Laporan Partus / Persalin

Bulan : 21 Mei - 20 Ju
Tahun : 2017
Instansi : RS Islam Bon

NAMA ALAMAT DOMISILI

TGL PARTUS UMUR G/P/A
IBU SUAMI RT KELURAHAN
22/5/17 Samsiar Abd Hamid 38 7 Bontang Baru 4/3/0
22/5/17 Rosnania Amran 42 3 Gn. Telihan 5/4/0
23/5/17 Mardiana Mustakim 31 31 Berbas Tengah 2/1/0
24/5/17 Lita Irwan 31 13 Berbas Tengah 4/3/0
25/5/17 Kiki Supriadi 36 24 Bontang Baru 2/1/0
25/5/17 Rubaidah Matsuri 27 13 BTG - SGT 4/2/1
25/5/17 Basiyah Haris 27 23 Tj. Laut 2/1/0
26/5/17 Almus Salamang 39 Api-api 3/3/0
27/5/17 Dita Edi 24 29 Gn. Elai 1/0/0
27/5/17 Lia Imam 30 45 Gn. Elai 3/2/0
27/5/17 Nurhidayat Afif 32 24 Api-api 1/0/0
28/5/17 Darus Danu 34 Gn. Elai 4/2/1
30/5/17 Putriana Rusli 28 10 Bontang Baru 1/0/0
31/5/17 Sumiat Muh Faisal 37 33 Tj. Laut 1/0/0
31/5/17 Rani Wanhar 28 51 Berbas Tengah 3/1/1
31/5/17 Sant Jhon 33 23 Gn. Telihan 4/2/1
2/6/2017 Sri Astut Rubang 30 30 Api-api 2/1/0
3/6/2017 Amirul Agus 36 9 Gn. Elai 1/0/0
4/6/2017 Rani Puspita Pribowo 30 23 Bontang Baru 2/1/0
4/6/2017 Ernita Safrudin 32 8 Bontang Kuala 2/1/0
4/6/2017 Asnidar M Arsyad 33 Teluk Pandan 3/2/0
5/6/2017 Sit Riatun Mahfud 24 Gn. Elai 1/0/0
5/6/2017 Syarifah Didit 25 5 Bontang Baru 1/0/0
6/6/2017 Elvina Didi Saputra 34 Gn. Elai 3/2/0
6/6/2017 Ani Latfah Makmur 27 35 Api-api 3/2/0
6/6/2017 Nur F Nur A 25 34 Tj. Laut 1/0/0
6/6/2017 Suharni Umar 29 Teluk Pandan 2/1/0
7/6/2017 Sit Kuraesin Didik 38 20 Satmpo 3/2/0
7/6/2017 Rusnah M Nasrullah 35 19 Gn. Elai 4/3/0
7/6/2017 Anita Sri Mulyono 28 30 Gn. Telihan 1/0/0
7/6/2017 Marlina Lukman 40 Gn. Elai 4/3/1
9/6/2017 Nirmala Ahmad 25 15 Tj. Laut 1/0/0
10/6/2017 Eva Melia Suyanto 27 15 Gn. Telihan 1/0/0
10/6/2017 Vevi Yulianita Arafik 35 21 Bontang Baru 4/2/0
10/6/2017 Julita Edi 24 44 Belimbing 2/1/0
11/6/2017 Polina Sini Bunga 24 11 Kanaan 2/1/0
11/6/2017 Sidratul Iksan 20 Segendis 2/1/0
11/6/2017 Ludia Samual 33 12 Kanaan 6/4/1
11/6/2017 Ramisa Anwar 34 Belimbing 4/3/0
12/6/2017 Ririn Kamaluddin 28 7 Gn. Elai 2/1/0
13/6/2017 Muliana Heryawan 21 24 Satmpo 1/0/0
13/6/2017 Anugrah Zulkifli 25 16 Loktuan 2/1/0
13/6/2017 Rahmawat Ardilas 27 Kanaan 2/1/0
13/6/2017 Astut Matarima 33 Teluk Pandan 2/1/0
13/6/2017 Samsinar Yunus 35 20 Sebuntal 2/1/0
13/6/2017 Erika Indra 20 28 Loktuan 2/0/1
14/6/2017 Widyastut Muh Zaki 33 Tj. Laut 5/3/1
14/6/2017 Fatmawat Sulman 30 5 Berbas Pantai 2/1/0
14/6/2017 Nungki Krisna 31 2 Berbas Tengah 3/2/0

