Kabupaten :

Puskesmas :
Bulan :

Form 2 (Persalinan Dan Nifas)

Persalinan Ditolong Nakes (PN)
Persalinan Ditolong
JLH SSR PN DI NON Non Nakes
NO. PUSTU BUMIL BULIN PN PN DI FASYANKES
FASYANKES
BAYI
Kum % Kum % Kum % Kum
1 Batu Bua I 33 32 30 1 3.33 0 0.00 1 3.33 0
2 Batu Bua II 15 14 14 1 7.14 0 0.00 1 7.14 0
3 Batu Karang 8 7 7 0 0.00 0 0.00 0 0.00 0
4 Tahujan Laung 2 1 1 0 0.00 0 0.00 0 0.00 0
5 Tumbang Bondang 25 23 22 0 0.00 0 0.00 0 0.00 0
6 Tumbang Tonduk 3 3 3 0 0.00 0 0.00 0 0.00 0
7 Beralang 5 5 5 0 0.00 0 0.00 0 0.00 0
8 Kalang Duhung 6 6 5 0 0.00 0 0.00 0 0.00 0
9 Lakutan 5 5 5 1 20.00 0 0.00 1 20.00 0
10 Tawai Haui 10 9 9 0 0.00 0 0.00 0 0.00 0
11 Muara Maruwei I 15 14 14 1 7.14 0 0.00 1 7.14 0
12 Muara Maruwei II 16 15 14 2 14.29 2 14.29 0 0.00 0
13 Pendasiron 10 9 9 2 22.22 0 0.00 2 22.22 0
TOTAL 153 143 138 8 5.59 2 1.45 6 59.84 0

Jumlah Bumil di sesuaikan dengan F1

 Kunjungan Nifas (KF) Jlh CAKUPAN KUNJUNGAN NEONATAL
Persalinan Ditolong Komplikasi Maternal SASARAN
Non Nakes Ditangani (PK)
VIT A NIFAS Komplikasi ASI EKSKLUSIF
KF1 KF2 KF3 Maternal KN1 KN2 KN3
yang di
% Kum % Kum % Kum % Kum % Kum % tangani KUM % KUM % KUM % ABS KUM %
0.00 0 #REF! 0 0.00 1 3.33 1 3.33 1 3.33 7 1 3.33 1 3.33 1 3.33 0 0 Err:509
0.00 0 #REF! 0 0.00 1 7.14 1 7.14 1 7.14 3 1 7.14 1 7.14 1 7.14 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 2 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 0 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 5 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 1 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 1 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 1 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 1 20.00 1 20.00 1 20.00 1 20.00 1 1 20.00 1 20.00 1 20.00 0 0 Err:509
0.00 0 #REF! 0 0.00 0 0.00 0 0.00 0 0.00 2 0 0.00 0 0.00 0 0.00 0 0 Err:509
0.00 0 #REF! 1 7.14 1 7.14 1 7.14 1 7.14 3 1 7.14 1 7.14 1 7.14 0 0 Err:509
0.00 0 #REF! 2 14.29 2 14.29 2 14.29 2 14.29 3 2 14.29 2 14.29 2 14.29 0 0 Err:509
0.00 0 #REF! 2 22.22 2 22.22 2 22.22 2 22.22 2 2 22.22 2 22.22 2 22.22 0 0 Err:509
0.00 0 #REF! 6 63.65 8 5.80 4 2.94 2 1.49 31 8 5.80 8 5.80 8 5.80 0 0 Err:509

Puruk Cahu........................

Mengetahui Pengelola Program,

Kepala Puskesmas..............................
Kabupaten Murung Raya

....................................................... ..............................................
NIP. .................................. NIP. .................................
Kabupaten : Murung Raya
Puskesmas : Batu Bua
Bulan : Februari

Form 2 (Persalinan Dan Nifas)

