LB3KIA Maternal 2022 PKM TRAJENG

FORMAT LAPORAN (LB3-KIA) MATERNAL
KOTA : PASURUAN
BULAN : TRIBULAN 1-4
Tahun : 2022
Diperiksa Hb K1 Hb K1 Hb K4
KEK Protein urin
Jumlah Bumil Jumlah Bumil K4 Anemia Anemia Anemia Anemia

NO. PUSKESMAS
K1 (pws kia) (pws kia) N % (8-11 mg/dl) (<8 mg/dl) (8-11 mg/dl) (<8 mg/dl) Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
BAKALAN 43 17 31 72.09 1 3.23 - - - 0 - 0 43 100.00 3 6.98 31 72.09 -

KRAMPYANGAN 15 22 14 93.33 - - - - - 0 - 0 15 100.00 3 20.00 14 93.33 -
BLANDONGAN 13 7 11 84.62 3 27.27 - - 1 14.285714 - 0 13 100.00 1 7.69 11 84.62 -
KEPEL 38 27 34 89.47 2 5.88 - - - 0 - 0 38 100.00 3 7.89 34 89.47 -
BUGULKIDUL Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
TAPAAN Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
PKM BUGULKIDUL Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
Protein urin Gula Darah (GD)
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
0.00 31 72.09 0 0.00

0.00 14 93.33 0 0.00
0.00 11 84.62 0 0.00
0.00 34 89.47 0 0.00
Err:509 Err:509 Err:509 Err:509 Err:509
KOTA : PASURUAN
BULAN : TRIBULAN 4
Tahun : 2022
KEK Protein urin
Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

NO. PUSKESMAS
K1 (pws kia) K4 (pws kia) N % (8-11 mg/dl) (<8 mg/dl) (8-11 mg/dl) (<8 mg/dl) Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
BAKALAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -

KRAMPYANGAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
BLANDONGAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
KEPEL 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
BUGULKIDUL 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
TAPAAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
PKM BUGULKIDUL - - - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! - #DIV/0! 0 #DIV/0!

#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : DESEMBER
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

KRAMPYANGAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
BLANDONGAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
KEPEL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
TAPAAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : NOVEMBER
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : OKTOBER
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

KRAMPYANGAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! - #DIV/0!
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : TRIBULAN 3
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

PKM BUGULKIDUL 0 - - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! - #DIV/0! 0 #DIV/0!

#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! 0 #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : SEPTEMBER
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : AGUSTUS
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : JULI
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : TRIBULAN 2
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

5 PKM BUGULKIDUL 0 - - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
Protein urin
22
(16/14*100)
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
KOTA : PASURUAN
BULAN : JUNI
Tahun : 2022
KEK Protein urin
Anemia Anemia Anemia Anemia

NO. PUSKESMAS
Jumlah Bumil Jumlah Bumil N % (8-11 mg/dl) (<8 mg/dl) (8-11 mg/dl) (<8 mg/dl) Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa
K1 (pws kia) K4 (pws kia)
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BLANDONGAN #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
TAPAAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0!
GD >140
Diperiksa
g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : MEI
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

KRAMPYANGAN #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
KEPEL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0!
BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
TAPAAN #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0! #DIV/0! - #DIV/0! #DIV/0!
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0!
#DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : APRIL
Tahun : 2022
KEK Protein urin Gula Darah (GD) HIV

NO. PUSKESMAS N % Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa Diperiksa
K1 (pws kia) K4 (pws kia) (8-11 mg/dl) (<8 mg/dl) (8-11 mg/dl) (<8 mg/dl) GD >140
Positif (+) Diperiksa
g/dl
N % N % N % N % N % N % N % % % % N
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100) (16/14*100) (18/3*100) (20/18*100)
BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
KRAMPYANGAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
BLANDONGAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
KEPEL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
BUGULKIDUL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
TAPAAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
PKM BUGULKIDUL - - - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -
HIV HBsAg Sifilis KASUS MATERNAL YANG DITEMUKAN
Diperiksa Diperiksa Diperiksa Konfirma Jumlah Bulin

