FORMAT PEMANTAUAN

( digunakan untuk orang dalam pemantauan, kontak erat, orang dalam kriteria)
Tempat Pemantauan : Puskesmas Sitiung I
Kab/Kota : Dharmasraya

Tanggal Kontak Tanggal dan Hasil Pemantauan

Jenis Terakhir(diisi
No Nama Umur Alamat No. Telp
Kelamin untuk Kontak Nov-20
Erat)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 Dani L 26 th Piruko Utara B A

2 Elyana P 36 th Sungai Duo DB DB A A
3 Neni P 28 th Piruko Utara DB DB A
4 Widia Arjuniati P 22 th Piruko Utara 10/26/2020 X X X X X X X X X X X X X X
5 Adib K Mingsen Topan Andika L 28 th Pulau Punjung 082385641578 11/1/2020 X X X A
6 Agus Wandri L 36 th Tebing tinggi 085263594799 1-Nov-20 X X X A
7 Andrian saputra L 20 th piruko tengah 081330354398 10/31/2020 X X X A
4 Darlis ZN L 53 th Koto Tuo Siguntur 085363790150 11/1/2020 X X X A
5 Darmaningsih P 33 th Koto Agung 085363725655 11/1/2020 X X X A
6 Defrizal L 42 th Pulai 082385872261 11/1/2020 X X X A
7 Desi Feriyatmi P 37 th Padang Bintungan 085263848650 11/1/2020 X X X A
8 Devi fatmawati P 24 th Koto Agung Kanan 082288054266 11/1/2020 X X X A
9 Dian Nofri Eka Saputra L 26 th Sitiung 081276560584 11/1/2020 X X X A
10 Erico saputra L 34 th Pulau Punjung 082161398643 10/31/2020 X X X A
11 Febry Aryunela P 24 th Koto Agung Kanan 082377953604 10/31/2020 X X X A
12 Hengki Martus L 33 th Padang 085264537138 10/31/2020 X X X A
13 Imam Syafi'i L 35 th Sitiung 081374571606 11/1/2020 X X X A
14 Indra Sepriadi L 30 th Piruko SeLatan 081268890222 10/31/2020 X X X A
15 Jefri Juandika R L 27 th Pulau Punjung 085265884869 10/31/2020 X X X A
16 Martha Sari Anjelia P 34 th Gn medan 082391838123 10/31/2020 X X X A
17 Mujib Handoko L 35 th Teluk sikai 085274936416 11/1/2020 X X X A
18 Nidawaty P 46 th Sungai Duo 082381528410 11/1/2020 X X X A
19 Osrial L 43 th Sungai dareh 082289271110 10/31/2020 X X X A
20 Paiman L 73 th piruko tengah 082391925753 10/31/2020 X X X A
21 Parto wiyono L 73 th Piruko Selatan 085363007558 10/31/2020 X X X A
22 Reza Enando Putra L 20 th Koto Tuo Siguntur 085363790150 11/1/2020 X X X A
23 Satimo L 61 th Piruko SeLatan 083189253137 11/1/2020 X X X A
24 Septia roberto L 24 th Sikabau 081374646959 10/31/2020 X X X A
25 Servy Susanty P 46 th Koto Padang 082172274670 11/30/2020 X X X A
26 Somo L 56 th Piruko SeLatan 081268890222 11/1/2020 X X X A
27 Suardi L 69 th Gn medan 082287894941 11/1/2020 DB DB DB A
28 Suherman L 35 th Sungai dareh 081364161183 11/1/2020 X X X A
29 Sutrisno L 63 th Batu Rijal 085274975157 11/1/2020 DB DB DB A
30 Syafrida P 49 th Koto Tuo Siguntur 085363790150 11/1/2020 X X X X A
31 Syamsuar P 61 th Sitiung 081267977188 11/1/2020 DB DB DB DB A
32 Tarmi P 75 th Piruko SeLatan 082130291601 11/1/2020 X X X X A
33 Wilarto L 39 th Koto Agung Kanan 082377953607 11/1/2020 X X X X A
34 Yocha Vastia Yuland P 27 th Sungai Duo 081365413420 11/1/2020 X X X X X X X X X X X X X X
35 Zikri Handika Kurniawan L 25 th Gn medan 082389271110 11/1/2020 X X X X A
36 Ridha P 14 th Pisang rebus 082229432384 D D D A
37 Arya L 7 th Pisang rebus 082391922619 B B B A
38 Bingkus L 70 th Pisang rebus 082391926544 B B B A
39 Upik ancak P 60 th Pisang rebus 082391926544 B B B A
40 Adek L 29 th Pisang rebus 085271138464 D D D A
41 Farhan L 6 th Pisang rebus DB DB DB A
42 Aris L 7 th Pisang rebus 085263088571 D D D D A
43 Rizki L 4 bln Pulai DB DB DB DB A
44 Desi Novita Sari P 25 th Teluk sikai 082288913862 DB DB DB DB DB
45 Kenzi L 3 th Piruko Utara D D D A
46 Mesritab P 13 th Padang Sidondang 085356046466 DB DB DB A
47 Neng P 33 th Padang Sidondang 082169132809 DB DB DB A
48 Latifa P 7 th Padang Sidondang 081380235965 DB DB DB A
49 Wahyu L 16 th Padang Sidondang 081277571140 DB DB DB A
50 Dika L 25 th Sungai duo B B B A
51 Haqi L 9 th Sitiung Tengah B B B B A
52 Taqia P 11 th Sitiung Tengah B B B B A
53 Hafiza P 10 th Pulai B B B B A
54 Dimas L 3 th Teluk sikai DB DB DB DB A
55 Evi P 25 th Teluk sikai DB DB DB DB A
