BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA

DI KABUPATEN PELALAWAN TAHUN 2015

Puskesmas : KERUMUTAN
Bulan : DESEMBER

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 231 213 378 349 727 52 48 80
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 45 43 115 114 194 190 384 34 33 44
3 Banjar Panjang 737 722 1,459 1 1 10 8 1 0 16 16 21 20 62 61 99 97 196 16 14 22 21 55 56 93 91 184 11 11 18
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 28 28 45 42 97 97 170 167 337 26 24 30
5 Pematang Tinggi 1,125 1,159 2,284 3 3 33 33 3 0 24 25 32 33 95 98 151 156 307 22 23 34 34 85 86 141 143 284 18 20 27
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 20 18 26 28 70 70 116 116 232 11 11 20
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 14 15 18 19 44 38 76 72 148 12 13 10
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 39 39 62 64 126 4 5 9
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 29 25 36 34 79 78 144 137 281 28 16 19
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 15 18 22 28 50 1 3 2

PUSKESMAS 11,270 10,822 22,092 33 33 195 179 29 4 244 235 318 304 950 912 1,512 1,451 2,963 241 231 325 317 830 809 1,396 1,357 2,753 197 184 259

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 1 0 4 3 5 3 8 4 3 0 0 0 0 4 3 7 56 51 83 77 165 154 304 282 586

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 1 1 0 0 1 1 2 0 0 0 0 0 0 0 0 0 34 33 45 41 104 99 183 173 356
3 Banjar Panjang 737 722 1,459 0 0 3 0 5 8 8 8 16 2 1 0 0 0 1 2 2 4 14 13 21 20 30 39 65 72 137
4 Beringin Makmur 1,318 1,311 2,629 0 0 2 1 4 1 6 2 8 1 0 0 0 0 0 1 0 1 27 24 35 33 88 83 150 140 290
5 Pematang Tinggi 1,125 1,159 2,284 0 0 1 0 1 1 2 1 3 0 1 0 0 0 1 0 2 2 19 21 30 31 68 70 117 122 239
6 Pangkalan Tampoi 913 834 1,747 1 1 1 2 4 3 6 6 12 2 1 0 0 0 0 2 1 3 16 16 25 21 63 56 104 93 197
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 2 12 15 11 16 24 24 47 55 102
8 Tanjung Air Hitam 468 485 953 0 1 1 1 2 1 3 3 6 0 0 2 1 2 3 4 4 8 5 6 13 11 16 18 34 35 69
9 Makteduh 1,317 1,155 2,472 0 0 2 0 3 6 5 6 11 0 1 0 0 0 0 0 1 1 28 17 22 24 48 53 98 94 192
10 Lipai Bulan 203 230 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 2 2 10 12 13 17 30

PUSKESMAS 11,270 10,822 22,092 1 2 12 5 23 23 36 30 66 9 9 2 1 2 5 13 15 28 212 199 287 276 616 608 1,115 1,083 2,198

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 727 586 556 15 1 95% 77% 95% 73% 0%

2
Bukit Lembah Subur
417 384 356 354 0 0 92% 85% 99% 85% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 184 137 99 18 2 94% 70% 72% 51% 1%
Beringin Makmur 2 Oralit 0
4 352 337 290 272 9 0 96% 82% 94% 77% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 284 239 218 16 0 93% 78% 91% 71% 0%
 Pangkalan Tampoi 4 Vitamin A 1,785
6 234 232 197 140 18 0 99% 84% 71% 60% 0%
Pangkalan Panduk
7 178 148 102 68 3 0 83% 57% 67% 38% 0%
Tanjung Air Hitam
8 128 126 69 47 8 0 98% 54% 68% 37% 0%
Makteduh
9 331 281 192 163 17 0 85% 58% 85% 49% 0%
Lipai Bulan
10 57 50 30 28 2 0 88% 53% 93% 49% 0%

2,963 2,753 2,198 1,945 106 3 93% 74% 88% 66% 0%

JUMLAH
247 229 183 162 9 0 93% 74% 88% 66% 0%
RATA - RATA

Mengetahui : Kerumutan, 28 Desember 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

74 156 146 288 268 556 0 0 2 3 5 5 7 8 15 763 727 586 556 15 1 95% 77% 95%
40 104 99 182 172 354 0 0 0 0 0 0 0 0 0 417 384 356 354 0 0 92% 85% 99%
18 20 21 49 50 99 1 1 0 2 5 9 6 12 18 196 184 137 99 18 2 94% 70% 72%
30 82 80 138 134 272 0 0 3 2 2 2 5 4 9 352 337 290 272 9 0 96% 82% 94%
29 62 62 107 111 218 1 0 2 2 5 6 8 8 16 307 284 239 218 16 0 93% 78% 91%
17 55 50 62 78 140 2 3 4 2 4 3 10 8 18 234 232 197 164 18 0 99% 84% 83%
15 24 23 17 51 68 0 0 1 1 0 1 1 2 3 178 148 102 97 3 0 83% 57% 95%
7 10 12 23 24 47 1 0 1 2 2 2 4 4 8 128 126 69 47 8 0 98% 54% 68%
24 38 38 85 78 163 0 0 1 0 7 9 8 9 17 331 281 192 163 17 0 85% 58% 85%
2 9 11 12 16 28 0 0 0 0 1 1 1 1 2 57 50 30 28 2 0 88% 53% 93%

256 560 542 963 982 1,945 5 4 14 14 31 38 50 56 106 2,963 2,753 2,198 1998 106 3

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

8 8 0 0 66 59 74 67 141 0 1 0 0 0 0 0 1 1
0 0 0 2 11 15 11 17 28 0 0 0 0 0 0 0 0 0
2 1 1 1 25 17 28 19 47 0 0 2 0 0 0 2 0 2
 1 4 10 9 9 14 20 27 47 0 0 0 0 0 0 0 0 0
3 2 4 3 17 16 24 21 45 0 0 0 0 0 0 0 0 0
4 2 1 7 7 14 12 23 35 0 0 0 0 0 0 0 0 0
2 0 7 3 20 14 29 17 46 0 0 0 0 0 0 0 0 0
5 5 0 3 23 21 28 29 57 0 0 0 0 0 0 0 0 0
1 8 14 10 31 25 46 43 89 0 0 0 0 0 0 0 0 0
3 2 1 3 5 6 9 11 20 0 0 0 0 0 0 0 0 0

29 32 38 41 214 201 281 274 555 0 1 2 0 0 0 2 1 3

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,747
N/S BGM/D
73% 0%
85% 0%
51% 1%
77% 0%
71% 0%
70% 0%
54% 0%
37% 0%
49% 0%
49% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : NOVEMBER

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 230 212 377 348 725 52 48 79
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 45 43 115 114 194 190 384 34 31 43
3 Banjar Panjang 737 722 1,459 1 1 10 8 1 0 16 16 21 20 62 61 99 97 196 16 14 22 21 50 52 88 87 175 12 11 18
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 28 28 45 42 92 88 165 158 323 25 27 35
5 Pematang Tinggi 1,125 1,159 2,284 3 3 33 33 3 0 24 25 32 33 95 98 151 156 307 22 22 34 34 80 80 136 136 272 18 18 30
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 20 18 26 28 70 70 116 116 232 8 11 20
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 13 14 18 19 42 36 73 69 142 9 10 9
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 39 39 62 64 126 4 5 6
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 27 24 30 34 64 65 121 123 244 24 15 16
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 13 17 20 27 47 1 3 1

PUSKESMAS 11,270 10,822 22,092 33 33 195 179 29 4 244 235 318 304 950 912 1,512 1,451 2,963 238 228 319 317 795 773 1,352 1,318 2,670 187 179 257

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 2 3 3 5 5 10 8 4 0 0 0 0 8 4 12 60 52 83 77 163 154 306 283 589

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 31 43 41 106 110 183 182 365
3 Banjar Panjang 737 722 1,459 1 0 2 0 10 12 13 12 25 2 1 0 0 0 1 2 2 4 15 14 21 20 40 47 76 81 157
4 Beringin Makmur 1,318 1,311 2,629 0 0 1 1 3 2 4 3 7 2 1 0 0 0 0 2 1 3 27 28 37 33 73 69 137 130 267
5 Pematang Tinggi 1,125 1,159 2,284 0 0 0 1 1 0 1 1 2 1 0 0 0 1 0 2 0 2 19 18 32 33 68 68 119 119 238
6 Pangkalan Tampoi 913 834 1,747 1 1 1 2 4 3 6 6 12 2 1 0 0 0 0 2 1 3 12 14 25 20 59 60 96 94 190
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 2 9 13 10 17 18 21 37 51 88
8 Tanjung Air Hitam 468 485 953 1 1 1 2 3 2 5 5 10 2 1 1 1 2 2 5 4 9 7 7 10 11 15 18 32 36 68
9 Makteduh 1,317 1,155 2,472 2 1 2 2 1 0 5 3 8 1 1 0 0 0 0 1 1 2 27 18 20 27 44 45 91 90 181
10 Lipai Bulan 203 230 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 1 3 9 11 11 17 28

PUSKESMAS 11,270 10,822 22,092 5 3 9 10 25 22 39 35 74 18 10 1 2 3 3 22 15 37 211 198 282 282 595 603 1,088 1,083 2,171

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 725 589 553 14 2 95% 77% 94% 72% 0%

2
Bukit Lembah Subur
417 384 365 363 2 0 92% 88% 99% 87% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 175 157 107 21 5 89% 80% 68% 55% 3%
Beringin Makmur 2 Oralit 0
4 352 323 267 252 5 0 92% 76% 94% 72% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 272 238 221 13 0 89% 78% 93% 72% 0%
 Pangkalan Tampoi 4 Vitamin A 1,823
6 234 232 190 144 12 0 99% 81% 76% 62% 0%
Pangkalan Panduk
7 178 142 88 62 5 0 80% 49% 70% 35% 0%
Tanjung Air Hitam
8 128 126 68 43 6 0 98% 53% 63% 34% 0%
Makteduh
9 331 244 181 158 13 0 74% 55% 87% 48% 0%
Lipai Bulan
10 57 47 28 27 1 0 82% 49% 96% 47% 0%