Reaktif Reaktif Reaktif Abortus Preeklampsi Jantung DM si Positif Normal
Hiper a/ Perdarahan Perdarahan Perdarahan Partus Covid 19 Kasus Lain -
% % N % % N % %
Emesis Eklampsia Kehamilan Persalinan Nifas Lama Infeksi TB Malaria Lain N
28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
(22/3*100) (24/22*100) (26/3*100) (28/26*100) (30/3*100) (32/30*100)
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - - - - - - - - - - - - - - 0 -
JENIS PERSALINAN
Persalinan Dukun
Normal SC Tindakan
Vakum/ Plasenta N %
% N % Drip % Forcep % Curetage % Manual %
55 56 57 58 59 60 61 62 63 64 65 66 67
(49/48*100) (51/48*100) (53/48*100) (55/48*100) (57/48*100) (59/48*100) (61/48*100)
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0!
KOTA : PASURUAN
BULAN : TRIBULAN 1
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 6 7 8 9 10 11 12 13 14 15 16
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
BAKALAN 43 17 31 72.09 1 3.23 - - - - - - 43 100.00 3 6.98 31 72.09 -

KRAMPYANGAN 15 22 14 93.33 - - - - - - - - 15 100.00 3 20.00 14 93.33 -
BLANDONGAN 13 7 11 84.62 3 27.27 - - 1 14.29 - - 13 100.00 1 7.69 11 84.62 -
KEPEL 38 27 34 89.47 2 5.88 - - - - - - 38 100.00 3 7.89 34 89.47 -
BUGULKIDUL Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
TAPAAN Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
PKM BUGULKIDUL Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
GD >140
Diperiksa g/dl
% % %
17 18 19 20 21
(16/14*100) (18/3*100) (20/18*100)
0.00 31 72.09 0 0.00

0.00 14 93.33 0 0.00
0.00 11 84.62 0 0.00
0.00 34 89.47 0 0.00
KOTA : PASURUAN
BULAN : MARET
Tahun : 2022
Diperiksa Hb Hb k1 Hb k4
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 6 7 8 9 10 11 12 13 14 15 16
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
1 TRAJENG 15 6 12 80.00 0 - 0 - 0 - 0 - 15 100.00 2 13.33 12 80.00 0

2 TAMBAAN 6 7 6 100.00 0 - 0 - 0 - 0 - 6 100.00 3 50.00 6 100.00 0
3 MAYANGAN 2 3 2 100.00 2 100.00 0 - 0 - 0 - 2 100.00 1 50.00 2 100.00 0
4 NGEMPLAKREJO 12 10 12 100.00 0 - 0 - 0 - 0 - 12 100.00 1 8.33 12 100.00 0
PKM TRAJENG 35 26 32 91.43 2 6.25 - - - - - - 35 100.00 7 20.00 32 91.43 -
GD >140
Diperiksa g/dl
% % %
17 18 19 20 21
(16/14*100) (18/3*100) (20/18*100)
0.00 12 80.00 0 0.00

0.00 6 100.00 0 0.00
0.00 2 100.00 0 0.00
0.00 12 100.00 0 0.00
0.00 32 91.43 - 0.00
KOTA : PASURUAN
BULAN : FEBRUARI
Tahun : 2022
Diperiksa Hb Hb K1 Hb K4
KEK Protein urin

NO. PUSKESMAS
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 6 7 8 9 10 11 12 13 14 15 16
Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
1 TRAJENG 12 5 11 91.67 0 - 0 - 0 - 0 - 12 100.00 1 8.33 11 91.67 0

