REGISTER IBU HAMIL KIA

PUSKESMAS NANGGALO 2019

SG KR GL LW IDENTITAS REG PARITAS USIA TGL LHR JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES ANAK
No. TGL NO HP HPHT TP D/
TI KEHA
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U PEK NAMA SUAMI (TTL) NIK BPJS U RM ALAMAT NO G P A H TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
MILAN

5/26/2020 0001332065294 013443 JL.KURAO 8/KR 4 3 0 3 11/3/2019 8/10/2020 29-30 170 59 125/66 90 27 12,5 O+ 60 60 60 PCT
1 1 NELVA YENTI 40 DIRVAN PAGANG
SINTA AMELIA 1371065701990004 0000283155849 JL PAGANG 54/KR 081277400142 1 0 0 0 2/26/2020 12/3/2020 12-13 158 54 120/80 82 Ball 25 10.7 O+ (-) (-) (+) 60 60 60
2 1 17/1/99 21 KARY JEFRI WANDI 4/1/96 015366 DALAM 

SARI DARMI 1371105301930004 S00178 JL. KURAO RT 55/KR 082288002345 2 1 0 1 8/30/2019 6/6/2020 38-39 1/14/2018 160 63 120/70 80 30 130 24.5 9.4 O+ (-) (-) (-)
FERMATA 13-01- 005 RW 002 Kel
1 1993 27 IRT AFRINALDI 12/4/92 KURAO PAGANG
JL.SIJUNJUNG 4
NO.361
IRA FARADILA KARYAW 1371105908920003 0002354485476 014586 51/SG 085376296373 1 0 0 0 10/9/2019 7/16/2020 32-33 160 89.3 121/69 93 32 132 32 10,6 30 30 30
RAHMI AN
4 1 1 /19/08/1992 27 SWASTA FERI WAHYUDI
GURUN
ARRY HERNES 1371104305840003 000078 LAWEH,RT/02/R 12/SG 082388359783 3 2 0 1 4/11/2020 1/18/2021 7 6/2/2018 158 48 125/75 89 27 11.6 A+ (-) (-) (-)
5 1 /03/05/1984 36 IRT WAHYU W 02

1371115201870008 0001333693675 014415 083165887150 3 1 1 1 4/21/2020 1/28/2021 5 152 48.2 120/80 82 23.5 10,8 O+ (-) (-) (-) 60 60 60
RISKA ANGGRAINI JL MARANSI
6 1 12-01-1987 33 IRT BENI NOVALDI 12/1/1987 INDAH
SRI WAHYUNI
jln puti bungsu no
VISKA 14 RT RW Kel 082174535209 2 1 0 1 9/17/2019 6/24/2020 36-37 158 78 124/70 103 28 136 30 9.6 O+ (-) (-) (-) 60 60 60
MENDROFA 27- GUNUNG
7 1 01-1994 26 IRT DWI AGUS SAPUTRA 18/8/94 S00179 PANGILUN

JL BANDES
5/27/2020 DESY RIAN 0001108413101 NO 18 RT RW 210/SG 085274644777 2 1 0 1 9/27/2019 7/4/2020 29 6/29/2018 1.5 153 56.2 105/65 85 26 145 29
ELVIANA Kel SURAU
8 1 7/12/91 28 IRT ADRI GUSTIANTO 13/8/91 137108019001308 GADANG

JL PERJUANGAN
5/28/2020 1371106906840003 0000283124417 726 RW 003 RT 005 62/KR 082386539050 4 3 0 3 9/17/2019 6/25/2020 36-37 164 48.6 113/82 85 31 132 22 5
KURAO RT RW
YULIA SYAFITRI Kel KURAO
9 1 29/6/84 35 IRT JAKARIAN 12/1/79 PAGANG
5/30/2020 137109018000224 0000987426549 00143 2 1 0 1 11/9/2019 8/16/2020 27 157 77 107/68 83 BAL BAL 36 13,5 RSIA CICIK perdarahan
10 1 RINA FERAWATI/ 34 BURHANUDDIN JL.BAWAH ASAM

MAIRITA SARI 1371106205920007 0000987399944 003664 JL.BUKITTINGGI 72/SG 082392314436 3 2 0 1 2/12/2020 11/19/2020 14-15 152 68 118/75 101 BAL BAL 25 10,2 (-) (-) (-) 60 60 60
11 1 YANTI/01/11/1992 28 IRT YULIZARNITO 1 NO.328
SINTA PUTRI
6/2/2020 MAYANG 0002259166544 002416 JL AGAM 2 73/SG 081270705466 5 1 3 1 3/15/2020 12/22/2020 10-11 158 66 120/80 80 BAL BAL 25 YOS SUDARSO ABORTUS IMINEN
12 1 1 SARI/02/02/1987 33 DOSEN RAFYAT HAMDI NO.13
DENA JL.BELAKANG
KURNIA/31/08/19 011272 KOMPI BAN 74/SG 082391242621 2 1 0 1 12/25/2019 9/2/2020 23-24 156 80 120/80 88 BAL BAL 30 11,4 (-) (-) (-) YOS SUDARSO KELUAR air2
13 1 910 27 SWASTA M.IKHLAS 1 NO.1 A
LARAH
OKTAVIARNI/17/1 012665 47/KR 085274686243 2 0 0 0 10/3/2019 7/10/2020 34-35 6/24/2019 152 63.4 110/70 87 28 136 30 11,5 IBNU SINA
14 1 0/1995 24 IRT ADRIANTO 1 KP.BARU BEROK
SILVIA
TARMITA.S/01/10/ 0000283649062 001778 JL.BANJIR KANAL 42/KR 081277330213 2 1 0 1 1/13/2020 10/20/2020 20-21 153 81 128/78 98 34 11,1 O+ (-) (-)
15 1 .1990 28 IRT EDI RT/01 RW 05
NURLINA
HARAHAP/14/04/1 1203055404960002 0000234344957 0015372 LAPAI 1 GANG 085363836237 1 0 0 0 10/19/2019 7/26/2020 31-32 141 54 101/61 77 25 HC. LAPAI 60 60 60
16 1 991 24 IRT RAHMAD HIDAYAT LIMAU BALI
TRI NADIA KOMP.KODAM
WAHYUNI/12/06/1 1371065206880005 0002927088393 0015375 BLOK H NO.9 75/SG 081365002183 2 1 0 1 10/7/2019 7/14/2020 33-34 154 61 120/68 93 28 12,1 A+ (-) (-) (-) RSIA CICIK BSC,PROTEIN +1
17 1 988 31 ITRT JAKA MUSTIKA RT.RW 03/02
JL.SAWAH LIAT
1371106812850003 014584 KP.MELAYU 081371189668 1 0 0 0 10/24/2019 8/1/2020 31-32 149 42.7 83/54 80 26 10,5 60 60 60
18 1 DEASY YULISTIA 33 DARLIS 1 NO.38
AFNITA
RAHMI/01/02/198 1371104102870005 010589 JL.BANDES 76/SG 081374482744 5 2 0 4 12/20/2019 9/27/2020 23-24 150 58 109/68 83 25 9,2 O (-) (-) (-) 90 60 60
19 1 7 33 IRT ROMI EFENDI 1 SURAU GADANG
MELDA MUSTIKA 1301065112930001 000215 JL.MARANSI AIR 085313899613 2 0 0 1 4/11/2020 1/18/2021 6-7 153 50 95/51 92 25 10,0 O+ (-) (-) (-) 60 60 60
20 1 SARI/11/12/1993 27 IRT WIWIN 1 PACAH
6/3/2020 DEVI AFRINA.ST 1404084307780002 KOMP KODAM 77/SG 081277193369 2 0 1 0 11/15/2019 8/22/2020 28-29 150 63.3 128/69 119 23 144 27 10.3 B + (-) (-) (-) 60 60 60
21 1 3/7/78 42 wrswt NOFRIADI 23/11/82 NO.D.4
GURUN LAWEH
6/4/2020 1371106401970002 0001330436531 010247 RT/RW 3/2 2/GL 081211005674 1 0 0 0 11/25/2019 9/2/2020 26-27 160 71.5 107/67 99 22 142 28 60 60 60
22 1 ALIANI 24/1/97 21 JASMAN NO.12
 REGISTER IBU HAMIL KIA
PUSKESMAS NANGGALO 2019
SG KR GL LW IDENTITAS REG PARITAS USIA TGL LHR JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES ANAK
No. TGL NO HP HPHT TP D/
TI KEHA
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U PEK NAMA SUAMI (TTL) NIK BPJS U RM ALAMAT NO G P A H TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
MILAN

FITRI KURAO
WIDAYAT/4/3/199 1371104403960003 0000283879552 9934 PAGANG,RT 5 158/KR 081267216263 3 2 0 2 10/5/2019 7/12/2020 27-28 147 62.6 113/70 106 29 144 27 60 60 60
23 1 6 22 IRT RENDY RW 2

PERUM
015572 PERMATA 78/SG 081261239345 4 3 0 3 2/5/2020 11/12/2020 16-17 162 68.7 104/66 95 BALL 31 7.5 O+ (-) (-) (-) 60 60 60
SURAU GADANG
RISNAWATI 16-06- BLOK D NO. 3
24 1 1 1975 45 IRT AZMA RINALDI 1/3/75 1371025606750000 SURAU GADANG
JL.KAMPUNG
BARU BEROK
137108016004951 NO109 RT 004 45/KR 082283851956 1 0 0 0 12/20/2019 9/27/2020 24 164 68.8 121/73 106 20 142 26 11.7 B + 60 60 60
RAHMADINA RW 004 KURAO
25 1 23/02/95 25 SWST YUDI PEFRIAN 15/12/95 PAGANG 

YESI NIA
6/5/2020 SAFARANI/12/06/1 010090 JL.JAMAL JAMIL 79/SG 081372094470 1 0 0 0 4/2/2020 1/9/2021 8-9 160 45 120/80 90 23,5 11,6 O (-) (-) (-) 60 60 60
26 1 995 24 IRT NO.9
RATNA
6/6/2020 JUMITA/13/08/19 1371025308960005 0000987354999 015576 JL.SOLOK NO.239 80/SG 085272079485 1 0 0 0 11/16/2019 8/23/2020 28-29 158 48 103/61 91 22 158 23 13,7 HC.ANDALEH
27 1 96 23 IRT FAKHRUL SATRIA RT 1 RW 10

