LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN

PUSKESMAS SUKASARI
BULAN JANUARI 2017

JENIS KELAMIN

KINJUNGAN
KUNJUNGAN

DI MTBS
KUNJUNGAN
JUMLAH

JUMLAH

STATUS
UMUR

ASKES / JAMSOSTEK
NO DESA

LAKI -LAKI

PEREMPU
JUMLAH

JUMLAH
TAHUN

TAHUN
BULAN
12bln-5
BULAN

UMUM

BPJS
0 -11

12- 5
0-11

KU
K.1
AN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
155
1 Sukasari 120 212 332 100 150 250 140 110 175 15 60 95
176
2 Sirnagalih 125 199 324 110 152 262 115 147 183 9 70 86
30
3 Sukakerta 25 20 45 18 20 38 12 26 28 0 10 8
12
4 Cibinong 33 28 61 20 28 48 19 9 21 0 27 36
30
5 Munjul 26 35 61 22 35 57 37 15 26 0 11 27

22 20 14 13 27 13 14 10 0 17 17 16
6 Ciharshas 42
20
7 Rahong 18 36 54 10 20 30 15 15 15 5 10 10
20
8 Sindangsari 21 30 51 10 10 20 8 12 18 0 2 0
16
9 Rancagoong 11 25 36 16 20 36 17 19 30 0 6 9
21
10 Mulyasari 11 25 36 9 20 29 18 11 19 0 10 8
497
JUMLAH 412 630 1042 329 468 797 394 378 525 29 223 295

Mengetahui
Kepala Puskesmas Sukasari

dr. Gumilar Farto Siswoyo

NIP. 198202012010011013
BULAN

K LA S I F I K A S I

PANAS
TANDA BAHAYA

ISPA DIARE
MALARIA CAMPAK DEGUE

MALARIA

CAMPAK
DMBM

CDKM

MDBD
PBDD

CDKB
DBM

DBD
DPB
DB

DS

DP
TD
PB

BP

D
P

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
0 1 2 122 0 5 20 0 1 2 0 0 0 20 0 0 1 0 35

0 0 0 145 1 3 30 0 0 4 0 0 0 29 0 0 0 0 31

0 0 0 12 0 8 8 0 0 0 0 0 0 6 0 0 0 0 6

0 0 2 13 0 0 2 0 0 1 0 0 0 7 0 0 0 0 7

0 0 0 27 0 0 11 0 0 0 0 0 0 7 0 0 0 0 7

0 0 0 25 0 0 10 0 0 0 0 0 0 3 0 0 11 0 2

0 3 3 2 2 2 2 0 2 0 0 0 0 4 0 0 0 0 4

0 0 0 13 0 0 2 0 0 0 0 0 0 2 0 0 0 0 2

0 0 0 15 0 0 7 0 0 4 0 0 1 10 0 0 0 10 5

0 0 0 26 0 2 2 0 0 2 0 0 0 10 0 0 0 0 7

0 4 7 400 3 20 94 0 3 13 0 0 1 98 0 0 12 10 106

Pelakasana

ROKAYAH .SST
NIP:197709252007012003
 IMUNISASI
FOLLOW UP
MASALAH TELINGA MAL & ANEMIA 2.BULAN 3.BULAN 4.BULAN 9.BULAN

VIT A
DEGUE
MASTOIDITIS

4. MINGGU
DPT-HB 2

DPT-HB 3
DPT-HB

2. HARI

7 HARI
POL 2

POL 2

POL 3

POL 4

POL 4
B &./ A

TB. TA
GB,AB

POL 1
TAIT
ITA

ITK

C
MDDBD

35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56
0 0 5 3 4 0 0 0 2 2 0 2 2 2 2 0 2 3 0 62 15 1

0 0 5 2 3 0 0 0 38 25 35 30 2 30 30 30 25 2 0 55 6 1

0 5 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 1 1 1 0 0 0 1 0 0 2 1 2 1 0 2 1 0 4 1 0

