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    CONTOH STP C1 DESEMBER 2019 PKM CAMPAKAMULYA

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    Contoh STP C1 Desember 2019 PKM Campakamulya

    Uploaded by

    Anonymous OdNEfoJZg

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 5

    SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS

    ( KASUS BARU )
    Propinsi : Jawa Barat
    Kabupaten : Cianjur
    Puskesmas : Campakamulya

    Golongan Umur
    Kode ICD
    No. Jenis Penyakit 0 - 7 hr 8 - 28 hr < 1 tahun 1 - 4 tahun 5 - 9 th 10 -14 th 15 - 19 th
    10
    L P L P L P L P L P L P L P
    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
    1 Kolera A 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    2 Diare A 09 0 0 0 0 0 0 0 0 4 4 3 3 3 6
    3 Diare Berdarah A 03.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    4 Tifus Perut Klinis A 01.4 0 0 0 0 0 0 0 0 1 2 0 0 1 3
    5 TBC Paru BTA (+) A 15.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    6 Tersangka TBC Paru A 16.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    7 Kusta PB A 30.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    8 Kusta MB A 30.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    9 Campak B 05.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    10 Difteri A 36.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    11 Batuk Rejan A 37.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    12 Tetanus A 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    13 Hepatitis Klinis B 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    14 Malaria Klinis B 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    15 Malaria Vivax B 51.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    16 Malaria Falsiparum B 50.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    17 Malaria Mix B 53.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    18 Demam Berdarah Dengue A 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    20 Pneumonia J 18.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    21 Sifilis A 51.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    22 Gonorhoe A 54.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    23 Frambusia A 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    24 Filariasis B 74.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    25 Influenza J 11.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    26 Hypertensi I 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    27 Diabetes Melitus E 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    total kunjungan X
    Jumlah Puskesmas pembantu yang ada bulan lapor 4
    Jumlah Puskesmas pembantu melapor bulan lapor 4
    Jumlah Puskesmas pembantu melapor tepat waktu bulan lapor 4

    Mengetahui
    Kepala Puskesmas Campakamulya

    Tb. Wahyu Rahayu, SKM


    NIP. 19700504 199003 1 003
    S

    Bulan : Desember
    Tahun : 2019

    Total Total
    20 - 44 th 45 - 54 th 55 - 59 th 60 - 69 th 70 + Kunjunga
    L P L P L P L P L P L P n
    18 19 20 21 22 23 24 25 26 27 28 29 30
    0 0 0 0 0 0 0 0 0 0 0 0 0
    9 9 7 0 0 0 0 0 0 0 26 22 48
    0 0 0 0 0 0 0 0 0 0 0 0 0
    2 2 0 0 0 0 0 0 0 0 4 7 11
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0
    966

    Cianjur, 02 Januari 2020


    Petugas Surveilens

    Badri Sanusi, A.Md.Kep.,S.Kep


    NR.PTT. 873.32.02.14.6.028
    Format : C1 [Rutin / KLB]
    LAPORAN KASUS CAMPAK
    BULAN : DESEMBER TAHUN 2019
    Kabupate : Cianjur
    Propinsi : Jawa Barat

    No Epid Tgl Ambil Klasifikasi Final Puskesmas


    Alamat Lengkap Umur/ Seks Vaksinasi Campak Tanggal Timbul Keadaan
    Spesimen Diberi Vit
    Nama Anak
    Nama Orang tua Sebelum Sakit Akhir Campak Rubella
    Kasus/K A Y/T
    (H/M)
    LB Desa RW/RT L P Brp kaliTdk/Tdk TahuDemam Rash Pilek Mata Merah Darah Urine Lab Epid Klinis
    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

    N I H I L

    Periode KLTgl 01 DESEMBER 2019 s/d tgl 31 DESEMBER 2019


    PenjelasanKolom 16 : Y=Ya , T=Tidak
    Kolom 15 : H=Hidup , M=Mati

    Mengetahui Cianjur,02 JANUARI 2020


    Kepala Puskesmas Campakamulya Petugas Surveilens Puskesmas Campakamulya

    Tb Wahyu Rahayu, SKM Badri Sanusi, A.Md.Kep.,S.Kep


    NIP. 19700504 199003 1 003 NR.PTT. 873.32.02.14.6.028

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