 3 1 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 0 0 0 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 1 0 2 0 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0

25 0 0 0 0 1 4 0 0 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0

10 0 0 0 0 0 4 0 3 2 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

22 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

93 0 0 0 0 0 1 0 2 2 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 4 0 2 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

19 0 0 0 4 0 4 0 0 2 3 2 1 0 0 0 0 0 0 0 0 0 0 0 0

13 0 0 0 0 0 2 0 1 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 0 0 0 0 0 2 0 3 2 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 0 0 0 0 5 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 0 0 0 0 2 3 0 0 0 1 0 0 0 0 0 0 0 1 3 6 0 0 0 0

308 0 0 0 4 3 30 0 19 27 25 6 11 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 16 0 0 2 0 16 0 0 0

0 0 0 0 0 0 0 0 4 0 0 2 0 4 0 0 0

0 0 0 0 0 0 0 0 8 0 2 2 0 8 0 0 0

0 0 0 0 0 0 0 0 8 0 0 1 0 8 0 0 0

0 0 0 0 0 0 0 0 9 0 3 3 0 9 0 0 0

0 0 0 0 0 0 0 0 25 0 4 5 0 25 0 0 0

0 0 0 0 0 0 0 0 10 0 0 3 0 10 0 0 0

0 0 0 0 0 0 0 0 22 0 0 4 0 22 0 0 0

0 0 0 0 0 0 0 0 93 0 13 7 0 93 0 0 0

0 0 0 0 0 0 0 0 17 0 4 6 0 17 0 0 0

0 0 0 0 0 0 0 0 19 0 4 5 0 19 0 0 0

0 0 0 0 0 0 0 0 13 0 3 8 0 13 0 0 0

0 0 0 0 0 0 0 0 16 0 4 2 0 16 0 0 0

0 0 0 0 0 0 0 0 8 0 0 3 0 8 0 0 0

0 0 0 0 0 0 0 0 13 0 2 3 0 13 0 0 0

0 0 0 0 0 0 0 0 4 0 0 2 0 4 0 0 0

0 0 0 0 0 0 0 0 20 0 5 5 0 20 0 0 0

0 0 0 0 0 0 0 0 3 0 2 0 0 3 0 0 0

0 0 0 0 0 0 0 0 308 0 46 63 0 308 0 0 0
 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : JUNI 2019

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 3 4 0 0 0 5 0 0 0 5 0 0 0 10

2. Redang 1 0 104 115 24 25 12 17 0 0 0 2 0 0 0 0 0 0 0 3 0 0 0 3

3. Danau Baru 1 0 0 1 2 0 0 0 1 0 0 0 0 0 0 0 1 0
174 213 23 26 10 10
4. Alang Kepayang 1 0 1 0 1 0 1 0 0 0 1 0 0 0 2 0 0 0
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 0 2 8 0 1 0 0 0 0 0 0 0 1 0 0
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 2 4 5 12 0 1 3 3 0 1 0 0 0 2 3 3
91 81 16 13 5 4
7. Pematang Reba 1 0 2 2 1 5 0 1 0 0 0 1 0 0 0 2 0 0
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 1 3 6 0 0 2 2 0 0 1 2 0 0 3 4
580 525 24 36 6 12
9. Tanah Datar 1 0 5 10 7 10 1 10 1 20 0 3 0 3 4 10 1 23
198 173 54 65 49 43
10. Sungai Dawu 1 0 0 0 9 20 0 0 2 2 0 0 0 0 0 0 2 20
88 84 28 25 16 8
11. Kota Lama 1 0 1 4 2 4 0 1 1 1 0 0 0 0 0 1 1 1
239 149 88 83 37 45
12. Bukit Petaling 1 0 2 0 2 3 0 1 1 2 0 0 0 0 0 1 1 2
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 0 2 1 0 0 2 12 0 0 0 0 0 0 2 12 0

14. Barangan 1 0 31 25 6 6 0 3 1 1 0 1 0 0 1 0 0 0 0 0 0 0 1 0

15. Tani Makmur 1 0 158 136 57 40 28 22 2 0 3 2 0 1 2 2 0 0 0 0 0 1 2 2

16. Sungai Baung 1 0 141 127 38 29 18 14 0 0 2 2 0 0 1 0 0 0 0 0 0 0 1 0

17. Danau Tiga 1 0 241 252 14 16 16 4 1 0 1 2 2 0 0 1 1 0 0 1 2 0 1 1

18. Air Jernih 1 0 67 62 17 17 7 7 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 1

JUMLAH 18 0 4019 3760 998 926 385 348 17 25 44 81 4 18 27 39 2 5 1 15 8 21 29 70

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
17 0 0 0 0 0 2 3 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 0 3 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 2 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 0 0 0 0 3 1 0 2 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0

31 0 0 0 0 1 4 2 0 5 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0

12 0 0 0 0 2 2 0 1 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 3 0 0 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

70 0 0 0 0 0 1 0 2 5 7 0 3 0 0 0 0 0 0 0 0 0 0 0 0

33 1 0 0 0 0 4 0 2 3 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

14 0 0 0 4 0 4 0 0 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

11 0 0 0 0 0 2 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 0 0 0 0 0 2 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