0 0 2 1 1 0 0 0 0 0 0 2 2 2 2 0 0 0 0 10 3 0

0 0 1 0 0 0 0 0 18 18 19 19 19 19 19 19 17 19 0 0 12 0

0 1 1 1 1 0 0 0 13 13 13 13 13 13 13 12 13 13 0 1 1 1

0 0 2 1 1 0 0 0 12 12 12 12 12 12 10 10 1 1 0 5 2 0

0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 2 0 1 0 0 0 11 11 11 11 1 1 10 1 10 1 0 8 1 0

0 6 23 11 13 0 0 0 95 81 90 91 52 81 87 72 70 40 0 145 41 3
6
0
0
0
2
0
1
0
0
2
1
57
DIRUJUK

MASALAH LAIN /

1
0
0
0
0
0
0
0
0
0
1
58
KETERANGAN
 LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN

PUSKESMAS SUKASARI
BULAN PEBUARI 2017

JENIS KELAMIN
KUNJUNGAN

DI MTBS
KUNJUNGAN
JUMLAH

JUMLAH

STATUS
UMUR

ASKES / JAMSOSTEK
NO DESA

PEREMPU
LAKI -LAKI
JUMLAH

JUMLAH
TAHUN

TAHUN
12bln-5
BULAN

BULAN

UMUM

BPJS
12- 5
0 -11
0-11

AN
1 2 3 4 5 6 7 8 9 10 11 12 13
1 Sukasari 122 212 334 85 150 235 125 110 146 14 75

2 Sirnagalih 125 199 324 92 142 234 115 119 183 9 42

3 Sukakerta 31 19 50 31 19 50 21 29 39 3 8

4 Cibinong 11 15 26 7 8 15 7 8 11 0 4

5 Munjul 12 17 29 12 17 29 17 12 18 0 11

6 Ciharshas 25 26 51 20 26 46 21 25 29 0 17

7 Rahong 25 30 55 24 25 49 21 28 36 3 10

8 Sindangsari 43 45 88 19 12 31 18 13 22 0 9

9 Rancagoong 29 73 102 29 73 102 48 54 86 2 14

10 Mulyasari 11 25 36 9 20 29 18 11 19 0 10

JUMLAH 434 661 1095 328 492 820 411 409 589 31 200

Mengetahui
Kepala Puskesmas Sukasari

dr. Gumilar Farto Siswoyo

NIP. 198202012010011013
YI UMUR 2 BULAN - 59 BULAN

K LA S I F I K A S I
KINJUNGAN

PANAS
TANDA BAHAYA

ISPA DIARE
MALARIA

MALARIA

DMBM
PBDD

DBM
DPB
KU
K.1

DB

DS

DP
PB

BP

TD

D
P

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
140 95 0 0 2 122 0 5 20 0 1 2 0 0 0 20

148 86 0 0 1 145 1 3 30 0 0 4 0 0 0 29

40 10 0 0 1 17 0 10 12 0 0 0 0 0 0 17

10 5 0 0 0 13 0 0 2 0 0 1 0 0 0 7

20 9 0 0 0 15 0 0 5 0 0 0 0 0 0 18

29 17 0 0 0 25 0 0 10 0 0 0 0 0 0 3

34 15 1 3 3 14 0 4 6 0 0 4 0 0 0 25

20 11 0 0 0 19 0 0 10 0 0 0 0 0 0 19

86 16 0 0 0 15 0 0 7 0 0 4 0 0 1 10

21 8 0 0 0 26 0 2 2 0 0 2 0 0 0 10

548 272 1 3 7 411 1 24 104 0 1 17 0 0 1 158

Pelakasana

ROKAYAH .SST
NIP:197709252007012003
K LA S I F I K A S I IMUNISASI

PANAS MASALAH TELINGA MAL & ANEMIA 2.BULAN 3.BULAN

CAMPAK DEGUE
MASTOIDITIS

DPT-HB 2
DPT-HB
TB. TA
B &./ A

POL 2
GB,AB

POL 1
TAIT
ITA

ITK
CAMPAK

MDDBD
CDKM

MDBD
CDKB

DBD

30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
0 0 0 0 35 0 0 5 3 4 0 0 0 2 0 0 2