Persalinan Ditolong Nakes (PN) Kunjungan Nifas
JLH Komplikasi Maternal
Persalinan Ditolong Non Nakes VIT A NIFAS
NO. PUSTU BUMIL BULIN SASAR PN PN DI FASYANKES PN DI NON FASYANKES Ditangani (PK) KF1
BAYI
Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum %
1 Batu Bua I 33 32 30 1 2 6.25 0 0 0.00 1 2 6.25 0 0 0.00 0 0 0.00 1 2 6.25 1 2 6.25
2 Batu Bua II 15 14 14 1 2 14.29 0 0 0.00 1 2 14.29 0 0 0.00 0 0 0.00 1 2 14.29 1 2 14.29
3 Batu Karang 8 7 7 0 2 28.57 0 0 0.00 0 2 28.57 0 0 0.00 0 0 0.00 0 1 14.29 0 2 28.57
4 Tahujan Laung 2 1 1 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
5 Tumbang Bondang 25 23 22 0 2 8.70 0 0 0.00 0 2 8.70 0 0 0.00 0 0 0.00 0 2 8.70 0 2 8.70
6 Tumbang Tonduk 3 3 3 0 2 66.67 0 0 0.00 0 2 66.67 0 0 0.00 0 0 0.00 0 2 66.67 0 2 66.67
7 Beralang 5 5 5 0 1 20.00 0 0 0.00 0 1 20.00 0 0 0.00 0 0 0.00 0 1 20.00 0 1 20.00
8 Kalang Duhung 6 6 5 0 2 33.33 0 0 0.00 0 2 33.33 0 0 0.00 0 0 0.00 0 2 33.33 0 2 33.33
9 Lakutan 5 5 5 1 1 20.00 0 0 0.00 1 1 20.00 0 0 0.00 0 0 0.00 1 1 20.00 1 1 20.00
10 Tawai Haui 10 9 9 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
11 Muara Maruwei I 15 14 14 1 5 35.71 0 0 0.00 1 5 35.71 0 0 0.00 0 0 0.00 1 5 35.71 1 5 35.71
12 Muara Maruwei II 16 15 14 2 3 20.00 2 2 13.33 0 1 6.67 0 0 0.00 0 0 0.00 2 2 13.33 2 3 20.00
13 Pendasiron 10 9 9 2 3 33.33 0 0 0.00 2 3 33.33 0 0 0.00 0 0 0.00 2 3 33.33 2 3 33.33
TOTAL 153 143 138 8 16 11.19 2 4 2.80 6 12 8.39 0 0 0.00 0 0 0.00 8 14 9.79 8 16 11.19

Jumlah Bumil di sesuaikan dengan F1

Mengetahui Batu Bua, 28 Februari 2017

Kepala Puskesmas Batu Bua Pengelola Program,
Kabupaten Murung Raya

Andes Sucipto, SKM Pratiwi Indah SM, A.Md.Keb

NIP. 19671022 198812 1 002 NIP. 19910524 201503 2 006
Kunjungan Nifas (KF) `
Jlh Sasaran
Komplikasi ASI EKSKLUSIF
KF2 KF3 Maternal yang KN1 KN2 KN3
Ditangani
Abs Kum % Abs Kum % ABS KUM % ABS KUM % ABS KUM % ABS KUM %
1 2 6.25 1 2 6.25 7 1 2 6.67 1 2 6.67 1 2 6.67 0 0 0.00
1 2 14.29 1 2 14.29 3 1 2 14.29 1 2 14.29 1 2 14.29 0 0 0.00
0 0 0.00 0 0 0.00 2 0 2 28.57 0 0 0.00 0 0 0.00 0 0 0.00
0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
0 0 0.00 0 2 8.70 5 0 2 9.09 0 0 0.00 0 2 9.09 0 0 0.00
0 0 0.00 0 1 33.33 1 0 2 66.67 0 0 0.00 0 1 33.33 0 0 0.00
0 0 0.00 0 0 0.00 1 0 1 20.00 0 0 0.00 0 0 0.00 0 0 0.00
0 0 0.00 0 1 16.67 1 0 2 40.00 0 0 0.00 0 1 20.00 0 0 0.00
1 1 20.00 1 1 20.00 1 1 1 20.00 1 1 20.00 1 1 20.00 0 0 0.00
0 0 0.00 0 0 0.00 2 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
1 2 14.29 1 2 14.29 3 1 5 35.71 1 2 14.29 1 2 14.29 0 0 0.00
2 4 26.67 2 4 26.67 3 2 3 21.43 2 4 28.57 2 4 28.57 0 0 0.00
2 4 44.44 2 3 33.33 2 2 3 33.33 2 4 44.44 2 3 33.33 0 0 0.00
8 16 11.19 8 10 7.03 31 8 2 1.45 8 2 1.45 8 2 1.45 0 0 0.00
KABUPATEN : MURUNG RAYA
PUSKESMAS : BATU BUA
BULAN : MARET

Form 2 (PERSALINAN DAN NIFAS)