JL.ANYERNRT/1/
0002927415183 015578 13 DADOK 085271930053 1 0 0 0 11/1/2019 8/8/2020 31-32 149 51 107/65 83 28 144 23 11,6 HC. DADOK
GUSRINI/16/08/20 TUNGGUL
28 1 00 20 IRT NOFNANTO HITAM
JL.
6/8/2020 FAUZIAH 1371106812890002 000094 PAYAKUMBUH 3 71/SG 085366525342 1 0 0 0 3/19/2020 12/26/2020 11-12 150 68 122/71 87 Ball 30 10,5 RestU IBU AB IMINENS
29 1 RAMI/28/12/1989 30 HONOR ANGGA NO.556
JL PD PANJANG
WIWIT 137108016004135 0000284094303 NO 217 RT 009 081929680512 2 1 0 1 09-Oct 7/17/2020 34-35 142 51.7 79/54 86 27 136 24 30 30 30
NOVRIANITA RW 001 Kel
30 1 12/11/91 29 IRT YULIATO 20/7/91 SURAU GADANG

Jl Parak Rumbio
1371025410860004 RT 003 Rw 007 56/kr 085355979011 7 5 1 2 1/8/2020 10/15/2020 21-22 155 55 106/57 95 17 142 29 60 60 60
31 1 Verawati 19/10/86 34 irt Hendri Afrizal Kurao Pagang
JL PADANG
PANJANG NO 217 62/SG 085272091927 1 0 0 0 2/24/2019 12/1/2020 15-16 155 42.5 96/54 94 23.5 10.9 60 60 60
DIAN NOLA ARTIKA RT RW Kel
32 1 01-09-1994 25 YOGI PUTRA 9/4/95 137108017000428 0000284094415 SURAU GADANG

JL RAYA SITEBA
6/9/2020 Tasya Dwi Afriyeni 1371106006980001 NO 16 RT 02/02 81/SG 081261762461 1 0 0 0 11/15/2019 8/22/2020 29-30 165 75 114/65 106 27 130 11.5 A+ (-) (-) (+) 60 60 60
33 1 20/6/98 22 mhs M. Rahul Saputra Surau Gadang
FONNY ANDHIKA Komp Kencana 13/GL 081364750255 1 0 0 0 10/9/2019 7/16/2020 34-35 162 61.8 112/62 95 29 142 28 11 O+ (-) (-) (-)
34 1 PUTRI 14-12-1994 25 Polwan RIO OKTA RULLIS 1371115412940000 D.2 Rt 04/01 GL

JL. CASA NO. 09

RT 02 RW 03 ,
137111018000218 008997 RT. - , RW. - , 081364945903 2 0 0 0 9/30/2019 6/7/2020 35-36 156 83.6 130/66 112 32 142 31 9.2 B + (-) (-) (-) RESTU IBU BSC 1X
KEL. DADOK
ENDAH KOMALA TUNGGUL
35 1 SARI 26-01-1992 28 IRT Robert Sanedy L 11/6/89 HITAM
SUCI
6/11/2020 ELVIANTI/08/01/1 0000284276439 003190 JL. RAYA KURAO 57/KR 085272712691 1 0 0 0 4/16/2020 1/23/2021 7-8 157 58 120/80 80 23 IBNU SINA O.21 PERDAAHAN AWAL
KEHAMILAN
36 996 21 IRT SYAHRIAL RT/RW 01/05

NURHASANAH/02/ 1371104205860010 0001786163073 009743 63/SG 081361716471 3 2 0 2 2/27/2020 11/4/2020 14-15 160 59.6 132/70 93 26 11,4 (-) (-) (-) 60 60 60
37 1 05/1986 32 IRT HAFIZUL CANDRA JL.SOLOK NO.257
JL.SIJUNJUNG 4
NO.361
6/13/2020 IRA FARADILA KARYAW 1371105908920003 0002354485476 014586 51/SG 085376296373 1 0 0 0 10/9/2019 7/16/2020 35-36 160 93.3 131/88 95 33 132 32 30 30 30
RAHMI AN
38 1 1 /19/08/1992 27 SWASTA FERI WAHYUDI

6/15/2020 ERINA OKTI 1371105010960007 000146 54/KR 081261737178 2 1 0 1 3/21/2020 12/28/2020 12-13 10 BULAN 10 154 38 115/70 96 21 10,3 IBNU SINAkek.jarak anak dekat,muntah
39 1 1 YOVA/10/10/1996 24 IRT BUJANG 1 JL.RAYA KURAO

OKFI 0001303154785 007128 83/SG 085272715555 6 5 0 5 11/21/2019 8/28/2020 29-30 147 63 106/62 102 28 124 30 11,2 (-) (-) (-) 60 60 60
40 1 YARNI/12/10/1986 35 IRT BORI ZULKARNI KOMP.PS SITEBA
JL. PAGANG
CHRISTINA 1371104208990002 0000283147716 00019 DALAM RT/RW 19/KR 081375081711 1 0 0 0 10/10/2019 2/17/2020 35-.36 154 50 111/64 89 24 10,6 30 30 30
41 1 1 SURYANI 20 ROY BETO 4/1
WINDA 1371106610930006 0001788993832 015598 KOMP.VILAKU 58/KR 082388343404 1 0 0 0 1/9/2020 10/16/2020 22-23 160 69 120/80 80 25 10,0 O (-) (-) (-) 60 60 60
42 1 1 LIDIA/26/10/1993 27PEG.SWASTA
ERWIN INDAH BLOK K3
 REGISTER IBU HAMIL KIA
PUSKESMAS NANGGALO 2019
SG KR GL LW IDENTITAS REG PARITAS USIA TGL LHR JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES ANAK
No. TGL NO HP HPHT TP D/
TI KEHA
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U PEK NAMA SUAMI (TTL) NIK BPJS U RM ALAMAT NO G P A H TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
MILAN

JATI TEPI
FEBRI YANTI 1371025102870005 0000283298591 BANDAR BEKALI 081363749656 3 2 0 2 9/1/2019 6/8/2020 27-28 159.5 69 133/76 122 34.5 11.6 B(+) SITI HAWA PROLONG PREGNENCY
43 1 11-02-1987 32 guru LAITOS FIRMON RW VII RT 4
ANNISA
KHAIRUL/03/09/19 1371104309950004 00022633009312 012359 JL.RAYA KURAO 59/KR 082288196187 1 0 0 0 4/1/2020 1/8/2021 10-11 157 53 120/80 111 24 8.5 AB + (-) (-) (-) 60 60 30
44 1 1 95 23 IRT WENO NO.234

EMI 1371106008870003 00056 JL.JAMAL JAMIL 46/SG 085364549563 2 1 0 1 10/3/2019 7/10/2020 36-37 165 74 105/57 92 30 11,0 MUTIARA BUNDA BSX 1X
ANGGRAINI/20/08 RT/RW: 03/01
45 1 1 /1987 37 IRT WANDI 1 SURAU GADANG

MERI 0000283634201 005038 JL.RAYA PAGANG 60/KR 082331079109 5 4 0 3 10/19/2019 6/26/2020 33-34 160 59 116/62 80 25 IBNU SINA asma,resti
46 1 SUSANTI/29/11/80 40 IRT YUSRIL RT 01/87
ELKA SURYA 1371105607900003 0001379732354 0015594 JL. PONDOK KOPI 83/SG 085263477087 3 1 1 1 11/9/2019 8/16/2020 31-32 158 71 113/70 123 30 10,0 O (-) (-) (-) 60 60 30
47 1 AMRINI 30 IRT MYKI NO 19
JL. TEKNOLOGI
PARAK BARUH ,
15603 RT. 4 , RW. 1 , 84/SG 6 5 0 5 1/17/2020 10/24/2020 22-23 158 42 120/80 102 22 10,2 (-) (-) (-) 60 60 30
KEL. SURAU
GADANG , KEC.
48 1 1 RINI MUSTIKA 40 IRT BUDI ENKA NANGGALO

JL BEROK
RAYA NO 35 ,
6/16/2020 RT. 006 , RW. 085274777232 2 1 0 1 12/10/2019 9/17/2020 26-27 4/2/2015 153 75 129/73 79 31 13.7 60 60 60
003 , KEL.
SURAU
49 1 ISRA MARIZA 32 FAJAR BUDIMAN 137108016005024 I00043 GADANG
YULIANTI/26/06/1 0000282452578 002186 KP BARU BEROK 61/KR 3 2 0 2 12/15/2019 9/22/2020 25-26 146 67 97/50 95 26 11,0 (-) (-) (-) 60 60 60
1 988 32 IRT AMRIZAL RT 6 RW 4
KOMP.VILAKU
6/17/2020 DINNY LEONI 1371105108890003 000014 INDAH 4 BLOK 61/KR 081374222999 1 0 0 0 10/12/2019 7/19/2020 35-.36 166 102 140/75 100 40
1 D.P/11/08/1989 30 P.SWASTAIRWAN 1 K/3
KOMP.
RESMIDARNI/22/0 137605620886001 000027813151 000230 KEHUTANAN 085274949212 4 3 0 3 10/17/2019 5/24/2020 34-35 160 104 137/81 101 40 11,6 (-) (-) (-) RSIA SITI HAWA BSC
1 8/1986 33 DOSEN NOVRIZAL KAMP.KELAWI

JL.BATU
RIDA 1301036704910001 000027813151 0015609 SANGKAR 1 NO 85/SG 085374254112 2 1 0 1 10/18/2019 7/25/2020 34-35 150 52 103/62 101 23 8,3 (-) (-) (-) (-) RESTU IBU BSC
PURWATI/27/04/1 726 RT/RW
1 1 991 29 IRT YOGA MAIZAN 04/017
1371104803820007 0000282937713 14289 DURIAN RATUS 79/KR 4 3 0 3 11/5/2019 8/4/2020 6-7 151 49 148/79 95 28 10,4 O+ (-) (-) (-) 60 60 30
1 1 RUSMADAIYANTI/ 37 INDRA TANJUNG KURAO

JL.PADANG
6/18/2020 WIWIT 1371105211910002 0000284094309 PANJANG 36/SG 082171008569 2 1 0 1 10/9/2019 7/17/2020 35-.36 142 44 83/45 101 24 12,3 RS BAYANGKARA BSC 1X
NOFRIANITA/12/1 NO.217 RT 1 RW
1 1/1991 36 IRT YULIANTO 9

