STATUS GPA UMUR PERNAH

PEKERJAAN PENDIDIKAN
TGL KODE UMUR (GRAVIDA, KEHAMILAN TAKSIRAN PUNYA
PEKERJAAN (1.pns 2.swasta
NO Nama ALAMAT (1.SD 2.SMP GEJALA
REGISTRASI SPESIMEN (th) (ya/tdk) 3.pedagang
3.SMA 4.PT) PARTUS, SEKARANG PARTUS HEPATITIS
4.lainnya ABORTUS) (minggu) (ya/tdk)

1 1-Oct-16 NANA HOTMAN 32 JL 11 UNIT 2 TDK 4 3 G4,P3,A0 35 10/28/2016 TDK

2 NURAFIFAH 43 JL 17 UNIT 1 TDK 4 3 G5,P2,A2 20 2/14/2017 TDK
3 SUMIATI 41 JL 3 UNIT 2 YA 3 2 G3,P2,A0 32 11/26/2016 TDK
4 SRI HIDAYATI 32 JL MERANTI UNIT 6 TDK 4 3 G3,P2,A0 26 1/11/2017 TDK
5 NOVA 28 JL POROS UNIT 2 YA 3 4 G3,P2,A0 20 2/14/2017 TDK
6 3-Oct-16 KUSNIAH 34 JL 11 UNIT 2 TDK 4 3 G4,P3,A0 11 4/27/2017 TDK
7 TITIN 27 JL 22 UNIT 3 YA 2 4 G1,P0,A0 5 4/30/2017 TDK
8 SRI HASTUTI 21 JL 6 UNIT 2 YA 2 3 G1,P0,A0 8 5/22/2017 TDK
9 SUMIYATI 33 JL 1 UNIT 2 YA 1 4 G3,P2,A1 19 3/3/2017 TDK
10 4-Oct-16 ISMIATI 26 JL 15 UNIT 3 TDK 4 4 G1,P1,A0 35 10/29/2016 TDK
11 SILVI 32 JL 3 UNIT 2 TDK 3 3 G4,P3,A0 12 4/12/2017 TDK
12 RESA 23 JL POROS UNIT 2 TDK 4 4 G1,P0,A0 11 4/22/2017 TDK
13 MISKA 23 JL POROS UNIT 2 TDK 2 3 G2,P1,A0 9 5/11/2017 TDK
14 5-Oct-16 ENI 32 JL 4 UNIT 2 YA 2 3 G2,P1,A0 14 4/4/2017 TDK
15 DESI 35 JL 3 UNIT 2 TDK 1 2 G4,P3,A0 37 10/13/2016 TDK
16 FITRI 25 JL 3 UNIT 2 YA 2 3 G2,P1,A0 15 4/8/2017 TDK
17 SISWATI 30 JL 10 UNIT 2 TDK 1 4 G3,P2,A0 38 10/25/2016 TDK
18 ENDANG NURYATI 21 JL 6 UNIT 2 YA 4 3 G2,P1,A0 7 5/22/2017 TDK
19 6-Oct-16 FERISKA 28 JL 8 UNIT 2 YA 3 4 G3,P2,A0 32 11/25/2016 TDK
20 ELI ANDRIANI 21 JL 8 UNIT 3 YA 4 3 G4,P1,A2 12 4/8/2017 TDK
21 ADE 26 JL PASAR UNIT 2 TDK 2 4 G2,P1,A0 37 10/11/2016 TDK
22 ENDANG 29 JL 6 UNIT 2 TDK 2 3 G3,P2,A0 26 1/11/2017 TDK
23 7-Oct-16 SUPRIANINGSIH 27 JL 12 UNIT 2 TDK 4 3 G3,P1,A1 26 1/13/2017 TDK
24 TRINURAINI 33 JL 17 UNIT 3 TDK 3 3 G2,P1,A0 12 4/15/2017 TDK
25 SARI 25 JL 17 UNIT 3 TDK 4 3 G1,P0,A0 28 12/29/2016 TDK
26 EVI 33 JL POROS UNIT 2 TDK 3 2 G3,P1,A1 33 11/20/2016 TDK
27 SITI MARTUTI 29 JL 19 UNIT 3 YA 4 3 G2,P1,A0 25 1/15/2017 TDK
28 SUSIANA 21 JL 21 UNIT 3 YA 2 4 G1,P0,A0 12 4/20/2017 TDK
29 10-Oct-16 NANA 32 JL 2 UNIT 2 YA 4 3 G4,P3,A0 37 10/9/2016 TDK
30 FITRI 21 JL 1 UNIT 2 TDK 3 4 G1,P0,A0 29 12/25/2016 TDK
31 VERA 25 JL 4 UNIT 2 TDK 4 3 G1,P0,A0 28-29 12/26/2016 TDK
32 DESI 26 JL POROS UNIT 2 TDK 3 4 G1,P0,A0 19-20 3/3/2017 TDK
33 SITI WASIKOH 29 JL 21 UNIT 3 YA 4 4 G3,P2,A0 28-29 12/27/2016 TDK
34 SRI JURNIARTI 31 JL 16 UNIT 3 TDK 2 3 G2,P1,A0 30-31 11/6/2016 TDK
35 10-Oct-16 ISWATI 32 JL 17 UNIT 3 TDK 2 4 G2,P1,A0 17-18 3/12/2017 TDK
36 RINI 33 JL PETALING 6 TDK 1 3 G5,P2,A2 15 4/10/2017 TDK
37 13-Oct-16 JUMIRAH 38 JL 16 UNIT 3 TDK 4 3 G3,P1,A1 28 12/25/2016 TDK
38 YANI 30 JL 12 UNIT 2 TDK 3 2 G2,P1,A0 10 5/11/2017 TDK
39 ENI 31 JL 8 UNIT 2 TDK 3 3 G2,P1,A0 37 10/9/2016 TDK
40 YENI JONFI 24 JL 5 UNIT 2 TDK 4 4 G1,P0,A0 9 8/7/2017 TDK
41 15-Oct-16 RATNA DEWI 31 JL 5 UNIT 2 TDK 2 3 G4,P3,A0 13-14 4/19/2017 TDK
42 DIAH FITRI 23 JL 5 UNIT 2 TDK 4 4 G1,P1,A0 38 10/27/2016 TDK
43 RORI SAFITRI 18 JL 28 UNIT 1 TDK 3 3 G1,P1,A0 15 4/5/2017 TDK
44 SUCI 23 JL 21 UNIT 3 TDK 4 4 G1,P1,A2 9 11/21/2016 TDK
45 17-Oct-16 LATIFUL 31 JL 9 UNIT 2 TDK 3 3 G2,P3,A0 10 5/14/2017 TDK
46 MUJIATI 22 JL 3 UNIT 2 TDK 4 3 G2,P1,A0 35-36 10/29/2016 TDK
47 HERNOVA 33 JL 5 UNIT 2 TDK 3 4 G2,P1,A0 15-16 4/5/2017 TDK
48 ERNAWATI 21 JL 4 UNIT 2 TDK 4 3 G1,P0,A0 30-31 12/19/2016 TDK
49 SARI RAHMADANI 21 JL 5 UNIT 2 TDK 3 4 G2,P1,A0 33-34 11/27/2016 TDK
50 18-Oct-16 MARISEM 26 JL 4 UNIT 2 TDK 4 3 G2,P1,A0 19 5/12/2017 TDK
51 KHADIJAH 28 JL 6 UNIT 2 TDK 2 4 G2,P1,A0 34-35 10/25/2016 TDK
52 RENI 27 JL POROS UNIT 2 TDK 2 3 G2,P1,A0 26-27 1/11/2017 TDK
53 ASPARIAH 21 JL 15 UNIT 3 TDK 1 3 G1,P1,A2 8 11/17/2016 TDK
54 19-Oct-16 ANA 27 JL 12 UNIT 2 TDK 4 3 G2,P1,A0 30-31 12/18/2016 TDK
55 RAUDYA 19 JL 6 UNIT 2 TDK 3 3 G1,P0,A0 31-32 12/18/2016 TDK
56 DEWI 23 JL TERMINAL UNIT 2 TDK 4 2 G2,P0,A0 15-16 4/5/2017 TDK
57 21-Oct-16 LENI AGUSTIN 21 JL 15 UNIT 3 TDK 3 3 G1,P0,A0 13-14 4/19/2017 TDK
58 SURYATI 23 JL 2 UNIT 2 TDK 4 3 G1,P0,A0 18 4/23/2017 TDK
59 WINDI 23 JL 3 UNIT 2 TDK 2 3 G2,P1,A1 9 11/21/2016 TDK
60 SAHYANI 33 JL 29 UNIT 1 TDK 2 3 G1,P0,A0 13 11/21/2016 TDK
61 22-Oct-16 YUNITA SARI 22 JL 5 UNIT 2 TDK 2 2 G1,P0,A0 30 12/25/2016 TDK
62 PRIMETA 26 JL 4 UNIT 2 TDK 2 1 G1,P0,A0 21-22 3/6/2017 TDK
63 IFA SUSANTI 26 JL 18 UNIT 1 TDK 3 3 G2,P1,A0 30 12/26/2016 TDK
64 24-Oct-16 MARIYANI 24 JL 5 UNIT 2 TDK 4 3 G1,P0,A0 12 5/14/2017 TDK
65 TRI ASTUTI 28 JL 4 UNIT 2 TDK 3 4 G2,P1,A0 26-27 1/24/2017 TDK
66 EVI 30 JL PASAR UNIT 2 YA 4 3 G2,P1,A0 35-36 11/20/2016 TDK
67 25-Oct-16 WENI SULASTRI 24 JL 8 UNIT 2 TDK 2 4 G1,P0,A0 17-18 4/2/2017 TDK
68 SRI ASTUTI 37 JL 2 UNIT 2 YA 2 3 G2,P1,A0 30 12/20/2016 TDK
69 SINDI KHAIRUNNISA 22 JL 29 UNIT 1 TDK 1 4 G1,P0,A0 13 5/5/2017 TDK
70 RAHMAWAATI 39 JL 5 UNIT 2 YA 4 3 G3,P2,A0 31 12/23/2016 TDK
71 YULI SRIATI 25 JL 3 UNIT 2 YA 3 3 G1,P0,A0 21 2/27/2017 TDK
72 25-Oct-16 UMI MARKAMAH 22 JL 5 UNIT 2 YA 4 3 G1,P0,A0 26-27 1/25/2017 TDK
73 SUHARYATI 35 JL 4 UNIT 2 TDK 2 3 G3,P1,A1 29 12/8/2016 TDK
74 VINA 23 JL 6 UNIT 2 TDK 2 2 G1,P0,A0 7 6/17/2017 TDK
75 RISKI WULANDARI 25 AUR CINO TDK 1 3 G2,P1,A0 30 12/28/2016 TDK
76 27-Oct-16 AFDELINA 37 JL PONDOK AYAH TDK 2 3 G2,P3,A0 13-14 7/25/2017 TDK
77 YULIANA 28 JL 5 UNIT 4 YA 1 3 G2,P1,A0 21-22 3/5/2017 TDK
78 28-Oct-16 VALDIAH 18 JL YOS SUDARSO UNIT 2 TDK 4 1 G1,P0,A0 22-23 30/02/2017 TDK
79
80
 FORMULIR REGISTRASI IBU HAMIL YANG MELKUKAN DETEKSI DINI HEPAT
UPTD PUSKESMAS PERAWATAN RIMBO BUJANG II KAB TEBO PROPINSI J
TAHUN 2016
HASIL PEMERIKSAAN SEBELUM DETEKSI DINI
PERNAH TES STATUS IMUNISASI
Gejala ANTI
HEPATITIS B HBsAg ANTI HBc PERNAH HEPATITIS B PERNAH
HBs PERNAH MENJALA PUNYA PERNAH
SERUMAH
NI PASANGA MENGGUNAKAN
TRANSFUS DENGAN
SGPT ANTI HBeA HBV N SEKS NARKOBA /
I DARAH HEMODI JARUM SUNTIK
PENDERITA
/ALT Hbe g DNA (ya/tdk) ALISA LAIN HEPATITIS B
TITER BERSAMA (ya/tdk) BELUM
1 2 TEMPAT WAKTU R NR IU/L) R NR (ya/tdk) (ya/tdk) PERNAH 1X 2X 3X
(ya/tdk)

