FORMAT LAPORAN KESWA BARU FIX DINAS Des 2019

LAPORAN BULANAN DATA KESAKITAN - KASUS BARU DAN LAMA
DINAS KESEHATAN KABUPATEN BANDUNG TAHUN 2019

Puskesmas : Cibiru Hilir
Jumlah Penduduk : 31.983
Kabupaten / Kota : Kab. Bandung
Bulan : Desember
I PENEMUAN BARU DAN LAMA
Jumlah Penderita
Total
0 - 7 Hr 8-28 Hr 1 Bl < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th 20 - 44 Th 45 - 54 Th 55 - 59 Th 60-69 Th > 70 Th
No Jenis Penyakit Jumlah
B L B L B L B L B L B L B L B L B L B L B L B L B L
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P
F00# Gangguan Mental Organik
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 Gangguan Penyalahgunaan NAPZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# Skizofrenia dan Gangguan Psikotik 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

Kronik Lain 0 0 4 0 4
F23 Gangguan Psikotik Akut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F31 Gangguan Bipolar 0 0 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2
F32# Gangguan Depresi 0 0 0 0 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 1 0 0 0 1
F40# Gangguan Neurotik 0 0 0 0 0
F41.1 Gangguan Ansietas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 Gangguan Campuran Ansietas dan 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

Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1
F42 Gangguan Obsesif Kompulsif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F43.2 Gangguan Penyesuaian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F45 Gangguan Somatoform 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Gangguan Perkembangan pada Anak dan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F80-90# Remaja 0 0
F70 Retardasi Mental 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Percobaan Bunuh Diri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Penyakit Jiwa lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
II PEMERIKSAAN DAN PENGOBATAN
Jumlah Penderita
Total

L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L B L P L P L P L P L P L P L P
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Gangguan Penyalahgunaan NAPZA 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4
Skizofrenia dan Gangguan Psikotik Kronik Lain
F40# Gangguan Neurotik

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.1 Gangguan Ansietas
F41.2 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 1 0 0 0 1
Gangguan Campuran Ansietas dan Depresi
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F42 Gangguan Obsesif Kompulsif
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Gangguan Perkembangan pada Anak dan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total
No Jenis Penyakit 0 - 7 Hr 8-28 Hr 1 Bl < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th 20 - 44 Th 45 - 54 Th 55 - 59 Th 60-69 Th > 70 Th Jumlah
III RUJUKAN DAN KONSULTASI

0 0 0 0 0
IV PENYULUHAN KHUSUS KESEHATAN JIWA

0 0 0 0 0
KUNJUNGAN RUMAH (Untuk evaluasi

V sosial, lingkungan,dan pembinaan
keluarga)
0 0 0 0 0
VI KUNJUNGAN KESELURUHAN
PASIEN sampai bulan terlapor
0 0 0 0 0
CAKUPAN PELAYANAN KES JIWA

VII (%) = (POIN 1+2) X 100% /
KUNJUNGAN KESELURUHAN
PUSKESMAS
#DIV/0!
Mengetahui, Cibiru Hilir, Desember 2019

Kepala UPF Cibiru Hilir Pelaksana tugas kegiatan
dr. Iyos Rosmawati dr. Trisyani Roslina

NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 1 1 0 0 4 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 7 3 4 1 15
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 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 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 4 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 3 4 1 14
Jumlah Penderita
Total

5 3 2 0 10

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!
Mengetahui, Cibiru Hilir, januari 2020

dr. Iyos Rosmawati teri arifianti jati

NIP. 197404162008012003 197610152014102000
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
Bulan : Desember
Jumlah Penderita
Total
F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Depresi 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja 0 0
F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40# 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epilepsi 0 0
Jumlah Total I 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

F00# Demensia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F05 Delirium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F20# 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4

0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
F41.2 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 1 0 0 0 1
F41.0 Gangguan Panik 0 0 0 0 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 1 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
F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F80-90# Remaja

F51.0 Insomnia 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 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 3 0 0 4
G40#
Epilepsi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 Total II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 1 0 0 0 1 0 0 3 0 3 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5 3 4 1 13
Jumlah Penderita
Total

0 0 0 0 0

0 0 0 0 0

keluarga)
0 0 0 0 0
0 0 0 0 0

VII (%) = (POIN 1+2) X 100% /
PUSKESMAS
#DIV/0!