Persalinan Ditolong Nakes (PN) Komplikasi Maternal Ditangani Kunjungan Nifas
JLH SSR Persalinan Ditolong Non Nakes VIT A NIFAS
NO. PUSTU BUMIL BULIN PN PN DI FASYANKES PN DI NON FASYANKES (PK) KF1
BAYI
ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS
1 Batu Bua I 33 32 30 2 2 6.25 0 0 0.00 2 2 6.25 0 2 0.63 0 0 0.00 2 4 12.50 2
2 Batu Bua II 15 14 14 2 3 21.43 0 0 0.00 2 3 21.43 0 0 0.00 0 0 0.00 2 3 21.43 2
3 Batu Karang 8 7 7 2 2 28.57 0 0 0.00 2 2 28.57 0 0 0.00 0 0 0.00 2 2 28.57 2
4 Tahujan Laung 2 1 1 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0
5 Tumbang Bondang 25 23 22 2 2 8.70 0 0 0.00 2 2 8.70 0 0 0.00 0 0 0.00 2 2 8.70 2
6 Tumbang Tonduk 3 3 3 2 2 66.67 0 0 0.00 2 2 66.67 0 0 0.00 0 0 0.00 2 2 66.67 2
7 Beralang 5 5 5 1 1 20.00 0 0 0.00 1 1 20.00 0 0 0.00 0 0 0.00 1 1 20.00 1
8 Kalang Duhung 6 6 5 2 3 50.00 0 0 0.00 2 3 50.00 0 0 0.00 0 0 0.00 2 3 50.00 2
9 Lakutan 5 5 5 1 3 60.00 0 0 0.00 1 3 60.00 0 0 0.00 0 0 0.00 1 3 60.00 1
10 Tawai Haui 10 9 9 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0
11 Muara Maruwei I 15 14 14 5 7 50.00 0 0 0.00 5 7 50.00 0 0 0.00 0 0 0.00 5 7 50.00 5
12 Muara Maruwei II 16 15 14 3 5 33.33 2 2 13.33 1 3 20.00 0 0 0.00 0 0 0.00 3 5 33.33 3
13 Pendasiron 10 9 9 3 3 33.33 0 0 0.00 3 3 33.33 0 2 2.22 0 0 0.00 3 5 55.56 3
TOTAL 153 143 138 25 41 28.67 2 6 4.20 23 35 24.48 0 0 0.00 0 0 0.00 25 39 27.27 25

Jumlah Bumil di sesuaikan dengan F1

 Kunjungan Nifas (KF) Jlh Sasaran Cakupan Kunjungan Neonatus (KN)
Komplikasi ASI EKSKLUSIF
KF1 KF2 KF3 Maternal yang KN1 KN2 KN3
Ditangani
KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM %
4 12.50 2 4 12.50 1 4 12.50 7 2 4 13.33 2 4 13.33 1 4 13.33 0 0 0.00
3 21.43 2 3 21.43 2 3 21.43 3 2 3 21.43 2 3 21.43 2 3 21.43 0 0 0.00
2 28.57 0 2 28.57 0 2 28.57 2 2 2 28.57 0 2 28.57 0 2 28.57 0 0 0.00
0 0.00 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
2 8.70 0 2 8.70 2 2 8.70 5 2 2 9.09 0 2 9.09 2 2 9.09 0 0 0.00
2 66.67 0 2 66.67 1 2 66.67 1 2 2 66.67 0 2 66.67 1 2 66.67 0 0 0.00
1 20.00 0 1 20.00 0 1 20.00 1 1 1 20.00 0 1 20.00 0 1 20.00 0 0 0.00
3 50.00 0 3 50.00 1 3 50.00 1 2 3 60.00 0 3 60.00 1 3 60.00 0 1 20.00
3 60.00 1 3 60.00 1 3 60.00 1 1 3 60.00 1 3 60.00 1 3 60.00 0 2 40.00
0 0.00 0 0 0.00 0 0 0.00 2 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
7 50.00 2 7 50.00 4 7 50.00 3 5 7 50.00 2 7 50.00 4 7 50.00 0 0 0.00
5 33.33 4 5 33.33 2 5 33.33 3 3 5 35.71 4 5 35.71 2 5 35.71 0 0 0.00
5 55.56 4 3 33.33 3 3 33.33 2 3 5 55.56 4 3 33.33 3 3 33.33 0 0 0.00
41 28.67 15 31 21.68 17 27 18.92 31 25 27 19.57 15 17 12.32 17 19 13.77 0 0 0.00

Mengetahui Batu Bua, 31 Maret 2017

Kepala Puskesmas Batu Bua Pengelola Program,

Kabupaten Murung raya

Andes Sucipto, SKM Pratiwi Indah Surya Meida, A.Md.Keb

NIP. 19671022 198812 1 002 NIP. 19910524 201503 2 006
KABUPATEN : MURUNG RAYA
PUSKESMAS : BATU BUA
BULAN : APRIL

Form 2 (PERSALINAN DAN NIFAS)