NISA 1371105001970002 122 JL. JAMAL JAMIL 87/SG 083161297511 1 0 0 0 12/15/2019 9/22/2020 26-27 155 45.8 110/80 87 22 11,1 B (-) (-) (-) (-)
RAHMITA/10/01/1 KE.SURAU
1 991 23 IRT DENI APRIANSYAH GADANG
RINI
HILDAYANI/23/05/ 8414 JL PADANG 88/SG 082385070255 2 1 0 1 1/12/2020 10/9/2020 22-23 164 65 110/80 93 27 9.1 B + (+) (-) (-) (-) RESTU IBU HEPATITIS
1 1985 35 K.SWASTARONALD RAHMAN 3NO.413
 REGISTER IBU HAMIL K1 KIA
PUSKESMAS NANGGALO 2019
TGL LHR
SG KR GL LW IDENTITAS REGISTER PARITAS USIA ANAK JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES
No. TGL TI NO HP HPHT TP D/
NAMA SUAMI
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U NIK BPJS U RM ALAMAT NO G P A H KEHAMILAN TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
(TTL)

JL.PESANTR
1 12/26/2019 1371115005900014 014776 EN NO 27 081266667602 1 0 0 0 9/15/2019 6/22/2020 14-15 160 73 125/96 114 33 13,2 A (-) (-) (-) (-) 30 30 30
RT/RW 1/2
LAILA BATANG
1 ALQAMARI/10/05/1990 29 SAIFUL HADI 1 KABUNG

JL.MANDAL
2 12/27/2019 1377014202990004 014789 A 081275322826 1 0 0 0 8/25/2019 5/2/2020 17-18 158 70 112/61 81 17 141 29 12,2 O+ (-) (-) (-) (-) 30 30 30
TUNGGUL
1 RINA YUSPITA/2/12/2019 20 ERMAN 1 ITAM
3 12/27/2019 NOVITA ELIA 1306034711900003 0002068952859 014792 JL.SAWAH 085296212666 2 1 0 1 10/17/2019 7/24/2020 9-10 153 51 107/76 70 30 13,8 O+ (-) (-) (-) (-) 30 30 30
1 ROZA/07/11/1990 29 IBRAHIM LIEK
4 12/31/2019 1371104601830007 0000283854003 010830 DURIAN 1/KR 085271649226 3 2 0 2 11/11/2019 9/18/2020 3-4 156 56 106/63 97 26 11,3 B + (-) (-) (-) (-) 30 30 30
1 ERLINA/06/01/1983 35 FIRDAUS RATUS

PAGANG
5 1/2/2020 1371104303850011 00151 DALAM 2/KR 082122326687 1 0 0 0 6/22/2019 3/29/2020 27-28 156 57 142/91 118 26 11,9 O (-) (-) (-) (-) 30 30 30
NO.30
NANGGAL
1 RITA MAYASARI/03/03/1985 34 IRVANDI KOTO 1 O

6 1/2/2020 1371094301900007 0002625928637 014823 PERUM.AS 082357973939 1 0 0 0 4/5/2019 1/12/2020 37-38 164 75 116/66 112 28 9,0 O (-) (-) (-) (-) 30 30 30
TEK
BL.BARU
1 1 FITA ERVENTY/03/01/1990 30 ALFRET KALUMBUK
7 1/2/2020 2102045205980004 00049 HANDAYAN 2/SG 082169000543 1 0 0 0 11/20/2019 8/27/2020 5-6 154 53 115/77 75 23 (-) (-) (-) (-) 30 30 30
1 ERA WATI/12/05/1998 20 NOFRONI 1 I 3 129
JL.JEMBAT
8 1/2/2020 1371115503910005 0002448142751 00160 AN BEROK 88/KR 081261796515 2 1 0 1 4/20/2019 1/27/2020 36-37 158 70 131/74 94 28 10,8 B (-) (-) (-) (-) 30 30 30 RS.BAYANGKARA BMC
1 MERI HASIBUAN/20/04/2019 28 RIKI KARDIFAL LAMA
JL.PERJUAN
9 1/4/2020 NANA ERNAWATI 1371106104930001 0001682815083 012564 GAN1 ,NO 3/SG 085363126793 2 1 0 1 8/11/2019 5/18/2020 20-21 149 46,9 121/89 93 17 158 28 12,4 O+ (-) (-) (-) (-) 30 30 30
1 ARWIN/21/04/1993 25 ALFISON 15 SG

10 1/4/2020 0000282754912 005700 JL.PUNGGA 4/SG 081347697181 4 2 1 2 11/11/2019 8/18/2020 7-8 152 61,9 127/75 80 32 10,1 A+ (-) (-) (-) (-) 30 30 30
I RT 3/RW
1 ENNA ERITA/11/07/1984 33 DONI ERIANTO 19 SG
JL.BIOLOGI
11 1/4/2020 GUSTI RAHAYU 1302076506970002 0002695757635 014846 GUNUNG 082389957435 1 0 0 0 10/18/2019 7/25/2020 10-11 157 58 131/80 84 28 11,P O (-) (-) (-) (-) 30 30 30
1 SURANTI/25/06/1997 22 AAD BAKHRI PANGILUN
JL
TEKNOLO
12 1/6/2019 1302106706940003 GI IV NO 7 5/SG 085264727114 1 0 0 0 11/21/2019 8/28/2020 6-7 158 82 128/76 11.7 B (-) (-) (-) (-) 90 30 30
RT RW Kel
FADHILA UMAIRA 27-06- SURAU
1 1994 25 IRT FAUZAN FERFITHON GADANG

JL. BEROK
RAYA NO.
13 1/6/2019 22 A RT 6/SG 081372756065 1 0 0 0 11/1/2019 8/8/2020 5-6 162 70 140/83 107 31 13.7 O+ (-) (-) (-) (-) 90 30 30
006 RW
003 Kel
MEGA PURMARIATI 26-10- SURAU
1 1990 29 IRT 14857 GADANG

KURAO
PAGANG
14 1/7/2020 RIKA OKTARIA PUTRI 07- 1371104710890003 RT RW Kel 4/KR 081266646664 1 0 0 0 10/30/2019 7/7/2020 9-10 150 53.8 139/63 82 Ball 29 3 11.9 AB + (-) (-) (-) (-) 90 30 30
10-1989 KURAO
1 30 GURU FEPI R00154 PAGANG

KOMPLEK
TARUKO
BLOK P
15 1/7/2020 1311014208960002 G00016 NO. 10 RT 082381752222 1 0 0 0 6/10/2019 3/17/2020 30-31 154 59.8 118/79 105 24 146 26.5 1 11.1 O+ (-) (-) (-) (-) 90 30 30
RW Kel
TABING
BANDA
1 GUSTINA YULIANTI 2/8/96 24 GADANG

JL RAYA
KURAO
16 1/8/2020 NO.02 RT 5/KR 085265808983 2 1 0 1 10/1/2019 7/8/2020 14-15 146 48.7 120/71 113 14 11.5 O+ (-) (-) (-) (-)
001 RW
002 Kel
KURAO
1 YELSA FITRI R.N 01-06-1988 31  M. NUR ARIF 1371104106880000 PAGANG

JATI TEPI
17 1/8/2020 1371025102870005 0000283298591 BANDAR 081363749656 3 2 0 2 9/1/2019 6/8/2020 17-18 159.5 69 133/76 122 34.5 11.6 B(+) (-) (-) (-) (-) 90 30 30
BEKALI RW
1 FEBRI YANTI 11-02-1987 guru LAITOS FIRMON VII RT 4
18 1/9/2020 1 YULIA WANDRI/06/07/2002 17 ALDO RAHMAT 137111607020006 0001500062354 014632 MARANSI 082169171992 1 0 0 0 7/6/2019 4/13/2020 26-27 158 52 114/58 94 BAL BAL 25 10,8 LABOR HC.DADOK 30 30 30
 REGISTER IBU HAMIL K1 KIA
PUSKESMAS NANGGALO 2019
TGL LHR
SG KR GL LW IDENTITAS REGISTER PARITAS USIA ANAK JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES
No. TGL TI NO HP HPHT TP D/
NAMA SUAMI
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U NIK BPJS U RM ALAMAT NO G P A H KEHAMILAN TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
(TTL)

JL.BEROK
19 1/9/2020 13171105607920001 014889 RAYA NO 7/SG 082288295275 1 0 0 0 8/12/2019 5/20/2020 21 157 51 104/59 98 16 23 10,3 (-) (-) (-) (-) 90 30 30
YULIANA 32 RT/RW
1 LARASATI/16/07/1992 27 DEDE ABDUL 1 06/03
20 1/9/2020 003482 GUSRA 6/KR 082386898105 1 0 0 0 11/25/2019 9/2/2020 6-7 156 56 100/20 26 13,3 O+ (-) (-) (-) (-) 90 30 30
1 GUSRA FITRI YANI/ AMRIL 1 FITRI YANI
21 1/9/2020 014882 KOMPI 8/SG 082110741503 1 0 0 0 8/3/2019 5/10/2020 22-23 151 58 106/67 84 27 12,5 (-) (-) (-) (-) 90 30 30
1 NURLIANA SARI LUBIS 26 RIDWAN 6/6/83 BATUAN
JL.PAYOKU
22 1/9/2020 SHINTA MONICA 1371095107950003 0002897086858 014892 MBUH 2 9/SG 082288999936 1 0 0 0 10/7/2019 6/14/2020 17-18 162 60,9 103/67 99 12 23,5 10,9 (-) (-) (-) (-) 90 30 30
1 1 P/11/07/1995 25 EDWIN YUDA NO 577
KP.BARU
23 1/9/2020 1371105810900001 0000283874141 014894 BEROK 7/KR 085356918091 2 1 0 1 9/15/2019 6/22/2020 16-17 155 59,6 132/51 97 25 10,2 (-) (-) (-) (-) 90 30 30
1 1 OVARIANI/18/10/1990 29 FIRDAUS KURAO
KOMP PWI
24 1/10/2020 1301015009870001 S00131 RT 02 RW 10/SG 085263630525 2 1 0 1 6/16/2019 3/23/2020 29-30 152 56 105/57 97 22 148 24 10.5 O+ (-) (-) (-) (-) 90 30
1 SYEFLI EWIMIA DARZA 32 IRT SYEFLI EWIMIA DARZA 02 KURAO
25 1/11/2020 13060687050130002 001405 JL BKT RT 202/SG 081374715654 2 1 0 1 8/8/2019 5/15/2020 33-34 155 66.1 110/75 109 31 136 27 90 30 30
1 VICHA MEIHONESTI 11/5/83 36 IRT KHAIRULLAH 1 1/18

