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Final Laporan Berkala.xlsx2
Final Laporan Berkala.xlsx2
Jumlah
Jumlah Peserta Didik Hasil Pemeriksaan Berkala
Sasaran SD/MI Yang
Peserta Didik Dilakukan Jumlah
SD/MI Pemeriksaan Pemberia Strata UKS
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Kela Imunisas Pember Didik
NO Nama Sekolah Cacing KIE
s Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina u an Kes.
Ganggu Berisik Reprod aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual M S O P
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SD 064029 2
3
4
5
6
2 SD 060818 2
3 SD 060829 2 10 14 7 9 0 1 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 16 0 0 0 24 0 0
3 10 11 3 8 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 0 21 0 0
4 17 19 11 2 0 1 0 0 1 0 0 0 7 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 26 0 0
5 17 14 6 11 0 1 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 31 0 0
6 22 9 11 6 0 2 0 0 1 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 31 0 0
JUMLAH 76 57 38 36 0 5 0 1 4 0 0 0 18 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 74 0 0 0 133 0 0
4 2 19
SD 060819 10 11 9 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 20 0 0 0 29 0 0
3 13
12 9 13 0 2 1 1 2 0 0 0 6 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 25 0 0
4 10
13 12 10 0 1 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 23 0 0
5 14 19 14 19 0 0 1 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N O 33 0 0 0 33 0
6 30 18 27 18 0 4 3 2 1 0 0 0 10 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 45 0 0 0 48 0 0
JUMLAH 79 79 73 69 0 7 5 3 3 0 0 0 32 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 142 0 0 0 158 0 0
5 SD 060817 2 16 10 14 8 0 2 1 2 0 0 0 0 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 22 0 0 0 26 0 0
3 13 12 10 11 0 0 1 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 21 0 0 0 25 0 0
4 12 15 8 11 0 0 1 0 0 0 0 0 3 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 19 0 0 0 27 0 0
5 15 10 14 6 0 2 0 0 0 0 0 0 6 0 0 0 0 0 3 0 0 0 N N N N N N N N 0 20 0 0 0 25 0
6 18 11 17 9 0 3 1 1 0 0 0 0 7 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 26 0 0 0 29 0 0
JUMLAH 74 58 63 45 0 7 3 2 3 0 0 0 20 0 0 0 0 0 6 0 0 0 N N N N N N N N 0 108 0 0 0 132 0 0
6 SD 067091 2 12 4 11 4 0 1 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 15 0 0 0 16 0 0
3 12 6 10 6 0 1 1 0 0 0 0 0 4 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 18 0 0
4 7 9 7 9 0 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 16 0 0
5 5 7 6 5 0 3 0 0 0 0 0 0 2 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 11 0 0 0 12 0
6 8 12 8 12 0 3 2 0 0 0 0 0 5 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 20 0 0 0 20 0 0
JUMLAH 44 38 42 36 0 11 3 0 1 0 0 0 15 0 0 0 1 0 5 0 0 0 N N N N N N N N 0 78 0 0 0 82 0 0
7 SD 066650 2
3
4
5
6
8 SD MUHAMMADIAH 2 2
3 3
4 4
5 5
6 6
9 SD PARULIAN A 2 9 10 7 9 0 2 0 0 1 0 0 0 3 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 19 0 0
3 14 11 14 9 0 4 0 2 1 0 0 0 1 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 25 0 0
4 11 6 10 4 0 2 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 14 0 0 0 17 0 0
5 9 13 9 13 0 2 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 22 0 0
6 15 12 14 10 0 2 0 1 0 0 0 0 5 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 24 0 0 0 27 0 0
JUMLAH 58 52 54 45 0 12 0 3 2 0 0 0 14 0 0 0 2 0 2 0 0 0 N N N N N N N N 0 99 0 0 0 110 0 0
10 SD PARULIAN B 2 15 11 9 8 0 0 0 0 2 0 0 O 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 26 0 0
3 11 14 11 10 0 1 0 0 1 0 0 O 6 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 21 0 0 0 22 0 0
4 8 5 7 5 0 3 0 1 0 0 0 O 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 12 0 0 0 13 0 0
5 7 7 6 6 0 1 1 0 0 0 0 O 3 0 0 0 2 0 0 0 0 0 N N N N N N N N 0 12 0 0 0 14 0 0
6 9 13 8 10 0 1 1 1 0 0 0 O 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 18 0 0 0 21 0 0
JUMLAH 50 50 41 39 0 5 2 2 3 0 0 0 20 0 0 0 2 0 0 0 0 0 N N N N N N N N 0 80 0 0 0 96 0 0
11 SD NASRANI 2
3
4
5
6
12 SD PRABHUDY 2
3
4
5
6
