LAPORAN BULANAN

REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA

PUSKESMAS FATUKOPA, BULAN DESEMBER TAHUN 2015

Besnam Taebone Fatukopa Nunfutu Nifulinah

No. ELEMEN DATA
L P L P L P L P L P
I Total Kunjungan KB :
1 Bulan ini 0 6 0 9 0 24 0 15 0 19
2 Kumulatif s.d. Bulan ini 0 76 0 175 0 385 0 189 0 128

II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 0 0 1 0 2 0 1
5 Implant 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 6 0 9 0 24 0 15 0 19
5 Implant 0 0 0 4 0 0 0 6 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
III Kondisi Peserta KB :
1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0
 Pil 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0

4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0

IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0
8 Fasilitas Keseh. Lainnya (sebutkan) 0 0 0 0 0 0 0 0 0 0

VI Kontrasepsi diterima :
1 Pil
2 IUD
3 Kondom
4 Suntik
5 Implant
6 MOW
7 Obat Vagina
8 Lain-lain (sebutkan)

VII Penggunaan :
1 Pil 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 6 0 9 0 24 0 15 0 19
5 Implant 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil
IUD
Kondom
Suntik
Implant
MOW
Obat Vagina
Lainnya sebutkan

Mengetahui Fatukopa, 30 Desember 2015

Kepala Puskesmas Fatukopa Yang Melapor

Rance B. Soinbala, A.Md. Kep Margerita Bagaisar, A.Md. Keb

NIP. 19821020 200604 2 037 NRPTT. 24.4. 027. 414
ARINGNYA
TAHUN 2015

Kiki Ello Total

L P L P L P L+P

0 8 0 11 0 92 92
0 198 0 126 0 1277 1277

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 0 8 8
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 8 0 11 0 92 92
0 2 0 0 0 12 12
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

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

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

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

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

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

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

0
0
0
0
0
0
0
0

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 8 0 11 0 92 92
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

137
0
0
41
10
0
0
0

, A.Md. Keb
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS FATUKOPA, BULAN JANUARI TAHUN 2016

Besnam Taebone Fatukopa Nunfutu Nifulinah Kiki Ello Total

No. ELEMEN DATA
L P L P L P L P L P L P L P L P L+P
I Total Kunjungan KB :
1 Bulan ini 0 1 0 29 0 35 0 27 0 6 0 20 0 14 0 132 132
2 Kumulatif s.d. Bulan ini 0 1 0 29 0 35 0 27 0 6 0 20 0 14 0 132 132

II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 2
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 2 2
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 0 0 8 0 30 0 7 0 5 0 3 0 3 0 56 56
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 21 0 5 0 20 0 1 0 17 0 11 0 76 76
5 Implant 0 0 0 4 0 0 0 6 0 0 0 2 0 0 0 12 12
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Peserta KB Pasca Bersalin :
1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

IV Di rujuk : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Fasilitas Keseh. Lainnya (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VI Kontrasepsi diterima :
1 Pil 0
2 IUD 0
3 Kondom 0
4 Suntik 0
5 Implant 0
6 MOW 0
7 Obat Vagina 0
8 Lain-lain (sebutkan) 0

VII Penggunaan :
1 Pil 105
2 IUD 0
3 Kondom 0
4 Suntik 76
5 Implant 0
6 MOW 0
7 Obat Vagina 0

V Sisa/Stok Kontrasepsi
Pil 32
IUD 0
Kondom 0
Suntik 0
Implant 10
MOW 0
Obat Vagina 0
Lainnya sebutkan 0

Mengetahui Fatukopa, 30 Januari 2016

Kepala Puskesmas Fatukopa Yang Melapor

Rance B. Soinbala, A.Md. Kep Margerita Bagaisar, A.Md. Keb

NIP. 19821020 200604 2 037 NRPTT. 24.4. 027. 414