HASIL KEGIATAN IMUNISASI BAYI

PUSKESMAS KREJENGAN
TAHUN 2018

JENIS ANTIGEN
JML SASARAN
NO BULAN HB 0 (0<24) JAM TOTAL HB 0 (1<7) HARI TOTAL BCG TOTAL POLIO1 TOTAL DPT/HB(1) TOTAL POLIO2 TOTAL
L P JML L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS %

1 JANUARI 8 9 17 1 12.5% 0.0% 1 5.9% 0 0.0% 0 0.0% 0 0.0% 2 25.0% 2 22.2% 4 23.5% 2 25.0% 2 22.2% 4 23.5% 4 50.0% 5 55.6% 9 52.9% 4 50.0% 5 55.6% 9 52.9%

2 PEBRUARI 8 9 17 1 12.5% 3 33.3% 4 23.5% 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 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

3 MARET 8 9 17 1 12.5% 1 11.1% 2 11.8% 0 0.0% 0 0.0% 0 0.0% 2 25.0% 2 22.2% 4 23.5% 1 12.5% 1 11.1% 2 11.8% 0 0.0% 0 0.0% 0 0.0% 1 12.5% 0 0.0% 1 5.9%

4 APRIL 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

5 MEI 8 9 17 4 50.0% 1 11.1% 5 29.4% 0 0.0% 0 0.0% 0 0.0% 2 25.0% 3 33.3% 5 29.4% 2 25.0% 3 33.3% 5 29.4% 2 25.0% 0 0.0% 2 11.8% 0 0.0% 0 0.0% 0 0.0%

6 JUNI 8 9 17 4 50.0% 2 22.2% 6 35.3% 0 0.0% 0 0.0% 0 0.0% 3 37.5% 0 0.0% 3 17.6% 3 37.5% 1 11.1% 4 23.5% 1 12.5% 5 55.6% 6 35.3% 3 37.5% 4 44.4% 7 41.2%

7 JULI 8 9 17 2 25.0% 0 0.0% 2 11.8% 0 0.0% 0 0.0% 0 0.0% 2 25.0% 2 22.2% 4 23.5% 2 25.0% 2 22.2% 4 23.5% 4 50.0% 0 0.0% 4 23.5% 3 37.5% 1 11.1% 4 23.5%

8 AGUSTUS 8 9 17 0 0.0% 1 11.1% 1 5.9% 0 0.0% 0 0.0% 0 0.0% 4 50.0% 1 11.1% 5 29.4% 4 50.0% 1 11.1% 5 29.4% 1 12.5% 2 22.2% 3 17.6% 2 25.0% 2 22.2% 4 23.5%

9 SEPTEMBER 8 9 17 1 12.5% 0 0.0% 1 5.9% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 5 62.5% 1 11.1% 6 35.3% 4 50.0% 1 11.1% 5 29.4%

10 OKTOBER 8 9 17 2 25.0% 1 11.1% 3 17.6% 0.0% 0.0% 0 0.0% 2 25.0% 1 11.1% 3 17.6% 2 25.0% 1 11.1% 3 17.6% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

11 NOPEMBER 8 9 17 1 12.5% 0 0.0% 1 5.9% 0.0% 0.0% 0 0.0% 1 12.5% 1 11.1% 2 11.8% 1 12.5% 1 11.1% 2 11.8% 1 12.5% 1 11.1% 2 11.8% 1 12.5% 1 11.1% 2 11.8%

12 DESEMBER 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 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 0 17 #DIV/0! 9 #DIV/0! 26 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 18 #DIV/0! 12 #DIV/0! 30 #DIV/0! 17 #DIV/0! 12 #DIV/0! 29 #DIV/0! 18 #DIV/0! 14 #DIV/0! 32 #DIV/0! 18 #DIV/0! 14 #DIV/0! 32 #DIV/0!
 HASIL KEGIATAN IMUNISASI BAYI

PUSKESMAS KREJENGAN
TAHUN 2018

JENIS ANTIGEN
JML SASARAN
NO BULAN DPT/HB(2) TOTAL POLIO3 TOTAL DPT/HB(3) TOTAL POLIO4 TOTAL MR TOTAL IPV TOTAL
L P JML L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS % L % P % ABS %