KOMPLEK
TAMAN
ASRI III
26 1303056305930001 NO. I/6 RT
082384797308 1 0 0 0 10/5/2019 7/12/2020 14-15 145 46 99/73 80 27 11,0 B (-) (-) (-) (-) 90 30
RW Kel
ATIKA TIRTASARI 23-05- SUNGAI
1993 26 APOTEKER SAPIH

27 0001332065294 013443 JL.KURAO 8/KR 4 3 0 3 11/3/2019 8/10/2020 9-10 170 59 125/66 90 27 12,5 O+ (-) (-) (-) (-) 30 30 30
1 NELVA YENTI 40 DIRVAN PAGANG

28 1301035909920002 158 JL.PASAMA 11/SG 081363718474 2 1 0 1 4/20/2019 1/27/2020 37-38 150 83 134/70 97 30 12,3 O+ (-) (-) (-) (-) 30 30 30
N 1 NO.181
1 ROSA DESPITA 27 AFRIZAL T SITEBA
JL.BELAKAN
29 1/13/2020 1371104603880002 0000283351513 014909 G KOMPI B. 12/SG 085271024388 3 0 2 0 12/7/2019 9/14/2020 5-6 157 55,9 135/79 90 25 14,0 B (-) (-) (-) (-) 30 30 30
1 YUSMARNI YOSEVA 31 SANDY SANJAYA NO.38

PAGANG
30 1371105205790001 0002784573819 014908 DALAM,RT/ 9/KR 082171508962 2 1 0 1 10/17/2019 7/24/2020 12-13 154 54 110/70 75 29 12,1 B (-) (-) (-) (-) 30 30 30
RW
1 1 WATRI WAHYUNI 40 SUARDI 04/08,KR
JL.TEKNOL
31 0000015853138 005397 OGO 9 13/SG 08238932 2 1 0 1 12/12/2019 9/19/2020 4-5 155 79,6 101/60 115 32 12,1 O+ (-) (-) (-) (-) 30 30 30
1 INGELA ERFANI 27 RAFIK AFANDI NO.20
JL.BUKITTI
32 1305156711820001 012914 NGGI 3 14/SG 085263062499 5 4 0 3 9/10/2019 6/17/2020 17-18 160 90,3 108/65 92 36 10,7 O+ (-) (-) (-) (-) 30 30 30
1 1 NOVA ASTARI 35 ZAINUDIN NO .285
KP.BARU
33 002562 BEROK 100/KR 3 2 0 2 10/26/2019 8/3/2020 11-12 156 50 118/67 60 27 11,2 AB (-) (-) (-) (-) 30 30 30
1 REFNI OKTAVIA 26 ADITOMA 1 NO.111
34 1371106308000004 0000283154321 011058 GURUN 1/GL 082385744625 1 0 0 0 11/20/2019 8/27/2020 7-8 154 52 129/72 73 25 13,6 B + (-) (-) (-) (-) 30 30 30
1 MONIKA 19 NOVENDRA LAWEH

JLN RAYA
PAGANG
NO 44
SITEBA ,
35 1/15/2020 RT. - , RW. 11/KR 82186707405 2 1 0 1 6/6/2019 3/13/2020 31-32 (-) (-) (-) 30 30 30
- , KEL.
KURAO
PAGANG ,
KEC.
NANGGAL
1 1 VIVI ARYANI 35 RONNY BHARCE 20 O

36 1371106104830006 008138 JL.PONDOK 16/SG 082386231233 2 1 0 1 8/10/2019 5/17/2020 22-23 148 48 116/76 48 27 11,1 (-) (-) (-)
1 EMI ROSTITA 34 RIKO 1 KOPI NO.48
37 014544 JL.BATUSA 17/SG 085835757032 6 5 0 5 11/23/2019 9/30/2020 7-8 165 64 128/80 84 29 11,8 (-) (-) (-) 30 30 30
1 IRA ARAINI 40 HENDRI NGKAR
38 1371100101890011 244 JL.DURIAN 12/KR 085263280221 1 0 0 0 5/18/2019 2/25/2020 34-35 158 72 140/64 85 30 11,7 (-) (-) (-) 30 30 30
1 ANGEL 18 GIAN 1 RATUS

JLK.PAGAN
39 1/16/2020 1371114812930003 0000283588716 000384 G LUAR 13/KR 081277370127 2 1 0 1 12/7/2019 9/14/2020 5-6 165 71 125/79 109 31 13,4 (-) (-) (-) 30 30 30
RT/RW
1 RIMA ANGRAINI 24 TAUFIK 02/01
40 1371116808920009 160 BUNGO 082387039407 1 0 0 0 4/20/2019 1/27/2020 38-39 166 60 120/63 98 22 9,8 HC DADOK 30 30 30
1 ROSI,SYAPUTRI 28 EFRIANTO 1 PASANG
 REGISTER IBU HAMIL K1 KIA
PUSKESMAS NANGGALO 2019
TGL LHR
SG KR GL LW IDENTITAS REGISTER PARITAS USIA ANAK JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY RUJUK
RES
No. TGL TI NO HP HPHT TP D/
NAMA SUAMI
1 4 U 1 4 U 1 4 U 1 4 U NAMA IBU (TTL) U NIK BPJS U RM ALAMAT NO G P A H KEHAMILAN TERAKHIR (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC B6 LC LAIN2 INTERNAL RS
(TTL)
WILDA YETTI 36 YESCANDRA

JLN RAYA
SITEBA NO
10
NANGGAL
O PADANG
41 , RT. - ,
18/SG 85266275559 1 0 0 0 8/30/2019 6/7/2020 19-20 157 75.4 120/82 30 13 (-) (-) (-) 30 30 30
RW. - ,
KEL.
SURAU
GADANG ,
KEC.
NANGGAL
1 O

JL.CENDRA
42 1371104304850001 72 WASIH 19/SG 082387310917 1 0 0 0 11/10/2019 8/17/2020 9-10 160 43,8 101/62 64 23 10,9 B + (-) (-) (-) 30 30 30
NO.2
RT/RW
1 YUSMIDA 35 NOFRIZAL 1 05/03
43 014940 JL.TANJUN 14/KR 085265203563 3 2 0 2 8/30/2019 6/7/2020 19-20 148 58 101/64 96 28 11,4 O (-) (-) (-) 30 30 30
1 RONALIS 35 EDSUGIANTO 1 G BEROK

GURUN
44 1/17/2020 1371106401970002 0001330436531 010247 LAWEH 2/GL 081211005674 1 0 0 0 11/25/2019 9/2/2020 7-8 160 61,2 110/63 88 27 11,5 B (-) (-) (-) 30 30 30
RT/RW 3/2
1 ALIANI 21 JASMAN NO.12

45 HANDIKA 014947 JL.SAWAH 1 0 0 0 11/14/2019 7/21/2020 7-8 150 40 105/78 78 22 HC.DADOK 30 30

1 TIKA NOVITA 20 FEDRIANSYAH 1 LIAT NO 30
JL.HANDAN
46 1/18/2020 2102045205380004 49 I NO.3 20/SG 082169000543 1 0 0 0 11/20/2010 8/27/2020 8-9 153 61 123/70 87 24 10,5 (-) (-) (-) 30 30 30
1 ERAWATI 22 NOFRONI 1 N0.129

47 1305025104930001 00051 JL.RAKIK 2 21/SG 082284269393 1 0 0 0 12/4/2019 9/11/2020 6-7 156 45 115/62 84 23,5 12,6 (-) (-) (-) 30 30 30
N0.14
1 ERFIANI 26 1 RT/RW 2/3
48 13 00017 JL.WIDURI 22/SG 085274088066 1 0 0 0 10/17/2019 7/24/2020 13-14 153 71 29 90 29 10,8 (-) (-) (-) 30 30 30
1 PUTRI SARI 28 DONI 1 NO.24
49 1/20/2020 1371104112860007 D92 JL RAYA 15/KR 082285449018 4 3 0 3 4/20/2019 1/27/2020 38-39 155 66 126/73 84 31 10,2 (-) (-) (-) 30 30 30
1 DESY PUTRI 34 PERI LEO 1 PAGANG
KOMP.GRE
50 1/21/2020 164 N BUKIT 082386633680 1 0 0 0 12/11/2019 9/18/2020 5-6 158 54 94/55 89 27 11,2 (-) (-) (-) 30 30 30
1 RAHMI FITHRI 23 M.TAQQI YUDDIN 1 PERMATA
51 137110600980000 00051 JL.AGAM 23/SG 085365988747 3 1 1 1 12/5/2020 8/12/2020 6-7 147 42 126/60 98 24 12,4 (-) (-) (-) 30 30 30
1 EMILZA TRI NJURNI 39 JUREDI 1 14 NO.239
TARUKO 1
52 1/22/2020 1302076211890002 000114110767 00026 NO.3 085274426004 3 1 0 1 11/05/22019 2/18/2020 36-37 159 75 119/79 90 31 11,4 (-) (-) (-) 30 30 30 RSIA CICIK Z35. RISTI
1 WIDRI NOLIA 30 BENI KURANJI

LOLO
53 0000283418785 014974 GUNUNG 085271102283 2 1 0 1 5/25/2019 3/2/2020 34-35 145 64 118/66 93 29 12,5 (-) (-) (-) 30 30 30
SARIK,KUR
1 RISKA WULAN DARI 26 ANJI
54 1/23/2020 1371105709860003 3572 DURIAN 16/KR 85363501891 2 1 0 1 9/11/2019 6/18/2020 19-20 148 47 115/76 103 23 10,8 (-) (-) (-) 30 30 30
1 RENI 33 SAHRIAL RATUS
55 1371105502980003 00097 JL.DURIAN 17/KR 085363340292 1 0 0 0 10/18/2019 7/25/2020 12-13 164 77 113/62 94 28 11,3 (-) (-) (-) 30 30 20
1 DIKA FEBRI DAHLIA 22 RISTOHADI 1 RATUS
56 1/24/2020 137110490490001 0002291557127 014993 JL.PUNGGA 24/SG 085272088119 2 1 0 1 11/20/2019 8/27/2020 9-10 172 103 143/86 76 35 14,8 (-) (-) (-) 30 30 20
1 FIRZA FAIKA 29 EPRIJON I NO.331