X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK

X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
X X X X X X X X X X X X X TDK TDK TDK TDK √ X X X TDK
 LKUKAN DETEKSI DINI HEPATITIS B
JANG II KAB TEBO PROPINSI JAMBI
16
HASIL PEMERIKSAAN SETELAH DETEKSI DINI
HASIL
HASIL PERIKSA CD4 ANTI SGPT/
TES HIV HBsAg ANTI HBe HBeAg HBV DNA TES HIV TES SIFILIS
HUB. DENGAN PERNAH PERNAH HBs ALT
PERNAH PERNAH
PENDERITA PERIKSA MENDERITA GEJALA
HEPATITIS B TES HIV CD4 DPT ARV PMS DLM 1 BL
SERUMAH (ya/tdk) (ya/tdk) (ya/tdk) TERAKHIR (ya/tdk)
TITER POSITI NEGA
R NR <=350 sel/ml >350 sel/ml R NR (IU/L) W: <32 R NR R NR IU/ml R NR F TIF

X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X

X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
X TDK X X TDK X X TDK TDK X √ X X X X X X X X X X X
 PEMANTAUAN TERHADAP BAYI (SAMPAI
REKOMENDA UMUR 12 BULAN)
SI JIKA HBsAg REKOMENDASI JIKA HASIL PEMERIKSAAN
HBsAg REAKTIF TANGGAL
NON REAKTIF
DAN IMUNIS KONSEL
TEMPAT
WAKTU TANGGAL TANGGAL TANGGAL TANGGAL TANGGAL ASI IBU ING IBU
PERSALIN BAYI IMUNISASI HBIG IMUNISAS IMUNISASI IMUNISASI ANTI (YA/TD (YA/TD KET
AN HBsAg HBs
DILAHIRK HB0(BAYI) (BAYI) I DPT/HB1 DPT/HB2 DPT/HB3 K) K)
PERIKSA ANTI (PUKUL) (PUKUL) (BAYI) (BAYI) (BAYI)
HBs
MONITOR TERAPI AN
TITER
R NR
IU/L
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
PUSKESMAS : RIMBO BUJANG II
BULAN/TAHUN : OKTOBER

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI

∑nilai SGPT
∑Anti HBs ∑ Anti
∑HBsAg ∑ Anti Hbe HBV DNA
DESA/KELURAHAN Reaktif HBeAg
BELUM IMUNISASI IMUNISASI 2X IMUNISASI
< 20 THN 20-29 THN 30-39 THN > 40 THN <2Xbatas >=2Xbatas
IMUNISASI 1X 3X
normal normal
R NR R NR R NR R NR D ND

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Perintis 1 4 1 1 7 0 0 0 0 7
Wirotho agung 1 33 19 1 54 0 0 0 0 54
Rimbo mulyo 0 9 7 0 16 0 0 0 0 16
Tirta kencana 0 0 1 0 1 0 0 0 0 1

2 46 28 2 78 0 0 0 0 78 0 0

Mengetahui :
Kepala UPTD Puskesmas Perawatan
Rimbo Bujang II

dr. Riana Elizabeth,S

NIP : 19730606 200501 2 007
I HEPATITIS B PADA IBU HAMIL

DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif

KETERANGAN
LAHIR BULAN DIIMUNISASI DAPAT ∑IMUNISASI ∑KOMSELING
INI HBO <12 JAM HBIG (IBU) (IBU)
∑Yg diperiksa ∑Yg ∑Yg
R NR Pos NeG
anti HBs dimonitor diterapi

22 23 24 25 26 27 28 29 30 31 32 33 34

Muara Tebo, Oktober 2016

Pengelola Program/ Pembuata Laporan

Ririn Lidya Pratama

NIP : 19910825 201402 2 002
 PEKERJAAN
TGL KODE UMUR PEKERJAAN (1.pns 2.swasta
NO Nama ALAMAT
REGISTRASI SPESIMEN (th) (ya/tdk) 3.pedagang
4.lainnya