56 Arfas L 54 th Kantor camat Sitiung 081363593752 11/8/2020 x x x A
57 Apri Kusnanto L 26 th Teluk sikai 085274573623 11/8/2020 x x x A
58 Darlis ZN L 53 th Kantor camat Sitiung 085363790150 11/8/2020 x x x A
59 Defri Zuhenda L 34 th Kantor camat Sitiung 08116667324 11/8/2020 x x x
60 Desi sasri P 39th Kantor camat Sitiung 081218968018 11/8/2020 x x x A
61 Desmaniar P 56 th Kantor camat Sitiung 081270224652 11/8/2020 x x x A
62 Dodi Yudista L 37 th Kantor camat Sitiung 082387722997 11/8/2020 x x x A
63 Dwiana Purnama Sari P 28 th Teluk sikai 082170254904 11/8/2020 x x x A
64 Evi Riwanto L 27 th Kantor camat Sitiung 085271063248 11/8/2020 x x x A
65 Febrison P 39 th Kantor camat Sitiung 081374747282 11/8/2020 x x x x A
66 Hartati P 64 th Kontak erat Desi NS 085274573623 11/8/2020 x x x x A
 67 Hengki Yuliadi L 36 th Kantor camat Sitiung 081267550711 11/8/2020 x x x x A
68 Lasiyem P 44 th Kontak erat Desi NS 082288913862 11/8/2020 x x x x A
69 Leni Wati P 36 th Kantor camat Sitiung 082386017541 11/8/2020 x x x x A
70 Minurillah P 30 th Piruko SeLatan 082130291601 - DB DB DB DB A
71 Nefsi Yella P 26 th Kantor camat Sitiung 082388740187 11/8/2020 x x x x A
72 Panimin L 59 th Kontak erat Desi NS 082288913862 11/8/2020 x x x x A
73 Rita Sintia Neli P 39 th Kantor camat Sitiung 082217356720 11/8/2020 x x x x A
74 Saisis L 42 th Kantor camat Sitiung 081266259878 11/8/2020 x x x x A
75 Sri Rahayu P 47 th Kantor camat Sitiung 081266150727 11/8/2020 x x x A A
76 Sularno L 65 th Teluk sikai 085274573623 11/8/2020 x x x x A
77 Susilo Wati Ningsih P 39 th Kantor camat Sitiung 085374337178 11/8/2020 x x x x A
78 Taufik Rusdi L 44 th Kantor camat Sitiung 081266077776 11/8/2020 x x x A A
79 Tetri Dian Fadila P 8 th Teluk sikai 085274573623 11/8/2020 x x x x A
80 Tuning Handayani P 40 th Kantor camat Sitiung 081363380003 11/8/2020 x x x x A
81 Wira Guswita P 40 th Kantor camat Sitiung 085263483722 11/8/2020 x x x x A
82 Wiwit Fitriyanti P 28 th Kantor camat Sitiung 082384147761 11/8/2020 x x x x A
83 Zulkadri L 44 th Kantor camat Sitiung 081275029681 11/8/2020 x x x x A
84 M Zarkasi Hafidz L 44 th Koto Agung Kanan '081266528755 B B B B A
85 Paldo L 10 th Pulai D D D A
86 Gofar L 7 th Sungai Duo B B B A
87 Sifa P 3 th Piruko SeLatan B B B A
88 Alayya P 4 th Koto Agung Kiri B B B A
89 Imam L 40 th Piruko SeLatan DB DB DB A
90 Salwa P 8,5 th Koto Agung Kanan B B B A
91 Mardi L 69 th Rawat inap pusk BS BS BS
92 Gani L 2 th Piruko SeLatan
93 Arka L 2,3 th Padang Sidondang
94 Aci Saputra L 35 th Koto Agung
96 Dian Rahmaningsih P 35 th Koto Agung
98 Khanza Diaci isyqi P 8 th Koto Agung
99 Mikayla Diaci Azzahra P 3 th Koto Agung
100 Suyati P 59 th Koto Agung
95 Aura Retno Pinasti P 13 th Piruko SeLatan
97 Jenjem P 58 th Rawat inap pusk
103 feby P 14 th Sitiung Tengah
104 Aksa L 13 bln Piruko Utara
105 Martin L 10 th Koto Daulat
106 Sabrina P 8 th Padang Sidondang 085278183910
107 Devi P 7 th Pisang rebus
108 Hawa P 8 bln Piruko Utara
109 Achmad Gabriel L 8 th BKR II 081266150644
110 Afika Putri Nelmi P 8 th BKN I 082284297129
111 Agus Widodo L 38 th Koto Agung Kiri 081277787942
112 Agustini P 39 th Piruko 085377080048
113 Alif Maulana Akbar L 8 th BKR II 083181818514
114 Andika Pratama Hamdani L 8 th BKN I 081363288690
115 Azka Zaidan Siregar L 7 th Sungai Duo 085355664457
116 Bulhanis Sulton L 43 th Koto Agung Kiri 085272824784
117 Bunga Aliatul Iffah P 8 th BKR II 085263463009
118 Denny Zulliyanto L 27 th Koto Agung Kiri 082373020354
119 Eagan Daffa Alfatih L 9 th Koto Agung Kanan 085263562400
120 Eni Ristya Ningsih P 29 th Piruko 081268254429
121 Faiz firjatullah L 6 th Piruko 085377080048
122 Febrizio Putra L 8 th BKN I 081266150644
123 Feby Riana Putri P 27 th Koto Agung Kiri 082170515372
124 Gen Feris L 35 th Gunung Medan 082268817482
125 Ghany Yuan L 5 th Piruko Selatan 085271825571
126 Janeeta Lovely Arla P 9 th BKR II 81363936004