SURAI
PATAI
57 137109400994008 0002884133483 014998 BALAI 082284559395 1 0 0 0 5/14/2019 2/21/2020 36-37 150 58 121/73 143 29 8,8 (-) (-) (-)
BARU
GUNUNG
1 1 SEPRI FENI 25 MUSRIZAL SARI
 REGISTER IBU HAMIL KF KIA
PUSKESMAS NANGGALO 2019
IDENTITAS REGISTER TGL LHR JRK PEMERIKSAAN DRH RUJUK
ANAK
No. TGL SG KR GL LW NO HP THERAPY D/
NAMA SUAMI
NAMA IBU (TTL) U NIK BPJS U RM ALAMAT NO P A H TERAKHIR (TH) TB BB TD N HB INTERNAL RS
(TTL)

8/15/2019 JL MARANSI GG MERPATI 78/LW 5 1 4 143 55.1 108/65 86 ANTASID, RANITIDIN

1 IRMA DINI 3/6/96 33 HAMDI TOMA 1371114306860010 0001246153487 012871 3 085274114629
1 NOVI LENDRA 6/4/84 34 ALDI 18/5/79 1371104804840003 0000282457214 012053 JL HANDAYANI IV 147 01/SG 081270717732 3 0 3 150
8/19/2019 SRI YUNITA 10/6/90 DURIAN RATUS KURAO 59/KR 1 0 0 144 53.6 126/83 38 PCT
1 29 RIO REAGAN YUDA 1371105006900005 0000283667332 013013 PAGANG 085278302164
8/22/2019 1 UCI MELA SARI 5/5/92 27 JAMALUDIN 1371114505920014 1 013704 JL ASRA I NO.21 139/LW 082392425942 1 0 0 154 77.1 121/79 106
JLN MARANSI GG 78/LW 5 1 4 155 50 120/80 86 AMOX, ASMEF
8/22/2019 1 IRMADINI 3/6/86 33 HAMDI TOMA 1371114306860010 0001246153487 012871 MERPATI 3 085274114629
RAHMAWATI 1/3/80 37 MULYADI 137108016002479 JL PERJUANGAN III/20 085274099133
RT/RW 3/5 23/KR 2 0 1 140 60 140/93 75 IBNU SINA N85.9
8/30/2019 1 0000282622882 Noninflammatory disorder of uterus, unspecified
HANIFUL HAQ KOMP PERMATA SG BLOK 163/SG 4 2 1 150 49.5 137/85 99
9/16/2019 1 MIRAYANI JAMBAK 24/12/85 33 MELAYU 1214056412850001 0002781787116 013906 C.6
JL MARANSI GG MERAK 47/LW 5 0 5 155 59 110/76 70 AMOX, VIT C
9/19/2019 1 DESVITA ANDRIANI 27/12/84 34 MAR EFENDI 1905016712850002 1 012356 NO.13 081275654141
HANIFUL HAQ KOMP PERMATA SG BLOK 163/SG 4 2 1 150 47.7 130/78 78
9/26/2019 1 MIRAYANI JAMBAK 24/12/85 33 MELAYU 1214056412850001 0002781787116 013906 C.6
9/30/2019 1 HASMIAH 30 RUSLI 137108019001220 H00005 KOMP PGRI 1 F41 RT 2/2 2 2 2 128 50 133/81 92
50/SG 5 2 2 155 64 125/81 106 IBNU SINA
10/3/2019 DESRI EFRIATI 33 GUS ANDRI 137108016000474 0000282396982 1 004088 JL KOMP KODAM NO 7 B 082377463749
10/3/2019 1 TITIN NURYANI 33 DEDI NOVRIANTO 1371095606860005 0001633955635 013281 JL.SIMP.BAWAH ASAM LW 085271829696 3 2 1 161 74 127/81 77 RESTU IBU
RICO PUTRA DURIAN RATUS KURAO 2 0 2 157 56 109/69 83 ASMEF
10/7/2019 1 YULIANA 13/7/88 29 15/6/83 0000282924393 0000282924393 009707 PAGANG 2/2 70/KR 081261091182
SALBOY SANDRI 137108016002447 0000283914584 9351 PAGANG DALAM 122/KR 085218167516 1 0 0 148 49 124/81 94
10/9/2019 1 INDAH PERMATA SARI 01-02-1992 27 28/12/93 RW.001/003 