1 1-Sep-16 Siti HB 20 Bengkoang ya Irt

2 RENI HB 24 Bengkoang ya Irt
3 Partiyem HB 33 Bengkoang ya 4
4 SRI HIDAYATI 32 JL MERANTI UNIT 6 TDK 4
5 NOVA 28 JL POROS UNIT 2 YA 3
6 3-Oct-16 KUSNIAH 34 JL 11 UNIT 2 TDK 4
7 TITIN 27 JL 22 UNIT 3 YA 2
8 SRI HASTUTI 21 JL 6 UNIT 2 YA 2
9 SUMIYATI 33 JL 1 UNIT 2 YA 1
10 4-Oct-16 ISMIATI 26 JL 15 UNIT 3 TDK 4
11 SILVI 32 JL 3 UNIT 2 TDK 3
12 RESA 23 JL POROS UNIT 2 TDK 4
13 MISKA 23 JL POROS UNIT 2 TDK 2
14 5-Oct-16 ENI 32 JL 4 UNIT 2 YA 2
15 DESI 35 JL 3 UNIT 2 TDK 1
16 FITRI 25 JL 3 UNIT 2 YA 2
17 SISWATI 30 JL 10 UNIT 2 TDK 1
18 ENDANG NURYATI 21 JL 6 UNIT 2 YA 4
19 6-Oct-16 FERISKA 28 JL 8 UNIT 2 YA 3
20 ELI ANDRIANI 21 JL 8 UNIT 3 YA 4
21 ADE 26 JL PASAR UNIT 2 TDK 2
22 ENDANG 29 JL 6 UNIT 2 TDK 2
23 7-Oct-16 SUPRIANINGSIH 27 JL 12 UNIT 2 TDK 4
24 TRINURAINI 33 JL 17 UNIT 3 TDK 3
25 SARI 25 JL 17 UNIT 3 TDK 4
26 EVI 33 JL POROS UNIT 2 TDK 3
27 SITI MARTUTI 29 JL 19 UNIT 3 YA 4
28 SUSIANA 21 JL 21 UNIT 3 YA 2
29 10-Oct-16 NANA 32 JL 2 UNIT 2 YA 4
30 FITRI 21 JL 1 UNIT 2 TDK 3
31 VERA 25 JL 4 UNIT 2 TDK 4
32 DESI 26 JL POROS UNIT 2 TDK 3
33 SITI WASIKOH 29 JL 21 UNIT 3 YA 4
34 SRI JURNIARTI 31 JL 16 UNIT 3 TDK 2
35 10-Oct-16 ISWATI 32 JL 17 UNIT 3 TDK 2
36 RINI 33 JL PETALING 6 TDK 1
37 13-Oct-16 JUMIRAH 38 JL 16 UNIT 3 TDK 4
38 YANI 30 JL 12 UNIT 2 TDK 3
39 ENI 31 JL 8 UNIT 2 TDK 3
40 YENI JONFI 24 JL 5 UNIT 2 TDK 4
41 15-Oct-16 RATNA DEWI 31 JL 5 UNIT 2 TDK 2
42 DIAH FITRI 23 JL 5 UNIT 2 TDK 4
43 RORI SAFITRI 18 JL 28 UNIT 1 TDK 3
44 SUCI 23 JL 21 UNIT 3 TDK 4
45 17-Oct-16 LATIFUL 31 JL 9 UNIT 2 TDK 3
46 MUJIATI 22 JL 3 UNIT 2 TDK 4
47 HERNOVA 33 JL 5 UNIT 2 TDK 3
48 ERNAWATI 21 JL 4 UNIT 2 TDK 4
49 SARI RAHMADANI 21 JL 5 UNIT 2 TDK 3
50 18-Oct-16 MARISEM 26 JL 4 UNIT 2 TDK 4
51 KHADIJAH 28 JL 6 UNIT 2 TDK 2
52 RENI 27 JL POROS UNIT 2 TDK 2
53 ASPARIAH 21 JL 15 UNIT 3 TDK 1
54 19-Oct-16 ANA 27 JL 12 UNIT 2 TDK 4
55 RAUDYA 19 JL 6 UNIT 2 TDK 3
56 DEWI 23 JL TERMINAL UNIT 2 TDK 4
57 21-Oct-16 LENI AGUSTIN 21 JL 15 UNIT 3 TDK 3
58 SURYATI 23 JL 2 UNIT 2 TDK 4
59 WINDI 23 JL 3 UNIT 2 TDK 2
60 SAHYANI 33 JL 29 UNIT 1 TDK 2
61 22-Oct-16 YUNITA SARI 22 JL 5 UNIT 2 TDK 2
62 PRIMETA 26 JL 4 UNIT 2 TDK 2
63 IFA SUSANTI 26 JL 18 UNIT 1 TDK 3
64 24-Oct-16 MARIYANI 24 JL 5 UNIT 2 TDK 4
65 TRI ASTUTI 28 JL 4 UNIT 2 TDK 3
66 EVI 30 JL PASAR UNIT 2 YA 4
67 25-Oct-16 WENI SULASTRI 24 JL 8 UNIT 2 TDK 2
68 SRI ASTUTI 37 JL 2 UNIT 2 YA 2
69 SINDI KHAIRUNNISA 22 JL 29 UNIT 1 TDK 1
70 RAHMAWAATI 39 JL 5 UNIT 2 YA 4
71 YULI SRIATI 25 JL 3 UNIT 2 YA 3
72 25-Oct-16 UMI MARKAMAH 22 JL 5 UNIT 2 YA 4
73 SUHARYATI 35 JL 4 UNIT 2 TDK 2
74 VINA 23 JL 6 UNIT 2 TDK 2
75 RISKI WULANDARI 25 AUR CINO TDK 1
76 27-Oct-16 AFDELINA 37 JL PONDOK AYAH TDK 2
77 YULIANA 28 JL 5 UNIT 4 YA 1
78 28-Oct-16 VALDIAH 18 JL YOS SUDARSO UNIT 2 TDK 4
79
80
 HASIL PEMERIKSAAN S
PERNAH TES
Gejala HEPATITIS B
PERNAH HBsAg
STATUS GPA UMUR
PENDIDIKAN (GRAVIDA, KEHAMILAN TAKSIRAN PUNYA
(1.SD 2.SMP GEJALA
3.SMA 4.PT) PARTUS, SEKARANG PARTUS HEPATITIS
ABORTUS) (minggu) (ya/tdk) TEMP WAKTU
1 2 R NR
AT