2,963 2,670 2,171 1,930 92 7 90% 73% 89% 65% 0%

JUMLAH
247 223 181 161 8 1 90% 73% 89% 65% 0%
RATA - RATA

Mengetahui : Kerumutan, 03 November 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 156 146 287 266 553 0 0 2 3 4 5 6 8 14 763 725 589 553 14 2 95% 77% 94%
40 106 109 183 180 363 0 0 0 1 0 1 0 2 2 417 384 365 363 2 0 92% 88% 99%
18 23 25 53 54 107 0 2 1 2 7 9 8 13 21 196 175 157 107 21 5 89% 80% 68%
32 68 65 128 124 252 0 0 1 0 2 2 3 2 5 352 323 267 252 5 0 92% 76% 94%
29 62 64 110 111 221 0 0 2 3 4 4 6 7 13 307 272 238 221 13 0 89% 78% 93%
17 53 54 62 82 144 1 1 4 1 2 3 7 5 12 234 232 190 163 12 0 99% 81% 86%
15 18 20 17 45 62 0 2 1 1 0 1 1 4 5 178 142 88 81 5 0 80% 49% 92%
7 9 12 19 24 43 0 0 2 1 1 2 3 3 6 128 126 68 43 6 0 98% 53% 63%
21 40 42 80 78 158 0 1 2 4 3 3 5 8 13 331 244 181 158 13 0 74% 55% 87%
2 9 11 11 16 27 0 0 0 1 0 0 0 1 1 57 47 28 27 1 0 82% 49% 96%

253 544 548 950 980 1,930 1 6 15 17 23 30 39 53 92 2,963 2,670 2,171 1968 92 7

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

4 7 0 0 86 77 90 84 174 0 2 0 0 0 0 0 2 2
0 2 2 2 28 18 30 22 52 0 0 0 0 0 0 0 0 0
1 2 0 0 22 14 23 16 39 0 0 1 2 1 1 2 3 5
 2 0 0 4 38 41 40 45 85 0 0 0 0 0 0 0 0 0
5 7 0 0 27 30 32 37 69 0 0 0 0 0 0 0 0 0
8 4 1 3 18 10 27 17 44 0 0 0 0 0 0 0 0 0
5 2 8 2 37 36 50 40 90 0 0 0 0 0 0 0 0 0
3 4 3 3 24 23 30 30 60 0 0 0 0 0 0 0 0 0
2 7 17 5 67 52 86 64 150 0 0 0 0 0 0 0 0 0
3 2 5 3 8 8 16 13 29 0 0 0 0 0 0 0 0 0

33 37 36 22 355 309 424 368 792 0 2 1 2 1 1 2 5 7

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,785
N/S BGM/D
72% 0%
87% 0%
55% 3%
72% 0%
72% 0%
70% 0%
46% 0%
34% 0%
48% 0%
47% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : OKTOBER

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 226 209 373 345 718 52 48 78
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 45 43 112 110 191 186 377 34 31 43
3 Banjar Panjang 737 722 1,459 1 1 10 8 1 0 16 16 21 20 62 61 99 97 196 16 14 22 21 44 46 82 81 163 11 11 18
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 27 28 45 42 91 87 163 157 320 25 27 32
5 Pematang Tinggi 1,125 1,159 2,284 3 3 33 33 3 0 24 25 32 33 95 98 151 156 307 21 24 34 34 79 80 134 138 272 18 19 29
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 28 67 70 112 116 228 8 10 17
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 13 14 18 19 42 36 73 69 142 9 10 9
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 3 4 8
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 27 24 29 34 51 55 107 113 220 22 15 16
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 13 17 20 27 47 2 3 2

PUSKESMAS 11,270 10,822 22,092 33 33 195 179 29 4 244 235 318 304 950 912 1,512 1,451 2,963 235 230 318 317 761 747 1,314 1,294 2,608 184 178 252

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 1 3 3 5 4 9 6 4 0 0 0 0 6 4 10 58 52 82 76 163 154 303 282 585

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 31 43 40 110 104 187 175 362
3 Banjar Panjang 737 722 1,459 0 0 1 1 10 12 11 13 24 2 1 0 0 0 0 2 1 3 14 13 21 20 36 42 71 75 146
4 Beringin Makmur 1,318 1,311 2,629 0 0 1 2 2 2 3 4 7 1 1 1 0 0 0 2 1 3 27 28 37 36 71 69 135 133 268
5 Pematang Tinggi 1,125 1,159 2,284 0 0 0 0 1 1 1 1 2 0 2 0 0 0 0 0 2 2 18 21 30 33 68 66 116 120 236
6 Pangkalan Tampoi 913 834 1,747 2 0 2 3 1 2 5 5 10 0 2 0 0 0 0 0 2 2 12 16 24 23 60 61 96 100 196
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 2 9 13 10 17 18 21 37 51 88
8 Tanjung Air Hitam 468 485 953 0 0 2 2 4 5 6 7 13 1 0 0 1 1 4 2 5 7 5 5 11 12 16 20 32 37 69
9 Makteduh 1,317 1,155 2,472 0 0 2 2 1 1 3 3 6 2 1 0 0 1 0 3 1 4 24 16 21 25 43 46 88 87 175
10 Lipai Bulan 203 230 433 0 0 1 1 0 0 1 1 2 0 1 0 0 0 0 0 1 1 2 4 3 5 3 13 8 22 30

PUSKESMAS 11,270 10,822 22,092 2 0 11 12 22 26 35 38 73 12 13 1 2 2 4 15 19 34 203 199 282 287 588 596 1,073 1,082 2,155

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 718 585 552 14 2 94% 77% 94% 72% 0%

2
Bukit Lembah Subur
417 377 362 362 0 0 90% 87% 100% 87% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 163 146 99 20 5 83% 74% 68% 51% 3%
Beringin Makmur 2 Oralit 0
4 352 320 268 250 8 0 91% 76% 93% 71% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 272 236 223 9 0 89% 77% 94% 73% 0%
 Pangkalan Tampoi 4 Vitamin A 1,861
6 234 228 196 141 26 0 97% 84% 72% 60% 0%
Pangkalan Panduk
7 178 142 88 62 5 0 80% 49% 70% 35% 0%
Tanjung Air Hitam
8 128 121 69 36 13 0 95% 54% 52% 28% 0%
Makteduh
9 331 220 175 154 11 0 66% 53% 88% 47% 0%
Lipai Bulan
10 57 47 30 25 2 0 82% 53% 83% 44% 0%

2,963 2,608 2,155 1,904 108 7 88% 73% 88% 64% 0%

JUMLAH
247 217 180 159 9 1 88% 73% 88% 64% 0%
RATA - RATA

Mengetahui : Kerumutan, 03 November 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 156 146 286 266 552 0 0 2 3 4 5 6 8 14 763 718 585 552 14 2 94% 77% 94%
40 110 104 187 175 362 0 0 0 0 0 0 0 0 0 417 377 362 362 0 0 90% 87% 100%
18 20 21 49 50 99 1 1 2 1 6 9 9 11 20 196 163 146 99 20 5 83% 74% 68%
33 68 65 125 125 250 1 0 3 1 1 2 5 3 8 352 320 268 250 8 0 91% 76% 93%
30 63 64 110 113 223 0 0 1 3 4 1 5 4 9 307 272 236 223 9 0 89% 77% 94%
16 54 53 62 79 141 2 4 5 4 5 6 12 14 26 234 228 196 158 26 0 97% 84% 81%
15 18 20 17 45 62 0 2 1 1 0 1 1 4 5 178 142 88 81 5 0 80% 49% 92%
5 8 8 19 17 36 1 1 1 4 3 3 5 8 13 128 121 69 36 13 0 95% 54% 52%
21 37 43 75 79 154 0 0 3 2 4 2 7 4 11 331 220 175 154 11 0 66% 53% 88%
4 2 12 6 19 25 0 0 0 0 1 1 1 1 2 57 47 30 25 2 0 82% 53% 83%

254 536 536 936 968 1,904 5 8 18 19 28 30 51 57 108 2,963 2,608 2,155 1940 108 7

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

6 7 1 1 86 77 93 85 178 0 2 0 0 0 0 0 2 2
0 2 2 3 24 24 26 29 55 0 0 0 0 0 0 0 0 0
2 3 0 0 26 19 28 22 50 0 0 1 2 1 1 2 3 5
 2 0 0 1 40 41 42 42 84 0 0 0 0 0 0 0 0 0
6 4 2 0 27 32 35 36 71 0 0 0 0 0 0 0 0 0
8 2 2 0 17 9 27 11 38 0 0 0 0 0 0 0 0 0
5 2 8 2 37 36 50 40 90 0 0 0 0 0 0 0 0 0
5 6 2 2 23 21 30 29 59 0 0 0 0 0 0 0 0 0
5 9 16 7 68 51 89 67 156 0 0 0 0 0 0 0 0 0
2 1 3 1 14 6 19 8 27 0 0 0 0 0 0 0 0 0

41 36 36 17 362 316 439 369 808 0 2 1 2 1 1 2 5 7

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,823
N/S BGM/D
72% 0%
87% 0%
51% 3%
71% 0%
73% 0%
68% 0%
46% 0%
28% 0%
47% 0%
44% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : SEPTEMBER

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 226 209 373 345 718 52 48 78
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 45 43 112 110 191 186 377 34 31 43
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 16 14 22 21 43 43 81 78 159 12 12 12
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 27 28 42 40 91 87 160 155 315 25 26 34
5 Pematang Tinggi 1,125 1,159 2,284 3 3 23 23 3 0 24 25 32 33 95 98 151 156 307 21 24 34 34 79 80 134 138 272 16 19 29
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 28 67 70 112 116 228 9 7 17
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 13 14 18 19 40 34 71 67 138 7 10 8
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 4 4 7
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 27 24 29 34 51 55 107 113 220 22 13 12
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 13 17 20 27 47 3 3 2

PUSKESMAS 11,270 10,822 22,092 33 33 186 172 29 4 244 235 318 304 950 912 1,512 1,451 2,963 235 230 315 315 758 742 1,308 1,287 2,595 184 173 242

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 1 4 3 6 4 10 5 5 0 0 0 0 5 5 10 57 53 82 76 164 154 303 283 586

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 31 43 41 109 105 186 177 363
3 Banjar Panjang 737 722 1,459 0 0 2 2 3 0 5 2 7 0 1 0 0 0 0 0 1 1 13 13 19 20 30 23 62 56 118
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 2 2 3 2 5 7 1 2 0 0 0 0 1 2 3 27 28 37 36 71 70 135 134 269
5 Pematang Tinggi 1,125 1,159 2,284 0 0 0 0 1 1 1 1 2 0 0 0 1 0 0 0 1 1 17 20 30 33 67 67 114 120 234
6 Pangkalan Tampoi 913 834 1,747 3 2 4 3 8 3 15 8 23 1 2 1 1 1 1 3 4 7 15 14 26 23 62 70 103 107 210
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 7 11 9 15 18 20 34 46 80
8 Tanjung Air Hitam 468 485 953 1 1 1 3 2 2 4 6 10 1 1 1 2 4 1 6 4 10 6 7 12 11 19 14 37 32 69
9 Makteduh 1,317 1,155 2,472 1 1 0 1 2 0 3 2 5 3 1 0 0 0 0 3 1 4 26 16 19 23 45 47 90 86 176
10 Lipai Bulan 203 230 433 0 0 0 0 1 1 1 1 2 0 0 0 0 0 0 0 0 0 3 3 4 6 6 14 13 23 36