0001481838355 002214 JL INDAH BERSAMA N0.8 39/KR 081365435222 3 2 0 150 80.6 133/77 84 PCT,VITC
10/10/2019 1 IRA SASMITA 15/2/82 36 DONI FEBRIYANTO KURAO
MAR EFFENDI 1
1/4/1974
137111016000124 0001843723912 JL. MARANSI GG MERAK 47/LW 081275654141 5 4 0 155 67 108/62 70 ASMEF
NO. 13 RT 4 RW 4 RT RW
10/12/2019 1 DESVITA ANDRIANI 35 Kel AIR PACAH
komp.pgri 1 blok 161/SG 2 0 2 159 63,3 119/91 85 VIT C,SF
10/23/2019 1 arni yuliza 33 f.8 siteba 1371105209840001 0001301451470 010534 KOMP.PGRI 1 BLOK F.8 081363016630
10/24/2019 1 SUCI NOVITA SARI 26 HENDRA MAIDI 1371104803930005 0000987393374 012597 JL.GURUN LAWEH 13/GL 081261925758 1 0 0 152 76 122/66 68 IBNU SINA 34
23 1371105603970001 014028 JL KURAO PAGANG 2 0 2 151 70.3 140/87 112 VIT A, SF, KALK, VIT C Z39
10/31/2009 1 NADIA RAHMARTA A DEFRIANTO 0002784574372 RT2/2 082384312899
JL.BANDES,GURUN 39/GL 2 1 0 155 45 103/69 83 ASMEF,VIT C IBNU SINA
11/7/2019 1 RESI PURNAMA SARI 25 RIKI WANDI P 0000283221922 007257 LAWEH 082169408153
11/7/2019 1 VIRA ADINDA 34 JASKO 1371114508850010 000078381666 005120 JL.RAYA KURAO 081374456479 8 4 3 155 66,6 153/93 86 PARASETAMOL,SETIRIZIN,AMBROKSOL,VIT C
JL.RAYA KURAO NO 243
RT 3 KEL.SURAU 47/SG 1 0 0 153 88 105/73 101 SETIRISINSEFIKSIM,PCT,AMBROKSOL
11/19/2019 1 SRI FITRI AMALIA 24 M.HALIM KHAIRUL 1371046208950002 0000164796434 012226 GADANG 081270569894
11/23/2019 1 ANNA DIANA 28 MUSFARDI 011662 JL.VILAKU INDAH NO F3 081371013624 1 0 0 155 55 147/91 85 GENTAMISIN,VIT C
11/28/2019 1 DIAN SEPTIA 30 ARMEN 1 003851 JL.50 KOTA 3 65/SG 085278255540 5 2 2 149 72 121/84 101 PCT
12/2/2019 1 DEFRIANI 35 BENI WAHYUDI 0000163571084 14622 JL.HANDAYANI 1,NO.8 085263011232 5 0 4 160 65 120/90 76 PCT,VITC
12/9/2019 1 IIS ROZA MARDANI 30 ADE KURNIAWAN 1371106103890003 0001333136193 12836 JL.GURUN LAWEH NO.32 16/SG 081363751375 1 0 0 160 56 142/94 107 IBNU SINA O34
12/16/2019 1 NURMALINDA 32 EDRIANTO 1371104508850006 0000283369915 005881 JL.JAMAL JAMIL 121/SG 081374370294 1 0 0 154 57 121/67 88 PCT,VIT C
JL.PONDOK KOPI 86/SG 3 0 2 148 59 142/72 102 FE,VIT C IBNU SINA
12/21/2019 1 ERMAYENTI 30 NARTA DONA 0000283009937 004879 NO.197 RT/RW 01/02 082170805039
1/9/2020 1 NORA PRAMADANI 17 FIRNANDO BIMA 1401066711000007 0000290085502 013434 JL.MARANSI INDAH 083184177754 1 0 0 152 46 91/61 106 AMOK,ASMEF,SETIRIZIN
1/9/2020 1 TRI MAULANA 24 ADE MA SYAF 0002264784254 002697 JL.PDANG NO.8 081277338558 2 1 0 162 88 136/86 95 ASMEF,AMOK,FE
1/14/2020 1 idmawati 36 wandi eka 0001386802866 010456 jl.raya siteba 88/sg 081276653266 4 3 0 156 60 127/41 88 ASMEF,VIT.A
PAGANG DALAM 2 1 0 157 82 130/70 94
1/15/2020 1 DERI SARMAYONKA 29 IRWAN 1371107007900003 0000282898179 000773 RW.001/003  082286217119
1/16/2020 1 WIDIA FITRI 18 OSMAN 0000284277925 003893 PAGANG DALAM 107/KR 082285263105 2 1 0 152 62 113/73 88 RUJUK RSUD T81
1/21/2020 1 IDMAWATI 36 WANDI EKA.P 0001386802866 010456 JL.RAYA SITEBA 88/SG 081276653266 4 2 0 156 56 113/53 94 RUJUK BMC Z.39.2
1/27/2020 1 LINDA DESNA 35 NOVENDRI 1371106305830007 1 009693 JL.50 KOTA 3 NO.685 83/SG 082287115953 2 1 0 150 62 121/93 102 RUJUK NAILI DBS T.81(INFEKSI LUKA SC)
1/28/2020 1 deri sarmayona 29 irwan 1371107007900003 0000282898179 000773 PAGANG DALAM 082286217119 2 1 0 157 72 149/84 68 antasid,rani,b6
2/3/2020 1 WIDIA FITRI 20 RIDO 0000284277925 003893 PAGANG DALAM 107/KR 082285263105 2 1 0 152 52.1 103/66 71
2/5/2020 1 CUT NENGSIH RAMLAN 34 ENDRI PUTRA 0001280245915 005258 JL.PGRI RAYA PERUMDAK 116/KR 082284330958 2 1 0 161 70 128/69 36 RUJUK RS BAYANGKARA INFEKSI BEKAS SC
ERNA GUSRIYANTI JL.JAMAL JAMIL 87/SG 2 1 1 163 59 128/83 71 SF,
2/6/2020 1 29 AFRIZAL 0000283434344 007346 NO.RT/RW 05/01 SG 081312213266
2/10/2020 1 DILLA INSANI 22 M IRVAN 1371116703970013 D00040 JL DENAI TG HTM 081270705551 1 0 0 159 59 122/79 94 PCT VITC
2/15/2020 1 ANDITA PRIMA OKTARISA 30 DEDE DWI BAHRI 0000170320781 014399 JL TEKONOLOGI RAYA 89 085363990771 2 0 2 159 69.5 136/78 95 PCT, VIT C
2/20/2020 AMAN SIMAMORA 082367700091
1 0 0 150 56 130/80 80
1 FEBRIANI SILALAHI 30 1 013673 JL.BY KM 14 AIR PACAH
2/26/2020 1 ANNISA FITRI DIAH 25 HENDRA SAPUTRA 1371105303940007 0001503248861 015213 JL.TANAH DATAR 4 NO.105 082379571117 2 1 0 146 40 107/67 92 PCT
3/4/2020 1 MUTHIA MONICA 31 137108018001441 0000171827954 011942 JL.PAYAKUMBUH 3 3 2 0 165 63 112/74 91 RSUD Z.39
3/5/2020 komp.griya madani tabing 3 2 0 154 40 120/80 98 asmef,rani,
1 yosvina silvia 35 indra praja 1371106301840006 0001583250301 014069 banda gadang 08219082487
3/5/2020 1 RENI FEBRIYANI 26 M TAUFIK 1371104410900002 0000282245321 002355 JL.RAYA PAGANG ,KR 95/KR 082364122664 2 1 0 154 58 120/80 98
 REGISTER IBU HAMIL KF KIA
PUSKESMAS NANGGALO 2019
IDENTITAS REGISTER TGL LHR JRK PEMERIKSAAN DRH RUJUK
ANAK
No. TGL SG KR GL LW NO HP THERAPY D/
NAMA SUAMI
NAMA IBU (TTL) U NIK BPJS U RM ALAMAT NO P A H TERAKHIR (TH) TB BB TD N HB INTERNAL RS
(TTL)
3/11/2020 1 RIA NOFITA SARI 24 NOFALDI 1371104801940002 0000284043802 0009373 JL.PUNGGAI NO.331 081276574719 2 1 0 150 58 128/73 93
3/17/2020 1 MUTIARA DEWI APRILIA 21 EXKY AFRY 137108718000120 0000283408424 007045 JL.KOMPI BANTUAN NO.3 1 0 0 160 57 111/71 94
3/24/2020 1 GUSRI MAYENI 35 SYARIFUDDIN 1371104708820001 0001295328295 4663 JL.ANGGREK NO.42 131/SG 081261930116 3 2 0 1 158 62 133/89 99
3/26/2020 1 DEFI INSANI 32 JANUAR 1371116810860011 0001681924138 6936 JL.MARANSI NO.5 085219086260 1 0 0 144 37 120/73 113 RSUD INFEKSI BEKAS SC
BAMBANG 1 0 0 160 54 122/88 88 PARASETAMOL,
4/3/2020 1 WIZA RAHMIADI 24 HIDAYAT 1371104208950002 0000015909772 014678 JL.PERJUANGAN 3 NO.17 082288507924
RANDU 131106303010001 0000283825721 015252 8/GL 082390639424 1 0 0 160 52 120/80 80
4/15/2020 1 PUJA REFFANDA/23/03/2002 18 GALANDRA GURUN LAWEH
5/8/2020 1 ENDANG YOLANDA/05/01/1994 26 FIRDAUS 1371104501940005 0001808171302 011332 SURAU GADANG 165/SG 082386045497 2 1 0 152 58 127/79 88 GENTAMISIN
5/16/2020 1 NOVA NOVITA 35 DONI ICHWAN 1371104611840003 0000283081689 014383 JL.RAYA PAGANG ,KR 082391233315 2 1 2 165 67 120/80 100 RESTU IBU HAEMOREGIC POSPARTUM
5/16/2020 JL. KOMP.PGRI 2 NO.8C 0 0 0 152 75 152/101 117 RS BAYANGKARA INFEKSI BEKAS OPERASI
1 YOSIE HENDIKO PUTRI 30 OSRINALDI 1371107101880001 0000283241081 014427 KEL.KURAO 082388053394
6/19/2020 KOMP.MELA SENTOSA
2 1 0 12/31/1899 160 77 125/73 101 IBNU SINA Z09.8
1 SELVINA PRIHANDAYANI 29 AGUS SAPUTRA 1372026109880061 0001292445011 8421 SAWAH LIAT 085274814080
 PU
IDENTITAS
No. TGL
NAMA IBU UMUR NAMA CALON SUAMI NIK BPJS
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
 REGISTER CATIN KIA IBU
PUSKESMAS NANGGALO 2019
REGISTER PEMERIKSAAN KEHAMILAN
NO HP
RM ALAMAT SG KR GL LW TB BB TD N S LILA
###
KEHAMILAN LAB DARAH URN
KET
TT HB GOL HEP HIV SIF PLANO
 KUNJUNGAN IDENTIT
No. TGL
1 2 3 4 U K NAMA IBU UMUR NAMA SUAMI
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
IDENTITAS REGISTER
NIK BPJS U RM ALAMAT NO SG
 REGISTER IBU HAMIL RESTI KIA
PUSKESMAS NANGGALO 2019
REGISTER PARITAS USIA TGL LHR ANAK JARAK
NO HP HPHT TP
KR GL LW G P A H KEHAMILAN TERAKHIR (THN)
 PEMERIKSAAN KEHAMILAN LAB DARAH URN THERAPY
TB BB TD N TFU PRES DJJ LILA TT HB GOL HEP HIV SIF PRO SF VC BC LC
THERAPY RUJUK
DIAGNOSA KET
LAIN2 INTERNAL RS
 REGISTER IBU HAMIL
PUSTU / KLINIK / BPS ..............................
BULAN : ..............................................................

TGL LHR
KUNJUNGAN IDENTITAS PARITAS USIA JRK PEMERIKSAAN KEHAMILAN LAB DARAH URN RUJUK
RES ANAK
NO TGL NO HP HPHT TP
TI
TGL KEHAMI TERAKHI
1 4 U NAMA IBU TGL LHR USIA PEK NAMA SUAMI NIK NO BPJS ALAMAT G P A H (TH) TB BB TD N TFU DJJ LILA TT HB GOL HEP HIV SIF PRO DIAGNOSA RS
LHR LAN R

10

11

12

13

14

15

16

17

18

19

20
 RISTI
UMUR < 20 THN
> 35 THN
BB < 45 KG
TB < 145 CM
LILA < 23.5 CM
TD > 140/90 mmHg
GRAVID >3
JARAK HAMIL < 2 THN
HB < 10.5 gr%
PENY PENYERTA
 IDEN
No.TGL RESTI
NAMA IBU (TTL) U NAMA SUAMI (TTL)

###

1 RIA ANGRIANA 32 PANDI AHMAD

2 SARMITA 26 RAVY ALHADI
3 ### 1 VITRI YENI 27 MHD BALENTINO
4 ### FATIMAH INDRA 22/5/90 29 RAHMAD ALIEZA
### ERI KISWANTO
5 JURNIATI 6/6/88 32 8/7/85
6 ### MUTHIA MONICA 31 DENI
7 AISAH FITRI 22 JUHE MANDRA
8 MONA RIZKA 27 OTMA YODI
9 ### LINDA RETNO DEWI 35

ISRA MARIZA

20 32 FAJAR BUDIMAN
CANDRA HIDAYAT
21 SUFRIYANTI 6/9/85 34 12/8/87
### SELVIANA
22 PUTRI/19/10/1995 25
23 ### 1 SRI MULYANA/30/05/1991 29 DANU PURNAMA
24 ### ANITA/05/05/1988 31 BENI CANDRA
### DESI ARIA
25 SANDI/22/12/1993 26 JHONI HENDRA
### EMI
26 1 ANGGRAINI/20/08/1987 37 WANDI
###
27 DEZELLA MEFRI/31/08/1990 29 MICKEY YOUSRI
28 ### 1 CICI WULANSARI 32 P.SWASTA
 ### ANITA
30 FEBRIANTI/19/02/1995 23 IRT
### IRA FARADILA KARYAWAN
31 1 RAHMI/19/08/1992 27 SWASTA
###
32 1 AFRIYENI/03/04/1981 39 M.ABDUL MUKMIN
### OKTARINA
34 ENDANG/16/10/1993 26 ROBBI HIDAYAT
###
35 YOVA HERMAN/12/01/1994 23 HERIANTO

### PUTRI MEILANI 17-05- RIKI PRIMA YUZA

36 1996 24 14/2/92
### NINDIA SURYANI
37 01/12/1988 32 HENJI SAPUTRA
### FITRIA
38 1 MARLINA/12/03/1983 35 AL ZAPRIN
39 ### YUNI SISKA/26/06/2000 20 REBDI
40 ### HANI SISVA/01/08/1988 32
110### FITRIA MARLINA/12/03/1983 35 AL ZAPRIN
111### 1 NOVITA ELIA ROZA/07/11/1990 29 IBRAHIM
RIO AUGUSTA
113### 1 MONICA LESTARI 23/1/98 21 WARDANA 18/11/94

114### DIAN OKTARINI 31-10-1986 33 NAFRIZAL 11/11/83

MEGA PURMARIATI 26-10-
### 1990 29
3 ### HANI SISVA/01/08/1988 32
5 ### SARMITA 26 RAVY ALHADI
7 ### 1 ENDANG YOLANDA 5/1/94 26 FIRDAUS 15/3/84
8 ### RAMA DARWITA 33 ARTAN NUGRAHA