3 G1, P0, A0 12 1/9/2017 TDK X X X X X X

4 G1, P0, A0 26 2/18/2017 TDK X X X X X X
2 G3, P2, A0 14 3/10/2017 TDK X X X X X X
3 G3,P2,A0 26 1/11/2017 TDK X X X X X X
4 G3,P2,A0 20 2/14/2017 TDK X X X X X X
3 G4,P3,A0 11 4/27/2017 TDK X X X X X X
4 G1,P0,A0 5 4/30/2017 TDK X X X X X X
3 G1,P0,A0 8 5/22/2017 TDK X X X X X X
4 G3,P2,A1 19 3/3/2017 TDK X X X X X X
4 G1,P1,A0 35 10/29/2016 TDK X X X X X X
3 G4,P3,A0 12 4/12/2017 TDK X X X X X X
4 G1,P0,A0 11 4/22/2017 TDK X X X X X X
3 G2,P1,A0 9 5/11/2017 TDK X X X X X X
3 G2,P1,A0 14 4/4/2017 TDK X X X X X X
2 G4,P3,A0 37 10/13/2016 TDK X X X X X X
3 G2,P1,A0 15 4/8/2017 TDK X X X X X X
4 G3,P2,A0 38 10/25/2016 TDK X X X X X X
3 G2,P1,A0 7 5/22/2017 TDK X X X X X X
4 G3,P2,A0 32 11/25/2016 TDK X X X X X X
3 G4,P1,A2 12 4/8/2017 TDK X X X X X X
4 G2,P1,A0 37 10/11/2016 TDK X X X X X X
3 G3,P2,A0 26 1/11/2017 TDK X X X X X X
3 G3,P1,A1 26 1/13/2017 TDK X X X X X X
3 G2,P1,A0 12 4/15/2017 TDK X X X X X X
3 G1,P0,A0 28 12/29/2016 TDK X X X X X X
2 G3,P1,A1 33 11/20/2016 TDK X X X X X X
3 G2,P1,A0 25 1/15/2017 TDK X X X X X X
4 G1,P0,A0 12 4/20/2017 TDK X X X X X X
3 G4,P3,A0 37 10/9/2016 TDK X X X X X X
4 G1,P0,A0 29 12/25/2016 TDK X X X X X X
3 G1,P0,A0 28-29 12/26/2016 TDK X X X X X X
4 G1,P0,A0 19-20 3/3/2017 TDK X X X X X X
4 G3,P2,A0 28-29 12/27/2016 TDK X X X X X X
3 G2,P1,A0 30-31 11/6/2016 TDK X X X X X X
4 G2,P1,A0 17-18 3/12/2017 TDK X X X X X X
3 G5,P2,A2 15 4/10/2017 TDK X X X X X X
3 G3,P1,A1 28 12/25/2016 TDK X X X X X X
2 G2,P1,A0 10 5/11/2017 TDK X X X X X X
3 G2,P1,A0 37 10/9/2016 TDK X X X X X X
4 G1,P0,A0 9 8/7/2017 TDK X X X X X X
3 G4,P3,A0 13-14 4/19/2017 TDK X X X X X X
4 G1,P1,A0 38 10/27/2016 TDK X X X X X X
3 G1,P1,A0 15 4/5/2017 TDK X X X X X X
4 G1,P1,A2 9 11/21/2016 TDK X X X X X X
3 G2,P3,A0 10 5/14/2017 TDK X X X X X X
3 G2,P1,A0 35-36 10/29/2016 TDK X X X X X X
4 G2,P1,A0 15-16 4/5/2017 TDK X X X X X X
3 G1,P0,A0 30-31 12/19/2016 TDK X X X X X X
4 G2,P1,A0 33-34 11/27/2016 TDK X X X X X X
3 G2,P1,A0 19 5/12/2017 TDK X X X X X X
4 G2,P1,A0 34-35 10/25/2016 TDK X X X X X X
3 G2,P1,A0 26-27 1/11/2017 TDK X X X X X X
3 G1,P1,A2 8 11/17/2016 TDK X X X X X X
3 G2,P1,A0 30-31 12/18/2016 TDK X X X X X X
3 G1,P0,A0 31-32 12/18/2016 TDK X X X X X X
2 G2,P0,A0 15-16 4/5/2017 TDK X X X X X X
3 G1,P0,A0 13-14 4/19/2017 TDK X X X X X X
3 G1,P0,A0 18 4/23/2017 TDK X X X X X X
3 G2,P1,A1 9 11/21/2016 TDK X X X X X X
3 G1,P0,A0 13 11/21/2016 TDK X X X X X X
2 G1,P0,A0 30 12/25/2016 TDK X X X X X X
1 G1,P0,A0 21-22 3/6/2017 TDK X X X X X X
3 G2,P1,A0 30 12/26/2016 TDK X X X X X X
3 G1,P0,A0 12 5/14/2017 TDK X X X X X X
4 G2,P1,A0 26-27 1/24/2017 TDK X X X X X X
3 G2,P1,A0 35-36 11/20/2016 TDK X X X X X X
4 G1,P0,A0 17-18 4/2/2017 TDK X X X X X X
3 G2,P1,A0 30 12/20/2016 TDK X X X X X X
4 G1,P0,A0 13 5/5/2017 TDK X X X X X X
3 G3,P2,A0 31 12/23/2016 TDK X X X X X X
3 G1,P0,A0 21 2/27/2017 TDK X X X X X X
3 G1,P0,A0 26-27 1/25/2017 TDK X X X X X X
3 G3,P1,A1 29 12/8/2016 TDK X X X X X X
2 G1,P0,A0 7 6/17/2017 TDK X X X X X X
3 G2,P1,A0 30 12/28/2016 TDK X X X X X X
3 G2,P3,A0 13-14 7/25/2017 TDK X X X X X X
3 G2,P1,A0 21-22 3/5/2017 TDK X X X X X X
1 G1,P0,A0 22-23 30/02/2017 TDK X X X X X X
 FORMULIR REGISTRASI IBU HAMIL YANG MELK
UPTD PUSKESMAS ALAI ILIR KAB T
TAHUN 2016
HASIL PEMERIKSAAN SEBELUM DETEKSI DINI
STATUS IMUNISASI
ANTI PERNAH HEPATITIS B
ANTI HBc
HBs PERNAH MENJALA PUNYA PERNAH
NI PASANGA MENGGUNAKAN
TRANSFUS
SGPT ANTI HBeA HBV N SEKS NARKOBA /
I DARAH HEMODI LAIN JARUM SUNTIK
TITER /ALT Hbe g DNA (ya/tdk) ALISA (ya/tdk) BERSAMA (ya/tdk) BELUM
R NR (ya/tdk) 1X 2X
IU/L) PERNAH

X X X X X X X TDK TDK TDK TDK √ X X

X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
X X X X X X X TDK TDK TDK TDK √ X X
AMIL YANG MELKUKAN DETEKSI DINI HEPATITIS B
S ALAI ILIR KAB TEBO PROPINSI JAMBI
TAHUN 2016

US IMUNISASI HASIL
PATITIS B TES HIV HASIL PERIKSA CD4
PERNAH
SERUMAH HUB. DENGAN PERNAH PERNAH PERNAH PERNAH
DENGAN PENDERITA PERIKSA MENDERITA GEJALA
PENDERITA HEPATITIS B TES HIV CD4 DPT ARV PMS DLM 1 BL
HEPATITIS B SERUMAH (ya/tdk) (ya/tdk) (ya/tdk) TERAKHIR (ya/tdk)
3X (ya/tdk) R NR <=350 sel/ml >350 sel/ml

X TDK X TDK X X TDK X X TDK TDK

X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
X TDK X TDK X X TDK X X TDK TDK
 HASIL PEMERIKSAAN SETELAH DETEKSI DINI
REKOMENDA
REKOMENDASI JIKA
ANTI SGPT/ SI JIKA HBsAg HBsAg REAKTIF
HBsAg ANTI HBe HBeAg HBV DNA TES HIV TES SIFILIS NON REAKTIF
HBs ALT

R NR TITER
W: <32 R NR R NR IU/ml R NR POSITI NEGA PERIKSA ANTI
MONITOR
(IU/L) F TIF HBs

X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
X √ X X X X X X X X X X X X X
 PEMANTAUAN TERHADAP BAYI (SAMPAI
REKOMENDASI JIKA
UMUR 12 BULAN)
HBsAg REAKTIF HASIL PEMERIKSAAN
TANGGAL
DAN IMUNIS
TEMPAT
WAKTU TANGGAL TANGGAL TANGGAL TANGGAL TANGGAL ASI IBU
PERSALIN BAYI IMUNISASI HBIG IMUNISAS IMUNISASI IMUNISASI ANTI (YA/TD
AN HBsAg
DILAHIRK HB0(BAYI) (BAYI) I DPT/HB1 DPT/HB2 DPT/HB3 HBs K)
TERAPI AN (PUKUL) (PUKUL) (BAYI) (BAYI) (BAYI)

R NR TITER
IU/L
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X
KONSEL
ING IBU
KET
(YA/TD
K)

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
 LAPORAN BULANA

KABUPATEN/KOTA : TEBO
PUSKESMAS : SUNGAI ABANG
BULAN/TAHUN : Oktober 2016

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

DESA/KELURAHAN
BELUM IMUNISASI IMUNISASI
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI 1X IMUNISASI 2X 3X

1 2 3 4 5 6 7 8 9
Kuamang 0 5 5 0
Teluk Kayu Putih 1 6 5 0
Sungai Abang 0 6 5 0
Aur Cino 0 12 4 1
Dusun baru 0 9 7 0
Tabun 1 8 5 0
Ma.Tabun 0 3 2 0
Ma. Niro 0 1 2 0

2 50 35 1 0 0 0 0

4
LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑nilai SGPT
∑Anti HBs ∑ Anti
∑HBsAg ∑ Anti Hbe HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR
Reaktif HBeAg

<2Xbatas >=2Xbatas
normal normal ∑Yg diperiksa
R NR R NR R NR R NR D ND R NR Pos NeG
anti HBs

10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
0 10 0 10
0 12 0 12
0 11 0 11
0 17 0 17
0 16 0 16
0 14 0 14
0 5 0 5
0 3 0 3

0 88 0 88
MIL

Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
KETERANGAN
LAHIR BULAN DIIMUNISASI DAPAT ∑IMUNISASI ∑KOMSELING
INI HBO <12 JAM HBIG (IBU) (IBU)
∑Yg ∑Yg
dimonitor diterapi

27 28 29 30 31 32 33 34

Sungai Abang, Oktober 2016

Kepala Puskesmas Sungai Abang

H. Diding Sunardi.SKM
NIP : 19641227 198312 1 001
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Oktober 2016

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

∑nilai SGPT
∑HBsAg ∑Anti HBs ∑ Anti Hbe ∑ Anti HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
PUSKESMAS Reaktif HBeAg KETERANGAN
BELUM LAHIR BULAN DIIMUNISASI DAPAT ∑IMUNISASI ∑KONSELING
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI 1 X IMUNISASI 2 X IMUNISASI 3 X <2Xbatas >=2Xbatas
IMUNISASI INI HBO <12 JAM HBIG (IBU) (IBU)
normal normal ∑Yg diperiksa ∑Yg ∑Yg
R NR R NR R NR R NR D ND R NR Pos NeG anti HBs dimonitor diterapi

