0

No. Nama No KK JK Umur Hub dlm KK Status Kawin Agama Suku Pend
1A Achmad 3578290407110008 1 4 1 1 1 1 3
Lilik Rosidah 2 4 2 1 1 1 4
Alfi Ansori 1 2 2 0 1 1 2
Ananda Zafira 2 2 2 0 1 1 1

2A Faturrohman 3578292404090000 1 4 1 1 1 1 5
Rochaini 2 4 2 1 1 1 5
Ahmad Ridho 1 3 2 0 1 1 2

3A Hj. Rohma 3578290101084740 2 6 1 3 1 2 3

4A Kari Abdul Imron 3578290101084375 1 4 1 1 1 1 5

Nikmatus Solichah 2 4 2 1 1 1 5
Ryan Bayu NS 1 2 2 0 1 1 3
Krisna R 1 2 2 0 1 1 2

5A Marhasan 3578290101086760 1 1 1 1 1 1 5
Yuliana 2 2 1 1 1 5
4 2 0 1 1 6

6A Imam Wahyudi 3578290101081860 1 4 1 1 1 1 4

Ari 2 4 2 1 1 1 5
Rrizki Adam 1 4 2 0 1 1 5
Aldiansyah 1 3 2 0 1 1 4
Wahyu 1 3 2 0 1 1 4
Putri Currotuaini 2 2 2 0 1 1 3

7A Abdul Mughi , 1 1 1 1 1 6
Masruroh 2 2 1 1 1 6
1 3 2 0 1 1 6

8A Imron 3578291405090002 1 5 1 1 1 1 5
Suliswat 2 4 2 1 1 1 5
M. Imam Wahyudi 1 4 2 2 1 1 5
Ma'idatul Izzah 2 3 2 2 1 1 5
Alfinnur Jannah 2 3 2 2 1 1 4
M. Iqbal M 1 2 2 2 1 1 3