127 Katmi P 64 th Koto Agung Kiri 0812660044744
128 Krisna Septianto L 26 th Piruko 082373049669
129 Lira Gani P 35 th Gunung Medan 082268817482
130 Luqhiana Ayvi P 12 th Gunung Medan 082268817482
131 Luxfangia Ferligent P 8 th Gunung Medan 082268817482
132 Martha Romani P 51 th Koto Agung Kiri 082387472631
133 Miradatul Husni Fajri P 9 th Koto Agung 081365690822
134 Miyarso L 50 th Sungai Duo 081311295485
135 Muhammad Nabil Ghaisan L 13 th Koto Agung Kiri 082387427771
136 Mujiono L 51 th Koto Agung Kiri 085374457821
137 Najwa Saqila Pardiansyah P 7 th BKN II 081266150644
138 Paryanto L 51 th Koto Agung Kiri 081372782341
139 Pirla Septiano P 17 th Piruko 085377080048
140 Putri Fauziah Sari P 25 th Sungai Duo 082177727348
141 Rismalaini P 47 th Sililuk 082388505383
142 Rosita P 31 th Piruko Selatan 085265290933
143 Rovalin sadewa L 39 th BKR II 08527811155
144 Septiawan Yulianto L 28 th Koto Agung Kiri 081364625965
145 Sepwinda Eka Sari P 28 th Koto Agung Kanan 085278696999
146 Sukar L 40 th Piruko Selatan 085271825571
147 Sukini P 57 th Koto Agung Kiri 081363636202
148 Sumarsono L 49 th Koto Agung Kiri 082387427771
149 Sunoto L 68 th Piruko 081267981969
150 Tukijem P 65 th Piruko 081267981969
151 Tumino L 46 th Koto Agung Kiri 085272824784
152 Winarni P 48 th Koto Agung Kanan 085278696999
153 Wiyadi L 42 th Piruko Selatan 085377080048
154 Yusmeita P 32 th Piruko Selatan 085271825571
155 Zealand Ghany Ghaszavhie L 11 th Piruko Selatan 085271825571
156 Zulfa Zawiati P 52 th Komplek SMA 081266150644
157 Gito L 30 th Padang Sidondang 082171744827
158 Satria L 2 th Padang Sidondang 081266906370
159 Langen L 3 th Padang Sidondang 081266906370
160 Sudirman L 22 th Koto Daulat
161 Aura P 9 th Koto Daulat
162 Ariani Zaltin Okvenda P 35 th Koto agung Kiri 082169778613 11/23/2020
163 Arista Melani P 33 th Koto Agung kanan 082389221118 11/23/2020
164 Aulia Wulandari L 30 th Koto agung Kiri 082288976180 11/23/2020
165 Darmaningsih P 33 th Koto Agung 085363725655 11/23/2020
166 Deddy Setyawan Eka Saputra L 33 th Koto Agung Kanan 085272646462 11/23/2020
167 Defi Melya Darma P 36 th BKR 1 081369688332 11/23/2020
168 Desi Feriyatmi P 36 th Padang Bintungan 081365617624 11/23/2020
169 Devi Fatmawati P 24 th Koto agung kanan 082288054266 11/23/2020
170 Dhea Olivia Cori P 8 th Koto Agung Kanan 085272646462 11/23/2020
171 Dina Eka Putri P 34 th Koto Baru 081363521234 11/23/2020
172 Dina Oliviana P 39 th Taratak 085376694645 11/23/2020
173 Dwi Ana Purnama Sari P 28 th Koto agung kanan 082170254904 11/23/2020
174 Dwinanda Emira P 41 th BKR 1 085274174274 11/23/2020
175 Ega Prianti P 28 th Sitiung 081363799577 11/23/2020
176 Eka Santia Dewi P 28 th Koto Padang 085263945961 11/23/2020
177 Elfiza P 46 th Koto Agung kiri 081363748803 11/23/2020
178 Erni R P 41 th Gunung Medan 081277800422 11/23/2020
179 Erya Winarti P 49 th Koto Agung kiri 081363906899 11/23/2020
180 Fitri Asmara P 29 th sungai salak 082283776680 11/23/2020
181 Fitri Yanti P 37 th Blok C 082170680090 11/23/2020
182 Fitri Yenti P 43 th Kotto Baru 081363498222 11/23/2020
183 Gardenia P 49 th BKR 1 085263499244 11/23/2020
184 Goura Genni Perca P 35 th Sungai Duo 081374391719 11/23/2020
185 Hafidzah Oktaviani P 30 th Koto Agung Kanan 082385617323 11/23/2020
186 Herzalinasari P 31 th Koto Agung Kanan 085366000025 11/23/2020
187 Hesti Wijayanti P 42 th Padang Bintungan 081270290835 11/23/2020
188 Husnah P 30 th Koto Padang 082386275538 11/23/2020
189 Ida Rohaya P 43 th BKR 1 081262946830 11/23/2020
190 Ikbal Hanif L 21 th Koto Beringin 082173176439 11/23/2020
191 Imam Safe'i P 23 th Piruko Selatan 08229811517 11/23/2020
192 Indra Rahmadani P 32 th Koto Daulat 085263354344 11/23/2020
193 Iswatun Hasanah P 26 th Ampalu 082288204891 11/23/2020
194 Jumiati P 68 th Sungai Duo 085278135973 11/23/2020
195 Linda Novitry Fahmi P 44 th Padang Sidondang 081266979243 11/23/2020