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
Muara Tebo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk Singkawang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengupeh 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pintas Tuo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sungai Bengkal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sungai Abang 2 50 35 1 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Rimbo Bujang II 2 46 28 2 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SP II Sekutur Jaya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pulau Temiang 5 60 28 5 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Alai Ilir 0 53 36 1 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tuo Pasir Mayang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lubuk Mandarsah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tegal Arum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk rendah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 209 127 9 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0

Mengetahui : Muara Tebo, 15 November 2016

Kasi P2 Dinkes Kab. Tebo Pengelola Program/ Pembuata Laporan

MERITA, SST Kms Vikri Abdullah, SKM

NIP : 19720323 199203 2 003 NIP : 19770202 200902 1 006
 LAPORAN TAHUN

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Januari s/d Desember 2016

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS
BELUM
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI IMUNISASI 1 X IMUNISASI 2 X

1 2 3 4 5 6 7 8
Muara Tebo 0 0 0 0 0 0 0
Teluk Singkawang 0 0 0 0 0 0 0
Mengupeh 0 0 0 0 0 0 0
Pintas Tuo 0 0 0 0 0 0 0
Sungai Bengkal 0 0 0 0 0 0 0
Sungai Abang 2 50 35 1 0 0 0
Rimbo Bujang II 2 46 28 2 0 0 0
SP II Sekutur Jaya 0 0 0 0 0 0 0
Pulau Temiang 5 60 28 5 0 0 0
Alai Ilir 0 53 36 1 0 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0
Tuo Pasir Mayang 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0
Lubuk Mandarsah 0 0 0 0 0 0 0
Tegal Arum 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0
Teluk rendah 0 0 0 0 0 0 0
9 209 127 9 0 0 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

MERITA, SST
NIP : 19720323 199203 2 003
 LAPORAN TAHUNAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI

∑nilai SGPT
∑Anti HBs ∑ Anti
∑HBsAg ∑ Anti Hbe HBV DNA ∑Tes HIV ∑Tes Sifilis
Reaktif HBeAg
IMUNISASI 3 X <2Xbatas >=2Xbatas
normal normal
R NR R NR R NR R NR D ND R NR Pos NeG

9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A IBU HAMIL

Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

∑HBsAgNR HBsAgReaktif
KETERANGAN
LAHIR BULAN DIIMUNISASI DAPAT ∑IMUNISASI ∑KONSELING
INI HBO <12 JAM HBIG (IBU) (IBU)
∑Yg diperiksa ∑Yg ∑Yg
anti HBs dimonitor diterapi

26 27 28 29 30 31 32 33 34
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 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 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 30 0 0 0 0

Muara Tebo, 16 Januari 2017

Pengelola Program/ Pembuata Laporan

Kms Vikri Abdullah, SKM

NIP : 19770202 200902 1 006
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Januari 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

∑nilai SGPT
∑Anti HBs ∑ Anti
∑HBsAg ∑ Anti Hbe HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
Reaktif HBeAg
PUSKESMAS KET
< 20 20-29 30-39 > 40 BELUM LAHIR DIIMUNISASI DAPAT ∑IMUNISASI ∑KONSELING
THN THN THN THN IMUNISASI IMUNISASI 1 X IMUNISASI 2 X IMUNISASI 3 X <2Xbatas >=2Xbatas BULAN INI HBO <12 JAM HBIG (IBU) (IBU)
normal normal ∑Yg diperiksa ∑Yg ∑Yg
R NR R NR R NR R NR D ND R NR Pos NeG
anti HBs dimonitor diterapi

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
Muara Tebo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk Singkawang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengupeh 0 3 1 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0
Pintas Tuo 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sungai Bengkal 1 9 4 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 14 0 14 0 0 0 38 38 0 0 0
Sungai Abang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Rimbo Bujang II 1 33 17 5 0 0 0 0 2 54 0 0 0 0 0 0 0 0 0 0 0 56 0 56 0 1 1 0 0 0 0 0
SP II Sekutur Jaya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pulau Temiang 3 14 8 1 26 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 26 0 26 0 0 0 0 0 0 0 0
Alai Ilir 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tuo Pasir Mayang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lubuk Mandarsah 7 14 2 0 23 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 23 0 23 0 0 0 0 0 0 0 0
Tegal Arum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk rendah 0 1 2 0 3 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0
Bangun Seranten 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TLK. Kmbang Jambu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suo-Suo 0 6 1 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0
12 74 34 6 52 0 0 0 2 124 0 0 0 0 0 0 0 0 0 0 0 126 0 126 0 1 1 38 38 0 0 0

Mengetahui : Muara Tebo, Februari 2019

Kasi P2 Dinkes Kab. Tebo Pengelola Program/ Pembuata Laporan

RICHY VERNANDO SAPUTRA,SKM HERNITA AM,Keb

NIP : 19831205 200604 1 004 NIP : 19721115 199303 2 003
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Februari 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA
∑nilai SGPT
∑HBsAg ∑Anti HBs ∑ Anti Hbe ∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
Reaktif LAHIR
PUSKESMAS < 20 20-29 30-39 > 40 BELUM IMUNISASI 1 IMUNISASI 2 IMUNISASI 3 X KET
<2Xbatas >=2Xbatas BULAN DIIMUNISASI DAPAT ∑IMUNISASI ∑KONSELING
THN THN THN THN IMUNISASI X X HBO <12 JAM HBIG (IBU) (IBU)
normal normal ∑Yg diperiksa ∑Yg ∑Yg INI
R NR R NR R NR R NR D ND R NR Pos NeG
anti HBs dimonitor diterapi

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
Muara Tebo 0 32 20 1 53 0 0 0 2 51 0 0 0 0 0 0 0 0 0 0 0 53 0 53 0 0 0 0 0 0 0 0
Teluk Singkawang 0 11 12 1 0 0 0 0 1 23 0 0 0 0 0 0 0 0 0 0 0 24 0 24 0 0 0 0 0 0 0 0
Mengupeh 19 33 3 0 55 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 55 0 55 0 0 0 0 0 0 0 0
Pintas Tuo 0 8 3 0 11 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 11 0 11 0 0 0 0 0 0 0 0
Sungai Bengkal 5 25 9 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 39 0 39 0 0 0 26 26 0 0 0
Sungai Abang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Rimbo Bujang II 0 74 54 5 0 133 0 0 1 132 0 0 0 0 0 0 0 0 0 0 0 133 0 133 0 0 0 0 0 0 0 0
SP II Sekutur Jaya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pulau Temiang 6 32 16 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 54 0 54 0 0 0 0 0 0 0 0
Alai Ilir 0 2 3 0 5 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0 0 0 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tuo Pasir Mayang 0 3 2 0 5 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lubuk Mandarsah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tegal Arum 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk rendah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Bangun Seranten 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tlk. Kembang jambu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suo-Suo 0 6 1 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0
30 221 122 0 129 133 0 0 4 376 0 0 0 0 0 0 0 0 0 0 0 380 0 380 0 0 0 26 26 0 0 0

Mengetahui : Muara Tebo, Maret 2019

Kasi P2 Dinkes Kab. Tebo Pengelola Program/ Pembuata Laporan

RICHY VERNANDO SAPUTRA,SKM HERNITA AM,Keb

NIP : 19831205 200604 1 004 NIP : 19721115 199303 2 003
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Maret 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA
∑Anti HBs ∑nilai SGPT ∑ Anti ∑ Anti
∑HBsAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
Reaktif Hbe HBeAg LAHIR DIIMUNISASI DAPAT
PUSKESMAS < 20 20-29 30-39 > 40 BELUM IMUNISASI 1 IMUNISASI 2 ∑IMUNISASI ∑KONSELING KET
IMUNISASI 3 X <2Xbatas >=2Xbatas BULAN
THN THN THN THN IMUNISASI X X INI HBO <12 JAM HBIG (IBU) (IBU)
normal normal ∑Yg diperiksa ∑Yg ∑Yg
R NR R NR R NR R NR D ND R NR Pos NeG anti HBs dimonitor diterapi