JLH Persalinan Ditolong Nakes (PN) Persalinan Ditolong Non Komplikasi Maternal Kunjungan Nifas (KF) Jlh Sasaran Cakupan Kunjungan Neonatus (KN)
VIT A NIFAS Komplikasi ASI EKSKLUSIF
NO. PUSTU BUMIL BULIN SSR PN PN DI FASYANKES PN DI NON FASYANKES Nakes Ditangani (PK) KF1 KF2 KF3 Maternal KN1 KN2 KN3
yang
BAYI ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % ABS KUM % Ditangani ABS KUM % ABS KUM % ABS KUM % ABS KUM %
1 Batu Bua I 33 32 30 2 2 6.25 0 0 0.00 2 2 6.25 0 2 0.63 0 0 0.00 2 4 12.50 2 4 12.50 2 4 12.50 1 4 12.50 7 2 4 13.33 2 4 13.33 1 4 13.33 0 0 0.00
2 Batu Bua II 15 14 14 2 3 21.43 0 0 0.00 2 3 21.43 0 0 0.00 0 0 0.00 2 3 21.43 2 3 21.43 2 3 21.43 2 3 21.43 3 2 3 21.43 2 3 21.43 2 3 21.43 0 0 0.00
3 Batu Karang 8 7 7 2 2 28.57 0 0 0.00 2 2 28.57 0 0 0.00 0 0 0.00 2 2 28.57 2 2 28.57 0 2 28.57 0 2 28.57 2 2 2 28.57 0 2 28.57 0 2 28.57 0 0 0.00
4 Tahujan Laung 2 1 1 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
5 Tumbang Bondang 25 23 22 2 2 8.70 0 0 0.00 2 2 8.70 0 0 0.00 0 0 0.00 2 2 8.70 2 2 8.70 0 2 8.70 2 2 8.70 5 2 2 9.09 0 2 9.09 2 2 9.09 0 0 0.00
6 Tumbang Tonduk 3 3 3 2 2 66.67 0 0 0.00 2 2 66.67 0 0 0.00 0 0 0.00 2 2 66.67 2 2 66.67 0 2 66.67 1 2 66.67 1 2 2 66.67 0 2 66.67 1 2 66.67 0 0 0.00
7 Beralang 5 5 5 1 1 20.00 0 0 0.00 1 1 20.00 0 0 0.00 0 0 0.00 1 1 20.00 1 1 20.00 0 1 20.00 0 1 20.00 1 1 1 20.00 0 1 20.00 0 1 20.00 0 0 0.00
8 Kalang Duhung 6 6 5 2 3 50.00 0 0 0.00 2 3 50.00 0 0 0.00 0 0 0.00 2 3 50.00 2 3 50.00 0 3 50.00 1 3 50.00 1 2 3 60.00 0 3 60.00 1 3 60.00 0 1 20.00
9 Lakutan 5 5 5 1 3 60.00 0 0 0.00 1 3 60.00 0 0 0.00 0 0 0.00 1 3 60.00 1 3 60.00 1 3 60.00 1 3 60.00 1 1 3 60.00 1 3 60.00 1 3 60.00 0 2 40.00
10 Tawai Haui 10 9 9 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00 2 0 0 0.00 0 0 0.00 0 0 0.00 0 0 0.00
11 Muara Maruwei I 15 14 14 5 7 50.00 0 0 0.00 5 7 50.00 0 0 0.00 0 0 0.00 5 7 50.00 5 7 50.00 2 7 50.00 4 7 50.00 3 5 7 50.00 2 7 50.00 4 7 50.00 0 0 0.00
12 Muara Maruwei II 16 15 14 3 5 33.33 2 2 13.33 1 3 20.00 0 0 0.00 0 0 0.00 3 5 33.33 3 5 33.33 4 5 33.33 2 5 33.33 3 3 5 35.71 4 5 35.71 2 5 35.71 0 0 0.00
13 Pendasiron 10 9 9 3 3 33.33 0 0 0.00 3 3 33.33 0 2 2.22 0 0 0.00 3 5 55.56 3 5 55.56 4 3 33.33 3 3 33.33 2 3 5 55.56 4 3 33.33 3 3 33.33 0 0 0.00
TOTAL 153 143 138 25 41 28.67 2 6 4.20 23 35 24.48 0 0 0.00 0 0 0.00 25 39 27.27 25 41 28.67 15 31 21.68 17 27 18.92 31 25 27 19.57 15 17 12.32 17 19 13.77 0 0 0.00

Jumlah Bumil di sesuaikan dengan F1 Mengetahui Batu Bua, 29 April 2017

Kepala Puskesmas Batu Bua Pengelola Program,
Kabupaten Murung raya

Andes Sucipto, SKM Pratiwi Indah Surya Meida, A.Md.Keb

NIP. 19671022 198812 1 002 NIP. 19910524 201503 2 006
Kabupaten :
Puskesmas :
Bulan :