1 JANUARI 8 9 17 1 12.5% 3 33.3% 4 23.5% 1 12.5% 3 33.3% 4 23.5% 2 25.0% 1 11.1% 3 17.6% 1 12.5% 0 0.0% 1 5.9% 1 12.5% 1 11.1% 2 11.8% 4 50.0% 6 66.7% 10 58.8%

2 PEBRUARI 8 9 17 0 0.0% 0 0.0% 0 0.0% 1 12.5% 0 0.0% 1 5.9% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 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 MARET 8 9 17 3 37.5% 2 22.2% 5 29.4% 2 25.0% 2 22.2% 4 23.5% 1 12.5% 2 22.2% 3 17.6% 1 12.5% 3 33.3% 4 23.5% 3 37.5% 1 11.1% 4 23.5% 0 0.0% 0 0.0% 0 0.0%

4 APRIL 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

5 MEI 8 9 17 0 0.0% 0 0.0% 0 0.0% 1 12.5% 0 0.0% 1 5.9% 3 37.5% 1 11.1% 4 23.5% 3 37.5% 1 11.1% 4 23.5% 0 0.0% 3 33.3% 3 17.6% 0 0.0% 0 0.0% 0 0.0%

6 JUNI 8 9 17 2 25.0% 0 0.0% 2 11.8% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 12.5% 1 11.1% 2 11.8% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 11.1% 1 5.9%

7 JULI 8 9 17 0 0.0% 3 33.3% 3 17.6% 3 37.5% 3 33.3% 6 35.3% 2 25.0% 1 11.1% 3 17.6% 0 0.0% 1 11.1% 1 5.9% 3 37.5% 1 11.1% 4 23.5% 0 0.0% 0 0.0% 0 0.0%

8 AGUSTUS 8 9 17 4 50.0% 2 22.2% 6 35.3% 3 37.5% 2 22.2% 5 29.4% 0 0.0% 3 33.3% 3 17.6% 3 37.5% 2 22.2% 5 29.4% 0 0.0% 0 0.0% 0 0.0% 5 62.5% 4 44.4% 9 52.9%

9 SEPTEMBER 8 9 17 1 12.5% 2 22.2% 3 17.6% 2 25.0% 2 22.2% 4 23.5% 4 50.0% 1 11.1% 5 29.4% 3 37.5% 1 11.1% 4 23.5% 1 12.5% 1 11.1% 2 11.8% 0 0.0% 0 0.0% 0 0.0%

10 OKTOBER 8 9 17 4 50.0% 1 11.1% 5 29.4% 3 37.5% 1 11.1% 4 23.5% 1 12.5% 3 33.3% 4 23.5% 2 25.0% 3 33.3% 5 29.4% 1 12.5% 0 0.0% 1 5.9% 5 62.5% 3 33.3% 8 47.1%

11 NOPEMBER 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 4 50.0% 1 11.1% 5 29.4% 3 37.5% 1 11.1% 4 23.5% 1 12.5% 4 44.4% 5 29.4% 1 12.5% 3 33.3% 4 23.5%

12 DESEMBER 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 5 62.5% 2 22.2% 7 41.2%

JUMLAH 0 15 #DIV/0! 13 #DIV/0! 28 #DIV/0! 16 #DIV/0! 13 #DIV/0! 29 #DIV/0! 17 #DIV/0! 13 #DIV/0! 30 #DIV/0! 17 #DIV/0! 13 #DIV/0! 30 #DIV/0! 10 #DIV/0! 11 #DIV/0! 21 #DIV/0! 20 #DIV/0! 19 #DIV/0! 39 #DIV/0!