PUSKESMAS 11,270 10,822 22,092 5 4 9 12 23 13 37 29 66 11 13 2 4 5 2 18 19 37 205 196 281 284 591 584 1,077 1,064 2,141

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 718 586 552 14 2 94% 77% 94% 72% 0%

2
Bukit Lembah Subur
417 377 363 361 2 0 90% 87% 99% 87% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 159 118 82 28 7 81% 60% 69% 42% 6%
Beringin Makmur 2 Oralit 0
4 352 315 269 252 7 0 89% 76% 94% 72% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 272 234 218 13 0 89% 76% 93% 71% 0%
 Pangkalan Tampoi 4 Vitamin A 1,861
6 234 228 210 144 23 0 97% 90% 69% 62% 0%
Pangkalan Panduk
7 178 138 80 59 4 0 78% 45% 74% 33% 0%
Tanjung Air Hitam
8 128 121 69 40 9 0 95% 54% 58% 31% 0%
Makteduh
9 331 220 176 148 19 0 66% 53% 84% 45% 0%
Lipai Bulan
10 57 47 36 31 3 0 82% 63% 86% 54% 0%

2,963 2,595 2,141 1,887 122 9 88% 72% 88% 64% 0%

JUMLAH
247 216 178 157 10 1 88% 72% 88% 64% 0%
RATA - RATA

Mengetahui : Kerumutan, 01 Oktober 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 156 146 286 266 552 0 0 2 3 4 5 6 8 14 763 718 586 552 14 2 94% 77% 94%
40 109 104 186 175 361 0 0 0 1 0 1 0 2 2 417 377 363 361 2 0 90% 87% 99%
13 19 14 43 39 82 1 0 5 5 8 9 14 14 28 196 159 118 82 28 7 81% 60% 69%
33 68 66 127 125 252 1 0 3 1 1 1 5 2 7 352 315 269 252 7 0 89% 76% 94%
30 63 61 108 110 218 1 1 1 2 3 5 5 8 13 307 272 234 218 13 0 89% 76% 93%
15 49 60 62 82 144 2 3 4 4 4 6 10 13 23 234 228 210 157 23 0 97% 90% 75%
14 18 18 17 42 59 0 0 1 1 0 2 1 3 4 178 138 80 75 4 0 78% 45% 94%
6 10 9 21 19 40 0 1 3 0 3 2 6 3 9 128 121 69 40 9 0 95% 54% 58%
22 37 42 71 77 148 0 1 7 0 6 5 13 6 19 331 220 176 148 19 0 66% 53% 84%
5 5 13 10 21 31 0 0 2 1 0 0 2 1 3 57 47 36 31 3 0 82% 63% 86%

250 534 533 931 956 1,887 5 6 28 18 29 36 62 60 122 2,963 2,595 2,141 1916 122 9

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

7 6 1 1 85 77 93 84 177 0 2 0 0 0 0 0 2 2
0 2 2 2 25 23 27 27 54 0 0 0 0 0 0 0 0 0
3 3 2 0 32 38 37 41 78 0 0 3 2 1 1 4 3 7
 2 0 0 1 40 40 42 41 83 0 0 0 0 0 0 0 0 0
7 5 2 0 28 31 37 36 73 0 0 0 0 0 0 0 0 0
5 4 0 0 15 0 20 4 24 0 0 0 0 0 0 0 0 0
7 4 9 4 37 37 53 45 98 0 0 0 0 0 0 0 0 0
4 4 1 3 20 27 25 34 59 0 0 0 0 0 0 0 0 0
3 9 18 9 66 50 87 68 155 0 0 0 0 0 0 0 0 0
1 2 2 0 11 5 14 7 21 0 0 0 0 0 0 0 0 0

39 39 37 20 359 328 435 387 822 0 2 3 2 1 1 4 5 9

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,823
N/S BGM/D
72% 0%
87% 0%
42% 6%
72% 0%
71% 0%
67% 0%
42% 0%
31% 0%
45% 0%
54% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : AGUSTUS

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 226 209 373 345 718 52 48 79
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 45 43 112 110 191 186 377 34 32 43
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 16 14 22 21 43 43 81 78 159 11 10 12
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 26 26 48 44 87 81 161 151 312 22 19 33
5 Pematang Tinggi 1,125 1,159 2,284 3 3 23 23 3 0 24 25 32 33 95 98 151 156 307 21 24 34 34 79 79 134 137 271 18 18 29
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 28 67 70 112 116 228 6 6 13
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 12 14 18 19 40 34 70 67 137 8 12 10
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 4 3 6
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 24 29 34 51 55 106 113 219 22 14 16
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 12 17 19 27 46 3 2 1

PUSKESMAS 11,270 10,822 22,092 33 33 186 172 29 4 244 235 318 304 950 912 1,512 1,451 2,963 232 228 321 319 753 735 1,306 1,282 2,588 180 164 242

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 2 4 3 6 5 11 5 6 0 0 0 0 5 6 11 57 54 83 77 177 180 317 311 628

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 32 43 43 109 105 186 180 366
3 Banjar Panjang 737 722 1,459 0 1 1 1 10 10 11 12 23 3 1 0 0 0 0 3 1 4 14 13 21 20 38 33 73 66 139
4 Beringin Makmur 1,318 1,311 2,629 1 3 1 1 2 3 4 7 11 1 1 0 0 0 0 1 1 2 26 24 37 37 76 71 139 132 271
5 Pematang Tinggi 1,125 1,159 2,284 0 0 1 0 1 0 2 0 2 0 2 0 0 0 0 0 2 2 18 20 31 29 70 65 119 114 233
6 Pangkalan Tampoi 913 834 1,747 4 3 3 2 4 2 11 7 18 1 2 1 2 2 0 4 4 8 14 13 26 22 59 70 99 105 204
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 0 2 9 12 12 15 20 23 41 50 91
8 Tanjung Air Hitam 468 485 953 0 2 2 0 2 1 4 3 7 0 0 1 1 0 6 1 7 8 6 5 10 10 13 16 29 31 60
9 Makteduh 1,317 1,155 2,472 0 1 4 3 10 8 14 12 26 1 1 0 1 0 0 1 2 3 24 16 22 24 49 45 95 85 180
10 Lipai Bulan 203 230 433 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 3 3 1 4 8 14 12 21 33

PUSKESMAS 11,270 10,822 22,092 5 10 14 9 34 27 53 46 99 12 13 3 4 2 6 17 23 40 205 192 286 281 619 622 1,110 1,095 2,205

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 718 628 591 15 3 94% 82% 94% 77% 0%

2
Bukit Lembah Subur
417 377 366 364 2 0 90% 88% 99% 87% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 159 139 82 30 7 81% 71% 59% 42% 5%
Beringin Makmur 2 Oralit 0
4 352 312 271 249 9 0 89% 77% 92% 71% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 271 233 217 12 1 88% 76% 93% 71% 0%
 Pangkalan Tampoi 4 Vitamin A 1,404
6 234 228 204 150 25 0 97% 87% 74% 64% 0%
Pangkalan Panduk
7 178 137 91 66 2 0 77% 51% 73% 37% 0%
Tanjung Air Hitam
8 128 121 60 37 8 0 95% 47% 62% 29% 0%
Makteduh
9 331 219 180 142 9 0 66% 54% 79% 43% 0%
Lipai Bulan
10 57 46 33 29 3 0 81% 58% 88% 51% 0%

2,963 2,588 2,205 1,927 115 11 87% 74% 87% 65% 0%

JUMLAH
247 216 184 161 10 1 87% 74% 87% 65% 0%
RATA - RATA

Mengetahui : Kerumutan, 04 September 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 168 172 299 292 591 0 0 2 3 5 5 7 8 15 763 718 628 591 15 3 94% 82% 94%
42 109 104 186 178 364 0 0 0 1 0 1 0 2 2 417 377 366 364 2 0 90% 88% 99%
12 23 14 46 36 82 0 1 8 7 5 9 13 17 30 196 159 139 82 30 7 81% 71% 59%
34 73 68 128 121 249 2 1 3 2 1 0 6 3 9 352 312 271 249 9 0 89% 77% 92%
28 64 60 111 106 217 0 0 1 1 5 5 6 6 12 307 271 233 217 12 1 88% 76% 93%
14 46 68 62 88 150 3 2 9 4 7 0 19 6 25 234 228 204 153 25 0 97% 87% 75%
14 20 23 17 49 66 0 0 1 1 0 0 1 1 2 178 137 91 87 2 0 77% 51% 96%
7 8 9 18 19 37 2 0 1 2 3 0 6 2 8 128 121 60 37 8 0 95% 47% 62%
20 36 34 74 68 142 1 0 2 0 3 3 6 3 9 331 219 180 142 9 0 66% 54% 79%
4 6 13 10 19 29 0 1 0 0 1 1 1 2 3 57 46 33 29 3 0 81% 58% 88%

247 553 565 951 976 1,927 8 5 27 21 30 24 65 50 115 2,963 2,588 2,205 1951 115 11

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

7 5 0 0 72 51 79 56 135 0 1 0 0 0 2 0 3 3
0 1 2 0 25 23 27 24 51 0 0 0 0 0 0 0 0 0
2 3 0 0 24 28 26 31 57 0 0 3 2 1 1 4 3 7
 3 4 0 0 35 39 38 43 81 0 0 0 0 0 0 0 0 0
6 5 1 4 25 33 32 42 74 0 1 0 0 0 0 0 1 1
6 5 0 1 18 0 24 6 30 0 0 0 0 0 0 0 0 0
5 3 6 4 35 34 46 41 87 0 0 0 0 0 0 0 0 0
4 6 3 4 26 25 33 35 68 0 0 0 0 0 0 0 0 0
5 9 15 8 62 52 82 69 151 0 0 0 0 0 0 0 0 0
1 2 5 2 9 5 15 9 24 0 0 0 0 0 0 0 0 0