NIP. 197404162008012003 NIP. 196012071989112001
LAPORAN PELAYANAN KESEHATAN JIWA MASYARAKAT
DINAS KESEHATAN KABUPATEN BANDUNG

Bulan : Desember
Tahun : 2019
Laporan Bulanan Jumlah Total
No
Pelayanan Kesehatan Jiwa Masyarakat L P
I Kegiatan Kesehatan Jiwa (Mental Health Activities)
1 Jumlah penderita gangguan jiwa baru di wilayah kerja puskesmas 5 3 8
2 Jumlah keseluruhan penderita gangguan jiwa di wilayah kerja puskesmas 9 4 13
Jumlah penderita gangguan jiwa yang dirawat oleh perawat kesehatan jiwa masyarakat
3
(PKJM)
4 Jumlah penderita gangguan jiwa yang berkunjung ke puskesmas 9 4 13
5 Jumlah penderita gangguan jiwa yang dirujuk ke RS Jiwa 0
a. Jumlah Rawat Jalan di RS Jiwa
b. Jumlah Rawat Inap di RS Jiwa
6 Jumlah penderita gangguan jiwa yang dirujuk balik dari RS Jiwa ( dikembalikan )
7 Jumlah penderita gangguan jiwa yang dirujuk ke RSU Daerah
a. Jumlah Rawat Jalan di RSU Daerah
b. Jumlah Rawat Inap di RSU Daerah
8 Jumlah penderita gangguan jiwa yang dikembalikan dari RSU Daerah
9 Jumlah penderita gangguan jiwa yang mendapatkan obat psikotropika
10 Jumlah penderita gangguan jiwa yang dilakukan kunjungan rumah oleh PKJM
11 Jumlah pelaksanaan penyuluhan kesehatan jiwa oleh PKJM 1 1 2
12 Jumlah pelaksanaan kegiatan rehabilitasi untuk penderita gangguan jiwa oleh PKJM
13 Jumlah penderita gangguan jiwa yang dilakukan kunjungan rumah oleh kader kesehatan jiwa
14 Jumlah penderita gangguan jiwa yang dipasung
15 Jumlah penderita gangguan jiwa yang telah dilepas dari pasung
16 Jumlah penderita gangguan jiwa yang dirawat belum bebas pasung
16 Jumlah penderita gangguan jiwa yang sudah mandiri ( Minimal Care )
17 Jumlah penderita gangguan jiwa yang bantuan ( Partial Care )
18 Jumlah penderita gangguan jiwa yang tergantung ( Total Care )
19 Jumlah penderita gangguan jiwa yang meninggal
II DATA KUNJUNGAN
1 Jumlah kunjungan penderita gangguan jiwa ke Puskesmas
2 Jumlah kunjungan PKJM ke rumah penderita gangguan jiwa
3 Jumlah kunjungan rumah oleh Kader Kesehatan Jiwa (PKJM)
Jumlah Kunjungan keseluruhan
II TENAGA KESWA DAN FASILITAS KESWA
1 Jumlah Gampong Siaga Sehat Jiwa ( GSSJ )
2 Jumlah Kader Kesehatan Jiwa ( KKJ )
3 Jumlah Fasilitator Perawat Kesehatan Jiwa
4 Jumlah Perawat Kes. Jiwa Masyarakat
5 Jumlah Dokter Mahir Kesehatan Jiwa (GP+)
6 Jumlah Psikiater
7 Jumlah Puskesmas
8 Jumlah Puskesmas Keswamas
Mengetahui, Cibiru Hilir,Desember 2019


NIP. 197404162008012003 NIP. 196012071989112001
LAPORAN ORANG DENGAN GANGGUAN JIWA (ODGJ) BERAT
DINAS KESEHATAN KABUPATEN BANDUNG TH 2020