9A Mardji 3578290101087317 1 5 1 3 1 1 3
M. Firdaus 1 4 2 0 1 1 5

10A M. Fuzan 35782901010084399 1 3 1 1 1 1 3

Yuyun Dwi 2 4 2 1 1 1 3
 Auliyatun R 2 2 2 0 1 1 2
Azril Avzan 1 1 2 0 1 1 1

11A Suryanto 3578291301100010 1 4 1 0 1 1 4

Imroatul M 2 4 2 0 1 1 4
M. Farid R.A 1 2 2 0 1 1 3
Zahra A.Q 2 1 2 0 1 1 1

12A Bambang S 3578170808110008 1 4 1 1 1 1 5

Ana Sulistowat 2 4 2 1 1 1 5
Moch. Fahri 1 2 2 0 1 1 2

13A Sugiharsono 3578290101086799 1 1 5 1 1 1 1

Julaika 2 2 5 2 1 1 1
Iin S 2 2 4 2 0 1 1
Dedik Budiawan 1 1 4 2 0 1 1

14A Husaini 3578290101087707 1 5 1 1 1 1 4

Husnul Chotmah 2 4 2 1 1 1 5

15A Fatkhur 3578290101085763 1 5 1 1 1 1 1

Rosidah 2 5 2 1 1 1 3
M. Ahsanul B 1 3 2 1 1 5 7
M. Rusdiyanto 1 2 2 1 1 3 7

16A Yudi 3578290108110005 1 4 1 1 1 1 4

Mariyatul 2 4 2 1 1 1 5
Erik Cahya 1 3 2 1 1 4 7
Albert Pradita 1 2 2 1 1 3 7

17A Nuris Salam 3578292307190003 1 4 1 1 1 5 3

Farida V 2 4 4 2 1 1 1

18A M Tajuddin 3578292307190003 1 4 1 1 2 4 2

Ulfatul M 2 4 2 1 1 2 5
Mustghit S 1 3 2 2 1 2 2
Farah Abida 2 2 2 2 1 2 2

19A Mustofa Hasan 3578290202090007 1 4 1 1 2 4 2

Yuyun Nalufa 2 4 2 1 2 5 0
M Khavin 1 2 2 2 1 2 1
Mustafi 2 2 2 2 1 2 1

20A Sigit 3321101310110002 1 4 1 1 1 1 4

Lilis Dahlia 2 4 2 1 1 1 4
 Indra Wahyu 1 2 2 2 1 1 1

21A Muttadin 3524172708100668 1 5 1 1 1 1 3

Amah 2 5 2 1 1 1 3
M Fahmi 1 4 2 2 1 1 3

22A Subadi 3578293112120009 1 4 1 1 1 2 4

Sumini 2 4 2 1 1 2 3
Aniatun 2 3 2 2 1 2 3
Ahmad 1 3 2 2 1 2 3
Muslim 1 3 2 2 1 2 1
Rochmi 2 2 2 2 1 2 1
Mar'iyam 2 2 2 2 1 2 1

23A Sudirwanto 3578291704090004 1 5 1 1 1 1 4

Sumarni 2 4 2 1 1 1 3
Dian Fernanda 2 4 2 2 1 1 1
Dania Hikmatul 2 2 2 2 1 1 1

24A Dion London 3578291802130003 1 4 1 1 1 1 1

Ika 1 4 2 2 1 1 1

25A M. Machtub 3578292501120005 1 4 1 1 1 1 5

Lailul Ishanah 2 4 2 1 1 1 6
Naura Haniana 2 2 2 0 1 1 3
Kayla Nadita 2 1 2 0 1 1 1

26A Fajar 3578290409120004 1 4 1 1 1 1 5

Susilowat 2 4 2 1 1 1 5
Ainur Roziq 1 3 2 0 1 1 5

27A Indro P 3578290101082800 1 5 1 1 1 6 2

Mudawamah 2 5 2 1 1 5 0
Adani M 1 3 2 1 1 5 0

28A M Tajuddin 3578191612090001 1 4 1 1 1 1 4

Ulfatul 2 4 2 1 1 1 5
Mustakib 2 2 2 0 1 1 3
Farah A 2 1 2 0 1 1 1

29A Santoso 3578291301100010 1 4 1 1 1 1 4

Umi Patera 2 4 2 1 1 1 4
M Farid 1 2 2 0 1 1 1
Zahra 2 1 2 0 1 1 1
30A Haris 3578290509110016 1 4 1 1 1 5 3
Faudiyah 2 4 2 1 1 5 0
Riko 1 2 2 1 1 1 0
Riki 1 2 2 1 1 1 0
Inayatul 2 1 2 1 1 1 0

31A Dwi Supant 3578292004150002 2 4 1 3 1 1 4

32A Sunarto 3578292805140003 1 5 1 1 1 4 2

Puji Lestari 2 4 2 1 1 5 2
Rafa Tsaqif 1 2 2 1 1 3 0
Jihan Ataleta 2 1 2 1 1 1 0

33A Najah 3578290211170003 2 6 1 1 3 0 0

Yunita 2 4 2 1 4 2 2
Adzkia S 2 2 2 1 2 0 0
 Status Kesehatan Pasangan Usia Subur Ibu Hamil
Peker Pendapatan Pengeluaran Peny 6 bln trkhir KB keluhan alsn tdk Kb Peny kel ANC Imun TT Buku KIA Pil Fe
2 0 0 1 0 0 0 0 0 0 0 0
2 2 2 0 2 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 0 0 0 0 0

2 2 2 3 0 0 0 0 0 0 0 0
2 0 0 0 3 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 3 0 0 0 0 0 0 0 0

2 2 2 0 2 2 0 0 0 0 0 0
3 0 0 1 2 2 0 0 0 0 0 0
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 2 2 12 0 0 0 0 0 0 0 0
7 0 0 3 3 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

3 2 2 0 0 0 0 0 0 0 0 0
3 0 0 0 3 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
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 2 2 2 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0

5 3 2 1 0 0 0 0 0 0 0 0
3 0 0 1 2 2 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0

7 0 0 6 0 0 0 0 0 0 0 0
3 2 2 0 0 0 0 0 0 0 0 0

2 3 2 0 0 0 0 0 0 0 0 0
0 0 0 0 4 2 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0