13 SD ADVENT 2 12 7 10 6 0 2 0 1 1 0 0 0 10 0 0 0 0 0 1 0 0 0 N N N N N N N N N 16 0 0 0 19 0 0
3 11 11 11 7 0 2 1 1 2 0 0 0 8 0 0 0 1 0 2 0 0 0 N N N N N N N N N 18 0 0 0 22 0 0
4 15 10 13 10 0 0 0 1 0 0 0 0 9 0 0 0 0 0 0 0 0 0 N N N N N N N N N 23 0 0 0 25 0 0
5 11 11 10 10 0 0 0 2 0 0 0 0 10 0 0 0 0 0 2 0 0 0 N N N N N N N N N 20 0 0 0 21 0 0
6 9 14 9 12 0 0 0 2 0 0 0 0 15 0 0 0 0 0 0 0 0 0 N N N N N N N N N 21 0 0 0 23 0 0
JUMLAH 58 53 53 45 0 4 1 7 3 0 0 0 52 0 0 0 1 0 5 0 0 0 N N N N N N N N N 98 0 0 0 111 0 0
14 SD ALWASHLIYAH 2 6 4 4 2 0 1 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 N N N N N N N N N 6 0 0 0 10 0 0
3 5 3 2 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 2 0 0 0 N N N N N N N N N 5 0 0 0 8 0 0
4 5 3 3 3 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N N 8 0 0 0 8 0 0
5 4 9 5 8 0 0 0 1 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N N 11 0 0 0 13 0 0
6 12 6 11 4 0 1 1 4 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N N 15 0 0 0 18 0 0
JUMLAH 32 25 25 20 0 2 1 5 0 0 0 0 18 0 0 0 0 0 4 0 0 0 N N N N N N N N N 45 0 0 0 57 0 0
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
Jumlah
Peserta Didik Hasil Pemeriksaan Berkala
Jumlah Sasaran Peserta SD/MI Yang
Didik SD/MI Dilakukan Jumlah
Pemeriksaan Pemberia
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Imunisas Pember Didik
NO Nama Sekolah Kelas Cacing KIE
Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina Ganggu
u an Kes.
aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi Berisik Reprod
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
1 SD 064029 2 #REF! #REF!
3 #REF! #REF!
4 #REF! #REF!
5 #REF! #REF!
6 #REF! #REF!
2 SD 060818 2 #REF! #REF!
3 #REF! #REF!
4 #REF! #REF!
5 #REF! #REF!
6 #REF! #REF!
3 SD 060829 2 #REF! #REF!
3 #REF! #REF!
4 #REF! #REF!
5 #REF! #REF!
6 #REF! #REF!
4 SD 060819 2 #REF! #REF!
3 #REF! #REF!
4 #REF! #REF!
5 #REF! #REF!
6 #REF! #REF!
5 SD 060817
6 SD 067091
7 SD 066650
8 SD MUHAMMADIAH
9 SD PARULIAN A
10 SD PARULIAN B
11 SD NASRANI 2 18 23 14 18 0 1 1 0 1 0 0 0 6 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 32 0 0 0 41 0
3 16 14 14 11 0 0 3 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 25 0 0 0 30 0
4 16 17 16 13 0 0 0 1 0 0 0 0 13 0 0 0 0 0 0 0 2 0 N N N N N N N N 0 29 1 0 0 33 0
5 18 20 13 14 0 5 2 2 1 0 0 0 9 1 0 0 1 0 0 0 3 0 N N N N N N N N 0 27 1 0 0 38 0
6 11 9 11 9 0 1 0 0 0 0 0 0 6 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 20 1 0 0 20 0
JUMLAH 79 83 68 65 0 7 7 3 2 0 0 0 41 1 0 0 2 0 1 1 5 0 N N N N N N N N 0 133 3 0 0 162 0
12 SD PRABHUDY 2 2 8 1 7 0 0 1 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 8 0 0 0 10 0 0
3 9 10 5 8 0 1 1 0 0 0 0 0 6 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 19 0 0
4 11 5 6 4 0 1 0 0 1 0 0 0 5 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 10 0 0 0 16 0 0
5 4 3 4 2 0 0 0 0 0 0 0 0 2 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 6 0 0 0 7 0 0
6 5 6 5 6 0 1 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 0 11 0 0
JUMLAH 31 32 21 27 0 3 3 0 1 0 0 0 19 3 0 0 3 0 0 0 0 0 N N N N N N N N 0 48 0 0 0 63 0 0
13 SD ADVENT 2 12 7 10 6 0 2 0 1 1 0 0 0 10 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 8 0 0 0 10 0 0
3 11 11 11 7 0 2 1 1 2 0 0 0 8 0 0 0 1 0 2 0 0 0 N N N N N N N N 0 13 0 0 0 19 0 0
4 15 10 13 10 0 0 0 1 1 0 0 0 9 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 10 0 0 0 16 0 0
5 11 11 10 10 0 0 0 2 0 0 0 0 10 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 6 0 0 0 7 0 0
6 9 14 9 12 0 0 0 2 0 0 0 0 15 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 0 11 0 0
JUMLAH 58 53 53 45 0 4 1 7 3 0 0 0 52 0 0 0 1 0 5 0 0 0 N N N N N N N N 0 98 0 0 0 111 0 0
14 SD ALWASHLIYAH
Strata UKS
M S O P
43 44 45 46
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
Jumlah
Jumlah Peserta Didik Hasil Pemeriksaan Berkala
Sasaran SD/MI Yang
Peserta Didik Dilakukan Jumlah
SD/MI Pemeriksaan Pemberia Strata UKS
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Imunisas Pember Didik
NO Nama Sekolah Kelas Cacing KIE
Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina Ganggu
u an Kes.
aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi Berisik Reprod
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual M S
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 SD 064029 2 44 22 44 22 0 1 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 66 0 0 0 66 0 0 0 0
3 30 16 29 16 0 0 1 0 1 0 0 0 4 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 45 0 0 0 46 0 0 0 0
4 34 29 33 28 0 2 1 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 61 0 0 0 63 0 0 0 0
5 26 18 26 18 0 0 0 0 0 0 0 0 7 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 44 0 0 0 44 0 0 0 0
6 33 27 30 25 0 0 1 0 0 0 0 0 10 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 56 0 0 0 60 0 0 0 0
JUMLAH 167 112 162 109 0 3 3 0 1 0 0 0 41 0 0 0 3 0 2 0 0 0 N N N N N N N N 0 271 0 0 0 279 0 0 0 0
2 SD 060818 2 21 38 21 36 0 1 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 57 0 0 0 59 0 0 0 0
3 31 20 30 20 0 0 1 0 0 0 0 0 12 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 50 0 0 0 51 0 0 0 0
4 29 28 28 27 0 2 0 0 1 0 0 0 8 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 55 0 0 0 57 0 0 0 0
5 25 24 25 23 0 1 2 0 0 0 0 0 5 0 0 0 1 0 2 0 0 0 N N N N N N N N 0 48 0 0 0 49 0 0 0 0
6 36 40 35 38 0 2 0 0 0 0 0 0 4 0 0 0 2 0 1 0 0 0 N N N N N N N N 0 73 0 0 0 76 0 0 0 0
JUMLAH 142 150 139 144 0 6 3 0 1 0 0 0 42 0 0 0 3 0 5 0 0 0 N N N N N N N N 0 283 0 0 0 292 0 0 0 0
7 SD 066650 2
3
4
5
Strata UKS
O P
45 46
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
Jumlah
Jumlah Peserta Didik Hasil Pemeriksaan Berkala
Sasaran SD/MI Yang
Peserta Didik Dilakukan Jumlah
SD/MI Pemeriksaan Pemberia Strata UKS
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Imunisas Pember Didik
NO Nama Sekolah Kelas Cacing KIE
Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina Ganggu
u an Kes.
aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi Berisik Reprod
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual M S
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
2 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
3 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
4 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
Dst…….
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
Strata UKS
O P
45 46
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
Jumlah
Jumlah Peserta Didik Hasil Pemeriksaan Berkala
Sasaran SD/MI Yang
Peserta Didik Dilakukan Jumlah
SD/MI Pemeriksaan Pemberia Strata UKS
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Imunisas Pember Didik
NO Nama Sekolah Kelas Cacing KIE
Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina Ganggu
u an Kes.
aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi Berisik Reprod
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual M S
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
2 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
3 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
4 #REF! #REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
#REF! #REF! #REF!
5 #REF! #REF! #REF!
7 SD 066650 2 27 32 25 32 0 2 0 0 0 0 0 0 5 0 0 0 0 0 3 0 0 0N N N N N N N N 0 57 0 0 0 59 0 0
3 22 16 19 16 0 3 2 0 0 0 0 0 7 0 0 0 1 0 0 0 0 0N N N N N N N N 0 35 0 0 0 38 0 0
4 32 22 32 22 0 2 0 0 0 0 0 0 5 0 0 0 2 0 4 0 0 0N N N N N N N N 0 54 0 0 0 54 0 0
5 22 24 22 22 0 1 1 0 1 0 0 0 8 0 0 0 1 0 2 0 0 0N N N N N N N N 0 44 0 0 0 46 0 0
103 94 98 92 0 8 3 0 1 0 0 0 25 0 0 0 4 0 9 0 0 0N N N N N N N N 0 190 0 0 0 197 0 0
8 SD Muhammadiyah 2 6 15 6 14 0 0 1 0 0 0 0 0 3 0 0 0 0 0 2 0 0 0N N N N N N N N 0 20 0 0 0 21 0 0
3 15 17 15 17 0 2 2 0 0 0 0 0 3 0 0 0 1 0 3 0 0 0N N N N N N N N 0 32 0 0 0 32 0 0
4 17 19 17 17 0 1 0 1 0 0 0 0 5 0 0 0 1 0 2 0 0 0N N N N N N N N 0 34 0 0 0 36 0 0
5 18 19 16 18 0 1 0 2 0 0 0 0 2 0 0 0 2 0 0 0 0 0N N N N N N N N 0 34 0 0 0 37 0 0
56 70 54 66 0 4 3 3 0 0 0 0 13 0 0 0 4 0 7 0 0 0N N N N N N N N 0 120 0 0 0 126 0 0
Strata UKS
O P
45 46
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
Jumlah
Jumlah Peserta Didik Hasil Pemeriksaan Berkala
Sasaran SD/MI Yang
Peserta Didik Dilakukan Jumlah
SD/MI Pemeriksaan Pemberia Strata UKS
Peserta
Berkala Penilaian Status Gizi Mata / Penglihatan Telinga / Pendengaran n Obat
Imunisas Pember Didik
NO Nama Sekolah Kelas Cacing KIE
Perilak Ganggu Gangguan Mental Emosional Modalitas Belajar i ian TTD
*Daerah
Memiliki
Penggun Kebugar Buku Rapor
Risiko Anemia Hipert Karies Kelaina Ganggu
u an Kes.