NO Nama KelurahanJumlah
1 Kanaan 3
2 Gn. Telihan 4
3 Belimbing 2
4 Guntung 0
5 Loktuan 2
6 Gn. Elai 9
7 Bontang Baru 6
8 Bontang Kuala 1
9 Api-api 4 MENYETUJUI
10 Satimpo 2 Direktur RS Islam Bontang
11 Tj Laut Indah
12 Tanjung Laut 5
13 Berbas Tengah 4
14 Berbas Pantai 1
15 Bontang Lestari 0 dr.Hari Prasetya
16 Luar Wilayah 6
Total 49
us / Persalinan Patologi

n : 21 Mei - 20 Juni
ahun : 2017
si : RS Islam Bontang

UK JENIS KOMPLIKASI
PENOLONG BBL PB L/P
(MINGGU) PERSALINAN OBSTETRI NEONATUS
39 Bidan Spontan 3685 52 L
36-37 Dokter SC 3050 46 L HT
39-40 Bidan Spontan 3150 46 P
39 Bidan Spontan 4270 53 L PEB
37 Dokter SC 3400 48 P Riw. SC + PEB+ DM
39-40 Dokter SC 3420 47 P Riw. SC + Asma
41-42 Bidan Spontan 3820 52 L
37 Dokter SC 3000 48 L Riw. SC 2X
37-38 Bidan Spontan 3045 49 L
37-38 Bidan Spontan 3300 47 L
37 Dokter SC 2760 48 L Minus
39 Bidan Spontan 2700 47 L
40-41 Bidan Spontan 3805 53 L
37-38 Bidan Spontan 2500 36 P
39 Bidan Spontan 3030 48 P
41 Bidan Spontan 3340 50 L
40 Dokter SC 3800 49 L Kala II Lama + Riw. SC
38 Dokter SC 2850 47 P Letak Sungsang
40-41 Bidan Spontan 3435 49 P
39 Bidan Spontan 3315 48 P
38-39 Bidan Spontan 3225 48 P
39-40 Dokter SC 3550 49 L Kala II Lama + Bartolini
40 Bidan Spontan 2895 46 P
38-39 Dokter SC 3160 47 P
40 Bidan Spontan 2665 46 L
39-40 Dokter SC 2720 47 L
37-38 Bidan Spontan 2685 46 L
40-41 Bidan Spontan 3200 47 P
38 Bidan Spontan 2920 48 L
38-39 Bidan Spontan 3675 47 P
39 Dokter SC 3100 48 P Kala II Lama
36-37 Dokter SC 2300 45 P Fetal Distress
37-38 Dokter SC 3100 46 P Letak Sungsang
40-41 Dokter SC 3900 48 L CPD
41 Bidan Spontan 3715 48 P
41 Bidan Spontan 3010 47 P
37-38 Bidan Spontan 3000 50 L
40 Bidan Spontan 3745 49 L
37 Bidan Spontan 2800 45 L
41-42 Bidan Spontan 3785 49 P
39-40 Dokter SC 3435 50 L Kala II Lama
40 Bidan Spontan 2550 46 P
41 Bidan Spontan 3350 50 P
40-41 Bidan Spontan 3310 47 P
37-38 Bidan Spontan 3330 49 P
37-38 Bidan Spontan 2890 47 P
41 Dokter Spontan 3200 47 L Letak Sungsang
39-40 Bidan Spontan 3130 49 P
41 Bidan Spontan 3945 53 P

MENGETAHUI Bontang,24 Juni 2017

Bag.Pelaporan.RM Pembuat Laporan

Suryadi Anna Marisa,Amd,Keb

Nik.02.09.03.113
KB PASCA VIT A PERLEKATA
HBO POLIO IMD JAMKES NO TLP
SALIN BUFAS N
+ + + - + BPJS 85387444239
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IUD + + + - + BPJS 82150112007
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+ + + - + TRUST 082154234413
+ + + - + BPJS 085250255920