39 43 32 23 331 290 402 356 758 0 2 3 2 1 3 4 7 11

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
2,750 1,861
N/S BGM/D
77% 0%
87% 0%
42% 5%
71% 0%
71% 0%
65% 0%
49% 0%
29% 0%
43% 0%
51% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : JULI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 226 209 373 345 718 53 50 79
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 33 49 45 109 104 192 182 374 34 33 43
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 16 13 22 21 41 42 79 76 155 11 10 11
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 26 25 48 43 86 80 160 148 308 21 17 36
5 Pematang Tinggi 1,125 1,159 2,284 3 3 23 23 3 0 24 25 32 33 95 98 151 156 307 21 23 34 34 76 78 131 135 266 17 18 27
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 28 67 65 112 111 223 11 10 14
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 10 20 20 22 20 26 50 68 118 5 12 9
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 3 4 6
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 24 29 34 51 55 106 113 219 20 12 16
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 12 17 19 27 46 3 4 2

PUSKESMAS 11,270 10,822 22,092 33 33 186 172 29 4 244 235 318 304 950 912 1,512 1,451 2,963 230 231 327 323 724 713 1,281 1,267 2,548 178 170 243

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 2 4 3 6 5 11 0 4 0 0 0 0 0 4 4 53 54 83 77 126 123 262 254 516

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 33 43 41 105 99 182 173 355
3 Banjar Panjang 737 722 1,459 0 0 0 0 2 2 2 2 4 1 0 0 0 0 0 1 0 1 14 10 20 20 27 31 61 61 122
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 1 1 3 1 4 5 2 2 0 0 0 0 2 2 4 23 20 37 37 73 74 133 131 264
5 Pematang Tinggi 1,125 1,159 2,284 0 0 1 1 0 0 1 1 2 0 1 0 0 0 0 0 1 1 17 19 31 30 67 63 115 112 227
6 Pangkalan Tampoi 913 834 1,747 1 2 2 3 3 3 6 8 14 0 1 1 0 0 0 1 1 2 15 14 19 23 58 57 92 94 186
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 1 2 3 6 14 9 16 4 23 19 53 72
8 Tanjung Air Hitam 468 485 953 0 1 2 0 3 4 5 5 10 1 1 2 1 1 4 4 6 10 5 6 11 9 14 20 30 35 65
9 Makteduh 1,317 1,155 2,472 0 0 2 2 8 3 10 5 15 2 2 0 1 2 1 4 4 8 23 14 20 21 39 48 82 83 165
10 Lipai Bulan 203 230 433 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 3 4 3 4 7 12 13 20 33

PUSKESMAS 11,270 10,822 22,092 1 3 10 9 21 18 32 30 62 7 13 3 2 3 5 13 20 33 193 188 276 278 520 550 989 1,016 2,005

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 718 516 486 15 3 94% 68% 94% 64% 1%

2
Bukit Lembah Subur
417 374 355 353 2 0 90% 85% 99% 85% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 155 122 79 38 4 79% 62% 65% 40% 3%
Beringin Makmur 2 Oralit 0
4 352 308 264 251 4 1 88% 75% 95% 71% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 266 227 211 13 1 87% 74% 93% 69% 0%
 Pangkalan Tampoi 4 Vitamin A 1404
6 234 223 186 143 12 0 95% 79% 77% 61% 0%
Pangkalan Panduk
7 178 118 72 65 3 0 66% 40% 90% 37% 0%
Tanjung Air Hitam
8 128 121 65 37 8 0 95% 51% 57% 29% 0%
Makteduh
9 331 219 165 134 8 0 66% 50% 81% 40% 0%
Lipai Bulan
10 57 46 33 30 2 0 81% 58% 91% 53% 0%

2,963 2,548 2,005 1,789 105 9 86% 68% 89% 60% 0%

JUMLAH
247 212 167 149 9 1 86% 68% 89% 60% 0%
RATA - RATA

Mengetahui : Kerumutan, 01 Agustus 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 117 115 249 237 486 0 0 2 3 5 5 7 8 15 763 718 516 486 15 3 94% 68% 94%
40 105 98 182 171 353 0 0 0 1 0 1 0 2 2 417 374 355 353 2 0 90% 85% 99%
12 17 18 39 40 79 2 0 9 8 8 11 19 19 38 196 155 122 79 38 4 79% 62% 65%
35 71 71 128 123 251 0 1 1 1 1 0 2 2 4 352 308 264 251 4 1 88% 75% 95%
27 62 60 106 105 211 0 0 3 2 5 3 8 5 13 307 266 227 211 13 1 87% 74% 93%
19 52 52 62 81 143 3 1 2 1 3 2 8 4 12 234 223 186 158 12 0 95% 79% 85%
14 4 22 17 48 65 0 0 0 2 0 1 0 3 3 178 118 72 66 3 0 66% 40% 92%
6 8 10 17 20 37 1 0 1 2 2 2 4 4 8 128 121 65 37 8 0 95% 51% 57%
18 27 41 63 71 134 1 0 2 0 2 3 5 3 8 331 219 165 134 8 0 66% 50% 81%
4 6 11 11 19 30 0 0 0 0 1 1 1 1 2 57 46 33 30 2 0 81% 58% 91%

247 469 498 874 915 1,789 7 2 20 20 27 29 54 51 105 2,963 2,548 2,005 1805 105 9

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

11 5 0 0 123 108 134 113 247 0 1 0 0 0 2 0 3 3

0 0 2 2 29 29 31 31 62 0 0 0 0 0 0 0 0 0
2 6 1 0 35 30 38 36 74 0 0 3 0 1 0 4 0 4
 6 8 0 0 38 36 44 44 88 0 0 0 0 1 0 1 0 1
7 6 1 3 28 35 36 44 80 0 1 0 0 0 0 0 1 1
5 4 7 0 19 13 31 17 48 0 0 0 0 0 0 0 0 0
8 1 9 3 51 34 68 38 106 0 0 0 0 0 0 0 0 0
5 5 2 5 25 21 32 31 63 0 0 0 0 0 0 0 0 0
6 11 17 11 72 49 95 71 166 0 0 0 0 0 0 0 0 0
1 1 3 2 10 7 14 10 24 0 0 0 0 0 0 0 0 0

51 47 42 26 430 362 523 435 958 0 2 3 0 2 2 5 4 9

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,381
N/S BGM/D
64% 1%
85% 0%
40% 3%
71% 0%
69% 0%
68% 0%
37% 0%
29% 0%
40% 0%
53% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : JUNI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 226 209 373 345 718 53 50 78
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 34 32 49 45 105 100 188 177 365 34 33 43
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 16 13 22 21 41 42 79 76 155 12 12 15
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 26 25 48 42 86 79 160 146 306 18 16 35
5 Pematang Tinggi 1,125 1,159 2,284 3 3 23 23 3 0 24 25 32 33 95 98 151 156 307 21 23 34 34 76 76 131 133 264 17 17 28
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 28 67 65 112 111 223 12 12 20
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 10 20 20 24 20 22 50 66 116 7 14 9
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 4 4 5
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 24 29 34 50 55 105 113 218 21 14 22
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 3 5 12 17 19 27 46 3 3 2

PUSKESMAS 11,270 10,822 22,092 33 33 186 172 29 4 244 235 318 304 950 912 1,512 1,451 2,963 230 230 327 324 719 702 1,276 1,256 2,532 181 175 257

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 2 4 3 6 5 11 3 4 0 0 0 0 3 4 7 56 54 82 77 126 123 264 254 518

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 34 33 44 41 102 97 180 171 351
3 Banjar Panjang 737 722 1,459 0 0 0 1 2 0 2 1 3 1 0 0 0 0 0 1 0 1 14 13 21 16 33 24 68 53 121
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 0 10 1 10 1 11 5 3 0 0 0 0 5 3 8 23 20 37 37 85 72 145 129 274
5 Pematang Tinggi 1,125 1,159 2,284 0 0 0 1 1 0 1 1 2 1 1 0 0 0 0 1 1 2 18 18 29 30 64 61 111 109 220
6 Pangkalan Tampoi 913 834 1,747 2 1 3 2 3 1 8 4 12 0 0 1 0 0 0 1 0 1 15 14 25 23 60 57 100 94 194
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 2 7 15 10 18 6 22 23 55 78
8 Tanjung Air Hitam 468 485 953 1 0 1 0 1 2 3 2 5 1 0 0 3 4 1 5 4 9 6 5 8 6 18 18 32 29 61
9 Makteduh 1,317 1,155 2,472 0 0 0 3 5 2 5 5 10 3 3 0 0 0 0 3 3 6 24 17 23 22 46 52 93 91 184
10 Lipai Bulan 203 230 433 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 3 3 5 5 6 11 14 19 33

PUSKESMAS 11,270 10,822 22,092 3 1 8 9 26 9 37 19 56 14 12 1 4 4 1 19 17 36 200 192 284 275 546 537 1,030 1,004 2,034

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 718 518 485 15 3 94% 68% 94% 64% 1%

2
Bukit Lembah Subur
417 365 351 348 2 0 88% 84% 99% 83% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN IN

Banjar Panjang 1 KMS 0

3 196 155 121 83 34 5 79% 62% 69% 42% 4%
Beringin Makmur 2 Oralit 0
4 352 306 274 251 4 0 87% 78% 92% 71% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 264 220 203 13 1 86% 72% 92% 66% 0%
 Pangkalan Tampoi 4 Vitamin A 1427
6 234 223 194 148 8 0 95% 83% 76% 63% 0%
Pangkalan Panduk
7 178 116 78 65 6 0 65% 44% 83% 37% 0%
Tanjung Air Hitam
8 128 121 61 37 10 0 95% 48% 61% 29% 0%
Makteduh
9 331 218 184 161 7 0 66% 56% 88% 49% 0%
Lipai Bulan
10 57 46 33 29 3 0 81% 58% 88% 51% 0%

2,963 2,532 2,034 1,810 102 9 85% 69% 89% 61% 0%

JUMLAH
247 211 170 151 9 1 85% 69% 89% 61% 0%
RATA - RATA

Mengetahui : Kerumutan, 01 Juli 2015

Ka.Puskesmas Kerumutan Pengelola Program

HARNO,SKM ENY SURYATI

NIP. 19780914 200604 1 014 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

72 117 115 248 237 485 0 0 2 3 5 5 7 8 15 763 718 518 485 15 3 94% 68% 94%
40 102 96 179 169 348 0 0 0 1 0 1 0 2 2 417 365 351 348 2 0 88% 84% 99%
13 20 11 47 36 83 1 1 6 2 11 13 18 16 34 196 155 121 83 34 5 79% 62% 69%
36 75 71 128 123 251 0 1 2 1 0 0 2 2 4 352 306 274 251 4 0 87% 78% 92%
25 59 57 104 99 203 0 0 1 4 4 4 5 8 13 307 264 220 203 13 1 86% 72% 92%
21 55 53 62 86 148 1 1 1 0 2 3 4 4 8 234 223 194 173 8 0 95% 83% 89%
14 6 20 17 48 65 0 0 1 3 0 2 1 5 6 178 116 78 70 6 0 65% 44% 90%
3 10 11 19 18 37 0 1 2 0 3 4 5 5 10 128 121 61 37 10 0 95% 48% 61%
18 39 47 82 79 161 0 0 1 1 2 3 3 4 7 331 218 184 161 7 0 66% 56% 88%
5 6 10 11 18 29 0 0 2 0 0 1 2 1 3 57 46 33 29 3 0 81% 58% 88%