0 0 1 0 31 0 0 5 2 3 0 0 0 3 0 0 4

0 0 1 0 17 0 3 3 3 1 0 0 0 0 0 0 0

0 0 0 0 7 0 0 1 1 1 0 0 0 1 0 0 2

0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 2

0 0 1 0 2 0 0 1 0 0 0 0 0 1 0 0 1

0 0 0 0 4 0 2 1 1 1 0 0 0 2 O 1 0

0 0 0 0 2 19 0 2 1 1 0 0 0 1 0 0 0

0 0 0 10 5 0 0 2 0 0 0 0 0 0 0 0 0

0 0 0 0 7 0 0 2 0 1 0 0 0 1 0 0 1

0 0 3 10 110 37 5 22 11 12 0 0 0 11 0 1 12
 IMUNISASI
FOLLOW UP
3.BULAN 4.BULAN 9.BULAN

MASALAH LAIN /
KETERANGAN
DIRUJUK
VIT A

4. MINGGU
DPT-HB 3

2. HARI

7 HARI
POL 2

POL 3

POL 4

POL 4
C

47 48 49 50 51 52 53 54 55 56 57 58
0 0 2 0 2 3 0 62 15 1 1 1

0 0 1 0 2 2 0 94 10 1 2 0

0 0 0 0 0 0 0 34 7 0 0 0

0 0 1 0 2 1 0 16 3 0 0 0

0 0 2 0 0 0 0 10 3 0 1 0

0 0 2 0 0 0 0 0 12 0 0 0

0 0 0 0 2 0 0 21 21 8 1 0

0 0 2 0 0 0 0 5 2 0 0 0

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

0 0 3 0 0 0 0 8 1 0 0 0

0 0 13 0 8 6 0 250 74 10 5 1
 LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN
PUSKESMAS SUKASARI
BULAN MARET 2017

KINJUNGAN
DI MTBS
12bln-5 TAHUN KUNJUNGAN

KUNJUNGAN

KELAMIN
JUMLAH

JUMLAH

STATUS
UMUR

JENIS
ISPA DI

TANDA BAHAYA
ASKES / JAMSOSTEK
NO DESA

PEREMPUAN
12- 5 TAHUN

LAKI -LAKI
2-11 BLN

JUMLAH

JUMLAH
2-11BLN

UMUM

BPJS

KU
K.1

DB
PB

BP
P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Sukasari 122 212 334 85 150 235 125 110 146 14 75 140 95 0 0 2 122 0

2 Sirnagalih 145 200 345 66 82 148 95 53 94 9 45 113 35 0 0 1 67 1

3 Sukakerta 18 22 40 18 22 40 22 18 32 0 8 30 10 0 0 1 12 0

4 Cibinong 6 20 26 1 5 6 1 5 6 0 0 6 0 0 0 1 2 0
5 Munjul 18 15 33 18 15 33 20 13 27 0 6 21 12 0 0 0 10 0
6 Ciharshas 27 28 55 27 28 55 24 31 45 0 10 29 26 0 0 0 18 0

7 Rahong 38 38 76 25 27 52 23 29 30 4 18 38 14 1 3 3 14 0

8 Sindangsari 12 29 41 12 12 24 13 11 21 0 3 24 0 4 2 1 12 2

9 Rancagoong 10 12 22 10 12 22 9 13 19 1 2 13 9 0 0 0 15 0
10 Mulyasari 21 24 45 21 24 45 23 22 34 0 11 28 17 0 0 0 26 0

JUMLAH 417 600 1017 283 377 660 355 305 454 28 178 442 218 5 5 9 298 3

Mengetahui
Kepala Puskesmas Sukasari Pelakasana

dr. Gumilar Farto Siswoyo ROKAYAH .SST

NIP. 198202012010011013 NIP:197709252007012003
 K LA S I F I K A S I IMUNISASI

PANAS MASALAH TELINGA MAL & ANEMIA 2.BULAN 3.BULAN

DIARE
MALARIA CAMPAK DEGUE

MASTOIDITIS

DPT-HB 2
DPT-HB
B &./ A

POL 2
TB. TA
GB,AB

POL 1
TAIT
ITA

ITK
MALARIA

CAMPAK

MDDBD
DMBM

CDKM

MDBD
PBDD

CDKB
DBM

DBD
DPB
DS

DP
TD

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
5 20 0 1 2 0 0 0 20 0 0 1 0 35 0 0 5 3 4 0 0 0 2 0 0 2