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
Muara Tebo 0 3 2 0 5 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0 0 0 0 0
Teluk Singkawang 1 17 7 0 0 25 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 25 0 25 0 0 0 0 0 0 0 0
Mengupeh 7 48 32 1 0 0 0 0 3 75 0 0 0 0 0 0 0 0 0 0 0 78 0 78 0 3 0 0 0 0 0 0
Pintas Tuo 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0
Sungai Bengkal 10 43 22 1 0 0 0 0 1 75 0 0 0 0 0 0 0 0 0 0 0 76 0 76 0 0 0 21 21 0 0 0
Sungai Abang 0 5 5 0 0 10 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0
Rimbo Bujang II 0 37 19 3 0 59 0 0 1 58 0 0 0 0 0 0 0 0 0 0 0 59 0 59 0 0 0 0 0 0 0 0
SP II Sekutur Jaya 4 9 8 0 0 21 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 21 1 20 0 0 0 0 0 0 0 0
Pulau Temiang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Alai Ilir 0 5 2 0 0 7 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0
Rimbo Bujang IX 7 29 15 1 52 0 0 0 1 51 0 0 0 0 0 0 0 0 0 0 0 52 0 52 0 0 0 0 0 0 0 0
Tuo Pasir Mayang 1 1 3 0 0 5 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lubuk Mandarsah 3 13 2 0 0 0 0 0 1 17 0 0 0 0 0 0 0 0 0 0 0 18 0 18 0 1 1 0 0 0 0 0
Tegal Arum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk rendah 2 0 2 0 0 4 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0
Bangun Seranten 0 6 5 0 0 11 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 11 0 11 0 0 0 0 0 0 0 0
Tlk. Kembang jambu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suo-Suo 2 6 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0
37 222 125 6 57 143 0 0 7 373 0 0 0 0 0 0 0 0 0 0 0 380 1 379 0 4 1 21 21 0 0 0

Mengetahui : Muara Tebo, April 2019

Kasi P2 Dinkes Kab. Tebo Pengelola Program/ Pembuata Laporan

RICHY VERNANDO SAPUTRA,SKM HERNITA AM,Keb

NIP : 19831205 200604 1 004 NIP : 19721115 199303 2 003
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Triwulan I 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA
∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe ∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2 LAHIR BULAN DIIMUNISASI ∑IMUNISASI ∑KONSELING KET
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI X X IMUNISASI 3 X <2Xbatas >=2Xbatas INI HBO <12 JAM DAPAT HBIG (IBU) (IBU)
normal normal ∑Yg diperiksa
R NR R NR R NR R NR D ND R NR Pos NeG anti HBs ∑Yg dimonitor ∑Yg diterapi

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
Muara Tebo 0 35 22 1 58 0 0 0 2 56 0 0 0 0 0 0 0 0 0 0 0 58 0 58 0 0 0 0 0 0 0 0
Teluk Singkawang 1 28 19 1 0 25 0 0 1 48 0 0 0 0 0 0 0 0 0 0 0 49 0 49 0 0 0 0 0 0 0 0
Mengupeh 26 84 36 1 55 0 0 0 3 134 0 0 0 0 0 0 0 0 0 0 0 137 0 137 0 3 0 0 0 0 0 0
Pintas Tuo 0 8 4 0 11 1 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 12 0 0 0 0 0 0 0 0
Sungai Bengkal 16 77 35 1 0 0 0 0 1 128 0 0 0 0 0 0 0 0 0 0 0 129 0 129 0 0 0 85 85 0 0 0
Sungai Abang 0 5 5 0 0 10 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0
Rimbo Bujang II 1 144 90 13 0 192 0 0 4 244 0 0 0 0 0 0 0 0 0 0 0 248 0 248 0 1 1 0 0 0 0 0
SP II Sekutur Jaya 4 9 8 0 0 21 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 21 1 20 0 0 0 0 0 0 0 0
Pulau Temiang 9 46 24 1 26 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 80 0 80 0 0 0 0 0 0 0 0
Alai Ilir 0 7 5 0 5 7 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 12 0 0 0 0 0 0 0 0
Rimbo Bujang IX 7 29 15 1 52 0 0 0 1 51 0 0 0 0 0 0 0 0 0 0 0 52 0 52 0 0 0 0 0 0 0 0
Tuo Pasir Mayang 1 4 5 0 5 5 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lubuk Mandarsah 10 27 4 0 23 0 0 0 1 40 0 0 0 0 0 0 0 0 0 0 0 41 0 41 0 1 1 0 0 0 0 0
Tegal Arum 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Teluk rendah 2 1 4 0 3 4 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0
Bangun Seranten 0 6 5 0 0 11 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 11 0 11 0 0 0 0 0 0 0 0
Tlk. Kembang jambu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suo-Suo 2 18 2 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 22 0 22 0 0 0 0 0 0 0 0
79 529 283 19 238 276 0 0 13 887 0 0 0 0 0 0 0 0 0 0 0 900 1 899 0 5 2 85 85 0 0 0

Mengetahui : Muara Tebo, Mei 2019

Kasi P2PM Dinkes Kab. Tebo Pengelola Program

RICHY VERNANDO SAPUTRA,SKM, M.Si HERNITA AM,Keb

NIP : 19831205 200604 1 004 NIP : 19721115 199303 2 003
Bumil 3zero %
35 36 37
58 #DIV/0!
49 #DIV/0!
137 #DIV/0!
12 #DIV/0!
129 #DIV/0!
10 #DIV/0!
248 #DIV/0!
21 #DIV/0!
80 #DIV/0!
12 #DIV/0!
52 #DIV/0!
10 #DIV/0!
0 #DIV/0!
41 #DIV/0!
1 #DIV/0!
0 #DIV/0!
7 #DIV/0!
11 #DIV/0!
0 #DIV/0!
22 #DIV/0!
900 #DIV/0!
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : April 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo 10 51 26 5 0 0 0
Teluk Singkawang 0 0 0 0 0 0 0
Mengupeh 5 19 7 0 0 0 0
Pintas Tuo 1 2 4 0 0 0 0
Sungai Bengkal 12 68 31 2 0 0 0
Sungai Abang 0 19 8 0 0 0 0
Rimbo Bujang II 8 62 27 3 0 100 0
SP II Sekutur Jaya 0 0 0 0 0 0 0
Pulau Temiang 0 0 0 0 0 0 0
Alai Ilir 0 4 8 0 12 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0
Tuo Pasir Mayang 0 0 0 0 0 0 0
Teluk Lancang 0 0 0 0 0 0 0
Lubuk Mandarsah 2 10 2 0 0 0 0
Tegal Arum 1 6 5 1 0 0 0
Sumber Sari 0 0 0 0 0 0 0
Teluk rendah 0 0 0 0 0 0 0
Bangun Seranten 0 3 7 0 0 0 0
Tlk. Kembang jambu 0 0 0 0 0 0 0
Suo-Suo 0 0 0 0 0 0 0
39 244 125 11 12 100 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEP

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3 X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17
0 2 90 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 31 0 0 0 0 0 0
0 0 7 0 0 0 0 0 0
0 1 112 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 100 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 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 14 0 0 0 0 0 0
0 0 13 0 0 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 3 389 0 0 0 0 0 0
SIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26
0 0 0 0 0 92 0 92 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 31 0 31 0
0 0 0 0 0 7 0 7 0
0 0 0 0 0 113 0 113 0
0 0 0 0 0 100 0 100 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 12 0 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 14 0 14 0
0 0 0 0 0 13 0 13 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 0 10 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 392 0 392 0
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 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
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

Muara Tebo, Mei 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : MEI 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo 0 7 10 1 0 0 0
Teluk Singkawang 1 11 8 1 22 0 0
Mengupeh 1 20 2 0 0 0 0
Pintas Tuo 0 2 0 0 0 0 0
Sungai Bengkal 14 86 37 3 0 0 0
Sungai Abang 1 10 4 1 0 0 0
Rimbo Bujang II 5 26 11 1 0 42 0
SP II Sekutur Jaya 2 9 2 0 0 0 0
Pulau Temiang 2 9 3 2 0 0 0
Alai Ilir 1 14 8 0 23 0 0
Rimbo Bujang IX 0 0 0 0 0 0 0
Tuo Pasir Mayang 8 2 0 0 0 0 0
Teluk Lancang 2 7 1 0 0 0 0
Lubuk Mandarsah 0 3 0 0 0 0 0
Tegal Arum 3 4 3 0 0 0 0
Sumber Sari 6 36 72 5 0 0 0
Teluk rendah 1 4 2 10 0 0 0
Bangun Seranten 2 6 0 0 0 0 0
Tlk. Kembang jambu 1 17 13 1 32 0 0
Suo-Suo 0 10 2 0 0 0 0
50 283 178 25 77 42 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEP

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3 X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17
0 0 18 0 0 0 0 0 0
0 0 22 0 0 0 0 0 0
0 0 23 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0
0 1 139 0 0 0 0 0 0
0 0 16 0 0 0 0 0 0
0 1 41 0 0 0 0 0 0
0 1 12 0 0 0 0 0 0
0 0 16 0 0 0 0 0 0
0 1 22 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 10 0 0 0 0 0 0
0 0 19 0 0 0 0 0 0
0 0 3 0 0 0 0 0 0
0 0 10 0 0 0 0 0 0
0 0 121 0 0 0 0 0 0
0 0 8 0 0 0 0 0 0
0 0 8 0 0 0 0 0 0
0 0 32 0 0 0 0 0 0
0 0 12 0 0 0 0 0 0
0 4 534 0 0 0 0 0 0
SIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