196 Lingga Saputra L 29 th Koto Agung kiri 082176542128 11/23/2020
197 Lisa Gusnita P 29 th Koto Agung kiri 082297146681 11/23/2020
198 Loli Septria Putri P 26 th Sungai Salak 082387121826 11/23/2020
199 Lussy Primayanti P 26 th Aur jaya 081275180770 11/23/2020
200 Mainetti P 51 th Piruko Selatan 085274340015 11/23/2020
201 Marios Sari Oska P 36 th Siguntur 081367755498 11/23/2020
202 Martha Romany P 51 th BKR 1 082387472631 11/23/2020
203 Martha Sari Anjelia P 34 th Gunung Medan 082391838123 11/23/2020
204 Meldawati P 39 th Pulai 085263826362 11/23/2020
205 Meliana P 23 th Koto Besar 082169021133 11/23/2020
206 Monalisa Neja Yanti P 34 th BKR 1 085274515690 11/23/2020
207 Muhammad Ilham L 28 th Lubuk Aur 085274845735 11/23/2020
208 Mujahidaturrahmah P 34 th Piruko Selatan 081276027363 11/23/2020
209 Murniati P 44 th sungai kalang I 081363636202 11/23/2020
210 Mutia Fardilla P 34 th Gunung Medan 085363958743 11/23/2020
211 Nelfida P 55 th BKR 1 085274135670 11/23/2020
212 Nidawaty P 46 th BKR 1 082381528410 11/23/2020
213 Nila Sari Dwi Martya Ningsih P 25 th Padang Bintungan 082170475372 11/23/2020
214 Nohel Penrisna P 27 th Tri Mulya 085376196588 11/23/2020
215 Nora Jeni Anggola P 30 th Koto Daulat 085295431945 11/23/2020
216 Oktaningsih P 29 th Piruko 085376288237 11/23/2020
217 Paijo L 47 th Koto Agung Kanan 081363953435 11/23/2020
218 Posmawati Sinabang P 43 th Koto Agung Kiri 085263408168 11/23/2020
219 Purnama Putra L 25 th Koto agung Kiri 085211994829 11/23/2020
220 Rahmat Fitriansyah L 21 th Koto Agung Kanan 082287495669 11/23/2020
221 Raini Angraini P 36 th Koto Beringin 082283519251 11/23/2020
222 Rika Dewi Puspa Ningrum P 37 th Koto Agung kiri 081378198743 11/23/2020
223 Rika Diana Putri P 33 th Koto Padang 082285910937 11/23/2020
224 Servy Susanti P 46 th Koto Padang 082172274670 11/23/2020
225 Shinta prima Sari P 27 th Koto Agung kiri 082286230867 11/23/2020
226 Siska Meilani P 25 th Pulai 082347370072 11/23/2020
227 Sri Murlaini P 35 th Koto Padang 082174465621 11/23/2020
228 Sri Sukatmi P 38 th Blok C 085295291156 11/23/2020
229 Sri Witati P 38 th Koto Agung Kiri 085376533633 11/23/2020
230 Sukarno L 48 th Koto Agung kanan 081353709522 11/23/2020
231 Sukini P 57 th Koto Agung kiri 082297146681 11/23/2020
232 Sumiati P 53 th Koto agung Kiri 085211994829 11/23/2020
233 Suparno L 35 th Koto Agung kanan 081267674854 11/23/2020
234 Susi Rejeki P 41 th BKR 1 081267333975 11/23/2020
235 Tumino L 46 th Koto Agung Kiri 085272824784 11/23/2020
236 Uul Anjar Yulvita P 28 th Tri Mulya 085263558222 11/23/2020
237 Wagimin L 70 th Koto agung Kiri 085211994829 11/23/2020
238 Wartini P 52 th Padang Bintungan 085274502018 11/23/2020
239 Wenny Yosdalinda P 39 th BKR 1 082284695229 11/23/2020
240 Wita Elbertis P 33 th Lawai 081374337447 11/23/2020
241 Yocca Vastia Yuland P 27 th Sungai Salak 081365413420 11/23/2020
242 Yosef Kardianto L 30 th Pinang Gadang 082390757827 11/23/2020
243 Yosi Angriani P 33 th Koto Baru 082174574297 11/23/2020
244 Yuan Persada P 34 th Sungai Salak 081267725005 11/23/2020
245 Yuliarni P 46 th Gunung Medan 081374048006 11/23/2020
246 EKA PUTRI SUSILAWATI P 45 TH Koto Padang 11/23/2020
247 SUKMA WITA P 31 TH Siguntur 11/23/2020
248 EMILDA HAYU PERTIWI P 45 TH Pulai 11/23/2020
249 VERA DWI SEPTIANA P 38 TH Lawai 11/23/2020
250 SISYANI P 40 TH Piruko 11/23/2020
251 DARNU SOKWITA P 38 TH Sungai Salak 11/23/2020
252 NURIDA SYARIF P 46 TH Sialang Gaung 11/23/2020
253 RONI HIDAYAT L 43 th Sitiung IV 11/23/2020
254 Elvin P 30 th Sitiung Tengah
255 Nova L 47 th Sitiung Tengah
256 Arkan L 3,5 th Piruko
257 Aiza P 7 bln Sungai Duo
258 Ahmad Khairul Abib L 4 th Piruko
259 Abib Biarobbi L 11 th Piruko
260 Mespawati P 32 th Pisang rebus 081374341521
261 Yudhaningsih P 29 th Pisang rebus 085247454594
262 Sriatun P 30t h Pisang rebus 082384846618
263 Fatih L 2 th Pisang rebus 085374007795
TAUAN
kontak erat, orang dalam kriteria)