3 31 0 0 4 0 0 0 35 0 0 1 0 35 0 0 5 2 3 0 0 0 3 0 0 4
8 8 0 0 0 0 0 0 17 0 0 0 0 17 0 2 2 2 2 0 0 0 2 2 2 2
0 6 0 0 1 0 0 0 7 0 0 0 0 7 0 0 1 1 1 0 0 0 1 0 0 2
0 3 0 0 0 0 0 0 18 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 2
0 4 0 0 0 0 0 0 5 0 0 1 0 2 0 0 1 0 2 0 0 0 1 0 0 1
4 6 0 0 4 0 0 0 25 0 0 0 0 4 0 2 1 1 1 0 0 0 2 O 1 0

2 8 0 0 2 0 0 0 8 0 0 0 0 2 19 0 1 1 1 0 0 0 1 0 0 0
0 13 0 0 4 0 0 1 10 0 0 0 10 5 13 0 0 7 0 0 0 0 0 0 0 0
2 3 0 0 9 0 0 0 10 0 0 0 0 12 0 0 2 0 1 0 0 0 1 0 0 1

24 102 0 1 26 0 0 1 155 0 0 3 10 119 50 4 18 17 15 0 0 0 13 2 3 14

 IMUNISASI
FOLLOW UP
3.BULAN 4.BULAN 9.BULAN

MASALAH LAIN /
KETERANGAN
DIRUJUK
VIT A

4. MINGGU
DPT-HB 3

2. HARI

7 HARI
POL 2

POL 3

POL 4

POL 4
C

47 48 49 50 51 52 53 54 55 56 57 58
0 0 2 0 2 3 0 62 15 1 1 1

0 0 1 0 2 2 0 94 10 1 2 0
0 0 0 0 0 0 0 34 7 0 0 0
0 0 1 0 2 1 0 16 3 0 0 0
0 0 2 0 0 0 0 10 3 0 1 0
0 0 2 0 0 0 0 0 12 0 0 0
0 0 0 0 2 0 0 21 21 8 1 0

0 0 2 0 0 0 0 5 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 3 0 0 0 0 8 1 0 0 0

0 0 13 0 8 6 0 250 74 10 5 1
 LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN
PUSKESMAS SUKASARI
BULAN april 2017

KUNJUNGAN
KUNJUNGAN

KINJUNGAN
KELAMIN
DI MTBS
JUMLAH

JUMLAH

ASKES / JAMSOSTEKSTATUS
UMUR

JENIS
NO DESA

12bln-5 TAHUN

PEREMPUAN
12- 5 TAHUN

LAKI -LAKI
2-11 BLN

JUMLAH

JUMLAH
2-11BLN

UMUM

BPJS

KU
K.1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Sukasari 55 82 137 28 46 74 40 34 55 0 19 32 42
2 Sirnagalih 145 200 345 66 82 148 95 53 94 9 45 113 35
3 Sukakerta 29 32 61 29 32 61 41 20 41 0 20 39 22
4 Cibinong 9 25 33 9 24 33 16 17 20 0 13 9 24
5 Munjul 18 15 33 18 15 33 20 13 27 0 6 21 12
6 Ciharshas 27 28 55 27 28 55 24 31 45 0 10 29 26
7 Rahong 24 26 50 22 24 46 20 26 29 0 17 36 10
8 Sindangsari 10 27 37 6 14 20 11 9 15 0 5 20 0
9 Rancagoong 9 12 21 9 12 21 10 11 8 5 8 14 7
10 Mulyasari 16 21 37 13 15 28 18 10 20 0 8 15 13
JUMLAH 342 468 810 227 292 519 295 224 354 14 151 328 191