12 0 0 0 0 3 2 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 1 0 1 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 0 0 0 0 2 3 0 0 0 0 0 0 0 0 0 0 0 1 3 6 0 0 0 0

278 1 0 0 4 14 35 6 13 29 22 3 10 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 17 0 2 5 0 17 0 0 0

0 0 0 0 0 0 0 0 5 0 2 3 0 5 0 0 0

0 0 0 0 0 0 0 0 4 0 3 0 0 4 0 0 0

0 0 0 0 0 0 0 0 4 0 2 2 0 4 0 0 0

0 0 0 0 0 0 0 0 11 0 2 9 0 11 0 0 0

0 0 0 0 0 0 0 0 31 0 5 9 0 31 0 0 0

0 0 0 0 0 0 0 0 12 0 4 5 0 12 0 0 0

0 0 0 0 0 0 0 0 17 0 2 4 0 17 0 0 0

0 0 0 0 0 0 0 0 70 0 28 33 0 70 0 0 0

0 0 0 0 0 0 0 0 33 0 15 10 0 33 0 0 0

0 0 0 0 0 0 0 0 14 0 6 5 0 14 0 0 0

0 0 0 0 0 0 0 0 11 0 5 6 0 11 0 0 0

0 0 0 0 0 0 0 0 17 0 1 10 0 17 0 0 0

0 0 0 0 0 0 0 0 4 0 2 2 0 4 0 0 0

0 0 0 0 0 0 0 0 12 0 4 6 0 12 0 0 0

0 0 0 0 0 0 0 0 5 0 0 4 0 5 0 0 0

0 0 0 0 0 0 0 0 9 0 0 9 0 9 0 0 0

0 0 0 0 0 0 0 0 2 0 0 2 0 2 0 0 0

0 0 0 0 0 0 0 0 278 0 83 124 0 278 0 0 0

POSYANDU :
DESA/KELURAHAN :
PUSKESMAS :
KECAMATAN :
BULAN :

Umur
Kunjungan
No Nama Lansia
45-59 60-69 > 70
B L L P L P L
1 2 3 4

JUMLAH

Mengetahui
Penanggung jawab wilayah

________________
 FORMAT PENCATATAN DAN PELAPORAN KE

Kegiatan sehari-hari

> 70 Kemandirian Ggn IMT Tek. Darah Hb

P A B C ME L N K T N R N
5 6 7 8 9
TATAN DAN PELAPORAN KESEHATAN LANJUT USIA DI POSYANDU LANSIA

Hasil pemeriksaan

Hb Kolesterol Gula Darah Asam Urat

Ggn ginjal Ggn kognitif
K N T N T N T
9 10 11 12 13 14
 Jml Kasus
Pengobatan
Konseling
Penyuluhan
Ggn Penglihatan Ggn pendengaran Diobati Dirujuk B L S

15 16 17 18 19 20

Ketua kader Posyandu ......

________________
Pemberdayaan
Ket.
Lansia

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 .
PUSKESMAS : Puskesmas PEKAN HERAN
KECAMATAN : PENCATATAN N PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS
BULAN : SEPTEMBER

Sasaran Kunjungan Usia ≥ 60 tahun yang diskrining

Jumlah Jumlah 45-59 60-69 ≥70 45-59 60-69 ≥70 kesehatannya
No Nama Desa Posyand Panti
u Wredha L P L P L P L P
L P L P L P
B L B L B L B L B L B L B L B L
1 2 3 4 5 6
1. Pekan Heran 1 0 218 210 71 44 23 18 0 0 0 5 0 0 0 3 0 0 0 2 0 0 0 5

2. Redang 1 0 104 115 24 25 12 17 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 1

3. Danau Baru 1 0 0 1 0 1 0 1 2 2 0 0 1 1 0 1 3 3
174 213 23 26 10 10
4. Alang Kepayang 1 0 0 3 0 3 0 0 0 0 0 1 0 1 0 1 0 1
68 62 19 24 12 13
5. Rantau Bakung 1 0 0 1 2 2 0 1 0 1 0 0 0 0 0 1 0 1
85 82 22 14 8 13
6. Sialang Dua Dahan 1 0 6 2 3 1 2 2 4 3 0 1 0 0 6 3 4 4
91 81 16 13 5 4
7. Pematang Reba 1 0 6 6 1 1 0 2 2 2 0 0 0 0 0 2 2 2
684 658 407 382 94 73
8. Talang Jerinjing 1 0 0 0 2 2 0 0 2 2 0 0 0 2 0 0 2 4
580 525 24 36 6 12
9. Tanah Datar 1 0 6 3 12 21 3 3 3 3 1 2 2 2 4 5 5 4
198 173 54 65 49 43
10. Sungai Dawu 1 0 1 0 9 10 1 0 3 0 1 0 0 0 2 0 3 0
88 84 28 25 16 8
11. Kota Lama 1 0 2 2 1 1 1 1 1 2 0 0 0 0 2 0 1 3
239 149 88 83 37 45
12. Bukit Petaling 1 0 1 0 5 5 1 0 2 0 0 1 0 0 1 1 2 0
106 108 28 28 16 14
13. Pematang Jaya 1 0 746 698 62 53 28 28 1 0 0 8 0 0 0 2 0 0 0 0 0 0 0 2