Hasil Pemeriksaan
Penunjang (jika berubah
ggal dan Hasil Pemantauan status)
Keterangan (Upaya yang
Jenis spesimen dan tgl pemantauan Lab (darah,
Nov-20 RO dilakukan
sputum)
17 18 19 20 21 22 23 24 25 26 27 28 29 30

A Jakarta
Kontak erat dedi /Damkar
Kontak erat dedi / Damkar
Kontak erat Dedi /Damkar
Kontak erat Regy
PPT / staf Puskesmas
Suspek
PPT / staf Puskesmas
PPT / staf Puskesmas
Kontak erat wiwi
Kontak erat dedi /Damkar
PPT
Kontak erat dedi
Kontak erat dedi /Damkar
Kontak erat Tokarjo
Kontak erat dedi /Damkar
PPT / staf Puskesmas
Kontak erat dedi /Damkar
PPT / staf Puskesmas
Kontak erat dedi /Damkar
Kontak erat Tokarjo
Kontak erat Tokarjo
Kontak erat Regy
Kontak erat Tokarjo
Kontak erat dedi /Damkar
PPT / staf Puskesmas
 Kontak erat Tokarjo
Suspek
Kontak erat dedi /Damkar
Suspek
Kontak erat Regy
Suspek
Kontak erat Tokarjo
PPT
A PPT / staf Puskesmas
Kontak erat dedi /Damkar