Mengetahui
Kepala Puskesmas Sukasari Pelakasana

dr. Gumilar Farto Siswoyo ROKAYAH .SST

NIP. 198202012010011013 NIP:197709252007012003
 K LA S I F I K A S I

PANAS MASALAH TELINGA

ISPA DIARE
TANDA BAHAYA

MALARIA CAMPAK DEGUE

MASTOIDITIS
MALARIA

CAMPAK

TAIT
MDDBD

ITA

ITK
DMBM

CDKM

MDBD
PBDD

CDKB
DBM

DBD
DPB
DB

DS

DP
PB

BP

TD

D
P

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
1 0 0 15 0 0 5 0 0 2 0 0 0 6 0 0 2 0 35 0 0 5 3 4
0 0 1 67 1 3 31 0 0 4 0 0 0 35 0 0 0 0 35 0 0 5 2 0
0 0 1 31 0 6 11 0 1 0 0 0 0 5 0 0 0 0 17 0 2 3 0 2
0 0 2 19 0 3 15 0 1 1 0 0 0 7 0 0 0 0 7 0 0 1 1 1
0 0 0 10 0 0 3 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0
0 0 0 18 0 0 4 0 0 0 0 0 0 5 0 0 0 0 2 0 0 0 5 2
5 3 3 16 0 4 8 0 0 5 0 0 0 9 0 0 0 0 3 0 1 3 2 0
0 2 2 11 0 0 4 0 0 2 0 0 0 3 0 0 0 0 2 0 0 1 1 1
0 0 0 16 0 0 15 0 0 4 0 0 1 12 0 0 0 10 10 0 0 0 7 0
0 0 0 10 0 2 4 0 0 9 0 0 0 7 0 0 0 0 12 6 0 2 0 1
6 5 9 213 1 18 100 0 2 27 0 0 1 107 0 0 2 10 123 6 3 20 21 11
 IMUNISASI
MAL & FOLLOW UP
2.BULAN 3.BULAN 4.BULAN 9.BULAN
ANEMIA

MASALAH LAIN /
KETERANGAN
DIRUJUK
VIT A

4. MINGGU
DPT-HB 2

DPT-HB 3
DPT-HB

2. HARI

7 HARI
B &./ A

TB. TA

POL 2

POL 2

POL 3

POL 4

POL 4
GB,AB

POL 1

C
40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58
0 0 0 3 0 0 3 0 3 2 0 2 3 0 62 15 1 1 1
0 0 0 0 2 0 4 0 0 1 0 2 2 0 94 10 1 2 0
0 0 0 2 2 2 2 0 0 0 0 0 0 0 34 7 0 0 0
0 0 0 1 0 0 2 0 0 1 0 2 1 0 16 3 0 2 0
0 0 0 0 0 0 2 0 0 2 0 0 0 0 10 3 0 1 0
0 0 0 1 0 0 1 0 0 2 0 0 0 0 0 12 0 0 0
0 0 0 1 3 2 2 2 2 2 0 2 2 0 13 12 12 3 0
0 0 0 1 0 0 0 0 0 2 0 0 0 0 5 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 2 0 0 0
0 0 0 1 0 0 1 0 0 3 0 0 0 0 8 1 0 0 0
0 0 0 10 7 4 17 2 5 15 0 8 8 0 263 67 14 9 1
 LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN
PUSKESMAS SUKASARI
BULAN MEI 2017

KUNJUNGAN

KUNJUNGAN
K LA S I F I

KINJUNGAN
KELAMIN
DI MTBS
JUMLAH

JUMLAH

ASKES / JAMSOSTEKSTATUS
UMUR

JENIS
ISPA DIARE

TANDA BAHAYA
NO DESA

12bln-5 TAHUN

PEREMPUAN
12- 5 TAHUN

LAKI -LAKI
2-11 BLN

JUMLAH

JUMLAH
2-11BLN

UMUM

BPJS

DPB
KU
K.1

DB

DS

DP
TD
PB

BP

D
P
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
1 Sukasari 223 298 521 61 163 224 115 34 55 0 19 32 42 1 0 0 24 0 0 28 0 0 2
2 Sirnagalih 341 125 466 36 48 84 30 54 52 0 16 12 62 0 0 3 10 0 5 17 0 0 4
3 Sukakerta 32 32 64 12 15 27 12 15 20 0 7 21 6 0 0 1 12 0 5 7 0 1 0
4 Cibinong 17 16 33 12 10 22 19 8 15 0 7 9 12 0 0 2 17 0 3 6 0 1 1
5 Munjul 49 10 33 12 10 22 12 10 14 0 8 21 12 0 0 0 18 0 0 4 0 0 0
6 Ciharshas 23 27 50 23 27 50 25 25 40 0 10 30 20 0 0 0 14 0 0 7 0 0 0
7 Rahong 24 26 50 22 24 46 20 26 29 0 17 36 10 5 0 0 16 0 4 8 0 0 0
8 Sindangsari 21 37 58 8 20 28 17 11 23 0 5 20 0 0 0 0 14 0 2 3 0 0 2
9 Rancagoong 11 15 26 11 15 26 10 16 14 4 8 15 11 0 1 0 17 0 0 14 0 0 4
10 Mulyasari 17 19 36 12 13 25 24 12 19 0 6 12 12 0 0 0 12 0 0 3 0 0 2
JUMLAH 758 605 1363 209 345 554 284 211 281 4 103 208 187 6 1 6 154 0 19 97 0 2 15