Bulan : Jan-20
KASUS BARU
Satus Pasien
No No NIK Nama Umur Alamat Kelurahan L/P Pasien Baru (B) Diagnosa Rujukan RS
Umum BPJS SKTM
1 320400000000000 Siti Kuswati Cibiru Hilir 2/ Cibiru Hilir P L F.20
2 320400000000000 Andy Burhanudin Cibiru wetan 7/29 Cibiru Wetan L L F.20
3 320400000000000 Ujang Mas Cibiru Hilir 6/12 Cibiru Hilir L L F.31
4 320400000000000 Aminah Cibiru Hilir 7/3 Cibiru Hilir P L F.20
5 320400000000000 Sari Cikoneng 1/3 Cikoneng P L F.31
6 320400000000000 Syahrul Ramdani Cibiru Hilir 6/8 Cibiru Hilir L L F.20
7 320400000000000 Yulia Setiawati Cibiru Hilir 1/2 Cibiru Hilir L L F.20
8 320400000000000 Robby M Cibiru Hilir Cibiru Hilir L L F.41
9 320400000000000 Deddy Heryana Pilar Biru Cibiru L L F.20
10 320400000000000 Ateng Cibiru wetan 2/11 Cibiru Wetan L L F.32
11 320400000000000 Riska F Cibiru Hilir Cibiru Hilir P L F.31
12 320400000000000 Dodi Suhardi Warung gede 1/1 Warung Gede L L F.20
13 320400000000000 Novansyah Cibiru Hilir Cibiru Hilir L L G.47
14 320400000000000 Siti Saebah Cibiru Hilir Cibiru Hilir P L F.31
15 320400000000000 Zaenal Cibiru Hilir Cibiru Hilir L L F.20
16 3200001876012468 Nasser Ariat 45 Cibiru Wetan 6/13 Cibiru Wetan L L Paranoid, Schizofrenia Nur Ilahi
17 3204051308140000 Rafi F 4 Cibiru Hilir 2/7 Cibiru Hilir L L Epilepsi AMC √
18 3204050405880006 Yenda 31 Cibiru Hilir 1/9 Cibiru Hilir L L Gangguan Bipolar Nurilahi √
19 320405470778432 Eneng Jubaedah 41 Cibiru Wetan 2/16 Cibiru Wetan P L Epilepsi
20 3204052109940007 Risman 75 Cipanileuman Cibiru Hilir L L Epilepsi AMC √
21 3204125507820000 Yuli Setiawati 37 Cibiru Hilir 1/2 Cibiru Hilir P L Gangguan Bipolar Nurilahi √
22 3204052906680004 Ateng 51 Cibiru Wetan 2/11 Cibiru Wetan L L skizofrenia Nurilahi √
23 3204052510790007 Dodi 40 Cibiru Wetan 1/17 Cibiru Wetan L L skizofrenia AMC √
24 3240000000000000 Faisal D.A 46 Permata Biru Blok A Cibiru Wetan L B Down Syndrom AMC
25 3200001867959532 Slamet H 46 Permata biru Cinunuk L B G.40 Saraf/Hermina
26 3200002197631619 Fazri . S 4 Cibiru Hilir 2/7 Cibiru Hilir P B G.80 Anak/AMC
27 3204052305010006 Ijal 18 Cibiru wetan 4/14 Cibiru Wetan L B G.40 Saraf/Hermina
28 3200001443152605 Supriyo 42 Cibiru wetan 5/18 Cibiru Wetan P B F.20
29 3200002074868662 M. Arya Z 13 Cibiru Hilir Cibiru Hilir L B F.84 anak/Hermina
30 3200001443152608 Alexander Tua 24 Cibiru Hilir Cibiru Hilir L B G.40 Saraf/AMC
31 3204052211800004 Ardiansyah 37 Cibiru Hilir 3/4 Cibiru Hilir L B Skizofrenia Nur Ilahi
32 3204052005830001 Herdiansyah 26 Cibiru Hilir 2/3 Cibiru Hilir L B Narkoba Rs AMC
33 3204051709300003 M Rizky 25 Cibiru Hilir 2/3 Cibiru Hilir L B Narkoba RS AMC
34 3204050089800001 Rizkia Gustiawan 17 Cibiru Hilir 1/2 Cibiru Hilir L B Narkoba Rs AMC
Mengetahui, Cibiru Hilir, januari 2020

Kepala Puskesmas Cibiru Hilir Pelaksana tugas kegiatan
dr. Iyos Rosmawati Teri arifianti jati