∑Yg diperiksa
R NR D ND R NR Pos NeG
anti HBs

18 19 20 21 22 23 24 25 26
0 0 0 0 0 0 0 0 0
0 0 0 0 0 22 0 22 0
0 0 0 0 0 0 0 0 23
0 0 0 0 0 2 0 2 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 16 0 16 16
0 0 0 0 0 0 0 0 0
0 0 0 0 0 13 0 13 0
0 0 0 0 0 16 0 16 0
0 0 0 0 0 230 0 230 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 10 0 10 10
0 0 0 0 0 19 0 19 0
0 0 0 0 0 3 0 3 0
0 0 0 0 0 10 0 10 0
0 0 0 0 0 121 0 121 0
0 0 0 0 0 8 1 7 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 32 0 32 0
0 0 0 0 0 12 0 12 0
0 0 0 0 0 514 1 513 49
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 23 0 0 0 0 0
0 0 0 0 0 0 0
0 0 22 22 1 0 0
16 0 0 0 16 0 0
0 0 0 0 0 0 0
0 0 2 2 2 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 15 15 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 13 13 0 0 0
16 38 52 37 19 0 0

Muara Tebo, Mei 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : JUNI 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo 1 19 14 3 36 0 0
Teluk Singkawang 0 13 8 1 22 0 0
Mengupeh 0 31 15 0 46 0 0
Pintas Tuo 0 2 0 0 0 0 0
Sungai Bengkal 0 106 46 5 0 0 0
Sungai Abang 0 3 3 0 0 0 0
Rimbo Bujang II 5 34 37 1 0 72 0
SP II Sekutur Jaya 0 7 5 0 0 0 0
Pulau Temiang 2 8 3 0 0 0 0
Alai Ilir 0 5 5 1 11 0 0
Rimbo Bujang IX 0 6 5 2 13 0 0
Tuo Pasir Mayang 0 4 5 4 0 0 0
Teluk Lancang 0 6 1 0 0 0 0
Lubuk Mandarsah 0 2 0 0 0 0 0
Tegal Arum 0 9 2 0 0 0 0
Sumber Sari 0 10 10 0 0 0 0
Teluk rendah 1 23 7 0 0 0 0
Bangun Seranten 1 6 6 0 0 0 0
Tlk. Kembang jambu 0 17 7 0 0 0 0
Suo-Suo 0 6 3 0 0 0 0
Kabupaten 10 317 182 17 128 72 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HE

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3
X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17
0 0 36 0 0 0 0 0 0
0 0 22 0 0 0 0 0 0
0 3 43 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0
0 1 156 0 0 0 0 0 0
0 0 6 0 0 0 0 0 0
0 3 69 0 0 0 0 0 0
0 0 12 0 0 0 0 0 0
0 0 11 0 0 0 0 0 0
0 0 11 0 0 0 0 0 0
0 0 13 0 0 0 0 0 0
0 0 13 0 0 0 0 0 0
0 0 7 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0
0 1 10 0 0 0 0 0 0
0 0 20 0 0 0 0 0 0
0 0 30 0 0 0 0 0 0
0 0 12 0 0 0 0 0 0
0 0 24 0 0 0 0 0 0
0 0 9 0 0 0 0 0 0
0 8 508 0 0 0 0 0 0
ASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26
0 0 0 0 0 36 0 36 0
0 0 0 0 0 22 0 22 0
0 0 0 0 0 46 0 46 0
0 0 0 0 0 2 0 2 0
0 0 0 0 0 157 0 157 0
0 0 0 0 0 6 0 6 0
0 0 0 0 0 72 0 72 0
0 0 0 0 0 12 0 12 0
0 0 0 0 0 11 0 11 0
0 0 0 0 0 11 0 11 0
0 0 0 0 0 13 0 13 0
0 0 0 0 0 13 0 13 13
0 0 0 0 0 7 0 7 0
0 0 0 0 0 2 0 2 0
0 0 0 0 0 11 0 11 0
0 0 0 0 0 20 0 20 0
0 0 0 0 0 30 0 30 0
0 0 0 0 0 12 0 12 0
0 0 0 0 0 24 0 24 0
0 0 0 0 0 9 0 9 0
0 0 0 0 0 516 0 516 13
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 31 31 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 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
13 0 0 0 0 0 0
0 0 8 5 0 0 0
0 0 0 0 0 0 0
0 0 1 0 1 0 0
0 0 0 0 0 0 0
0 0 18 18 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 10 10 0 0 8
13 0 69 65 2 0 8

Muara Tebo, Mei 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
 LAPORAN BULANAN REKAPITU

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Triwulan II 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI
∑HBsAg ∑Anti HBs Reaktif
PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI 3 X
IMUNISASI X X
R NR R NR

1 2 3 4 5 6 7 8 9 10 11 12 13
NENGSI ERISE GULTOM, Am.Keb
RUBIATUN Am.Keb
HELMAWATI, Am.Keb
SUJIATI, Am.Keb
NURHIKMAH, Am. Keb
SANIATI, Am Keb
RENI PRIANA,Amd..Keb
PUSPITA HARDAYENI,SKM
YESSI OKTAVIA,Amd.Keb
MAYA SARI.AmD.Keb
RIRIN FITRIWULANDARI,Amd.Keb
YENI DENIATI,Amd.Keb
 Mengetahui :
Kasi P2PM Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM, M.Si

NIP : 19831205 200604 1 004

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2 ∑HBsAg ∑Anti HBs Reaktif

< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI X X IMUNISASI 3 X
R NR R NR
1 2 3 4 5 6 7 8 9 10 11 12 13
ISDON SALDI, SKM
ZULIATUN
DEPITA ELYATI,SKM
DESRAN MUHARDI, S. Kep
JULIANNE, SKM
HAIRUL, AMK
HAMZAH RONI, AMK
dr.SELVI AGUSTYA
Drg. WANDA AMALIA
YULIANTI, AMKL
YETRI YANTI, AMF
ANI SUSANTI,Am.Keb
SULASTRI, AM.Far
DAHLIAWATI, Am.Kep
MULNIYATI, AMAK
RADIAN TIRTAYOSA, Am.Kep
YUSTIANI, AMK
EKA RAUDATISSA'ADAH, AM. Keb
FITRIDAWATI, Am. Keb
DESMA ANGGRAINI, AM. Keb
MUHAMMAD NUR
SAMSUL BAHRI
ROSMAINI
RIRIN ERMAYANTI, A.md. Keb
Mengetahui :
Kasi P2PM Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM, M.Si

NIP : 19831205 200604 1 004
N BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

Rekomendasi JUMLAH BAYI

∑nilai SGPT
∑ Anti Hbe ∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
<2Xbatas >=2Xbatas LAHIR BULAN
normal normal ∑Yg diperiksa INI
R NR R NR D ND R NR Pos NeG anti HBs ∑Yg dimonitor ∑Yg diterapi

14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

0 0 0 0 0 0 0 0 0 0
 Muara Tebo, Juli 2019
Pengelola Program

HERNITA AM,Keb
NIP : 19721115 199303 2 003

HASIL PEMERIKSAAN SETELAH DETEKASI DINI

∑nilai SGPT
∑ Anti Hbe ∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis
<2Xbatas >=2Xbatas
normal normal R NR R NR D ND R NR Pos NeG
14 15 16 17 18 19 20 21 22 23 24 25
0 0 0 0 0
JUMLAH BAYI LAYANAN LAINNYA

DIIMUNISASI ∑IMUNISASI ∑KONSELING KET

DAPAT HBIG
HBO <12 JAM (IBU) (IBU)
Bumil 3zero %
30 31 32 33 34 35 36 37
0 #DIV/0!
0 #DIV/0!
0.0 #DIV/0!
0 #DIV/0!
0.0 #DIV/0!
0.0 #DIV/0!
0.0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0.0 #DIV/0!
0 #DIV/0!
0 #DIV/0!
0 0 0 0 #DIV/0!
Muara Tebo, Juli 2019
Pengelola Program