aan Alat an Dirujuk Tertentu
Kesehatan
TB/U ensi Berisik Reprod
n Low Buta Kaca Serum an Bantu Jasmani
L P L P SK K G O (Stunti Infeksi o uksi
Refrak Vision Warna Mata en Pendeng Kinest
ng) L P E C H P Pr Audio Visual M S
si aran etik
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 SD 064029 2 44 22 44 22 0 1 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 66 0 0 0 66 0 0 0 0
3 30 16 29 16 0 0 1 0 1 0 0 0 4 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 45 0 0 0 46 0 0 0 0
4 34 29 33 28 0 2 1 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 61 0 0 0 63 0 0 0 0
5 26 18 26 18 0 0 0 0 0 0 0 0 7 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 44 0 0 0 44 0 0 0 0
6 33 27 30 25 0 0 1 0 0 0 0 0 10 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 56 0 0 0 60 0 0 0 0
JUMLAH 167 112 162 109 0 3 3 0 1 0 0 0 41 0 0 0 3 0 2 0 0 0 N N N N N N N N 0 271 0 0 0 279 0 0 0 0
2 SD 060818 2 21 38 21 36 0 1 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 57 0 0 0 59 0 0 0 0
3 31 20 30 20 0 0 1 0 0 0 0 0 12 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 50 0 0 0 51 0 0 0 0
4 29 28 28 27 0 2 0 0 1 0 0 0 8 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 55 0 0 0 57 0 0 0 0
5 25 24 25 23 0 1 2 0 0 0 0 0 5 0 0 0 1 0 2 0 0 0 N N N N N N N N 0 48 0 0 0 49 0 0 0 0
6 36 40 35 38 0 2 0 0 0 0 0 0 4 0 0 0 2 0 1 0 0 0 N N N N N N N N 0 73 0 0 0 76 0 0 0 0
JUMLAH 142 150 139 144 0 6 3 0 1 0 0 0 42 0 0 0 3 0 5 0 0 0 N N N N N N N N 0 283 0 0 0 292 0 0 0 0
3 SD 060829 2 10 14 7 9 0 1 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 16 0 0 0 24 0 0
3 10 11 3 8 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 0 21 0 0
4 17 19 11 2 0 1 0 0 1 0 0 0 7 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 26 0 0
5 17 14 6 11 0 1 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 31 0 0
6 22 9 11 6 0 2 0 0 1 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 31 0 0
JUMLAH 76 57 38 36 0 5 0 1 4 0 0 0 18 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 74 0 0 0 133 0 0
4 SD 060819 2 10 19 11 9 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 20 0 0 0 29 0 0
3 12 13 9 13 0 2 1 1 2 0 0 0 6 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 25 0 0
4 13 10 12 10 0 1 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 23 0 0
5 14 19 14 19 0 0 1 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N O 33 0 0 0 33 0
6 30 18 27 18 0 4 3 2 1 0 0 0 10 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 45 0 0 0 48 0 0
JUMLAH 79 79 73 69 0 7 5 3 3 0 0 0 32 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 142 0 0 0 158 0 0
5 SD 060817 2 16 10 14 8 0 2 1 2 0 0 0 0 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 22 0 0 0 26 0 0
3 13 12 10 11 0 0 1 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 21 0 0 0 25 0 0
4 12 15 8 11 0 0 1 0 0 0 0 0 3 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 19 0 0 0 27 0 0
5 15 10 14 6 0 2 0 0 0 0 0 0 6 0 0 0 0 0 3 0 0 0 N N N N N N N N 0 20 0 0 0 25 0
6 18 11 17 9 0 3 1 1 0 0 0 0 7 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 26 0 0 0 29 0 0