Bontang,24 Juni 2017

Pembuat Laporan

Anna Marisa,Amd,Keb
 Laporan Partus / Persalinan Fisiologi

Bulan : 21 Mei - 20 Juni

Tahun : 2017
Instansi : RS Islam Bontang

NAMA ALAMAT DOMISILI ALAMAT KTP

NO TGL PARTUS UMUR
IBU SUAMI RT KELURAHAN RT
4 21/5/17 ny.Ratnasari justan 23 LW
5 21/5/17 desi risman 27 5 API API
6 21/5/17 oky slamet riyadi 24 24 SATIMPO
7 23/5/17 maria stefanus 36 6 GN TELIHAN
8 23/5/17 samsiar arbain 43 LW
9 24/5/17 rina zainal 30 14 G.ELAI
10 25/5/17 zainal ahmad 39 1 TJNG LAUT
11 27/5/17 ratnasari rudi 21 13 LW
12 28/5/17 kasmah sukarman 31 6 LW
13 29/5/17 kutmah joyo 31 23 BONTANG BARU
14 29/5/17 eka mas ni 32 9 LW
16 1/6/2017 ria mat rofik 27 17 BONTANG BARU
17 2/6/2017 yuliana m amin 28 16 TJ LAUT
18 3/6/2017 hasnidar rizki 24 BONTANG UTARA
19 4/6/2017 munawaroh kurniawan 32 44
20 5/6/2017 riska wadah 23 LW
21 6/6/2017 suriani arifin 37 LW
22 6/6/2017 nrul aini andriansyah 26 34 BERBAS TENGAH
23 6/6/2017 dahlia berton 24 20
24 9/6/2017 tsna tulus 31 15
25 11/6/2017 ida dedi 32 7 LW
26 12/6/2017 erni sugiato 27 19 G EIAI
27 12/6/2017 uli suardoyo 30 21 LOKTUAN

No Nama Kelurahan Jumlah

1 Tanjung Laut 2
2 Tanjung Laut Indah
3 Satmpo 1
4 Kanaan
5 Telihan 1
6 Bontang Baru 2
7 Api-api 2
8 Guntung
9 Belimbing
10 Gn. Elai 3
11 Bontang Kuala
12 Luar daerah 13
13 Loktuan 1
14 Berbas Tengah 1
15 Berbas Pantai
16 Tj. Limau
Total 27
ersalinan Fisiologis

Mei - 20 Juni
: 2017
slam Bontang

ALAMAT KTP KOMPLIKASI

G/P/A UK (MINGGU) PENOLONG JENIS PERSALINAN BBL PB L/P
KELURAHAN OBSTETRI NEONATUS
2/1/0 40 bidan spontan 3240 44 L
1/0/0 40 bidan spontan 3260 47 P
3/1/1 39 bidan spontan 3440 47 P
4/3/0 39 bidan spontan 3180 49 L
3/2/0 39 bidan spontan 3325 49 L
4/3/0 39 bidan spontan 3180 49 L
3/2/0 38 bidan spontan 2300 46 P
4/3/0 39 bidan spontan 2180 50 P
5/2/2 39 bidan spontan 2850 48 P
1/0/0 38 bidan spontan 3255 47 P
2/1/0 39 bidan spontan 3670 48 L
1/0/0 40 bidan spontan 2720 48 P
3/1/1 40 bidan spontan 3150 50 P
1/0/0 39 bidan spontan 2885 47 L
4/2/1 39 bidan spontan 2635 47 P
2/1/0 39 bidan spontan 3100 49 L
3/2/0 39 bidan spontan 2910 49 L
2/1/0 38 bidan spontan 3035 49 P
2/1/0 39 bidan spontan 3200 46 L
3/2/1 39 bidan spontan 2940 50 L
2/0/1 38 bidan spontan 3570 48 L
2/1/0 39 bidan spontan 2525 47 P
3/1/1 40 bidan spontan 2750 48 L
 KB
VIT A
PASCA HBO POLIO IMD JAMKES NO TLP
BUFAS
SALIN
+ + + BPJS .085347606635
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