swab tgl 04 November 2020 Isolasi mandiri sampai hasil swab keluar

swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif

swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab ( + ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
 swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Suspek
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab ( + ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif
swab nasoorofaring 10 November 2020 swab (- ) Kontak erat kasus positif

BS BS x x x
D D D A
DB DB DB A
DB DB DB A swab nasoorofaring tgl 17 /11/2020 swab ( + )
DB DB DB A swab nasoorofaring tgl 17 /11/2020 swab ( + )
DB DB DB A swab nasoorofaring tgl 17 /11/2020 swab ( + )
DB DB DB A swab nasoorofaring tgl 17 /11/2020 swab ( + )
DB DB DB A swab nasoorofaring tgl 17 /11/2020 swab ( + )
x x x A A A swab nasoorofaring tgl 17 /11/2020 swab - Kontak erat kasus positif
DB DB DB A A A swab nasoorofaring tgl 17 /11/2020 swab -
DB DB DB A A
DB DB DB A A
D D A A
DB DB A A
DB DB A A
B A A
x x x x A swab nasoorofaring 21 November 2020 swab ( - ) Kontak erat kasus positif
 x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
DB DB DB DB A swab nasoorofaring 21 November 2020 swab (-) Suspek
x x x x swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (+) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
x x x x A swab nasoorofaring 21 November 2020 swab (-) Kontak erat kasus positif
DB DB DB x A
DB DB DB x A
DB DB DB x A
D D D x A
DB DB DB A
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x swab nasoorofaring 25 November 2020 swab (+) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x x swab nasoorofaring 25 November 2020 swab (+) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 25 November 2020 swab (-) Kontak erat kasus positif
x x A swab nasoorofaring 26 November 2021 swab (-)
x x x A swab nasoorofaring 26 November 2021 swab (-)
x x x x A swab nasoorofaring 26 November 2021
x x x x A swab nasoorofaring 26 November 2021
x x x x A swab nasoorofaring 26 November 2021
x x x A swab nasoorofaring 26 November 2021 swab ( - )
x x x A swab nasoorofaring 26 November 2021 swab ( - )
x x x A swab nasoorofaring 26 November 2021 swab ( - )
x x x x A swab nasoorofaring 26 November 2021
B
B
B
B
B
B
D
D
D
D
 PEMETAAN DAFTAR PPT DAN ODP WILAYAH PUSKESMAS SITIUNG I