Mengetahui Probolinggo, 1 Pebruari 2012

Kepala Puskesmas Krejengan Koordinator Imunisasi,
 HASIL KEGIATAN IMUNISASI BATITA

PUSKESMAS KREJENGAN
TAHUN 2018

JENIS ANTIGEN
JML SASARAN
NO BULAN PENTA 4 TOTAL CAMPAK 2 TOTAL
L P JML L % P % ABS % L % P % ABS %
1 JANUARI 8 9 17 3 37.5% 0 0.0% 3 17.6% 0 0.0% 0 0.0% 0 0.0%

2 PEBRUARI 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

3 MARET 8 9 17 1 12.5% 3 33.3% 4 23.5% 1 12.5% 0 0.0% 1 5.9%

4 APRIL 8 9 17 0 0.0% 0 0.0% 0 0.0% 1 12.5% 1 11.1% 2 11.8%

5 MEI 8 9 17 0 0.0% 0 0.0% 0 0.0% 3 37.5% 3 33.3% 6 35.3%

6 JUNI 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

7 JULI 8 9 17 2 25.0% 7 77.8% 9 52.9% 0 0.0% 0 0.0% 0 0.0%

8 AGUSTUS 8 9 17 0 0.0% 0 0.0% 0 0.0% 1 12.5% 2 22.2% 3 17.6%

9 SEPTEMBER 8 9 17 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

10 OKTOBER 8 9 17 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

11 NOPEMBER 8 9 17 0.0% 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0%

12 DESEMBER 8 9 17 0 0.0% 0 0.0% 0 0.0% 4 50.0% 3 33.3% 7 41.2%

JUMLAH 0 6 #DIV/0! 10 #DIV/0! 16 #DIV/0! 10 #DIV/0! 9 #DIV/0! 19 #DIV/0!

 LAPORAN IMUNISASI WUS KABUPATEN PROBOLINGGO
PUSKESMAS : KREJENGAN
TAHUN : 2018

STATUS T AWAL (SAAT PENDATAAN atau SAAT PERTAMA KALI DATANG) HASIL KEGIATAN IMUNISASI TT STATUS T WUS SAMPAI DENGAN BULAN
SAS INI
NO BULAN SAS WUS NON HAMIL HAMIL
BUMIL T5 NON HAMIL HAMIL
T2 PLUS T2 PLUS BUMIL T5
T-0 T-1 T-2 T-3 T-4 T5 ABS T-0 T-1 T-2 T-3 T-4 T5
ABS % ABS % T-1 T-2 T-3 T-4 T5 T-1 T-2 T-3 T-4 T5 KUM % KUM %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

1 JANUARI 318 19 0 0 0 0 0 0 0 1 0 0 4 0 0 4 1.3% 0 0.0 0 0 0 0 0 1 2 2 2 1 7 36.8% 1 0.1

2 PEBRUARI 318 19 0 0 0 0 0 0 0 0 0 2 0 0 0 2 0.6% 0 0.0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0.0

3 MARET 318 19 0 0 0 0 0 0 0 0 0 1 1 0 0 2 0.6% 0 0.0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0.0

4 APRIL 318 19 0 0 0 7 0 0 7 1 0 0 1 0 0 1 0.3% 0 0.0 0 0 0 7 0 0 0 0 0 0 0 0.0% 0 0.0

5 MEI 318 19 1 1 1 1 1 0.3% 0 0.0 1 2 2 10.5% 0 0.0

6 JUNI 318 19 0 1 1 0.3% 0 0.0 0 0.0% 0 0.0

7 JULI 318 19 0 2 2 0.6% 0 0.0 3 2 5 26.3% 0 0.0

8 AGUSTUS 318 19 0 1 1 0.3% 0 0.0 1 1 1 5.3% 0 0.0

9 SEPTEMBER 318 19 0 1 1 0.3% 0 0.0 0 0.0% 0 0.0

10 OKTOBER 318 19 0 1 1 0.3% 0 0.0 0 0.0% 0 0.0

11 NOPEMBER 318 19 0 0 0.0% 0 0.0 1 1 3 5 26.3% 0 0.0

12 DESEMBER 0 NIHIL 0 #DIV/0! 0 #DIV/0! NIHIL 0 #DIV/0! 0 #DIV/0!

JUMLAH 0 0 1 7 0 0 8 2 1 4 12 0 0 16 #DIV/0! 0 #DIV/0! 0 1 0 7 0 2 3 6 10 1 20 #DIV/0! 1 #DIV/0!

