Professional Documents
Culture Documents
Laporan Ims
Laporan Ims
Laporan Ims
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Januari
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Februari
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Maret
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : April
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Mei
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Juni
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Juli
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Agustus
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : September
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009
LAPORAN BULANAN
PENDERITA IMS
PUSKESMAS : Tentang
BULAN/TAHUN : Oktober
DESA
Desa Tentang Desa Golo Bore Desa Pong Narang Desa Golo Rua Desa Golo Poleng Desa Golo Keli Desa Raka Desa Kasong
NO ELEMEN DATA L P L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L
1 2 3 4 5 6 7 8 9 10 11
I Total Penderita IMS :
1 Bulan ini - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Kumulatif s.d. bulan ini - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
II Asal Pasien :
1 Datang Sendiri - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujukan - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kiriman Kader - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kumulatif s.d. bulan ini 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
IV Diagnosa :
1 Klinis - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Laboratorium - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Kumulatif s.d. bulan ini - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
V Kategori Klinis :
1 Duh tubuh vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Erosi Partio - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Condiloma acuminata - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Duh tubuh urethra - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Ulkus vagina - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI Pemeriksaan Laboratorium :
1 STO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 GO - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Clue cell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Candida - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Tricho - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Syphilis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7 PMN > 30/LP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8 Kumulatif s.d. bulan ini 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VII Pelayanan :
1 Dapat kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
2 Rujuk - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
3 Konseling - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4 Kasi Kondom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5 Kumulatif s.d. bulan ini - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6 Keterangan Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Mengetahui
Kepala UPTD Puskesmas Tentang
DESA
TOTAL
P 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 B L B L B L B L B L B L B L
11 12 13 14 15 16 17 18
- 1 - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - -
- 1 - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- 1 - -
- - - -
- - - -
- - - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- 1 - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- - - -
- - - -
- 1 - -
- - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - -
Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok Ok
Frans Edison
NIP : 19860129 201001 1 009