Form 2 (Persalinan Dan Nifas)

Persalinan Ditolong Nakes (PN) Komplikasi Maternal Ditangani
JLH SSR Persalinan Ditolong Non Nakes VIT A NIFAS
NO. PUSTU BUMIL BULIN PN PN DI FASYANKES PN DI NON FASYANKES (PK)
BAYI
Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum %
1 PURUKCAHU 606 601 599 46 48 7.99 41 41 6.82 5 7 1.16 1 3 0.05 6 6 4.95 47 51 8.49
2 PURUKCAHU SEBRANG 181 175 171 14 17 9.71 0 0 0.00 14 17 9.71 0 0 0.00 2 2 5.52 14 17 9.71
3 MANGKAHUI 175 169 166 21 23 13.61 18 18 10.65 3 5 2.96 2 2 0.12 2 2 5.71 15 17 10.06
4 DATAH KOTOU 152 146 140 6 6 4.11 0 0 0.00 6 6 4.11 0 0 0.00 0 0 0.00 6 6 4.11
5 MUARA LAUNG 285 274 256 14 16 5.84 8 8 2.92 0 2 0.73 5 5 0.18 2 2 3.51 19 21 7.66
6 MUARA TUHUP 111 109 102 8 10 9.17 2 2 1.83 6 8 7.34 0 0 0.00 0 0 0.00 7 9 8.26
7 MAKUNJUNG 149 138 127 0 1 0.72 0 0 0.00 0 1 0.72 1 1 0.07 0 0 0.00 0 1 0.72
8 BATU BUA 204 190 178 8 11 5.79 0 0 0.00 8 11 5.79 0 0 0.00 0 0 0.00 8 11 5.79
9 KONUT 176 163 153 11 14 8.59 5 5 3.07 6 9 5.52 0 0 0.00 1 1 2.84 11 14 8.59
10 SARIPOI 298 278 258 15 15 5.40 4 4 1.44 14 14 5.04 4 4 0.14 0 0 0.00 19 19 6.83
11 TUMBANG LAHUNG 302 286 271 16 23 8.04 0 0 0.00 16 23 8.04 3 3 0.10 0 0 0.00 19 26 9.09
12 TUMBANG BANTIAN 60 59 58 8 13 22.03 3 5 8.47 4 7 11.86 0 0 0.00 0 0 0.00 2 7 11.86
13 TUMBANG KUNYI 165 155 143 10 13 8.39 0 0 0.00 10 13 8.39 0 2 0.13 0 0 0.00 10 15 9.68
14 MUARA JOLOI 86 77 71 41 53.25 6 7.79 35 45.45 0 0.00 0 0.00 39 50.65
15 TUMBANG OLONG 75 68 57 5 Err:509 Err:509 2 Err:509 Err:509 3 Err:509 Err:509 1 Err:509 Err:509 0 Err:509 Err:509 5 Err:509 Err:509
16
17
18
TOTAL 3,025 2,888 2,750 182 Err:509 Err:509 83 Err:509 Err:509 95 Err:509 Err:509 17 Err:509 Err:509 13 Err:509 Err:509 182 Err:509 Err:509

Jumlah Bumil di sesuaikan dengan F1

Mengetahui
Kepala Puskesmas..............................
Kabupaten Murung Raya

.......................................................

NIP. ..................................
 Jlh Sasaran
Kunjungan Nifas (KF) Komplikasi
Cakupan Kunjungan Neonatus
ASI EKSKLUSIF
Maternal
KF1 KF2 KF3 yang di
KN1 KN2 KN3
tangani
Abs Kum % Abs Kum % Abs Kum % ABS KUM % ABS KUM % ABS KUM % ABS KUM %