19
 LAPORAN KIPI ( KEJADIAN IKUTAN PASCA IMUNISASI )

PUSKESMAS : KREJENGAN
TAHUN : 2018

IDENTITAS GEJALA YANG DIALAMI

JENIS PEMBERIAN TEMPAT PELY
NO NAMA ORANG JENIS VAKSIN NO BATCH EXP DATE TANGGAL IMUNISASI DEMAM BENGKAK MERAH MUNTAH LAIL-LAIN
NAMA ANAK KELAMIN TANGGAL LAHIR UMUR ALAMAT IMUNISASI IMUNISASI
TUA
L P JIKA YA DITANDAI P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

1 NADIF ADYATAMA V 12.08.2017 5 BL KRISMA L PETTE DPT/HB PAHA KANAN RUMAH IBU 22.01.2018 V

2 M KHALIL G V 25.08.2017 5 BL ULFA S KRAJAN DPT/HB PAHA KANAN RUMAH IBU 22.01.2018 V

3 M HAMZAH T V 26,09.2917 4 BL ENDANG S PETTE DPT/HB PAHA KANAN RUMAH IBU 22.01.2018 V

4 ABIZARD FARAZ V 05.10.2017 3 SITI RAHMAWATI KRAJAN DPT/HB PAHA KANAN RUMAH IBU 22.01.2018 V

5 AZZAM V 18.05.2018 5BL SANA KRAJAN DPT/HB PAHA KANAN RUMAH IBU 12.10.2018 V
 Format : Imundaskap-Pusk
LAPORAN HASIL PENGHITUNGAN BAYI YANG TELAH MENDAPATKAN IMUNISASI DASAR LENGKAP
DI PROVINSI JAWA TIMUR, 2018
PUSKESMAS : KREJENGAN
KABUPATEN : PROBOLINGGO TAHUN : 2018

JUMLAH BAYI YG TELAH MENDAPAT IMUNISASI DASAR JUMLAH BAYI YG TELAH MENDAPAT IMUNISASI
JUMLAH BAYI KETERANGAN :
NO DESA/KELURAHAN LENGKAP PADA BULAN INI DASAR LENGKAP JANUARI - MARET
UCI /NON UCI
L P JML L P ABSOLUT % L P ABSOLUT %
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 JANUARI 8 9 17 0 1 1 5.9% 0 1 1 5.9%

2 PEBRUARI 8 9 17 0 1 1 5.9% 0 2 2 11.8%

3 MARET 8 9 17 1 0 1 5.9% 1 2 3 17.6%

4 APRIL 8 9 17 1 2 3 17.6% 2 4 6 35.3%

5 MEI 8 9 17 2 0 2 11.8% 4 4 8 47.1%

6 JUNI 8 9 17 0 0 0 0.0% 4 4 8 47.1%

7 JULI 8 9 17 0 2 2 11.8% 4 6 10 58.8%

8 AGUSTUS 8 9 17 2 1 3 17.6% 6 7 13 76.5%

9 SEPTEMBER 8 9 17 1 2 3 17.6% 7 9 16 94.1%

10 OKTOBER 8 9 17 1 0 1 5.9% 8 9 17 100.0%

11 NOPEMBER 8 9 17 0 0 0 0.0% 8 9 17 100.0%

12 DESEMBER 8 9 17 1 1 2 11.8% 9 10 19 111.8%

IMUNDASKAP SAMA DENGAN LAPORAN BAYI PARIPURNA

DATA SASARAN IPV
DESA
(DATA BAYI YANG BELUM MENDAPAT IPV, DAN BAYI SAMPAI DENGAN BULAN LAPORAN)
(DITAMBAHKAN TERUS SETIAP BULAN /BAYI BARU LAHIR)