NIP. 197404162008012003 NIP. 197610152014102002
LAPORAN KUNJUNGAN PELAYANAN KESEHATAN JIWA DI PUSKESMAS

Bulan : Jan-20
Terapi Rujukan
No Tanggal No RM No NIK Nama Umur Alamat Kelurahan L/P Diagnosa B/L Nama
Jml Rujukan RS Umum BPJS SKTM
Obat
1 02/12/2019 113081/20143204055105640006 Oom Komariah 55 Cibiru Hilir 1/3 Cibiru Hilir P Anxiety L
2 06/12/2019 00259/15 3217025106950004 Siti Nurhasanah 26 Bandung Barat - P Anxiety B
3 10/12/2019 00529/2014 3204056506560011 H Wardi A 63 Cibiru Wetan 3/7 Cibiru Wetan L Insomnia B
4 10/12/2019 00137/2017 3243666115400001 Yuningsih 64 Bumi Harapan Cibiru Hilir P Anxiety L
5 16/12/2019 01225/2015 3204054907850006 Pipit Mahyuran 34 Cibiru Hilir 1/3 Cibiru Hilir 1/3 P Anxiety B
6 18/12/2019 04085/18 3204280107770276 Agus Dadang 42 Cibiru Hilir 2/3 Cibiru Hilir L Anxiety B
7 19/12/2019 05372/2019 3204000000000000 Resih 51 Griya Asri Posindo Cinunuk P Anxiety B
8 19/12/2019 06139/15 3204054505730024 Yuyun Yuningsih 46 Cibiru wetan 4/5 Cibiru Wetan P Anxiety L
9 21/12/2019 956415 3200001876012468 Naser 45 Cibiru Wetan 6/13 Cibiru Wetan L Paranoid, Schizofrenia B Nur llahi
10 21/12/2019 6513 3204050610660001 Brijarno 52 Griya Mustika 7/26 Cinunuk L Anxiety B
11 21/12/2019 07116/2019 3213124505000003 Destryana 19 Cibiru Wetan 4/12 Cibiru Wetan P Anxiety B
12 21/12/2019 00693/2016 3204050512650001 Dedy Heryana 53 L Anxiety, Depresi B
13 26/12/2019 101065/14 3204052211800004 Ardiansyah 37 Cibiru Hilir 3/4 Cibiru Hilir L Skizofrenia L Nur Ilahi
17 26/12/2019 3033/14 3204051512410001 Iyo Rohman 77 Cibiru Hilir 5/6 Cibiru hilir L Anxiety B
18 06/01/2020 2985/18 3204081701780000 m dudi 42 cinunuk 7/29 cinunuk L Skizofrenia B
19 07/01/2020 3204050602010010 zidan qurota 60 cibiru hilir 3/4 cibiru hilir L B
20 07/01/2020 1228/16 3404072504660000 48 bumi Harapan cc/2 no26 cibiru hilir L B
21 08/01/2020 1262/14 3204055407710000 Lina yuliani 43 bbk cimekar 4/13 cibiru hilir P
22 08/01/2020 herik cibiru hilir 2/3 cibiru hilir L
23 11/01/2020 3205032808770000 sahrul ramdani 42 garut 5/1 garut L residual skizofrenia L
24 27/01/2020 02503/2014 3204051808000000 dadan ruhiyat 40 cibiru hilir 2/3 cibiru hilir L
25 28/01/2020 1761/17 azizah cibiru hilir 1/9 cibiru hilir P
26 30/01/2020 007/17 320405270497006 robi 50 wrg gede 1/11 cibiru wetan L
Mengetahui, Pengelola Program

Kepala Puskesmas Cibiru Hilir
dr. Iyos Rosmawati Teri arifianti jati

NIP. 197404162008012003 NIP. 197610152014102002
Nomor Kasus Registrasi Nama Jenis Kelamin Tanggal Lahir Alamat Diagnosis Diagnosis Masalah/
Kasus Jiwa Keperawatan Penyakit Fisik
(1) (2) (3) (4) (5) (6) (7) (8) (9)

