Laporan Survailans Campak 2020 PDF

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FORMAT : C - 1

LAPORAN KASUS CAMPAK

BULAN : JANUARI 2020

Puskesmas : Latowu
Kecamatan : Batuputih
Umur/ Vaksin Campak Tgl diambil Hasil
Tgl Timbul Klasifikasi Final *
Sex sebelum sakit Spesimen spesimen
NO Epid Diberi Keadaa
Nama Alamat Lengkap Campak
Kasus/ Nama Anak Tidak/ Vit. A n Akhir Bukan
Orang Tua (Desa/RT/RW) Dema Dara Dar Rubella
KLB L P Brp Kali Tdk Rash Urin Urin Y/T (H/M) Camp/
m h ah Lab (+) Epid Klinis Lab (+)
Tahu Rub
1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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
14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kepala Puskesmas Latowu Latowu 31 Januari 2020

KAHARULLAH.SKM Asriana,Amd Kep


NIP:1810103 200507 1 007 Nip:
FORMAT : C - 1
LAPORAN KASUS CAMPAK

BULAN : FEBRUARI 2020

Puskesmas : Latowu
Kecamatan : Batuputih
Umur/ Vaksin Campak Tgl diambil Hasil
Tgl Timbul Klasifikasi Final *
Sex sebelum sakit Spesimen spesimen
NO Epid Diberi Keadaa
Nama Alamat Lengkap Campak
Kasus/ Nama Anak Tidak/ Vit. A n Akhir Bukan
Orang Tua (Desa/RT/RW) Dema Dara Dar Rubella
KLB L P Brp Kali Tdk Rash Urin Urin Y/T (H/M) Camp/
m h ah Lab (+) Epid Klinis Lab (+)
Tahu Rub
1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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
14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kepala Puskesmas Latowu Latowu 28 Februari 2020

Kaharullah.SKM Asriana Amd Kep


NIP:19810103 200502 1 007 Nip:
MN
FORMAT : C - 1
LAPORAN KASUS CAMPAK

BULAN : MARET 2020

Puskesmas : Latowu
Kecamatan : Batuputih
Umur/ Vaksin Campak Tgl diambil Hasil
Tgl Timbul Klasifikasi Final *
Sex sebelum sakit Spesimen spesimen
NO Epid Diberi Keadaa
Nama Alamat Lengkap Campak
Kasus/ Nama Anak Tidak/ Vit. A n Akhir Bukan
Orang Tua (Desa/RT/RW) Dema Dara Dar Rubella
KLB L P Brp Kali Tdk Rash Urin Urin Y/T (H/M) Camp/
m h ah Lab (+) Epid Klinis Lab (+)
Tahu Rub
1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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
14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kepala Puskesmas Latowu Latowu 31 Maret 2020

Kaharullah.SKM Asriana Amd Kep


NIP:19810103 200502 1 007 Nip:
MN

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