You are on page 1of 1

Lampiran III

KEGIATAN ANTENATAL CARE (ANC)


N
o

Hari/
Tanggal

1.

Selasa,
10/06/14
Senin,
16/06/14
Senin,
16/06/14

2.
3.

Nama Ibu

Umur
(Thn)

Nurlaila

38

Fiki
wulandari

24

Zubaidah

35

Usia
Kehamil
an

32-34
minggu
30-32
minggu
18-20
minggu

DJJ

BB
(kg)

TD
(mmHg)

TT

TFU

Tab.
Besi/
Hb

148

57,5

120/80

33 cm

+/(-)

139

60

110/70

28 cm

+/(-)

140

80

100/70

15 cm

+/(-)

Banda Aceh, Juni 2014


Menyetujui,
Kepala Puskesmas/DokterPembimbing I

dr. Asti Marningsih


Peg. 800/SKP/006/2014

You might also like