Alamat

No Nama JK Umur Sung Koto

Teluk S
BKR BKN ai Daul
Sikai salak
duo at

1 Adib K Mingsen Topan Andika L 28 th 1

2 Agus Wandri L 36 th
3 Andrian saputra L 20 th 1
4 Darlis ZN L 53 th 1
5 Darmaningsih P 33 th 1
6 Defrizal L 42 th 1
7 Desi Feriyatmi P 37 th 1
8 Devi fatmawati P 24 th
9 Dian Nofri Eka Saputra L 26 th 1
10 Erico saputra L 34 th 1
11 Febry Aryunela P 24 th
12 Hengki Martus L 33 th 1
13 Imam Syafi'i L 35 th 1
14 Indra Sepriadi L 30 th
15 Jefri Juandika R L 27 th 1
16 Martha Sari Anjelia P 34 th 1
17 Mujib Handoko L 35 th
18 Nidawaty P 46 th 1
19 Osrial L 43 th 1
20 Paiman L 73 th 1
21 Parto wiyono L 73 th 1
22 Reza Enando Putra L 20 th 1
23 Satimo L 61 th 1
24 Septia roberto L 24 th 1
25 Servy Susanty P 46 th 1
26 Somo L 56 th 1
27 Suardi L 69 th 1
28 Suherman L 35 th 1
29 Sutrisno L 63 th 1
30 Syafrida P 49 th 1
31 Syamsuar P 61 th 1
32 Tarmi P 75 th 1
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34 Wilarto L 39 th
35 Yocha Vastia Yuland P 27 th
36 Zikri Handika Kurniawan L 25 th
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351 Err:509 Err:509 Err:509
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Jumlah 79 74 15 12 21 2
ESMAS SITIUNG I

Alamat

Koto
Tang Psg Jumlah
Lawa Sitiu Pd
Pirut Pisel Pulai ah Rebu
i ng sdd
sitiun s
g
selesai pemantauan

Pulau Punjung
1 Tebing tinggi
piruko tengah
Koto Tuo Siguntur
Koto Agung
Pulai
Padang Bintungan
1 Koto Agung Kanan
Sitiung
Pulau Punjung
1 Koto Agung Kanan
Padang
Sitiung
1 Piruko SeLatan
Pulau Punjung
Gn medan
1 Teluk sikai
Sungai Duo
Sungai dareh
piruko tengah
Piruko Selatan
Koto Tuo Siguntur
Piruko SeLatan
Sikabau
Koto Padang
Piruko SeLatan
Gn medan
Sungai dareh
Batu Rijal
Koto Tuo Siguntur
Sitiung
Piruko SeLatan
Err:509
1 Koto Agung Kanan
1 Sungai Duo
1 Gn medan
1 Err:509
Err:509
1 Err:509
1 Err:509
1 Err:509
1 Err:509
1 Err:509
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Err:509
Err:509

44 47 6 39 21 26 74 29 489
 FORMAT PEMANTAUAN
( digunakan untuk orang dalam pemantauan, kontak erat, orang dalam kriteria)
Tempat Pemantauan :
Kab/Kota : Dharmasraya
Hasil Pemeriksaan
Tanggal Jenis Penunjang (jika
Jenis Kontak Tanggal dan Hasil Pemantauan spesimen berubah status) Keterangan
No Nama Kela Umur Alamat No. Hp Terakhir(diisi dan tgl Lab (darah, (Asal
min untuk Kontak pemanta sputum) RO kedatangan )
Erat) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 uan
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
Keterangan : X Sehat B = Batuk L Gejala lain R Rujuk RS
D Demam S = Sesak Napas A Aman
No Nama Jenis Kelamin Umur Alamat

