FORMAT LAPORAN (LB3-KIA) HASIL PELAYANAN SDIDTK BAYI KIA_BAYI_Ngantang_Januari_2022

Puskesmas : Ngantang Bulan : JANUARI

Kecamatan : Ngantang Tahun : 2022

Kabupaten : Kabupaten Malang

BAYI

Jumlah Penyimpangan SDIDTK Jumlah yang Dirujuk

Jumlah Sasaran Jumlah Bayi (0-12 bulan)
Desa/ Jumlah Bayi di SDIDTK (Pertama KPSP Penyimpangan /Gangguan Perkembangan
NO. Bayi (0-12 mendapatkan pelayanan DDTK 4
Kelurahan kali)
bulan) x setahun
LKA tidak normal Motorik Kasar Motorik Halus Bicara, Bahasa Sosialisasi, Kemandirian Gangguan TDL Gangguan TDD MME mungkin ada gangguan
L % P % N %
L P N L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % 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 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 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71

(10/5 (16/5 (70/5

Rumus (6/3*100) (8/4*100) (12/3*100) (14/4*100) (18/3*100) (20/4*100) (22/5*100) (24/3*100) (26/4*100) (28/5*100) (30/3*100) (32/4*100) (34/5*100) (36/3*100) (38/4*100) (40/5*100) (42/3*100) (44/4*100) (45/5*100) (48/3*100) (50/4*100) (52/5*100) (54/3*100) (56/4*100) (58/5*100) (60/3*100) (62/4*100) (64/5*100) (66/3*100) (68/4*100)
*100) *100) *100)

1 Jombok 34 33 67 4 11.76 2 6.06 6 8.96 16 47.06 12 36.36 28 41.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Tulungrejo 27 26 53 1 3.70 1 3.85 2 3.77 1 3.70 1 3.85 2 3.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Waturejo 28 27 55 1 3.57 1 3.70 2 3.64 2 7.14 2 7.41 4 7.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Kaumrejo 47 43 90 13 27.66 5 11.63 18 20.00 1 2.13 2 4.65 3 3.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Sumberagung 38 37 75 2 5.26 2 5.41 4 5.33 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 Mulyorejo 36 31 67 4 11.11 8 25.81 12 17.91 5 13.89 11 35.48 16 23.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Purworejo 29 28 57 2 6.90 0 0.00 2 3.51 11 37.93 9 32.14 20 35.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Banjarejo 36 35 71 1 2.78 3 8.57 4 5.63 4 11.11 0 0.00 4 5.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Pagersari 24 28 52 3 12.50 2 7.14 5 9.62 6 25.00 2 7.14 8 15.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Sidodadi 38 37 75 4 10.53 1 2.70 5 6.67 1 2.63 3 8.11 4 5.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Ngantru 39 38 77 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Banturejo 25 27 52 1 4.00 2 7.41 3 5.77 1 4.00 1 3.70 2 3.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Pandansari 36 35 71 1 2.78 3 8.57 4 5.63 4 11.11 12 34.29 16 22.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL PUSKESMAS 437 425 862 37 8.47 30 7.06 67 7.77 52 11.90 55 12.94 107 12.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 FORMAT LAPORAN (LB3-KIA) HASIL PELAYANAN SDIDTK ANAK BALITA
Puskesmas : Ngantang Bulan : JANUARI

Kecamatan : Ngantang Tahun : 2022

Kabupaten : Kabupaten Malang

BAYI

Jumlah Penyimpangan SDIDTK

Jumlah Sasaran Jumlah Anak Balita (12-59 bulan)
Desa/ Jumlah Anak Balita di SDIDTK (Pertama KPSP Penyimpangan /Gangguan Perkembangan
NO. Anak Balita (12-59 mendapatkan pelayanan SDIDTK (2 x
Kelurahan kali)
bulan) setahun)
LKA tidak normal Motorik Kasar Motorik Halus Bicara, Bahasa Sosialisasi, Kemandirian Gangguan TDL Gangguan TDD MME mungkin ada gangguan

L P N L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L %

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 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 55 56 57 58 59 60 61

(10/5* (16/5*
Rumus (6/3*100) (8/4*100) (12/3*100) (14/4*100) (18/3*100) (20/4*100) (22/5*100) (24/3*100) (26/4*100) (28/5*100) (30/3*100) (32/4*100) (34/5*100) (36/3*100) (38/4*100) (40/5*100) (42/3*100) (44/4*100) (45/5*100) (48/3*100) (50/4*100) (52/5*100) (54/3*100) (56/4*100) (58/5*100) (60/3*100)
100) 100)