HERNITA AM,Keb
P : 19721115 199303 2 003
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Semester I 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKASI DINI Rekomendasi JUMLAH BAYI LAYANAN LAINNYA
∑Anti HBs ∑nilai SGPT
∑HBsAg ∑ Anti Hbe ∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR HBsAgReaktif
Reaktif
PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2 LAHIR BULAN DIIMUNISASI ∑IMUNISASI ∑KONSELING KET
< 20 THN 20-29 THN 30-39 THN > 40 THN IMUNISASI 3 X <2Xbatas >=2Xbatas DAPAT HBIG
IMUNISASI X X INI HBO <12 JAM (IBU) (IBU)
normal normal ∑Yg diperiksa
R NR R NR R NR R NR D ND R NR Pos NeG ∑Yg dimonitor ∑Yg diterapi
anti HBs
Bumil 3zero %
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
Muara Tebo 1 0 35 22 1 58 0 0 2 56 0 0 0 0 0 0 0 0 0 0 0 58 0 58 0 0 0 0 0 0 0 0 877 58 6.61
Teluk Singkawang 0 1 28 19 1 0 25 0 1 48 0 0 0 0 0 0 0 0 0 0 0 49 0 49 0 0 0 0 0 0 0 0 349 49 14.04
Mengupeh 0 26 84 36 1 55 0 0 3 134 0 0 0 0 0 0 0 0 0 0 0 137 0 137 0 3 0 0 0 0 0 0 297 137.0 46.13
Pintas Tuo 0 0 8 4 0 11 1 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 12 0 0 0 0 0 0 0 0 221 12 5.43
Sungai Bengkal 0 16 77 35 1 0 0 0 1 128 0 0 0 0 0 0 0 0 0 0 0 129 0 129 0 0 0 85 85 0 0 0 393 129.0 32.82
Sungai Abang 0 0 5 5 0 0 10 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0 343 10.0 2.92
Rimbo Bujang II 5 1 144 90 13 0 192 0 4 244 0 0 0 0 0 0 0 0 0 0 0 248 0 248 0 1 1 0 0 0 0 0 1146 248.0 21.64
SP II Sekutur Jaya 0 4 9 8 0 0 21 0 0 21 0 0 0 0 0 0 0 0 0 0 0 21 1 20 0 0 0 0 0 0 0 0 201 21 10.45
Pulau Temiang 2 9 46 24 1 26 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 80 0 80 0 0 0 0 0 0 0 0 431 80 18.56
Alai Ilir 0 0 7 5 0 5 7 0 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0 12 0 0 0 0 0 0 0 0 542 12 2.21
Rimbo Bujang IX 0 7 29 15 1 52 0 0 1 51 0 0 0 0 0 0 0 0 0 0 0 52 0 52 0 0 0 0 0 0 0 0 483 52 10.77
Tuo Pasir Mayang 0 1 4 5 0 5 5 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0 330 10 3.03
Teluk Lancang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0.00
Lubuk Mandarsah 0 10 27 4 0 23 0 0 1 40 0 0 0 0 0 0 0 0 0 0 0 41 0 41 0 1 1 0 0 0 0 0 236 41 17.37
Tegal Arum 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 289 1 0.35
Sumber Sari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0.00
Teluk rendah 1 2 1 4 0 3 4 0 0 7 0 0 0 0 0 0 0 0 0 0 0 7 0 7 0 0 0 0 0 0 0 0 192 7 3.65
Bangun Seranten 1 0 6 5 0 0 11 0 0 11 0 0 0 0 0 0 0 0 0 0 0 11 0 11 0 0 0 0 0 0 0 0 165 11.0 6.67
Tlk. Kembang jambu 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0.00
Suo-Suo 0 2 18 2 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 22 0 22 0 0 0 0 0 0 0 0 70 22 31.43
10 79 529 283 19 238 276 0 13 887 0 0 0 0 0 0 0 0 0 0 0 900 1 899 0 5 2 85 85 0 0 0 7296 900 12.34
900

Mengetahui : Muara Tebo, Agustus 2019

Kasi P2PM Dinkes Kab. Tebo Pengelola Program

RICHY VERNANDO SAPUTRA,SKM, M.Si HERNITA AM,Keb

NIP : 19831205 200604 1 004 NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : JULI 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo
Teluk Singkawang
Mengupeh
Pintas Tuo
Sungai Bengkal
Sungai Abang
Rimbo Bujang II
SP II Sekutur Jaya
Pulau Temiang
Alai Ilir
Rimbo Bujang IX
Tuo Pasir Mayang
Teluk Lancang
Lubuk Mandarsah
Tegal Arum
Sumber Sari
Teluk rendah
Bangun Seranten
Tlk. Kembang jambu
Suo-Suo
Kabupaten

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI H

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3
X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17
HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34

Muara Tebo, Agustus 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Agustus 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo
Teluk Singkawang
Mengupeh
Pintas Tuo
Sungai Bengkal
Sungai Abang
Rimbo Bujang II
SP II Sekutur Jaya
Pulau Temiang
Alai Ilir
Rimbo Bujang IX
Tuo Pasir Mayang
Teluk Lancang
Lubuk Mandarsah
Tegal Arum
Sumber Sari
Teluk rendah
Bangun Seranten
Tlk. Kembang jambu
Suo-Suo
Kabupaten 0 0 0 0 0 0 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEP

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3
X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0
SIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26

0 0 0 0 0 0 0 0 0
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34

0 0 0 0 0 0 0

Muara Tebo, September 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : September 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo
Teluk Singkawang
Mengupeh
Pintas Tuo
Sungai Bengkal
Sungai Abang
Rimbo Bujang II
SP II Sekutur Jaya
Pulau Temiang
Alai Ilir
Rimbo Bujang IX
Tuo Pasir Mayang
Teluk Lancang
Lubuk Mandarsah
Tegal Arum
Sumber Sari
Teluk rendah
Bangun Seranten
Tlk. Kembang jambu
Suo-Suo
Kabupaten 0 0 0 0 0 0 0

Mengetahui :
Kasi P2 Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI HEP

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3
X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0
SIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26

0 0 0 0 0 0 0 0 0
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34

0 0 0 0 0 0 0

Muara Tebo, Oktober 2019

Pengelola Program/ Pembuata Laporan

HERNITA AM,Keb
NIP : 19721115 199303 2 003
KABUPATEN/KOTA : TEBO
BULAN/TAHUN : Triwulan III 2019

KELOMPOK UMUR STATUS IMUNISASI SAAT INI

PUSKESMAS BELUM IMUNISASI 1 IMUNISASI 2

< 20 THN 20-29 THN 30-39 THN > 40 THN
IMUNISASI X X

1 2 3 4 5 6 7 8
Muara Tebo
Teluk Singkawang
Mengupeh
Pintas Tuo
Sungai Bengkal
Sungai Abang
Rimbo Bujang II
SP II Sekutur Jaya
Pulau Temiang
Alai Ilir
Rimbo Bujang IX
Tuo Pasir Mayang
Teluk Lancang
Lubuk Mandarsah
Tegal Arum
Sumber Sari
Teluk rendah
Bangun Seranten
Tlk. Kembang jambu
Suo-Suo
#NAME? 0 0 0 0 0 0

Mengetahui :
Kasi P2PM Dinkes Kab. Tebo

RICHY VERNANDO SAPUTRA,SKM, M.Si

NIP : 19831205 200604 1 004
 LAPORAN BULANAN REKAPITULASI HASIL DETEKSI DINI H

SASI SAAT INI HASIL PEMERIKSAAN SETELAH DETEKAS

∑nilai SGPT
∑HBsAg ∑Anti HBs Reaktif ∑ Anti Hbe
IMUNISASI 3 X <2Xbatas >=2Xbatas
R NR R NR normal normal R NR

9 10 11 12 13 14 15 16 17

0 0 0 0 0 0 0 0 0
HASIL DETEKSI DINI HEPATITIS B PADA IBU HAMIL

MERIKSAAN SETELAH DETEKASI DINI Rekomendasi

∑ Anti HBeAg HBV DNA ∑Tes HIV ∑Tes Sifilis ∑HBsAgNR

R NR D ND R NR Pos NeG ∑Yg diperiksa

anti HBs

18 19 20 21 22 23 24 25 26

0 0 0 0 0 0 0 0 0
Rekomendasi JUMLAH BAYI LAYANAN LAINNYA

HBsAgReaktif
LAHIR BULAN DIIMUNISASI DAPAT HBIG ∑IMUNISASI ∑KONSELING KET
INI HBO <12 JAM (IBU) (IBU)
∑Yg dimonitor ∑Yg diterapi

27 28 29 30 31 32 33 34

0 0 0 0 0 0 0

Muara Tebo, Oktober 2019

Pengelola Program

HERNITA AM,Keb
NIP : 19721115 199303 2 003