2 TAMBAAN 6 6 6 100.00 0 - 0 - 0 - 0 - 6 100.00 0 0.00 6 100.00 0
3 MAYANGAN 6 3 6 100.00 1 16.67 0 - 1 33.33 0 - 6 100.00 0 0.00 6 100.00 0
4 NGEMPLAKREJO 15 12 13 86.67 2 15.38 0 - 0 - 0 - 15 100.00 1 6.67 13 86.67 0
PKM TRAJENG 39 26 36 92.31 3 8.33 - - 1 3.85 - - 39 100.00 2 5.13 36 92.31 -
GD >140
Diperiksa g/dl
% % %
17 18 19 20 21
(16/14*100) (18/3*100) (20/18*100)
0.00 11 91.67 0 0.00

0.00 6 100.00 0 0.00
0.00 6 100.00 0 0.00
0.00 13 86.67 0 0.00
0.00 36 92.31 - 0.00
KOTA : PASURUAN
BULAN : JANUARI
Tahun : 2022
KEK Protein urin

NO. PUSKESMAS
K1 (pws kia) K4 (pws kia) (8-11 mg/dl) (<8 mg/dl) (8-11 mg/dl) (<8 mg/dl) Diperiksa LiLA KEK (LiLA < 23,5 cm) Diperiksa
Positif (+)
N % N % N % N % N % N % N %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Rumus (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)
1 TRAJENG 16 6 8 50.00 1 12.50 0 0.00 0 0.00 0 0.00 16 100.00 0 0.00 8 50.00 0

2 TAMBAAN 3 9 2 66.67 0 0.00 0 0.00 0 0.00 0 0.00 3 100.00 0 0.00 2 66.67 0
3 MAYANGAN 5 1 3 60.00 0 0.00 0 0.00 0 0.00 0 0.00 5 100.00 0 0.00 3 60.00 0
4 NGEMPLAKREJO 11 5 9 81.82 0 0.00 0 0.00 0 0.00 0 0.00 11 100.00 1 9.09 9 81.82 0
PKM TRAJENG 35 21 22 62.86 1 4.55 0 0.00 0 0.00 0 0.00 35 100.00 1 2.86 22 62.86 0
GD >140
Diperiksa g/dl
% % %
22 23 24 25 26
(16/14*100) (18/3*100) (20/18*100)
0.00 8 50.00 0 0.00

0.00 2 66.67 0 0.00
0.00 3 60.00 0 0.00
0.00 9 81.82 0 0.00
0.00 22 62.86 0 0.00
KASUS MATERNAL YANG
NO. Kabupaten / Kota Preeklampsi
Hiper Abortus a/ Perdarahan Perdarahan
Emesis Eklampsia Kehamilan Persalinan
1 2 22 23 24 25 26
Rumus
1 KAB. PACITAN 65 212 162 44 32
2 KAB. PONOROGO 156 391 347 77 43
3 KAB. TRENGGALEK 114 390 219 81 48
4 KAB. TULUNGAGUNG 202 473 312 74 120
5 KAB. BLITAR 273 374 270 112 117
6 KAB. KEDIRI 223 512 561 150 108
7 KAB. MALANG 1093 627 573 197 196
8 KAB. LUMAJANG 66 284 538 85 60
9 KAB. JEMBER 485 921 929 233 227
10 KAB. BANYUWANGI 527 668 554 165 138
11 KAB. BONDOWOSO 84 428 387 117 136
12 KAB. SITUBONDO 33 354 527 60 110
13 KAB. PROBOLINGGO 107 692 536 120 187
14 KAB. PASURUAN 431 503 735 276 164
15 KAB. SIDOARJO 732 267 503 161 136
16 KAB. MOJOKERTO 134 386 588 200 73
17 KAB. JOMBANG 281 625 581 93 96
18 KAB. NGANJUK 87 776 401 127 66
19 KAB. MADIUN 118 242 245 56 44
20 KAB. MAGETAN 81 252 189 72 72
21 KAB. NGAWI 185 306 479 53 49
22 KAB. BOJONEGORO 87 771 785 115 112
23 KAB. TUBAN 141 574 552 137 98
24 KAB. LAMONGAN 271 546 479 117 93
25 KAB. GRESIK 176 473 411 157 75
26 KAB. BANGKALAN 609 274 348 51 86
27 KAB. SAMPANG 206 428 565 88 268
28 KAB. PAMEKASAN 217 323 272 75 75
29 KAB. SUMENEP 166 232 408 112 176
30 KOTA KEDIRI 2 103 62 26 2
31 KOTA BLITAR 1 87 36 10 7
32 KOTA MALANG 106 312 244 130 58
33 KOTA PROBOLINGGO 7 28 98 20 38
34 KOTA PASURUAN 16 95 83 29 3
35 KOTA MOJOKERTO 6 83 59 13 22
36 KOTA MADIUN 11 38 95 15 4
37 KOTA SURABAYA 649 606 1704 398 34
38 KOTA BATU 22 39 62 15 1
KASUS MATERNAL YANG DITEMUKAN
Perdarahan Partus Kasus Lain -