2 2 0 0 0 0 0 0 0 0 0 0
7 1 0 0 3 2 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 12 0 0 0 0 0 0 0 0

2 2 3 2 0 0 0 0 0 0 0 0
7 0 0 0 2 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

3 3 2 2 0 0 0 0 0 0 0 0
3 7 0 0 2 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0

3 2 2 1 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0

3 3 2 2 1 0 0 0 0 0 0 0
7 2 0 0 0 0 0 0 0 0 0 0
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 2 0 0 0 0 0 0 0 0 0 0
7 2 2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

2 2 0 0 0 0 0 0 0 0 0 0
5 7 0 0 0 0 0 0 0 0 0 0

2 2 0 0 0 0 0 0 0 0 0 0
0 0 0 0 3 2 0 0 0 0 0 0
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 0 0 0 0 0 0 0 0
0 0 0 0 2 2 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 0 0 0

3 1 1 0 0 0 0 0 0 0 0 0
0 0 0 0 3 2 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0

3 1 1 0 0 0 0 0 0 0 0 0
0 0 0 0 2 2 0 0 0 0 0 0
0 0 0 8 0 0 0 0 0 0 0 0

3 1 1 1 0 0 0 0 0 0 0 0
0 0 0 6 0 0 3 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 8 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 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

3 2 2 0 0 0 0 0 0 0 0 0
2 0 0 0 1 2 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 0 0 0 0 0

2 2 2 0 0 0 0 0 0 0 0 0
7 0 0 0 4 2 0 0 0 0 0 0

2 2 0 0 0 0 0 0 0 0 0 0
2 2 0 0 4 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 6 0 0 0 0 0 0 0 0 0

3 2 2 1 0 0 0 0 0 0 0 0
0 0 0 0 2 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

3 2 1 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0

2 2 2 1 0 0 0 0 0 0 0 0
7 0 0 0 1 2 0 0 0 0 0 0
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 2 2 1 0 0 0 0 0 0 0 0
0 0 0 0 3 2 0 0 0 0 0 0
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 2 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 0 0 0 0 0
0 0 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 0 0 0 0 0 0

0 1 1 3 0 0 0 0 0 0 0 0

3 2 1 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 0 0 0 0 0 0
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 2 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
Ibu Hamil Bufas/Buteki Balita Anak Se
Keluhan Gizi Rencana lhr Penolong ASI Keluhan BB di KMS ASI eksklusif Imun Dsr Posyandu Vit.A MPASI Gizi
0 0 0 0 0 0 0 0 0 0 0 0 0
0 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 0 0 0 0 0 0 0 0 0 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 1
0 0 0 0 0 0 0 0 0 0 0 0 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 1
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 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 2
0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 2

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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 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 0 0 0 1 1 1 1 1 2 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 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 0 0 0 1 1 1 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 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 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 2

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 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 2

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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 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 0 0 0 0 0 0 0 0 0 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 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 3 1 3 1 1 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 1 1 1 1 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 1 1 1 1 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 1
0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 1 1 1 1 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 1
0 0 0 0 0 0 3 3 1 1 1 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 1
 Anak Sekolah Remaja Lansia
Imun Gosok gigi Sakit gigi TN kls Knklan Rmja Ikut orang Posyandu Priksa Kes keg Sos
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
1 1 0 2 0 0 0 0 0
1 1 0 2 0 0 0 0 0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 6 1 0 0 0

0 0 0 0 0 0 3 2 1

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
1 1 2 2 0 0 0 0 0
1 1 2 2 0 0 0 0 0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 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 2 1 0 0 0 0
1 1 0 2 0 2 0 0 0
1 1 0 2 0 2 0 0 0
1 1 0 2 0 0 0 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 0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
1 1 2 2 0 0 0 0 0
1 1 2 2 0 0 0 0 0
1 1 2 2 0 0 0 0 0
1 1 2 2 0 0 0 0 0

0 0 0 0 0 0 0 0 0
0 0 0 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 2 2 0 0 0 0 0
0 0 0 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
1 1 2 2 0 0 0 0 0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 6 2 0 0 0
0 0 0 0 6 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
1 1 2 2 0 0 0 0 0
1 1 2 2 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 2 2 0 0 0 0 0
1 1 2 1 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 2 2 0 0 0 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 2 0 0 0