Mengetahui Pelakasana
Kepala Puskesmas Sukasari

dr. Gumilar Farto Siswoyo ROKAYAH .SST

NIP. 198202012010011013 NIP:197709252007012003
 K LA S I F I K A S I IMUNISASI
MASALAH MAL & 9.BULA FOLLOW UP
PANAS 2.BULAN 3.BULAN 4.BULAN
TELINGA ANEMIA N

MASALAH LAIN /
KETERANGAN
MALARIA CAMPAK DEGUE

DIRUJUK
VIT A
MASTOIDITIS

4. MINGGU
DPT-HB 2

DPT-HB 3
DPT-HB

2. HARI

7 HARI
B &./ A
TB. TA

POL 2

POL 2
POL 3

POL 4

POL 4
GB,AB

POL 1
MALARIA

CAMPAK

TAIT
MDDBD

ITA

ITK
DMBM

CDKM

MDBD
PBDD

CDKB

C
DBM

DBD

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
0 0 0 24 0 0 2 24 0 0 0 5 3 4 0 0 0 3 0 0 3 0 3 2 0 2 3 0 62 15 1 1 1
0 0 0 17 0 0 0 32 0 0 0 5 2 0 0 0 0 0 2 0 4 0 0 1 0 2 2 0 94 10 1 0 0
0 0 0 5 0 0 0 5 0 0 2 3 0 2 0 0 0 2 2 2 2 0 0 0 0 0 0 0 34 7 0 0 0
0 0 0 7 0 0 0 9 0 0 0 1 1 1 0 0 0 1 0 0 2 0 0 1 0 2 1 0 16 3 0 0 0
0 0 0 18 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 10 3 0 0 0
0 0 0 5 0 0 0 5 0 0 0 0 5 2 0 0 0 1 0 0 1 0 0 2 0 0 0 0 0 12 0 1 0
0 0 0 9 0 0 0 9 3 0 1 3 2 0 0 0 0 1 3 2 2 2 2 2 0 2 2 0 13 12 12 0 0
0 0 0 3 0 0 0 3 2 0 0 1 1 1 0 0 0 1 0 0 0 0 0 2 0 0 0 0 5 2 0 0 0
0 0 1 8 0 0 2 8 0 0 0 3 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 2 0 1 0
0 0 0 14 0 0 0 14 0 6 2 3 0 1 0 0 0 1 0 0 1 0 0 3 0 0 0 0 8 1 0 0 0
0 0 1 110 0 0 4 124 5 6 5 24 21 11 0 0 0 10 7 4 17 2 5 15 0 8 8 0 263 67 14 3 1

SST
11
 LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN
PUSKESMAS SUKASARI
BULAN JULI 2017

KUNJUNGAN

KUNJUNGAN

KINJUNGAN
KELAMIN
DI MTBS
JUMLAH

JUMLAH

ASKES / JAMSOSTEKSTATUS
UMUR

JENIS
NO DESA

12bln-5 TAHUN

PEREMPUAN
12- 5 TAHUN

LAKI -LAKI
0-11 BLN

JUMLAH

JUMLAH
0-11BLN

UMUM

BPJS

KU
K.1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Sukasari 150 170 320 74 47 121 51 70 106 8 7 62 59
2 Sirnagalih 27 49 76 27 49 76 42 34 58 0 18 50 26

