You are on page 1of 4

REGISTER LABORATORIUM TB

PROGRAM TB NASIONAL

PUSKESMAS : MALINJAK
BULAN : November

NO IDENTITAS NOMOR TANGGAL NAMA TERSANGKA UMUR ALAMAT


NO SEDIAN DAHAK REG LAB PEMERIKSAAN PENDERITA L P LENGKAP
1 001/06/295 295 3/11/2017 Paulina Bangi Lika 40 Manurara
2 001/06/296 296 5/11/2017 Lince Bita Dopi 17 Tanamodu
3 001/06/297 297 9/11/2017 Samuel D. A. Mara 23 Tanamodu
4 001/06/298 298 9/11/2017 Noviana R. Hana 18 Tanamodu
5 001/06/299 299 11/11/2017 Aldi K. dolung 12 Tanamodu
6 001/06/300 300 11/11/2017 Fajar U. Deta 16 Tanamodu
7 001/06/301 301 13/11/2017 Yustus B. Kipa 17 Manurara
8 001/06/302 302 16/11/2017 Yunita P. Boka 15 Manurara
9 001/06/303 303 17/11/2017 Petrus P. Pare 14 Manurara
10 001/06/304 304 18/11/2017 Kanisius K. B. Wali 18 Manurara
11 001/06/305 305 23/11/2017 Agus P. Pasi 19 Manurara
12 001/06/306 306 23/11/2017 Karolus J. Runga 21 Manurara
13 001/06/307 307 24/11/2017 Ferdinandus B. Reri 40 Tanamodu
14 001/06/308 308 24/11/2017 Ani B. Kahi 38 Tanamodu
15 001/06/309 309 24/11/2017 Alfian Umbu Madiata 17 Tanamodu
16 001/06/310 310 25/11/2017 Denison G. Memang 15 Tanamodu
17 001/06/311 311 25/11/2017 Fredi S. Kawawu 16 Tanamodu
18 001/06/312 312 26/11/2017 Petrus M. Ngara 17 Wailawa
19 001/06/313 313 26/11/2017 Marsila R. Dowi 19 Wailawa
20 001/06/314 314 27/11/2017 Ninu L. Bana 35 Malinjak
21 001/06/315 315 27/11/2017 Datu Ngulu 40 Malinjak
TB.04

NAMA ALASAN PEMERIKSAAN HASIL PEMERIKSAAN TTD


PUSKESMAS DIAGNOSA FOLLOW UP A B C
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
Malinjak √ _ _ _ _
PROGRAM TB NASIONAL
PROGRAM TB NASIONAL TB.06
DAFTAR TERSANGKA PENDERITA (SUSPEK) TBC YANG DIPERIKSA DAHAK SPS
PUSKESMAS : Malinjak
BULAN : November
NO IDENTITAS HASIL PEMERIKSAAN
NAMA TERSANGKA UMUR ALAMAT NOMOR
NO SEDIAAN A B C
PENDERITA LENGKAP REG LAB
DAHAK L P TANGGAL HASIL TANGGAL HASIL TANGGAL HASIL
1 2 3 4 5 6 7 8 9 10 11 12 13
001/06/295 Paulina Bangi Lika 40 Manurara 2/11/2017 _ 3/11/2017 _ 3/11/2017 _ 301
001/06/296 Lince Bita Dopi 17 Tanamodu 4/11/2017 _ 5/11/2017 _ 5/11/2017 _ 303
001/06/297 Samuel D. A. Mara 23 Tanamodu 8/11/2017 _ 9/11/2017 _ 9/11/2017 _ 304
001/06/298 Noviana R. Hana 18 Tanamodu 8/11/2017 _ 9/11/2017 _ 9/11/2017 _ 305
001/06/299 Aldi K. dolung 12 Tanamodu 10/11/2017 _ 11/11/2017 _ 11/11/2017 _ 306
001/06/300 Fajar U. Deta 16 Tanamodu 10/11/2017 _ 11/11/2017 _ 11/11/2017 _ 307
001/06/301 Yustus B. Kipa 17 Manurara 12/11/2017 _ 13/11/2017 _ 13/11/2017 _ 308
001/06/302 Yunita P. Boka 15 Manurara 15/11/2017 _ 16/11/2017 _ 16/11/2017 _ 309
001/06/303 Petrus P. Pare 14 Manurara 16/11/2017 _ 17/11/2017 _ 17/11/2017 _ 310
001/06/304 Kanisius K. B. Wali 18 Manurara 17/11/2017 _ 18/11/2017 _ 18/11/2017 _ 311
001/06/305 Agus P. Pasi 19 Manurara 22/11/2017 _ 23/11/2017 _ 23/11/2017 _ 312
001/06/306 Karolus J. Runga 21 Manurara 22/11/2017 _ 23/11/2017 _ 23/11/2017 _ 313
001/06/307 Ferdinandus B. Reri 40 Tanamodu 23/11/2017 _ 24/11/2017 _ 24/11/2017 _ 315
001/06/308 Ani B. Kahi 38 Tanamodu 23/11/2017 _ 24/11/2017 _ 24/11/2017 _ 316
001/06/309 Alfian Umbu Madiata 17 Tanamodu 23/11/2017 _ 24/11/2017 _ 24/11/2017 _ 317
001/06/310 Denison G. Memang 15 Tanamodu 24/11/2017 _ 25/11/2017 _ 25/11/2017 _ 318
001/06/311 Fredi S. Kawawu 16 Tanamodu 24/11/2017 _ 25/11/2017 _ 25/11/2017 _ 319
001/06/312 Petrus M. Ngara 17 Wailawa 25/11/2017 _ 26/11/2017 _ 26/11/2017 _ 320
001/06/313 Marsila R. Dowi 19 Wailawa 25/11/2017 _ 26/11/2017 _ 26/11/2017 _ 321
001/06/314 Ninu L. Bana 35 Malinjak 26/11/2017 _ 27/11/2017 _ 27/11/2017 _ 323
001/06/315 Datu Ngulu 40 Malinjak 26/11/2017 _ 27/11/2017 _ 27/11/2017 _ 324
001/06/326 Ninu L. Bana 35 Malinjak 27/11/2017 _ 28/11/2017 _ 28/11/2017 _ 326
001/06/327 Datu Ngulu 40 Malinjak 27/11/2017 _ 28/11/2017 _ 28/11/2017 _ 327

You might also like