47 51 8.49 47 51 8.49 47 51 8.49 121 46 2 0.33 46 50 8.35 46 50 8.35 0 0.00

14 17 9.71 14 17 9.71 14 17 9.71 36 14 17 9.94 14 17 9.94 14 17 9.94 3 3 1.75
15 17 10.06 15 17 10.06 15 17 10.06 35 14 16 9.64 14 16 9.64 14 16 9.64 0 0 0.00
6 6 4.11 6 6 4.11 6 6 4.11 30 6 6 4.29 6 6 4.29 6 6 4.29 0 0 0.00
19 21 7.66 19 21 7.66 19 21 7.66 57 18 20 7.81 18 20 7.81 18 20 7.81 0 0 0.00
7 9 8.26 7 9 8.26 7 9 8.26 22 7 9 8.82 7 9 8.82 7 9 8.82 1 1 0.98
1 2 1.45 1 2 1.45 1 2 1.45 30 0 1 0.79 0 1 0.79 0 1 0.79 3 3 2.36
8 11 5.79 8 11 5.79 8 11 5.79 41 8 11 6.18 8 11 6.18 7 10 5.62 0 1 0.56
11 14 8.59 10 13 7.98 11 14 8.59 35 11 14 9.15 10 13 8.50 11 14 9.15 1 3 1.96
19 19 6.83 19 19 6.83 19 19 6.83 60 18 18 6.98 18 18 6.98 18 18 6.98 0 0 0.00
19 26 9.09 19 26 9.09 19 26 9.09 60 19 26 9.59 19 26 9.59 19 26 9.59 4 4 1.48
2 7 11.86 2 7 11.86 2 7 11.86 12 2 7 12.07 2 7 12.07 2 7 12.07 2 2 3.45
10 15 9.68 10 13 8.39 10 13 8.39 33 9 14 9.79 9 12 8.39 9 12 8.39 0 0 0.00
41 53.25 31 40.26 27 35.14 17 27 38.03 17 23.94 19 26.76 0 0 0.00
5 Err:509 Err:509 5 Err:509 Err:509 5 Err:509 Err:509 15 5 Err:509 Err:509 5 Err:509 Err:509 5 Err:509 Err:509 0 Err:509 Err:509

183 Err:509 Err:509 182 Err:509 Err:509 183 Err:509 Err:509 605 177 Err:509 Err:509 176 Err:509 Err:509 176 Err:509 Err:509 14 Err:509 Err:509

Puruk Cahu........................

Pengelola Program,

..............................................

NIP. .................................
Kabupaten : Murang Raya
Puskesmas :
Bulan :Juli

Form 2 (Persalinan Dan Nifas)

Persalinan Ditolong Nakes (PN) Komplikasi Maternal Ditangani
JLH SSR Persalinan Ditolong Non Nakes VIT A NIFAS
NO. PUSTU BUMIL BULIN PN PN DI FASYANKES PN DI NON FASYANKES (PK)
BAYI
Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum %
1 PURUKCAHU 606 601 599 45 93 15.47 30 71 11.81 15 22 3.66 1 4 0.07 5 11 9.08 46 97 16.14
2 PURUKCAHU SEBRANG 181 175 171 15 32 18.29 4 4 2.29 11 28 16.00 0 0 0.00 3 5 13.81 15 32 18.29
3 MANGKAHUI 175 169 166 8 31 18.34 8 26 15.38 0 5 2.96 1 3 0.18 2 4 11.43 8 25 14.79
4 DATAH KOTOU 152 146 140 5 11 7.53 1 1 0.68 4 10 6.85 1 1 0.07 3 3 9.87 6 12 8.22
5 MUARA LAUNG 285 274 256 13 29 10.58 4 12 4.38 9 11 4.01 3 8 0.29 0 2 3.51 15 36 13.14
6 MUARA TUHUP 111 109 102 7 17 15.60 1 3 2.75 6 14 12.84 0 0 0.00 1 1 4.50 7 16 14.68
7 MAKUNJUNG 149 138 127 5 6 4.35 0 0 0.00 5 6 4.35 1 2 0.14 0 0 0.00 4 5 3.62
8 BATU BUA 204 190 178 8 19 10.00 0 0 0.00 8 19 10.00 1 1 0.05 0 0 0.00 9 20 10.53
9 KONUT 176 163 153 9 23 14.11 2 7 4.29 7 16 9.82 0 0 0.00 1 2 5.68 9 23 14.11
10 SARIPOI 298 278 258 9 24 8.63 0 4 1.44 9 23 8.27 3 7 0.25 0 0 0.00 12 31 11.15
11 TUMBANG LAHUNG 302 286 271 13 36 12.59 0 0 0.00 13 36 12.59 1 4 0.14 0 0 0.00 14 40 13.99
12 TUMBANG BANTIAN 60 59 58 8 21 35.59 3 8 13.56 5 12 20.34 1 1 0.17 1 1 8.33 6 13 22.03
13 TUMBANG KUNYI 165 155 143 8 21 13.55 0 0 0.00 8 21 13.55 1 3 0.19 0 0 0.00 9 24 15.48
14 MUARA JOLOI 86 77 71 41 53.25 6 7.79 35 45.45 0 0.00 0 0.00 39 50.65
15 TUMBANG OLONG 75 68 57 1 Err:509 Err:509 0 Err:509 Err:509 1 Err:509 Err:509 0 Err:509 Err:509 0 Err:509 Err:509 1 Err:509 Err:509
16
17
18
TOTAL 3,025 2,888 2,750 154 Err:509 Err:509 53 Err:509 Err:509 101 Err:509 Err:509 14 Err:509 Err:509 16 Err:509 Err:509 161 Err:509 Err:509

Jumlah Bumil di sesuaikan dengan F1

Mengetahui
Kepala Puskesmas..............................
Kabupaten Murung Raya

.......................................................