3 Sukakerta 28 13 41 28 13 41 29 12 31 0 10 30 11

4 Cibinong 16 16 32 13 12 25 11 14 13 0 12 10 15

5 Munjul 45 10 49 6 10 15 10 5 9 0 6 14 2

6 Ciharshas 23 27 50 23 27 50 25 25 40 0 10 30 20

7 Rahong 20 28 48 10 15 25 13 12 19 0 6 12 13

8 Sindangsari 16 39 55 16 28 44 23 21 31 0 13 0 0

9 Rancagoong 14 19 33 14 19 33 18 15 20 2 11 16 17

10 Mulyasari 17 21 36 16 17 30 16 14 22 0 8 12 24

JUMLAH 356 392 748 227 237 464 238 222 349 10 101 236 187

Mengetahui
Kepala Puskesmas Sukasari

dr. Gumilar Farto Siswoyo

NIP. 198202012010011013
 K LA S I F I K A S I
MASALAH
PANAS
ISPA DIARE TELINGA
TANDA BAHAYA

MALARIA CAMPAK DEGUE

MASTOIDITIS
MALARIA

CAMPAK

MDDBD

ITA

ITK
DMBM

CDKM

MDBD
PBDD

CDKB
DBM

DBD
DPB
DB

DS

DP
PB

BP

TD

D
P

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38
0 0 0 21 0 0 8 0 0 0 0 0 0 15 0 0 0 0 15 0 2 4 1
0 0 0 22 0 0 25 0 0 0 0 0 0 28 0 0 0 0 29 0 0 3 0
0 0 0 30 0 3 6 0 0 0 0 0 0 6 0 0 0 0 6 0 1 1 2
0 0 1 15 0 2 7 0 1 1 0 0 0 7 0 0 0 0 7 0 0 1 0
0 0 0 11 0 0 5 0 0 0 0 0 0 5 0 0 0 0 3 0 0 1 0
0 0 0 14 0 0 7 0 0 0 0 0 0 5 0 0 0 0 2 0 0 0 5
2 4 1 8 0 2 2 0 0 4 0 0 0 6 0 0 0 0 3 2 0 2 2
0 0 0 23 0 0 10 0 0 0 0 0 0 11 0 0 0 0 6 0 0 2 0
0 0 2 14 0 0 10 0 0 0 0 0 0 20 0 0 0 0 20 0 0 1 0
0 0 0 14 0 0 5 0 0 0 0 0 0 14 0 0 0 0 9 0 0 2 0
2 4 4 172 0 7 85 0 1 5 0 0 0 117 0 0 0 0 100 2 3 17 10

Pelakasana

ROKAYAH .SST
NIP:197709252007012003
 IMUNISASI
MASALAH MAL & 9.BULA FOLLOW UP
2.BULAN 3.BULAN 4.BULAN
TELINGA ANEMIA N

MASALAH LAIN /
KETERANGAN
DIRUJUK
VIT A

4. MINGGU
DPT-HB 2

DPT-HB 3
DPT-HB

2. HARI

7 HARI
B &./ A

POL 2

POL 2
POL 3

POL 4

POL 4
TB. TA
GB,AB

POL 1
TAIT

C
39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58
0 0 0 0 5 5 0 3 3 0 5 5 0 0 0 11 12 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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 2 0 0 1 0 2 1 0 16 3 0 0 0
0 0 0 0 9 0 9 12 0 12 10 10 8 0 0 5 0 20 0 0
2 0 0 0 1 0 0 1 0 0 2 0 0 0 0 0 12 0 0 0
0 0 0 0 2 2 2 1 0 0 0 0 1 1 0 0 2 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 18 7 11 19 3 12 18 15 11 2 0 32 29 20 6 0
LAPORAN MTBS KUNJUNGAN BAYI UMUR 2 BULAN - 59 BULAN
PUSKESMAS SUKASARI
BULAN JULI 2017
K LA S I F I K A S I