JUMLAH 74 58 63 45 0 7 3 2 3 0 0 0 20 0 0 0 0 0 6 0 0 0 N N N N N N N N 0 108 0 0 0 132 0 0
6 SD 067091 2 12 4 11 4 0 1 0 0 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 15 0 0 0 16 0 0
3 12 6 10 6 0 1 1 0 0 0 0 0 4 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 18 0 0
4 7 9 7 9 0 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 16 0 0
5 5 7 6 5 0 3 0 0 0 0 0 0 2 0 0 0 1 0 1 0 0 0 N N N N N N N N 0 11 0 0 0 12 0
6 8 12 8 12 0 3 2 0 0 0 0 0 5 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 20 0 0 0 20 0 0
JUMLAH 44 38 42 36 0 11 3 0 1 0 0 0 15 0 0 0 1 0 5 0 0 0 N N N N N N N N 0 78 0 0 0 82 0 0
7 SD 066650 2 27 32 25 32 0 2 0 0 0 0 0 0 5 0 0 0 0 0 3 0 0 0N N N N N N N N 0 57 0 0 0 59 0 0
3 22 16 19 16 0 3 2 0 0 0 0 0 7 0 0 0 1 0 0 0 0 0N N N N N N N N 0 35 0 0 0 38 0 0
4 32 22 32 22 0 2 0 0 0 0 0 0 5 0 0 0 2 0 4 0 0 0N N N N N N N N 0 54 0 0 0 54 0 0
5 22 24 22 22 0 1 1 0 1 0 0 0 8 0 0 0 1 0 2 0 0 0N N N N N N N N 0 44 0 0 0 46 0 0
JUMLAH 103 94 98 92 0 8 3 0 1 0 0 0 25 0 0 0 4 0 9 0 0 0N N N N N N N N 0 190 0 0 0 197 0 0
8 SD MUHAMMADIAH 2 6 15 6 14 0 0 1 0 0 0 0 0 3 0 0 0 0 0 2 0 0 0N N N N N N N N 0 20 0 0 0 21 0 0
3 15 17 15 17 0 2 2 0 0 0 0 0 3 0 0 0 1 0 3 0 0 0N N N N N N N N 0 32 0 0 0 32 0 0
4 17 19 17 17 0 1 0 1 0 0 0 0 5 0 0 0 1 0 2 0 0 0N N N N N N N N 0 34 0 0 0 36 0 0
5 18 19 16 18 0 1 0 2 0 0 0 0 2 0 0 0 2 0 0 0 0 0N N N N N N N N 0 34 0 0 0 37 0 0
JUMLAH 56 70 54 66 0 4 3 3 0 0 0 0 13 0 0 0 4 0 7 0 0 0N N N N N N N N 0 120 0 0 0 126 0 0
9 SD PARULIAN A 2 9 10 7 9 0 2 0 0 1 0 0 0 3 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 16 0 0 0 19 0 0
3 14 11 14 9 0 4 0 2 1 0 0 0 1 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 25 0 0
4 11 6 10 4 0 2 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 14 0 0 0 17 0 0
5 9 13 9 13 0 2 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 22 0 0 0 22 0 0
6 15 12 14 10 0 2 0 1 0 0 0 0 5 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 24 0 0 0 27 0 0
JUMLAH 58 52 54 45 0 12 0 3 2 0 0 0 14 0 0 0 2 0 2 0 0 0 N N N N N N N N 0 99 0 0 0 110 0 0
10 SD PARULIAN B 2 15 11 9 8 0 0 0 0 2 0 0 O 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 17 0 0 0 26 0 0
3 11 14 11 10 0 1 0 0 1 0 0 O 6 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 21 0 0 0 22 0 0
4 8 5 7 5 0 3 0 1 0 0 0 O 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 12 0 0 0 13 0 0
5 7 7 6 6 0 1 1 0 0 0 0 O 3 0 0 0 2 0 0 0 0 0 N N N N N N N N 0 12 0 0 0 14 0 0
6 9 13 8 10 0 1 1 1 0 0 0 O 3 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 18 0 0 0 21 0 0
JUMLAH 50 50 41 39 0 5 2 2 3 0 0 0 20 0 0 0 2 0 0 0 0 0 N N N N N N N N 0 80 0 0 0 96 0 0
11 SD NASRANI 2 18 23 14 18 0 1 1 0 1 0 0 0 6 0 0 0 0 0 1 1 0 0N N N N N N N N 0 32 0 0 0 41 0 0
3 16 14 14 11 0 0 3 0 0 0 0 0 7 0 0 0 0 0 1 1 0 0N N N N N N N N 0 25 0 0 0 30 0 0
4 16 17 16 13 0 0 1 2 0 0 0 0 13 0 0 0 0 0 0 0 2 0N N N N N N N N 0 29 1 0 0 33 0 0
5 18 20 13 14 0 5 2 0 1 0 0 0 9 0 0 0 1 0 0 0 3 0N N N N N N N N 0 27 1 0 0 38 0 0
6 11 9 11 9 0 1 0 1 0 0 0 0 6 1 0 0 1 0 0 0 0 0N N N N N N N N 0 20 1 0 0 20 0 0