14 2 VENITA LOREN 1/6/84 35

15 3 FADILLAH YUHENDRI 29 IGO ANUGRAH
16 4 1 LESNITA 19/9/70 46 BASRIL
20 8
21 9 SRI SUKMA/16/11/1997 22 PENDI ANDIKA

22 ### DEVI YULIANTI 17/7/84 35 MAREDA WADI

25 ### DEVI LIDIA WATI/03/09/1977 42 NOVRIALDI

26 ### RAHMADINA 23/02/95 25 SWST

27 ### WIWIT NOVRIANITA 12/11/91 29 IRT

28 ### DIAN NOLA ARTIKA 01-09-1994 25

29 ### RESA ANA FITRI 24-04-1991 28

30 ### SRI RAHAYU/12/06/1989 29 YOGI PUTRA 9/4/95

FERDIAN ZAINUS
34 ### AYU SURYANI/02/04/1996 21 17/7/93
DESFERI AKBAR
42 ### SINTA YASIN 4/1/95 24 5/12/91
seprino bayu putra
43 ### LARAH OKTAVIARNI/17/10/1995 24 9/9/82
44 ### YOLANDA OKTRI/12/07/1999 21 OKTRIZAL WALDI
45 ### SISKA HUDAYANI/19/08/1991 28 FAUZAN NURYASIN
46 ### SRI RAHMI 2/2/90 27 IWAN S RIZAL 3/1/83
NANA ERNAWATI
47 ### ARWIN/21/04/1993 25 ALFISON
48 ### LUSI HANDAYANI 30 AYU HENDRA
### ANNISA ISTIQOMAH 16/3/95 23 SALMAN
### NURHASANAH/02/05/1986 32 HAFIZUL CANDRA
### cut mutia 28 HENDRI KURNIAWAN
### SARI FITRIA DIAN NOLA 29 MOURIKO
RONI Y RIDWAN
### EDRIA NOVARIZA 03-03-1979 41 12/5/79
### DESWITA/03/06/1985 35
ROMUALDES
### NURLIANA MUNTE/20/10/1991 28 SIHALOHO
### LEGI SATYA/05/11/1990 29 ROBI
### RADHA AMELIA/06/05/2002 18 JACKYM GUSTI
 IDENTITAS

NIK BPJS U RM

1371105008880010 167

1
1371107001930004 1 015009
1371105508920003 24
1311036205900003
1371094606880010 J00023
1
0000171827954 011942
1371105003950005 0000282562525 007475
1 015096
1 00048

137108016005024 I00043
0009879
137108019000104
1371105910950003 0000282464605 003925
1371107005910003 0001288389161 0009895
1305044505880001 1 280
1312105010930003 00116
1
1371106008870003 00056
1
1312037108900002 015267
1
AGUS SALYM PUTRA 1371105601880002
0001828604564
000023
 1301025962950001
0000271566314
011364
DODI NOFRIANTO
1371105908920003
0002354485476
014586
FERI WAHYUDI
1371104304810002
1
1307025610930001
1
0000284229088

1311015705960000
1371104112880004 0001387718302 015545

011085
1
1405126006000002 1 015490
1371104108880008 1 39338
1 011085
1306034711900003 0002068952859 014792

1572056301980001 0001686096595 M00026

1371107110860003

14857
1371104108880008 1 39338
1371107001930004 1 015009
1371104501940005 0001808171302 011332
0000282590008 1696
1371114106840017
0001628161615
0002915268456 1 00069
1371105909700001 0000282516280
 1 206/SG

1371065707840007 0002623671944

1371104309770002 1 00104
137108016004951
YUDI PEFRIAN 15/12/95
137108016004135
0000284094303
YULIATO 20/7/91

YOGI PUTRA 9/4/95 137108017000428 0000284094415

DION SAPUTRA 1/1/78 137108018003632 0000283017025

137108017000428 0000284094415

1371036708870004

137108016004127 0000284243714 002636

137108016005552
0001334710484
1371045907990003 1 101
131095908910003 0001080840159 171
137108017004728 0000282892656

1371106104930001 0001682815083 012564

1302034603690001 1 L00010
1371105603950003 0000282934282 011096
1371104205860010 0001786163073 009743
1371104110910007 1 42157
0000283445594 010782

1371114303790014

13050243065001 009212

1371046010910006 0002239627511 000115

1371106511900004 1 54
1 015473
 REGISTER PARIT
NO HP
ALAMAT NO G

25/SG 082169099929 2

KOMP.KODAM BLOK K NO.5 RT/RW 02/02

JL.50 KOTA SITEBA 26/SG 082280182021 1
JL.PAGANG 2 NO.532 27/SG 2
JL GN JUARO bLOK D SG 082284195787 2
081374530835 3
JL PERMATA F16 SG
JL.PAYAKUMBUH 3 NO 558 28/SG 3
JL.HIDAYAH NO 34 081267599009 2
JL.SAWAH LUNTO 3/183 29/SG 085263358096 1
TUNGGUL HITAM 3

085274777232 2
JL BEROK RAYA NO 35 , RT. 006 ,
RW. 003 , KEL. SURAU GADANG
JL DAHLIA NO 60 RT RW Kel SURAU 0821272270208 1
GADANG
41/SG 081267546920 2
JL.BATUSANGKAR NO.768
JL. WIDURI NO.13 42/SG 082395352004 2
SURAU GADANG 44/SG 085365047481 3
45/SG 082387828796 3
JL.PERJUANGAN RAYA NO.20
JL.JAMAL JAMIL RT/RW: 03/01 SURAU 46/SG 085364549563 2
GADANG
47/SG 085363424204 2
JL.JAYA PURA K/110 SURAU GADANG
JL.AGAM RAYA NO.33 48/SG 081374084748 3
JL.GUNUNG JUARO BLOK D NO.7 RT/RW 50/SG 0000271566314 3
2/1
JL.SIJUNJUNG 4 NO.361
51/SG 085376296373 1

52/SG 085375610948 2
JL.DAHLIA NO.60 RT/RW 01/03 SG
JL.TEKNOLOGI RAYA DEPAN MASJID RAYA 53/SG 085274044228 1
NANGGALO
54/SG 081276572944 2
JL.JAMAL JAMIL NO.3 GADANG
ASRAMA MILITER KOMPI BANT , RT.
- , RW. - , KEL. SURAU GADANG , 56/SG 082389658988 1
KEC. NANGGALO
57/SG 081374536754 4
JL.WIRASAKTI 4 N0.18 RT/RW 02/13 SG
58/SG 082383979224 2
JL.BEROK RAYA NO.2 RT/RW 03/03 SG
KOMP.PGRI 59/SG 081371043786 1
JL.PASAMAN NO.205 60/SG 081372082840 2
JL.BEROK RAYA NO.2 RT/RW 03/03 SG 58/SG 082383979224 2
JL.SAWAH LIEK 085296212666 2

082281597924 1
JL GUNUNG JUARO 
JL. TEKNOLOGI III /B1 , RT. - , RW. - , KEL. SURAU 085274712268 2
GADANG , KEC. NANGGALO
JL. BEROK RAYA NO. 22 A RT 006 RW 003 6/SG 081372756065 1
Kel SURAU GADANG
JL.PASAMAN NO.205 60/SG 081372082840 2
JL.50 KOTA SITEBA 26/SG 082280182021 1
JL TEKNOLOGI VII NO 24 165/SG 082386045497 2
JL.PADANG PANJANG NO.1227 212/SG 085381993599 6
PERUM PERMATA SURAU GADANG BLOK G NO. 6 085374242727 3
RT 7 RW 1 Kel SURAU GADANG
JL.KESEHATAN1 NO.3 LAPAI 75/KR 085355426861 1
JL JAMAL JAMIL G 081267858720 5
JL.TEKNOLOGI 9 NO.15 206/SG 085335745912 2

085265002277 4
JL BINGKUANG NO.8 RT.4 RW.11 DADOK TGL HTM
JL.PAYAKUMBUH 5 NO.511 30/SG 085375112754 6
JL.KAMPUNG BARU BEROK NO109 RT 004 RW 004 45/KR 082283851956 1
KURAO PAGANG 
JL PD PANJANG NO 217 RT 009 RW 001 Kel SURAU 081929680512 2
GADANG
JL PADANG PANJANG NO 217 RT RW Kel SURAU 62/SG 085272091927 1
GADANG
JL KOMPLEK INDAH PRATAMA BLOK G2 085356903268 2
RT 006 RW 001 Kel SURAU GADANG
JL PADANG PANJANG NO 217 RT RW Kel SURAU 62/SG 085272091927 1
GADANG

jln palangkaraya L2 NO 8 WISMA INDAH 4 SITEBA RT 085365952825 1

RW Kel SURAU GADANG

159/KR 081364602682 1
BEROK RAKIK NO 13
JL. RAYA PAGANG KURAO RT 005 RW 002 Kel 085263333300 4
KURAO PAGANG
KP. BARU BEROK NO.200 48/KR 085355811290 1
VILAKU INDAH 3 BLOK A NO.10 49/KR 085263945123 2
JL PERJUANGAN RAYA III NO.33 081374834190 1

3/SG 085363126793 2
JL.PERJUANGAN1 ,NO 15 SG
JL DAHLIA 62 SG 157/SG 081267523843 1
JL PERJUANGAN I NO.22 RT5/2 KP 137/KR 085375047175 1
JL.SOLOK NO.257 63/SG 081361716471 3
DEPAN SD 13 41/SG 082165778599 2
JL.CENDRAWASIH NO.9 199/KR 082385070348 2

081267000701 3
jl. maransi RT 002 RW 004 Kel AIR PACAH
JL.GANG SAIYO RT/07/04 51/KR 081263025014 5

64/SG 08136175218 2
ASRAMA KOMPI C SG
JL. ARAUMPINANG 2 NO.2 081374533166 2
JL. WIDURI NO.17 65/SG 083180004992 1
PARITAS
TP
P A H

1 0 1 5/19/2019 2/26/2020

0 0 0 8/9/2019 5/16/2020
1 0 1 6/1/2019 3/8/2020
1 0 0 5/27/2019 3/6/2020
2 0 2 7/29/2019 5/6/2020
2 0 2 5/29/2019 3/26/2020
1 0 1 12/22/2019 9/29/2020
0 0 0 11/15/2019 8/22/2020
2 0 2 12/13/2019 9/20/2020