0 0 0 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 2 1 1 0 0 0 0
1 1 2 1 0 2 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0
1 1 1 2 0 0 0 0 0

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

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 6 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 6 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 6 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 6 1 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
1 1 1 1 0 0 0 0 0
1 1 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
1 1 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
1 1 1 2 2 0 0 0 0
DATA SUBSISTEM

no No KK status rmh jenis rmh lantai ventlasi L Rmh 8m/smbr air besumber ai
1A 1 2 2 1 2 1 2

2A 1 1 1 2 1 1 2

3A 1 1 1 2 1 1 2

4A 1 1 2 2 1 2 1

5A 1 1 1 1 1 2 1

6A 1 1 1 2 1 2 1

7A 1 1 2 1 2 2 1

8A 1 1 1 2 1 1 2

9A 1 1 1 1 1 1 2

10A 1 1 1 2 1 1 2

11A 1 1 1 2 1 2 2

12A 1 1 1 2 1 1 2

13A 1 1 1 2 1 1 2
 LINGKUNGAN FISIK
jenis jamb tempatjentk tempat sam saluran lim binatang kandang ternak fanyankes
2 1 1 3 1 1 2 3

2 1 2 3 1 1 1 2

2 1 2 3 1 1 1 2

2 1 1 3 1 1 1 2

2 1 2 3 1 0 3 2

2 1 2 3 1 0 3 1

2 1 2 3 1 0 3 2

2 1 2 3 1 1 1 2

2 1 2 3 1 0 0 1

2 1 2 3 1 0 0 2

2 1 2 3 1 1 1 3

1 1 2 3 1 0 3 2

1 1 2 3 1 0 0 2
jaminan kesehatan
kebiasaan CTPS
konsumsi lauk permakan
hari sayur tdak mero
olahraga/ hari
1 2 2 1 1 1

1 1 1 2 1 1

1 2 2 1 1 1

1 1 1 1 2 2

1 1 1 1 2 1

1 1 1 1 2 2

1 1 1 1 1 2

1 1 1 1 2 2

1 2 1 2 2 2

1 2 1 1 1 2

1 2 1 1 1 2

2 1 1 1 1 1

1 1 1 1 1 1
LINGKUNGAN FISIK
UKK (UNIT KESEHATAN KERJA)
NO No KK Lama bekerja Waktu bekerja Keluhan Nelayan (cara menangkap) Tmpt pengolahan
1A Achmad 2 2 2 0 0
Lilik Rosidah 1 2 0 0 0
Alfi Ansori 0 0 0 0 0
Ananda Zafira 0 0 0 0 0

2A Faturohman 2 2 4 0 0
Rochaini 0 0 0 0 0
Achmad Ridho 0 0 0 0 0

3A Hj. Rochma 0 0 0 0 0

4A 3 2 2 0 0
3 3 2 0 0
0 0 0 0 0
0 0 0 0 0

5A 3 2 2 0 0
0 0 0 0 0
0 0 0 0 0

6A 3 2 2 0 0
3 3 2 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0

7A 3 3 2 1 0
3 3 2 0 0
0 0 0 0 0

8A 1 2 1 3 0
1 3 0 3 0
1 2 0 3 0
0 0 1 0 0
0 0 0 0 0
0 0 0 0 0

9A 0 0 0 3 3

10A 2 2 2 1 3
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0

11A 2 2 1 3 3
2 2 1 0 0
0 0 0 0 0
0 0 0 0 0

12A 1 2 4 3 3
0 0 0 0 0
0 0 0 0 0

13A 3 2 2 3 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

14A 2 2 2 3 1
0 0 0 0 0
Fasilitas K3 APD
2 1
2 2
0 0
0 0

2 2
0 0
0 0

0 0

0 0
0 0
0 0
0 0

0 0
0 0
0 0

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

0 0
0 0
0 0

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

2 2

0 0
0 0
0 0
0 0

2 2
2 2
0 0
0 0

1 2
0 0
0 0

2 2
0 0
0 0
0 0

2 2
0 0
 KUSTA TBC Diare
NO No KK batuk berkepanjangan
Rwyt peny Bercak merah penurunan BB Demam BAB>4× ASI SUFOR
1A Achmad 2 2 2 2 2 2 0
Lilik Rosid 2 2 2 2 1 2 0
Alfi Ansori 2 2 2 ###
2 2 2 0
Ananda Zaf 2 2 2 2 2 2 0