NIP. ..................................
 Jlh Sasaran
Kunjungan Nifas (KF) Komplikasi
Cakupan Kunjungan Neonatus
ASI EKSKLUSIF
Maternal
KF1 KF2 KF3 yang di
KN1 KN2 KN3
tangani
Abs Kum % Abs Kum % Abs Kum % ABS KUM % ABS KUM % ABS KUM % ABS KUM %

46 97 16.14 46 97 16.14 46 97 16.14 121 46 48 8.01 46 96 16.03 46 96 16.03 0 0 0.00

15 32 18.29 15 32 18.29 15 32 18.29 36 15 32 18.71 15 32 18.71 15 32 18.71 4 7 4.09
8 25 14.79 8 25 14.79 8 25 14.79 35 8 24 14.46 8 24 14.46 8 24 14.46 0 0 0.00
6 12 8.22 6 12 8.22 6 12 8.22 30 6 12 8.57 6 12 8.57 6 12 8.57 0 0 0.00
13 34 12.41 15 36 13.14 12 33 12.04 57 12 32 12.50 14 34 13.28 11 31 12.11 2 2 0.78
7 16 14.68 7 16 14.68 7 16 14.68 22 7 16 15.69 7 16 15.69 7 16 15.69 0 1 0.98
6 8 5.80 6 8 5.80 6 8 5.80 30 6 7 5.51 6 7 5.51 6 7 5.51 1 4 3.15
9 20 10.53 9 20 10.53 9 20 10.53 41 9 20 11.24 9 20 11.24 9 19 10.67 0 1 0.56
9 23 14.11 9 22 13.50 9 23 14.11 35 9 23 15.03 9 22 14.38 9 23 15.03 0 3 1.96
12 31 11.15 12 31 11.15 12 31 11.15 60 12 30 11.63 12 30 11.63 12 30 11.63 1 1 0.39
14 40 13.99 14 40 13.99 14 40 13.99 60 14 40 14.76 14 40 14.76 14 40 14.76 3 7 2.58
8 15 25.42 7 14 23.73 1 8 13.56 12 8 15 25.86 8 15 25.86 2 9 15.52 2 4 6.90
9 24 15.48 9 22 14.19 9 22 14.19 33 9 23 16.08 9 21 14.69 9 21 14.69 0 0 0.00
41 53.25 31 40.26 27 35.14 17 27 38.03 17 23.94 19 26.76 0 0.00
1 Err:509 Err:509 1 Err:509 Err:509 1 Err:509 Err:509 15 1 Err:509 Err:509 0 Err:509 Err:509 0 Err:509 Err:509 0 Err:509 Err:509

163 Err:509 Err:509 164 Err:509 Err:509 155 Err:509 Err:509 605 162 Err:509 Err:509 163 Err:509 Err:509 154 Err:509 Err:509 13 Err:509 Err:509

Puruk Cahu........................

Pengelola Program,

..............................................

NIP. .................................
Kabupaten : Murang Raya
Puskesmas :
Bulan :Juli

Form 2 (Persalinan Dan Nifas)