247 489 491 897 913 1,810 2 4 18 15 27 36 47 55 102 2,963 2,532 2,034 1840 102 9

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

8 5 1 0 123 108 132 113 245 0 1 0 0 0 2 0 3 3

0 0 1 2 32 31 33 33 66 0 0 0 0 0 0 0 0 0
2 3 0 4 29 37 31 44 75 0 0 2 2 1 0 3 2 5
 6 8 0 0 26 38 32 46 78 0 0 0 0 0 0 0 0 0
6 7 3 3 31 37 40 47 87 0 1 0 0 0 0 0 1 1
5 4 1 0 17 13 23 17 40 0 0 0 0 0 0 0 0 0
7 0 8 1 49 35 64 36 100 0 0 0 0 0 0 0 0 0
4 6 5 8 21 23 30 37 67 0 0 0 0 0 0 0 0 0
5 8 14 10 65 45 84 63 147 0 0 0 0 0 0 0 0 0
1 2 1 1 11 8 13 11 24 0 0 0 0 0 0 0 0 0

44 43 34 29 404 375 482 447 929 0 2 2 2 1 2 3 6 9

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,404
N/S BGM/D
64% 1%
83% 0%
42% 4%
71% 0%
66% 0%
74% 0%
39% 0%
29% 0%
49% 0%
51% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : MEI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 225 209 372 345 717 53 51 79
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 32 31 49 45 102 97 183 173 356 32 31 44
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 16 13 22 21 41 42 79 76 155 11 10 11
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 23 23 45 39 83 75 151 137 288 17 14 37
5 Pematang Tinggi 1,125 1,159 2,284 3 3 23 23 3 0 24 25 32 33 95 98 151 156 307 21 21 32 32 73 74 126 127 253 18 20 26
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 19 18 26 23 67 65 112 106 218 15 11 18
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 10 20 20 24 20 22 50 66 116 7 14 9
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 4 4 7
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 24 29 34 50 55 105 113 218 15 10 18
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 2 5 12 17 18 27 45 3 4 2

PUSKESMAS 11,270 10,822 22,092 33 33 186 172 29 4 244 235 318 304 950 912 1,512 1,451 2,963 225 225 321 314 709 693 1,255 1,232 2,487 175 169 251

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 2 2 2 3 4 5 9 0 1 0 0 0 0 0 1 1 53 52 83 77 124 124 260 253 513

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 32 31 45 43 101 97 178 171 349
3 Banjar Panjang 737 722 1,459 0 0 1 2 0 0 1 2 3 1 1 0 0 0 0 1 1 2 13 13 19 20 30 30 62 63 125
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 0 0 1 0 1 1 4 6 0 0 0 0 4 6 10 21 20 37 34 67 63 125 117 242
5 Pematang Tinggi 1,125 1,159 2,284 0 0 0 1 0 0 0 1 1 2 0 0 0 0 0 2 0 2 20 20 29 28 62 58 111 106 217
6 Pangkalan Tampoi 913 834 1,747 2 2 4 4 3 3 9 9 18 1 0 1 0 1 0 3 0 3 19 15 23 22 58 59 100 96 196
7 Pangkalan Panduk 651 672 1,323 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 2 7 15 10 17 5 16 22 48 70
8 Tanjung Air Hitam 468 485 953 1 1 1 0 2 1 4 2 6 1 1 1 1 1 3 3 5 8 8 8 12 13 17 21 37 42 79
9 Makteduh 1,317 1,155 2,472 0 0 0 1 2 0 2 1 3 3 1 0 0 0 0 3 1 4 18 11 20 25 43 47 81 83 164
10 Lipai Bulan 203 230 433 0 0 1 0 1 1 2 1 3 0 0 0 0 0 0 0 0 0 3 4 4 6 6 13 13 23 36

PUSKESMAS 11,270 10,822 22,092 3 3 10 10 10 9 23 22 45 12 11 2 2 2 3 16 16 32 194 189 282 285 513 528 989 1,002 1,991

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 717 513 488 15 3 94% 67% 95% 64% 1%

2
Bukit Lembah Subur
417 356 349 346 2 1 85% 84% 99% 83% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0

3 196 155 125 82 38 3 79% 64% 66% 42% 2%
Beringin Makmur 2 Oralit 0
4 352 288 242 231 0 1 82% 69% 95% 66% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 253 217 196 18 1 82% 71% 90% 64% 0%
 Pangkalan Tampoi 4 Vitamin A 1427
6 234 218 196 145 6 2 93% 84% 74% 62% 1%
Pangkalan Panduk
7 178 116 70 59 5 0 65% 39% 84% 33% 0%
Tanjung Air Hitam
8 128 121 79 51 14 1 95% 62% 65% 40% 1%
Makteduh
9 331 218 164 150 7 0 66% 50% 91% 45% 0%
Lipai Bulan
10 57 45 36 29 4 0 79% 63% 81% 51% 0%

2,963 2,487 1,991 1,777 109 12 84% 67% 89% 60% 1%

JUMLAH
247 207 166 148 9 1 84% 67% 89% 60% 1%
RATA - RATA

Mengetahui : Kerumutan, 30 Mei 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
ALITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

73 117 115 249 239 488 0 0 2 2 5 6 7 8 15 763 717 513 488 15 3 94% 67% 95%
42 101 96 177 169 346 0 0 0 1 0 1 0 2 2 417 356 349 346 2 1 85% 84% 99%
12 19 19 41 41 82 1 2 7 6 11 11 19 19 38 196 155 125 82 38 3 79% 64% 66%
34 67 62 121 110 231 0 0 0 0 0 0 0 0 0 352 288 242 231 0 1 82% 69% 95%
22 56 54 100 96 196 0 0 3 5 6 4 9 9 18 307 253 217 196 18 1 82% 71% 90%
17 53 55 62 83 145 1 2 0 1 1 1 2 4 6 234 218 196 169 6 2 93% 84% 86%
14 5 14 17 42 59 0 0 1 2 0 2 1 4 5 178 116 70 63 5 0 65% 39% 90%
9 12 15 23 28 51 2 2 3 3 2 2 7 7 14 128 121 79 51 14 1 95% 62% 65%
22 40 45 73 77 150 0 0 2 2 1 2 3 4 7 331 218 164 150 7 0 66% 50% 91%
4 5 11 10 19 29 0 0 1 2 0 1 1 3 4 57 45 36 29 4 0 79% 63% 81%

249 475 486 873 904 1,777 4 6 19 24 26 30 49 60 109 2,963 2,487 1,991 1805 109 12

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

11 7 0 0 125 107 136 114 250 0 1 0 0 0 2 0 3 3

2 2 0 0 33 31 35 33 68 0 1 0 0 0 0 0 1 1
3 3 2 0 32 31 37 34 71 0 0 1 2 0 0 1 2 3
 8 8 0 3 44 47 52 58 110 0 0 1 0 0 0 1 0 1
4 5 3 5 33 40 40 50 90 0 1 0 0 0 0 0 1 1
1 3 3 1 19 11 23 15 38 0 0 0 1 1 0 1 1 2
7 0 8 2 50 41 65 43 108 0 0 0 0 0 0 0 0 0
2 3 1 1 22 20 25 24 49 0 0 0 1 0 0 0 1 1
11 14 17 7 68 50 96 71 167 0 0 0 0 0 0 0 0 0
1 1 2 0 11 6 14 7 21 0 0 0 0 0 0 0 0 0

50 46 36 19 437 384 523 449 972 0 3 2 4 1 2 3 9 12

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,404
N/S BGM/D
64% 1%
83% 0%
42% 2%
66% 0%
64% 0%
72% 1%
35% 0%
40% 1%
45% 0%
51% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : APRIL

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 225 209 372 345 717 56 51 78
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 30 28 49 45 88 85 167 158 325 28 27 45
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 14 13 22 21 41 42 77 76 153 11 13 16
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 22 23 43 38 81 75 146 136 282 17 13 36
5 Pematang Tinggi 1,125 1,159 2,284 3 3 21 21 3 0 24 25 32 33 95 98 151 156 307 21 21 31 30 70 70 122 121 243 17 17 21
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 17 17 26 23 67 61 110 101 211 9 7 15
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 10 20 20 23 20 22 50 65 115 8 12 8
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 4 4 7
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 24 29 34 50 55 105 113 218 13 10 17
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 2 5 12 17 18 27 45 4 3 2

PUSKESMAS 11,270 10,822 22,092 33 33 184 170 29 4 244 235 318 304 950 912 1,512 1,451 2,963 218 221 318 310 690 673 1,226 1,204 2,430 167 157 245

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 2,951 2,738 5,689 0 0 3 2 2 3 5 5 10 1 2 0 0 0 0 1 2 3 57 53 83 77 124 131 264 261 525

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 28 45 43 83 82 156 153 309
3 Banjar Panjang 737 722 1,459 0 0 1 0 2 2 3 2 5 0 0 0 0 0 0 0 0 0 11 13 21 17 30 31 62 61 123
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 0 1 1 1 1 2 3 7 0 0 0 0 3 7 10 20 20 37 36 70 66 127 122 249
5 Pematang Tinggi 1,125 1,159 2,284 0 0 1 0 2 0 3 0 3 0 1 1 1 0 0 1 2 3 17 18 27 24 57 56 101 98 199
6 Pangkalan Tampoi 913 834 1,747 2 4 3 2 5 2 10 8 18 1 1 1 0 1 0 3 1 4 14 13 21 23 59 58 94 94 188
7 Pangkalan Panduk 651 672 1,323 0 0 1 0 0 0 1 0 1 0 1 0 1 0 0 0 2 2 8 13 10 19 5 22 23 54 77
8 Tanjung Air Hitam 468 485 953 1 1 1 0 2 1 4 2 6 1 1 1 1 1 3 3 5 8 8 8 12 13 17 21 37 42 79
9 Makteduh 1,317 1,155 2,472 0 0 2 1 9 5 11 6 17 1 0 0 0 0 0 1 0 1 15 10 20 24 41 48 76 82 158
10 Lipai Bulan 203 230 433 0 0 0 0 1 1 1 1 2 0 0 0 0 0 0 0 0 0 4 3 2 5 10 13 16 21 37