Nifas Lama Infeksi AIDS TB Malaria Lain
27 28 29 30 31 32 33
21 375 6 0 0 1 687
50 429 9 2 4 1 1326
18 217 6 4 5 1 515
25 519 10 7 1 0 1279
14 252 66 9 9 0 1312
40 435 30 33 11 0 1831
84 608 106 25 26 15 2738
17 561 6 16 9 0 2035
76 981 315 36 28 23 2242
62 512 33 39 9 0 2294
38 406 18 18 5 0 1332
25 384 11 29 8 0 1312
40 619 35 43 16 1 3961
57 702 379 47 25 1 1807
60 350 211 4 4 0 5499
26 345 191 25 8 0 3196
48 218 28 27 10 0 1037
15 264 1 14 4 0 6944
17 107 32 10 25 14 512
24 154 76 10 7 0 1003
14 335 21 9 6 0 1356
31 283 18 10 10 0 2607
46 416 7 16 11 0 2646
49 516 139 2 3 0 2320
25 242 26 10 8 0 2661
37 216 28 4 21 3 506
38 540 16 0 7 0 1174
21 133 85 10 5 2 1696
35 420 26 2 12 0 1516
5 58 2 2 0 0 390
19 77 2 7 1 0 169
9 628 85 8 9 0 908
4 28 18 7 1 0 263
2 28 4 2 1 0 399
4 62 5 1 0 0 232
2 41 3 1 1 0 299
129 288 162 39 23 5 6512
2 23 1 2 0 0 92

LB3KIA Maternal 2022 PKM TRAJENG

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FORMAT LAPORAN (LB3-KIA) MATERNAL

Jumlah Bumil Jumlah Bumil K4 Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN 43 17 31 72.09 1 3.23 - - - 0 - 0 43 100.00 3 6.98 31 72.09 -

(16/14*100) (18/3*100) (20/18*100)

0.00 31 72.09 0 0.00

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! - #DIV/0! 0 #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! - #DIV/0! 0 #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN 0 0 0 #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! - #DIV/0! -

Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

(16/14*100) (18/3*100) (20/18*100)

#DIV/0! #DIV/0! #DIV/0!

Jumlah Bumil Jumlah Bumil Anemia Anemia Anemia Anemia

Rumus (4/3*100) (6/4*100) (8/4*100) (6/4*100) (8/4*100) (10/3*100) (12/10*100) (14/3*100)

BAKALAN #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

(22/3100) (24/22100) (26/3100) (28/26100) (30/3100) (32/30100)

(49/48100) (51/48100) (53/48100) (55/48100) (57/48100) (59/48100) (61/48*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (4/3100) (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3100)

(16/14100) (18/3100) (20/18*100)

Rumus (6/4100) (8/4100) (6/4100) (8/4100) (10/3100) (12/10100) (14/3*100)

(16/14100) (18/3100) (20/18*100)