14. Barangan 1 0 31 25 6 6 0 3 0 3 2 3 0 1 0 0 0 0 0 0 0 1 0 0

15. Tani Makmur 1 0 158 136 57 40 28 22 0 0 0 0 2 2 2 2 0 0 0 2 2 2 2 4

16. Sungai Baung 1 0 141 127 38 29 18 14 0 1 1 1 0 0 1 0 0 0 0 0 0 1 0 0

17. Danau Tiga 1 0 241 252 14 16 16 4 0 1 0 1 9 0 3 0 2 0 2 2 0 3 5 2

18. Air Jernih 1 0 67 62 17 17 7 7 0 1 0 3 0 0 0 1 0 0 0 0 0 0 0 1

JUMLAH 18 0 4019 3760 998 926 385 348 23 25 38 69 19 13 25 24 4 5 5 12 17 21 29 37

Mengetahui
Plt. Kepala UPTD Puskesmas PEKAN HERAN Pengelola Program Kesehatan Lansia

DWI AHMAD SUDRAJAT, SKM ERNA NURIYANI

NIP. 19711016 199103 1 002 NIP.19781114 200801 2 013
 Kegiatan sehari-hari Jumlah Lansia dengan Kelainan
Kemandirian IMT Tek. Darah
Ggn ME Hb Kurang Kolesterol tinggi DM As. Urat tinggi Ggn ginjal Ggn kognitif
L K T R
A B C
(-) (+) L P L P L P L P L P L P L P L P L P L P
7 8 9 10 11 12 13 14 15 16
10 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

3 0 0 0 0 0 3 0 2 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 2 0 3 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

8 0 0 0 0 0 0 0 0 2 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0

7 0 0 0 0 0 1 0 2 1 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0

24 0 0 0 0 1 4 0 0 5 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 0 4 0 3 3 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0

10 0 0 0 0 0 0 0 1 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0

61 0 0 0 0 0 1 0 2 6 8 0 1 0 0 0 0 0 0 0 0 0 0 0 0

25 1 0 0 0 0 4 0 2 1 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0

11 0 0 0 0 0 4 0 0 2 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0

15 0 0 0 0 0 2 0 1 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 0 0 0 0 0 2 0 3 1 4 0 2 0 0 0 0 0 0 0 0 0 0 0 0

9 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0

10 0 0 0 0 0 0 0 0 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0

4 0 0 0 0 0 0 0 0 1 1 1 2 0 0 0 0 0 0 0 0 0 0 0 0

20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 0 0 0 0 2 3 0 0 0 1 0 0 0 0 0 0 0 1 3 6 0 0 0 0

262 1 0 0 0 3 30 0 19 31 37 3 20 0 0 0 0 0 2 3 6 0 0 0 0
 Pengobatan Jumlah
Konseling Jumlah
Jml Lansia dgn kelainan Pemberday Panti
Ggn Penglihatan Ggn pendengaran Lain-lain Penyuluhan Kunjungan Ket.
Diobati Dirujuk aan Lansia Wredha
B L S Rumah
L P L P L P L P dibina
17 18 19 20 21 22 23 24 25 26 27 28
0 0 0 0 0 0 0 0 10 0 0 10 0 10 0 0 0

0 0 0 0 0 0 0 0 3 0 0 3 0 3 0 0 0

0 0 0 0 0 0 0 0 9 0 3 6 0 9 0 0 0

0 0 0 0 0 0 0 0 8 0 0 8 0 8 0 0 0

0 0 0 0 0 0 0 0 7 0 2 5 0 7 0 0 0

0 0 0 0 0 0 0 0 24 0 15 9 0 24 0 0 0

0 0 0 0 0 0 0 0 20 0 9 11 0 20 0 0 0

0 0 0 0 0 0 0 0 10 0 4 6 0 10 0 0 0

0 0 0 0 0 0 0 0 61 0 28 33 0 61 0 0 0

0 0 0 0 0 0 0 0 25 0 15 10 0 25 0 0 0

0 0 0 0 0 0 0 0 11 0 6 5 0 11 0 0 0

0 0 0 0 0 0 0 0 15 0 9 6 0 15 0 0 0

0 0 0 0 0 0 0 0 11 0 1 10 0 11 0 0 0

0 0 0 0 0 0 0 0 9 0 2 7 0 9 0 0 0

0 0 0 0 0 0 0 0 10 0 4 6 0 10 0 0 0

0 0 0 0 0 0 0 0 4 0 0 4 0 4 0 0 0

0 0 0 0 0 0 0 0 20 0 11 9 0 20 0 0 0

0 0 0 0 0 0 0 0 5 0 0 5 0 5 0 0 0

0 0 0 0 0 0 0 0 262 0 109 153 0 262 0 0 0