PUSKESMAS 11,270 10,822 22,092 3 5 12 5 24 15 39 25 64 7 13 3 3 2 3 12 19 31 182 179 278 281 496 528 956 988 1,944

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 717 525 496 16 3 94% 69% 94% 65% 1%

2
Bukit Lembah Subur
417 325 309 308 1 0 78% 74% 100% 74% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0

3 196 153 123 81 37 3 78% 63% 66% 41% 2%
Beringin Makmur 2 Oralit 0
4 352 282 249 231 6 1 80% 71% 93% 66% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 243 199 176 17 1 79% 65% 88% 57% 1%
 Pangkalan Tampoi 4 Vitamin A 1427
6 234 211 188 142 10 2 90% 80% 76% 61% 1%
Pangkalan Panduk
7 178 115 77 67 3 0 65% 43% 87% 38% 0%
Tanjung Air Hitam
8 128 121 79 51 14 1 95% 62% 65% 40% 1%
Makteduh
9 331 218 158 129 11 0 66% 48% 82% 39% 0%
Lipai Bulan
10 57 45 37 32 3 0 79% 65% 86% 56% 0%

2,963 2,430 1,944 1,713 118 11 82% 66% 88% 58% 1%

JUMLAH
247 203 162 143 10 1 82% 66% 88% 58% 1%
RATA - RATA

Mengetahui : Kerumutan, 01 Mei 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
ALITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

73 117 121 251 245 496 0 0 2 2 5 7 7 9 16 763 717 525 496 16 3 94% 69% 94%
43 83 82 156 152 308 0 1 0 0 0 0 0 1 1 417 325 309 308 1 0 78% 74% 100%
10 20 11 47 34 81 0 0 4 7 8 18 12 25 37 196 153 123 81 37 3 78% 63% 66%
35 67 63 120 111 231 0 0 1 1 2 2 3 3 6 352 282 249 231 6 1 80% 71% 93%
19 50 52 88 88 176 0 0 4 4 5 4 9 8 17 307 243 199 176 17 1 79% 65% 88%
19 52 54 62 80 142 2 1 2 2 1 2 5 5 10 234 211 188 156 10 2 90% 80% 83%
17 5 21 17 50 67 0 0 1 1 0 1 1 2 3 178 115 77 71 3 0 65% 43% 92%
9 12 15 23 28 51 2 2 3 3 2 2 7 7 14 128 121 79 51 14 1 95% 62% 65%
20 29 40 59 70 129 1 0 1 3 3 3 5 6 11 331 218 158 129 11 0 66% 48% 82%
5 8 10 14 18 32 0 0 0 0 1 2 1 2 3 57 45 37 32 3 0 79% 65% 86%

250 443 469 837 876 1,713 5 4 18 23 27 41 50 68 118 2,963 2,430 1,944 1731 118 11

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

7 6 0 0 125 100 132 106 238 0 1 0 0 0 2 0 3 3

6 5 0 0 51 46 57 51 108 0 0 0 0 0 0 0 0 0
5 3 0 3 32 30 37 36 73 1 0 1 1 0 0 2 1 3
 9 8 0 1 41 44 50 53 103 0 0 1 0 0 0 1 0 1
7 7 5 9 38 42 50 58 108 0 1 0 0 0 0 0 1 1
6 5 5 0 18 12 29 17 46 0 0 0 1 1 0 1 1 2
6 2 8 0 50 35 64 37 101 0 0 0 0 0 0 0 0 0
2 3 1 1 22 20 25 24 49 0 0 0 1 0 0 0 1 1
14 15 17 8 70 49 101 72 173 0 0 0 0 0 0 0 0 0
0 2 4 1 7 6 11 9 20 0 0 0 0 0 0 0 0 0

62 56 40 23 454 384 556 463 1,019 1 2 2 3 1 2 4 7 11

RIMA BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,404
N/S BGM/D
65% 1%
74% 0%
41% 2%
66% 0%
57% 1%
67% 1%
40% 0%
40% 1%
39% 0%
56% 0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : MARET

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk Pr

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 83 77 249 231 396 367 763 64 59 83 77 225 209 372 345 717 53 50 79 75
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 45 43 134 128 213 204 417 30 27 45 42 88 85 163 154 317 28 27 43 41
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 21 20 62 61 99 97 196 14 13 22 21 41 42 77 76 153 12 12 14 11
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 111 110 177 175 352 21 19 43 38 79 73 143 130 273 17 13 36 34
5 Pematang Tinggi 1,125 1,159 2,284 3 3 21 21 3 0 24 25 32 33 95 98 151 156 307 20 20 30 28 67 69 117 117 234 17 17 21 19
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 26 23 77 70 123 111 234 17 14 26 23 65 59 108 96 204 8 8 16 14
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 18 19 55 57 87 91 178 10 20 22 19 23 24 55 63 118 5 14 15 18
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 13 14 39 41 62 66 128 10 11 13 14 36 37 59 62 121 5 2 7 5
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 37 32 111 97 177 154 331 26 22 24 34 50 55 100 111 211 13 10 11 21
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 6 6 17 19 27 30 57 4 5 2 5 12 17 18 27 45 3 3 2 4

PUSKESMAS 11,270 10,822 22,092 33 33 184 170 29 4 244 235 318 304 950 912 1,512 1,451 2,963 216 210 310 301 686 670 1,212 1,181 2,393 161 156 244 242

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total A
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk

1 Kerumutan 2,951 2,738 5,689 0 0 0 0 2 3 2 3 5 3 4 0 0 0 0 3 4 7 56 54 81 77 124 131 261 262 523 8

2 Bukit Lembah Subur 1,587 1,516 3,103 0 0 0 1 0 1 0 2 2 0 0 0 0 0 0 0 0 0 28 27 43 42 82 81 153 150 303 6
3 Banjar Panjang 737 722 1,459 0 0 2 2 4 5 6 7 13 0 1 0 0 0 0 0 1 1 13 13 20 19 37 34 70 66 136 3
4 Beringin Makmur 1,318 1,311 2,629 0 0 0 0 1 1 1 1 2 2 3 0 0 0 0 2 3 5 19 16 37 35 53 51 109 102 211 10
5 Pematang Tinggi 1,125 1,159 2,284 0 0 2 1 1 0 3 1 4 2 2 0 1 1 1 3 4 7 19 20 26 25 57 59 102 104 206 5
6 Pangkalan Tampoi 913 834 1,747 2 2 5 5 16 14 23 21 44 2 0 0 1 2 2 4 3 7 14 11 26 23 62 58 102 92 194 6
7 Pangkalan Panduk 651 672 1,323 0 0 1 0 0 0 1 0 1 0 1 0 1 0 0 0 2 2 5 15 17 19 8 23 30 57 87 9
8 Tanjung Air Hitam 468 485 953 1 4 3 3 6 5 10 12 22 0 0 0 2 4 1 4 3 7 8 6 12 12 26 18 46 36 82 2
9 Makteduh 1,317 1,155 2,472 0 0 6 2 8 5 14 7 21 1 0 0 0 0 0 1 0 1 14 10 19 26 39 46 72 82 154 15
10 Lipai Bulan 203 230 433 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 4 3 3 5 7 9 14 17 31 0

PUSKESMAS 11,270 10,822 22,092 3 6 19 14 38 34 60 54 114 11 11 0 5 7 4 18 20 38 180 175 284 283 495 510 959 968 1,927 64

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 763 717 523 495 16 3 94% 69% 95% 65% 1%

2
Bukit Lembah Subur
417 317 303 300 1 0 76% 73% 99% 72% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0

3 196 153 136 95 27 3 78% 69% 70% 48% 2%
Beringin Makmur 2 Oralit 0
4 352 273 211 198 6 1 78% 60% 94% 56% 0%
Pematang Tinggi 3 Tablet Fe 0
5 307 234 206 176 19 0 76% 67% 85% 57% 0%
 Pangkalan Tampoi 4 Vitamin A 1450
6 234 204 194 119 26 2 87% 83% 61% 51% 1%
Pangkalan Panduk
7 178 118 87 72 1 0 66% 49% 83% 40% 0%
Tanjung Air Hitam
8 128 121 82 37 16 1 95% 64% 45% 29% 1%
Makteduh
9 331 211 154 121 11 0 64% 47% 79% 37% 0%
Lipai Bulan
10 57 45 31 27 3 0 79% 54% 87% 47% 0%

2,963 2,393 1,927 1,640 126 10 81% 65% 85% 55% 1%

JUMLAH
247 199 161 137 11 1 81% 65% 85% 55% 1%
RATA - RATA

Mengetahui : Kerumutan, 06 April 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
TA

N T

C jumlah Total A B C jumlah Total

LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D N/S

117 121 249 246 495 0 0 2 2 5 7 7 9 16 763 717 523 495 16 3 94% 69% 95% 65%
81 80 152 148 300 0 0 0 0 1 0 1 0 1 417 317 303 300 1 0 76% 73% 99% 72%
24 22 50 45 95 1 0 4 6 9 7 14 13 27 196 153 136 95 27 3 78% 69% 70% 48%
50 48 103 95 198 0 0 1 1 2 2 3 3 6 352 273 211 198 6 1 78% 60% 94% 56%
50 52 88 88 176 0 1 3 4 5 6 8 11 19 307 234 206 176 19 0 76% 67% 85% 57%
36 35 62 57 119 2 1 5 3 8 7 15 11 26 234 204 194 117 26 2 87% 83% 60% 50%
8 23 17 55 72 0 0 1 0 0 0 1 0 1 178 118 87 83 1 0 66% 49% 95% 47%
10 8 22 15 37 2 0 2 2 6 4 10 6 16 128 121 82 37 16 1 95% 64% 45% 29%
27 39 51 70 121 0 0 2 3 4 2 6 5 11 331 211 154 121 11 0 64% 47% 79% 37%
7 8 12 15 27 0 0 1 1 0 1 1 2 3 57 45 31 27 3 0 79% 54% 87% 47%

410 436 806 834 1,640 5 2 21 22 40 36 66 60 126 2,963 2,393 1,927 1649 126 10

( - ) BGM

A B C jumlah Total A B C jumlah Total

Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

5 2 0 125 100 135 105 240 0 1 0 0 1 1 1 2 3

6 2 1 52 47 60 54 114 0 0 0 0 0 0 0 0 0
3 1 1 25 27 29 31 60 1 0 1 1 0 0 2 1 3
 12 0 2 58 59 68 73 141 0 0 1 0 0 0 1 0 1
5 6 8 38 39 49 52 101 0 0 0 0 0 0 0 0 0
7 0 0 15 12 21 19 40 0 0 0 1 1 0 1 1 2
0 1 0 47 34 57 34 91 0 0 0 0 0 0 0 0 0
5 1 2 13 23 16 30 46 0 0 0 1 0 0 0 1 1
15 18 6 72 51 105 72 177 0 0 0 0 0 0 0 0 0
2 3 1 10 10 13 13 26 0 0 0 0 0 0 0 0 0