JUMLAH 79 83 68 65 0 7 7 3 2 0 0 0 41 1 0 0 2 0 2 2 5 0N N N N N N N N 0 133 3 0 0 162 0 0
12 SD PRABHUDY 2 2 8 1 7 0 0 1 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 8 0 0 0 10 0 0 0 0
3 9 10 5 8 0 1 1 0 0 0 0 0 6 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 13 0 0 0 19 0 0 0 0
4 11 5 6 4 0 1 0 0 1 0 0 0 5 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 10 0 0 0 16 0 0 0 0
5 4 3 4 2 0 0 0 0 0 0 0 0 2 1 0 0 1 0 0 0 0 0 N N N N N N N N 0 6 0 0 0 7 0 0 0 0
6 5 6 5 6 0 1 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 0 11 0 0 0 0
JUMLAH 31 32 21 27 0 3 3 0 1 0 0 0 19 3 0 0 3 0 0 0 0 0 N N N N N N N N 0 48 0 0 0 63 0 0 0 0
13 SD ADVENT 2 12 7 10 6 0 2 0 1 1 0 0 0 10 0 0 0 0 0 1 0 0 0 N N N N N N N N N 16 0 0 0 19 0 0 0 0
3 11 11 11 7 0 2 1 1 2 0 0 0 8 0 0 0 1 0 2 0 0 0 N N N N N N N N N 18 0 0 0 22 0 0 0 0
4 15 10 13 10 0 0 0 1 0 0 0 0 9 0 0 0 0 0 0 0 0 0 N N N N N N N N N 23 0 0 0 25 0 0 0 0
5 11 11 10 10 0 0 0 2 0 0 0 0 10 0 0 0 0 0 2 0 0 0 N N N N N N N N N 20 0 0 0 21 0 0 0 0
6 9 14 9 12 0 0 0 2 0 0 0 0 15 0 0 0 0 0 0 0 0 0 N N N N N N N N N 21 0 0 0 23 0 0 0 0
JUMLAH 58 53 53 45 0 4 1 7 3 0 0 0 52 0 0 0 1 0 5 0 0 0 N N N N N N N N N 98 0 0 0 111 0 0 0 0
14 SD ALWASHLIYAH 2 6 4 4 2 0 1 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 N N N N N N N N N 6 0 0 0 10 0 0 0 0
3 5 3 2 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 2 0 0 0 N N N N N N N N N 5 0 0 0 8 0 0 0 0
4 5 3 3 3 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 N N N N N N N N N 8 0 0 0 8 0 0 0 0
5 4 9 5 8 0 0 0 1 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N N 11 0 0 0 13 0 0 0 0
6 12 6 11 4 0 1 1 4 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N N 15 0 0 0 18 0 0 0 0
JUMLAH 32 25 25 20 0 2 1 5 0 0 0 0 18 0 0 0 0 0 4 0 0 0 N N N N N N N N N 45 0 0 0 57 0 0 0 0
JUMLAH KESELURUHAN 1049 953 931 838 0 84 37 29 24 0 0 0 370 4 0 0 24 0 47 2 5 0 N N N N N N N N N 1770 3 0 0 2022 0 0 0 0
O P
45 46
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP A 2
3
2 SMP B 2
3
3 SMP C 2
3
4 SMP D 2
3
5 SMP E 2
3
Dst….
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS SIMPANG LIMUN KOTA MEDAN TAHUN AJARAN 2023/2024
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP N 8 8
9
2 SMP YPK 8
9
JUMLAH
3 SMP NASRANI 8
9
4 SMP YAPIM 8
9
JUMLAH
5 SMP PGRI 8
9
JUMLAH
6 SMP ADVENT 8
9
7 SMP IT 8
9
JUMLAH
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP N 8
2 SMP YPK
3 SMP NASRANI 8 26 23 21 20 0 5 3 1 0 0 0 0 7 1 0 0 1 1 0 0 0 0 N N N N N N N 1 0 41 1 0 23 0 0 0 0 0 0 0
9 24 29 20 28 0 1 1 6 0 0 0 0 8 2 1 0 2 0 0 0 6 0 N N N N N N N N 0 48 0 0 29 0 0 0 0 0 0 0
JUMLAH 50 52 41 48 0 6 4 7 0 0 0 0 15 3 1 0 3 1 0 0 6 0 N N N N N N N N 0 89 1 0 51 0 0 0 0 0 0 0
4 SMP YAPIM
5 SMP PGRI
6 SMP ADVENT 8 22 18 17 17 0 0 1 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 34 0 0 18 0 0 0 0 0 0 0
9 13 13 11 12 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 23 0 0 13 0 0 0 0 0 0 0
JUMLAH 35 31 28 29 0 0 1 0 0 0+M28:AS28 0 0 15 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 57 0 0 31 0 0 0 0 0 0 0