TANGGAL
NO NAMA TANGGAL LAHIR NAMA ORANG TUA ALAMAT
PEMBERIAN
1 BAROKATUR RIZGIYAH 07.01.2017 NUR MAILA SEMAR 02.01.2018
2 SYAKIRA GINA 09.02.2017 MISYANI KRAJAN 22.01.2018
3 HASAN TAUFIQURRAHMAN 18.03.2017 ALPIYAH KRAJAN 22.01.2018
4 M RIDWAN HAQIQI 08.04.2017 JUNAIDAH PETTE 22.01.2018
5 LAILATUL MAGFIROH 17.04.2017 IRMA QORIK SEMAR 22.01.2018
6 LAILATUL SAVIRA APRILIA 25.04.2017 EVI S KRAJAN 22.01.2018
7 M LUTFIAH A 07.05.2017 FATMAWATI SEMAR 22.01.2018
8 M WONI R 29.05.2017 HAMSATUN KRAJAN 22.01.2018
9 IMA FAZA MAULIDA 19.07.2017 SUDARYATI SEMAR
10 ZAHRATUL DINIAH ABADIAH 20.07.2017 SITTI ROFIKA SEMAR 11.08.2018
11 LAILATUS SAFIRA 07.08.2017 SUDARWATI PETTE 11.08.2018
12 NADHIF ADYATAMA KHARISMA 12.08.2017 KRISMA LESTARI PETTE 11.08.2018
13 M KHALIL GIBRAN 25.08.2017 ULFA SAFIAH KRAJAN 11.08.2018
14 ALIKA NAYLA P 19.09.2017 FARIDA PETTE 11.08.2018
15 M HAMZAH T 26.09.2017 ENDANG SRI P PETTE 11.08.2018
16 DEVI FARANISA 28.09.2017 ARIFATUL M SEMAR 11.08.2018
17 ABIZARD FARAZ 05.10.2017 SITI RAHMAWATI KRAJAN 11.08.2018
18 M HAFIDUL AHKAM 11.12.2017 SITTI MARDIA KRAJAN 11.08.2018
19 AZIZKA FIRDA K 28.12.2017 DEWI SARTIKA PETTE 17.10.2018
20 KARIMATUL M 11.01.2018 SIANA SEMAR 17.10.2018
21 BILQIS HAURA M 12.02.2018 ZULFAWATI KRAJAN 21.12.2018
21 NURIL JANNAH W 14.02.2018 WASIAH KRAJAN 17.10.2018
22 KAYRA AURELIA E 22.02.2018 ENDANG P PETTE 17.10.2018
23 AHMAD RIZKI F 26.02.2018 HUMAIDAH PETTE 17.10.2018
24 ALIYA KHOIRUNISAK 01.03.2018 SITI MARYAM PETTE 26.11.2018
25 M ZIDNI ILMA 03.03.2018 MUDMAINAH SEMAR 17.10.2018
26 ANANG NARENDRA B 04.05.2018 NUR HALIMAH KRAJAN 21.12.2018
27 MUHAMMAD MAULANA 08.05.2018 SUSILOWATI SEMAR 18.10.2018
28 M IVAN AS SHIDQI 08.05.2018 ISKA MAULITA D PETTE 12.10.2018
29 AZZAM KHALIF P 18.05.2018 SANA KRAJAN 21.12.2018
30 ISNAINI N 28.05.2018 HASANAH KRAJAN 22.11.2018
31 ALVIAN RIZKI R 05.06.2018 ASIH SEMAR 22.11.2018
32 NUR AINI 08.06.2018 MISYANI KRAJAN 22.11.2018
33 M TAUFAN M 15.06.2018 SALMA KRAJAN
34 FITRIATUL FAIZAH 15.06.2018 YAYUK KRAJAN 21.12.2018
35 HUBIBUL M 15.06.2018 HOSMIYATI KRAJAN 21.12.2018
36 MOH FERDIAN 17.06.2018 SHOLEHA KRAJAN 21.12.2018
37 ABDIR ROZIQ H 30.06.2018 UMMI HOBIBAH KRAJAN 21.12.2018
38 M FAJAR ARIFIN 15.07.2018 SUHERLIN PETTE
39 ALESHA FAIRA N 01.08.2018 IRA WINARSIH SEMAR
40 AHMAD FADHOL ILAHI JAZIL 07.09.2018 KHOLIFATUL SEMAR
41 BILQIS NAJWA KHUMAIROH 01.07.2018 YATI OKTAVIA PETTE
42 M RAFA ZAFRAN MAULANA 11.10.2018 NURFADILAH SEMAR
43 NOVA INAYAH 19.10.2018 MURSIDA SEMAR
44 MUSA 22.10.2018 LELA ANGGRAENI KRAJAN
45 M HAFIDZ MAULIDI 19.11.2018 LULUK KHALISATUN SEMAR
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60