60 34 21 455 402 553 483 1,036 1 1 2 3 2 1 5 5 10

BLN INI SISA BLN INI

0 0

0 0

0 -
0 1,427
BGM/D
1%
0%
2%
0%
0%
1%
0%
1%
0%
0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : FEBRUARI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk Pr

1 Kerumutan 2,951 2,738 5,689 8 8 30 30 5 3 64 59 106 99 225 209 395 367 762 60 54 90 85 168 167 318 306 624 44 39 79 77
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 57 55 121 116 213 203 416 30 26 46 42 83 78 159 146 305 27 25 41 41
3 Banjar Panjang 737 722 1,459 1 1 11 11 1 0 16 16 27 26 56 55 99 97 196 14 13 22 21 41 39 77 73 150 12 11 14 12
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 47 47 101 100 177 176 352 20 19 40 38 69 66 129 123 252 16 13 33 33
5 Pematang Tinggi 1,125 1,159 2,284 3 3 21 21 3 0 24 25 41 42 86 88 151 155 306 18 18 27 26 50 47 95 91 186 15 15 20 18
6 Pangkalan Tampoi 913 834 1,747 5 5 20 15 5 0 20 18 33 30 70 64 122 112 234 15 13 26 20 49 47 90 80 170 8 7 14 12
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 14 15 23 24 50 51 87 90 177 10 20 22 20 23 24 55 64 119 5 14 15 21
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 17 17 36 37 63 65 128 7 8 17 14 23 21 47 43 90 5 3 5 5
9 Makteduh 1,317 1,155 2,472 5 5 22 22 4 1 29 25 47 42 100 88 176 155 331 26 22 24 34 50 55 100 111 211 10 7 9 20
10 Lipai Bulan 203 230 433 1 1 10 4 1 0 4 5 7 8 15 18 27 31 58 4 5 2 5 12 17 18 27 45 4 5 1 4

PUSKESMAS 11,270 10,822 22,092 33 33 184 170 29 4 245 235 406 390 860 826 1,510 1,450 2,960 204 198 316 305 568 561 1,088 1,064 2,152 146 139 231 243

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total A
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk

1 Kerumutan 3,041 2,645 5,686 0 0 0 0 2 3 2 3 5 5 6 0 0 0 0 5 6 11 49 45 82 78 125 132 256 255 511 15

2 Bukit Lembah Subur 1,410 1,277 2,687 0 0 1 1 0 0 1 1 2 0 3 0 0 0 0 0 3 3 27 28 42 42 76 74 145 144 289 7
3 Banjar Panjang 654 612 1,266 0 0 2 3 4 3 6 6 12 1 1 0 0 0 0 1 1 2 13 12 18 18 36 29 67 59 126 3
4 Beringin Makmur 1,217 1,168 2,385 0 0 4 2 13 4 17 6 23 2 0 0 0 0 0 2 0 2 18 13 38 36 67 54 123 103 226 11
5 Pematang Tinggi 1,005 982 1,987 0 0 1 1 2 2 3 3 6 1 2 0 0 0 0 1 2 3 17 18 24 24 48 48 89 90 179 7
6 Pangkalan Tampoi 824 720 1,544 2 3 4 4 12 6 18 13 31 3 1 0 1 5 4 8 6 14 15 12 24 20 46 41 85 73 158 5
7 Pangkalan Panduk 587 567 1,154 0 0 1 0 0 0 1 0 1 0 1 0 2 0 0 0 3 3 5 15 17 24 8 23 30 62 92 9
8 Tanjung Air Hitam 442 436 878 0 0 3 2 2 0 5 2 7 0 0 1 0 2 2 3 2 5 7 4 11 9 16 10 34 23 57 3
9 Makteduh 867 779 1,646 0 0 12 7 19 21 31 28 59 3 3 1 0 0 0 4 3 7 13 10 22 31 42 49 77 90 167 16
10 Lipai Bulan 182 192 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 5 2 4 9 11 15 20 35 0

PUSKESMAS 10,229 9,378 19,607 2 3 28 20 54 39 84 62 146 15 17 2 3 7 6 24 26 50 168 162 280 286 473 471 921 919 1,840 77

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 762 624 511 477 18 3 82% 67% 93% 63% 1%

2
Bukit Lembah Subur
416 305 289 283 1 0 73% 70% 98% 68% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0

3 196 150 126 96 16 4 77% 64% 76% 49% 3%
Beringin Makmur 2 Oralit 0
4 352 252 226 191 10 1 72% 64% 85% 54% 0%
Pematang Tinggi 3 Tablet Fe 0
5 306 186 179 146 24 0 61% 58% 82% 48% 0%
 Pangkalan Tampoi 4 Vitamin A 1327 2,15
6 234 170 158 105 26 2 73% 67% 66% 45% 1%
Pangkalan Panduk
7 177 119 92 75 2 0 67% 52% 82% 42% 0%
Tanjung Air Hitam
8 128 90 57 36 9 0 70% 45% 63% 28% 0%
Makteduh
9 331 211 167 93 8 0 64% 50% 56% 28% 0%
Lipai Bulan
10 58 45 35 33 2 0 78% 60% 94% 57% 0%

2,960 2,152 1,840 1,535 116 10 73% 62% 83% 52% 1%

JUMLAH
247 179 153 128 10 1 73% 62% 83% 52% 1%
RATA - RATA

Mengetahui : Kerumutan, 06 Maret 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
TA

N T

C jumlah Total A B C jumlah Total

LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D N/S

117 121 240 237 477 0 0 3 1 6 8 9 9 18 762 624 511 477 18 3 82% 67% 93% 63%
75 74 143 140 283 0 0 0 0 1 0 1 0 1 416 305 289 283 1 0 73% 70% 98% 68%
26 21 52 44 96 0 0 2 3 6 5 8 8 16 196 150 126 96 16 4 77% 64% 76% 49%
49 47 98 93 191 0 0 1 1 5 3 6 4 10 352 252 226 191 10 1 72% 64% 85% 54%
39 39 74 72 146 1 1 3 5 7 7 11 13 24 306 186 179 146 24 0 61% 58% 82% 48%
22 24 62 43 105 2 1 6 3 7 7 15 11 26 234 170 158 87 26 2 73% 67% 55% 37%
8 23 17 58 75 0 0 1 1 0 0 1 1 2 177 119 92 86 2 0 67% 52% 93% 49%
10 8 20 16 36 2 1 2 2 2 0 6 3 9 128 90 57 36 9 0 70% 45% 63% 28%
21 26 40 53 93 0 0 0 4 2 2 2 6 8 331 211 167 93 8 0 64% 50% 56% 28%
8 11 13 20 33 0 0 1 0 1 0 2 0 2 58 45 35 33 2 0 78% 60% 94% 57%

375 394 759 776 1,535 5 3 19 20 37 32 61 55 116 2,960 2,152 1,840 1528 116 10

( - ) BGM

A B C jumlah Total A B C jumlah Total

Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

14 24 21 100 77 139 112 251 0 0 0 0 1 2 1 2 3

5 15 13 45 42 68 59 127 0 0 0 0 0 0 0 0 0
4 9 8 20 26 32 38 70 1 0 1 2 0 0 2 2 4
 15 9 11 34 46 54 73 126 0 0 1 0 0 0 1 0 1
7 17 18 38 40 62 65 127 0 0 0 0 0 0 0 0 0
6 9 10 24 23 37 39 76 0 0 0 1 1 0 1 1 2
0 6 0 42 28 57 28 85 0 0 0 0 0 0 0 0 0
7 6 8 20 27 29 42 71 0 0 0 0 0 0 0 0 0
15 25 11 58 39 99 65 164 0 0 0 0 0 0 0 0 0
0 5 4 6 7 12 11 23 0 0 0 0 0 0 0 0 0

73 126 104 387 355 589 531 1,120 1 0 2 3 2 2 5 5 10

BLN INI SISA BLN INI

0 0

0 0

0 -
2,150 1,450
BGM/D
1%
0%
3%
0%
0%
1%
0%
0%
0%
0%
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2016
Puskesmas : KERUMUTAN
Bulan : JANUARI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk

1 Kerumutan 2,951 2,738 5,689 5 5 26 26 5 0 64 59 106 99 225 209 395 367 762
2 Bukit Lembah Subur 1,587 1,516 3,103 3 3 30 30 3 0 34 33 57 55 121 116 213 203 416
3 Banjar Panjang 737 722 1,459 1 1 10 8 1 1 16 16 27 26 56 55 99 97 196
4 Beringin Makmur 1,318 1,311 2,629 3 3 20 17 3 0 29 28 37 37 110 111 176 176 352
5 Pematang Tinggi 1,125 1,159 2,284 3 3 35 35 3 0 24 25 41 42 86 88 151 155 306
6 Pangkalan Tampoi 913 834 1,747 3 3 20 15 3 0 18 18 33 30 70 64 121 112 232
7 Pangkalan Panduk 651 672 1,323 2 2 10 10 2 0 19 18 23 19 25 21 67 58 125
8 Tanjung Air Hitam 468 485 953 2 2 10 10 2 0 10 11 17 17 36 37 63 65 128
9 Makteduh 1,317 1,155 2,472 5 5 19 19 5 1 26 23 40 34 76 64 142 121 263
10 Lipai Bulan 203 230 433 1 1 10 5 1 0 4 5 7 8 15 18 27 31 58

PUSKESMAS 11,270 10,822 22,092 28 28 190 175 28 2 245 236 388 367 820 782 1,453 1,385 2,838 0 0 0 0 0 0 0 0 0 0 0 0

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

1 Kerumutan 3,041 2,645 5,686

2 Bukit Lembah Subur 1,410 1,277 2,687
3 Banjar Panjang 654 612 1,266
4 Beringin Makmur 1,217 1,168 2,385
5 Pematang Tinggi 1,005 982 1,987
6 Pangkalan Tampoi 824 720 1,544
7 Pangkalan Panduk 587 567 1,154
8 Tanjung Air Hitam 442 436 878
9 Makteduh 867 779 1,646
10 Lipai Bulan 182 192 374

PUSKESMAS 10,229 9,378 19,607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1

2
Bukit Lembah Subur NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0

3
Beringin Makmur 2 Oralit 0
4
 Pematang Tinggi 3 Tablet Fe 0
5
Pangkalan Tampoi 4 Vitamin A 1361
6
Pangkalan Panduk
7
Tanjung Air Hitam
8
Makteduh
9
Lipai Bulan
10

JUMLAH

RATA - RATA

Mengetahui : Kerumutan, 29 Januari 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
LITA

N T

B C jumlah Total A B C jumlah Total

Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D

762 0 0 0 0 0 0% 0% #DIV/0!
416 0 0 0 0 0 0% 0% #DIV/0!
196 0 0 0 0 0 0% 0% #DIV/0!
352 0 0 0 0 0 0% 0% #DIV/0!
306 0 0 0 0 0 0% 0% #DIV/0!
232 0 0 0 0 0 0% 0% #DIV/0!
125 0 0 0 0 0 0% 0% #DIV/0!
128 0 0 0 0 0 0% 0% #DIV/0!
263 0 0 0 0 0 0% 0% #DIV/0!
58 0 0 0 0 0 0% 0% #DIV/0!