Tahun Awal Riwayat Layanan Cara Pemasungan Frekuensi Tahun Awal
Sakit Pengobatan Kesehatan (13) pemasungan
(10) (11) (12) Balok kayu Rantai Tali Kurung Lainnya (14) (15)
Inisiator Alasan Pemasungan Dilepaskan Petugas yang Layanan Pengobatan Jenis Tatalaksana
Pasung (17) Melepaskan (20) (21)
(16) Riwayat Perilaku kacau Lainnya (18) (19) PKM Rujuk RSU Rujuk RSJ Terapi Obat
yang bisa
tindak membahayakan
kekerasan pasien
Jenis Tatalaksana Pemasungan
(21) Kembali &
Tanggal
Edukasi Edukasi Rehabilitasi (22)

Keluarga Masyarakat Psikososial

FORMAT LAPORAN KESWA BARU FIX DINAS Des 2019

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FORMAT LAPORAN KESWA BARU FIX DINAS Des 2019

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LAPORAN BULANAN DATA KESAKITAN - KASUS BARU DAN LAMA

DINAS KESEHATAN KABUPATEN BANDUNG TAHUN 2019

F20# Skizofrenia dan Gangguan Psikotik 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

F41.2 Gangguan Campuran Ansietas dan 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

F42 Gangguan Obsesif Kompulsif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 - 7 Hr 8-28 Hr 1 Bl < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th 20 - 44 Th 45 - 54 Th 55 - 59 Th 60-69 Th > 70 Th

F23 Gangguan Psikotik Akut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F31 Gangguan Bipolar 0 0 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2

F32# Gangguan Depresi 0 0 0 0 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 1 0 0 0 1

F40# Gangguan Neurotik

F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F43.2 Gangguan Penyesuaian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F45 Gangguan Somatoform 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Gangguan Perkembangan pada Anak dan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F70 Retardasi Mental 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Percobaan Bunuh Diri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Penyakit Jiwa lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III RUJUKAN DAN KONSULTASI

IV PENYULUHAN KHUSUS KESEHATAN JIWA

KUNJUNGAN RUMAH (Untuk evaluasi

CAKUPAN PELAYANAN KES JIWA

Mengetahui, Cibiru Hilir, Desember 2019

dr. Iyos Rosmawati dr. Trisyani Roslina

F20# Skizofrenia dan Gangguan Psikotik 0 0 0 0 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 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

F41.2 Gangguan Campuran Ansietas dan 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

F42 Gangguan Obsesif Kompulsif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 - 7 Hr 8-28 Hr 1 Bl < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th 20 - 44 Th 45 - 54 Th 55 - 59 Th 60-69 Th > 70 Th

F23 Gangguan Psikotik Akut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F31 Gangguan Bipolar 0 0 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2

F32# Gangguan Depresi 0 0 0 0 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 1 0 0 0 1

F40# Gangguan Neurotik

F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F43.2 Gangguan Penyesuaian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F45 Gangguan Somatoform 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Gangguan Perkembangan pada Anak dan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F70 Retardasi Mental 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Percobaan Bunuh Diri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Penyakit Jiwa lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III RUJUKAN DAN KONSULTASI

IV PENYULUHAN KHUSUS KESEHATAN JIWA

KUNJUNGAN RUMAH (Untuk evaluasi

CAKUPAN PELAYANAN KES JIWA

Mengetahui, Cibiru Hilir, januari 2020

dr. Iyos Rosmawati teri arifianti jati

F20# Skizofrenia dan Gangguan Psikotik 0 0 0 0 0 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0

F41.2 Gangguan Campuran Ansietas dan 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

F42 Gangguan Obsesif Kompulsif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 - 7 Hr 8-28 Hr 1 Bl < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th 20 - 44 Th 45 - 54 Th 55 - 59 Th 60-69 Th > 70 Th

F23 Gangguan Psikotik Akut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F31 Gangguan Bipolar 0 0 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2

F32# Gangguan Depresi 0 0 0 0 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 1 0 0 0 1

F40# Gangguan Neurotik

F41.0 Gangguan Panik 0 0 0 0 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 1 0 0 0 1

F43.2 Gangguan Penyesuaian 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F40 Gangguan Fobik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F45 Gangguan Somatoform 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Gangguan Perkembangan pada Anak dan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

F70 Retardasi Mental 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0