1 Wiza Trisni P 40 th Jrg Sungai Salak

2 Wike Nasrida P 29 th Jrg padang sidondang
3 Yorie Destia Yuland P 30 th Jrg Sungai Salak
4 Harsono L 39 th Jrg Sungai Salak
5 Chrismeiyenly P P 19 th BKR
6 Randa Prasetya R L 25 th BKR
7 Rizki Rahmat S L 22 th BKR
8 Pepen L 40 th jrg Pulai
9 Rogi Aliyan Can L 35 th Koto Daulat
10 Hanifaturrodiah P 18 th BKR
11 Devi P 21 th Piruko Selatan
12 Neneng P 35 th Teluk Sikai
13 Harlin Yuliana P 22 th Teluk Sikai
14 Ayu Dika P 21 th Piruko Selatan
15 Riza Haditia L 26 th BKR 2
16 Edi Yanto L 46 th BKR 2
17 Tri Suratmi P 21 th Pisang Rebus
18 Sona Belia Adha L 27 th BKN
19 Lia Nurjanah P 23 th BKN
20 dr Dwinanda Emira P 40 th BKR
21 Ahmad Fadly L 42 th BKR
22 Ali Amran L 40 th Jrg Sungai Salak
23 Toni Pradana L 18 th BKR
24 Rina Fitriana P 25 th BKR
25 Maya Monica Manurung P 20 th BKN
26 Rega P 20 th Sungai Duo
27 Akmal Dasril L 20 th BKR
28 Usman Fattah L 50 th Teluk Sikai
29 Regi L 23 th BKR 1
30 Tania P 20 th BKN
31 Suwarno L 59 th BKR 2
32 Nindi P 27 th BKR 2
33 Bela P 23 th Sungai Duo
34 Dandi L 19 th Piruko Utara
35 Arif L 36 th Piruko Utara
36 Satino L 56 th Piruko Utara
37 Rio L 19 th Piruko Utara
38 Dede Parmadi L 21 th Pisang Rebus
39 Bayuni L 45 th Pisang Rebus
40 Burmawi L 55 th Pisang Rebus
41 Mariam P 18 th Pisang Rebus
42 Binasrillah L 12 th Pisang Rebus
43 Fatmawati P 9 th Pisang Rebus
44 Dendi L 28 th Pulai
45 Sumiarti P 40 th Pisang Rebus
46 Wulan P 19 th Pisang Rebus
47 Riski L 23 th Pisang Rebus
48 Danu L 12 th Pisang Rebus
49 Aprilia P 8 th Pisang Rebus
50 Yanti P 35 th Pisang Rebus
51 Tulimin L 43 th Pisang Rebus
52 Naslan L 55 th Pisang Rebus
53 Junaidi L 55 th Pisang Rebus
54 Tarminah P 43 th Pisang Rebus
55 Tegar L 14 th Pisang Rebus
56 Yosep L 12 th Pisang Rebus
57 Nurhayati P 35 th Pisang Rebus
58 Zaskia P 6 th Pisang Rebus
59 Agus Sanusi L 45 th Pisang Rebus
60 Saham L 50 th Pisang Rebus
61 Ida P 39 th Pisang Rebus
62 Niken P 20 th Pisang Rebus
63 Najid L 16 th Pisang Rebus
64 Febi Andra L 26 th BKR 2
65 Andre Golota L 16 th BKR 2
66 Risa P 19 th Piruko Utara
67 Irvan L 19 th Teluk Sikai
68 Sarto P 56 th BKR 2
69 Lisnawati P 52 th BKR 2
70 Auza P 6,5 th BKN
71 Supriadi L 35 th BKN
72 M Miftah Arifin L 15 th BKN
73 Nepal L 43 th Sungai Duo
74 Amalia Ruhama Putri P 9 th Piruko Selatan
75 Rohatil Jannah P 24 th Piruko Utara
76 Sulaiman L 47 th Sitiung Koto Tangah
77 Hengki Suhendri L 37 th Sitiung Koto Tangah
78 Yuliardi L 30 th Sitiung
79 Sefriani P 28 th Sitiung
80 By Sefriani 7 hr Sitiung
81 Rapita P 21 th BKN
82 Eko Widodo L 46 th Piruko Selatan
83 Ade Witsu Prayoga L 18 th Piruko Selatan
84 Surya Darna P 42 th Pulai
85 Alfin L 9 th Pulai
86 Handan L 4 th Pulai
87 Alfian Rostiadi L 19 th BKR 1
88 Soleh L 38 th Pd Sidondang