2A 2 2 2 2 2 2 0
2 2 2 ###
2 2 2 0
2 2 2 2 2 2 0

3A 0 2 2 1 2 2 0

4A 2 2 2 2 2 2 2
2 2 2 2 2 2 2
0 0 2 2 2 2 2
0 0 2 ###
2 2 2 2

5A 2 2 2 2 2 2 2
0 0 2 2 2 2 2
0 0 2 ###
2 2 2 2

6A 2 2 2 ###
2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 2 2 2 2
2 2 2 2 2 2 2

7A 2 2 1 ###
1 3 2 2
2 2 2 ###
2 2 2 2
2 2 2 2 2 2 2

8A 2 2 2 2 2 2 2
2 2 2 2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 ###
2 2 2 2

9A 2 2 2 ###
2 2 2 0

10A 2 2 2 ###
2 2 2 0
2 2 2 2 1 2 2
2 2 2 2 1 2 2
2 2 2 2 2 2 2
11A 2 2 2 2 2 2 2
2 2 2 2 2 2 2
2 2 2 ###
2 2 2 2
2 2 2 2 2 2 2

12A 2 2 2 2 2 2 0
2 2 2 2 2 2 0
2 2 2 2 2 2 0

13A 2 2 2 ###
2 2 2 0
2 2 2 2 2 2 0
2 2 2 2 2 2 0
2 2 2 2 2 2 0

14A 2 2 2 ###
2 2 2 0
2 2 2 ###
2 2 2 0
Diare Pneumoni
Jenis Snack Btk+sesak Terapi obat
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 2 2
1 1 1
1 2 2
1 2 2

1 0 0
1 0 0
1 0 0

1 2 0
1 2 0
1 2 0
1 1 1
1 1 1
1 1 1

1 1 1
1 1 2
1 2 2

1 2 2
1 2 2
1 2 2
1 2 2
1 2 2

0 0 0

0 0 0
0 2 2
0 2 2
2 0 2
0 2 2
0 2 2
0 2 2
0 2 2

0 2 0
0 2 0
0 2 0

0 1 2
0 2 0
0 2 0
0 2 0

0 2 1
0 2 1
KUESIONER POKJA
ANAK USIA SEKOLAH (AUS) BALITA +IMUNISASI
No Nama No KK P1 P2 P3 P4 P5 P6 P7 P8 P1 P2 P3 P4 P5 P6
1A Achmad 3578290407110008
M. Alfi Anshori 3 3 1 3 2 2 1 2
Ananda Zhafira 3 3 1 3 2 2 1 2

2A Fathurahman 3578292404090004
Achmad Ridho

3A H. Rocmah 3578290101084740

4A
MUNISASI UKK KIA
P7 P1 P2 P3 P4 P5 P6 P7 P1 P2 P3 P4 P5 P6 P7 P8 P9 P9 P10 P11 P12 P13 P14
2 2 2 3 3 2 1

2 2 4 3 3 2 2
 LANSIA KESLING
P15 P16 P17 P1 P2 P3 P4 P5 P6 P1 P2 P3 P4 P5 P6 P7 P8 P9 P9 P10 P11 P12

2 3 1 2 2 1
 REMAJA
P13 P14 P15 P1 P2 P3 P4 P5 P6 P7 P8 P9 P10 P11 P12 P13 P14 P15 P16

2 0 0 0 0 1 1 2 2 0 0 2 1 2 2
 SKRINNING KUSTA SKRINNING TBC SKRINNING DIARE
No Nama No KK P1 P2 P3 P1 P2 P3 P1
SKRINNING DIARE SKRINNING PNEUMONIA
P2 P3 P1 P2