1 0 1 12/10/2019 9/17/2020

0 0 0 1/16/2020 10/23/2020

1 0 1 1/9/2020 10/16/2020
1 0 1 1/8/2020 10/15/2020
2 0 2 10/5/2019 7/1/2020
2 0 2 8/8/2019 5/16/2020

1 0 1 10/3/2019 7/10/2020

1 0 1 1/21/2020 10/28/2020
1 1 1 1/1/2020 9/8/2020
2 1 0 12/17/2019 9/23/2020

0 0 0 10/9/2019 7/16/2020

1 0 1 11/5/2019 8/12/2020

0 0 0 12/28/2019 10/5/2020

1 0 1 12/13/2019 9/20/2020

0 0 0 9/4/2020 6/10/2020

2 1 2 6/14/2019 3/21/2020

1 0 1 9/6/2019 6/3/2020
0 0 0 9/28/2019 6/4/2020
1 0 1 12/30/2019 05/10/020
1 0 1 9/6/2019 6/3/2020
1 0 1 10/17/2019 7/24/2020

0 0 0 7/23/2019 4/30/2020

1 0 1 6/20/2019 3/27/2020

0 0 0 11/1/2019 8/8/2020

1 0 1 12/30/2019 05/10/020
0 0 0 8/9/2019 5/16/2020
1 0 1 8/3/2019 5/10/2020
3 2 3 9/21/2019 6/28/2020
2 0 2 1/27/2020 11/4/2020
0 0 0 8/16/2019 5/23/2020
4 0 4 LUPA
1 0 1 9/15/2019 6/22/2020

3 0 3 2/22/2019 4/29/2020

3 2 3 11/13/2019 8/20/2020
0 0 0 12/20/2019 9/27/2020

1 0 1 09-Oct 7/17/2020

0 0 0 2/24/2019 12/1/2020

1 0 1 6/15/2019 3/22/2020

0 0 0 2/24/2019 12/1/2020

0 0 0 9/24/2019 7/1/2020

0 0 0 9/22/2019 6/29/2020

3 0 3 2/10/2020 11/17/2020

0 0 0 2/16/2020 11/23/2020
1 0 1 8/7/2019 5/14/2020
0 0 0 2/7/2020 11/14/2020

1 0 1 8/11/2019 5/18/2020

0 0 0 6/29/2019 4/6/2020
0 0 0 8/14/2019 5/21/2020
2 0 2 2/27/2020 11/4/2020
1 0 1 8/23/2019 5/30/2020
1 0 1 7/31/2019 5/7/2020

2 0 2 8/18/2019 5/25/2020

4 0 4 8/15/2019 5/22/2020

1 0 1 7/28/2019 5/4/2020

1 0 1 6/10/2020 9/3/2020
0 0 0 10/25/2019 8/2/2020
 TGL LHR
USIA ANAK JRK PEMERIKSAAN KEHAMILAN

KEHAMILAN TERAKHIR (TH) TB BB TD N TFU

36-37 154 68 111/66 96

24-25 145 58 128/81 106

33-34 158 46 95/55 80
36 153 57 119/63 118 34
26-27 155.5 57.6 125/69 113 19
35-.36 165 63 111/60 91
6-7 158 59 126/83 93
11-12 157 65 114/81 98
8-9 159 68 129/85 120

10-11 4/2/2015 153 75 133/90 79

5-6 155 44 99/66 81

6-7 152 47 110/70 80

6-7 162 87 140/82 85
20-21 150 52 113/62 83
33-34 152 49 100/67 101

20-21 165 71 105/57 92

6-7 153 54.3 130/81 96

9-10 147 53 108/87 108
11-12 151 45 100/56 88

6-7 160 80 128/75 85

17-18 150 61,2 107/69 112

10-11 154 48,1 125/69 98

12-13 160 73 129/70 85

158 46 92/58 93

38-39 162 94 129/68 101

28-29 156 45 105/63 89 16

24-25 155 52 109/61 120
11-12 160 85,5 120/80 98
28-29 156 45 105/63 89 16
22 153 61.9 119/72 80 16

34 154 62.2 115/68 83

39 150 84 142/99 95 41

15-16 162 70 140/83 107

11-12 160 85,5 120/80 98

32 145 60,9 129/79 92
32-33 6/29/2015 4.5 152 63,4 110/68 85
12-13 155 77 152/116 111
8-9 158 61 112/65 80
31-32 159 66.3 122/74 98
151 59.4 135/81 80
27-28 157 60.1 112/58 71

35-36 153 57.7 126/77 93 31

19-20 152 72 131/75 132 132

14-15 164 62.6 119/64 95

25 142 48.7 93/63 142 24

5 155 42.5 96/63 91

37-38 5/9/2016 158 67.5 133/84 107 35

5 155 42.5 96/63 91

27-28 150 68.1 112/64 91 24

28 165 64 110/68 117 32

8 162 51.6 119/83 106

7-8 161 46,5 114/71 102

34-35 161 45 100/61 100
9-10 152 45 124/77 128

34-35 149 53 133/76 93 17

40-41 153 59.9 104/58 73

34 149 82 141/85 105 29
9-10 160 55 123/66 74
34-35 148 58 103/55 98
37 158 69.1 113/66 100 35

156 51 99/58 110 28

34-35 155 61,5 95/80 103

37-38 158 73 124/58 90

32-33 155 60 123/87 89

24-25 149 47 109/88 97
N KEHAMILAN LAB DARAH URN

DJJ LILA TT HB GOL HEP HIV SIF PRO

29 12,3 O PUSK.LINTAU

28 12,1 (-) (-) (-)

21,5 9,9 O (-) (-) (-)
165 23,5 10.1 B+ (-) (-) (-)
155 25.5 11.4 (-) (-) (-)
25 13,1 HC JAMBI
25 13,8 O (-) (-)
29 12,8 (-) (-)
29 12,8 O (-) (-)

13.7 (-) (-)

11.8 (-) (-)

28 11,8 AB (-) (-)

32 12,3 A+ (-) (-)
24 11,2 (-) (-)
24 11,2 (-) (-)

30 11,0 (-) (-)

27 12,7 (-) (-)

31 11,6 (+) (-) (-)
 25 12,7 (-) (-)

32 10,6 (-) (-)

27 10,6 (-) (-)

26,5 12,4 A (-) (-)

29 12,6 O+ (-) (-)

23.5 11,5 (-) (-)

35 12,0 (-) (-)

133 23,5 9,8 (-) (-)

25 10,3 A+ (-) (-)
34 14 B (-) (-)
133 23,5 9,8 (-) (-)
148 28 4

136 12.8 (-) (-)

31 13.7 O+

34 14 B (-) (-)
29 12,1
28 8,1 O+
34 O
29 11.2 B+ (-) (-)
26
30
 25 11,4

136 24 (-) (-) (-)

158 25
11.7 11.7 B+ (-) (-)

145

23 10.9 10.9 O (-) (-)

134 31

23 10.9 O (-) (-) (-)

145 24 O (-) (-) (-)

144 26

24 11,0 (-) (-) (-)

22 9,0 (-) (-) (-)

23,5 11,5 (-) (-) (-)
A+

158 28 12,4 O+

29 3 10.2
146 31 12,1
26 11,4 (-) (-) (-)
26 11,0 O+
150

24 10.8 O+ (-) (-) (-)

28 (-) (-) (-)

36 (-) (-) (-)

25 12,5 (-) (-) (-)

23 9,5 (-) (-) (-)
 THERAPY RUJUK
D/
SF VC BC B6 LC LAIN2 INTERNAL RS

90 20 30

30 30 20
30 30 20

RSUD PADANG
HBSAG (+)
30 30 30 RESTU
ABORTUS
IBU IMINEN
30 30 30
30 30 30

30 30 30

30 30 30

30 30 30
30 30 30 RS BAYANGKARA
PEB
30 30 30
30 30 30

30 30 30

30 30 30
30 30 30
30 30 30

30 30 30

30 30 30 ANJURANANJURAN
DIRUJUKDIRUJUK

30 30 30

30 30 30

30 30 30

RESTU IBUBSC 2X

30 30
30 30 30
30 30 30
30 30

RESTU IBU TBJ 4000

30 30 30

30 30 30
30 30 30
30 30 30 BSC
NAILI DBS ABORTUS IMINEN

60 60 60
IBNU SINA HT & DM
60 30 30

RS BAYANGKARA
BSC 1X

30 60 PCT
(-)

60 60 60

(-) 60 60 60

RS IBNU SINA

60 60 60

60 60 60

60 60 60

60 60 60
SITIPLASENTA
HAWA LETAK BAWAH
30 30

30 30 30

RS HERMINA
LEWAT BULAN
RS HERMINA
letak lintang
60 60 60
60 60 60
BSC 1X

60 60 60

60 60 60

60 60 60

60 60 60
60 60 60
 HBSAG (+)
ABORTUS IMINEN

PEB
 ABORTUS IMINEN

TBJ 4000 TBJ 4000

BSC BSC
ABORTUS IMINEN
 BSC 1X BSC 1X

BSC 1X BSC 1X

BSC 1X

PLASENTA LETAK BAWAH

LEWAT BULAN
letak lintang

BSC 1X BSC 1X
BULAN : ..............................................................

KUNJUNGAN IDENTITA
NO TGL RESTI
NAMA TGL
1 4 U USIA
IBU LHR

RIA
ANGRIA
1 NA 32

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
 REGIST
PUSTU / KLINIK

IDENTITAS PARITAS
NO HP
NAMA TGL ALAMA
PEK NIK NO BPJS G P
SUAMI LHR T

KOMP.K
1371105008880010 167 ODAM 25/SG082169099929 2
BLOK K
NO.5
PANDI RT/RW
AHMAD 1 02/02

jln
palangkara
ya L2 NO
8 WISMA
INDAH 4
SITEBA
RT RW
Kel
SURAU
GADANG
 REGISTER IBU HAMIL
PUSTU / KLINIK / BPS ..............................

TGL
PARITAS USIA LHR JRK PEMERIKSAAN
HPHT TP ANAK
KEHA TERAK
A H (TH) TB BB
MILAN HIR

1 0 1 ### ### 36-37 154

PEMERIKSAAN KEHAMILAN LAB DARAH

TD N TFU DJJ LILA TT HB GOL HEP

68 111/66 96 29 12,3 O
AB DARAH URN RUJUK

HIV SIF PRO DIAGNOSA RS

PUSK.LINTAU 90 20 30