1 Jombok 138 134 272 3 2.17 2 1.49 5 1.84 11 7.97 15 11.19 26 9.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Tulungrejo 107 104 211 1 0.93 1 0.96 2 0.95 2 1.87 1 0.96 3 1.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Waturejo 113 110 223 1 0.88 3 2.73 4 1.79 4 3.54 1 0.91 5 2.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Kaumrejo 178 172 350 5 2.81 4 2.33 9 2.57 11 6.18 10 5.81 21 6.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Sumberagung 153 149 302 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 Mulyorejo 126 122 248 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Purworejo 118 114 232 2 1.69 0 0.00 2 0.86 11 9.32 9 7.89 20 8.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Banjarejo 143 139 282 1 0.70 2 1.44 3 1.06 6 4.20 11 7.91 17 6.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Pagersari 98 95 193 2 2.04 3 3.16 5 2.59 2 2.04 5 5.26 7 3.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Sidodadi 154 149 303 1 0.65 2 1.34 3 0.99 16 10.39 16 10.74 32 10.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Ngantru 156 151 307 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Banturejo 100 97 197 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Pandansari 143 139 282 1 0.70 1 0.72 2 0.71 7 4.90 13 9.35 20 7.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL PUSKESMAS 1,727 1,675 3,402 17 0.98 18 1.07 35 1.03 70 4.05 81 4.84 151 4.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FORMAT LAPORAN (LB3-KIA) HASIL PELAYANAN SDIDTK ANAK BALITA KIA_BALITA_Ngantang_Januari_2022

BAYI

Jumlah Penyimpangan SDIDTK

Jumlah yang Dirujuk
KPSP Penyimpangan /Gangguan Perkembangan

MME mungkin ada gangguan

L % P % N %
P % N %

62 63 64 65 66 67 68 69 70 71

(70/5*
(60/3*100) (62/4*100) (64/5*100) (66/3*100) (68/4*100)
100)

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0
 FORMAT LAPORAN (LB3-KIA) HASIL PELAYANAN SDIDTK ANAK PRASEKOLAH
Puskesmas : NGANTANG BULAN : JANUARI

Kecamatan : NGANTANG TAHUN : 2022

Kabupaten : MALANG

BAYI

Jumlah Penyimpangan SDIDTK

Desa/ Jumlah Sasaran Jumlah Apras (60-72 bulan) mendapatkan KPSP Penyimpangan /Gangguan Perkembangan
NO. Jumlah Apras di SDIDTK (Pertama kali)
Kelurahan Apras (60-72 bulan) pelayanan DDTK 2 x setahun

LKA tidak normal Motorik Kasar Motorik Halus Bicara, Bahasa Sosialisasi, Kemandirian Gangguan TDL

L P N L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L % P % N % L %

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 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49

(10/5*1 (16/5*1
Rumus (6/3*100) (8/4*100) (12/3*100) (14/4*100) (18/3*100) (20/4*100) (22/5*100) (24/3*100) (26/4*100) (28/5*100) (30/3*100) (32/4*100) (34/5*100) (36/3*100) (38/4*100) (40/5*100) (42/3*100) (44/4*100) (45/5*100) (48/3*100)
00) 00)

1 Jombok 34 33 67 1 2.94 1 3.03 2 2.99 2 5.88 2 6.06 4 5.97 0 0 0 0 0 0 0 0 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 Tulungrejo 26 26 52 1 3.85 1 3.85 2 3.85 1 3.85 1 3.85 2 3.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Waturejo 28 27 55 0 0.00 0 0.00 0 0.00 2 7.14 1 3.70 3 5.45 0 0 0 0 0 0 0 0 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 Kaumrejo 44 43 87 0 0.00 2 4.65 2 2.30 1 2.27 1 2.33 2 2.30 0 0 0 0 0 0 0 0 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 Sumberagu
ng 38 37 75 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 Mulyorejo 31 30 61 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Purworejo 29 28 57 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Banjarejo 36 34 70 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Pagersari 24 23 47 1 4.17 2 8.70 3 6.38 3 12.50 2 8.70 5 10.64 0 0 0 0 0 0 0 0 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 Sidodadi 38 37 75 3 7.89 1 2.70 4 5.33 2 5.26 1 2.70 3 4.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Ngantru 38 37 75 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Banturejo 25 24 49 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Pandansari 35 34 69 3 8.57 4 11.76 7 10.14 6 17.14 19 55.88 25 36.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL 426 413 839 9 2.11 11 2.66 20 2.38 17 3.99 27 6.54 44 5.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PUSKESMAS
FORMAT LAPORAN (LB3-KIA) HASIL PELAYANAN SDIDTK ANAK PRASEKOLAH KIA_APRAS_Ngantang_Januari_2022

BAYI MTBS

Jumlah Penyimpangan SDIDTK

Jumlah yang Dirujuk Jumlah Balita di MTBS
KPSP Penyimpangan /Gangguan Perkembangan Jumlah Balita Sakit

Gangguan TDL Gangguan TDD MME mungkin ada gangguan

L % P % N % L % P % N %
P % N % L % P % N % L % P % N % L P N

50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

(70/5*1 (73/68*
(48/3*100) (50/4*100) (52/5*100) (54/3*100) (56/4*100) (58/5*100) (60/3*100) (62/4*100) (64/5*100) (66/3*100) (68/4*100) (69/66*100) (71/67*100)
00) 100)

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0