KUNJUNG

KUNJUNG

KUNJUNG
PEREMPU KELAMIN
JUMLAH

JUMLAH

STATUS
UMUR

JENIS
MTBS

ASKES/JAMSOSTEK
AN DI
MASALAH

AN
PANAS

TANDA BAHAYA
AN
ISPA DIARE TELINGA
MALARIA CAMPAK DEGUE

MASTOIDITIS
NO DESA

LAKI -LAKI

MALARIA

CAMPAK
2-11 BLN

JUMLAH

JUMLAH
2-11BLN

MDDBD

TAIT
TAHUN

TAHUN
12bln-5

UMUM

DMBM

CDKM

MDBD

ITA
ITK
CDKB
PBDD
BPJS
12- 5

DBM

DBD
DPB
KU
K.1

DB
DS

DP
AN

PB

BP

TD

D
P
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
1 Sukasari 158 232 390 55 150 205 91 114 190 7 8 126 79 1 1 0 18 0 0 21 0 0 2 0 0 0 19 0 0 2 0 19 0 4 1 3 4

2 Sirnagalih 341 125 466 36 48 84 30 54 68 0 16 22 62 0 0 3 10 0 5 17 0 0 4 0 0 0 17 0 0 0 0 17 0 0 5 2 0

3 Sukakerta 18 21 39 18 21 39 18 21 28 0 11 32 7 0 0 0 15 0 9 8 0 1 0 0 0 0 5 0 0 0 0 8 0 2 3 0 2
4 Cibinong 16 16 32 13 12 25 11 14 13 0 12 10 15 0 0 1 15 0 2 7 0 1 1 0 0 0 7 0 0 0 0 7 0 0 0 0 0
5 Munjul 36 48 84 36 20 56 22 34 51 0 6 20 36 1 0 0 11 0 0 9 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0
6 Ciharshas 23 27 50 23 27 50 25 25 40 0 10 30 20 0 0 0 14 0 0 7 0 0 0 0 0 0 5 0 0 0 0 9 0 0 0 5 2
7 Rahong 24 34 58 17 20 37 18 19 23 2 12 27 10 5 4 4 4 3 2 4 0 0 5 0 0 0 3 0 0 0 0 3 0 1 2 2 1
8 Sindangsari 21 34 55 16 19 35 20 15 30 0 5 23 12 0 2 0 17 1 3 3 0 0 2 0 0 0 7 0 0 0 0 7 0 0 1 1 1
9 Rancagoong 12 17 29 12 17 29 16 13 11 9 9 14 15 0 0 1 13 0 0 11 0 0 4 0 0 0 18 0 0 1 0 18 0 0 2 0 0
10 Mulyasari 15 21 36 15 21 36 20 16 29 0 7 15 21 0 0 0 18 0 0 5 0 0 2 0 0 0 8 0 0 0 0 8 0 0 0 0 0
JUMLAH 664 575 1239 241 355 596 271 325 483 18 96 319 277 7 7 9 135 4 21 92 0 2 20 0 0 0 89 0 0 3 0 105 0 7 14 13 10

Mengetahui Pelakasana

dr. Gumilar Farto Siswoyo ROKAYAH .SST

NIP. 198202012010011013 NIP:197709252007012003
 IMUNISASI

MASALAH LAIN /
MAL & FOLLOW UP

KETERANGAN
2.BULAN 3.BULAN 4.BULAN 9.BULAN
ANEMIA

DIRUJUK
VIT A

4. MINGGU
DPT-HB 2

DPT-HB 3
DPT-HB

2. HARI

7 HARI
B &./ A

TB. TA

POL 2

POL 2

POL 3

POL 4

POL 4
GB,AB

POL 1

C
40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58
0 0 0 4 6 4 4 0 4 3 3 2 3 0 33 26 1 1 PB

0 0 0 0 2 0 4 0 0 1 0 2 2 0 94 10 1 1 0

0 0 0 2 2 2 2 0 0 0 0 0 0 0 34 7 0 1 AFP
0 0 0 1 0 0 2 0 0 1 0 2 1 0 16 3 0 0 0
0 0 0 0 0 0 2 0 0 2 0 0 0 0 10 3 0 1 KEJANG
0 0 0 1 0 0 1 0 0 2 0 0 0 0 0 12 0 0 0
0 0 0 1 3 2 2 2 2 2 0 2 2 0 13 12 12 4 0
0 0 0 1 0 0 0 0 0 2 0 0 0 0 5 2 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 2 0 1 DDB
0 0 0 1 0 0 1 0 0 3 0 0 0 0 8 1 0 0 0
0 0 0 11 13 8 18 2 6 16 3 8 8 0 234 78 14 6 0