7 SMP IT
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMPN 8 8 0 0
9
2 SMP YPK 8 27 16 22 15 0 3 2 0 1 0 1 0 6 0 0 0 5 0 0 0 0 0 N N N N N N N N 0 37 0 0 16 0 0 0 0 0 0 0
9 21 25 20 22 0 3 1 1 0 0 0 0 5 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 42 0 0 25 0 0 0 0 0 0 0
JUMLAH 48 41 42 37 0 6 3 1 1 0 1 0 11 0 0 0 5 0 1 0 0 0 N N N N N N N N 0 79 0 0 41 0 0 0 0 0 0 0
3 SMP NASRANI 8 0 0
9 0 0
4 SMP YAPIM 8 11 16 10 13 0 0 1 1 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 23 0 0 16 0 0 0 0 0 0 0
9 16 15 13 12 0 0 1 0 1 0 0 0 5 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 25 0 0 15 0 0 0 0 0 0 0
JUMLAH 27 31 23 25 0 0 2 1 2 0 0 0 9 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 48 0 0 31 0 0 0 0 0 0 0
5 SMP PGRI 8 16 14 10 8 0 0 0 1 0 0 0 0 8 0 0 0 0 0 0 0 3 0 N N N N N N N N 0 18 3 0 8 0 0 0 0 0 0 0
9 12 13 12 13 0 1 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 25 0 0 13 0 0 0 0 0 0 0
JUMLAH 28 27 22 21 0 1 0 1 0 0 0 0 13 0 0 0 0 0 0 0 3 0 N N N N N N N N 0 43 3 0 21 0 0 0 0 0 0 0
6 SMP ADVENT 8 8
9 9
7 SMP IT 8 25 21 22 15 0 7 1 4 0 0 0 0 1 0 1 0 1 1 1 0 1 0N N N N N N N N 0 37 2 0 21 0 0 0 0 0 0 0
9 10 12 8 11 0 1 0 3 0 0 0 0 2 0 0 0 0 0 3 0 0 0N N N N N N N N 0 19 3 0 12 0 0 0 0 0 0 0
JUMLAH 35 33 30 26 0 8 1 7 0 0 0 0 3 0 1 0 1 1 4 0 1 0N N N N N N N N 0 56 5 0 33 0 0 0 0 0 0 0
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP A 2 0 0
3 0 0
2 SMP B 2 0 0
3 0 0
3 SMP C 2 0 0
3 0 0
4 SMP D 2 0 0
3 0 0
5 SMP E 2 0 0
3 0 0
Dst….
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP N 8 8 146 165 146 160 2 10 5 2 2 0 0 0 15 6 0 0 6 0 10 0 4 0 N N N N N N N N 0 306 0 0 165 0 0 0 0 0 0 0
0 0
2 SMP B 2 0 0
3 0 0
3 SMP C 2 0 0
3 0 0
4 SMP D 2 0 0
3 0 0
5 SMP E 2 0 0
3 0 0
Dst….
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………..
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMP N 8 8 146 165 146 160 2 10 5 2 2 0 0 0 15 6 0 0 6 0 10 0 4 0 N N N N N N N N 0 306 0 0 165 0 0 0 0 0 0 0
2 SMP YPK 8 27 16 22 15 0 3 2 0 1 0 1 0 6 0 0 0 5 0 0 0 0 0 N N N N N N N N 0 37 0 0 16 0 0 0 0 0 0 0
9 21 25 20 22 0 3 1 1 0 0 0 0 5 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 42 0 0 25 0 0 0 0 0 0 0
3 SMP NASRANI 8 26 23 21 20 0 5 3 1 0 0 0 0 7 1 0 0 1 1 0 0 0 0 N N N N N N N 1 0 41 1 0 23 0 0 0 0 0 0 0
9 24 29 20 28 0 1 1 6 0 0 0 0 8 2 1 0 2 0 0 0 6 0 N N N N N N N N 0 48 0 0 29 0 0 0 0 0 0 0
4 SMP YAPIM 8 11 16 10 13 0 0 1 1 1 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 23 0 0 16 0 0 0 0 0 0 0
9 16 15 13 12 0 0 1 0 1 0 0 0 5 0 0 0 0 0 1 0 0 0 N N N N N N N N 0 25 0 0 15 0 0 0 0 0 0 0
5 SMP PGRI 8 16 14 10 8 0 0 0 1 0 0 0 0 8 0 0 0 0 0 0 0 3 0 N N N N N N N N 0 18 3 0 8 0 0 0 0 0 0 0
9 12 13 12 13 0 1 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 25 0 0 13 0 0 0 0 0 0 0
6 SMP ADVENT 8 22 18 17 17 0 0 1 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 34 0 0 18 0 0 0 0 0 0 0
9 13 13 11 12 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 23 0 0 13 0 0 0 0 0 0 0
Kepala Puskesmas ……………………………..
