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  • Form Bumil Des19

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    Agus Salamun
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    form BUMIL

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    form bumil des19

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    form BUMIL

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    8 views2 pages

    Form Bumil Des19

    Uploaded by

    Agus Salamun
    form BUMIL

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    FORMULIR 2.A.

    PEMANTAUAN BULANAN IBU HAMIL

    BULAN: Desember 2019

    Usia Kehamilan dan Persalinan Status Penerimaan Indikator

    Dapat & Konsumsi Pil FE


    Pemeriksaan Kehamilan

    Konseling Gizi (Kelas IH)


    Usia Kehamilan (Bulan)

    Kepemilikan Akses Air


    Status

    Kepemilikan Jamban

    Jaminan Kesehatan
    Kehamilan Perkiraan Lahir

    Pemeriksaan Nifas

    Kunjungan Rumah
    No. Blok Nama Ibu
    (KEK/RESTI) (Tgl/Bln/Thn)

    Bersih
    Tanggal Melahirkan
    (Tgl/Bln/Thn)

    a b c d e f g h i j k l m n

    1 dpk Nurul N 5/6/2020 5 x x x x x v v v


    2 dpk Nurhasanah N 5/17/2020 4 v v x v x v v x
    3 dpk Riska N 3/13/2020 7 v v x v x v v v
    4 dpk Pipin N Jul-20 2 v v x v x v v v
    5 skht Ipah N - 6 v v x v x v v v
    6 skht Elah RESTI 11/8/2019 9 00/11/2019 x x v x x v v v
    7 skht Nurlaelawati N 12/20/2019 9 v v x v x v v v
    8 skht Yuke N 1/1/2020 9 v v x v x v v v
    9 skht Desi N 3/20/2020 6 v v x v x v v v
    10 skht Devi N 3/20/2020 6 v v x v x v v v
    11 skht Juju N 6 v v x v x v v v
    12 skht Lusiana N 5/9/2020 7 v v x v x v v v
    13 skht Piqroh N 1/25/2020 8 v v x v x v v v
    14 skht Engkes RESTI 3/17/2020 6 v v x v v v v v
    15 skht Wati RESTI 5/22/2020 4 v v x v v v v v
    16 skht Rita N 7 v v x v x v v v
    17 skht Iceu N 4/12/2020 5 v v x v x v v v
    18 skht Eem N 5 v v x v x v v v
    19 skht Nuratih RESTI 2/24/2020 8 v v x v v v v v
    20 skht Nova N 4 v v x v x v v v
    21 skht Yosi N 5 v v x v x v v v
    22 skht Lina N 9 v v x v x v v v
    23 skht Kiki N 6 v v x v x v v v
    24 skjd Tuti RESTI 11/11/2019 _ 11/2/2019 x x v x x v v v
    25 skjd Iis N 12/14/2019 9 12/5/2019 x x v x x v v v
    26 skjd Vika N 10/17/2019 _ 11/9/2019 x x v x x v v v
    27 skjd Diyah N 12/14/2019 9 v v x v x v v v
    28 skjd Mimi N 2/8/2020 5 v v x v x v v v
    29 skjd Yayah N 3/3/2020 6 v v x v x v v v
    30 skjd Eti N 9 Oct-19 x x v x x v v v
    31 skjd Windy N 1/1/2020 9 v v x v x v v v
    32 skjd Satri N 9 11/27/2019 x x v x x v v v
    33 skjd Tasmi N 7 v v x v x v v v
    34 skjd Tina N 4 v v x v x v v v
    35 skjd Acih N 9 v v x v x v v v
    36 skmh Irna N 11/28/2019 9 00/11/2019 v x v x x v v v
    37 skmh Unah N 9 10/14/2019 v x v x x v v v
    38 skmh Yulianti N 12/17/2019 9 v v x v x v v v
    39 skmh Ari N 11/14/2019 9 11/5/2019 x x v x x v v v
    40 skmh Nurseha N 1/13/2020 8 v v x v x v v v
    41 skmh Yani N 10/5/2019 3 10/2/2019 x x v x x v v v
    42 skmh Eris N 4/17/2020 5 v v x v x v v v
    43 trkt Eprilia N 10/8/2019 9 10/1/2019 x x v x x v v v
    44 trkt Elisah N 10/13/2019 9 10/10/2019 x x v x x v v v
    45 trkt Lia KEK 1/12/2020 8 v v x v v v v v
    46 trkt Eka N 1/4/2020 8 v v x v x v v v
    47 trkt Wulan N 12/25/2020 9 v v x v x v v v

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