LAPORAN BULANAN

REKAPITULASI KB DI PUSKESMAS DAN JEJARIN

PUSKESMAS FATUKOPA, BULAN DESEMBER TAHU

Besnam Taebone Fatukopa Nunfutu

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

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

2 Aktif : (KB Baru dan Lama)

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

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0
8 Obat Vagin 0 0 0 0 0 0 0 0
9 Lain-lain ( 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
III Kondisi Peserta KB :
1 Ada kompli 0 0 0 0 0 0 0 0
 Pil 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0
Obat Vagin 0 0 0 0 0 0 0 0
Lainnya se 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0
Obat Vagin 0 0 0 0 0 0 0 0
Lainnya se 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0
Obat Vagin 0 0 0 0 0 0 0 0
Lainnya se 0 0 0 0 0 0 0 0

4 Drop-out
Pil 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0
Obat Vagin 0 0 0 0 0 0 0 0
Lainnya se 0 0 0 0 0 0 0 0

IV Di rujuk :
1 Puskesmas 0 0 0 0 0 0 0 0
2 Puskesmas 0 0 0 0 0 0 0 0
3 Puskesmas 0 0 0 0 0 0 0 0
4 RSUD Pone 0 0 0 0 0 0 0 0
5 RSUD Non 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0
8 Fasilitas K 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
2 IUD 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0
4 Suntik 0 6 0 9 0 24 0 15
5 Implant 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0
7 Obat Vagin 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
 RAN BULANAN
PUSKESMAS DAN JEJARINGNYA
, BULAN DESEMBER TAHUN 2015

Nifulinah Kiki Ello Total

L P L P L P L P L+P

0 19 0 8 0 11 0 92 92
0 128 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 0 0 0
0 1 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 19 0 8 0 11 0 92 92
0 0 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 0 0 0 0

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

0
0
0
0
0
0
0
0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 19 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 0 0 0 0 0 0

137
0
0
41
10
0
0
0

a, 30 Desember 2015
Yang Melapor

a Bagaisar, A.Md. Keb

TT. 24.4. 027. 414
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS FATUKOPA, BULAN MARET TAHUN 2016

Besnam Taebone Fatukopa Nunfutu Nifulinah Kiki

No. ELEMEN DATA
L P L P L P L P L P L P
I Total Kunjungan KB :
1 Bulan ini 0 4 0 6 0 16 0 17 0 14 0 12
2 Kumulatif s.d. Bulan ini 0 13 0 56 0 124 0 60 0 31 0 64

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

2 Aktif : (KB Baru dan Lama)

1 Pil 0 0 0 9 0 31 0 8 0 5 0 4
2 IUD 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
4 Suntik 0 13 0 42 0 91 0 48 0 26 0 58
5 Implant 0 0 0 6 0 1 0 6 0 0 0 2
6 MOW 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
9 Lain-lain (sebutkan) 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
2 IUD 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
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 1
5 Implant 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
8 Obat Vagina 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 0 0 0 0 0 0 0
III Kondisi Peserta KB :
1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0
 Pil 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
Kondom 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
Implant 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
Obat Vagina 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

2 Kontrasepsi gagal
Pil 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
Kondom 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
Implant 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
Obat Vagina 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

3 Ada efek samping

Pil 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
Kondom 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
Implant 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
Obat Vagina 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

4 Drop-out
Pil 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
Kondom 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
Implant 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
Obat Vagina 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

IV Di rujuk :
1 Puskesmas RI 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
3 Puskesmas Poned 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
5 RSUD Non Ponek 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
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0
8 Fasilitas Keseh. Lainnya (sebu 0 0 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 3 0 0 0 0 0 0
2 IUD 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
4 Suntik 0 4 0 6 0 15 0 17 0 14 0 12
5 Implant 0 0 0 1 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 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, 31 Maret 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
GNYA
2016

Ello Total
L P L P L+P

0 10 0 79 79
0 42 0 390 390

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 5 5
0 0 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 60 60
0 0 0 0 0
0 0 0 0 0
0 39 0 317 317
0 0 0 13 13
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

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

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

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

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

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 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 3
0 0 0 0 0
0 0 0 0 0
0 10 0 78 78
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0

17
0
0
259
7
0
0
0