7 SMP IT 8 25 21 22 15 0 7 1 4 0 0 0 0 1 0 1 0 1 1 1 0 1 0N N N N N N N N 0 37 2 0 21 0 0 0 0 0 0 0
9 10 12 8 11 0 1 0 3 0 0 0 0 2 0 0 0 0 0 3 0 0 0N N N N N N N N 0 19 3 0 12 0 0 0 0 0 0 0
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA A 2
3
2 SMA B 2
3
3 SMA C 2
3
4 SMA D 2
3
5 SMA E 2
3
6 SMA F 2
3
7 SMA G 2
3
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA A 2 0 0
3 0 0
2 SMA B 2 0 0
3 0 0
3 SMA C 2 0 0
3 0 0
4 SMA D 2 0 0
3 0 0
5 SMA E 2 0 0
3 0 0
6 SMA F 2 0 0
3 0 0
7 SMA G 2 0 0
3 0 0
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA YPK 11 40 50 35 48 0 2 0 0 0 0 0 0 2 0 0 0 3 0 0 0 0 0 N N N N N N N N 0 83 0 0 50 0 0 0
12 45 38 23 15 0 1 2 0 0 0 0 0 2 0 0 0 2 0 1 0 0 0 N N N N N N N N 0 38 0 0 38 0 0 0
JUMLAH 85 88 58 63 0 3 2 0 0 0 0 0 4 0 0 0 5 0 1 0 0 0 N N N N N N N N 0 121 0 0 88 0 0 0
2 SMK YPK 11 38 51 35 45 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 80 0 0 51 0 0 0
12 31 112 27 80 0 2 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 107 0 0 112 0 0 0
JUMLAH 69 163 62 125 0 4 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 N N N N N N N N 0 187 0 0 163 0 0 0
3 SMA NASRANI 11 15 11 15 11 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 26 0 0 11 0 0 0
12 6 9 6 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 15 0 0 9 0 0 0
JUMLAH 21 20 21 20 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 41 0 0 20 0 0 0
4 SMA ADVENT 11
12
JUMLAH
5 SMA YAPIM
6 SMK TI YAPIM
8 SMK BM YAPIM
9 SMK ADVENT 11 8 4 8 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 12 0 0 4 0 0 0
12 9 4 8 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 4 0 0 0
17 8 16 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 23 0 0 8 0 0 0
(………………………………………)
NIP …………………………………..
NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA YPK
JUMLAH
2 SMK YPK
JUMLAH
3 SMA NASRANI
JUMLAH
4 SMA ADVENT 11 23 25 23 24 0 2 1 0 0 0 0 0 0 2 0 0 0 2 2 0 0 0 N N N N N N N N 0 47 0 0 25 0 0 0
5 SMA YAPIM 11 53 49 52 47 0 2 1 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 N N N N N N N N 0 99 0 0 49 0 0 0
JUMLAH
6 SMK TI YAPIM
JUMLAH
JUMLAH
8 SMK BM YAPIM 11 2 34 2 33 0 1 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 25 0 0 34 0 0 0
JUMLAH
9 SMK ADVENT
JUMLAH
(………………………………………)
NIP …………………………………..
………………………………………..
NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA A 2 0 0
3 0 0
2 SMA B 2 0 0
3 0 0
3 SMA C 2 0 0
3 0 0
4 SMA D 2 0 0
3 0 0
5 SMA E 2 0 0
3 0 0
6 SMA F 2 0 0
3 0 0
7 SMA G 2 0 0
3 0 0
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA A 2 0 0
3 0 0
2 SMA B 2 0 0
3 0 0
3 SMA C 2 0 0
3 0 0
4 SMA D 2 0 0
3 0 0
5 SMA E 2 0 0
3 0 0
6 SMA F 2 0 0
3 0 0
7 SMA G 2 0 0
3 0 0
TOTAL
Medan ,
Yang melaporkan,
Pengelola Program UKS Kepala Puskesmas ……………………………..
(………………………………………) ………………………………………..
NIP ………………………………….. NIP. ……………………….
LAPORAN KEGIATAN KESEHATAN ANAK USIA SEKOLAH DAN REMAJA DI SEKOLAH
PUSKESMAS ……………………………………… KOTA MEDAN TAHUN AJARAN ……………………….
1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 SMA YPK 11 40 50 35 48 0 2 0 0 0 0 0 0 2 0 0 0 3 0 0 0 0 0 N N N N N N N N 0 83 0 0 50 0 0 0 0 0 0 0
12 45 38 23 15 0 1 2 0 0 0 0 0 2 0 0 0 2 0 1 0 0 0 N N N N N N N N 0 38 0 0 38 0 0 0 0 0 0 0
2 SMK YPK 11 38 51 35 45 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 80 0 0 51 0 0 0 0 0 0 0
12 31 112 27 80 0 2 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 N N N N N N N N 0 107 0 0 112 0 0 0 0 0 0 0
3 SMA NASRANI 11 15 11 15 11 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 26 0 0 11 0 0 0 0 0 0 0
12 6 9 6 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 15 0 0 9 0 0 0 0 0 0 0
4 SMA ADVENT 11 23 25 23 24 0 2 1 0 0 0 0 0 0 2 0 0 0 2 2 0 0 0 N N N N N N N N 0 47 0 0 25 0 0 0 0 0 0 0
0 0 0 0
5 SMA YAPIM 11 53 49 52 47 0 2 1 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 N N N N N N N N 0 99 0 0 49 0 0 0 0 0 0 0
0 0 0 0
8 SMK BM YAPIM 11 2 34 2 33 0 1 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 N N N N N N N N 0 25 0 0 34 0 0 0
9 SMK ADVENT 11 8 4 8 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 12 0 0 4 0 0 0
12 9 4 8 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N N N N N N N N 0 11 0 0 4 0 0 0
JUMLAH KESELURUHAN 415 434 340 363 0 18 10 2 1 0 0 0 10 4 0 0 11 2 6 0 0 0N N N N N N N N 0 693 0 0 434 0 0 0