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2,838 0 0 0 0 0

( - ) BGM

A B C jumlah Total A B C jumlah Total

Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

RIMA BLN INI SISA BLN INI

0 0

0 0
0 -

0 1,327
N/S BGM/D
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!
 BLANGKO LAPORAN REKAPITULASI LAPORAN PWS - GIZI TENTANG PENIMBANGAN BALITA
DI KABUPATEN PELALAWAN TAHUN 2015
Puskesmas : KERUMUTAN
Bulan : JANUARI

JLH POS JLH Jlh

JLH
PENIMBANGAN KADER Dacin
S K N

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B
ADA MELP ADA AKTIF Ada (-)
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr Lk Pr Lk Pr

1 Kerumutan 2,839 2,507 5,346 8 8 30 30 5 3 58 51 91 80 171 151 320 283 603 56 50 88 78 166 147 310 275 585 44 39 77 77
2 Bukit Lembah Subur 1,528 1,388 2,916 3 3 30 30 3 0 31 28 49 44 92 84 172 157 329 30 24 46 42 83 78 159 144 303 26 24 40 41
3 Banjar Panjang 709 662 1,371 1 1 11 11 1 0 14 14 23 21 43 40 80 75 155 14 13 22 21 40 31 76 65 141 12 11 12 12
4 Beringin Makmur 1,271 1,199 2,470 3 3 20 17 3 0 26 24 41 38 77 72 143 135 279 20 16 40 38 69 66 129 120 249 14 11 25 21
5 Pematang Tinggi 1,086 1,060 2,146 3 3 21 21 3 0 22 22 35 34 66 64 123 120 242 17 16 27 26 50 47 94 89 183 14 13 19 18
6 Pangkalan Tampoi 878 764 1,642 5 5 20 15 5 0 18 16 28 24 53 46 99 86 185 13 14 26 20 48 43 87 77 164 6 8 12 9
7 Pangkalan Panduk 629 615 1,244 2 2 10 10 2 0 13 13 20 20 38 37 71 69 140 10 13 20 20 20 24 50 57 107 4 10 11 20
8 Tanjung Air Hitam 452 444 896 2 2 10 10 2 0 9 9 14 14 27 27 51 50 101 7 8 13 14 23 21 43 43 86 4 4 9 7
9 Makteduh 1,264 1,059 2,323 5 5 22 22 4 1 26 22 40 34 76 64 143 119 262 26 22 24 34 41 50 91 106 197 22 10 4 20
10 Lipai Bulan 197 212 409 1 1 10 5 1 0 4 4 6 7 12 13 22 24 46 4 4 6 8 10 8 20 20 40 4 4 5 6

PUSKESMAS 10,853 9,910 20,763 33 33 184 171 29 4 221 202 347 317 656 599 1,224 1,118 2,342 197 180 312 301 550 515 1,059 996 2,055 150 134 214 231

JLH O B D

No Desa
PDDK
A B C jumlah Total A B C jumlah Total A B C jumlah Total A
LK Pr Jlh
Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr Lk

1 Kerumutan 3,041 2,645 5,686 0 0 0 0 2 3 2 3 5 5 6 0 0 0 0 5 6 11 49 45 80 78 87 94 216 217 433 9

2 Bukit Lembah Subur 1,410 1,277 2,687 0 2 3 1 10 4 13 7 20 5 1 0 0 0 0 5 1 6 31 27 43 42 85 78 159 147 306 0
3 Banjar Panjang 654 612 1,266 0 0 1 1 2 1 3 2 5 2 0 0 0 0 0 2 0 2 14 11 17 16 34 27 65 54 119 0
4 Beringin Makmur 1,217 1,168 2,385 1 0 1 1 3 2 5 3 8 1 2 0 0 0 0 1 2 3 16 13 28 25 41 38 85 76 161 10
5 Pematang Tinggi 1,005 982 1,987 0 1 1 1 1 1 2 3 5 1 1 0 0 0 0 1 1 2 16 16 23 23 46 41 85 80 165 6
6 Pangkalan Tampoi 824 720 1,544 2 3 4 4 7 6 13 13 26 2 0 1 0 1 0 4 0 4 11 11 21 18 44 40 76 69 145 7
7 Pangkalan Panduk 587 567 1,154 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0 2 1 3 7 12 12 20 5 24 24 56 80 6
8 Tanjung Air Hitam 442 436 878 0 0 1 1 2 2 3 3 6 3 0 1 0 1 0 5 0 5 8 4 14 10 15 7 37 21 58 1
9 Makteduh 867 779 1,646 0 0 14 0 12 6 26 6 32 0 2 1 2 0 1 1 5 6 22 15 19 25 32 34 73 74 147 4
10 Lipai Bulan 182 192 374 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 4 4 6 7 7 5 17 16 33 0

PUSKESMAS 10,229 9,378 19,607 3 6 25 9 40 25 68 40 108 21 13 3 2 2 1 26 16 42 178 158 263 264 396 388 837 810 1,647 43

Jumlah Cakupan
NO NAMA DESA
PERSEDIAAN BAHAN - BAHAN
S K D N T BGM K/S D/S N/D N/S BGM/D

Kerumutan
1 603 585 433 399 18 3 97% 72% 92% 66% 1%

2
Bukit Lembah Subur
329 303 306 280 0 0 92% 93% 92% 85% 0% NO BAHAN - BAHAN SISA BLN LALU DITERIMA BLN INI

Banjar Panjang 1 KMS 0 0

3 155 141 119 94 18 2 91% 77% 79% 61% 2%
Beringin Makmur 2 Oralit 0 0
4 279 249 161 140 10 2 89% 58% 87% 50% 1%
Pematang Tinggi 3 Tablet Fe 0 0
5 242 183 165 136 22 0 76% 68% 82% 56% 0%
Pangkalan Tampoi 4 Vitamin A 1361 0
6 185 164 145 103 31 2 89% 78% 71% 56% 1%
Pangkalan Panduk
7 140 107 80 71 3 0 76% 57% 89% 51% 0%
Tanjung Air Hitam
8 101 86 58 40 7 0 85% 57% 69% 40% 0%
 Makteduh
9 262 197 147 100 9 0 75% 56% 68% 38% 0%
Lipai Bulan
10 46 40 33 30 2 0 87% 72% 91% 65% 0%

2,342 2,055 1,647 1,393 120 9 88% 70% 85% 59% 1%

JUMLAH
195 171 137 116 10 1 88% 70% 85% 59% 1%
RATA - RATA

Mengetahui : Kerumutan, 29 Januari 2015

Ka.Puskesmas Kerumutan Pengelola Program

ARDI ARSYAD,SKM ENY SURYATI

NIP. 19710125 199703 1 004 NIP. 19831018 200502 2 001
TA

N T

C jumlah Total A B C jumlah Total

LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk Pr Lk + Pr S K D N T BGM K/S D/S N/D N/S

79 83 200 199 399 0 0 3 1 6 8 9 9 18 603 585 433 399 18 3 97% 72% 92% 66%
75 74 141 139 280 0 0 0 0 0 0 0 0 0 329 303 306 280 0 0 92% 93% 92% 85%
26 21 50 44 94 0 0 4 3 6 5 10 8 18 155 141 119 94 18 2 91% 77% 79% 61%
35 34 74 66 140 0 0 2 3 3 2 5 5 10 279 249 161 140 10 2 89% 58% 87% 50%
38 34 71 65 136 1 1 3 4 7 6 11 11 22 242 183 165 136 22 0 76% 68% 82% 56%
25 24 62 41 103 1 0 4 5 11 10 16 15 31 185 164 145 84 31 2 89% 78% 58% 45%
5 24 17 54 71 1 1 1 0 0 0 2 1 3 140 107 80 74 3 0 76% 57% 93% 53%
11 5 24 16 40 1 0 3 2 1 0 5 2 7 101 86 58 40 7 0 85% 57% 69% 40%
18 26 44 56 100 0 3 0 3 2 1 2 7 9 262 197 147 100 9 0 75% 56% 68% 38%
6 5 15 15 30 0 0 1 1 0 0 1 1 2 46 40 33 30 2 0 87% 72% 91% 65%

318 330 698 695 1,393 4 5 21 22 36 32 61 59 120 2,342 2,055 1,647 1377 120 9

( - ) BGM

A B C jumlah Total A B C jumlah Total

Pr Lk Pr LK Pr Lk pr Lk + Pr Lk Pr Lk Pr LK Pr Lk pr Lk + Pr

6 11 2 84 57 104 66 170 0 0 0 0 1 2 1 2 3
1 6 2 7 6 13 10 23 0 0 0 0 0 0 0 0 0
3 6 5 9 13 15 21 36 0 0 1 1 0 0 1 1 2
 11 13 13 36 34 58 59 118 0 0 1 1 0 0 1 1 2
6 12 11 20 23 38 40 77 0 0 0 0 0 0 0 0 0
5 7 6 9 6 23 17 40 0 0 0 1 1 0 1 1 2
1 8 0 33 13 47 13 60 0 0 0 0 0 0 0 0 0
5 0 4 12 20 14 29 43 0 0 0 0 0 0 0 0 0
7 21 9 44 30 70 45 115 0 0 0 0 0 0 0 0 0
0 0 0 5 8 5 8 13 0 0 0 0 0 0 0 0 0

44 84 53 260 211 387 308 695 0 0 2 3 2 2 4 5 9

BLN INI SISA BLN INI

0 0

0 0

0 -

0 1,327
BGM/D
1%
0%
2%
1%
0%
1%
0%
0%
0%
0%