Persalinan Ditolong Nakes (PN) Komplikasi Maternal Ditangani
JLH SSR Persalinan Ditolong Non Nakes VIT A NIFAS
NO. PUSTU BUMIL BULIN PN PN DI FASYANKES PN DI NON FASYANKES (PK)
BAYI
Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum % Abs Kum %
1 PURUKCAHU 606 601 599 47 140 23.29 35 106 17.64 12 34 5.66 0 4 0.07 3 14 11.55 47 144 23.96
2 PURUKCAHU SEBRANG 181 175 171 14 46 26.29 4 8 4.57 10 38 21.71 0 0 0.00 0 5 13.81 14 46 26.29
3 MANGKAHUI 175 169 166 5 36 21.30 2 28 16.57 3 8 4.73 1 4 0.24 1 5 14.29 6 31 18.34
4 DATAH KOTOU 152 146 140 11 7.53 1 0.68 10 6.85 1 0.07 3 9.87 12 8.22
5 MUARA LAUNG 285 274 256 12 41 14.96 6 18 6.57 6 17 6.20 2 10 0.36 0 2 3.51 12 48 17.52
6 MUARA TUHUP 111 109 102 4 21 19.27 1 4 3.67 3 17 15.60 0 0 0.00 1 2 9.01 0 16 14.68
7 MAKUNJUNG 149 138 127 8 14 10.14 3 3 2.17 5 11 7.97 3 5 0.36 0 0 0.00 8 13 9.42
8 BATU BUA 204 190 178 11 30 15.79 2 2 1.05 9 28 14.74 1 2 0.11 1 1 2.45 11 31 16.32
9 KONUT 176 163 153 8 31 19.02 2 9 5.52 6 22 13.50 0 0 0.00 2 4 11.36 8 31 19.02
10 SARIPOI 298 278 258 6 30 10.79 0 4 1.44 6 29 10.43 0 7 0.25 0 0 0.00 6 37 13.31
11 TUMBANG LAHUNG 302 286 271 9 45 15.73 0 0 0.00 9 45 15.73 3 7 0.24 0 0 0.00 12 52 18.18
12 TUMBANG BANTIAN 60 59 58 4 25 42.37 2 10 16.95 2 14 23.73 0 1 0.17 0 1 8.33 4 17 28.81
13 TUMBANG KUNYI 165 155 143 11 32 20.65 0 0 0.00 11 32 20.65 0 3 0.19 0 0 0.00 11 35 22.58
14 MUARA JOLOI 86 77 71 41 53.25 6 7.79 35 45.45 0 0.00 0 0.00 39 50.65
15 TUMBANG OLONG 75 68 57 2 Err:509 Err:509 0 Err:509 Err:509 2 Err:509 Err:509 1 Err:509 Err:509 0 Err:509 Err:509 4 Err:509 Err:509
16
17
18
TOTAL 3,025 2,888 2,750 141 Err:509 Err:509 57 Err:509 Err:509 84 Err:509 Err:509 11 Err:509 Err:509 8 Err:509 Err:509 143 Err:509 Err:509

Jumlah Bumil di sesuaikan dengan F1

Mengetahui
Kepala Puskesmas..............................
Kabupaten Murung Raya

.......................................................

NIP. ..................................
 Jlh Sasaran
Kunjungan Nifas (KF) Komplikasi
Cakupan Kunjungan Neonatus
ASI EKSKLUSIF
Maternal
KF1 KF2 KF3 yang di
KN1 KN2 KN3
tangani
Abs Kum % Abs Kum % Abs Kum % ABS KUM % ABS KUM % ABS KUM % ABS KUM %

47 144 23.96 47 144 23.96 47 144 23.96 121 47 95 15.86 47 143 23.87 47 143 23.87 0 0 0.00
14 46 26.29 14 46 26.29 14 46 26.29 36 14 46 26.90 14 46 26.90 14 46 26.90 10 17 9.94
6 31 18.34 6 31 18.34 6 31 18.34 35 6 30 18.07 6 30 18.07 6 30 18.07 0 0 0.00
12 8.22 12 8.22 12 8.22 30 12 8.57 12 8.57 12 8.57 0 0.00
12 46 16.79 12 48 17.52 12 45 16.42 57 12 44 17.19 12 46 17.97 12 43 16.80 0 2 0.78
3 19 17.43 3 19 17.43 3 19 17.43 22 4 20 19.61 4 20 19.61 4 20 19.61 0 1 0.98
11 19 13.77 11 19 13.77 5 13 9.42 30 10 17 13.39 10 17 13.39 5 12 9.45 0 4 3.15
10 30 15.79 10 30 15.79 10 30 15.79 41 10 30 16.85 10 30 16.85 10 29 16.29 1 2 1.12
8 31 19.02 7 29 17.79 7 30 18.40 35 8 31 20.26 7 29 18.95 7 30 19.61 0 3 1.96
6 37 13.31 6 37 13.31 6 37 13.31 60 6 36 13.95 6 36 13.95 6 36 13.95 0 1 0.39
12 52 18.18 12 52 18.18 12 52 18.18 60 12 52 19.19 12 52 19.19 12 52 19.19 0 7 2.58
4 19 32.20 14 23.73 8 13.56 12 15 25.86 15 25.86 9 15.52 4 6.90
11 35 22.58 11 33 21.29 11 33 21.29 33 11 34 23.78 11 32 22.38 11 32 22.38 11 11 7.69
41 53.25 31 40.26 27 35.14 17 27 38.03 17 23.94 19 26.76 0 0.00
4 Err:509 Err:509 4 Err:509 Err:509 4 Err:509 Err:509 15 4 Err:509 Err:509 4 Err:509 Err:509 4 Err:509 Err:509 4 Err:509 Err:509

148 Err:509 Err:509 143 Err:509 Err:509 137 Err:509 Err:509 605 144 Err:509 Err:509 143 Err:509 Err:509 138 Err:509 Err:509 26 Err:509 Err:509

Puruk Cahu........................

Pengelola Program,

..............................................

NIP. .................................